Increased microvessel density in the peri-infarct region has been reported and has been correlated with longer survival times in ischemic stroke patients and has improved outcomes in ischemic animal models.This raises...Increased microvessel density in the peri-infarct region has been reported and has been correlated with longer survival times in ischemic stroke patients and has improved outcomes in ischemic animal models.This raises the possibility that enhancement of angiogenesis is one of the strategies to facilitate functional recovery after ischemic stroke.Blood vessels and neuronal cells communicate with each other using various mediators and contribute to the pathophysiology of cerebral ischemia as a unit.In this mini-review,we discuss how angiogenesis might couple with axonal outgrowth/neurogenesis and work for functional recovery after cerebral ischemia.Angiogenesis occurs within 4 to 7 days after cerebral ischemia in the border of the ischemic core and periphery.Post-ischemic angiogenesis may contribute to neuronal remodeling in at least two ways and is thought to contribute to functional recovery.First,new blood vessels that are formed after ischemia are thought to have a role in the guidance of sprouting axons by vascular endothelial growth factor and laminin/β1-integrin signaling.Second,blood vessels are thought to enhance neurogenesis in three stages:1)Blood vessels enhance proliferation of neural stem/progenitor cells by expression of several extracellular signals,2)microvessels support the migration of neural stem/progenitor cells toward the peri-infarct region by supplying oxygen,nutrients,and soluble factors as well as serving as a scaffold for migration,and 3)oxygenation induced by angiogenesis in the ischemic core is thought to facilitate the differentiation of migrated neural stem/progenitor cells into mature neurons.Thus,the regions of angiogenesis and surrounding tissue may be coupled,representing novel treatment targets.展开更多
目的:髋关节置换术是治疗髋部骨折和股骨头坏死最主要的手术方法。肢体功能恢复是反映手术疗效和患者生活质量的一个重要标准,术后康复锻炼对肢体功能恢复至关重要。奥塔戈运动(Otage exercise programme,OEP)是一项安全、有效、实用及...目的:髋关节置换术是治疗髋部骨折和股骨头坏死最主要的手术方法。肢体功能恢复是反映手术疗效和患者生活质量的一个重要标准,术后康复锻炼对肢体功能恢复至关重要。奥塔戈运动(Otage exercise programme,OEP)是一项安全、有效、实用及经济的康复运动,已被证实可预防患者跌倒,提升肢体功能、步行能力、下肢力量等。本研究旨在探讨OEP对老年股骨颈骨折髋关节置换术患者肢体功能康复的效果。方法:将符合纳入和排除标准的77例老年股骨颈骨折髋关节置换术患者作为研究对象,随机分为对照组(n=39)和干预组(n=38)。对照组给予常规康复训练,干预组在常规康复训练的基础上实施OEP。在干预前、出院时、出院后12周采用计时起立行走测试时间(time get up and go test,TGUT)、5次坐立测试时间(five times sit to stand test,FTSST)、10 m步行测试时间(10-meter walking test,10MWT)、髋关节功能量表(Harris Hip Score,HHS)、日常活动能力量表的Barthel指数(Barthel index)、中文版简易健康调查表(the Mos 36-Item Short Form Health Survey,SF-36)进行评价。结果:干预前,2组TGUT、FTSST、10MWT、HHS评分、Barthel指数、SF-36评分差异均无统计学意义(均P>0.05);出院时,两组TGUT差异无统计学意义(P>0.05),但对照组FTSST和10MWT均长于干预组(均P<0.05),对照组HHS评分、Barthel指数、SF-36评分均低于干预组(均P<0.05);出院后12周,干预组TGUT、FTSST、10MWT、HHS评分、Barthel指数、SF-36评分均优于对照组(均P<0.05)。结论:OEP能够有效促进老年股骨颈骨折髋关节置换术患者肢体功能和髋关节功能恢复,提高日常活动能力和生活质量,适合在临床推广使用。展开更多
基金supported by a Grant-in-Aid for Scientific Research(Research Project No.15K19478 and 18K07493,both to MK)Japan Science and Technology Agency(JST),the Translational Research program+7 种基金Strategic Promotion for practical application of Innovative medical Technology(TR-SPRINT)supported by Japan Agency for Medical Research and Development(AMED)under Grant No.JP19lm0203023a grant from Takeda Science Foundationthe Bayer Scholarship for Cardiovascular ResearchJapan Cardiovascular Research FoundationAstellas Foundation for Research on Metabolic DisordersYoung Investigator Okamoto AwardMedical Research Encouragement Prize of the Japan Medical Association(to MK)supported by a grant from Tsubaki Memorial Foundation(to MH and IN)
文摘Increased microvessel density in the peri-infarct region has been reported and has been correlated with longer survival times in ischemic stroke patients and has improved outcomes in ischemic animal models.This raises the possibility that enhancement of angiogenesis is one of the strategies to facilitate functional recovery after ischemic stroke.Blood vessels and neuronal cells communicate with each other using various mediators and contribute to the pathophysiology of cerebral ischemia as a unit.In this mini-review,we discuss how angiogenesis might couple with axonal outgrowth/neurogenesis and work for functional recovery after cerebral ischemia.Angiogenesis occurs within 4 to 7 days after cerebral ischemia in the border of the ischemic core and periphery.Post-ischemic angiogenesis may contribute to neuronal remodeling in at least two ways and is thought to contribute to functional recovery.First,new blood vessels that are formed after ischemia are thought to have a role in the guidance of sprouting axons by vascular endothelial growth factor and laminin/β1-integrin signaling.Second,blood vessels are thought to enhance neurogenesis in three stages:1)Blood vessels enhance proliferation of neural stem/progenitor cells by expression of several extracellular signals,2)microvessels support the migration of neural stem/progenitor cells toward the peri-infarct region by supplying oxygen,nutrients,and soluble factors as well as serving as a scaffold for migration,and 3)oxygenation induced by angiogenesis in the ischemic core is thought to facilitate the differentiation of migrated neural stem/progenitor cells into mature neurons.Thus,the regions of angiogenesis and surrounding tissue may be coupled,representing novel treatment targets.
文摘目的:髋关节置换术是治疗髋部骨折和股骨头坏死最主要的手术方法。肢体功能恢复是反映手术疗效和患者生活质量的一个重要标准,术后康复锻炼对肢体功能恢复至关重要。奥塔戈运动(Otage exercise programme,OEP)是一项安全、有效、实用及经济的康复运动,已被证实可预防患者跌倒,提升肢体功能、步行能力、下肢力量等。本研究旨在探讨OEP对老年股骨颈骨折髋关节置换术患者肢体功能康复的效果。方法:将符合纳入和排除标准的77例老年股骨颈骨折髋关节置换术患者作为研究对象,随机分为对照组(n=39)和干预组(n=38)。对照组给予常规康复训练,干预组在常规康复训练的基础上实施OEP。在干预前、出院时、出院后12周采用计时起立行走测试时间(time get up and go test,TGUT)、5次坐立测试时间(five times sit to stand test,FTSST)、10 m步行测试时间(10-meter walking test,10MWT)、髋关节功能量表(Harris Hip Score,HHS)、日常活动能力量表的Barthel指数(Barthel index)、中文版简易健康调查表(the Mos 36-Item Short Form Health Survey,SF-36)进行评价。结果:干预前,2组TGUT、FTSST、10MWT、HHS评分、Barthel指数、SF-36评分差异均无统计学意义(均P>0.05);出院时,两组TGUT差异无统计学意义(P>0.05),但对照组FTSST和10MWT均长于干预组(均P<0.05),对照组HHS评分、Barthel指数、SF-36评分均低于干预组(均P<0.05);出院后12周,干预组TGUT、FTSST、10MWT、HHS评分、Barthel指数、SF-36评分均优于对照组(均P<0.05)。结论:OEP能够有效促进老年股骨颈骨折髋关节置换术患者肢体功能和髋关节功能恢复,提高日常活动能力和生活质量,适合在临床推广使用。
