Traditional Chinese medicine for foot pain in a patient with complex regional pain syndrome: A case report

BACKGROUND Complex regional pain syndrome(CRPS)is characterized by pain as well as sensory,motor,and sudomotor disorders.Generally,it is classified into two types CRPS-I and CRPS-II.There is no single diagnostic test or treatment approach for CRPS,and a multidisciplinary approach is gaining attention to improve patients’symptoms and their quality of life.CASE SUMMARY A 35-year-old woman with an unremarkable medical history sought treatment for CRPS at a hospital of Korean medicine.During her first visit,she was wheelchairbound due to severe pain in her left lower extremity.She had edema and discoloration of the left foot.She was treated with a combination of traditional Chinese medicine(TCM)approaches,including acupuncture,moxibustion,pharmacopuncture,and herbal decoction,for approximately 20 sessions.The foot and ankle outcome score(FAOS)and visual analog scale(VAS)score for pain were evaluated,along with general signs and functions.Her symptoms,signs,FAOS,and VAS scores improved after treatment,with a significant 7-degree decrease in the VAS score and a 62-point increase in the FAOS score.Additionally,the foot swelling and discoloration gradually resolved.During the phone follow-up,5 mo after the last visit,additional improvements in outcomes were observed.CONCLUSION Combined TCM treatment may be a reasonable and safe option for alleviating symptoms and improving function in patients with CRPS.

Traditional Chinese medicine for gait disturbance in adrenoleukodystrophy:A case report and review of literature

BACKGROUND Adrenoleukodystrophy(ALD)is caused by a deficit in the ABCD1 gene,which leads to demyelination of neurons and dysfunction of the adrenal cortices and testicles.Of the three known phenotypes,30%-50%of male ALD patients present with the adrenomyeloneuropathy phenotype,characterized by gait disturbance as the initial symptom.CASE SUMMARY A 46-year-old man with a prior diagnosis of ALD was admitted to a Korean medicine hospital for the treatment of gait disturbance.His ability to walk was severely impaired at admission,significantly affecting the patient’s quality of life.He was treated with acupuncture,pharmacopuncture,electroacupuncture,and herbal medicine for 23 d.The 25-Foot Walk test(25FW),timed up and go(TUG),comfortable gait speed(CGS),numeric rating scale(NRS),Berg Balance Scale(BBS),Tinetti test,manual muscle test(MMT),and 3-level version of EuroQol-5 dimension(EQ-5D-3L)were used to evaluate the patient.The outcomes of the 25FW,TUG,and CGS improved during hospitalization.From the time of admission to discharge we observed:A decrease in NRS scores in the lower extremities and the lower back;an increase of 3 points in the BBS;a 1-point increase in the balancing part of the Tinetti Test;MMT and EQ-5D-3L performances remained unchanged.CONCLUSION Traditional Chinese medicine treatments could be a therapeutic option to alleviate issues related to gait disturbance in ALD.

Circulating immune cell landscape in patients who had mild ischaemic stroke

Introduction Patients who had a mild ischaemic stroke who present with subtle or resolving symptoms sometimes go undiagnosed,are excluded from treatment and in some cases clinically worsen.Circulating immune cells are potential biomarkers that can assist with diagnosis in ischaemic stroke.Understanding the transcriptomic changes of each cell population caused by ischaemic stroke is critical because they work closely in a complicated relationship.In this study,we investigated peripheral blood mononuclear cells(PBMCs)transcriptomics of patients who had a stroke using a single-cell RNA sequencing to understand peripheral immune response after mild stroke based on the gene expression in an unbiased way.Methods Transcriptomes of PBMCsfrom 10 patients who had an acute ischaemic stroke within 24 hours after stroke onset were compared with 9 race-matched/age-matched/gender-matched controls.Individual PBMCs were prepared with ddSeqTM(Illumina-BioRad)and sequenced on the Illumina NovaSeq 6000 platform.Results Notable population changes were observed in patients who had a stroke,especially in NK cells and CD14+monocytes.The number of NK cells was increased,which was further confirmed by flow cytometry.Functional analysis implied that the activity of NK cells also is enhanced in patients who had a stroke.CD14+monocytes were clustered into two groups;dendritic cell-related CD14+monocytes and NK cell-related CD14+monocytes.We found CD14+monocyte subclusters were dramatically reduced in patients who had a stroke.Discussion This is the first study demonstrating the increased number of NK cells and new monocyte subclusters of mild ischaemic stroke based on the transcriptomic analysis.Our findings provide the dynamics of circulating immune response that could assist diagnosis and potential therapeutic development of mild ischaemic stroke.