[Effect of a Simple Home-Based Oral Care Regimen on Oral Mucositis in Patients With Oral Cavity and Nasopharyngeal Cancer: A Quasi-Experimental Study].

BACKGROUND: The majority of patients with oral cavity and nasopharyngeal cancer experience severe oral mucositis during concurrent radiochemotherapy. The effectiveness of routine nursing education remains limited. PURPOSE: To evaluate the effect of a simple home-based oral care regimen on oral mucositis. METHODS: A double-group quasi-experimental design was adopted in this study. The participants were all newly diagnosed patients with oral cavity and nasopharyngeal cancer who were scheduled to receive concurrent radiochemotherapy in a northern medical center. A total of 31 patients in the experimental group and 32 patients in the control group were enrolled as participants. The control group received routine care, while the experimental group received an additional six- to seven-week two-way interactive home-based oral care regimen. The measurement tools included a plaque record and oral assessment guide (OAG) implemented twice during the study period. Study data were collected at 8 time points, including before treatment, at 1-5 weeks of treatment, at the end of treatment, and at one-month post-treatment. Data analysis was performed using two-way repeated measures ANCOVA. RESULTS: After controlling for OAG score, nutrition, age, living habits, and oral hygiene, the development of mucositis was found to be significantly slower in the experimental group than in the control group during the traumatic phase (effect of group: F = 11.1, p < .01; effect of group x time: F = 3.5, p = .01). However, both groups reported a statistically similar rate of improvement during the repair phase (effect of group and group x time: F = 0.19, p = .67). CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The simple home-based oral care regimen introduced in this study may be used to improve traumatic oral mucositis in patients with oral cavity and nasopharyngeal cancer. It is recommended that even after the completion of radiotherapy, medical staffs should continue to strengthen patients' execution of proper oral care to maintain the positive effect until the mucositis has abated.

A hybrid method for real-time stimulation artefact removal during functional electrical stimulation with time-variant parameters.

Objective. In this study, a hybrid method combining hardware and software architecture is proposed to remove stimulation artefacts (SAs) and extract the volitional surface electromyography (sEMG) in real time during functional electrical stimulations (FES) with time-variant parameters.Approach. First, an sEMG detection front-end (DFE) combining fast recovery, detector and stimulator isolation and blanking is developed and is capable of preventing DFE saturation with a blanking time of 7.6 ms. The fragment between the present stimulus and previous stimulus is set as an SA fragment. Second, an SA database is established to provide six high-similarity templates with the current SA fragment. The SA fragment will be de-artefacted by a 6th-order Gram-Schmidt (GS) algorithm, a template-subtracting method, using the provided templates, and this database-based GS algorithm is called DBGS. The provided templates are previously collected SA fragments with the same or a similar evoking FES intensity to that of the current SA fragment, and the lengths of the templates are longer than that of the current SA fragment. After denoising, the sEMG will be extracted, and the current SA fragment will be added to the SA database. The prototype system based on DBGS was tested on eight able-bodied volunteers and three individuals with stroke to verify its capacity for stimulation removal and sEMG extraction.Results.The average stimulus artefact attenuation factor, SA index and correlation coefficient between clean sEMG and extracted sEMG for 6th-order DBGS were 12.77 ± 0.85 dB, 1.82 ± 0.37 dB and 0.84 ± 0.33 dB, respectively, which were significantly higher than those for empirical mode decomposition combined with notch filters, pulse-triggered GS algorithm, 1st-order and 3rd-order DBGS. The sEMG-torque correlation coefficients were 0.78 ± 0.05 and 0.48 ± 0.11 for able-bodied volunteers and individuals with stroke, respectively.Significance.The proposed hybrid method can extract sEMG during dynamic FES in real time.

An Anti Stimulation Artifacts and M-waves Surface Electromyography Detector with a Short Blanking Time.

A surface electromyography (sEMG) detector, that not only removes stimulation artifacts entirely but also increases the recording time, has been developed in this paper. The sEMG detector consists of an sEMG detection circuit and a stimulation isolator. The sEMG detection circuit employs a stimulus isolate switch (SIS), a blanking (BLK) and non-linear feed-back (NFB) circuit to remove the artifacts and to increase the recording time. In the SIS, the connection between stimulator and stimulation electrodes, along with the stimulation electrodes and the ground are controlled by an opto-isolator, and the connection of instrument amplifier and the recording electrodes are controlled by CMOS-based switches. The mode switches of the BLK and the NFB circuit also employs CMOS-based switches. By an accurate timing adjustment, the voluntary EMG can be recorded during electrical stimulation. Two 6 able-bodied experiments have been performed to test the three anti-artifact sEMG detector: BLK, BLK&SIS, BLK&SIS&NFB. The results indicate that the BLK&SIS&NFB proposed in this work effectively removes stimulus artifacts and M-waves, and has a longer recording time compared with BLK and BLK&SIS circuits.

Motility characteristics in the transition zone in Gastroesophageal Reflux Disease (GORD) patients.

BACKGROUND: Defects in distal oesophageal peristalsis was thought to be an indication of incomplete bolus transit (BT). However, the role of transition zone (TZ) defects in the BT in gastroesophageal reflux disease (GORD) patients needs clarification. The aim of this study was to assess the TZ defects in GORD patients and to explore the relationship between TZ defects and BT. METHODS: One hundred and two patients with reflux symptoms and 20 healthy adults were included in the study. All subjects underwent upper gastrointestinal endoscopy, high resolution impedance manometry (HRiM) and 24-h ambulatory multichannel impedance-pH (MII-pH) monitoring. Patients were subgrouped into reflux oesophagitis (RE), non-erosive reflux disease (NERD), hypersensitive oesophagus (HO) and functional heartburn (FH) classified following MII-pH monitoring. Oesophageal pressure topography was analysed to define TZ defects by spatial or temporal TZ measurements exceeding 2 cm or 1 s, weak and fragmented swallows were excluded, and the association between TZ and BT was investigated. RESULTS: Following liquid swallows, there were no significant differences in TZ delay time and TZ length between groups (RE: 1.75 s (1.32-2.17) and 2.50 cm (2.40-3.20); NERD: 1.60 s (1.10-2.00) and 2.20 cm (2.10-2.65); HO: 1.60 s (1.30-1.80) and 2.70 cm (2.30-3.00); FH: 1.55 s (1.20-2.17) and 3.10 cm (2.25-5.00); Healthy volunteers: 1.50 s (1.20-1.90) and 2.30 cm (2.10-3.00). However, individuals with TZ defects had lower complete BT rates compared with those without TZ defects (p < 0.001). There were also significantly more incomplete BT in patients with RE, HO and FH than in healthy controls (p < 0.05). CONCLUSIONS: In GORD patients, TZ defects correlated with proximal bolus retention in the corresponding area independent of distal weak peristalsis.

The -A2518G polymorphism in the MCP-1 gene and inflammatory bowel disease risk: A meta-analysis.

OBJECTIVE: The monocyte chemoattractant protein-1 (MCP-1) -A2518G gene polymorphism has been found to be involved in the susceptibility to inflammatory bowel disease (IBD); however, the results of existing studies are controversial. The aim of this meta-analysis was to assess the relationship between the MCP-1 -A2518G polymorphism and the risk of IBD. METHODS: PubMed, EMBASE and MEDLINE were searched for studies assessing the relationship between the -A2518G polymorphism in MCP-1 gene and the risk of IBD. Available data were extracted and statistically analyzed using STATA 12.0. RESULTS: A total of five publications involving 3137 individuals (1818 IBD cases and 1319 controls) were included in the meta-analysis. A combined analysis revealed that the MCP-1 -A2518G polymorphism in was a protective factor for GG + AG vs AA (OR 0.76, 95% CI 0.67-0.87, P = 0.000). Subgroup analysis by ethnicity showed that among European patients the AG + GG homozygote, unlike the AA homozygote, had a protective effect against IBD (OR 0.73, 95% CI 0.63-0.84, P = 0.000), but did not do so among Asian and African patients. Subgroup analysis by disease subtype suggested the -A2518G polymorphism in MCP-1 had a protective effect against Crohn's disease (OR 0.69, 95% CI 0.58-0.81, P = 0.000), but not against ulcerative colitis. CONCLUSIONS: Our meta-analysis suggested that the -A2518G polymorphism in MCP-1 may be a protective factor for IBD in European populations. Further studies are required to confirm these findings.

Aldolase A-HBsAg interaction and its effect on ultraviolet radiation induced apoptosis in 293FT cells.

BACKGROUND AND AIM: Hepatitis B virus (HBV) infection poses great challenges to humans, claiming one million lives annually worldwide. Solid data have related HBV to hepatocellular carcinoma. METHODS: In the present research, we verified the interaction between surface protein (HBs) encoded by HBV and aldolase A (ALDA) using yeast two-hybrid, mammalian two-hybrid, co-immunoprecipitation, GST pull-down and laser scanning confocal. RESULTS: Anti-ALDA antibody precipitated Gal4-HBs fusion protein in the presence of HBs. Anti-HBs antibody precipitated p65ΔN-ALDA only in the presence of ALDA. Small HBs could be pulled down by GST-ALDA. Cells transfected with pCMV-AD-ALDA showed a protection from ultraviolet radiation-induced apoptosis (21.3% ± 1.3% for ALDA, 35.4% ± 2.1% for control, P < 0.05). CONCLUSIONS: An interaction does exist between ALDA and HBs. The S region within HBs is sufficient for binding ALDA. In addition, ALDA conferred protection to ultraviolet radiation-induced apoptosis, and this effect was enhanced by the interaction between HBs and ALDA.

Interacting with HBsAg compromises resistance of jumping translocation breakpoint protein to ultraviolet radiation-induced apoptosis in 293FT cells.

Jumping translocation breakpoint protein (JTB) is suppressed in many cancers, implying it plays a role in the neoplastic transformation of cells. In order to explore the role of JTB in the carcinogenesis of liver, we used mammalian two-hybrid, co-immunoprecipitation, GST pull-down and laser scanning confocal to verify the interaction between HBs and JTB. According to the results, HBs interacts with JTB. In addition, we further determined that S region within HBs is sufficient for binding JTB. Overexpression of JTB conferred resistance to apoptosis induced by ultraviolet radiation, whereas this effect was compromised by the co-overexpression of HBs.