Implementation of a standardized out-of-hospital management method for Parkinson dysphagia

Summary Objective: Our objective is to explore the effectiveness and feasibility of establishing a swallowing management clinic to implement out-of-hospital management for Parkinson disease (PD) patients with dysphagia. Method: Two-hundred seventeen (217) voluntary PD patients with dysphagia in a PD outpatient clinic were divided into a control group with 100 people, and an experimental group with 117 people. The control group was given dysphagia rehabilitation guidance. The experimental group was presented with the standardized out-of-hospital management method as overall management and information and education materials. Rehabilitation efficiency and incidence rate of dysphagia, as well as relevant complications of both groups were compared after a 6-month intervention. Results: Rehabilitation efficiency and the incidence rate of dysphagia including relevant complications of patients treated with the standardized out-of-hospital management were compared with those seen in the control group. The differences have distinct statistics meaning (p<0.01). Conclusion: Establishing a swallowing management protocol for outpatient setting can effectively help the recovery of the function of swallowing, reduce the incidence rate of dysphagia complications and improve the quality of life in patients with PD.

Implementation of a standardized out-of-hospital management method for Parkinson dysphagia.

OBJECTIVE: Our objective is to explore the effectiveness and feasibility of establishing a swallowing management clinic to implement out-of-hospital management for Parkinson disease (PD) patients with dysphagia. METHOD: Two-hundred seventeen (217) voluntary PD patients with dysphagia in a PD outpatient clinic were divided into a control group with 100 people, and an experimental group with 117 people. The control group was given dysphagia rehabilitation guidance. The experimental group was presented with the standardized out-of-hospital management method as overall management and information and education materials. Rehabilitation efficiency and incidence rate of dysphagia, as well as relevant complications of both groups were compared after a 6-month intervention. RESULTS: Rehabilitation efficiency and the incidence rate of dysphagia including relevant complications of patients treated with the standardized out-of-hospital management were compared with those seen in the control group. The differences have distinct statistics meaning (p<0.01). CONCLUSION: Establishing a swallowing management protocol for outpatient setting can effectively help the recovery of the function of swallowing, reduce the incidence rate of dysphagia complications and improve the quality of life in patients with PD.

Endosialin­expressing bone sarcoma stem­like cells are highly tumor­initiating and invasive.

It has been reported that the presence of a small group of cancer stem­like 'side population (SP)' cells is responsible for therapy failure and tumor recurrence. The present study demonstrated that primary human osteosarcoma samples contained a SP of about 3.9% which overexpressed ABC transporters, including ABCA1, ABCB1, ABCB2 and ABCG2, which are associated with drug resistance and may have contributed to multi­drug resistance of SP cells. Furthermore, these SP cells displayed increased expression of endosialin (CD248) and other stem cell surface proteins, including CD133, octamer­binding transcription factor 3/4A, Nanog and Nestin, which are ultimately responsible for high self­renewal and deregulated cell proliferation. In addition, it was shown that endosialin­overexpressing SP cells were able to regenerate the tumor population and had a high invasive potential. Therefore, the present study suggested that osteosarcoma SP cells were cancer stem cells, as they displayed stem­like properties; furthermore, endosialin may be a potential target to prevent osteosarcoma recurrence following chemotherapy.

Effect of methotrexate on the mechanical properties and microstructure of calcium phosphate cement.

Calcium phosphate cement (CPC) is widely used as an antitumor bone-filling material. Methotrexate (MTX) is recognized as an effective chemotherapy medicine. The current study examined the effects of MTX on the mechanical properties and microstructure of CPC. Methotrexate-loaded CPC at mass ratios of 0%, 0.1%, 0.2%, and 0.5% were designated as groups A, B, C, and D, respectively, and were pressed into precast cylindrical molds. Solidification time, axial compressive strength, transverse compressive strength, and rotational tensile strength were measured, and scanning electron microscopy images were captured before and after MTX-CPC microstructure changes occurred. Average initial and final setting times increased gradually with increasing drug concentration, but this increase was not significant among the groups. Average axial transverse compressive strength and rotational tensile strength of groups B and C were not significantly different from those of group A (P>.05); however, there was a significant difference in these properties between groups A and D (P<.05). Scanning electron microscopy observations showed a porous crystalline structure. The addition of MTX to CPC does not significantly affect the basic crystal structure and setting time of CPC. Adding MTX at mass ratios of 0.1% and 0.2% to CPC does not lead to a significant difference in mechanical strength and can therefore be applied in clinical practice. This study may shed some light on the future application of MTX-loaded CPC in the treatment of bone defects after tumor excision.

[Math1 gene therapy for kanamycin and furosemide-induced deaf guinea pigs].

OBJECTIVE: To observe the morphology and function changes of cochlear hair cells before and after math1 gene injection into the cochlea of deaf guinea pigs which were induced by kanamycin and furosemide. To explore the feasibility of Math1 gene for medicine-induced deafness therapy. METHODS: Kanamycin (500 mg/kg) and furosemide (50 mg/kg) were given to the healthy adult guinea pigs intramuscularly and intravenously to establish the deafness model. The guinea pigs whose auditory brainstem response (ABR) threshold > 95 dB SPL were randomly divided into five groups. Blank control group (without any treatment, n = 3), operation control group (right ear scala tympani operation, n = 3), artificial perilymph group (right ear scala tympani injection artificial perilymph, n = 3), virus vector group [right ear scala tympani injection adenovirus which carrying enhanced green fluorescent protein (EGFP) gene (Ad. EGFP) , n = 4], Math1 gene therapy group [right ear scala tympani injection adenovirus which carrying Math1 and EGFP gene (Ad. Math1-EGFP), n = 6]. Each animal received ABR test before and after injection. The cochlear tissue was observed by scanning electronic microscopy. RESULTS: The ABR thresholds of tone burst( 4, 8, 16, 20 kHz ) were not statistically significant in different groups (P > 0.05). The number of hair cells increased in some of severe deaf guinea pigs after the injection of Ad. Math1-EGFP gene. However, there was no obvious difference with morphology and numbers of cochlea hair cells in other groups. CONCLUSIONS: The injection of Math1 gene to cochlea can regenerate or repair the hair cells of medicine-induced deaf guinea pigs, but there was no improvement on the hearing loss.