ABSTRACT
Objective:To investigate the clinical characteristics of circadian rhythm disorder of blood pressure and its impact on orthostatic hypotension (OH) in Parkinson′s disease (PD).Methods:A total of 165 PD patients from Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from August 2019 to October 2021 were consecutively enrolled. Medical history and scores of motor and non-motor symptoms of patients were collected. Twenty-four-hour ambulatory blood pressure and OH data were collected, and the OH questionnaire was completed. The incidence of each type of circadian rhythm disorder of blood pressure was investigated. The t test, chi-square test and Mann-Whitney U test were used to determine between-group differences of circadian rhythm disorder of blood pressure. The linear trends in clinical characteristics were tested by linear regression analysis. Logistic regression analysis was used to analyze the relationship between different circadian rhythm disorders of blood pressure and OH as well as symptomatic OH (SOH). Results:In 165 PD patients, the incidence of reverse dipping pattern was 39.39% (65/165), nocturnal hypertension was 43.64% (72/165), and awakening hypotension was 31.52% (52/165). Compared with patients without reverse dipping pattern, patients with reverse dipping pattern were older [(71.72±7.81) years vs (65.29±9.68) years, t=-4.491, P<0.001], had later onset age [(66.67±9.10) years vs (62.16±10.66) years, t=-2.809, P=0.006], longer duration [36.00(20.50, 95.50) months vs 24.00(12.00, 41.75) months, Z=-3.393, P<0.001], higher dose of levodopa (LD) [(426.15±267.38) mg/d vs (284.00±235.58) mg/d, t=-3.590, P<0.001], higher levodopa equivalent dose (LED) [(514.80±360.03) mg/d vs (341.44±284.57) mg/d, t=-3.440, P=0.001], higher Unified Parkinson′s Disease Rating Scale (UPDRS)-Ⅱ scores (12.92±6.38 vs 9.54±5.59, t=-3.434, P=0.001), higher UPDRS-Ⅲ scores (28.34±11.60 vs 21.41±12.18, t=-3.508, P=0.001) and higher percentages of hallucinations [18.46% (12/65) vs 7.00% (7/100), χ2 =5.079, P=0.024]. Compared with patients without awakening hypotension, patients with awakening hypotension were older [(70.83±7.09) years vs (66.44±10.16) years, t=-2.811, P=0.006]. Compared with patients without nocturnal hypertension, patients with nocturnal hypertension had longer duration [39.50(15.00, 96.00) months vs 24.00 (12.00, 36.00) months, Z=-2.944, P=0.003], higher LD [(398.61±251.19) mg/d vs (294.62±254.25) mg/d, t=-2.619, P=0.010], higher LED [(493.28±344.02) mg/d vs (345.05±298.59) mg/d, t=-2.959, P=0.004], higher percentages of hallucinations [19.44% (14/72) vs 5.38% (5/93), χ2 =7.882, P=0.005], higher UPDRS-Ⅱ scores (12.08±6.33 vs 10.00±5.86, t=-2.086, P=0.039), higher UPDRS-Ⅲ scores (26.50±11.72 vs 22.42±12.66, t=-2.034, P=0.044), and greater blood pressure variability (BPV) (20.66±5.47 vs 17.44±5.36, t=-3.798, P<0.001). Trend analysis showed that the variety of circadian rhythm was positively correlated with age and duration, use of levodopa and monoamine oxidase B inhibitors and amantidine, morning and daily LD and LED, UPDRS-Ⅱ, UPDRS-Ⅲ and Hamilton Anxiety Scale scores, hallucinations, OH and SOH, and BPV in PD ( P<0.05). Multivariate Logistic regression analysis showed that awakening hypotension ( OR=3.35, 95% CI 1.55-7.22, P=0.002) and nocturnal hypertension ( OR=2.44, 95% CI 1.20-4.97, P=0.014) were risk factors for OH, and LED ( OR=1.21, 95% CI 1.01-1.43, P=0.035), UPDRS-Ⅲ scores ( OR=1.09, 95% CI 1.02-1.16, P=0.009) and w-BPV ( OR=1.14, 95% CI 1.01-1.29, P=0.029) were independent risk factors for SOH. Conclusions:Circadian rhythm disorder of blood pressure was correlated with age, duration, severity of motor symptoms. Awakening hypotension and nocturnal hypertension are independent risk factors for OH in PD.
ABSTRACT
In recent years, a number of studies have found that the dysregulation of intestinal microbes and their metabolites plays an important role in the occurrence and development of Parkinson′s disease (PD), and is closely related to the severity of PD clinical symptoms. Short-chain fatty acids are the main metabolites of intestinal microorganisms and may be involved in the pathogenesis of PD by regulating the inflammatory response, neuronal autophagy and apoptosis and the integrity of the blood-brain barrier and intestinal barrier. In this paper, the research progresses on the role of short-chain fatty acids in the pathogenesis of PD are reviewed, in order to provide new ideas for the treatment of PD.
ABSTRACT
Chemotherapy is an important adjuvant treatment of glioma, while the efficacy is far from satisfactory, due not only to the biological barriers of blood‒brain barrier (BBB) and blood‒tumor barrier (BTB) but also to the intrinsic resistance of glioma cells via multiple survival mechanisms such as up-regulation of P-glycoprotein (P-gp). To address these limitations, we report a bacteria-based drug delivery strategy for BBB/BTB transportation, glioma targeting, and chemo-sensitization. Bacteria selectively colonized into hypoxic tumor region and modulated tumor microenvironment, including macrophages repolarization and neutrophils infiltration. Specifically, tumor migration of neutrophils was employed as hitchhiking delivery of doxorubicin (DOX)-loaded bacterial outer membrane vesicles (OMVs/DOX). By virtue of the surface pathogen-associated molecular patterns derived from native bacteria, OMVs/DOX could be selectively recognized by neutrophils, thus facilitating glioma targeted delivery of drug with significantly enhanced tumor accumulation by 18-fold as compared to the classical passive targeting effect. Moreover, the P-gp expression on tumor cells was silenced by bacteria type III secretion effector to sensitize the efficacy of DOX, resulting in complete tumor eradication with 100% survival of all treated mice. In addition, the colonized bacteria were finally cleared by anti-bacterial activity of DOX to minimize the potential infection risk, and cardiotoxicity of DOX was also avoided, achieving excellent compatibility. This work provides an efficient trans-BBB/BTB drug delivery strategy via cell hitchhiking for enhanced glioma therapy.
ABSTRACT
Objective:To investigate whether the presynaptic dopamine neuronal depletion in different striatal subregions predicts future development of wearing-off (WO) in Parkinson′s disease (PD) patients.Methods:A retrospective longitudinal study included 57 PD patients who were referred to the Department of Neurology of Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2019 to September 2020, and completed 11C-2β-carbomethoxy-3β-(4-fluorophenyl) tropane dopamine transporter (DAT) positron emission tomography scans at the initial evaluation and received dopaminergic drugs for at least 12 months during follow-up. The time of starting dopaminergic drug treatment and the occurrence of WO were recorded. After adjusting for clinical related factors, the predictive value of DAT uptake and related parameters in striatal subregions for WO was evaluated by Cox proportional hazards model. Results:During a median follow-up period of 23 months, 10 patients (18.18%) developed WO. Patients with WO exhibited less DAT uptake in the caudate nucleus and anterior putamen nucleus (0.66±0.52 vs 1.08±0.42, t=2.76, P=0.008 and 0.66±0.20 vs 0.87±0.28, t=2.27, P=0.027 respectively), especially in these subregions contralateral to the less-affected side of the body, compared to those without WO. Cox proportional hazard models revealed that after adjusting for gender, age, course of disease, baseline Unified Parkinson′s Disease Rating Scale Ⅲ score and increment of levodopa equivalent dosage, the lower the DAT uptake of the caudate ipsilateral to the less-affected side of the body ( HR=0.20, 95% CI 0.07-0.63, P=0.006), as well as the lower the DAT uptake of the caudate nucleus and posterior putamen nucleus ( HR=0.28, 95% CI 0.11-0.69, P=0.006 and HR=0.08, 95% CI 0.01-0.64, P=0.018 respectively) and the higher the ratio of putamen/caudate contralateral to the less-affected side of the body ( HR=2.33, 95% CI 1.02-5.33, P=0.045), the higher the risk of WO. Conclusion:The presynaptic dopamine neuronal loss, particularly bilateral caudate nucleus dopaminergic depletion at the early stage, has predictive value of development of WO in PD.
ABSTRACT
Antipyretic-analgesics are currently one of the most prescribed drugs in children.The clinical application of antipyretic-analgesics for children in our country still have irrational phenomenon, which affects the therapeutic effect and even poses hidden dangers to the safety of children.In this paper, suggestions were put forward from the indications, dosage form/route, dosage suitability, pathophysiological characteristics of children with individual differences and drug interactions in the symptomatic treatment of febrile children, so as to provide reference for the general pharmacists when conducting prescription review.
ABSTRACT
Objective:To determine the evolution of gait impairment over the course of Parkinson′s disease (PD) by assessing the changes of gait characteristics in different disease stages, which could be helpful for disease monitoring.Methods:A total of 276 PD patients [PD group, Hoehn-Yahr (H-Y) stage 1-3] and 63 healthy controls (control group) enrolled in Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2019 to September 2021 were included in this cross-sectional study. The gait spatiotemporal variables were recorded by a portable inertial measurement unit system. Exploratory factor analysis was performed to obtain gait domains representing different gait characteristics. One way analysis of variance was used to evaluate the differences of gait variables and gait domains among the control group and 3 different H-Y stages of the PD group, as well as the differences among the control group and 2 motor subtypes of PD in different stages. The sensitivity of different gait variables and gait domains in evaluating the severity of gait impairments at different disease stages was compared.Results:Eleven gait spatiotemporal variables were grouped in 4 gait domains: pace (step length, gait speed and stride length), rhythm/phase (cadence, stride time and double support time), pace-related variability/asymmetry [step length coefficient of variation (CV), gait speed CV and step length asymmetry] and rhythm/phase-related variability/asymmetry (swing time CV and swing time asymmetry). As the disease progresses, most evolution trends of the 4 gait domains in the tremor-dominant PD patients were consistent with those in the non-tremor-dominant subtype. Compared with the control group, PD patients at H-Y stage 1 began to show the mild impairment of rhythm/phase-related variability/asymmetry (effect size 0.42; standardized score -0.03±0.69 vs -0.33±0.49, P<0.05), especially swing time asymmetry in tremor-dominant patients; the pace domain was damaged moderately in PD patients at H-Y stage 2 (effect size 0.64; standardized score 0.12±0.80 vs 0.64±0.81, P<0.05), especially in non-tremor-dominant PD patients, but not in PD patients at H-Y stage 1 ( P>0.05). Pace-related variability/asymmetry showed great impairment in PD patients at H-Y stage 3 (effect size 0.62; standardized score 0.27±1.12 vs -0.27±0.52, P<0.05), but not in PD patients at H-Y stages 1 and 2 ( P>0.05). Conclusions:The characteristic impairments of gait in PD evolve in the process of disease progression. The rhythm/phase-related variability/asymmetry domain may be a marker to distinguish early PD from healthy controls. The pace domain and the pace-related variability/asymmetry domain are important markers to evaluate the progression of PD.
ABSTRACT
Circadian rhythm disorder of blood pressure is a common abnormal form of blood pressure in Parkinson′s disease, including abnormal circadian blood pressure pattern, nocturnal hypertension, increased blood pressure variability and awakening hypotension. The pathogenesis of circadian rhythm disorder of blood pressure in Parkinson′s disease is complex, which involves the disruption of circadian rhythm, cardiovascular dysfunction, abnormal hormone secretion and the disorders of sleep-wake cycle and structure. At the same time, it is affected by many factors such as circadian activity rhythm, emotion, anti-Parkinson′s disease drugs and so on. Studies have shown that the circadian rhythm disturbance of blood pressure is closely related to the clinical phenotypes, progression and prognosis of Parkinson′s disease. Therefore, it is suggested to enhance the screening and intervention of circadian rhythm disorders of blood pressure to optimize treatment and improve quality of life in Parkinson′s disease.
ABSTRACT
Objective:To investigate the clinical and electrophysiological characteristics of tremor in patients with epilepsy, and explore the related factors affecting the occurrence of tremor.Methods:A cross-sectional survey was conducted to collect 80 patients with epilepsy in the Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from September 2018 to September 2019. Patients were divided into tremor group and non-tremor group according to clinical evaluation. All patients with epilepsy were evaluated by the Clinical Rating Scale for Tremor and were examined by electromyography (EMG).Results:There were 22 (27.5%, 22/80) patients who were found with tremor by self-reported complaint and (or) physical examination by clinicians, mainly manifested as postural tremor in the upper limbs, and 7.5% (6/80) patients also showed resting tremor. The EMG examination revealed that 51 patients (63.8%, 51/80) had tremor in the upper limbs. The incidence was 2.3 times as much as clinical evaluation. Among them, 42 patients (82.3%, 42/51) manifested postural tremor in upper limbs, 32 patients (62.7%, 32/51) manifested resting tremor. The peak frequency of postural tremor was (7.2±4.1) Hz, and synchronous burst pattern was mainly showed. The peak frequency of resting tremor was (5.3±2.2) Hz, and alternating burst pattern was mainly showed. Multivariate analysis showed that large number of medications and long duration of taking valproate acid were significantly related to the occurrence of tremor in patients with epilepsy.Conclusions:Tremor is mainly manifested as postural tremor in the upper limbs in patients with epilepsy. The EMG is a more sensitive and objective examination, which can detect tremor that was not yet noticed. Large number of medications and long duration of taking valproate acid might be the mainly associated factors for occurrence of tremor in patients with epilepsy.
ABSTRACT
Objective:To identify and quantify spatiotemporal and kinematic gait parameters in a group of early-stage Parkinson′s disease (PD) patients compared with healthy subjects.Methods:Eight patients with PD (PD group, Hoehn-Yahr stage≤2.5) and seven age-matched healthy subjects (control group) were enrolled from the Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine between May 2017 and August 2018 for the study. The spatiotemporal and kinematic gait parameters were obtained by Vicon 3D optical motion analysis system under three conditions: single-task walking, dual-task walking and turning. The linear mixed model was used to compare the gait parameters between the two groups and analyze the interactive effects.Results:Arm swing amplitude in the PD group was lower than that in the control group ((0.63±0.15) m vs (0.89±0.27) m in single-task walking, (0.64±0.16) m vs (0.99±0.22) m in dual-task walking, β=-0.353, 95% CI -0.558--0.148, P=0.002). The PD group showed significantly higher arm swing asymmetry than the control group (12.48%±5.48% vs 6.96%±4.39% in single-task walking, 17.13%±4.05% vs 7.67%±5.23% in dual-task walking, β=8.992, 95% CI 4.148-13.836, P=0.001). A notable interactive effect of groups and task factors in arm swing asymmetry was found. The arm swing asymmetry of the PD group increased more than the control group in dual-task walking than in single-task walking (β=3.916, 95% CI 1.367-6.466, P=0.003). As for the gait characteristics of the lower limbs, stride length and step length of the PD group were lower than those of the control group ((1.10±0.17) m vs (1.31±0.10) m in stride length, β=-0.169, 95% CI -0.300--0.038, P=0.015; (0.55±0.09) m vs (0.65±0.04) m in step length, β=-0.081, 95% CI -0.150--0.013, P=0.023). For both groups, statistically significant differences were not observed in step width, stride length and step length between single-task and dual-task walking ( P>0.05). The PD group completed the turning process faster than the control group ((1.66±0.30) s vs (1.37±0.23) s, β=0.302, 95% CI 0.049-0.555, P=0.023). As for the rotation-onset pattern, no statistically significant differences were found between the PD and the control group for the onset of the head, trunk and pelvic rotation ( P>0.05). Participants started to rotate their heads before the pelvis in all groups (β=-0.060, 95% CI-0.107--0.014, P=0.011). Conclusions:The quantified gait parameters can more accurately reflect the gait characteristics of early PD. Patients with PD exhibited smaller arm swing magnitude, greater arm swing asymmetry, shorter stride length, and slower turning speed compared to the controls. Arm swing asymmetry further differs between subjects with early PD and controls under dual-task walking.
ABSTRACT
Parkinson′s disease (PD) is the common progressive neurodegenerative disorder affecting older adults. Alterations of the circadian system occur in PD patients. However, the molecular mechanisms and pathophysiological process remain elusive. Circadian rhythm is modulated by both internal and external factors and using bright light and melatonin as chronotherapeutic tools may be potential therapies to improve symptoms of PD in the future. This article reviewed the abnormal changes of circadian parameters in clinical symptoms of PD and the possible mechanisms of circadian rhythm to provide basis for exploring the therapeutic strategies of circadian rhythm in PD.
ABSTRACT
Impulsive control disorders in Parkinson′s disease refer to a heterogeneous group of disorders that involve pleasurable behaviors performed repetitively, excessively, and compulsively. All these disorders are the failure to resist an impulse or temptation to control an act or specific behavior, which is ultimately harmful to oneself or others. The major symptoms of impulsive control disorders in Parkinson′s disease include pathological gambling, compulsive buying, binge eating and hypersexualtiy. The mechanism of impulse control disorders in Parkinson′s disease may be based on genetic and neural circuit, dopaminergic receptors, and neurotransmitters. Therefore, the identification and intervention of controllable factors should be emphasized in clinical diagnosis and treatment. Impulse control disorder questionnaire and functional imaging are helpful for the clinical diagnosis and evaluation of impulse control disorders in Parkinson′s disease. Patient education and individualized treatment are key points in clinical management for impulse control disorders in Parkinson′s disease. Meanwhile, exploring the gene-brain function network of impulse control disorders in Parkinson′s disease is important.
ABSTRACT
Ocular symptoms and signs related to Parkinson′s disease are a kind of clinical syndromes caused by pathological changes in the visual pathway, including abnormal eye movements and visual disorders. The syndromes appear in the early stages of the disease, associated with many factors, such as the course of the disease and the use of therapeutic drugs for Parkinson′s disease. Optical coherence tomography, video eye tracker, magnetic resonance imaging and evaluation scales can be used to examine ocular symptoms and signs of Parkinson′s disease. The eye symptoms and signs make the Parkinson′s syndromes present a wide spectrum of clinical manifestations. Early identification of these syndromes can help to diagnose Parkinson′s disease and to predict disease progression and prognosis.
ABSTRACT
Objective To analyze the characteristic changes of macular thickness in patients with Parkinson's disease by spectral-domain optical coherence tomography (SD-OCT),and find out the association between macular thickness and disease progression,cognitive dysfunction,visuospatial impairment and asymmetry of motor symptoms.Methods Seventy-one Parkinson's disease (PD) patients who were admitted to the Department of Neurology,Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine from January 2016 to May 2018 and sixty-one healthy controls who volunteered to participate for the same period were enrolled and underwent SD-OCT examination.The macular thickness of all retinal quadrant segments,foveal thickness,and macular volume between the two groups were comparatively analyzed.Associations between macular measurements and clinical parameters such as disease duration,Unified Parkinson's Disease Rating Scale part Ⅲ (UPDRS-Ⅲ) scores,Montreal Cognitive Assessment (MoCA) total scores,and visuospatial subscores were analyzed using generalized estimated equation fitted with linear regression models.Results Mean macular thickness in the PD group was significantly reduced compared with those in the control group ((261.94± 12.90) μm vs (270.96± 10.71) μm,B=-8.135,P＜0.01).All quadrants of macular thickness (except fovea and 1 mm central zone) in the PD group were reduced compared with those in the control group.Receiver operating characteristic (ROC) curve analysis revealed that inner superior thickness could predict the presence of PD with an area under ROC of 0.727 (95％CI 0.662-0.792,P＜0.01).UPDRS-Ⅲ scores were negatively correlated with foveal thickness (B=-9.132,P=0.034),1 mm central zone thickness (B=6.963,P=0.036) and all quadrants of the inner ring (superior (B=-7.727,P＜0.01),inferior (B=-5.169,P=0.044),nasal (B=-5.960,P＜0.01) and temporal (B=-5.905,P＜0.01)) macular thickness.The disease duration had no relationship with any quadrant of macular measurements.No statistically significant difference was found between the macula parameters of the hemiretinae corresponding to more and less severely affected cerebral hemisphere.MoCA total scores were positively correlated with all quadrants of the inner ring (superior (B=2.693,P=0.007),inferior (B=3.391,P=0.002),nasal (B=2.609,P=0.001) and temporal (B=2.115,P=0.013)) macular thickness.MoCA visuospatial subscores were positively associated with average macular thickness (B=4.368,P=0.042),macular volume (B=0.161,P=0.004),inferior (B=8.582,6.541),nasal (B=8.130,6.017) and temporal (B=5.938,5.316)quadrants of outer and inner rings macular thickness (all P＜0.05).Conclusions In PD patients,the macular thickness and macular volume were decreased.Asymmetry was not identified between hemiretinae in PD.Some quadrants of macular thickness were associated with disease progression,cognitive dysfunction,and visuospatial impairment.
ABSTRACT
Objective To observe the proliferation ability of cocultured dendritic cells(DCs)loaded with tumor antigen and cytokine-induced killer cells( CIKs)and its killing effect on hepatocarcinoma cells HepG2. Methods The antigen of hepatocarcinoma cells HepG2 was prepared by repeated freezing and thawing of liquid nitrogen. Peripheral blood mononuclear cells(PBMNCs)were isolated from healthy donors by blood cell separator,then DCs and CIKs were induced. Ag-DCs were obtained by impinging DCs with tumor antigens. CIKs were divided into three groups:the first group was CIKs alone,the second group was mixed in the propor-tion of DCs : CIKs = 1 : 5,and the third group was mixed in the proportion of Ag-DCs : CIKs = 1 : 5. The three groups of cells were recorded as CIK group,DC-CIK group and Ag-DC-CIK group. The proliferation and cell phenotype of the three groups of cells were observed and the killing effects on hepatocarcinoma cells HepG2 were detected by methyl thiazolyl tetrazolium(MTT)assay. Results The proliferation multiples of the three groups of cells were gradually increased with the prolongation of culture time,and the proliferation rates of Ag-DC-CIK on the 9th day(61. 32 ± 1. 72),the 12th day(190. 83 ± 3. 53)and the 15th day(399. 09 ± 5. 60) were significantly higher than those of CIK group(22. 47 ± 2. 07,55. 91 ± 1. 81,83. 20 ± 2. 34)and DC-CIK group(40. 26 ±2. 49,125. 03 ±4. 16,251. 55 ±3. 25),and the difference between the three group was statisti-cally significant(F =185. 78,P =0. 033;F = 297. 35,P = 0. 018;F = 455. 37,P < 0. 001),in addition,the differences between each two groups were statistically significant(all P <0. 05). The cytotoxicity of Ag-DC-CIK to HepG2 cells at the effective target ratios of 5 : 1(31. 71％ ±0. 29％ ),10 : 1(42. 43％ ±1. 86％ )and 20 : 1 (57. 69％ ±1. 11％ )were significantly higher than those of CIK group(12. 11％ ±1. 14％ ,21. 30％ ±0. 52％ , 30. 71％ ±1. 26％ )and DC-CIK group(20. 06％ ± 0. 67％ ,29. 89％ ± 1. 37％ ,39. 11％ ± 0. 92％ ),and the difference between the three group was statistically significant(F =159. 64,P =0. 037;F =199. 36,P =0. 025;F =302. 08,P <0. 001),in addition,the differences between each two groups were statistically significant(all P <0. 05). On the 15th day of cell culture,the flow cytometry analysis showed that all the three groups were expressed CD3 + CD8 + ,CD3 + CD56 + double positive cells,the contents of CD3 + CD8 + 、CD3 + CD56 + double positive cells in the Ag-DC-CIK group(88. 12％ ± 1. 24％ ,61. 35％ ± 2. 63％ )were significantly higher than those in the CIK group(54. 37％ ± 3. 08％ ,18. 22％ ± 1. 83％ )and DC-CIK group(69. 80％ ± 1. 46％ , 39. 51％ ±2. 17％ ),and the difference between the three group was statistically significant(F = 414. 32,P <0. 001;F =378. 60,P <0. 001),in addition,the differences between each two groups were statistically signifi-cant(all P <0. 001). Conclusion The proliferation ability and killing effect of Ag-DC-CIK that obtained from antigen-pulsed DCs co-cultured with CIKs are significantly higher than those of CIKs and DC-CIKs.
ABSTRACT
Objective To investigate the effects of sevoflurane post treatment on cerebral ischemia-reperfusion injury in diabetic rats and non-diabetic rats.Methods Thirty-two male SD rats,aged 3.0-3.5 months,weighing 280-320 g,were divided into four groups by random number method (n =8):non diabetic ischemia reperfusion group (group NDC);diabetic ischemia reperfusion group (group DC2);non diabetic ischemia reperfusion group with the sevoflurane post-treatment (group NDS);diabetic ischemia reperfusion group with the sevoflurane post-treatment (group DS).The middle cerebral artery occlusion method and streptozotocin were used to establish the ischemiareperfusion injury model and diabetic model.2 h after ischemia and 24 h after reperfusion,the rats nerve defect scale was detected,the cerebral infarction volume was evaluated by TTC method,and Western blot method was used to detect angiogenin-1 (Ang 1) expression.Results Between the four groups of rats,nerve deficit score and infarct volume were significantly higher,Ang-1 protein relative expression was significantly lower in group DC than those in group NDC (P＜0.05);neural deficit score and infarct volume were significantly lower,Ang-1 protein relative expression was significantly higher in group NDS than those in group NDC (P＜0.05);nerve deficit score and infarct volume were significantly lower,Ang-1 protein relative expression was significantly higher in group DS than those in group DC (P＜0.05).Conclusion In the rats after cerebral ischemia reperfusion,diabetes could aggravate the nerve defect,increase the volume of cerebral infarction,reduce the expression of Ang-1;sevoflurane could reduce nerve defects,reduce infarct volume,increase the expression of Ang-1.The expression of Ang-1 and degree of injury after cerebral ischemia reperfusion in rats have relationship.
ABSTRACT
Dyskinesia is one kind of motor complications caused by prolonged administration of levodopa to patients affected by Parkinson's disease. The mechanisms of dyskinesia in Parkinson's disease are still unknown. Recent research suggests the prevalence of dyskinesia mainly depends on genetic factors, levodopa therapy,clinical subtype, body weight and gender. Accumulating evidence indicates that assessment scales, functional magnetic resonance imaging and biomarkers could improve the clinical diagnosis and assessment of dyskinesia. In addition, a number of clinical trials of dyskinesia have indicated that new drugs such as an extended-release formulation of adamantine, and physical therapy such as repetitive transcranial magnetic stimulation are beneficial to the treatment of dyskinesia.
ABSTRACT
In the course of the training of clinical specialty degree graduate education and standard-ized training of residents(referred to as"temporary residence"),students are required to obtain"four certifi-cates" in 3 years". Here, our department of Neurology reviewed residents who were trained by this training mode. Their ability of clinical neurological profession, clinical thinking and clinical research was with effective promotion through"one to one"teaching method,the tutor-responsibility system,PBL teaching and literature-reading meeting. The objective is to get the best effect in 3 years, to explore a more suitable training mode for these residents and train high-level clinicians with applied and academic types.
ABSTRACT
Objective To evaluate the clinical value of the level of plasma procalcitonin,blood lactic acid an1 endotoxin in patients of severe pneumonia complicated with sepsis.Methods The 40 cases of severe pneumonia complicated with sepsis(observation group)were analyzed retrospectively,they were divided into survival group included 20 cases and the death group included 20 cases.Meanwhile the 20 cases of healthy persons were selected as control group.The worst score of Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) within 24 hours after admission were record.The level of plasma procalcitonin,blood lactic acid and endotoxin were compared between three groups.In addition do a correlation study between the above indexes and the score of APACHE Ⅱ.Results The level of plasma Procalcitonin,blood lactic acid and endotoxin of observation group increased significantly compared with the control group [(0.02±0.01 ng/ml,0.87 ± 0.27 mmol/L,4.15±1.63 pg/ml) vs (18.29±11.02 ng/ml,6.55 ± 3.02 mmol/L and 15.5±10.38 pg/ml),t=10.48,11.79,6.75,all P＜0.05].The level of plasma procalcitonin,blood lactic acid and endotoxin of the death group increased significantly compared with the survival group [(9.52±2.93 ng/ml,4.26±1.78 mmol/L,7.62±3.04 pg/ml) vs (27.06±8.88 ng/ml,8.84± 2.14 mmol/L and 23.39± 9.00 pg/ml),t=8.39,7.35,7.42,all P＜0.05].In the all patients of severe pneumonia complicated with sepsis,there was positive correlation among plasma procalcitonin,blood lactic acid,endotoxin and the score of APACHE Ⅱ (r=0.919,P=0.001;r=0.914,P=0.002;r=0.909,P=0.004).Conclusion The level of plasma procalcitonin,blood lactic acid and endotoxin are very important indexes in assessment of the severity and the prognosis of severe pneumonia complicated with sepsis,that has important value in clinical application.
ABSTRACT
Objective To investigate the gait differences among patients with Alzheimer's disease (AD) and mild cognitive impairment(AD-MCI) and the person with normal cognitive function,and analyze the reasons for the abnormal gait.Methods Eighty patients were included and divided into 3 groups according to the cognitive status:noncognitive impairment (NCI group,n =30),patients with mild cognitive impairment (AD-MCI group,n =29),Alzheimer's disease (AD group,n =21).The mini-mental state examination (MMSE),the Montreal Cognitive Assessment (MoCA),Addenbrooke's Cognitive Examination (ACE-R),the connection test (TMT-A),Digit Span Test(DST),activities of daily living questionnaire(ADL) and associated gait and balance scale (5 times sit to stand test (FTSTT),3 m walking test (TUG),Berg balance scale) were used to evaluate all research objects in each group.Results There were significant differences in NCI group compared with AD-MCI group and AD group in terms of FTSTT,TUG,Berg balance Scale and leg speed((9.59±2.39) s vs.(13.71±4.65) s vs.(14.15±4.20) s,(7.70±1.58) s vs.(11.13±3.02) s vs.(11.35±4.43) s,(54.20±1.56) points vs.(48.17±4.93) points vs.(48.10±5.46) points,(82.12±22.79) cm/s vs.(57.49± 14.89) cm/s vs.(57.70±14.68) cm/s;P＜0.05).There were significant differences in NCI group compared with AD-MCI group and AD group in terms of MMSE,MoCA,ACE-R,TMT-A,DST((28.67±1.27) points vs.(26.76±2.59) points vs.(21.86±5.29) points,(26.03±2.58) points vs.(22.39±5.05) points vs.(16.90±5.05) points,(85.80±5.90) points vs.(78.03±7.58) points vs.(60.95± 13.99) points,(12.66±5.36) s vs.(18.99 ± 11.46) s vs.(30.49±26.98)s,(18.60±4.64) points vs.(15.94±4.76) points vs.(12.86±5.23) points;P ＜0.05).Conclusion Gait disorder might be an early sign for cognitive impairment.
ABSTRACT
Objective To investigate that ox-LDL inhibits endothelial differentiation of bone marrow mesenchymal stem cells (MSCs) in rats and its underlying mechanism .Methods Cultured MSCs were divided into four groups:blank groups , ox-LDL groups ( 5 μg/mL ox-LDL ) , ox-LDL +NAC groups ( 5 μg/mL ox-LDL and pre-treated NAC), and negative LDL groups (5 μg/mL nLDL).Cell morphology, endothelial marker and differentiation effi-ciency as well as signal of oxidative and pathway protein were detected after induction by Western blot , real-time PCR.Results MSCs can differentiate into endothelial cells with the expression of endothelial marker vWF , Flk-1 and CD31 at the mRNA and protein level , vascular morphology , ox-LDL obvious inhibited endothelial differentia-tion of MSCs ( P<0.05 ) , but NAC can reverse the inhibition , the amount of ROS in ox-LDL groups was higher than that in ox-LDL+NAC groups ( P <0.05 ) , The expression of phosphorylated Akt decreased distinctly after treatment with ox-LDL( P<0.05 ) , NAC can stimulated its expression close to normal .Conclusions ox-LDL can inhibit endothelial differentiation of MSCs via ROS , NAC in this procese shows inhibition to effect of ox-LDL and Akt signaling also played a critical role .