The relationship between serum neurofilament light chain and glial fibrillary acidic protein with the REM sleep behavior disorder subtype of Parkinson's disease.

Studies have shown that rapid eye movement (REM) sleep behavior disorder (RBD) is a subtype of Parkinson's disease (PD) characterized by severe cognitive impairment and rapid disease progression. However, reliable biological markers are lacking presently. Neurofilament light chain (NFL) and glial fibrillary acidic protein (GFAP) have been widely studied as biomarkers of cognition impairment. This study aimed to find biomarkers for the RBD subtype of PD by investigating the possible relationship between serum NFL, GFAP levels, and the RBD subtype. A total of 109 PD patients and 37 healthy controls (HCs) were included, and their clinical characteristics were evaluated. PD patients were divided into two groups based on whether they had probable RBD or not. Serum NFL and GFAP levels were measured using the ultrasensitive single molecule array (Simoa) platform. The obtained data were statistically analyzed using SPSS 25.0 (IBM, Chicago, IL, USA). NFL and GFAP in the PD-RBD group were elevated compared with the PD-nRBD and control groups. Moreover, serum NFL and GFAP levels positively correlated with RBD. The combination of NFL and GFAP showed good performance in identifying PD-RBD patients from PD-nRBD. After considering potential confounding factors such as age, and disease duration, serum NFL and GFAP emerged as independent risk factors for RBD. Serum NFL and GFAP were related to RBD in PD patients. Concludingly, serum NFL and GFAP might serve as promising biomarkers for the RBD subtype of PD.

Surgical management of acute compartment syndrome and sequential complications.

BACKGROUND: Acute compartment syndrome occurs when pressure within a compartment increases and affects the function of the muscle and tissues after an injury. Compartment syndrome is most common in lower leg and may lead to permanent injury to the muscle and nerves if left untreated. METHODS: 46 patients with acute compartment syndrome were enrolled, including 8 cases with serious complications, between January 2008 and December 2012. The protocols combining early management and the correction of deformities were adjusted in order to attempt to enable full recovery of all patients. RESULTS: All patients had necrotic muscles and nerves, damaged vascular, and severe foot deformities. In the early stage, each patient received systemic support and wound debridement to promote wound healing. For patients with serious complications, a number of medical measures, including installation of Ilizarov external frames, arthrodesis, osteotomy fusion, arthroplasty, or tendon lengthening surgery, were performed to achieve satisfactory clinical outcomes. All the patients resumed weight-bearing walking and daily exercises. CONCLUSION: Acute compartment syndrome and sequential complications could be managed using a number of medical procedures.

[Tibiotalar or tibiocalcaneal arthrodesis using the ilizarov technique in the presence of infected nonunions of ankle joints].

OBJECTIVE: To evaluate the results of managing the infected nonunions of distal tibial fractures combined with talar fracture and calcaneal fracture with tibial bone transport, tibiotalar or tibiocalcaneal arthrodesis using the hybrid external fixator. METHODS: A retrospective review of 26 patients who underwent either tibiotalar arthodesis or tibiocalcaneal arthodesis using an hybrid external fixator for infected nonunions of distal tibial fractures, talar and calcaneal fractures after tibial bone distraction was made. Each patient had a debridement of all infected and nonviable bones, the wound area were 2 cm×4 cm-4 cm×8 cm. The bony surfaces of distal tibia and talus were prepared for the fusion followed by application of an Orthofix's hybrid external fixator. RESULTS: The remaining 18 patients undertook debridement at the docking sites, and 14 of them had autogenous bone grafting. There was a mean follow-up of 32 months (22-38 months). All the patients had successful fusions. There were no recurrent deep infections or amputations. Two patients had 6° of varus deformity at the docking site. CONCLUSION: Tibiotalar or tibiocalcaneal arthrodesis using the Ilizarov technique is viable alternative to amputation in patients with infected nonunions,especially if there is a large bone loss of the tibias, talus and calcaneus.

Association of serum neurofilament light chain and glial fibrillary acidic protein levels with cognitive decline in Parkinson's disease.

OBJECTIVES: To investigate whether serum neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) levels are associated with motor and cognitive function in Parkinson's disease (PD). METHODS: This cross-sectional study recruited 140 participants, including 103 PD patients and 37 healthy controls (HC). Serum NfL and GFAP levels were measured using the ultrasensitive single-molecule array (Simoa) technique. Motor and cognitive function were evaluated using the Movement Disorder Society Unified Parkinson's Disease Rating Scale Part III (MDS-UPDRS III) and Beijing version of the Montreal Cognitive Assessment (MoCA). Spearman's correlation analyses were used to determine the correlation between serum NfL and GFAP levels and clinical features in PD patients. Binary logistic regression analysis was used to assess the association between serum biomarkers and cognitive impairment in PD patients. RESULTS: We observed significantly higher serum NfL and GFAP levels in PD patients than in HC (p < 0.001). Serum NfL and GFAP levels were negatively correlated with MoCA scores (NfL: r =  - 0.472, p < 0.001; r = 0.395, p < 0.001) and multiple cognitive domains and showed no correlation with motor symptom severity after adjusting for age and sex. Binary logistic regression analysis showed that the serum NfL and GFAP levels were independent contributors to PD with dementia (p < 0.05). CONCLUSIONS: Both serum NfL and GFAP levels correlated with cognitive impairment, but not motor symptoms, in PD patients. Serum NfL and GFAP levels can serve as biomarkers for PD patients at risk of cognitive decline.

[Effect of freshening technique on docking site in tibial bone transport management].

OBJECTIVE: To study the effect of freshening technique on docking site in tibial bone transport management. METHODS: Retrospective cohort study was conducted about the effect of freshening technique on docking site in 20 cases(15 males and 5 females) treated with tibial bone transport from January of 2014 to December of 2019. The age of patients ranged from 19 to 62 years old, with an average of (42.3±11.5)years old. Seven patients had infectious bone defect and 13 patients had non-infectious. Application of freshening technique immediately after docking included resection of invaginated skin or soft tissue, removal of closed sclerotic bone, re-apposition, increasing the contact, acute compression of freshened docking site and grafting from adjacent medullary or bone debris, followed by post-operative gradual compression. RESULTS: The amount of segmented bone defect ranged from 5 to 15 cm, with an average of(9.2±2.9) cm. Time required from osteotomy to contact of butt end ranged from 26 to 243 days, with an average of(109.1±51.1) days. The duration needed from 3 to 7 months with an average of(3.7±1.1) months before reaching radiological healing criterion in docking site. Fourteen out of 15 concurrent fibular osteotomy were united. Consolidation time for distracted callus ranged from 5 to 28 months, with an average of (15.0±6.5) months. Bone healing index(BHI) ranged from 0.8 to 2.8 months/cm, with an average of (1.6±0.5) months. One surgical site infection (5%) in tibial was noted. No refractures were found in follow-up ranged from 12 to 73 months, with an average of(37.6±20.3) months after fixator removal. CONCLUSION: Freshening technique immediately after docking had advantages of the shorter healing time, avoidance of refracture, and independance of necessity for remote autograft harvest.

Application of a pre-filled tissue expander for preventing soft tissue incarceration during tibial distraction osteogenesis.

BACKGROUND: Bone transport and distraction osteogenesis has been widely used to treat bone defects after traumatic surgery, but, skin and soft tissue incarceration can be as high as 27.6%. AIM: To investigate the efficacy of inserting a tissue expander to prevent soft tissue incarceration. METHODS: Between January 2016 and December 2018, 12 patients underwent implantation of a tissue expander in the subcutaneous layer in the vicinity of a tibial defect to maintain the soft tissue in position. A certain amount of normal saline was injected into the tissue expander during surgery and was then gradually extracted to shrink the expander during the course of transport distraction osteogenesis. The tissue expander was removed when the two ends of the tibial defect were close enough. RESULTS: In all 12 patients, the expanders remained intact in the subcutaneous layer of the bone defect area during the course of transport distraction osteogenesis. When bone transport was adequate, the expander was removed and the bone transport process was completed. During the whole process, there was no incarceration of skin and soft tissue in the bone defect area. Complications occurred in one patient, who experienced poor wound healing. CONCLUSION: The pre-filled expander technique can effectively avoid soft tissue incarceration. The authors' primary success with this method indicates that it may be a valuable tool in the management of incarcerated soft tissue.

[Posterior monteggia fracture-dislocations of proximal ulna].

OBJECTIVES: To discuss the diagnosis and differential diagnosis, and to establish an effective protocol to treat the posterior Monteggia fracture-dislocations of proximal ulna in adult according to our experience. METHODS: Between April 2004 and December 2007, 16 patients with posterior Monteggia fracture-dislocations were treated surgically, 13 were followed up at a mean of 28 months (range, 12 - 58 months). All the operations were through the posterior midline approach. The fractures of radial head and coronoid process were reduced and fixed, if possible. The proximal ulna fractures were fixed with a single plate in 7 cases, plate combined with K-wires in 2, plate combined with K-wires tension band in 3, and K-wires tension band combined with screws in 1. RESULTS: No elbow was painful or unstable at the last follow up examination. They had an average of 100 degrees (range, 0 degrees to 145 degrees ) of flexion-extension of elbow. The average motion of forearm rotation was 119 degrees (range, 0 degrees to 170 degrees ). The mean Mayo Elbow Performance Score (MEPS) was 93.1 points (67 - 100 points), excellent and good results were achieved in 92.3%. The mean system of Broberg and Morrey score was 88.8 points (53 - 100 points), excellent and good results were achieved in 76.9%. CONCLUSIONS: Attention should be paid to the diagnosis and differential diagnosis of the posterior Monteggia fracture-dislocation of proximal ulna. Anatomically reduction and stable fixation of proximal ulna is the keystone for the surgical treatment.

Plants can benefit from herbivory: stimulatory effects of sheep saliva on growth of Leymus chinensis.

BACKGROUND: Plants and herbivores can evolve beneficial interactions. Growth factors found in animal saliva are probably key factors underlying plant compensatory responses to herbivory. However, there is still a lack of knowledge about how animal saliva interacts with herbivory intensities and how saliva can mobilize photosynthate reserves in damaged plants. METHODOLOGY/PRINCIPAL FINDINGS: The study examined compensatory responses to herbivory and sheep saliva addition for the grass species Leymus chinensis in three experiments over three years. The first two experiments were conducted in a factorial design with clipping (four levels in 2006 and five in 2007) and two saliva treatment levels. The third experiment examined the mobilization and allocation of stored carbohydrates following clipping and saliva addition treatments. Animal saliva significantly increased tiller number, number of buds, and biomass, however, there was no effect on height. Furthermore, saliva effects were dependent on herbivory intensities, associated with meristem distribution within perennial grass. Animal saliva was found to accelerate hydrolyzation of fructans and accumulation of glucose and fructose. CONCLUSIONS/SIGNIFICANCE: The results demonstrated a link between saliva and the mobilization of carbohydrates following herbivory, which is an important advance in our understanding of the evolution of plant responses to herbivory. Herbivory intensity dependence of the effects of saliva stresses the significance of optimal grazing management.

Study on structure-property-reactivity-function relationship of human neuronal growth inhibitory factor (hGIF).

Human metallothionein-3 (hMT3), also named as human neuronal growth inhibitory factor (hGIF), can inhibit the outgrowth of embryonic cortical neurons in the presence of brain extracts. In order to systematically study the structure-property-reactivity-function relationship of hGIF, our laboratory designed a series of mutants and studied their structure, property, reactivity and functions by a series of chemical and biological tools including UV spectroscopy, CD spectroscopy, NMR, chemical reaction and primary neuronal culture assays. In summary, we concluded that the bioactivity of hGIF was regulated by multiple factors, including the (6)CPCP(9) motif, an additional threonine insert at sequence position 5, domain-domain interactions, the structure and stability of the metal-thiolate cluster and the linker. Our studies provide more and more evidences which revealed that the bioactivity of hGIF is mainly related to the essential metal release and its characteristic conformation.