Clinical features and survival in Takayasu's arteritis-associated pulmonary hypertension: a nationwide study.

AIMS: This study aimed to assess the clinical characteristics and long-term survival outcome in patients with Takayasu's arteritis-associated pulmonary hypertension (TA-PH). METHODS AND RESULTS: We conducted a nationally representative cohort study of TA-PH using data from the National Rare Diseases Registry System of China. Patients with pulmonary artery involvement who fulfilled the diagnostic criteria of Takayasu's arteritis and pulmonary hypertension were included. The primary outcome was the time from diagnosis of TA-PH to the occurrence of all-cause death. Between January 2007 and January 2019, a total of 140 patients were included, with a mean age of 41.4 years at diagnosis, and a female predominance (81%). Patients with TA-PH had severely haemodynamic and functional impairments at diagnosis. Significant improvements have been found in N-terminal pro-B-type natriuretic peptide (NT-proBNP) and haemodynamic profiles in patients with TA-PH receiving drugs approved for pulmonary arterial hypertension. The overall 1-, 3-, and 5-year survival rates in TA-PH were 94.0%, 83.2%, and 77.2%, respectively. Predictors associated with an increased risk of all-cause death were syncope [adjusted hazard ratio (HR) 5.38 (95% confidence interval 1.77-16.34), P = 0.003], NT-proBNP level [adjusted HR 1.04 (1.03-1.06), P < 0.001], and mean right atrial pressure [adjusted HR 1.07 (1.01-1.13), P = 0.015]. CONCLUSION: Patients with TA-PH were predominantly female and had severely compromised haemodynamics. More than 80% of patients in our cohort survived for at least 3 years. Medical treatment was based on investigators' personal opinions, and no clear risk-to-benefit ratio can be derived from the presented data.

Heterometal-Organic Cages as Photo-Fenton-like Catalysts.

Metal-organic cages, a class of supramolecular containers constructed by the self-assembly of metal ions and organic ligands, show great promise as catalytic agents. In this work, we designed and synthesized a series of rhombic dodecahedral Ni-Cu heterometal imidazolate cages (Ni8Cu6L24) that can act as highly active photo-Fenton-like catalysts. These cages possess a high ability to generate hydroxyl radicals (•OH) under visible light in the presence of H2O2, which can rapidly degrade organic pollutants (e.g., rhodamine B, methylene blue, and methyl orange) into CO2 and H2O. Besides, they are robust catalysts, with high catalytic activity and reusability under conditions in high H2O2 concentration, providing potentially advanced materials for degrading persistent organic pollutants.

Effects of Robot-Assisted Rehabilitation on Hand Function of People With Stroke: A Randomized, Crossover-Controlled, Assessor-Blinded Study.

IMPORTANCE: The effects of robot-assisted task-oriented training with tangible objects among patients with stroke remain unknown. OBJECTIVE: To investigate the effects of robot-assisted therapy (RT) with a Gloreha device on sensorimotor and hand function and ability to perform activities of daily living (ADLs) among patients with stroke. DESIGN: Randomized, crossover-controlled, assessor-blinded study. SETTING: Rehabilitation clinic. PARTICIPANTS: Patients (N = 24) with moderate motor and sensory deficits. INTERVENTION: Patients participated in 12 RT sessions and 12 conventional therapy (CT) sessions, with order counterbalanced, for 6 wk, with a 1-mo washout period. OUTCOMES AND MEASURES: Performance was assessed four times: before and after RT and before and after CT. Outcomes were measured using the Fugl-Meyer Assessment-Upper Extremity (FMA-UE), Box and Block Test, electromyography of the extensor digitorum communis (EDC) and brachioradialis, and a grip dynamometer for motor function; Semmes-Weinstein hand monofilament and the Revised Nottingham Sensory Assessment for sensory function; and the Modified Barthel Index (MBI) for ADL ability. RESULTS: RT resulted in significantly improved FMA-UE proximal (p = .038) and total (p = .046) and MBI (p = .030) scores. Participants' EDC muscles exhibited higher efficacy during the small-block grasping task of the Box and Block Test after RT than after CT (p = .050). CONCLUSIONS AND RELEVANCE: RT with the Gloreha device can facilitate whole-limb function, leading to beneficial effects on arm motor function, EDC muscle recruitment efficacy, and ADL ability for people with subacute and chronic stroke. WHAT THIS ARTICLE ADDS: The evidence suggests that a task-oriented approach combined with the Gloreha device can facilitate engagement in whole-limb active movement and efficiently promote functional recovery.

[Effect of microRNA-133b on Myocardial Fibrosis].

Objective To investigate the effect of microRNA-133b(miR-133b)on cardiac fibrosis and its mechanism.Methods Human cardiac fibroblasts(CFs)were harvested.The proliferation of CFs was detected by CCK8 during the overexpression and knock-down of miR-133b.The expressions of connective tissue growth factor(CTGF),α-smooth muscle actin(α-SMA),collagen Ⅰ,and collagen Ⅲ were detected with qRT-PCR and Western blot analysis after miR-133b overexpression or downexpression.Target genes of miR-133b were predicted by bioinformatics software.Dual-luciferase activity assay were used to verify a target gene of miR-133b.Results qRT-PCR showed that the expression level of miR-133b in the miR-133b mimic group was significantly higher than that in the negative control group(t=26.219,P=0.000).The expression level of miR-133b in the miR-133b inhibitor group was significantly lower than that in the negative control group(t=6.738,P=0.003).After 21,45,69,93,and 117 hours of transfection,the proliferation ability of CFs significantly decreased in the miR-133b mimic group but significantly increased in the miR-133b group(all P<0.05,compared with the negative control group).After overexpression of miR-133b,the mRNA and protein levels of CTGF(t=9.213,P=0.001;t=8.195,P=0.001),α-SMA(t=6.511,P =0.003;t=4.434,P=0.011),collagenⅠ(t=3.172,P=0.034;t=4.053,P=0.015)and collagen Ⅲ(t=6.404,P=0.003;t=5.319,P=0.006)were significantly down-regulated.After the expression of miR-133b was knocked down,the mRNA and protein levels of CTGF(t=9.439,P=0.001;t=14.100,P=0.000),α-SMA(t=4.519,P=0.011;t=4.377,P=0.012),collagen Ⅰ(t=5.966,P=0.004;t=5.514,P=0.005)and collagen Ⅲ(t=4.622,P=0.010;t=4.996,P=0.008)were significantly increased.The relative luciferase activity of the cells co-transfected with miR-133b mimic and WT 3'UTR expression vector was significantly lower than that of the cells co-transfected with mimic control and WT 3'UTR expression vectors(t=5.654,P=0.005);however,there was no significant difference in relative luciferase activity between cells co-transfected with miR-133b mimic and MUT 3'UTR expression vectors and cells co-transfected with mimic control and MUT 3'UTR expression vectors(t=0.380,P=0.724).Conclusion miR-133b may affect the activation and proliferation of CFs by targeting CTGF and thus improve cardiac fibrosis.

Resistin may be an independent predictor of subclinical atherosclerosis formale smokers.

To investigate whether resistin is associated with early atherosclerosis in male smokers. The present study consecutively enrolled 50 male smokers. Their serum resistin contents were detected with enzyme linked immunosorbent assay (ELISA), and subclinical atherosclerosis indices, including carotid inner middle thickness (IMT) and arterial elasticity indices (C1 and C2), were measured. The association between serum resistin levels and IMT, C1 and C2 were respectively evaluated with the Pearson's correlation coefficient method. The results showed that the serum resistin level had a positive association with IMT (r = 0.307, p = .030), but were both inversely associated with C1 (r = -0.440, p = .001) and C2 (r = -0.381, p = .006). These associations remained significant even after adjustment for cardiovascular confounders. In conclusion, serum resistin concentration was independently associated with early atherosclerosis in male smokers.

Minichromosome maintenance (MCM) protein 4 overexpression is a potential prognostic marker for laryngeal squamous cell carcinoma.

PURPOSE: The minichromosomal maintenance (MCM) proteins are involved in the initiation and DNA replication. The role of MCM4 remains to be elucidated. The purpose of this study was to investigate the effects of MCM4 in laryngeal squamous cell carcinoma (LSCC) cell growth and apoptosis. METHODS: LSCC cell line UMSCC 5 was used in this study. The small interfering RNA (siRNA) of MCM 4 gene was used to identify the effects of MCM4 on the proliferation and apoptosis using methylimidazole tetrazolium (MTT) assay and flow-cytometry, respectively. Confirmed LSCC and adjacent non-tumor tissues were collected from 34 patients who were willing to participate in the study, from 2010 through 2015, from 163 patients undergoing treatment in the Department of Otorhinolaryngology/Head and Neck Surgery of Beijing Tongren Hospital in Capital Medical University of P.R. China. Immunohistochemical staining of MCM4 expression in the resected tissues was performed to analyze the correlation between its expression and the clinicopathological characteristics. RESULTS: The results showed that siRNA of MCM4 could significantly inhibit LSCC cell line UMSCC 5 proliferation and induce apoptosis. MCM4 mRNA was higher expressed in carcinoma tissues than in adjacent normal tissues. MCM4 expression was correlated with male gender, smoking history and poor differentiation. CONCLUSIONS: We noticed a significant role for MCM4 overexpression in human LSCC tissues and their corresponding adjacent non-neoplastic tissues and found that siRNA of MCM4 can significantly decrease the proliferation of cancer cells. It is suggested that MCM4 profiling could potentially be used to predict response to treatment and prognosis in LSCC.

Respiratory Rate Estimation by Using ECG, Impedance, and Motion Sensing in Smart Clothing.

The needs for light-weight and soft smart clothing in homecare have been rising since the past decade. Many smart textile sensors have been developed and applied to automatic physiological and user-centered environmental status recognition. In the present study, we propose wearable multi-sensor smart clothing for homecare monitoring based on an economic fabric electrode with high elasticity and low resistance. The wearable smart clothing integrated with heterogeneous sensors is capable to measure multiple human biosignals (ECG and respiration), acceleration, and gyro information. Five independent respiratory signals (electric impedance plethysmography, respiratory induced frequency variation, respiratory induced amplitude variation, respiratory induced intensity variation, and respiratory induced movement variation) are obtained. The smart clothing can provide accurate respiratory rate estimation by using three different techniques (Naïve Bayes inference, static Kalman filter, and dynamic Kalman filter). During the static sitting experiments, respiratory induced frequency variation has the best performance; whereas during the running experiments, respiratory induced amplitude variation has the best performance. The Naïve Bayes inference and dynamic Kalman filter have shown good results. The novel smart clothing is soft, elastic, and washable and it is suitable for long-term monitoring in homecare medical service and healthcare industry.

The effects of the 5-HT2A receptor antagonist sarpogrelate hydrochloride on chronic hypoxic pulmonary hypertension in rats.

PURPOSE OF THE STUDY: This study investigated whether sarpogrelate hydrochloride (SPG), a 5-HT2A receptor antagonist, alleviates chronic hypoxic pulmonary hypertension (CH-PH) in rats by stimulating apoptosis and inhibiting proliferation in pulmonary artery smooth muscle cells (PASMCs). MATERIALS AND METHODS: Forty male Sprague-Dawley rats were pretreated with SPG (50 mg/kg/day by oral gavage) or saline vehicle and then subjected to chronic hypoxia (CH) (hypobaric chamber set to 380 mmHg, 10% oxygen) or normoxia for 14 days. Mean pulmonary artery pressure (PAP) and right ventricular hypertrophy (RVH) were measured. Hypertensive pulmonary vascular remodeling was assayed by light microscopy. Terminal deoxynucletidyl transferase dUTP nick end ligase (TUNEL) assays, western blotting, and real-time polymerase chain reaction were used to assess apoptosis, proliferation and underlying signaling pathways in PASMCs from lung tissue and isolated pulmonary artery rings. RESULTS: CH increased mean PAP and RVH. CH increased the percentage of muscularized arteries in the peripheral pulmonary vasculature and medial wall thickness in small muscular arteries. CH increased pulmonary protein and mRNA levels of the B-cell lymphoma protein 2 (Bcl-2), pyruvate dehydrogenase kinase (PDK), phosphorylation of extracellular signal-regulated kinases 1 and 2 (pERK1/2), cyclin D1, proliferating cell nuclear antigen (PCNA) and decreased protein and mRNA levels of Bcl-2-associated X protein (BAX), cleaved caspase-3. Pretreatment with SPG, which has been shown previously to inhibit ERK1/2 phosphorylation and PDK, countered all of these effects. Isolated pulmonary artery rings incubated with 5-HT increased pERK1/2, PDK, and Bcl-2 expression, and decreased Bax expression. CONCLUSION: Administration of SPG ameliorated the development of CH-PH by stimulating apoptosis in and inhibiting proliferation of PASMCs.

Differentiating parts of Cinnamomum cassia using LC-qTOF-MS in conjunction with principal component analysis.

Cinnamon bark (Rou Gui in Chinese), cinnamon twig (Gui Zhi) and shaved cinnamon bark (Gui Sin) have been widely used as spices and in traditional Chinese medicine since ancient times. On-going issues related to quality and authenticity necessitate the development of analytical methods capable of providing an objective evaluation of samples. In this study, chemical fingerprints of cinnamon bark, cinnamon twigs and shaved cinnamon bark were established using liquid chromatography quadruple time-of-flight mass spectrometry in conjunction with principal component analysis (PCA). From 125 samples of cinnamon, we identified the following eight compounds and their the detection ratios: coumarin, cinnamaldehyde, cinnamyl alcohol, cinnamic acid, 2-hydroxycinnamaldehyde, 2-hydroxycinnamic acid, 2-methoxycinnamaldehyde and 4-methoxycinnamaldehyde. Of these, 4-methoxycinnamaldehyde presented the largest variations in detection ratio, making up 64.0, 97.4 and 50.0% in cinnamon bark, cinnamon twig, and shaved cinnamon bark, respectively. The quantities of cinnamyl alcohol, coumarin and cinnamaldehyde also varied between the three parts of the plant. Chemical fingerprints of the three cinnamon samples were established using principal component analysis, the results of which indicate that cinnamon bark and shaved cinnamon bark could be easily differentiated, despite a marked similarity in outward appearance. Cinnamon twig was also shown to depart from the other clusters. The proposed method provides a fast and efficient means of identifying cinnamon herbs for quality control purposes. Copyright © 2016 John Wiley & Sons, Ltd.

Evaluation of a 3D-Printed Writing Assistive Device for People With Brain Injury.

Three-dimensional-printed assistive devices hold promise for improving writing abilities, yet factors influencing device selection and their impact on satisfaction and effectiveness remain unclear, especially in adults, as they are typically tested on children. The aim of this article is to assess the efficacy and satisfaction with a writing assistive device at different angles among individuals with brain injury and explore device selection factors. Twenty-six participants with brain injuries selected their preferred device angle. Writing speed, quality, and satisfaction were recorded. Immediate speed improvements were significant at 5° and 30° (p = .006, .013, respectively). Satisfaction scores did not significantly differ among angles. Normotonia in elbow (p < .001; odds ratio: 3.403) and wrist (p ≤ .001; odds ratio: 2.695) muscles increased the likelihood of selecting the 5° device. Immediate speed improvements at specific angles highlight the influence of muscle normotonia on device selection, vital for tailored brain injury rehabilitation.

Evaluation of a 3D-Printed Writing Assistive Device for People With Brain InjuryThis study, titled "Evaluation of a 3D-Printed Writing Assistive Device for People with Brain Injury," aimed to understand how 3D-printed devices could improve writing for individuals with brain injuries. The researchers explored the effectiveness and satisfaction of using these devices at different angles (5°, 20°, and 30°) among 26 participants with brain injuries. Participants chose the device angle that felt most comfortable to them, and the study measured their writing speed, quality, and satisfaction. The findings revealed that using 3D-printed writing devices significantly improved writing speed immediately, regardless of the chosen angle (5° or 30°). Satisfaction scores were similar across all angles. Interestingly, individuals with normal elbow and wrist muscle tone were more likely to prefer the 5° device. In summary, this study concludes that 3D-printed writing devices can promptly enhance writing for people with brain injuries. The specific angle of the device significantly affect outcomes, and participants generally find satisfaction with their choice. If you have normal elbow and wrist muscle tone, the 5° angle may be the optimal choice for you.

Effects of a wearable sensor-based virtual reality game on upper-extremity function in patients with stroke.

BACKGROUND: PABLO is a virtual reality game where a motion sensor system is used. Few studies have investigated the effects of the PABLO system in stroke rehabilitation. We investigated the effects of upper-extremity virtual reality training with the PABLO system in patients with stroke. METHODS: Stroke patients were randomly assigned to the virtual reality (n = 19) or standard rehabilitation groups (n = 18). Total of 18 sessions were conducted twice per week. The primary outcome measure was the Fugl-Meyer Assessment-Upper Extremity subscale. Secondary outcome measures included the active ranges of motion of the shoulder and elbow, the box and block test, hand grip strength, and the Stroke Impact Scale. Enjoyment of activities and side effects were also recorded. FINDINGS: No difference was observed between two groups in primary outcome. Virtual reality group exhibited greater improvements in the hand dexterity between groups (p = .05). In active motion, virtual reality group showed greater improvement in shoulder flexion between groups (p = .03). Virtual reality group also showed greater improvements in elbow pronation between groups (p = .03). The groups differed in their assessments of how enjoyment the rehabilitation activities were found (p = .01). No significant differences between groups were observed in any other tests. INTERPRETATION: Interventions based on the PABLO virtual reality system improved upper extremity hand function, shoulder and elbow movements, and elicited a higher degree of enjoyment from study participants, than did traditional treatment. TRIALS REGISTRATION: The study protocol was registered at ClinicalTrials.gov PRS (No.NCT04296032).

Effects of 3D-printed assistive device on daily life function in patients with neurological impairment: a pilot study.

PURPOSE: To explore the effects of customized 3D-printed assistive technology (AT) on functional performance and feasibility in patients with neurological impairment. METHODS: Patients with neurological impairment were recruited and randomized into customized 3D-printed assistive device group (group 1; n = 17) or standard device group (group 2; n = 14). The device was designed to assist their writing, spoon using, and typing. Each patient underwent 4-week intervention with the device (30 min per session, twice a week). RESULTS: We observed significant differences in shoulder abduction (p = .00), external rotation (p = .01), and internal rotation (p = .02) in group 1. And significant differences in abduction (p = .05) and external rotation (p = .05) between the 2 groups. Group 1 achieved significant improvements in writing without AT (p = .04) and with AT (p = .02), spoon use without AT (p = .02) and with AT (p = .03), and hemiplegia-side typing with AT (p = .00). Group 2 achieved significant improvements in writing without AT (p = .01), hemiplegia-side typing without AT (p = .01), and bil-side typing with AT (P = .05). Moreover, no significant differences were noted in other outcome measures. CONCLUSIONS: This study demonstrated that customized 3D-printed AT can improve shoulder active motion for patients with neurological impairment. A positive effect in functional hand tasks after AT intervention. Offering customized AT with specific training could enhance the efficacy of interventions. The feasibility of using 3D printing technology to produce customized AT, which has the potential to be cost-effective and efficient.

3D-printed assistive device incorporating a splint can improve shoulder active motion compared to conventional assistive device for patients with neurological impairment.A positive effect in functional hand tasks after assistive device intervention.

Targeted disruption of the prostaglandin E2 E-prostanoid 2 receptor exacerbates vascular neointimal formation in mice.

OBJECTIVE: Restenosis after angioplasty remains a major clinical problem. Prostaglandin E(2) (PGE(2)) plays an important role in vascular homeostasis. The PGE(2) receptor E-prostanoid 2 (EP2) is involved in the proliferation and migration of various cell types. We aimed to determine the role of EP2 in the pathogenesis of neointimal formation after vascular injury. METHODS AND RESULTS: Wire-mediated vascular injury was induced in the femoral arteries of male wild-type (EP2+/+) and EP2 gene-deficient (EP2-/-) mice. In EP2+/+ mice, EP2 mRNA expression was increased in injured vessels for at least 4 weeks after vascular injury. Neointimal hyperplasia was markedly accelerated in EP2-/- mice, which was associated with increased proliferation and migration of vascular smooth muscle cells (VSMCs) and increased cyclin D1 expression in the neointima layer. Platelet-derived growth factor-BB (PDGF-BB) treatment resulted in more significant cell proliferation and migration in VSMCs of EP2-/- mice than in those of EP2+/+ mice. Activation and overexpression of EP2 attenuated PDGF-BB-elicited cell proliferation and migration, induced G(1)→S-phase arrest and reduced PDGF-BB-stimulated extracellular signal-regulated kinase phosphorylation in EP2+/+ VSMCs. CONCLUSIONS: These findings reveal a novel role of the EP2 receptor in neointimal hyperplasia after arterial injury. The EP2 receptor may represent a potential therapeutic target for restenosis after angioplasty.

Synthesis and evaluation of ursolic acid derivatives as potent cytotoxic agents.

Structural modification was performed at the C-3 and C-28 positions of ursolic acid (UA). Ten UA derivatives with distinct electrical property were synthesized. They could be divided into two groups according to their charge under physiological conditions: (1) Group I negatively charged and (2) Group II positively charged. The anti-proliferative capability of the derivatives was evaluated against HepG2, AGS, HT-29 and PC-3 cells by the MTT assay. Flow cytometry and Annexin V/PI dual staining assay were carried out to explore the antitumor mechanism. The results showed the cytotoxic capacity of the compounds was: Group I

Synthesis of [3ß-acetoxy-urs-12-en-28-oyl]-1-monoglyceride and investigation on its anti tumor effects against BGC-823.

Ursolic acid (UA) as the leader compound was designed to prepare a series of derivatives (three novel compounds UA-1a, UA-1b and UA-2) by modification at the C3 and C28 positions. Their chemical structures were confirmed by IR, (1)H NMR and MS. The cytotoxic activity of the derivatives was evaluated against HepG2, BGC-823 and HT-29 by the MTT assay. The novel derivative UA-1a, [3ß-acetoxy-urs-12-en-28-oyl]-1-monoglyceride showed significant anti-growth ability against the assayed cancer cell lines, particularly against BGC-823, while low cytotoxicity to human normal gastric cell line GES-1. Further investigation revealed that UA-1a could induce apoptotic events of the treated BGC-823 cells, such as comet-like DNA bend, sub-G0/G1 phase accumulation and phosphatidylserine externalization. The activity of Caspase-3 was found to be up-regulated, while the expression of Bcl-2 and Survivin were down-regulated in UA-1a treated cells. UA-1a might trigger the death of BGC-823 cells by inducing apoptosis via the mitochondria pathway. UA-1a exerted stronger ability than Taxol to retard tumor growth in nude mice without leaving apparent toxicity to the hosts. The experimental data suggested that UA-1a would have a therapeutic potential in the treatment of gastric cancer.

CD147 receptor is essential for TFF3-mediated signaling regulating colorectal cancer progression.

Major gaps in understanding the molecular mechanisms of colorectal cancer (CRC) progression and intestinal mucosal repair have hampered therapeutic development for gastrointestinal disorders. Trefoil factor 3 (TFF3) has been reported to be involved in CRC progression and intestinal mucosal repair; however, how TFF3 drives tumors to become more aggressive or metastatic and how TFF3 promotes intestinal mucosal repair are still poorly understood. Here, we found that the upregulated TFF3 in CRC predicted a worse overall survival rate. TFF3 deficiency impaired mucosal restitution and adenocarcinogenesis. CD147, a membrane protein, was identified as a binding partner for TFF3. Via binding to CD147, TFF3 enhanced CD147-CD44s interaction, resulting in signal transducer and activator of transcription 3 (STAT3) activation and prostaglandin G/H synthase 2 (PTGS2) expression, which were indispensable for TFF3-induced migration, proliferation, and invasion. PTGS2-derived PGE2 bound to prostaglandin E2 receptor EP4 subtype (PTGER4) and contributed to TFF3-stimulated CRC progression. Solution NMR studies of the TFF3-CD147 interaction revealed the key residues critical for TFF3 binding and the induction of PTGS2 expression. The ability of TFF3 to enhance mucosal restitution was weakened by a PTGS2 inhibitor. Blockade of TFF3-CD147 signaling using competitive inhibitory antibodies or a PTGS2 inhibitor reduced CRC lung metastasis in mice. Our findings bring strong evidence that CD147 is a novel receptor for TFF3 and PTGS2 signaling is critical for TFF3-induced mucosal restitution and CRC progression, which widens and deepens the understanding of the molecular function of trefoil factors.

Role of prostaglandin E and its receptors in the process of ductus arteriosus maturation and functional closure in the rabbit.

1. Patent ductus arteriosus (PDA) is a common congenital heart defect in premature infants. The present study was designed to determine the role of the prostaglandin (PG) E(2) pathway in the process of ductus arteriosus (DA) maturation and functional closure. 2. Changes in PGE(2) pathway-related enzymes and receptors in DA in preterm and term rabbits were examined at both the mRNA and protein levels. In addition, responses of DA rings to Po(2) and PGE(2) were determined. 3. Circulating PGE(2) levels remained high until 2 h after birth. High levels of the EP(4) receptor were found in preterm DA. These tissues were sensitive to PGE(2), which caused vessel dilation, but were insensitive to increased Po(2). In contrast, DA tissues from term rabbits exhibited an immediate contractile response to increased Po(2) and PGE(2) treatment resulted in vasoconstriction, which was associated with increased EP(3) and decreased EP(4) receptor expression in term DA. 4. In conclusion, the preterm PDA is maintained by high levels of PGE(2), which mainly binds to the EP(4) receptor under conditions of hypoxia. In contrast, in the term DA, in which levels of the EP(3) receptor are higher than in preterm DA, exposure to PGE(2) resulted in vasoconstriction under normoxic conditions. These findings suggest that blocking the EP(4) receptor may represent a more selective treatment for the preterm PDA, whereas activating the EP(3) receptor may be more suitable for the treatment of the term PDA.

Robotic-assisted hand therapy for improvement of hand function in children with cerebral palsy: a case series study.

BACKGROUND: Most types of robot-assisted training (RT) have been used in Cerebral Palsy (CP) patients only focus on proximal upper extremity. Few of study investigated the effect of distal upper extremity training. CASE REPORT: Pediatric CP patients (N.=7) participated the RT sessions for 6 weeks (12 60-min sessions 2 times a week). Performance was assessed at 3 time points (pretest, posttest, and 1-month follow-up). RT significantly improved in body structure and function domains: FMA-UE scores (P=0.002). On electromyography, significant improvements in the mean brachioradialis muscle amplitude (P=0.015) and electrical agonist-antagonist muscle ratio (P=0.041) in the 1-inch cube-grasping task. The effects were maintained after 1 month. CLINICAL REHABILITATION IMPACT: RT using a Gloreha device which focuses on the distal part of the upper limb benefit on body structure and function, including upper-extremity motor function, brachioradialis muscle recruitment, and coordination in children with cerebral palsy.