Therapeutic effect of pregabalin on radiotherapy-induced trismus in nasopharyngeal carcinoma patients

AimsTo evaluate the effect of pregabalin on radiotherapy-induced trismus in patients with nasopharyngeal carcinoma, a hospital-based, clinical retrospective cohort study was conducted.Materials and methodsData were collected on patients diagnosed with radiotherapy-induced trismus from March 2014 and March 2016 in the department of neurology in our hospital. Patients in the treatment group were administrated pregabalin for 8 weeks combined with rehabilitation, while the control group only received rehabilitation. The clinical therapeutic effects were observed and evaluated by mandibular motion, severity of trismus measured by late effects of normal tissues/subjective and objective medical analysis (LENT/SOMA) scales, and quality of life (QOL) assessed using the World Health Organization QOL instrument (WHOQOL-BREF) at baseline, week 4 and week 8 during treatment in these two groups, respectively.ResultsIn the treatment group, the number of patients with improvement on maximal vertical dimension (MVD) was significantly more than controls at week 4 and week 8 (P = 0.013, P = 0.004, respectively). Moreover, at week 4 and week 8, the severity of trismus was both significantly improved on LENT/SOMA grade in treatment group (P = 0.047, P = 0.032, respectively). And at week 8, the physical health and the whole life domain of the WHOQOL-BREF score were significantly increased (P = 0.037, P = 0.034, respectively). In the treatment group, 11 patients (36.7%) presented dizziness, and 7 patients (23.3%) presented somnolence.ConclusionsAdministration of pregabalin, in adjunct to rehabilitation, might provide a better outcome in patients with radiotherapy-induced trismus.     

精神科急诊分诊标准化问诊流程的应用效果观察

目的探讨精神科急诊分诊标准化问诊流程在临床实践中的应用效果。方法选择2018年3-5月就诊的精神科急诊患者96例作为对照组,采用常规问诊流程;选择2019年3-5月就诊的精神科急诊患者104例作为观察组,采用精神科急诊分诊标准化问诊流程。比较两组患者急诊停留时间、住院时间、镇静药物使用次数、急诊期间严重不良事件发生率及家属满意度。结果观察组急诊停留时间、住院时间短于对照组,镇静药物使用次数少于对照组,差异具有统计学意义(P<0.05);观察组患者家属满意度高于对照组,差异具有统计学意义(P<0.05);观察组患者急诊期间自伤、伤害医护人员等不良事件发生率低于对照组,差异具有统计学意义(P<0.05)。结论精神科急诊分诊标准化问诊流程能够有效缩短急诊停留时间、住院时间,降低镇静药物使用次数,降低不良事件发生率,提升家属满意度。     

The effect of neurotrophin-3/chitosan carriers on the proliferation and differentiation of neural stem cells

In this study, the behavior of neural stem cells from the newborn rat spinal cord was compared at neurosphere level after the addition of neurotrophin-3 (NT-3) once or daily, blank chitosan carriers, or NT-3-chitosan carriers respectively. We found that NT-3 enhanced the viability and differentiation of neural stem cells, but as NT-3 has an extremely short half-life at 37 °C, in order to maintain the NT-3-mediated proliferation and differentiation effects on neural stem cells, NT-3 needed to be added to the medium every 24 h. However, NT-3-chitosan carriers dramatically increase the differentiation percentage of neural stem cells into neurons, which includes GABAergic and as cholinergic neurons. Although blank chitosan carriers also showed good biocompatibility to the neural stem cells, they induced the differentiation of these cells into neurons at a much lower percentage than the daily addition of NT-3 or the NT-3-chitosan carriers. Our results suggest that NT-3-chitosan carriers may not only maintain the viability of neural stem cells and increase their differentiation percentage into neurons, but also reduce the amount of NT-3 required for the survival and differentiation of these cells. These results may provide an experimental basis for the maximum replacement of dead neurons by neural stem cell transplant after spinal cord injury (SCI).     

BMP2 and BMP4 variations and risk of non-syndromic cleft lip and palate

ObjectiveNon-syndromic cleft lip with or without cleft palate (CL/P) is one of the most common congenital anomalies and arises from the interaction of environmental and genetic factors. The objective of this study was to investigate the association between the BMP2 (bone morphogenetic protein 2) and BMP4 (bone morphogenetic protein 4) polymorphisms with non-syndromic CL/P to clarify the potential role of these genes in the etiology of CL/P in Iranian population.DesignThe allelic and genotypic frequencies of BMP2 rs235768 A > T and BMP4 rs17563 T > C polymorphisms were determined in 107 unrelated Iranian subjects with non-syndromic CL/P and 186 control subjects using PCR and RFLP methods, and the results were compared with healthy controls. A p-value of <0.05 was considered statistically significant.ResultsThe BMP2 rs235768 AT genotype was significantly higher (P = 0.009, OR = 3, 95% CI = 1.3–7.0) in the CL/P (59.8%) than the control group (33.3%). Similarly, the BMP4 rs17563 TC genotype were significantly higher (P = 0.008, OR = 3.7, 95% CI = 1.4–9.9) in the CL/P (70.0%) than the control group (44.6%).ConclusionThe BMP2 rs235768 A > T and BMP4 rs17563 T > C polymorphisms could be considered as the risk factor for non-syndromic CL/P in Iranian population.     

Role of the systemic immune system in brain metastasis

Metastatic disease in the central nervous system (CNS) is a cause of increasing mortality amongst cancer patients. As with other types of cancer, cells of the systemic immune system play a range of important roles in the development of metastatic lesions in the CNS, both repressing and promoting tumour growth. Recent advances in immunotherapy have changed the emphasis in cancer treatment away from conventional chemotherapy and radiotherapy for certain tumour types. Despite this, our understanding of systemic immune system involvement in CNS metastases remains poor. The blood–brain barrier prevents the majority of diagnostic and therapeutic agents from crossing into the brain parenchyma until the late stages of metastatic disease. Thus, the development of immunotherapy for CNS pathologies is particularly desirable. This review draws together our current understanding in the relationships between CNS metastases and circulating systemic immune cells. We discuss the roles that circulating systemic immune cells may play in the homing of metastatic cells to the perivascular space, and the pro-metastatic and antagonistic roles that infiltrating systemic immune cells may play at sites of metastasis. This article is part of a Special Issue entitled 'Neuroinflammation in neurodegeneration and neurodysfunction'.