Electroacupuncture improves learning and memory functions in a rat cerebral ischemia/reperfusion injury model through PI3K/Akt signaling pathway activation

Electroacupuncture has been widely used to treat cognitive impairment after cerebral ischemia, but the underlying mechanism has not yet been fully elucidated. Studies have shown that autophagy plays an important role in the formation and development of cognitive impairment, and the phosphoinositide 3-kinase(PI3 K)/Akt signaling pathway plays an important role in autophagy regulation. To investigate the role played by the PI3 K/Akt signaling pathway in the electroacupuncture treatment of cerebral ischemia/reperfusion rat models, we first established a rat model of cerebral ischemia/reperfusion through the occlusion of the middle cerebral artery using the suture method. Starting at 2 hours after modeling, electroacupuncture was delivered at the Shenting(GV24) and Baihui(GV20) acupoints, with a dilatational wave(1–20 Hz frequency, 2 mA intensity, 6 V peak voltage), for 30 minutes/day over 8 consecutive days. Our results showed that electroacupuncture reduced the infarct volume in a rat model of cerebral ischemia/reperfusion injury, increased the mRNA expression levels of the PI3 K/Akt signaling pathwayrelated factors Beclin-1, mammalian target of rapamycin(mTOR), and PI3 K, increased the protein expression levels of phosphorylated Akt, Beclin-1, PI3 K, and mTOR in the ischemic cerebral cortex, and simultaneously reduced p53 mRNA and protein expression levels. In the Morris water maze test, the latency to find the hidden platform was significantly shortened among rats subjected to electroacupuncture stimulation compared with rats without electroacupuncture stimulation. In the spatial probe test, the number of times that a rat crossed the target quadrant was increased in rats subjected to electroacupuncture stimulation compared with rats without electroacupuncture stimulation. Electroacupuncture stimulation applied to the Shenting(GV24) and Baihui(GV20) acupoints activated the PI3 K/Akt signaling pathway and improved rat learning and memory impairment. This study was approved by the Animal Ethics Committee of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine, China(approval No. 8150150901) on March 10, 2016.     

Atrial Failure as a Clinical Entity: JACC Review Topic of the Week

Atrial dysfunction has been widely considered a marker or consequence of other cardiac conditions rather than the cause itself. Here, we propose the term atrial failure as a clinically relevant entity, defined as any atrial dysfunction causing impaired heart performance, symptoms, and worsening quality of life or life expectancy. Aspects of the etiology, mechanisms, and consequences of atrial failure are discussed. Recent advances in cardiac electrophysiology and imaging have improved our understanding of the highly complex atrial anatomy and function, underlying the paramount importance of the atria in optimal heart performance. It is time to reappraise the concept of the failing atrium as a primary cause or aggravating factor of the symptoms in many of our patients. The concept of atrial failure may foster basic and translational research to gain a better understanding of how to identify and manage atrial dysfunction.     

阿司匹林联合氯吡格雷治疗进行性脑卒中的效果评价

目的观察进行性脑卒中患者使用阿司匹林联合氯吡格雷治疗的临床效果。方法选取2015年6月—2016年6月某医院收治的进行性脑卒中患者108例作为研究对象,依据随机数表法分为对照组和观察组,每组各54例。对照组使用阿司匹林药物进行治疗,观察组则使用阿司匹林联合氯吡格雷药物进行治疗,经过2周治疗后,对比两组患者临床疗效、神经功能缺损程度、日常自理能力以及不良反应。结果治疗后,观察组患者治疗总有效率(96.30%)高于对照组(83.33%),神经功能缺损程度评分(4.91±1.01)低于对照组(7.69±1.97),生活自理能力评分(86.52±4.36)高于对照组(74.69±4.83),不良反应发生率(7.41%)低于对照组(25.93%,P<0.05)。结论进行性脑卒中患者在接受氯吡格雷联合治疗后,临床效果显著提高,神经功能缺损程度降低,日常自理能力提高,不良反应较少。     

24-h urinary sodium excretion and the risk of adverse outcomes

Abstract

Aims

The objective was to evaluate whether sodium intake, assessed with the gold standard 24-h urinary collections, was related to long-term incidence of death, cardiovascular disease (CVD) and diabetes mellitus (DM).     

Effects of dynamic lycra orthosis as an adjunct to rehabilitation after botulinum toxin-A injection of the upper-limb in adults following stroke: A single-blinded randomized controlled pilot study

ABSTRACT

Background

Dynamic lycra splints are proposed to modify hypertonicity due to their characteristics – neutral warmth, circumferential pressure, and creating a low-intensity prolonged stretch on hypertonic muscles – to contribute to increased sensory awareness of the involved limb.     

头针联合工娱治疗对脑卒中后偏瘫的康复预后影响

目的评估头针联合工娱治疗对脑卒中后偏身功能障碍治疗的临床效果。方法选取2015年1月—2018年12月期间大连市友谊医院康复科病房收治的90例脑卒中恢复期存在偏身功能障碍的患者,病程在30~90 d,采取随机的方法,分为头针组30人,工娱组30人;综合组(头针联合工娱治疗组)30人。3组均给予运动疗法训练。头针组予头针治疗;工娱组予工娱治疗;综合组予头针+工娱治疗。治疗周期为4周,采用MAS运动量表进行肢体功能评定,比较3组临床疗效。经过四周的治疗后,三组患者治疗后MAS运动量表评分高于同一组治疗前评分,差异有统计学意义(P<0.05);3组患者治疗后MAS运动量表评分比较,综合组明显高于头针组及工娱组,差异有统计学意义(P<0.01)。结论头针联合工娱治疗可显著改善脑卒中后患者偏身功能障碍。     

吡拉西坦注射液联合胞磷胆碱注射液治疗缺血性脑卒中的临床研究

目的观察吡拉西坦注射液联合胞磷胆碱注射液治疗缺血性脑卒中的临床疗效与安全性。方法将94例缺血性脑卒中患者随机分为对照组47例和试验组47例。对照组予以吡拉西坦每次20 g,qd,静脉注射;试验组在对照组治疗的基础上,予以胞磷胆碱每次0.5 g,qd,静脉滴注。2组患者均治疗14 d。比较2组患者的临床疗效、血清单核细胞趋化蛋白-1(MCP-1)、同型半胱氨酸(HCY)、高密度脂蛋白胆固醇(HDL-C)水平,以及药物不良反应的发生情况。结果治疗后,试验组和对照组的总有效率分别为87.23%(41例/47例)和63.83%(30例/47例),差异有统计学意义(P<0.05)。治疗后,试验组和对照组的血清MCP-1分别为(90.74±10.33)和(120.71±15.42)pg·mL^-1,HCY分别为(16.68±2.24)和(21.01±3.03)μmol·L^-1,HDL-C分别为(1.31±0.16)和(1.12±0.13)mmol·L^-1,差异均有统计学意义(均P<0.05)。试验组发生的药物不良反应以失眠、食欲缺乏和口干为主,对照组发生的药物不良反应以皮疹、腹泻和低血压为主。试验组和对照组的总药物不良反应发生率分别为10.64%和14.89%,差异无统计学意义(P>0.05)。结论吡拉西坦注射液联合胞磷胆碱注射液治疗缺血性脑卒中的临床疗效确切,其能显著降低患者的血清MCP-1及HCY水平,升高HDL-C水平,且不增加药物不良反应的发生率。     

不同屈膝肌群和伸膝肌群肌力比值的等速肌力训练治疗脑卒中后膝过伸的疗效评价

设置不同的屈膝肌群与伸膝肌群肌力比值参数,观察应用等速肌力训练纠正脑卒中后膝过伸患者的疗效,为该病的治疗提供依据。