Effects of robot-assisted gait training on motor performance of lower limb in poststroke survivors: a systematic review with meta-analysis.

OBJECTIVE: This study aimed to investigate the effects of robot-assisted gait training (RAGT) on improving walking ability, and to determine the optimal dosage of task-specific training based on RAGT for stroke patients. MATERIALS AND METHODS: Two investigators independently searched electronic databases, including PubMed, Embase, Cochrane Library, and Physiotherapy Evidence Database (PEDro) from inception to 31 January 2020. The study design was a systematic review with meta-analysis of randomized controlled trials (RCTs), comparing the intervention of RAGT plus conventional therapy to conventional therapy alone. RCTs mainly focus on lower limb motor function as the primary outcomes, while the secondary outcomes involve gait speed, walking distance, cadence, balance, and activities of daily living (ADL). Pooled effect estimates were calculated by comparing the change from baseline to the end of the study in each group. RESULTS: Twenty-eight RCTs were included. The pooled analysis showed that RAGT had a significantly short-term effect on improving lower limb function [standardized mean difference (SMD) 0.32, 95% CI 0.10 to 0.55]. Additionally, there were significant improvements in gait speed (MD 0.10, 95% CI 0.06 to 0.14) and ADL (SMD 0.17, 95% CI 0.02 to 0.32). Subgroup analyses indicated that RAGT lasting for 30-60 minutes per day over 4 weeks yielded a moderate effect size (SMD 0.53, 95% CI 0.16 to 0.90). Additionally, RAGT significantly promoted lower limb function recovery in the early stage after a stroke (SMD 0.33, 95% CI 0.07 to 0.58) or in non-ambulatory patients (SMD 0.35, 95% CI 0.10 to 0.59). CONCLUSIONS: RAGT demonstrated significant positive effects on lower limb function post-stroke. Our results provide additional evidence to support that RAGT is a potentially appropriate intervention to promote lower limb recovery in individuals who have had a stroke.

[Microwave ablation versus radiofrequency ablation for solid or predominantly solid benign thyroid nodules: a randomized controlled clinical trial].

Objective: To compare the short-term efficacy and the safety of microwave ablation (MWA) and radiofrequency ablation (RFA) in the treatment of benign thyroid nodules (BTNs). Methods: This prospective randomized controlled trial, performed from December 2019 to September 2021, included 36 patients with solid or predominantly solid BTNs who met the eligibility criteria and provided written informed consent at the Nanjing sub-center (Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine). Patients were assigned to either the MWA group or the RFA group (18 patients in each group) at a ratio of 1∶1 using a block randomization design and allocation concealment using sealed envelope randomization. The independent-sample t-test and χ2 test were used to compare the volume reduction rates (VRRs), effective rates (VRRs≥50%), cosmetic scores, and complication rates at 1, 3, and 6 months after treatment between the two groups. Results: The clinical characteristics of the two groups of patients were comparable. After ablation, the nodule volume was significantly reduced in both groups. At 1, 3, and 6 months, there was no significant difference in the volume between the two groups (all P>0.05). At 3 months, the RFA group had a larger VRRs than that in the MWA group (62.08%±12.46% vs. 46.90%±23.16%, t=-2.45, P=0.021). However, at 1 and 6 months, no statistical significance was observed (both P>0.05). No significant difference was observed in the effective rates at the last follow-up (14/18 vs. 18/18, P=0.104). However, the RFA group had a lower cosmetic score than that in the MWA group (1.78±0.43 vs. 2.17±0.51, t=-2.47, P=0.019). There was no statistically significant difference in the complication rates between the two groups (all P>0.05). Conclusions: Both MWA and RFA were effective and safe treatments for BTNs, with no significant differences in short-term efficacy and safety. In addition, the RFA group showed slightly more favorable outcomes than the MWA group in terms of cosmetic improvement.

[Association between internet use and healthy lifestyles in urban adults in Hangzhou, China].

Objective: To explore the association between internet use and healthy lifestyles in urban adults. Methods: From May to August, 2022, a face-to-face questionnaire survey was conducted in residents aged 18-64 years selected in the urban area of Hangzhou by integrated cluster stratified random sampling and Kish grid method. The information about internet use included the internet use time in the past 7 days and 12 kinds of internet use contents. Using factor analysis and K-means clustering, three types of internet use were summarized, i.e. general type, video game type and working/learning type. Healthy lifestyles were defined as active physical activity, healthy diet habit, non-smoking, non-drinking, healthy weight, and healthy waist circumference. The correlations between internet use and healthy lifestyles were evaluated by using binary logistic regression and multinomial logistic regression analyses. Results: A total of 1 624 participants were included. After adjusting for potential confounding factors, the longer internet use time group (≥8.5 h/d) was less likely to have healthy weight (OR=0.59, 95%CI:0.41-0.85) and 5-6 healthy lifestyles (OR=0.55, 95%CI: 0.32-0.96) compared with those with shorter internet use time group (<2.5 h/d). For different types of internet use, it was found that compared with working/learning type group, the general type group was less likely to have healthy diet habits (OR=0.63, 95%CI: 0.46-0.86), non-drinking (OR=0.68, 95%CI: 0.47-0.99), healthy waist circumference (OR=0.59, 95%CI: 0.42-0.84) and 5-6 healthy lifestyles (OR=0.40, 95%CI: 0.23-0.69), the video game type group was less likely to have active physical activity (OR=0.73, 95%CI: 0.55-0.97) and healthy diet habits (OR=0.79, 95%CI: 0.62-0.99). Conclusion: Too long internet use (≥8.5 h/d), general type and video game type of internet use were associated with unhealthy lifestyles.

[Analysis of the incidence and mortality of leukemia in the cancer registration area of Zhejiang Province from 2010 to 2014].

The incidence and mortality rate of leukemia in the cancer registration areas of Zhejiang Province from 2010 to 2014 were analyzed to depict their epidemiological characteristics. From 2010 to 2014, 3789 new cases were diagnosed as leukemia in Zhejiang cancer registration areas, with a crude incidence rate of 6.47 per 100 000. The age-standardized incidence rate of males (standardized by China census data 2000) was 1.35 times that of females. The age-standardized incidence rate of urban areas was similar to that in rural areas (1.04∶1). From 2010 to 2014, 2 568 cases died due to leukemia, with a crude mortality rate of 4.38 per 100 000. The age-standardized mortality rate of males was 1.44 times that of females. The age-standardized mortality rate of urban areas was 0.99 times that of rural areas. The age-standardized incidence and mortality rate did not show any significant change from 2010 to 2014. The annual percent change of these two metrics was -2.36% (t=-0.62, P=0.579) and -3.46% (t=-2.41, P=0.095).

[Incidence and mortality of thyroid cancer in cancer registries of Zhejiang Province, 2010-2014].

From 2010 to 2014, a total of 17 150 new cases of thyroid cancer (TC) reported in cancer registration areas of Zhejiang province, the crude incidence rate of TC was 29.28/100 000. Using the Chinese Census in 2000 and the World Segi's population as the standard population, the age-standardized incidence rate by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 24.11/100 000 and 20.65/100 000 respectively. 256 TC death cases reported in all, the crude mortality rate was 0.44/100 000, the age-standardized mortality rate by Chinese standard population (ASMRC) and by World standard population (ASMRW) were 0.23/100 000 and 0.23/100 000 respectively. The ASIRC had a upward trend [annual percent change (APC)=28.62%, 95%CI: 21.00%-36.72%, t=13.10, P=0.001], while the ASMRC trend seemed stable (APC=0.73%, 95%CI: -7.47%-9.66%, t=0.27, P=0.803).

Correlations of serum VEGF and MMP-2 levels with CLM in CRC patients and effects of TACE on their expressions.

OBJECTIVE: To investigate the correlations of serum vascular endothelial growth factor (VEGF) and matrix metalloproteinase-2 (MMP-2) levels with colorectal liver metastasis (CLM) in patients with colorectal cancer (CRC), and determine the effects of transhepatic arterial chemoembolization (TACE) on their expressions. PATIENTS AND METHODS: A total of 110 CRC patients treated in the department of interventional radiology of our hospital from May 2013 to May 2016 were randomly enrolled. All patients received treatment of TACE after surgery. During surgery, 10 mL venous blood was taken, and the protein levels of VEGF and MMP-2 in serum were detected via enzyme-linked immunosorbent assay (ELISA). The correlations of VEGF and MMP-2 levels with clinicopathological features of patients were analyzed. The values of VEGF and MMP-2 in predicting CLM were analyzed using the receiver operating characteristic (ROC) curve. Moreover, changes in serum VEGF and MMP-2 levels in CRC patients were analyzed before TACE, and at 1 and 6 months after TACE. RESULTS: The median VEGF and MMP-2 levels in serum of CRC patients were 64.8 ng/mL and 114.4 ng/mL, respectively, which were significantly higher than those in healthy control group (5.3 ng/mL and 6.8 ng/mL) (p<0.05). The expressions of VEGF and MMP-2 in serum of CRC patients were correlated with the depth of tumor infiltration, Dukes' staging, CLM and lymph node metastasis (p<0.05). Logistic regression analyses showed that the expression levels of VEGF and MMP-2 were positively correlated with CLM (p<0.05). The ROC curve revealed that the sensitivity, specificity and accuracy of serum VEGF in the diagnosis of CLM were 62.2%, 78.5% and 80.2%, respectively. The sensitivity, specificity and accuracy of serum MMP-2 in the diagnosis of CLM were 68.9%, 85.5% and 82.2%, respectively. The serum VEGF levels in CRC patients before TACE, and at 1 and 6 months after TACE were (64.8±58.8) ng/mL, (43.1±27.3) ng/mL and (24.8±12.3) ng/mL, respectively, showing a downward trend (p<0.05). The serum MMP-2 levels in CRC patients before TACE, and at 1 and 6 months after TACE were (114.4±136.2) ng/mL, (73.4±58.5) ng/mL and (39.6±30.4) ng/mL, respectively, also indicating a reducing trend (p<0.05). CONCLUSIONS: The levels of VEGF and MMP-2 in portal vein serum of CRC patients can be used as effective indexes for judging the prognosis of CRC and predicting CLM. Patients with high expression of VEGF and MMP-2 should be actively treated with TACE after surgery to improve the survival rate.

Analytical theory and possible detection of the ac quantum spin Hall effect.

We develop an analytical theory of the low-frequency ac quantum spin Hall (QSH) effect based upon the scattering matrix formalism. It is shown that the ac QSH effect can be interpreted as a bulk quantum pumping effect. When the electron spin is conserved, the integer-quantized ac spin Hall conductivity can be linked to the winding numbers of the reflection matrices in the electrodes, which also equal to the bulk spin Chern numbers of the QSH material. Furthermore, a possible experimental scheme by using ferromagnetic metals as electrodes is proposed to detect the topological ac spin current by electrical means.

Nucleus accumbens-associated protein-1 promotes glycolysis and survival of hypoxic tumor cells via the HDAC4-HIF-1α axis.

Nucleus accumbens-associated protein-1 (NAC1), a nuclear factor of the BTB/POZ gene family, has emerging roles in cancer. In this study, we identified the NAC1-HDAC4-HIF-1α axis as an important pathway in regulating glycolysis and hypoxic adaptation in tumor cells. We show that nuclear NAC1 binds to histone deacetylase type 4 (HDAC4), hindering phosphorylation of HDAC4 at Ser246 and preventing its nuclear export that leads to cytoplasmic degradation of the deacetylase. Accumulation of HDAC4 in the nuclei results in an attenuation of HIF-1α acetylation, enhancing the stabilization and transcriptional activity of HIF-1α and strengthening adaptive response of cells to hypoxia. We also show the role of NAC1 in promoting glycolysis in a mouse xenograft model, and demonstrate that knockdown of NAC1 expression can reinforce the antitumor efficacy of bevacizumab, an inhibitor of angiogenesis. Clinical implication of the NAC1-HDAC4-HIF-1α pathway is suggested by the results showing that expression levels of these proteins are significantly correlative in human tumor specimens and associated with the disease progression. This study not only reveals an important function of NAC1 in regulating glycolysis, but also identifies the NAC1-HDAC4-HIF-1α axis as a novel molecular pathway that promotes survival of hypoxic tumor cells.

Effect of SNX-2112 on proliferation of esophageal cancer cells via regulation of excision repair cross-complementing 1, epidermal growth factor receptor, and p53 expression.

SNX-2112 is a potential molecular targeted therapeutic drug against esophageal cancer (EC). However, its exact mechanism of action remains to be explained. The aim of this study was to investigate the effect of SNX-2112 on excision repair cross- complementing 1 (ERCC1), epidermal growth factor receptor (EGFR), and p53, to elucidate the mechanism of action of SNX-2112 on EC. Fresh tumor sections were surgically obtained from 65 patients with EC, and the expression of ERCC1, EGFR, and p53 was determined by immunohistochemical staining. Furthermore, the effect of SNX-2112 (0.2 µM) on the proliferation of EC-9706 cells and the expression of ERCC1, EGFR, and p53 in these cells were analyzed by a cell proliferation assay and western blot, respectively. We observed a significant decrease and increase in ERCC1 (P = 0.001) and p53 (P = 0.043) expression, respectively, and no significant difference in EGFR (P = 0.59) expression, with the TNM stage of EC, which suggested that ERCC1 and p53 could be potential markers for the TNM stage of EC. We also observed a significant increase in ERCC1 expression, and decrease in p53 and EGFR expression, in EC-9706 cells treated with SNX-2112 (P < 0.05), indicating the regulation of EC by SNX-2112. Furthermore, SNX-2112 treatment induced a significant decrease in the proliferation of EC-9706, which confirmed the function of SNX- 2112. In summary, SNX-2112 inhibits the proliferation of EC cells by regulating the expression of ERCC1, EGFR, and p53.

Meta-analysis of association between IL-6 -634C/G polymorphism and osteoporosis.

Osteoporosis is a common disease in the aging population and studies have shown that interleukin-6 (IL-6) is potentially implicated in its pathogenesis. This study was designed to assess the association between the IL-6 gene -634C/G polymorphism and osteoporosis. PubMed, Embase, China National Knowledge Infrastructure, and Wanfang databases were searched for eligible studies published up to and including December 2014 in English or Chinese. Meta-analysis was conducted by the RevMan5.2 software. Weighted mean difference and 95% confidence interval (95%CI) were calculated by a fixed-effect or random-effect model. Bone mineral density (BMD) was regarded as the assessment index. As a result, a total of four articles with 3068 subjects were included. Differences in BMD between the CC and GG genotypes were 0.03 g/cm(2) (95%CI = 0.01 to 0.05) at total body, 0.01 g/cm(2) (95%CI = 0.00 to 0.03) at femoral neck, and 0.03 g/cm(2) (95%CI = 0.00 to 0.06) at the lumbar spine (P < 0.05). For the CG versus GG genotypes, the differences in BMD were 0.03 g/cm(2) (95%CI = 0.02 to 0.05) at total body and 0.02 g/cm(2) (95%CI = 0.00 to 0.03 at the femoral neck (P < 0.05). For the CC versus CG genotypes, the differences in BMD were not significant (P > 0.05). In conclusion, the GG genotype of the -634C/G polymorphism in IL-6 appears to play a role in reducing BMD, which affects normal bone metabolism and leads to osteoporosis.

Genetic characteristics of Chinese isolates of the tapeworm Taenia pisiformis based on two mitochondrial genes.

Cysticercosis is caused by infections with embryonated eggs of the tapeworm Taenia pisiformis. Knowledge of the genetic characteristics of T. pisiformis could be applied to study the epidemiology and transmission of this parasite. In this study, 61 isolates of intraperitoneal cysticerci from eight geographically distinct regions in Sichuan province, China, were subjected to a molecular analysis in order to determine their intra-regional genetic characteristics. Partial sequences of the mitochondrial cytochrome c oxidase subunit I (cox1, 1427 bp) and NADH dehydrogenase 1 (nad1, 738 bp) were concatenated. Five haplotypes were identified, and 89.04% of total genetic variation was found in collections of T. pisiformis isolates from a single region. According to the phylogenetic reconstruction, the T. pisiformis isolates from eight regions did not form geographical clusters. Our study highlights the genetic characteristics of T. pisiformis with the aim of accelerating the genetic research and control of cysticercosis.

Regulation of autophagy by miR-30d impacts sensitivity of anaplastic thyroid carcinoma to cisplatin.

miR-30d has been observed to be significantly down-regulated in human anaplastic thyroid carcinoma (ATC), and is believed to be an important event in thyroid cell transformation. In this study, we found that miR-30d has a critical role in modulating sensitivity of ATC cells to cisplatin, a commonly used chemotherapeutic drug for treatment of this neoplasm. Using a mimic of miR-30d, we demonstrated that miR-30d could negatively regulate the expression of beclin 1, a key autophagy gene, leading to suppression of the cisplatin-activated autophagic response that protects ATC cells from apoptosis. A reporter gene assay demonstrated that the binding sequences of miR-30d in the beclin 1-3' UTR was the region required for the inhibition of beclin 1 expression by this miRNA. We further showed that inhibition of the beclin 1-mediated autophagy by the miR-30d mimic sensitized ATC cells to cisplatin both in vitro (cell culture) and in vivo (animal xenograft model). These results suggest that dysregulation of miR-30d in ATC cells is responsible for the insensitivity to cisplatin by promoting autophagic survival. Thus, miR-30d may be exploited as a potential target for therapeutic intervention in the treatment of ATC.

Relationship between smoking and dyslipidemia in western Chinese elderly males.

The relationship between smoking and dyslipidemia was studied in 2,160 elderly Chinese males. Levels of triglycerides (TGs) in current smokers were shown to be significantly higher and levels of high-density lipoprotein cholesterol (HDL-C) lower than for those who had never smoked or had stopped smoking. Interestingly, the level of apoprotein B (apoB) was more frequently abnormal in very heavy smokers compared with light smokers, while low-density lipoprotein cholesterol (LDL-C) levels were more frequently normal in very heavy smokers. When comparing other factors that influence blood lipids, such as alcohol intake, body mass index (BMI), and age, smoking had the greatest influence and was shown to be an independent risk factor for dyslipidemia.

Hypercholesterolemia alters vascular functions and gene expression of potassium channels in rat aortic smooth muscle cells.

AIM: To investigate the effects of hypercholesterolemia on functions of rat aorta and on gene expression of inward rectifier and ATP-sensitive potassium channels in aortic smooth muscle. METHODS: Rats were treated with high-cholesterol emulsion ig for 2 weeks; the aortic rings with and without endothelium were prepared to examine the aortic contractile and relaxation responses; RT-PCR was used to observe the gene expression of inward rectifier and ATP-sensitive potassium channels. RESULTS: Hypercholesterolemia damaged the endothelium-dependent vascular functions severely, but did not affect the endothelium-independent vascular functions; Kir6.2 mRNA expression was upregulated (P < 0.05) and Kir3.1 mRNA expression was downregulated markedly (P < 0.05) in hypercholesterolemic smooth muscle. CONCLUSION: Hypercholesterolemia altered the vascular functions and regulated gene expression levels of specific inward rectifier and ATP-sensitive potassium channel subtypes.

Pre-column derivatization and gas chromatographic determination of alkaloids in bulbs of Fritillaria.

A method of precolumn derivatization GC with FID detection was developed for a simultaneous analysis of five major steroidal alkaloids of Fritillaria species, namely ebeiedine, ebeiedinone, verticine, verticinone and imperialine. Derivatization was carried out by trimethylsilylation of the hydroxyl-containing Fritillaria alkaloids to the corresponding trimethylsilylates with trimethylsilylimidazole. Reaction conditions were optimised and the alkaloids derivatives were characterised by on-line GC-MS. The validated GC method demonstrated a good linearity at the sampling ranges used. This analytical method is simple, convenient and reproducible. The developed assay was successfully applied to the determination of the major pharmacologically active alkaloids in three commonly used antitussive Fritillaria species: F. cirrhosa, F. thunbergii and F. pallidiflora.

Inhibitory effects of nimodipine on platelet aggregation and thrombosis.

AIM: To study the inhibitory effects of nimodipine (Nim) on rat platelet aggregation and arterial thrombosis in vivo. METHODS: The aggregation rate of platelets induced by ADP and inhibition rate of Nim were measured by the change of light transmission. Effect of Nim on arterial occlusion time was measured by electric stimulation. Effect of Nim on the contents of 6-keto-PGF1 alpha and TXB2 in serum was measured by radioimmunoassay. RESULTS: Nim 4.5, 9, 18, and 36 mg.kg-1.d-1 ig for 4 d restrained the platelet aggregation. The IC50 (95% confidence limits) was 26 (9-44) mg.kg-1. Nim 4.5, 9, and 18 mg.kg-1.d-1 ig for 4 d markedly prolonged the time of thrombotic occlusion in carotid artery induced by electric stimulation. Nim 9 and 18 mg.kg-1.d-1 improved the imbalance of 6-keto-PGF1 alpha/TXB2 in serum after thrombosis. CONCLUSION: Nim was a potent inhibitor of platelet aggregation, which was partially concerned with the improved balance of 6-keto-PGF1 alpha/TXB2.