OBJECTIVE To investigate the therapeutic mechanisms of electroacupuncture at"Tianshu"(ST25)and"Sanyinjiao"(SP6)acupoints combined with metformin in the treatment of type 2 diabetes mellitus(T2DM)using serum non-targeted metabolomics.METHODS Male SD rats were randomly divided into blank group,model group,metformin group,electroacupunc-ture group,and acupuncture-medicine combination(electroacupuncture combined with metformin)group.A type 2 diabetes model was established by high-fat diet combined with intraperitoneal injection of streptozotocin.The metformin group was treated with 250 mg·kg-1 metformin by gavage,the electroacupuncture group was treated with bilateral Tianshu and Sanyinjiao,the acupuncture-medicine combination group was treated with metformin by gavage combined with electroacupuncture,and the blank group and model group were treated with normal saline by gavage.All rats were treated 6 times a week for 7 weeks.After the intervention,the blood glucose level in the tail vein of the rats was measured using a blood glucose meter in the fasting state.The blood glucose levels of the rats were measured at 30,60,120,and 240 min after intraperitoneal injection of 50%glucose solution(4 mL·kg-1)to evaluate glu-cose tolerance.The serum insulin level of the rats was detected by ELISA and the insulin resistance index was calculated.The blood biochemical parameters were measured by an automatic blood biochemical analyzer.HE staining was used to evaluate the pathological conditions of the liver and pancreatic tissues of the rats.Ultra-performance liquid chromatography-mass spectrometry(UPLC-MS)technology was used for mass spectrometry detection to identify differential metabolites,and MetaboAnalyst 5.0 was used for pathway enrichment analysis.RESULTS Compared with the blank group,the fasting blood glucose,area under the glucose tolerance curve,and insulin resistance index of the model group rats were significantly increased(P<0.001),blood TP and GLB were significantly de-creased(P<0.01),AST,ALT,and ALP were significantly increased(P<0.05,P<0.01,P<0.001),and obvious inflammatory cell infiltration and pathological damage were observed in the liver and pancreas tissues;compared with the model group,the fasting blood glucose,area under the glucose tolerance curve,and insulin resistance index of the acupuncture-medicine combination group were sig-nificantly decreased(P<0.05,P<0.01,P<0.001),blood ALP was significantly decreased(P<0.01),TP and GLB were significant-ly increased(P<0.05),and the pathological damage of the liver and pancreas was significantly improved.Serum metabolomics showed that the metabolic profiles of the groups were well distinguished.Compared with the blank group,the differential metabolites in the model group were enriched in histidine metabolism,thiamine metabolism,taurine and hypotaurine metabolism,ascorbic acid and alde-hyde ester metabolism,valine,leucine and isoleucine biosynthesis pathways;compared with the model group,237 metabolites such as 3-aminoadipic acid,3-oxocyclobutanecarboxylic acid and phosphorylcholine in the acupuncture-medicine combination group were sig-nificantly reduced,and the pathways were enriched in histidine metabolism,linoleic acid metabolism,thiamine metabolism,taurine and hypotaurine metabolism,valine,leucine and isoleucine biosynthesis pathways.CONCLUSION Electroacupuncture combined with metformin can effectively improve the glucose and lipid metabolism of T2DM rats,and its potential mechanism may be related to the regulation of amino acid metabolism.

BACKGROUND:Shaker exercise can enhance the contraction force of the hyoid muscles,which is effective in the treatment of oropharyngeal dysphagia.Shaker exercise should be performed through the main force of the anterior cervical region to train the hyoid muscles.However,patients often experience physical fatigue,leading to compensatory abdominal force exertion.Moreover,the effect of different forms of shaker exercises on the activation of the hyoid muscles in healthy adults is currently unknown.OBJECTIVE:To investigate the effects of shaker exercises with varying force on the activation of the hyoid muscles in healthy adults.METHODS:Twenty healthy adults,including 10 males and 10 females with a mean age of(26.8±3.4)years were recruited as participants for the study.They performed isometric movements of the shaker exercise in the anterior neck and abdominal force modes in sequence.Simultaneously,real-time surface electromyography data were collected from the suprahyoid and infrahyoid muscles and rectus abdominis muscle.At the end of the experiment,participants were asked to rate the physical exertion levels for each type of force using the Borg Rating of Perceived Exertion Scale at the end of the training.Following a series of processing of the original electromyography signals,the peak amplitude and/or average amplitude values of the suprahyoid and infrahyoid muscles and rectus abdominis in the 60-second movement window were calculated and compared,and the differences in the subjective fatigue scores corresponding to the two force modes were compared.RESULTS AND CONCLUSION:The average amplitude of the rectus abdominis muscle in the abdominal force mode was found to be higher than that in the neck force mode(P<0.05).However,there were no significant differences in the mean and peak amplitudes between the suprahyoid and infrahyoid muscles in the two force modes(P>0.05).There was also no significant difference in the Borg Rating of Perceived Exertion Scale scores in the two force modes(P>0.05).These findings suggest that shaker exercises with different force modes(anterior neck and abdomen)have minimal impact on the hyoid muscles and similar feeling of fatigue in healthy adults.

OBJECTIVE To investigate the therapeutic mechanisms of electroacupuncture at"Tianshu"(ST25)and"Sanyinjiao"(SP6)acupoints combined with metformin in the treatment of type 2 diabetes mellitus(T2DM)using serum non-targeted metabolomics.METHODS Male SD rats were randomly divided into blank group,model group,metformin group,electroacupunc-ture group,and acupuncture-medicine combination(electroacupuncture combined with metformin)group.A type 2 diabetes model was established by high-fat diet combined with intraperitoneal injection of streptozotocin.The metformin group was treated with 250 mg·kg-1 metformin by gavage,the electroacupuncture group was treated with bilateral Tianshu and Sanyinjiao,the acupuncture-medicine combination group was treated with metformin by gavage combined with electroacupuncture,and the blank group and model group were treated with normal saline by gavage.All rats were treated 6 times a week for 7 weeks.After the intervention,the blood glucose level in the tail vein of the rats was measured using a blood glucose meter in the fasting state.The blood glucose levels of the rats were measured at 30,60,120,and 240 min after intraperitoneal injection of 50%glucose solution(4 mL·kg-1)to evaluate glu-cose tolerance.The serum insulin level of the rats was detected by ELISA and the insulin resistance index was calculated.The blood biochemical parameters were measured by an automatic blood biochemical analyzer.HE staining was used to evaluate the pathological conditions of the liver and pancreatic tissues of the rats.Ultra-performance liquid chromatography-mass spectrometry(UPLC-MS)technology was used for mass spectrometry detection to identify differential metabolites,and MetaboAnalyst 5.0 was used for pathway enrichment analysis.RESULTS Compared with the blank group,the fasting blood glucose,area under the glucose tolerance curve,and insulin resistance index of the model group rats were significantly increased(P<0.001),blood TP and GLB were significantly de-creased(P<0.01),AST,ALT,and ALP were significantly increased(P<0.05,P<0.01,P<0.001),and obvious inflammatory cell infiltration and pathological damage were observed in the liver and pancreas tissues;compared with the model group,the fasting blood glucose,area under the glucose tolerance curve,and insulin resistance index of the acupuncture-medicine combination group were sig-nificantly decreased(P<0.05,P<0.01,P<0.001),blood ALP was significantly decreased(P<0.01),TP and GLB were significant-ly increased(P<0.05),and the pathological damage of the liver and pancreas was significantly improved.Serum metabolomics showed that the metabolic profiles of the groups were well distinguished.Compared with the blank group,the differential metabolites in the model group were enriched in histidine metabolism,thiamine metabolism,taurine and hypotaurine metabolism,ascorbic acid and alde-hyde ester metabolism,valine,leucine and isoleucine biosynthesis pathways;compared with the model group,237 metabolites such as 3-aminoadipic acid,3-oxocyclobutanecarboxylic acid and phosphorylcholine in the acupuncture-medicine combination group were sig-nificantly reduced,and the pathways were enriched in histidine metabolism,linoleic acid metabolism,thiamine metabolism,taurine and hypotaurine metabolism,valine,leucine and isoleucine biosynthesis pathways.CONCLUSION Electroacupuncture combined with metformin can effectively improve the glucose and lipid metabolism of T2DM rats,and its potential mechanism may be related to the regulation of amino acid metabolism.

BACKGROUND:Shaker exercise can enhance the contraction force of the hyoid muscles,which is effective in the treatment of oropharyngeal dysphagia.Shaker exercise should be performed through the main force of the anterior cervical region to train the hyoid muscles.However,patients often experience physical fatigue,leading to compensatory abdominal force exertion.Moreover,the effect of different forms of shaker exercises on the activation of the hyoid muscles in healthy adults is currently unknown.OBJECTIVE:To investigate the effects of shaker exercises with varying force on the activation of the hyoid muscles in healthy adults.METHODS:Twenty healthy adults,including 10 males and 10 females with a mean age of(26.8±3.4)years were recruited as participants for the study.They performed isometric movements of the shaker exercise in the anterior neck and abdominal force modes in sequence.Simultaneously,real-time surface electromyography data were collected from the suprahyoid and infrahyoid muscles and rectus abdominis muscle.At the end of the experiment,participants were asked to rate the physical exertion levels for each type of force using the Borg Rating of Perceived Exertion Scale at the end of the training.Following a series of processing of the original electromyography signals,the peak amplitude and/or average amplitude values of the suprahyoid and infrahyoid muscles and rectus abdominis in the 60-second movement window were calculated and compared,and the differences in the subjective fatigue scores corresponding to the two force modes were compared.RESULTS AND CONCLUSION:The average amplitude of the rectus abdominis muscle in the abdominal force mode was found to be higher than that in the neck force mode(P<0.05).However,there were no significant differences in the mean and peak amplitudes between the suprahyoid and infrahyoid muscles in the two force modes(P>0.05).There was also no significant difference in the Borg Rating of Perceived Exertion Scale scores in the two force modes(P>0.05).These findings suggest that shaker exercises with different force modes(anterior neck and abdomen)have minimal impact on the hyoid muscles and similar feeling of fatigue in healthy adults.

Objective To investigate the correlation between the voice handicap index(VHI)and motor symp-toms,cognitive function,and respiratory function in Parkinson disease(PD).Methods A total of 124 patients with PD hospitalized in the Parkinson Medical Center,Beijing Rehabilitation Hospital,Capital Medical University from April 2020 to March 2023 were included,and the general data of the subjects were collected.We used the Hoehn and Yahr scale to determine the clinical stage of the PD patients;the Movement Disorder Society Unified Parkinson Disease Rating Scale Part Ⅲ(MDS-UPDRS Ⅲ)to assess the motor symptoms of the patients;the VHI-10 to assess voice status;the Parkinson's Disease-Cognitive Rating Scale(PD-CRS),the Trail Making Test(TMT),and the Digit Symbol Substitution Test(DSST)to assess cognitive function;and the forced vital capacity(FVC),forced expiratory volume in the 1st second(FEV1),FEV1/FVC,and maximal voluntary ventilation(MVV)to measure respiratory function.The correlation between voice sta-tus and motor symptoms,cognitive function,and respiratory function in patients with PD using Spearman correlation analy-sis.Results The VHI-10 score of the PD patients was positively correlated with the MDS-UPDRS Ⅲ score,facial expression score,rigidity score,axial symptom score,and time to complete the TMT(r=0.20,0.22,0.18,0.31,0.22;P＜0.05),and was negatively correlated with the DSST score and FEV1/FVC(r=-0.24,-0.24;P＜0.05).Conclusion Voice impairment in PD patients may be influenced by multiple factors and may correlate with motor symptoms,cognitive function,and respira-tory function.

ObjectiveTo investigate the current trend of non-drug therapy for gait abnormality of Parkinson's disease. MethodsThe clinical trials about non-drug therapy for gait abnormality of Parkinson's disease were retrieved from the clinical trial registration platform ClinicalTrials.gov, from inception to October 25th, 2022. The records were screened by two researchers independently, and the registration time, registration count, sample sizes, interventions, primary outcome measurements and study design, etc., were summarized and analyzed, according to the PICOS principle. ResultsA total of 218 eligible records were included. The registration count increased in recently years. Almost all of the trials (93.6%) were with a relatively small sample size less than 100, mainly 21 to 30 cases. The major intervention approach was the neuromodulation technique, however, virtual reality and robot-assisted gait training were coming to use in recent years. The primary outcome measurements were the clinical scales, the questionnaires and the exercise examinations. Randomized parallel controlled trials were the most (111, 50.9%). ConclusionThe number of non-drug therapy for gait abnormality of Parkinson's disease increased year by year. The new technologies such as virtual reality and robot-assisted gait training may be used more in the future.

Objective Our objective was to identify factors predicting health-related quality of life (HRQoL) in patients with Parkinson's disease (PD) Methods A cross-sectional study was carried out in 161 PD patients. QoL was assessed with the PDQ-39.Motor symptoms and non-motor symptoms were evaluated by a list of assessment tools including the Hoehn and Yahr scale,The Movement Disorder Society Unified Parkinson Disease Rating Scale et al. The Spearman correlation coefficient r was used to evaluate the correlation between PDQ-39 and motor and non-motor factors. Multiple linear regression models were used to demonstrate whether the factors investigated contribute significantly to QoL. Results PDQ-39 Summary Index was highly correlated with Voice handicap index(r=0.616) and correlated at a moderate level (r=0.30-0.50) with UPDRS-I,UPDRS-II,Parkinson Fatigue Scale,Modified Apathy Evaluation Scale,Geriatric Depression Scale,Gait and Falls Questionnaire,Eating Assessment Tool Scale. Depression,gait,swallowing,voice handicap and gender were independent predictors of HRQoL in the multivariate analysis model. Depression showed to be the most consistent determinant of HRQoL,followed by gait problems,swallowing,voice handicap and gender. Conclusion Depression,gait problems,swallowing,voice handicap and gender are significant factors contributing to a poor quality of life in Parkinson's disease patients. Swallowing and voice handicap,as well as depression,gait problems that are widely recognized,are also factors that cannot be ignored.

Methods The literatures on rehabilitation for Parkinson's disease in the Web of Science Core Collection Database fromthe establishment of the library to December, 2021 were retrieved. The sources, authors, institutions, cited literature and keywords of the literatures were visually analyzed with CiteSpace 5.8.R3 software. ObjectiveTo investigate the hot spots and trends of researches related to rehabilitation for Parkinson's disease. ResultsThe most of researches came from the United States. The author publishing the most researches was Bastiaan R Bloem and the institute was Radboud University. The keywords such as basal ganglia, movement, abnormalities were the most frequent. The top three bursted keywords were physical therapy, non-motor symptoms and stride regulation. Keywords attracting more attention in recent years were non-motor symptoms and virtual reality. ConclusionThe research on rehabilitation for Parkinson's disease is increasing, and new technologies can be used to enhance rehabilitation effects.

The core symptoms of Parkinson's disease include motor symptoms and non-motor symptoms. For the motor symptoms, the rehabilitation includes the basic training of joints, gait training, the training of core muscle group and posture balance, the training of oral, facial, neck muscle and pharyngeal reflex, the training of lip movement, vocalization, sound volume, rhythm and speed, and the training of deep breathing exercises and abdominal pressure. For the non-motor symptoms, the rehabilitation includes the training of memory, attention, problem solving ability, activities of daily living and others, psychotherapy, family support, social participation, and other comprehensive treatments combined with medicine.

Dysphagia commonly occurs in Parkinson's disease (PD) at any stage, which may result in serious complications. The mechanism is uncertain. Swallowing Disturbance Questionnaire (SDQ) and Munich Dysphagia Test-Parkinson's Disease (MDT-PD) are often used for screening dysphagia in PD patients. But Non-motor Symptoms Questionnaire (NMSQ) and Unified Parkinson's Disease Rating Scale (UPDRS) underestimate the severity of dysphagia in PD patients. Videofluoroscopic Swallowing Examination (VFSE) and Videoendoscoptic Swallowing Study (VESS) are the gold standards for the dysphagia. There is no systemic management yet. Interventions includes medication, deep brain stimulation, etc. Early diagnosis and management facilitate to decrease the complications.