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Objective:To investigate the clinical efficacy of repetitive transcranial magnetic stimulation (rTMS) versus functional electrical stimulation (FES) in the treatment of post-stroke complex regional pain syndrome. Methods:The randomized controlled study included 60 patients with post-stroke complex regional pain syndrome who received treatment at the Wenzhou TCM Hospital of Zhejiang Chinese Medical University from July 2021 to February 2023. These patients were divided into an rTMS group ( n = 30) and an FES group ( n = 30) using a random number table method. Patients in the rTMS group were treated with rTMS, while those in the FES group were treated with FES. All treatments were performed once daily for 8 consecutive weeks. The clinical efficacy, total active movement score of the fingers, Fugl-Meyer assessment scale score, Activity of Daily Living score, modified Barthel Index score, shoulder joint range of motion, and safety were compared between the two groups. Results:The total response rate in the FES group was 86.7% (26/30), which was significantly higher than 83.3% (25/30) in the rTMS group ( Z = 0.09, P = 0.93). After treatment, there were no significant differences between the two groups in terms of total active movement score of the fingers and Fugl-Meyer assessment scale score ( P = 0.244, 0.262). No significant differences were found between the two groups in MBI score and ADL score (both P > 0.05). There was also no significant difference in shoulder joint range of motion between the two groups ( P > 0.05). Conclusion:Both rTMS and FES are highly effective for post-stroke complex regional pain syndrome. They can improve upper limb function, enhance daily living abilities, and remodel neurological functions of the brain.
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AIM: To investigate t h e impacts of theaflavins (TFs) on neuronal apoptosis and blood-brain barrier (BBB) by regulating the calcium/calmodulin-dependent protein kinase kinase 2 (CaMKK2)/5 '-adenosine monophosphate-activated protein kinase (AMPK) signaling pathway. METHODS: Ninety rats were randomly separated into sham operation group, model group, low-dose TFs group (20 mg/kg TFs), high-dose TFs group (40 mg/kg TFs), and high-dose TFs + STO-609 group (40 mg/kg TFs + 10 ΜL CaMKK2 inhibitor-STO-609), positive control group (2 mg/kg nimodipine injection), with 15 rats in each group. A rat model of intracerebral hemorrhage was induced by collagenase type VII. The behavior of rats and the water content of brain tissue were detected; the serum of rats was isolated, and the levels of inflammatory factors-vascular cell adhesion molecule-1 (VCAM-1), tumor necrosis factor-α (TNF-α), and intercellular adhesion molecule-1 (ICAM-1) were detected; brain tissue around the hematoma was collected to detect neuronal apoptosis, BBB permeability parameter-EB level, and expressions of p-CaMKK2/CaMKK2, p-AMPK/AMPK and apoptosis-related protein Bax. RESULTS: Compared with the sham operation group, the mNSS score, ICAM-1, TNF-α, VCAM-1, brain tissue water content, apoptosis rate, EB level and Bax protein expression in the model group were all increased, both pCaMKK2/CaMKK2 and p-AMPK/AMPK were decreased (P < 0.05); compared with the model group, the mNSS score, ICAM-1, TNF-α, VCAM-1, brain water content, apoptosis rate, EB level and Bax expression in the low- and high-dose TFs groups and the positive control group were all lower than those in the model group, both pCaMKK2/CaMKK2 and p-AMPK/AMPK were increased (P < 0.05); compared with the high-dose TFs group, the mNSS score, ICAM-1, TNF-α, VCAM-1, brain tissue water content, apoptosis rate, EB level and Bax expression were all increased in the high dose TFs + STO-609 group, both p-CaMKK2/CaMKK2 and p-AMPK/AMPK were decreased (P < 0.05). CONCLUSION: TFs can reduce neuronal apoptosis, inflammatory response, BBB permeability, and play a protective role in rats with cerebral hemorrhage injury. Its mechanism is related to the activation of CaMKK2/AMPK signaling pathway.
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Objective To observe the effect of Zhen'gan Xifeng decoction combined with mirror therapy on the recovery of upper limb function of stroke patients with syndrome of Yin deficiency and wind stirring.Methods From January 2015 to October 2017,90 stroke patients with syndrome of Yin deficiency and wind stirring complicated with hemiplegia of upper limbs in Wenzhou Hospital of Traditional Chinese Medicine were randomly divided into the combined treatment group,the mirror treatment group and the control group according to the digital table,with 30 cases in each group.All patients were treated with conventional western medicine,combined with limb function rehabilitation training;on this basis,the combined treatment group was given mirror therapy in conjunction with Zhen'gan Xifeng decoction,the mirror group was given mirror treatment,the control group only received routine treatment.The three groups were treated for 8 weeks.The recovery of upper limb function score (FMA),arm action test score (ARAT),functional independent measurement (FIM) were used to evaluate the curative effect,and the TCM syndrome scores of the patients before and after treatment were compared in the three groups.Results After treatment,the FMA scores,ARAT scores and FIM scores of the three groups were higher than those before treatment(all P ＜ 0.01).The upper limbFMA score[(33.80 ± 7.17) points],ARAT score[(13.57 ± 4.62) points],FIM score[(69.54 ±19.23)points] in the combined treatment group were significantly higher than those in the mirror group [(25.90 ±6.47) points,(11.57 ± 3.84) points and (59.89 ± 22.56) points,P =0.001,0.036,0.001] and the control group [(21.90 ± 4.87) points,(10.32 ± 3.21) points,(49.80 ± 23.51) points,P =0.001,0.025,0.000].The Ashworth upper limb spasticity score in the combined treatment group [(1.23 ± 0.34) points] was significantly lower than that in the mirror group[(1.91 ± 0.46) points,P =0.048] and the control group [(1.72 ± 0.51) points,P =0.043],compared with before treatment,the scores in the mirror group and the control group had no statistically statistical differences (t =0.58,P =0.290,t =1.21,P =0.079).The effectiveness of the combined treatment group was 24 cases after treatment of TCM syndrome,and 18 cases were effective in the mirror group,and 6 cases were effective in the control group.Conclusion The combination of Zhen'gan Xifeng decoction and mirror therapy can better improve the upper extremity motor function of the stroke patients with syndrome of Yin deficiency and wind stirring,promote the recovery of the motor function of the affected side and improve the daily living ability of the patients.The improvement of upper limb spasm is more effective,it is worthy of clinical promotion.
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Objective@#To observe the effect of Zhen′gan Xifeng decoction combined with mirror therapy on the recovery of upper limb function of stroke patients with syndrome of Yin deficiency and wind stirring.@*Methods@#From January 2015 to October 2017, 90 stroke patients with syndrome of Yin deficiency and wind stirring complicated with hemiplegia of upper limbs in Wenzhou Hospital of Traditional Chinese Medicine were randomly divided into the combined treatment group, the mirror treatment group and the control group according to the digital table, with 30 cases in each group.All patients were treated with conventional western medicine, combined with limb function rehabilitation training; on this basis, the combined treatment group was given mirror therapy in conjunction with Zhen′gan Xifeng decoction, the mirror group was given mirror treatment, the control group only received routine treatment.The three groups were treated for 8 weeks.The recovery of upper limb function score(FMA), arm action test score(ARAT), functional independent measurement(FIM) were used to evaluate the curative effect, and the TCM syndrome scores of the patients before and after treatment were compared in the three groups.@*Results@#After treatment, the FMA scores, ARAT scores and FIM scores of the three groups were higher than those before treatment(all P<0.01). The upper limb FMA score[(33.80±7.17)points], ARAT score[(13.57±4.62)points], FIM score[(69.54±19.23)points] in the combined treatment group were significantly higher than those in the mirror group[(25.90±6.47)points, (11.57±3.84)points and (59.89±22.56)points, P=0.001, 0.036, 0.001] and the control group[(21.90±4.87)points, (10.32±3.21)points, (49.80±23.51)points, P=0.001, 0.025, 0.000]. The Ashworth upper limb spasticity score in the combined treatment group[(1.23±0.34) points] was significantly lower than that in the mirror group[(1.91±0.46)points, P=0.048]and the control group[(1.72±0.51)points, P=0.043], compared with before treatment, the scores in the mirror group and the control group had no statistically statistical differences(t=0.58, P=0.290, t=1.21, P=0.079). The effectiveness of the combined treatment group was 24 cases after treatment of TCM syndrome, and 18 cases were effective in the mirror group, and 6 cases were effective in the control group.@*Conclusion@#The combination of Zhen′gan Xifeng decoction and mirror therapy can better improve the upper extremity motor function of the stroke patients with syndrome of Yin deficiency and wind stirring, promote the recovery of the motor function of the affected side and improve the daily living ability of the patients.The improvement of upper limb spasm is more effective, it is worthy of clinical promotion.
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ObjectiveTo investigate the effect of intensive dose atorvastatin on preventive contrast-induced nephropathy (CIN) in elder with coronary heart disease (CHD) after elective percutaneous coronary intervention (PCI).Methods110 subjects older than 60 who received elective PCI,were randomly divided into intensive dose atorvastatin group (the study group,n =50) and conventional treatment group (the control group,n =50).On the ba sis of the hydration therapy,the study group received atorvastatin and the control group received atorvastatin.Scr、β2- MG and liver function were checked for evidence of tubular or glomemlar damage before and after elective PCI were compared between the two groups.Ccr was calculated according to Cockcroft-Gault formula;The incidence of the major adverse cardiovascular events (MACE) and cytotoxicity and hepatotoxicity of rosuvastation were respectively recorded in 30 days follow-up period.ResultsCcr in the study group was significantly higher than that in the control group at day 1 [( 73.12 ± 16.89 ) ml/min vs ( 63.89 ± 18.42 ) ml/min,P =0.036],day 2 [( 65.32 ± 13.46 ) ml/min vs (55.63 ± 15.47 )mL/min,P =0.021] ;Blood β2-M in the study group was significantly lower than that in the control group at day 1 [( 2.44 ± 0.42 ) ml/min vs ( 2.69 ± 0.63 ) mL/min,P =0.009],day 3 ( 2.52 ± 0.46 ) mL/min vs (2.81 ±0.63) ml/min,P =0.011],day 3[(2.37 ±0.43) ml/min vs (2.54 ±0.65 ) ml/min,P =0.021].The incidence of CIN was lower in the study group than that in the control group(6％ vs 24％,P =0.012).During 30days clinical follow-up,the incidence of the MACE in the control group was more than the study group ( x2 =5.316,P =0.021).There was no significant difference between the two groups for the cytotoxicity and hepatotoxicity.ConclusionHigh dose atorvastatin may be more efficient in prevention CIN in elder before elective PCI and this higher dose may be safe to the elder.