OBJECTIVE： To explore the long-term effects and pain relief mechanism of acupotomy by observing changes in nitric oxide synthase （NOS） and beta-en- dorphin （~3-EP） in the hypothalamus, spinal cord, and peripheral...OBJECTIVE： To explore the long-term effects and pain relief mechanism of acupotomy by observing changes in nitric oxide synthase （NOS） and beta-en- dorphin （~3-EP） in the hypothalamus, spinal cord, and peripheral blood of rats with third lumbar ver- tebrae （L3） transverse process syndrome. METHODS： Twenty-eight SD rats were randomly as- signed to normal, model, electroacupuncture （EA）, and acupotomy group. The last three groups were put through an operation to emulate L3 transverse process syndrome. Fourteen days after the simulation operation, EA and acupotomy treatments were applied to the respective groups. Fifty-six days afterthe simulation operation, biochemistry tests and enzyme-linked immunosorbent assay were used to measure NOS and 13-EP in the hypothalamus, spinal cord, and peripheral blood. RESULTS： Rats with the simulation operation showed significantly higher levels of NOS and II3-EP in the hypothalamus, spinal cord, and peripheral blood than those in the normal group. The EA and acupotomy groups had significantly lower levels of NOS and β-EP than those in the model group. There was no statistical difference between the EA and acupotomy groups. CONCLUSION： EA and acupotomy treatments significantly lowered NOS and β-EP levels in the hypothalamus, spinal cord, and peripheral blood and alleviated L3 transverse process syndrome.展开更多
The current health system in China has evolved by embracing both traditional Chinese medicine and Western medicine. China is the only country in the world where the number of doctors is larger than the number of nurse...The current health system in China has evolved by embracing both traditional Chinese medicine and Western medicine. China is the only country in the world where the number of doctors is larger than the number of nurses but education programmes for other health professions like physical therapy have been slow to develop. In the case of physical therapy it was not until China won the bid for the Olympic Games that permission to establish the first physical therapy programme was granted. Since then China has undergone a period of rapid economic growth enabling many people to have a higher standard of living and improved health, but at the same time the country is faced with massive urbanization, industrialization, increasing environmental health threats, increased health disparities and an aging population. With the support of the Chinese Association of Rehabilitation Medicine, an increased investment by the Government in public health and rehabilitation and engagement of international education experts, entry-level education programmes for physical therapy have started to develop and there are now nine which are modeled, at least to some extent, on the World Confederation for Physical Therapy's international guidelines. The paper explores the development of physical therapy education in China and discusses possible options for the way forward so that as the demand for physical therapy to service 1.4 billion people grows, the profession is prepared and the standards expected of the entrylevel physical therapist will not be compromised.展开更多
OBJECTIVE:To assess skin temperature response to menstruation at acupuncture points in primary dysmenorrhea(PD) patients and healthy volunteers so as to explore acupuncture point specificity in reflecting diseases in ...OBJECTIVE:To assess skin temperature response to menstruation at acupuncture points in primary dysmenorrhea(PD) patients and healthy volunteers so as to explore acupuncture point specificity in reflecting diseases in the light of skin temperature.METHODS:Fifty-two PD patients and 49 healthy volunteers were recruited.Skin temperature measurements were performed with a skin temperature assessment device at 10 points.Absolute difference between skin temperature of the same point on the left and right side is used as main outcome measure.RESULTS:On the first day of menstruation, when menstrual pain attacking in PD patients, a significant increase in skin temperature difference was detected at Taixi(KI 3) compared with the healthy group(P < 0.01).A significant reduction in skin temperature difference was detected at Taixi(KI 3) in the first day of menstruation compared with those values in the third day after menstruation(P < 0.01)in the healthy group.On the third day after menstruation, a significant reduction in skin temperature difference was found at Zhongdu(LR 6) in PD group compared with the healthy group(P < 0.05).No significant differences of skin temperature were detected at other points(P > 0.05).CONCLUSION:The skin temperature difference at menstruation-relevant points in PD patients did not all change significantly more than those in women without PD.Significant difference was only found in Taixi(KI 3), the Yuan-source point of Kidney meridian.展开更多
Physical rehabilitation of lung transplant candidates and recipients plays an important in optimizing physical function prior to transplant and facilitating recovery of function post-transplant. As medical and surgica...Physical rehabilitation of lung transplant candidates and recipients plays an important in optimizing physical function prior to transplant and facilitating recovery of function post-transplant. As medical and surgical interventions in lung transplantation have evolved over time, there has been a demographic shift of individuals undergoing lung transplantation including older individuals, those with multiple co-morbidites, and candidates with respiratory failure requiring bridging to transplantation. These changes have an impact on the rehabilitation needs of lung transplant candidates and recipients. This review provides a practical approach to rehabilitation based on research and clinical practice at our transplant centre. It focuses on functional assessment and exercise prescription during an uncomplicated and complicated clinical course in the pre-transplant, early and late post-transplant periods. The target audience includes clinicians involved in pre- and posttransplant patient care and rehabilitation researchers.展开更多
Purpose: Low back pain (LBP), Gonarthrosis, knee, and Carpal Tunnel Syndrome have been regarded as affecting more than three-quarters’ of individuals in their lifetime. The aim of this study was conducted to determin...Purpose: Low back pain (LBP), Gonarthrosis, knee, and Carpal Tunnel Syndrome have been regarded as affecting more than three-quarters’ of individuals in their lifetime. The aim of this study was conducted to determine and compare the effects of topical patients with sand compared with control related to Gonarthrosis, LBP, knee, and Carpal Tunnel Syndrome pain. Methods: This is a prospective case and control designed study based on 101 pain case with Sand and 101 control subjects. The interventional groups in addition either topical sand or without sand 2 months after the intervention were assessed. We assessed tolerability of an established pain perception scale by the Numeric Rating Scale (NRS). Categorical variables were compared using the chi-square (χ<sup>2</sup>) test. The paired t-test was used to compare the two groups before and after the intervention. One-way analysis of variance (ANOVA) was employed for comparison of several group means. Results: The study was based on 202 patients, 41 males (20.3%) and 161 females (79.7%). There were statistically significant differences between subjects with and without Sand in term of Gonarthrosis, Rheumatoid Arthritis LBP, knee, and Carpal Tunnel Syndrome pain (p = 0.033). Majority of patients were over age 55 years old (55%) and females 78 (77.2%). The mean score of total pain experience before and after the intervention was 7.41 ± 1.1 for black sand, and 4.24 ± 2.38 for without sand as control group. The mean scores of these 5 groups were highly significant before and after the intervention (p There was statistically highly significant in regarding subjects with Sand as compared with those before Sand after treatment mean score specifically with gonarthrosis before pain 7.23 ± 1.86 vs after treatment 4.54 ± 2.18 p < 0.001;rheumatoid arthritis before 8.28 ± 1.48 vs after treatment 4.80 ± 3.71 p < 0.001;Low Back Pain before 8.42 ± 1.83 vs after treatment 4.37 ± 1.52 p < 0.001;knee pain before 8.93 ± 0.89 vs after treatment 4.24 ± 0.24 p < 0.001;Carpal T展开更多
Background: Physical functional decline is common among elderly individuals with mental disorders, worsening their symptoms. Physiotherapy interventions have shown some evidence in improving physical function and ment...Background: Physical functional decline is common among elderly individuals with mental disorders, worsening their symptoms. Physiotherapy interventions have shown some evidence in improving physical function and mental health outcomes in this population. This study aimed to assess the impact of physiotherapy interventions on the elderly with mental health conditions at Chainama Hills College Hospital in Zambia. Methods: A pre-post single sample design was used to track patient progress over six weeks, with 10 physiotherapy sessions. The study population (N = 30) comprised of all elderly individuals with mental health conditions, encompassing both men and women, who were hospitalized during the research period. The Katz Index of Activities of Daily Living and the six-minute walk test were evaluated before and after the intervention. The IBM SPSS version 26 was used to analyze data and results were presented as mean ± SD with a 95% confidence interval. The variables were described in terms of their mean, SD, and range. A significance level of 0.05 was used for a paired T-test to detect changes and multiple logistic regression was used to identify factors associated with mental health. Results: Following the intervention, the percentage of participants achieving full function and independence increased significantly to 96.7% from the initial 73.3%, supported by a 95% CI = [0.82 - 0.99]. There was also a notable decrease in the proportion of individuals experiencing moderate impairment, dropping from 26.7% to just 3.3%, with a corresponding 95% CI = [0.00 - 0.17]. Conclusion: The findings derived from this study illustrate an enhancement in the aspects of participants’ overall health and functional condition, including blood pressure, heart rate, and respiratory rate. Consequently, physiotherapy exercises can be employed as a tactic to ameliorate the functional status and physical well-being of older individuals afflicted with mental disorders in Zambia.展开更多
To the Editor:As society continues to advance,individuals are increasingly exposed to various stressors in their personal and professional lives.The World Health Organization claims that nearly 1 billion people worldw...To the Editor:As society continues to advance,individuals are increasingly exposed to various stressors in their personal and professional lives.The World Health Organization claims that nearly 1 billion people worldwide suffer from mental disorders in 2019,including 14%of the world’s adolescents.[1]Depression among Chinese adults is a serious public health challenge that requires urgent attention.Due to the combined inuence of various life stresses and unhealthy lifestyles,individuals face a signicantly increased risk of developing depression.[2]Depression is often misdiagnosed because its symptoms overlap with those of other mental health conditions.A misdiagnosis of depression can have a signicant impact on all aspects of an individual’s life.In children,a misdiagnosis can lead to inappropriate academic interventions or unnecessary treatments that can adversely affect their school life and overall well-being.For adults,a misdiagnosis can strain relationships.展开更多
Research indicates that high levels of sedentary behavior(sitting or lying with low energy expenditure) are adversely associated with health. A key factor in improving our understanding of the impact of sedentary beha...Research indicates that high levels of sedentary behavior(sitting or lying with low energy expenditure) are adversely associated with health. A key factor in improving our understanding of the impact of sedentary behavior(and patterns of sedentary time accumulation) on health is the use of objective measurement tools that collect date and time-stamped activity information. One such tool is the activP AL monitor. This thigh-worn device uses accelerometer-derived information about thigh position to determine the start and end of each period spent sitting/lying, standing, and stepping, as well as stepping speed, step counts, and postural transitions. The activP AL is increasingly being used within field-based research for its ability to measure sitting/lying via posture. We summarise key issues to consider when using the activP AL in physical activity and sedentary behavior field-based research with adult populations. It is intended that the findings and discussion points be informative for researchers who are currently using activP AL monitors or are intending to use them. Pre-data collection decisions, monitor preparation and distribution, data collection considerations, and manual and automated data processing possibilities are presented using examples from current literature and experiences from 2 research groups from the UK and Australia.展开更多
The practice of soccer involves carrying-out actions of high intensity, which demand a great generation of eccentric strength, which in turn results in an increase in the inflammatory response after training practice ...The practice of soccer involves carrying-out actions of high intensity, which demand a great generation of eccentric strength, which in turn results in an increase in the inflammatory response after training practice and game matches. The study aimed to investigate, in combination and individually, the association of 28 polymorphisms with the inflammatory responses of soccer athletes. The sample consisted of 47 male under-20 soccer athletes who belong to clubs in the first division of Brazilian soccer. Blood samples were collected at Pre, and 03, 24, and 48 hours after the training session to evaluate the inflammatory responses (hematological analyzes (hemogram), creatine phosphokinase (CK), high sensitivity quantitative C-reactive protein (CRP), tumor necrosis factor-alpha, (TNFα), interleukin 6 (IL-6) and insulin-like growth factor 1 (IGF-1)). DNA was obtained through scraping of buccal cells, where a sterile swab was rubbed on the inner side of the mouth of each participant 06 times. The database was built using the TruSeq DNA PCRFree kit (Illumina®) and the Covaris equipment for shearing genomic DNA (gDNA) by ultrasound. Of the analyzed SNPs, 09 (ACTN3 rs1815739, COL5A1 rs12722, COL5A1 rs3196378, HGF rs5745697, IGF1 rs35767, IL-6 rs1800795, MMP3 rs679620, SLC30A8 rs13266634, SOX15 rs4227) were individually associated with biomarkers and 07 SNPs, (COL5A1 rs12722, COL5A1 rs3196378, COL5A1 rs1800012, HGF rs5745697, IGF1 rs35767, IL-6 rs1800795 and MMP3 rs679620) analyzed in combination, explained 16% to 40% of the variation of inflammatory responses in soccer athletes. The results suggest that the genotypic profile can be taken into account for a more individualized distribution of the training load, along with the elaboration of recovery strategies for high-level athletes between training sessions and games of high physical and physiological demand.展开更多
Background As one of the most common musculoskeletal ailments,chronic nonspecific low-back pain(CNLBP)causes persistent disability and substantial medical expenses.Epidemiological evidence shows that the incidence rat...Background As one of the most common musculoskeletal ailments,chronic nonspecific low-back pain(CNLBP)causes persistent disability and substantial medical expenses.Epidemiological evidence shows that the incidence rate of CNLBP in young and middle-aged people who are demanded rapidly recovery and social contribution is rising.Recent guidelines indicate a reduced role for medicines in the management of CNLBP.Objective The present study investigates the short-term effects of cupping and scraping therapy using a medicated balm,compared to nonsteroidal anti-inflammatory drug(NSAID)with a capsaicin plaster,in the treatment of CNLBP.Design,setting,participants and interventions We designed a prospective multicenter randomized clinical trial enrolling patients from January 1,2022 to December 31,2022.A total of 156 patients with CNLBP were randomized into two parallel groups.Diclofenac sodium-sustained release tablets were administered orally to participants in the control group for one week while a capsaicin plaster was applied externally.Patients in the test group were treated with cupping and scraping using a medical device and medicated balm.Main outcome measures Primary outcome was pain recorded using the visual analogue scale(VAS).Two secondary outcomes were recorded using the Japanese Orthopedic Association low-back pain scale(JOA)and the traditional Chinese medicine(TCM)syndrome integral scale(TCMS)as assessment tools.Results Between baseline and postintervention,all changes in outcome metric scales were statistically significant(P<0.001).Compared to the control group,patients in the test group had a significantly greater treatment effect in all outcome variables,as indicated by lower VAS and TCMS scores and higher JOA scores,after the one-week intervention period(P<0.001).Further,according to the findings of multivariate linear regression analysis,the participants’pain(VAS score)was related to their marital status,age,smoking habits and body mass index.No adverse reactions were reported for any participants in展开更多
Laboratory-based pathogen isolation, identification, and toxicity determination were performed on samples from a suspected case of infant botulism. Mice injected with cultures generated from the enema sample and inges...Laboratory-based pathogen isolation, identification, and toxicity determination were performed on samples from a suspected case of infant botulism. Mice injected with cultures generated from the enema sample and ingested Powered infant formula （PIF） presented typical signs of botulism. Antitoxins to polyvalent botulinum neurotoxins （BoNTs） and monovalent BoNT type B antitoxin had protective effects. Clostridium botulinum isolated from the enema and residual PIF samples were positive for type B toxin. Pulsed-field gel electrophoresis （PFGE） revealed that the two strains of C. botulinum isolated from the two samples produced indistinguishable pulsotypes. These findings confirmed this case of type B infant botulism associated with the ingestion of PIF contaminated bv type B C. botulinum spores.展开更多
BACKGROUND Lack of mobilization and prolonged stay in the intensive care unit(ICU)are major factors resulting in the development of ICU-acquired muscle weakness(ICUAW).ICUAW is a type of skeletal muscle dysfunction an...BACKGROUND Lack of mobilization and prolonged stay in the intensive care unit(ICU)are major factors resulting in the development of ICU-acquired muscle weakness(ICUAW).ICUAW is a type of skeletal muscle dysfunction and a common complication of patients after cardiac surgery,and may be a risk factor for prolonged duration of mechanical ventilation,associated with a higher risk of readmission and higher mortality.Early mobilization in the ICU after cardiac surgery has been found to be low with a significant trend to increase over ICU stay and is also associated with a reduced duration of mechanical ventilation and ICU length of stay.Neuromuscular electrical stimulation(NMES)is an alternative modality of exercise in patients with muscle weakness.A major advantage of NMES is that it can be applied even in sedated patients in the ICU,a fact that might enhance early mobilization in these patients.AIM To evaluate safety,feasibility and effectiveness of NMES on functional capacity and muscle strength in patients before and after cardiac surgery.METHODS We performed a search on Pubmed,Physiotherapy Evidence Database(PEDro),Embase and CINAHL databases,selecting papers published between December 2012 and April 2023 and identified published randomized controlled trials(RCTs)that included implementation of NMES in patients before after cardiac surgery.RCTs were assessed for methodological rigor and risk of bias via the PEDro.The primary outcomes were safety and functional capacity and the secondary outcomes were muscle strength and function.RESULTS Ten studies were included in our systematic review,resulting in 703 participants.Almost half of them performed NMES and the other half were included in the control group,treated with usual care.Nine studies investigated patients after cardiac surgery and 1 study before cardiac surgery.Functional capacity was assessed in 8 studies via 6MWT or other indices,and improved only in 1 study before and in 1 after cardiac surgery.Nine studies explored the effects of NMES on muscle strength 展开更多
Directional axon regeneration and remyelination are crucial for repair of spinal cord injury(SCI),but existing treatments do not effectively promote those processes.Here,we propose a strategy for construction of niche...Directional axon regeneration and remyelination are crucial for repair of spinal cord injury(SCI),but existing treatments do not effectively promote those processes.Here,we propose a strategy for construction of niche-specific spinal white matter-like tissue(WMLT)using decellularized optic nerve(DON)loaded with neurotrophin-3(NT-3)-overexpressing oligodendrocyte precursor cells.A rat model with a white matter defect in the dorsal spinal cord of the T10 segment was used.The WMLT transplantation group showed significant improvement in coordinated motor functions compared with the control groups.WMLT transplants integrated well with host spinal cord white matter,effectively addressing several barriers to directional axonal regeneration and myelination during SCI repair.In WMLT,laminin was found to promote development of oligodendroglial lineage(OL)cells by binding to laminin receptors.Interestingly,laminin could also guide linear axon regeneration via interactions with specific integrins on the axon surface.The WMLT developed here utilizes the unique microstructure and bioactive matrix of DON to create a niche rich in laminin,NT-3 and OL cells to achieve significant structural repair of SCI.Our protocol can help to promote research on repair of nerve injury and construction of neural tissues and organoids that form specific cell niches.展开更多
Parkinson's disease(PD)is an incurable,devastating disorder that is characterized by pathological protein aggregation and neurodegeneration in the substantia nigra.In recent years,growing evidence has implicated t...Parkinson's disease(PD)is an incurable,devastating disorder that is characterized by pathological protein aggregation and neurodegeneration in the substantia nigra.In recent years,growing evidence has implicated the gut environment and the gut-brain axis in the pathogenesis and progression of PD,especially in a subset of people who exhibit prodromal gastrointestinal dysfunction.Specifically,perturbations of gut homeostasis are hypothesized to contribute toα-synuclein aggregation in enteric neurons,which may spread to the brain over decades and eventually result in the characteristic central nervous system manifestations of PD,including neurodegeneration and motor impairments.However,the mechanisms linking gut disturbances andα-synuclein aggregation are still unclear.A plethora of research indicates that toll-like receptors(TLRs),especially TLR2 and TLR4;are critical mediators of gut homeostasis.Alongside their established role in innate immunity throughout the body,studies are increasingly demonstrating that TLR2 and TLR4 signalling shapes the development and function of the gut and the enteric nervous system.Notably,TLR2 and TLR4 are dysregulated in patients with PD,and may thus be central to early gut dysfunction in PD.To better understand the putative contribution of intestinal TLR2 and TLR4 dysfunction to earlyα-synuclein aggregation and PD,we critically discuss the role of TLR2 and TLR4 in normal gut function as well as evidence for altered TLR2 and TLR4 signalling in PD;by reviewing clinical,animal model and in vitro research.Growing evidence on the immunological aetiology ofα-synuclein aggregation is also discussed,with a focus on the interactions ofα-synuclein with TLR2 and TLR4.We propose a conceptual model of PD pathogenesis in which microbial dysbiosis alters the permeability of the intestinal barrier as well as TLR2 and TLR4 signalling,ultimately leading to a positive feedback loop of chronic gut dysfunction promotingα-synuclein aggregation in enteric and vagal neurons.In turn,α-synuclein aggre展开更多
Atrial fibrillation is a cardiac arrhythmia of high prevalence in the population, especially in the elderly. Its main electrical characteristics are the interval between two successive irregular R waves, absence of P ...Atrial fibrillation is a cardiac arrhythmia of high prevalence in the population, especially in the elderly. Its main electrical characteristics are the interval between two successive irregular R waves, absence of P waves and presence of f waves between QRS complexes. The most common symptoms of atrial fibrillation are irregular palpitations associated with dyspnea, dizziness, feeling tired, fatigue and general malaise, but not all patients have any symptoms. The present report presents the history of an elderly patient who arrived at the hospital’s emergency department with irregular heart rhythm and palpitations. The patient’s symptoms, associated with the electrocardiogram results, indicated paroxysmal atrial fibrillation. Electrical cardioversion was performed, and after, cardiac ablation via the femoral vein at the hospital’s cardiology service. There were no complications during the procedure. As a routine imaging exam after ablation, control esophagogastroduodenoscopy was requested to verify that there was no formation of atrio-esophageal fistula developed by the invasive ablation procedure and electrocardiogram, which showed normal sinus rhythm. The patient remained in the cardiac intensive care unit for observation for 24 hours. After the electrical cardioversion and catheter ablation procedures, the patient improved his clinical picture of atrial fibrillation and was discharged after 24 hours of hospitalization. He received treatment to perform at home, to reduce acid reflux into the esophagus and to prevent thrombosis. He did not present pulmonary thromboembolism after hospital discharge. It is believed, therefore, that this form of treatment and management of paroxysmal atrial fibrillation is effective for the solution of the proposed problem and can also serve as a reference for other professionals within the cardiology service.展开更多
Background： Breast cancer patients experience various side effects during cancer therapy, often resulting in reduced quality of life and poor adherence to treatment. A limited range of proven interventions has been d...Background： Breast cancer patients experience various side effects during cancer therapy, often resulting in reduced quality of life and poor adherence to treatment. A limited range of proven interventions has been developed to target such side effects. While Tai Chi offers benefits for the health and well-being of breast cancer survivors, the effectiveness of Tai Chi across the treatment continuum has not been evalu- ated. Improved patient education and support has been suggested as a priority for breast cancer care. This pilot study assesses the feasibility of a randomized controlled trial （RCT） to evaluate the effectiveness of ＂an integrative Tai Chi＂ （ANITA） program for breast cancer patients undergoing cancer therapy. Methods/design： This is a single-centre, two-arm feasibility RCT. Twenty-four patients with breast cancer who have undergone surgical treatment will be recruited from the Dunedin Hospital （New Zealand） over a 12-month period （from August 2017 to July 2018）. Subject to informed consent, patients will be ran- domized to receive standard cancer treatment alone or standard cancer treatment plus the ANITA pro- gram, consisting of peer support, health education, and Tai Chi Ruler exercise. The program runs alongside the patient＇s adjuvant cancer therapy, which may include chemotherapy, radiation therapy, antibody treatment, and/or antihormonal therapy. Analysis in this study will focus on process evaluation of participant recruitment, retention, treatment fidelity, acceptability of the program, and occurrence of adverse events. Clinical outcomes （i.e., fatigue, sleep quality, anxiety and depression and quality of life） will be assessed at baseline, and at 12 weeks and 24 weeks post-randomization. Discussion： Outcomes from this study will inform the feasibility and methodology for a future fully- powered RCT.展开更多
Salmonella enterica serovar 4,[5],12:i:-(S.4,[5],12:i:-)is a monophasic variant of Salmonella enterica serovar Typhimurium that has emerged as a global serovar causing public health concern.To date,the epidemiology an...Salmonella enterica serovar 4,[5],12:i:-(S.4,[5],12:i:-)is a monophasic variant of Salmonella enterica serovar Typhimurium that has emerged as a global serovar causing public health concern.To date,the epidemiology and genomic characterization of this pathogen in China have not been well described.We investigated the prevalence,antimicrobial resistance(AMR)phenotypes,and population genomics of sequence type 34(ST34)S.4,[5],12:i:-among cases of human salmonellosis in Henan Province,China.A total of 100 ST34 S.4,[5],12:i:-isolates were studied from 2008 to 2017 and found mostly resistant to ampicillin(AMP),streptomycin(STR),sulfonamides(SUL),and tetracycline(TET)(ASSu T).Bayesian phylogenetic analysis demonstrated that isolates identified in China were mostly related to the European lineage and evolved into two major clades with different resistance genes and plasmid profiles.Notably,clade 1 showed a significantly higher rate of mutations in gyr A and plasmid-mediated quinolone resistance genes.The carrying of the resistance-containing region(encoding R-type ASSu T),including bla(conferring resistance to AMP),str AB(STR),sul2(SUL),and tet(B)(TET)inserted into the flj BA operon,was responsible for most of the monophasic variants in clade 2.Inc HI2 plasmids were the dominant multi-drug resistance mobile genetic elements accounting for the transmission of acquired resistance genes in this serovar,and these were more prevalent in clade 1.Our findings highlighted the increasing prevalence of multi-drug resistant S.4,[5],12:i:-in China,along with the differential characteristics of resistance gene acquisition among various lineages.Based on our data,control measures are required to address the spread of this zoonotic pathogen.Further owing to its potential origin in food-producing animals,a"One Health"approach,should be implemented to support surveillance whilst informing interventional strategies.展开更多
Objective:This study aimed to investigate the feasibility of implementing a manual therapy technique(muscle energy technique,MET)protocol in a hospital pulmonary rehabilitation(PR)program for patients with moderate to...Objective:This study aimed to investigate the feasibility of implementing a manual therapy technique(muscle energy technique,MET)protocol in a hospital pulmonary rehabilitation(PR)program for patients with moderate to severe chronic obstructive pulmonary disease(COPD).Methods:Participants aged 40 years and over,with moderate to severe COPD,were recruited into this 12-week study.The primary outcome measures were feasibility(acceptability of the intervention and attendance/adherence to the trial)and safety(adverse events,AEs).All participants received the MET and PR therapies.Participants and assessors were unblinded.Semi-standardized MET was delivered on 6 occasions(a maximum of once per week)at the hospital directly before a PR session.Participants undertook PR sessions as per the hospital program at a frequency of two days per week for 8 weeks.Participants were contacted 4 weeks after their final MET treatment via a telephone call to assess acceptability of the intervention.Results:Thirty-three participants were enrolled,with a median age of 74 years(range 45-89 years).The median number of MET sessions that participants attended was 5(range O-6)out of a possible 6 sessions(83%attendance).At follow-up,participants overwhelmingly enjoyed the MET treatment with some subjectively reporting improved breathing.There were no major AEs related to the intervention,with the majority of AEs classified as expected events related to COPD exacerbations.Conclusion:It is feasible to implement a manual therapy protocol using MET as an adjunct to PR in a hospital setting.Recruitment rates were satisfactory and there were no AEs related to the MET component of the intervention.展开更多
Background: Major burns are life threatening. Fluid resuscitation is required for survival to maintain intravascular volumes and prevent hypovolemic shock. Bioimpedance spectroscopy (BIS) has been recognised as a pote...Background: Major burns are life threatening. Fluid resuscitation is required for survival to maintain intravascular volumes and prevent hypovolemic shock. Bioimpedance spectroscopy (BIS) has been recognised as a potential method of monitoring fluid shifts after burn and in other disease states. The aims of this study were to examine the reliability of BIS across different dressing conditions and electrode positions, establish the influence of Acticoat?on BIS variable measures and determine the validity of whole-body BIS to assess net fluid shift in the presence of moderate to major burns. Methods: An observational longitudinal cohort study was conducted from December 2014 to February 2016. Patients with over 15% total body surface area (TBSA) burns and injury less than 48 h were enrolled in the study. BIS triplicate measures were collected in an open wound and with an ActicoatTMdressing (at 5 half hour intervals). Standard and alternate electrode placements were utilised for the reliability analysis and standard placement only for determining the validity of BIS in moderate to major burns. The ImpediMde SFB7 was used to collect whole-body and segmental BIS measures. Stata statistical software, release 14 was utilised to analyse all results. Descriptive analyses were performed and were reported using the means and standard deviations (SD). Results: BIS-repeated measures established BIS raw resistance (R), and predicted volume variables were reliable in any condition (intra-class correlation coefficient (ICC) 0.996-0.999, 95% confidence intervals (CI) 0.996-0.999) without a systematic difference. Acticoat?dressings significantly influenced all BIS-predicted volumes (p≤0.01) as determined by multilevel mixed effects (MLME) linear regression analysis. Validity of BIS was demonstrated by resistance variables significantly decreasing with increasing net ionic fluid shift and increased TBSA (severity of injury) and calculated fluid volumes increasing with increasing net fluid shift and TBSA. BIS resistance also decre展开更多
OBJECTIVE: To summarize the literature about the effectiveness of dry needling(DN) on relieving pain and increasing range of motion(ROM) in individuals with myofascial pain syndrome(MPS).METHODS: Papers published from...OBJECTIVE: To summarize the literature about the effectiveness of dry needling(DN) on relieving pain and increasing range of motion(ROM) in individuals with myofascial pain syndrome(MPS).METHODS: Papers published from January 2000 to January 2013 were identified through an electronic search in the databases MEDLINE, Dialnet, Cochrane Library Plus, Physiotherapy Evidence Database(PEDro) and Spanish Superior Council of Scientific Research(CSIC). The studies included were randomized controlled trials written in English and/or Spanish about the effectiveness of DN on pain and ROM in individuals with MPS.RESULTS: Out of 19 clinical trials that were potentially relevant, a total of 10 were included in the Meta-analysis. Regarding pain intensity reduction when measured before and immediately after the intervention, DN achieved improvement compared with the placebo treatment [d =-0.49; 95% CI(-3.21, 0.42)] and with the control group [d =-9.13;95% CI(- 14.70,- 3.56)]. However, other treatments achieved better results on the same variable compared with DN, considering the measurements for pre-treatment and immediately after [d = 2.54;95% CI(-0.40, 5.48)], as well as the pre-treatment and after 3-4 weeks [d = 4.23; 95% CI(0.78, 7.68)].DN showed a significantly increased ROM when measured before the intervention and immediately after, in comparison with the placebo [d = 2.00;95% CI(1.60, 2.41)]. However, other treatments achieved a significant better result regarding ROM when it was measured before the intervention and immediately after, as compared with DN [d =-1.42;95% CI(-1.84,-0.99)].CONCLUSION: DN was less effective on decreasing pain comparing to the placebo group. Other treatments were more effective than DN on reducing pain after 3-4 weeks. However, on increasing ROM,DN was more effective comparing to that of placebo group, but less than other treatments.展开更多
基金Supported by a Grant from the National Basic Research Program of China (973 Program)(No.2006CB504508)
文摘OBJECTIVE： To explore the long-term effects and pain relief mechanism of acupotomy by observing changes in nitric oxide synthase （NOS） and beta-en- dorphin （~3-EP） in the hypothalamus, spinal cord, and peripheral blood of rats with third lumbar ver- tebrae （L3） transverse process syndrome. METHODS： Twenty-eight SD rats were randomly as- signed to normal, model, electroacupuncture （EA）, and acupotomy group. The last three groups were put through an operation to emulate L3 transverse process syndrome. Fourteen days after the simulation operation, EA and acupotomy treatments were applied to the respective groups. Fifty-six days afterthe simulation operation, biochemistry tests and enzyme-linked immunosorbent assay were used to measure NOS and 13-EP in the hypothalamus, spinal cord, and peripheral blood. RESULTS： Rats with the simulation operation showed significantly higher levels of NOS and II3-EP in the hypothalamus, spinal cord, and peripheral blood than those in the normal group. The EA and acupotomy groups had significantly lower levels of NOS and β-EP than those in the model group. There was no statistical difference between the EA and acupotomy groups. CONCLUSION： EA and acupotomy treatments significantly lowered NOS and β-EP levels in the hypothalamus, spinal cord, and peripheral blood and alleviated L3 transverse process syndrome.
文摘The current health system in China has evolved by embracing both traditional Chinese medicine and Western medicine. China is the only country in the world where the number of doctors is larger than the number of nurses but education programmes for other health professions like physical therapy have been slow to develop. In the case of physical therapy it was not until China won the bid for the Olympic Games that permission to establish the first physical therapy programme was granted. Since then China has undergone a period of rapid economic growth enabling many people to have a higher standard of living and improved health, but at the same time the country is faced with massive urbanization, industrialization, increasing environmental health threats, increased health disparities and an aging population. With the support of the Chinese Association of Rehabilitation Medicine, an increased investment by the Government in public health and rehabilitation and engagement of international education experts, entry-level education programmes for physical therapy have started to develop and there are now nine which are modeled, at least to some extent, on the World Confederation for Physical Therapy's international guidelines. The paper explores the development of physical therapy education in China and discusses possible options for the way forward so that as the demand for physical therapy to service 1.4 billion people grows, the profession is prepared and the standards expected of the entrylevel physical therapist will not be compromised.
基金Supported by the National Basic Research Program of China(973 Program)-the Effect of De Qi on Acupoint Specific Effect Based on Meridians and its Characteristics and Molecular Response Mechanisms(No.2012CB518506)Research on Acupoint Specificity in Regulating Uterus(No.2006CB504503)National Natural Science Foundation of China-Research on Variations of Biophysical Properties of Acupoints on Different Meridians with the Same Spinal Segments Based on Primary Dysmenorrhea(No.81573884)
文摘OBJECTIVE:To assess skin temperature response to menstruation at acupuncture points in primary dysmenorrhea(PD) patients and healthy volunteers so as to explore acupuncture point specificity in reflecting diseases in the light of skin temperature.METHODS:Fifty-two PD patients and 49 healthy volunteers were recruited.Skin temperature measurements were performed with a skin temperature assessment device at 10 points.Absolute difference between skin temperature of the same point on the left and right side is used as main outcome measure.RESULTS:On the first day of menstruation, when menstrual pain attacking in PD patients, a significant increase in skin temperature difference was detected at Taixi(KI 3) compared with the healthy group(P < 0.01).A significant reduction in skin temperature difference was detected at Taixi(KI 3) in the first day of menstruation compared with those values in the third day after menstruation(P < 0.01)in the healthy group.On the third day after menstruation, a significant reduction in skin temperature difference was found at Zhongdu(LR 6) in PD group compared with the healthy group(P < 0.05).No significant differences of skin temperature were detected at other points(P > 0.05).CONCLUSION:The skin temperature difference at menstruation-relevant points in PD patients did not all change significantly more than those in women without PD.Significant difference was only found in Taixi(KI 3), the Yuan-source point of Kidney meridian.
文摘Physical rehabilitation of lung transplant candidates and recipients plays an important in optimizing physical function prior to transplant and facilitating recovery of function post-transplant. As medical and surgical interventions in lung transplantation have evolved over time, there has been a demographic shift of individuals undergoing lung transplantation including older individuals, those with multiple co-morbidites, and candidates with respiratory failure requiring bridging to transplantation. These changes have an impact on the rehabilitation needs of lung transplant candidates and recipients. This review provides a practical approach to rehabilitation based on research and clinical practice at our transplant centre. It focuses on functional assessment and exercise prescription during an uncomplicated and complicated clinical course in the pre-transplant, early and late post-transplant periods. The target audience includes clinicians involved in pre- and posttransplant patient care and rehabilitation researchers.
文摘Purpose: Low back pain (LBP), Gonarthrosis, knee, and Carpal Tunnel Syndrome have been regarded as affecting more than three-quarters’ of individuals in their lifetime. The aim of this study was conducted to determine and compare the effects of topical patients with sand compared with control related to Gonarthrosis, LBP, knee, and Carpal Tunnel Syndrome pain. Methods: This is a prospective case and control designed study based on 101 pain case with Sand and 101 control subjects. The interventional groups in addition either topical sand or without sand 2 months after the intervention were assessed. We assessed tolerability of an established pain perception scale by the Numeric Rating Scale (NRS). Categorical variables were compared using the chi-square (χ<sup>2</sup>) test. The paired t-test was used to compare the two groups before and after the intervention. One-way analysis of variance (ANOVA) was employed for comparison of several group means. Results: The study was based on 202 patients, 41 males (20.3%) and 161 females (79.7%). There were statistically significant differences between subjects with and without Sand in term of Gonarthrosis, Rheumatoid Arthritis LBP, knee, and Carpal Tunnel Syndrome pain (p = 0.033). Majority of patients were over age 55 years old (55%) and females 78 (77.2%). The mean score of total pain experience before and after the intervention was 7.41 ± 1.1 for black sand, and 4.24 ± 2.38 for without sand as control group. The mean scores of these 5 groups were highly significant before and after the intervention (p There was statistically highly significant in regarding subjects with Sand as compared with those before Sand after treatment mean score specifically with gonarthrosis before pain 7.23 ± 1.86 vs after treatment 4.54 ± 2.18 p < 0.001;rheumatoid arthritis before 8.28 ± 1.48 vs after treatment 4.80 ± 3.71 p < 0.001;Low Back Pain before 8.42 ± 1.83 vs after treatment 4.37 ± 1.52 p < 0.001;knee pain before 8.93 ± 0.89 vs after treatment 4.24 ± 0.24 p < 0.001;Carpal T
文摘Background: Physical functional decline is common among elderly individuals with mental disorders, worsening their symptoms. Physiotherapy interventions have shown some evidence in improving physical function and mental health outcomes in this population. This study aimed to assess the impact of physiotherapy interventions on the elderly with mental health conditions at Chainama Hills College Hospital in Zambia. Methods: A pre-post single sample design was used to track patient progress over six weeks, with 10 physiotherapy sessions. The study population (N = 30) comprised of all elderly individuals with mental health conditions, encompassing both men and women, who were hospitalized during the research period. The Katz Index of Activities of Daily Living and the six-minute walk test were evaluated before and after the intervention. The IBM SPSS version 26 was used to analyze data and results were presented as mean ± SD with a 95% confidence interval. The variables were described in terms of their mean, SD, and range. A significance level of 0.05 was used for a paired T-test to detect changes and multiple logistic regression was used to identify factors associated with mental health. Results: Following the intervention, the percentage of participants achieving full function and independence increased significantly to 96.7% from the initial 73.3%, supported by a 95% CI = [0.82 - 0.99]. There was also a notable decrease in the proportion of individuals experiencing moderate impairment, dropping from 26.7% to just 3.3%, with a corresponding 95% CI = [0.00 - 0.17]. Conclusion: The findings derived from this study illustrate an enhancement in the aspects of participants’ overall health and functional condition, including blood pressure, heart rate, and respiratory rate. Consequently, physiotherapy exercises can be employed as a tactic to ameliorate the functional status and physical well-being of older individuals afflicted with mental disorders in Zambia.
基金The Project of Natural Science Foundation of Hunan Province(No.CX20221185)and the Science Foundation of Hunan Province(Nos.2022JJ70072 and 2021JJ70151)supported this work.
文摘To the Editor:As society continues to advance,individuals are increasingly exposed to various stressors in their personal and professional lives.The World Health Organization claims that nearly 1 billion people worldwide suffer from mental disorders in 2019,including 14%of the world’s adolescents.[1]Depression among Chinese adults is a serious public health challenge that requires urgent attention.Due to the combined inuence of various life stresses and unhealthy lifestyles,individuals face a signicantly increased risk of developing depression.[2]Depression is often misdiagnosed because its symptoms overlap with those of other mental health conditions.A misdiagnosis of depression can have a signicant impact on all aspects of an individual’s life.In children,a misdiagnosis can lead to inappropriate academic interventions or unnecessary treatments that can adversely affect their school life and overall well-being.For adults,a misdiagnosis can strain relationships.
基金supported by the National Institute for Health Researsch (NIHR) DietLifestyle & Physical Activity Biomedical Research Unit based at University Hospitals of Leicester and Loughborough University+5 种基金the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care-East Midlands (NIHR CLAHRC- EM)the Leicester Clinical Trials Unitsupported by a National Health and Medical Research Council (NHMRC) Centre for Research Excellence Grant on Sitting Time and Chronic Disease Prevention-Measurement, Mechanisms and Interventions (APP1057608)supported by a Heart Foundation Postdoctoral (PH 12B 7054)NHMRC Career Development (#1086029) Fellowshipsupported by an Australian Research Council Future Fellowship (FTE 100100918)
文摘Research indicates that high levels of sedentary behavior(sitting or lying with low energy expenditure) are adversely associated with health. A key factor in improving our understanding of the impact of sedentary behavior(and patterns of sedentary time accumulation) on health is the use of objective measurement tools that collect date and time-stamped activity information. One such tool is the activP AL monitor. This thigh-worn device uses accelerometer-derived information about thigh position to determine the start and end of each period spent sitting/lying, standing, and stepping, as well as stepping speed, step counts, and postural transitions. The activP AL is increasingly being used within field-based research for its ability to measure sitting/lying via posture. We summarise key issues to consider when using the activP AL in physical activity and sedentary behavior field-based research with adult populations. It is intended that the findings and discussion points be informative for researchers who are currently using activP AL monitors or are intending to use them. Pre-data collection decisions, monitor preparation and distribution, data collection considerations, and manual and automated data processing possibilities are presented using examples from current literature and experiences from 2 research groups from the UK and Australia.
文摘The practice of soccer involves carrying-out actions of high intensity, which demand a great generation of eccentric strength, which in turn results in an increase in the inflammatory response after training practice and game matches. The study aimed to investigate, in combination and individually, the association of 28 polymorphisms with the inflammatory responses of soccer athletes. The sample consisted of 47 male under-20 soccer athletes who belong to clubs in the first division of Brazilian soccer. Blood samples were collected at Pre, and 03, 24, and 48 hours after the training session to evaluate the inflammatory responses (hematological analyzes (hemogram), creatine phosphokinase (CK), high sensitivity quantitative C-reactive protein (CRP), tumor necrosis factor-alpha, (TNFα), interleukin 6 (IL-6) and insulin-like growth factor 1 (IGF-1)). DNA was obtained through scraping of buccal cells, where a sterile swab was rubbed on the inner side of the mouth of each participant 06 times. The database was built using the TruSeq DNA PCRFree kit (Illumina®) and the Covaris equipment for shearing genomic DNA (gDNA) by ultrasound. Of the analyzed SNPs, 09 (ACTN3 rs1815739, COL5A1 rs12722, COL5A1 rs3196378, HGF rs5745697, IGF1 rs35767, IL-6 rs1800795, MMP3 rs679620, SLC30A8 rs13266634, SOX15 rs4227) were individually associated with biomarkers and 07 SNPs, (COL5A1 rs12722, COL5A1 rs3196378, COL5A1 rs1800012, HGF rs5745697, IGF1 rs35767, IL-6 rs1800795 and MMP3 rs679620) analyzed in combination, explained 16% to 40% of the variation of inflammatory responses in soccer athletes. The results suggest that the genotypic profile can be taken into account for a more individualized distribution of the training load, along with the elaboration of recovery strategies for high-level athletes between training sessions and games of high physical and physiological demand.
基金supported by the 13th Five-Year Army Key Discipline Construction Project(No.2020SZ06-17).
文摘Background As one of the most common musculoskeletal ailments,chronic nonspecific low-back pain(CNLBP)causes persistent disability and substantial medical expenses.Epidemiological evidence shows that the incidence rate of CNLBP in young and middle-aged people who are demanded rapidly recovery and social contribution is rising.Recent guidelines indicate a reduced role for medicines in the management of CNLBP.Objective The present study investigates the short-term effects of cupping and scraping therapy using a medicated balm,compared to nonsteroidal anti-inflammatory drug(NSAID)with a capsaicin plaster,in the treatment of CNLBP.Design,setting,participants and interventions We designed a prospective multicenter randomized clinical trial enrolling patients from January 1,2022 to December 31,2022.A total of 156 patients with CNLBP were randomized into two parallel groups.Diclofenac sodium-sustained release tablets were administered orally to participants in the control group for one week while a capsaicin plaster was applied externally.Patients in the test group were treated with cupping and scraping using a medical device and medicated balm.Main outcome measures Primary outcome was pain recorded using the visual analogue scale(VAS).Two secondary outcomes were recorded using the Japanese Orthopedic Association low-back pain scale(JOA)and the traditional Chinese medicine(TCM)syndrome integral scale(TCMS)as assessment tools.Results Between baseline and postintervention,all changes in outcome metric scales were statistically significant(P<0.001).Compared to the control group,patients in the test group had a significantly greater treatment effect in all outcome variables,as indicated by lower VAS and TCMS scores and higher JOA scores,after the one-week intervention period(P<0.001).Further,according to the findings of multivariate linear regression analysis,the participants’pain(VAS score)was related to their marital status,age,smoking habits and body mass index.No adverse reactions were reported for any participants in
基金financially supported by the National Natural Science Foundation of China for Youth Fund Project:Integrated Identification and Risk Assessment of Clostridium and its Metabolites(81402684)
文摘Laboratory-based pathogen isolation, identification, and toxicity determination were performed on samples from a suspected case of infant botulism. Mice injected with cultures generated from the enema sample and ingested Powered infant formula （PIF） presented typical signs of botulism. Antitoxins to polyvalent botulinum neurotoxins （BoNTs） and monovalent BoNT type B antitoxin had protective effects. Clostridium botulinum isolated from the enema and residual PIF samples were positive for type B toxin. Pulsed-field gel electrophoresis （PFGE） revealed that the two strains of C. botulinum isolated from the two samples produced indistinguishable pulsotypes. These findings confirmed this case of type B infant botulism associated with the ingestion of PIF contaminated bv type B C. botulinum spores.
文摘BACKGROUND Lack of mobilization and prolonged stay in the intensive care unit(ICU)are major factors resulting in the development of ICU-acquired muscle weakness(ICUAW).ICUAW is a type of skeletal muscle dysfunction and a common complication of patients after cardiac surgery,and may be a risk factor for prolonged duration of mechanical ventilation,associated with a higher risk of readmission and higher mortality.Early mobilization in the ICU after cardiac surgery has been found to be low with a significant trend to increase over ICU stay and is also associated with a reduced duration of mechanical ventilation and ICU length of stay.Neuromuscular electrical stimulation(NMES)is an alternative modality of exercise in patients with muscle weakness.A major advantage of NMES is that it can be applied even in sedated patients in the ICU,a fact that might enhance early mobilization in these patients.AIM To evaluate safety,feasibility and effectiveness of NMES on functional capacity and muscle strength in patients before and after cardiac surgery.METHODS We performed a search on Pubmed,Physiotherapy Evidence Database(PEDro),Embase and CINAHL databases,selecting papers published between December 2012 and April 2023 and identified published randomized controlled trials(RCTs)that included implementation of NMES in patients before after cardiac surgery.RCTs were assessed for methodological rigor and risk of bias via the PEDro.The primary outcomes were safety and functional capacity and the secondary outcomes were muscle strength and function.RESULTS Ten studies were included in our systematic review,resulting in 703 participants.Almost half of them performed NMES and the other half were included in the control group,treated with usual care.Nine studies investigated patients after cardiac surgery and 1 study before cardiac surgery.Functional capacity was assessed in 8 studies via 6MWT or other indices,and improved only in 1 study before and in 1 after cardiac surgery.Nine studies explored the effects of NMES on muscle strength
基金supported by grants from the National Natural Science Foundation of China,Nos.81891003(to YSZ),81971157(to BQL)the National Key R&D Program of China,Nos.2017YFA0104704(to BQL),2017YFA0104701(to YSZ)+5 种基金the Young Elite Scientist Sponsorship Program by CAST(YESS),No.2018QNRC001(to BQL)the Fundamental Research Funds for the Central Universities,China,Nos.20ykpy156(to YHM)the 111 Project for Academic Exchange Program,China,No.B13037(to YSZ,YD and YHM)the Natural Science Foundation of Guangdong Province,China,Nos.2018A030310110(to YHM),2020A1515011537(to YHM)the Foundation of Guangdong Province,China,No.2017B020210012(to YSZ and XZ)the Start-up Foundation of Guangdong Province,China,No.2018A030310113(to GL).
文摘Directional axon regeneration and remyelination are crucial for repair of spinal cord injury(SCI),but existing treatments do not effectively promote those processes.Here,we propose a strategy for construction of niche-specific spinal white matter-like tissue(WMLT)using decellularized optic nerve(DON)loaded with neurotrophin-3(NT-3)-overexpressing oligodendrocyte precursor cells.A rat model with a white matter defect in the dorsal spinal cord of the T10 segment was used.The WMLT transplantation group showed significant improvement in coordinated motor functions compared with the control groups.WMLT transplants integrated well with host spinal cord white matter,effectively addressing several barriers to directional axonal regeneration and myelination during SCI repair.In WMLT,laminin was found to promote development of oligodendroglial lineage(OL)cells by binding to laminin receptors.Interestingly,laminin could also guide linear axon regeneration via interactions with specific integrins on the axon surface.The WMLT developed here utilizes the unique microstructure and bioactive matrix of DON to create a niche rich in laminin,NT-3 and OL cells to achieve significant structural repair of SCI.Our protocol can help to promote research on repair of nerve injury and construction of neural tissues and organoids that form specific cell niches.
基金supported by an Australian Government Research Training Program Scholarship at the University Western AustraliaRSA is supported by a Zrinski Grant from Parkinson's WA and the Pierce Armstrong Foundation.
文摘Parkinson's disease(PD)is an incurable,devastating disorder that is characterized by pathological protein aggregation and neurodegeneration in the substantia nigra.In recent years,growing evidence has implicated the gut environment and the gut-brain axis in the pathogenesis and progression of PD,especially in a subset of people who exhibit prodromal gastrointestinal dysfunction.Specifically,perturbations of gut homeostasis are hypothesized to contribute toα-synuclein aggregation in enteric neurons,which may spread to the brain over decades and eventually result in the characteristic central nervous system manifestations of PD,including neurodegeneration and motor impairments.However,the mechanisms linking gut disturbances andα-synuclein aggregation are still unclear.A plethora of research indicates that toll-like receptors(TLRs),especially TLR2 and TLR4;are critical mediators of gut homeostasis.Alongside their established role in innate immunity throughout the body,studies are increasingly demonstrating that TLR2 and TLR4 signalling shapes the development and function of the gut and the enteric nervous system.Notably,TLR2 and TLR4 are dysregulated in patients with PD,and may thus be central to early gut dysfunction in PD.To better understand the putative contribution of intestinal TLR2 and TLR4 dysfunction to earlyα-synuclein aggregation and PD,we critically discuss the role of TLR2 and TLR4 in normal gut function as well as evidence for altered TLR2 and TLR4 signalling in PD;by reviewing clinical,animal model and in vitro research.Growing evidence on the immunological aetiology ofα-synuclein aggregation is also discussed,with a focus on the interactions ofα-synuclein with TLR2 and TLR4.We propose a conceptual model of PD pathogenesis in which microbial dysbiosis alters the permeability of the intestinal barrier as well as TLR2 and TLR4 signalling,ultimately leading to a positive feedback loop of chronic gut dysfunction promotingα-synuclein aggregation in enteric and vagal neurons.In turn,α-synuclein aggre
基金funded in part by the Coordination of Improvement of Higher Level Personnel—Brazil(CAPES)—Finance Code 001 by the National Council of Scientific and Technological Development—Brazil(CNPq)—Doctorate GDby Research Foundation of the State of Rio Grande do Sul(FAPERGS).
文摘Atrial fibrillation is a cardiac arrhythmia of high prevalence in the population, especially in the elderly. Its main electrical characteristics are the interval between two successive irregular R waves, absence of P waves and presence of f waves between QRS complexes. The most common symptoms of atrial fibrillation are irregular palpitations associated with dyspnea, dizziness, feeling tired, fatigue and general malaise, but not all patients have any symptoms. The present report presents the history of an elderly patient who arrived at the hospital’s emergency department with irregular heart rhythm and palpitations. The patient’s symptoms, associated with the electrocardiogram results, indicated paroxysmal atrial fibrillation. Electrical cardioversion was performed, and after, cardiac ablation via the femoral vein at the hospital’s cardiology service. There were no complications during the procedure. As a routine imaging exam after ablation, control esophagogastroduodenoscopy was requested to verify that there was no formation of atrio-esophageal fistula developed by the invasive ablation procedure and electrocardiogram, which showed normal sinus rhythm. The patient remained in the cardiac intensive care unit for observation for 24 hours. After the electrical cardioversion and catheter ablation procedures, the patient improved his clinical picture of atrial fibrillation and was discharged after 24 hours of hospitalization. He received treatment to perform at home, to reduce acid reflux into the esophagus and to prevent thrombosis. He did not present pulmonary thromboembolism after hospital discharge. It is believed, therefore, that this form of treatment and management of paroxysmal atrial fibrillation is effective for the solution of the proposed problem and can also serve as a reference for other professionals within the cardiology service.
基金funded by the Breast Cancer Foundation New Zealandsupport of which is gratefully acknowledged+1 种基金This funding source has no role in this study other than providing funding supportLL is funded as the Breast Cancer Foundation New Zealand Belinda Scott Clinical Fellowship 2017
文摘Background： Breast cancer patients experience various side effects during cancer therapy, often resulting in reduced quality of life and poor adherence to treatment. A limited range of proven interventions has been developed to target such side effects. While Tai Chi offers benefits for the health and well-being of breast cancer survivors, the effectiveness of Tai Chi across the treatment continuum has not been evalu- ated. Improved patient education and support has been suggested as a priority for breast cancer care. This pilot study assesses the feasibility of a randomized controlled trial （RCT） to evaluate the effectiveness of ＂an integrative Tai Chi＂ （ANITA） program for breast cancer patients undergoing cancer therapy. Methods/design： This is a single-centre, two-arm feasibility RCT. Twenty-four patients with breast cancer who have undergone surgical treatment will be recruited from the Dunedin Hospital （New Zealand） over a 12-month period （from August 2017 to July 2018）. Subject to informed consent, patients will be ran- domized to receive standard cancer treatment alone or standard cancer treatment plus the ANITA pro- gram, consisting of peer support, health education, and Tai Chi Ruler exercise. The program runs alongside the patient＇s adjuvant cancer therapy, which may include chemotherapy, radiation therapy, antibody treatment, and/or antihormonal therapy. Analysis in this study will focus on process evaluation of participant recruitment, retention, treatment fidelity, acceptability of the program, and occurrence of adverse events. Clinical outcomes （i.e., fatigue, sleep quality, anxiety and depression and quality of life） will be assessed at baseline, and at 12 weeks and 24 weeks post-randomization. Discussion： Outcomes from this study will inform the feasibility and methodology for a future fully- powered RCT.
基金supported by grants from the National Natural Science Foundation of China(31871899 and 31930110)Henan Medical Science and Technology Research Plan(LHGJ20200128)。
文摘Salmonella enterica serovar 4,[5],12:i:-(S.4,[5],12:i:-)is a monophasic variant of Salmonella enterica serovar Typhimurium that has emerged as a global serovar causing public health concern.To date,the epidemiology and genomic characterization of this pathogen in China have not been well described.We investigated the prevalence,antimicrobial resistance(AMR)phenotypes,and population genomics of sequence type 34(ST34)S.4,[5],12:i:-among cases of human salmonellosis in Henan Province,China.A total of 100 ST34 S.4,[5],12:i:-isolates were studied from 2008 to 2017 and found mostly resistant to ampicillin(AMP),streptomycin(STR),sulfonamides(SUL),and tetracycline(TET)(ASSu T).Bayesian phylogenetic analysis demonstrated that isolates identified in China were mostly related to the European lineage and evolved into two major clades with different resistance genes and plasmid profiles.Notably,clade 1 showed a significantly higher rate of mutations in gyr A and plasmid-mediated quinolone resistance genes.The carrying of the resistance-containing region(encoding R-type ASSu T),including bla(conferring resistance to AMP),str AB(STR),sul2(SUL),and tet(B)(TET)inserted into the flj BA operon,was responsible for most of the monophasic variants in clade 2.Inc HI2 plasmids were the dominant multi-drug resistance mobile genetic elements accounting for the transmission of acquired resistance genes in this serovar,and these were more prevalent in clade 1.Our findings highlighted the increasing prevalence of multi-drug resistant S.4,[5],12:i:-in China,along with the differential characteristics of resistance gene acquisition among various lineages.Based on our data,control measures are required to address the spread of this zoonotic pathogen.Further owing to its potential origin in food-producing animals,a"One Health"approach,should be implemented to support surveillance whilst informing interventional strategies.
基金support from the School of Health and Biomedical Sciences,Royal Melbourne Institute of Technology University.
文摘Objective:This study aimed to investigate the feasibility of implementing a manual therapy technique(muscle energy technique,MET)protocol in a hospital pulmonary rehabilitation(PR)program for patients with moderate to severe chronic obstructive pulmonary disease(COPD).Methods:Participants aged 40 years and over,with moderate to severe COPD,were recruited into this 12-week study.The primary outcome measures were feasibility(acceptability of the intervention and attendance/adherence to the trial)and safety(adverse events,AEs).All participants received the MET and PR therapies.Participants and assessors were unblinded.Semi-standardized MET was delivered on 6 occasions(a maximum of once per week)at the hospital directly before a PR session.Participants undertook PR sessions as per the hospital program at a frequency of two days per week for 8 weeks.Participants were contacted 4 weeks after their final MET treatment via a telephone call to assess acceptability of the intervention.Results:Thirty-three participants were enrolled,with a median age of 74 years(range 45-89 years).The median number of MET sessions that participants attended was 5(range O-6)out of a possible 6 sessions(83%attendance).At follow-up,participants overwhelmingly enjoyed the MET treatment with some subjectively reporting improved breathing.There were no major AEs related to the intervention,with the majority of AEs classified as expected events related to COPD exacerbations.Conclusion:It is feasible to implement a manual therapy protocol using MET as an adjunct to PR in a hospital setting.Recruitment rates were satisfactory and there were no AEs related to the MET component of the intervention.
文摘Background: Major burns are life threatening. Fluid resuscitation is required for survival to maintain intravascular volumes and prevent hypovolemic shock. Bioimpedance spectroscopy (BIS) has been recognised as a potential method of monitoring fluid shifts after burn and in other disease states. The aims of this study were to examine the reliability of BIS across different dressing conditions and electrode positions, establish the influence of Acticoat?on BIS variable measures and determine the validity of whole-body BIS to assess net fluid shift in the presence of moderate to major burns. Methods: An observational longitudinal cohort study was conducted from December 2014 to February 2016. Patients with over 15% total body surface area (TBSA) burns and injury less than 48 h were enrolled in the study. BIS triplicate measures were collected in an open wound and with an ActicoatTMdressing (at 5 half hour intervals). Standard and alternate electrode placements were utilised for the reliability analysis and standard placement only for determining the validity of BIS in moderate to major burns. The ImpediMde SFB7 was used to collect whole-body and segmental BIS measures. Stata statistical software, release 14 was utilised to analyse all results. Descriptive analyses were performed and were reported using the means and standard deviations (SD). Results: BIS-repeated measures established BIS raw resistance (R), and predicted volume variables were reliable in any condition (intra-class correlation coefficient (ICC) 0.996-0.999, 95% confidence intervals (CI) 0.996-0.999) without a systematic difference. Acticoat?dressings significantly influenced all BIS-predicted volumes (p≤0.01) as determined by multilevel mixed effects (MLME) linear regression analysis. Validity of BIS was demonstrated by resistance variables significantly decreasing with increasing net ionic fluid shift and increased TBSA (severity of injury) and calculated fluid volumes increasing with increasing net fluid shift and TBSA. BIS resistance also decre
文摘OBJECTIVE: To summarize the literature about the effectiveness of dry needling(DN) on relieving pain and increasing range of motion(ROM) in individuals with myofascial pain syndrome(MPS).METHODS: Papers published from January 2000 to January 2013 were identified through an electronic search in the databases MEDLINE, Dialnet, Cochrane Library Plus, Physiotherapy Evidence Database(PEDro) and Spanish Superior Council of Scientific Research(CSIC). The studies included were randomized controlled trials written in English and/or Spanish about the effectiveness of DN on pain and ROM in individuals with MPS.RESULTS: Out of 19 clinical trials that were potentially relevant, a total of 10 were included in the Meta-analysis. Regarding pain intensity reduction when measured before and immediately after the intervention, DN achieved improvement compared with the placebo treatment [d =-0.49; 95% CI(-3.21, 0.42)] and with the control group [d =-9.13;95% CI(- 14.70,- 3.56)]. However, other treatments achieved better results on the same variable compared with DN, considering the measurements for pre-treatment and immediately after [d = 2.54;95% CI(-0.40, 5.48)], as well as the pre-treatment and after 3-4 weeks [d = 4.23; 95% CI(0.78, 7.68)].DN showed a significantly increased ROM when measured before the intervention and immediately after, in comparison with the placebo [d = 2.00;95% CI(1.60, 2.41)]. However, other treatments achieved a significant better result regarding ROM when it was measured before the intervention and immediately after, as compared with DN [d =-1.42;95% CI(-1.84,-0.99)].CONCLUSION: DN was less effective on decreasing pain comparing to the placebo group. Other treatments were more effective than DN on reducing pain after 3-4 weeks. However, on increasing ROM,DN was more effective comparing to that of placebo group, but less than other treatments.
