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Lankinen K, Wang R, Tian Q, Wang QM, Perry BJ, Green JR, Kimberley TJ, Ahveninen J, Li S. Individualized white matter connectivity of the articulatory pathway: An ultra-high field study. Brain Lang 2024; 250:105391. [PMID: 38354542 PMCID: PMC10940181 DOI: 10.1016/j.bandl.2024.105391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 01/29/2024] [Accepted: 02/07/2024] [Indexed: 02/16/2024]
Abstract
In current sensorimotor theories pertaining to speech perception, there is a notable emphasis on the involvement of the articulatory-motor system in the processing of speech sounds. Using ultra-high field diffusion-weighted imaging at 7 Tesla, we visualized the white matter tracts connected to areas activated during a simple speech-sound production task in 18 healthy right-handed adults. Regions of interest for white matter tractography were individually determined through 7T functional MRI (fMRI) analyses, based on activations during silent vocalization tasks. These precentral seed regions, activated during the silent production of a lip-vowel sound, demonstrated anatomical connectivity with posterior superior temporal gyrus areas linked to the auditory perception of phonetic sounds. Our study provides a macrostructural foundation for understanding connections in speech production and underscores the central role of the articulatory motor system in speech perception. These findings highlight the value of ultra-high field 7T MR acquisition in unraveling the neural underpinnings of speech.
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Affiliation(s)
- Kaisu Lankinen
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Ruopeng Wang
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, United States
| | - Qiyuan Tian
- Harvard Medical School, Boston, MA, United States
| | - Qing Mei Wang
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, the teaching affiliate of Harvard Medical School, Charlestown, MA, United States
| | - Bridget J Perry
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions Boston, MA, United States
| | - Jordan R Green
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions Boston, MA, United States
| | - Teresa J Kimberley
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA, United States
| | - Jyrki Ahveninen
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Shasha Li
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
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Liang J, Feng J, Lin Z, Wei J, Luo X, Wang QM, He B, Chen H, Ye Y. Research on prognostic risk assessment model for acute ischemic stroke based on imaging and multidimensional data. Front Neurol 2023; 14:1294723. [PMID: 38192576 PMCID: PMC10773779 DOI: 10.3389/fneur.2023.1294723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 11/30/2023] [Indexed: 01/10/2024] Open
Abstract
Accurately assessing the prognostic outcomes of patients with acute ischemic stroke and adjusting treatment plans in a timely manner for those with poor prognosis is crucial for intervening in modifiable risk factors. However, there is still controversy regarding the correlation between imaging-based predictions of complications in acute ischemic stroke. To address this, we developed a cross-modal attention module for integrating multidimensional data, including clinical information, imaging features, treatment plans, prognosis, and complications, to achieve complementary advantages. The fused features preserve magnetic resonance imaging (MRI) characteristics while supplementing clinical relevant information, providing a more comprehensive and informative basis for clinical diagnosis and treatment. The proposed framework based on multidimensional data for activity of daily living (ADL) scoring in patients with acute ischemic stroke demonstrates higher accuracy compared to other state-of-the-art network models, and ablation experiments confirm the effectiveness of each module in the framework.
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Affiliation(s)
- Jiabin Liang
- Postgraduate Cultivation Base of Guangzhou University of Chinese Medicine, Panyu Central Hospital, Guangzhou, China
- Graduate School, Guangzhou University of Chinese Medicine, Guangzhou, China
- Medical Imaging Institute of Panyu, Guangzhou, China
| | - Jie Feng
- Radiology Department of Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhijie Lin
- Laboratory for Intelligent Information Processing, Guangdong University of Technology, Guangzhou, China
| | - Jinbo Wei
- Postgraduate Cultivation Base of Guangzhou University of Chinese Medicine, Panyu Central Hospital, Guangzhou, China
| | - Xun Luo
- Kerry Rehabilitation Medicine Research Institute, Shenzhen, China
| | - Qing Mei Wang
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, Teaching Affiliate of Harvard Medical School, Charlestown, MA, United States
| | - Bingjie He
- Panyu Health Management Center, Guangzhou, China
| | - Hanwei Chen
- Postgraduate Cultivation Base of Guangzhou University of Chinese Medicine, Panyu Central Hospital, Guangzhou, China
- Medical Imaging Institute of Panyu, Guangzhou, China
- Panyu Health Management Center, Guangzhou, China
| | - Yufeng Ye
- Postgraduate Cultivation Base of Guangzhou University of Chinese Medicine, Panyu Central Hospital, Guangzhou, China
- Medical Imaging Institute of Panyu, Guangzhou, China
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Lankinen K, Ahveninen J, Uluç I, Daneshzand M, Mareyam A, Kirsch JE, Polimeni JR, Healy BC, Tian Q, Khan S, Nummenmaa A, Wang QM, Green JR, Kimberley TJ, Li S. Role of articulatory motor networks in perceptual categorization of speech signals: a 7T fMRI study. Cereb Cortex 2023; 33:11517-11525. [PMID: 37851854 PMCID: PMC10724868 DOI: 10.1093/cercor/bhad384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 09/28/2023] [Accepted: 09/29/2023] [Indexed: 10/20/2023] Open
Abstract
Speech and language processing involve complex interactions between cortical areas necessary for articulatory movements and auditory perception and a range of areas through which these are connected and interact. Despite their fundamental importance, the precise mechanisms underlying these processes are not fully elucidated. We measured BOLD signals from normal hearing participants using high-field 7 Tesla fMRI with 1-mm isotropic voxel resolution. The subjects performed 2 speech perception tasks (discrimination and classification) and a speech production task during the scan. By employing univariate and multivariate pattern analyses, we identified the neural signatures associated with speech production and perception. The left precentral, premotor, and inferior frontal cortex regions showed significant activations that correlated with phoneme category variability during perceptual discrimination tasks. In addition, the perceived sound categories could be decoded from signals in a region of interest defined based on activation related to production task. The results support the hypothesis that articulatory motor networks in the left hemisphere, typically associated with speech production, may also play a critical role in the perceptual categorization of syllables. The study provides valuable insights into the intricate neural mechanisms that underlie speech processing.
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Affiliation(s)
- Kaisu Lankinen
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA 02129, United States
- Harvard Medical School, Boston, MA 02115, United States
| | - Jyrki Ahveninen
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA 02129, United States
- Harvard Medical School, Boston, MA 02115, United States
| | - Işıl Uluç
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA 02129, United States
- Harvard Medical School, Boston, MA 02115, United States
| | - Mohammad Daneshzand
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA 02129, United States
- Harvard Medical School, Boston, MA 02115, United States
| | - Azma Mareyam
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA 02129, United States
| | - John E Kirsch
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA 02129, United States
- Harvard Medical School, Boston, MA 02115, United States
| | - Jonathan R Polimeni
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA 02129, United States
- Harvard Medical School, Boston, MA 02115, United States
| | - Brian C Healy
- Partners Multiple Sclerosis Center, Brigham and Women's Hospital, Boston, MA 02115, United States
- Department of Neurology, Harvard Medical School, Boston, MA 02115, United States
- Biostatistics Center, Massachusetts General Hospital, Boston, MA 02114, United States
| | - Qiyuan Tian
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA 02129, United States
- Harvard Medical School, Boston, MA 02115, United States
| | - Sheraz Khan
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA 02129, United States
- Harvard Medical School, Boston, MA 02115, United States
| | - Aapo Nummenmaa
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA 02129, United States
- Harvard Medical School, Boston, MA 02115, United States
| | - Qing Mei Wang
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, The Teaching Affiliate of Harvard Medical School, Charlestown, MA 02129, United States
| | - Jordan R Green
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, MA 02129, United States
| | - Teresa J Kimberley
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA 02129, United States
| | - Shasha Li
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA 02129, United States
- Harvard Medical School, Boston, MA 02115, United States
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Zhu X, Luo Z, Tian G, Hu Z, Li S, Wang QM, Luo X, Chen L. Hypotension and cognitive impairment among the elderly: Evidence from the CLHLS. PLoS One 2023; 18:e0291775. [PMID: 37725634 PMCID: PMC10508618 DOI: 10.1371/journal.pone.0291775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/25/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND While high blood pressure has been linked to cognitive impairment, the relationship between low blood pressure, especially hypotension, and cognitive impairment has not been well studied. Therefore, this study aimed to assess the prevalence of hypotension and cognitive impairment in the seniors of China, and the association between hypotension and cognitive function impairment. METHODS The data was derived from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Systolic blood pressures (SBP) and diastolic blood pressures (DBP) were measured by objective examination. The Chinese version of the Mini-Mental State Examination (CMMSE) was used to evaluate the cognitive impairment of the elderly. Generalized linear models were conducted to evaluate the association of hypotension with cognitive impairment. RESULTS The prevalence of hypotension and cognitive impairment in the Chinese elderly were 0.76% and 22.06%, respectively. Participants with hypotension, lower SBP, and lower DBP, had odds ratios of 1.62, 1.38, and 1.48 for cognitive impairment, respectively. Besides, the CMMSE scores decreased by 2.08, 0.86, and 1.08 in the elderly with hypotension, lower SBP, and DBP, compared with those with non-hypotension, higher SBP, and DBP, respectively. Subgroup analyses showed that the association of cognitive impairment with hypotension was stronger in Chinese elderly who had decreased activity of daily living. Moreover, there was statistical evidence of a nonlinear dose-response relationship of SBP and DBP with cognitive impairment (Pnonlinear < 0.05). CONCLUSION Hypotension was a potential risk factor for cognitive impairment of the Chinese elderly, especially for those having decreased activity of daily living. Blood pressure management should be conducted to prevent them from cognitive impairment.
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Affiliation(s)
- Xidi Zhu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, the Teaching Affiliate of Harvard Medical School, Boston, Massachusetts, United States of America
| | - Zhicheng Luo
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Gang Tian
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Zhao Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Shaojie Li
- School of Public Health, Peking University, Beijing, China
| | - Qing Mei Wang
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, the Teaching Affiliate of Harvard Medical School, Boston, Massachusetts, United States of America
| | - Xun Luo
- Kerry Rehabilitation Medicine Research Institute, Shenzhen, China
- School of Medicine, Shenzhen University, Shenzhen, China
| | - Lizhang Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
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Cataldo AVR, Collimore AN, Spangler J, Ribeirinha-Braga L, Hutchinson K, Wang QM, Thompson L, Awad LN. Enhancing Neuroplasticity in the Chronic Phase After Stroke: Effects of a Soft Robotic Exosuit on Training Intensity and Brain-Derived Neurotrophic Factor. IEEE Open J Eng Med Biol 2023; 4:284-291. [PMID: 38196979 PMCID: PMC10776098 DOI: 10.1109/ojemb.2023.3313396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 03/21/2023] [Accepted: 09/03/2023] [Indexed: 01/11/2024] Open
Abstract
Objective: High intensity training may enhance neuroplasticity after stroke; however, gait deficits limit the ability to achieve and sustain high walking training intensities. We hypothesize that soft robotic exosuits can facilitate speed-based gait training at higher intensities and longer durations, resulting in a corresponding increase in circulating brain-derived neurotrophic factor (BDNF). Results: Eleven individuals >6-mo post-stroke completed a two-session, pilot randomized crossover trial (NCT05138016). Maximum training speed (Δ: 0.07 ± 0.03 m/s), duration (Δ: 2.07 ± 0.88 min), and intensity (VO2 peak, Δ: 1.75 ± 0.60 ml-O2/kg/min) significantly increased (p < 0.05) during exosuit-augmented training compared to no-exosuit training. Post-session increases in BDNF (Δ: 5.96 ± 2.27 ng/ml, p = 0.03) were observed only after exosuit-augmented training. Biomechanical changes were not observed after exosuit-augmented training; however, a deterioration in gait propulsion symmetry (%Δ: -5 ± 2 %) and an increase in nonparetic propulsion (Δ: 0.9 ± 0.3 %bw) were observed (p < 0.05) after no-exosuit training. Conclusion: Soft robotic exosuits facilitate faster, longer duration, and higher intensity walking training associated with enhanced neuroplasticity.
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Affiliation(s)
- Anna V. Roto Cataldo
- Boston University, College of Health and Rehabilitation Sciences: SargentBostonMA02215USA
| | - Ashley N. Collimore
- Boston University, College of Health and Rehabilitation Sciences: SargentBostonMA02215USA
| | - Johanna Spangler
- Boston University, College of Health and Rehabilitation Sciences: SargentBostonMA02215USA
| | | | - Karen Hutchinson
- Boston University, College of Health and Rehabilitation Sciences: SargentBostonMA02215USA
| | - Qing Mei Wang
- Spaulding Rehabilitation HospitalCharlestownMA02129USA
| | - LaDora Thompson
- Boston University, College of Health and Rehabilitation Sciences: SargentBostonMA02215USA
| | - Louis N. Awad
- Boston University, College of Health and Rehabilitation Sciences: SargentBostonMA02215USA
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Daneshzand M, Lankinen K, Ahveninen J, Wang QM, Green JR, Kimberley TJ, Li S. Personalized 7T fMRI-Guided navigation TMS targeting: Preliminary data of speech-motor cortex in speech perception. Brain Stimul 2023; 16:1455-1457. [PMID: 37774914 PMCID: PMC10810261 DOI: 10.1016/j.brs.2023.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 09/12/2023] [Accepted: 09/18/2023] [Indexed: 10/01/2023] Open
Affiliation(s)
- Mohammad Daneshzand
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Kaisu Lankinen
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Jyrki Ahveninen
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Qing Mei Wang
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, The Teaching Affiliate of Harvard Medical School, Charlestown, MA, USA
| | - Jordan R Green
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions Boston, MA, USA
| | - Teresa J Kimberley
- Department of Physical Therapy, School of Health and Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA, USA
| | - Shasha Li
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
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Zhang S, Yu Y, Xu P, Shen X, Fang C, Wu X, Qu P, Wu T, Wang QM, Luo X, Hong Y. Mechanical digit sensory stimulation: a randomized control trial on neurological and motor recovery in acute stroke. Front Neurosci 2023; 17:1134904. [PMID: 37287803 PMCID: PMC10242038 DOI: 10.3389/fnins.2023.1134904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 05/10/2023] [Indexed: 06/09/2023] Open
Abstract
Background Mechanical digit sensory stimulation (MDSS) is a novel therapy designed to accelerate the recovery of upper limb (including hand) function in patients with hemiplegia following a stroke. The primary goal of this study was to investigate the effect of MDSS on patients with acute ischemic stroke (AIS). Methods Sixty-one inpatients with AIS were randomly divided into conventional rehabilitation group (RG) and stimulation group (SG), and the latter group received MDSS therapy. A healthy group consisting of 30 healthy adults was also included. The interleukin-17A (IL-17A), vascular endothelial growth factor A (VEGF-A), and tumor necrosis factor-alpha (TNF-α) plasma levels were measured in all subjects. The neurological and motor functions of patients were evaluated using the National Institutes of Health Stroke Scale (NIHSS), Mini-Mental State Examination (MMSE), Fugel-Meyer Assessment (FMA), and Modified Barthel Index (MBI). Results After 12 days of intervention, the IL-17A, TNF-α, and NIHSS levels were significantly decreased, while the VEGF-A, MMSE, FMA, and MBI levels were significantly increased in both disease groups. No significant difference was observed between both disease groups after intervention. The levels of IL-17A and TNF-α were positively correlated with NIHSS but negatively correlated with MMSE, FMA, and MBI. The VEGF-A levels were negatively correlated with NIHSS but positively correlated with MMSE, FMA, and MBI. Conclusion Both MDSS and conventional rehabilitation significantly reduce the production of IL-17A and TNF-α, increase the VEGF-A levels, and effectively improve cognition and motor function of hemiplegic patients with AIS, and the effects of MDSS and conventional rehabilitation are comparable.
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Affiliation(s)
- Shuting Zhang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Yang Yu
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Panpan Xu
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Xianshan Shen
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Chuanqin Fang
- Department of Neurology, The Second Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Xiaosan Wu
- Department of Neurology, The Second Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Ping Qu
- Department of Neurology, The Second Hospital of Anhui Medical University, Hefei, Anhui Province, China
| | - Tingting Wu
- Key Laboratory of Oral Disease Research of Anhui Province, Stomatologic Hospital and College, Anhui Medical University, Hefei, Anhui Province, China
| | - Qing Mei Wang
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, United States
| | - Xun Luo
- School of Medicine, Shenzhen University, Shenzhen, Guangdong Province, China
| | - Yongfeng Hong
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, China
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Zhang Y, Song H, Wang J, Xi X, Cefalo P, Wood LJ, Luo X, Wang QM. Multiplex array analysis of serum cytokines offers minimal predictive value for cognitive function in the subacute phase after stroke. Front Neurol 2022; 13:886018. [PMID: 36330425 PMCID: PMC9622930 DOI: 10.3389/fneur.2022.886018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 08/29/2022] [Indexed: 10/28/2023] Open
Abstract
OBJECTIVE The effects of inflammation on post-stroke cognitive function are still unclear. This study investigated the correlation between the Th17-related cytokines in peripheral blood and post-stroke cognitive function after ischemic stroke in the subacute phase. DESIGN A retrospective cohort study. SETTING Academic acute inpatient rehabilitation facility. PARTICIPANTS One hundred and fourteen patients with first ischemic stroke were categorized as the poor cognitive recovery group (n = 58) or good cognitive recovery group (n = 56) based on their cognitive MRFS efficiency. INTERVENTIONS All subjects received routine physical, occupational, and speech-language pathology therapy. MAIN OUTCOME MEASURES Serum cytokines/chemokine (IL-1 β, IL-2, IL-4, IL-5, IL-6, IL-9, IL-10, IL-12p70, IL-13, IL-15, IL-17A, IL-17E, IL-17F, IL-21, IL-22, IL-23, IL-27, IL-28A, IL-31, IL-33, GM-CSF, IFN-γ, MIP-3 α, TNF-α, and TNF-β) levels were measured in duplicate using Human Th17 magnetic bead panel and multiplex array analysis (Luminex-200 system). The primary functional outcome was a gain in functional independence measure (FIM) cognitive subscore at discharge. The secondary outcome measures were FIM total score at discharge, length of stay in the hospital, and discharge destination. Cognitive Montebello Rehabilitation Factor Score (MRFS) and cognitive MRFS efficiency were calculated. Demographic and clinical characteristics were obtained from the medical record. RESULTS The good cognitive recovery group had an interesting trend of higher IL-13 than the poor cognitive recovery group (good cognitive recovery group 257.82 ± 268.76 vs. poor cognitive recovery group 191.67 ± 201.82, p = 0.049, unit: pg/ml). However, Pearson's correlation analysis showed no significant correlation between cytokine levels and gain of cognition, cognitive MRFS, or cognitive MRFS efficiency. Receiver operating characteristic (ROC) analysis of cytokines also suggested a low accuracy of prediction as a predictor for post-stroke cognitive recovery improvement. CONCLUSION Our preliminary findings suggested that the level of serum cytokines had minimal predictive value for the recovery of cognitive function during the subacute inpatient rehabilitation after stroke.
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Affiliation(s)
- Yuling Zhang
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, The Teaching Affiliate of Harvard Medical School, Charlestown, MA, United States
- School of Health Science and Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Haixin Song
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, The Teaching Affiliate of Harvard Medical School, Charlestown, MA, United States
- Rehabilitation Department, Sir Run Run Show Hospital, Hangzhou, China
| | - Jun Wang
- School of Medicine, Shenzhen University, Shenzhen, China
| | - Xiao Xi
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, The Teaching Affiliate of Harvard Medical School, Charlestown, MA, United States
- Department of Rehabilitation Medicine, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Philip Cefalo
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, The Teaching Affiliate of Harvard Medical School, Charlestown, MA, United States
| | - Lisa J. Wood
- William F. Connell School of Nursing at Boston College, Boston, MA, United States
| | - Xun Luo
- School of Medicine, Shenzhen University, Shenzhen, China
- Kerry Rehabilitation Medicine Research Institute, Shenzhen, China
| | - Qing Mei Wang
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, The Teaching Affiliate of Harvard Medical School, Charlestown, MA, United States
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, The Teaching Affiliate of Harvard Medical School, Charlestown, MA, United States
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9
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Annaswamy TM, Rizzo JR, Schnappinger A, Morgenroth DC, Engkasan JP, Ilieva E, Arnold WD, Boninger ML, Bean AC, Cirstea CM, Dicianno BE, Fredericson M, Jayabalan P, Raghavan P, Sawaki L, Suri P, Suskauer SJ, Wang QM, Hosseini M, Case CM, Whyte J, Paganoni S. Evidence-Based Medicine Training in United States-Based Physiatry Residency Programs. Am J Phys Med Rehabil 2022; 101:S40-S44. [PMID: 33852491 PMCID: PMC9444380 DOI: 10.1097/phm.0000000000001752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Although the physiatric community increasingly embraces evidence-based medicine (EBM), the current state of EBM training for trainees in physiatry is unclear. The purposes of this article are to report the results of the Association of Academic Physiatrists' surveys of physiatry residency programs in the United States, to discuss the implications of their findings, and to better delineate the "baseline" upon which sound and clear recommendations for systematic EBM training can be made. The two Association of Academic Physiatrists surveys of US physiatry residency programs reveal that most survey respondents report that they include EBM training in their programs that covers the five recommended steps of EBM core competencies. However, although most respondents reported using traditional pedagogic methods of training such as journal club, very few reported that their EBM training used a structured and systematic approach. Future work is needed to support and facilitate physiatry residency programs interested in adopting structured EBM training curricula that include recommended EBM core competencies and the evaluation of their impact.
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Affiliation(s)
- Thiru M Annaswamy
- From the PM&R Service, VA North Texas Health Care System, Dallas, Texas (TMA); Department of PM&R, UT Southwestern Medical Center, Dallas, Texas (TMA); Departments of Rehabilitation Medicine and Neurology, New York University Langone Health, New York City, New York (J-RR); Association of Academic Physiatrists, Owings Mills, Maryland (AS); VA RR&D Center for Limb Loss and Mobility (CLiMB), VA Puget Sound Health Care System, Seattle, Washington (DCM); Department of Rehabilitation Medicine, University of Washington, Seattle, Washington (DCM, PS); Department of Rehabilitation Medicine, University of Malaya, Kuala Lumpur, Malaysia (JPE); Department of Physical and Rehabilitation Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria (EI); Departments of Neurology, PM&R, Neuroscience, and Physiology and Cell Biology, The Ohio State University Wexner Medical Center, Columbus, Ohio (WDA); Department of PM&R, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (MLB, ACB, BED); Department of Physical Medicine & Rehabilitation, University of Missouri, Columbia, Missouri (CM Cirstea); Division of PM&R, Stanford University School of Medicine, Stanford, California (MF); Shirley Ryan AbilityLab, Department of Physical Medicine and Rehabilitation, Northwestern Feinberg School of Medicine, Chicago, Illinois (PJ); Johns Hopkins School of Medicine, Baltimore, Maryland (PR); Department of PM&R, University of Kentucky, Lexington, Kentucky (LS); Seattle Epidemiologic Research and Information Center and Division of Rehabilitation Care Services, VA Puget Sound Health Care System, Seattle, Washington (PS); Clinical Learning, Evidence, and Research Center, University of Washington, Seattle, Washington (PS); Departments of Physical Medicine & Rehabilitation and Pediatrics, Johns Hopkins University School of Medicine, Kennedy Krieger Institute, Baltimore, Maryland (SJS); Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, Massachusetts (QMW, SP); Department of Physical Medicine and Rehabilitation, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York (MH); Creighton University, Omaha, Nebraska (CM Case); Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania (JW); and Healey & AMG Center for ALS and Neurological Clinical Research Institute, Massachusetts General Hospital, Boston, Massachusetts (SP)
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10
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Chen YC, Wang QM, Chen L, Zhu MH, Zhang J. [Arf6 regulates endometriotic epithelial-mesenchymal transition and mitochondrial distribution]. Zhonghua Fu Chan Ke Za Zhi 2022; 57:442-448. [PMID: 35775252 DOI: 10.3760/cma.j.cn112141-20220126-00050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To investigate the role of adenosine diphosphate ribosylation factor 6 (Arf6) in the pathogenesis of endometriosis. Methods: Endometrial tissues were sampled from women who were hospitalized in the Affiliated Hospital of Medical School of Ningbo University and Ningbo Women and Children's Hospital from November 2020 to May 2021 with endometriosis (n=44, endometriosis group) and without endometriosis (n=17, control group). The expression of Arf6 protein in the endometrial tissues was detected by western blot. Endometrial epithelial cells from both groups were primary cultured and the distribution of intracellular mitochondria was detected by immunofluorescence. The expression of Arf6 protein was down-regulated by small interference RNA (siRNA), the distribution of mitochondria in cells with decreased Arf6 protein expression was observed, and the expression of mitochondria-related proteins development and differentiation enhancing factor 1 (DDEF1, also called AMAP1), reactive oxygen species 1 (ROS1) and epithelial-mesenchymal transition (EMT)-related proteins E-cadherin, vimentin were detected. Transwell assay was used to detect the changes in the migration ability of the cells. Results: Compared with the control group, ectopic endometrial tissue of endometriosis group showed high expression of Arf6 protein (0.174±0.019 vs 0.423±0.033; t=29.630, P<0.01); and in ectopic endometrial epithelial cells, mitochondria were distributed near the edge of the cell membrane. While Arf6 expression was down-regulated by siRNA, the distribution of mitochondria in ectopic cells returned to natural, close to the control level. In addition, the expression levels of AMAP1 and ROS1 in ectopic cells after Arf6 protein knockdown were significantly decreased. Transwell assay results indicated that knockdown of Arf6 could reduce the migration ability of ectopic epithelial cells [migration cell count: (34.3±7.5) cells]; and immunofluorescence verified low expression of E-cadherin but high expression of vimentin in ectopic epithelial cells, whereas knockdown of Arf6 protein E-cadherin expression increased but vimentin expression decreased. Conclusions: High expression of Arf6 protein in ectopic endometrial epithelial cells leads to the distribution of mitochondria tending to membrane marginalization, while inducing EMT, which are involved in the mechanism of endoheterosis pathogenesis.
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Affiliation(s)
- Y C Chen
- Department of Obstetrics and Gynecology, Ningbo Women and Children's Hospital, Ningbo 315012, China
| | - Q M Wang
- Department of Obstetrics and Gynecology, Ningbo Women and Children's Hospital, Ningbo 315012, China
| | - L Chen
- Department of Obstetrics and Gynecology, Ningbo Women and Children's Hospital, Ningbo 315012, China
| | - M H Zhu
- Department of Obstetrics and Gynecology, the Affiliated Hospital of Medical School of Ningbo University, Ningbo 315020, China
| | - J Zhang
- Department of Obstetrics and Gynecology, Ningbo Women and Children's Hospital, Ningbo 315012, China
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11
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Yang N, Zhao W, Pan Y, Lyu XZ, Hao XY, Qi WA, Du L, Liu EM, Chen T, Zhang WS, Zhang CF, Zhu GN, Wang QM, Meng WB, Liang YB, Jin YH, Wang W, Xing D, Tian JH, Ma B, Wang XH, Song XP, Ge L, Yang KH, Liu XQ, Wei JM, Chen Y. [Development of a Ranking Tool for Scientificity, Transparency and Applicability of Clinical Practice Guidelines]. Zhonghua Yi Xue Za Zhi 2022; 102:1-10. [PMID: 35701091 DOI: 10.3760/cma.j.cn112137-20220219-00340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Objective: To address the limitations of existing methods and tools for evaluating clinical practice guidelines, we aimed to develop a comprehensive instrument focusing on the three main dimensions of guideline development: scientificity, transparency, applicability. We will use it to rank the guidelines according to the scores. We abbreviated it as STAR, and its reliability, validity and usability were also tested. Methods: A multidisciplinary expert working group was set up, including methodologists, statisticians, journal editors, medical professionals, and others. Scoping review, Delphi methods and hierarchical analysis were used to determine the final checklist of STAR. Results: The new instrument contained 11 domains and 39 items. Intrinsic reliability of each domain was indicated by Cronbach's α coefficient, with a average value of 0.646. The Cohen's kappa coefficients for methodological evaluators and clinical evaluators were 0.783 and 0.618. The overall content validity index was 0.905. The R2 for the criterion validity analysis was 0.76. The average score for usability of the items was 4.6, and the mean time spent to evaluate each guideline was 20 minutes. Conclusion: The instrument has good reliability, validity and evaluating efficiency, and can be used for evaluating and ranking guidelines more comprehensively.
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Affiliation(s)
- N Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - W Zhao
- General Editorial Office, Chinese Medical Association Publishing House, Beijing 100052, China
| | - Y Pan
- Marketing and Sales Department, Chinese Medical Association Publishing House, Beijing 100052, China
| | - X Z Lyu
- Editorial Department, Chinese Medical Journal, Chinese Medical Association Publishing House, Beijing 100052, China
| | - X Y Hao
- Editorial Department, Chinese Medical Journal (English Edition), Chinese Medical Association Publishing House, Beijing 100052, China
| | - W A Qi
- Editorial Department, British Medical Journal (Chinese Edition), Chinese Medical Association Publishing House, Beijing 100052, China
| | - L Du
- Evidence-Based Medicine Center, West China School of Medicine, West China Hospital, Sichuan University, Chengdu 610041
| | - E M Liu
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014
| | - T Chen
- Department of Hematology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - W S Zhang
- Department of Obstetrics and Gynecology, Xiangya Hospital, Central South University, Changsha 410008, China
| | - C F Zhang
- Children's Hospital of Fudan University, Shanghai 201102, China
| | - G N Zhu
- Department of Dermatology, Xijing Hospital, Xi'an 710032, China
| | - Q M Wang
- Department of Medical Oncology, Henan Cancer Hospital, Zhengzhou 450008, China
| | - W B Meng
- Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou 730000, China
| | - Y B Liang
- Department of Ophthalmology, The Eye Hospital of Wenzhou Medical University, Wenzhou 325027, China
| | - Y H Jin
- Center for Evidence-Based and Translational Medicine, Zhongnan Hospital of Wuhan University, Wuhan 430072, China
| | - W Wang
- Department of Urology, The Fifth People's Hospital of Shanghai, Fudan University, Shanghai 200240, China
| | - D Xing
- Department of Trauma and Orthopaedics, Peking University People's Hospital, Beijing 100044, China
| | - J H Tian
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - B Ma
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - X H Wang
- School of Public Health, Lanzhou University, Lanzhou 730000
| | - X P Song
- School of Public Health, Lanzhou University, Lanzhou 730000
| | - L Ge
- School of Public Health, Lanzhou University, Lanzhou 730000
| | - K H Yang
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
| | - X Q Liu
- Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union & Peking Union Medical College, Beijing 100730
| | - J M Wei
- Chinese Medical Association Publishing House, Beijing 100052, China
| | - Yaolong Chen
- Research Unit of Evidence-Based Evaluation and Guidelines (2021RU017), Chinese Academy of Medical Sciences, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China Guidelines and Standards Research Center, Chinese Medical Association Publishing House, Beijing 100052, China
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12
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Zhu JY, Mei ZB, Zhang ZJ, Yang W, Zhao WW, Xu J, Zou QQ, Wang QM. [Clinical efficacy of the modified separation of external anal sphincter for the treatment of high horseshoe anal fistula]. Zhonghua Wei Chang Wai Ke Za Zhi 2021; 24:1111-1115. [PMID: 34923798 DOI: 10.3760/cma.j.cn441530-20201031-00581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
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13
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Wang S, Li SM, Wu X, Zhu H, Wang QM. [Crizotinib treatment for a lung adenocarcinoma patient with anaplastic lymphoma kinase gene rearrangement and disseminated intravascular coagulation]. Zhonghua Zhong Liu Za Zhi 2021; 43:1195-1196. [PMID: 34794223 DOI: 10.3760/cma.j.cn112152-20200611-00549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- S Wang
- Department of Respiratory Medicine, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China
| | - S M Li
- Department of Respiratory Medicine, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China
| | - X Wu
- Department of Respiratory Medicine, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China
| | - H Zhu
- Department of Respiratory Medicine, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China
| | - Q M Wang
- Department of Respiratory Medicine, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou 450008, China
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Sun J, Sun R, Li C, Luo X, Chen J, Hong J, Zeng Y, Wang QM, Wen H. NgR1 pathway expression in cerebral ischemic Sprague-Dawley rats with cognitive impairment. Iran J Basic Med Sci 2021; 24:767-775. [PMID: 34630954 PMCID: PMC8487595 DOI: 10.22038/ijbms.2021.53316.12011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 04/27/2021] [Indexed: 11/29/2022]
Abstract
Objective(s): This study aimed to determine the effect of ischemic occlusion duration and recovery time course on motor and cognitive function, identify optimal conditions for assessing cognitive function with minimal interference from motor deficits, and elucidate the underlying mechanism of axonal inhibitors. Materials and Methods: Sprague-Dawley (SD) rats were randomly allocated to the transient middle cerebral artery occlusion (tMCAO) 60-min (tMCAO60min), tMCAO90min, tMCAO120min, and sham groups. We conducted forelimb grip strength, two-way shuttle avoidance task, and novel object recognition task (NORT)tests at three time points (14, 21, and 28 days). Expression of Nogo receptor-1 (NgR1), the endogenous antagonist lateral olfactory tract usher substance, ras homolog family member A (Rho-A), and RhoA-activated Rho kinase (ROCK) was examined in the ipsilateral thalamus. Results: There was no difference in grip strength between sham and tMCAO90min rats at 28 days. tMCAO90min and tMCAO120min rats showed lower discrimination indices in the NORT than sham rats on day 28. Compared with that in sham rats, the active avoidance response rate was lower in tMCAO90min rats on days 14, 21, and 28 and in tMCAO120min rats on days 14 and 21. Furthermore, 50-54% of rats in the tMCAO90min group developed significant cognitive impairment on day 28, and thalamic NgR1, RhoA, and ROCK expression were greater in tMCAO90min rats than in sham rats. Conclusion: Employing 90-min tMCAO in SD rats and assessing cognitive function 28 days post-stroke could minimize motor dysfunction effects in cognitive function assessments. Axonal inhibitor deregulation could be involved in poststroke cognitive impairment.
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Affiliation(s)
- Ju Sun
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou 510630, Guangdong Province, China.,Department of Rehabilitation Medicine, Guangzhou Panyu Central Hospital, No.8 Fuyu east Road, Guangzhou 511400, Guangdong Province, China
| | - Ruifang Sun
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou 510630, Guangdong Province, China
| | - Chao Li
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou 510630, Guangdong Province, China
| | - Xun Luo
- Kerry Rehabilitation Medicine Research Institute, Shenzhen 518048, Guangdong Province, China.,Shenzhen Dapeng New District Nan'ao People's Hospital Shenzhen 518048, Guangdong Province, China
| | - Jiemei Chen
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou 510630, Guangdong Province, China
| | - Jiena Hong
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou 510630, Guangdong Province, China
| | - Yan Zeng
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou 510630, Guangdong Province, China
| | - Qing Mei Wang
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, The Teaching Affiliate of Harvard Medical School,96 13 Street, Charlestown, MA 02129, USA
| | - Hongmei Wen
- Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, 600 Tianhe Road, Guangzhou 510630, Guangdong Province, China
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Han B, Jiang W, Cui P, Zheng K, Dang C, Wang J, Li H, Chen L, Zhang R, Wang QM, Ju Z, Hao J. Microglial PGC-1α protects against ischemic brain injury by suppressing neuroinflammation. Genome Med 2021; 13:47. [PMID: 33771213 PMCID: PMC8004413 DOI: 10.1186/s13073-021-00863-5] [Citation(s) in RCA: 81] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 03/04/2021] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Neuroinflammation and immune responses occurring minutes to hours after stroke are associated with brain injury after acute ischemic stroke (AIS). PPARγ coactivator-1α (PGC-1α), as a master coregulator of gene expression in mitochondrial biogenesis, was found to be transiently upregulated in microglia after AIS. However, the role of microglial PGC-1α in poststroke immune modulation remains unknown. METHODS PGC-1α expression in microglia from human and mouse brain samples following ischemic stroke was first determined. Subsequently, we employed transgenic mice with microglia-specific overexpression of PGC-1α for middle cerebral artery occlusion (MCAO). The morphology and gene expression profile of microglia with PGC-1α overexpression were evaluated. Downstream inflammatory cytokine production and NLRP3 activation were also determined. ChIP-Seq analysis was performed to detect PGC-1α-binding sites in microglia. Autophagic and mitophagic activity was further monitored by immunofluorescence staining. Unc-51-like autophagy activating kinase 1 (ULK1) expression was evaluated under the PGC-1α interaction with ERRα. Finally, pharmacological inhibition and genomic knockdown of ULK1 were performed to estimate the role of ULK1 in mediating mitophagic activity after ischemic stroke. RESULTS PGC-1α expression was shortly increased after ischemic stroke, not only in human brain samples but also in mouse brain samples. Microglia-specific PGC-1α overexpressing mice exhibited significantly decreased neurologic deficits after ischemic injury, with reduced NLRP3 activation and proinflammatory cytokine production. ChIP-Seq analysis and KEGG pathway analysis revealed that mitophagy was significantly enhanced. PGC-1α significantly promoted autophagic flux and induced autolysosome formation. More specifically, the autophagic clearance of mitochondria was enhanced by PGC-1α regulation, indicating the important role of mitophagy. Pharmacological inhibition or knockdown of ULK1 expression impaired autophagic/mitophagic activity, thus abolishing the neuroprotective effects of PGC-1α. CONCLUSIONS Mechanistically, in AIS, PGC-1α promotes autophagy and mitophagy through ULK1 and reduces NLRP3 activation. Our findings indicate that microglial PGC-1α may be a promising therapeutic target for AIS.
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Affiliation(s)
- Bin Han
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Wei Jiang
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Pan Cui
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Kai Zheng
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Chun Dang
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Junjie Wang
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - He Li
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Lin Chen
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, 300052, China
| | - Rongxin Zhang
- Laboratory of Immunology and Inflammation, Department of Immunology and Research Center of Basic Medical Sciences, Key Laboratory of Immune Microenvironments and Diseases of Educational Ministry, Tianjin Medical University, Tianjin, 300070, China
| | - Qing Mei Wang
- Stroke Biological Recovery Laboratory, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, the teaching affiliate of Harvard Medical School Charlestown, Boston, MA, 02129, USA
| | - Zhenyu Ju
- Key Laboratory of Regenerative Medicine of Ministry of Education, Institute of Aging and Regenerative Medicine, Jinan University, Guangzhou, 510632, China
| | - Junwei Hao
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, 300052, China.
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Peng Y, Li Q, Qin L, He Y, Luo X, Lan Y, Chen X, Wang X, Wang QM. Combination of Serum Neurofilament Light Chain Levels and MRI Markers to Predict Cognitive Function in Ischemic Stroke. Neurorehabil Neural Repair 2021; 35:247-255. [PMID: 33522401 DOI: 10.1177/1545968321989354] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND It is important to predict poststroke cognitive outcome to guide individualized treatment and prevention strategy. We aimed to evaluate the predictive value of the combination of a serum biomarker for axonal damage (neurofilament light chain [NfL]) and neuroimaging markers (volume of infarction and white matter hyperintensities [WMH]) for neuronal abnormality in poststroke cognitive outcome. METHODS A total of 1028 patients were screened; among them, 144 patients with acute ischemic stroke (stroke group) and 30 patients without stroke (control group) were enrolled. Serum NfL levels of samples obtained from both groups were measured through single molecule array assay. Neuroimaging markers of neuroaxonal injury, including infarct volume and WMH in the stroke group were quantified on magnetic resonance images using an in-house MATLAB code (MATLAB 2017; MathWorks). The primary outcome was the functional independence measure (FIM) cognitive subscores on discharge. We assessed the association of serum NfL levels and neuroimaging markers with cognitive outcome. The prognosis value of the combination of serum NfL levels and imaging markers for predicting FIM cognitive subscores on discharge was calculated using the area under curve (AUC) of the receiver operating characteristic. RESULTS Serum NfL levels of the stroke group were 9-fold higher than those of the control group (1449.7 vs 157.2 pg/mL, n = 144/30, P < .001). There was a correlation of serum NfL levels with infarct volume (r = 0.530, P < .001) and functional outcome, including FIM cognitive subscores (r = -0.387, P < .001) and FIM motor subscores on admission (r = -0.306, P < .001), but not with WMH volume after adjusting for infarct volume (r = -0.196, P = .245). Serum NfL levels on admission independently predicted poststroke FIM cognitive subscores on discharge (AUC = 0.672, P < .001). The predictive value for poststroke cognitive outcome was improved by combining serum NfL levels with infarct and WMH volume (AUC = 0.760, P < .001). CONCLUSION The combination of serum NfL levels with volume of infarct and WMH shows an improved predictive value for cognitive function during acute rehabilitation phase after stroke, providing a promising panel of biomarkers for prognosis and guidance of treatment.
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Affiliation(s)
- Yuan Peng
- Spaulding Rehabilitation Hospital, the teaching affiliate of Harvard Medical School, Charlestown, MA, USA.,Guangzhou First People's Hospital, Second Affiliated Hospital of South China University of Technology, Guangzhou, Guangdong, China
| | - Qianfeng Li
- Spaulding Rehabilitation Hospital, the teaching affiliate of Harvard Medical School, Charlestown, MA, USA.,Shenzhen Dapeng New District Nan'ao People's Hospital, Shenzhen, China
| | - Lei Qin
- Dana-Farber Cancer Institute, Boston, MA, USA
| | - Yating He
- Spaulding Rehabilitation Hospital, the teaching affiliate of Harvard Medical School, Charlestown, MA, USA.,Tianjin Medical University General Hospital, Tianjin, China
| | - Xun Luo
- Shenzhen Dapeng New District Nan'ao People's Hospital, Shenzhen, China.,Kerry Rehabilitation Medicine Research Institute, Shenzhen, Guangdong, China
| | - Yue Lan
- Guangzhou First People's Hospital, Second Affiliated Hospital of South China University of Technology, Guangzhou, Guangdong, China
| | - Xin Chen
- Guangzhou First People's Hospital, Second Affiliated Hospital of South China University of Technology, Guangzhou, Guangdong, China
| | - Xin Wang
- Spaulding Rehabilitation Hospital, the teaching affiliate of Harvard Medical School, Charlestown, MA, USA.,Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Qing Mei Wang
- Spaulding Rehabilitation Hospital, the teaching affiliate of Harvard Medical School, Charlestown, MA, USA
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Zhou L, Wang Y, Qiao J, Wang QM, Luo X. Acupuncture for Improving Cognitive Impairment After Stroke: A Meta-Analysis of Randomized Controlled Trials. Front Psychol 2020; 11:549265. [PMID: 33424671 PMCID: PMC7793937 DOI: 10.3389/fpsyg.2020.549265] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 10/19/2020] [Indexed: 11/13/2022] Open
Abstract
Objective: This meta-analysis evaluated the efficacy of acupuncture in improving cognitive impairment of post-stroke patients. Design: Randomized controlled trials (RCTs) investigating the effects of acupuncture compared with no treatment or sham acupuncture on post-stroke cognitive impairment (PSCI) before December 2019 were identified from databases (PubMed, EMBASE, Ovid library, Cochrane Library, Chinese National Knowledge Infrastructure, VIP Chinese Periodical Database, Wanfang Database, and SinoMed). The literature searching and data extracting were independently performed by two investigators. Study quality was assessed using the Cochrane Handbook for Systematic Reviews of Interventions. Meta-analyses were performed for the eligible RCTs with Revman 5.3 software. Results: Thirty-seven RCTs (2,869 patients) were included in this meta-analysis. Merged Random-effects estimates of the gain of MMSE (Mini-Mental State Examination) or MoCA (Montreal Cognitive Assessment) were calculated for the comparison of acupuncture with no acupuncture or sham acupuncture. Following 2-8 weeks of intervention with acupuncture, pooled results demonstrated significant effects of acupuncture in improving PSCI assessed by MMSE (MD [95% CI] = 2.88 [2.09, 3.66], p < 0.00001) or MoCA (MD [95% CI] = 2.66 [1.95, 3.37], p < 0.00001). Conclusion: The results suggest that acupuncture was effective in improving PSCI and supported the needs of more rigorous design with large-scale randomized clinical trials to determine its therapeutic benefits.
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Affiliation(s)
- Liang Zhou
- Department of Reproductive Medicine, Peking University Shenzhen Hospital, Shenzhen, China
| | - Yao Wang
- Department of Rehabilitation Medicine, Dapeng New District Nan'ao People's Hospital, Shenzhen, China
| | - Jun Qiao
- The Second Rehabilitation Hospital of Shanghai, Shanghai, China
| | - Qing Mei Wang
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, The Teaching Affiliate of Harvard Medical School, Boston, MA, United States
| | - Xun Luo
- Department of Rehabilitation Medicine, Dapeng New District Nan'ao People's Hospital, Shenzhen, China.,Kerry Rehabilitation Medicine Research Institute, Shenzhen, China
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Zhang P, Yang L, Li G, Jin Y, Wu D, Wang QM, Huang P. Agrin Involvement in Synaptogenesis Induced by Exercise in a Rat Model of Experimental Stroke. Neurorehabil Neural Repair 2020; 34:1124-1137. [PMID: 33135566 DOI: 10.1177/1545968320969939] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Agrin is a proteoglycan that aggregates nicotinic acetylcholine receptors (AChRs) on neuromuscular junctions and takes part in synaptogenesis in the development of the central nervous system. However, its effects on neural repair and synaptogenesis after stroke are still unclear. OBJECTIVE This study aimed to investigate the effects of agrin on neural repair and synaptogenesis after stroke and the effects of exercise on this process in vivo and in vitro. METHODS Exercise with gradually increased intensity was initiated at 1 day after middle cerebral artery occlusion (MCAO) for a maximum of 14 days. Neurological deficit scores and foot fault tests were used to assess the behavioral recovery. Western blotting, immunofluorescence, and electron microscopic images were used to detect the expression of agrin, synaptogenesis-related proteins, and synaptic density in vivo. In vitro, the ischemic neuron model was established via oxygen-glucose deprivation (OGD). The lentivirus overexpressed agrin and CREB inhibitor were used to investigate the mechanism by which agrin promoted synaptogenesis. RESULTS Exercise promoted behavioral recovery and this beneficial role was linked to the upregulated expression of agrin and increased synaptic density. Overexpressed agrin promoted synaptogenesis in OGD neuron, CREB inhibitor downregulated the expression of agrin and hampered synaptogenesis in cultured neurons. CONCLUSIONS These results indicated that exercise poststroke improved the recovery of behavioral function after stroke. Synaptogenesis was an important and beneficial factor, and agrin played a critical role in this process and could be a potential therapeutic target for the treatment of stroke and other nervous system diseases.
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Affiliation(s)
- Pengyue Zhang
- Yunnan University of Traditional Chinese Medicine, Kunming, China.,Kunming University of Science and Technology, Kunming, China
| | - Liqiang Yang
- Kunming University of Science and Technology, Kunming, China
| | - Guangxiang Li
- Kunming University of Science and Technology, Kunming, China
| | - Yaju Jin
- Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Danli Wu
- Yunnan University of Traditional Chinese Medicine, Kunming, China
| | - Qing Mei Wang
- Spaulding Rehabilitation Hospital, Charlestown, MA, USA
| | - Peidong Huang
- Yunnan University of Traditional Chinese Medicine, Kunming, China
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19
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Bose E, Wood LJ, Wang QM. Topographical data analysis to identify high-density clusters in stroke patients undergoing post-acute rehabilitation. Top Stroke Rehabil 2020; 28:498-507. [PMID: 33118467 DOI: 10.1080/10749357.2020.1841439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND During acute stroke rehabilitation, the recovery of motor and cognitive function is highly variable: while some patients regain function, others do not. OBJECTIVE Our objective was to identify data-driven subgroups of stroke patients undergoing acute rehabilitation using topological data analysis (TDA), compare TDA with K-means clustering, and to assess inter-group demographic and clinical differences among the subgroups. METHODS This is a secondary data analysis of clinical, functional outcomes, and demographic data collected from 339 stroke patients undergoing acute rehabilitation post-stroke. We identified stroke recovery sub-groups using TDA on the point cloud, persistent homology, and finally, density clustering. We assessed inter-group differences in demographic and clinical characteristics using one-way ANOVA, Kruskal-Wallis, or χ2 tests. RESULTS TDA revealed three high-density clusters among 137 subjects in the point cloud- poor-recoverers (G1(n = 34)), intermediate-recoverers (G2 (n = 88)) and good-recoverers (G3(n = 15)).Significant differences across clusters were observed for amantadine use (p = .009), number of stroke risk factors (p = .047), creatinine (p = .015), length of stay (p < .001), discharge destination (p < .001), FIM motor, FIM cognition, and FIM total on admission and discharge (all p < .001), and motor, cognition, and total MRFS scores (all p < .001). CONCLUSION This study revealed that in addition to functional status on admission, stroke risk factors are associated with recovery outcomes. Future studies using TDA to analyze omic data, including clinical, biological, and sociodemographic factors, will accelerate the development of personalized treatment plans in post-acute stroke rehabilitation patients.
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Affiliation(s)
- Eliezer Bose
- School of Nursing, MGH Institute of Health Professions, Charlestown, MA, USA
| | - Lisa J Wood
- Connell School of Nursing, Boston College, Boston, MA, USA
| | - Qing Mei Wang
- Director, Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, the teaching affiliate of Harvard Medical School, Boston, MA, USA
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20
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Zeng QL, Wang QM, Tao LJ, Hao F, Luo QZ. [Establishment of nomogram predicting model for the death risk of extremely severe burn patients and the predictive value]. Zhonghua Shao Shang Za Zhi 2020; 36:845-852. [PMID: 32972070 DOI: 10.3760/cma.j.cn501120-20190620-00280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To explore the death risk factors of extremely severe burn patients, establish a death risk nomogram predicting model, and investigate the predictive value for death risk of extremely severe burn patients. Methods: The medical records of 231 extremely severe burn patients (190 males and 41 females, aged 18-60 years) who were admitted to the Institute of Burn Research of the First Affiliated Hospital of Army Medical University from January 2010 to October 2018 and met the inclusion criteria were analyzed retrospectively. According to the final outcome, the patients were divided into survival group of 173 patients and death group of 58 patients. The sex, age, severity of inhalation injury, total burn area, full-thickness burn area, burn index, rehydration coefficient and urine volume coefficient of the first and second 24 h after injury, the first base excess, shock index, and hematocrit (HCT) after admission, whether to have pre-hospital fluid infusion, use of ventilator, and use of continuous renal replacement therapy (CRRT), and abbreviated burn severity index (ABSI ) and Baux score on admission of patients in the two groups were recorded or calculated. According to the use of ventilator, the patients were divided into with ventilator group of 131 patients and without ventilator group of 100 patients, and the death, total burn surface area, burn index, incidence and severity of inhalation injury were recorded. According to the use of CRRT, the patients were divided into with CRRT group of 59 patients and without CRRT group of 172 patients, and the death, total burn surface area, and burn index were recorded. Data were statistically analyzed with t test, chi-square test, and Mann-Whitney U test to screen the death related factors of patients. The indexes with statistically significant differences between survival group and death group were included in the multivariate logistic regression analysis to screen the independent death risk factors of patients, and the death risk nomogram predicting model was constructed based on the results.The Bootstrap method was used to validate the death risk nomogram predicting model internally. The predictive value of the nomogram model for predicting death risk of patients was detected by drawing calibration graph and calculating concordance index, and the death risk scores of 231 patients were acquired according to the death risk nomogram model. The receiver's operating characteristic (ROC) curve was drawn, and the optimal threshold and the sensitivity and specificity of optimal threshold in the ROC curve and the area under the curve were calculated. Results: (1) There were statistically significant differences in burn index, ABSI on admission, severity of inhalation injury, total burn area, full-thickness burn area, rehydration coefficient at the first 24 h after injury, use of ventilator, use of CRRT, and Baux score on admission of patients between the two groups (Z=-7.696, -7.031, χ(2)=18.304, 63.065, 23.300, 13.073, 34.240, 59.586, t=-7.536, P<0.01). (2) There were statistically significant differences in death, incidence and severity of inhalation injury, total burn area, and burn index of patients between with ventilator group and without ventilator group (χ(2)=34.240, 17.394, 25.479, Z=-6.557, -7.049, P<0.01). (3) There were statistically significant differences in death, total burn area, and burn index of patients between with CRRT group and without CRRT group (χ(2)=62.982, Z= -47.421, -6.678, P<0.01). (4) The use of ventilator, use of CRRT, and burn index were independent risk factors for the death of extremely severe burn patients (odds ratio=3.277, 5.587, 1.067, 95% confidence interval=1.073-10.008, 2.384-13.093, 1.038-1.096, P<0.05 or P<0.01). (5) The initial concordance index of nomogram predicting model was 0.90 and the corrected concordance index was 0.89. The concordance indexes before and after correction were higher and similar, which showed that the nomogram had good concordance and predictive effect. The optimum threshold of ROC curve was 0.23, the sensitivity and specificity of optimum threshold were 86.0% and 80.0%, respectively, and the area under ROC curve was 0.90 (95% confidence interval=0.86-0.94, P<0.01). Conclusions: Severe burns and damage and/or failure of organ are the main death causes of extremely severe burn patients. The death risk nomogram predicting model established on the basis of use of ventilator, use of CRRT, and burn index have good predictive ability for death of extremely severe burn patients.
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Affiliation(s)
- Q L Zeng
- Department of Nursing, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Chongqing 400038, China
| | - Q M Wang
- Department of Nursing, Chinese PLA General Hospital, Beijing 100853, China
| | - L J Tao
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burn Research, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Chongqing 400038, China
| | - F Hao
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burn Research, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Chongqing 400038, China
| | - Q Z Luo
- State Key Laboratory of Trauma, Burns and Combined Injury, Institute of Burn Research, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Chongqing 400038, China
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Zubcevik N, Mao C, Wang QM, Bose EL, Octavien RN, Crandell D, Wood LJ. Symptom Clusters and Functional Impairment in Individuals Treated for Lyme Borreliosis. Front Med (Lausanne) 2020; 7:464. [PMID: 32974369 PMCID: PMC7472530 DOI: 10.3389/fmed.2020.00464] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 07/13/2020] [Indexed: 11/17/2022] Open
Abstract
Context: Persistent fatigue, pain, and neurocognitive impairment are common in individuals following treatment for Lyme borreliosis (LB). Poor sleep, depression, visual disturbance, and sensory neuropathies have also been reported. The cause of these symptoms is unclear, and widely accepted effective treatment strategies are lacking. Objectives: To identify symptom clusters in people with persistent symptoms previously treated for LB and to examine the relationship between symptom severity and perceived disability. Methods: This was a retrospective chart review of individuals with a history of treatment of LB referred to The Dean Center for Tick-Borne Illness at Spaulding Rehabilitation Hospital between 2015 and 2018 (n = 270) because of persistent symptoms. Symptoms and functional impairment were collected using the General Symptom Questionnaire-30 (GSQ-30), and the Sheehan Disability Scale. Clinical tests were conducted to evaluate for tick-borne co-infections and to rule out medical disorders that could mimic LB symptomatology. Exploratory factor analysis was performed to identify symptom clusters. Results: Five symptom clusters were identified. Each cluster was assigned a name to reflect the possible underlying etiology and was based on the majority of the symptoms in the cluster: the neuropathy symptom cluster, sleep-fatigue symptom cluster, migraine symptom cluster, cognitive symptom cluster, and mood symptom cluster. Symptom severity for each symptom cluster was positively associated with global functional impairment (p < 0.001). Conclusion: Identifying the interrelationship between symptoms in post-treatment LB in a cluster can aid in the identification of the etiological basis of these symptoms and could lead to more effective symptom management strategies. Key Message: This article describes symptom clusters in individuals with a history of Lyme borreliosis. Five clusters were identified: sleep-fatigue, neuropathy, migraine-like, cognition, and mood clusters. Identifying the interrelationship between symptoms in each of the identified clusters could aid in more effective symptom management through identifying triggering symptoms or an underlying etiology.
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Affiliation(s)
- Nevena Zubcevik
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States.,The Dean Center for Tickborne Illness, Spaulding Research Institute, Spaulding Rehabilitation Hospital, Boston, MA, United States.,Invisible International, Cambridge, MA, United States
| | - Charlotte Mao
- The Dean Center for Tickborne Illness, Spaulding Research Institute, Spaulding Rehabilitation Hospital, Boston, MA, United States.,Massachusetts General Hospital, Department of Pediatric Infectious Diseases, Boston, MA, United States
| | - Qing Mei Wang
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, United States.,Stroke Biological Recovery Laboratory, Spaulding Research Institute, Spaulding Rehabilitation Hospital, Boston, MA, United States
| | - Eliezer L Bose
- Stroke Biological Recovery Laboratory, Spaulding Research Institute, Spaulding Rehabilitation Hospital, Boston, MA, United States
| | - Rose Nadlyne Octavien
- The Dean Center for Tickborne Illness, Spaulding Research Institute, Spaulding Rehabilitation Hospital, Boston, MA, United States
| | - David Crandell
- The Dean Center for Tickborne Illness, Spaulding Research Institute, Spaulding Rehabilitation Hospital, Boston, MA, United States
| | - Lisa J Wood
- Massachusetts General Hospital, Institute for Health Professions, School of Nursing, Charlestown, MA, United States.,William F. Connell School of Nursing, Boston College, Chestnut Hill, MA, United States
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22
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Li S, Eshghi M, Khan S, Tian Q, Joutsa J, Ou Y, Wang QM, Kong J, Rosen BR, Ahveninen J, Nummenmaa A. Localizing central swallowing functions by combining non-invasive brain stimulation with neuroimaging. Brain Stimul 2020; 13:1207-1210. [PMID: 32504829 DOI: 10.1016/j.brs.2020.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Revised: 05/26/2020] [Accepted: 06/01/2020] [Indexed: 10/24/2022] Open
Affiliation(s)
- Shasha Li
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA; Harvard Medical School, Boston, MA, USA.
| | - Marziye Eshghi
- Speech and Feeding Disorders Lab, MGH Institute of Health Professions, Charlestown, MA, USA
| | - Sheraz Khan
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Qiyuan Tian
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Juho Joutsa
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA; Havard Medical School, Boston, MA, USA; Turku Brain and Mind Center and Clinical Neurosciences, University of Turku, Turku, Finland; Division of Clinical Neurosciences and Turku PET Centre, Turku University Hospital, Turku, Finland
| | - Yangming Ou
- Department of Radiology and Pediatrics, Boston Children's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Computational Health Informatics Program (CHIP), Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Qing Mei Wang
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, The Teaching Affiliate of Harvard Medical School, Charlestown, MA, USA
| | - Jian Kong
- Department of Psychiatry, Massachusetts General Hospital, Charlestown, MA, USA; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Bruce Robert Rosen
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA; Harvard Medical School, Boston, MA, USA; Harvard-MIT Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Jyrki Ahveninen
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Aapo Nummenmaa
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA; Harvard Medical School, Boston, MA, USA
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23
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Han Z, Wang Y, Qi L, Wang J, Wong J, Chen J, Luo X, Wang QM. Differential Association of Serum BDNF With Poststroke Depression and Poststroke Anxiety. Arch Phys Med Rehabil 2020; 101:1355-1366. [PMID: 32416148 DOI: 10.1016/j.apmr.2020.04.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 04/08/2020] [Accepted: 04/19/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To investigate the correlation between brain-derived neurotrophic factor (BDNF) and risk factors, as well as functional outcome in poststroke depression (PSD) or poststroke anxiety (PSA). DESIGN Cohort study. SETTING Stroke patients admitted to an urban rehabilitation hospital. PARTICIPANTS Stroke patients (N=162) without any previous history of depression and anxiety. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Sociodemographic information and comorbidities were recorded during hospital admission. Functional outcomes were assessed using FIM scores at time of admission and discharge. The influence of various factors such as BDNF and patient characteristics on functional outcome was investigated. Single-factor effect was examined using simple logistic regression, as was multi-factor effect using multiple logistic regression. The goodness-of-fit of those regression models was evaluated by the integrated area under ROC curve. RESULTS PSD was diagnosed in 61 (37.7%) patients, and PSA was diagnosed in 40 (24.7%). Multiple logistic analysis showed that BDNF, divorce or separation, and history of smoking were significantly associated with the occurrence of PSD but not with the occurrence of PSA. The model combining low BDNF level and divorce or separation improved the prediction for PSD. Among the variables analyzed for prediction of functional outcome, serum BDNF had a minimum correlation with motor FIM scores in PSD but no significant correlation with motor FIM scores in PSA. CONCLUSIONS BDNF is a valuable prediction for the occurrence of PSD but not for PSA. More strikingly, ischemic stroke patients who are divorced or separated with low serum BDNF have a much higher risk for PSD. BDNF has a minimum correlation with motor function outcome in PSD but no significant correlation with motor outcome in PSA.
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Affiliation(s)
- Zhenxiang Han
- Stroke Biological Recovery Laboratory, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA; Department of Neurology and Rehabilitation, Seventh People's Hospital of Shanghai University of TCM, Shanghai, P.R. China
| | - Yao Wang
- Stroke Biological Recovery Laboratory, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA; Department of Rehabilitation Medicine, Nan'ao People's Hospital of Shenzhen, The First Affiliated Hospital, Shenzhen University, Shenzhen, Guangdong, P.R. China
| | - Lili Qi
- Department of Emergency, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of TCM, Shanghai, P.R. China
| | - Jiening Wang
- Department of Neurology and Rehabilitation, Seventh People's Hospital of Shanghai University of TCM, Shanghai, P.R. China
| | - John Wong
- School of Nursing and Department of Occupational Therapy, MGH Institute of Health Professions, Boston, MA
| | - Jiaohua Chen
- Department of Neurology and Rehabilitation, Seventh People's Hospital of Shanghai University of TCM, Shanghai, P.R. China
| | - Xun Luo
- Department of Rehabilitation Medicine, Nan'ao People's Hospital of Shenzhen, The First Affiliated Hospital, Shenzhen University, Shenzhen, Guangdong, P.R. China; Kerry Rehabilitation Medicine Research Institute, Shenzhen, Guangdong, P.R. China
| | - Qing Mei Wang
- Stroke Biological Recovery Laboratory, Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA.
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24
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Fan W, Zhang Y, Wang QM, Bai Y, Wu Y. An interactive motion-tracking system for home-based assessing and training reach-to-target tasks in stroke survivors-a preliminary study. Med Biol Eng Comput 2020; 58:1529-1547. [PMID: 32405968 DOI: 10.1007/s11517-020-02173-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 03/26/2020] [Indexed: 01/08/2023]
Abstract
Quantitative evaluation and training of the reach-to-target ability in stroke patients are needed for postdischarge rehabilitation, which can be achieved using a motion-tracking system. However, most of these systems are either costly, involve sophisticated parameter interpretation, or are not designed for rehabilitation. We developed an interactive reach-to-target assessment and training system (IRTATS) based on a camera and three marker straps to detect tracking signals. IRTATS supports audiovisual feedback, personal goal setting, and use in a small clinic or home without the internet. This study aims to evaluate the reliability, validity of IRTATS, and its measurement accuracy of the range of motion (ROM). Ninety-nine stroke patients and 20 healthy adults were recruited for the study. Kinematic variables and active joint ROM (AROM) were assessed using IRTATS. The AROM was measured by a universal goniometer, and scores from multiple clinical scales concerning motor and activity capability were calculated. Although the AROMs measured by IRTATS and the goniometer did not agree, IRTATS has clinically acceptable reliability and validity. Three variables in IRTATS could discriminate the motor performance of patients and healthy subjects. IRTATS may provide a new supplement to conventional physiotherapy in the assessment of the reach-to-target ability in stroke patients. Graphical abstract System configuration • The system is based on an infrared camera and the adjustable marker straps as a sensor module. • It is portable and compact, and has clinically acceptable reliability and validity. • It supports audiovisual feedback, personal goal setting, and use in regions without the internet. • It can be used as an adjunct to conventional physiotherapy in the assessment of the reach-to-target ability.
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Affiliation(s)
- Wenke Fan
- Department of Rehabilitation Medicine, Huashan Hospital Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China
| | - Yuling Zhang
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Qing Mei Wang
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Yulong Bai
- Department of Rehabilitation Medicine, Huashan Hospital Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China
| | - Yi Wu
- Department of Rehabilitation Medicine, Huashan Hospital Fudan University, 12 Wulumuqi Middle Road, Shanghai, 200040, China.
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Chen GQ, Wang QM, Yu M, Cheng YD, Zhang ZC, Wang WS, Qiu Y, Sun LH, Peng K, Yang H. Notch signaling is involved in regulation of LPS-induced macrophage apoptosis through JNK/NF-kB signaling pathway. J BIOL REG HOMEOS AG 2020; 34:04. [PMID: 32048500 DOI: 10.23812/19-283-a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Notch signaling plays a critical role in the development and function of macrophages. The aim of the present study was to investigate the relationship between Notch signaling pathway and macrophage apoptosis after LPS stimulation. In RAW 264.7 cells, the mRNA expression of Jagged1, Hes1, Hes 5 and GM-CSF, and protein expression of NICD1 and GM-CSF were increased after LPS stimulation. Inhibition of Notch signaling by γ-secretase inhibitor DAPT and the suppression of Notch1 expression using siRNA both significantly prevented LPS induced activation of JNK and NF-kB, and simultaneously the expression of GM-CSF was also down regulated significantly. JNK inhibitor SP600125 was used to block the phosphorylation of JNK signaling, Western blot results showed that the activation of NF-kB was blocked and expression of GM-CSF was down-regulated. Finally, flow cytometry analyses showed that the Notch signaling was involved in the regulation of macrophage apoptosis after LPS stimulation. Our study showed that the Notch signaling pathway was activated and involved in the regulation of macrophage apoptosis after LPS stimulation through JNK/ NF-kB signaling regulated GM-CSF expression.
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Affiliation(s)
- G Q Chen
- Department of General Surgery, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Q M Wang
- Department of General Surgery, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - M Yu
- Department of General Surgery, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Y D Cheng
- Department of General Surgery, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Z C Zhang
- Department of General Surgery, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - W S Wang
- Department of General Surgery, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Y Qiu
- Department of General Surgery, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - L H Sun
- Department of General Surgery, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - K Peng
- Department of General Surgery, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - H Yang
- Department of General Surgery, Xinqiao Hospital, Army Medical University, Chongqing, China
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Han B, Jiang W, Liu H, Wang J, Zheng K, Cui P, Feng Y, Dang C, Bu Y, Wang QM, Ju Z, Hao J. Upregulation of neuronal PGC-1α ameliorates cognitive impairment induced by chronic cerebral hypoperfusion. Am J Cancer Res 2020; 10:2832-2848. [PMID: 32194838 PMCID: PMC7052889 DOI: 10.7150/thno.37119] [Citation(s) in RCA: 81] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 09/17/2019] [Indexed: 12/18/2022] Open
Abstract
Rationale: Mitochondrial dysfunction and oxidative stress occur in vascular dementia (VaD), but the specific molecular mechanism regulating these events remains unclear. Peroxisome proliferator-activated receptor-γ co-activator-1α (PGC-1α) is a master regulator for mitochondrial function. This study aims to investigate whether PGC-1α is involved in the pathophysiology of VaD. Methods: We firstly generated PGC-1α f/f Eno2-Cre mice to induce neuron-specific overexpression of PGC-1α by crossbreeding PGC-1α f/f mice with Eno2-cre mice. Then, the mice were subjected to bilateral common carotid artery stenosis to induce chronic cerebral hypoperfusion. Neurological function and hippocampal PGC-1α expression was evaluated. Next, RNA-Seq analysis and Seahorse assay were performed on the hippocampal neurons. In addition, mitochondrial antioxidants, uncoupling proteins, ROS production and the activation of glial cells were also measured. Results: Our results showed that hippocampal PGC-1α expression is down-regulated in the mouse VaD model induced by chronic cerebral hypoperfusion. In contrast, neuronal PGC-1α overexpression significantly ameliorated cognitive deficits. RNA-Seq analysis indicated that PGC-1α improved energy metabolism of neurons under hypoxic condition, and Seahorse assay confirmed that PGC-1α increases the metabolic activity of neurons. Further study demonstrated that PGC-1α boosted the expressions of mitochondrial antioxidants and uncoupling proteins (UCPs), including SOD2, Prx3, GPx1, UCP2, UCP4 and UCP5, which in turn reduced reactive oxygen species (ROS) production. Moreover, the activation of microglia and astrocytes was also found to decrease in the hippocampus. All of these changes greatly contributed to protect hippocampal neurons against ischemic insults. Conclusions: PGC-1α could suppress the excessive ROS and neuroinflammation in the hippocampus, opening up a potential therapeutic target for cognitive impairment.
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Han Z, Qi L, Xu Q, Xu M, Cai L, Wong J, Hu X, Luo X, Wang J, Zhang Y, Li Y, Wang QM. BDNF Met allele Is Associated With Lower Cognitive Function in Poststroke Rehabilitation. Neurorehabil Neural Repair 2020; 34:247-259. [PMID: 32009534 DOI: 10.1177/1545968320902127] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Background and purpose. The identification of a genetic role for cognitive outcome could influence the design of individualized treatment in poststroke rehabilitation. The aim of this study is to determine whether brain-derived neurotrophic factor ( BDNF) Val66Met polymorphism is independently associated with poststroke functional outcome. Methods. A total of 775 stroke patients with genomic data were identified from the Partners HealthCare Biobank, which contains a large number of genotypes from Biobank’s consented patients. Of 775 stroke patients who met the inclusion/exclusion criteria, 86 were enrolled. Functional outcomes were assessed using the Functional Independence Measure scores at the time of admission and discharge. Logistic and linear regression models adjusted for covariate variables, including age, sex, and medical conditions, were used to evaluate the association between BDNF Val66Met and functional outcome. Results. We detected a significant correlation between Met alleles and lower cognitive function at discharge in both ischemic and hemorrhagic stroke patients. Genotyping findings confirmed that BDNF Met allele frequency was higher in contrast to Val/Val allele frequency in lower cognitive functional recovery. Furthermore, after adjusting for covariate variables, BDNF Met alleles were found to be associated with lower cognitive outcome [ P = .003; odds ratio (OR) = 5.95 (1.81-19.52)] and recovery [ P = .006; OR = 3.16 (1.4-7.15)], especially with lower problem solving, expression, and social recovery in all stroke patients. Conclusions. Met allele carriers exhibited impaired poststroke cognitive function. The BDNF genotype may be a useful predictor of cognitive function in inpatient poststroke rehabilitation.
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Affiliation(s)
- Zhenxiang Han
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA, USA
- Seventh People’s Hospital of Shanghai University of TCM, Shanghai, PR China
| | - Lili Qi
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of TCM, Shanghai, PR China
| | | | - Mingzhu Xu
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA, USA
- Southern Medical University, Shenzhen, PR China
| | - Lei Cai
- Southwest Hospital, Third Military Medical University, Chongqing, PR China
| | - John Wong
- MGH Institute of Health Professions, Boston, MA, USA
| | - Xinjia Hu
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA, USA
- Shenzhen People’s Hospital, Clinical Medical College of Jinan University, Shenzhen, Guangdong Province, PR China
| | - Xun Luo
- Kerry Rehabilitation Medicine Research Institute, Shenzhen, Guangdong, PR China
- Dapeng New District Nan’ao People’s Hospital, Shenzhen, Guangdong, PR China
| | - Jiening Wang
- Seventh People’s Hospital of Shanghai University of TCM, Shanghai, PR China
| | - Yuling Zhang
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA, USA
- University of Shanghai for Science and Technology, Shanghai, PR China
| | - Yapeng Li
- Fudan University, Shanghai, PR China
| | - Qing Mei Wang
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA, USA
- Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
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Wang X, Liu T, Song H, Cui S, Liu G, Christoforou A, Flaherty P, Luo X, Wood L, Wang QM. Targeted Metabolomic Profiling Reveals Association Between Altered Amino Acids and Poor Functional Recovery After Stroke. Front Neurol 2020; 10:1425. [PMID: 32082239 PMCID: PMC7001531 DOI: 10.3389/fneur.2019.01425] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 12/31/2019] [Indexed: 01/27/2023] Open
Abstract
Amino acids have been shown to be among the most important metabolites to be altered following stroke; however, they are a double-edged sword with regard to regulating hemostasis. In this study, we conducted a targeted metabolomic study to examine the association between serum levels of amino acids and functional recovery after stroke. Three hundred and fifty-one patients with stroke admitted to an acute rehabilitation hospital were screened, and 106 patients were selected based on inclusion and exclusion criteria. Recruited patients were stratified using Montebello Rehabilitation Factor Score (MRFS) efficiency. We selected the top (n = 20, 19%) and bottom (n = 20, 19%) of MRFS efficiency for metabolomic analysis. A total of 21 serum amino acids levels were measured using ultra high performance liquid chromatography and mass spectrometry. The normalized data were analyzed by multivariate approaches, and the selected potential biomarkers were combined in different combinations for prediction of stroke functional recovery. The results demonstrated that there were significant differences in leucine-isoleucine, proline, threonine, glutamic acid, and arginine levels between good and poor recovery groups. In the training (0.952) and test (0.835) sets, metabolite biomarker panels composed of proline, glutamic acid, and arginine had the highest sensitivity and specificity in distinguishing good recovery from poor. In particular, arginine was present in the top 10 combinations of the average area under the receiver operating characteristic curve (AUC) test set. Our findings suggest that amino acids related to energy metabolism and excitotoxicity may play an important role in functional recovery after stroke. Therefore, the level of serum arginine has predictive value for the recovery rate after stroke.
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Affiliation(s)
- Xin Wang
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, Boston, MA, United States.,Department of Rehabilitation, Clinical Medical College, Yangzhou University, Yangzhou, China
| | - Tao Liu
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, Boston, MA, United States.,Clinical School of Acupuncture, Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Haixin Song
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, Boston, MA, United States
| | - Shaoyang Cui
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, Boston, MA, United States
| | - Gang Liu
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, Boston, MA, United States
| | - Andrea Christoforou
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, Boston, MA, United States
| | - Patrick Flaherty
- Department of Mathematics, College of Science and Mathematics, University of Massachusetts Boston, Boston, MA, United States
| | - Xun Luo
- Kerry Rehabilitation Medicine Research Institute, Shenzhen, China
| | - Lisa Wood
- William F. Connell School of Nursing, Boston College, Chestnut Hill, MA, United States
| | - Qing Mei Wang
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, Boston, MA, United States
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Bonin Pinto C, Morales-Quezada L, de Toledo Piza PV, Zeng D, Saleh Vélez FG, Ferreira IS, Lucena PH, Duarte D, Lopes F, El-Hagrassy MM, Rizzo LV, Camargo EC, Lin DJ, Mazwi N, Wang QM, Black-Schaffer R, Fregni F. Combining Fluoxetine and rTMS in Poststroke Motor Recovery: A Placebo-Controlled Double-Blind Randomized Phase 2 Clinical Trial. Neurorehabil Neural Repair 2019; 33:643-655. [PMID: 31286828 DOI: 10.1177/1545968319860483] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background. Although recent evidence has shown a new role of fluoxetine in motor rehabilitation, results are mixed. We conducted a randomized clinical trial to evaluate whether combining repetitive transcranial magnetic stimulation (rTMS) with fluoxetine increases upper limb motor function in stroke. Methods. Twenty-seven hemiparetic patients within 2 years of ischemic stroke were randomized into 3 groups: Combined (active rTMS + fluoxetine), Fluoxetine (sham rTMS + fluoxetine), or Placebo (sham rTMS + placebo fluoxetine). Participants received 18 sessions of 1-Hz rTMS in the unaffected primary motor cortex and 90 days of fluoxetine (20 mg/d). Motor function was assessed using Jebsen-Taylor Hand Function (JTHF) and Fugl-Meyer Assessment (FMA) scales. Corticospinal excitability was assessed with TMS. Results. After adjusting for time since stroke, there was significantly greater improvement in JTHF in the combined rTMS + fluoxetine group (mean improvement: -214.33 seconds) than in the placebo (-177.98 seconds, P = 0.005) and fluoxetine (-50.16 seconds, P < 0.001) groups. The fluoxetine group had less improvement than placebo on both scales (respectively, JTHF: -50.16 vs -117.98 seconds, P = 0.038; and FMA: 6.72 vs 15.55 points, P = 0.039), suggesting that fluoxetine possibly had detrimental effects. The unaffected hemisphere showed decreased intracortical inhibition in the combined and fluoxetine groups, and increased intracortical facilitation in the fluoxetine group. This facilitation was negatively correlated with motor function improvement (FMA, r2 = -0.398, P = 0.0395). Conclusion. Combined fluoxetine and rTMS treatment leads to better motor function in stroke than fluoxetine alone and placebo. Moreover, fluoxetine leads to smaller improvements than placebo, and fluoxetine's effects on intracortical facilitation suggest a potential diffuse mechanism that may hinder beneficial plasticity on motor recovery.
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Affiliation(s)
- Camila Bonin Pinto
- 1 Harvard Medical School, Boston, MA, USA.,2 University of Sao Paulo, Sao Paulo, Brazil.,3 Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | - Leon Morales-Quezada
- 1 Harvard Medical School, Boston, MA, USA.,3 Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | - Polyana Vulcano de Toledo Piza
- 1 Harvard Medical School, Boston, MA, USA.,3 Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA.,6 Albert Einstein Hospital, Sao Paulo, Brazil
| | - Dian Zeng
- 1 Harvard Medical School, Boston, MA, USA.,3 Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | - Faddi Ghassan Saleh Vélez
- 1 Harvard Medical School, Boston, MA, USA.,3 Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA.,4 University of Chicago Medical Center, Chicago, IL, USA
| | - Isadora Santos Ferreira
- 1 Harvard Medical School, Boston, MA, USA.,3 Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | - Pedro Henrique Lucena
- 1 Harvard Medical School, Boston, MA, USA.,3 Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | - Dante Duarte
- 1 Harvard Medical School, Boston, MA, USA.,3 Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | - Fernanda Lopes
- 1 Harvard Medical School, Boston, MA, USA.,3 Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | - Mirret M El-Hagrassy
- 1 Harvard Medical School, Boston, MA, USA.,3 Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | - Luiz Vicente Rizzo
- 3 Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA
| | - Erica C Camargo
- 1 Harvard Medical School, Boston, MA, USA.,5 Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - David J Lin
- 1 Harvard Medical School, Boston, MA, USA.,5 Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Nicole Mazwi
- 1 Harvard Medical School, Boston, MA, USA.,3 Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA.,5 Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Qing Mei Wang
- 1 Harvard Medical School, Boston, MA, USA.,5 Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,6 Albert Einstein Hospital, Sao Paulo, Brazil.,7 Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Randie Black-Schaffer
- 1 Harvard Medical School, Boston, MA, USA.,3 Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA.,5 Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Felipe Fregni
- 1 Harvard Medical School, Boston, MA, USA.,3 Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, USA.,5 Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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30
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Wang Y, Guo S, Zheng J, Wang QM, Zhang Y, Liang Z, Zhang L, Yang Y, Zhai H, Chen M, Wang Y, Li Y, Lyu X, Li X, Geng H, Zhu X, Yu F, Yuan J, Zhou J, Liu F, Luo H, Long J, Chen W, Li H, Fu G, Zhou C, Zhang J, Wang Y, Huo Y, Ke X, Zeng Y, Liu J, Xing H, Xiao H, Jiao R, Wu M, Tang Q, Luo X. User testing of the psychometric properties of pictorial-based disability assessment Longshi Scale by healthcare professionals and non-professionals: a Chinese study in Shenzhen. Clin Rehabil 2019; 33:1479-1491. [PMID: 31081365 DOI: 10.1177/0269215519846543] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The aim of this study was to validate a novel pictorial-based Longshi Scale for evaluating a patient's disability by healthcare professionals and non-professionals. DESIGN Prospective study. SETTING Rehabilitation departments from a grade A, class 3 public hospital, a grade B, class 2 public hospital, and a private hospital and seven community rehabilitation centers. SUBJECTS A total of 618 patients and 251 patients with functional disabilities were recruited in a two-phase study, respectively. MAIN MEASURES Outcome measure: pictorial scale of activities of daily living (ADLs, Longshi Scale). Reference measure: Barthel Index. The Spearman correlation coefficient was used to analyze the validity of Longshi Scale against Barthel Index. RESULTS In phase 1 study, from March 2016 to August 2016, the results demonstrated that the Longshi Scale was both reliable and valid (intraclass correlation coefficient based on two-way random effect (ICC2,1) = 0.877-0.974 for intra-rater reliability; ICC2,1 = 0.928-0.979; κ = 0.679-1.000 for inter-rater reliability; intraclass correlation coefficient based on one-way random effect (ICC1,1) = 0.921-0.984 for test-retest reliability and Spearman correlation coefficient = 0.836-0.899). In the second phase, in March 2018, results further demonstrated that the Longshi Scale had good inter-rater and intra-rater reliability among healthcare professionals and non-professionals including therapists, interns, and personal care aids (ICC1,1 = 0.822-0.882 on Day 1; ICC1,1 = 0.842-0.899 on Day 7 for inter-rater reliability). In addition, the Longshi Scale decreased assessment time significantly, compared with the Barthel Index assessment (P < 0.01). CONCLUSION The Longshi Scale could potentially provide an efficient way for healthcare professionals and non-professionals who may have minimal training to assess the ADLs of functionally disabled patients.
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Affiliation(s)
- Yulong Wang
- 1 Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital, Shenzhen University School of Medicine, Shenzhen, China.,2 Shenzhen Dapeng New District Nan'ao People's Hospital, Shenzhen, China
| | - Shanshan Guo
- 1 Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital, Shenzhen University School of Medicine, Shenzhen, China
| | - Jiejiao Zheng
- 3 Department of Rehabilitation Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Qing Mei Wang
- 4 Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, A Teaching Affiliate of Harvard Medical School, Charlestown, MA, USA
| | - Yuling Zhang
- 4 Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, A Teaching Affiliate of Harvard Medical School, Charlestown, MA, USA.,5 School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Zhenwen Liang
- 6 College of Rehabilitation Sciences, Shanghai University of Medicine & Health Sciences, Shanghai, China
| | - Lihai Zhang
- 7 Department of Infrastructure Engineering, The University of Melbourne, Melbourne, VIC, Australia
| | - Yi Yang
- 7 Department of Infrastructure Engineering, The University of Melbourne, Melbourne, VIC, Australia
| | - Haohan Zhai
- 1 Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital, Shenzhen University School of Medicine, Shenzhen, China
| | - Miaoling Chen
- 1 Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital, Shenzhen University School of Medicine, Shenzhen, China
| | - Yuzhen Wang
- 1 Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital, Shenzhen University School of Medicine, Shenzhen, China
| | - Yawei Li
- 1 Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital, Shenzhen University School of Medicine, Shenzhen, China
| | - Xing Lyu
- 1 Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital, Shenzhen University School of Medicine, Shenzhen, China
| | - Xuhui Li
- 1 Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital, Shenzhen University School of Medicine, Shenzhen, China
| | - Hongli Geng
- 1 Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital, Shenzhen University School of Medicine, Shenzhen, China
| | - Xiaolong Zhu
- 1 Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital, Shenzhen University School of Medicine, Shenzhen, China
| | - Fei Yu
- 1 Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital, Shenzhen University School of Medicine, Shenzhen, China
| | - Jian Yuan
- 1 Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital, Shenzhen University School of Medicine, Shenzhen, China
| | - Jing Zhou
- 1 Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital, Shenzhen University School of Medicine, Shenzhen, China
| | - Fang Liu
- 1 Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital, Shenzhen University School of Medicine, Shenzhen, China
| | - Haoming Luo
- 1 Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital, Shenzhen University School of Medicine, Shenzhen, China
| | - Jianjun Long
- 1 Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital, Shenzhen University School of Medicine, Shenzhen, China
| | - Wensheng Chen
- 1 Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital, Shenzhen University School of Medicine, Shenzhen, China
| | - Hua Li
- 1 Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital, Shenzhen University School of Medicine, Shenzhen, China
| | - Guanqi Fu
- 1 Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital, Shenzhen University School of Medicine, Shenzhen, China
| | - Chunxiu Zhou
- 1 Department of Rehabilitation, Shenzhen Second People's Hospital, The First Affiliated Hospital, Shenzhen University School of Medicine, Shenzhen, China
| | - Jiehong Zhang
- 2 Shenzhen Dapeng New District Nan'ao People's Hospital, Shenzhen, China
| | - Yao Wang
- 2 Shenzhen Dapeng New District Nan'ao People's Hospital, Shenzhen, China
| | - Yongyang Huo
- 2 Shenzhen Dapeng New District Nan'ao People's Hospital, Shenzhen, China
| | - Xiujun Ke
- 2 Shenzhen Dapeng New District Nan'ao People's Hospital, Shenzhen, China
| | - Yuanyuan Zeng
- 2 Shenzhen Dapeng New District Nan'ao People's Hospital, Shenzhen, China
| | - Jiayu Liu
- 2 Shenzhen Dapeng New District Nan'ao People's Hospital, Shenzhen, China
| | - Hailan Xing
- 2 Shenzhen Dapeng New District Nan'ao People's Hospital, Shenzhen, China
| | - Huixiang Xiao
- 8 Department of Rehabilitation, Shenzhen Nanshan People's Hospital, 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China
| | - Rui Jiao
- 9 Rehabilitation Center, The Second Affiliated Hospital, Shenzhen University School of Medicine, Shenzhen, China
| | - Miao Wu
- 10 Acupuncture and Moxibustion Rehabilitation Hospital, Shenzhen Bao'an Traditional Chinese Medicine Hospital Group, Shenzhen, China
| | - Qiang Tang
- 11 Dongguan Humen Hospital, Dongguan, China
| | - Xun Luo
- 2 Shenzhen Dapeng New District Nan'ao People's Hospital, Shenzhen, China.,12 Kerry Rehabilitation Medicine Research Institute, Shenzhen, China.,13 Shenzhen Sanming Project Group, Spaulding Rehabilitation Hospital, A Teaching Affiliate of Harvard Medical School, Charlestown, MA, USA
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31
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Ma QY, Zhang SK, Liu J, Wang QM, Shen HP, Zhang YP, Liu M. [Anemia status of Chinese rural women of reproductive age in 2012]. Zhonghua Yi Xue Za Zhi 2018; 98:2115-2119. [PMID: 30032511 DOI: 10.3760/cma.j.issn.0376-2491.2018.26.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To study the hemoglobin concentration, anemia status and its determinant factors among Chinese rural women of reproductive age in 2012. Methods: This was a cross-sectional study. The data was obtained from the National Free Preconception Health Examination Project (NFPHEP). A total of 712 101 Chinese rural reproductive age women aged 21-49 years old who came from 193 counties of 30 provinces were included. The demographic characteristics were obtained from questionnaires. Hemoglobin concentration was measured using the cyanomethemoglobin method. The definition of anemia we used was recommended by World Health Organization, and was adjusted according to altitude level. The hemoglobin concentration level, the prevalence of anemia and its 95% CI was calculated. Determinant factors of anemia such as demographic characteristics and histories of pregnancy and miscarriage were analyzed using logistic regression. Results: In 2012, the level of hemoglobin concentration in Chinese rural women of reproductive age was (127.77±13.47) g/L, with the lowest in 21-24 years group, which was (127.54±13.54) g/L, and highest in 35-39 years group, which was (128.39±14.12) g/L. In terms of region, the hemoglobin concentration level was lowest in central south, which was (125.79±12.00) g/L, and highest in southwest, which was (129.91±14.37) g/L. The prevalence of anemia in Chinese rural women of reproductive age was 24.80%, with the highest seen in 21-24 years, which was 25.92% (95% CI: 25.74%-26.11%), and lowest in 30-34 years, which was 23.61% (95% CI: 23.37%-23.85%). The prevalence in northwest (28.31%, 95% CI: 28.01%-28.61%) was the highest among all regions, and the prevalence in east (20.88%, 95% CI: 20.68%-21.09%) was the lowest. Conclusions: The prevalence of anemia in Chinese rural reproductive age women was 24.80% in 2012. The anemia prevalence was higher among women who were young, had low educational level, and lived in northwest region.
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Affiliation(s)
- Q Y Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China
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32
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Zeng QL, Wang QM, Li N, Luo QZ. [Advances in the research of application of urine output monitoring in prevention and treatment of burn shock]. Zhonghua Shao Shang Za Zhi 2018; 34:29-31. [PMID: 29374924 DOI: 10.3760/cma.j.issn.1009-2587.2018.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Fluid therapy is a crucial treatment for patients with extensive burn, which affects patients'prognosis directly. Accurate urine output measurement plays an irreplaceable role in guiding fluid resuscitation in clinic. As one of the best indexes in traditional burn resuscitation, urine output comprehensively reflects systemic circulation. However, it doesn't fully reflect all the specific chapters of microcirculation and systemic circulation and deficient cellular oxygen metabolism exactly. We need to use urine output combined with other shock parameters to ensure adequate fluid replacement. Currently, the most common way of urine output monitoring is manual measurement. The article reviews the application of urine output monitoring in guiding fluid resuscitation of burn shock.
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Affiliation(s)
- Q L Zeng
- Department of Nursing, the First Affiliated Hospital of Army Medical University (the Third Military Medical University), Chongqing 400038, China
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33
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Liu T, Wang X, Tang X, Gong T, Ye W, Pan C, Ding H, Luo X, Li X, Wang QM. Surface Modification with ECM-Inspired SDF-1α/Laminin-Loaded Nanocoating for Vascular Wound Healing. ACS Appl Mater Interfaces 2017; 9:30373-30386. [PMID: 28816035 DOI: 10.1021/acsami.7b08516] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Surface biomimetic modification with extra-cellular matrix (ECM)-derived biomolecules is an emerging potential method of accelerating the healing of vascular stent lesions. However, insufficient capacity of the constructed biofunctional layer in maintaining its long-term efficiency and preventing thrombus and neointimal hyperplasia continue to be major limitations in clinical application. On the basis of the structure and function of ECM, in this study, we constructed a novel stromal cell-derived factor-1α (SDF-1α)/laminin-loaded nanocoating on the 316L stainless steel (SS) surface to provide improved function in modulation of vascular remodeling. The modified surface was found to control delivery of biomolecules and exhibit promising potential to provide stage-adjusted treatment after injury. An in vitro biocompatibility study suggested that the constructed layer may effectively prevent thrombosis formation by inhibiting platelet adhesion and activation, while accelerating endothelium regeneration by inducing endothelial cell (EC) migration and endothelial progenitor cell (EPC) aggregation. An in vivo animal test further demonstrated that the nanocoating may prevent thrombus and neointimal hyperplasia after implantation for 3 months. Therefore, the ECM-inspired nanocoating described in this study is a promising novel approach for vascular stent surface modification.
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Affiliation(s)
- Tao Liu
- Jiangsu Provincial Key Laboratory for Interventional Medical Devices, Huaiyin Institute of Technology , Huai'an 223003, China
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, Harvard Medical School , Charlestown, Massachusetts 02129, United States
| | - Xin Wang
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, Harvard Medical School , Charlestown, Massachusetts 02129, United States
- Department of Rehabilitation, Clinical Medical College, Yangzhou University, Northern Jiangsu Province Hospital , Yangzhou 225009, China
| | - Xiaohan Tang
- Jiangsu Provincial Key Laboratory for Interventional Medical Devices, Huaiyin Institute of Technology , Huai'an 223003, China
| | - Tao Gong
- Jiangsu Provincial Key Laboratory for Interventional Medical Devices, Huaiyin Institute of Technology , Huai'an 223003, China
| | - Wei Ye
- Jiangsu Provincial Key Laboratory for Interventional Medical Devices, Huaiyin Institute of Technology , Huai'an 223003, China
| | - Changjiang Pan
- Jiangsu Provincial Key Laboratory for Interventional Medical Devices, Huaiyin Institute of Technology , Huai'an 223003, China
| | - Hongyan Ding
- Jiangsu Provincial Key Laboratory for Interventional Medical Devices, Huaiyin Institute of Technology , Huai'an 223003, China
| | - Xun Luo
- Kerry Rehabilitation Medicine Research Institute , Shenzhen 518048, China
| | - Xia Li
- Department of Geriatrics, The Affiliated Huai'an Hospital of Xuzhou Medical College , Huai'an 223002, China
| | - Qing Mei Wang
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, Harvard Medical School , Charlestown, Massachusetts 02129, United States
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34
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Wang QM, Liu SL, Chen EF. [Advances on epidemiological research of human infections with novel avian influenza A (H7N9) virus]. Zhonghua Yu Fang Yi Xue Za Zhi 2017; 51:183-187. [PMID: 28219161 DOI: 10.3760/cma.j.issn.0253-9624.2017.02.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Human infections with novel avian influenza A(H7N9)virus was an emerging infectious disease discovered in March, 2013. As of June30, 2016, 770 cases of H7N9 were reported in worldwide including 315 deaths with 40.9% of high case fatality rate. Yangtze River Delta and Pearl River Delta were the high-prevalence area. Formerly, the cases of H7N9 were concentrated on the municipalities. However, most of the case-patients were from smaller cities or rural areas nowadays. The H7N9 human infections mainly occurred in winter and spring every waves as similar as seasonal and H5N1 human infections. Middle aged and old (the median age was 61 years) male patients were occupied the large proportion among the cases of H7N9. In addition, the phenomenon of the limited and unsustained human-to-human transmission were existed. At present, the 4 major epidemic waves had happened and human infections with novel avian influenza A (H7N9) virus could be outbreak regularly in China. In this paper, the pathogenic characteristics and disease distribution of H7N9 influenza A viruses were elaborated, with both transmission factors and control measures, which were helpful to provide the scientific evidence for prevention and control in H7N9avian influenza epidemic.
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Affiliation(s)
- Q M Wang
- Medical School of Ningbo University, Ningbo 315020, China
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35
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Yang LQ, Sun XC, Qin SK, Cheng Y, Shi JH, Chen ZD, Wang QM, Zhang HL, Hu B, Liu B, Zhang QY, Wu Q, Wang D, Shu YQ, Dong J, Han BH, Wang KM, Dang CX, Li JL, Wang HB, Li BL, Lu JG, Zhang ZH, Chen YX. Efficacy and safety of fosaprepitant in the prevention of nausea and vomiting following highly emetogenic chemotherapy in Chinese people: A randomized, double-blind, phase III study. Eur J Cancer Care (Engl) 2017; 26. [PMID: 28393417 PMCID: PMC5697660 DOI: 10.1111/ecc.12668] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2017] [Indexed: 11/30/2022]
Abstract
The prevention of chemotherapy‐induced nausea and vomiting was one of the most challenging supportive care issues in oncology, especially to highly emetogenic chemotherapy (HEC). A total of 645 patients were randomized into fosaprepitant group (fosaprepitant/placebo 150 mg d1 in combination with granisetron and dexamethasone) or aprepitant group (aprepitant/placebo 125 mg d1; 80 mg d2‐d3 plus granisetron and dexamethasone).The primary endpoint was the percentage of patients who had a complete response (CR) over the entire treatment course (0–120 hr, overall phase [OP]). It was assessed by using a non‐inferiority model, with a non‐inferiority margin of 10%. The difference of the CR rate was compared between two groups with chi‐square analysis. Six hundred and twenty‐six patients were included in the per protocol analysis. The percentage of patients with a CR in the fosaprepitant group was not inferior to that in the aprepitant group (90.85% versus 94.17%, p = .1302) during OP. Whether the cisplatin‐based chemotherapy or not, the CR rate of the fosaprepitant group was not inferior to that of the aprepitant group. Both regimens were well tolerated. The most common adverse event was constipation. Fosaprepitant provided effective and well‐tolerated control of nausea and vomiting associated with HEC in Chinese patients.
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Affiliation(s)
- L Q Yang
- Nanjing Medical University, Nanjing, China.,The Affiliated Bayi Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - X C Sun
- Nanjing Medical University, Nanjing, China.,The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - S K Qin
- The Affiliated Bayi Hospital of Nanjing University of Chinese Medicine, Nanjing, China
| | - Y Cheng
- Jilin Cancer Hospital, Changchun, China
| | - J H Shi
- Linyi Cancer Hospital, Linyi, China
| | - Z D Chen
- The Second Affiliated Hospital of Anhui Medical University, Anhui, China
| | - Q M Wang
- Henan Cancer Hospital, Zhengzhou, China
| | | | - B Hu
- Anhui Provincial Hospital, Hefei, China
| | - B Liu
- Shandong Cancer Hospital, Qingdao, China
| | - Q Y Zhang
- Harbin Medical University Cancer Hospital, Harbin, China
| | - Q Wu
- The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - D Wang
- The Third Affiliated Hospital of Third Military Medical University, Chongqing, China
| | - Y Q Shu
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - J Dong
- Yunnan Provincial Cancer Hospital, Kunming, China
| | - B H Han
- Shanghai Chest Hospital, Shanghai, China
| | - K M Wang
- The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - C X Dang
- The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - J L Li
- Cancer Hospital Chinese Academy of Medical Sciences, Beijing, China
| | - H B Wang
- The Affiliated Hospital of Xuzhou Medical College, Xuzhou, China
| | - B L Li
- Beijing Chest Hospital of the Capital Medical College, Beijing, China
| | - J G Lu
- Nantong Tumor Hospital, Nantong, China
| | - Z H Zhang
- Sichuan Province Cancer Hospital, Chengdu, China
| | - Y X Chen
- The Affiliated Bayi Hospital of Nanjing University of Chinese Medicine, Nanjing, China
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Chen J, Zhang SK, Wang QM, Shen HP, Zhang YP, Yan DH, Liu J, Liu M. [Investigation on folic acid supplementation status among Chinese women in the first trimester of pregnancy]. Zhonghua Yi Xue Za Zhi 2016; 96:1215-9. [PMID: 27117372 DOI: 10.3760/cma.j.issn.0376-2491.2016.15.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To investigate folic acid (FA) supplementation status among Chinese rural reproductive women in their early pregnancy, and to provide evidence for the evaluation of FA supplementation project from national basic public health services. METHODS The data on intake status of FA supplementation from "National Free Preconception Health Examination Project (NFPHEP)" database between January 1, 2010 and December 31, 2012 was used and analyzed.A total of 902 270 women who achieved follow-up during early pregnancy from 220 pilot counties of 31 provinces were recruited. RESULTS From 2010 to 2012, the rate of FA intake among women recuited were 73.58% (134 131/182 289), 75.88% (329 288/433 970) and 76.53% (218 896/286 011), respectively, which increased year by year (χtrend(2)=13 371.8, P<0.001). Among 682 315 women who took FA, 350 738(51.40%) women began to take FA 3 months before amenorrhea; 130 683 (19.15%) women began to take FA 1-2 months before amenorrhea, and 200 894 (29.44%) began to take FA after amenorrhea.Among 682 315 women who took FA, 645 310 (94.58%) women took it regularly, and 342 418 (50.18%) women took FA in a standardized way. CONCLUSIONS The status of FA intake among Chinese rural women in the first trimester of pregnancy was good, and 75.62% (682 315/902 270) of them took FA.It is also important for basic public health services to improve the rate of FA intake and increase the rate of taking FA in a standardized way in Chinese rural pregnant women.
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Affiliation(s)
- J Chen
- Peking University Health Science Center, Beijing 100083, China
| | - S K Zhang
- Department of Maternal and Child Health, National Health and Family Planning Commission, Beijing 100044, China
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Li ZD, Bao FJ, Wang QM, Huang JH. [Finite element analysis of astigmatic keratotomy based on corneal biomechanical properties]. Zhonghua Yan Ke Za Zhi 2016; 52:674-80. [PMID: 27647248 DOI: 10.3760/cma.j.issn.0412-4081.2016.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To establish a finite-element biomechanical model of astigmatic keratotomy, and to investigate the impact of surgical parameters on corneal deformation, stress distribution and astigmatism correction. METHODS With Rhinoceros modeling and Abaqus finite element analysis software, a three-dimensional finite-element model of astigmatic cornea was developed, and surgical parameters such as incision optical zone, incision depth and length were varied. Postoperative corneal stress, apical deformation and astigmatism correction were assessed. RESULTS A significant increase of stress was noticed near corneal incisions, and maximum corneal stress decreased with the increase of incision depth. Both anterior and posterior corneal surface moved slightly forward postoperatively. Maximum corneal stress was 340 392, 361 022 and 214 187 Pa, and anterior and posterior apical deformation was 49.80, 51.64, 55.53 μm and 54.15, 55.91, 59.67 μm, with 45°, 60° and 90° in arc length of the incision, respectively. The refractive power decreased in steep meridian and increased in flat meridian, resulting in a total decrease of corneal astigmatism. The magnitude of astigmatism correction was 0.85, 1.59, 2.23 and 3.06 D with 30°, 45°, 60° and 90° in arc length of the incision, respectively. CONCLUSIONS The finite-element biomechanical model of astigmatic keratotomy could be used to predict the optical outcomes after surgery. The magnitude of astigmatism correction is positively correlated with the surgical incision arc length. (Chin J Ophthalmol, 2016, 52: 674-680).
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Affiliation(s)
- Z D Li
- Affiliation School of Ophthalmology and Optometry and Eye Hospital, Wenzhou Medical University, Wenzhou 325027, China
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Chen SH, Zhang J, Li YN, Ding P, Wang QM. [Clinical results of transepithelial corneal collagen cross-linking in the treatment of keratoconus]. Zhonghua Yan Ke Za Zhi 2016; 52:525-5. [PMID: 27531114 DOI: 10.3760/cma.j.issn.0412-4081.2016.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To evaluate the effect of transepithelial corneal collagen cross-linking (CXL) in the treatment of keratoconus. METHODS Prospective study. Sixteen eyes of 16 patients with keratoconus underwent transepithelial CXL, and the fellow eyes were considered as the controls. The mean age was (22.4±6.5) years old. In the CXL group, topical anesthesia (0.1% tetracaine) was given for 15 minutes, and 0.5% riboflavin was applied until saturated in the anterior chamber. Then an ultraviolet A irradiance of 3 mW/cm(2) on the cornea was performed for 30 minutes. Postoperative corneal reepithelization time was recorded. Preoperative and postoperative examinations included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refractive error, topography, corneal biomechanical parameters, thinnest corneal thickness, and endothelial cell density. RESULTS The mean corneal reepithelization time was 1.0(1.0 to 2.0) days. In the transepithelial CXL group, at the end of the 12-month follow-up, CDVA and refractive outcomes were significantly improved (P<0.05). Maximum K-value, anterior and posterior elevations were significantly decreased by (-2.23 ± 2.82)D (t=-3.153, P=0.007), (-4.69 ± 4.99) μm (t=-3.758, P=0.002), and (-13.94 ± 25.81) μm (t=-2.160, P=0.047), respectively. Corneal hysteresis, corneal resistance factor, thinnest corneal thickness, and endothelial cell density showed no significant difference (P>0.05). The differences in the changes of UDVA, CDVA, spherical equivalent refraction, and maximum K-value between the CXL and control groups were significant at 12 months (P<0.05). CONCLUSION Transepithelial CXL is effective in optimizing the irregular corneal surface of keratoconus, and might halt its progression. (Chin J Ophthalmol, 2016, 52: 525-530).
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Affiliation(s)
- S H Chen
- The Affiliated Eye Hospital of Wenzhou Medical University, Wenzhou 325027, China
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Wang QM, Johnson RB, Cohen JD, Voy GT, Richardson JM, Jungheim LN. Development of a Continuous Fluorescence Assay for Rhinovirus 14 3C Protease Using Synthetic Peptides. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/095632029700800402] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Rhinovirus 3C protease is an attractive target for therapeutic intervention owing to its important role in virion maturation and infectivity. In order to facilitate the identification of potential 3C protease inhibitors, we have developed a continuous fluorescence assay using 5-[(2-aminoethyl)amino]naphthalene-1-sulphonic acid (Edans) as a fluorescent donor and 4-(4-dimethylaminophenylazo)benzoic acid (Dabcyl) as a quenching acceptor. Several fluorogenic peptide substrates for 3C protease were synthesized by both solution chemistry and solid phase peptide synthesis. One of the synthetic Edans/Dabcyl substrates, with an amino acid sequence derived from the 2C/3A site of the virus polyprotein, yielded a 24-fold increase in fluorescence intensity after 3C cleavage. Data regarding substrate cleavage kinetics, assay sensitivity and optimization are presented. The application of this assay to the evaluation of 3C protease inhibitors is also shown.
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Affiliation(s)
- QM Wang
- Infectious Diseases Research, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN 46285, USA
| | - RB Johnson
- Infectious Diseases Research, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN 46285, USA
| | - JD Cohen
- Infectious Diseases Research, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN 46285, USA
| | - GT Voy
- Infectious Diseases Research, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN 46285, USA
| | - JM Richardson
- Infectious Diseases Research, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN 46285, USA
| | - LN Jungheim
- Infectious Diseases Research, Lilly Research Laboratories, Eli Lilly and Company, Indianapolis, IN 46285, USA
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Wen H, Alshikho MJ, Wang Y, Luo X, Zafonte R, Herbert MR, Wang QM. Correlation of Fractional Anisotropy With Motor Recovery in Patients With Stroke After Postacute Rehabilitation. Arch Phys Med Rehabil 2016; 97:1487-1495. [PMID: 27178097 DOI: 10.1016/j.apmr.2016.04.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 04/13/2016] [Accepted: 04/15/2016] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To investigate the relation between fractional anisotropy (FA), a suggested biomarker for tissue integrity, and motor recovery in patients with stroke after postacute rehabilitation. DESIGN Retrospective study. SETTING Acute rehabilitation hospital. PARTICIPANTS Subjects (N=43) diagnosed with ischemic stroke (n=28) and hemorrhagic stroke (n=15). The average age for subjects was 68±14 years. INTERVENTIONS Magnetic resonance imaging and diffusion tensor imaging were conducted on all patients. MAIN OUTCOME MEASURES The admission and discharge motor subscores of the FIM were obtained from medical records, and relative gain was calculated using the Montebello Rehabilitation Factor Score (MRFS). K-means cluster analysis (K=3) using both the MRFS and the gain of the FIM motor subscore (ΔFIM) was performed. Analysis of variance was used to determine the difference in FA among the clusters. Spearman analysis was conducted to examine the relation between FA, ΔFIM, and MRFS in each cluster. RESULTS FA was significantly higher in the clusters of good and moderate recovery in the corticospinal tract (CST), peduncle, and posterior limb of the internal capsule bilaterally (all P<.05) compared with the poor recovery group. Significant positive correlations were observed in multiple regions along the CST between FA, ΔFIM, and MRFS in the clusters of good and moderate recovery, but not in the poor recovery group. CONCLUSIONS Our results showed an association between FA values within the corticospinal tract and motor recovery in patients with stroke undergoing postacute rehabilitation. This finding may help to identify novel targets for new interventions to promote stroke recovery.
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Affiliation(s)
- Hongmei Wen
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA; Department of Rehabilitation Medicine, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Mohamad J Alshikho
- Transcend Research Laboratory, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA
| | - Yao Wang
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA; Department of Rehabilitation Medicine, Nan'ao People's Hospital of Shenzhen, The First Affiliated Hospital, Shenzhen University, Shenzhen, China
| | - Xun Luo
- Department of Rehabilitation Medicine, Nan'ao People's Hospital of Shenzhen, The First Affiliated Hospital, Shenzhen University, Shenzhen, China; Kerry Rehabilitation Medicine Research Institute, Shenzhen, China
| | - Ross Zafonte
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA
| | - Martha R Herbert
- Transcend Research Laboratory, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA
| | - Qing Mei Wang
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, Harvard Medical School, Charlestown, MA.
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Song Q, Ma YL, Song JQ, Chen Q, Xia GS, Ma JY, Feng F, Fei XJ, Wang QM. Sevoflurane induces neurotoxicity in young mice through FAS/FASL signaling. Genet Mol Res 2015; 14:18059-68. [PMID: 26782453 DOI: 10.4238/2015.december.22.32] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Sevoflurane, the most widely used anesthetic in clinical practice, has been shown to induce apoptosis, inhibit neurogenesis, and cause learning and memory impairment in young mice. However, the underlying mechanism is still unknown. In this study, wild-type and the FAS- or FAS ligand (FASL)-knockout mice (age 7 days) were exposed to sevoflurane or pure oxygen. Western blotting was used to examine the expression of FAS protein. Terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) and bromodeoxyuridine (BrdU) staining were employed to quantify the apoptotic cells and newborn cells in the hippocampus and Morris water maze (MWM) in order to evaluate learning and memory status. Sevoflurane significantly increased the expression of FAS protein in wild-type mice. Compared to FAS- and FASL-knockout mice treated with sevoflurane, sevoflurane-treated wild-type mice exhibited more TUNEL-positive hippocampal cells and less BrdU-positive hippocampal cells. The MWM showed that compared with FAS- and FASL-knockout mice treated with sevoflurane, sevoflurane treatment of wild-type mice significantly prolonged the escape latency and reduced platform crossing times. These data suggest that sevoflurane induces neurotoxicity in young mice through FAS-FASL signaling.
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Affiliation(s)
- Q Song
- Department of Anesthesiology, Zhengzhou Central Hospital, Zhengzhou, Henan Province, China
| | - Y L Ma
- Department of Anesthesiology, Zhengzhou Central Hospital, Zhengzhou, Henan Province, China
| | - J Q Song
- Department of Anesthesiology, Zhengzhou Central Hospital, Zhengzhou, Henan Province, China
| | - Q Chen
- Department of Anesthesiology, Zhengzhou Central Hospital, Zhengzhou, Henan Province, China
| | - G S Xia
- Department of Anesthesiology, Zhengzhou Central Hospital, Zhengzhou, Henan Province, China
| | - J Y Ma
- Department of Anesthesiology, Zhengzhou Central Hospital, Zhengzhou, Henan Province, China
| | - F Feng
- Department of Anesthesiology, Zhengzhou Central Hospital, Zhengzhou, Henan Province, China
| | - X J Fei
- Department of Anesthesia and Critical Care, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA.,Department of Hospital Infections, Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Q M Wang
- Department of Anesthesiology, Zhengzhou Central Hospital, Zhengzhou, Henan Province, China
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Qin J, Ma X, Qi H, Song B, Wang Y, Wen X, Wang QM, Sun S, Li Y, Zhang R, Liu X, Hou H, Gong G, Xu Y. Transplantation of Induced Pluripotent Stem Cells Alleviates Cerebral Inflammation and Neural Damage in Hemorrhagic Stroke. PLoS One 2015; 10:e0129881. [PMID: 26086994 PMCID: PMC4472717 DOI: 10.1371/journal.pone.0129881] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 05/15/2015] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Little is known about the effects of induced pluripotent stem cell (iPSC) treatment on acute cerebral inflammation and injuries after intracerebral hemorrhage (ICH), though they have shown promising therapeutic potentials in ischemic stoke. METHODS An ICH model was established by stereotactic injection of collagenase VII into the left striatum of male Sprague-Dawley (SD) rats. Six hours later, ICH rats were randomly divided into two groups and received intracerebrally 10 μl of PBS with or without 1 × 10(6) of iPSCs. Subsequently, neural function of all ICH rats was assessed at days 1, 3, 7, 14, 28 and 42 after ICH. Inflammatory cells, cytokines and neural apoptosis in the rats' perihematomal regions, and brain water content were determined on day 2 or 3 post ICH. iPSC differentiation was determined on day 28 post ICH. Nissl(+) cells and glial fibrillary acidic protein (GFAP)(+) cells in the perihematoma and the survival rates of rats in two groups were determined on post-ICH day 42. RESULTS Compared with control animals, iPSCs treatment not only improved neurological function and survival rate, but also resulted in fewer intracephalic infiltrations of neutrophils and microglia, along with decreased interleukin (IL)-1β, IL-6 and tumour necrosis factor-alpha (TNF-α), and increased IL-10 in the perihematomal tissues of ICH rats. Furthermore, brain oedema formation, apoptosis, injured neurons and glial scar formation were decreased in iPSCs-transplanted rats. CONCLUSIONS Our findings indicate that iPSCs transplantation attenuate cerebral inflammatory reactions and neural injuries after ICH, and suggests that multiple mechanisms including inflammation modulation, neuroprotection and functional recovery might be involved simultaneously in the therapeutic benefit of iPSC treatment against hemorrhagic stroke.
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Affiliation(s)
- Jie Qin
- Third Department of Neurology and Key Disciplines Laboratory of Clinical Medicine of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P. R. China
| | - Xun Ma
- Third Department of Neurology and Key Disciplines Laboratory of Clinical Medicine of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P. R. China
| | - Haiyun Qi
- Third Department of Neurology and Key Disciplines Laboratory of Clinical Medicine of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P. R. China
| | - Bo Song
- Third Department of Neurology and Key Disciplines Laboratory of Clinical Medicine of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P. R. China
| | - Yanlin Wang
- Third Department of Neurology and Key Disciplines Laboratory of Clinical Medicine of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P. R. China
| | - Xuejun Wen
- Department of Chemical and Life Science Engineering, Institute for Engineering and Medicine, Virginia Commonwealth University, Richmond, VA 23284, United States of America
| | - Qing Mei Wang
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA 02114, United States of America
| | - Shilei Sun
- Third Department of Neurology and Key Disciplines Laboratory of Clinical Medicine of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P. R. China
| | - Yusheng Li
- Third Department of Neurology and Key Disciplines Laboratory of Clinical Medicine of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P. R. China
| | - Rui Zhang
- Third Department of Neurology and Key Disciplines Laboratory of Clinical Medicine of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P. R. China
| | - Xinjing Liu
- Third Department of Neurology and Key Disciplines Laboratory of Clinical Medicine of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P. R. China
| | - Haiman Hou
- Third Department of Neurology and Key Disciplines Laboratory of Clinical Medicine of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P. R. China
| | - Guangming Gong
- Department of Microbiology and Immunology, College of Basic Medical Sciences, Zhengzhou University, Zhengzhou, Henan 450001, P. R. China
- * E-mail: (YX); (GG)
| | - Yuming Xu
- Third Department of Neurology and Key Disciplines Laboratory of Clinical Medicine of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, P. R. China
- * E-mail: (YX); (GG)
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Shi L, Qin J, Song B, Wang QM, Zhang R, Liu X, Liu Y, Hou H, Chen X, Ma X, Jiang C, Sun X, Gong G, Xu Y. Increased frequency of circulating regulatory T cells in patients with acute cerebral hemorrhage. Neurosci Lett 2015; 591:115-120. [PMID: 25703227 DOI: 10.1016/j.neulet.2015.02.042] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 02/01/2015] [Accepted: 02/17/2015] [Indexed: 01/09/2023]
Abstract
Cerebral hemorrhage (ICH) is a serious stroke subtype, currently lacking effective treatment. Recent research has shown that CD4(+)CD25(+)FOXP3(+) regulatory T cells (Tregs) play a key role in the immune response of ischemic stroke. However, Tregs in human hemorrhagic stroke are poorly investigated. In this study, a total of 90 ICH patients and 60 healthy controls were recruited. The frequency of circulating Tregs, plasma levels of TGF-β and IL-10, and the severity of neural dysfunction in ICH patients were investigated at different time points post ICH. We found that the peripheral frequency of Tregs in ICH patients was significantly increased, accompanied by boosted activated T cells. Importantly, the elevation of circulating Tregs in patients with severe dysfunction was much higher than that in less-severe patients, suggesting that disease severity affects circulating Tregs to exert regulatory function. Furthermore, both TGF-β and IL-10 that are related to the function of Tregs, were also increased in the peripheral blood of ICH patients. Our results demonstrate that Tregs-mediated immune imbalance might affect the development and severity of ICH, and suggest that Tregs may be used as tools and targets of cellular immunotherapy to effectively treat acute hemorrhagic stroke.
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Affiliation(s)
- Lijin Shi
- Third Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Henan Province 450052, China; Department of Neurology, The First Affiliated Hospital of Xinxiang Medical University, Henan Province 453100, China
| | - Jie Qin
- Third Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Henan Province 450052, China
| | - Bo Song
- Third Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Henan Province 450052, China
| | - Qing Mei Wang
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA 02114, United States
| | - Rui Zhang
- Third Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Henan Province 450052, China
| | - Xinjing Liu
- Third Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Henan Province 450052, China
| | - Yutao Liu
- Third Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Henan Province 450052, China
| | - Haiman Hou
- Third Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Henan Province 450052, China
| | - Xiulan Chen
- Department of Intensive Care Unit, The First Affiliated Hospital of Xinxiang Medical University, Henan Province 453100, China
| | - Xun Ma
- Third Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Henan Province 450052, China
| | - Chenyang Jiang
- Third Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Henan Province 450052, China
| | - Xiao Sun
- Third Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Henan Province 450052, China
| | - Guangming Gong
- Department of Microbiology and Immunology, Basic Medical College of Zhengzhou University, Henan Province 450000, China.
| | - Yuming Xu
- Third Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Henan Province 450052, China.
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Wang QM, Cui H, Han SJ, Black-Schaffer R, Volz MS, Lee YT, Herman S, Latif LA, Zafonte R, Fregni F. Combination of transcranial direct current stimulation and methylphenidate in subacute stroke. Neurosci Lett 2014; 569:6-11. [PMID: 24631567 DOI: 10.1016/j.neulet.2014.03.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 03/01/2014] [Accepted: 03/05/2014] [Indexed: 01/23/2023]
Abstract
Noninvasive transcranial direct current stimulation (tDCS) and methylphenidate (MP) are associated with motor recovery after stroke. Based on the potentially complementary mechanisms of these interventions, we examined whether there is an interactive effect between MP and tDCS. In this preliminary study, we randomized subacute stroke subjects to receive tDCS alone, MP alone or combination of tDCS and MP. A blinded rater measured safety, hand function, and cortical excitability before and after treatment. None of the treatments caused any major or severe adverse effects or induced significant differences in cortical excitability. Analysis of variance of gain score, as measured by Purdue pegboard test, showed a significant between-group difference (F(2,6)=12.167, p=0.008). Post hoc analysis showed that the combination treatment effected greater Purdue pegboard gain scores than tDCS alone (p=0.017) or MP alone (p=0.01). Our preliminary data with nine subjects shows an interesting dissociation between motor function improvement and lack of motor corticospinal plasticity changes as indexed by transcranial magnetic stimulation in subacute stroke subjects.
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Affiliation(s)
- Qing Mei Wang
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, United States
| | - Huashun Cui
- Department of Acupuncture, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, China; Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital, Harvard Medical School, United States
| | - Soo Jeong Han
- Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital, Harvard Medical School, United States; Department of Rehabilitation Medicine, School of Medicine, Ewha Womans University, Republic of Korea
| | - Randie Black-Schaffer
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, United States
| | - Magdalena Sarah Volz
- Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital, Harvard Medical School, United States; Charité - Universitätsmedizin Berlin, Medical Department I Gastroenterology, Infectiology and Rheumatology, Berlin, Germany
| | - Yong-Tae Lee
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, United States
| | - Seth Herman
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, United States
| | - Lydia Abul Latif
- Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital, Harvard Medical School, United States; Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Malaysia
| | - Ross Zafonte
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, United States
| | - Felipe Fregni
- Laboratory of Neuromodulation, Spaulding Rehabilitation Hospital, Harvard Medical School, United States.
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Du JY, Yang H, Tian DR, Wang QM, He L. Identification and functional analysis of differentially expressed genes related to obesity using DNA microarray. Genet Mol Res 2014; 13:64-72. [PMID: 24446288 DOI: 10.4238/2014.january.8.5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We looked for differentially expressed genes at different stages of preadipocyte differentiation and examined their functions, based on DNA microarrays of preadipocytes obtained from healthy subjects undergoing cosmetic liposuction. We downloaded gene expression profile GSE25910 from the Gene Expression Omnibus database and identified the differentially expressed genes with packages in R language. The selected differentially expressed genes were further analyzed using bioinformatics methods. Comparing gene expression at different stages of preadipocytes differentiation, we found that expression of 668 and 1007 genes were altered in middle and late stages compared with the early stage, respectively. Function analysis revealed that the differentially expressed genes were mainly related to fatty acid metabolic processes in the former two stages.
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Affiliation(s)
- J Y Du
- Department of Anatomy, Tianjin Medical University, Tianjin, China
| | - H Yang
- Department of Anatomy, Tianjin Medical University, Tianjin, China
| | - D R Tian
- Department of Anatomy, Tianjin Medical University, Tianjin, China
| | - Q M Wang
- Department of Anatomy, Tianjin Medical University, Tianjin, China
| | - L He
- Department of Anatomy, Tianjin Medical University, Tianjin, China
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Qin J, Gong G, Sun S, Qi J, Zhang H, Wang Y, Wang N, Wang QM, Ji Y, Gao Y, Shi C, Yang B, Zhang Y, Song B, Xu Y. Functional recovery after transplantation of induced pluripotent stem cells in a rat hemorrhagic stroke model. Neurosci Lett 2013; 554:70-5. [PMID: 24005132 DOI: 10.1016/j.neulet.2013.08.047] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 08/21/2013] [Accepted: 08/23/2013] [Indexed: 12/12/2022]
Abstract
Transplantation of induced pluripotent stem cells (iPSCs) has shown promising therapeutic effects for ischemic stroke. However, it is not clear if this treatment would promote recovery after intracerebral hemorrhage (ICH). In this study, we investigated the functional outcome of iPSCs transplantation in experimental ICH in rats. IPSCs were derived from an ICH patient's fibroblasts and were injected into the ipsilateral side of ICH in rats. IPSCs transplantation significantly improved the neurological functions after ICH as compared to vehicle and fibroblast injection. The grafted iPSCs migrated into brain tissue around the hematoma, survived after 4 weeks of transplantation, and exhibited the neural cell-specific biomarkers nestin, β-tubulin, and GFAP. Immunohistochemical staining showed that the densities of brain derived neurophic factors (BDNF)-positive cells and vascular endothelial growth factor (VEGF)-positive cells were significantly increased around the hemorrhagic brain tissues of iPSCs-treated rats. In addition, iPSCs treatment increased the protein expression of BDNF and VEGF in the surrounding region of hematoma. These findings demonstrate that the transplantation of ICH patient-derived iPSCs contributes toward the improved neurological function in experimental ICH rats. The mechanisms are possibly due to neuronal replacement and enhanced secretion of neurophic factors. Our data suggest that transplantation of ICH patient-derived iPSCs may be a therapeutic strategy for hemorrhagic stroke.
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Affiliation(s)
- Jie Qin
- Third Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450052, PR China
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Wang QM, Stalker TJ, Gong Y, Rikitake Y, Scalia R, Liao JK. Inhibition of Rho-kinase attenuates endothelial-leukocyte interaction during ischemia-reperfusion injury. Vasc Med 2012; 17:379-85. [PMID: 23015643 DOI: 10.1177/1358863x12459790] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Resuscitation from hemorrhagic shock induces endothelial dysfunction and activates inflammatory cascades leading to organ damage. Following restoration of blood flow to ischemic vascular beds, leukocyte-endothelium interactions leading to leukocyte infiltration into the vascular wall occur very early due, in part, to the loss of endothelium-derived nitric oxide (NO). The mechanism by which ischemia-reperfusion injury impairs endothelium-derived NO is not completely understood. We hypothesized that inhibition of Rho-kinase could exert beneficial effects following hemorrhagic shock by preserving endothelial function and attenuating leukocyte trafficking in the microcirculation. Using intravital microscopy, we found that resuscitation from hemorrhage acutely increased the number of rolling and adherent leukocytes in the mouse splanchnic microcirculation. Treatment of mice with the Rho-kinase inhibitor fasudil, markedly attenuated leukocyte-endothelium interaction in response to hemorrhage/reinfusion. The beneficial effect of fasudil was not observed in endothelial nitric oxide synthase (eNOS)(-/-) mice. In conclusion, inhibition of Rho-kinase prevents inflammatory leukocyte trafficking in the microcirculation via an eNOS-dependent mechanism. Our data support a role for Rho-kinase inhibitors in the treatment of ischemia-reperfusion injury.
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Affiliation(s)
- Qing Mei Wang
- Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA, USA
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Abstract
INTRODUCTION Stroke is the third leading cause of death and a major cause of long-term disability in the adult population. Growing evidence suggests that inflammation may play an important role in the evolution of stroke. Because Rho-associated coiled-coil containing kinases (ROCKs) are important mediators of inflammation, they may contribute to stroke and stroke recovery. AREAS COVERED The pathophysiological role of ROCKs in mediating inflammation at different phases of stroke, and the therapeutic opportunities for stroke prevention and stroke treatment with ROCK inhibitors will be discussed. EXPERT OPINION Inflammation is a double-edged sword during the evolution of stroke. Immunomodulation might provide a novel therapeutic approach for stroke prevention and stroke treatment. ROCK plays an important role in mediating the inflammatory response following vascular injury as well as platelet activation and thrombus formation. ROCK inhibitors have been shown to be beneficial in stroke prevention, acute neuroprotection and chronic stroke recovery by affecting inflammatory-mediated platelet and endothelial function, smooth muscle contraction and neuronal regeneration. Thus, ROCK-mediated inflammation could be a potential therapeutic target for stroke prevention and stroke treatment. However, the mechanism by which ROCKs regulate the inflammatory response is unclear, and the role of the two ROCK isoforms in stroke and stroke recovery remains to be determined.
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Affiliation(s)
- Qing Mei Wang
- Spaulding Rehabilitation Hospital, Department of Physical Medicine and Rehabilitation, Boston, MA, USA
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Wang QM, Garkas W, Renteria AF, Leyens C, Kim KH. Oxidation behaviour of Ti2AIN films composed mainly of nanolaminated MAX phase. J Nanosci Nanotechnol 2011; 11:8959-8966. [PMID: 22400287 DOI: 10.1166/jnn.2011.3504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
In this paper, we reported the oxidation behaviour of Ti2AIN films on polycrystalline Al2O3 substrates. The Ti2AIN films composed mainly of nanolaminated MAX phase was obtained by first depositing Ti-Al-N films using reactive sputtering of two elemental Ti and Al targets in Ar/N2 atmosphere and subsequent vacuum annealing at 800 degrees C for 1 h. The Ti2AIN films exhibited excellent oxidation resistance and thermal stability at 600-900 degrees C in air. Very low mass gain was observed. At low temperature (600 degrees C), no oxide crystals were observed on film surface. Blade-like Theta-Al2O3 fine crystals formed on film surfaces at 700-800 degrees C. At high temperature (900 degrees C), firstly Theta-Al2O3 formed on film surface and then transformed into alpha-Al2O3. At 700-900 degrees C, a continuous Al2O3 layer formed on Ti2AIN films surface, acting as diffusion barrier preventing further oxidation attack. The mechanism of the excellent oxidation resistance of Ti2AIN films was discussed based on the experimental results.
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Affiliation(s)
- Q M Wang
- Chair of Physical Metallurgy and Materials Technology, Technical University of Brandenburg at Cottbus, Konrad-Wachsmann-Allee 17, 03046 Cottbus, Germany
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