Motor dysfunction in stroke of subacute stage treated with acupuncture: multi-central randomized controlled study / 中国针灸

<p><b>OBJECTIVE</b>To verify the clinical efficacy of acupuncture on motor dysfunction in ischemic stroke of subacute stage.</p><p><b>METHODS</b>The multi-central randomized controlled trial was adopted. One hundred and twenty-six cases of ischemic stroke of subacute stage were randomized into an acupuncture group (61 cases) and a conventional treatment group (65 cases). The basic treatment of western internal medicine and rehabilitation training were applied to the patients of the two groups. In the acupuncture group, acupuncture was supplemented at the body points located on the extensor of the upper limbs and the flexor of the lower limbs. In combination, scalp acupuncture was applied to NS5, MS6 and MS6 on the affected side. The treatment was given 5 times a week and totally 8 weeks were required. The follow-up observation lasted for 3 months. The scores in Fugl-Meyer scale and NIHSS scale and Barthel index were compared between the two groups before treatment, in 4 and 8 weeks of treatment and the 3-month follow-up observation after treatment separately.</p><p><b>RESULTS</b>In 4 and 8 weeks of treatment and the follow-up observation, Fugl-Meyer scale score was improved obviously in the patients of the two groups (all P<0. 01). In 8 weeks of treatment and the follow-up observation, Fugl-Meyer scale score in the acupuncture groupwas im proved much apparently as compared with that in the conventional treatment group [68. 0 (43. 0,86. 5) vs 52. 5 (30.3, 77.0), 77.0 (49.5, 89.0) vs 63. 0 (33.0, 84.0), both P<0. 05]. Except that NIHSS scale score was not reduced apparently in 4 weeks of treatment in the conventional treatment group (P>0.05), the results of NIHSS scale at the other time points were all decreased obviously as compared with those before treatment in the patients of the two groups (all P<0. 01). In 8 weeks of treatment and the follow-up observation, the results in the acupuncture group were reduced much apparently as compared with those in the conventional treatment group [5. 0 (3.0,8.0) vs 7. 0 (3.0,13.8), 4. 0 (1.5,7.0) vs 6.0 (2.0,11.7) ,both P<0. 05]. In 8 weeks of treatment and the follow-up observation, Barthel index was improved obviously as compared with that before treatment in the patients of the two groups (all P<0. 05). The improvement in the acupuncture group was much more significant as compared with the conventional treatment group [75. 0 (60. 0,87. 5) vs 65. O (36. 3, 87. 5), P<0. 051.</p><p><b>CONCLUSION</b>Based on the conventional treatment, Acupuncture achieves the satisfactory clinical efficacy on motor dysfunction in ischemic stroke of subacute stage.</p>

Effects and mechanism of low-intensity pulsed ultrasound on extracellular matrix in rabbit knee osteoarthritis / 中国骨伤

<p><b>OBJECTIVE</b>To observe the effects of low-intensity pulsed ultrasound (LIPUS) on repairing extracellular matrix in rabbit knee osteoarthritis and analyze its mechanism.</p><p><b>METHODS</b>Sixty adult female rabbits with an average weight of (2.0 ± 0.2) kg, were divided randomly into two groups (experimental group and control group, 30 rabbits in each group). All rabbits were replicated in right knees by Hulth method for knee osteoarthritis model. Two weeks after operation, the rabbits in experimental group were treated with LIPUS, and the ultrasonic frequency was (800 ± 5%)KHz and the maximum intensities of spatially averaged and time averaged (SATA) was (50 ± 10%) mw/cm2, for 1 time a day and every time 20 min, while the rabbits in control group were treated with sham LIPUS,the same operation with experimental group but without energy output. At the 2, 4, 8 weeks after treatment, 10 rabbits in each group were randomly killed for each time. The general changes of cartilage and its histopathological changes by HE staining were observed; the expression of collagen type II, proteoglycan, MMP-3, 7, 13 in cartilage were analyzed by immunohistochemical and RT-PCR technique; and the expression of NO in cartilage was analyzed by nitrate reduction method.</p><p><b>RESULTS</b>On the same observed time point, the damage degree of cartilage in experimental group was slighter than that of control group (P < 0.01), the expression of MMP-3, 7, 13 and NO in cartilage in experimental group was lower than that of control group (P < 0.01) while collagen type II and proteoglycan was higher than that of control group (P < 0.01).</p><p><b>CONCLUSION</b>Low-intensity pulsed ultrasound can repair the damaged cartilage by reducing the expression of MMP-3, 7, 13, inhibiting the secretion of NO and promoting the synthesis of collagen type II and proteoglycan in cartilage.</p>

Research advance on signaling pathways and protein metabolism for skeletal muscle disuse atrophy / 中国骨伤

Disuse atrophy of skeletal muscle is a common clinical problem and its exact mechanisms have not been fully understood. Previous studies suggested that disuse muscle atrophy is realized through the activation of one or more cell signaling pathways, but studies have shown that disuse atrophy is the activation of the ubiquitin-proteasome caused extensive decomposition of the protein. The present researches for disuse atrophy mainly focus on regulatory role in the upstream signaling molecules MuRF1 and Atroginl/MAFbx by NF-kappaB, IGF-1/PI3K/Akt, TGF-beta/Smad and MAPK signal pathway and a plurality of signal pathway activation or inhibition and interaction,and then through the ubiquitin--proteasome to influence the metabolism of protein. But regulation of expression of MuRF1 and Atroginl/MAFbxs still to be studied. Participate in disuse atrophy also needs to be further studied with atrophy confirmation and functional gene verification. The paper summarized recent original articles about the researches of skeletal muscle disuse atrophy and reviewed the various signal pathways and related u-biquitin-proteasome protein metabolism of disuse muscle atrophy.

Effect of HSP70 on apoptotic of cartilage cells in knee osteoarthritis / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the expression and relationship between HSP70 and caspase-3 in knee osteoarthritis.</p><p><b>METHODS</b>Forty adult SD rats were divided into experimental group and control group. Thirty rats in experimental group, anterior cruciate ligament transaction (ACLT) was cut off and partial meniscectomy of 1/3 inside incision were performed to reproduce knee osteoarthritis (KOA) model according to Hulth methos, and the other 10 rats was treated with nothing as control group. The rats were sent to the cage and free to move. At 1, 2 and 4 weeks later, the arthritis cartilage of femoral and tibial end were observed through immunohistochemistry staining and light microscope. Meanwhile, Mankin scale system was adopted for histomorphology evaluation.</p><p><b>RESULTS</b>Changes of KOA such as hyperplastic synovium,erosion on the surface of cartilage and so on were found in experiment group, the expression of HSP70 was augmentation all the time, but the expression of caspase-3 was reduction 1 week later; no similar changes were found in control group. Mankin scale system showed that there were significant differences in the first week as compared with the second week and 4th week (both P < 0.01).</p><p><b>CONCLUSION</b>Heat shock protein inhibit the apoptosis of cartilage cells and protect the cartilage cells in knee osteoarthritis, the conservative treatment for clinical provide objective scientific basis.</p>

Basic research progress of knee osteoarthritis / 中国骨伤

The exact etiology and pathogenesis of knee osteoarthritis (KOA) are still unknown and it is hard to treat the disease fundamentally. With new therapeutic methods and techniques appearing, the present situation of treating the disease will be changed in the near future. Basic research of knee osteoarthritis will contribute to clarifying the pathogenesis and exploring the therapeutic methods. This article makes a brief review on the up-to-date basic researches of knee osteoarthritis by reviewing literature concerned in recent years.

Clinicopathological and immunohistochemical features of 24 cases of gastrointestinal stromal tumor / 肿瘤

Objective: To explore the clinicopathological and immunohistochemical characteristics of gastrointestinal stromal tumor(GIST). Methods: The clinical and pathological features of 24 cases of GIST were observed. The protein expression of CD117, CD34, SMA, and S-100, desmin, and Vimentin were detected by using En Vision Immunohistochemical method. Results: The 24 patients with GIST had an average age of 52.7 years old. They were common in the stomach. The most common presenting signs and symptoms included abdominal pain and GI bleeding. The tumor diameters ranged from 0.6 to 12 cm (mean 4.1 cm). Microscopically, most GIST were composed of spindle cells(14 cases, 59.3%), epithelioid cells (4 cases, 16.6%), or mixed cells(6 cases, 25.0%). The GIST were generally benign in 5 cases (20.8%), borderline in 5 cases (20.8%), and malignant in 14 cases (58.4%). In terms of immunophenotypes, about 23 GIST patients (95.8%) expressed CD117 antigen and 20 patients (83.3%) expressed CD34 antigen. They showed diffuse strong positivities. Conclusion: GIST has a peak incidence in the elderly persons. GIST often occurred in the stomach. The tumors were mainly composed of spindle cells. Most GIST were malignant and borderline. Immunohistochemical detection of CD117 and CD34 antigens is necessary for differential diagnosis.