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Objective:To apply the ultrasound elastography in quantitative evaluation for spasticity of forearm flexor muscles after stroke, and observe its characteristics. Methods:From January to October, 2019, 30 inpatients with stroke were recruited, followning spasticity of wrist and finger flexor muscles. They were measured the shear wave velocity (SWV) of flexor carpi ulnaris (FCU), flexor digitorum superficialis (FDS), flexor digitorum profundus (FDP) and flexor carpi radialis (FCR) with ultrasound elastography, and assessed the tension of wrist and finger flexors with modified Ashworth Scale (MAS). Results:The SWV of all the muscles were more in stretching position than in relaxation position in both sides (|Z| > 3.844， P < 0.001). The SWV of all the muscles were more in the affected side than in the unaffected side in stretching position (|Z| > 3.593， P < 0.001). The differences of SWV between stretching and relaxation were more in all the muscles in the affected side than in the unaffected side (t > 3.199, P < 0.01). The mean SWV of all the muscles significantly correlated with the MAS score of wrist (r = 0.605, P < 0.001), while the mean SWV of FDS and FDP correlated with the MAS score of finger (r = 0.540, P < 0.01). Conclusion:Ultrasound elastography is useful to quantitatively evaluate the spasticity of each muscle of forearm flexors after stroke.
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OBJECTIVE@#To investigate the effect of Modified Xiaochaihu Decoction (MXD, ) on collagen degradation in rats with chronic pancreatitis (CP).@*METHODS@#Rats were injected dibutyltin dichloride (DBTC, 7 mg/kg of body weight) into the right caudal vein to induce CP model. Thirty heallhy male Wistar rats were randomly divided into three groups by a random number table: the control, the model and the treatment groups. Rats of treatment group were administered MXD (10 g/kg of body weight) orally once daily starting from the day post-model establishment. Pancreatic tissues were harvested after 28-day feeding and fibrosis was evaluated by picro-sirius red staining. The contents of collagen type I and III were detected using enzymelinked immunosorbent assay (ELISA), the expression of matrix metalloproteinase 13 (MMP13) and tissue inhibitor of metalloproteinase 1 (TIMP1) was analyzed by Western blot and real-time polymerase chain reaction (PCR).@*RESULTS@#The fibrosis scoring of pancreatic tissues, the concentrations of collagen type I and III, the expression levels of MMP13 and TIMP1 proteins and mRNA in the model group were all increased compared with the control group (P0.05).@*CONCLUSIONS@#MXD could promote collagen degradation and reverse pancreatic fibrosis in CP rats via a mechanism involve up-regulation of MMP13 expression.
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Objective:To compare the effects of Botulinum toxin type A (BTX-A) injection guided with electromyographic/electric stimulation or ultrasonography in patients with post-stroke spasticity of wrist and finger flexor muscles. Methods:Inpatients with post-stroke spasticity of wrist and finger flexor muscles accepted BTX-A injection from January, 2015 to May, 2019 were reviewed. They were divided into electromyographic/electric stimulation-guided group (n = 36) and ultrasound-guided group (n = 37). They were assessed with modified Ashworth Scale (MAS) and Fugl-Meyer Assessment (FMA) before injection and four weeks after treatment. Results:The scores of both MAS and FMA improved in both groups after treatment (|Z| > 4.654, P < 0.001), and the scores of MAS improved more in the ultrasound-guided group (|Z| > 1.980, P < 0.05), with less dosage of BTX-A (t = 4.023, P < 0.001). Conclusion:Ultrasound-guided injection of BTX-A is more effective on wrist and finger flexion muscles spasticity than electromyographic/electric stimulation-guided method in stroke patients.
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Modified Da-chai-hu Decoction (MDD), a traditional Chinese medicinal formulation, which was empirically generated from Da-chai-hu decoction, has been utilized to treat severe acute pancreatitis (SAP) for decades. The aim of the present study was to explore its potential organprotective mechanism in SAP. In the present study, rat SAP model was induced by retrograde injection of 3.5% sodium taurocholate into the biliopancreatic duct, MDD (23.35 g/kg body weight, twelve times the clinical dose) were orally given at 2 h before and 10 h after injection. At 12 h after model induction, blood was taken from vena cava for analysis of amylase, diamine oxidase (DAO), pulmonary surfactant protein-A (SP-A), and C-reactive protein (CRP). Histopathological change of pancreas, ileum and lung was assayed by H&E staining, myeloperoxidase (MPO) activity were determinated using colorimetric assay, and the expressions of occludin and nuclear factor-κB (NF-κB) were detected by real-time RT-PCR and western blot, respectively. In addition, the tissue concentrations of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and monocyte chemoattractant protein-1 (MCP-1) were measured by enzyme-linked immunosorbent assay (ELISA). The results showed that in SAP rats, MDD significantly alleviated histopathological damage, depressed the MPO activity and the concentrations of TNF-α, IL-1β, and MCP-1 of pancreas, ileum and lung, and reduced the serum levels of amylase [(3283.4 ± 585.5) U·Lvs (5626.4 ± 795.1)U·L], DAO [(1100.1 ± 334.3) U·Lvs (1666.4 ± 525.3) U·L] and CRP [(7.6 ± 1.2) μg·mLvs (17.8 ± 3.8) μg·mL]. However, the serum SP-A concentration [(106.1 ± 16.6) pg·mLvs (90.1 ± 14.9) pg·mL] was elevated when treated SAP rats with MDD. Furthermore, MDD increased the occludin expression and reduced the NF-κB expression in pancreas, ileum and lung of SAP rats. Our findings suggested that MDD administration was an effective therapeutic approach for SAP treatment. It could up-regulate occludin expression to protect intercellular tight junction and down-regulate NF-κB expression to inhibit inflammatory reaction of pancreas, ileum and lung.
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Patellofemoral pain syndrome (PFPS) is one of the most common diseases that cause pain in the knee joint. At present, there is no specific diagnostic measure. The diagnosis of patellofemoral pain syndrome may be considered when imaging is performed without cartilage, ligament and soft tissue injuries. The etiology includes abnormalities of the patellar motion caused by various anatomical abnormalities, such as abnormal patellar position, increased Q angle, and excessive valgus foot. Dysfunction of the lower extremity muscles such as the imbalance of the four biceps and the dysfunction of the gluteal muscles also play an important role in the development of patellofemoral pain syndrome. At present, there are many treatments, and the exercises of four biceps exercises and hip abductor exercises are aimed at improving the dynamic stability of patella; The muscle patch and the patellar brace mainly reduce the pressure of the patellofemoral joint by improving the patellar trajectory; Foot orthopedic pads are used primarily in patients with valgus feet. After the conservative treatment is ineffective, the patellar lateral retinaculum can be loosened under arthroscopy. Because the patellofemoral pain syndrome is caused by the combined effects of various etiologies, a variety of treatments are helpful to improve the therapeutic effect.
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@#Objective To explore the effect of traditional Chinese massage on upper limbs spasticity in stroke patients who accepted Botulinum toxin type A (BTX-A) injection. Methods 74 stroke patients with upper limbs spasticity were divided into treatment group (n=36)and control group (n=38). The control group received BTX-A injection, and the treatment group received massage after injection. Both groups received rehabilitation training after injection and were assessed with modified Ashworth scale, Fugl-Meyer assessment and modified Barthel index before and 2 weeks, 4 weeks, 8 weeks and 12 weeks after treatment. Results All the scores of assessments improved in both groups after treatment (P<0.001), and there was no significant difference between them (P>0.05). Conclusion Addition of traditional Chinese massage doesn't work more on spasticity of upper limbs after stroke when accepted BTX-A injection.
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Objective: To compare and evaluate the efficacy and adverse reactions of tizanidine, baclofen and eperisone for treatment of limb spasticity in patients after stroke. Method: One hundred and three patients with stroke were enrolled in this prospective, randomized, controlled study. They were randomly divided into 4 groups: Tizanidine (n = 30), baclofen (n = 25), eperisone (n = 22) and control (n = 26) groups. The muscular tone, motor function and daily live activities (ADL) were evaluated with the modified Ashworth scale (MAS), Fugl-Meyer ssessment (FMA) and modified Bathel index (BI) respectively 4 and 12 weeks before and after the medication. Results: Circled digit oneTwelve weeks after the medication, the MAS scores of the upper and lower limbs of the patients were decreased in the 3 treatment groups as compared to the control group (P 0.05). Circled digit twoThe FMA scores of the upper limbs in patients of the 4 groups showed that there were no significant differences before and after the treatment (P > 0.05 all); the FMA scores of the lower limbs in patients of the 4 groups after the 12-week treatment were significantly higher than those before treatment. The average increased scores were 5 ± 3, 6 ± 5, 5 ± 4, and 4 ± 4, respectively (P 0.05). Circled digit threeCompare to the scores before the treatment, the MBI showed that there were significant differences in the average scores in the 4 groups 12 weeks after the treatment (P 0.05). Circled digit fourBlood, urine, liver and renal function tests of all patients were in the normal range before and after treatment. 10% and 8% of patients in the tizanidine and baclofen groups experienced drowsiness; 6.7%, 8%, and 4.5%. of patients in the tizanidine, baclofen, and eperisone groups had gastrointestinal discomfort; 6.7% and 8% of patients in the tizanidine and baclofen groups had blood pressure drop; and 22.7% of patients in the eperisone group had generalized weakness. The symptoms were relieved in all patients after reduce or stop the medication. Conclusion: Tizanidine, baclofen and eperisone have obviously effects for reducing muscular tone and relieving spasticity. Their therapeutic effects has no differences, but the three medicines did not show significant effect on functional recovery.
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@#Objective To explore the effect of acupuncture on stroke patients in hemiplagic spasm period.Methods63 stroke patients in hemiplagic spasm period were randomly divided into the electro-acupuncture group(n=31) and control group(n=32).All patients of two groups received routine rehabilitation training,but those of the electro-acupuncture group were added with electro-acupuncture at "Zusanli"(ST36).The composite spasticity scale(CSS) score,H/Mmax and muscular compliance of two groups before and after treatment were observed and compared.ResultsThe CSS scores and H/Mmax and grading gastrocnemius muscular compliance of the electro-acupuncture group were superior to that of the control group(P<0.05～0.01).ConclusionAcupuncture can decrease muscular tension and increase motor function of stroke patients in hemiplagic spasm period.
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@#Objective To explore the effect of acupuncture on stroke patients in hemiplagic spasm period.Methods63 stroke patients in hemiplagic spasm period were randomly divided into the electro-acupuncture group(n=31) and control group(n=32).All patients of two groups received routine rehabilitation training,but those of the electro-acupuncture group were added with electro-acupuncture at "Zusanli"(ST36).The composite spasticity scale(CSS) score,H/Mmax and muscular compliance of two groups before and after treatment were observed and compared.ResultsThe CSS scores and H/Mmax and grading gastrocnemius muscular compliance of the electro-acupuncture group were superior to that of the control group(P<0.05～0.01).ConclusionAcupuncture can decrease muscular tension and increase motor function of stroke patients in hemiplagic spasm period.
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@#Objective To observe the effect of botulinum toxin A (BTX-A) on spasticity of upper extremity with different functional status after stroke.Methods 32 post-stroke patents with upper extremity spasticity were divided into the good function group (n=13) and poor function group (n=19) according to the function of upper extremity. All patients in two groups were treated with injection of domestic BTX-A at the biceps brachii and rehabilitation therapy. The efficacy was assessed with rang of motion, Modified Ashowrth Scale (MAS), Fugl-Meyer Assessment (FMA) and Mot-FIM upper extremity before and 8-week after treatment.Results After treatment, the rang of motion and FMA scores of patients in two groups improved ( P<0.05), but the good function group was superior to the poor function group; the scores of MAS of two groups were not different ( P>0.05); the scores of Mot-FIM upper extremity of the patients in two groups increased ( P<0.05), and there was no significant difference between two groups ( P>0.05).Conclusion The effect of BTX-A injection at the biceps brachii on post-stroke patients with good function of upper extremity is superior to the patients with poor function of upper extremity.