The Association Between Late Gadolinium Enhancement by Cardiac Magnetic Resonance and Ventricular Arrhythmia in Patients With Mitral Valve Prolapse: A Systematic Review and Meta-Analysis.

INTRODUCTION: Malignant ventricular arrhythmia (VA) and sudden cardiac death (SCD) have been reported in patients with mitral valve prolapse (MVP); however, effective risk stratification methods are still lacking. Myocardial fibrosis is thought to play an important role in the development of VA; however, observational studies have produced contradictory findings regarding the relationship between VA and late gadolinium enhancement (LGE) in MVP patients. The aim of this meta-analysis and systematic review of observational studies was to investigate the association between left ventricular LGE and VA in patients with MVP. METHODS: We searched the PubMed, Embase, and Web of Science databases from 1993 to 2023 to identify case-control, cross-sectional, and cohort studies that compared the incidence of VA in patients with MVP who had left ventricular LGE and those without left ventricular LGE. RESULTS: A total of 1464 subjects with MVP from 12 observational studies met the eligibility criteria. Among them, VA episodes were reported in 221 individuals (15.1%). Meta-analysis demonstrated that the presence of left ventricular LGE was significantly associated with an increased risk of VA (pooled risk ratio 2.96, 95% CI: 2.26-3.88, p for heterogeneity = 0.07, I2 = 40%). However, a meta-regression analysis of the prevalence of mitral regurgitation (MR) showed that the severity of MR did not significantly affect the association between the occurrence of LGE and VA (p = 0.079). CONCLUSION: The detection of LGE could be helpful for stratifying the risk of VA in patients with MVP.

Decadal analysis of efficacy and safety profiles of mesenchymal stem cells from varied sources in knee osteoarthritis patients: A systematic review and network meta-analysis.

OBJECTIVE: Knee Osteoarthritis (KOA) is a debilitating degenerative joint ailment afflicting millions of patients. Numerous studies have assessed the efficacy of mesenchymal stem cells (MSCs) derived from various sources for KOA treatment, yet direct comparisons are scarce and inconsistent. Furthermore, network meta-analysis (NMA) conclusions require updating, while the safety of MSCs therapy remains contentious. This study evaluates therapeutic approaches involving MSCs from different sources in patients with KOA through randomized controlled trials (RCTs) and cohort studies. The objective is to compare the effectiveness and safety of MSCs strategies from various sources for KOA treatment. METHODS: A systematic literature review was conducted to identify RCTs and cohort studies comparing different sources of MSCs in KOA patients. A randomized effects network meta-analysis was used to concurrently evaluate both direct and indirect comparisons across all protocols. RESULTS: The NMA included 16 RCTS and reported 1005 participants. Adipose-derived mesenchymal stem cells (AD-MSCs) were the most effective treatment, showing significant improvements in the Visual Analogue Scale (VAS), the Short Form 36 (SF-36 scale), the International Knee Literature Committee Knee Evaluation Scale (IKDC subjective scores), and the Knee Injury and OA Outcome Score (KOOS). The probabilities are P = 85.3, P = 70.5, P = 88 and P = 87, respectively. Compared with placebo, AD-MSCs resulted in a VAS Score (SMD 0.97; 95%CI 0.37, 1.57), IKDC subjective scores (SMD -0.71; 95%CI -1.20, -0.21) was significantly reduced. Umbilical cord-derived mesenchymal stem cells (UC-MSCs) showed significant improvements in the University of Western Ontario and McMaster University OA (WOMAC) (P = 91.4). Compared with placebo, UC-MSCs had a higher WOMAC Score (SMD 1.65; 95%CI 0.27, 3.03) and ranked first. Compared with MSCs, placebo emerged as the safer option (P = 74.9), with a notable reduction in AEs associated with HA treatment (RR 0.77; 95%CI 0.61, 0.97). AD-MSCs were found to have the least favorable impact on AEs with a probability of P = 13.3. CONCLUSIONS: This network meta-analysis established that MSCs offer pain relief and enhance various knee scores in KOA patients compared to conventional treatment. It also identifies other therapeutic avenues warranting further exploration through high-quality studies. Nonetheless, it underscores the necessity to emphasize the potential complications and safety concerns associated with MSCs.

Unveiling the best predictive models for early­onset metastatic cancer: Insights and innovations (Review).

Cancer metastasis is the primary cause of cancer deaths. Metastasis involves the spread of cancer cells from the primary tumors to other body parts, commonly through lymphatic and vascular pathways. Key aspects include the high mutation rate and the capability of metastatic cells to form invasive tumors even without a large initial tumor mass. Particular emphasis is given to early metastasis, occurring in initial cancer stages and often leading to misdiagnosis, which adversely affects survival and prognosis. The present review highlighted the need for improved understanding and detection methods for early metastasis, which has not been effectively identified clinically. The present review demonstrated the clinicopathological and molecular characteristics of early­onset metastatic types of cancer, noting factors such as age, race, tumor size and location as well as the histological and pathological grade as significant predictors. In conclusion, the present review underscored the importance of early detection and management of metastatic types of cancer and called for improved predictive models, including advanced techniques such as nomograms and machine learning, so as to enhance patient outcomes, acknowledging the challenges and limitations of the current research as well as the necessity for further studies.

Comparative analysis of the phenolic contents and antioxidant activities of different parts of two pomegranate (Punica granatum L.) Cultivars: 'Tunisia' and 'Qingpi'.

Pomegranate (Punica granatum L.), with its abundant phenolic substances and strong antioxidant activity, holds significant research and utilization potential across various organs. However, there have been few studies on the phenolic content and antioxidant activity of different parts of pomegranate, especially the placenta. This study investigated the phenolic content and antioxidant activity of fruits, flowers, and leaves of two pomegranate varieties, 'Tunisia' and 'Qingpi', throughout their growth and development. Results indicated significant variations in phenolic content among different organs, with petals exhibiting the highest total polyphenol content (TPC, 49.40 mg GAE/g FW) and total anthocyanin content (TMAC, 1938.54 nmol/g FW). Placenta contained the highest levels of total flavonoids (TFC, 173.58 mg RE/g FW) and punicalagin (109.30 mg/g FW). The peel had the highest content of total flavanols (TFAC, 19.42 mg CE/g FW). Over the course of pomegranate development, total polyphenols, total flavonoids, total flavanols, punicalagin, and antioxidant activity declined in different organs. Antioxidant activity followed the order: fruit > flower > leaf, with the placenta exhibiting the highest antioxidant activity among fruits. Antioxidant activity showed a significant positive correlation with total polyphenols (R2 = 0.77-1.00), total flavonoids (R2 = 0.71-0.99, except tegmens), and punicalagin (R2 = 0.71-1.00). This study provides a comparative analysis of the phenolic content and antioxidant activity in different organs of pomegranate, highlighting the placenta as the primary source of punicalagin. This study provides a theoretical basis for the development and utilization of pomegranate phenolic compounds.

Effects of L-Cysteine and γ-Aminobutyric Acid Treatment on Postharvest Quality and Antioxidant Activity of Loquat Fruit during Storage.

Sichuan is the China's leading producer of loquat, with the largest cultivation area and yield ranked first in China. Loquat is a seasonal fruit highly appreciated by consumers; however, the fruit is prone to browning and lignification after harvest, affecting its storage quality. The effects of L-Cysteine (L-Cys, 0.01, 0.05, 0.1, 0.2%) and γ-aminobutyric acid (GABA, 0.025, 0.05, 0.075, 0.1%) on the sensory quality and antioxidant activity of loquat fruit during cold storage at 4 °C for 35 days and simulated shelf life for 5 days were investigated. The results showed that after 40 days of storage, compared with the control, 0.05% L-Cys and 0.05% GABA treatment of 'Zaozhong No. 6' loquat fruit effectively reduced the weight loss rate, browning index, decay index, respiratory rate, firmness, and lignin content and slowed the decreases in total soluble solids, soluble sugar, titratable acidityand vitamin C contents. The application of 0.05% L-Cys and 0.05% GABA significantly increased the contents of total phenols, total flavonoids, flavanols, and carotenoids; delayed the increase of relative electric conductivity, MDA, POD, and PPO activities; and significantly enhanced the activities of SOD and CAT, DPPH free radical scavenging ability, and FRAP, thereby improving antioxidant capacity. In summary, 0.05% L-Cys and 0.05% GABA treatment promotes the quality of loquat fruit after 40 days of storage, and significantly enhances antioxidant capacity, thus delaying senescence after harvest.

Comparison of Rhizospheric and Endophytic Bacterial Compositions between Netted and Oriental Melons.

To elucidate the biological mechanism of formation of the netted pattern in melons, the characteristics of the soil bacterial community structure in the rhizosphere and of the endophytic bacteria in the stems of netted melons were analyzed. High-throughput sequencing technology was used for the analysis of plant stem and soil samples collected from netted melons (NM) and oriental melons (OM). At the phylum level, Acidobacteria, Dependentiae, and Chloroflexi were the dominant endophytic bacteria in the stems of NM only. In addition, at the genus level, the soil bacteria enriched in the rhizospheres of NM and OM were different. Five unique dominant bacterial genera, including Gaiella, Actinoplanes, norank_f__Gemmatimonadaceae, Devosia, and Bradyrhizobium, were the dominant soil bacteria unique to the rhizosphere of NM. In contrast, Mycobacterium and unclassified_f__Acetobacteraceae were the dominant soil bacteria in the rhizosphere of OM. Moreover, Hyphomicrobium, Nocardioides, norank_f__norank_o__Gaiellales, Bryobacter, unclassified_f__Pseudonocardiaceae, Pseudolabrys, norank_f__Micropepsaceae, Ideonella, Mizugakiibacter, norank_f__Vermiphilaceae, unclassified_f__Xanthobacteraceae, Bacillus, and Pseudaminobacter were the dominant endophytic bacteria in the stems of NM. In contrast, Flavobacterium, Stenotrophomonas, unclassified_f__Burkholderiaceae, Paenibacillus, Bordetella, Hephaestia, and Ideonella were the dominant endophytic bacteria in the stems of OM. The specific substances (enzymes, proteins, endogenous hormones, etc.) secreted by unique rhizospheric and endophytic bacteria, such as Bacillus and Bradyrhizobium, may activate the promoters of genes. Therefore, the expression of genes can be regulated by unique rhizospheric and endophytic bacteria for formation or nonformation of netting in melons. IMPORTANCE The study of the differential structures and functions of rhizospheric and endophytic bacterial communities between netted melon and oriental melon treatments is investigated. Our findings make a significant contribution to the literature because they are the first step in coupling the study of rhizospheric and endophytic microbial community structure to reticulation formation in netted melon. Further, we believe that this research appears to be meaningful because it provides new insights into the mechanisms of reticulation formation in netted melon in modern agricultural production.

Sphincter electromyography in diabetes mellitus and multiple system atrophy.

AIMS: Abnormalities of external anal sphincter electromyography (EAS-EMG) characterize multiple system atrophy (MSA) and focal cauda equina or conus medullaris lesions. This study is designed to determine whether and how diabetic polyneuropathy (DPN) affects EAS as compared to the abnormalities seen in MSA. METHODS: We conducted multi-motor unit potential (MUP) analysis of EAS in 22 healthy controls, 32 diabetes mellitus (DM) patients without neuropathy, 38 DPN patients, and 68 MSA patients. RESULTS: DPN patients had a significant (P < 0.01) increase in MUP mean duration, mean amplitude, percentage of long duration MUPs, and satellite rate, but to a lesser extent than MSA. Mean duration and satellite rate showed the least overlap among different groups in individual value distributions. CONCLUSIONS: Compared with MSA, DPN affects EAS to a lesser degree as judged by neurogenic MUP abnormalities in EMG. Mean duration and satellite rate may serve as the most discriminating aspects in MUP analysis of EAS.

[Manipulative reduction of shoulder lift for the treatment of posterior dislocation of hip joint].

OBJECTIVE: To observe the effects of shoulder lift reduction for treatment of posterior dislocation of hip joint. METHODS: From July 2001 to June 2010, 14 cases of posterior dislocation of hip joint were treated with shoulder lift reduction involving 12 males and 2 females with an average age of 34.6 years ranging from 18 to 57 years. After recduction, all patients were assisted with the traction, exercise and traditional Chinese medicine. The mean duration between injured and treatment was 1.1 days (2 hours to 3 days). According to Harris scoring system the hip joint function were evaluated. RESULTS: All patients were followed-up for 8 to 24 months (means 16 months). Fourteen cases were reset well in first without any complication. The Harris score was (97.14 +/- 4.90) in total, involving hip pain (42.86 +/- 1.88), articular activity (4.71 +/- 0.47), daily activity (45.57 +/- 9.26), deformity (4.00 +/- 0.00), the clinical outcome was excellent in 12 cases,good in 2. There were not complications such as avascular necrosis of the femoral head, and so on. CONCLUSION: The shoulder lift reduction can be used by one person, and the treatment of posterior dislocation of hip joint is effective. It established a good foundation for the rehabilitation of trouble hip.

[Clinical and neurophysiological features of 700 patients with diabetic peripheral neuropathy].

OBJECTIVE: To study the clinical and electrophysiological features of diabetic peripheral neuropathy in 700 patients to elucidate the relationships between them and evaluate the value of electromyography in the diagnosis of diabetic peripheral neuropathy. METHODS: Standard sensory and motor nerve conduction studies were performed in the 700 patients, sensory nerve conduction velocity (SCV), amplitude of sensory nerve action potential (SNAP), distal motor latency (DML) and amplitude of compound muscle action potential (CMAP) of median nerve, ulnar nerve, posterior tibial nerve and common peroneal nerve were studied simultaneously. Needle electromyogram (EMG) test was performed in 239 patients. RESULTS: (1) The most common symptoms of peripheral neuropathy were numbness and pain in limbs, while impaired or lost tendon reflexes were the most common abnormal signs in lower limbs. (2) The abnormal rate of nerve conduction studies was 72.4% in the 700 patients. Slow SCV, prolonged DML and decreased amplitude of SNAP and CMAP were detected. (3) More severe abnormal nerve conduction was found in lower limbs than in upper limbs. The abnormal degree was more severe in sensory nerve than in motor nerve and severity was more in amplitude than in conduction velocity (P < 0.05). (4) Abnormal motor and/or sensory nerve conduction was detected in 67.3% of the patients with clinical manifestations of neuropathy and 5.1% patients without signs or symptoms of neuropathy, while motor or sensory nerve conduction was normal in 27.6% patients with manifestations of neuropathy. Needle EMG showed neurogenic lesion in 4.6% of the patients with normal motor and sensory nerve conduction. (5) polyneuropathy is the most common type of diabetic neuropathy and carpal tunnel syndrome the next. CONCLUSIONS: The most common clinical and electrophysiological manifestation of diabetic neuropathy is sensory disturbance, which is more severe in lower limbs. The electrophysiological changes are not always accordant with clinical manifestations. Subclinical diabetic peripheral neuropathy can be detected by electrophysiological tests, which are useful to verify the range and extent of the nerve lesion involved in the early stage of diabetic peripheral neuropathy. Needle EMG is not recommended for screening diabetic neuropathy.

Single fiber electromyography in 78 patients with amyotrophic lateral sclerosis.

BACKGROUND: Single fiber electromyography (SFEMG) is a sensitive technique for detecting abnormalities in neuromuscular transmission and is mainly used in the diagnosis of neuromuscular junction disorders, such as myasthenia gravis. While the process of denervation-reinnervation in amyotrophic lateral sclerosis (ALS) can also result in immature collateral nerve terminals and instability of neuromuscular transmission, the purpose of this study was to investigate the changes and clinical values of SFEMG in patients with ALS. METHODS: Volitional SFEMG was performed on the extensor digitorum communis (EDC) of 78 patients with ALS (men 52, women 26) who had been previously diagnosed by history, clinical features, and neurophysiological studies. The mean jitter, the percentage of jitter >55 micros, the impulse blocking percentage, and fiber density (FD) were determined. These results were compared to normal controls. In addition, the SFEMG indices were analyzed for correlations with the duration of ALS, the EDC strength score on the Medical Research Council (MRC) scale, and spontaneous activity detected by EMG studies. RESULTS: SFEMG indices were abnormal in all patients with ALS. Mean jitter ranged from 30 to 178 micros (mean 80.2 micros); the percentage of jitter >55 micros ranged from 5% to 100% (mean 60.5%). In addition, the impulse blocking percentage ranged from 0% to 90% (mean 28.1%) and FD ranged from 1.4 to 4.1 (mean 2.6). Mean jitter, the percentage of jitter >55 micros, and the blocking percentage in 57 patients with definite or probable ALS were significantly higher than in patients with possible or suspected ALS. MRC scores of the EDC negatively correlated with mean jitter, the percentage of jitter >55 micros, blocking percentage, and FD. CONCLUSIONS: SFEMG is the most sensitive tool for diagnosing definite or probable ALS. Increased jitter, blocking percentage, and FD can indicate the degree of immature collateral sprouts and motor end plates resulting from the progressive denervation and reinnervation associated with ALS, and may be helpful in evaluating prognosis.

Single fiber electromyography in the diagnosis of ocular myasthenia gravis: report of 90 cases.

BACKGROUND: The aim of this study was to evaluate single fiber electromyography (SFEMG) in the diagnosis of ocular myasthenia gravis (OMG), compared with repetitive nerve stimulation (RNS) and blood concentration of antibody to acetylcholine receptor (AchRAb). METHODS: SFEMG, RNS and AchRAb titration were measured in 90 patients with OMG (44 men, 46 women). RESULTS: Markedly increased jitter and ratio of block in the frontalis and the extensor digitorum communis (EDC) were observed (83.3% and 61.1%, respectively). The mean jitter was 43.6 +/- 14.5 micros, and the percentages of jitter>55 micros and blocking were 16.9% +/- 19% and 3.5% +/- 9.5% respectively in the EDC. The mean jitter was 64.3 +/- 25.6 micros, and the percentages of jitter > 55 micros and blocking were 33.5% +/- 27.6% and 29.3% +/- 23.2% respectively in the frontalis. The percentage of abnormal RNS was 27.8% (25/90). There was an increased AchRAb titration in 29 (32.2%) of the 90 patients. Increased jitter, blocking was negatively correlated with maximum decrement to RNS (P < 0.01). 11.4% (4/35) of patients with abnormal RNS and 24.1% (7/29) patients with abnormal AchRAb were seen in the patients with normal SFEMG in the EDC. CONCLUSION: SFEMG test showed the highest sensitivity in the diagnosis of OMG. To our knowledge, the three methods (SFEMG, RNS and AchRAb) are complementary in the diagnosis and differential diagnosis of OMG.

[Phrenic radix conduction time in inflammatory demyelinating polyneuropathy patients].

OBJECTIVE: To investigate the features and application of phrenic radix conduction time (PRCT) in inflammatory demyelinating polyneuropathy (IDP) patients. METHODS: Distal motor latency (DML) was recorded by stimulating phrenic nerve electrically and phrenic nerve root magnetically in 20 IDP patients with surface electrodes at intercostal space. The difference of the two DML was calculated and compared with those recorded previously from 61 sides in 31 healthy control subjects. RESULTS: PRCT of the IDP patients was longer than that of the controls, and it correlated with the severity of clinical dyspnea. The abnormal rate of PRCT was higher than the incidence of clinical dyspnea. CONCLUSIONS: PRCT could reflect the functional status of the spinal roots related to respiration in IDP patients at an electrophysiological level. It correlates well with the degree of clinical dyspnea. Its detection is helpful to find out the subclinical dyspnea in IDP patients.

[Diaphragmatic motor evoked potential in amyotrophic lateral sclerosis patients].

OBJECTIVE: To investigate the features and application of diaphragmatic motor evoked potential (DMEP) in amyotrophic lateral sclerosis (ALS) patients. METHODS: To record the latency and amplitude of diaphragmatic compound muscle action potential (DCMAP) from 37 ALS patients and 31 control subjects with surface electrodes after transcranial and transcervical magnetic stimulation, central motor conduction time (CMCT) was calculated. The percentage of forced vital capacity (%FVC) was performed in 22 ALS patients simultaneously. RESULTS: Cortical and cervical latencies of the ALS patients were longer than those of the controls, and cortical and cervical amplitudes of the ALS patients were lower than those of the controls. CMCT of the ALS patients were longer than that of the controls. Cortical latency, cortical amplitude and CMCT were all correlated with the dysfunction of the pyramidal tract. Cortical latency and CMCT were also correlated with the clinical respiratory dysfunction, cervical latency was correlated with %FVC. CONCLUSIONS: CMCT, Cortical and cervical latencies are sensitive index in DMEP parameters reflecting respiratory dysfunction in ALS, CMCT reflects cortical spinal tract function of ALS patients associated with respiration. It would be helpful to detect the neurological basis of the respiratory disturbance in ALS combining CMCT with cervical latency.

[Phrenic nerve conduction in amyotrophic lateral sclerosis patients].

OBJECTIVE: To investigate the features and application of phrenic nerve conduction in amyotrophic lateral scle-rosis (ALS) patients. METHODS: The latency and amplitude of diaphragmatic compound muscle action potential (DCMAP) were recorded among 44 ALS patients and 31 control subjects with surface electrodes after the cervical part of phrenic nerve was stimulated with electricity. The percentage of forced vital capacity (%FVC) was examined in 28 ALS patients simultaneously. RESULTS: Right and left phrenic distal motor latencies (PDML) of ALS patients were 8.4 ms +/- 2.2 ms and 7.6 ms +/- 1.4 ms respectively, longer than those of the controls, and the logarithmic value of amplitudes among ALS patients was 2.68 +/- 0.37, lower than that among the controls. Take the right side for example, although PDML was correlated with %FVC, it had no correlation with clinical respiratory dysfunction. Neither %FVC nor clinical respiratory dysfunction was correlated with the amplitude of DCMAP. The rate of abnormal PDML (47.7%) was higher than the rate of clinical dyspnea (25%). CONCLUSION: PDML is a sensitive index in phrenic conduction parameter reflecting respiratory dysfunction in ALS. Only when the PDML is combined with the central motor conduction time of the diaphragmatic motor evoked potential the nervous system basis of the respiratory disturbance in ALS can be revealed.

[Primary study of diaphragmatic electromyography in amyotrophic lateral sclerosis patients].

OBJECTIVE: To investigate the features and application of diaphragmatic electromyography (DEMG) in amyotrophic lateral sclerosis (ALS) patients. METHODS: We recorded the electromyography of 43 diaphragms from 43 ALS patients by inserting concentric needle electrode from intercostal space, when they held their breath, breathed smoothly and drew deep breath, and took electromyography of 22 healthy diaphragms as controls. The percentage of forced vital capacity (%FVC) was performed simultaneously in 28 ALS patients. RESULTS: All subjects showed no side-effect. The spontaneous activities could be found when ALS patients held their breath. During the period of their smooth breath, the duration of their diaphragmatic motor unit action potential (DMUAP) (12.1 ms +/- 2.7 ms) was longer than those of controls, and the common logarithmic value of the amplitude (2.585 +/- 0.132) and the area (2.722 +/- 0.208) of DMUAP were larger than those of controls. The percentage of polyphasic (53%) and satellite potential (5%) was also increased in ALS patients. The duration (13.6 ms +/- 3.6 ms) of the ALS patients with clinical dyspnoea was longer than that (11.6 ms +/- 2.2 ms) of others without it. The spontaneous activities were correlated with clinical dyspnoea and %FVC. CONCLUSION: DEMG with needle electrode could evaluate the respiratory state of ALS patients at the level of electrophysiology. The duration and the spontaneous activity were its sensitive indexes.