Objective To explore the effect of the pneumatic and electric hand training system with multiple sensory stimulation mo-dalities combined with low-frequency repetitive transcranial magnetic stimulation on hand movement and tactile pressure sensation in patients with stroke.Methods From May,2023 to October,2024,62 stroke patients from the First Affiliated Hospital of University of South China were randomly divided into control group(n=31)and experimental group(n=31).Both groups received conventional rehabilitation,and 1 Hz low-frequency repetitive transcranial magnetic stimulation in the primary cerebral motor cortex on the unaffected side,while the experimental group received the pneumatic and electric hand training system with multiple sensory stimulation modalities in addition,for four weeks.They were as-sessed with Fugl-Meyer Assessment-Upper Extremities(FMA-UE),Motor Assessment Scale(MAS),Semmes Weinstein Monofilament Test(SWMT)and modified Barthel index(MBI)before and after treatment.Results One case dropped out in control group and one in the experimental group.After treatment,the scores of FMA-UE,MAS,SWMT and MBI increased in both groups(|t|>5.464,P<0.001),expect the score of SWMT in the control group(P>0.05),and all scores were better in the experimental group than in the control group(|t|>2.195,P<0.05).Conclusion The pneumatic and electric hand training system with multiple sensory stimulation modalities combined with low-frequency repetitive transcranial magnetic stimulation can improve the motor and tactile pressure func-tion of stroke patients,and improve their activity of daily living.

Objective To explore the effect of the pneumatic and electric hand training system with multiple sensory stimulation mo-dalities combined with low-frequency repetitive transcranial magnetic stimulation on hand movement and tactile pressure sensation in patients with stroke.Methods From May,2023 to October,2024,62 stroke patients from the First Affiliated Hospital of University of South China were randomly divided into control group(n=31)and experimental group(n=31).Both groups received conventional rehabilitation,and 1 Hz low-frequency repetitive transcranial magnetic stimulation in the primary cerebral motor cortex on the unaffected side,while the experimental group received the pneumatic and electric hand training system with multiple sensory stimulation modalities in addition,for four weeks.They were as-sessed with Fugl-Meyer Assessment-Upper Extremities(FMA-UE),Motor Assessment Scale(MAS),Semmes Weinstein Monofilament Test(SWMT)and modified Barthel index(MBI)before and after treatment.Results One case dropped out in control group and one in the experimental group.After treatment,the scores of FMA-UE,MAS,SWMT and MBI increased in both groups(|t|>5.464,P<0.001),expect the score of SWMT in the control group(P>0.05),and all scores were better in the experimental group than in the control group(|t|>2.195,P<0.05).Conclusion The pneumatic and electric hand training system with multiple sensory stimulation modalities combined with low-frequency repetitive transcranial magnetic stimulation can improve the motor and tactile pressure func-tion of stroke patients,and improve their activity of daily living.

BACKGROUND:Exercise training can improve osteoporosis,but its effects and mechanisms on senile osteoporosis are not fully understood. OBJECTIVE:To observe the effect of treadmill exercise on osteoporosis and wnt/β-catenin signal pathway in aged rats. METHODS:Sixteen 24-month-old male Sprague-Dawley rats were randomly divided into osteoporosis group(n=8)and treadmill group(n=8)and eight 6-month-old male Sprague-Dawley rats were used as young control group.The model of senile osteoporosis was replicated by natural aging and the rats in the treadmill group were treated with treadmill exercise once a day,5 days a week,for 8 weeks.Levels of bone metabolic markers such as type I collagen cross-linked C-terminal peptide,tartrate resistant acid phosphatase,osteocalcin and bone specific alkaline phosphatase were detected by ELISA;bone mineral density of the left femur and L5 was measured by dual energy X-ray;bone scanning and bone microstructure quantitative analysis were performed by bone micro-CT;and the mRNA and protein expression levels of wnt3a,β-catenin,LRP5,DKK1 and GSK3β were detected by RT-PCR and western blot,respectively. RESULTS AND CONCLUSION:Compared with the young control group,the osteoporosis group showed a reduction in serum bone specific alkaline phosphatase and osteocalcin levels(P<0.05),bone mineral density of the femur and L5,the number of tibia and L4 bone trabeculae,bone volume,bone volume fraction(P<0.05),and mRNA and protein expression of wnt3a,β-catenin,and LRP5 in bone marrow tissue(P<0.05)as well as an increase in serum levels of tartrate resistant acid phosphatase and type I collagen cross-linked C-terminal peptide(P<0.05),the intertrabecular space between the tibia and L4,structural model index(P<0.05),and mRNA and protein expression of DKK1 and GSK3 β in bone marrow tissue(P<0.05).In addition to the reduced number of trabeculae in the tibia and L4 vertebrae,the trabeculae were structurally disturbed and sparsely aligned and fractured.Compared with the osteoporosis group,the treadmill group showed an increase in serum bone specific alkaline phosphatase and osteocalcin levels(P<0.05),bone mineral density of the femur and L5(P<0.05),the number of tibial trabeculae,bone volume,bone volume fraction(P<0.05),mRNA and protein expression of wnt3a,β-catenin,and LRP5 in bone marrow tissue(P<0.05)but a reduction in the serum levels of tartrate resistant acid phosphatase and type I collagen cross-linked C-terminal peptide,L4 trabecular space,tibial trabecular space,structural model index,and mRNA and protein expression of DKK1 and GSK3 β in bone marrow tissue(P<0.05).In addition to the increased number of tibial and L4 trabeculae,the trabeculae were arranged in a regular and dense pattern and were connected to a network.To conclude,treadmill exercise may improve osteoporosis in aged rats by activating the wnt/β-catenin signal pathway.

BACKGROUND:There are many treatment methods for knee osteoarthritis,among which electroacupuncture,as an important non-drug treatment,is effective in the treatment of knee osteoarthritis,but its exact mechanism is not clear. OBJECTIVE:Effect of electroacupuncture on the expression of p53 and P21 in articular cartilage and subchondral bone of aged rats with knee osteoarthritis. METHODS:Eight 6-month-old male Sprague-Dawley rats were included in the young group and sixteen 24-month-old male Sprague-Dawley rats were randomly divided into old group(n=8)and electroacupuncture group(n=8).The rats in the electroacupuncture group received electroacupuncture stimulation once a day,5 days a week,for 8 continuous weeks,and the other two groups did not do any treatment.Eight weeks later,the level of type Ⅱ collagen C-terminal peptide in peripheral blood was detected by ELISA,the morphology of left knee cartilage and subchondral bone was observed by safranin O-fast green staining,the degree of knee cartilage degeneration was evaluated by modified Mankin's score,the microstructure of left knee cartilage and subchondral bone was detected by micro-CT,and the expression levels of matrix metalloproteinase 13,P53,P21 Mrna and protein were detected by RT-PCR and western blot respectively. RESULTS AND CONCLUSION:Compared with the young group,the level of C-terminal peptide of type Ⅱ collagen in the peripheral blood was increased in the old group(P<0.05).The micro-CT results showed that the bone volume fraction,bone mineral density and the number of bone trabeculae were decreased in the old group compared with the young group(P<0.05),while the trabecular separation increased(P<0.05).Safranin O-fast green staining showed that in the old group,the surface layer of cartilage was uneven with fissures,the morphology of chondrocytes was irregular and stained unevenly,the boundary between the cartilage and subchondral bone was blurred,and the matrix loss was serious.The Mankin's score was higher in the old group than the young group(P<0.05).The expression of matrix metalloproteinase 13,P53,P21 at Mrna and protein levels increased in the old group compared with the young group(P<0.05).Compared with the old group,electroacupuncture decreased the level of C-terminal peptide of type Ⅱ collagen(P<0.05),increased the bone volume fraction,bone mineral density and the number of bone trabeculae(P<0.05),and decreased the trabecular separation(P<0.05).Safranin O-fast green staining showed that in the electroacupuncture group,the surface of cartilage was smooth and red staining was uniform,and the cell morphology and structure were between the young group and the old group.Following electroacupuncture treatment,the Mankin's score(P<0.05),matrix metalloproteinase 13 and P21 Mrna expression(P<0.05),and matrix metalloproteinase 13 and P53 protein expression decreased(P<0.05),while there was a decreasing trend of P53 Mrna and P21 protein expression,but with no statistical significance(P>0.05).To conclude,electroacupuncture may delay articular cartilage degeneration and subchondral osteoporosis in aged rats by inhibiting the expression of P53 and P21,so as to protect joints and delay joint aging.