Integrative bioinformatics and in vitro exploration of EVI2A expression:unraveling its immunological and prognostic implications in kidney renal clear cell carcinoma

EVI2A has emerged as a significant biomarker in various diseases;however,its biological role and mechanism in kidney renal clear cell carcinoma(KIRC)remains unexplored.We used TCGA and GEO databases to analyze EVI2A gene expression comprehensively and performed pan-cancer assessments.Clinical relevance was evaluated through Kaplan-Meier analysis and ROC curves.The gene’s immune relevance was explored through analyses of the tumor microenvironment(TME),Tumor Immune Single-cell Hub(TISCH),immune checkpoints,and immunotherapy sensitivity.Our results indicate that EVI2A expression is upregulated in KIRC,showing correlations with tumor grade and T/N/M stage.EVI2A demonstrates high diagnostic accuracy(AUC=0.906)and predicts poor overall and progression-free survival in KIRC patients.Furthermore,EVI2A expression exhibits significant associations with immunity,including TME scores and specific immune cell types such as Tfh cells,CD4 memory T cells,and CD8+T cells.Elevated EVI2A expression suggests increased sensitivity to PD-1/CTLA-4 and tyrosine kinase inhibitors.In vitro assays confirmed the impact of EVI2A on KIRC behavior,with its knockdown resulting in reduced cell proliferation and migration.In conclusion,our comprehensive analysis identifies EVI2A as a promising biomarker and a novel therapeutic target for intervening in KIRC.These findings hold significant implications for further research and potential clinical applications.

Elimination mechanism of coal and gas outburst based on geo‑dynamic system with stress–damage–seepage interactions

Coal and gas outburst is a complex dynamic disaster during coal underground mining.Revealing the disaster mechanism is of great signifcance for accurate prediction and prevention of coal and gas outburst.The geo-dynamic system of coal and gas outburst is proposed.The framework of geo-dynamic system is composed of gassy coal mass,geological dynamic environment and mining disturbance.Equations of stress–damage–seepage interaction for gassy coal mass is constructed to resolve the outburst elimination process by gas extraction with boreholes through layer in foor roadway.The results show the occurrence of outburst is divided into the evolution process of gestation,formation,development and termination of geo-dynamic system.The scale range of outburst occurrence is determined,which provides a spatial basis for the prevention and control of outburst.The formation criterion and instability criterion of coal and gas outburst are established.The formation criterion F1 is defned as the scale of the geo-dynamic system,and the instability criterion F2 is defned as the scale of the outburst geo-body.According to the geo-dynamic system,the elimination mechanism of coal and gas outburst—‘unloading+depressurization’is established,and the gas extraction by boreholes through layer in foor roadway for outburst elimination is given.For the research case,when the gas extraction is 120 days,the gas pressure of the coal seam is reduced to below 0.4 MPa,and the outburst danger is eliminated efectively.

以Cameron适时理论为基础的全程护理模式在烧伤后瘢痕整形患者中的应用

目的:研究以Cameron适时理论为基础的全程护理模式对烧伤后瘢痕整形患者的干预效果。方法:选择2021年9月-2022年6月笔者医院收治的60例烧伤后瘢痕整形患者为研究对象,采用随机数字表法分为对照组(30例)和观察组(30例)。对照组给予常规护理干预,观察组在对照组的基础上采用以Cameron适时理论为基础的全程护理模式进行干预,两组均干预8周。统计比较两组瘢痕恢复效果、并发症发生情况、心理状态、应对方式及护理满意度。结果:干预后,观察组创面渗出持续时间、疼痛持续时间均短于对照组(P<0.05);两组创面愈合时间、色素沉着率比较差异无统计学意义(P<0.05)。干预8周后,观察组瘢痕恢复总有效率显著高于对照组(P<0.05);观察组心理韧性评分高于对照组(P<0.05),焦虑、抑郁、心理困扰评分低于对照组(P<0.05);观察组屈服、回避评分低于对照组(P<0.05),面对评分高于对照组(P<0.05);观察组护理总满意率高于对照组(P<0.05)。干预期间,观察组总并发症发生率低于对照组(P<0.05)。结论:以Cameron适时理论为基础的全程护理模式对烧伤后瘢痕整形患者进行干预,可有效促进患者创面愈合,改善患者心理状态及应对方式,降低并发症发生率,患者满意度高,具有较好的应用价值。

压力波发生器的调制与控制方法研究

泥浆压力波发生器通过控制转阀产生压力波信号,是石油钻井和煤矿开采中的重要通信装置。针对压力波信号调制和转阀控制需求:首先提出下边带恒包络平滑相位调制方法,保证信号幅值恒定并降低驱动功率需求;然后,基于自抗扰控制算法设计控制系统,实现转阀位置精准控制,保证压力波信号质量;最后,开发具备力矩加载、参数调试和数据管理等功能的实验测试装置对所提方法进行验证。实验结果表明,所提方法有效实现了压力波信号平滑相位调制和转阀抗干扰控制。所提方法和实验装置具有多学科融合特性,有助于提高学生解决实际复杂工程问题的能力。

尺度适应性起沙机制在CMA-CUACE/Dust中的应用

沙尘暴是影响我国重要的灾害性天气之一,针对中国气象局亚洲沙尘暴数值预报系统CMA-CUACE/Dust(China Meteorological Administration Unified Atmospheric Environment for Dust)的沙尘质量浓度在中亚高估、蒙古北部低估、在我国消散过快以及极端沙尘暴预报峰值偏低等问题,应用与模式格距匹配的尺度适应性起沙机制并更新风蚀资料库对模式进行改进。对2021年3月13—17日东亚最强沙尘暴个例和2023年3—5月与业务运行环境一致的连续预报试验表明,改进后的模式(CMA-CUACE/Dust V1.5)有效改善了上述不足,极端沙尘暴过程传输至我国后的沙尘质量浓度峰值与观测接近。连续预报试验TS(threat score)评分显示:CMA-CUACE/Dust V1.5预报一致性和连续性较好,1~5 d不同时效预报TS评分明显高于改进前和韩国模式ADAM(the Asian Dust Aerosol Model),漏报率明显降低,对2023年5次沙尘过程的4次预报TS评分高于0.3,部分过程超过0.5。

老年综合评估在老年心血管疾病诊治中的应用

中国社会老龄化兼具快速与深度特点,据《中国发展报告2020:中国人口老龄化的发展趋势和政策》数据分析,预计2050年我国年龄≥65岁老年人口将达3.8亿,约占总人口比例的30%。心血管疾病是导致老年人死亡的首要原因,并且老年心血管疾病患者中60%~70%合并其他多种慢性疾病,约超过三分之二的人还患有非心血管疾病合并症[1]。

Uncarialines A-E,new alkaloids from Uncaria rhynchophylla and their anticoagulant activity

Uncarialines A-E(1-5),five undescribed monoterpene indole alkaloids,together with five known analogues were obtained from the stems of Uncaria rhynchophylla.Alkaloids 1-3 were unique 3,4-seco-tricyclic alkaloids with a 6/5/10 ring system,while 4 and 5 possessed a rare rearranged scaffold originated from corynantheine-type alkaloids with C-2/C-7 oxidation.Their structures were characterized by a comprehensive analysis of MS,NMR,and ECD.Their effects on blood clotting times of human plasma were evaluated and alkaloid 5 had a slight prolongation effect on both thrombin time and activated partial thromboplastin time(p<0.001).

Correction:Uncarialines A-E,new alkaloids from Uncaria rhynchophylla and their anticoagulant activity

Correction:Natural Products and Bioprospecting(2023)13:13 https://doi.org/10.1007/s13659-023-00377-0 Following publication of the original article[1],it was reported that the original version of this article unfortu-nately contained a mistake.Prof.Hong-Ping He is also one of the corresponding authors.The correct corresponding information should read:Hong-Ping He1,*E-mail address:hehongping@yahoo.com Yu Zhang2,*E-mail address:zhangyu@mail.kib.ac.cn The original article[1]has been updated.

伴PTPN11基因突变的成人急性髓系白血病患者的临床特征分析

目的:探讨成人急性髓系白血病(AML)患者PTPN11基因突变及其伴随基因突变的发生情况及临床特征。方法:应用二代测序技术联合Sanger测序,回顾性分析从2017年1月至2022年7月由江南大学附属医院、常州市第二人民医院、无锡市人民医院以及无锡市第二人民医院收治的初诊成人AML患者51种基因突变,采用多重PCR检测41种常见白血病融合基因。结果:451例初诊成人AML中,共检测出34例患者携带PTPN11基因突变,突变率为7.5%。34例患者中,检测出37个PTPN11突变位点,其受N-SH2(31例)和PTP(6例)结构域内的错义突变影响,且大部分聚集在第3外显子(31例)。伴有PTPN11突变患者的血小板计数为76.5(23.5,119.0)×10^(9)/L,高于野生型患者的41.0(22.0,82.5)×10^(9)/L(P<0.05),而两组性别、年龄、外周血白细胞计数、血红蛋白水平及骨髓原始细胞比例差异均无统计学意义(P>0.05)。PTPN11突变主要表现为M5亚型,其次为M2及M4亚型,较少发生于M3及M6亚型。PTPN11突变型及野生型患者的FAB亚型分布差异无统计学意义(P>0.05)。共有118例AML患者检测到融合基因阳性,其中,伴有PTPN11突变患者的MLL-AF6阳性发生率高于野生型患者(P<0.01)。34例PTPN11基因突变中有97.1%同时伴随其他基因突变,最常见的由高到低依次为NPM1(38.2%)、NRAS(32.4%)、FLT3-ITD(32.4%)、DNMT3A(32.4%)、KRAS(23.5%)等。结论:PTPN11基因突变在AML患者中有一定的发生率,多见于第3号外显子,且均为错义突变。该基因突变多与NPM1基因突变同时存在,FAB分型多表现为M5亚型,具有更高的血小板水平。

基于多时相Sentinel-2卫星影像的冬小麦面积提取

及时准确地提取冬小麦种植信息,对开展冬小麦农情遥感监测具有重要的意义.以杭州市余杭区冬小麦越冬期(2021-12-04)、扬花期(2022-04-08)和乳熟期(2022-05-03)Sentinel-2遥感影像为数据源,分别采用最大似然法、支持向量机、归一化差值植被指数(normalized difference vegetation index,NDVI)相加和相减合成运算提取冬小麦种植面积.结合冬小麦地面调查数据与实测种植面积,对不同方法的提取结果进行精度评价.结果显示,利用越冬期影像NDVI阈值将常绿植被区(茶园、林地)掩膜处理,对非常绿植被区(建筑、水体、冬小麦)扬花期与乳熟期影像NDVI值进行和值运算,是提取余杭区冬小麦种植面积的最佳方法,面积精度为91.96%,说明基于多时相遥感影像结合植被物候特征与典型地物类型,能够实现冬小麦种植面积的高精度提取.

Research advances in enhanced coal seam gas extraction by controllable shock wave fracturing

With the continuous increase of mining in depth,the gas extraction faces the challenges of low permeability,great ground stress,high temperature and large gas pressure in coal seam.The controllable shock wave(CSW),as a new method for enhancing permeability of coal seam to improve gas extraction,features in the advantages of high efficiency,eco-friendly,and low cost.In order to better utilize the CSW into gas extraction in coal mine,the mechanism and feasibility of CSW enhanced extraction need to be studied.In this paper,the basic principles,the experimental tests,the mathematical models,and the on-site tests of CSW fracturing coal seams are reviewed,thereby its future research directions are provided.Based on the different media between electrodes,the CSW can be divided into three categories:hydraulic effect,wire explosion and excitation of energetic materials by detonating wire.During the process of propagation and attenuation of the high-energy shock wave in coal,the shock wave and bubble pulsation work together to produce an enhanced permeability effect on the coal seam.The stronger the strength of the CSW is,the more cracks created in the coal is,and the greater the length,width and area of the cracks being.The repeated shock on the coal seam is conducive to the formation of complex network fracture system as well as the reduction of coal seam strength,but excessive shock frequency will also damage the coal structure,resulting in the limited effect of the enhanced gas extraction.Under the influence of ground stress,the crack propagation in coal seam will be restrained.The difference of horizontal principal stress has a significant impact on the shape,propagation direction and connectivity of the CSW induced cracks.The permeability enhancement effect of CSW is affected by the breakage degree of coal seam.The shock wave is absorbed by the broken coal,which may hinder the propagation of CSW,resulting in a poor effect of permeability enhancement.When arranging two adjacent boreholes for CSW permeability enhancement test,the spacing of boreholes should not be too close,which may lead to negative pressure mutual pulling in the early stage of drainage.At present,the accurate method for effectively predicting the CSW permeability enhanced range should be further investigated.

Isotropic sintering shrinkage of 3D glass-ceramic nanolattices:backbone preforming and mechanical enhancement

There is a perpetual pursuit for free-form glasses and ceramics featuring outstanding mechanical properties as well as chemical and thermal resistance.It is a promising idea to shape inorganic materials in three-dimensional(3D)forms to reduce their weight while maintaining high mechanical properties.A popular strategy for the preparation of 3D inorganic materials is to mold the organic–inorganic hybrid photoresists into 3D micro-and nano-structures and remove the organic components by subsequent sintering.However,due to the discrete arrangement of inorganic components in the organic-inorganic hybrid photoresists,it remains a huge challenge to attain isotropic shrinkage during sintering.Herein,we demonstrate the isotropic sintering shrinkage by forming the consecutive–Si–O–Si–O–Zr–O–inorganic backbone in photoresists and fabricating 3D glass–ceramic nanolattices with enhanced mechanical properties.The femtosecond(fs)laser is used in two-photon polymerization(TPP)to fabricate 3D green body structures.After subsequent sintering at 1000℃,high-quality 3D glass–ceramic microstructures can be obtained with perfectly intact and smooth morphology.In-suit compression experiments and finite-element simulations reveal that octahedral-truss(oct-truss)lattices possess remarkable adeptness in bearing stress concentration and maintain the structural integrity to resist rod bending,indicating that this structure is a candidate for preparing lightweight and high stiffness glass–ceramic nanolattices.3D printing of such glasses and ceramics has significant implications in a number of industrial applications,including metamaterials,microelectromechanical systems,photonic crystals,and damage-tolerant lightweight materials.

Gut microbiota intervention attenuates thermogenesis in broilers exposed to high temperature through modulation of the hypothalamic 5‑HT pathway

Background Broilers have a robust metabolism and high body temperature,which make them less tolerant to hightemperature(HT)environments and more susceptible to challenges from elevated temperatures.Gut microbes,functioning as symbionts within the host,possess the capacity to significantly regulate the physiological functions and environmental adaptability of the host.This study aims to investigate the effects of gut microbial intervention on the body temperature and thermogenesis of broilers at different ambient temperatures,as well as the underlying mechanism involving the"gut-brain"axis.Methods Broilers were subjected to gut microbiota interference with or without antibiotics(control or ABX)starting at 1 day of age.At 21 day of age,they were divided into 4 groups and exposed to different environments for 7 d:The control and ABX groups at room temperature(RT,24±1℃,60%relative humidity(RH),24 h/d)and the control-HT and ABX-HT groups at high temperature(HT,32±1℃,60%RH,24 h/d).Results The results demonstrated that the antibiotic-induced gut microbiota intervention increased body weight and improved feed conversion in broiler chickens(P<0.05).Under HT conditions,the microbiota intervention reduced the rectal temperature of broiler chickens(P<0.05),inhibited the expression of avUCP and thermogenesisrelated genes in breast muscle and liver(P<0.05),and thus decreased thermogenesis capacity.Furthermore,the gut microbiota intervention blunted the hypothalamic‒pituitary‒adrenal axis and hypothalamic–pituitary–thyroid axis activation induced by HT conditions.By analyzing the cecal microbiota composition of control and ABX chickens maintained under HT conditions,we found that Alistipes was enriched in control chickens.In contrast,antibioticinduced gut microbiota intervention resulted in a decrease in the relative abundance of Alistipes(P<0.05).Moreover,this difference was accompanied by increased hypothalamic 5-hydroxytryptamine(5-HT)content and TPH2 expression(P<0.05).Conclusions These findings underscore the critical role of the gut microbiota in regulating broiler thermogenesis via the gut-brain axis and suggest that the hypothalamic 5-HT pathway may be a potential mechanism by which the gut microbiota affects thermoregulation in broilers.

系统性炎症指标可以改善弥漫大B细胞淋巴瘤患者的生存预测:模型的开发和评价

目的:基于全身炎症指标建立一个用于预测弥漫大B细胞淋巴瘤(DLBCL)患者总生存(OS)率的模型,并研究结合炎症相关参数的新模型是否比仅使用临床因素的常规模型能更有效地预测DLBCL患者的OS。方法:回顾性分析了213例DLBCL患者的临床数据,向后逐步Cox回归分析筛选与OS相关的独立预后因素,基于这些因素构建预测OS的列线图。使用Akaike信息准则(AIC)和Bayesian信息准则(BIC)评估模型的拟合情况,一致性指数、受试者工作特征曲线下面积(AUC)和校准曲线评估列线图的预测准确性,使用决策曲线分析和Kaplan-Meier曲线评估列线图的临床实用性。结果:多变量分析确定年龄、美国东部合作组体能状态评分、血清乳酸脱氢酶水平、全身免疫炎症指数、预后营养指数用于构建列线图。列线图的AIC和BIC低于国际预后指数(IPI)和美国国家综合癌症网络(NCCN)-IPI,表明列线图具有更好的拟合优度。列线图的一致性指数和AUC高于IPI和NCCN-IPI,表明列线图的预测准确性明显改善,校准曲线显示出预测结果和实际生存结果具有良好的一致性。决策曲线分析显示列线图具有更好的临床净收益。Kaplan-Meier曲线显示,根据列线图评分可以很好地将患者分为低危、中危、高危三个风险组(P<0.001)。结论:结合炎症指标的列线图可以准确地预测DLBCL患者个体化的生存概率。

Review on dietary supplements as an effective improvement of Alzheimer's disease:focus on structures and mechanisms

Alzheimer’s disease(AD),the major form of neurodegenerative diseases that can severely impede normal cognitive function,makes it one of the most common fatal diseases.There are currently over 50 million AD patients worldwide.The neuropathology of AD is perplexing and there is a scarcity of disease-modifying treatments.Currently,early diagnosis of AD has been made possible with the discovery of biological markers associated with pathology,providing strong support for the improvement of the disease status.The search for inhibitors of AD markers from dietary supplements(DSs)has become a major hot topic.Especially with the widespread use of DSs,DSs containing polyphenols,alkaloids,terpenes,polysaccharides and other bioactive components can prevent AD by reducing Aβdeposition,inhibiting tau protein hyperphosphorylation,reconstructing synaptic dysfunction,weakening cholinesterase activity,regulating mitochondrial oxidative stress,neuronal inflammation and apoptosis.This review summarizes the anti-AD effects of the main DSs and their bioactive constituents,as well as the potential molecular mechanisms covers from 2017 to 2023.Additionally,we discussed the opportunities and challenges faced by DSs in the process of AD prevention and treatment,aiming to further provide new perspectives for functional food development.

Ultrafast Laser-Induced Excellent Thermoelectric Performance of PEDOT:PSS Films

Because poly(3,4-ethylenedioxythiophene)-poly(styrenesulfonate)(PEDOT:PSS)is water processable,thermally stable,and highly conductive,PEDOT:PSS and its composites have been considered to be one of the most promising flexible thermoelectric materials.However,the PEDOT:PSS film prepared from its commercial aqueous dispersion usually has very low conductivity,thus cannot be directly utilized for TE applications.Here,a simple environmental friendly strategy via femtosecond laser irradiation without any chemical dopants and treatments was demonstrated.Under optimal conditions,the electrical conductivity of the treated film is increased to 803.1 S cm^(-1)from 1.2 S cm^(-1)around three order of magnitude higher,and the power factor is improved to 19.0μW m^(-1)K^(-2),which is enhanced more than 200 times.The mechanism for such remarkable enhancement was attributed to the transition of the PEDOT chains from a coil to a linear or expanded coil conformation,reduction of the interplanar stacking distance,and the removal of insulating PSS with increasing the oxidation level of PEDOT,facilitating the charge transportation.This work presents an effective route for fabricating high-performance flexible conductive polymer films and wearable thermoelectric devices.

脂联素受体介导小檗碱减轻糖尿病肾病肾脏脂毒性

目的探讨脂联素受体1/2(adiponectin receptor 1/2,AdipoR1/R2)介导小檗碱减轻糖尿病肾病肾脏脂毒性的作用。方法选择C57BLKS/J db/db小鼠,以db/m小鼠为对照,分为4组,每组8只,分别给予小檗碱(150 mg·kg^(﹣1)·d^(﹣1))或安慰剂灌胃,连续12周。干预结束后测定血糖、血脂、尿微量白蛋白/肌酐比值、尿白蛋白排泄率;取肾脏组织进行病理形态学检查,通过油红O染色、免疫组化、ELISA和Western印迹测定肾脏脂质沉积、AdipoR1/R2表达、转化生长因子β1(TGF-β1)及Ⅳ型胶原(Col-Ⅳ)表达等。用人肾小球内皮细胞系(HGEC)验证AdipoR1/R2介导小檗碱减轻肾脏脂毒性的作用。结果小檗碱干预后,db/db小鼠体质量减轻,血糖、血脂、蛋白尿减少(P<0.05),肾脏脂质沉积、病理改变减轻;db/db小鼠肾脏组织AdipoR1/R2表达上调,TGF-β1、Col-Ⅳ表达下调,PPAR-α、p-AMPK表达上调(P<0.05)。db/db小鼠血清干预后,高脂培养的HGEC细胞中TGF-β1、Col-Ⅳ表达下调,PPAR-α、p-AMPK表达上调(P<0.05);沉默HGEC细胞上的AdipoR1/R2后,TGF-β1、Col-Ⅳ表达上调,PPAR-α及p-AMPK表达下调(P<0.05)。结论小檗碱可以减轻糖尿病肾病小鼠模型的肾脏脂毒性,该作用可能由脂联素受体介导。

应用双向长短时记忆神经网络的微地震信号降噪方法

地面微地震监测数据噪声干扰强、信噪比低,对后续的微地震初至拾取、成像定位等产生严重影响。因此,微地震信号降噪是微地震数据预处理中的关键步骤,而常规降噪方法常依赖于算法参数的设置,不具备普遍的适用性。为此,提出了一种应用双向长短时记忆(Bi-LSTM)神经网络的微地震信号降噪方法。首先,使用合成信号和实际信号构造样本数据集,对构建的Bi-LSTM模型进行训练和测试,得到降噪效果最好的模型;然后,利用训练好的Bi-LSTM网络对不同信噪比的合成信号和川渝地区油气井的实际压裂监测微地震信号进行降噪处理。降噪后的实际微地震信号用于地震发射层析成像,并分析图像以实现地面微地震信号的震源定位。实验分析结果表明,该方法能够有效降低微地震信号中的各类噪声,提高信噪比,从而提高震源定位的精度。与传统算法相比,该方法不需要参数调整,具有良好的泛化特性。

Transcatheter arterial chemoembolization combined with CT-guided percutaneous thermal ablation versus hepatectomy in the treatment of hepatocellular carcinoma

Introduction:Transcatheter arterial chemoembolization(TACE)plus thermal ablation has been widely used recently in the treatment of hepatocellular carcinoma(HCC).In this study,we aimed to compare results of the combination of TACE and percutaneous thermal ablation with those of hepatectomy in patients with HCC.Methods:The clinical data of 137 HCC patients who sequentially received TACE and computed tomography(CT)-guided percutaneous thermal ablation as an initial curative treatment(combination group)and 148 matched HCC patients who received hepatectomy(surgery group)between 2004 and 2011 were collected and analyzed.After TACE,multiphase contrast-enhanced CT was performed to identify the total number of tumors as well as lipiodol deposition in the liver.Survival was calculated by using the Kaplan-Meier method and compared by using the log-rank test.The prognostic factors were assessed with multivariate Cox proportional hazards regression analysis.Results:Of all 285 patients,225(79.0%)had cancerous lesions≤5 cm in diameter.In preoperative contrast-enhanced CT or magnetic resonance imaging,the number of tumors was 1–4 for each patient.The 1-,3-,and 5-year overall survival rates were 95,74%,and 67%in the combination group and 88,66,and 47%in the surgery group,respectively(P=0.004);the corresponding recurrence-free survival rates for the two groups were 92,69,and 61%and 75,58,and44%,respectively(P=0.001).In the multivariate analysis,treatment allocation was an independent prognostic factor for survival.Only 60 patients in the combination group had sufficient imaging data,and 135 new lesions with lipiodol deposition were diagnosed as malignancies in 22 of 60 patients,whereas 20 new lesions were found in 11 of 148patients in the surgery group.Conclusion:The combination of TACE and CT-guided percutaneous thermal ablation for HCC improves survival of HCC patients compared with hepatectomy.

Botulinum toxin injection improved voluntary motor control in selected patients with post-stroke spasticity

The effect of botulinum toxin type A injection on voluntary grip control was examined in a 53-year-old female, who sustained a hemorrhagic right middle cerebral artery stroke 3 years previously, which resulted in finger flexor spasticity and residual weak finger/wrist extension. The patient received 50 units of botulinum toxin type A injection each to the motor points （2 sites/muscle） of the left flexor digitorum superficialis and flexor digitorum profundus, respectively. Botulinum toxin injection led to weakness and tone reduction in the spastic finger flexors, but improved grip release time in grip initiation/release reaction time tasks. Improved release time was accompanied by shortened extensor electromyography activity, and improved release time likely correlated with blocked co-contraction of finger flexors during voluntary finger extension. This case report demonstrated that botulinum toxin injection improved voluntary motor control of the hand in a chronic stroke patient with residual finger extension.