BACKGROUND Hematoma expansion(HE)typically portends a poor prognosis in spontaneous intracerebral hemorrhage(ICH).Several radiographic and laboratory values have been proposed as predictive markers of HE.AIM To perfor...BACKGROUND Hematoma expansion(HE)typically portends a poor prognosis in spontaneous intracerebral hemorrhage(ICH).Several radiographic and laboratory values have been proposed as predictive markers of HE.AIM To perform a systematic review and meta-analysis on the association of neu-trophil-to-lymphocyte ratio(NLR)and HE in ICH.A secondary outcome exa-mined was the association of NLR and perihematomal(PHE)growth.METHODS Three databases were searched(PubMed,EMBASE,and Cochrane)for studies evaluating the effect of NLR on HE and PHE growth.The inverse variance me-thod was applied to estimate an overall effect for each specific outcome by combining weighted averages of the individual studies’estimates of the logarithm odds ratio(OR).Given heterogeneity of the studies,a random effect was applied.Risk of bias was analyzed using the Newcastle-Ottawa Scale.The study was conducted following the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines.The protocol was registered in PROSPERO(No.CRD42024549924).RESULTS Eleven retrospective cohort studies involving 2953 patients were included in the meta-analysis.Among those,HE was investigated in eight studies,whereas PHE growth was evaluated in three.Blood sample was obtained on admission in ten studies,and at 24 hours in one study.There was no consensus on cut-off value among the studies.NLR was found to be significantly associated with higher odds of HE(OR=1.09,95%CI:1.04-1.15,I2=86%,P<0.01),and PHE growth(OR=1.28,95%CI:1.19-1.38,I2=0%,P<0.01).Qualitative analysis of each outcome revealed overall moderate risk of bias mainly due to lack of control for systemic confounders.CONCLUSION The available literature suggests that a possible association may exist between NLR on admission and HE,and PHE growth.Future studies controlled for systemic confounders should be designed to consolidate this finding.If confirmed,NLR could be added as a readily available and inexpensive biomarker to identify a subgroup of patients at higher risk of developing HE.展开更多
BACKGROUND Administration of thrombolytics for acute ischemic stroke(AIS)via telemedicine has expanded in recent years at institutions without on-site neurology specialists.This helped to improve the care of stroke pa...BACKGROUND Administration of thrombolytics for acute ischemic stroke(AIS)via telemedicine has expanded in recent years at institutions without on-site neurology specialists.This helped to improve the care of stroke patients in rural areas.However,it is uncertain if telemedicine-administered thrombolytics is as safe and effective as inperson evaluation by neurology specialists.AIM The authors conducted a meta-analysis evaluating stroke metrics,safety and outcomes of telemedicine compared to in-person evaluation by neurologist specialist in AIS patients receiving intravenous thrombolytics.METHODS PubMed,EMBASE,and Cochrane were searched for randomized clinical trials and observational cohort studies.The Mantel-Haenszel method or inverse variance,as applicable,were applied to calculate an overall effect estimate for each outcome by combining specific risk ratio(RR)or standardized mean difference(SMD).Risk of bias was analyzed using the Newcastle-Ottawa Scale.Primary outcome examined was door-to-needle time(DTN).Secondary outcomes were symptomatic intracranial hemorrhage(sICH),mortality,and mRS≤2.RESULTS Eleven retrospective cohort studies involving 2350 patients were included in the analysis.Of those,34%(n=794)received thrombolytics via telemedicine.Telemedicine was associated with a significantly longer mean DTN compared to inperson evaluation[SMD:0.72 minutes;95%confidence interval(CI)0.22-1.22;P<0.01],a similar rate of sICH[3.9%vs 4.2%;Odds ratio(OR):0.75;95%CI 0.42-1.37;P=0.35],similar rate of mortality(13.2%vs 14.7%;OR:0.87;95%CI 0.47-1.63;P=0.67),and comparable rate of favorable short-term functional outcome(46.8%vs 50.7%;OR:0.79;95%CI 0.41-1.53;P=0.48).Risk of bias was low to moderate for each outcome.CONCLUSION The available literature suggests that telemedicine is associated with longer DTN compared to in-person evaluation.This difference in stroke metric does not affect safety or outcome.Further studies are needed to understand and address the underlying factors of the longer DTN time.展开更多
OBJECTIVE:To investigate the synergistic effects of polyphyllin Ⅰ(PPⅠ)combined with tumor necrosis factorrelated apoptosis-inducing ligand(TRAIL)on the growth of osteosarcoma cells through downregulating the Wnt/β-...OBJECTIVE:To investigate the synergistic effects of polyphyllin Ⅰ(PPⅠ)combined with tumor necrosis factorrelated apoptosis-inducing ligand(TRAIL)on the growth of osteosarcoma cells through downregulating the Wnt/β-catenin signaling pathway.METHODS:Cell viability,apoptosis and cell cycle distribution were examined using cell counting kit-8 and flow cytometry assays.The morphology of cancer cells was observed with inverted phase contrast microscope.The migration and invasion abilities were examined by xCELLigence real time cell analysis DP system and transwell assays.The expressions of poly(adenosine diphosphate-ribose)polymerase,C-Myc,Cyclin B1,cyclin-dependent kinases 1,N-cadherin,Vimentin,Active-β-catenin,β-catenin,p-glycogen synthase kinase 3β(GSK-3β)and GSK-3βwere determined by Western blotting assay.RESULTS:PPⅠ sensitized TRAIL-induced decrease of viability,migration and invasion,as well as increase of apoptosis and cell cycle arrest of MG-63 and U-2 OS osteosarcoma cells.The synergistic effect of PPⅠwith TRAIL in inhibiting the growth of osteosarcoma cells was at least partially realized through the inactivation of Wnt/β-catenin signaling pathway.CONCLUSION:The combination of PPⅠ and TRAIL is potentially a novel treatment strategy of osteosarcoma.展开更多
Previous studies have shown that transplanted enteric glia enhance axonal regeneration, reduce tissue damage, and promote functional recovery following spinal cord injury. However, the mechanisms by which enteric glia...Previous studies have shown that transplanted enteric glia enhance axonal regeneration, reduce tissue damage, and promote functional recovery following spinal cord injury. However, the mechanisms by which enteric glia mediate these beneficial effects are unknown. Neurotrophic factors can promote neuronal differentiation, survival and neurite extension. We hypothesized that enteric glia may exert their protective effects against spinal cord injury partially through the secretion of neurotrophic factors. In the present study, we demonstrated that primary enteric glia cells release nerve growth factor, brain-derived neurotrophic factor and glial cell line-derived neurotrophic factor over time with their concentrations reaching approximately 250, 100 and 50 pg/mL of culture medium respectively after 48 hours. The biological relevance of this secretion was assessed by incubating dissociated dorsal root ganglion neuronal cultures in enteric glia-conditioned medium with and/or without neutralizing antibodies to each of these proteins and evaluating the differences in neurite growth. We discovered that conditioned medium enhances neurite outgrowth in dorsal root ganglion neurons. Even though there was no detectable amount of neurotrophin-3 secretion using ELISA analysis, the neurite outgrowth effect can be attenuated by the antibody-mediated neutralization of each of the aforementioned neurotrophic factors. Therefore, enteric glia secrete nerve growth factor, brain-derived neurotrophic factor, glial cell line-derived neurotrophic factor and neurotrophin-3 into their surrounding environment in concentrations that can cause a biological effect.展开更多
The evaluation of such novel therapies for acute spinal cord injury in clinical trials is extremely challenging.Our current dependence upon the clinical assessment of neurologic impairment renders many acute SCI patie...The evaluation of such novel therapies for acute spinal cord injury in clinical trials is extremely challenging.Our current dependence upon the clinical assessment of neurologic impairment renders many acute SCI patients ineligible for trials because they are not examinable.Furthermore,the difficulty in predicting neurologic recovery based on the early clinical assessment forces investigators to recruit large cohorts to have sufficient power.Biomarkers that objectively classify injury severity and better predict neurologic outcome would be valuable tools for translational research.As such,the objective of the present review was to describe some of the translational challenges in acute spinal cord injury research and examine the potential utility of neurochemical biomarkers found within cerebrospinal fluid and blood.We focus on published efforts to establish biological markers for accurately classifying injury severity and precisely predict neurological outcome.展开更多
Chronic spinal cord compression(CSCC)is induced by disc herniation and other reasons,leading to movement and sensation dysfunction,with a serious impact on quality of life.Spontaneous disc herniation rarely occurs in ...Chronic spinal cord compression(CSCC)is induced by disc herniation and other reasons,leading to movement and sensation dysfunction,with a serious impact on quality of life.Spontaneous disc herniation rarely occurs in rodents,and therefore establishing a chronic spinal cord compression(CSCC)animal model is of crucial importance to explore the pathogenesis and treatment of CSCC.The absence of secreted protein,acidic,and rich in cysteine(SPARC)leads to spontaneous intervertebral disc degeneration in mice,which resembles human disc degeneration.In this study,we evaluated whether SPARC-null mice may serve as an animal model for CSCC.We performed rod rotation test,pain threshold test,gait analysis,and Basso Mouse Scale score.Our results showed that the motor function of SPARC-null mice was weakened,and magnetic resonance images revealed compression at different spinal cord levels,particularly in the lumbar segments.Immunofluorescence staining and western blot assay showed that the absence of SPARC induced apoptosis of neurons and oligodendrocytes,activation of microglia/macrophages with M1/M2 phenotype and astrocytes with A1/A2 phenotype;it also activated the expression of the NOD-like receptor protein 3 inflammasome and inhibited brain-derived neurotrophic factor/tyrosine kinase B signaling pathway.Notably,these findings are characteristics of CSCC.Therefore,we propose that SPARC-null mice may be an animal model for studying CSCC caused by disc herniation.展开更多
Several techniques have been reported to address different endovascular device failures. We report the case of a premature deployment of a covered balloon mounted stent during endovascular repair of a posttraumatic ca...Several techniques have been reported to address different endovascular device failures. We report the case of a premature deployment of a covered balloon mounted stent during endovascular repair of a posttraumatic carotid-cavernous fistula(CCF). A 50-year-old male suffered a fall resulting in loss of consciousness and multiple facial fractures. Five weeks later, he developed decreased left visual acuity, proptosis, chemosis, limited eye movements and cranial/orbit bruit. Cerebral angiography demonstrated a direct left CCF and endovascular repair with a 5.0 mm × 19 mm covered stent was planned. Once in the lacerum segment, increased resistance was encountered and the stent was withdrawn resulting in premature deployment. A 3 mm × 9 mm balloon was advanced over an exchange length microwire and through the stent lumen. Once distal to the stent, the balloon was inflated and slowly pulled back in contact with the stent. All devices were successfully withdrawn as a unit. The use of a balloon to retrieve a prematurely deployed balloon mounted stent is a potential rescue option if leaving the stent in situ carries risks.展开更多
Background: Chatbots are easy to use and simulate a human conversation through text or voice via smartphones or computers. In the field of health, chatbots can improve patient information, monitoring, or treatment adh...Background: Chatbots are easy to use and simulate a human conversation through text or voice via smartphones or computers. In the field of health, chatbots can improve patient information, monitoring, or treatment adherence. Method: The objective of this article is to describe how a chatbot dedicated to disease monitoring and support of patients can interact with them and how data are exploited to be safe. Results: Wefight designed a chatbot named Vik to empower patients with cancers or chronic diseases and their relatives via personalized text messages. Natural Language Processing models were used. We built several Vik for each disease. Each Vik has its contents, its own NLP model and interacts its way with the patient. Conclusion: Conversational agents may help patients with minor health concerns without seeing a real physician. If the quality of these softwares is not thoroughly assessed, they could be dangerous. If chatbots are effective and safe, they could be prescribed like a drug to improve patient information, monitoring, or treatment adherence.展开更多
Objective:To critically assess the neurological recovery and antioxidant effects of resveratrol in rat models of spinal cord injury.Data sources:Using“spinal cord injury”,“resveratrol”and“animal experiment”as th...Objective:To critically assess the neurological recovery and antioxidant effects of resveratrol in rat models of spinal cord injury.Data sources:Using“spinal cord injury”,“resveratrol”and“animal experiment”as the main search terms,all studies on the treatment of spinal cord injury in rats by resveratrol were searched for in PubMed,EMBASE,MEDLINE,Web of Science,Science Direct,China National Knowledge Infrastructure,Wanfang,VIP,and SinoMed databases by computer.The search was conducted from their inception date to April 2017.No language restriction was used in the literature search.Data selection:The methodological quality of each study was assessed by the initial Stroke Therapy Academic Industry Roundtable recommendations.Two reviewers independently selected studies according to the title,abstract and full text.The risk of bias in the included studies was also evaluated.Meta-analyses were performed with Review Manager 5.3 software.Outcome measures:Neurological function was assessed by the Basso,Beattie,and Bresnahan scale score,inclined plane score and Gale’s motor function score.Molecular-biological analysis of antioxidative effects was conducted to determine superoxide dismutase levels,malondialdehyde levels,nitric oxide synthase activity,nitric oxide levels,xanthine oxidase and glutathione levels in spinal cord tissues.Results:The methodological quality of the 12 included studies was poor.The results of meta-analysis showed that compared with the control group,resveratrol significantly increased the Basso,Beattie,and Bresnahan scale scores after spinal cord injury(n=300,mean difference(MD)=3.85,95%confidence interval(CI)[2.10,5.59],P<0.0001).Compared with the control group,superoxide dismutase levels were significantly elevated(n=138,standardized mean difference(SMD)=5.22,95%CI[2.98,7.45],P<0.00001),but malondialdehyde levels were significantly diminished(n=84,SMD=–3.64,95%CI[–5.84,–1.43],P=0.001)in the spinal cord of the resveratrol treatment group.Conclusions:Resveratrol promoted neurological recovery and exerted antioxidative effects in rat models of spinal cord injury.The limited quality of the included studies reduces the application of this meta-analysis.Therefore,more high-quality studies are needed to provide more rigorous and objective evidence for the pre-clinical treatment of spinal cord injury.展开更多
Axinl is a negative regulator of β-catenin signaling and its role in osteoblast precursor cells remains undefined.In the present studies,we determined changes in postnatal bone growth by deletion of Axinl in osteobla...Axinl is a negative regulator of β-catenin signaling and its role in osteoblast precursor cells remains undefined.In the present studies,we determined changes in postnatal bone growth by deletion of Axinl in osteoblast precursor cells and analyzed bone growth in newborn and postnatal Axin1 O5X mice and found that hypertrophic cartilage area was largely expanded in AxinlOSX KO mice.A larger number of chondrocytes and unabsorbed cartilage matrix were found in the bone marrow cavity of Axin1OSX KO mice.Osteoclast formation in metaphyseal and subchondral bone areas was significantly decreased,demonstrated by decreased TRAPpositive cell numbers,associated with reduction of MMP9-and cathepsin K-positive cell numbers in Axin1 O5X KO mice.OPG expression and the ratio of O p g to Rankl were significantly increased in osteoblasts of Axinl O5X KO mice.Osteoclast formation in primary bone marrow derived microphage(BMM)cells was significantly decreased when BMM cells were cultured with conditioned media(CM)collected from osteoblasts derived from Axin1OSX mice compared with BMM cells cultured with CM derived from WT mice.Thus,the loss of Axinl in osteoblast precursor cells caused increased OPG and the decrease in osteoclast formation,leading to delayed bone growth in postnatal Axin1°sx KO mice.展开更多
Lumbar spinal stenosis (LSS) causes ischemia, inflammation, demyelination and results in cauda equina (CE) syndrome, with pain and locomotor functional deficits. We investigated whether exogenous administration of S-n...Lumbar spinal stenosis (LSS) causes ischemia, inflammation, demyelination and results in cauda equina (CE) syndrome, with pain and locomotor functional deficits. We investigated whether exogenous administration of S-nitrosoglutathione (GSNO), an endogenous redox modulating anti-neuroinflammatory agent, hastens functional recovery in a CE compression (CEC) rat model. CEC was induced in adult female rats by the surgical implantation of two silicone blocks within the epidural spaces of L4-L6 vertebrae. GSNO (50 μg/kg body weight) was administered by gavage 1 h after the injury, and the treatment was continued daily thereafter. GSNO induced change in the pain threshold was evaluated for four days after the compression. Tissue analyses and locomotor function evaluation were carried out at two weeks and four weeks after the CEC respectively. GSNO significantly improved motor function in CEC rats as evidenced by an increased latency on rotarod compared with vehicle-treated CEC rats. CEC induced hyperalgesia was decreased by GSNO. GSNO also increased the expression of VEGF, reduced cellular infiltration (H&E staining) and apoptotic cell death (TUNEL assay), and hampered demyelination (LFB staining and g-ratio). These data demonstrate that administration of GSNO after CEC decreased inflammation, hyperalgesia and cell death leading to improved locomotor function of CEC rats. The therapeutic potential of GSNO observed in the present study with CEC rats suggests that GSNO is a candidate drug to test in LSS patients.展开更多
Background: Isolated thoracolumbar vertebral transverse process fractures (TPF) are often considered a stable injury. However, the use of advanced imaging such as magnetic resonance imaging and spine specialist consul...Background: Isolated thoracolumbar vertebral transverse process fractures (TPF) are often considered a stable injury. However, the use of advanced imaging such as magnetic resonance imaging and spine specialist consultation are often ordered as part of the routine workup of these fractures. The routine ordering of advanced imaging, spine specialist consultation, and delayed mobilization causes unnecessary economic and clinical burdens to patients and the overall healthcare system. Purpose: To determine if a higher number of isolated TPFs (iTPFs) lead to an increase in ligamentous injury to the spine, and whether ligamentous injury—if present—requires surgical intervention. Methods: The retrospective review was performed from 2009 to 2015, using a surgical trauma database to identify patients with greater than 3 isolated TPF (iTPF) to determine if iTPF leads to an increase in ligamentous injury to the spine and if this increase leads to increased surgical intervention. Results: A total of 102 patients were identified with complete follow up at 6 - 8 weeks post injury. The majority of the included patients suffered from blunt trauma. There was a small rate of ligamentous injury (n = 7, 7%) that did not require additional treatment. None of the fractures included were considered unstable. None of the patients included required surgical intervention during their hospital visit or in follow up visits. Conclusion: iTPFs are a stable injury to the thoracolumbar spine. There is a small rate of associated ligamentous injury that does not change the management or require further interventions. Thoracolumbar iTPFs do not automatically need spine specialist consultation and advanced imaging techniques.展开更多
Hippocrates (460-377 BC) first described stroke over 2400 years ago. Stroke is the 4th leading cause of death in Canada (3rd in the USA) and the primary cause of permanent motor and cognitive disability. The majority ...Hippocrates (460-377 BC) first described stroke over 2400 years ago. Stroke is the 4th leading cause of death in Canada (3rd in the USA) and the primary cause of permanent motor and cognitive disability. The majority of strokes are ischemic. The extent of cerebral dysfunction and thus the severity of stroke are based on the location, severity and duration of ischemia. Stroke management and prognosis encompass early recognition of the onset of stroke and post-stroke determination of the extent of brain injury aided by clinical stroke scores and diffusion-weighted imaging. Cognitive domains most likely to be affected following stroke are memory, orientation, language, attention and executive function. While the vast majority of functional recovery occurs within the first 3 months post-stroke, the neural mechanisms promoting recovery are not well understood. Investigations into the neural plasticity of brain areas after a lesion demonstrate that the adult brain can be shaped by environmental inputs, such as rehabilitation techniques. Many rehabilitation techniques are actively being pursued, including brain-computer interfaces providing sophisticated methods for detecting rehabilitation-associated changes in cerebral physiology. The success of such strategies visualized with functional magnetic resonance imaging and positron emission tomography may provide an objective complement to clinical evaluations.展开更多
Previous studies examining coherence and connectivity deviations in schizophrenia patients relied on standard coherence measures between recording sites (at the sensor level). A coherence source imaging (CSI) methodol...Previous studies examining coherence and connectivity deviations in schizophrenia patients relied on standard coherence measures between recording sites (at the sensor level). A coherence source imaging (CSI) methodology where coherence is assessed within imaged brain structures (at the source level) was developed recently by our group and applied successfully for detecting coherent areas in the cortical networks of patients with epilepsy. We applied this Magnetoencephalography (MEG)-CSI technique to measure normal and pathological patterns of brain oscillations (biomarkers) in normal subjects and patients diagnosed with schizophrenia. Twelve patients diagnosed with schizophrenia and twelve healthy control subjects were studied. A ten-minute resting state MEG brain scan was performed with eyes open. MEG-CSI analysis was performed to identify the cortical areas that interacted strongly within the 3 - 50 Hz frequency range. Statistically significant increased regions of coherence were detected in schizophrenia patients compared to controls in the right inferior frontal gyrus (BA 47—pars orbitalis), left superior frontal gyrus (BA9— dorsolateral prefrontal cortex), right middle frontal gyrus (BA 10—anterior prefrontal cortex & BA 46—dorsolateral prefrontal cortex), and right cingulate gyrus (BA 24—ventral anterior cingulate cortex). These areas are involved in language, memory, decision making, empathy, executive and, higher cognitive functioning. We conclude that MEG-CSI can detect imaging biomarkers from resting state brain activity in schizophrenia patients that deviates from normal control subjects in several behaviorally salient brain regions. Analysis with MEG-CSI can provide biomarkers of abnormalities in the resting-state. The findings and procedures described can be used to probe the pathophysiology of schizophrenia and possibly detect subtypes.展开更多
Objective:Rheumatoid arthritis(RA)is a common autoimmune disease characterized by multiple joint lesions and systemic complications.Danggui Niantong decoction(DGNTT)has been clinically used for RA treatment;however,it...Objective:Rheumatoid arthritis(RA)is a common autoimmune disease characterized by multiple joint lesions and systemic complications.Danggui Niantong decoction(DGNTT)has been clinically used for RA treatment;however,its beneficial effect on cardiopulmonary complications has not been reported.Methods:Female tumor necrosis factor-transgenic(TNF-Tg)mice were used to evaluate the therapeutic effects of DGNTT on arthritis and cardiopulmonary complications.Methotrexate(MTX)served as a positive control.Histopathological assessment of the joint sections was performed using hematoxylin and eosin(HE),Alcian Blue/Orange G,and tartrate-resistant acid phosphatase staining.Bone mass was assessed by micro-computed tomography,inflammatory infiltrates in the heart and lungs were evaluated by HE staining,cardiopulmonary fibrotic injury was identified by Masson’s trichrome staining,and hypertrophy of mouse cardiomyocytes was measured by wheat germ agglutinin(WGA)staining.Results:DGNTT mitigated the inflammation of the ankle joint synovium,decreased the number of osteoclasts,and increased the area of cartilage and bone mass in TNF-Tg mice.In addition,DGNTT decreased the infiltration of inflammatory cells into the lung and heart tissues,accompanied by a reduction in cardiopulmonary fibrosis and myocardial cell hypertrophy in TNF-Tg mice.As a positive control drug,MTX attenuated the pathological changes in joints,but had no beneficial effect on cardiopulmonary inflammation and fibrosis in TNF-Tg mice.Conclusions:DGNTT improved joint lesions and alleviated cardiopulmonary complications in TNF-Tg mice.展开更多
Co-inhibitory receptors serve as crucial regulators of T-cell function,playing a pivotal role in modulating the delicate balance between immune tolerance and autoimmunity.Initially identified in autoimmune disease mod...Co-inhibitory receptors serve as crucial regulators of T-cell function,playing a pivotal role in modulating the delicate balance between immune tolerance and autoimmunity.Initially identified in autoimmune disease models,co-inhibitory receptors,including CTLA-4,PD-1,TIM-3,and TIGIT,were found to be integral to immune regulation.Their blockade or absence in these models resulted in the induction or exacerbation of autoimmune diseases.Additionally,scholars have observed that co-inhibitory receptors on lymphocytes hold the potential to influence the prognosis in the context of chronic inflammation.Consequently,the blocking of co-suppressor receptors has emerged as a novel therapeutic approach for inhibiting refractory inflammatory diseases,particularly rheumatoid arthritis.From the standpoint of traditional Chinese medicine(TCM),the treatment of rheumatoid arthritis based on the“strengthening body resistance(FúZhèng)”theory can be construed as the regulation of co-suppressor receptors to modulate the body’s immune function in combating chronic inflammation.This article provides a succinct overview of the role of co-suppressor receptors in anti-inflammatory processes and explores the research prospects of co-suppressor receptor intervention in the treatment of rheumatoid arthritis.The exploration integrates the“strengthening body resistance(FúZhèng)”theory with relevant Chinese medicine formulations.展开更多
Traumatic spinal cord injury is potentially catastrophic and can lead to permanent disability or even death.China has the largest population of patients with traumatic spinal cord injury.Previous studies of traumatic ...Traumatic spinal cord injury is potentially catastrophic and can lead to permanent disability or even death.China has the largest population of patients with traumatic spinal cord injury.Previous studies of traumatic spinal cord injury in China have mostly been regional in scope;national-level studies have been rare.To the best of our knowledge,no national-level study of treatment status and economic burden has been performed.This retrospective study aimed to examine the epidemiological and clinical features,treatment status,and economic burden of traumatic spinal cord injury in China at the national level.We included 13,465 traumatic spinal cord injury patients who were injured between January 2013 and December 2018 and treated in 30 hospitals in 11 provinces/municipalities representing all geographical divisions of China.Patient epidemiological and clinical features,treatment status,and total and daily costs were recorded.Trends in the percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department and cost of care were assessed by annual percentage change using the Joinpoint Regression Program.The percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department did not significantly change overall(annual percentage change,-0.5%and 2.1%,respectively).A total of 10,053(74.7%)patients underwent surgery.Only 2.8%of patients who underwent surgery did so within 24 hours of injury.A total of 2005(14.9%)patients were treated with high-dose(≥500 mg)methylprednisolone sodium succinate/methylprednisolone(MPSS/MP);615(4.6%)received it within 8 hours.The total cost for acute traumatic spinal cord injury decreased over the study period(-4.7%),while daily cost did not significantly change(1.0%increase).Our findings indicate that public health initiatives should aim at improving hospitals’ability to complete early surgery within 24 hours,which is associated with improved sensorimotor recovery,increasing the awareness rate of clinical guidelines related to high-dose MPSS/MP to reduce the use of the treatment with insufficient evidence.展开更多
1.The complex spectrum of neurodegenerative diseases Epidemiologic data indicate that neurodegenerative diseases(NDDs)show high prevalence with a trend of a progressively growing incidence,especially in aging societie...1.The complex spectrum of neurodegenerative diseases Epidemiologic data indicate that neurodegenerative diseases(NDDs)show high prevalence with a trend of a progressively growing incidence,especially in aging societies.This presents an increasing social and economic burden.展开更多
Objective:To explore the efficacy and safety of Juan Bi Pill(JBP)in treatment of active rheumatoid arthritis(RA).Methods:From February 2017 to May 2018,115 participants from 4 centers were randomly divided into JBP gr...Objective:To explore the efficacy and safety of Juan Bi Pill(JBP)in treatment of active rheumatoid arthritis(RA).Methods:From February 2017 to May 2018,115 participants from 4 centers were randomly divided into JBP group(57 cases)and placebo group(58 cases)in a 1:1 ratio using a random number table method.Participants received a dose of JBP(4 g,twice a day,orally)combined with methotrexate(MTX,10 mg per week)or placebo(4 g,twice a day,orally)combined with MTX for 12 weeks.Participants were required with follow-up visits at 24 and 48 weeks,attending 7 assessment visits.Participants were undergo disease activity assessment 7 times(at baseline and 2,4,8,12,24,48 weeks)and safety assessments 6 times(at baseline and 4,8,12,24,48 weeks).The primary endpoint was 28-joint Disease Activity Score(DAS28-ESR and DAS28-CRP).The secondary endpoints included American College of Rheumatology(ACR)criteria for 20%and 50%improvement(ACR20/50),Health Assessment Questionnaire Disability Index(HAQ-DI),clinical disease activity index(CDAI),visual analog scale(VAS),Short Form-36(SF-36)score,Medial Outcomes Study(MOS)sleep scale score,serum erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),tender joint count,swollen joint count,and morning stiffness.The adverse reactions were observed during the treatment.Results:After 12 weeks of treatment,DAS28-ESR and DAS28-CRP scores in both groups were lower than before treatment(both P<0.01),while the remission rate of DAS28-ESR and DAS28-CRP and low disease activity of JBP group were higher than those in the placebo group(both P<0.01).JBP demonstrated better efficacy on ACR20 and ACR50 compliance rate at 12 and 48 weeks comparing to placebo(all P<0.05).The CDAI and HAQ-DI score,pain VAS and global VAS change of RA patients and physicians,the serum ESR and CRP levels,and the number of tenderness and swelling joints were lower than before treatment at 4,8,12,24,48 weeks in both groups(P<0.05 or P<0.01),while the reduction of above indices in the JBP group was more obvious than those in the placebo group at 12 weeks(ESR and CRP,both P<0.05)or at 12 and 48 weeks(all P<0.01).There was no difference in adverse reactions between the 2 groups during treatment(P=0.75).Conclusion:JBP combined with MTX could effectively reduce disease activity in patients with RA in active stage,reduce the symptoms of arthritis,and improve the quality of life,while ensuring safety,reliability,and fewer adverse effects.(Trial registration:Clinical Trials.gov,No.NCT02885597)。展开更多
文摘BACKGROUND Hematoma expansion(HE)typically portends a poor prognosis in spontaneous intracerebral hemorrhage(ICH).Several radiographic and laboratory values have been proposed as predictive markers of HE.AIM To perform a systematic review and meta-analysis on the association of neu-trophil-to-lymphocyte ratio(NLR)and HE in ICH.A secondary outcome exa-mined was the association of NLR and perihematomal(PHE)growth.METHODS Three databases were searched(PubMed,EMBASE,and Cochrane)for studies evaluating the effect of NLR on HE and PHE growth.The inverse variance me-thod was applied to estimate an overall effect for each specific outcome by combining weighted averages of the individual studies’estimates of the logarithm odds ratio(OR).Given heterogeneity of the studies,a random effect was applied.Risk of bias was analyzed using the Newcastle-Ottawa Scale.The study was conducted following the Preferred Reporting Items for Systematic Review and Meta-analysis guidelines.The protocol was registered in PROSPERO(No.CRD42024549924).RESULTS Eleven retrospective cohort studies involving 2953 patients were included in the meta-analysis.Among those,HE was investigated in eight studies,whereas PHE growth was evaluated in three.Blood sample was obtained on admission in ten studies,and at 24 hours in one study.There was no consensus on cut-off value among the studies.NLR was found to be significantly associated with higher odds of HE(OR=1.09,95%CI:1.04-1.15,I2=86%,P<0.01),and PHE growth(OR=1.28,95%CI:1.19-1.38,I2=0%,P<0.01).Qualitative analysis of each outcome revealed overall moderate risk of bias mainly due to lack of control for systemic confounders.CONCLUSION The available literature suggests that a possible association may exist between NLR on admission and HE,and PHE growth.Future studies controlled for systemic confounders should be designed to consolidate this finding.If confirmed,NLR could be added as a readily available and inexpensive biomarker to identify a subgroup of patients at higher risk of developing HE.
文摘BACKGROUND Administration of thrombolytics for acute ischemic stroke(AIS)via telemedicine has expanded in recent years at institutions without on-site neurology specialists.This helped to improve the care of stroke patients in rural areas.However,it is uncertain if telemedicine-administered thrombolytics is as safe and effective as inperson evaluation by neurology specialists.AIM The authors conducted a meta-analysis evaluating stroke metrics,safety and outcomes of telemedicine compared to in-person evaluation by neurologist specialist in AIS patients receiving intravenous thrombolytics.METHODS PubMed,EMBASE,and Cochrane were searched for randomized clinical trials and observational cohort studies.The Mantel-Haenszel method or inverse variance,as applicable,were applied to calculate an overall effect estimate for each outcome by combining specific risk ratio(RR)or standardized mean difference(SMD).Risk of bias was analyzed using the Newcastle-Ottawa Scale.Primary outcome examined was door-to-needle time(DTN).Secondary outcomes were symptomatic intracranial hemorrhage(sICH),mortality,and mRS≤2.RESULTS Eleven retrospective cohort studies involving 2350 patients were included in the analysis.Of those,34%(n=794)received thrombolytics via telemedicine.Telemedicine was associated with a significantly longer mean DTN compared to inperson evaluation[SMD:0.72 minutes;95%confidence interval(CI)0.22-1.22;P<0.01],a similar rate of sICH[3.9%vs 4.2%;Odds ratio(OR):0.75;95%CI 0.42-1.37;P=0.35],similar rate of mortality(13.2%vs 14.7%;OR:0.87;95%CI 0.47-1.63;P=0.67),and comparable rate of favorable short-term functional outcome(46.8%vs 50.7%;OR:0.79;95%CI 0.41-1.53;P=0.48).Risk of bias was low to moderate for each outcome.CONCLUSION The available literature suggests that telemedicine is associated with longer DTN compared to in-person evaluation.This difference in stroke metric does not affect safety or outcome.Further studies are needed to understand and address the underlying factors of the longer DTN time.
基金National Key R&D Program of China:Cooperating Studies on Measurement Technologies of Human Phenome and Crossscale Correlation of Phenotypic Data(No.2020YFE0201600)National Nature Science Foundation:Study on LncRNA-CCDC18-AS1 Mediated Osteosarcoma Occurrence by Activating YAP/TAZ and Tumor Microenvironment M2 TAM-dependent Lung Metastasis,and Efficacy/mechanism of Removing Blood Stasis/clearing heat/eliminating Toxic Material Principle(No.81973877)+2 种基金Mechanism Study on m6A Methyltransferase RBM15 Mediated YAP Epigenetic Modification to Promote Osteosarcoma Lung Metastasis through Lymphatic System and Management with Qichong Powder(No.82174408)Shanghai Collaborative Innovation Center of Industrial Transformation of Hospital TCM Preparation:Preclinical Study on the Treatment of Osteosarcoma with Qingre Jiedu GranulesResearch Projects within Budget of Shanghai University of Traditional Chinese Medicine:the Research on the Mechanism of the HIPK3 Activation of Wnt/β-catenin Induction the Osteosarcoma and the Intervention of Banmao Decoction(No.2021LK047)。
文摘OBJECTIVE:To investigate the synergistic effects of polyphyllin Ⅰ(PPⅠ)combined with tumor necrosis factorrelated apoptosis-inducing ligand(TRAIL)on the growth of osteosarcoma cells through downregulating the Wnt/β-catenin signaling pathway.METHODS:Cell viability,apoptosis and cell cycle distribution were examined using cell counting kit-8 and flow cytometry assays.The morphology of cancer cells was observed with inverted phase contrast microscope.The migration and invasion abilities were examined by xCELLigence real time cell analysis DP system and transwell assays.The expressions of poly(adenosine diphosphate-ribose)polymerase,C-Myc,Cyclin B1,cyclin-dependent kinases 1,N-cadherin,Vimentin,Active-β-catenin,β-catenin,p-glycogen synthase kinase 3β(GSK-3β)and GSK-3βwere determined by Western blotting assay.RESULTS:PPⅠ sensitized TRAIL-induced decrease of viability,migration and invasion,as well as increase of apoptosis and cell cycle arrest of MG-63 and U-2 OS osteosarcoma cells.The synergistic effect of PPⅠwith TRAIL in inhibiting the growth of osteosarcoma cells was at least partially realized through the inactivation of Wnt/β-catenin signaling pathway.CONCLUSION:The combination of PPⅠ and TRAIL is potentially a novel treatment strategy of osteosarcoma.
基金supported by Canadian Spinal Research Organization, No. #84831
文摘Previous studies have shown that transplanted enteric glia enhance axonal regeneration, reduce tissue damage, and promote functional recovery following spinal cord injury. However, the mechanisms by which enteric glia mediate these beneficial effects are unknown. Neurotrophic factors can promote neuronal differentiation, survival and neurite extension. We hypothesized that enteric glia may exert their protective effects against spinal cord injury partially through the secretion of neurotrophic factors. In the present study, we demonstrated that primary enteric glia cells release nerve growth factor, brain-derived neurotrophic factor and glial cell line-derived neurotrophic factor over time with their concentrations reaching approximately 250, 100 and 50 pg/mL of culture medium respectively after 48 hours. The biological relevance of this secretion was assessed by incubating dissociated dorsal root ganglion neuronal cultures in enteric glia-conditioned medium with and/or without neutralizing antibodies to each of these proteins and evaluating the differences in neurite growth. We discovered that conditioned medium enhances neurite outgrowth in dorsal root ganglion neurons. Even though there was no detectable amount of neurotrophin-3 secretion using ELISA analysis, the neurite outgrowth effect can be attenuated by the antibody-mediated neutralization of each of the aforementioned neurotrophic factors. Therefore, enteric glia secrete nerve growth factor, brain-derived neurotrophic factor, glial cell line-derived neurotrophic factor and neurotrophin-3 into their surrounding environment in concentrations that can cause a biological effect.
基金provided by the Rick Hansen InstituteMichael Smith Foundation for Health Research+1 种基金Craig Neilsen Foundationsupported by MITACS
文摘The evaluation of such novel therapies for acute spinal cord injury in clinical trials is extremely challenging.Our current dependence upon the clinical assessment of neurologic impairment renders many acute SCI patients ineligible for trials because they are not examinable.Furthermore,the difficulty in predicting neurologic recovery based on the early clinical assessment forces investigators to recruit large cohorts to have sufficient power.Biomarkers that objectively classify injury severity and better predict neurologic outcome would be valuable tools for translational research.As such,the objective of the present review was to describe some of the translational challenges in acute spinal cord injury research and examine the potential utility of neurochemical biomarkers found within cerebrospinal fluid and blood.We focus on published efforts to establish biological markers for accurately classifying injury severity and precisely predict neurological outcome.
基金supported by the National Natural Science Foundation of China,Nos.82074454(to XJC),82174409(to MY),81930116(to YJW),81873317(to XJC)the National Key R&D Program of China,No.2018YFC1704300(to YJW)the Natural Science Foundation of Shanghai,No.20ZR1459000(to MY)。
文摘Chronic spinal cord compression(CSCC)is induced by disc herniation and other reasons,leading to movement and sensation dysfunction,with a serious impact on quality of life.Spontaneous disc herniation rarely occurs in rodents,and therefore establishing a chronic spinal cord compression(CSCC)animal model is of crucial importance to explore the pathogenesis and treatment of CSCC.The absence of secreted protein,acidic,and rich in cysteine(SPARC)leads to spontaneous intervertebral disc degeneration in mice,which resembles human disc degeneration.In this study,we evaluated whether SPARC-null mice may serve as an animal model for CSCC.We performed rod rotation test,pain threshold test,gait analysis,and Basso Mouse Scale score.Our results showed that the motor function of SPARC-null mice was weakened,and magnetic resonance images revealed compression at different spinal cord levels,particularly in the lumbar segments.Immunofluorescence staining and western blot assay showed that the absence of SPARC induced apoptosis of neurons and oligodendrocytes,activation of microglia/macrophages with M1/M2 phenotype and astrocytes with A1/A2 phenotype;it also activated the expression of the NOD-like receptor protein 3 inflammasome and inhibited brain-derived neurotrophic factor/tyrosine kinase B signaling pathway.Notably,these findings are characteristics of CSCC.Therefore,we propose that SPARC-null mice may be an animal model for studying CSCC caused by disc herniation.
文摘Several techniques have been reported to address different endovascular device failures. We report the case of a premature deployment of a covered balloon mounted stent during endovascular repair of a posttraumatic carotid-cavernous fistula(CCF). A 50-year-old male suffered a fall resulting in loss of consciousness and multiple facial fractures. Five weeks later, he developed decreased left visual acuity, proptosis, chemosis, limited eye movements and cranial/orbit bruit. Cerebral angiography demonstrated a direct left CCF and endovascular repair with a 5.0 mm × 19 mm covered stent was planned. Once in the lacerum segment, increased resistance was encountered and the stent was withdrawn resulting in premature deployment. A 3 mm × 9 mm balloon was advanced over an exchange length microwire and through the stent lumen. Once distal to the stent, the balloon was inflated and slowly pulled back in contact with the stent. All devices were successfully withdrawn as a unit. The use of a balloon to retrieve a prematurely deployed balloon mounted stent is a potential rescue option if leaving the stent in situ carries risks.
文摘Background: Chatbots are easy to use and simulate a human conversation through text or voice via smartphones or computers. In the field of health, chatbots can improve patient information, monitoring, or treatment adherence. Method: The objective of this article is to describe how a chatbot dedicated to disease monitoring and support of patients can interact with them and how data are exploited to be safe. Results: Wefight designed a chatbot named Vik to empower patients with cancers or chronic diseases and their relatives via personalized text messages. Natural Language Processing models were used. We built several Vik for each disease. Each Vik has its contents, its own NLP model and interacts its way with the patient. Conclusion: Conversational agents may help patients with minor health concerns without seeing a real physician. If the quality of these softwares is not thoroughly assessed, they could be dangerous. If chatbots are effective and safe, they could be prescribed like a drug to improve patient information, monitoring, or treatment adherence.
基金supported by the National Natural Science Foundation of China,No.81873317(to XJC),No.81704096(to MY),No.81603635(to JY)a grant from the Municipal Science and Technology Commission of Shanghai-TCM Key Project in China,No.16401970100(to YJW)+1 种基金a grant from the Shanghai TCM Medical Center of Chronic Disease in China,No.2017ZZ01010(to YJW)the National Thirteenth Five-Year Science and Technology Major Special Project for New Drug Innovation and Development in China,No.2017ZX09304001(to YJW)
文摘Objective:To critically assess the neurological recovery and antioxidant effects of resveratrol in rat models of spinal cord injury.Data sources:Using“spinal cord injury”,“resveratrol”and“animal experiment”as the main search terms,all studies on the treatment of spinal cord injury in rats by resveratrol were searched for in PubMed,EMBASE,MEDLINE,Web of Science,Science Direct,China National Knowledge Infrastructure,Wanfang,VIP,and SinoMed databases by computer.The search was conducted from their inception date to April 2017.No language restriction was used in the literature search.Data selection:The methodological quality of each study was assessed by the initial Stroke Therapy Academic Industry Roundtable recommendations.Two reviewers independently selected studies according to the title,abstract and full text.The risk of bias in the included studies was also evaluated.Meta-analyses were performed with Review Manager 5.3 software.Outcome measures:Neurological function was assessed by the Basso,Beattie,and Bresnahan scale score,inclined plane score and Gale’s motor function score.Molecular-biological analysis of antioxidative effects was conducted to determine superoxide dismutase levels,malondialdehyde levels,nitric oxide synthase activity,nitric oxide levels,xanthine oxidase and glutathione levels in spinal cord tissues.Results:The methodological quality of the 12 included studies was poor.The results of meta-analysis showed that compared with the control group,resveratrol significantly increased the Basso,Beattie,and Bresnahan scale scores after spinal cord injury(n=300,mean difference(MD)=3.85,95%confidence interval(CI)[2.10,5.59],P<0.0001).Compared with the control group,superoxide dismutase levels were significantly elevated(n=138,standardized mean difference(SMD)=5.22,95%CI[2.98,7.45],P<0.00001),but malondialdehyde levels were significantly diminished(n=84,SMD=–3.64,95%CI[–5.84,–1.43],P=0.001)in the spinal cord of the resveratrol treatment group.Conclusions:Resveratrol promoted neurological recovery and exerted antioxidative effects in rat models of spinal cord injury.The limited quality of the included studies reduces the application of this meta-analysis.Therefore,more high-quality studies are needed to provide more rigorous and objective evidence for the pre-clinical treatment of spinal cord injury.
基金National Natural Science Foundation of China(NSFC)(81973876,81673991 to BS,81730107 to YJW and 81603643 to YJZ)The National Key R&D Program of China(2018YFC1704302 to YJW)+3 种基金The Program for Innovative Research Team in University,Ministry of Education of China(IRT1270 to YJW)The Program for Innovative Research Team,Ministry of Science and Technology of China(2015RA4002 to YJW)The Three Years Action to Accelerate the Development of Traditional Chinese Medicine Plan(ZY(2018-2020)-CCCX-3003 to YJW)National Natural Science Foundation of China(NSFC)(81672227)and a Frontier Science of CAS grant(QYZDB-SSW-JSC030)to HP.National Natural Science Foundation of China(NSFC)(81991513)to GX.
文摘Axinl is a negative regulator of β-catenin signaling and its role in osteoblast precursor cells remains undefined.In the present studies,we determined changes in postnatal bone growth by deletion of Axinl in osteoblast precursor cells and analyzed bone growth in newborn and postnatal Axin1 O5X mice and found that hypertrophic cartilage area was largely expanded in AxinlOSX KO mice.A larger number of chondrocytes and unabsorbed cartilage matrix were found in the bone marrow cavity of Axin1OSX KO mice.Osteoclast formation in metaphyseal and subchondral bone areas was significantly decreased,demonstrated by decreased TRAPpositive cell numbers,associated with reduction of MMP9-and cathepsin K-positive cell numbers in Axin1 O5X KO mice.OPG expression and the ratio of O p g to Rankl were significantly increased in osteoblasts of Axinl O5X KO mice.Osteoclast formation in primary bone marrow derived microphage(BMM)cells was significantly decreased when BMM cells were cultured with conditioned media(CM)collected from osteoblasts derived from Axin1OSX mice compared with BMM cells cultured with CM derived from WT mice.Thus,the loss of Axinl in osteoblast precursor cells caused increased OPG and the decrease in osteoclast formation,leading to delayed bone growth in postnatal Axin1°sx KO mice.
文摘Lumbar spinal stenosis (LSS) causes ischemia, inflammation, demyelination and results in cauda equina (CE) syndrome, with pain and locomotor functional deficits. We investigated whether exogenous administration of S-nitrosoglutathione (GSNO), an endogenous redox modulating anti-neuroinflammatory agent, hastens functional recovery in a CE compression (CEC) rat model. CEC was induced in adult female rats by the surgical implantation of two silicone blocks within the epidural spaces of L4-L6 vertebrae. GSNO (50 μg/kg body weight) was administered by gavage 1 h after the injury, and the treatment was continued daily thereafter. GSNO induced change in the pain threshold was evaluated for four days after the compression. Tissue analyses and locomotor function evaluation were carried out at two weeks and four weeks after the CEC respectively. GSNO significantly improved motor function in CEC rats as evidenced by an increased latency on rotarod compared with vehicle-treated CEC rats. CEC induced hyperalgesia was decreased by GSNO. GSNO also increased the expression of VEGF, reduced cellular infiltration (H&E staining) and apoptotic cell death (TUNEL assay), and hampered demyelination (LFB staining and g-ratio). These data demonstrate that administration of GSNO after CEC decreased inflammation, hyperalgesia and cell death leading to improved locomotor function of CEC rats. The therapeutic potential of GSNO observed in the present study with CEC rats suggests that GSNO is a candidate drug to test in LSS patients.
文摘Background: Isolated thoracolumbar vertebral transverse process fractures (TPF) are often considered a stable injury. However, the use of advanced imaging such as magnetic resonance imaging and spine specialist consultation are often ordered as part of the routine workup of these fractures. The routine ordering of advanced imaging, spine specialist consultation, and delayed mobilization causes unnecessary economic and clinical burdens to patients and the overall healthcare system. Purpose: To determine if a higher number of isolated TPFs (iTPFs) lead to an increase in ligamentous injury to the spine, and whether ligamentous injury—if present—requires surgical intervention. Methods: The retrospective review was performed from 2009 to 2015, using a surgical trauma database to identify patients with greater than 3 isolated TPF (iTPF) to determine if iTPF leads to an increase in ligamentous injury to the spine and if this increase leads to increased surgical intervention. Results: A total of 102 patients were identified with complete follow up at 6 - 8 weeks post injury. The majority of the included patients suffered from blunt trauma. There was a small rate of ligamentous injury (n = 7, 7%) that did not require additional treatment. None of the fractures included were considered unstable. None of the patients included required surgical intervention during their hospital visit or in follow up visits. Conclusion: iTPFs are a stable injury to the thoracolumbar spine. There is a small rate of associated ligamentous injury that does not change the management or require further interventions. Thoracolumbar iTPFs do not automatically need spine specialist consultation and advanced imaging techniques.
文摘Hippocrates (460-377 BC) first described stroke over 2400 years ago. Stroke is the 4th leading cause of death in Canada (3rd in the USA) and the primary cause of permanent motor and cognitive disability. The majority of strokes are ischemic. The extent of cerebral dysfunction and thus the severity of stroke are based on the location, severity and duration of ischemia. Stroke management and prognosis encompass early recognition of the onset of stroke and post-stroke determination of the extent of brain injury aided by clinical stroke scores and diffusion-weighted imaging. Cognitive domains most likely to be affected following stroke are memory, orientation, language, attention and executive function. While the vast majority of functional recovery occurs within the first 3 months post-stroke, the neural mechanisms promoting recovery are not well understood. Investigations into the neural plasticity of brain areas after a lesion demonstrate that the adult brain can be shaped by environmental inputs, such as rehabilitation techniques. Many rehabilitation techniques are actively being pursued, including brain-computer interfaces providing sophisticated methods for detecting rehabilitation-associated changes in cerebral physiology. The success of such strategies visualized with functional magnetic resonance imaging and positron emission tomography may provide an objective complement to clinical evaluations.
文摘Previous studies examining coherence and connectivity deviations in schizophrenia patients relied on standard coherence measures between recording sites (at the sensor level). A coherence source imaging (CSI) methodology where coherence is assessed within imaged brain structures (at the source level) was developed recently by our group and applied successfully for detecting coherent areas in the cortical networks of patients with epilepsy. We applied this Magnetoencephalography (MEG)-CSI technique to measure normal and pathological patterns of brain oscillations (biomarkers) in normal subjects and patients diagnosed with schizophrenia. Twelve patients diagnosed with schizophrenia and twelve healthy control subjects were studied. A ten-minute resting state MEG brain scan was performed with eyes open. MEG-CSI analysis was performed to identify the cortical areas that interacted strongly within the 3 - 50 Hz frequency range. Statistically significant increased regions of coherence were detected in schizophrenia patients compared to controls in the right inferior frontal gyrus (BA 47—pars orbitalis), left superior frontal gyrus (BA9— dorsolateral prefrontal cortex), right middle frontal gyrus (BA 10—anterior prefrontal cortex & BA 46—dorsolateral prefrontal cortex), and right cingulate gyrus (BA 24—ventral anterior cingulate cortex). These areas are involved in language, memory, decision making, empathy, executive and, higher cognitive functioning. We conclude that MEG-CSI can detect imaging biomarkers from resting state brain activity in schizophrenia patients that deviates from normal control subjects in several behaviorally salient brain regions. Analysis with MEG-CSI can provide biomarkers of abnormalities in the resting-state. The findings and procedures described can be used to probe the pathophysiology of schizophrenia and possibly detect subtypes.
基金sponsored by the National Natural Science Foundation (81822050,81920108032)Young Qihuang Scholar of State Administration of Traditional Chinese Medicine of Qianqian Liang,Innovation Team Project of the Scientific Research Project of Traditional Chinese Medicine of Shanghai Health Committee (2022CX001)+2 种基金Shanghai Hospital Chinese Medicine Preparation Industry Transformation Synergy Innovation Center of Qianqian Liang,Program for Innovative Research Team of Ministry of Science and Technology of China (2015RA4002),“Innovation Team”Development Projects (IRT1270)Shanghai TCM Medical Center of Chronic Disease (2022ZZ01009)Jing’an District Health Research Project of Shanghai (2022MS03).
文摘Objective:Rheumatoid arthritis(RA)is a common autoimmune disease characterized by multiple joint lesions and systemic complications.Danggui Niantong decoction(DGNTT)has been clinically used for RA treatment;however,its beneficial effect on cardiopulmonary complications has not been reported.Methods:Female tumor necrosis factor-transgenic(TNF-Tg)mice were used to evaluate the therapeutic effects of DGNTT on arthritis and cardiopulmonary complications.Methotrexate(MTX)served as a positive control.Histopathological assessment of the joint sections was performed using hematoxylin and eosin(HE),Alcian Blue/Orange G,and tartrate-resistant acid phosphatase staining.Bone mass was assessed by micro-computed tomography,inflammatory infiltrates in the heart and lungs were evaluated by HE staining,cardiopulmonary fibrotic injury was identified by Masson’s trichrome staining,and hypertrophy of mouse cardiomyocytes was measured by wheat germ agglutinin(WGA)staining.Results:DGNTT mitigated the inflammation of the ankle joint synovium,decreased the number of osteoclasts,and increased the area of cartilage and bone mass in TNF-Tg mice.In addition,DGNTT decreased the infiltration of inflammatory cells into the lung and heart tissues,accompanied by a reduction in cardiopulmonary fibrosis and myocardial cell hypertrophy in TNF-Tg mice.As a positive control drug,MTX attenuated the pathological changes in joints,but had no beneficial effect on cardiopulmonary inflammation and fibrosis in TNF-Tg mice.Conclusions:DGNTT improved joint lesions and alleviated cardiopulmonary complications in TNF-Tg mice.
基金supported by the National Innovation and Entrepreneurship Training Program for College Students(202310268058)Exploration of the Mechanism on Therapeutic Efficacy of Gulong Capsules in Treatment of Osteoarthritis from the Perspective of Multi-omics(E4-H23066).
文摘Co-inhibitory receptors serve as crucial regulators of T-cell function,playing a pivotal role in modulating the delicate balance between immune tolerance and autoimmunity.Initially identified in autoimmune disease models,co-inhibitory receptors,including CTLA-4,PD-1,TIM-3,and TIGIT,were found to be integral to immune regulation.Their blockade or absence in these models resulted in the induction or exacerbation of autoimmune diseases.Additionally,scholars have observed that co-inhibitory receptors on lymphocytes hold the potential to influence the prognosis in the context of chronic inflammation.Consequently,the blocking of co-suppressor receptors has emerged as a novel therapeutic approach for inhibiting refractory inflammatory diseases,particularly rheumatoid arthritis.From the standpoint of traditional Chinese medicine(TCM),the treatment of rheumatoid arthritis based on the“strengthening body resistance(FúZhèng)”theory can be construed as the regulation of co-suppressor receptors to modulate the body’s immune function in combating chronic inflammation.This article provides a succinct overview of the role of co-suppressor receptors in anti-inflammatory processes and explores the research prospects of co-suppressor receptor intervention in the treatment of rheumatoid arthritis.The exploration integrates the“strengthening body resistance(FúZhèng)”theory with relevant Chinese medicine formulations.
基金supported by the National Key Research and Development Project,No.2019YFA0112100(to SF).
文摘Traumatic spinal cord injury is potentially catastrophic and can lead to permanent disability or even death.China has the largest population of patients with traumatic spinal cord injury.Previous studies of traumatic spinal cord injury in China have mostly been regional in scope;national-level studies have been rare.To the best of our knowledge,no national-level study of treatment status and economic burden has been performed.This retrospective study aimed to examine the epidemiological and clinical features,treatment status,and economic burden of traumatic spinal cord injury in China at the national level.We included 13,465 traumatic spinal cord injury patients who were injured between January 2013 and December 2018 and treated in 30 hospitals in 11 provinces/municipalities representing all geographical divisions of China.Patient epidemiological and clinical features,treatment status,and total and daily costs were recorded.Trends in the percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department and cost of care were assessed by annual percentage change using the Joinpoint Regression Program.The percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department did not significantly change overall(annual percentage change,-0.5%and 2.1%,respectively).A total of 10,053(74.7%)patients underwent surgery.Only 2.8%of patients who underwent surgery did so within 24 hours of injury.A total of 2005(14.9%)patients were treated with high-dose(≥500 mg)methylprednisolone sodium succinate/methylprednisolone(MPSS/MP);615(4.6%)received it within 8 hours.The total cost for acute traumatic spinal cord injury decreased over the study period(-4.7%),while daily cost did not significantly change(1.0%increase).Our findings indicate that public health initiatives should aim at improving hospitals’ability to complete early surgery within 24 hours,which is associated with improved sensorimotor recovery,increasing the awareness rate of clinical guidelines related to high-dose MPSS/MP to reduce the use of the treatment with insufficient evidence.
基金funding from the program Investissements d'avenir ANR-10-IAIHU-06
文摘1.The complex spectrum of neurodegenerative diseases Epidemiologic data indicate that neurodegenerative diseases(NDDs)show high prevalence with a trend of a progressively growing incidence,especially in aging societies.This presents an increasing social and economic burden.
基金Supported by National Natural Science Foundation of China(Nos.81920108032,81822050)State Administration of Traditional Chinese Medicine Young Qi Huang Scholar,Shanghai Science and Technology Innovation Action Plan Medical Innovation Research Project(No.21Y11921400)+4 种基金Innovation Team Project of Scientific Research Project of Traditional Chinese Medicine of Shanghai Health Committee(No.2022CX001)the Program for Innovative Research Team of Ministry of Science and Technology of China(No.2015RA4002)"Innovation Team"Development Projects(No.IRT1270)Shanghai TCM Medical Center of Chronic Disease(No.2022ZZ01009)Shandong Provincial Natural Science Foundation(Nos.ZR2022LZY002 and ZR2021QH230)。
文摘Objective:To explore the efficacy and safety of Juan Bi Pill(JBP)in treatment of active rheumatoid arthritis(RA).Methods:From February 2017 to May 2018,115 participants from 4 centers were randomly divided into JBP group(57 cases)and placebo group(58 cases)in a 1:1 ratio using a random number table method.Participants received a dose of JBP(4 g,twice a day,orally)combined with methotrexate(MTX,10 mg per week)or placebo(4 g,twice a day,orally)combined with MTX for 12 weeks.Participants were required with follow-up visits at 24 and 48 weeks,attending 7 assessment visits.Participants were undergo disease activity assessment 7 times(at baseline and 2,4,8,12,24,48 weeks)and safety assessments 6 times(at baseline and 4,8,12,24,48 weeks).The primary endpoint was 28-joint Disease Activity Score(DAS28-ESR and DAS28-CRP).The secondary endpoints included American College of Rheumatology(ACR)criteria for 20%and 50%improvement(ACR20/50),Health Assessment Questionnaire Disability Index(HAQ-DI),clinical disease activity index(CDAI),visual analog scale(VAS),Short Form-36(SF-36)score,Medial Outcomes Study(MOS)sleep scale score,serum erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),tender joint count,swollen joint count,and morning stiffness.The adverse reactions were observed during the treatment.Results:After 12 weeks of treatment,DAS28-ESR and DAS28-CRP scores in both groups were lower than before treatment(both P<0.01),while the remission rate of DAS28-ESR and DAS28-CRP and low disease activity of JBP group were higher than those in the placebo group(both P<0.01).JBP demonstrated better efficacy on ACR20 and ACR50 compliance rate at 12 and 48 weeks comparing to placebo(all P<0.05).The CDAI and HAQ-DI score,pain VAS and global VAS change of RA patients and physicians,the serum ESR and CRP levels,and the number of tenderness and swelling joints were lower than before treatment at 4,8,12,24,48 weeks in both groups(P<0.05 or P<0.01),while the reduction of above indices in the JBP group was more obvious than those in the placebo group at 12 weeks(ESR and CRP,both P<0.05)or at 12 and 48 weeks(all P<0.01).There was no difference in adverse reactions between the 2 groups during treatment(P=0.75).Conclusion:JBP combined with MTX could effectively reduce disease activity in patients with RA in active stage,reduce the symptoms of arthritis,and improve the quality of life,while ensuring safety,reliability,and fewer adverse effects.(Trial registration:Clinical Trials.gov,No.NCT02885597)。
