Central motor conduction time in spinocerebellar ataxia: a meta-analysis

The dominantly inherited spinocerebellar ataxias (SCAs) are a large class of neurodegenerative diseases. Transcranial magnetic stimulation has been used to evaluate the function of the pyramidal tract, and central motor conduction time (CMCT) is one index used to detect pyramidal tract dysfunction. We conducted a comprehensive search of PubMed, Embase and Web of Science. Eight eligible studies were included in the meta-analysis. For upper limb CMCT, the mean difference (95% confidence interval (CI)) between the combined SCA group and the control group was 2.24 [1.76-2.72], while the mean differences (95% CIs) between the subtypes and the control group were as follows: 4.43 [3.58-5.28] for SCA1, 0.25 [-0.15,0.65] for SCA2, 1.04 [-0.37,2.46] for SCA3 and 0.49 [-0.29,1.28] for SCA6. Additionally, SCA1 significantly differed from SCA2 and SCA3 in terms of CMCT (P=0.0006 and P=0.010, respectively). We also compared lower limb CMCT between the SCA2 and control groups. The mean difference (95% CI) was 6.58 [4.49-8.67], which was clearly statistically significant. The differences in CMCT values among different subtypes suggests diverse pathological mechanisms. In general, CMCT is a promising objective index to judge the severity of disease deserving further investigation.

Heart transplantation ten-year follow-ups: Deformation differentiation comparison of myocardial performance in left ventricle and right ventricle

BACKGROUND

We try to investigate whether the values of three-dimensional principal longitudinal strain present differently between the left and right ventricles in patients with long-time follow-ups after heart transplantation (HTx).

METHODS AND RESULTS

Transthoracic echocardiography with three-dimensional speckle tracking was performed at one-, five- and ten-year follow-ups in 62 "healthy" HTx patients together with routine echocardiographic evaluation in 32 control group (CG) individuals. Longitudinal strain was applied in all subjects assessing without myocardium wall motion abnormality. Firstly, left ventricular ejection fraction preserved in HTx and had no significant difference in comparison with the controls (p > .05). 3D measurement showed obvious reduction in global (%: CG: -20.5 ± 3.5 vs. HT1y: -13.7 ± 4.6, HT5y: -14.4 ± 4.5, HT10y: -14.6 ± 4.7. p < .01) and horizontal segmental (basal, mid, apical, CG vs. HTx: all p < .01) strain values of the left compared HTx with control subjects. Secondly, tissue Doppler imaging s' velocity and tricuspid annular plane systolic excursion reduced in HTx as compared to the controls in right ventricle (p < .01). Longitudinal strain presented a more distinctive reduction in global (%: CG: -24.5 ± 4.6 vs. HT1y:-14.8 ± 7.5, HT5y: -15.5 ± 6.4, HT10y: -15.9 ± 6.8. p < .01) and horizontal segmental (basal, mid, apical, CG vs. HTx: all p < .01) average values of the right compared HTx with control subjects. Thirdly, there weren't any significant changes between one-, five- and ten-year of all the values with HTx inter-group comparison in both the left and right ventricles (p > .05). Fourthly, the global and segmental strain of the right ventricle decreased more than that of the left ventricle in all HTx groups, with the global decreased differentiation rates of 7%, 7%, 6%, respectively.

CONCLUSIONS

Compared HTx with control subjects in both ventricles, conventional evaluation showed preserved or decreased functions in the left and right separately. Myocardial function evaluating by 3D longitudinal strain reduced after HTx, but the deformation of the right ventricle reduced more than those of the left ventricle. Additionally, 3D strain values almost remained with stable decreased differentiation rates during the long-time follow-ups.

Four-Dimensional Volume-Strain Expression in Asymptomatic Primary Hypertension Patients Presenting with Subclinical Left Atrium-Ventricle Dysfunction

OBJECTIVE

The purpose of this study was to evaluate the different components of left atrial (LA) dysfunction predictors in asymptomatic primary systemic hypertension patients with preserved left ventricular (LV) ejection fraction, particularly using LA 4-dimensional (4D) longitudinal and circumferential strain values.

METHODS AND RESULTS

Patients with no left ventricular hypertrophy (NLVH) and left ventricular hypertrophy (LVH) are all asymptomatic regarding primary blood hypertension. Thirty NLVH patients and 30 LVH patients according to LV mass index and 40 controls analyzed by 4D echocardiography were prospectively enrolled. LA volumes and longitudinal and circumferential strains were measured using 4D volume-strain echocardiography with a Vivid E95 Version 203 instrument. Correlation analysis indicated a significant relation between LV 4D mass index and LA 4D longitudinal/circumferential strain (r = -0.446 to 0.381, p = 0.000-0.042). LVH patients had a reduced LA emptying fraction compared with NLVH patients and control subjects (p < 0.01). NLVH patients had an impaired LA conduit function and increased contractile function compared with the control group (p < 0.01). LVH patients had increased LA volumes and significantly decreased reservoir, conduit and contractile functions compared with the controls (p < 0.01). LVH patients had increased LA volumes and decreased reservoir and contractile functions compared with NLVH patients (p < 0.01). The clinical utility of LA 4D volume-strain measurement was verified by receiver-operating characteristic curve analysis showing larger net benefits as evaluated with NLVH, LVH and control group comparisons. Interclass correlation coefficients of interobserver and intraobserver assessments in the LV and LA 4D value evaluations were >0.75 and >0.85, respectively.

CONCLUSIONS

LVH patients showed increased LA volumes and decreased LA emptying fractions. LA reservoir, conduit and contractile functions were significantly impaired in LVH patients. Decreased LA conduit function and increased contractile function were revealed in NLVH patients. LA volumetric and functional analyses with 4D volume-strain echocardiography may facilitate the recognition of subtle LA and LV dysfunctions in asymptomatic systemic hypertension patients.

Use of del Nido cardioplegia in acute aortic dissection surgery

Objective:

Del Nido cardioplegia solution provides a depolarized hyperkalemic arrest lasting up to 60 minutes. Single-dose del Nido cardioplegia solution may offer an alternative myocardial protection strategy to conventional whole blood cardioplegia following acute aortic dissection surgery.

Methods:

We retrospectively reviewed 122 consecutive patients with acute aortic dissection undergoing arch reconstruction surgery procedure with cardioplegia arrest from January 2017 to December 2019. Patients exclusively received with whole blood cardioplegia (n = 60, January 2017–December 2018) or del Nido cardioplegia (n = 62, January 2018–December 2019). Preoperative and postoperative data were retrospectively reviewed.

Results:

No significant difference between two groups in mortality (4/60 vs 3/62, p = 0.964), cardiopulmonary bypass time (168.0 ± 10.5 minute vs 165.0 ± 12.5 minute, p = 0.154), aortic cross-clamp time (91.8 ± 9.0 minute vs 93.2 ± 9.5 minute, p = 0.405), selective antegrade cerebral perfusion time (21.8 ± 5.0 minute vs 22.4 ± 4.7 minute, p = 0.496) and postoperative vasoactive inotropic score (34.8 ± 1.9 vs 35.2 ± 2.1, p = 0.272), neurological complications rate (8/60 vs 12/62, p = 0.523), renal insufficiency rate (5/60 vs 7/62, p = 0.807) and the troponin T level (304.8 ± 111.3 vs 315.0 ± 94.9, p = 0.588), respectively. Mean volume of crystalloid was significantly higher in the del Nido group compared to the whole blood cardioplegia group (1010.2 ± 20.3 mL vs 300.0 ± 19.6 mL, p < 0.001). Patients requiring defibrillation was 7/62 vs 28/60 (p < 0.001), with statistical difference in both groups.

Conclusion:

Short-term outcomes in acute aortic dissection surgery using del Nido cardioplegia solution were acceptable and comparable to conventional multi-dose whole blood cardioplegia. Del Nido cardioplegia technique is associated with lower defibrillations rate and requires a reduced frequency of infusions that results in longer durations between infusions and may be a feasible alternative to conventional whole blood cardioplegia solution in acute aortic dissection surgery.

[Clinical effects assessment of nasal cellulose powder on allergic rhinitis]

Objective:To evaluate the role of nasal cellulose powder locally applied in allergic rhinitis patients.Method:Fifty patients with allergic rhinitis were divided randomly into two groups: the study group and the control group. The study group were treated with nasal cellulose powder while the control group were treated with physiological sea water.Objective and subjective examinations (nasal airway resistance, nasal syndrome score, rhinoconjunctivitis qualityof life questionnaire and olfactory function,nasal mucus cilia clearance ) were performed before and 3 months after treatment.Result:After treatment, partial parameters in nasal syndrome store ( nasal itching, nasal discharge,sneezing and total store) and rhinoconjunctivitis qualityof life questionnaire (sleep, nasal symptom, non-hay-fever symptom, emotional function and total score) in the study group were significantly improved than those in the control group (P< 0.05). However, no significant difference was found in olfactory function, Nasal airway resistance, nasal mucus cilia clearance and the eye symptom in rhinoconjunctivitis qualityof life questionnaire between the two groups after treatment (P> 0.05). No adverse reaction was found in both groups.Conclusion:Nasal cellulose powder can help alleviate clinical symptoms and improve the quality of life in allergic rhinitis patients with no significant side effect.

[Studies on transgenic oilseed rape (Brassica napus) plants transformed with beta-1,3-glucanase and chitinase genes and its resistance to Sclerotinia sclerotiorium]

By Agrobacterium-mediated method, the cotyledonary petiole of good quality rape variety H165 was transformed with plant expression vector pBLGC which constitutively express beta-1,3-glucanase and chitinase genes. We obtained some Kanamycin(Kan)-resistant regenerational green shoots, with these shoots, PCR identification was conducted. Results showed that 30% green shoots which grew in medium of Kan 15 mg/L and 53% green shoots in Kan 25 mg/L had positive reaction. We also made dot blot analysis with those green shoots, some of them gave positive signal, indicating that the foreign genes had integrated into rape genome. Fungal challenge of these transgenic plants showed that some plants were much more resistant to Sclerotinia sclerotiorium than non-transgenic control plants.

Effects of enalapril on heart rate variability in patients with congestive heart failure

Congestive heart failure (CHF) is characterized by sympathetic activation and parasympathetic withdrawal, and the magnitude of sympathoneural activation is associated with adverse outcome. Angiotensin-converting enzyme inhibitor therapy has been shown to reduce mortality and improve prognosis in patients with CHF, but whether this therapy improves cardiac autonomic control is not well known. This double-blind, placebo-controlled, crossover study examines the effects of enalapril on autonomic control in 12 patients with mild to moderate CHF by heart rate variability analysis. Compared with placebo, enalapril increased the SD of all normal RR intervals (SDNN) from 39 +/- 13 to 48 +/- 15 ms (p < 0.01), the SD of the average RR intervals for all 5-minute segments from 33 +/- 12 to 42 +/- 15 ms (p < 0.01), and the mean of the SDs of all RR intervals for all 5-minute segments (SDNN index) from 19 +/- 5 to 23 +/- 6 ms (p < 0.01). The root-mean-square successive differences and the percent differences between adjacent RR intervals > 50 ms were also increased from 17 +/- 8 to 21 +/- 8 ms (p < 0.01) and from 1.1 +/- 2.1 to 2.8 +/- 2.9% (p < 0.05). In addition, total, low-frequency, and high-frequency power were increased from 560 +/- 349 to 786 +/- 504 ms2/Hz (p < 0.01), from 125 +/- 107 to 179 +/- 135 ms2/Hz (p < 0.01), and from 46 +/- 32 to 94 +/- 78 ms2/Hz (p < 0.01), respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of posture on creatinine clearance and urinary protein excretion in patients with various renal diseases

To investigate the effects of a change in posture on renal function, we measured Ccr and the urinary excretion of protein, albumin, immunoglobulin G (IgG) and transferrin in 80 patients with renal disease and in 9 healthy controls. Patients and controls were studied serially while supine for 60 min; then after standing upright for 60 min. Almost all subjects showed a drop in the Ccr with standing (p < 0.01). The percent change in Ccr after standing was more remarkable in patients with glomerulonephritis vs the healthy subjects (74.0 +/- 21.9% vs 89.9 +/- 12.3%, p < 0.01). The change in urinary excretion of protein and albumin after standing in patients with membranous nephropathy (MN-N) significantly exceeded that in patients with IgA nephropathy (IgA-N) (182.1 +/- 89.3% vs 108.1 +/- 59.2% in urinary protein and 181.7 +/- 98.7% vs 113.3 +/- 40.9% in urinary albumin, p < 0.01). Urinary excretion of IgG and transferrin tended to increase after standing in those two groups, but not significantly. Results indicate that posture affects urinary protein excretion, probably via an increase of glomerulocapillary hydrostatic pressure and/or change in the permeability of the glomerular capillary walls. We recommend that comparable postures should be used when protein excretion is used as a diagnostic tool and in monitoring structural damage to glomeruli, particularly in patients with membranous nephropathy.

[Effects of shi-ka-ron and Chinese herbs in mice treated with anti-tumor agent mitomycin C]

The Shi-ka-Ron, and its constituent Chinese herbs Lithospermum erythrorhizon, Astragalus membranaceus and Ligusticum Wallichii were administered with antitumor agent, mitomycin C (MMC) to ICR mice, and their effects on murine macrophages and lymphocytes were studied. Peritoneal macrophages were significantly inhibited both in their number and chemotactic activity by MMC treatment. Splenic weight and blastogenic responsiveness to Concanavalin A of spleen lymphocytes also decreased significantly in MMC-treated mice. NK cell activity was also suppressed by MMC treatment. When these mice were orally treated with extracts of Shi-ka-ron or each Chinese herbs mentioned above, it showed protective effects to immunosuppressive mice on all 5 items studied. The number of macrophages, and the functions of macrophages and lymphocytes maintained the same or more than normal levels in MMC plus each group of these extracts treated mice. These results suggest that the Shi-Ka-Ron and Chinese herbs could resist immunosuppression induced by antitumor agent MMC, and its mechanisms might be correlated with stimulation of the RES (reticuloendothelial system), activation of T cell blastogenesis and NK cell cytotoxicity.

[Immunomodulative effects of Chinese herbs in mice treated with anti-tumor agent cyclophosphamide]

Extracts of Chinese herbs were administered with antitumor agent, cyclophosphamide (CY), and their effects on macrophages and lymphocytes were studied. Number of peritoneal macrophages significantly decreased and their chemotactic activity was suppressed by treatment with CY. Blastogenic responsiveness to Concanavalin A and NK cell activity of spleen lymphocytes were suppressed significantly in CY-treated mice. Extracts of Lithospermi radix, Astragali radix and Glycyrrhizae radix showed protective effects on immunosuppressive mice. The number of macrophages, chemotactic activity of macrophages and blastogenic response of lymphocytes were recovered to the same or more than that of normal levels. An extract of Ginseng radix showed protective effects on the number and functions of macrophages by treatment with CY but did not show any effects on the lymphocytic blastogenesis. On the contrary it showed a strong inhibitory effect on the NK cell activity. These results suggest that Chinese herbs could modulate cellular immune response, especially in the activation of macrophages and splenic lymphocytes.

Effect of shi-ka-ron and Chinese herbs on cytokine production of macrophage in immunocompromised mice

Shi-Ka-Ron is a prescription composed of 8 crude extracts of Chinese herbs. It reduces suppression of cytokine production by peritoneal macrophages in mice Immunocompromised by the anti-tumor agent, cyclophosphamide (CY), in vivo. Although it dose not increase IL-1 production in vitro, it enhances TNF production. We found that Ginseng radix, Lithospermi radix, Astragli radix and Glycyrrhizae radix somewhat reduced suppression of cytokine production in CY treated macrophages. Especially, Glycyrrhizae radix shows an active immune response both in vivo and in vitro. Our results suggested that the mechanism underlying immunomodulation of Shi-Ka-Ron is closely related to cytokine production: each herb stimulating macrophages.

Electrophysiologic follow-up in dogs receiving intracoronary ethyl alcohol injection

96% ethyl alcohol was injected into a diagonal branch of the left anterior descending coronary artery of 10 out of 12 anesthetized dogs, and saline solution was injected in the remaining 2. After chest closure, the dogs were subjected to ambulatory monitoring (H) during days 1, 2, 3 and 7. The electrophysiologic study (EPS) and signal-averaged electrocardiography. (SA-ECG) were performed before the injection and again at day 7 after injection. H failed in one dog which died of ventricular fibrillation. In the other 9 dogs that received alcohol injection, H showed frequent ventricular premature and ventricular tachycardia (VT) after injection; six of the 9 dogs sustained VT, which was not inducible by EPS. VT was not found in 2 control dogs receiving saline solution injection. The SA-ECG showed no ventricular late potentials in dogs receiving alcohol injection. Post-ablation ventricular arrhythmia (including VT) occurred after intracoronary ethyl alcohol injection in all dogs. Arrhythmogenicity markedly declined during the first 3 days and almost completely disappeared on day 7 after ablation. There was no evidence in favor of reentry as the mechanism of these arrhythmias. Enhanced automaticity was considered as the mechanism for ventricular arrhythmia.