Changes in depressive-like behaviors induced by spinal cord injury based on the hypothalamic-pituitary-adrenal axis and hippocampal neurogenesis.

A reduction in sucrose preference is a key characteristic of depressive-like behaviors after spinal cord injury as judged by the sucrose preference test, the hypothalamic-pituitary-adrenal axis and adult hippocampal neurogenesis. Male rats were divided into three groups: control, sham and spinal cord injury groups. The spinal cord injury rats received a severe mid-thoracic contusion. The Basso, Beattie and Bresnahan score was used to assess motor function. The sucrose preference test and forced swim test were used to evaluate depressive-like behaviors. Serum corticosterone levels were examined by enzyme-linked immunosorbent assay and hippocampal glucocorticoid receptor levels were examined by Western blot to evaluate the function of the hypothalamic-pituitary-adrenal axis. Adult hippocampal neurogenesis was assessed by testing hippocampal brain-derived neurotrophic factor and tropomyosin receptor kinase B levels by Western blot and doublecortin levels by immunohistochemistry. Data showed that spinal cord injury impaired motor function. The spinal cord injury rats exhibited decreased sucrose preference on day six, which continued to decrease until day twelve, followed by a plateau phase. Additionally, the immobility time of the spinal cord injury rats was increased on day thirty-four. Moreover, serum corticosterone levels in the spinal cord injury group peaked on day seven, was decreased by day twenty-one and was increased again on day thirty-five. Serum corticosterone levels were significantly negatively correlated with sucrose preference and positively correlated with immobility time. Finally, hippocampal doublecortin levels on days twenty-one and thirty-five were lower in the spinal cord injury group than in the other groups. These results suggest that hyperactivation of the hypothalamic-pituitary-adrenal axis and the inhibition of adult hippocampal neurogenesis may be part of the underlying mechanism responsible for depressive-like behaviors after spinal cord injury.

Sex Differences in Prodromal Symptoms and Individual Responses to Acute Coronary Syndrome.

BACKGROUND: Although researchers have shown that prodromal symptoms can predict acute coronary events, the ability of patients with acute coronary syndrome (ACS) to identify these symptoms in a timely manner is limited. OBJECTIVES: We aimed to assess prodromal symptoms in Chinese patients with ACS and their responses to symptoms by sex. DESIGN: This cross-sectional, multicenter study involved 5 teaching hospitals in China and included 806 patients admitted for ACS between June 2013 and February 2014. The McSweeney Acute and Prodromal Myocardial Infarction Symptom Survey (Chinese version) was used to gather data. RESULTS: Among 806 patients (including 483 women), 688 (85.4%) experienced at least 1 prodromal symptom before ACS onset. Using adjusted logistic regression models, we determined that women were significantly more likely than men to report back pain, between- or under-shoulder blade pain/discomfort, sleep disturbances, anxiousness, or heart racing. The prevalence of generalized chest pain and loss of appetite was higher among men than women. Only 41% of patients attributed their prodromal symptoms to the heart, and women were more likely than men to attribute prodromal symptoms to a heart attack. CONCLUSIONS: More than two-thirds of patients with ACS reported at least 1 prodromal symptom, with some significant sex differences. Most patients do not attribute their symptoms to an impending ACS event.

Inhibition of UDP-Glucuronosyltransferases (UGTs) Activity by constituents of Schisandra chinensis.

Structure-activity relationship for the inhibition of Schisandra chinensis's ingredients toward (Uridine-Diphosphate) UDP-glucuronosyltransferases (UGTs) activity was performed in the present study. In vitro incubation system was employed to screen the inhibition capability of S. chinensis's ingredients, and in silico molecular docking method was carried out to explain possible mechanisms. At 100 µM of compounds, the activity of UGTs was inhibited by less than 90% by schisandrol A, schisandrol B, schisandrin, schisandrin C, schisantherin A, gomisin D, and gomisin G. Schisandrin A exerted strong inhibition toward UGT1A1 and UGT1A3, with the residual activity to be 7.9% and 0% of control activity. Schisanhenol exhibited strong inhibition toward UGT2B7, with the residual activity to be 7.9% of control activity. Gomisin J of 100 µM inhibited 91.8% and 93.1% of activity of UGT1A1 and UGT1A9, respectively. Molecular docking prediction indicated different hydrogen bonds interaction resulted in the different inhibition potential induced by subtle structure alteration among schisandrin A, schisandrin, and schisandrin C toward UGT1A1 and UGT1A3: schisandrin A > schisandrin > schisandrin C. The detailed inhibition kinetic evaluation showed the strong inhibition of gomisin J toward UGT1A9 with the inhibition kinetic parameter (Ki ) to be 0.7 µM. Based on the concentrations of gomisin J in the plasma of the rats given with S. chinensis, high herb-drug interaction existed between S. chinensis and drugs mainly undergoing UGT1A9-mediated metabolism. In conclusion, in silico-in vitro method was used to give the inhibition information and possible inhibition mechanism for S. chinensis's components toward UGTs, which guide the clinical application of S. chinensis.

Calcium supplementation reducing the risk of hypertensive disorders of pregnancy and related problems: A meta-analysis of multicentre randomized controlled trials.

Hypertensive disorders of pregnancy are closely related to maternal mortality and morbidity. Calcium supplementation during pregnancy seems to reduce the risk of hypertensive disorders. No systematic review on multicentre RCTs of calcium supplementation during pregnancy has been published. The purpose of this study was to report a quantitative systematic review of the effectiveness of calcium supplementation during pregnancy on reducing the risk of hypertensive disorders of pregnancy and related problems. Publications over the years of 1991-2012 were searched through PubMed, Science Direct, EMBASE, CINAHL and Web of Science. The literatures were selected of the multicentre RCTs on calcium supplementation during pregnancy in prevention of hypertensive disorders and related problems. Reference lists from the studies were also examined for additional references. Studies were critically appraised by three independent reviewers, and the Cochrane Handbook was used to assess the quality of those included trials. Four studies were included in this systematic review. All included studies were high quality, with low risk of bias. There was an observed risk reduction in hypertension in calcium group. However, there was no reduction in the risk of severe gestational hypertension, pre-eclampsia, severe pre-eclampsia, preterm birth and low birthweight. Calcium supplementation appears to reduce the risk of hypertension in pregnancy.

The effects of walking training onset on motor evoked potentials after acute spinal cord injury.

AIM: The purposes of this study were to explore the optimal time for starting walking training in the first month after spinal cord injury (SCI) in rats and to discuss the relationship between changes in motor function and transcranial electrical motor evoked potentials (tceMEPs). METHODS: Four groups of rats with SCI (BSWTT-3, 7, 14, 12) performed body-weight-supported treadmill training (BWSTT) for three weeks beginning at 3, 7, 14, and 21 days after SCI, respectively. The Basso, Beattie, and Bresnahan (BBB) score and tceMEPs were assessed weekly. Weekly repeated measures and multiple comparisons between groups were performed to identify differences in motor function and tceMEPs. Correlation analysis was performed to clarify the relationship between BBB scores and tceMEPs over time. RESULTS: Although there was no significant difference between the BWSTT-14 group and the other three BWSTT groups at the end of the experiment in terms of BBB scores and the latency of tceMEPs, the BWSTT-14 group obtained the best trends in improvement of BBB scores and the latencies and amplitudes of tceMEPs over time. The BBB scores of rats with SCI were strongly negatively correlated with tceMEPs latency. The BBB scores of rats with SCI, except for the rats in the BWSTT-3 group, were strongly positively correlated with the tceMEPs amplitude. CONCLUSIONS: The preliminary conclusion was that based on a rat model, 14 days after SCI was the optimal time for starting BWSTT. tceMEPs were an objective indicator of spinal cord nerve function, which was strongly correlated with motor function recovery. However, one limitation of this study was that the rats in the Sham group did not undergo BWSTT, which made the training itself a confounding factor for the results.

Effects of body weight-supported treadmill training at different speeds on the motor function and depressive behaviors after spinal cord injury in rats.

Spinal cord injury (SCI) causes motor dysfunction and depression, which hinders the recovery of motor function. Body weight-supported treadmill training (BWSTT) should be considered an effective method for functional rehabilitation after SCI, as it is an efficacious intervention in healthcare with no side effects. Because exercise exerts different effects on motor function recovery and inhibiting depression after SCI, we aimed to determine the appropriate intensity of BWSTT. In this study, fixed durations, frequencies, and percentages of BWSTT with different speeds of BWSTT (7, 15, and 21 cm/s) were chosen to explore the appropriate intensity, which affected the recovery of motor function and antidepressant effects on SCI rats. Based on our results, BWSTT at 21 cm/s produced the best outcomes for motor function recovery and the spinal cord levels of brain-derived neurotrophic factor (BDNF) and tropomyosin receptor kinase B (TrkB). The antidepressant effects of BWSTT at 15 and 21 cm/s were confirmed based on the increasing sucrose preference, the time spent in the central area and social time, and reduced immobility time. BWSTT at 15 and 21 cm/s improved the modulation of the hypothalamic-pituitary-adrenal axis by decreasing serum corticosterone levels and increasing hippocampal glucocorticoid receptor levels. In addition, higher levels of neurogenesis-related proteins were observed in the hippocampus of the group subjected to BWSTT at 21 cm/s than in the other groups. Thus, BWSTT at 21 cm/s is a potentially favorable treatment that synchronously improves motor function recovery and exerts an antidepressant effect.

Design and Evaluation of a Novel Laminectomy Auxiliary Device Based on Rats.

Most types of spinal cord injury (SCI) observed in humans can be replicated in adult rat models, which are widely used for laboratory studies of SCI rehabilitation. To ensure the effectiveness and efficiency of an SCI rat model, the minimal time spent performing the laminectomy procedure and the damage caused to the body are of great importance. We describe and evaluate the effectiveness and advantages of a laminectomy auxiliary device (LAD) for removing the rat vertebral lamina without injuring the spinal cord. The incision size, success rate, operation duration, body weight, BBB score, step detection, latency and amplitude of transcranial electrical motor-evoked potentials (tceMEPs), and serum MDA and SOD levels were recorded in 8 normal rats, 8 rats treated with traditional laminectomy and 8 rats treated with LAD laminectomy. Compared with traditional laminectomy, in our LAD, the surgical incision was smaller (approximately 2.2 and 1.3 cm, respectively), the success rate was higher (88.89% and 100%, respectively) and the duration shorter (14.644±1.617 and 4.821±0.668 minutes, respectively). Compared with normal rats, those treated with either laminectomy using LAD or the traditional method showed slower body weight gain and temporarily increased oxidative stress levels. However, there were no significant differences between these two groups. Our results show that laminectomy using this LAD provides three main advantages in rats: a high success rate, time savings, small incisions and reduced trauma. We believe this LAD can be used as an effective assistant tool for rodent laminectomy.

MAP­1B, PACS­2 and AHCYL1 are regulated by miR­34A/B/C and miR­449 in neuroplasticity following traumatic spinal cord injury in rats: Preliminary explorative results from microarray data.

Spinal cord injury (SCI) is a specific type of damage to the central nervous system causing temporary or permanent changes in its function. The present aimed to identify the genetic changes in neuroplasticity following SCI in rats. The GSE52763 microarray dataset, which included 15 samples [3 sham (1 week), 4 injury only (1 week), 4 injury only (3 weeks), 4 injury + treadmill (3 weeks)] was downloaded from the Gene Expression Omnibus database. An empirical Bayes linear regression model in limma package was used to identify the differentially expressed genes (DEGs) in injury vs. sham and treadmill vs. non­treadmill comparison groups. Subsequently, time series and enrichment analyses were performed using pheatmap and clusterProfile packages, respectively. Additionally, protein­protein interaction (PPI) and transcription factor (TF)­microRNA (miRNA)­target regulatory networks were constructed using Cytoscape software. In total, 159 and 105 DEGs were identified in injury vs. sham groups and treadmill vs. non­treadmill groups, respectively. There were 40 genes in cluster 1 that presented increased expression levels in the injury (1 week/3 weeks) groups compared with the sham group, and decreased expression levels in the injury + treadmill group compared with the injury only groups; conversely, 52 genes in cluster 2 exhibited decreased expression levels in the injury (1 week/3 weeks) groups compared with the sham group, and increased expression levels in the injury + treadmill group compared with the injury only groups. Enrichment analysis indicated that clusters 1 and 2 were associated with immune response and signal transduction, respectively. Furthermore, microtubule associated protein 1B, phosphofurin acidic cluster sorting protein 2 and adenosylhomocysteinase­like 1 exhibited the highest degrees in the regulatory network, and were regulated by miRNAs including miR­34A, miR­34B, miR­34C and miR­449. These miRNAs and their target genes may serve important roles in neuroplasticity following traumatic SCI in rats. Nevertheless, additional in­depth studies are required to confirm these data.

Acute coronary syndromes presentations and care outcomes in white, South Asian and Chinese patients: a cohort study.

OBJECTIVES: Successful treatment of acute coronary syndrome (ACS) relies on its rapid recognition. It is unclear whether the accepted presentation of chest pain applies to different ethnic groups. We thus examined potential ethnic variations in ACS symptoms and clinical care outcomes in white, South Asian and Chinese patients. DESIGN: Cross-sectional survey. SETTING: Participants were hospitalised at 1 of 12 Canadian centres across four provinces. PARTICIPANTS: 1334 patients with ACS (630 white; 488 South Asian; 216 Chinese). MAIN OUTCOME MEASURES: ACS presentation symptoms (classic/typical midsternal pain/discomfort with or without radiation to the left neck, shoulder or arm) were assessed by self-report. Clinical care outcomes (time to emergency room [ER] presentation, cardiac catheterisation; receipt of cardiac catheterisation, percutaneous coronary intervention [PCI] or coronary artery bypass grafting [CABG]) were obtained by health record audit. RESULTS: The mean age of the sample was 62 years and 30% had ST-elevation myocardial infarction (STEMI). The most common presenting symptom was midsternal pain/discomfort of any intensity regardless of ethnic status. Yet, a substantial proportion of patients reported atypical symptoms (33% white, 19% South Asian, 20% Chinese; p<0.006). After adjustment for age, sex, education, current smoking, extent of coronary artery disease, presence of diabetes or chronic kidney disease and STEMI vs non-STEMI/unstable angina, South Asians were more likely to present with at least moderate intensity midsternal pain/discomfort (adjusted OR [AOR] 1.44; 95% CI 1.05 to 1.98), whereas Chinese were less likely to present with radiating symptoms (AOR 0.53; 95% CI 0.38 to 0.74) compared with whites. South Asians with atypical pain (relative to those with midsternal pain/discomfort) took significantly longer to present to the ER (p=0.037), and were less likely to receive PCI (p=0.008) or CABG (p=0.041). CONCLUSIONS: Atypical presentations were associated with greater delays in arrival to the emergency department and reduced invasive cardiovascular care in South Asians.

Gender difference of symptoms of acute coronary syndrome among Chinese patients: a cross-sectional study.

BACKGROUND: The incidence of acute coronary syndrome is increasing in China. OBJECTIVE: To investigate gender differences in Chinese patients' acute coronary syndrome symptoms, attribution of symptoms and reasons for seeking medical service. METHODS: This was a cross-sectional, multicentre study. Acute coronary syndrome patients were recruited from five university hospitals located in four cities, between June 2013 and February 2014. Data were collected using the McSweeney acute and prodromal myocardial infarction symptom survey. RESULTS: A total of 806 patients with acute coronary syndrome (323 men, 483 women) participated in the study. Adjusted (diabetes, smoking, age) logistic regression models revealed that women were significantly more likely to have pain or discomfort in the: central high chest; back, between, or under the shoulder blades; neck or throat; or arms relative to men. Women were also more likely to have unusual fatigue, weakness, shortness of breath or difficulty breathing, or dizziness relative to men. Conversely, women were significantly less likely to have generalised chest pain relative to men. Gender difference in the attribution of symptoms was largely driven by women's attribution to having a heart attack more frequently than men. Finally, women were more often told by a friend to seek medical help or they knew their symptoms were different, while men more frequently sought medical help because their symptoms did not go away. CONCLUSIONS: There were gender differences in pain, discomfort and other symptoms. Both potential patients and healthcare providers need to be more aware of potential gender differences in acute coronary syndrome symptoms and decisions to seek care to ensure quick access.

Application of predictive model for vaginal birth after caesarean delivery.

Medical practitioners are concerned with the selection of delivery mode after caesarean delivery. Several researchers have developed numerous models for predicting vaginal birth after caesarean delivery. This study selected seven widely used and representative advanced models, such as those of Grobman, Troyer and Parisi, Schoorel, Flamm, Gonen, Weinstain and Smith et al., analysed the constitutions and clinical applications of the models and identified the factors associated with patients to provide midwives a scientific reference for vaginal delivery evaluation of pregnant women after caesarean delivery.

Association between secondhand smoke exposure and abnormal cervical cytology: A one-to-one matched case-control study.

INTRODUCTION: The aim was to evaluate the association between secondhand smoke (SHS) exposure and abnormal cervical cytology among Chinese adult women. METHODS: A one-to-one matched case-control study was conducted with outpatients of the First Hospital of Jilin University between October 2013 to September 2016. In all, 228 cytologic confirmed new cases of abnormal cervical cytology and the equivalent number of age and ethnic matched controls were interviewed about SHS exposure and related factors. RESULTS: Although 78.3% of all the participants had been exposed to SHS (78.1% subjects vs 78.5% controls), there were no statistical significance of cervical cytological abnormalities and SHS exposure status (never, former, current exposure), exposure intensity in cigarettes per day (none, 1-9, 10-19, and ≥20), SHS exposure duration in years (none, 1-9, 10-19, and ≥20) and the Brinkman Index (BI) (none, 1-99, 100-399, ≥400) between the two groups. The univariate analysis results showed that there were statistical differences between subjects and controls in marital status, sexual frequency in past year, number of sexual partners, age at first intercourse, age at first delivery. The stratified Cox regression model only showed that the age at first sexual intercourse was associated with the cervical cytological abnormalities (OR=1.206, 95% CI: 1.104-1.319). CONCLUSIONS: Studies on the association between SHS exposure and cervical lesions have been equivocal. In this study, the SHS exposure could not be detected as an independent risk factor of abnormal cervical cytology among Chinese adult women.

Effective robotic assistive pattern of treadmill training for spinal cord injury in a rat model.

The purpose of the present study was to establish an effective robotic assistive stepping pattern of body-weight-supported treadmill training based on a rat spinal cord injury (SCI) model and assess the effect by comparing this with another frequently used assistive stepping pattern. The recorded stepping patterns of both hind limbs of trained intact rats were edited to establish a 30-sec playback normal rat stepping pattern (NRSP). Step features (step length, step height, step number and swing duration), BBB scores, latencies, and amplitudes of the transcranial electrical motor-evoked potentials (tceMEPs) and neurofilament 200 (NF200) expression in the spinal cord lesion area during and after 3 weeks of body-weight-supported treadmill training (BWSTT) were compared in rats with spinal contusion receiving NRSP assistance (NRSPA) and those that received manual assistance (MA). Hind limb stepping performance among rats receiving NRSPA during BWSTT was greater than that among rats receiving MA in terms of longer step length, taller step height, and longer swing duration. Furthermore a higher BBB score was also indicated. The rats in the NRSPA group achieved superior results in the tceMEPs assessment and greater NF200 expression in the spinal cord lesion area compared with the rats in the MA group. These findings suggest NRSPA was an effective assistive pattern of treadmill training compared with MA based on the rat SCI model and this approach could be used as a new platform for animal experiments for better understanding the mechanisms of SCI rehabilitation.

Evaluation of anti-smoking television advertising on tobacco control among urban community population in Chongqing, China.

BACKGROUND: China is the largest producer and consumer of tobacco in the world. Considering the constantly growing urban proportion, persuasive tobacco control measures are important in urban communities. Television, as one of the most pervasive mass media, can be used for this purpose. METHODS: The anti-smoking advertisement was carried out in five different time slots per day from 15 May to 15 June in 2011 across 12 channels of Chongqing TV. A cross-sectional study was conducted in the main municipal areas of Chongqing. A questionnaire was administered in late June to 1,342 native residents aged 18-45, who were selected via street intercept survey. RESULTS: Respondents who recognized the advertisement (32.77 %) were more likely to know or believe that smoking cigarettes caused impotence than those who did not recognize the advertisement (26.11 %). According to 25.5 % of smokers, the anti-smoking TV advertising made them consider quitting smoking. However, females (51.7 %) were less likely to be affected by the advertisement to stop and think about quitting smoking compared to males (65.6 %) (OR = 0.517, 95 % CI [0.281-0.950]). In addition, respondents aged 26-35 years (67.4 %) were more likely to try to persuade others to quit smoking than those aged 18-25 years (36.3 %) (OR = 0.457, 95 % CI [0.215-0.974]). Furthermore, non-smokers (87.4 %) were more likely to find the advertisement relevant than smokers (74.8 %) (OR = 2.34, 95 % CI [1.19-4.61]). CONCLUSIONS: This study showed that this advertisement did not show significant differences on smoking-related knowledge and attitude between non-smokers who had seen the ad and those who had not. Thus, this form may not be the right tool to facilitate change in non-smokers. The ad should instead be focused on the smoking population. Gender, smoking status, and age influenced the effect of anti-smoking TV advertising on the general population in China.

Comparison of three different time points of starting treadmill training in spinal cord injured rats.

OBJECTIVE: It has been widely acknowledged that early treadmill training plays an important role in rewiring neurons in a functionally meaningful manner in spinal cord injury (SCI) treatment. However, it is still unclear how early to start treadmill training to obtain the most efficacious results after SCI. The purpose of this study was to find the earliest time point when treadmill training was most effective in rewiring neurons. METHODS: The rats were randomly divided into five groups: a sham group, control group, and three treadmill groups based on training start time post-injury: a 24 h group, 48 h group, and 72 h group. RESULTS: The results revealed that in the 72 h group, Basso, Beattie, and Bresnaham scores increased and apoptotic cells decreased significantly compared to the other groups. There were no statistically differences in neuron counting and 5-bromo-2V-deoxyuridine assays between the groups. CONCLUSION: These results indicated that the best start time for treadmill training is 72 h after SCI.