Carpets with visual cues can improve gait in Parkinson's disease patients: may be independent of executive function.

BACKGROUND: Gait impairment is common in Parkinson's disease (PD) patients, which greatly reduces their quality of life. Executive dysfunction is associated with gait impairment. Compensatory strategies, including visual cues, have been shown to be effective in improving PD gait. In this study, we aimed to understand whether carpets with visual cues could improve PD gait, and how the improvement varies across patients with different executive function state. METHODS: We designed carpets with chessboard and stripe cues. A total of 65 Chinese PD patients were recruited. Movement Disorder Society Unified Parkinson's Disease Rating Scale, L-dopa equivalent daily dosage, Hoehn & Yahr stage, Frontal Assessment Battery, Mini Mental State Examination Scale, Hamilton Anxiety Scale, and Hamilton Depression Scale were evaluated. Gait parameters including stride length, gait speed and fall risk were recorded by a wearable electronic device. RESULTS: The stride length and gait speed were significantly improved and the fall risk was significantly mitigated when PD patients walked on carpets with chessboard and stripe patterns. Further analysis showed the amelioration of gait parameters was independent of executive dysfunction. CONCLUSIONS: Our study demonstrates that carpets with visual cues can improve the gait of PD patients even in those with mild executive dysfunction.

Neck pain and absence of cranial nerve symptom are clues of cervical myelopathy mimicking stroke: Two case reports.

BACKGROUND: Cervical myelopathy is a potential stroke imitator, for which intravenous thrombolysis would be catastrophic. CASE SUMMARY: We herein present two cases of cervical myelopathy. The first patient presented with acute onset of right hemiparesis and urinary incontinence, and the second patient presented with sudden-onset right leg monoplegia. The initial diagnoses for both of them were ischemic stroke. However, both of them lacked cranial nerve symptom and suffered neck pain at the beginning of onset. Their cervical spinal cord lesions were finally confirmed by cervical computed tomography. A literature review showed that neck pain and absence of cranial nerve symptom are clues of cervical myelopathy. CONCLUSION: The current report and the review remind us to pay more attention to these two clues in suspected stroke patients, especially those within the thrombolytic time window.

Effects of Exogenous Potassium (K+) Application on the Antioxidant Enzymes Activities in Leaves of Tamarix ramosissima under NaCl Stress.

Saline soil is a worldwide distributed resource that seriously harms plants' growth and development. NaCl is the most widely distributed salt in saline soil. As a typical representative of halophytes, Tamarix ramosissima Lcdcb (T. ramosissima) is commonly grown in salinized soil, and halophytes have different abilities to retain more K+ under salt stress conditions. Halophytes can adapt to different salt environments by improving the scavenging activity of reactive oxygen species (ROS) by absorbing and transporting potassium (K+). In this study, electron microscope observation, hydrogen peroxide (H2O2) and malondialdehyde (MDA) contents determination, primary antioxidant enzyme activity determination and transcriptome sequencing analysis were carried out on the leaves of T. ramosissima under NaCl stress at 0 h, 48 h and 168 h. The results showed that H2O2 and MDA contents increased in the 200 mM NaCl + 10 mM KCl and 200 mM NaCl groups, but the content increased the most in the 200 mM NaCl group at 168 h. In addition, the leaves of T. ramosissima in the 200 mM NaCl + 10 mM KCl group had the most salt secretion, and its superoxide dismutase (SOD), peroxidase (POD) and catalase (CAT) activities were all higher than those of the 200 mM NaCl group and significantly higher than those of the control group. According to the results of transcriptome sequencing, it was found that the expression of 39 genes related to antioxidant enzyme activity changed significantly at the transcriptional level. Among them, 15 genes related to antioxidant enzyme activities were upregulated, and 24 genes related to antioxidant enzyme activities were downregulated in the leaves of T. ramosissima when exogenous potassium (K+) was applied under NaCl stress for 48 h; when exogenous potassium (K+) was used for 168 h under NaCl stress, 21 antioxidant enzyme activity-related genes were upregulated, and 18 antioxidant enzyme activity-related genes were downregulated in T. ramosissima leaves. Based on the changes of expression levels at different treatment times, 10 key candidates differentially expressed genes (DEGs) (Unigene0050462, Unigene0014843, Unigene0046159, Unigene0046160, Unigene0008032, Unigene0048033, Unigene0004890, Unigene0015109, Unigene0020552 and Unigene0048538) for antioxidant enzyme activities were further screened. They played an important role in applying exogenous potassium (K+) for 48 h and 168 h to the leaves of T. ramosissima in response to NaCl stress. Their expression levels were dominated by upregulation, which enhanced the activity of antioxidant enzymes, and helped T. ramosissima mitigate NaCl poison and resist NaCl stress. Particularly, Unigene0048538 in glutathione S-transferase (GST) activity had the largest log2 fold-change in the comparison groups of 200 mM NaCl-48 h vs. 200 mM NaCl + 10 mM KCl-48 h and 200 mM NaCl-168 h vs. 200 mM NaCl + 10 mM KCl-168 h. Its expression level was upregulated and played an important role in NaCl toxicity. At the same time, the results of the phylogenetic tree analysis showed that Unigene0048538 had the closest genetic distance to Prunus persica in the evolutionary relationship. In summary, with the increase of exogenous potassium (K+) application time under NaCl stress, T. ramosissima can resist high NaCl stress by enhancing antioxidant enzymes' activity and maintaining the growth of T. ramosissima. Still, it is not enough to completely eliminate NaCl poison. This study provides a theoretical basis for the molecular mechanism of salt tolerance and K+ mitigation of NaCl poison by the representative halophyte T. ramosissima in response to NaCl stress.

Parkinsonism-Hyperpyrexia Syndrome and Dyskinesia-Hyperpyrexia Syndrome in Parkinson's Disease: Two Cases and Literature Review.

Parkinsonism-hyperpyrexia syndrome (PHS) and dyskinesia-hyperpyrexia syndrome (DHS) are rare but exhibit life-threatening complications in Parkinson's disease (PD). We herein presented two cases of PD patients and performed a comprehensive and comparative literature review for these two syndromes. The first case was diagnosed as PHS with cerebral salt wasting syndrome caused by abrupt withdrawal of antiparkinsonian medication. Her symptoms were gradually remitted with reinstitution of the medication. The second one was an early-stage PD patient diagnosed as DHS in association with abuse of antiparkinsonian drugs. Her symptoms were gradually remitted with reduced dosage of dopaminergic drugs. Results of literature reviews revealed a total of 56 and 13 cases of PHS and DHS, respectively, and they were more likely to occur in elderly and long-term PD patients. These two syndromes showed different female-to-male ratio, similar mortality, and different recovery time. There were stark differences between PHS and DHS, including triggers (abrupt drug stoppage versus drug abuse), symptoms (worsened tremor and rigidity versus continuous dyskinesia), and treatment (drug reinstitution versus drug reduction). In summary, our reports and the review provide new insights into PHS and DHS in association with PD and may facilitate rapid discrimination of the syndromes for timely and proper treatment to reduce mortality.

Roles of toll-like receptors: From inflammation to lung cancer progression.

Lung cancer is among the most common malignant tumors worldwide, and is characterized by a low survival rate compared with other cancers. Toll-like receptors (TLRs) are highly conserved in evolution and widely expressed on immune cells, where they serve an important role in the innate immune system by evoking inflammatory responses. Evasion of immune destruction is an important hallmark in the development of cancer. There is an established association between chronic inflammation and cancer, with TLRs serving important roles in the immune response against tumor cells. Recently, TLRs have been identified on tumor cells, where their activation may orchestrate the downstream signaling pathways that serve crucial functions in tumorigenesis and tumor progression. The present review summarizes the roles of TLRs as sensors on lung cancer cells that regulate lung cancer progression with regard to cell growth and invasion, angiogenesis and cancer stem cell behavior. This aimed to provide theoretical support for the development of therapies that target TLR signaling pathways for the treatment of lung cancer.