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The term "glymphatic" emerged roughly a decade ago, marking a pivotal point in neuroscience research. The glymphatic system, a glial-dependent perivascular network distributed throughout the brain, has since become a focal point of investigation. There is increasing evidence suggesting that impairment of the glymphatic system appears to be a common feature of neurodegenerative disorders, and this impairment exacerbates as disease progression. Nevertheless, the common factors contributing to glymphatic system dysfunction across most neurodegenerative disorders remain unclear. Inflammation, however, is suspected to play a pivotal role. Dysfunction of the glymphatic system can lead to a significant accumulation of protein and waste products, which can trigger inflammation. The interaction between the glymphatic system and inflammation appears to be cyclical and potentially synergistic. Yet, current research is limited, and there is a lack of comprehensive models explaining this association. In this perspective review, we propose a novel model suggesting that inflammation, impaired glymphatic function, and neurodegenerative disorders interconnected in a vicious cycle. By presenting experimental evidence from the existing literature, we aim to demonstrate that: (1) inflammation aggravates glymphatic system dysfunction, (2) the impaired glymphatic system exacerbated neurodegenerative disorders progression, (3) neurodegenerative disorders progression promotes inflammation. Finally, the implication of proposed model is discussed.
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Sistema Glinfático , Doenças Neurodegenerativas , Humanos , Encéfalo/metabolismo , Doenças Neurodegenerativas/metabolismo , Aquaporina 4 , Inflamação/metabolismoRESUMO
ZFYVE21 is an ancient, endosome-associated protein that is highly expressed in endothelial cells (ECs) but whose function(s) in vivo are undefined. Here, we identified ZFYVE21 as an essential regulator of vascular barrier function in the aging kidney. ZFYVE21 levels significantly decline in ECs in aged human and mouse kidneys. To investigate attendant effects, we generated EC-specific Zfyve21-/- reporter mice. These knockout mice developed accelerated aging phenotypes including reduced endothelial nitric oxide (ENOS) activity, failure to thrive, and kidney insufficiency. Kidneys from Zfyve21 EC-/- mice showed interstitial edema and glomerular EC injury. ZFYVE21-mediated phenotypes were not programmed developmentally as loss of ZFYVE21 in ECs during adulthood phenocopied its loss prenatally, and a nitric oxide donor normalized kidney function in adult hosts. Using live cell imaging and human kidney organ cultures, we found that in a GTPase Rab5- and protein kinase Akt-dependent manner, ZFYVE21 reduced vesicular levels of inhibitory caveolin-1 and promoted transfer of Golgi-derived ENOS to a perinuclear Rab5+ vesicular population to functionally sustain ENOS activity. Thus, our work defines a ZFYVE21- mediated trafficking mechanism sustaining ENOS activity and demonstrates the relevance of this pathway for maintaining kidney function with aging.
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Envelhecimento , Caveolina 1 , Células Endoteliais , Rim , Camundongos Knockout , Óxido Nítrico Sintase Tipo III , Óxido Nítrico , Proteínas Proto-Oncogênicas c-akt , Transdução de Sinais , Óxido Nítrico Sintase Tipo III/metabolismo , Óxido Nítrico Sintase Tipo III/genética , Animais , Humanos , Envelhecimento/metabolismo , Envelhecimento/fisiologia , Células Endoteliais/metabolismo , Proteínas Proto-Oncogênicas c-akt/metabolismo , Rim/metabolismo , Caveolina 1/metabolismo , Caveolina 1/genética , Óxido Nítrico/metabolismo , Proteínas rab5 de Ligação ao GTP/metabolismo , Proteínas rab5 de Ligação ao GTP/genética , Camundongos , Masculino , Complexo de Golgi/metabolismo , Insuficiência Renal/metabolismo , Insuficiência Renal/fisiopatologia , Insuficiência Renal/genética , Doadores de Óxido Nítrico/farmacologia , Fenótipo , Camundongos Endogâmicos C57BLRESUMO
The glymphatic system is a system of specialized perivascular spaces in the brain that facilitates removal of toxic waste solutes from the brain. Evaluation of glymphatic system function by means of magnetic resonance imaging (MRI) has thus far been largely focused on rodents because of the limitations of intrathecal delivery of gadolinium-based contrast agents to humans. This review discusses MRI methods that can be employed clinically for glymphatic-related measurements intended for early diagnosis, prevention, and the treatment of various neurological conditions. Although glymphatic system-based MRI research is in its early stages, recent studies have identified promising noninvasive MRI markers associated with glymphatic system alterations in neurological diseases. However, further optimization in data acquisition, validation, and modeling are needed to investigate the glymphatic system within the clinical setting.
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Sistema Glinfático , Imageamento por Ressonância Magnética , Sistema Glinfático/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética/métodos , Animais , Encéfalo/diagnóstico por imagemRESUMO
Cerebrospinal fluid (CSF) circulation plays a key role in cerebral waste clearance via the glymphatic system. Although CSF flow velocity is an essential component of CSF dynamics, it has not been sufficiently characterized, and particularly, in studies of the glymphatic system in rat. To investigate the relationship between the flow velocity of CSF in the brain aqueduct and the glymphatic waste clearance rate, using phase-contrast MRI we performed the first measurements of CSF velocity in rats. Phase-contrast MRI was performed using a 7 T system to map mean velocity of CSF flow in the aqueduct in rat brain. The effects of age (3 months old versus 18 months old), gender, strain (Wistar, RNU, Dark Agouti), anesthetic agents (isoflurane versus dexmedetomidine), and neurodegenerative disorder (Alzheimer' disease in Fischer TgF344-AD rats, males and females) on CSF velocity were investigated in eight independent groups of rats (12 rats per group). Our results demonstrated that quantitative velocities of CSF flow in the aqueduct averaged 5.16 ± 0.86 mm/s in healthy young adult male Wistar rats. CSF flow velocity in the aqueduct was not altered by rat gender, strain, and the employed anesthetic agents in all rats, also age in the female rats. However, aged (18 months) Wistar male rats exhibited significantly reduced the CSF flow velocity in the aqueduct (4.31 ± 1.08 mm/s). In addition, Alzheimer's disease further reduced the CSF flow velocity in the aqueduct of male and female rats.
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AIM: The aim of the study was to observe the effect of acupuncture on regulating interleukin (IL)-17, tumor necrosis factor (TNF)-É, and aquaporins (AQPs) in Sjögren's syndrome (SS) on patients and on non-obese diabetic (NOD) models. METHODS: Levels of anti-AQP 1, 5, 8, and 9 antibodies, IL-17, and TNF-É in the serum of SS patients were compared prior and following 20 acupuncture treatment visits during 8 weeks. While in murine model, five groups were divided to receive interventions for 4 weeks, including control, model, acupuncture, isoflurane, and hydroxychloroquine. The submaxillofacial gland index, histology, immunohistochemistry of AQP1, 5, salivary flow, together with IL-17, and TNF-É expression in peripheral blood were compared among the groups. RESULTS: Acupuncture reduced IL-17, TNF-É, and immunoglobin A levels, and numeric analog scale of dryness in 14 patients with SS (p < 0.05). The salivary flow was increased, and the water intake decreased in NOD mice receiving acupuncture treatments. IL-17 and TNF-É levels in peripheral serum were down-regulated (p < 0.05) and AQP1, 5 expression in the submandibular glands up-regulated in mice. CONCLUSION: The effect on relieving xerostomia with acupuncture may be achieved by up-regulating the expression of AQP1. AQP5, down-regulating levels of IL-17 and TNF-É, and a decrease in inflammation of glands.
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Terapia por Acupuntura , Síndrome de Sjogren , Humanos , Animais , Camundongos , Síndrome de Sjogren/patologia , Fator de Necrose Tumoral alfa/metabolismo , Interleucina-17/metabolismo , Camundongos Endogâmicos NOD , Glândula Submandibular/metabolismo , Modelos Animais de DoençasRESUMO
Short fiber-reinforced thermoplastic polymers (SFRTPs) are commonly used in various molding methods due to their high specific elasticity and strength. To evaluate the interfacial strength, several determination methods have been proposed, including the interfacial shear strength (IFSS). In previous research, an IFSS evaluation method based on the short beam shear method was proposed. However, this method is only applicable to micrometer-sized fibers with high stiffness levels that are not easily bent. When utilizing cellulose fiber, the interfacial shear strength (IFSS) results frequently exhibit significant deviations. To tackle this issue, we suggest an enhanced experimental technique that employs beam-shaped specimens with welding points based on the short beam shear test. Furthermore, we conducted a three-dimensional analysis of the original method to determine the fiber orientation angle and IFSS. The outcomes were compared with previously reported determinations. The IFSS achieved through the novel method proposed in this paper exhibits high precision and reliability, rendering it suitable for use with soft and flexible fibers.
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BACKGROUND: Hypomobility syndrome (HMS), or limited hip range of motion (ROM), is often reported in adolescents who train heavily. This study was aimed to investigate the impact of traditional static stretching (STR) and self-myofascial release (MFR) in adolescents with HMS hip. METHODS: This study was a randomized controlled trial. Adolescent athletes with HMS hip were grouped as 23 STR and 23 MFR. Foam rolling was employed as the training method for MFR. Both interventions were performed twice a day for 20 minutes in 6 weeks. The training was filmed and distributed via the mobile video. Self-assessed Copenhagen Hip & Groin Outcome Score, ROM, strength, and hop tests were measured before and after the interventions. The healthy side without limitations was designated as non-HMS (nHMS) and taken as reference value. RESULTS: The study participants had limitations in flexion (FLX), abduction (ABD), internal rotation (IR), and external rotation (ER). The ROM of STR group was recovered to nHMS level. The FLX and ABD of MFR group was also recovered, however the IR and ER had lower angles compared to nHMS. MFR FLX, ABD, ER strength, and single hop test were restored like that of nHMS, however STR group was substantially lower than nHMS despite the improvements. Both groups depicted lower pre-intervention Copenhagen Hip & Groin Outcome Score subscale activities daily living, sport, and physical activity compared to nHMS. Activities daily living and physical activity were improved to healthy levels after the intervention, however sport was lower than that of nHMS. CONCLUSION: Both STR and MFR had impact on hip mobility and hip self-assessment score. Furthermore, MFR had strength improvements in FLX, ABD, and ER. However, the improvements in MFR group regarding triples, crossover hops, and self-assessed sports were limited. Therefore, STR and MFR are effective in improving not only ROM but also muscle function asymmetry in HMS hip.
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Amplitude de Movimento Articular , Futebol , Humanos , Adolescente , Futebol/fisiologia , Masculino , Articulação do Quadril/fisiopatologia , Exercícios de Alongamento Muscular , Resultado do TratamentoRESUMO
The mechanical recycling of discarded plastic products as resources for environmental preservation has recently gained research attention. In this context, it is necessary to use waste materials for fiber-reinforced thermoplastics (FRTP). Glass and carbon fibers are often damaged by shear and compression during melt-forming processes. To achieve a sustainable society, it is necessary for thermal recycling to produce minimal to no residue and for mechanical recycling to maintain the length of fibers used in FRTP to preserve their performance as a reinforcing agent. Aramid fibers (AFs) do not shorten during the melt-molding process, and their composites have excellent impact strength. On the other hand, plastics reinforced with glass or carbon fibers are reported to have a superior strength and modulus of elasticity compared to aramid fibers. This study investigates the dispersion of a carbon nanofiber (CNF), a whisker, as the third component in aramid-fiber-reinforced polypropylene (PP/AF). The results and discussion sections demonstrate how the dispersion of CNF in PP/AF can enhance the mechanical properties of injection-molded products without compromising their impact resistance. The proposed composition will have excellent material recyclability and initial mechanical properties compared to glass-fiber-reinforced thermoplastics.
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In deep underground engineering, the deformation, failure characteristics, and mechanism of surrounding rock under the influence of grain sizes and mineral compositions are not clear. Based on CJPL-II variously colored marbles, the differences in grain size and mineral composition of the marble were analyzed by thin-section analysis and XRD tests, and the effect of intermediate principal stress on the mechanical properties of marble was investigated. Both SEM and microfracture analysis were coupled to reveal the failure mechanisms. The results highlight that the crack initiation strength, damage strength, peak strength, and elasticity modulus of Jinping marble exhibit an increasing trend with an increase in intermediate principal stress, while the peak strain initially increases and subsequently decreases. Moreover, this study established negative correlations between marble strength, brittleness characteristics, and fracture angle with grain size, whereas positive correlations were identified with the content of quartz, sodium feldspar, and the magnitude of the intermediate principal stress. The microcrack density in marble was found to increase with larger grain sizes and decrease with elevated quartz and sodium feldspar content, as well as with increasing intermediate principal stress. Notably, as the intermediate principal stress intensifies and grain size diminishes, the transgranular tensile failure of marble becomes more conspicuous. These research findings contribute to the effective implementation of disaster prevention and control strategies.
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Low temperatures significantly influence feeding behavior in ectothermic vertebrates, but the underlying mechanisms remain elusive. This study investigated the role of transient receptor potential ankyrin 1 (TRPA1) channels in mediating the appetite-suppressing effects of low temperature in Nile tilapia. TRPA1 was found to be highly expressed in the hypothalamus and co-localized with neuropeptide Y (NPY) neurons. Exposure to low temperatures reduced feeding frequency and increased TRPA1 expression. In vitro experiments demonstrated that low temperature and TRPA1 agonists induced calcium influx, which was blocked by a TRPA1 inhibitor. TRPA1 expression exhibited post-prandial increases and was downregulated by fasting. TRPA1 activation dose-dependently inhibited food intake, while its inhibition restored feeding suppressed by low temperature. TRPA1 activation downregulated orexigenic factors and upregulated anorexigenic factors through Ca2+/calmodulin-dependent pathways. These findings suggest that TRPA1 plays a crucial role in sensing low temperatures and regulating feeding behavior in tilapia.
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Irisin is a recently discovered myokine that facilitates the browning of white adipose tissue, increases glucose uptake in skeletal muscle, and influences metabolic processes in the liver. However, its potential effects on amino acid absorption remained largely unexplored. This study aimed to elucidate the role of irisin in modulating amino acid uptake and delineate the underlying molecular mechanisms involved. To this end, juvenile tilapia were administered intraperitoneal irisin injections at 100 ng/g body weight over 8 weeks. Evaluation of various physiological parameters revealed that irisin supplementation significantly improved the specific growth rate and feed conversion efficiency while reducing feed consumption. Muscle tissue analysis revealed that irisin significantly modified the proximate composition by increasing protein content and reducing lipid levels. It also significantly raised the levels of both essential and non-essential amino acids in the muscle. Histological analysis demonstrated that irisin-stimulated muscle growth through hyperplasia rather than hypertrophy, corroborated by upregulated IGF-1 mRNA and downregulated myostatin mRNA expression. Mechanistic studies in cultured tilapia muscle cells elucidated that irisin activated integrin receptors on muscle cells, which subsequently engaged IGF-1/IGF-1R signaling. Downstream of IGF-1R activation, irisin simultaneously stimulates the ERK1/2 and PI3K/mTORC2/Akt pathways. The convergence of these pathways upregulates L-type amino acid transporter 1 expression, thereby augmenting amino acid uptake into muscle cells. In summary, irisin supplementation in tilapia leads to improved muscle growth, predominantly via hyperplasia and augmented amino acid assimilation, governed by intricate cellular signaling pathways. These findings provide valuable aquaculture applications and novel insights into muscle development.
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Aminoácidos , Fibronectinas , Fator de Crescimento Insulin-Like I , Músculo Esquelético , Transdução de Sinais , Tilápia , Animais , Fator de Crescimento Insulin-Like I/metabolismo , Tilápia/metabolismo , Tilápia/crescimento & desenvolvimento , Fibronectinas/metabolismo , Fibronectinas/genética , Aminoácidos/metabolismo , Transdução de Sinais/efeitos dos fármacos , Músculo Esquelético/metabolismo , Músculo Esquelético/efeitos dos fármacos , Músculo Esquelético/crescimento & desenvolvimentoRESUMO
Internalized pools of membrane attack complexes (MACs) promote NF-kB and dysregulated tissue inflammation. Here, we show that C9, a MAC-associated protein, promotes loss of proteostasis to become intrinsically immunogenic. Surface-bound C9 is internalized into Rab5 + endosomes whose intraluminal acidification promotes C9 aggregates. A region within the MACPF/CDC domain of C9 stimulates aggrephagy to induce NF-kB, inflammatory genes, and EC activation. This process requires ZFYVE21, a Rab5 effector, which links LC3A/B on aggresome membranes to RNF34-P62 complexes to mediate C9 aggrephagy. C9 aggregates form in human tissues, C9-associated signaling responses occur in three mouse models, and ZFYVE21 stabilizes RNF34 to promote C9 aggrephagy in vivo. Gene-deficient mice lacking ZFYVE21 in ECs showed reduced MAC-induced tissue injury in a skin model of chronic rejection. While classically defined as cytotoxic effectors, MACs may impair proteostasis, forming aggregates that behave as intracellular alarmins.
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The glymphatic system has recently been shown to be important in neurological diseases, including diabetes. However, little is known about how the progressive onset of diabetes affects the glymphatic system. The aim of this study is to investigate the glymphatic system response to the progressive onset of diabetes in a rat model of type 2 diabetic mellitus. Male Wistar rats (n = 45) with and without diabetes were evaluated using MRI glymphatic tracer kinetics, functional tests, and brain tissue immunohistochemistry. Our data demonstrated that the contrast agent clearance impairment gradually progressed with the diabetic duration. The MRI data showed that an impairment in contrast clearance occurred prior to the cognitive deficits detected using functional tests and permitted the detection of an early DM stage compared to the immuno-histopathology and cognitive tests. Additionally, the quantitative MRI markers of brain waste clearance demonstrated region-dependent sensitivity in glymphatic impairment. The improved sensitivity of MRI markers in the olfactory bulb and the whole brain at an early DM stage may be attributed to the important role of the olfactory bulb in the parenchymal efflux pathway. MRI can provide sensitive quantitative markers of glymphatic impairment during the progression of DM and can be used as a valuable tool for the early diagnosis of DM with a potential for clinical application.
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The present retrospective study was designed to explore the value of conventional ultrasound (US) and Virtual Touch Tissue Imaging and Quantification (VTIQ) in the assessment of mesenteric lymphadenitis (ML) in a paediatric population. A total of 103 patients with ML and 60 healthy paediatric patients were examined. VTIQ was performed to assess mesenteric lymph node (MLN) stiffness via shear-wave velocity (SWV). Univariate and multivariate logistic regression analyses were conducted to reveal independent variables for the identification of ML. The diagnostic performance of US, and US combined with VTIQ, were compared. All the quantitative VTIQ parameters (including the SWVMean, SWVMax and SWVMin) were significantly greater for MLNs in the control group than for MLNs in the ML group (all P<0.001). The SWV values in the control group were nearly 2-fold greater than that in the ML group. According to the multivariate logistic regression analysis, the longest diameter [odds ratio (OR)=6.042; P=0.046] was revealed to be the strongest independent predictor for ML, followed by the CRP level (OR=2.310; P<0.001) and the SWVMean (OR=0.106; P<0.001). According to the receiver operating characteristic analysis, the area under the curve (AUC) for US combined with VTIQ was 0.890 (95% CI: 0.831-0.949) with a greater sensitivity of 91.26% and a greater specificity of 86.67% than that for US alone (AUC: 0.798; 95% CI: 0.724-0.872; sensitivity: 79.61%; specificity: 80.00%). A significant negative correlation between increased VTIQ parameters and ML was observed. Utilizing VTIQ to assess MLN stiffness offers a non-invasive, convenient, reliable and reproducible approach for identifying mesenteric lymphadenopathy.
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Daytime radiative cooling technology offers a low-carbon, environmentally friendly, and nonpower-consuming approach to realize building energy conservation. It is important to design materials with high solar reflectivity and high infrared emissivity in atmospheric windows. Herein, a porous calcium silicate composite SiO2 aerogel water-borne coating with strong passive radiative cooling and high thermal insulation properties is proposed, which shows an exceptional solar reflectance of 94%, high sky window emissivity of 96%, and 0.0854 W/m·K thermal conductivity. On the SiO2/CaSiO3 radiative cooling coating (SiO2-CS-coating), a strategy is proposed to enhance the atmospheric window emissivity by lattice resonance, which is attributed to the eight-membered ring structure of porous calcium silicate, thereby increasing the atmospheric window emissivity. In the daytime test (solar irradiance 900W/m2, ambient temperature 43 °C, wind speed 0.53 m/s, humidity 25%), the temperature inside the box can achieve a cooling temperature of 13 °C lower than that of the environment, which is 30 °C, and the theoretical cooling power is 96 W/m2. Compared with the commercial white coating, SiO2-CS-coating can save 70 kW·h of electric energy in 1 month, and the energy consumption is reduced by 36%. The work provides a scalable, widely applicable radiative-cooling coating for building comfort, which can greatly reduce indoor temperatures and is suitable for building surfaces.
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BACKGROUND: Mesenteric lymphadenitis (ML) demonstrates a distinctive inclination for the pediatric and adolescent demographic and the diagnosis of ML in young children poses a substantial challenge. OBJECTIVE: This prospective study aimed to assess the diagnostic efficacy of Superb Microvascular Imaging (SMI) and Virtual Touch Tissue Imaging quantification (VTIQ) in distinguishing pediatric mesenteric lymphadentitis. METHODS: We examined 82 mesentric lymph node (MLN) in pediatric patients with mesenteric lymphadentitis and 50 MLN in a healthy group. SMI was utilized to evaluate vascularity within the MLN, while MLN stiffness, quantified as shear wave velocity (SWV) in meters per second (m/s), was assessed using VTIQ. We compared the diagnostic performance of greyscale Ultrasound, US combined with SMI, US combined with VTIQ, and US combined with both SMI and VTIQ. RESULTS: SMI revealed a significant distinction between mesenteric lymphadentitis and normal MLN (pâ< â0.001). MLN affected by mesenteric lymphadentis exhibited increased vascularity (marked vascularity: 13/82, 15.85%) compared to normal MLN (marked vascularity: 1/50, 2.00%). Statistically significant differences were observed in SWV values beween mesenteric lymphadentitis and normal MLN (all p-values <0.001). The mean and minimum SWV values for MLN with mesenteric lymphadentitis were 1.66±0.77âm/s and 1.51±0.53âm/s, respectively. Control group SWV values were approximately three times higher than those in the mesenteric lymphadenitis group. The highest area under the curve values were achieved with the combination of all three modalities (0.837, 95% confidence interval: 0.763- 0.896), followed by US + VTIQ (0.795, 0.716- 0.860), US + SMI (0.753, 0.670- 0.824) and US alone (0.642, 0.554- 0.724). CONCLUSION: SMI and VTIQ offer a promising noninvasive adjunct to grayscale ultrasound for identifying mesenteric lymphadentitis in pediatric patients.
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OBJECTIVE: The aim of this study was to investigate the status of health-related quality of life in Chinese patients with ankylosing spondylitis (AS) and to analyze factors associated with the Assessment of SpondyloArthritis international Society Health Index (ASAS-HI) in AS and its relationship with disease activity and psychological status. METHODS: A cross-sectional study of 484 patients with AS attending 10 hospitals in China from March 2021 to September 2023 was recruited. The ASAS-HI assessed general health and functional status; the Depression Anxiety Stress Scales (DASS-21) assessed psychological disorders such as anxiety, depression, and stress; and the Functional Assessment of Chronic illness Therapy-Fatigue Scale (FACIT-F) assessed patients' fatigue symptoms; the Ankylosing Spondylitis Disease Activity Score-C-Reactive Protein (ASDAS-CRP), Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), and Bath Ankylosing Spondylitis Measurement Index (BASMI) were used to assess patients' disease activity and functional impairment. The correlation between ASAS-HI and the ASDAS, poor psychological status, and fatigue symptoms was observed. Univariate and multivariate logistic regression analyses were used to explore the relevant influencing factors of ASAS-HI. RESULTS: A total of 484 patients were included in this study of whom 162 were in poor health, 139 in moderate health, and 183 in good health. On univariate analysis, disease activity is an important factor affecting ASAS-HI. People with extremely high disease activity (ASDAS ≥ 3.5) had a 12 times elevated risk of having poor health status (OR = 12.53; P < 0.001). Other significant covariates included age ≥ 36 (OR = 1.58; P = 0.015), BMI ≥ 24 kg/m2 (OR = 2.93; P = 0.013), smoke (OR = 1.96; P = 0.002), BASFI (OR = 1.49; P < 0.001), BASMI (OR = 1.22; P < 0.001), fatigue (OR = 6.28; P < 0.001), and bad psychological conditions such as depression (OR = 10.86; P < 0.001), anxiety (OR = 3.88; P < 0.001), and stress (OR = 4.65; P < 0.001). The use of bMARDs is inversely associated with the appearance of adverse health status (OR = 0.54; P = 0.012). There was no significant relationship between HLA-B27 and sex. Multivariable logistic regression showed that higher disease activity (ASDAS ≥ 3.5) (OR = 5.14; P = 0.005), higher scores of BASMI (OR = 1.10; P = 0.009), self-reported depression (OR = 3.68; P = 0.007), and fatigue (OR = 2.76; P < 0.001) were factors associated with adverse health status. CONCLUSION: The health status of AS patients is related to age, BMI, smoking, disease activity, poor psychological status, and fatigue and is influenced by a combination of multiple factors such as emotional state, economic level, pain, and dysfunction. Therefore, clinicians should pay attention to the early assessment of ASAS-HI in order to improve the prognosis of the disease. Key Points â¢Ankylosing spondylitis (AS) is a chronic inflammatory autoimmune disease with a long course and heavy disease burden, which greatly affects patients' quality of life. Therefore, this study aims to evaluate the health status of ankylosing spondylitis in the Chinese population and its influencing factors. â¢This is a multi-center cross-sectional study in China, which can better reflect the overall situation of the Chinese population.
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Fadiga , Qualidade de Vida , Índice de Gravidade de Doença , Espondilite Anquilosante , Humanos , Espondilite Anquilosante/psicologia , Espondilite Anquilosante/fisiopatologia , Masculino , Feminino , Adulto , Estudos Transversais , China , Pessoa de Meia-Idade , Depressão , Ansiedade , Nível de Saúde , Adulto Jovem , População do Leste AsiáticoRESUMO
This study showcases a comprehensive treatment protocol for high-risk hepatocellular carcinoma (HCC) patients, focusing on the combined use of Y-90 transarterial radioembolization (TARE) and Programmed Cell Death-1 (PD-1) inhibitors as neoadjuvant therapy. Highlighted through a case report, it offers a step-by-step reference for similar therapeutic interventions. A retrospective analysis was conducted on a patient who underwent hepatectomy following Y-90 TARE and PD-1 inhibitor treatment. Key demographic and clinical details were recorded at admission to guide therapy selection. Y-90 TARE suitability and dosage calculation were based on Technetium-99m (Tc-99m) macroaggregated albumin (MAA) perfusion mapping tests. Lesion coverage by Y-90 microspheres was confirmed through single photon emission computed tomography/computed tomography (SPECT/CT) fusion imaging, and adverse reactions and follow-up outcomes were meticulously documented. The patient, with a 7.2 cm HCC in the right hepatic lobe (T1bN0M0, BCLC A, CNLC Ib) and an initial alpha-fetoprotein (AFP) level of 66,840 ng/mL, opted for Y-90 TARE due to high recurrence risk and initial surgery refusal. The therapy's parameters, including the lung shunting fraction (LSF) and non-tumor ratio (TNR), were within therapeutic limits. A total of 1.36 GBq Y-90 was administered. At 1 month post-therapy, the tumor shrank to 6 cm with partial necrosis, and AFP levels dropped to 21,155 ng/mL, remaining stable for 3 months. After 3 months, PD-1 inhibitor treatment led to further tumor reduction to 4 cm and AFP decrease to 1.84 ng/mL. The patient then underwent hepatectomy; histopathology confirmed complete tumor necrosis. At 12 months post-surgery, no tumor recurrence or metastasis was observed in follow-up sessions. This protocol demonstrates the effective combination of Y-90 TARE and PD-1 inhibitor as a bridging strategy to surgery for HCC patients at high recurrence risk, providing a practical guide for implementing this approach.
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Carcinoma Hepatocelular , Embolização Terapêutica , Neoplasias Hepáticas , Terapia Neoadjuvante , Radioisótopos de Ítrio , Humanos , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/terapia , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/patologia , Carcinoma Hepatocelular/diagnóstico por imagem , Carcinoma Hepatocelular/terapia , Carcinoma Hepatocelular/tratamento farmacológico , Carcinoma Hepatocelular/patologia , Terapia Neoadjuvante/métodos , Embolização Terapêutica/métodos , Radioisótopos de Ítrio/uso terapêutico , Masculino , Estudos Retrospectivos , Inibidores de Checkpoint Imunológico/uso terapêutico , Pessoa de Meia-Idade , Idoso , Compostos Radiofarmacêuticos/uso terapêuticoRESUMO
The glymphatic system suggests the convective bulk flow of cerebrospinal fluid (CSF) through perivascular spaces and the interstitial spaces of the brain parenchyma for the rapid removal of toxic waste solutes from the brain. However, the presence of convective bulk flow within the brain interstitial spaces is still under debate. We first addressed this argument to determine the involvement of the glymphatic system in brain waste clearance utilizing contrast-enhanced 3D T1-weighted imaging (T1WI), diffusion tensor imaging (DTI), and confocal microscopy imaging. Furthermore, perivascular macrophages (PVMs), which are immune cells located within perivascular spaces, have not been thoroughly explored for their association with the glymphatic system. Therefore, we investigated tracer uptake by PVMs in the perivascular spaces of both the arteries/arterioles and veins/venules and the potential association of PVMs in assisting the glymphatic system for interstitial waste clearance. Our findings demonstrated that both convective bulk flow and diffusion are responsible for the clearance of interstitial waste solutes from the brain parenchyma. Furthermore, our results suggested that PVMs may play an important function in glymphatic system-mediated interstitial waste clearance. The glymphatic system and PVMs could be targeted to enhance interstitial waste clearance in patients with waste-associated neurological conditions and aging.
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Distal pancreatic carcinoma is a highly malignant tumor with strong invasiveness, often growing to the edge of the pancreas and penetrating the pancreatic capsule to infiltrate surrounding tissues. In conventional distal pancreatosplenectomy (DPS), tumor cells are prone to spread along the direction of blood and lymphatic reflux due to surgical compression. Additionally, inflammation makes it challenging to achieve R0 resection, leading to a lower patient survival rate. To address these limitations, radical antegrade modular pancreatosplenectomy (RAMPS) was developed, emphasizing deeper excision, including the left anterior renal fascia, the left anterior renal adipose sac, and even the left adrenal gland, to improve the R0 resection rate. With the advancement of minimally invasive surgical techniques, laparoscopic RAMPS (L-RAMPS) is being considered technically safe and feasible in oncology. However, due to technical difficulties and a lack of supporting evidence for clinical application, only a few institutions are currently conducting L-RAMPS. In this context, this article presents detailed techniques for laparoscopic posterior radical antegrade modular pancreatosplenectomy (L-pRAMPS), offering promise for future clinical applications.