OBJECTIVE:Repetitive transcranial magnetic stimulation and transcranial direct current stimulation have shown positive effects in improving gross motor function in children with cerebral palsy.A network meta-analysis was performed to analyze the clinical efficacy of repetitive transcranial magnetic stimulation and transcranial direct current stimulation on the improvement of lower limb motor function and gait in children with cerebral palsy.METHODS:Randomized controlled trials(RCT)about repetitive transcranial magnetic stimulation and transcranial direct current stimulation on lower limb motor function and gait in children with cerebral palsy were collected from CNKI,WanFang,VIP,SinoMed,PubMed,Web of Science,Medline.The search time limit was from the inception to October 5,2024.After screening literature,extracting data and evaluating the risk of bias of included studies,Stata 15.0 software was used for network meta-analysis,AND GRADE profiler was used for quality evaluation.RESULTS:A total of 19 studies were included,involving 4 treatment measures:conventional therapy,high-frequency repetitive transcranial magnetic stimulation,low-frequency repetitive transcranial magnetic stimulation and anodic transcranial direct current stimulation.The results of network meta-analysis showed that in terms of improving gross motor function,low-frequency repetitive transcranial magnetic stimulation[mean difference(MD)=9.48,95％confidence interval(CI)(6.61,12.34),P＜0.05]was the most effective.In terms of alleviating spasticity,high-frequency repetitive transcranial magnetic stimulation[MD=-0.63,95％CI(-1.72,0.45),P＜0.05]had the best efficacy.In terms of improving ankle joint range of motion and step speed,transcranial direct current stimulation[MD=2.27,95％CI(1.37,3.17),P＜0.05;MD=0.11,95％CI(0.05,0.17),P＜0.05]was the most effective.CONCLUSION:Existing clinical evidence suggests that low-frequency repetitive transcranial magnetic stimulation has the best therapeutic effect compared with other intervention measures in terms of improving lower limb gross motor function.In terms of reducing spasticity,high-frequency repetitive transcranial magnetic stimulation has a more significant effect.In terms of improving gait,transcranial direct current stimulation has more advantages.

OBJECTIVE:Repetitive transcranial magnetic stimulation and transcranial direct current stimulation have shown positive effects in improving gross motor function in children with cerebral palsy.A network meta-analysis was performed to analyze the clinical efficacy of repetitive transcranial magnetic stimulation and transcranial direct current stimulation on the improvement of lower limb motor function and gait in children with cerebral palsy.METHODS:Randomized controlled trials(RCT)about repetitive transcranial magnetic stimulation and transcranial direct current stimulation on lower limb motor function and gait in children with cerebral palsy were collected from CNKI,WanFang,VIP,SinoMed,PubMed,Web of Science,Medline.The search time limit was from the inception to October 5,2024.After screening literature,extracting data and evaluating the risk of bias of included studies,Stata 15.0 software was used for network meta-analysis,AND GRADE profiler was used for quality evaluation.RESULTS:A total of 19 studies were included,involving 4 treatment measures:conventional therapy,high-frequency repetitive transcranial magnetic stimulation,low-frequency repetitive transcranial magnetic stimulation and anodic transcranial direct current stimulation.The results of network meta-analysis showed that in terms of improving gross motor function,low-frequency repetitive transcranial magnetic stimulation[mean difference(MD)=9.48,95％confidence interval(CI)(6.61,12.34),P＜0.05]was the most effective.In terms of alleviating spasticity,high-frequency repetitive transcranial magnetic stimulation[MD=-0.63,95％CI(-1.72,0.45),P＜0.05]had the best efficacy.In terms of improving ankle joint range of motion and step speed,transcranial direct current stimulation[MD=2.27,95％CI(1.37,3.17),P＜0.05;MD=0.11,95％CI(0.05,0.17),P＜0.05]was the most effective.CONCLUSION:Existing clinical evidence suggests that low-frequency repetitive transcranial magnetic stimulation has the best therapeutic effect compared with other intervention measures in terms of improving lower limb gross motor function.In terms of reducing spasticity,high-frequency repetitive transcranial magnetic stimulation has a more significant effect.In terms of improving gait,transcranial direct current stimulation has more advantages.

Objective:To observe the effect of acupuncture-synchronized exercise training on the learning and memory of rats after middle cerebral artery occlusion (MCAO), and to explore its mechanism.Methods:Among sixty 8-week-old SPF-grade Sprague-Dawley male rats, 6 were randomly chosen to form a sham group, and the rest received MCAO. After successful modeling, 18 rats were assigned at random to either the model, asynchronous or synchronous group, each of 6. The asynchronous group received 20 minutes of acupuncture followed by 20 minutes of treadmill training, while the synchronous group received the acupuncture during their treadmill training. There was no special intervention for the sham and model groups. There were 5 sessions/week for 21 days. Neurological deficit in the rats was assessed using Longa scoring 24h after the modeling and after the 21 days. The localization navigation test was performed on days 17-20 of the experiment, and the latency to escape was recorded. A space exploration experiment was performed the next day, and rats were tested for dwell time and the number of transits of the original platform quadrant. After the intervention, the morphology of hippocampal tissue was observed using HE staining. The mitochondria of the rats′ hippocampal neurons were observed using transmission electron microscopy. MDA and SOD levels were recorded. And the protein expression levels of the Parkin, PINK1, LC3-II/ LC3-Ⅰ, P62 and Beclin-1 genes were detected using western blotting.Results:The model group showed significantly higher average Longa scores than the sham group, with less time spent in the target quadrant and fewer crossings of the platform quadrant. The HE staining revealed numerous degenerating neurons, and swollen mitochondria with vacuolization and sparse cristae. There was also a significant decrease in Parkin, PINK1, LC3-II/LC3-I and Beclin-1 expression and in SOD. But there was a significant increase in P62 expression and MDA, on average. Compared with the model group, both the non-synchronous and synchronous groups showed significantly lower average Longa scores, with more time spent in the target quadrant and more platform crossings. Their neuron morphology was close to normal, with more intact cristae and autophagic bodies in the mitochondria. Those groups showed greater Parkin, PINK1, LC3-II/LC3-I and Beclin-1 expression and had higher SOD levels, on average, with significantly lower P62 expression and less MDA. But compared with the non-synchronous group, the synchronous group spent more time in the target quadrant and had significantly more platform crossings. LC3-II/LC3-I and Beclin-1 expression were higher, on average, as were SOD levels. P62 expression and MDA levels were significantly lower.Conclusions:Acupuncture synchronized with exercise improves the learning and memory of rates after MCAO. The mechanism may be related to reducing oxidative stress levels and activating mitochondrial autophagy.

Objective:To explore the correlation between abdominal muscle morphological parameters and balance func-tion indexes in stroke patients,and to elucidate the mechanism of core muscle groups in postural control,so as to provide evidence-based basis for optimizing the rehabilitation assessment system and intervention strate-gies for balance disorders after stroke.Method:A total of 60 stroke patients admitted to the Rehabilitation Center of the Affiliated Hospital of Shan-dong University of Traditional Chinese Medicine from March to December 2024 were selected.The musculosk-eletal ultrasound diagnostic system was used to quantitatively measure the muscle fiber thickness of the exter-nal abdominal oblique muscle(EO),internal oblique muscle(IO)and transverse abdominis muscle(TrA),and the balance test system was used to collect the center of gravity swing parameters of the patient's stand-ing on both feet with eyes open and closed,including the area of the motion ellipse and the length of the tra-jectory.Correlation analysis was used to evaluate the correlation between abdominal muscle thickness ratio(af-fected side/unaffected side)and thickening rate(contraction/relaxation)and balance parameters,and the predic-tive performance of each abdominal muscle parameter was analyzed by receiver operating characteristic curve(ROC).Result:Bilateral abdominal muscle thickness asymmetry was observed in stroke patients,and the abdominal muscle thickness ratio in patients in the subacute stage was significantly lower than that in the chronic phase(P＜0.05),but the thickening rate was higher(P＜0.05).The abdominal muscle thickness ratio and thickening rate were significantly negatively correlated with the motion elliptical area and exercise length in the open and closed states(r=-0.273—-0.807,P＜0.05).The prediction model analysis showed that the prediction efficien-cy of transverse abdominis(TrA)muscle thickening rate was the best(AUC=0.797),while the combined pre-diction efficiency of internal oblique(IO)muscle and TrA thickening rate was the highest(AUC=0.835).Conclusion:Bilateral abdominal muscle thickness asymmetry occurs in stroke patients and is related to the course of the disease.Abdominal muscle thickness parameters were negatively correlated with balance function,and the thickening rate of TrA and IO could be used as effective predictors to evaluate the balance function of stroke patients,and musculoskeletal ultrasound could be used as a quantitative evaluation tool for abdomi-nal muscle thickness in stroke patients.

Objective:To explore the correlation between abdominal muscle morphological parameters and balance func-tion indexes in stroke patients,and to elucidate the mechanism of core muscle groups in postural control,so as to provide evidence-based basis for optimizing the rehabilitation assessment system and intervention strate-gies for balance disorders after stroke.Method:A total of 60 stroke patients admitted to the Rehabilitation Center of the Affiliated Hospital of Shan-dong University of Traditional Chinese Medicine from March to December 2024 were selected.The musculosk-eletal ultrasound diagnostic system was used to quantitatively measure the muscle fiber thickness of the exter-nal abdominal oblique muscle(EO),internal oblique muscle(IO)and transverse abdominis muscle(TrA),and the balance test system was used to collect the center of gravity swing parameters of the patient's stand-ing on both feet with eyes open and closed,including the area of the motion ellipse and the length of the tra-jectory.Correlation analysis was used to evaluate the correlation between abdominal muscle thickness ratio(af-fected side/unaffected side)and thickening rate(contraction/relaxation)and balance parameters,and the predic-tive performance of each abdominal muscle parameter was analyzed by receiver operating characteristic curve(ROC).Result:Bilateral abdominal muscle thickness asymmetry was observed in stroke patients,and the abdominal muscle thickness ratio in patients in the subacute stage was significantly lower than that in the chronic phase(P＜0.05),but the thickening rate was higher(P＜0.05).The abdominal muscle thickness ratio and thickening rate were significantly negatively correlated with the motion elliptical area and exercise length in the open and closed states(r=-0.273—-0.807,P＜0.05).The prediction model analysis showed that the prediction efficien-cy of transverse abdominis(TrA)muscle thickening rate was the best(AUC=0.797),while the combined pre-diction efficiency of internal oblique(IO)muscle and TrA thickening rate was the highest(AUC=0.835).Conclusion:Bilateral abdominal muscle thickness asymmetry occurs in stroke patients and is related to the course of the disease.Abdominal muscle thickness parameters were negatively correlated with balance function,and the thickening rate of TrA and IO could be used as effective predictors to evaluate the balance function of stroke patients,and musculoskeletal ultrasound could be used as a quantitative evaluation tool for abdomi-nal muscle thickness in stroke patients.

Objective:To observe the effect of acupuncture-synchronized exercise training on the learning and memory of rats after middle cerebral artery occlusion (MCAO), and to explore its mechanism.Methods:Among sixty 8-week-old SPF-grade Sprague-Dawley male rats, 6 were randomly chosen to form a sham group, and the rest received MCAO. After successful modeling, 18 rats were assigned at random to either the model, asynchronous or synchronous group, each of 6. The asynchronous group received 20 minutes of acupuncture followed by 20 minutes of treadmill training, while the synchronous group received the acupuncture during their treadmill training. There was no special intervention for the sham and model groups. There were 5 sessions/week for 21 days. Neurological deficit in the rats was assessed using Longa scoring 24h after the modeling and after the 21 days. The localization navigation test was performed on days 17-20 of the experiment, and the latency to escape was recorded. A space exploration experiment was performed the next day, and rats were tested for dwell time and the number of transits of the original platform quadrant. After the intervention, the morphology of hippocampal tissue was observed using HE staining. The mitochondria of the rats′ hippocampal neurons were observed using transmission electron microscopy. MDA and SOD levels were recorded. And the protein expression levels of the Parkin, PINK1, LC3-II/ LC3-Ⅰ, P62 and Beclin-1 genes were detected using western blotting.Results:The model group showed significantly higher average Longa scores than the sham group, with less time spent in the target quadrant and fewer crossings of the platform quadrant. The HE staining revealed numerous degenerating neurons, and swollen mitochondria with vacuolization and sparse cristae. There was also a significant decrease in Parkin, PINK1, LC3-II/LC3-I and Beclin-1 expression and in SOD. But there was a significant increase in P62 expression and MDA, on average. Compared with the model group, both the non-synchronous and synchronous groups showed significantly lower average Longa scores, with more time spent in the target quadrant and more platform crossings. Their neuron morphology was close to normal, with more intact cristae and autophagic bodies in the mitochondria. Those groups showed greater Parkin, PINK1, LC3-II/LC3-I and Beclin-1 expression and had higher SOD levels, on average, with significantly lower P62 expression and less MDA. But compared with the non-synchronous group, the synchronous group spent more time in the target quadrant and had significantly more platform crossings. LC3-II/LC3-I and Beclin-1 expression were higher, on average, as were SOD levels. P62 expression and MDA levels were significantly lower.Conclusions:Acupuncture synchronized with exercise improves the learning and memory of rates after MCAO. The mechanism may be related to reducing oxidative stress levels and activating mitochondrial autophagy.

Objective:To evaluate the correlation between peri-implant probing depth (PPD) and radiographic bone level (rBL) in implants with peri-implantitis.Methods:From January 2019 to December 2022, 24 patients with 30 implants who suffered from peri-implantitis at the Department of Periodontology, Peking University School and Hospital of Stomatology were included in the present research. SPSS 26.0 software was used to simple random sampling select 30 healthy implants from which with electronic examination records in Department of Periodontology, Peking University School and Hospital of Stomatology from January 2007 to June 2023 as the control group. On the premise of retaining the implant prosthesis, PPD (distance between pocket bottom and peri-implant soft tissue margin) was examined using a Williams periodontal probe with a light force (about 0.2 N), and a total of 4 sites were recorded for each implant. Periapical radiography and cone beam CT were applied to measure the rBL (distance between the reference point at the neck of the implant and the apical point of the bone defect) and the width of the bone defect (DW), and the type of the bone defect was recorded. The correlation and consistency between the diagnosis of PPD and rBL were analyzed.Results:PPD was significantly correlated with rBL in a total of 60 implants in 180 sites ( r=0.64, P<0.001). The chi-square test showed an 8.15-fold increase in the detection rate of PD≥6 mm at sites with rBL≥1 mm ( P<0.001). Multivariate logistic regression analysis showed that rBL was still statistically associated with PPD after adjustment for jaw position and examination position of implants. Take rBL <1 mm as reference, the odds ratios ( OR) of 1 mm≤rBL<2 mm, 2 mm≤rBL<3 mm and rBL≥3 mm group with PPD were 6.23 ( P=0.014), 2.77 ( P=0.183) and 10.87 ( P=0.001), respectively. Conclusions:There is a positive correlation between PPD and rBL in implants with peri-implantitis. PPD can be used as a clinical examination index to assist in estimating the level of peri-implant bone under the premise of retaining the prosthesis.