human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To determine whether needle acupuncture may be useful in the reduction of leg spasticity in a chronic state . DESIGN Single-blind , r and omized , placebo-controlled trial . SETTING Neurologic outpatient department of a medical school in Germany . PARTICIPANTS Twenty-five patients ( 14 women ) suffering from chronic poststroke leg spasticity with pes equinovarus deformity ( Modified Ashworth Scale [ MAS ] score , > /=1 ) , aged 38 to 77 years ( mean + /- st and ard deviation , 58.5+/-10.4 y ) , were enrolled in the study . The mean time from stroke to inclusion in the study was approximately 5 years ( mean , 65.4+/-48.3 mo ; range , 7 - 180 mo ) . INTERVENTIONS Participants were r and omly assigned to placebo treatment ( n=12 ) by using a specially design ed placebo needling procedure , or verum treatment ( n=13 ) . MAIN OUTCOME MEASURES MAS score of the affected ankle , pain ( visual analog scale ) , and walking speed . RESULTS There was no demonstrated beneficial clinical effects from verum acupuncture . After 4 weeks of treatment , mean MAS score was 3.3+/-0.9 in the placebo group versus 3.3+/-1.1 in the verum group . The neurophysiologic measure of H-reflex indicated a significant increase of spinal motoneuron excitability after verum acupuncture ( H-response/M-response ratio : placebo,.39+/-.19 ; verum,.68+/-.41 ; P<.05 ) . CONCLUSIONS This effect might be explained by afferent input of A delta and C fibers to the spinal motoneuron . The results from our study indicate that needle acupuncture may not be helpful to patients with chronic poststroke spasticity . However , there was neurophysiologic evidence for specific acupuncture effects on a spinal ( segmental ) level involving nociceptive reflex mechanisms An effective and safe remedy for shoulder pain is needed as shoulder pain is a common complication of stroke and restricts recovery of patients . This study was carried out to evaluate the effect of Ouhyul herbal acupuncture point injection ( O-API ) on shoulder pain in patients with stroke . Twenty-four participants with shoulder pain after stroke were recruited and r and omized to the O-API and control groups . Treatment was conducted for 2 weeks three times per week . We evaluated the effects of treatment with a numerical rating scale ( NRS ) , painless passive range of motion ( PROM ) of external shoulder rotation , and the Fugl-Meyer Motor Assessment ( FMMA ) at baseline , each week , and 1 week after the final treatment . All measures were similar between the O-API and control groups at baseline . The O-API group showed significant improvement on the NRS compared with that in the control group after 2 weeks of treatment , and the treatment effect was maintained until the follow-up period . PROM decreased significantly in both groups , but the reduction was maintained only in the O-API group . No significant difference was observed on the FMMA between the two groups . O-API result ed in significant improvement in shoulder pain after stroke , and its effect was maintained after termination of treatment without any severe side effects OBJECTIVE To evaluate the therapeutic effect of comprehensive therapeutic protocol of electroacupuncture combined with active-blood- and -dissolve-stasis herbs and rehabilitation training for cerebral infa rct ion . METHODS A multi-center r and omized controlled trial was done , three hundred and twenty cases were divided into four groups : electroacupuncture combined with active-blood and dissolve-stasis herbs and rehabilitation training group ( group A ) , electroacupuncture combined with rehabilitation training group ( group B ) , herbs combined with rehabilitation training group ( group C ) and rehabilitation training group ( group D ) , 80 cases in each group . The following two groups of acupoints were used alternatively in electroacupuncture treatment : the first group including Vasomotor Area , Jianyu ( LI 15 ) , Biguan ( ST 31 ) , Hegu ( LI 4 ) and Taichong ( LR 3 ) ; the second group including Motor Area , Quchi ( LI 11 ) , Yanglingquan ( GB 34 ) and Shenshu ( BL 23 ) . 20 mL Xiangdan injection and 250 mL 5 % glucose injection or 250 mL 0.9 % sodium chloride injection were used by intravenous drip in herbs treatment once a day . The rehabilitation training was performed by the professional physical therapist . Each group was treated with corresponding treatment protocol . The therapeutic effect was evaluated by index of the mortality or disability rate 3 months after the onset of disease . The intention to treat analysis ( ITT ) was used in data . RESULTS The mortality or h and icap rate 3 months after the onset of disease of four groups were 17.5 % ( 14/80 ) in group A , 22.5 % ( 18/80 ) in group B , 40 . 0 % ( 32/80 ) in group C , and 31.3 % ( 25/80 ) in group D , respectively . The group A has a best therapeutic effect ( vs group C , group D , both P<0.05 ) , and there was no adverse event . CONCLUSION The combined application of electroacupuncture , active-blood and dissolve-stasis herbs and rehabilitation training is a better treatment for cerebral infa rct ion in clinic Background and Purpose In a r and omized study of hemiparetic stroke patients with a median age of 75 years , functional recovery was significantly better in those who received additional  sensory stimulation  ( n=38 ) , including electrostimulation , than in control patients ( n=40 ) given the same physiotherapy and occupational therapy ; group differences for balance , mobility , and activities of daily living were significant . The present study was design ed to investigate postural control in patients who survived more than 2 years after stroke onset . Methods The 48 survivors ( mean , 2.7 years ; range , 2.0 to 3.8 years ) , 22 from the treatment group and 26 from the control group , were compared with 23 age-matched healthy subjects . Subjects were perturbed by vibrators applied to calf muscles or with galvanic vestibular stimulation . We evaluated postural control in terms of sway variances or sway velocities and the dynamics of postural control as a feedback system using system identification with a model previously vali date d for human postural control . Results Significantly more patients of the treatment group than of the control group maintained stance during perturbations ( P<.01 ) . Among patients capable of maintaining stance during perturbation , the control patients were characterized by significant divergence from normal values in two of the three characteristic parameters of dynamic postural control ( ie , swiftness and stiffness ; P<.05 ) compared with the treatment subgroup or age-matched subjects . Conclusions The course of sensory stimulation enhanced recovery of postural function , an enhancement still significant 2 years after the lesion and treatment . The differences and near normalization of characteristic parameters of dynamic postural control among treated patients suggest that improved recovery after sensory stimulation may be achieved by patients regaining normal or near normal dynamics of human postural control Abstract Objective : To observe the effect of electro-acupuncture ( EA ) on dendritic spine and ephrin-A5 and to investigate the action of EA on neural plasticity after acute cerebral ischemic infa rct ion . Methods : Focal acute cerebral ischemia model was established by middle cerebral artery occlusion ( MCAO ) with electrocoagulation contralateral method . Ninety male Sprague – Dawley rats were r and omly divided into sham operation ( SO ) group , MCAO group and EA treatment ( ET ) group . Golgi dying , double immunofluorescence method and RT-PCR were used to detect dendritic spine density , expression patterns of ephrin-A5 and the effect of EA on them at the end of the first , second and fourth week after ischemia . Results : The dendritic spine density in MCAO group significantly decreased after ischemia ( p<0.01 ) . The dendritic spine density was raised in ET group in the corresponding time period ( p<0.01 ) and among the ET groups . It was higher at the end of the fourth week than before ( p<0.05 ) . The signal of ephrin-A5 was detected mainly in neuron cytoplasm , and the mRNA expression in MCAO group and ET group increased compared to that in SO group ( p<0.01 ) . The mRNA expression in ET group at the first week was much higher than that in MCAO group ( p<0.01 ) . In ET groups , the mRNA expression of ephrin-A5 was down-regulated along with the time going ( p<0.01 ) . Conclusion : It is possibly the regulation of the ephrin-A5 expression by which EA treatment improves the neural plasticity at the peri-infa rct cerebral cortex in acute cerebral ischemia rat . There may be a time window in EA treatment for acute cerebral ischemia 63 patients with senile vascular dementia were r and omly divided into the treatment group ( treated by acupuncture ) and the control group ( treated with piracetam ) . The authors observed the changes in the score of Hasegawa 's dementia scale ( HDS ) , p300 , rheoencephalogram , topographic EEG , superoxide dismutase ( SOD ) activity in erythrocytes , and lipid peroxide ( LPO ) level in plasma before and after treatment . The statistical data showed that the total effective rate in the treatment group ( 80.6 % ) was significantly higher than that in the control group ( 25 % ) , and the differences in the observed indexes before and after treatment were significant ( P < 0.05 or P < 0.01 ) in the treatment group but not in the control group ( P > 0.05 ) , indicating that the acupuncture treatment was superior in immediate therapeutic effect on senile vascular dementia to drug treatment OBJECTIVE To observe the clinical effect of electroacupuncture and acupuncture on vascular dementia ( VaD ) and the influence on superoxide dismutase ( SOD ) , lipid peroxide ( LPO ) and nitric oxide ( NO ) levels . METHODS Forty-six cases of VaD were r and omly divided into two groups , the electroacupuncture group ( EA group ) and the acupuncture group ( AP group ) . Assessment of Hasgawa 's dementia scale ( HDS ) , functional activities question naire ( FAQ ) and neurologic deficit scoring were done before and after treatment , and the changes on SOD , LPO and NO levels were observed . RESULTS After treatment , in the EA group , the HDS elevated , the FAQ lowered , SOD increased and LPO and NO decreased significantly , as compared with before treatment , P < 0.01 . But these parameters were not changed significantly in the AP group after treatment . The clinical symptoms were improved in both groups , but the reduction on neurologic deficit score was not significant . The total effective rate of the EA group was higher than that of the AP group . CONCLUSION The immediate effect of electroacupuncture was superior to that of acupuncture , suggesting that the electroacupuncture was more effective in promoting the intelligence recovery than acupuncture This study is a double-blind r and omized controlled trial on the effect of intradermal acupuncture on insomnia after stroke . Hospitalized stroke patients with insomnia were enrolled in the study and were r and omly assigned to either a real intradermal acupuncture group ( RA group ) or a sham acupuncture group ( SA group ) . The RA group received intradermal acupuncture on Shen-Men ( He-7 ) and Nei-Kuan ( EH-6 ) for three days , and the SA group received sham acupuncture on the same points . The effect of acupuncture on insomnia was measured using Insomnia Severity Index ( ISI ) and Athens Insomnia Scale ( AIS ) at baseline and three days after treatment . To assess the effect of acupuncture on the autonomic nervous function , the subjects ' blood pressure and heart rate variability were monitored . Fifty-two subjects ( 27 in the RA group and 25 in the SA group ) were included in the final analysis . The insomnia-related scales ISI and AIS showed greater improvement of insomnia in the RA group than in the SA group . Moreover , there is a greater reduction of the number of non-dippers and a greater decrease of the LF/HF ratio ( heart rate variability ) in the RA group than in the SA group . These results indicate that sympathetic hyperactivities were stabilized in the RA group . It can thus be concluded that intradermal acupuncture on Shen-Men and Nei-Kuan is a useful therapeutic method for post stroke-onset insomnia as it reduces sympathetic hyperactivities OBJECTIVE To observe clinical therapeutic effect of head point-through-point electroacupuncture ( EA ) on poststroke depression ( PSD ) and to study the mechanism . METHODS One hundred and eight cases of PSD were r and omly divided into a point-through-point EA group ( n = 38 ) , a non point-through-point group ( n = 36 ) and a western medicine group ( n = 34 ) . After treatment of 28 days , their therapeutic effects , scores of HAMD depression scale and SDS self-rating scale , and plasma 5-HT contents were compared before and after treatment among the 3 groups . RESULTS The effective rate of 86.84 % in the point-through-point EA group was better than 63.89 % in the non point-through-point group and 67.65 % in the western medicine group ( P < 0.05 or P < 0.01 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To determine whether needle acupuncture may be useful in the reduction of leg spasticity in a chronic state . DESIGN Single-blind , r and omized , placebo-controlled trial . SETTING Neurologic outpatient department of a medical school in Germany . PARTICIPANTS Twenty-five patients ( 14 women ) suffering from chronic poststroke leg spasticity with pes equinovarus deformity ( Modified Ashworth Scale [ MAS ] score , > /=1 ) , aged 38 to 77 years ( mean + /- st and ard deviation , 58.5+/-10.4 y ) , were enrolled in the study . The mean time from stroke to inclusion in the study was approximately 5 years ( mean , 65.4+/-48.3 mo ; range , 7 - 180 mo ) . INTERVENTIONS Participants were r and omly assigned to placebo treatment ( n=12 ) by using a specially design ed placebo needling procedure , or verum treatment ( n=13 ) . MAIN OUTCOME MEASURES MAS score of the affected ankle , pain ( visual analog scale ) , and walking speed . RESULTS There was no demonstrated beneficial clinical effects from verum acupuncture . After 4 weeks of treatment , mean MAS score was 3.3+/-0.9 in the placebo group versus 3.3+/-1.1 in the verum group . The neurophysiologic measure of H-reflex indicated a significant increase of spinal motoneuron excitability after verum acupuncture ( H-response/M-response ratio : placebo,.39+/-.19 ; verum,.68+/-.41 ; P<.05 ) . CONCLUSIONS This effect might be explained by afferent input of A delta and C fibers to the spinal motoneuron . The results from our study indicate that needle acupuncture may not be helpful to patients with chronic poststroke spasticity . However , there was neurophysiologic evidence for specific acupuncture effects on a spinal ( segmental ) level involving nociceptive reflex mechanisms An effective and safe remedy for shoulder pain is needed as shoulder pain is a common complication of stroke and restricts recovery of patients . This study was carried out to evaluate the effect of Ouhyul herbal acupuncture point injection ( O-API ) on shoulder pain in patients with stroke . Twenty-four participants with shoulder pain after stroke were recruited and r and omized to the O-API and control groups . Treatment was conducted for 2 weeks three times per week . We evaluated the effects of treatment with a numerical rating scale ( NRS ) , painless passive range of motion ( PROM ) of external shoulder rotation , and the Fugl-Meyer Motor Assessment ( FMMA ) at baseline , each week , and 1 week after the final treatment . All measures were similar between the O-API and control groups at baseline . The O-API group showed significant improvement on the NRS compared with that in the control group after 2 weeks of treatment , and the treatment effect was maintained until the follow-up period . PROM decreased significantly in both groups , but the reduction was maintained only in the O-API group . No significant difference was observed on the FMMA between the two groups . O-API result ed in significant improvement in shoulder pain after stroke , and its effect was maintained after termination of treatment without any severe side effects OBJECTIVE To evaluate the therapeutic effect of comprehensive therapeutic protocol of electroacupuncture combined with active-blood- and -dissolve-stasis herbs and rehabilitation training for cerebral infa rct ion . METHODS A multi-center r and omized controlled trial was done , three hundred and twenty cases were divided into four groups : electroacupuncture combined with active-blood and dissolve-stasis herbs and rehabilitation training group ( group A ) , electroacupuncture combined with rehabilitation training group ( group B ) , herbs combined with rehabilitation training group ( group C ) and rehabilitation training group ( group D ) , 80 cases in each group . The following two groups of acupoints were used alternatively in electroacupuncture treatment : the first group including Vasomotor Area , Jianyu ( LI 15 ) , Biguan ( ST 31 ) , Hegu ( LI 4 ) and Taichong ( LR 3 ) ; the second group including Motor Area , Quchi ( LI 11 ) , Yanglingquan ( GB 34 ) and Shenshu ( BL 23 ) . 20 mL Xiangdan injection and 250 mL 5 % glucose injection or 250 mL 0.9 % sodium chloride injection were used by intravenous drip in herbs treatment once a day . The rehabilitation training was performed by the professional physical therapist . Each group was treated with corresponding treatment protocol . The therapeutic effect was evaluated by index of the mortality or disability rate 3 months after the onset of disease . The intention to treat analysis ( ITT ) was used in data . RESULTS The mortality or h and icap rate 3 months after the onset of disease of four groups were 17.5 % ( 14/80 ) in group A , 22.5 % ( 18/80 ) in group B , 40 . 0 % ( 32/80 ) in group C , and 31.3 % ( 25/80 ) in group D , respectively . The group A has a best therapeutic effect ( vs group C , group D , both P<0.05 ) , and there was no adverse event . CONCLUSION The combined application of electroacupuncture , active-blood and dissolve-stasis herbs and rehabilitation training is a better treatment for cerebral infa rct ion in clinic Background and Purpose In a r and omized study of hemiparetic stroke patients with a median age of 75 years , functional recovery was significantly better in those who received additional  sensory stimulation  ( n=38 ) , including electrostimulation , than in control patients ( n=40 ) given the same physiotherapy and occupational therapy ; group differences for balance , mobility , and activities of daily living were significant . The present study was design ed to investigate postural control in patients who survived more than 2 years after stroke onset . Methods The 48 survivors ( mean , 2.7 years ; range , 2.0 to 3.8 years ) , 22 from the treatment group and 26 from the control group , were compared with 23 age-matched healthy subjects . Subjects were perturbed by vibrators applied to calf muscles or with galvanic vestibular stimulation . We evaluated postural control in terms of sway variances or sway velocities and the dynamics of postural control as a feedback system using system identification with a model previously vali date d for human postural control . Results Significantly more patients of the treatment group than of the control group maintained stance during perturbations ( P<.01 ) . Among patients capable of maintaining stance during perturbation , the control patients were characterized by significant divergence from normal values in two of the three characteristic parameters of dynamic postural control ( ie , swiftness and stiffness ; P<.05 ) compared with the treatment subgroup or age-matched subjects . Conclusions The course of sensory stimulation enhanced recovery of postural function , an enhancement still significant 2 years after the lesion and treatment . The differences and near normalization of characteristic parameters of dynamic postural control among treated patients suggest that improved recovery after sensory stimulation may be achieved by patients regaining normal or near normal dynamics of human postural control Abstract Objective : To observe the effect of electro-acupuncture ( EA ) on dendritic spine and ephrin-A5 and to investigate the action of EA on neural plasticity after acute cerebral ischemic infa rct ion . Methods : Focal acute cerebral ischemia model was established by middle cerebral artery occlusion ( MCAO ) with electrocoagulation contralateral method . Ninety male Sprague – Dawley rats were r and omly divided into sham operation ( SO ) group , MCAO group and EA treatment ( ET ) group . Golgi dying , double immunofluorescence method and RT-PCR were used to detect dendritic spine density , expression patterns of ephrin-A5 and the effect of EA on them at the end of the first , second and fourth week after ischemia . Results : The dendritic spine density in MCAO group significantly decreased after ischemia ( p<0.01 ) . The dendritic spine density was raised in ET group in the corresponding time period ( p<0.01 ) and among the ET groups . It was higher at the end of the fourth week than before ( p<0.05 ) . The signal of ephrin-A5 was detected mainly in neuron cytoplasm , and the mRNA expression in MCAO group and ET group increased compared to that in SO group ( p<0.01 ) . The mRNA expression in ET group at the first week was much higher than that in MCAO group ( p<0.01 ) . In ET groups , the mRNA expression of ephrin-A5 was down-regulated along with the time going ( p<0.01 ) . Conclusion : It is possibly the regulation of the ephrin-A5 expression by which EA treatment improves the neural plasticity at the peri-infa rct cerebral cortex in acute cerebral ischemia rat . There may be a time window in EA treatment for acute cerebral ischemia 63 patients with senile vascular dementia were r and omly divided into the treatment group ( treated by acupuncture ) and the control group ( treated with piracetam ) . The authors observed the changes in the score of Hasegawa 's dementia scale ( HDS ) , p300 , rheoencephalogram , topographic EEG , superoxide dismutase ( SOD ) activity in erythrocytes , and lipid peroxide ( LPO ) level in plasma before and after treatment . The statistical data showed that the total effective rate in the treatment group ( 80.6 % ) was significantly higher than that in the control group ( 25 % ) , and the differences in the observed indexes before and after treatment were significant ( P < 0.05 or P < 0.01 ) in the treatment group but not in the control group ( P > 0.05 ) , indicating that the acupuncture treatment was superior in immediate therapeutic effect on senile vascular dementia to drug treatment OBJECTIVE To observe the clinical effect of electroacupuncture and acupuncture on vascular dementia ( VaD ) and the influence on superoxide dismutase ( SOD ) , lipid peroxide ( LPO ) and nitric oxide ( NO ) levels . METHODS Forty-six cases of VaD were r and omly divided into two groups , the electroacupuncture group ( EA group ) and the acupuncture group ( AP group ) . Assessment of Hasgawa 's dementia scale ( HDS ) , functional activities question naire ( FAQ ) and neurologic deficit scoring were done before and after treatment , and the changes on SOD , LPO and NO levels were observed . RESULTS After treatment , in the EA group , the HDS elevated , the FAQ lowered , SOD increased and LPO and NO decreased significantly , as compared with before treatment , P < 0.01 . But these parameters were not changed significantly in the AP group after treatment . The clinical symptoms were improved in both groups , but the reduction on neurologic deficit score was not significant . The total effective rate of the EA group was higher than that of the AP group . CONCLUSION The immediate effect of electroacupuncture was superior to that of acupuncture , suggesting that the electroacupuncture was more effective in promoting the intelligence recovery than acupuncture This study is a double-blind r and omized controlled trial on the effect of intradermal acupuncture on insomnia after stroke . Hospitalized stroke patients with insomnia were enrolled in the study and were r and omly assigned to either a real intradermal acupuncture group ( RA group ) or a sham acupuncture group ( SA group ) . The RA group received intradermal acupuncture on Shen-Men ( He-7 ) and Nei-Kuan ( EH-6 ) for three days , and the SA group received sham acupuncture on the same points . The effect of acupuncture on insomnia was measured using Insomnia Severity Index ( ISI ) and Athens Insomnia Scale ( AIS ) at baseline and three days after treatment . To assess the effect of acupuncture on the autonomic nervous function , the subjects ' blood pressure and heart rate variability were monitored . Fifty-two subjects ( 27 in the RA group and 25 in the SA group ) were included in the final analysis . The insomnia-related scales ISI and AIS showed greater improvement of insomnia in the RA group than in the SA group . Moreover , there is a greater reduction of the number of non-dippers and a greater decrease of the LF/HF ratio ( heart rate variability ) in the RA group than in the SA group . These results indicate that sympathetic hyperactivities were stabilized in the RA group . It can thus be concluded that intradermal acupuncture on Shen-Men and Nei-Kuan is a useful therapeutic method for post stroke-onset insomnia as it reduces sympathetic hyperactivities OBJECTIVE To observe clinical therapeutic effect of head point-through-point electroacupuncture ( EA ) on poststroke depression ( PSD ) and to study the mechanism . METHODS One hundred and eight cases of PSD were r and omly divided into a point-through-point EA group ( n = 38 ) , a non point-through-point group ( n = 36 ) and a western medicine group ( n = 34 ) . After treatment of 28 days , their therapeutic effects , scores of HAMD depression scale and SDS self-rating scale , and plasma 5-HT contents were compared before and after treatment among the 3 groups . RESULTS The effective rate of 86.84 % in the point-through-point EA group was better than 63.89 % in the non point-through-point group and 67.65 % in the western medicine group ( P < 0.05 or P < 0.01 
    Output:
    