Yong-Hui Wang

A transient receptor potential vanilloid 4 contributes to mechanical allodynia following chronic compression of dorsal root ganglion in rats.

The aim of the present study was to investigate the role of transient receptor potential vanilloid 4 (TRPV4) in mediating mechanical allodynia in rodent models of chronic compression of the dorsal root ganglion (CCD). First, the levels of TRPV4 mRNA and protein expression in the dorsal root ganglion (DRG) were assessed using real-time RT-PCR and Western blotting analysis respectively at 7, 14, and 28 days post-CCD. Then, the effects of spinal administration of TRPV4 antisense oligodeoxynucleotide (ODN) and mismatch ODN on CCD-induced mechanical allodynia were evaluated. Lastly, the calcium responses to hypotonic solution and 4alpha-phorbol 12,13-didecanoate (4alpha-PDD) were assessed following sham surgery, CCD, spinal application of TRPV4 antisense ODN and mismatch ODN. The results showed that the levels of TRPV4 mRNA and protein expression increased significantly at 7-28 days post-CCD when compared with the sham group, with the highest level at 7 days post-CCD. TRPV4 antisense ODN, but not mismatch ODN, partly reversed the CCD-induced mechanical allodynia. Additionally, TRPV4 antisense ODN had no effect on the baseline nociceptive response. The percentage of DRG neurons responsive to hypotonic solution and 4alpha-PDD and the fluorescence ratio of calcium response were also enhanced significantly in both the CCD group and the mismatch ODN group. These increased responses were significantly inhibited by TRPV4 antisense ODN. In conclusion, TRPV4 plays a crucial role in CCD-induced mechanical allodynia.

Beneficial Effects of the Herbal Medicine Di Huang Yin Zi in Patients with Spinal Cord Injury: A Randomized, Placebo-Controlled Clinical Study

Objective: This study investigated the safety and therapeutic efficacy of Di Huang Yin Zi (DHYZ), a traditional Chinese decoction used to treat neurological disorders, in spinal cord injury (SCI). Methods: In this doubleblind, placebo-controlled study, patients with traumatic SCI and American Spinal Injury Association (ASIA) impairment grades B - D were randomized to receive DHYZ (n = 30) or placebo (n = 30) for 12 weeks. Both groups also received rehabilitation therapy during the study period. Motor and sensory function and activities of daily living (ADL) were assessed before treatment and at 4-week intervals. Results: Significantly more patients in the DHYZ group showed an improved ASIA impairment grade during the treatment period (32.1%) compared with the placebo group (10.3%), and scores for sensory and motor function and ADL at the end of the treatment period were significantly higher in the DHYZ group than in the placebo group. No serious side-effects were reported. Conclusions: DHYZ was found to improve neurological function in patients with SCI and may be an effective adjuvant therapy to enhance functional recovery.

Serious Antimicrobial Resistance Status of Pathogens Causing Hospital-acquired Lower Respiratory Tract Infections in North China

Antimicrobial resistance patterns of pathogens causing hospital-acquired lower respiratory tract infections (LRTIs) in Shandong Province, China were investigated using data collected from January 2002 to December 2006. A total of 10337 isolates were characterized in sputum samples from 39 920 LRTI patients: 68.72% were Gram-negative bacteria, 20.65% were Gram-positive bacteria, and 10.62% were fungi. Organisms most frequently isolated were: Pseudomonas aeruginosa (16.88%), Klebsiella pneumoniae (10.80%), Escherichia coli (10.71%), fungi (10.62%), Staphylococcus aureus (9.68%) and Acinetobacter baumannii (9.03%). Imipenem was the most effective antibiotic against Gram-negative bacteria. Most Gram-positive bacteria were susceptible to vancomycin. Susceptibility to cephalosporins was not optimal and resistance to fluoroquinolones was high. Resistance of Gram-negative bacteria showed a rapid increase over the study period, while resistance of Gram-positive bacteria remained relatively stable. The emergence of resistance to commonly prescribed antimicrobial agents used against LRTI pathogens has compounded the problem of using empirical therapy and created selective pressure on physicians to use certain antibiotics.

Full-movement neuromuscular electrical stimulation improves plantar flexor spasticity and ankle active dorsiflexion in stroke patients: a randomized controlled study

Objective: To investigate whether full-movement neuromuscular electrical stimulation, which can generate full range of movement, reduces spasticity and/or improves motor function more effectively than control, sensory threshold—neuromuscular electrical stimulation, and motor threshold—neuromuscular electrical stimulation in sub-acute stroke patients. Design: A randomized, single-blind, controlled study. Setting: Physical therapy room and functional assessment room. Participants: A total of 72 adult patients with sub-acute post-stroke hemiplegia and plantar flexor spasticity. Method: Patients received 30-minute sessions of neuromuscular electrical stimulation on the motor points of the extensor hallucis and digitorum longus twice a day, five days per week for four weeks. Measures: Composite Spasticity Scale, Ankle Active Dorsiflexion Score, and walking time in the Timed Up and Go Test were assessed at pretreatment, posttreatment, and at two-week follow-up. Results: After four weeks of treatment, when comparing interclass pretreatment and posttreatment, only the full-movement neuromuscular electrical stimulation group had a significant reduction in the Composite Spasticity Scale (mean % reduction = 19.91(4.96)%, F = 3.878, p < 0.05) and improvement in the Ankle Active Dorsiflexion Score (mean scores = 3.29(0.91), F = 3.140, p < 0.05). Furthermore, these improvements were maintained two weeks after the treatment ended. However, there were no significant differences in the walking time after four weeks of treatment among the four groups (F = 1.861, p > 0.05). Conclusions: Full-movement neuromuscular electrical stimulation with a stimulus intensity capable of generating full movement can significantly reduce plantar flexor spasticity and improve ankle active dorsiflexion, but cannot decrease walking time in the Timed Up and Go Test in sub-acute stroke patients.

Role of colchicine-induced microtubule depolymerization in hyperalgesia via TRPV4 in rats with chronic compression of the dorsal root ganglion

Abstract The aim of this study is to investigate the effect of microtubule depolymerization by colchicine on hyperalgesia mediated by transient receptor potential vanilloid 4 (TRPV4) in a neuropathic pain model of chronic compression of the dorsal root ganglion (DRG) (hereafter termed CCD) in rat. Intrathecal administration of microtubule-depolymerizing agent, colchicine, attenuated the activated effect of 4alpha-phorbol 12, 13-didecanoate (4alpha-PDD, TRPV4 specific agonist) on mechanical and thermal hyperalgesia in CCD rats. This observation is in agreement with our in vitro experiments with DRG cells that showed a significant attenuation of 4alpha-PDD-activated Ca2+-influx and substance P (SP) release with the colchicine treatment. We conclude that microtubule depolymerization by colchicine can regulate pain sensitivity by depressing the hyperalgesia mediated by TRPV4.

Myelinated Afferents Are Involved in Pathology of the Spontaneous Electrical Activity and Mechanical Hyperalgesia of Myofascial Trigger Spots in Rats

Myofascial trigger points (MTrPs) are common causes for chronic pain. Myelinated afferents were considered to be related with muscular pain, and our clinical researches indicated they might participate in the pathology of MTrPs. Here, we applied myofascial trigger spots (MTrSs, equal to MTrPs in human) of rats to further investigate role of myelinated afferents. Modified pyridine-silver staining revealed more nerve endings at MTrSs than non-MTrSs (P < 0.01), and immunohistochemistry with Neurofilament 200 indicated more myelinated afferents existed in MTrSs (P < 0.01). Spontaneous electrical activity (SEA) recordings at MTrSs showed that specific block of myelinated afferents in sciatic nerve with tetrodotoxin (TTX) led to significantly decreased SEA (P < 0.05). Behavioral assessment showed that mechanical pain thresholds (MPTs) of MTrSs were lower than those of non-MTrSs (P < 0.01). Block of myelinated afferents by intramuscular TTX injection increased MPTs of MTrSs significantly (P < 0.01), while MPTs of non-MTrSs first decreased (P < 0.05) and then increased (P > 0.05). 30 min after the injection, MPTs at MTrSs were significantly lower than those of non-MTrSs (P < 0.01). Therefore, we concluded that proliferated myelinated afferents existed at MTrSs, which were closely related to pathology of SEA and mechanical hyperalgesia of MTrSs.

A afferent fibers are involved in the pathology of central changes in the spinal dorsal horn associated with myofascial trigger spots in rats

Abstract A afferent fibers have been reported to participate in the development of the central sensitization induced by inflammation and injuries. Current evidence suggests that myofascial trigger points (MTrPs) induce central sensitization in the related spinal dorsal horn, and clinical studies indicate that A fibers are associated with pain behavior. Because most of these clinical studies applied behavioral indexes, objective evidence is needed. Additionally, MTrP-related neurons in dorsal root ganglia and the spinal ventral horn have been reported to be smaller than normal, and these neurons were considered to be related to A fibers. To confirm the role of A fibers in MTrP-related central changes in the spinal dorsal horn, we studied central sensitization as well as the size of neurons associated with myofascial trigger spots (MTrSs, equivalent to MTrPs in humans) in the biceps femoris muscle of rats and provided some objective morphological evidence. Cholera toxin B subunit-conjugated horseradish peroxidase was applied to label the MTrS-related neurons, and tetrodotoxin was used to block A fibers specifically. The results showed that in the spinal dorsal horn associated with MTrS, the expression of glutamate receptor (mGluR1α/mGluR5/NMDAR1) increased, while the mean size of MTrS-related neurons was smaller than normal. After blocking A fibers, these changes reversed to some extent. Therefore, we concluded that A fibers participated in the development and maintenance of the central sensitization induced by MTrPs and were related to the mean size of neurons associated with MTrPs in the spinal dorsal horn.

Hyperexcitability to electrical stimulation and accelerated muscle fatiguability of taut bands in rats

Objective Myofascial trigger points contribute significantly to musculoskeletal pain and motor dysfunction and may be associated with accelerated muscle fatiguability. The aim of this study was to investigate the electrically induced force and fatigue characteristics of muscle taut bands in rats. Methods Muscle taut bands were dissected out and subjected to trains of electrical stimulation. The electrical threshold intensity for muscle contraction and maximum contraction force (MCF), electrical intensity dependent fatigue and electrical frequency dependent fatigue characteristics were assessed in three different sessions (n=10 each) and compared with non-taut bands in the biceps femoris muscle. Results The threshold intensity for muscle contraction and MCF at the 10th, 15th and 20th intensity dependent fatigue stimuli of taut bands were significantly lower than those of non-taut bands (all p<0.05). The MCF at the 15th and 20th intensity dependent fatigue stimuli of taut bands were significantly lower than those at the 1st and 5th stimuli (all p<0.01). The MCF in the frequency dependent fatigue test was significantly higher and the stimulus frequency that induced MCF was significantly lower for taut bands than for non-taut bands (both p<0.01). Conclusions The present study demonstrates that the muscle taut band itself was more excitable to electrical stimulation and significantly less fatigue resistant than normal muscle fibres.