BACKGROUND:Spinal cord injury is a serious hazard.Walking dysfunction affects the patients'quality of life most.Researches on assisted-walking with exoskeleton robots on patients with spinal cord injury have become increasingly active. OBJECTIVE:To map scientific researches of exoskeleton-assisted walking after spinal cord injury using the CiteSpace software,and to discuss the state of art,cutting-edges in the past 10 years,and trends of research in this field,in hope of providing insights for future investigations and clinical applications. METHODS:Using the Web of Science core database to conduct subject term search by Boolean logical operators,the language English was selected,search strategy:TS="spinal cord injury OR SCI"AND"walk OR walking"AND"robot OR exoskeleton OR(exoskeleton-assisted walking)OR EAW".The knowledge graph software CiteSpace 6.2.R4 was used to de-emphasize the high-quality literature.The high-quality literature obtained after reweighting was subjected to visualization analysis of hotspots and international frontier trends,such as the number of publications,country/research institution cooperation,high-influence authors/literature co-citation,keyword co-occurrence/clustering/emergence,and the scientific knowledge graph was mapped. RESULTS AND CONCLUSION:(1)A total of 544 high-quality articles were included,and the number of articles and total citation frequency in this field have shown an increasing trend in the past 10 years.(2)The top 3 countries in terms of number of publications are the USA,China,and Italy,and the top 3 research institutions are the U.S.Department of Veterans Affairs,the U.S.Veterans Health Administration,and the Swiss Federal Institute of Technology Domian.(3)The authors with the highest citation frequency(167)and betweenness centrality(0.13)are Professor Esquenazi A,University of Pennsylvania,USA,showing a high influence in this field.(4)The analysis of the top 5 cited documents in terms of citation frequency and betweenness centrality shows that:the current research on walking rehabilitation for spinal cord injury patients equipped with powered exoskeleton devices focuses on the judgment of the safety of walking rehabilitation training in real-life environments such as institutions and homes,analysis of the advantages and disadvantages of walking rehabilitation training,design of individualized training programs,and the advantages and disadvantages of the application of powered exoskeleton devices in assisted walking for patients with complete loss of locomotor function in thoracic vertebrae and the segments below,the factors affecting the effectiveness of assisted walking,and the potential for application.(5)In recent years,research in this field has focused on individuals,gait,powered exoskeleton,body weight support,functional electrical stimulation,rehabilitation,assistive technology,ambulation,recovery,and so on.(6)Early research in this field was mostly applied to stroke patients,and the frontier includes weight loss support,reciprocating gait orthosis,functional electrical stimulation and other technical means.Spinal cord injury exoskeleton-assisted walking rehabilitation research has shown an upward trend in recent years,and the focus of attention to the development of adaptive control as the mechanism of the medical lower extremity exoskeleton equipment,safety enhancement,the application of the potential to tap into the cutting-edge direction of the change,the research and detection means on the joint function of the near-infrared spectroscopic imaging and other high-end technologies,focusing on the quality of life of the patient to enhance the ability of athletic training,and to improve the body's structure of the field of the future hotspots and the frontier of the research.

Objective:To assess the effectiveness of a 6-month Ba Duan Jin exercise program in improving the balance of community-dwelling older adults.Methods:A two arms, parallel-group, cluster randomized controlled trial was conducted in 1 028 community residents aged 60-80 years in 40 communities in 5 provinces of China. Participants in the intervention group (20 communities, 523 people) received Ba Duan Jin exercise 5 days/week, 1 hour/day for 6 months, and three times of falls prevention health education, and the control group (20 communities, 505 people) received falls prevention health education same as the intervention group. The Berg balance scale (BBS) score was the leading outcome indicator, and the secondary outcome indicators included the length of time of standing on one foot (with eyes open and closed), standing in a tandem stance (with eyes open and closed), the closed circle test, and the timed up to test.Results:A total of 1 028 participants were included in the final analysis, including 731 women (71.11%) and 297 men (28.89%), and the age was (69.87±5.67) years. After the 3-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 3.05 (95% CI: 2.23-3.88) points ( P<0.001). After the 6-month intervention, compared with the baseline data, the BBS score of the intervention group was significantly higher than the control group by 4.70 (95% CI: 4.03-5.37) points ( P<0.001). Ba Duan Jin showed significant improvement ( P<0.05) in all secondary outcomes after 6 months of exercise in the intervention group compared with the control group. Conclusions:This study showed that Ba Duan Jin exercise can improve balance in community-dwelling older adults aged 60-80. The longer the exercise time, the better the improvement.

Nonalcoholic fatty liver disease(NAFLD)has developed into the most common chronic liver disease and can lead to liver cancer.Our laboratory previously developed a novel prescription for NAFLD,"Eight Zhes Decoction"(EZD),which has shown good curative effects in clinical practice.However,the pharmaco-dynamic material basis and mechanism have not yet been revealed.A strategy integrating lipidomics,network pharmacology and pharmacokinetics was used to reveal the active components and mecha-nisms of EZD against NAFLD.The histopathological results showed that EZD attenuated the degrees of collagen deposition and steatosis in the livers of nonalcoholic steatofibrosis model mice.Furthermore,glycerophospholipid metabolism,arachidonic acid metabolism,glycerolipid metabolism and linoleic acid metabolism with phospholipase A2 group IVA(PLA2G4A)and cytochrome P450 as the core targets and 12,13-cis-epoxyoctadecenoic acid,12(S)-hydroxyeicosatetraenoic acid,leukotriene B4,prostaglandin E2,phosphatidylcholines(PCs)and triacylglycerols(TGs)as the main lipids were found to be involved in the treatment of NAFLD by EZD.Importantly,naringenin,artemetin,canadine,and bicuculline were iden-tified as the active ingredients of EZD against NAFLD;in particular,naringenin reduces PC consumption by inhibiting the expression of PLA2G4A and thus promotes sufficient synthesis of very-low-density lipoprotein to transport excess TGs in the liver.This research provides valuable data and theoretical support for the application of EZD against NAFLD.

In order to provide a basic theory for the materials of repairing central nervous system injury, we have studied the growth and differentiation of neural stem cells (NSCs) on poly (L-lysine) modified silk fibroin film. First, we used poly (L-lysine) to modify silk fibroin film and confirmed by UV-vis and 1H NMR spectra. Then NSCs were isolated and seeded on the silk fibroin film (Silk group), poly (L-lysine) (PLL group) and poly (L-lysine) modified Silk fibroin film (Silk-PIL group). The proliferation of NSCs was evaluated by Cell Counting Kit-8 (CCK-8) assay on days 1, 3, 5 and 7 after seeding. Immunofluorescence was used to analyze the differentiation of NSCs at the 7th day. The levels of apoptosis were detected by Western blotting and TUNEL. The mRNA level of brain derived neurotrophic factor (BDNF) was identified by real-time PCR. UV-vis and 1H NMR spectra confirmed that poly (L-lysine) was successfully grafted onto the silk fibroin film. From the 3rd day after seeding to the 7th day, the CCK-8 test showed that proliferation rate of NSCs in the Silk-PIL was significantly higher than Silk group (P<0.05) but had no significant difference compared with PLL group (P>0.05). Immunofluorescence staining displayed that more NSCs in Silk-PIL group were differentiated into neuron compared with Silk group (P<0.05), however, there was no significant difference compared with PLL group (P>0.05). The number of NSCs differentiated into astrocytes was not significantly different between the three groups. Western blotting and TUNEL test presented that the degree of apoptosis of NSCs in the Silk-PIL group was significantly lower than Silk group (P<0.05). RT-PCR exhibited that mRNA level of brain derived neurotrophic factor (BDNF) of NSCs was higher in Silk-PIL group compared with Silk group (P<0.05) but had no significant difference compared with PLL group (P>0.05). Thus, poly (L-lysine) modified silk fibroin film could promote the proliferation of NSCs and reduce NSCs apoptosis. Furthermore, it also can enhance the differentiation of NSCs into neurons. It is expected to become a new type of tissue engineering scaffold carrying NSCs to repair central nervous system injury.

Objective To explore prophylactic bilateral internal iliac arteries balloon occlusion in treating pernicious placenta previa complicated with placenta implantation before cesarean section.Methods Data of 32 patients with pernicious placenta previa complicated with placenta implantation underwent prophylactic bilateral internal iliac arteries balloon occlusion(Balloon Group)were analyzed retrospectively.40 patients with pernicious placenta previa complicated with placenta implantation without treatment of prophylactic bilateral internal iliac arteries balloon occlusion(Control Group)were selected.The mean blood loss and infusion amount during the operation,operative time,newborn Apgar score were compared between the two groups.Results The mean blood loss and infusion amount during the operation,operative time,newborn Apgar score of balloon group was superior to the control group and the difference was significant.All mothers and infants were healthy detected by clinical checking on 3-6 months after birth.Conclusion Prophylactic bilateral internal iliac arteries balloon occlusion is a safe and effective treatment before cesarean section used in pernicious placenta previa complicated with placenta implantation,and worthy of further promotion.

[Objective]To observe the dynamic changes of serum LH levels in different GnRH-along protocols ,and investigate the relationship between GnRH-adosage and LH levels ,and compare the clinical outcomes among different GnRH-a long protocols.[Methods]In this retrospective study,1.0 mg,0.8 mg,0.375 mg long-acting and 0.1 mg/d,0.05 mg/d short-acting GnRH-a long protocols were included from January to June in 2015 at the Reproductive Medicine Center of the First Affiliated Hospital of Sun Yat-Sen University. Serum LH levels were evaluated from a total of 250 women at the four time points,on the day before gonadotropin stimulation(Gn0),the fourth day of Gn stimulation(Gn4),the seventh day of Gn stimulation(Gn7),and the HCG administration day(HCG day),then the relationship between serum LH levels and the dosage of GnRH-a were analyzed. The number of oocytes retrieved,fertilization rate,good quality embryos rate,blastocyst transferred rate,the number of transferred embryos,implantation rate and clinical pregnancy rate were also compared.[Results]Among the long-acting groups,LH levels in 0.375 mg group were higher than those in 1.0 mg and 0.8 mg groups at the four time points(P<0.05). Total Gn dose,duration of Gnstimualtion and HMG dosage of 1.0 mg protocol and 0.8 mg protocol were significantly higher than those of 0.375 mg group(P < 0.05). In addition,the implantation rate showed an increasing tendency when the level of LH increases(P>0.05). In short-acting groups,the LH levels in 0.05 mg/d protocol were significantly lower than those in the 0.1 mg/d group at Gn0,Gn7 and HCG day(P<0.05). Total Gn dose,du?ration of Gn stimulation and HMG dosage did not show significant difference between 0.05mg and 0.1mg group. What′s more,the im?plantation rate in 0.1 mg/d group was higher than in 0.05 mg/d group(P>0.05).[Conclusion]Among the long-acting groups,the smaller amount of GnRH-a was administrated ,the higher LH levels during ovarian stimulation and implantation rate the patients ob?tained. As to the short-acting groups,the LH level and implantation rate in 0.1 mg/d group is higher than those in 0.05 mg/d group.

AIM: To investigate the effect of cobalt chloride (CoCl2) on the apoptosis of neural stem cells (NSCs) and the expression of microRNA-26a (miR-26a) in vitro, and to explore the mechanisms of NSC apoptosis in-duced by CoCl 2 .METHODS:NSCs were exposed to CoCl 2 at different doses (200~600μmol/L) for 24 h.The cell via-bility and apoptosis were measured by CCK-8 assay and TUNEL method.The expression of miR-26a-3p, miR-26a-5p, GSK-3β, caspase-3, Bcl-2 and Bax was examined by real-time PCR.The protein levels of Bcl-2 and Bax were detected by Western blotting .RESULTS: The cell viability was inhibited and the apoptosis of NSCs was increased significantly by CoCl2 in a dose-dependent manner (P<0.05).CoCl2 at concentration of 400μmol/L for 24 h was used to induce apopto-sis and the expression of miR-26a was down-regulated compared with control (P<0.05).Exposure to CoCl2 at concentra-tion of 400μmol/L up-regulated the expression of GSK-3β, caspase-3 and Bax , down-regulated the expression of Bcl-2 and Bcl-2/Bax (P<0.05).CONCLUSION:CoCl2 at concentration of 400μmol/L induces the apoptosis of NSCs obviously . CoCl2 may induce the NSC apoptosis by mitochondrial apoptotic pathway .Declining miR-26a may be related to NSC apopto-sis.

AIM:To evaluate the influence of scutellarin on the expression of vascular endothelial growth factor ( VEGF) in high glucose-treated human retinal pigment epithelial cell line ARPE-19 and to observe the effects of scutellarin on the protein expression of VEGF, p-ERK and VEGFR2 in the retinas of type II diabetic rats.METHODS: Cultured ARPE-19 cells were divided into normal control group, scutellarin group, high glucose group and high glucose+scutellarin group.The protein levels of VEGF, p-ERK and VEGFR2 were measured by Western blot.The VEGF release in ARPE-19 cells was detected by ELISA.Normal rats were randomly divided into normal control group and scutellarin group.Diabetic rat model was established by feeding with high-fat diet and injecting with streptozocin, and randomly divided into diabetes group and diabetes treated with scutellarin group.After 16 weeks, the eyes were removed.The morphological changes of the retinas were observed under light microscope with HE staining, and histopathological score was recorded.The expres-sion of VEGF in the retinas was observed by the method of immunohistochemistry.RESULTS:Compared with normal con-trol group, the protein levels of VEGF, p-ERK and VEGFR2 in the ARPE-19 cells decreased in scutellarin group, but in-creased in high glucose group.The histopathological score of the retinas showed significant difference among diabetes group, diabetes treated with scutellarin group and normal control group, and no significant difference between normal con-trol group and scutellarin group was observed.The expression of VEGF increased in diabetic group and was significantly higher than that in scutellarin treatment group (P<0.05).CONCLUSION:Scutellarin inhibits the increased protein le-vels of VEGF, p-ERK and VEGFR2 in ARPE-19 cells, and decreases the expression of VEGF in the retinas of diabetic rats.The suppression of the diabetic retinopathy development by scutellarin may be partly involved in the ERK/MAPK pathway.

BACKGROUND:Hyperbranched cationic amylopectin is a kind of nonviral gene vectors with low toxicity and good transfection efficiency. However, searching for more efficient methods to delivery it into the body and making the genes expressed are being explored.
OBJECTIVE:To study the expression of DMAPA-Amp wrapped green fluorescent protein (GFP) transferred by modified carotid injection into cerebral ischemic area.
METHODS:Male Sprague-Dawley rats subjected to middle cerebral artery infarction were randomly divided into two groups after 24 hours:experimental group (injected with GFP entrapped DMAPA-Amp via the internal carotid artery) and control group (injected with GFP entrapped DMAPA-Amp via the tail vein). These rats were put to death and their brain tissue was removed after 7 days. The expression of GFP was detected by quantitative PCR and western blot assay, and immunofluorescence staining was performed to detect the expression of GFP located near cerebrovascular endothelial cel s by frozen section.
RESULTS AND CONCLUSION:Compared with the control group, the expression of GFP was much higher in the experimental group detected by quantitative PCR and western blot (P< 0.05). Additional y, the expression of GFP located near cerebrovascular endothelial cel s by frozen section was also higher than that in the control group. Modified carotid injection could significantly promote the expression of hyperbranched cationic amylopectin derivates and GFP in the brain tissue of Sprague-Dawley rats undergoing middle cerebral artery infarction compared with tail vein injection, which indicates DMAPA-Amp and modified carotid injection may cast new lights on the therapy for angiogenesis of ischemic stroke.

Gene therapy has been considered as a promising method for treatment of many diseases, such as acquired and genetic diseases. At present, there are two major vehicles for gene delivery including viral vectors and nonviral vectors. Viral vectors appear as high gene transfection efficiency, but some deficiencies such as inflammatory responses, recombination and mutagenesis have limited their use. On account of low pathogenicity, safety and cost-effectiveness, nonviral vectors have been attracted much attention. Cationic polymers are one of the nonviral vectors which have been widely studied. This review focuses on the structure of the cationic polymers and the interaction mechanism between the vector and DNA. We try to provide a framework for the future design and synthesis of nonviral vectors with high transfection efficiency and low toxicity for gene therapy.
Cations ; chemistry ; DNA ; genetics ; Gene Transfer Techniques ; Genetic Therapy ; methods ; Genetic Vectors ; genetics ; Polymers ; chemistry