Robot-assisted gait training can improve lower limb function in cases of acute flaccid paralysis resulting from hand-foot-and-mouth disease / 中华物理医学与康复杂志

Objective To explore the effect of robot-assisted gait training on the standing and walking balance of persons with acute flaccid paralysis (AFP) resulting from hand-foot-and-mouth disease (HFMD).Methods Thirty-six persons with AFP resulting from HFMD were randomly divided into a control group and a training group,each of 18.Both groups were given conventional rehabilitation training,while the training group was additionally provided with robot-aided gait training.The control group received additional massage of their affected limbs.Before and after 15 days of treatment the subjects' standing and walking ability were evaluated using parts D and E of the gross motor function (GMFM) scale.Their balance was quantified using the Berg balance scale (BBS) and integrated surface electromyograms were recorded.Results There were no significant differences between the two groups before the treatment.After 6 weeks of treatment the average scores of both groups had improved significantly,with a significantly bigger increase observed in the training group.After the treatment,the average GMFM and BBS scores of the training group were significantly higher than those of the control group.Conclusion Gait training in addition to conventional rehabilitation training can significantly improve the standing,walking and balance of patients with HFMD resulting from AFP and promote their recovery.

Expressions of P-JNK in nerve cell apoptosis of A2AR knockout newborn mice after hypoxia/ischemia brain damage / 中国应用生理学杂志

<p><b>OBJECTIVE</b>To investigate the effect of adenosine A2A receptor knockout (A(2A)RKO) on relationship between continuous activation of phospho-c-Jun N-terminal kinase (P-JNK) and expression of nerve cell apoptosis in hippocampus CA1 domain of newborn mice after hypoxia/ischemia brain damage(HIBD) and its potential mechanism.</p><p><b>METHODS</b>A(2A)RKO mice and adenosine A2A receptor wildtype (A(2A)RWT) littermates (n = 80) were divided into Sham operation group (S) and model group (M), 1, 3 and 7 day after HIBD, totally 8 groups. HIBD was developed with 7 day-old neonatal mice according classical Rice-Vannucci method. It was tested the effect of A(2A)RKO on short-term neurofunctional outcomes consisted of three developmental reflexes (righting, geotaxis and cliff aversion), the changes of brain pathology with hematoxylin-eosin (HE) staining and Nissl staining, the expressions of nerve cell apoptosis with terminal deoxynucleotidyl transferase mediated dUTP-biotin nick-end labeling(TUNEL) staining and P-JNK were observed by immunohistochemistry.</p><p><b>RESULTS</b>The neurological behavior injuries and brain histopathological damages and nerve apoptosis cells were aggravated in A(2A)RKO newborn mice after HIBD. The positive expressions of P-JNK were significantly higher in the ischemic hippocampus CA1 domain after HIBD than ones in group S respectively (P < 0.01), reaching to peak at 1 day and then began gradually decreasing. P-JNK expression in model knockout(MKO) at 1, 3 and 7 day increased greatly compared to those in the previous time point of corresponding model wildtype (MWT) (P < 0.01, P < 0.05, P > 0.05); there was a positive correlation between the expressions of P-JNK and nerve cell apoptosis after HIBD in newborn mice(r = 0.837, P < 0.01).</p><p><b>CONCLUSION</b>Early continuous activation of P-JNK might be involved in the aggravated nerve apoptosis cells and brain damage induced by A(2A) RKO newborn mice after HIBD.</p>

Diagnostic accuracy of early brain magnetic resonance imaging for predicting cerebral palsy in premature infants : a meta-analysis / 中华围产医学杂志

Objective To evaluate the value of early brain magnetic resonance imaging (MRI) in predicting future cerebral palsy in premature infants. Methods Searching the related literatures in PubMed,Embase,Cochrane,China Biological Medical Literature Database,China Academic Journal Full-Text Database,VIP Database and Wanfang Database.Inclusion criteria:(1) the purpose of the research was to evaluate the value of early brain MRI in predicting cerebral palsy of premature infants;(2) the type of research was prospective cohort study,randomized controlled trial,retrospective case analysis or case control studies; (3) the inspection was taken within 3 months of correction age; (4)the gold standard in diagnosing cerebral palsy was based on follow-up results,and the diagnosis criteria was clear.The sensitivity,specificity,positive and negative likelihood ratio were calculated and pooled by Stata11.0. Results Seven studies were enrolled into this meta-analysis including 772 premature infants and among which 92 were diagnosed as cerebral palsy.The pooled sensitivity was 0.93 (95％CI:0.65-0.99),specificity was 0.89 (95％CI:0.81-0.93),positive likelihood ratio was 8.19 (95％CI:4.48-14.94) and the negative likelihood ratio was 0.08 (95％CI:0.01-0.52),the area under the summary receiver operating characteristic curve was 0.95 (95％ CI:0.92-0.96).Significant heterogeneity was found (P＜0.05).When one retrospective study and one low morbidity study was removed,heterogeneity reduced significantly (P＞0.10),and predictive accuracy slightly decreased.The pooled sensitivity was 0.81 (95％CI:0.58-0.93 ),specificity was 0.82 (95％CI:0.76-0.87). Conclusions Early brain MRI has high accuracy in predicting future cerebral palsy of premature infant,especially for negative results.And for the premature infants with high risk factors,positive brain MRI result might have a higher predictive efficiency.