The Impact of Home Cardiac Rehabilitation on Quality of Life and Psychological Well-Being in Patients with Coronary Heart Disease: A Randomized Controlled Study.

BACKGROUND Percutaneous coronary intervention (PCI), a therapeutic approach to coronary heart disease, significantly alleviates symptoms of coronary heart disease (CHD) and substantially improves quality of life. This study aimed to investigate the effect of home cardiac rehabilitation (HCR) on patients after PCI. MATERIAL AND METHODS We randomly divided 106 patients after PCI into an Intervention group (n=52) and a Control group (n=53). Left ventricular ejection fraction (LVEF), blood pressure, blood glucose, and low-density lipoprotein were measured in both groups before hospital discharge and after 3 months of engaging in the intervention. Patients were assessed using the short-form health survey (SF-12) scale and Hospital Anxiety and Depression Scale (HADS) scale. RESULTS After 3 months of HCR intervention, SF-12 scores of patients in the Intervention group were significantly higher compared to patients in the Control group (physical component summary (PCS): 47.46±9.86 vs 43.28±8.21; and Mental Component Summary (MCS): 50.68±9.82 vs 48.26±9.69) (P.

Role of RAGE in Alzheimer's Disease.

Receptor for advanced glycation end products (RAGE) is a receptor of the immunoglobulin super family that plays various important roles under physiological and pathological conditions. Compelling evidence suggests that RAGE acts as both an inflammatory intermediary and a critical inducer of oxidative stress, underlying RAGE-induced Alzheimer-like pathophysiological changes that drive the process of Alzheimer's disease (AD). A critical role of RAGE in AD includes beta-amyloid (Aß) production and accumulation, the formation of neurofibrillary tangles, failure of synaptic transmission, and neuronal degeneration. The steady-state level of Aß depends on the balance between production and clearance. RAGE plays an important role in the Aß clearance. RAGE acts as an important transporter via regulating influx of circulating Aß into brain, whereas the efflux of brain-derived Aß into the circulation via BBB is implemented by LRP1. RAGE could be an important contributor to Aß generation via enhancing the activity of ß- and/or γ-secretases and activating inflammatory response and oxidative stress. However, sRAGE-Aß interactions could inhibit Aß neurotoxicity and promote Aß clearance from brain. Meanwhile, RAGE could be a promoting factor for the synaptic dysfunction and neuronal circuit dysfunction which are both the material structure of cognition, and the physiological and pathological basis of cognition. In addition, RAGE could be a trigger for the pathogenesis of Aß and tau hyper-phosphorylation which both participate in the process of cognitive impairment. Preclinical and clinical studies have supported that RAGE inhibitors could be useful in the treatment of AD. Thus, an effective measure to inhibit RAGE may be a novel drug target in AD.

Prevention of catheter tip malposition with an ultrasound-guided finger-pressure method to block the internal jugular vein during PICC placement: a meta-analysis.

Introduction: Peripherally inserted central catheters (PICC) are a type of deep venipuncture, for which the catheter tip malposition rate is high. Aim: To examine the feasibility of preventing catheter tip malposition during PICC placement using an ultrasound-guided finger-pressure method to block the internal jugular vein. Material and methods: We conducted a double-blinded randomized controlled trial (RCT) at a tertiary public hospital in Hubei province, China. A total of 600 patients were recruited and randomly allocated to the ultrasound-guided finger compression method (UGFCM) and traditional partial head method (TPHM) group (n = 300/group). Incidence of catheter tip malposition was assessed as the primary outcome of the study. A systematic literature review and meta-analysis was performed. We searched MEDLINE, EMBASE, Cochrane Library, China-National Knowledge Infrastructure, and Chinese Biomedicine Database and performed publication bias and sensitivity analyses on 10 extracted studies. Results: There were no significant differences in baseline demographic and clinical characteristics between the two groups (p > 0.05). Overall incidence of catheter tip malposition was significantly lower in the UGFCM and TPHM group (1.67% vs. 10.3%) and particularly the incidence of malposition in the internal jugular vein (1% vs. 9%). In the meta-analysis of 10 eligible studies, with 1263 cases using the UGFCM method while 1261 adopted the TPHM method, the results showed that the incidence of catheter tip malposition was significantly lower in the group using the UGFCM method (OR = 0.17, 95% CI: 0.11-0.27, p < 0.01), which is in line with the results of our RCT study. Conclusions: This study may add valuable evidence on adopting the finger-pressure method for blocking neck veins to reduce the incidence of catheter tip malposition, particularly in the internal jugular vein.

[Efficacy of repetitive transcranial magnetic stimulation for alleviating clinical symptoms and suicidal ideation in elderly depressive patients: a randomized controlled trial].

OBJECTIVE: To assess the efficacy of repetitive transcranial magnetic stimulation (rTMS) for alleviating the clinical symptoms and suicidal ideation in elderly patients with depression. METHODS: A total of 178 elderly depressive patients with suicidal ideation were randomized into rTMS treatment group (n=80) and control group (n=98) and treated with rTMS or sham rTMS treatment for 4 weeks in addition to conventional therapy with medications. The 24-item Hamilton Depression Scales (HAMD) and Self-rating Idea of Suicide Scale (SIOSS) were used to assess the severity of depression and the risk of suicide at the baseline and after 2 and 4 weeks of treatment. The treatment response was defined as a 25% reduction in HAMD scores from baseline, and an early improvement as 20% reduction in HAMD scores after 2 weeks of treatment. RESULTS: The two groups of patients were comparable for baseline socio-demographic characteristics and baseline SIOSS and HAMD scores (P>0.05). After 2 and 4 weeks of treatment, both SIOSS and HAMD scores were improved in the two groups, but the patients in rTMS group showed a significantly faster score reduction. A significantly higher rate of early improvement at 2 weeks (52.5% vs 28.6%; χ2=10.569, P<0.01) and a higher response rate at 4 weeks (77.5% vs 53.1%; χ2=15.470, P<0.05) were observed in rTMS group. CONCLUSIONS: rTMS combined with medications can effectively improve sleep quality, cognitive impairment and somatization symptom and reduce suicidal ideation in elderly patients with depression.

Interleukin-8 gene polymorphism -251T>A contributes to Alzheimer's disease susceptibility.

BACKGROUND: Published association studies have investigated the correlation between interleukin-8 (IL-8) gene polymorphism -251T>A and susceptibility to Alzheimer's disease (AD); however, the results are conflicting. Thus, we conducted the meta-analysis to reassess the effect of IL-8 gene -251T>A variant on the risk of AD. METHODS: Relevant studies regarding this association were electronically searched and identified from the PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and the Chinese Biomedicine Database. The odds ratios (ORs) with the corresponding 95% confidence intervals (95% CIs) were pooled to calculate the strength of this association. RESULTS: Nine studies with a total of 1406 cases and 2152 controls were included in the meta-analysis. Overall, a significant association of IL-8 gene -251T>A polymorphism with increased risk of AD was observed in several genetic models (allele, A vs T: OR=1.32, 95%CI=1.16-1.50; homozygous, AA vs TT: OR=1.70, 95%CI=1.21-2.21; heterozygous, TA vs TT: OR=1.37, 95%CI=1.12-1.69; recessive, AA vs TA+TT: OR=1.40, 95%CI=1.12-1.75). Similarly, such association was also revealed both in Asian and European populations in the subgroup analysis by ethnicity. CONCLUSION: The current study suggested that IL-8 gene polymorphism -251T>A may contribute to the susceptibility to AD.

Clinicopathological significance of Sox2 expression in patients with breast cancer: a meta-analysis.

Sex-determining region Y-box protein 2 (Sox2), an embryonic transcription factor located at chromosome 3q26.33, has been frequently demonstrated to be an important prognostic marker for various tumors, including breast cancer. However, its clinicopathological role in breast cancer has not been fully elucidated. To derive a more precise evaluation, we here performed a meta-analysis focusing on the association between Sox2 expression and various clinicopathological characteristics of breast cancer. Relevant publications were identified and retrieved using PubMed, Embase, Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure, and Chinese Biomedical databases. Ten studies with a total of 1713 patients with breast cancer were included in our meta-analysis. Reported odds ratios (OR) and the corresponding 95% confidence intervals (95% CI) were pooled to assess the strengths of the analyzed associations. Our results revealed significant positive associations between Sox2 expression and increased tumor size (pooled OR=2.61, 95% CI=1.91-3.58), histological grade (pooled OR=2.28, 95% CI=1.72-3.03), lymph node metastasis (pooled OR=4.17, 95% CI=1.20-14.45), and the highly aggressive triple-negative phenotype (pooled OR=2.64, 95% CI=1.11-6.29). However, no associations were observed for TNM stage and estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 statuses. Overall, the results of this meta-analysis indicate that Sox2 may be considered as a prognostic marker for breast cancer. More well-designed studies with larger sample sizes are warranted to clarify the prognostic significance of Sox2 in breast cancer.

Lack of associations between rs2910164 and rs11614913 polymorphisms and the risk of ischemic stroke.

Emerging evidence suggests that single nucleotide polymorphisms (SNPs) in microRNA genes may play a role in the development of cerebrovascular diseases including ischemic stroke through functionally modulating the expression of microRNA target genes. However, the current studies regarding the associations of the common microRNA polymorphisms with susceptibility to ischemic stroke have obtained discrepant results, which prompted us to perform a meta-analysis for a more precise estimation of the concerned associations. Relevant studies evaluating the associations between two common polymorphisms (miR-146a rs2910164 and miR-196a2 rs11614913) and the risk of ischemic stroke were retrieved from the PubMed, Embase, Cochrane Library, Google Scholar, Chinese Wanfang, Chinese Biomedical Database, and Chinese National Knowledge Infrastructure databases. The odds ratio (OR) with its 95% confidence interval (95% CI) were pooled to assess the strength of the associations using RevMan 5.2 and Stata 12.0 software. A total of 5 case-control studies with 2069 cases and 2061 controls on rs2910164, 4 case-control studies with 1873 cases and 1856 controls on rs11614913 polymorphisms were enrolled in the meta-analysis. Overall, neither allele frequency nor genotype distribution of the two common polymorphisms was found to be associated with risk for ischemic stroke in all genetic models. The subgroup analysis revealed a significant association between miR-146a rs2910164 polymorphism and increased risk of ischemic stroke in large sample size group and in Koreans under homozygous, allele, dominant and recessive models. The present meta-analysis suggests that the two common polymorphisms (rs2910164, rs11614913) may not contribute to the susceptibility to ischemic stroke. However, more well-designed studies with large sample size are warranted to further validate the results in different ethnicities.