ABSTRACT
BACKGROUND:Stimulation of the pudendal nerve as a target can improve neurogenic bladder dysfunction after spinal cord injury, by adjusting the frequency, intensity, pulse width, as wel as regulating synergistic effect of detrusor and urethral sphincter. OBJECTIVE: To assess the research status of electrical stimulation of the pudendal nerve in the treatment of neurogenic bladder dysfunction after spinal cord injury. METHODS: We searched the folowing databases for articles addressing electrical stimulation of the pudendal nerve for neurogenic bladder dysfunction after spinal cord injury: PubMed, Cochrane Central Register of Controled Trials (CENTRAL), China National Knowledge Infrastructure, Wanfang Database, and VIP Database. The search was updated to July 2014, and the reference lists of the identified studies were manualy screened for additional studies. The study selection and data extraction were independently conducted by two reviewers. RESULTS AND CONCLUSION:Fourteen studies were included in this review. We derived the folowing points by analyzing the included studies: Electrical stimulation of the pudendal nerve has positive effects on rehabilitation of neurogenic bladder dysfunction after spinal cord injury; pudendal nerve electrical stimulation can modulate the coordination of the detrusor and the external urethral sphincter, improve the bladder compliance and restore bladder function by regulating pudendal-to-bladder reflex and spinal reflexes to the bladder. Electrical stimulation of the pudendal nerve may be potentialy implemented as a feasible treatment of neurogenic bladder dysfunction after spinal cord injury. More high quality researches should be conducted to clarify the efficacy and the potential active mechanisms of pudendal nerve electrical stimulation for neurogenic bladder dysfunction after spinal cord injury because the number of clinical reports published in this study area is limited, neurophysiological mechanisms underlying biphasic regulation of frequency on bladder function are not wel known, and which intensity of pudendal nerve electrical stimulation is more effective than others for the treatment of neurogenic bladder dysfunction after spinal cord injury remains unknown.
ABSTRACT
@#Per2 gene plays one of the most critical roles of clock gene which modulates circadian rhythm both in the physiological, biochemical and behavioral processes of organisms. The distributions of per2 gene include suprachiasmatic nucleus of the hypothalamus, central nucleus of amygdala, bed nucleus of the stria terminalis, hippocampus and other components of limbic system; it affects the emotional and visceral activities through participating in the system of circadian rhythm. The central per2 gene regulates the hypothalamus-pituitaryadrenal axis through integration of light input, steroid hormones and other neurotransmitters integration, acting on the target organs, and presentes a circadian rhythm of movement. This article reviewed the morphology and biology of per2 gene, and its participation in limbic system regulating the circadian rhythm of motional and visceral activities.
ABSTRACT
Objective To evaluate the effectiveness of mirror therapy in treating the upper limbs of patients with stroke.Methods The PUBMED,MEDLINE,EMbase,Cochrane Central Register of Controlled Trials (CENTRAL),ISI Web of Knowledge,OVID,CNKI,VIP and Wanfang Data databases were searched for reports of randomized controlled trials (RCTs) of mirror therapy in the treatment of the upper limbs of patients with stroke from the date of establishment of each database to April 2012.The bibliographies of the studies retrieved were also searched.Two independent researchers evaluated the included studies using the risk of bias provided by Cochrane Library.The extracted data were analyzed using RevMan 5.1 software and version 3.6 of the GRAED profiler.Results Reports of 9 trials were discovered.Meta-analysis showed that compared to the group that didn't have visual feedback,mirror therapy did not significantly increase Fugl-Meyer assessment (FMA) (Upper Limb) scores after 4 weeks of treatment compared with groups that did not have visual feedback.Mirror therapy also did not significantly increase average scores on the action research arm test (ARAT) after 6 weeks of treatment.Mirror therapy did,however,increase average Brunnstrom stage scores for the hand after 4 weeks of treatment and at a 6-month follow-up.Mirror therapy did not increase average scores on the modified Ashworth scale (MAS) after 4 weeks of treatment,but increased MAS scores were observed at a 6-month follow-up compared with a group which had no visual feedback.Mirror therapy increased functional independence measure (FIM) self-care scores after 4 weeks of treatment and at a 6-month follow-up,and it also increased modified Barthel index (MBI) scores after 4 weeks of treatment.In the GRADE system,the scores of Brunnstrom stages for the hand after 4 weeks of treatment were of moderate quality,but those scores and the MAS scores at the 6-month follow-up were of low quality.The FIM selfcare scores after 4 weeks and at the 6-month follow-up and the MBI scores measured after 4 weeks were of very low quality.Conclusion This evidence shows that mirror therapy can improve upper limb function and quality of daily life to some extent after stroke.However,because of the limitations of the previous studies such as poor quality,different end points,different rating scales and different courses of stroke,more high-quality,randomized,controlled trials with larger samples are needed to evaluate the effectiveness of mirror therapy in the rehabilitation of upper limb function after stroke.
