Objectives Numbers of research have reported the usage of robot-assisted gait training for walking restoration post-stroke. However, no consistent conclusion has been reached yet about the efficacy of exoskeleton robot-assisted training (ERAT) on gait function of stroke survivors, especially during the chronic period. We conducted a systematic review to investigate the efficacy of ERAT on gait function for chronic stroke survivors. Design This review followed the Participant, Intervention, Comparison and Outcome principle. Data sources PubMed, Cochrane Library, Web of Science, Embase and Cumulative Index to Nursing and Allied Health Literature databases were systematically searched until December 2022. Eligibility criteria Only randomised controlled trials (RCTs) were included and these RCTs took patients who had a chronic stroke as participants, exoskeleton robot-assisted gait training as intervention, regular rehabilitation therapy as comparison and gait-related functional assessments as outcomes. Data extraction and synthesis Data extraction and synthesis used the reporting checklist for systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The risk of bias and methodological quality of included studies were evaluated by two independent investigators under the guidance of Cochrane risk of bias. Results Out of 278 studies, a total of 10 studies (n=323, mean age 57.6 years, 63.2% males) were identified in this systematic review. According to the Cochrane risk of bias, the quality of these studies was assessed as low risk. Six studies reported favourable effects of ERAT on gait function involving gait performance, balance function and physical endurance, and the ERAT group was significantly superior when compared with the control group. In contrast, the other four trials showed equal or negative effects of ERAT considering different study designs. All the included studies did not claim any serious adverse events. Conclusion ERAT could be an efficient intervention to improve gait function for individuals who had a chronic stroke. However, more rigorously designed trials are required to draw more solid evidence. PROSPERO registration number CRD42023410796.

Intraparenchymal transplantation of neural stem/progenitor cells (NSPCs) has been extensively investigated in animal models of ischemic stroke. However, the reported therapeutic efficacy was inconsistent among studies. To evaluate this situation, PubMed, Embase, and Web of Science databases were searched for preclinical studies using NSPC intraparenchymal transplantation in ischemic stroke animals. Data of study quality score, neurobehavioral (mNSS, rotarod test, and cylinder test) and histological (infarct volume) outcomes, cell therapy-related serious adverse events, and related cellular mechanisms were extracted for meta-analysis and systematic review. A total of 62 studies containing 73 treatment arms were included according to our criterion, with a mean quality score of 5.10 in 10. Among these studies, almost half of the studies claimed no adverse events of tumorigenesis. The finally pooled effect sizes for neurobehavioral and histological assessments were large (1.27 for mNSS, 1.63 for the rotarod test, 0.71 for the cylinder test, and 1.11 for infarct volume reduction). With further analysis, it was found that the administration time poststroke, NSPC donor species, and transplantation immunogenicity had close correlations with the degree of infarct volume reduction. The NSPC dosage delivered into the brain parenchyma was also negatively correlated with the effect of the cylinder test. Intriguingly, endogenous apoptosis inhibition and axonal regeneration played the most critical role in intraparenchymal NSPC transplantation among the cellular mechanisms. These results indicate that intraparenchymal NSPC transplantation is beneficial for neurobehavioral and histological improvement and is relatively safe for ischemic stroke animals. Therefore, intraparenchymal NSPC transplantation is a promising treatment for stroke patients.

Because of rising traumatic accidents and diseases, the number of patients suffering from nerve injury is increasing. Without effective rehabilitation therapy, the patients will get motor or sensory function losses or even a lifelong disability. As for amputees, neural interface technology can be used to splice nerves and electrical wires together in a way that allows them to control an artificial limb as if it was a natural extension of the body. However, the means the need for an autologous nerve to stimulate axonal regeneration and extension into target tissues, which are limited by the supply of donor nerves. Based on the principle of mechanical force regulating axon growth, in this paper, we developed a three-dimensional nerve stretch growth device for an implantable neural interface. The device consists of three motors controlled by single chip microcomputer and some mechanical parts. The stability and reliability of the device were tested. Then, we used neurons derived from human pluripotent stem cells by small chemical molecules to explore the optimal three-dimensional stretch culture parameters. Furthermore, we found that the axons were intact through 10 rotations per day and 1 mm of horizontal pulling per day. The results of this research will provide convenience for patients treated through an implantable neural interface.

According to recent studies, synaptic connections by axons formed can resist stronger mechanical stresses. A large number of nerve tissues with regular growth can be achieved quickly by appropriately managing the pulling pace and force. However, currently there are few studies on the physiological characteristics of stretching growth axons. Until now there is no mature technology for determining whether the axons can normally transmit neural signals following continuous mechanical stimulation. In this paper, an improved HH model was proposed to investigate the effect of mechanical stimuli. After mechanical pulling stimulation, the improved model successfully replicated the generation and propagation of action potentials in several different axon segments. The axon membrane capacitance was increased due to the increase of diameter. When the stretch growth axon was stimulated again by traction, the inward current was large enough to depolarize the membrane and produce an action potential. The transmission speed of action potential increased as axons grew. Longer axons may be able to reach the action potential threshold faster. The larger the diameter of axon segments with the same length but different diameters, the faster the action potential diffused from the stimulation point to both sides. After stretching, nerve fibers could still receive signals sent by other neuron cells and complete the signal transmission. This proposed research can help to optimize axon stretch culture conditions, avoid mechanical force damage to nerve tissue, and achieve a more effective nerve tissue culture process.

INPLASY202230101 Acupuncture for chemotherapy-induced myelosuppression of cervical cancer: A protocol for systematic review Keywords: Cervical cancer; Myelosuppression; Acupuncture; Efficacy; Syste…