Clinical efficacy of low-intensity pulsed ultrasound in Parkinson's disease with cognitive impairment.

OBJECTIVE: Low-intensity pulsed ultrasound (LIPUS), is a new technique for invasive brain stimulation and modulation that has emerged recently, but the effects in Parkinson's disease with cognitive impairment (PD-CI) have been less observed. In this study, we collected 56 patients with PD-CI who were continuously treated with LIPUS for 8 weeks, and observed the clinical efficacy of LIPUS on PD-CI patients by comparing with the Sham stimulation continuous treatment. METHODS: Fifty-six PD-CI patients were divided into the Sham group (given Sham stimulation on top of conventional medication, n = 28) and the LIPUS group (given LIPUS stimulation on top of conventional medication, n = 28), and both groups continued treatment for 8 weeks. Post-treatment efficacy and pre- and post-treatment cognitive function [Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA)], emotional state [Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI)], quality of life [Unified Parkinson's Disease Rating Scale (UPDRS), 39-item Parkinson's Disease Questionnaire (PDQ-39)], and serologic indices [5-hydroxytryptamine (5-HT), norepinephrine (NE), and dopamine (DA)] were compared. RESULTS: The total effective rate of the LIPUS group was higher versus that of the Sham group. In both groups, MMSE and MoCA scores increased; BDI and BAI scores decreased; UPDRS and PDQ-39 scores were reduced; the levels of 5-HT, NE, and DA were elevated. The above changes were more pronounced in the LIPUS group (all P < 0.05). CONCLUSION: The application of LIPUS on PD-CI could ameliorate patients' cognitive function, emotional state and quality of life, and regulate and optimize neurotransmitter expression levels.

Short sleep duration is associated with worse quality of life in Parkinson's disease: A multicenter cross-sectional study.

OBJECTIVE: To characterize sleep duration and investigate its association with quality of life among Parkinson's Disease (PD) patients. METHODS: In this multicenter cross-sectional study, 970 PD patients were divided into five groups based on self-reported sleep duration: <5, ≥5 to <6, ≥6 to <7, ≥7 to ≤8, and >8 h. The quality of life was evaluated using the 39-Item Parkinson's Disease Questionnaire (PDQ-39). Multivariable linear regression analysis, subgroup analysis, and mediation analysis were conducted to examine the association between sleep duration and quality of life. RESULTS: In multivariable linear regression model, patients with sleep duration (<5 h) had significantly higher PDQ-39 scores (ß = 8.132, 95 % CI: 3.99 to 12.266), especially in mobility, activities of daily living, emotional well-being, stigma, social support, cognition, communication, and bodily discomfort (p < 0.05). The association between sleep duration (<5 h) and worse quality of life was more pronounced in patients with higher HY stage, longer disease duration, and sleep disorders. Moreover, a significant indirect effect of sleep duration (<5 h) on quality of life was observed, with UPDRS I, UPDRS II, and UPDRS IV scores acting as mediators. CONCLUSIONS: Short sleep duration (<5 h) is associated with worse quality of life among PD patients. This association was stronger among patients with advanced PD and sleep disorders, while non-motor symptoms and motor complications were identified as significant mediators in this association. These findings highlight the significance of adequate sleep duration and suitable interventions for sleep may help improve quality of life.

The Relationship Between Serum Netrin-1 Expression Levels and Prognosis in Revascularized Patients with Acute Ischemic Stroke.

BACKGROUND: This study aimed to explore the relationship between serum netrin-1 expression levels and acute prognosis in patients with acute ischemic stroke (AIS) within 24 hours after revascularization. METHODS: A total of 121 revascularized patients admitted to the Jinshan Branch of the Shanghai Sixth People's Hospital, China, between July 2019 and July 2021 were selected as study subjects. The primary outcome was the modified Rankin Scale (mRS) score three months after revascularization: patients with an mRS score >2 were classified into the unfavorable prognosis group and others into the favorable prognosis group. Those with serum netrin-1 expression levels greater than the median of all patients were classified into the elevated protein group and others into the decreased protein group. Multivariate logistic regression analysis was used to analyze the independent risk factors for prognosis in patients with AIS after revascularization. RESULTS: The differences between the unfavorable prognosis group and the favorable prognosis group in gender, age, coronary heart disease, and netrin-1 levels were not statistically significant (p > 0.05). However, the National Institute of Health Stroke Scale (NIHSS) scores and number of patients with comorbid hypertension in the unfavorable prognosis group were significantly higher than in the favorable prognosis group (p < 0.05). Multivariate logistic regression analysis showed that NIHSS score before revascularization was an independent risk factor for unfavorable prognosis but that netrin-1 expression levels were not significantly associated with prognosis in patients after revascularization. CONCLUSIONS: Serum netrin-1 expression levels in the acute phase are not significantly associated with prognosis in patients with AIS after revascularization.

A series of naphthalenediimide-based metal-organic frameworks: synthesis, photochromism and inkless and erasable printing.

Three new three-dimensional metal-organic frameworks were synthesized based on a naphthalenediimide derivative ligand, all of which exhibit photochromic behaviour due to the presence of the naphthalenediimide core. Interestingly, two of them possess significant colour changes under light, excellent stability, and appropriate photochromic lifetimes, thus showing potential for application in inkless and erasable printing media.

Identification of Novel Biomarkers in Platelets for Diagnosing Parkinson's Disease.

BACKGROUND: Parkinson's disease (PD) is a common neurodegenerative disease affecting the elderly, but there is no blood test for PD diagnosis in the clinic currently. This study aimed to explore promising biomarkers in platelets (PLTs) for PD diagnosis. METHODS: PLTs were isolated from whole blood samples of PD patients and healthy controls (HCs), and RNA was extracted for sequencing. RNA-seq was performed on the Illumina HiSeq platform. RESULTS: A total of 2,221 genes with differential transcript levels (GDTLs) were identified between PD patients and HCs, 1,041 of which are upregulated genes and 1,180 of which are downregulated genes. WASH5P was the most upregulated gene and AC114491.1 was the most downregulated gene. Among the top 12 most relevant genes, metastasis-associated lung adenocarcinoma transcript 1 (MALAT1), eukaryotic elongation factor 1A (EEF1A1), and cathepsin S (CTSS) were reported to be associated with PD. Furthermore, gene ontology analysis showed that the most significant term in biological processes was neutrophil degranulation; the most enriched term in cellular components was cytoplasmic vesicle lumen; and tumor necrosis factor receptor superfamily binding was the most significant term in molecular functions. In the Kyoto Encyclopedia of Genes and Genomes enrichment analysis, inflammation-related pathway accounts for the majority. CONCLUSION: Our findings demonstrated WASH5P, MALAT1, EEF1A1, and CTSS may be promising biomarkers in PD, which may contribute to improving the effectiveness and accuracy of diagnosis for PD in the future.

Phosphodiesterase-4D Knockdown in the Prefrontal Cortex Alleviates Memory Deficits and Synaptic Failure in Mouse Model of Alzheimer's Disease.

Phosphodiesterase 4 (PDE4)-dependent cAMP signaling plays a crucial role in cognitive impairment associated with Alzheimer's disease (AD). However, whether inhibition of PDE4 subtypes or their splice variants in the prefrontal cortex positively regulates synaptic plasticity and antioxidative stress, and reverses ß-amyloid 1-42 (Aß1-42, Aß42)-induced cognitive impairment still need to be clarified. The present study determined whether and how PDE4D knockdown by microinjection of lenti-PDE4D-miRNA into the prefrontal cortex reversed Aß1-42-induced cognitive impairment in behavioral, neurochemical, and molecular biology assays. The results suggested that PDE4D knockdown increased time to explore the novel object and decreased latency to leave the platform in novel object recognition and step-down passive avoidance tests. Further study suggested that PDE4D knockdown decreased the number of working memory errors in the eight-arm maze test. These effects were prevented by PKA inhibitor H89. The subsequent experiment suggested that inhibition of PDE4D in the prefrontal cortex rescued the long-term potentiation (LTP) and synaptic proteins' expression; it also increased antioxidant response by increasing superoxide dismutase (SOD) and decreasing malondialdehyde (MDA) levels. PDE4D knockdown also increased phosphorylated cAMP response element-binding protein (pCREB), brain-derived neurotrophic factor (BNDF), and anti-apoptotic proteins' expression, i.e., the ratio of Bcl-2/Bax, and decreased caspase-3 level in the prefrontal cortex. These findings extend the previous findings and support the hypothesis that RNA interference-mediated PDE4D knockdown in the prefrontal cortex ameliorated memory loss associated with synaptic failure in an AD mouse model by its antioxidant, anti-apoptotic, and neuroprotective properties.

Personalized risk prediction of symptomatic intracerebral hemorrhage after stroke thrombolysis using a machine-learning model.

BACKGROUND: Personalized prediction of the risk of symptomatic intracerebral hemorrhage (sICH) after stroke thrombolysis is clinically useful. Machine-learning-based modeling may provide the personalized prediction of the risk of sICH after stroke thrombolysis. METHODS: We identified 2578 thrombolysis-treated ischemic stroke patients between January 2013 and December 2016 from a multicenter database, where 70% were used to train models and the remaining 30% were used as the nominal test sets. Another 136 consecutive tissue plasminogen-activated-treated patients between January 2017 and December 2017 from our institute were enrolled as the independent test sets for clinical usability evaluation. Five machine-learning models were developed to predict the risk of sICH after stroke thrombolysis, and the receiving operating characteristic (ROC) was used to compare the prediction performance. RESULTS: In total, 2237 cases were included in our study, of which 102 had sICH transformation (4.56%). Finally, the three-layer neuro network was selected with the best performance on nominal test sets (AUC = 0.82). The probability of the model score was further categorized into three risk ranks (18.97%, 5.63%, and 0.81%) according to the risk distribution. Implementing our system in clinical practice was associated with reduced computed tomography (CT)-to-treatment time (CTT; 41 min versus 52 min, p < 0.001). All sICH patients were correctly predicted to be within the high-sICH risk rank. CONCLUSIONS: The machine-learning-based modeling is feasible for providing personalized risk prediction of sICH after stroke thrombolysis, and is able to reduce the CTT. More data are needed to further optimize the model and improve the accuracy of prediction.

Gastric fundus splenosis with hemangioma masquerading as a gastrointestinal stromal tumor in a patient with schistosomiasis and cirrhosis who underwent splenectomy: A case report and literature review.

RATIONALE: Splenosis is the heterotopic auto-transplantation of the splenic tissues. Gastric splenosis in a rare location mimics a gastrointestinal stromal tumor (GIST). Gastric splenosis with hemangioma has not been reported throughout the literature. PATIENT CONCERNS: We report a case of a 74-year-old schistosomiasis cirrhosis splenectomy woman diagnosed with gastric fundus mass. Preoperative computed tomography and endoscopic ultrasonography revealed findings suggestive of a GIST. DIAGNOSES: The mass located in the gastric fundus muscularis propria, measuring 3.9 × 2.8 × 2.4 cm with a dark red color, was removed by surgery. In the mass, a 1 × 1-cm red-purple nodule was also found. On microscopic examination, a well-formed splenic tissue divided into two compartments-white pulp and red pulp-separated by an ill-defined interphase known as the marginal zone. However, a nodule in the heterotopic spleen was mainly composed of larger thin-walled muscular vessels. The final diagnosis was gastric splenosis with hemangioma. INTERVENTIONS: After discussion in a multidisciplinary conference, the patient was considered for a GIST resection under gastroscopy. In the process of peeling, the surface of the mucosal, submucosal, muscle layers and the tumor surface were diffusely oozing. The effect of electrocoagulation and hemostasis was extremely poor. Therefore, endoscopic surgery was arrested. After dealing with the patient's family, a combination of laparoscopic-gastroscope double-mirror surgery was decided in accordance with the principle of minimally invasive surgery to preserve the stomach. Owing to several adhesions and concealed the location of tumor, we stopped the double-mirror combination surgery plan. Considering the great possibility of a malignant GIST, we still decided to continue the traditional surgical resection. The tumor was then removed via surgery OUTCOMES:: The patient was favorable with healing and discharged on postoperative day 10. LESSONS: Gastric splenosis with an associated hemangioma is the first well-documented case. Its pathogenesis may be direct implantation. Appropriate medical history taking and Tc-99 m heat-denatured RBC spleen scintigraphy (Tc-99MHDRS) are valuable for its diagnosis; however, pathology is the gold standard. Surgery is a reasonable treatment for gastric splenosis with hemangioma.

An Optimization Routing Algorithm for Green Communication in Underground Mines.

With the long-term dependence of humans on ore-based energy, underground mines are utilized around the world, and underground mining is often dangerous. Therefore, many underground mines have established networks that manage and acquire information from sensor nodes deployed on miners and in other places. Since the power supplies of many mobile sensor nodes are batteries, green communication is an effective approach of reducing the energy consumption of a network and extending its longevity. To reduce the energy consumption of networks, all factors that negatively influence the lifetime should be considered. The degree constraint minimum spanning tree (DCMST) is introduced in this study to consider all the heterogeneous factors and assign weights for the next step of the evaluation. Then, a genetic algorithm (GA) is introduced to cluster sensor nodes in the network and balance energy consumption according to several heterogeneous factors and routing paths from DCMST. Based on a comparison of the simulation results, the optimization routing algorithm proposed in this study for use in green communication in underground mines can effectively reduce the network energy consumption and extend the lifetimes of networks.

Interaction between alcohol consumption and CYP 2C19 gene polymorphism in relation to oesophageal squamous cell carcinoma.

OBJECTIVES: The purpose of this study is to explore the relationship between the interactions of CYP2C19 gene polymorphisms and several environmental factors and oesophageal squamous cell carcinoma (OSCC). METHODS: In a case-control study of OSCC patients (n = 350) and healthy controls (n = 350), we investigated the roles of polymorphism in the CYP2C19 gene by the use of polymerase chain reaction--restriction fragment length polymorphism (PCR - RFLP) analysis. RESULTS: The CYP2C19(*)3 AG+AA genotype was significantly more prevalent in OSCC patients (10.0% versus 3.43%; P<0.01). Multiple logistic regression analysis showed drinking (OR: 5.603, 95% CI: 3.431-11.112; P = 0.005) and smoking (OR: 4.341, 95% CI: 3.425-10.241; P = 0.001) was the independent risk factor of OSCC respectively, and there were significant interaction between CYP2C19(*)3 and drinking (OR: 8.747, 95% CI: 6.321-18.122; P = 0.009). CONCLUSIONS: The CYP2C19(*)3 polymorphism and OSCC were synergistically and significantly associated in Chinese Han patients.

Regulation of inflammatory mediators in lipopolysaccharide-stimulated RAW 264.7 cells by 2''-hydroxy-3''-en-anhydroicaritin involves down-regulation of NF-kappaB and MAPK expression.

2''-hydroxy-3''-en-anhydroicaritin, a flavone, was isolated from the Chinese medicinal herb Epimedium brevicornum for the first time. In our previous study, we have carried out a screening program to identify the anti-inflammatory potentials of 2''-hydroxy-3''-en-anhydroicaritin. In the present study, we further found that this compound regulated lipopolysaccharide (LPS)-induced levels of nitric oxide (NO), and prostaglandin E(2) (PGE(2)) (**p<0.01 or *p<0.05), and reduced levels of iNOS and COX-2 in RAW 264.7 macrophages in a concentration-dependent manner. We further investigated signal transduction mechanisms to determine how 2''-hydroxy-3''-en-anhydroicaritin affects RAW264.7 macrophages pretreated with 0.5, 2.5, or 12.5mg/L of 2''-hydroxy-3''-en-anhydroicaritin 1h prior to treatment with 1mg/L of LPS. Thirty minutes later, cells were harvested and mitogen-activated protein kinases (MAPK) activation and I kappaB alpha were measured by western blotting. Alternatively, the macrophages were fixed and nuclear factor-kappaB (NF-kappaB) activation was measured by immunocytochemical analysis. Signal transduction studies showed that the flavone significantly inhibited extracellular signal-regulated kinase (ERK), p38, and c-jun NH2-terminal kinase (JNK) phosphorylation protein expression. The flavone also inhibited p65-NF-kappaB translocation into the nucleus by I kappaB alpha degradation. Therefore, 2''-hydroxy-3''-en-anhydroicaritin may inhibit LPS-induced production of inflammatory cytokines by blocking NF-kappaB and MAPK signaling in RAW264.7 cells.

Isolation of two new prenylflavonols from Epimedium brevicornum and their effects on cytokine production in vitro.

In an attempt to search for bioactive natural products, two new prenylflavonols, 2''-hydroxy-3''-en-anhydroicaritin (1) and 2''-hydroxy-beta-anhydroicaritin (2), were isolated from the Chinese medicinal herb Epimedium brevicornum. Their structures were determined by 1D and 2D NMR spectroscopic analysis. The effects of compounds 1 and 2 on cytokine production in vitro were investigated. Compound 1 could significantly downregulate tumor necrosis factor-alpha (TNF-alpha) production and increase interleukin-10 (IL-10) production. These results suggested that compound 1 may have anti-inflammatory activity in lipopolysaccharide (LPS)-stimulated mouse macrophages. In addition, the biogenetic relationships among compounds 1 and 2 are discussed.