BACKGROUND:A large number of studies have found that pyroptosis is closely related to the occurrence and development of motor system diseases,but there are few studies and reviews on pyroptosis in motor system diseases.OBJECTIVE:To review the current clinical and preclinical studies,summarize the role of pyroptosis in motor system diseases and related molecular mechanisms,and provide reference for the pyroptosis-targeted treatment for motor system diseases in the future.METHODS:The relevant literatures in PubMed and CNKI database were searched by computer from January 2000 to January 2024.The English search terms were"pyroptosis,tendons,ligaments,cartilage,muscles,bones"and the Chinese search terms were"pyroptosis,tendon,ligament,cartilage,skeletal muscle,bone"in Chinese.A combination of subject terms and free search terms was used.There were a total of 422 documents,including 334 in English and 88 in Chinese.After excluding duplicate literature and irrelevant literature,the literature without inclusion value was further excluded by reading the whole paper,and finally 78 documents were included for review and analysis.RESULTS AND CONCLUSION:Different pathways of pyroptosis and subsequent inflammatory responses can affect the progression of motor system diseases and the repair process of injuries.Excessive pyroptosis can not only cause a large number of tissue cells to die,but also aggravate tissue inflammation and degrade the extracellular matrix through substances such as inflammatory factors released after cell lysis,and damaging related molecular patterns can act as upstream signals to further aggravate pyroptosis.Current methods for preventing and treating motor system diseases mainly include NOD-like receptor thermal protein domain-associated protein 3 inhibitors,Chinese herbal extracts,exosome therapy,mesenchymal stem cell therapy,and exercise therapy.The review suggests that targeted intervention of some key factors in the process of pyroptosis may be a new direction for the treatment and prevention of motor system diseases.

Objective:To explore the impact of a comprehensive fall prevention training program on early postural con-trol disorders in elderly patients with Parkinson's disease(PD).Method:Thirty-five early PD patients were randomized into two groups:a conventional training group(n=18)and a fall prevention training group(n=17).Both groups received standard pharmacological therapy and routine functional training,which included strength training and aerobic exercise.The fall prevention training group ad-ditionally received posture control training based on central regulatory mechanisms.All the training were con-ducted 5 sessions per week over an 8-week period.Assessments were performed using a dynamic and static balance training system prior to the program and again after 8 weeks of intervention.The evaluation comprised the sensory organization test(SOT),limits of stability(LOS),and timed up and go test(TUG),as well as the unified Parkinson's disease rating scale Ⅲ(UPDRS-Ⅲ)and Parkinson's disease questionnaire 39(PDQ-39).Result:Within-group comparisons:the total SOT score,SOT proprioception,SOT vestibular function,and the max excursions(MXE)in forward,backward,leftward,and rightward directions in the fall prevention training group were significantly higher after treatment(P<0.05).The visual dependency and visual scores of the SOT in the fall prevention training group did not show significant differences compared to before treat-ment(P>0.05).In the conventional training group,there were no significant differences in total SOT scores,SOT proprioception,SOT visual dependence,SOT vestibular function,or visual scores before and after treat-ment(P>0.05).The leftward MXE in the conventional training group showed a significant increase after treat-ment(P<0.05),while there were no significant differences in forward,backward,and rightward MXE(P>0.05).Both groups exhibited significant decreased TUG,UPDRS-Ⅲ,and PDQ-39 scores after treatment(P<0.05).Between-group comparisons:the total SOT score and vestibular function score in the fall prevention training group was higher than in the conventional training group after treatment(P<0.05,P<0.01).The TUG score in the fall prevention training group was lower than in the conventional training group after treatment(P<0.05).Prior to treatment,there were no significant differences in all indicators between the two groups(P>0.05).There were no significant differences in SOT proprioception,SOT visual dependence,SOT visual scores,MXE in forward,backward,leftward,and rightward directions,UPDRS-Ⅲ,and PDQ-39 after treat-ment between the two groups(P>0.05).Conclusion:The fall prevention training program designed for early PD patients in this study can significantly improve the balance-related sensory integration,proprioception,and vestibular function in these patients,en-hance their MXE in LOS.However,the effects on functional mobility,motor function,and quality of life re-main unclear.Further studies are needed to explore the long-term efficacy of this training program on early postural control disorders in PD patients and its effects on PD patients with cognitive impairments.

BACKGROUND:Various clinical strategies for the treatment of tendinopathy have good short-term effects but poor long-term effects,and some studies have proven that mitochondria are closely related to the occurrence and development of tendinopathy.However,the relationship between mitochondria and tendinopathy and mitochondria-targeting therapeutic strategies for tendinopathy have not been summarized so far,which is not good for specialists and scholars in related fields to understand the recent research situation.OBJECTIVE:To review the existing clinical or preclinical original studies,in order to summarize the relationship between mitochondrial dysfunction and tendinopathy and the mitochondria-targeting methods for the treatment of tendinopathy,and to provide certain prospects for the evaluation and management of mitochondria in tendinopathy in the future.METHODS:The relevant literatures in PubMed,Web of Science,CNKI,WanFang and VIP databases were searched.The search time was from January 2009 to March 2024,and the search terms were"tendinopathy,tendon injuries,tendon,tendons,mitochondria,mitochondria dysfunction,mitochondria disease"both in English and Chinese.According to the exclusion and inclusion criteria,62 articles were finally included for review and analysis.RESULTS AND CONCLUSION:(1)In clinical tendinopathy patients or tendinopathy models,mitochondrial dysfunction is common,mainly represented by excessive production of reactive oxygen species,decreased activity of superoxide dismutase,ridge clutter and decreased number of mitochondria,which indicates that mitochondrial dysfunction will occur due to tendon injury,thus further worsening tendinopathy and forming a vicious cycle.(2)When the tendon has not been injured or tendinopathy has not yet occurred,the mitochondrial function will be affected by various internal and external factors,resulting in tendinopathy.This indicates that the normal tendon will be damaged,lesioned or even ruptured due to the abnormal function of the mitochondria.(3)Mechanical tensile stress,advanced glycosylation end products,aging and other internal and external factors are the main causes of mitochondrial dysfunction,and these factors will damage and weaken the biological activity and mechanical properties of normal tendons through molecular mechanisms such as apoptosis,inflammation and respiratory chain damage,and thereby induce tendinopathy.(4)According to molecular mechanisms,mitochondria-targeting therapies mainly include mitochondrial transfer/transplantation,transplantation,targeted antioxidants,etc.(5)This review mainly aims at clinical patients with tendinopathy or animal models with similar modeling methods,providing a reliable idea for clinical exploration of the pathogenesis of tendinopathy and targeted therapies for tendinopathy.However,the disadvantage is that the included studies are mainly animal experiments,and there is a lack of more clinical trials for verification.

BACKGROUND:A large number of studies have found that pyroptosis is closely related to the occurrence and development of motor system diseases,but there are few studies and reviews on pyroptosis in motor system diseases.OBJECTIVE:To review the current clinical and preclinical studies,summarize the role of pyroptosis in motor system diseases and related molecular mechanisms,and provide reference for the pyroptosis-targeted treatment for motor system diseases in the future.METHODS:The relevant literatures in PubMed and CNKI database were searched by computer from January 2000 to January 2024.The English search terms were"pyroptosis,tendons,ligaments,cartilage,muscles,bones"and the Chinese search terms were"pyroptosis,tendon,ligament,cartilage,skeletal muscle,bone"in Chinese.A combination of subject terms and free search terms was used.There were a total of 422 documents,including 334 in English and 88 in Chinese.After excluding duplicate literature and irrelevant literature,the literature without inclusion value was further excluded by reading the whole paper,and finally 78 documents were included for review and analysis.RESULTS AND CONCLUSION:Different pathways of pyroptosis and subsequent inflammatory responses can affect the progression of motor system diseases and the repair process of injuries.Excessive pyroptosis can not only cause a large number of tissue cells to die,but also aggravate tissue inflammation and degrade the extracellular matrix through substances such as inflammatory factors released after cell lysis,and damaging related molecular patterns can act as upstream signals to further aggravate pyroptosis.Current methods for preventing and treating motor system diseases mainly include NOD-like receptor thermal protein domain-associated protein 3 inhibitors,Chinese herbal extracts,exosome therapy,mesenchymal stem cell therapy,and exercise therapy.The review suggests that targeted intervention of some key factors in the process of pyroptosis may be a new direction for the treatment and prevention of motor system diseases.

Objective:To explore the impact of a comprehensive fall prevention training program on early postural con-trol disorders in elderly patients with Parkinson's disease(PD).Method:Thirty-five early PD patients were randomized into two groups:a conventional training group(n=18)and a fall prevention training group(n=17).Both groups received standard pharmacological therapy and routine functional training,which included strength training and aerobic exercise.The fall prevention training group ad-ditionally received posture control training based on central regulatory mechanisms.All the training were con-ducted 5 sessions per week over an 8-week period.Assessments were performed using a dynamic and static balance training system prior to the program and again after 8 weeks of intervention.The evaluation comprised the sensory organization test(SOT),limits of stability(LOS),and timed up and go test(TUG),as well as the unified Parkinson's disease rating scale Ⅲ(UPDRS-Ⅲ)and Parkinson's disease questionnaire 39(PDQ-39).Result:Within-group comparisons:the total SOT score,SOT proprioception,SOT vestibular function,and the max excursions(MXE)in forward,backward,leftward,and rightward directions in the fall prevention training group were significantly higher after treatment(P<0.05).The visual dependency and visual scores of the SOT in the fall prevention training group did not show significant differences compared to before treat-ment(P>0.05).In the conventional training group,there were no significant differences in total SOT scores,SOT proprioception,SOT visual dependence,SOT vestibular function,or visual scores before and after treat-ment(P>0.05).The leftward MXE in the conventional training group showed a significant increase after treat-ment(P<0.05),while there were no significant differences in forward,backward,and rightward MXE(P>0.05).Both groups exhibited significant decreased TUG,UPDRS-Ⅲ,and PDQ-39 scores after treatment(P<0.05).Between-group comparisons:the total SOT score and vestibular function score in the fall prevention training group was higher than in the conventional training group after treatment(P<0.05,P<0.01).The TUG score in the fall prevention training group was lower than in the conventional training group after treatment(P<0.05).Prior to treatment,there were no significant differences in all indicators between the two groups(P>0.05).There were no significant differences in SOT proprioception,SOT visual dependence,SOT visual scores,MXE in forward,backward,leftward,and rightward directions,UPDRS-Ⅲ,and PDQ-39 after treat-ment between the two groups(P>0.05).Conclusion:The fall prevention training program designed for early PD patients in this study can significantly improve the balance-related sensory integration,proprioception,and vestibular function in these patients,en-hance their MXE in LOS.However,the effects on functional mobility,motor function,and quality of life re-main unclear.Further studies are needed to explore the long-term efficacy of this training program on early postural control disorders in PD patients and its effects on PD patients with cognitive impairments.

BACKGROUND:Various clinical strategies for the treatment of tendinopathy have good short-term effects but poor long-term effects,and some studies have proven that mitochondria are closely related to the occurrence and development of tendinopathy.However,the relationship between mitochondria and tendinopathy and mitochondria-targeting therapeutic strategies for tendinopathy have not been summarized so far,which is not good for specialists and scholars in related fields to understand the recent research situation.OBJECTIVE:To review the existing clinical or preclinical original studies,in order to summarize the relationship between mitochondrial dysfunction and tendinopathy and the mitochondria-targeting methods for the treatment of tendinopathy,and to provide certain prospects for the evaluation and management of mitochondria in tendinopathy in the future.METHODS:The relevant literatures in PubMed,Web of Science,CNKI,WanFang and VIP databases were searched.The search time was from January 2009 to March 2024,and the search terms were"tendinopathy,tendon injuries,tendon,tendons,mitochondria,mitochondria dysfunction,mitochondria disease"both in English and Chinese.According to the exclusion and inclusion criteria,62 articles were finally included for review and analysis.RESULTS AND CONCLUSION:(1)In clinical tendinopathy patients or tendinopathy models,mitochondrial dysfunction is common,mainly represented by excessive production of reactive oxygen species,decreased activity of superoxide dismutase,ridge clutter and decreased number of mitochondria,which indicates that mitochondrial dysfunction will occur due to tendon injury,thus further worsening tendinopathy and forming a vicious cycle.(2)When the tendon has not been injured or tendinopathy has not yet occurred,the mitochondrial function will be affected by various internal and external factors,resulting in tendinopathy.This indicates that the normal tendon will be damaged,lesioned or even ruptured due to the abnormal function of the mitochondria.(3)Mechanical tensile stress,advanced glycosylation end products,aging and other internal and external factors are the main causes of mitochondrial dysfunction,and these factors will damage and weaken the biological activity and mechanical properties of normal tendons through molecular mechanisms such as apoptosis,inflammation and respiratory chain damage,and thereby induce tendinopathy.(4)According to molecular mechanisms,mitochondria-targeting therapies mainly include mitochondrial transfer/transplantation,transplantation,targeted antioxidants,etc.(5)This review mainly aims at clinical patients with tendinopathy or animal models with similar modeling methods,providing a reliable idea for clinical exploration of the pathogenesis of tendinopathy and targeted therapies for tendinopathy.However,the disadvantage is that the included studies are mainly animal experiments,and there is a lack of more clinical trials for verification.

BACKGROUND:Increasing studies have found that estrogen has a certain correlation with tendinopathy,but for a long time,there are few experiments and summaries of estrogen in tendinopathy,which makes it difficult for specialists and scholars in related fields to fully understand the research status. OBJECTIVE:To summarize the current clinical or preclinical original research,so as to summarize the role of estrogen in tendinosis,and make a certain prospect for the evaluation and management of estrogen in tendinosis in the future. METHODS:Relevant literature in PubMed,Web of Science,CNKI,WanFang,and VIP databases were searched by computer.Search time was from January 2008 to September 2023.The search terms were"oestrogen,estrogen,estrogen receptor,tendinopathy,tendonopathy,sinew,tendon,tendons,myotenositis"in English and"estrogen,estrogen receptor,tendinosis,tendon,tendinitis"in Chinese.According to the selection criteria,the search results were screened and excluded,and finally 60 documents were included for review and analysis. RESULTS AND CONCLUSION:In vivo studies have shown that estrogen can promote tendon anabolism.In vitro experiments have also proved that various estrogens can promote the proliferation of tendon cells and reduce inflammation and apoptosis,but most of the experiments are limited to animal models.Estrogen receptor β acts more in tendon injury and repair processes,but estrogen receptor α has not been found to have a major impact on tendon injury.The expression of estrogen receptor β can repair the tendon by affecting the formation of fat,the deposition of type I collagen and reducing the apoptosis of tendon cells,while its over-expression may promote inflammation and angiogenesis,thus promoting the inflammatory process and playing a role in tendon injury.Animal studies have shown that estrogen deficiency may reduce the synthesis efficiency of collagen in the tendon,decrease the elasticity of tendon,inhibit the synthesis and metabolism of the tendon,which is not conducive to the repair of tendon injury,while normal level of estrogen may stimulate the synthesis of type I collagen in tendon and promote the proliferation and metabolism of tendon cells.At present,the molecular mechanism of estrogen in tendon injury has not been fully explained.More experiments focus on tendon collagen synthesis,cell proliferation and apoptosis.Only a few documents have studied the molecular mechanisms of estrogen receptor β deficiency regulating interferon regulatory factor 5-chemokine ligand 3 axis,E2 regulating estrogen receptor α and PI-3K-Akt signaling pathways,and high levels of estradiol reducing the level of free-circulating insulin-like growth factor.Various estrogens,including endogenous estrogens and phytoestrogens,are beneficial to the repair of tendinopathy at normal levels,and estrogen receptor β mainly affects the formation of fat,the deposition of type I collagen and the reduction of apoptosis of tendon cells through,which lays a foundation for the future treatment of tendinopathy with different subtypes of estrogens in vivo and the influence of estrogen membrane receptors on tendinopathy.

Objective:To evaluate the success rate and influencing factors of auscultation-assisted bedside blind placement of the spiral nasojejunal feeding tube in oldest-old patients.Methods:A case series study was conducted in those elderly hospitalized patients who met the indications for naso intestinal intubation from January 2019 to May 2021 in China-Japan Friendship Hospital. Auscultation-assisted bedside blind placement of the spiral nasojejunal feeding tube was implemented. In addition, abdominal X-ray imaging was performed to confirm the location of the catheter tip. The primary indicators included were the success rate and the first attempt success rate of nasojejunal tube placement;, while the secondary indicators included were the number of attempts and the time of insertion. The rate of operational-related adverse events was ustreated as to evaluate the indicator of safety. Logistic regression analysis was used to conduct multi factor analysis.Results:The total success rate and the first-attempt success rate of tube implantation reached were 90.1%(73/81) and 85.2%(69/81), respectively. The mean attempt per individual patient was (1.2 ± 0.2) times for each patient. The median length of operation time was 40.0(27.0, 45.0) minutes, more specifically, among which the median length time of nasogastric and gastrojejunal placement was 20.0(15.0, 25.0) and 18.0(12.5, 20.0) minutes, respectively; while the median lengthtime of nasogastric placement was greaterhigher than that of gastrojejunal placement ( Z = -2.78, P<0.05). As suggested by multivariate analysis, indicated that the conscious conditions of patients had a signific antlyimpact affect on the success rate of for tube implantation ( OR = 19.25, 95% CI 1.24-299.63, P<0.05). In addition, the incidence rate of operational-related adverse events was 37.0%(30/81). By contrast, there were no serious adverse events occurring during the study period. Conclusions:The auscultation-assisted bedside blind placement of the nasojejunal feeding tube technique is effective and safe for early nutrition support in oldest-old patients in terms of early nutritionsupport, the success rate of which is significant largely affected by the patients′ conscious conditions of patients.

Diffusion tensor imaging (DTI) is a noninvasive MRI technique, which can identify changes in microstructure of the brain, especially in the variations of the nerve fiber bundles. For stroke rehabilitation, DTI is applied in the functional evaluation and prognosis, ba-sic experimental research and efficacy evaluation of rehabilitation therapy.