Acceptability and practicability of self-management for patients with Parkinson's disease based on smartphone applications in China.

BACKGROUND: China has had about 1.2 billion mobile-phone users, and this number continues to grow. However, mobile-health services (mHealth) are currently in the initial stage, and have not yet prevailed in China. Additionally, the prevalence of Parkinson's disease (PD) in China is 1700/100,000 (≥65 years). Indeed, these PD patients would benefit from mHealth to manage their disease. Therefore, we designed a study to determine attitudes toward smartphone applications (apps) for chronic condition self-management, and to discover the practicality of these apps among PD patients in China. METHODS: We selected 204 participants with PD between 52 and 87 years old and surveyed their attitudes concerning the use of smartphone apps for chronic condition management via questionnaires. RESULTS: Among the participants, 65.19% had smartphones. Among these smartphone users, 82.84% expressed a preference for using apps for PD management. This group tended to be younger and more frequent web users with higher education and better medication compliance, and they tended to have a longer PD course and worse conditions (P < 0.001, P = 0.001, P < 0.001, P = 0.041, P < 0.001, P = 0.013). Additionally, the willingness to apply apps for PD self-management was positively related to education (P < 0.001) and negatively related to age and PD course (P = 0.017, P < 0.001). CONCLUSION: In China, patients with PD have a generally positive attitude towards self-management through smartphone apps. Consequently, improving the coverage of smartphones with practical and handy apps is a promising strategy for PD self-management.

Calcium-calmodulin-dependent protein kinase type 2 induces apoptosis of hepatocytes after liver transplantation.

OBJECTIVE: The warm ischemia-reperfusion injury confines the prevalence of allografts. To improve the success rate of allotransplantation, we designed experiments to study the mechanism of calcium-calmodulin-dependent protein kinase type 2 (CaMK II) in ischemia-reperfusion (I/R) injury. MATERIALS AND METHODS: We established the I/R model in SD rats and performed the liver transplantation (LT). As a result, the expression of CaMK II in tissues was detected. CaMK II was interfered with and overexpressed by the transference of the lentivirus vector, and the hepatocyte apoptosis and viability were inspected. At the same time, the content of cytochrome c and apoptosis-inducing factor (AIF) were determined. The measurement of mitochondrial membrane potential and detection of intercellular calcium levels were performed. RESULTS: The expression of CaMK II significantly increased and is highly corresponded with the duration of warm ischemia. In BRL-3A cells and liver tissues, increased cellular apoptosis and less viability had been observed in the CaMK II overexpression group. Cytochrome c and AIF were also largely increased compared to the interfered group. Moreover, apparent mitochondrial membrane potential loss has also been detected in the CaMK II overexpression group. CONCLUSIONS: It suggested that CaMK II induces cell apoptosis. Our findings may give a novel indication that inhibition of CaMK II could be a new way for the therapy of warm ischemia-reperfusion injury after LT in future clinical practice.

Effect of different doses of dexmedetomidine on median effective concentration of propofol for anesthesia induction: a randomized controlled trial.

OBJECTIVE: Dexmedetomidine, a highly selective α2-adrenergic receptor agonist with sedative and analgesic properties, is used as an anesthetic adjunct. We determined the effects of different dexmedetomidine doses on the median effective concentration (EC50) of propofol and bispectral index (BIS) values during anesthesia induction. PATIENTS AND METHODS: This randomized, prospective, case-control clinical trial involved 120 patients (56 women; physical status, American Society of Anesthesiologists grades I or II) scheduled to undergo surgery requiring general anesthesia from July 15th, 2014 to June 15th, 2015. The patients were divided into groups of 30 and received dexmedetomidine (0.5 µg/kg, group L; 0.75 µg/kg, group M; 1 µg/kg, group H) with propofol for loss of consciousness or propofol only (control group, group C). EC50, BIS, hemodynamics, and side effects were assessed. RESULTS: The EC50 of propofol was significantly lower in the dexmedetomidine groups than in group C, and decreased with increasing dexmedetomidine dose (p < 0.05). BIS values significantly decreased after 2 min of dexmedetomidine infusion in all dexmedetomidine groups; the values at 8 and 10 min were lower in the dexmedetomidine groups than in group C. The heart rate was lower in the dexmedetomidine groups than in group C. The incidence of bradycardia at loss of consciousness increased with increasing dexmedetomidine dose. CONCLUSIONS: Dexmedetomidine significantly and dose-dependently reduced the EC50 of propofol and BIS values during anesthesia induction. A loading dexmedetomidine dose of 0.5 µg/kg significantly reduced the EC50 of propofol and BIS value, and was associated with a lower incidence of bradycardia than higher doses.

In vitro proliferation and differentiation of hepatic oval cells and their potential capacity for intrahepatic transplantation.

Hepatic oval cells (HOCs) are recognized as facultative liver progenitor cells that play a role in liver regeneration after acute liver injury. Here, we investigated the in vitro proliferation and differentiation characteristics of HOCs in order to explore their potential capacity for intrahepatic transplantation. Clusters or scattered HOCs were detected in the portal area and interlobular bile duct in the liver of rats subjected to the modified 2-acetylaminofluorene and partial hepatectomy method. Isolated HOCs were positive for c-kit and CD90 staining (99.8% and 88.8%, respectively), and negative for CD34 staining (3.6%) as shown by immunostaining and flow cytometric analysis. In addition, HOCs could be differentiated into hepatocytes and bile duct epithelial cells after leukemia inhibitory factor deprivation. A two-cuff technique was used for orthotopic liver transplantation, and HOCs were subsequently transplanted into recipients. Biochemical indicators of liver function were assessed 4 weeks after transplantation. HOC transplantation significantly prolonged the median survival time and improved the liver function of rats receiving HOCs compared to controls (P = 0.003, Student t-test). Administration of HOCs to rats also receiving liver transplantation significantly reduced acute allograft rejection compared to control liver transplant rats 3 weeks following transplantation (rejection activity index score: control = 6.3 ± 0.9; HOC = 3.5 ± 1.5; P = 0.005). These results indicate that HOCs may be useful in therapeutic liver regeneration after orthotopic liver transplantation.

In vitro proliferation and differentiation of hepatic oval cells and their potential capacity for intrahepatic transplantation

Hepatic oval cells (HOCs) are recognized as facultative liver progenitor cells that play a role in liver regeneration after acute liver injury. Here, we investigated the in vitro proliferation and differentiation characteristics of HOCs in order to explore their potential capacity for intrahepatic transplantation. Clusters or scattered HOCs were detected in the portal area and interlobular bile duct in the liver of rats subjected to the modified 2-acetylaminofluorene and partial hepatectomy method. Isolated HOCs were positive for c-kit and CD90 staining (99.8% and 88.8%, respectively), and negative for CD34 staining (3.6%) as shown by immunostaining and flow cytometric analysis. In addition, HOCs could be differentiated into hepatocytes and bile duct epithelial cells after leukemia inhibitory factor deprivation. A two-cuff technique was used for orthotopic liver transplantation, and HOCs were subsequently transplanted into recipients. Biochemical indicators of liver function were assessed 4 weeks after transplantation. HOC transplantation significantly prolonged the median survival time and improved the liver function of rats receiving HOCs compared to controls (P=0.003, Student t-test). Administration of HOCs to rats also receiving liver transplantation significantly reduced acute allograft rejection compared to control liver transplant rats 3 weeks following transplantation (rejection activity index score: control=6.3±0.9; HOC=3.5±1.5; P=0.005). These results indicate that HOCs may be useful in therapeutic liver regeneration after orthotopic liver transplantation.

An anatomical study of the recurrent laryngeal nerve: its branching patterns and relationship to the inferior thyroid artery.

The aim of this study was to provide information about the morphology and topography of the recurrent laryngeal nerve (RLN), its external features and branches, as well as its relationship to the inferior thyroid artery, the inferior horn of the thyroid cartilage and the thyroid gland. The RLNs in 50 adult cadavers (100 sides) were dissected and analyzed. A communicating loop connecting one branch of the RLN to another or a twig originating from the cervical sympathetic trunk was present in 13 of 100 sides. A double left RLN appeared in 2 sides; a right non-recurrent inferior laryngeal nerve appeared in one side. All of the RLNs, including looped ones, bifurcated into laryngeal branches and extralaryngeal branches, with most of the former further dividing into the anterior and posterior branches entering the larynx. The relations of the RLN to the inferior thyroid artery, the inferior horn of the thyroid cartilage and the thyroid gland were inconstant. The information gained from this study will be of value in thyroid surgery.