Outcome of manipulation under anesthesia with or without intra-articular steroid injection for treating frozen shoulder: A retrospective cohort study

Manipulation under anesthesia (MUA) combined with intra-articular steroid injection (ISI) is preferred in management of the refractory frozen shoulder (FS). This study aimed to evaluate the effect of MUA with ISI or not on pain severity and function of the shoulder.Data on 141 patients receiving MUA with primary FS refractory to conservative treatments for at least 1 month were retrospectively obtained from medical records. We performed propensity score matching analysis between patients receiving MUA only and those receiving MUA plus ISI, and then conducted logistic regression analysis to identify the risk factors for the need to other treatments during 6-month follow-up.More improvement in terms of the SPADI pain scores and passive ROM at 2 weeks after first intervention remained in patients receiving MUA plus ISI after matching. The need to other treatments during 6-month follow-up occurred in 10.6% patients (n = 141). Logistic regression analysis revealed that a repeat MUA 1 week after first intervention was a protective factor (OR 0.042; 95% CI 0.011–0.162; P = .000) and duration of disease was the only one risk factor (OR 1.080; 95% CI 1.020–1.144; P = .008) for the need to other treatments during follow-up.ISI immediately following MUA provided additional benefits in rapid relief of pain and disability for patients with refractory FS. Pain and disability of the shoulder may be rapidly alleviated by an earlier MUA from the onset of the symptoms and a repeat MUA 1 week after first intervention.     

Feishu Acupuncture Inhibits Acetylcholine Synthesis and Restores Muscarinic Acetylcholine Receptor M2 Expression in the Lung When Treating Allergic Asthma

Acupuncture was proven beneficial in treating allergic inflammation. We aimed to explore the regulation underlying the effects of acupuncture on Feishu, an acupoint most commonly used in the acupuncture therapy for respiratory diseases, with respect to the system of sympathetic nerve neurotransmitter acetylcholine (Ach). Male Wistar rats were randomly grouping. No treatment was taken in the normal group. Allergic asthma was induced using ovalbumin on the model, Feishu acupuncture, and sham acupuncture groups; then control or acupuncture treatment lasting for 3 weeks was performed. Bronchoalveolar lavage fluid (BALF) from the four groups was examined. And pulmonary tissues were subjected to histological analysis with H&E staining; besides, immunofluorescent staining, quantitative PCR, and western blot were used to detect synthetase (ChAT) and Ach hydrolase (AchE), and its muscarinic receptors (mAchRs) M1-M3. There was inflammatory infiltration in the lung upon allergic asthma, which was alleviated by the Feishu acupuncture. The eosinophilic granulocytes, neutrophils, and lymphocytes in BALF from the Feishu acupuncture group were all significantly decreased compared with those of the model and sham acupuncture groups. The specific acupuncture on Feishu upon allergic asthma put down the pulmonary expression of ChAT, repaired at the level of gene expression the pulmonary expression of mAchR M1, and restored the pulmonary expression of mAchR M2 (especially in the bronchiolar epithelium) which has a role in inhibiting Ach release; while sham acupuncture had no effect. These results confirmed the therapeutic effects of Feishu acupuncture on allergic asthma, suggesting that the mechanisms may involve suppression of the Ach signal both from its synthesis and during its release.     

DNA Modifications and Neurological Disorders

Mounting evidence has recently underscored the importance of DNA methylation in normal brain functions. DNA methylation machineries are responsible for dynamic regulation of methylation patterns in discrete brain regions. In addition to methylation of cytosines in genomic DNA (5-methylcytosine; 5mC), other forms of modified cytosines, such as 5-hydroxymethylcytosine, 5-formylcytosine, and 5-carboxylcytosine, can potentially act as epigenetic marks that regulate gene expression. Importantly, epigenetic modifications require cognate binding proteins to read and translate information into gene expression regulation. Abnormal or incorrect interpretation of DNA methylation patterns can cause devastating consequences, including mental illnesses and neurological disorders. Although DNA methylation was generally considered to be a stable epigenetic mark in post-mitotic cells, recent studies have revealed dynamic DNA modifications in neurons. Such reversibility of 5mC sheds light on potential mechanisms underlying some neurological disorders and suggests a new route to correct aberrant methylation patterns associated with these disorders.     

Bufalin,a bufanolide steroid from the parotoid glands of the Chinese toad,suppresses hERG K+ currents expressed in HEK293 cells

In this study, we investigated the effect of bufalin on the human ether‐à‐go‐go‐related gene (hERG) K⁺ channels using the perforated patch recording technique. We measured a half‐maximal inhibitory concentration (IC₅₀) of 24.83 μM and maximal inhibitory effect of 39.45 ± 1.14% with bufalin. These findings suggest that bufalin is a potent hERG K⁺ channel blocker and may provide a new way for understanding Chan Su‐induced arrhythmia.     

Diffusion tensor imaging detects treatment effects of FTY720 in experimental autoimmune encephalomyelitis mice

Fingolimod (FTY720) is an orally available sphingosine‐1‐phosphate (S1P) receptor modulator reducing relapse frequency in patients with relapsing–remitting multiple sclerosis (RRMS). In addition to immunosuppression, neuronal protection by FTY720 has also been suggested, but remains controversial. Axial and radial diffusivities derived from in vivo diffusion tensor imaging (DTI) were employed as noninvasive biomarkers of axonal injury and demyelination to assess axonal protection by FTY720 in experimental autoimmune encephalomyelitis (EAE) mice. EAE was induced through active immunization of C57BL/6 mice using myelin oligodendrocyte glycoprotein peptide 35–55 (MOG_35–55). We evaluated both the prophylactic and therapeutic treatment effect of FTY720 at doses of 3 and 10 mg/kg on EAE mice by daily clinical scoring and end‐point in vivo DTI. Prophylactic administration of FTY720 suppressed the disease onset and prevented axon and myelin damage when compared with EAE mice without treatment. Therapeutic treatment by FTY720 did not prevent EAE onset, but reduced disease severity, improving axial and radial diffusivity towards the control values without statistical significance. Consistent with previous findings, in vivo DTI‐derived axial and radial diffusivity correlated with clinical scores in EAE mice. The results support the use of in vivo DTI as an effective outcome measure for preclinical drug development. Copyright © 2013 John Wiley & Sons, Ltd.     

急性心肌梗死后快速延迟整流K~+通道基因表达的变化

目的探讨猪心肌梗死(MI)后梗死边缘区快速延迟整流K+通道KCNH2和KCNE2基因表达水平的改变及意义。方法通过结扎猪左前降支远端1/3～1/2处2h建立急性心肌梗死(AMI)模型,手术后存活猪进入MI组,术后24h取左心室梗死边缘区内层(Endo)、中层(Mid)和外层(Epi)心肌,应用半定量RT-PCR方法检测KCNH2和KCNE2mRNA含量。同时,设立相应的假手术组(SH组),SH组取与MI组对应区域的心肌组织。结果 KCNH2和KCNE2基因的表达在SH组左心室En-do、Mid和Epi心肌间没有差异,与SH组比较,AMI后梗死边缘区3层心肌KCNH2mRNA表达均明显下降(P<0.05),而且3层心肌间的基因表达呈不均一性(P<0.05),KCNE2mRNA表达量差异无统计学意义(P>0.05)。结论 AMI后梗死边缘区3层心肌KCNH2基因表达的不均一性下调,可能在MI后早期室性心律失常的发生中起重要作用。