Objective To study the immune system regulatory effects of CD8+CD28-regulatory T lymphocytes in an experimental bone marrow mesenchymal stem cell treatment of autoimmune encephalomyelitis.Methods A model of autoimmune encephalomyelitis (EAE) was established in twenty-eight C57BL/6 female mice,6 to 8 weeks old weighing 16 to 20 g using myelinoligodendrocyte glycoprotein 35-55 amino acid peptide (MOG35-55).The mice were randomly divided into a phosphate-buffered solution (PBS) group (n =7),an MSCs-Low group [n =7 which received an injection of 2× 105 mesenchymal stem cells (MSCs)],an MSCs-Med group (n=7,1× 106 MSCs),and an MSCs-High group (n=7,5×106 MSCs).Their clinical condition was then evaluated daily.On the 15th day after the MOG35-55 immunization,the different MSC doses were administered intravenously via the tail.On the 30th day the mice were sacrificed to observe any neuropathology of the spinal cord.At the same time,FACS flow cytometry was used to assay CD8+CD28-T cells in the spleen.Results Compared with the PBS control group,the MSC treatment effectively alleviated illness among the mice by the 15th day after the immunization.The maximum and average disease scores and clinical illness scores had all improved significantly.The medium dosage worked best.Neuropathological analysis showed that the MSC treatment could significantly reduce the invasion of inflammatory cells and minimize demyelination in the spinal cord.Furthermore,the CD8+ CD28-regulatory T cells in the spleens of the MSCtreated animals increased compared with the PBS control group,though the secreted levels of IL-10 showed no obvious difference.Conclusions Treatment with MCSs can promote the recovery of neural function in autoimmune encephalomyelitis,at least in mice.CD8+CD28-regulatory T cells may not be the main effector cells,playing only a synergistic therapeutic role.

Objective To observe the effects of repeated low and high-frequency transcranial magnetic stimulation (rTMS) on neuropathic pain and the expression of specific activation markers of astrocytes and glial fibrillary acidic protein (GFAP) in the lumbar spinal cord.Methods Twenty-eight male Sprague-Dawley rats were randomly divided into a sham-operated group,a sham-rTMS group,a 1 Hz group and a 20 Hz group,with 7 in each group.The rats in the sham-operated group had their sciatic nerve exposed without ligation,while the other groups underwent sciatic nerve ligation to induce neuropathic pain.Three days after the operation,rTMS was applied to the primary motor cortex (M1) contralateral to the pain once a day for 10 consecutive days.Pain-related behavior and thermal pain response were tested before the operation and before and after the course of rTMS therapy.The expression of GFAP in the lumbar spinal cord was examined.Results All of the rats which underwent sciatic nerve ligation showed pain-related behavior and significantly decreasing thermal pain latency compared with the sham-operated group.After the rTMS therapy the thermal hyperalgia was significantly attenuated in the 20 Hz group but not in the 1 Hz group compared with the sham-rTMS group.The expression of GFAP in the dorsal horn of the lumbar spinal cord ipsilateral to the neuropathic pain was significantly increased in the sham-rTMS group and the 1 Hz group compared with the sham-operated group.Compared with the sham-rTMS group,GFAP levels were significantly lower in the 20 Hz group but not in the 1 Hz group.The pain relief in the 20 Hz group was negatively related to the expression of GFAP.Conclusions Neuropathic pain induced by peripheral nerve injury is associated with increased activity and proliferation of astrocytes in the dorsal horns of the spinal cord.High-frequency rTMS can relieve neuropathic pain through inhibiting the activity and proliferation of astrocytes in the dorsal horns,but low-frequency rTMS has no clinically significant effect.

Objective To observe the effects of an enriched environment (EE) on cognitive functioning and the synaptic plasticity of mice modeling post-stroke cognitive impairment (PSCI) and explore the possible mechanisms involved.Methods Mice modeling PSCI and sham-operated mice were randomly divided into 3 groups:sham-operated mice in a standard environment (the Sham+SE group),PSCI mice in a standard environment (the PSCI+SE group) and PSCI mice in an enriched environment (the PSCI+EE group).The cognitive functioning of all of the mice was quantified using a Morris water maze and their hippocampal long-term potentiation (LTP) was recorded using an electrophysiological method.The level of synaptophysin was detected using Western blotting.Synaptic ultrastructure in the hippocampus was imaged using electron microscopy.Results Compared with the Sham +SE group,the PSCI+SE group showed significantly poorer water maze performance and failed induction of contralateral LTP.Their average level of synaptophysin was significantly lower,and significant adverse changes in the synaptic ultrastructure of the hippocampus were observed,including a decreased number of synapses.The average width of the synaptic cleft,postsynaptic density and the interface curvature of the synapses were all less desirable.All of the measurements of the PSCI+EE group improved significantly compared to those of the PSCI+SE group,but were still significantly poorer than those of the Sham+SE group.Conclusions An enhanced environment can improve the cognitive functioning of mice modelling PSCI.It may be that an EE can improve synaptic plasticity in the hippocampus contralateral to the stroke.

Objective To explore the analgesic effect of intra-articular botulinum neurotoxin type A (BoNTA) injection in rats with adjuvant-arthritis pain,to quantify the expression of calcitonin gene-related peptide (CGRP) in the dorsal root ganglia (DRG) associated with arthritis pain,and to investigate the retrograde axonal transport of BoNT-A into the DRG after peripheral injection.Methods Ninety Sprague-Dawley rats were randomly divided into groups A,B,C,D and E,each of 18.A murine model of adjuvant-arthritis pain was established by injecting 50 μL of complete Freund's adjuvant into the left ankle in all the mice except those in group A.The control group A was treated with intra-articular injection of 50 μL of saline solution.Three weeks later,groups A and B were treated with a 20 μL intra-articular saline injection,while groups C,D and E received an intra-articular injection of BoNT-A at 1 U/20 μL,3 U/20 μL or 10 U/20 μL respectively.Pain threshold and muscle strength were graded before and 1,5,15 and 21 days after the modelling,as well as at 1,3,5 and 14 days after the BoNT-A treatments.Protein expression and the CGRP-positive cell number were observed,as well as any BoNT-A-cleaved synaptosomal-associated 25 kDa protein (cl-SNAP-25) in the DRG using Western blotting and immunofluorescence.Results Compared with group A,there was a significant decrease in the average mechanical withdrawal threshold and muscle strength and a significant increase in the protein expression and the CGRP-positive cell number in the other 4 groups.Compared with group B,the mechanical withdrawal threshold had increased significantly more in groups D and E at 5 days after the BoNT-A injection and in group C at 14 days after the treatment.Compared with group B,the protein expression and the number of CGRP-positive cells were significantly lower in groups D and E at 3 days after the BoNT-A injection.The decrease in group C was significant after 14 days.No significant differences were found between groups D and E in any measurement at any time point.There was no significant difference among groups B,C and D in terms of muscle strength.Five days after the BoNT-A injection,significantly decreased muscle strength was observed in group E.In addition,BoNT-A cleaved-SNAP-25 was detected in the DRG.Conclusion BoNT-A can reduce arthritis pain through inhibiting the expression of CGRP in the DRG.Its analgesic effect has a dose response.A peripheral injection of BoNT-A can arrive at the DRG through retrograde axonal transport.

Objective To observe the effect of repetitive transcranial magnetic stimulation (rTMS) on behavior in response to chronic but unpredictable mild stress and explore potential neuroendocrine mechanisms.Methods Forty adult SD male rats were randomly divided into a control group (n =8) and a model preparation group (n=32).The control group was given normal care while a model of depression was induced in the model preparation group through giving an unpredictable mild stimulus (CUMS).The depressive rats were randomly divided into a model group,an rTMS group and a sham rTMS group (8 cases in each group).The rTMS group and sham rTMS groups accepted the rTMS or sham stimulation for 3 weeks.The changes in behavior in each group were quantified using body weight,sucrose consumption and an open field test before and after stimulation.Enzyme-linked immunosorbent assays (Elisas) were conducted to detect plasma adrenocorticotropic hormone (ACTH) and corticosterone (CORT) levels.Reverse-transcription polymerase chain reactions (RT-PCRs) were carried out to allow the detection of mRNA expression in hypothalamus related to levels of adrenocorticotropic hormone releasing hormone (CRH).Results After the modeling there were significant differences between the model preparation group and the control group in terms of weight increase,sucrose consumption and open field test results.After rTMS the rate of weight increase,sucrose consumption and the scores in the open field test of the rTMS group had increased significantly more than in the control group.Elisas showed significantly higher plasma ACTH and CORT levels in the model group as well.The average expression of CRH mRNA in the model group was significantly higher than in either of the other two groups.Conclusions rTMS can relieve depression-like behavior induced by chronic stress,at least in rats.This may be related to a downgrading of the hyperactive functioning of the hypothalamus-pituitary-adrenal axis.

Objective To develop the quality of life questionnaire applicable to the Chinese patients with dysphagia by the translation and modification,as well as psychometric evaluation of the original swallowing quality of life questionnaire (SWAL-QOL).Methods The English version of the SWAL-QOL was translated into Chinese according to the well-accepted scale translation procedure.Then 103 patients with dysphagia were tested using the translated Chinese SWAL-QOL.The inter-rater reliability,test-retest reliability,internal consistency reliability,the content validity and construct validity were tested.Results The inter-rater reliability correlation coefficient of the SWAL-QOL was between 0.945-0.990 (P＜0.01).Its test-retest coefficients ranged from 0.965 to 0.992 (P＜0.01).The Cronbach coefficients ranged from 0.708 to 0.933 (P＜0.01).There revealed significant correlation between each item of SWAL-QOL and its domain,with correlation coefficients between 0.723 and 0.982 (P＜0.01).Factor analysis of each item of the 10 domains of SWAL-QOL extracted 10 common factors,which were with a cumulative contribution of 79.029％.Factor analysis of the total score of the 10 dimensions extracted 2 common factors including dysphagia-related quality of life and general quality of life,with a cumulative contribution of 54.718％.Conclusions The Chinese version of SWAL-QOL is reliable and valid.It can be used as an effective measuring tool to evaluate the quality of life of dysphagia patients.

Objective To explore the effect of functional electrical stimulation combined with treadmill training and botulinum toxin type A injection on foot-drop and strephenopodia among stroke survivors.Methods Sixty-seven stroke survivors with foot-drop and strephenopodia were randomly divided into an electrical stimulation group (n=23),a conventional treatment group (n =22) and a combined treatment group (n =22).All 3 groups received a 400 U injection of BTX-A and electrical stimulation.After 24 hours,the patients in the conventional treatment group received conventional treatment including a brain protection agent,limb function exercises,gait training,balance training and training in the activities of daily living.The patients in the combined treatment group received that conventional treatment,plus functional electrical stimulation and weight loss training on a treadmill.The patients in the electrical stimulation group received functional electrical stimulation treatment supplementing the conventional treatment.Therapeutic effects were evaluated before and after six weeks of treatment using integral electromyography (iEMS) of the anterior tibial muscle and the lateral head of the gastrocnemius muscle,the co-contraction ratio (CR) during ankle dorsiflexion,the modified Ashworth Scale (MAS),the Berg balance scale (BBS),a functional walking score (FAC),and the active range of motion (AROM) of the ankle in dorsiflexion and eversion.Results After the treatment,significant improvement was observed in all three groups in the average iEMS value of the anterior tibial muscle and the lateral head of the gastrocnemius muscle,the CR in ankle dorsiflexion,and in their MAS,BBS,FAC and AROM results.There was no significant difference among the three groups after treatment in their average iEMS values at the lateral head of the gastrocnemius.The average values of the other indicators were,however,significantly better in the combined treatment group than in the other 2 groups.Conclusion Functional electrical stimulation combined with treadmill training and botulinum toxin type A injection can significantly improve foot-drop,strephenopodia and the walking function of stroke survivors.This combined treatment deserves popularization and application in clinical practice.

Objective To investigate the effect of functional training on knee pain,functional movement screen (FMS) score and balance in Chinese elite fencing athletes with patellar tendinopathy.Methods Twenty-four fencing athletes with a diagnosed patellar tendinopathy were randomized into a treatment group (TG) and a control group (CG),each of 12.Both groups were given routine physical therapy,while TG received motor function training in addition for eight weeks.Both groups completed the numerical rating scale (NRS),FMS and balance test before and after the intervention.Results After the intervention,the average PRS and FMS of TG were 2.08± 1.24 and 16.25±0.97 respectively,which significantly outperformed those of TG before the intervention and those of CG after the intervention (P＜0.05).Moreover,TG indicated superior results in parameters of static postural balance including center of pressure,total length of swinging pathway,maximal length of swinging pathway,and area of swinging pathway when compared to TG before the intervention and CG after the intervention(P＜0.05).Conclusion The motor functiontraining is effective in improving functional movement and balance in elite fencing athletes with patellar tendinopathy.

Objective To analyze the characteristics of fat infiltration into the muscles of patients with Becker and Duchenne muscular dystrophy (DMD) so as to provide a guide for rehabilitation therapy.Methods Twenty-three children with Becker muscular dystrophy (BMD) and 47 with DMD who had never been treated with glucocorticoids were enrolled.MRI was performed on both of their thigh muscles.T1 weighted images were used to assess the fat infiltration of their thigh muscles using a 0-5 modified version of Mercuri's scale.The progression of fatty infiltration of the thigh muscles in BMD was analyzed using descriptive statistics.The differences in fat infiltration between BMD and DMD were analyzed using rank sum tests.Results In patients with BMD the adductor magnus most often showed severe fat infiltration,followed by the biceps femoris,quadriceps,semimembranosus and semitendinosus,while the sartorius,gracilis and adductor longus had the lowest percentages of severe fat infiltration.Among the BMD patients the adductor magnus,biceps femoris and quadriceps showed moderate to severe involvement at the age of 8 to 9.The semimembranosus and semitendinosus showed moderate to severe involvement at the age of 10 to 11,and the sartorius,gracilis and adductor longus showed mild to moderate involvement after 15 years of age.Among the age groups of 8,9,10 and 11 years old,the median total fat infiltration scores were 10,22,28 and 25 respectively among the BMD patients,and 29,34,34 and 30 respectively among the DMD patients.At age 8 significant differences between the BMD and DMD patients were observed in the infiltration scores of the adductor magnus,biceps femoris,vastus lateralis,rectus femoris,vastus medialis,vastus intermedius and in the total scores.At age 9 significant differences persisted in the scores of the adductor magnus,rectus femoris,vastus medialis,vastus intermedius and the total scores.Conclusions The muscle MRIs showed significant differences in the degree of fatty infiltration between BMD and DMD patients.These findings may be useful when designing therapeutic regimens and rehabilitation programs for patients with BMD and DMD.

Objective To investigate the efficacy of BrainHQ visual training in rehabilitating memory function among stroke survivors.Methods Sixty stroke patients with memory disorders were recruited from the rehabilitation center of Tangshan Workers' Hospital.They were randomly assigned to a control group or an intervention group,each of 30.Both groups accepted conventional rehabilitation,while the intervention group was additionally given BrainHQ visual training five times a week for 30 minutes,lasting four weeks.Before and after the treatment,both groups completed the Rivermead behavioral memory test.Results After the 4 weeks of treatment,the average scores in recalling full names,recalling hidden items,recalling appointments,recognizing pictures,recognizing faces,recalling a story immediately,delayed story recall,recalling a route promptly,delayed route recall and the average total score in both groups were all significantly higher than before the treatment.The treatment group scored significantly better than the control group except in recalling hidden items,and recognizing faces and pictures.Conclusion BrainHQ visual training can improve the memory of stroke survivors.