Early implementation of group rehabilitation exercise improves quality of life in patients with Parkinson's disease / 中华老年医学杂志

Objective:To investigate the impact of group-based rehabilitation exercise on motor and non-movement symptoms of Parkinson's disease(PD).Methods:A total of 88 patients from out-patient and in-patient services at our hospital were randomly assigned to an early exercise group(E-EG), a late exercise group(L-EG), and a control group(CG)using a randomized delayed-start design.Patients in the E-EG carried out a rigorous, formal group exercise program, one hour per session, twice per week, for 18 months(May 2018-November 2019). Patients in the L-EG took part in the exercise program in the final 6-12 months of the study.We assessed outcomes using the Unified Parkinson's Disease Rating Scale(UPDRS), Parkinson's disease questionnaire-39(PDQ-39 Q), trail-making test part A & B, nine-hole peg test(9-HPT), 30 second sit to stand test(30s SST), 10 m walk test(10 m W), mini-balance evaluation systems test(Mini-BEST), Fullerton Advanced Balance(FAB)Scale and time up and go(TUG)test.Results:Compared with pre-exercise levels, patients with PD in the E-EG had lower performance in UPDRS(17.5±8.3 vs.20.0±8.6, t=-2.2, P=0.02)and lower performance in PDQ-39(27.2±2.1 vs.29.0±9.8, t=-2.6, P=0.001)after exercise.Moreover, compared with pre-exercise levels, patients with PD in the E-EG showed decreased post-exercise performance in trail-making test part B(114.2±25.5 vs.129.8±28.4, t=-2.3, P=0.02)and in 9-HPT(33.7±7.3 vs.39.6±9.3, t=-2.6, P=0.001). Conclusions:The practice of group-based rehabilitation exercise can improve movement abilities and quality of life in PD patients, especially if implemented early.Targeted rehabilitation exercise should be taken as part of the treatment strategy for PD patients as early as possible to deliver the best benefits.

Study on the relationship between body image disturbance and depression and anxiety symptoms in pregnant women： a scoping review / 四川精神卫生

BackgroundPsychological problems such as depression and anxiety are common in pregnant women， and many studies have found that body image disturbance is closely related to depression and anxiety symptoms. Still， there is large variability in previous findings. ObjectiveTo review the researches on the relation of body image disturbance to depression and anxiety in pregnant women， and to provide a reference for interventions targeting maternal body image disturbance and depression and anxiety symptoms. MethodsOn January 10， 2023， well qualified literature focusing on the relationship between body image disturbance and depression and anxiety symptoms in pregnant women were searched in PubMed， Embase， CINAHL， Web of Science， China National Knowledge Infrastructure （CNKI）， VIP databases， Wanfang Data Database and China Biology Medicine disc （CBMdisc） from inception to January 1， 2023. The research content， factors influencing body image disturbance and relevant findings were extracted and summarized for analysis. ResultsA total of 14 articles were included in this review. The body image disturbance in pregnant women was manifested predominantly by an excessive concern about body weight and shape， and was affected by demographic characteristics， sociocultural factors， obstetric factors and other factors. Furthermore， body image disturbance significantly predicted the occurrence of depression， and proved a close relationship with anxiety symptoms. ConclusionBody image disturbance seriously affects the physical functioning and psychological status of pregnant women and may further exacerbate the symptoms of depression and anxiety.

Autologous peripheral blood stem cell mobilization following dose-adjusted cyclophosphamide, doxorubicin, vincristine, and prednisolone chemotherapy alone or in combination with rituximab in treating high-risk non-Hodgkin's lymphoma / 癌症

<p><b>BACKGROUND</b>The regimen of cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) is an efficient treatment of non-Hodgkin's lymphoma (NHL). This study aimed to assess the efficacy and toxicity of dose-adjusted CHOP alone or in combination with rituximab (R-CHOP) by examining the stem cell mobilization in NHL patients. Factors affecting the collection of CD34+ cells were also explored.</p><p><b>METHODS</b>Our retrospective study included 39 patients eligible for autologous stem cell transplantation: 14 patients who expressed CD20 and were financially eligible received R-CHOP for autologous peripheral blood stem cell (APBSC) mobilization; the remaining 25 patients received CHOP.</p><p><b>RESULTS</b>The median CD34+ cell yield was 7.01×10(6) cells/kg body weight (range 1.49-28.39×10(6) cells/kg body weight), with only two patients failing to meet the target CD34+ cell harvest of ≥2.0×10(6) cells/kg body weight. The median number of apheresis procedures per patient was 1 (range 1-3). The APBSC mobilization yield of the CHOP group appeared to be higher than that of the R-CHOP group (P=0.005), whereas the success rate was similar between groups. R-CHOP elevated the complete response (CR) rate in B cell lymphoma patients as compared with CHOP (P=0.01). No significant differences in toxicity or engraftment were observed between the two groups.</p><p><b>CONCLUSION</b>The present study demonstrated that dose-adjusted CHOP chemotherapy effectively mobilized APBSCs in NHL patients and that the addition of rituximab to dose-adjusted CHOP chemotherapy elevated the CR rate for patients with B-cell lymphoma.</p>

Comparison of immunohistochemistry with fluorescence in situ hybridization in determining the human epidermal growth factor receptor 2 status of breast cancer specimens: a multicenter study of 3,149 Chinese patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Accurate detection of human epidermal growth factor receptor 2 (HER2) expression and gene amplification is crucial for the application of HER2-specific therapy and for evaluating the response of patients with breast cancer. A uniform and standard procedure of immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) needs to be established for evaluating the HER2 status in breast cancer tissues for the treatment of patients with real HER2-positive tumors. The present multicenter study was aimed to examine the HER2 status in breast cancer specimens from Chinese patients using both IHC and FISH methods.</p><p><b>METHODS</b>A multicenter study was performed on the HER2 status in 3 149 breast cancer specimens from different ethnic populations and areas in China by IHC and FISH assays. The potential association of HER2 status with demographic and clinical characteristics was analyzed.</p><p><b>RESULTS</b>The positive rates for HER2 over-expression and HER2 amplification were 23.3% and 27.5% in this study, respectively. The concordance between IHC and FISH was 71.2% (κ = 0.494, P < 0.001). Furthermore, 72.9% of specimens with IHC 2+ were negative to FISH. The discordance rates among laboratories were from 5% to 28% for IHC and 1% to 16% for FISH. HER2 amplification was associated significantly with advanced tumor stage (III or IV, P = 0.002), large tumor size (>5 cm, P = 0.002), moderate and poor histological grades (P < 0.0001), post-menopause (P < 0.0001), ER-PR- (P = 0.002), and having ≥ 4 lymph nodes affected (P < 0.0001) in this population. The positive rates of HER2 amplification in specimens from Man and Hui Chinese were significantly higher than that in other Chinese populations. There are slightly higher positive rates of HER2 expression and amplification in Chinese patients with breast cancer.</p><p><b>CONCLUSION</b>These findings may provide new insights into understanding the epidemiological features of HER2 expression and amplification, and may be valuable for clinical practice.</p>

A prospective multicenter study of HER-2/neu status in human breast cancer patients of mainland China: comparison of fluorescence in situ hybridization and immunohistochemistry / 中华检验医学杂志

Objective To investigate the expression of the HER-2 in human breast carcinomas by comparing the concordance between IHC staining and FISH, and analyze the relationship between the gene expression of HER-2/neu and clinical characteristics of patients. Methods A prospective clinical trial was performed involving a large multicenter patients' samples. Totally 3 249 breast cancer samples were collected from October 2007 to September 2009 in 73 hospitals across mainland China. HER-2 status was assessed by both IHC and FISH using formalin-fixed paraffin sections of consecutive tumor samples. The relationship between the expression of HER-2/neu gene and clinical parameters was analyzed using statistical methods. Results HER-2/neu was detected by FISH in 42.6% (1342/3149) of cases, whereas IHC analysis found 46. 9% (1477/3149) of cases to be HER-2/neu positive (2 +/3 + ). A higher concordance was observed in 94. 1% (892/948) of the patients with scores of 3 + and 89. 9% (660/734) with scores of 0 + by IHC, but relatively low concordance was also observed in 71. 0% (514/725) of patients with scores of 1 + and 55. 9% (415/742) in scores of 2 + by IHC. HER-2/neu gene amplification was associated with negativity of estrogen receptor and progesterone receptor (r = 0. 45, P < 0.01) , high histological grade ( r = 0. 51,P<0.01), more than 4 positive lymph nodes (r =0. 35, P<0.01), advanced stage (r=0. 33, P< 0. 01) , large tumor size ( > 2 cm, r = 0. 38, P < 0. 01 ) , postmenopause (r = 0. 24, P < 0. 01). No statistically significant relationship was found between HER-2 gene status and the other variables including age(r=0.36, P = 0.068), CA125 (r=0.11, P=0.722) or CA153 (r = 0. 23, P=0.45) protein status, lymph node involvement (r=0. 15, P =0. 18), CEA (r = 0.22, P=0.074) , number stage of tumor (r = 0. 21, P = 0.056 ) and blood vessel invasion (r = 0. 12, P = 0. 133 ). Conclusions The comparison of IHC and FISH demonstrated an excellent correlation of HER-2/neu overexpression and gene amplification. The results availabledemonstrate that FISH-analysis as a gold standard should be performed to guide reasonable clinical treatment.