OBJECTIVE:To evaluate the effectiveness of the combined use of 7 commonly used Traditional Chinese Medicine external treatment methods and rehabilitation training in improving limb function in patients with cerebral h...OBJECTIVE:To evaluate the effectiveness of the combined use of 7 commonly used Traditional Chinese Medicine external treatment methods and rehabilitation training in improving limb function in patients with cerebral hemorrhage through a network Meta-analysis.METHODS:A computer-based search was conducted in 8 databases,including China National Knowledge Infrastructure Database,Wanfang Database,China Science and Technology Journal Database,Pub Med,Cochrane Library,Web of Science,Scopus,and Embase,from their inception until February 19,2023.Randomized controlled trials(RCTs)investigating the effectiveness of the combined use of 7 commonly used Traditional Chinese Medicine external treatment methods and rehabilitation training in improving limb function in patients with cerebral hemorrhage were included.Two researchers independently screened the literature,extracted data from the included studies,and performed quality assessment using the Cochrane Collaboration's standards.The software Stata 17.0 was used to create a network evidence graph for each combination of Traditional Chinese Medicine external treatment methods and rehabilitation training,and to generate a publication bias funnel plot.Network Meta-analysis was conducted using Rev Man 5.3 to assess the risk of bias in the included studies,with mean difference(MD)used for continuous variables and odds ratio(OR)used for dichotomous variables.If there was good consistency among the included studies(P>0.05),a consistency model was applied for data analysis.If there was poor consistency among the included studies(P<0.05),an inconsistency model was used.RESULTS:A total of 27 studies involving 2113 patients with limb dysfunction caused by cerebral hemorrhage were included.The results of the network Meta-analysis indicated that the combined use of 7 Traditional Chinese Medicine external treatment methods and rehabilitation training was more effective in improving limb function in patients with cerebral hemorrhage compared to rehabilitation training alone.In terms of improving simplified Fugl-Meyer Assessment(FMA)scores,the effectiveness ranking was as follows:acupuncture+rehabilitation training>Acupoint sticking therapy+rehabilitation training>massage+rehabilitation training>electroacupuncture+rehabilitation training>moxibustion+rehabilitation training>Traditional Chinese Medicine therapy+rehabilitation training>Chinese herbal fumigation+rehabilitation training.In terms of improving Barthel Index(BI)scores,the effectiveness ranking was as follows:electroacupuncture+rehabilitation training>Acupoint sticking therapy+rehabilitation training>acupuncture+rehabilitation training>massage+rehabilitation training>moxibustion+rehabilitation training>Traditional Chinese Medicine fumigation+rehabilitation training>Traditional Chinese Medicine therapy+rehabilitation training.CONCLUSION:Based on existing literature evidence,our findings suggest the following:(a)The combination of the seven commonly used external treatment methods with rehabilitation training is superior to using rehabilitation training alone for the treatment of hemiplegia resulting from cerebral hemorrhage.(b)In terms of improving FMA scores,the combination of acupuncture and rehabilitation training shows the most significant effectiveness.(c)In terms of improving BI scores,the combination of electro-acupuncture and rehabilitation training demonstrates the most significant effectiveness.Therefore,we still need more multicenter,large-sample,high-quality randomized controlled trials to further validate the findings of this study.展开更多
Citrin deficiency,autosomal recessive disorder,caused by mutation of SLC25A13 gene on chromosome 7q21.3 has two major phenotypes:neonatal intrahepatic cholestatic hepatitis(NICCD)and adult-onset type Ⅱ citrullinemia(...Citrin deficiency,autosomal recessive disorder,caused by mutation of SLC25A13 gene on chromosome 7q21.3 has two major phenotypes:neonatal intrahepatic cholestatic hepatitis(NICCD)and adult-onset type Ⅱ citrullinemia(CTLN2).So far,we have identified 52 SLC25A13 mutations and diagnosed the patients not only in Japan(166 CTLN2 and 238 NICCD) but also in other countries.We have detected 76 Chinese,13 Korean and 15 Vietnamese patients with the same mutations as Japanese,and 13 patients(from Israel,UK,USA or Czech)with mutations different from those found in Japanese,indicating a wide distribution of citrin deficiency.DNA diagnoses of 13 known SLC25A13 mutations revealed that the carrier frequency was high in East Asian populations:Chinese(73/4 600=1/63),Japanese(21/1 372=1/65) and Korean(25/2 690=1/108),suggesting that near by 100 000 East Asians are homozygotes.It is important to find out patients with citrin deficiency,to treat them,and to prevent onset of severe CTLN2.展开更多
Objective:To comprehensively evaluate the risk of recurrence after initial ischemic stroke,and to provide a relatively comprehensive reference for the prevention and control of stroke recurrence.Methods:CNKI,VIP,Wanfa...Objective:To comprehensively evaluate the risk of recurrence after initial ischemic stroke,and to provide a relatively comprehensive reference for the prevention and control of stroke recurrence.Methods:CNKI,VIP,Wanfang,PubMed,Web of Science,Embase and other databases were collected to investigate the status of recurrence after initial ischemic stroke,the search period of which was from the establishment of databases to March 2019.And then quality evaluation and data extraction were carried out.The overall cumulative risks of stroke recurrence at 3 months,6 months,1 year,2 years and 5 years after initial ischemic stroke were calculated,and heterogeneity analysis was performed.Results:A total of 29 studies from 19 provinces(cities,autonomous regions)in China were included.The cumulative total sample size was 22484 cases,the cumulative recurrent sample size was 3309 cases.The pooled cumulative risk was 4.5%(95%CI:3.1-5.8)at 3 months,7.8%(95%CI:5.6-10.0)at 6 months,13.6%(95%CI:11.0-16.2)at 1 year,17.5%(95%CI:12.4-22.6)at 2 years and 30.9%(95%CI:20.2-41.7)at 5 years after initial ischemic stroke.Conclusions:The recurrence rate of acute ischemic stroke in China is high.It is recommended that all levels of medical and health departments strengthen the prevention and treatment of ischemic stroke recurrence to reduce the recurrence of ischemic stroke and improve the prognosis of patients.展开更多
Exosomes,minute vesicles ubiquitously released by diverse cell types,serve as critical mediators in intercellular communication.Their pathophysiological relevance,especially in malignancies,has garnered significant at...Exosomes,minute vesicles ubiquitously released by diverse cell types,serve as critical mediators in intercellular communication.Their pathophysiological relevance,especially in malignancies,has garnered significant attention.A meticulous exploration of the exosomal impact on cancer development has unveiled avenues for innovative and clinically valuable techniques.The cargo conveyed by exosomes exerts transformative effects on both local and distant microenvironments,thereby influencing a broad spectrum of biological responses in recipient cells.These membranebound extracellular vesicles(EVs)play a pivotal role in delivering bioactive molecules among cells and organs.Cellular and biological processes in recipient cells,ranging from stromal cell reprogramming to immunological responses,extracellular matrix formation,and modulation of cancer cell activation,expansion,and metastasis,are subject to exosome-mediated cell-to-cell communication.Moreover,exosomes have been implicated in endowing cancer cells with resistance to treatment.Extensive research has explored the potential of exosomes as therapeutic targets and diagnostic indicators.This comprehensive review seeks to provide an in-depth understanding of the pivotal components and roles of exosomes in tumorigenesis,growth,progression,and therapeutic responses.The insights into the multifaceted involvement of exosomes in malignant cancers are essential for the scientific community,fostering the development of novel therapeutic and diagnostic strategies in the relentless pursuit of cancer.展开更多
Objective To examine the neuroprotective effects of a novel manganese porphyrin, manganese （Ill） meso-tetrakis （N,N＇-diethylimidazolium-2-yl） porphyrin （MnTDM）, in the mouse model of Parkinson＇s disease （PD）...Objective To examine the neuroprotective effects of a novel manganese porphyrin, manganese （Ill） meso-tetrakis （N,N＇-diethylimidazolium-2-yl） porphyrin （MnTDM）, in the mouse model of Parkinson＇s disease （PD） induced by paraquat （PQ）. Methods Male C57BL / 6 mice were subcutaneously injected with either saline or PQ at 2-day intervals for a total of 10 doses, MnTDM was subcutaneously injected with the PQ 2 h before treatment. Performance on the pole and swim test were measured 7 days after the last injection and animals were sacrificed one day later. Levels of dopamine （DA） and its metabolites in the striatum were measured by high-performance liquid chromatography with an electrochemical detector （HPLC-ECD）. Thiobarbituric acid （TBA） method was used to assay the lipid peroxidation product, malondialdehyde （MDA）, and the number of tyrosine hydroxylase （TH） positive neurons was estimated using immunohistochemistry. Results Pretreatment with MnTI）M significantly attenuated PQ-impaired behavioral performance, depleted dopamine content in striata, increased MDA, and dopaminergic neuron loss in the substantia nigra. Conclusions Oxidative stress plays an important role in PQ-induced neurotoxicity which can be potentially prevented by manganese porphyrin. These findings also propose a possible therapeutical strategy for neurodegenerative disorders associated with oxidative stress such as PD.展开更多
基金Supported by the Key Research and Development Plan Project of Shaanxi Province:Standardized Diagnosis and Treatment Protocol for Cerebral Hemorrhage with Integrated Traditional Chinese and Western Medicine and Research on its Therapeutic Mechanisms(No.2019ZDLSF04-06-01)the National Key Research and Development Plan Project:Development and Implementation of a Clinical Research Information Sharing System for Traditional Chinese Medicine(No.2017YFC1703500,No.2017YFC1703502)the Discipline Innovation Team Building Project of Shaanxi University of Chinese Medicine:Innovative Research Team for the Construction of Integrated Traditional Chinese and Western Medicine Cerebrovascular Disease Diagnosis and Treatment System and Its Clinical Application(No.2019-YL15)。
文摘OBJECTIVE:To evaluate the effectiveness of the combined use of 7 commonly used Traditional Chinese Medicine external treatment methods and rehabilitation training in improving limb function in patients with cerebral hemorrhage through a network Meta-analysis.METHODS:A computer-based search was conducted in 8 databases,including China National Knowledge Infrastructure Database,Wanfang Database,China Science and Technology Journal Database,Pub Med,Cochrane Library,Web of Science,Scopus,and Embase,from their inception until February 19,2023.Randomized controlled trials(RCTs)investigating the effectiveness of the combined use of 7 commonly used Traditional Chinese Medicine external treatment methods and rehabilitation training in improving limb function in patients with cerebral hemorrhage were included.Two researchers independently screened the literature,extracted data from the included studies,and performed quality assessment using the Cochrane Collaboration's standards.The software Stata 17.0 was used to create a network evidence graph for each combination of Traditional Chinese Medicine external treatment methods and rehabilitation training,and to generate a publication bias funnel plot.Network Meta-analysis was conducted using Rev Man 5.3 to assess the risk of bias in the included studies,with mean difference(MD)used for continuous variables and odds ratio(OR)used for dichotomous variables.If there was good consistency among the included studies(P>0.05),a consistency model was applied for data analysis.If there was poor consistency among the included studies(P<0.05),an inconsistency model was used.RESULTS:A total of 27 studies involving 2113 patients with limb dysfunction caused by cerebral hemorrhage were included.The results of the network Meta-analysis indicated that the combined use of 7 Traditional Chinese Medicine external treatment methods and rehabilitation training was more effective in improving limb function in patients with cerebral hemorrhage compared to rehabilitation training alone.In terms of improving simplified Fugl-Meyer Assessment(FMA)scores,the effectiveness ranking was as follows:acupuncture+rehabilitation training>Acupoint sticking therapy+rehabilitation training>massage+rehabilitation training>electroacupuncture+rehabilitation training>moxibustion+rehabilitation training>Traditional Chinese Medicine therapy+rehabilitation training>Chinese herbal fumigation+rehabilitation training.In terms of improving Barthel Index(BI)scores,the effectiveness ranking was as follows:electroacupuncture+rehabilitation training>Acupoint sticking therapy+rehabilitation training>acupuncture+rehabilitation training>massage+rehabilitation training>moxibustion+rehabilitation training>Traditional Chinese Medicine fumigation+rehabilitation training>Traditional Chinese Medicine therapy+rehabilitation training.CONCLUSION:Based on existing literature evidence,our findings suggest the following:(a)The combination of the seven commonly used external treatment methods with rehabilitation training is superior to using rehabilitation training alone for the treatment of hemiplegia resulting from cerebral hemorrhage.(b)In terms of improving FMA scores,the combination of acupuncture and rehabilitation training shows the most significant effectiveness.(c)In terms of improving BI scores,the combination of electro-acupuncture and rehabilitation training demonstrates the most significant effectiveness.Therefore,we still need more multicenter,large-sample,high-quality randomized controlled trials to further validate the findings of this study.
基金Grant-in-Aids for Scientific Research(B:No.16390100 and 19390096)Asia-Africa Scientific Platform Program(AASPP)+1 种基金the Japan Society for the Promotion of Science(JSPS)a Grant for Child Health and Development(17-2 and 20-2)the Ministry of Health,Labour and Welfare in Japan
文摘Citrin deficiency,autosomal recessive disorder,caused by mutation of SLC25A13 gene on chromosome 7q21.3 has two major phenotypes:neonatal intrahepatic cholestatic hepatitis(NICCD)and adult-onset type Ⅱ citrullinemia(CTLN2).So far,we have identified 52 SLC25A13 mutations and diagnosed the patients not only in Japan(166 CTLN2 and 238 NICCD) but also in other countries.We have detected 76 Chinese,13 Korean and 15 Vietnamese patients with the same mutations as Japanese,and 13 patients(from Israel,UK,USA or Czech)with mutations different from those found in Japanese,indicating a wide distribution of citrin deficiency.DNA diagnoses of 13 known SLC25A13 mutations revealed that the carrier frequency was high in East Asian populations:Chinese(73/4 600=1/63),Japanese(21/1 372=1/65) and Korean(25/2 690=1/108),suggesting that near by 100 000 East Asians are homozygotes.It is important to find out patients with citrin deficiency,to treat them,and to prevent onset of severe CTLN2.
文摘Objective:To comprehensively evaluate the risk of recurrence after initial ischemic stroke,and to provide a relatively comprehensive reference for the prevention and control of stroke recurrence.Methods:CNKI,VIP,Wanfang,PubMed,Web of Science,Embase and other databases were collected to investigate the status of recurrence after initial ischemic stroke,the search period of which was from the establishment of databases to March 2019.And then quality evaluation and data extraction were carried out.The overall cumulative risks of stroke recurrence at 3 months,6 months,1 year,2 years and 5 years after initial ischemic stroke were calculated,and heterogeneity analysis was performed.Results:A total of 29 studies from 19 provinces(cities,autonomous regions)in China were included.The cumulative total sample size was 22484 cases,the cumulative recurrent sample size was 3309 cases.The pooled cumulative risk was 4.5%(95%CI:3.1-5.8)at 3 months,7.8%(95%CI:5.6-10.0)at 6 months,13.6%(95%CI:11.0-16.2)at 1 year,17.5%(95%CI:12.4-22.6)at 2 years and 30.9%(95%CI:20.2-41.7)at 5 years after initial ischemic stroke.Conclusions:The recurrence rate of acute ischemic stroke in China is high.It is recommended that all levels of medical and health departments strengthen the prevention and treatment of ischemic stroke recurrence to reduce the recurrence of ischemic stroke and improve the prognosis of patients.
文摘Exosomes,minute vesicles ubiquitously released by diverse cell types,serve as critical mediators in intercellular communication.Their pathophysiological relevance,especially in malignancies,has garnered significant attention.A meticulous exploration of the exosomal impact on cancer development has unveiled avenues for innovative and clinically valuable techniques.The cargo conveyed by exosomes exerts transformative effects on both local and distant microenvironments,thereby influencing a broad spectrum of biological responses in recipient cells.These membranebound extracellular vesicles(EVs)play a pivotal role in delivering bioactive molecules among cells and organs.Cellular and biological processes in recipient cells,ranging from stromal cell reprogramming to immunological responses,extracellular matrix formation,and modulation of cancer cell activation,expansion,and metastasis,are subject to exosome-mediated cell-to-cell communication.Moreover,exosomes have been implicated in endowing cancer cells with resistance to treatment.Extensive research has explored the potential of exosomes as therapeutic targets and diagnostic indicators.This comprehensive review seeks to provide an in-depth understanding of the pivotal components and roles of exosomes in tumorigenesis,growth,progression,and therapeutic responses.The insights into the multifaceted involvement of exosomes in malignant cancers are essential for the scientific community,fostering the development of novel therapeutic and diagnostic strategies in the relentless pursuit of cancer.
文摘Objective To examine the neuroprotective effects of a novel manganese porphyrin, manganese （Ill） meso-tetrakis （N,N＇-diethylimidazolium-2-yl） porphyrin （MnTDM）, in the mouse model of Parkinson＇s disease （PD） induced by paraquat （PQ）. Methods Male C57BL / 6 mice were subcutaneously injected with either saline or PQ at 2-day intervals for a total of 10 doses, MnTDM was subcutaneously injected with the PQ 2 h before treatment. Performance on the pole and swim test were measured 7 days after the last injection and animals were sacrificed one day later. Levels of dopamine （DA） and its metabolites in the striatum were measured by high-performance liquid chromatography with an electrochemical detector （HPLC-ECD）. Thiobarbituric acid （TBA） method was used to assay the lipid peroxidation product, malondialdehyde （MDA）, and the number of tyrosine hydroxylase （TH） positive neurons was estimated using immunohistochemistry. Results Pretreatment with MnTI）M significantly attenuated PQ-impaired behavioral performance, depleted dopamine content in striata, increased MDA, and dopaminergic neuron loss in the substantia nigra. Conclusions Oxidative stress plays an important role in PQ-induced neurotoxicity which can be potentially prevented by manganese porphyrin. These findings also propose a possible therapeutical strategy for neurodegenerative disorders associated with oxidative stress such as PD.
