ABSTRACT
Objective:To observe any effects of contralateral repeated transcranial magnetic stimulation (rTMS) of the swallowing motor cortex on the swallowing and brainstem auditory evoked potentials (BAEPs) of stroke survivors with dysphagia.Methods:A total of 83 stroke survivors with dysphagia were randomly divided into an ipsilesional stimulation group ( n=22), a contralesional stimulation group ( n=21), a bilateral stimulation group ( n=20), and a control group ( n=20). In addition to their conventional dysphagia training, those in the three stimulation groups received 3Hz rTMS while the control group was given fake stimulation. The treatment was administered daily for 20 minutes, 6 days a week, for 5 consecutive weeks. Before and after the treatment, swallowing function was assessed videofluoroscopically and using the Dysphagia Outcome and Severity Scale (DOSS). The oral and pharyngeal stages of swallowing were evaluated using the videofluoroscopic dysphagia scale (VDS). Brain stem conduction was assessed using BAEPs. Results:After treatment the average DOSS scores of all 4 groups were significantly better than before the treatment. The average DOSS scores of the contralesional and bilateral sti-mulation groups were then significantly better than those of the other two groups. The sub-item and total VDS scores of all 4 groups had decreased significantly, but the average score of the bilateral stimulation group was significantly lower than the control group′s average. Ipsilesional stimulation significantly improved the VDS sub-item scores for the triggering of pharyngeal swallowing, laryngeal elevation, and pharyngeal transit time compared with the control group. In the contralesional stimulation group the average total score and the VDS sub-item scores for apraxia, premature bolus loss, oral transit times, the triggering of pharyngeal swallowing, vallecular residue, laryngeal elevation, coating on the pharyngeal wall, and pharyngeal transit time were significantly lower than those of the control group, on average. After the treatment the latencies of BAEP waves I, III and V and the I-III, III-V and I-V interpeak intervals had decreased significantly in all four groups, but the average latencies and intervals of the bilateral and contralesional groups were significantly shorter than those of the control group. The latencies and intervals of the bilateral stimulation group were then significantly shorter than those in the ipsilesional stimulation group on average. The average latency of wave V in the bilateral stimulation group (6.53±0.73ms) was significantly shorter than that in the contralesional stimulation group after the treatment.Conclusion:Bilateral rTMS over the swallowing motor cortex combined with conventional dysphagia training can significantly improve the swallowing of dysphagic stroke survivors.
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Objective:To learn about the incidence of hypertension in residents of arsenic exposure areas of Togtoh County, Inner Mongolia Autonomous Region, and to analyze the influencing factors of hypertension.Methods:In Inner Mongolia Autonomous Region, Ciweigou of Togtoh County, a drinking water-type endemic arsenic poisoning area, and Lanjiayao of Horinger County, a non-arsenic poisoning area with similar living habits and economic conditions, permanent residents who had lived for ≥10 years were selected as the survey subjects. Totally 116 residents of Ciweigou (exposure group) and 68 residents of Lanjiayao (control group) were included in the survey. Blood pressure was measured and the contents of arsenic, selenium, lead and chromium in urine were detected, multivariate logistic regression was used to analyze the influencing factors of hypertension.Results:The detection rates of hypertension in exposure group and control group were 53.45% (62/116) and 70.59% (48/68), respectively, and the difference between the two groups was statistically significant (χ 2 = 5.33, P = 0.022). The contents of arsenic, selenium and chromium in urine of exposure group were higher than those of control group, and the content of lead in urine was lower than that of control group, and the differences were statistically significant ( Z = 13.04, 6.34, 11.28, - 9.91, P < 0.001). The results of multivariate logistic regression analysis showed that female, age ≥60 years old and high urinary arsenic content were the influencing factors of hypertension [odds ratio ( OR) = 2.074, 2.004, 0.424, 95% confidence interval ( CI): 1.113 - 3.866, 1.035 - 3.879, 0.219 - 0.820] in arsenic exposure areas. Conclusion:Female, age ≥60 years old and high urinary arsenic content are the influencing factors of hypertension in arsenic exposure areas of Togtoh County, Inner Mongolia Autonomous Region.
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Fulvestrant is a selective estrogen receptor degrader (SERD), that can specifically bind to estrogen receptor (ER), block ER transcription activity, and induce the degradation of ER protein. However, along with its widespread use in breast cancer endocrine therapy, drug resistance does gradually develop. A better understanding of mechanisms on fulvestrant resistance and the exploration on precise targeted therapy is the key to breaking through treatment bottlenecks and subsequently improving the prognosis of patients. Here, we review research advances in the potential mechanisms of fulvestrant resistance and outline promising approaches such as combination therapy to overcome the resistance.
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Objective To investigate the expression levels of adiponectin and visfatin in the gingival crevicular fluid (GCF) and serum of patients with obesity and chronic periodontitis.Methods The study included 80 patients.Among them,20 were healthy controls (H group),20 had periodontitis (CP group),20 had obesity (OB group),and 20 had both obesity and periodontitis (OB+CP group).The patients' baseline information and clinical parameters were recorded,and the GCF and serum were collected.The concentration of adiponectin and visfatin in the GCF and serum were then assayed using ELISA.Use the SPSS 17.0 software package for statistical analysis.Results The concentration of adiponectin in the serum of the CP group,the OB group,and the OB+CP group were significantly lower than that of the H group (P ＜ 0.05).The concentration of adiponectin in the serum of the OB+CP group was lower than that of both the CP and OB groups (P ＜ 0.05).The concentration of adiponectin in the GCF of the CP group,the OB group,and the H group were higher than that of the OB+CP group (P ＜ 0.05).The concentration of adiponectin in the GCF of the CP group,the OB group,and the H group were lower than that of the OB+CP group (P ＜ 0.05).Conclusion Obesity may aggravate the destruction of periodontal tissue by inhibiting the expression of adiponectin and promoting the expression of visfatin.