Post-stroke dysphagia treated with acupuncture of meridian differentiation:a randomized controlled trial / 中国针灸

<p><b>OBJECTIVE</b>To observe the effect on post-stroke dysphagia treated with acupuncture of meridian differentiation.</p><p><b>METHODS</b>One hundred and thirty patients of post-stroke dysphagia were randomized into an observation group (67 cases) and a control group (63 cases). Conventional medication and rehabilitation training were applied in the two groups. In the observation group, acupuncture based on meridian differentiation was adopted. The main acupoints were Neiguan (PC 6), Shuigou (GV 26), Sanyinjiao (SP 6), Fengchi (GB 20), Lianquan (CV 23), Jialianquan (Extra), Jinjin (EX-HN 12), Yuye (EX-HN 13), etc. The supplementary points were selected according to different patterns/syndromes. In the control group, the points were selected 5 cm lateral to the acupoints used in the observation groups and stimulated with shallow puncture. The needles were retained for 30 min, once daily, 5 treatments a week and continuously for 6 weeks in the two groups. Separately, before treatment, in 6 weeks after treatment and in follow-up after 3 months, the standardized swallowing assessment (SSA), the video fluoroscopic swallowing study (VFSS), the modified Barthel index (MBI) and the swallowing related quality of life (SWAL-QOL) were observed in the two groups and the efficacy was assessed.</p><p><b>RESULTS</b>In 6 weeks of treatment, the scores of SSA, VFSS, MBI and SWAL-QOL were improved apparently as compared with those before treatment (<0.01,<0.05) in the patients of the two groups. The results in the observation group were better apparently than those in the control group (<0.01,<0.05). In follow-up after 3 months, the scores of SSA, MBI and SWAL-QOL were improved apparently as compared with those before treatment in thepatients of the two groups (all<0.01), in which, MBI score was improved apparently as compared with that in 6 weeks of treatment in the patients of the two groups (both<0.05). Those scores in the observation group were improved apparently as compared with those in the control group (<0.01,<0.05). In 6 weeks of treatment and in 3 months of follow-up, the effective rates in the observation group were 91.8% (56/61) and 93.4% (57/61), better than 80.0% (44/55) and 85.5% (47/55) in the control group separately, indicating the significant difference (both<0.05).</p><p><b>CONCLUSIONS</b>The acupuncture of meridian differentiation improves significantly swallowing function and survival quality in patients of stroke.</p>

Clinical Observation of Acupuncture plus Rehabilitation Training for Post-stroke Depression / 上海针灸杂志

ObjectiveTo observe the effect of acupuncture plus rehabilitation training on the function recovery of patients with post-stroke depression.MethodNinety-eight patients with post-stroke depression were randomized into two groups to receive conventional management and anti-depressants. The control group was intervened by sham-acupuncture plus Fluoxetine tablets and comprehensive rehabilitation training, while the observation group was by acupuncture plus Fluoxetine tablets and comprehensive rehabilitation training. Prior to the intervention and after 8-week treatments, the depression state, motor function and activities of daily life (ADL) were evaluated by using Hamilton Depression Scale (HAMD), Fugl-Meyer Assessment (FMA) and Modified Barthel Index (MBI). The indexes and quality of life were also determined during the 3-month follow-up study.ResultBefore intervention, there were no significant differences in comparing HAMD, FMA and MBI scores (P>0.05). After 8-week treatment, the HAMD, FMA and MBI scores were significantlyimprovedin both groups (P<0.01,P<0.05). After treatment, the HAMD, FMA, and MBI scores in the observation group were significantlydifferent fromthat in the control group (P<0.01,P<0.05). The total effective rate was 90.0% in the observation group versus 79.2% in the control group, and the difference was statistically significant (P<0.05). The 3-month follow-up study showed significant differences in comparing the indexes between the two groups (P<0.05, P<0.01).ConclusionAcupuncture plus rehabilitation training benefits the improvement of depression state, motor function, cognitive function and quality of life in patients withpost-stroke depression, and is worth promotion.

Establishment of experimental allergic encephalomyelitis in C57BL/6 mice and testing of expressions of Foxp3 and quantifies of CD4~+ CD25~+ regulatory T cells / 中华微生物学和免疫学杂志

Objective To induce experimental allergic encephalomyelitis (EAE) in female C57BL/6 mice with the extracellular domain of myelin oligedendroglia glycoprotein(MOG~(Igd)). Percentages of CD4~+ CD25~+ T cell (Tr) were tested , and also normalized expressions of Foxp3. Methods Molecular cloning technology was used to produce MOG~(Igd) fusion protein. The MOG~(Igd)-TrxA fusion protein and TrxA protein were purified by metal chelate affinity chromatography (MCAC). Mice were injected s. c. in the flank with 300 μg MOG~(Igd) in complete Frcund's adjuvant (CFA) supplemented with 4 μg/μl Mycobacterium tuberculosis. H37Rv. Mice received 0.4 ml emulsion of spinal cord homogenate of guinea pigs (GPSCH) in positive control group, and the same volume emulsiom of TrxA in negative control group, while mice served as normal control received only saline/adjuvant. Mice were monitored two times a day for continuously 30 days by double bind. Clinical scores and histopathology were evaluated. Then, mice were sacrificed. The spinal cord and brain were removed and fixed in buffered formalin. Horizontal sections taken from the central nervous system(CNS) were stained with haematoxylin and eosin (HE), and Kluver-Barrera staining. Also, immunohistochemistry was performed. Percentages of CD4~+ CD25~+ T cells were tested through flow cytometric analysis, and real-time PCR was performed to test normalized expressions of Foxp3 mRNA. Then, correlations between the two were performanced. Results Mice in both MOG group and GPSCH group shew chronic non-remitting course. The onset of disease, time when the most severe clinical symptoms happened and the clinical score between the two groups shew no significant differnces (P>0.05). However, neither in TrxA treated group nor in normal control group did animals exhibit clinical signs of EAE. Histologic sections of the brain and spinal cord taken from affected animals shew perivascular infiltration of mononuclear cells, gliosis, and multifocal demyelination. Lesions scattered throughout the CNS including brainstem, spinal cord, cerebellum, and penventricular white matter. There were significant differences between MOG group and TrxA group in the level of lesion-ceutric AQP-4 expression showing up by immunohistochemistry (P<0.05). Percentages of CD4~+ CD25~+ T cells in MOG group and GPSCH group were (4.71±1.61) % and (1.44±0.65) %, respectively, both of which were significantly lower than those in the normal control group or TrxA treated group (P<0.01). And the difference between MOG group and GPSCH group also reached statistics meaning (P<0.01). Normalized expression of Foxp3 mRNA in MOG group was 2.26± 1.97, and was not significantly higher than the 1.44±1.20 level in GPSCH group (P>0.05). However, they beth were statistically lower than that in the negative control group, namely 8.58±3.34 (P<0.01). Percentages of CD4~+ CD25~+ T cells was statistically correlated with expressions of Foxp3 mRNA (P< 0.05). Conclusion EAE induced in C57BL/6 mice with MOG~(Igd) is reproduceable. It shares the similar clinial signs and pathologic features with human multiple sclerosis(MS). Thus, we find a good way to further study the immune mechanisms of MS and also to search for the effective treatments.

Alterations in levels of CD8+ CD28- regulatory T cell in the peripheral blood of multiple sderosis patients / 中华急诊医学杂志

Objective To investigate the levels of peripheral blood CD8+ CD28- regulatory lymphocytes and their clinical values in the patients with multiple sclerosis (MS). Method From October 2005 to August 2008, 51 patients with active rehpsing-remitting MS were enrrolled from Department of Neurology of the First Affil-iated Hospital of Wenzliou Medical College. The diagnostic criteria for MS were the 2005 revisions to the "McDon-ald criteria". All the admitted patients received 1 g of methylprednisoione per day intravenously for 5 days, fol-lowed by 60 mg prednisone per day orally for 12 days,and tapered in 6 weeks. Fourteen patients were reevaluated after corticosteroid therapy. Twenty healthy individuals ,as normal controls,matched for age and sex with the MS patients were also enrolled in this study. The percentages of peripheral blood T cells (CD8+ CD28-, CD8+CD28+, CD8+, CD4+ CD8-) were measured by flow cytometric analysis. Parametric statistical analysis were per-formed using standard methods, and linear regression analysis was conducted using Pearson correlation test. Re-sults (1)Compared with controls,the patients with active MS had significantly lower percentage of CD8+ CD28-T cells [(18.48±9.89)% vs. (24.48±4.86)%, P <0.01], and higher percentage of CD8+ CD28+ T cells [(12.23±4.31) % vs. (8.55±3.49) %, P <0.01]. (2)The percentage of CD8+ CD28- T cells was negative-ly correlated with that of CD4+ CDS- T cells (r = -0.488, P < 0.01). (3) After corticosteroid therapy, the per-eentage of peripheral blood CD8+ CD28- / CD8+ CD28+ T cells didn' t significantly decrease or increase in 14 ac-tive MS patients (P > 0.05). Conclusions The decrease of peripheral blood CD8+ CD28- regulatory T cells might be associated with the pathogenesis of MS, and CD8+ CD28- regulatory T cells perhaps played their roles through CD4+ T cells. Corticosteroid therapy could not reverse the levels of CD8+ CD28- T cells.

Lipoprotein-associated phospholipase A2 activity and cerebral feeding artery atherosclerosis / 中国医师进修杂志

Objective To estimate the relationships between lipoprotein-associated phospholipase A2 (Lp-PLA2) activity and cerebral feeding artery athemsclemsis.Methods The blood samples were obtained from 148 atheroselerosis patients (atheroselerosis group) and 40 normal controls (control group).Activity of plasma Lp-PLA2 and traditional factors were determined.Logistic and regression model was adopted to analyze the roles of Lp-PLA2 and generally inflammatory risk factors in athemselemsis.Results Lp-PLA2 activity was significantly higher in atheroselerosis group than that in control group [(29.84±3.50)lesion number showed positive correlation with Lp-PLA2 (r=0.491,P＜0.01 and r=0.249,P=0.026).Adjusted other risk factors,Lp-PLA2 was an independent risk factor in cerebral feeding artery atherosclerosis.Conclusion Lp-PLA2,a novel inflammatory marker,is an independent risk factor of cerebral feeding artery atherosclerosis.

The relationship between angiotension converting enzyme gene polymorphism and Binswanger's disease in Chinese / 临床神经病学杂志

Objective To study the relationship between angiotensin converting enzyme (ACE)gene polymorphism and the risk factors of Binswanger's disease (BD) in Chinese Han nationality.Methods ACE gene insertion/deletion(ID) polymorphism in 111 Chinese Han Nationality patients with BD, 98 patients with hypertension and 102 normal controls were detected by polymorase chain reaction (PCR) technology,serum ACE was measured by colorimetric method,the risk factors of BD and family histories were assessed.Results The DD genotype frequency(0.64) was higher in BD group than in hypertension group (0.31, P