OBJECTIVES: This study aimed to explore the impact of cell spreading area on odontoblast polarization and differentiation using micropatterned surfaces ge-nerated by photolithography. METHODS: Micropatterned surfaces with differential adhesive properties were prepared using polyethylene glycol diacrylate (PEGDA)-ba-sed photolithography. Human dental pulp stem cells (hD-PSCs) were isolated into single cells and cultured on micropatterned surfaces with areas of 1 800, 2 700, and 3 600 μm². Immunofluorescence staining was used to observe cell morphology and analyze the relocating of the golgi apparatus and nucleus. Alkaline phosphatase staining was preformed to examine odontogenic differentiation. RESULTS: The hDPSCs were successfully isolated and cultured on micropatterned surfaces mimicking the morphology of polarized odontoblasts. Phalloidin staining confirmed that the isolated hDPSCs successfully recapitulated the morphology of predesigned micropatterns. Immunofluorescence staining showed that the polarization and differentiation levels of the hDPSCs with a 3600 μm² area were significantly higher than those with 1 800 and 2 700 μm² areas (P<0.05). CONCLUSIONS The polarization and differentiation of single hDPSCs increased with the cell areas on micropatterned surfaces.
Cell Differentiation ; Humans ; Dental Pulp/cytology* ; Odontoblasts/cytology* ; Stem Cells/cytology* ; Cells, Cultured ; Cell Polarity ; Surface Properties

BACKGROUND:Increasing evidence has indicated that early reinforcement of correct posture is particularly important for improving abnormal gait in stroke patients.Wearable exoskeleton-assisted training can improve patients'walking function in a short period of time,and can also assist the coordinated movement of muscles around the pelvis,hip,knee,and ankle joints,control the walking trajectory of the lower limbs,and improve walking ability in patients with stroke.OBJECTIVE:To explore the improvement of abnormal gait in stroke patients by a wearable exoskeleton with posture feedback,and to explore the rehabilitation mechanism.METHODS:A total of 52 patients in the recovery period of stroke admitted to the Affiliated Hospital of Jining Medical College from January 2023 to January 2024 were included in this study and randomly divided into an experimental group(n=26)and a control group(n=26)using a random number table method.Based on conventional rehabilitation training,the patients in the experimental group participated in training using a wearable exoskeleton with posture feedback(15 minutes per day,6 times per week),while those in the control group were given conventional gait therapy(15 minutes per day,6 times per week).Training in each group lasted for 4 weeks.Before and after training,the lower limb motor function scores,gait parameters(step length,step speed,step width)and gait symmetry were compared between the two groups,and the brain functional connectivity values of the prefrontal motor area,the primary motor cortex and the sensorimotor area were detected using portable near-infrared spectroscopy.RESULTS AND CONCLUSION:After training,lower limb motor function scores,gait parameters and gait symmetry were significantly improved in the two groups(P＜0.05).Meanwhile,the experimental group was superior to the control group in terms of gait parameters and gait symmetry(P＜0.05).Brain functional connectivity values of the right sensorimotor area-left prefrontal motor area and right sensorimotor area-right prefrontal motor area were significantly increased in the two groups after training(P＜0.05).The functional connectivity values of the left sensorimotor area-right primary motor cortex and left sensorimotor area-left primary motor cortex in the experimental group were increased after training(P＜0.05).Compared with the control group,the functional connectivity values of the left sensorimotor area-right primary motor cortex and left sensorimotor area-left primary motor cortex were increased in the experimental group after training(P＜0.05).To conclude,based on conventional rehabilitation training,a wearable exoskeleton with posture feedback can not only effectively improve the abnormal gait of stroke patients,but also activate the functional sensorimotor areas of the brain associated with abnormal gait.

Objective:To explore the effects of respiratory muscle training(RMT)combined with phrenic nerve electrical stimulation(PNES)on coughing ability and lung function in stroke patients with pulmonary infection.Method:A total of 66 patients with pulmonary infection after stroke,admitted to our hospital from January 2022 to January 2024,were randomly assigned to either an observation group or a control group,with 33 cas-es in each group.During the study,three patients from each group dropped out.Both groups received conven-tional pharmacological and rehabilitation treatment.Additionally,the observation group received combined RMT and PNES,administered once a day,5 days per week,for 4 weeks.Outcome measures included:Cough peak flow rate(CPF),Clinical Pulmonary Infection Score(CPIS),and Borg Dyspnea Scale scores,assessed at baseline,1 week,2 weeks,and 4 weeks.Pulmonary function tests were performed at baseline and after 4 weeks,including maximum inspiratory pressure(MIP),maximum expiratory pressure(MEP),forced vital ca-pacity(FVC),forced expiratory volume in the first second(FEV1),maximum volume per minute(MVV).The percentages of predicted values(FVC％,FEV1％,MVV％)were calculated.Coughing ability and pulmo-nary function were compared between the groups.Result:At baseline and after 1 week of treatment,there were no significant between-group differences in CPF,CPIS,or Borg Dyspnea scores(P>0.05).However,after 2 and 4 weeks of treatment,the observation group showed significantly greater improvements in CPF,CPIS,and Borg Dyspnea scores compared to the control group(P<0.05).Furthermore,after 4 weeks of treatment,the improvement in all pulmonary function parame-ters(MIP,MEP,FVC％,FEV1％,MVV％)was significantly greater in the observation group than in the con-trol group(P<0.05).Conclusion:Respiratory muscle training combined with phrenic nerve electrical stimulation can effectively improve the coughing ability,alleviate pulmonary infection,and enhance lung function in stroke patients within a short peri-od of time,which is worthy of promotion and application in the treatment of lung infection in early stroke.

Objective:To explore the effect of different swallowing tasks on cortex activation and functional connectivity in stroke survivors with dysphagia using functional near-infrared spectroscopy (fNIRS).Methods:Thirty stroke survivors with dysphagia performed three different swallowing tasks: swallowing action observation (SO), swallowing action execution (SE), and swallowing action imagination (SI). During each task, fNIRS was used to document the brain concentrations of oxyhemoglobin and deoxyhemoglobin. Cortex activation (β value) and brain functional connectivity were assessed.Results:Compared with the resting state, the areas activated during the SO task included the left primary sensory cortex and the right prefrontal cortex. During the SE and SI tasks the left prefrontal cortex and the left motor cortex were activated as well. Compared with hemorrhagic stroke survivors, ischemic stroke survivors showed significantly greater activation of the right primary sensory cortex, the right motor cortex, and the left primary sensory cortex during the SE task. Functional connectivity during the SO, SE and SI tasks was significantly greater than in the resting state, with the average connectivity values during the SE task significantly higher than during the SI task.Conclusions:Stroke survivors with dysphagia exhibit increased activation in the prefrontal cortex and primary sensory cortex during different swallowing tasks. Such tasks can improve their brain functional connectivity.

Objective:To explore the effect of different swallowing tasks on cortex activation and functional connectivity in stroke survivors with dysphagia using functional near-infrared spectroscopy (fNIRS).Methods:Thirty stroke survivors with dysphagia performed three different swallowing tasks: swallowing action observation (SO), swallowing action execution (SE), and swallowing action imagination (SI). During each task, fNIRS was used to document the brain concentrations of oxyhemoglobin and deoxyhemoglobin. Cortex activation (β value) and brain functional connectivity were assessed.Results:Compared with the resting state, the areas activated during the SO task included the left primary sensory cortex and the right prefrontal cortex. During the SE and SI tasks the left prefrontal cortex and the left motor cortex were activated as well. Compared with hemorrhagic stroke survivors, ischemic stroke survivors showed significantly greater activation of the right primary sensory cortex, the right motor cortex, and the left primary sensory cortex during the SE task. Functional connectivity during the SO, SE and SI tasks was significantly greater than in the resting state, with the average connectivity values during the SE task significantly higher than during the SI task.Conclusions:Stroke survivors with dysphagia exhibit increased activation in the prefrontal cortex and primary sensory cortex during different swallowing tasks. Such tasks can improve their brain functional connectivity.

Objective:To explore the effects of respiratory muscle training(RMT)combined with phrenic nerve electrical stimulation(PNES)on coughing ability and lung function in stroke patients with pulmonary infection.Method:A total of 66 patients with pulmonary infection after stroke,admitted to our hospital from January 2022 to January 2024,were randomly assigned to either an observation group or a control group,with 33 cas-es in each group.During the study,three patients from each group dropped out.Both groups received conven-tional pharmacological and rehabilitation treatment.Additionally,the observation group received combined RMT and PNES,administered once a day,5 days per week,for 4 weeks.Outcome measures included:Cough peak flow rate(CPF),Clinical Pulmonary Infection Score(CPIS),and Borg Dyspnea Scale scores,assessed at baseline,1 week,2 weeks,and 4 weeks.Pulmonary function tests were performed at baseline and after 4 weeks,including maximum inspiratory pressure(MIP),maximum expiratory pressure(MEP),forced vital ca-pacity(FVC),forced expiratory volume in the first second(FEV1),maximum volume per minute(MVV).The percentages of predicted values(FVC％,FEV1％,MVV％)were calculated.Coughing ability and pulmo-nary function were compared between the groups.Result:At baseline and after 1 week of treatment,there were no significant between-group differences in CPF,CPIS,or Borg Dyspnea scores(P>0.05).However,after 2 and 4 weeks of treatment,the observation group showed significantly greater improvements in CPF,CPIS,and Borg Dyspnea scores compared to the control group(P<0.05).Furthermore,after 4 weeks of treatment,the improvement in all pulmonary function parame-ters(MIP,MEP,FVC％,FEV1％,MVV％)was significantly greater in the observation group than in the con-trol group(P<0.05).Conclusion:Respiratory muscle training combined with phrenic nerve electrical stimulation can effectively improve the coughing ability,alleviate pulmonary infection,and enhance lung function in stroke patients within a short peri-od of time,which is worthy of promotion and application in the treatment of lung infection in early stroke.

BACKGROUND:Increasing evidence has indicated that early reinforcement of correct posture is particularly important for improving abnormal gait in stroke patients.Wearable exoskeleton-assisted training can improve patients'walking function in a short period of time,and can also assist the coordinated movement of muscles around the pelvis,hip,knee,and ankle joints,control the walking trajectory of the lower limbs,and improve walking ability in patients with stroke.OBJECTIVE:To explore the improvement of abnormal gait in stroke patients by a wearable exoskeleton with posture feedback,and to explore the rehabilitation mechanism.METHODS:A total of 52 patients in the recovery period of stroke admitted to the Affiliated Hospital of Jining Medical College from January 2023 to January 2024 were included in this study and randomly divided into an experimental group(n=26)and a control group(n=26)using a random number table method.Based on conventional rehabilitation training,the patients in the experimental group participated in training using a wearable exoskeleton with posture feedback(15 minutes per day,6 times per week),while those in the control group were given conventional gait therapy(15 minutes per day,6 times per week).Training in each group lasted for 4 weeks.Before and after training,the lower limb motor function scores,gait parameters(step length,step speed,step width)and gait symmetry were compared between the two groups,and the brain functional connectivity values of the prefrontal motor area,the primary motor cortex and the sensorimotor area were detected using portable near-infrared spectroscopy.RESULTS AND CONCLUSION:After training,lower limb motor function scores,gait parameters and gait symmetry were significantly improved in the two groups(P＜0.05).Meanwhile,the experimental group was superior to the control group in terms of gait parameters and gait symmetry(P＜0.05).Brain functional connectivity values of the right sensorimotor area-left prefrontal motor area and right sensorimotor area-right prefrontal motor area were significantly increased in the two groups after training(P＜0.05).The functional connectivity values of the left sensorimotor area-right primary motor cortex and left sensorimotor area-left primary motor cortex in the experimental group were increased after training(P＜0.05).Compared with the control group,the functional connectivity values of the left sensorimotor area-right primary motor cortex and left sensorimotor area-left primary motor cortex were increased in the experimental group after training(P＜0.05).To conclude,based on conventional rehabilitation training,a wearable exoskeleton with posture feedback can not only effectively improve the abnormal gait of stroke patients,but also activate the functional sensorimotor areas of the brain associated with abnormal gait.

Objective:To explore any effect of repeated transcranial magnetic stimulation (rTMS) on the upper limb motor function and cerebral cortex activation of stroke survivors.Methods:Sixty stroke survivors were randomly divided into an intervention group and a control group, each of 30. In addition to routine rehabilitation training (including drug therapy, comprehensive hemiplegic limb training and physical factor therapy), the intervention group received 15 minutes of rTMS daily, five days a week for 4 weeks while the control group was given false rTMS. Upper limb motor function was evaluated before and after the treatment using the Fugl Meyer upper limb motor function rating scale (FMA-UE). Functional near-infrared spectroscopy was used to detect and compare the activation (β values) of the prefrontal cortex, the motor cortex and the primary somatosensory cortex in the 2 groups. The correlation between the FMA-UE scores and the β values was quantified.Results:①There was no significant difference in the average FMA-UE scores between the two groups before the treatment. Afterward, though both groups′ average scores had increased significantly, there was significantly greater improvement in the treatment group. ②There was also no significant difference in average β value between the two groups before the experiment, but afterward the average βs of channels 27 and 13 in the intervention group were significantly higher than in the control group. Moreover, in patients with lesion in the left brain, the β-values of CH27 and CH13 were also significantly higher than the control group ( P<0.05). ③The FMA-UE scores of the intervention group were moderately correlated with the CH27 and CH13 β values, but those of the control group were only weakly correlated with the β values of CH27. Conclusion:Transcranial magnetic stimulation activates a lesioned left brain region, improving upper limb motor function. The improvement is correlated with the activation of the left prefrontal cortex and the left primary somatosensory cortex.

Objective:To explore the method of fertility preservation in severe β-thalassemia prepubertal boys who cannot produce sperm before gonadotoxicity therapy.Methods:Three cases of severe β-thalassemia patients who were going to undergo hematopoietic stem cell transplantation (HSCT) were reported. They were received testis cryopreservation by slow-rate freezing. The necessity of fertility preservation in prepubertal boys and the methods of fertility persevation, testicular cryopreservation and the downstream techniques were stated.Results:Totally 31, 31, 20 pieces of testicular tissue were frozen by slow-rate freezing in three boys respectively and the freezing process went smoothly.Conclusion:The cryopreservation of testicular tissue can preserve the fertility of severe β-thalassemia prepuberty boys who will receive HSCT, leaving hope for offspring.

Objective:To explore the method of fertility preservation in severe β-thalassemia prepubertal boys who cannot produce sperm before gonadotoxicity therapy.Methods:Three cases of severe β-thalassemia patients who were going to undergo hematopoietic stem cell transplantation (HSCT) were reported. They were received testis cryopreservation by slow-rate freezing. The necessity of fertility preservation in prepubertal boys and the methods of fertility persevation, testicular cryopreservation and the downstream techniques were stated.Results:Totally 31, 31, 20 pieces of testicular tissue were frozen by slow-rate freezing in three boys respectively and the freezing process went smoothly.Conclusion:The cryopreservation of testicular tissue can preserve the fertility of severe β-thalassemia prepuberty boys who will receive HSCT, leaving hope for offspring.