Factors Influencing Early Diagnosis and Poor Prognosis of Dysphagia After Senile Ischemic Stroke.

Dysphagia is often a long-term problem after ischemic stroke, which are often accompanied by complications and results in poor outcome. This study aimed to investigate the influencing factors associated with the prognosis of dysphagia after senile ischemic stroke and evaluate the diagnostic performance of crucial factors. A total of 192 elderly ischemic stroke patients (96 patients without dysphagia with average age of 69.81 ± 4.61 years and 96 patients with dysphagia with average of 70.00 ± 6.66 years) were enrolled in the retrospective study. The clinical factors of the patients were collected and recorded for chi-square analysis and logistic analysis. The receiver operating characteristic (ROC) curve was performed to evaluate the diagnostic performance of international normalized ratio (INR) and homocysteine (Hcy) in senile ischemic stroke patients. The age, cough reflex, history of stroke, mechanical ventilation, eating posture, insufficient elevation of the larynx, standard swallowing assessment (SSA) score, Hcy value, and INR were closely related to endpoint events of patients with dysphagia. The joint model (combined INR and Hcy value) can increase the area under the curve (AUC) value (0.948) with higher sensitivity and specificity for predicting patients with dysphagia occurred endpoint events. The influencing factors for older ischemic stroke patients with dysphagia include age, cough reflex, history of stroke, mechanical ventilation, eating posture, insufficient elevation of the larynx, SSA score, Hcy value, and INR. INR and Hcy were independent risk factors for prognosis and diagnostic markers for patients with dysphagia after senile ischemic stroke.

Effectiveness of smart health-based rehabilitation on patients with poststroke dysphagia: A brief research report.

Objective: This study aimed to evaluate the effectiveness of smart health-based rehabilitation on patients with poststroke dysphagia (PSD). Methods: We recruited 60 PSD patients and randomly allocated them to the intervention (n = 30) and control (n = 30) groups. The former received the smart health-based rehabilitation for 12 weeks, whereas the latter received routine rehabilitation. Water swallow test (WST), standardized swallowing assessment (SSA), swallow quality-of-life questionnaire (SWAL-QOL), stroke self-efficacy questionnaire (SSEQ), perceived social support scale (PSSS) and nutritional measurements including body weight, triceps skinfold thickness (TSF), total protein (TP), serum albumin (ALB) and serum prealbumin (PA) in both groups were measured. Results: When the baseline WST, SSA, SWAL-QOL, SSEQ, PSSS and nutritional measurements were examined, there was no significant difference between the intervention group and the control group (P > 0.05). After rehabilitation interventions, the WST and SSA scores in the intervention group were significantly lower than those in the control group (P < 0.01). The SWAL-QOL, SSEQ and PSSS scores in the intervention group were significantly higher than in the control group (P < 0.01). Compared with the control group, the intervention group showed an increase in the serum levels of PA (P < 0.01). However, no statistically significant difference existed between the intervention group and the control group in terms of body weight, TSF, TP or ALB (P > 0.05). Conclusions: Overall, our data revealed that smart health-based rehabilitation is significantly beneficial to the swallowing function, quality of life, self-efficacy, and social support for PSD patients when compared with routine rehabilitation. However, nutritional measurements were not significantly improved in such patients under the smart health-based rehabilitation when compared the routine rehabilitation. In the future, it is necessary to extend the intervention time to further evaluate the long-term efficacy of smart health-based rehabilitation on nutritional measurements of PSD patients.

Effect of the Mendelsohn maneuver and swallowing training in patients with senile vascular dementia complicated with dysphagia.

OBJECTIVE: We investigated the effect of the Mendelsohn maneuver and swallowing training in patients with senile vascular dementia complicated with dysphagia. METHODS: We randomly classified 214 patients with senile vascular dementia and swallowing dysfunction into a control group (CG, n = 106) and observation group (OG, n = 108). Both groups underwent health education, psychological intervention, and training of the oral muscle group. The OG additionally underwent the Mendelsohn maneuver and swallowing training. The Hasegawa Dementia Scale (HDS), China Stroke Scale (CSS), and Neurobehavioral Cognitive Status Examination (NCSE) were used to evaluate dementia, neurological impairment, and cognitive dysfunction, respectively. RESULTS: The OG had a higher rate of effective therapy than the CG. After intervention, the OG showed better swallowing function than the CG. At 15 days and 1 month after intervention, the OG had higher video fluoroscopic swallowing exam scores than the CG. The OG had lower serum interleukin (IL)-1, IL-6, and tumor necrosis factor-α levels than the CG. After intervention, the OG had higher HDS and NCSE scores and lower CSS scores than the CG. CONCLUSIONS: The Mendelsohn maneuver and swallowing training can improve swallowing function in patients with senile vascular dementia complicated with dysphagia and help to ameliorate the inflammatory response.

Genetic variant rs3750625 in the 3'UTR of ADRA2A affects the sleep quality of patients in the ICU by promoting miR­34a binding to ADRA2A.

Poor sleep is very common in patients in the ICU and hence, sleep quality is considered an important aspect of intensive care; however, the underlying mechanisms of poor sleep in patients in the ICU remain unknown. In this study, we aimed to explore the role of rs3750625, which is located in the 3'UTR of adrenoceptor alpha 2A (ADRA2A), in sleep quality. For this purpose, luciferase assay was conducted to investigate the association between miR­34a and ADRA2A, and the effect of rs3750625 on the binding affinity between miR­34a and ADRA2A was examined. RT­qPCR and western blot analysis were carried out to examine the regulatory association between miR­34a and ADRA2A. The differences in sleep time and efficiency were compared between groups carrying the AC and CC genotypes of rs3750625, respectively. According to the results from an online search, miR­34a could directly bind to the 3'UTR of ADRA2A, and such binding was confirmed by the observation that miR­34a inhibited the luciferase activity of major or minor ADRA2A 3'UTR in a dose­dependent manner in HCN­1A and U251 cells. In addition, the ADRA2A protein and mRNA levels in the HCN­1A and U251 cells were evidently decreased following transfection with miR­34a precursors. Notably, patients in the AC group exhibited a similar level of miR­34a mRNA expression compared with patients in the CC group; however, the ADRA2A mRNA and protein levels in the CC group were significantly increased in comparison with those in the AC group. In addition, the sleep time and sleep efficiency in the CC group were much higher than those in the AC group. Furthermore, the mean arterial pressure (MAP) values in both the AC and CC groups remained stable from 22:00 to 08:00, and the respiratory rates in both groups were quite similar. However, the heart rate of patients in the CC group was much lower than that of patients in the AC group. On the whole, the findings of this study suggest that the genetic variant rs3750625 in the 3'UTR of ADRA2A affects the sleep quality of patients in the ICU by promoting the binding of miR­34a to ADRA2A, and hence it may serve as a novel biomarker for the prediction of the sleep quality of patients in the ICU.

Complete chloroplast genome sequence of the rose apple, Syzygium jambos (Myrtaceae).

Plants in the genus Syzygium have been widely used as traditional medicine, fruit crops, and ornamental trees. In this study, we reported the complete chloroplast genome of Syzygium jambos (L.) Alston which was known as rose apple. The chloroplast genome of this species is 158541 bp in length, including a pair of inverted repeat regions (IRs) (26076 bp) that is divided by a large single copy area (LSC) (88036 bp) and a small single copy area (SSC) (18353 bp). The circular chloroplast genome of S. jambos contains 132 unique genes, composing of 85 protein-coding genes, 39 tRNA genes and 8 rRNA genes. Phylogenetic analysis indicates that S. jambos is clustered with species in genus Syzygium. This complete chloroplast genome of S. jambos will provide a powerful tool to accelerate breeding, biotechnological and phylogenetic study.

Oral Delivery of Propofol with Methoxymethylphosphonic Acid as the Delivery Vehicle.

Phosphonamidate 3a of methoxymethylphosphonic acid (MMPA) with propofol (1) and l-alanine ethyl ester was found to be an efficient scaffold for the oral delivery of compound 1. The synthesis and evaluation of MMPA based phosphonamidates of compound 1, HSK3486 (2), and other phenolic drugs revealed the general application of MMPA as the effective delivery vehicle for phenolic drugs. On the basis of plasma concentrations of compound 1 and SN38 (14), the oral bioavailability of compound 3a and 15 in beagle dogs was found to be 97.6% and 34.1%, respectively.

Retromer Is Essential for Autophagy-Dependent Plant Infection by the Rice Blast Fungus.

The retromer mediates protein trafficking through recycling cargo from endosomes to the trans-Golgi network in eukaryotes. However, the role of such trafficking events during pathogen-host interaction remains unclear. Here, we report that the cargo-recognition complex (MoVps35, MoVps26 and MoVps29) of the retromer is essential for appressorium-mediated host penetration by Magnaporthe oryzae, the causal pathogen of the blast disease in rice. Loss of retromer function blocked glycogen distribution and turnover of lipid bodies, delayed nuclear degeneration and reduced turgor during appressorial development. Cytological observation revealed dynamic MoVps35-GFP foci co-localized with autophagy-related protein RFP-MoAtg8 at the periphery of autolysosomes. Furthermore, RFP-MoAtg8 interacted with MoVps35-GFP in vivo, RFP-MoAtg8 was mislocalized to the vacuole and failed to recycle from the autolysosome in the absence of the retromer function, leading to impaired biogenesis of autophagosomes. We therefore conclude that retromer is essential for autophagy-dependent plant infection by the rice blast fungus.

A conserved homeobox transcription factor Htf1 is required for phialide development and conidiogenesis in Fusarium species.

Conidia are primary means of asexual reproduction and dispersal in a variety of pathogenic fungi, and it is widely recognized that they play a critical role in animal and plant disease epidemics. However, genetic mechanisms associated with conidiogenesis are complex and remain largely undefined in numerous pathogenic fungi. We previously showed that Htf1, a homeobox transcription factor, is required for conidiogenesis in the rice pathogen Magnaporthe oryzae. In this study, our aim was to characterize how Htf1 homolog regulates common and also distinctive conidiogenesis in three key Fusarium pathogens: F. graminearm, F. verticillioides, and F. oxysporum. When compared to wild-type progenitors, the gene-deletion mutants in Fusarium species failed to form conventional phialides. Rather, they formed clusters of aberrant phialides that resembled elongated hyphae segments, and it is conceivable that this led to the obstruction of conidiation in phialides. We also observed that mutants, as well as wild-type Fusaria, can initiate alternative macroconidia production directly from hyphae through budding-like mechanism albeit at low frequencies. Microscopic observations led us to conclude that proper basal cell division and subsequent foot cell development of macroconidia were negatively impacted in the mutants. In F. verticillioides and F. oxysporum, mutants exhibited a 2- to 5- microconidia complex at the apex of monophialides resulting in a floral petal-like shape. Also, prototypical microconidia chains were absent in F. verticillioides mutants. F. graminearum and F. verticillioides mutants were complemented by introducing its native HTF1 gene or homologs from other Fusarium species. These results suggest that Fusarium Htf1 is functionally conserved homeobox transcription factor that regulates phialide development and conidiogenesis via distinct signaling pathways yet to be characterized in fungi.