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Lactate has always been regarded as a metabolic waste in the brain‚ and the understanding of its functions have been seriously lagging behind. In recent years‚ more and more experimental evidence has shown that lactate plays an important role in a variety of physiological and pathological processes. Among nerve cells‚ astrocytes are the main source of cells for the production and release of lactate. The cells produce lactate through aerobic glycolysis‚ which is then released to the outside of the cells via transmembrane channels and enters neurons to supply energy. In the central nervous system‚ lactate plays a significant role in homeostasis regulation. Lactate regulates the functions and activities of neurons mainly through two pathways: metabolic pathways (as energy substrates) and signal pathways (as signal molecules) ‚which is extensively manifested in the regulation of physiological processes such as neuronal energy metabolism‚ excitatory‚ plasticity‚ learning and memory‚ and nervous system development‚ as well as the pathological processes including depression‚ Alzheimer’ s disease (AD) and brain injury. There is a lactate-specific receptor (GPR81) in brain tissue‚ and lactate binds to it to regulate the intracellular second messenger. In addition‚ it was also found that lactate can modulate the excitability of neurons through unknown receptors and other functions as signal molecules. Therefore‚ this article focus on the research progress of lactate as an energy substrate and signaling molecule and its involvement in related neurological diseases‚ which may provide new ideas for the prevention and treatment of related central nervous system diseases.
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<p><b>OBJECTIVE</b>The Chinese Children's Leukemia Group (CCLG)-acute lymphoblastic leukemia (ALL) 08 protocol for childhood ALL was established in 2008. This study aims to evaluate the drug-related toxicities of CCLG-ALL 08 protocol in the treatment of childhood ALL.</p><p><b>METHODS</b>A total of 114 children with newly diagnosed ALL were treated with the CCLG-ALL 08 protocol. The protocol was divided into five phases: remission induction (VDLD), early reinforcement (CAM), consolidation therapy, delayed reinforcement (DIa & DIb) and maintenance treatment. Drug-related toxicities in each phase were evaluated according to the Common Terminology Criteria for Adverse Events version 4.0.</p><p><b>RESULTS</b>Toxicities were more frequent in phase VDLD than other treatment phases, including hepatotoxicity (87.7%), dental ulcer (20.2%), hyperglycemia (20.2%), prolonged activated partial thromboplastin time (21.1%) and decreased fibrinogen (34.2%), with the incidence rates of severe adverse events at 7%, 0, 1.3%, 0.8% and 2.7% respectively. The incidence of allergic reaction to L-ASP was significantly higher in phase DIa than in phase VDLD (28.0% vs 7.9%; P<0.01), and there were no longer any allergic reactions in 15 patients who received continuing treatment with pegaspargase instead. There was no severe arrhythmia, myocardial ischemia, decreased left ventricular function, osteonecrosis, myopathy, organ failure or treatment-related mortality.</p><p><b>CONCLUSIONS</b>The drug-related toxicities of CCLG-ALL 08 protocol are common in phase VDLD, but they are mild and reversible. There is no treatment-related mortality. The CCLG-ALL 08 protocol for childhood ALL is safe.</p>
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Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Protocolos de Quimioterapia Combinada Antineoplásica , Asparaginase , Leucemia-Linfoma Linfoblástico de Células Precursoras , Tratamento Farmacológico , Indução de RemissãoRESUMO
<p><b>OBJECTIVE</b>To analyze the clinical and laboratory data from acute lymphoblastic leukemia (ALL) patients and the results of treatment using 04 Protocol (suggested by the Pediatric Hematology Group of Chinese Medical Association in 2004).</p><p><b>METHODS</b>This study included 88 children with ALL below the age of 18 years during the period from October 1, 2004 to June 30, 2007. Minimal inhibitory concentration (MIC) and clinical risk classification were done and the new chemotherapy regimen was used according to the protocol. Patients were stratified into low-risk (LR), medium-risk (MR), and high-risk (HR) groups. Life table method was used to estimate survival rate and statistical analysis was done by using software SPSS for Windows.</p><p><b>RESULTS</b>From October 2004 to June 2007, 88 childhood ALL patients were treated with the 04 Protocol. Sixty-three (91.30%) patients attained complete remission (CR) and 17 patients lost to follow up. The overall 4-year-event-free survival (EFS) rate (+/- SE) was (59.73 +/- 7.22)%. EFS was (75.60 +/- 9.71)% in the LR (n = 30), (65.50 +/- 11.69)% in the MR (n = 20) and (44.03 +/- 12.36)% in the HR. Relapse occurred in 18.18% of patients. Seven (7.95%) of 88 patients with ALL died during he induction therapy. Infection was the most common cause of death.</p><p><b>CONCLUSION</b>The outcome of patients treated with the 04 Protocol was favorable. Clinical risk classification and the leukemia cells of D19 are independent predictors of prognosis of ALL. High dose methotrexate played an important role in prevention and treatment of central nervous system leukemia. The mortality rate of this chemotherapeutic protocol during induction therapy was high.</p>
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Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Protocolos de Quimioterapia Combinada Antineoplásica , Usos Terapêuticos , China , Leucemia-Linfoma Linfoblástico de Células Precursoras , Diagnóstico , Tratamento Farmacológico , Estudos Retrospectivos , Fatores de Risco , Resultado do TratamentoRESUMO
@#ObjectiveTo explore effect of family rehabilitation on motor function of stroke patients.MethodsTo provide family rehabilitation with community guide for 106 stroke patients, and observe therapeutic effect.ResultsFamily rehabilitation was effective on 106 cases, and the earlier therapy started, the better effect was.ConclusionFamily rehabilitation is playing an important role in treatment of stroke patients.