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Neuroimage Clin ; 22: 101691, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30708349


BACKGROUND: Computerized multi-model training has been widely studied for its effect on delaying cognitive decline. In this study, we designed the first Chinese-version computer-based multi-model cognitive training for mild cognitive impairment (MCI) patients. Neuropsychological effects and neural activity changes assessed by functional MRI were both evaluated. METHOD: MCI patients in the training group were asked to take training 3-4 times per week for 6 months. Neuropsychological and resting-state fMRI assessment were performed at baseline and at 6 months. Patients in both groups were continuously followed up for another 12 months and assessed by neuropsychological tests again. RESULTS: 78 patients in the training group and 63 patients in the control group accomplished 6-month follow-up. Training group improved 0.23 standard deviation (SD) of mini-mental state examination, while control group had 0.5 SD decline. Addenbrooke's cognitive examination-revised scores in attention (p = 0.002) and memory (p = 0.006), as well as stroop color-word test interference index (p = 0.038) and complex figure test-copy score (p = 0.035) were also in favor of the training effect. Difference between the changes of two groups after training was not statistically significant. The fMRI showed increased regional activity at bilateral temporal poles, insular cortices and hippocampus. However, difference between the changes of two groups after another 12 months was not statistically significant. CONCLUSIONS: Multi-model cognitive training help MCI patients to gained cognition benefit, especially in memory, attention and executive function. Functional neuroimaging provided consistent neural activation evidence. Nevertheless, after one-year follow up after last training, training effects were not significant. The study provided new evidence of beneficial effect of multi-model cognitive training.

Córtex Cerebral/fisiopatologia , Disfunção Cognitiva/fisiopatologia , Disfunção Cognitiva/reabilitação , Remediação Cognitiva/métodos , Terapia Assistida por Computador/métodos , Idoso , Córtex Cerebral/diagnóstico por imagem , China , Disfunção Cognitiva/diagnóstico por imagem , Feminino , Seguimentos , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Resultado do Tratamento
Zhonghua Nei Ke Za Zhi ; 49(7): 572-6, 2010 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-20979766


OBJECTIVE: To investigate the serum level of free fatty acid (FFA) and explore its relationship with cytokines and atherosclerosis (AS) in chronic kidney disease (CKD). METHODS: The serum level of FFA was determined with enzymatic colorimetry. IL-1ß, IL-6 and TNFα were determined with ELISA. High-sensitivity C-reactive protein (hsCRP) was measured with immunoturbidimetry. Prevalence of atherosclerosis was detected with carotid ultrasonography. We evaluated the relationship between serum levels of FFA and IL-1ß, IL-6, TNFα, hsCRP as well as the renal function in 130 adult patients with CKD, stratified according to the GFR (based on the National Kidney Foundation/Kidney Dialysis Outcomes Quality Initiatives) and in 58 hemodialytic (HD) patients. The relationship between FFA level and cardiac geometry incidence in CKD patients was analyzed with logistic regression model. RESULTS: The serum level of FFA was significantly higher in CKD patients as compared with that in the healthy controls [(492.63±143.59) vs (302.65±142.18) µmol/L, P<0.01], even in the early stage of CKD. The level of FFA increased with the progression of renal dysfunction. In the non-dialytic CKD group, the level of FFA was negatively related to GFR and positively related to the proteinuria (P<0.05), while in the HD group, it was positively correlated with dialysis duration (P<0.05). The serum levels of FFA were higher in CKD patients with carotid artery atherosclerosis than those in patients without (P<0.05or<0.01). However, in both groups with impairment of renal function, the levels of FFA were positively correlated with hsCRP, IL-1ß, IL-6, TNFα and TG (all P<0.05). A positive correlation between the level of FFA and the clinical manifestations such as carotid intimal medial thickness (IMT) and AS was also found. A negative correlation was found between the level of FFA and the serum level of albumin and GFR (P<0.05). CONCLUSION: Serum levels of FFA are significantly higher either in non-dialytic CKD or in HD patients and it is related with hsCRP, IL-1ß, IL-6, TNFα as well as carotid artery atherosclerosis, indicating that FFA is an independent risk factor of AS in CKD.

Doenças das Artérias Carótidas/etiologia , Citocinas/sangue , Ácidos Graxos não Esterificados/sangue , Falência Renal Crônica/sangue , Adulto , Idoso , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
Kidney Int ; 77(11): 974-88, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20375980


Membranous nephropathy is a major cause of nephrotic syndrome in adults where podocyte injuries were found to mediate the development of proteinuria. Triptolide, a major active component of Tripterygium wilfordii Hook F, has potent immunosuppressive, anti-inflammatory and antiproteinuric effects. To study its antiproteinuric properties, we established an experimental rat model of passive Heymann nephritis and a C5b-9 injury model of podocytes in vitro. Treatment or pretreatment with triptolide markedly reduced established proteinuria as well as the titer of circulating rat anti-rabbit IgG antibodies in these nephritic rats, accompanied by a reduction in glomerular C5b-9 deposits. Expression of desmin, a marker of podocyte injury, diminished after triptolide treatment, whereas quantitative analysis of mean foot process width showed that effacement of foot processes was substantially reversed. In in vitro studies we found that triptolide deactivated NADPH oxidase, suppressed reactive oxygen species generation and p38 mitogen-activated protein kinase, and restored RhoA signaling activity. Triptolide did not interfere with the formation of C5b-9 on the membrane of podocytes. Thus, triptolide reduces established heavy proteinuria and podocyte injuries in rats with passive Heymann nephritis, and protects podocytes from C5b-9-mediated injury.

Complexo de Ataque à Membrana do Sistema Complemento/imunologia , Diterpenos/farmacologia , Glomerulonefrite Membranosa/tratamento farmacológico , Imunossupressores/farmacologia , Fenantrenos/farmacologia , Podócitos/efeitos dos fármacos , Proteinúria/prevenção & controle , Administração Oral , Animais , Linhagem Celular , Citoproteção , Desmina/metabolismo , Modelos Animais de Doenças , Diterpenos/administração & dosagem , Diterpenos/efeitos adversos , Compostos de Epóxi/administração & dosagem , Compostos de Epóxi/efeitos adversos , Compostos de Epóxi/farmacologia , Feminino , Glomerulonefrite Membranosa/imunologia , Glomerulonefrite Membranosa/patologia , Complexo Antigênico da Nefrite de Heymann/imunologia , Imunoglobulina G/sangue , Imunossupressores/administração & dosagem , Imunossupressores/efeitos adversos , Camundongos , NADPH Oxidases/metabolismo , Fenantrenos/administração & dosagem , Fenantrenos/efeitos adversos , Podócitos/imunologia , Podócitos/patologia , Proteinúria/imunologia , Proteinúria/patologia , Coelhos , Ratos , Ratos Sprague-Dawley , Ratos Wistar , Espécies Reativas de Oxigênio/metabolismo , Transdução de Sinais/efeitos dos fármacos , Tacrolimo/farmacologia , Fatores de Tempo , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismo , Proteínas rho de Ligação ao GTP/metabolismo