Correlation of visual area with tremor improvement after MRgFUS thalamotomy in Parkinson's disease.

OBJECTIVE: MRI-guided focused ultrasound (MRgFUS) thalamotomy is a novel and minimally invasive alternative for medication-refractory tremor in Parkinson's disease (PD). However, the impact of MRgFUS thalamotomy on spontaneous neuronal activity in PD remains unclear. The purpose of the current study was to evaluate the effects of MRgFUS thalamotomy on local fluctuations in neuronal activity as measured by the fractional amplitude of low-frequency fluctuations (fALFF) in patients with PD. METHODS: Participants with PD undergoing MRgFUS thalamotomy were recruited. Tremor scores were assessed before and 3 and 12 months after treatment using the Clinical Rating Scale for Tremor. MRI data were collected before and 1 day, 1 week, 1 month, 3 months, and 12 months after thalamotomy. The fALFF was calculated. A whole-brain voxel-wise paired t-test was used to identify significant changes in fALFF at 12 months after treatment compared to baseline. Then fALFF in the regions with significant differences were extracted from fALFF maps of patients for further one-way repeated-measures ANOVA to investigate its dynamic alterations. The association between fALFF changes induced by thalamotomy and tremor improvement were evaluated using the nonparametric Spearman rank test. RESULTS: Nine participants with PD (mean age ± SD 64.7 ± 6.1 years, 8 males) were evaluated. Voxel-based analysis showed that fALFF in the left occipital cortex (Brodmann area 17 [BA17]) significantly decreased at 12 months after thalamotomy compared to baseline (voxel p < 0.001, cluster p < 0.05 family-wise error [FWE] corrected). At baseline, fALFF in the left occipital BA17 in patients was elevated compared with that in 9 age- and gender-matched healthy subjects (p < 0.05). Longitudinal analysis displayed the dynamic changes of fALFF in this region (F (5,40) = 3.61, p = 0.009). There was a significant positive correlation between the falling trend in fALFF in the left occipital BA17 and hand tremor improvement after treatment over 3 time points (Spearman's rho = 0.44, p = 0.02). CONCLUSIONS: The present study investigated the impact of MRgFUS ventral intermediate nucleus thalamotomy on spontaneous neural activity in medication-refractory tremor-dominant PD. The visual area is, for the first time, reported as relevant to tremor improvement in PD after MRgFUS thalamotomy, suggesting a distant effect of MRgFUS thalamotomy and the involvement of specific visuomotor networks in tremor control in PD.

Convergent structural network and gene signatures for MRgFUS thalamotomy in patients with Parkinson's disease.

MRgFUS has just been made available for the 1.7 million Parkinson's disease patients in China. Despite its non-invasive and rapid therapeutic advantages for involuntary tremor, some concerns have emerged about outcomes variability, non-specificity, and side-effects, as little is known about its impact on the long-term plasticity of brain structure. We sought to dissect the characteristics of long-term changes in brain structure caused by MRgFUS lesion and explored potential biological mechanisms. One-year multimodal imaging follow-ups were conducted for nine tremor-dominant Parkinson's disease patients undergoing unilateral MRgFUS thalamotomy. A structural connectivity map was generated for each patient to analyze dynamic changes in brain structure. The human brain transcriptome was extracted and spatially registered for connectivity vulnerability. Genetic functional enrichment analysis was performed and further clarified using in vivo emission computed tomography data. MRgFUS not only abolished tremors but also significantly disrupted the brain network topology. Network-based statistics identified a U-shape MRgFUS-sensitive subnetwork reflective of hand tremor recovery and surgical process, accompanied by relevant cerebral blood flow and gray matter alteration. Using human brain gene expression data, we observed that dopaminergic signatures were responsible for the preferential vulnerability associated with these architectural alterations. Additional PET/SPECT data not only validated these gene signatures, but also suggested that structural alteration was significantly correlated with D1 and D2 receptors, DAT, and F-DOPA measures. There was a long-term dynamic loop between structural alteration and dopaminergic signature for MRgFUS thalamotomy, which may be closely related to the long-term improvements in clinical tremor.

[Huangqin Qingre Chubi Capsules in improving oxidative stress of patients with ankylosing spondylitis via activating PPARγ mediated AMPK/FOXO3a pathway].

To investigate the efficacy of Huangqin Qingre Chubi Capsules(HQC) in patients with ankylosing spondylitis(AS) and its effect on oxidative stress, and to explore its possible mechanism. Fifty-eight cases of AS patients were randomly divided into HQC group and salazosulfapyridine(SASP) group. Another 30 healthy people were employed as a control group. Superoxide dismutase(SOD), total antioxidant capacity(TAOC), malondialdehyde(MDA), lipid peroxidatio(LPO), interleukin-1ß(IL-1ß), IL-10, IL-4, and tumor necrosis factor-α(TNF-α) were detected by ELISA. The mRNA expression levels of AMP-activated protein kinase(AMPK-α), forkhead box O3a(FOXO3a), manganese superoxide dismutase(MnSOD), and peroxisome proliferator-activated receptor gamma(PPARγ) were detected by Real-time fluorescence quantitative polymerase chain reaction(RT-qPCR). The protein expression levels of AMPK-α, FOXO3a, p-FOXO3a, MnSOD, and PPARγ were detected by Western blot. A questionnaire was used to evaluate the disease activity score and observe the clinical efficacy of HQC in AS patients. The levels of MDA, LPO, TNF-α, and IL-1ß were significantly increased in the peripheral blood of AS patients, and SOD, TAOC, IL-4, IL-10 levels were significantly decreased. After HQC treatment, scores of disease active indexes were all decreased, and its clinical efficacy was significantly higher than that in SASP group. After HQC treatment, TAOC, SOD, IL-4, IL-10 were increased and MDA, LPO, TNF-α, IL-1ß were decreased; mRNA levels of AMPK-α, FOXO3a, MnSOD, PPARγ and protein levels of AMPK-α, FOXO3a, p-FOXO3a, MnSOD, PPARγ were increased(P<0.01 or P<0.05). HQC can effectively improve the clinical symptoms and oxidative stress of AS patients, and its mechanism may be related to activating PPARγ and up-regulating AMPK/FOXO3a signal pathway.

A Novel Chinese Medicine, Xinfeng Capsule, Modulates Proinflammatory Cytokines via Regulating the Toll-Like Receptor 4 (TLR4)/Mitogen-Activated Protein Kinase (MAPK)/Nuclear Kappa B (NF-κB) Signaling Pathway in an Adjuvant Arthritis Rat Model.

BACKGROUND Rheumatoid arthritis (RA) is a chronic autoimmune disease targeting joints. This research aimed to explore the effects of Xinfeng capsules (XFC) on cardiac injury in adjuvant arthritis (AA) model rats and assessed the associated mechanism. MATERIAL AND METHODS An adjuvant arthritis (AA) rat model was established by intracutaneously injection with Freund's complete adjuvant (FCA). Model rats were divided into 4 groups: an AA model group, an astragalus polysaccharides (APS) group, a methotrexate (MTX) group, and an XFC and triptolide (TPT) group. Hematoxylin-eosin (HE) staining was used to observe histopathologic changes. TUNEL assay was utilized to evaluate the apoptosis of cardiomyocytes. ELISA was utilized to evaluate levels of tumor necrosis factor alpha (TNF-alpha), interleukin 17 (IL-17), and interleukin 6 (IL-6) in myocardial tissues. Quantitative RT-PCR (qRT-PCR) was used to detect microRNA-21 (miRNA21) levels. Mitogen-activated protein kinase (MAPK)/p38, Toll-like receptor 4 (TLR4), and nuclear kappa B (NF-kappaB)/p65 levels were evaluated using Western blot. RESULTS XFC significantly improved proinflammatory response compared to the AA model group (p<0.05). XFC treatment significantly decreased the number of cells staining TUNEL-positive compared with the model group (p<0.05). XFC treatment significantly reduced TNF-alpha, IL-17, and IL-6 levels in myocardial tissues compared to the model group (p<0.05). Levels of miRNA21 were significantly lower in the XFC group compared to the AA model group (p<0.05). TLR4, MAPK/p38, and NF-kappaB/p65 expression levels were significantly lower in the XFC group than in the model group (p<0.05). CONCLUSIONS Xinfeng capsule, a traditional Chinese medicine preparation, protects against cardiac injury in AA rats by modulating proinflammatory cytokines expression via the TLR4/MAPK/NF-kappaB signaling pathway.

Xinfeng capsule for the treatment of rheumatoid arthritis patients with decreased pulmonary function--a randomized controlled clinical trial.

OBJECTIVE: To determine the effectiveness and safety of Xinfeng Capsules (XFC) for the treatment of rheumatoid arthritis (RA) patients with decreased pulmonary function. METHODS: This was a randomized controlled clinical trial of 80 RA patients. Participants were assigned to the trial group (40 cases) and the control group (40 cases) by block randomization. The trial group was treated with XFC, three pills each time three times daily for 2 months. The control group was treated with tripterygium glycoside (TPT), two pills each time three times daily for 2 months. Both groups were followed up after 2 months. The clinical effects, changes in joint and pulmonary function, and quality of life before and after treatment were observed; safety indices were also evaluated. RESULTS: Pain, swelling, tenderness, and duration of morning stiffness of joints were obviously decreased after treatment in both the trial and the control groups compared with baseline (P<0.01). Compared with before treatment, hand grip strength increased significantly after treatment in the trial group (P=0.0000); pulmonary function parameters such as forced expiratory volume in the first second of expiration/forced vital capacity (FEV1/FVC), 50% of the expiratory flow of forced vital capacity (FEF50), carbon monoxide diffusing capacity (DLco) were increased (P<0.01 or P<0.05); measures of quality of life such as role-physical, body pain, vitality and mental health were also improved after treatment in the trial group (all P<0.05). Joint swelling in the trial group decreased compared with the control group (P=0.0043), while hand grip strength was increased after treatment (P=0.0000). The increase in FEF50, DLco, and the dimensions of quality of life such as vitality and mental health were all significantly greater in the trial group than the control group (P<0.05 or P<0.01). CONCLUSIONS: XFC not only relieved joint pain in RA patients, but also significantly improved the ventilation and diffusion function of the lungs. Therefore, XFC could improve the whole body function and enhance the quality of life of RA patients.

Effect of vegetation rehabilitation on soil carbon and its fractions in Mu Us Desert, northwest China.

Although vegetation rehabilitation on semi-arid and arid regions may enhance soil carbon sequestration, its effects on soil carbon fractions remain uncertain. We carried out a study after planting Artemisia ordosica (AO, 17 years), Astragalus mongolicum (AM, 5 years), and Salix psammophila (SP, 16 years) on shifting sand land (SL) in the Mu Us Desert, northwest China. We measured total soil carbon (TSC) and its components, soil inorganic carbon (SIC) and soil organic carbon (SOC), as well as the light and heavy fractions within soil organic carbon (LF-SOC and HF-SOC), under the SL and shrublands at depths of 100 cm. TSC stock under SL was 27.6 Mg ha(-1), and vegetation rehabilitation remarkably elevated it by 40.6 Mgha(-1), 4.5 Mgha(-1), and 14.1 Mgha(-1) under AO, AM and SP land, respectively. Among the newly formed TSC under the three shrublands, SIC, LF-SOC and HF-SOC accounted for 75.0%, 10.7% and 13.1% for AO, respectively; they made up 37.0%, 50.7% and 10.6% for AM, respectively; they occupied 68.6%, 18.8% and 10.0% for SP, respectively. The accumulation rates of TSC within 0-100 cm reached 238.6 g m(-2) y(-1), 89.9 g m(-2) y(-1) and 87.9 g m(-2) y(-1) under AO, AM and SP land, respectively. The present study proved that the accumulation of SIC considerably contributed to soil carbon sequestration, and vegetation rehabilitation on shifting sand land has a great potential for soil carbon sequestration.

Effects of Xinfeng Capsule on the expression of platelet derived growth factor in synovium of adjuvant arthritis rats.

OBJECTIVE: To observe the effects of Xinfeng Capsule (, XFC) on platelet parameters in peripheral blood and expression of platelet derived growth factor (PDGF) in synovium of adjuvant arthritis (AA) rats. METHODS: A total of 40 male Sprague-Dawley (SD) rats were randomized into 5 groups: normal control (NC), AA model control (MC), methotrexate (MTX) treatment, Tripterygium wilfordii polycoride tablet (TPT) treatment, and XFC treatment. Excluding the NC group, the AA model was induced by intracutaneous injection of 0.1 mL Freund's complete adjuvant in the right hind limb. Induction of AA and the effects of drug treatments were assessed by voix pedis swelling, arthritis index (AI), body mass, and the pathological changes of joints and cartilage with a light microscopy. Platelet parameters in peripheral blood were detected with an automated hematology analyzer. PDGF in synovium was detected with immunohistochemical methods and PDGF mRNA expression in synovium was detected with reverse transcription polymerase chain reaction. RESULTS: Compared with the NC group, the MC group had significantly increased voix pedis swelling, AI, platelet (PLT) and plateletcrit (PCT) in peripheral blood and PDGF as well as PDGF mRNA in synovium (all P<0.01) and the joint cartilage was also highly degenerated. Compared with the MC group, the 3 treated groups had significantly decreased voix pedis swelling, AI, PLT, PCT, PDGF, and PDGF mRNA (P<0.01). The body mass in the XFC group was significantly higher than those in MTX and TPT groups (P <0.05). The levels of PLT, PCT, PDGF, and PDGF mRNA in the XFC group showed a decreasing tendency with no significant difference compared with the MTX and TPT groups (P >0.05). PDGF and PDGF mRNA of AA rats were positively correlated with voix pedis swelling, AI, PLT, and PCT (P <0.05 or P <0.01). CONCLUSIONS: The expression and biosynthesis of PDGF increase in the synovium of AA rats and correlate with voix pedis swelling, AI, PLT, and PCT. XFC can decrease the levels of PDGF, PDGF mRNA, PLT, and PCT, thereby mitigating inflammation induced by platelet activation and reducing voix pedis swelling and the AI in AA rats.

[Effects of Chinese herbal medicine Xinfeng Capsule on expressions of platelet-activating factor and interleukins 6 and 17 in peripheral blood of rats with adjuvant arthritis].

OBJECTIVE: To observe the levels of platelet-activating factor (PAF), interleukin-6 (IL-6) and IL-17 in peripheral blood of rats with adjuvant arthritis (AA), and the effects of Xinfeng Capsule (XFC), a compound traditional Chinese herbal medicine. METHODS: A total of 40 male Sprague-Dawley rats were randomized into normal control group, model group, methotrexate (MTX) group, Tripterygium Wilfordii polycoride Tablet (TPT) group, and XFC group, respectively. AA was induced in rats by intracutaneous injection of 0.1 mL Freund's complete adjuvant in the right hindlimb. Contents of PAF, IL-6 and IL-17 in peripheral blood were measured by enzyme-linked immunosorbent assay. Body weight of rats, paw swelling and arthritis index (AI) were also observed. RESULTS: Compared with the normal control group, the levels of PAF, IL-6 and IL-17 in peripheral blood, paw swelling and AI were significantly increased in the model group (P<0.01). Compared with the model group, levels of PAF, IL-6 and IL-17, paw swelling and AI of the three drug-treated groups were significantly decreased (P<0.01). The body weight of the XFC group was significantly higher than those of the MTX- and TPT-treated groups. Compared with the MTX- and TPT-treated groups, level of PAF in the XFC group was significantly increased (P<0.05). The level of PAF in peripheral blood of the AA rats was positively correlated with IL-6 and IL-17 levels in peripheral blood, paw swelling and AI (P<0.01). CONCLUSION: The expression of PAF increases in peripheral blood of rats with AA, and it correlates with IL-6, IL-17, paw swelling and AI. XFC can decrease the expression of PAF, restrain infection induced by the activation of platelets, decrease the levels of IL-6 and IL-17, and hence decrease the paw swelling of rats with AA.

[Effects of Xinfeng Capsule on behaviors and myocardial ultrastructure in adjuvant arthritis rats].

OBJECTIVE: To observe the effects of Xinfeng Capsule (XFC), a compound Chinese herbal medicine, on behaviors and myocardial ultrastructure in adjuvant arthritis (AA) rats. METHODS: Fifty-five rats were randomly divided into normal control group, untreated group, methotrexate (MTX) group, Tripterygium wilfordii glycosides tablet (TGT) group and XFC group. There were 11 rats in each group. Except for those in the normal control group, the rats in the other groups were all intracutaneously given 0.1 ml Freund's complete adjuvant in the right hind limb. Changes of behaviors and myocardial ultrastructure of the rats in different groups were observed. RESULTS: Voix pedis' swelling and arthritis index in XFC, MTX and TPT groups were all obviously improved as compared with the untreated group. After XFC treatment, the autonomic activities were obviously increased, number of errors in exercise period and test period were obviously decreased, step-down latency (SDL) was lengthened and escape latency (EL) was shortened. Overall structure of myocardial myofibril and the majority of cristae was intact in XFC group. The effects of XFC in improving the behaviors and myocardial ultrastructure were better than those of MTX and TPT. CONCLUSION: Changes of behaviour and myocardial ultrastructure of AA rats can be observed. XFC can improve the myocardial ultrastructure of AA rats as well as their behaviors.