BACKGROUND Fecal incontinence(FI)is an involuntary passage of fecal matter which can have a significant impact on a patient’s quality of life.Many modalities of treatment exist for FI.Sacral nerve stimulation is a we...BACKGROUND Fecal incontinence(FI)is an involuntary passage of fecal matter which can have a significant impact on a patient’s quality of life.Many modalities of treatment exist for FI.Sacral nerve stimulation is a well-established treatment for FI.Given the increased need of magnetic resonance imaging(MRI)for diagnostics,the In-terStim which was previously used in sacral nerve stimulation was limited by MRI incompatibility.Medtronic MRI-compatible InterStim was approved by the United States Food and Drug Administration in August 2020 and has been widely used.AIM To evaluate the efficacy,outcomes and complications of the MRI-compatible InterStim.METHODS Data of patients who underwent MRI-compatible Medtronic InterStim placement at UPMC Williamsport,University of Minnesota,Advocate Lutheran General Hospital,and University of Wisconsin-Madison was pooled and analyzed.Patient demographics,clinical features,surgical techniques,complications,and outcomes were analyzed.Strengthening the Reporting of Observational studies in Epidemiology(STROBE)cross-sectional reporting guidelines were used.RESULTS Seventy-three patients had the InterStim implanted.The mean age was 63.29±12.2 years.Fifty-seven(78.1%)patients were females and forty-two(57.5%)patients had diabetes.In addition to incontinence,overlapping symptoms included diarrhea(23.3%),fecal urgency(58.9%),and urinary incontinence(28.8%).Fifteen(20.5%)patients underwent Peripheral Nerve Evaluation before proceeding to definite implant placement.Thirty-two(43.8%)patients underwent rechargeable InterStim placement.Three(4.1%)patients needed removal of the implant.Migration of the external lead connection was observed in 7(9.6%)patients after the stage I procedure.The explanation for one patient was due to infection.Seven(9.6%)patients had other complications like nerve pain,hematoma,infection,lead fracture,and bleeding.The mean follow-up was 6.62±3.5 mo.Sixty-eight(93.2%)patients reported significant improvement of symptoms on follow-up evaluation.CONCLUSION This study shows promising results with significant symptom improvement,good efficacy and good patient outcomes with low complication rates while using MRI compatible InterStim for FI.Further long-term follow-up and future studies with a larger patient population is recommended.展开更多
Generalized Tonic Clonic Seizure(GTCS)is a form of epileptic seizure in which a patient loses control over their entire body,ultimately leading to loss of consciousness.The Vagus Nerve Stimulator(VNS)is a tool/method ...Generalized Tonic Clonic Seizure(GTCS)is a form of epileptic seizure in which a patient loses control over their entire body,ultimately leading to loss of consciousness.The Vagus Nerve Stimulator(VNS)is a tool/method for treating epileptic episodes that sends counter-electrical stimulations to the Vagus Nerve in order to mitigate epileptic signals from the brain.The machine is a stand-alone device that depends on human decision-making.The proposed framework uses an IoT and Blockchain oversight mechanism to augment the device's transparency.The system counteracts against false-activation by monitoring the patient's vitals through a smart watch and allows only legitimate use.The nominal operating threshold is determined by preprocessing inferences that include an 18-year-old GTCS epileptic patient and a data set of 281 non-GTCS epileptic patients.The proposed system functions as a dual control lock where the IoT system and the manually activation system work in tandem to activate the device.Based on the values sensed by the IoT device,the deployed system is able to make deci-sions and regulate the use of the VNS.The IoT-Blockchain framework is able to fully eradicate false activation by increasing accuracy and transparency,ensur-ing the device is used correctly and safely.展开更多
BACKGROUND The utility of novel oral soluble guanylate cyclase(sGC)stimulators(vericiguat and riociguat),in patients with reduced or preserved ejection fraction heart failure(HFrEF/HFpEF)is currently unclear.AIM To de...BACKGROUND The utility of novel oral soluble guanylate cyclase(sGC)stimulators(vericiguat and riociguat),in patients with reduced or preserved ejection fraction heart failure(HFrEF/HFpEF)is currently unclear.AIM To determine the efficacy and safety of sGC stimulators in HF patients.METHODS Multiple databases were searched to identify relevant randomized controlled trials(RCTs).Data on the safety and efficacy of sGC stimulators were compared using relative risk ratio(RR)on a random effect model.RESULTS Six RCTs,comprising 5604 patients(2801 in sGC stimulator group and 2803 placebo group)were included.The primary endpoint(a composite of cardiovascular mortality and first HF-related hospitalization)was significantly reduced in patients receiving sGC stimulators compared to placebo[RR 0.92,95%confidence interval(CI):0.85-0.99,P=0.02].The incidence of total HF-related hospitalizations were also lower in sGC group(RR 0.91,95%CI:0.86-0.96,P=0.0009),however,sGC stimulators had no impact on all-cause mortality(RR 0.96,95%CI:0.86-1.07,P=0.45)or cardiovascular mortality(RR 0.94,95%CI:0.83-1.06,P=0.29).The overall safety endpoint(a composite of hypotension and syncope)was also similar between the two groups(RR 1.50,95%CI:0.93-2.42,P=0.10).By contrast,a stratified subgroup analysis adjusted by type of sGC stimulator and HF(vericiguat vs riociguat and HFrEF vs HFpEF)showed near identical rates for all safety and efficacy endpoints between the two groups at a mean follow-up of 19 wk.For the primary composite endpoint,the number needed to treat was 35,the number needed to harm was 44.CONCLUSION The use of vericiguat and riociguat in conjunction with standard HF therapy,shows no benefit in terms of decreasing HF-related hospitalizations or mortality.展开更多
BACKGROUND: Han's acupoint nerve stimulator (HANS) has been frequently used to relieve pain by promoting the central nerve system's release of endogenous opioid peptides through electric stimulation to the body s...BACKGROUND: Han's acupoint nerve stimulator (HANS) has been frequently used to relieve pain by promoting the central nerve system's release of endogenous opioid peptides through electric stimulation to the body surface. OBJECTIVE: To investigate the pain-relieving effects of HANS, combined with patient-controlled analgesia, following neurosurgery, and to observe adverse reactions and effects. DESIGN, TIME AND SETTING: A randomized control observation was performed at the Department of Neurology in the First Affiliated Hospital of Gannan Medical College (Ganzhou, Jiangxi Province, China) from January 2005 to February 2006. PARTICIPANTS: Forty patients, who were selected for craniotomy and required pain relief following surgery at the Department of Neurology in the First Affiliated Hospital of Gannan Medical College (China), were included in this study. METHODS: Forty patients underwent neurosurgery and were randomly divided into two groups: patient-controlled analgesia plus HANS (+HANS, n = 20) and patient-controlled analgesia (-HANS, n = 20). Both groups were well matched in baseline data. Automatic syringe infusion pump ZZB-150 was the product of Nantong Aipeng Medical Instruments Co., Ltd. (China). Patient-controlled analgesia consisted of 100 mL 0.02% lappaconitine/0.02% metoclopramide. LH-402 HANS instrument was produced in Beijing (China), with a serial number of 402183. The HANS instrumentation was used to stimulate the Hegu-Laogong acupoint on one side and Jiaogan, Shenmen penetrating Shen, Waifei, Naogan penetrating Pizhixia ear acupoints on the affected side for one hour, with 2-hour intervals. The disperse-dense wave was alternating, with a 2/100 Hz frequency of electrical stimulation. MAIN OUTCOME MEASURE: The scores of visual analogue scale and incidence of adverse reaction were observed in two groups following surgery. RESULTS: Compared with the HANS group, the visual analogue scale scores were remarkably lower in the +HANS group six hours after surgery (P 〈 0.01), and the incidence rate of adverse reactions, such as nausea and vomiting, was also decreased (P 〈 0.05).CONCLUSION: The application of HANS to induce body surface stimulation can enhance the effect of pain relief and reduce adverse reactions when used in combination with patient-controlled analgesia following neurosurgery. The effect of combined therapy is superior to patient-controlled analgesia alone.展开更多
Sorgaab, an aqueous extract of sorghum leaves was applied to probe the modulation in growth and physiological attributes of maize under drought in lab and greenhouse studies. Sorgaab soaked seeds (10 dilutions) were g...Sorgaab, an aqueous extract of sorghum leaves was applied to probe the modulation in growth and physiological attributes of maize under drought in lab and greenhouse studies. Sorgaab soaked seeds (10 dilutions) were germinated to assess drought tolerance at germination and seedling growth stages. More concentrated Sorgaab solutions (2 mL·L-1) were damaging, while lower concentration in the range of 0.75 to 1.5 mL·L-1 improved the root and shoot growth of maize under drought. Applied drought stress decreased chlorophyll b greater than chlorophyll a that improved the chl a/b ratio. Application of Sorgaab also improved the internal CO2 assimilation, which increased the net photosynthesis and A/E ratio of drought affected plants. Soluble phenolics and anthocyanins were also more increased in plant receiving Sorgaab under drought than control. Although greater concentrations of phenolic acids inhibit the uptake of ions, but its lower concentrations stimulate the uptake of K+, Ca2+, NO3, PO4. In conclusion, although high concentrations of Sorgaab reduced the growth of plants, it might alleviate the adverse effects of drought, if applied at the low concentration. Dilute concentrations of Sorgaab can be utilized as a natural source for improving drought resistance in maize both at germination and later growth stages.展开更多
In this article we discuss the effect of posture on impedance during the placement of a spinal cord stimulator. Although, according to several studies, there appears not to be a specific and consistent change in imped...In this article we discuss the effect of posture on impedance during the placement of a spinal cord stimulator. Although, according to several studies, there appears not to be a specific and consistent change in impedance with change in posture, we noticed on multiple occasions that if the impedance remains very high during spinal cord stimulator (SCS) lead placement, asking the patient to sit up from the prone position may drop the impedance down. This could be explained by having air around the lead, from using loss of resistance to air technique in finding the epidural space, which moves up when sitting the patient up, or having the lead immersed in epidural fat. Sitting the patient up from the prone position should be tried if the impedance remains very high before aborting the procedure and taking the lead out.展开更多
Application of growth stimulators can be especially effective on plantlets in vitro of tree species which are usually worse rooted and adapted in comparison with annual plants. In our work we evaluate effects of natur...Application of growth stimulators can be especially effective on plantlets in vitro of tree species which are usually worse rooted and adapted in comparison with annual plants. In our work we evaluate effects of natural (dihydroquercetin, Zircon) and synthetic growth stimulators (Melafen, Fumar, Epin-Extra) on rooting and acclimatization of common ash (Fraxinus excelsior L.) microplants. The 0.05% -?0.2% Zircon and 10-5%?Melafen enhanced in vitro rooting by 29% -?37% and 31%, respectively. Melafen also stimulated root formation faster compared to control plants. The dihydroquercetin concentration of 0.01% increased rooting by 24% and root number per shoot by 1.8 times. In vitro plants rooted on media supplemented with Melafen, Fumar and Zircon demonstrated enhanced ability to adapt to non-sterile conditions and accelerated growth. Two months after planting to the greenhouse, plants rooted on 0.01% dihydroquercetin were 45% taller than the control. Weekly spraying of plantlets with 0.02% Epin-Extra containing 24-epibrassinolid stimulated growth of uniform plants with large leaves. The obtained results support the use of growth stimulators for application in clonal micropropagation of common ash both for large-scale production of planting stock and for conservation of rare and valuable genotypes.展开更多
Objective: To study the effect of nerve stimulator-guided nerve block on the pain mediator secretion and stress degree after lower extremity operation. Methods: Patients who received lower extremity operation in Miany...Objective: To study the effect of nerve stimulator-guided nerve block on the pain mediator secretion and stress degree after lower extremity operation. Methods: Patients who received lower extremity operation in Mianyang Orthopaedic Hospital between March 2015 and August 2017 were selected, and the analgesia methods within the medical records were reviewed and used to divide the patients into nerve block group, spinal analgesia group and intravenous analgesia group. The secretion of pain mediators, stress hormones, stress products and inflammatory factors in serum was measured 24 h after surgery. Results: CGRP, β-EP, 5-HT, HA, ACTH, Cor, PRL, GH, TSH, sTNFR-1, IL-2, IL-10 and TGF-β1 secretion as well as CRP, MPO, MDA and ROS generation in serum of nerve block group were significantly lower than those of spinal analgesia group and intravenous analgesia group, and the differences in serum pain mediators, stress hormones, stress products and inflammatory factors were statistically significant between nerve block group and spinal analgesia group as well as between nerve block group and intravenous analgesia group. Conclusion: The nerve stimulator-guided nerve block can be more effective than spinal analgesia and intravenous analgesia to reduce the secretion of pain mediators and relieve the degree of stress after lower extremity operation.展开更多
Optimal activation of T cells requires at least 2signals. Signal one is generated by interactionsbetween T cell receptor and antigenic peptide-majorhistocompatibility complex on antigen-presentingcells. Signal two is ...Optimal activation of T cells requires at least 2signals. Signal one is generated by interactionsbetween T cell receptor and antigenic peptide-majorhistocompatibility complex on antigen-presentingcells. Signal two is delivered by co-stimulatory ligandson antigen-presenting cells to their receptors on展开更多
To make rat do active exercise to counteract bone loss in the rat tail-suspension model, a pulse electrical stimulator based on single-electrode with a low-current and a high-voltage was designed. The stimulator was c...To make rat do active exercise to counteract bone loss in the rat tail-suspension model, a pulse electrical stimulator based on single-electrode with a low-current and a high-voltage was designed. The stimulator was controlled by SCM (single chip micyoco) that could accurately control the stimulation duration and the interval between stimulations, and cease the operation after the recorded number of stimulation had reached the value set by the program. With the help of posture estimation part, the device would operate intelligently by determining whether to stimulate or not, depending on the posture of rat's limb. Software was developed to make operator control the stimulator using computer, save the experiment data and print the report. In practical experiment, the voltaic arc is generated by the stimulator, and impacted on the rat's thenar. This induced pain to the rat and the rat would actively contract its hindlimb to evade the pain, so active exercise was carried out. The tail-suspension rats were trained twice every day for 14 d. At the 0 and 14th day, bone mineral density of rat femurs was determined by dual energy X-ray absorptiometry (DXA). The results show that the active exercise stimulated by the pulse electrical arc stimulator can attenuate weightlessness-induced bone loss, and this device is a convenient steady performance electrical stimulator that can surely induce rat's hindlimb to do active exercise.展开更多
Introduction: Collecting a patient’s pain scores and the analgesic effect achieved during spinal cord stimulation (SCS) trials can be difficult, and no standard exists for doing so. We propose a topographical mapping...Introduction: Collecting a patient’s pain scores and the analgesic effect achieved during spinal cord stimulation (SCS) trials can be difficult, and no standard exists for doing so. We propose a topographical mapping tool that was derived from a patient’s perspective. Case: A 60-year-old man with postherpetic neuralgia (PHN) underwent a SCS trial after conservative treatment failed to relieve his pain. During the SCS trial, with the SCS off and on in five different settings, he recorded pain levels in each of the six different painful zones he identified. The data collected were transferred to a topographical and anatomical map, which helped the physicians to better understand the effects of the SCS at different settings. Ultimately, the data collected by the patient helped the physicians to implant a permanent SCS successfully. Conclusions: Patient pain diaries have been used in pain medicine for years. This particular patient’s collection of pain scores and SCS effects inspired the construction of a more standardized tool for collecting such data during SCS trials. We propose that use of our Topographical Anatomical Neuropathic-pain Guided (TANG) mapping tool will enable physicians to choose SCS lead positions more precisely than is currently possible.展开更多
Gastric disorders play an important role in digestive system of a human subject. Gastric disorder is due to the gastric dysmotility due to delayed gastric emptying and other motor dysfunctions like impaired fundic dis...Gastric disorders play an important role in digestive system of a human subject. Gastric disorder is due to the gastric dysmotility due to delayed gastric emptying and other motor dysfunctions like impaired fundic distention. Nowadays invasive technique like laparoscopy procedure, endoscopy procedure and surgery procedure plays a vital role in investigation of gastric disorders. Electrogastrogram is a noninvasive technique for analyzing digestive system disorders. In this proposed work, stimulation is delivered with the electrode package with camera, which travels through an esophagus to reach stomach and stimulate the interstitial cajal cells. Due to this stimulation the stomach starts, its activity a potential is provided that is recorded with electrode setup, which is called electrogastrogram. It is verified with its normal range 3 cpm. The stimulation includes pulses mode and continuous mode. Stomach function is recovered and its frequency is measured and the same is compared with normal range value. Depending upon the subject condition, the gastric activity is improved by setting different values of duty cycle. By this procedure the subject avoid painful procedure, stay in hospital, frequently and the cost is minimum.展开更多
1) Background: Osteoarthritis (OA) is defined as a degenerative joint disease that mainly affects the bone. This study aims to evaluate the effect of low-intensity continuous ultrasound (LICUS) treatment on the knee o...1) Background: Osteoarthritis (OA) is defined as a degenerative joint disease that mainly affects the bone. This study aims to evaluate the effect of low-intensity continuous ultrasound (LICUS) treatment on the knee of osteoarthritis patients through home-based intervention using the LICUS medical device. 2) Methods: The clinical trials were designed in a single-arm, open-label, and intervention study. Thirty-five participants, including those who dropped out (12%), were screened and enrolled. The patients received LICUS (1.1 MHz, 1.5 W/cm2, collimated beams) on the knee by the instructions of the investigator at home (5 min/session, 3 times/day, for four-weeks). Outcome measures were assessed using the Visual Analog Scale (VAS) as a primary endpoint and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) as a secondary endpoint to evaluate pain relief and functional recovery of the knee between pre-treatment (baseline) and post-treatment (four-weeks). 3) Results: Knee pain scores measured using the VAS and WOMAC indices were significantly reduced after a four-week treatment with LICUS compared to baseline. Knee stiffness and functional capacity were significantly reduced after the LICUS application. In addition, there were no reports of adverse effects during the study period. 4) Conclusion: Long-term and home-based application of LICUS can be recommended as an alternative option for the treatment of OA patients, as evidenced by the effect of pain relief and knee function recovery.展开更多
Objective This work explores the impact of electroacupuncture(EA)on acute postoperative pain(APP)and the role of stimulator of interferon genes/type-1 interferon(STING/IFN-1)signaling pathway modulation in the analges...Objective This work explores the impact of electroacupuncture(EA)on acute postoperative pain(APP)and the role of stimulator of interferon genes/type-1 interferon(STING/IFN-1)signaling pathway modulation in the analgesic effect of EA in APP rats.Methods The APP rat model was initiated through abdominal surgery and the animals received two 30 min sessions of EA at bilateral ST36(Zusanli)and SP6(Sanyinjiao)acupoints.Mechanical,thermal and cold sensitivity tests were performed to measure the pain threshold,and electroencephalograms were recorded in the primary somatosensory cortex to identify the effects of EA treatment on APP.Western blotting and immunofluorescence were used to examine the expression and distribution of proteins in the STING/IFN-1 pathway as well as neuroinflammation.A STING inhibitor(C-176)was administered intrathecally to verify its role in EA.Results APP rats displayed mechanical and thermal hypersensitivities compared to the control group(P<0.05).APP significantly reduced the amplitude ofθ,αandγoscillations compared to their baseline values(P<0.05).Interestingly,expression levels of proteins in the STING/IFN-1 pathway were downregulated after inducing APP(P<0.05).Further,APP increased pro-inflammatory factors,including interleukin-6,tumor necrosis factor-αand inducible nitric oxide synthase,and downregulated anti-inflammatory factors,including interleukin-10 and arginase-1(P<0.05).EA effectively attenuated APP-induced painful hypersensitivities(P<0.05)and restored theθ,αandγpower in APP rats(P<0.05).Meanwhile,EA distinctly activated the STING/IFN-1 pathway and mitigated the neuroinflammatory response(P<0.05).Furthermore,STING/IFN-1 was predominantly expressed in isolectin-B4-or calcitonin-gene-related-peptide-labeled dorsal root ganglion neurons and superficial laminae of the spinal dorsal horn.Inhibition of the STING/IFN-1 pathway by intrathecal injection of C-176 weakened the analgesic and anti-inflammatory effects of EA on APP(P<0.05).Conclusion EA can generate robust analgesic and anti-inflammatory effects on APP,and these effects may be linked to activating the STING/IFN-1 pathway,suggesting that STING/IFN-1 may be a target for relieving APP.展开更多
Intracytoplasmic sperm injection(ICSI)is an effective method for human-assisted reproductive technology,especially for male-factor infertility.However,the average fertilization rate of ICSI is 70%,and total fertilizat...Intracytoplasmic sperm injection(ICSI)is an effective method for human-assisted reproductive technology,especially for male-factor infertility.However,the average fertilization rate of ICSI is 70%,and total fertilization failure occurs in 3%of cycles.[1]Oocyte activation deficiency is the primary cause of fertilization failure.展开更多
Dear Editor,Great progress has been made in the clinical use of photodynamic therapy(PDT)for the treatment of patients with superficial tumors[1].However,cancer recurrence and metastasis have limited the application o...Dear Editor,Great progress has been made in the clinical use of photodynamic therapy(PDT)for the treatment of patients with superficial tumors[1].However,cancer recurrence and metastasis have limited the application of PDT in the treatment of solid tumors and advanced cancers.In this context,combining PDT with other complementary immunotherapy regimens may overcome these limitations of PDT[2].展开更多
Non-invasive cerebral neuromodulation technologies are essential for the reorganization of cerebral neural networks,which have been widely applied in the field of central neurological diseases,such as stroke,Parkinson...Non-invasive cerebral neuromodulation technologies are essential for the reorganization of cerebral neural networks,which have been widely applied in the field of central neurological diseases,such as stroke,Parkinson’s disease,and mental disorders.Although significant advances have been made in neuromodulation technologies,the identification of optimal neurostimulation paramete rs including the co rtical target,duration,and inhibition or excitation pattern is still limited due to the lack of guidance for neural circuits.Moreove r,the neural mechanism unde rlying neuromodulation for improved behavioral performance remains poorly understood.Recently,advancements in neuroimaging have provided insight into neuromodulation techniques.Functional near-infrared spectroscopy,as a novel non-invasive optical brain imaging method,can detect brain activity by measuring cerebral hemodynamics with the advantages of portability,high motion tole rance,and anti-electromagnetic interference.Coupling functional near-infra red spectroscopy with neuromodulation technologies offe rs an opportunity to monitor the cortical response,provide realtime feedbac k,and establish a closed-loop strategy integrating evaluation,feedbac k,and intervention for neurostimulation,which provides a theoretical basis for development of individualized precise neuro rehabilitation.We aimed to summarize the advantages of functional near-infra red spectroscopy and provide an ove rview of the current research on functional near-infrared spectroscopy in transcranial magnetic stimulation,transcranial electrical stimulation,neurofeedback,and braincomputer interfaces.Furthermore,the future perspectives and directions for the application of functional near-infrared spectroscopy in neuromodulation are summarized.In conclusion,functional near-infrared spectroscopy combined with neuromodulation may promote the optimization of central pellral reorganization to achieve better functional recovery form central nervous system diseases.展开更多
Non-invasive brain stimulation techniques(NIBS),including repetitive transcranial magnetic stimulation(rTMS) and transcranial electric stim ulation(tES),are increasingly being adopted clinically for treatment of neuro...Non-invasive brain stimulation techniques(NIBS),including repetitive transcranial magnetic stimulation(rTMS) and transcranial electric stim ulation(tES),are increasingly being adopted clinically for treatment of neuropsychiatric and neurological disorders,albeit with varying success.The rationale behind the use of NIBS has historically been that stim ulation techniques modulate neuronal activity in the targeted region and consequently induce plasticity which can lead to therapeutic outcomes.展开更多
Reconstruction of irregular oral-maxillofacial bone defects with an inflammatory microenvironment remains a challenge,as chronic local inflammation can largely impair bone healing.Here,we used magnesium silicate nanos...Reconstruction of irregular oral-maxillofacial bone defects with an inflammatory microenvironment remains a challenge,as chronic local inflammation can largely impair bone healing.Here,we used magnesium silicate nanospheres(MSNs)to load microRNA-146a-5p(miR-146a)to fabricate a nanobiomaterial,MSN+miR-146a,which showed synergistic promoting effects on the osteogenic differentiation of human dental pulp stem cells(hDPSCs).In addition,miR-146a exhibited an anti-inflammatory effect on mouse bone marrow-derived macrophages(BMMs)under lipopolysaccharide(LPS)stimulation by inhibiting the NF-κB pathway via targeting tumor necrosis factor receptor-associated factor 6(TRAF6),and MSNs could simultaneously promote M2 polarization of BMMs.MiR-146a was also found to inhibit osteoclast formation.Finally,the dual osteogenic-promoting and immunoregulatory effects of MSN+miR-146a were further validated in a stimulated infected mouse mandibular bone defect model via delivery by a photocuring hydrogel.Collectively,the MSN+miR-146a complex revealed good potential in treating inflammatory irregular oralmaxillofacial bone defects.展开更多
文摘BACKGROUND Fecal incontinence(FI)is an involuntary passage of fecal matter which can have a significant impact on a patient’s quality of life.Many modalities of treatment exist for FI.Sacral nerve stimulation is a well-established treatment for FI.Given the increased need of magnetic resonance imaging(MRI)for diagnostics,the In-terStim which was previously used in sacral nerve stimulation was limited by MRI incompatibility.Medtronic MRI-compatible InterStim was approved by the United States Food and Drug Administration in August 2020 and has been widely used.AIM To evaluate the efficacy,outcomes and complications of the MRI-compatible InterStim.METHODS Data of patients who underwent MRI-compatible Medtronic InterStim placement at UPMC Williamsport,University of Minnesota,Advocate Lutheran General Hospital,and University of Wisconsin-Madison was pooled and analyzed.Patient demographics,clinical features,surgical techniques,complications,and outcomes were analyzed.Strengthening the Reporting of Observational studies in Epidemiology(STROBE)cross-sectional reporting guidelines were used.RESULTS Seventy-three patients had the InterStim implanted.The mean age was 63.29±12.2 years.Fifty-seven(78.1%)patients were females and forty-two(57.5%)patients had diabetes.In addition to incontinence,overlapping symptoms included diarrhea(23.3%),fecal urgency(58.9%),and urinary incontinence(28.8%).Fifteen(20.5%)patients underwent Peripheral Nerve Evaluation before proceeding to definite implant placement.Thirty-two(43.8%)patients underwent rechargeable InterStim placement.Three(4.1%)patients needed removal of the implant.Migration of the external lead connection was observed in 7(9.6%)patients after the stage I procedure.The explanation for one patient was due to infection.Seven(9.6%)patients had other complications like nerve pain,hematoma,infection,lead fracture,and bleeding.The mean follow-up was 6.62±3.5 mo.Sixty-eight(93.2%)patients reported significant improvement of symptoms on follow-up evaluation.CONCLUSION This study shows promising results with significant symptom improvement,good efficacy and good patient outcomes with low complication rates while using MRI compatible InterStim for FI.Further long-term follow-up and future studies with a larger patient population is recommended.
文摘Generalized Tonic Clonic Seizure(GTCS)is a form of epileptic seizure in which a patient loses control over their entire body,ultimately leading to loss of consciousness.The Vagus Nerve Stimulator(VNS)is a tool/method for treating epileptic episodes that sends counter-electrical stimulations to the Vagus Nerve in order to mitigate epileptic signals from the brain.The machine is a stand-alone device that depends on human decision-making.The proposed framework uses an IoT and Blockchain oversight mechanism to augment the device's transparency.The system counteracts against false-activation by monitoring the patient's vitals through a smart watch and allows only legitimate use.The nominal operating threshold is determined by preprocessing inferences that include an 18-year-old GTCS epileptic patient and a data set of 281 non-GTCS epileptic patients.The proposed system functions as a dual control lock where the IoT system and the manually activation system work in tandem to activate the device.Based on the values sensed by the IoT device,the deployed system is able to make deci-sions and regulate the use of the VNS.The IoT-Blockchain framework is able to fully eradicate false activation by increasing accuracy and transparency,ensur-ing the device is used correctly and safely.
文摘BACKGROUND The utility of novel oral soluble guanylate cyclase(sGC)stimulators(vericiguat and riociguat),in patients with reduced or preserved ejection fraction heart failure(HFrEF/HFpEF)is currently unclear.AIM To determine the efficacy and safety of sGC stimulators in HF patients.METHODS Multiple databases were searched to identify relevant randomized controlled trials(RCTs).Data on the safety and efficacy of sGC stimulators were compared using relative risk ratio(RR)on a random effect model.RESULTS Six RCTs,comprising 5604 patients(2801 in sGC stimulator group and 2803 placebo group)were included.The primary endpoint(a composite of cardiovascular mortality and first HF-related hospitalization)was significantly reduced in patients receiving sGC stimulators compared to placebo[RR 0.92,95%confidence interval(CI):0.85-0.99,P=0.02].The incidence of total HF-related hospitalizations were also lower in sGC group(RR 0.91,95%CI:0.86-0.96,P=0.0009),however,sGC stimulators had no impact on all-cause mortality(RR 0.96,95%CI:0.86-1.07,P=0.45)or cardiovascular mortality(RR 0.94,95%CI:0.83-1.06,P=0.29).The overall safety endpoint(a composite of hypotension and syncope)was also similar between the two groups(RR 1.50,95%CI:0.93-2.42,P=0.10).By contrast,a stratified subgroup analysis adjusted by type of sGC stimulator and HF(vericiguat vs riociguat and HFrEF vs HFpEF)showed near identical rates for all safety and efficacy endpoints between the two groups at a mean follow-up of 19 wk.For the primary composite endpoint,the number needed to treat was 35,the number needed to harm was 44.CONCLUSION The use of vericiguat and riociguat in conjunction with standard HF therapy,shows no benefit in terms of decreasing HF-related hospitalizations or mortality.
文摘BACKGROUND: Han's acupoint nerve stimulator (HANS) has been frequently used to relieve pain by promoting the central nerve system's release of endogenous opioid peptides through electric stimulation to the body surface. OBJECTIVE: To investigate the pain-relieving effects of HANS, combined with patient-controlled analgesia, following neurosurgery, and to observe adverse reactions and effects. DESIGN, TIME AND SETTING: A randomized control observation was performed at the Department of Neurology in the First Affiliated Hospital of Gannan Medical College (Ganzhou, Jiangxi Province, China) from January 2005 to February 2006. PARTICIPANTS: Forty patients, who were selected for craniotomy and required pain relief following surgery at the Department of Neurology in the First Affiliated Hospital of Gannan Medical College (China), were included in this study. METHODS: Forty patients underwent neurosurgery and were randomly divided into two groups: patient-controlled analgesia plus HANS (+HANS, n = 20) and patient-controlled analgesia (-HANS, n = 20). Both groups were well matched in baseline data. Automatic syringe infusion pump ZZB-150 was the product of Nantong Aipeng Medical Instruments Co., Ltd. (China). Patient-controlled analgesia consisted of 100 mL 0.02% lappaconitine/0.02% metoclopramide. LH-402 HANS instrument was produced in Beijing (China), with a serial number of 402183. The HANS instrumentation was used to stimulate the Hegu-Laogong acupoint on one side and Jiaogan, Shenmen penetrating Shen, Waifei, Naogan penetrating Pizhixia ear acupoints on the affected side for one hour, with 2-hour intervals. The disperse-dense wave was alternating, with a 2/100 Hz frequency of electrical stimulation. MAIN OUTCOME MEASURE: The scores of visual analogue scale and incidence of adverse reaction were observed in two groups following surgery. RESULTS: Compared with the HANS group, the visual analogue scale scores were remarkably lower in the +HANS group six hours after surgery (P 〈 0.01), and the incidence rate of adverse reactions, such as nausea and vomiting, was also decreased (P 〈 0.05).CONCLUSION: The application of HANS to induce body surface stimulation can enhance the effect of pain relief and reduce adverse reactions when used in combination with patient-controlled analgesia following neurosurgery. The effect of combined therapy is superior to patient-controlled analgesia alone.
文摘Sorgaab, an aqueous extract of sorghum leaves was applied to probe the modulation in growth and physiological attributes of maize under drought in lab and greenhouse studies. Sorgaab soaked seeds (10 dilutions) were germinated to assess drought tolerance at germination and seedling growth stages. More concentrated Sorgaab solutions (2 mL·L-1) were damaging, while lower concentration in the range of 0.75 to 1.5 mL·L-1 improved the root and shoot growth of maize under drought. Applied drought stress decreased chlorophyll b greater than chlorophyll a that improved the chl a/b ratio. Application of Sorgaab also improved the internal CO2 assimilation, which increased the net photosynthesis and A/E ratio of drought affected plants. Soluble phenolics and anthocyanins were also more increased in plant receiving Sorgaab under drought than control. Although greater concentrations of phenolic acids inhibit the uptake of ions, but its lower concentrations stimulate the uptake of K+, Ca2+, NO3, PO4. In conclusion, although high concentrations of Sorgaab reduced the growth of plants, it might alleviate the adverse effects of drought, if applied at the low concentration. Dilute concentrations of Sorgaab can be utilized as a natural source for improving drought resistance in maize both at germination and later growth stages.
文摘In this article we discuss the effect of posture on impedance during the placement of a spinal cord stimulator. Although, according to several studies, there appears not to be a specific and consistent change in impedance with change in posture, we noticed on multiple occasions that if the impedance remains very high during spinal cord stimulator (SCS) lead placement, asking the patient to sit up from the prone position may drop the impedance down. This could be explained by having air around the lead, from using loss of resistance to air technique in finding the epidural space, which moves up when sitting the patient up, or having the lead immersed in epidural fat. Sitting the patient up from the prone position should be tried if the impedance remains very high before aborting the procedure and taking the lead out.
文摘Application of growth stimulators can be especially effective on plantlets in vitro of tree species which are usually worse rooted and adapted in comparison with annual plants. In our work we evaluate effects of natural (dihydroquercetin, Zircon) and synthetic growth stimulators (Melafen, Fumar, Epin-Extra) on rooting and acclimatization of common ash (Fraxinus excelsior L.) microplants. The 0.05% -?0.2% Zircon and 10-5%?Melafen enhanced in vitro rooting by 29% -?37% and 31%, respectively. Melafen also stimulated root formation faster compared to control plants. The dihydroquercetin concentration of 0.01% increased rooting by 24% and root number per shoot by 1.8 times. In vitro plants rooted on media supplemented with Melafen, Fumar and Zircon demonstrated enhanced ability to adapt to non-sterile conditions and accelerated growth. Two months after planting to the greenhouse, plants rooted on 0.01% dihydroquercetin were 45% taller than the control. Weekly spraying of plantlets with 0.02% Epin-Extra containing 24-epibrassinolid stimulated growth of uniform plants with large leaves. The obtained results support the use of growth stimulators for application in clonal micropropagation of common ash both for large-scale production of planting stock and for conservation of rare and valuable genotypes.
文摘Objective: To study the effect of nerve stimulator-guided nerve block on the pain mediator secretion and stress degree after lower extremity operation. Methods: Patients who received lower extremity operation in Mianyang Orthopaedic Hospital between March 2015 and August 2017 were selected, and the analgesia methods within the medical records were reviewed and used to divide the patients into nerve block group, spinal analgesia group and intravenous analgesia group. The secretion of pain mediators, stress hormones, stress products and inflammatory factors in serum was measured 24 h after surgery. Results: CGRP, β-EP, 5-HT, HA, ACTH, Cor, PRL, GH, TSH, sTNFR-1, IL-2, IL-10 and TGF-β1 secretion as well as CRP, MPO, MDA and ROS generation in serum of nerve block group were significantly lower than those of spinal analgesia group and intravenous analgesia group, and the differences in serum pain mediators, stress hormones, stress products and inflammatory factors were statistically significant between nerve block group and spinal analgesia group as well as between nerve block group and intravenous analgesia group. Conclusion: The nerve stimulator-guided nerve block can be more effective than spinal analgesia and intravenous analgesia to reduce the secretion of pain mediators and relieve the degree of stress after lower extremity operation.
文摘Optimal activation of T cells requires at least 2signals. Signal one is generated by interactionsbetween T cell receptor and antigenic peptide-majorhistocompatibility complex on antigen-presentingcells. Signal two is delivered by co-stimulatory ligandson antigen-presenting cells to their receptors on
基金Project(10872024) supported by the National Natural Science Foundation of China
文摘To make rat do active exercise to counteract bone loss in the rat tail-suspension model, a pulse electrical stimulator based on single-electrode with a low-current and a high-voltage was designed. The stimulator was controlled by SCM (single chip micyoco) that could accurately control the stimulation duration and the interval between stimulations, and cease the operation after the recorded number of stimulation had reached the value set by the program. With the help of posture estimation part, the device would operate intelligently by determining whether to stimulate or not, depending on the posture of rat's limb. Software was developed to make operator control the stimulator using computer, save the experiment data and print the report. In practical experiment, the voltaic arc is generated by the stimulator, and impacted on the rat's thenar. This induced pain to the rat and the rat would actively contract its hindlimb to evade the pain, so active exercise was carried out. The tail-suspension rats were trained twice every day for 14 d. At the 0 and 14th day, bone mineral density of rat femurs was determined by dual energy X-ray absorptiometry (DXA). The results show that the active exercise stimulated by the pulse electrical arc stimulator can attenuate weightlessness-induced bone loss, and this device is a convenient steady performance electrical stimulator that can surely induce rat's hindlimb to do active exercise.
文摘Introduction: Collecting a patient’s pain scores and the analgesic effect achieved during spinal cord stimulation (SCS) trials can be difficult, and no standard exists for doing so. We propose a topographical mapping tool that was derived from a patient’s perspective. Case: A 60-year-old man with postherpetic neuralgia (PHN) underwent a SCS trial after conservative treatment failed to relieve his pain. During the SCS trial, with the SCS off and on in five different settings, he recorded pain levels in each of the six different painful zones he identified. The data collected were transferred to a topographical and anatomical map, which helped the physicians to better understand the effects of the SCS at different settings. Ultimately, the data collected by the patient helped the physicians to implant a permanent SCS successfully. Conclusions: Patient pain diaries have been used in pain medicine for years. This particular patient’s collection of pain scores and SCS effects inspired the construction of a more standardized tool for collecting such data during SCS trials. We propose that use of our Topographical Anatomical Neuropathic-pain Guided (TANG) mapping tool will enable physicians to choose SCS lead positions more precisely than is currently possible.
文摘Gastric disorders play an important role in digestive system of a human subject. Gastric disorder is due to the gastric dysmotility due to delayed gastric emptying and other motor dysfunctions like impaired fundic distention. Nowadays invasive technique like laparoscopy procedure, endoscopy procedure and surgery procedure plays a vital role in investigation of gastric disorders. Electrogastrogram is a noninvasive technique for analyzing digestive system disorders. In this proposed work, stimulation is delivered with the electrode package with camera, which travels through an esophagus to reach stomach and stimulate the interstitial cajal cells. Due to this stimulation the stomach starts, its activity a potential is provided that is recorded with electrode setup, which is called electrogastrogram. It is verified with its normal range 3 cpm. The stimulation includes pulses mode and continuous mode. Stomach function is recovered and its frequency is measured and the same is compared with normal range value. Depending upon the subject condition, the gastric activity is improved by setting different values of duty cycle. By this procedure the subject avoid painful procedure, stay in hospital, frequently and the cost is minimum.
文摘1) Background: Osteoarthritis (OA) is defined as a degenerative joint disease that mainly affects the bone. This study aims to evaluate the effect of low-intensity continuous ultrasound (LICUS) treatment on the knee of osteoarthritis patients through home-based intervention using the LICUS medical device. 2) Methods: The clinical trials were designed in a single-arm, open-label, and intervention study. Thirty-five participants, including those who dropped out (12%), were screened and enrolled. The patients received LICUS (1.1 MHz, 1.5 W/cm2, collimated beams) on the knee by the instructions of the investigator at home (5 min/session, 3 times/day, for four-weeks). Outcome measures were assessed using the Visual Analog Scale (VAS) as a primary endpoint and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) as a secondary endpoint to evaluate pain relief and functional recovery of the knee between pre-treatment (baseline) and post-treatment (four-weeks). 3) Results: Knee pain scores measured using the VAS and WOMAC indices were significantly reduced after a four-week treatment with LICUS compared to baseline. Knee stiffness and functional capacity were significantly reduced after the LICUS application. In addition, there were no reports of adverse effects during the study period. 4) Conclusion: Long-term and home-based application of LICUS can be recommended as an alternative option for the treatment of OA patients, as evidenced by the effect of pain relief and knee function recovery.
基金This work was supported by the National Natural Science Foundation of China(Grant No.82071251)National Key Research and Development Program of China(Grant No.2018YFC2001802)Hubei Province Key Research and Development Program(Grant No.2021BCA145).
文摘Objective This work explores the impact of electroacupuncture(EA)on acute postoperative pain(APP)and the role of stimulator of interferon genes/type-1 interferon(STING/IFN-1)signaling pathway modulation in the analgesic effect of EA in APP rats.Methods The APP rat model was initiated through abdominal surgery and the animals received two 30 min sessions of EA at bilateral ST36(Zusanli)and SP6(Sanyinjiao)acupoints.Mechanical,thermal and cold sensitivity tests were performed to measure the pain threshold,and electroencephalograms were recorded in the primary somatosensory cortex to identify the effects of EA treatment on APP.Western blotting and immunofluorescence were used to examine the expression and distribution of proteins in the STING/IFN-1 pathway as well as neuroinflammation.A STING inhibitor(C-176)was administered intrathecally to verify its role in EA.Results APP rats displayed mechanical and thermal hypersensitivities compared to the control group(P<0.05).APP significantly reduced the amplitude ofθ,αandγoscillations compared to their baseline values(P<0.05).Interestingly,expression levels of proteins in the STING/IFN-1 pathway were downregulated after inducing APP(P<0.05).Further,APP increased pro-inflammatory factors,including interleukin-6,tumor necrosis factor-αand inducible nitric oxide synthase,and downregulated anti-inflammatory factors,including interleukin-10 and arginase-1(P<0.05).EA effectively attenuated APP-induced painful hypersensitivities(P<0.05)and restored theθ,αandγpower in APP rats(P<0.05).Meanwhile,EA distinctly activated the STING/IFN-1 pathway and mitigated the neuroinflammatory response(P<0.05).Furthermore,STING/IFN-1 was predominantly expressed in isolectin-B4-or calcitonin-gene-related-peptide-labeled dorsal root ganglion neurons and superficial laminae of the spinal dorsal horn.Inhibition of the STING/IFN-1 pathway by intrathecal injection of C-176 weakened the analgesic and anti-inflammatory effects of EA on APP(P<0.05).Conclusion EA can generate robust analgesic and anti-inflammatory effects on APP,and these effects may be linked to activating the STING/IFN-1 pathway,suggesting that STING/IFN-1 may be a target for relieving APP.
基金National Natural Science Foundation of China(No.82071607)LiaoNing Revitalization Talents Program(No.XLYC1907071)+1 种基金Fok Ying Tung Education Foundation(No.151039)Outstanding Scientific Fund of Shengjing Hospital(No.202003)
文摘Intracytoplasmic sperm injection(ICSI)is an effective method for human-assisted reproductive technology,especially for male-factor infertility.However,the average fertilization rate of ICSI is 70%,and total fertilization failure occurs in 3%of cycles.[1]Oocyte activation deficiency is the primary cause of fertilization failure.
基金Yang Hao received finacial support from the China Scholarship and Jilin Province Chinese Postdoctoral International Exchange Program(YJ20220406)Zili Gu,Zhenfeng Yu and Sen Ma received financial support from the China Scholarship Council,and Peter ten Dijke received funding from Cancer Genomics Centre NetherlandsTimo Schomann and Alireza Haghparast received funding from the European Commission,grants H2020-MSCA-RISE CANCER(777682)and H2020-WIDESPREAD-05-2017-Twinning SIMICA(852985).
文摘Dear Editor,Great progress has been made in the clinical use of photodynamic therapy(PDT)for the treatment of patients with superficial tumors[1].However,cancer recurrence and metastasis have limited the application of PDT in the treatment of solid tumors and advanced cancers.In this context,combining PDT with other complementary immunotherapy regimens may overcome these limitations of PDT[2].
文摘Non-invasive cerebral neuromodulation technologies are essential for the reorganization of cerebral neural networks,which have been widely applied in the field of central neurological diseases,such as stroke,Parkinson’s disease,and mental disorders.Although significant advances have been made in neuromodulation technologies,the identification of optimal neurostimulation paramete rs including the co rtical target,duration,and inhibition or excitation pattern is still limited due to the lack of guidance for neural circuits.Moreove r,the neural mechanism unde rlying neuromodulation for improved behavioral performance remains poorly understood.Recently,advancements in neuroimaging have provided insight into neuromodulation techniques.Functional near-infrared spectroscopy,as a novel non-invasive optical brain imaging method,can detect brain activity by measuring cerebral hemodynamics with the advantages of portability,high motion tole rance,and anti-electromagnetic interference.Coupling functional near-infra red spectroscopy with neuromodulation technologies offe rs an opportunity to monitor the cortical response,provide realtime feedbac k,and establish a closed-loop strategy integrating evaluation,feedbac k,and intervention for neurostimulation,which provides a theoretical basis for development of individualized precise neuro rehabilitation.We aimed to summarize the advantages of functional near-infra red spectroscopy and provide an ove rview of the current research on functional near-infrared spectroscopy in transcranial magnetic stimulation,transcranial electrical stimulation,neurofeedback,and braincomputer interfaces.Furthermore,the future perspectives and directions for the application of functional near-infrared spectroscopy in neuromodulation are summarized.In conclusion,functional near-infrared spectroscopy combined with neuromodulation may promote the optimization of central pellral reorganization to achieve better functional recovery form central nervous system diseases.
基金supported by the Bryant Stokes Neurological Research Fund (to JM)a fellowship from Multiple Sclerosis Western Australia (MSWA)+1 种基金the Perron Institute for Neurological and Translational Sciencethe Bryant Stokes Neurological Research Fund (to JR)。
文摘Non-invasive brain stimulation techniques(NIBS),including repetitive transcranial magnetic stimulation(rTMS) and transcranial electric stim ulation(tES),are increasingly being adopted clinically for treatment of neuropsychiatric and neurological disorders,albeit with varying success.The rationale behind the use of NIBS has historically been that stim ulation techniques modulate neuronal activity in the targeted region and consequently induce plasticity which can lead to therapeutic outcomes.
基金This work is supported by the National Key R&D Program of China(No.2022YFC2402900)the National Natural Science Foundation of China(No.81991502)+3 种基金the Key Research and Development Program of Zhejiang Province,China(No.2021C03074)the Basic Public Welfare Project of Zhejiang Province,China(No.LY22H140002)the Research and Development Program of the Stomatology Hospital,Zhejiang University School of Medicine(No.RD2022JCEL20)the Student Research Training Program of Zhejiang University School of Stomatology(No.2022S001).
文摘Reconstruction of irregular oral-maxillofacial bone defects with an inflammatory microenvironment remains a challenge,as chronic local inflammation can largely impair bone healing.Here,we used magnesium silicate nanospheres(MSNs)to load microRNA-146a-5p(miR-146a)to fabricate a nanobiomaterial,MSN+miR-146a,which showed synergistic promoting effects on the osteogenic differentiation of human dental pulp stem cells(hDPSCs).In addition,miR-146a exhibited an anti-inflammatory effect on mouse bone marrow-derived macrophages(BMMs)under lipopolysaccharide(LPS)stimulation by inhibiting the NF-κB pathway via targeting tumor necrosis factor receptor-associated factor 6(TRAF6),and MSNs could simultaneously promote M2 polarization of BMMs.MiR-146a was also found to inhibit osteoclast formation.Finally,the dual osteogenic-promoting and immunoregulatory effects of MSN+miR-146a were further validated in a stimulated infected mouse mandibular bone defect model via delivery by a photocuring hydrogel.Collectively,the MSN+miR-146a complex revealed good potential in treating inflammatory irregular oralmaxillofacial bone defects.