Effects of Intervention Strategies-Based on Positive Psychology on the Emotional Cognition, Mental Health, and Recovery of Speech Function in Speech Disabilities.

Background: Compared with able-bodied people, speech disabilities are more prone to various mental health problems. We aimed to explore the impact of positive psychology-based intervention strategies on emotional cognition, mental health, and recovery of speech function in speech disabilities. Methods: In May 2023, 306 cases of speech disabilities were selected from 112 village committees and 129 neighborhood committees in Jingmen City, China. The control group was given routine speech rehabilitation training, and the observation group was given an intervention strategies-based on positive psychology based on the above training. The Symptom Checklist-90 (SCL-90), Chinese Facial Emotion Test (CFET), Comprehensive Function Assessment for Disabled Children (CFADC), and Boston Diagnostic Aphasia Examination (BDAE) were used to evaluate the two groups of patients before and after intervention. Results: After the intervention, the mental state scores (psychotic, obsessive-compulsive symptoms, somatization, paranoia, terror, hostility, anxiety, and depression) of the observation group were lower than those of the control group (P<0.05). The correct emotional scores in the observation group were higher than those in the control group were. However, the remote error scores of the observation group were lower than those of the control group were. The difference was also statistically significant (P<0.05). The cognitive function score, speech function score, and BDAE score (retelling, writing, fluency, and reading comprehension) of the observation group were all higher than those of the control group (P<0.05). Conclusion: The intervention strategies-based on positive psychology could promote the improvement of health problems and speech function in speech disabilities.

Electrical Impedance Analysis for Lung Cancer: A Prospective, Multicenter, Blind Validation Study.

Hypothesis: Patients with cancer have different impedances or conductances than patients with benign normal tissue; thus, we can apply electrical impedance analysis (EIA) to identify patients with cancer. Method: To evaluate EIA's efficacy and safety profile in diagnosing pulmonary lesions, we conducted a prospective, multicenter study among patients with pulmonary lesions recruited from 4 clinical centers (Zhongshan Hospital Ethics Committee, Approval No. 2015-16R and 2017-035(3). They underwent EIA to obtain an Algorithm Composite Score or 'Prolung Index,' PI. The classification threshold of 29 was first tested in an analytical validation set of 144 patients and independently validated in a clinical validation set of 418 patients. The subject's final diagnosis depended on histology and a 2-year follow-up. Results: In total, 418 patients completed the entire protocol for clinical validation, with 186 true positives, 145 true negatives, 52 false positives, and 35 false negatives. The sensitivity, specificity, and diagnostic yield were 84% (95% CI 79.3%-89.0%), 74% (95% CI 67.4%-79.8%), and 79% (95%CI 75.3%-83.1%), respectively, and did not differ according to age, sex, smoking history, body mass index, or lesion types. The sensitivity of small lesions was comparable to that of large lesions (p = 0.13). Four hundred eighty-four patients who underwent the analysis received a safety evaluation. No adverse events were considered to be related to the test. Conclusion: Electrical impedance analysis is a safe and efficient tool for risk stratification of pulmonary lesions, especially for patients with a suspicious lung lesion.

[The Value of CD44+ Mononuclear Cells and Spleen Stiffness Measurement in Minimal Residual Disease in Acute Myeloid Leukemia and Its Prognosis].

OBJECTIVE: To investigate the value of CD44+ mononuclear cells (MNC) and spleen stiffness measurement (SSM) in minimal residual disease (MRD) in acute myeloid leukemia (AML) and its prognosis. METHODS: Flow cytometry was used to detected the proportion of CD44+ and CD24+ MNC in 44 AML patients after induction chemotherapy. The SSM was tested by FS. The value of MNC and SSM in MRD and its prognosis was explored. RESULTS: The percentage of CD44+ MNC and SSM in MRD positive group were significantly higher than those in MRD negative group (P<0.05). In MRD positive group, there were positive correlation between CD44+ MNC, SSM and MRD level (r=0.998, r=0.939, P<0.05). The median EFS and OS in HCD44+ MNC and HSSM groups were significantly shorter than those in LCD44+ MNC and LSSM (P<0.05). CD24+ MNC showed no association with MRD and its prognosis. CONCLUSION: HCD44+ MNC and HSSM may be used to predict high level MRD and poor prognosis.

[Relationship between Leukocytes Derived Microparticles and Minimal Residual Disease and Prognosis of Acute Myeloid Leukemia].

OBJECTIVE: To detect the relationship between leukocytes derived microparticle (CD45+ MP) and minimal residual disease (MRD) and prognosis of acute myeloid leukemia (AML). METHODS: The expression of CD45+ MP, CD44+ MP and CD24+ MP in peripheral blood of 47 AML patients at the time after induction chemotherapy were detected by using flow cytometry, and the relationship between MP, MRD and prognosis were analyzed. RESULTS: The percentages of CD45+ MP, CD44+ MP and CD24+ MP in MRD positive group were significantly higher than those in MRD negative group. In MRD positive group, there were positive correlation between CD45+ MP, CD44+ MP, CD24+ MP and MRD level. The AUC of CD45+ MP, CD44+ MP, CD24+ MP in predicting positive MRD was 0.949, 0.782, and 0.817, respectively. The EFS and OS in HCD45+ MP, HCD44+ MP and HCD24+ MP groups were significantly shorter than low level group. CONCLUSION: High level of CD45+ MP, CD44+ MP, CD24+ MP can be used to predict high level MRD and poor prognosis.

Bone marrow-derived mesenchymal stem cells modulate autophagy in RAW264.7 macrophages via the phosphoinositide 3-kinase/protein kinase B/heme oxygenase-1 signaling pathway under oxygen-glucose deprivation/restoration conditions.

BACKGROUND: Autophagy of alveolar macrophages is a crucial process in ischemia/reperfusion injury-induced acute lung injury (ALI). Bone marrow-derived mesenchymal stem cells (BM-MSCs) are multipotent cells with the potential for repairing injured sites and regulating autophagy. This study was to investigate the influence of BM-MSCs on autophagy of macrophages in the oxygen-glucose deprivation/restoration (OGD/R) microenvironment and to explore the potential mechanism. METHODS: We established a co-culture system of macrophages (RAW264.7) with BM-MSCs under OGD/R conditions in vitro. RAW264.7 cells were transfected with recombinant adenovirus (Ad-mCherry-GFP-LC3B) and autophagic status of RAW264.7 cells was observed under a fluorescence microscope. Autophagy-related proteins light chain 3 (LC3)-I, LC3-II, and p62 in RAW264.7 cells were detected by Western blotting. We used microarray expression analysis to identify the differently expressed genes between OGD/R treated macrophages and macrophages co-culture with BM-MSCs. We investigated the gene heme oxygenase-1 (HO-1), which is downstream of the phosphoinositide 3-kinase/protein kinase B (PI3K/Akt) signaling pathway. RESULTS: The ratio of LC3-II/LC3-I of OGD/R treated RAW264.7 cells was increased (1.27 ±â€Š0.20 vs. 0.44 ±â€Š0.08, t = 6.67, P  < 0.05), while the expression of p62 was decreased (0.77 ±â€Š0.04 vs. 0.95 ±â€Š0.10, t = 2.90, P  < 0.05), and PI3K (0.40 ±â€Š0.06 vs. 0.63 ±â€Š0.10, t = 3.42, P  < 0.05) and p-Akt/Akt ratio was also decreased (0.39 ±â€Š0.02 vs. 0.58 ±â€Š0.03, t = 9.13, P  < 0.05). BM-MSCs reduced the LC3-II/LC3-I ratio of OGD/R treated RAW264.7 cells (0.68 ±â€Š0.14 vs. 1.27 ±â€Š0.20, t = 4.12, P  < 0.05), up-regulated p62 expression (1.10 ±â€Š0.20 vs. 0.77 ±â€Š0.04, t = 2.80, P  < 0.05), and up-regulated PI3K (0.54 ±â€Š0.05 vs. 0.40 ±â€Š0.06, t = 3.11, P  < 0.05) and p-Akt/Akt ratios (0.52 ±â€Š0.05 vs. 0.39 ±â€Š0.02, t = 9.13, P  < 0.05). A whole-genome microarray assay screened the differentially expressed gene HO-1, which is downstream of the PI3K/Akt signaling pathway, and the alteration of HO-1 mRNA and protein expression was consistent with the data on PI3K/Akt pathway. CONCLUSIONS: Our results suggest the existence of the PI3K/Akt/HO-1 signaling pathway in RAW264.7 cells under OGD/R circumstances in vitro, revealing the mechanism underlying BM-MSC-mediated regulation of autophagy and enriching the understanding of potential therapeutic targets for the treatment of ALI.

Prolonged progression-free survival and overall survival are associated with diabetes mellitus but inversely associated with levels of blood glucose in patients with lung cancer.

BACKGROUND: Previous studies have provided conflicting evidence about the increased overall survival (OS) in lung cancer patients with diabetes mellitus (DM) compared with those without DM. This study assessed progression-free survival (PFS)/OS in lung cancer patients with or without DM and tentatively analyzed the impact of blood glucose levels on PFS/OS in lung cancer patients. METHODS: Data were collected from lung cancer patients based upon admission records from January 2010 to January 2012 and follow-up records from January 2010 to January 2015 in the Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai. The data included patient sex, age, body mass index (BMI), smoking status, history of DM, level of blood glucose, pathological type, clinical stage of cancer, chemotherapy regimen, and history of anti-DM drugs. The Cox regression model and Kaplan-Meier method were used for the analysis of hazard factors and PFS/OS. For comparison of PFS/OS in lung cancer with or without DM, patients were divided into three groups: lung cancer with DM, lung cancer without DM but with elevated level of blood glucose, lung cancer without DM or elevated level of blood glucose. RESULTS: In total, the data from 200 lung cancer patients (138 males/62 females, aged 29.0 to 78.0 years, mean 60.0 ±â€Š8.6 years) were collected. For the comparison of PFS/OS in lung cancer patients with or without DM, patients were divided into three groups: lung cancer with DM (n = 31); lung cancer without DM but with elevated levels of blood glucose (n = 40); and lung cancer without both DM and elevated levels of blood glucose (n = 128), whereas 1 patient dropped out of the study. All the patients underwent complete chemotherapy and were followed up for 36.0 to 60.0 months. Kaplan-Meier survival analysis showed that lung cancer patients with DM had increased PFS and OS compared with those without DM (log-rank, P < 0.05, P < 0.01); the median PFS in lung cancer with DM was 12.0 months (95% confidence interval [CI], 4.0-16.0) vs. 6.0 months in those without DM (95% CI, 5.8-6.3); and the median OS in lung cancer patients with DM was 37.0 months (95% CI, 29.0-46.6) vs. 12.0 months in those without DM (95% CI, 10.9-13.1). For the other two groups of patients without DM, there was a trend toward a shorter PFS and OS in patients with elevated blood glucose compared with those without elevated blood glucose. Cox regression showed that PFS in lung cancer patients was favorably associated with the usage of anti-DM drugs, BMI, clinical stage of cancer, and chemotherapy regimen (all P < 0.05) but was inversely associated with the level of blood glucose (P < 0.05). CONCLUSIONS: Lung cancer patients with DM have prolonged PFS and OS compared with those without DM, and the level of blood glucose was inversely associated with PFS. The current results indicate that PFS may be a meaningful intermediate endpoint for OS and that the levels of blood glucose hopefully represent a prognostic factor in lung cancer patients.

Direct factor Xa inhibition attenuates acute lung injury progression via modulation of the PAR-2/NF-κB signaling pathway.

The role of coagulation in acute lung injury (ALI) remains unclear. As factor Xa-dependent protease-activated receptor 2 (PAR-2) is reported to be an important target in blood coagulation and other processes, an inhibitor of factor Xa, rivaroxaban, was tested in vivo in C57BL/6 mice with ALI induced by intratracheal injections of lipopolysaccharide (LPS) and in vitro in LPS-stimulated human umbilical vein endothelial cells. Plasma concentrations and coagulation indices were measured in mice fed normal chow or chow containing rivaroxaban (0.2 or 0.4 mg/g) for 10 days. The rivaroxaban-treated mice had significantly reduced neutrophil sequestration with preservation of the lung tissue architecture compared with that in the untreated controls. The levels of tumor necrosis factor alpha, interleukin 1 beta, and interleukin 6, as well as total protein and Evans blue concentrations, were all significantly reduced in bronchoalveolar lavage fluid from mice treated with rivaroxaban. Rivaroxaban treatment also ameliorated the LPS-induced PAR-2 increase and nuclear factor kappa B (NF-κB) activation. In vitro, cells treated with rivaroxaban had higher cell viability with an attenuation of LPS-induced increases in membrane permeability and proinflammatory cytokine levels, as well as reduced apoptosis. Furthermore, rivaroxaban inhibited the phosphorylation of TAK1 and p65. These data show that rivaroxaban attenuates ALI and inflammation by inhibiting the PAR-2/NF-κB signaling pathway.

Duodenal cryptococcus infection in an AIDS patient: retrospective clinical analysis.

Cryptococcal infection primarily affects the lung or the central nervous system and rare cases have been reported involving the gastrointestinal tract. However, among patients with HIV/AIDS, the gastrointestinal involvement is increasing. According to the PubMed search results, there were seven cases reported involving duodenal cryptococcosis combined with AIDS in five reports. Here, we report the case of a patient found to have AIDS combined with duodenal, pulmonary, and subsequent neurological cryptococcal infection simultaneously. The duodenal cryptococcosis was diagnosed on the basis of PET/computed tomography, which showed intense captation of glucose metabolism in duodenum (maximum standardized uptake value 16.53); a positive serum cryptococcal latex agglutination test; and upper gastrointestinal endoscopy-guided duodenal biopsy that confirmed Cryptococcus neoformans yeast. The patient's HIV screen test was positive. Because of refusal of lumbar puncture and the difficulty of performing transbronchial lung biopsy, the pulmonary and neurological involvements were the only clinical diagnoses. This case indicates that when cryptococcosis exists in a rare location, AIDS should be considered and when cryptococcosis occurs in the HIV-infected patient, disseminated disease is more common.

Decompression of acute left-sided malignant colorectal obstruction: comparing transanal drainage tube with metallic stent.

BACKGROUND AND AIM: Acute left-sided colorectal malignant obstruction is a life-threatening condition and need emergent treatment. Many nonsurgical treatments to palliate obstruction have been developed in clinics. The aim of this study was to evaluate the clinical effects of transanal drainage tube (TDT) and metallic stent for the decompression of acute left-sided malignant colorectal obstruction. MATERIALS AND METHODS: Twenty-nine patients with acute left-sided malignant colorectal obstruction were enrolled in this study from January 2005 to December 2010, they were randomly divided into TDT group (13 patients) and metallic stent group (16 patients). RESULTS: There were 13 cases in TDT group (male:female=8:5, age from 65 to 80 y, mean age was 72.6±4.7 y). The sites of lesions were located in the rectum of 3 patients, sigmoid colon of 7 patients, and descending colon of 3 patients. TDT was successfully inserted in 11 cases (84.6%). Among the 11 patients, 1-stage operation with sufficient lymph node dissection was performed in 8 cases after adequate lavage without complications. One case underwent emergent Hartmann operation because of colonic tumor perforation 3 days after ileus tube decompression. Two cases were discharged without surgery after relief of symptom. There were 16 cases in the metallic stent group (male:female=10:6 age from 48 to 86 y, mean age was 73.3±8.5 y). The sites of the lesions were located in the rectum of 4 patients, sigmoid colon of 6 patients, and descending colon of 6 patients. Successful stent placement was achieved in 13 cases (81.3%) with no severe complications. Among the 13 patients, 1-stage operation with sufficient lymph node dissection was performed in 7 cases and 6 cases refused to underwent surgery with stent as the definitive palliative treatment. The price of a TDT is only one third of an expandable metallic stent. CONCLUSIONS: Both TDT and metallic stent can achieve preoperative colonic lavage for 1-stage operation for patients with acute left-sided malignant colorectal obstruction with no increase in complications.

Covered stents versus uncovered stents for the palliation of malignant extrahepatic biliary obstruction caused by direct tumor invasion: a cohort comparative study.

Biliary stenting is a well-established palliative treatment in patients with unresectable malignant biliary strictures. The aim of the present study was to compare clinical outcomes of covered and uncovered stents in patients with malignant extrahepatic biliary obstruction caused by direct tumor invasion. Patients diagnosed with malignant extrahepatic biliary obstruction caused by direct tumor invasion were enrolled in this study. Of these patients, 37 received ePTFE-covered stent placement and were prospectively studied, and 47 received uncovered stent placement and were retrospectively studied. The technical success rate, tumor ingrowth rate, complication rate, stent patency, and patient survival were evaluated for both groups. Stent placement was successful in all cases except one in the covered group due to stent kinking. Tumor ingrowth occurred exclusively in the uncovered group. No significant differences were observed for the complication rate and patient survival between the two groups. Three patients in the covered group experienced stent migration, whereas no patients did in the uncovered group. A significant difference was found regarding stent patency, which was greater for the covered group compared to the uncovered group. The placement of ePTFE-covered stents for the treatment of malignant biliary obstruction caused by direct tumor invasion was a safe and an effective method characterized by greater stent patency.

Human ether-a-go-go-related gene K+ channels regulate shedding of leukemia cell-derived microvesicles.

Microvesicles (MVs) are released by various cancer cells, including leukemia cells. They can "hijack" membrane components from their parental cells and exert pleiotropic effects on tumor progression. Human ether-a-go-go-related gene (hERG1) K(+) channels are highly expressed in cancer cells and appear of exceptional importance in favoring cancer development. Given the attributes of MVs and hERG1 K(+) channels in disease progression, we investigated the putative relationship between hERG1 K(+) channels and MVs in leukemia. The protein content of MVs isolated from K562 cell supernatants was significantly higher than that from HL-60 cells. The molecular profile of these MVs showed that in addition to the myeloid lineage antigen (CD11b), MVs contained hERG1 K(+) channels. Interestingly, inhibition of hERG1 K(+) channels rapidly reduced MV fractions in supernatants. Furthermore, MVs created positive feedback loops to facilitate leukemogenesis. Upon exposure to MVs, the plasma membrane expression of hERG1 protein was in turn up-regulated, the migration of leukemia cells was significantly increased, and the adhesion of leukemia cells to human umbilical vein endothelial cells (HUVECs) was markedly enhanced. Importantly, hERG1 K(+) channel inhibitor E-4031 impaired these effects. We conclude that leukemia cell-derived MVs can "hijack" the plasma membrane hERG1 K(+) channels, which regulate the release of MVs and their biological effects upon leukemia cells.

Detection of circulating tumor cells and tumor stem cells in patients with breast cancer by using flow cytometry: a valuable tool for diagnosis and prognosis evaluation.

Circulating tumor stem cells (CTSC), a subpopulation of circulating tumor cells (CTC), may lead to recurrent diseases. The aim of this study was to detect CTC (CD45(-)EpCAM(+)) and CTSC (CD45(-)EpCAM(+)CD44(+)CD24(-)) of breast cancer (BC) patients, as well as to explore their clinical relevance. CTC and CTSC in peripheral blood (PB) of 45 female BC patients were detected by using flow cytometry (FCM). SKBR-3 cells were mixed with MNC of four healthy volunteers at different ratios in order to evaluate the sensitivity of FCM. Real-time quantitative polymerase chain reaction (QRT-PCR) was conducted and compared with FCM. The expression of EPCAM between CTC < 50 and CTC ≥ 50 groups (19.98 ± 23.93 versus 29.46 ± 29.27 × 10(-5)), and the expression of CD44 between CTSC negative and positive groups (0.85 ± 0.91 versus 0.81 ± 0.75) were statistically the same. FCM had higher specificity than QRT-PCR. Statistical differences were obtained between CTC < 50 and CTC ≥ 50 groups among different TNM stages, histology stages, estrogen receptor (ER) status and progesterone receptor (PR) status (P < 0.05). Statistical differences between CTSC negative and positive groups within different TNM stages and regional lymph node metastasis (RLNM) status (P < 0.05) were also obtained. Moreover, the percentage of CTC on CD45 negative cells (CD45(-)C) among different clinical pathology was statistically different, P = 0.000. Additionally, the percentage of CTSC on CD45(-)C with TNM stage was rising (0: 0.00 ± 0.00‰, I: 0.03 ± 0.05‰, II: 0.06 ± 0.14‰, III: 0.10 ± 0.09‰, IV: 0.29 ± 0.35‰, P = 0.034). Statistical difference in the percentage of CTSC on CD45(-)C among different RLNM status (P = 0.001) was also obtained. FCM to detect CTC and CTSC may be used to diagnose disease at early stage, to guide clinical therapy or to predict prognosis.

[Significance of urinary nucleosides in diagnosis of gastric carcinoma].

BACKGROUND & OBJECTIVE: It was reported that urinary modified nucleosides with abnormally high amounts were found in many cancer patients. This study was designed to investigate the usefulness of urinary nucleosides in the diagnosis of gastric carcinoma. METHODS: The concentrations of 15 kinds of urinary nucleosides from 50 healthy persons and 48 patients with gastric carcinoma were determined by high-performance liquid chromatography (HPLC). Of 48 patients with gastric carcinoma, 25 underwent serum CEA examination. RESULTS: The average levels of 14 kinds of urinary nucleosides, m5U excepted, from patients with gastric carcinoma were higher than those from health persons (P< 0.05). Pseu 22.91+/-4.90, 34.87+/-21.41; U 0.34+/-0.32, 0.62+/-0.82; A 0.58+/-0.16, 0.96+/-0.75; C 0.17+/-0.15,0.24+/-0.19; m5U 0.03+/-0.07,0.07+/-0.06; I 0.26+/-0.10, 0.43+/-0.36; m1I 1.34+/-0.34, 2.44+/-1.39; ac4C 0.75+/-0.24, 1.08+/-0.72; G 0.09+/-0.04, 0.14+/-0.10; X 1.20+/-0.42, 1.90+/-1.09; m2G 0.61+/-0.16, 1.00+/-0.69; m6A 0.04+/-1.13, 0.07+/-0.08; m1A 2.26+/-0.56, 3.71+/-2.21; m22G 1.34+/-0.27, 2.25+/-1.39; m1G 0.80+/-0.25, 1.41+/-0.86. The level of nucleoside I was positively correlated with the tumor size (P< 0.05). The level of nucleoside X was positively correlated with lymph node metastasis (P< 0.05). Using the concentrations of 15 nucleosides as the data vectors, principal component analysis was applied to classify gastric cancer patients and normal adults, 63%(30/48) of cancer patients were correctly classified, in which the identification rate was higher than that of CEA method (12%). CONCLUSION: Urinary modified nucleoside increased in the patients with gastric carcinoma, and it may be helpful in the diagnosis of gastric carcinoma.