1.Effect of repetitive transcranial magnetic stimulation and transcranial direct current stimulation on motor function and gait in children with cerebral palsy:a network meta-analysis
Xinyan CAO ; Zifu YU ; Xiaoxuan LENG ; Shiai GAO ; Jinhui CHEN ; Xihua LIU
Chinese Journal of Tissue Engineering Research 2026;30(6):1539-1548
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.
2.Effect of repetitive transcranial magnetic stimulation and transcranial direct current stimulation on motor function and gait in children with cerebral palsy:a network meta-analysis
Xinyan CAO ; Zifu YU ; Xiaoxuan LENG ; Shiai GAO ; Jinhui CHEN ; Xihua LIU
Chinese Journal of Tissue Engineering Research 2026;30(6):1539-1548
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.
3.Effect of scalp combined with intradermal-needle acupuncture synchronized rehabilitation therapy on upper limb motor function after stroke
Zifu YU ; Xiaoxia YANG ; Xia ZHAO ; Xinyan CAO ; Liangxia CHEN ; Xihua LIU
Chinese Journal of Rehabilitation Theory and Practice 2025;31(10):1194-1205
Objective To explore the effect of scalp combined with intradermal-needle acupuncture synchronized rehabilitation ther-apy on upper limb motor function in stroke patients.Methods From December,2022 to December,2023,144 stroke patients with upper limb motor dysfunction in the Affili-ated Hospital of Shandong University of Traditional Chinese Medicine were randomly divided into control,intra-dermal-needle,scalp-acupuncture and acupuncture groups(36 cases repectively).All groups received convention-al treatment and upper limb rehabilitation training,the intradermal-needle group added intradermal-needle thera-py,the scalp-acupuncture group added scalp-acupuncture therapy,and the acupuncture group added both scalp-and intradermal-needle therapies,for four weeks.They were assessed with Fugl-Meyer Assessment-Upper Ex-tremities(FMA-UE),Wolf Motor Function Test(WMFT)and modified Barthel Index(MBI)before and after treatment.Twenty cases were selected randomly from each group,fractional anisotropy(FA)values and ratio of fractional anisotropy(rFA)of the lesion area and the posterior limb of the internal capsule were also measured with diffusion tensor imaging.Results Two cases dropped out in both the control group and the intradermal-needle group,while one case dropped out in both the scalp-acupuncture group and the acupuncture group.All groups showed significant improvement in FMA-UE,WMFT and MBI scores,as well as in the FA and rFA values of the lesion area and the posterior limb of the internal capsule(t>5.532,P<0.001)after treatment.The acupuncture group demonstrated the greatest pre-to post-treatment differences in FMA-UE scores,lesion-area FA and rFA values,and posterior-limb rFA val-ues compared with the other three groups(|Z|>3.256,P<0.05),and more WMFT and MBI improvements than those of the intradermal-needle group and the control group(|Z|>5.483,P<0.001).A significant interaction ef-fect was observed between intradermal and scalp acupuncture in improving FMA-UE scores(partial η2=0.035,P=0.029).The change in FMA-UE scores was positively correlated with the change in FA values of the posteri-or limb of the internal capsule(r>0.453,P<0.05)across four groups.Conclusion Scalp combined with intradermal-needle acupuncture synchronized rehabilitation therapy can more effec-tively improve upper-limb motor function in stroke patients,which may associate with the recovery of internal capsule.
4.Effect of scalp combined with intradermal-needle acupuncture synchronized rehabilitation therapy on upper limb motor function after stroke
Zifu YU ; Xiaoxia YANG ; Xia ZHAO ; Xinyan CAO ; Liangxia CHEN ; Xihua LIU
Chinese Journal of Rehabilitation Theory and Practice 2025;31(10):1194-1205
Objective To explore the effect of scalp combined with intradermal-needle acupuncture synchronized rehabilitation ther-apy on upper limb motor function in stroke patients.Methods From December,2022 to December,2023,144 stroke patients with upper limb motor dysfunction in the Affili-ated Hospital of Shandong University of Traditional Chinese Medicine were randomly divided into control,intra-dermal-needle,scalp-acupuncture and acupuncture groups(36 cases repectively).All groups received convention-al treatment and upper limb rehabilitation training,the intradermal-needle group added intradermal-needle thera-py,the scalp-acupuncture group added scalp-acupuncture therapy,and the acupuncture group added both scalp-and intradermal-needle therapies,for four weeks.They were assessed with Fugl-Meyer Assessment-Upper Ex-tremities(FMA-UE),Wolf Motor Function Test(WMFT)and modified Barthel Index(MBI)before and after treatment.Twenty cases were selected randomly from each group,fractional anisotropy(FA)values and ratio of fractional anisotropy(rFA)of the lesion area and the posterior limb of the internal capsule were also measured with diffusion tensor imaging.Results Two cases dropped out in both the control group and the intradermal-needle group,while one case dropped out in both the scalp-acupuncture group and the acupuncture group.All groups showed significant improvement in FMA-UE,WMFT and MBI scores,as well as in the FA and rFA values of the lesion area and the posterior limb of the internal capsule(t>5.532,P<0.001)after treatment.The acupuncture group demonstrated the greatest pre-to post-treatment differences in FMA-UE scores,lesion-area FA and rFA values,and posterior-limb rFA val-ues compared with the other three groups(|Z|>3.256,P<0.05),and more WMFT and MBI improvements than those of the intradermal-needle group and the control group(|Z|>5.483,P<0.001).A significant interaction ef-fect was observed between intradermal and scalp acupuncture in improving FMA-UE scores(partial η2=0.035,P=0.029).The change in FMA-UE scores was positively correlated with the change in FA values of the posteri-or limb of the internal capsule(r>0.453,P<0.05)across four groups.Conclusion Scalp combined with intradermal-needle acupuncture synchronized rehabilitation therapy can more effec-tively improve upper-limb motor function in stroke patients,which may associate with the recovery of internal capsule.
5.Acupuncture-synchronized exercise can improve the learning and memory of rats with middle cerebral artery occlusion
Fang QIN ; Tiantian MA ; Zifu YU ; Shiai GAO ; Jinhui CHEN ; Xihua LIU
Chinese Journal of Physical Medicine and Rehabilitation 2025;47(7):577-584
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.
6.Acupuncture-synchronized exercise can improve the learning and memory of rats with middle cerebral artery occlusion
Fang QIN ; Tiantian MA ; Zifu YU ; Shiai GAO ; Jinhui CHEN ; Xihua LIU
Chinese Journal of Physical Medicine and Rehabilitation 2025;47(7):577-584
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.
7.METTL14 as a predictor of postoperative survival outcomes of patients with hepatocellular carcinoma.
Tengfei ZHOU ; Zifu REN ; Chaoshuang CHEN
Journal of Southern Medical University 2020;40(4):567-572
OBJECTIVE:
To investigate the expression of RNA methyltransferase METTL14 in hepatocellular carcinoma (HCC) and its clinical significance.
METHODS:
Immunohistochemical staining was used to detect the expression of METTL14 in 147 pairs of HCC and adjacent hepatic tissues. According to the scores rated by pathologists, the 147 cases of HCC were divided into high and low METTL14 expression groups. The correlation between the expression of METTL14 and clinicopathological parameters was analyzed, and Kaplan-Meier method was used to analyze the relationship between the expression of METTL14 and the prognosis and survival (including the overall survival and disease-free survival) of the patients with HCC after operation. Univariate analysis and multivariate analysis were carried out to assess the impact of METTL14 expression level on the overall survival and tumor-free survival of the patients after operation using a COX regression model and explore whether METTL14 expression level is an independent prognostic risk factor of the postoperative patients.
RESULTS:
The expression of METTL14 was significantly lower in HCC tissues than in the adjacent tissues ( < 0.001). METTL14 expression in HCC tissues was significantly correlated with the tumor size (=0.044) and TNM stage (=0.046). A low expression of METTL14 in HCC tissues was significantly correlated with a poor prognosis and a significantly shortened overall survival time and disease-free survival time of the patients ( < 0.05), and was an independent risk factor affecting the overall survival and disease-free survival of HCC patients.
CONCLUSIONS
METTL14 may be a new prognostic marker for patients with HCC after hepatectomy.
Biomarkers, Tumor
;
Carcinoma, Hepatocellular
;
Disease-Free Survival
;
Hepatectomy
;
Humans
;
Kaplan-Meier Estimate
;
Liver Neoplasms
;
Methyltransferases
;
Prognosis
8.Research Progress of Omega-3 Polyunsaturated Fatty Acids in Regulating Blood Lipid and Atherosclerosis
Zehua CHEN ; Huiyun HU ; Ying CHEN ; Zifu LI
Herald of Medicine 2018;37(11):1334-1338
Regulation of blood lipid and anti-atherosclerosis is a hot topic in the study of poly unsaturated fatty acids in recent years. Many research showed that polyunsaturated fatty acids can inhibit atherosclerosis by reducing lipid, anti-inflammatory,anti-oxidative, inhibiting thrombosis and protecting vascular endothelial cells. Polyunsaturated fatty acids, due to their medicinal and edible homologues,have great potential drugs for regulating blood lipids and anti-atherosclerosis.
9.Clinical significance and management of prostatic intraepithelial neoplasia.
National Journal of Andrology 2004;10(12):883-885
Prostatic intraepithelial neoplasia (PIN) refers to the cellular proliferations within prostatic ducts, ductules, and acini. PIN is divided into three grades, PIN 1, PIN 2 and PIN 3, PIN 1 is a low grade (LPIN); PIN 2 and PIN 3 are high grades (HPIN). Clinically, the term PIN is usually used to indicate HPIN. LPIN is not used as a separate pathological diagnostic entity. HPIN is widely regarded as the precancerous change of prostatic carcinoma. HPIN and prostatic carcinoma share many similarities in epidemiology, genetics, morphology, as well as in location and clinical features. And so they are two closely related entities. HPIN is pathologically diagnosed, and shows no specificity on digital rectal examination (DRE) and transrectal ultrasonography (TRUS). HPIN does not elevate serum prostatic specific antigen (PSA) concentration. HPIN with an elevation of serum PSA should be considered as the possible coexistence of HPIN and prostatic carcinoma. There has been no consensus on the management of HPIN, but it is widely held that simple HPIN detected by extended needle biopsy has no therapeutic implications, but should be followed up at regular intervals. If there are changes in PSA and/or DRE, repeated needle biopsy is imperative. The natural biological behaviour of HPIN is yet poorly understood. Currently, most urological experts do not recommend antiandrogen therapy to patients with simple HPIN.
Biopsy, Needle
;
Humans
;
Male
;
Neoplasm Staging
;
Prostate-Specific Antigen
;
blood
;
Prostatic Intraepithelial Neoplasia
;
diagnosis
;
pathology
;
Prostatic Neoplasms
;
diagnosis
;
pathology
10.Correlation of apoptosis with androgen receptor in prostate cancer
Zuolin SHI ; Yanqing LIN ; Yanrong ZHANG ; Yanhui LI ; Zifu CHEN
Chinese Journal of Clinical and Experimental Pathology 2001;(2):136-138
Purpose To investigate relationship between androgen receptor and apoptotic index and to further understand the tumor biology of prostate cancer. Methods Fifty-six patients with histologically proven prostate cancer and 20 cases with benign prostatic hyperplasia(BPH) were collected. Androgen receptor(AR) were stained by 2H12 monoclonal antibody using immunohistochemical method. The apoptotic index (AI) was determined by the terminal deoxynucleotidyl transterase-mediated dUTP biotin nick end labeling (TUNEL) technique on serial sections of formalin fixed, paraffin embedded tissues. Results AR was not found significantly difference (P>0.05) between prostate cancer and BPH. The association of AR with AI according to Gleason score were not observed in prostate cancer. AI were significantly higher in prostate cancer compared to BPH (P<0.05).AI were also significantly higher in AR-positive prostate cancer than in AR-negative prostate cancer(P<0.05). Conclusion AR expression can induce prostate cancer cells to become apoptosis, and may be a useful predictor in functional classification and endocrine response of prostate cancer.

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