The Effects of Functional Training,Bicycle Exercise,and Exergaming on Walking Capacity of Elderly Patients With Parkinson Disease: A Pilot Randomized Controlled Single-blinded Trial

Objectives

To compare the effects of functional training, bicycle exercise, and exergaming on walking capacity of elderly with Parkinson disease (PD).

Neurodynamic Techniques Versus “Sham” Therapy in the Treatment of Carpal Tunnel Syndrome: A Randomized Placebo-Controlled Trial

Objective

To evaluate the efficacy of neurodynamic techniques used as the sole therapeutic component compared with sham therapy in the treatment of mild and moderate carpal tunnel syndromes (CTS).

Effects of Wrist Weights on Kinematic and Myographic Movement Characteristics During a Reaching Task in Individuals With Parkinson Disease

Objective

To investigate the kinematic and myographic effects of weighted wrist cuffs on individuals with Parkinson disease (PD) during a reaching task.

紫杉醇通过mTOR信号通路影响乳腺癌细胞的增殖迁移

目的 探讨紫杉醇通过雷帕霉素靶蛋白(mTOR)信号通路影响乳腺癌MCF-7细胞的增殖迁移.方法 实验分为4组,分别为对照组,紫杉醇低剂量组(0.25 μmol/L),紫杉醇中剂量组(0.5 μmol/L),紫杉醇高剂量组(1μmol/L).MTT法检测各组MCF-7细胞活力;流式细胞术检测各组MCF-7细胞周期变化;Transwell迁移实验检测各组MCF-7细胞迁移能力;Western blot检测各组mTOR信号通路相关蛋白表达水平.结果 与对照组比较,紫杉醇低、中、高剂量组能显著抑制MCF-7细胞活力(P＜0.05),且在48 h抑制程度最高(P＜0.05),紫杉醇低、中、高剂量组都能使穿过滤膜进入下腔的乳腺癌MCF-7细胞数目显著减少[(98 ±9.78) vs (86.21 ±6.58)、(53.41 ±3.16)及(42.00 ±4.69),P＜0.05];紫杉醇低、中、高剂量组能使G1期的细胞明显增多[(52.14±6.13)％vs (67.93±8.16)％、(72.32±3.67)％及(78.53±6.28)％,P＜0.01],使G2期的细胞明显减少[(13.68±0.85)％vs(8.57±1.03)％、(5.30±0.89)％及(3.46±0.78)％,P＜0.01];紫杉醇低、中、高剂量组中4E结合蛋白1(4EBP1)及mTOR磷酸化水平下降,细胞周期蛋白D1(Cyclin D1)及基质金属蛋白酶-9(MMP-9)表达量也降低(P＜0.01).结论 紫杉醇抑制乳腺癌MCF-7细胞的增殖迁移,与mTOR信号通路有关.     

急性肾损伤并肺部感染患者的抗菌方案阶段性调整探析

目的：对急性肾损伤并肺部感染患者临床抗菌方案进行评价和调整。方法：利用PK/PD理论优化抗菌治疗的综合评价参数的定量范围,以及根据CCr值（内生肌酐清除率）对用药方案进行调整。结果及结论：急性肾损伤初期处于肾衰阶段的患者,CCr大幅下降,全程使用PIP/TAZ（哌拉西林/他唑巴坦）4.5 g q8h的给药方案,其给药剂量或给药频次明显超量。对该类患者,建议初期采用PIP/TAZ 4.5 g q24h～q36h的给药方案,逐步过渡到4.5 g q8h。     

Serum lipase on postoperative day one is a strong predictor of clinically relevant pancreatic fistula after pancreaticoduodenectomy: A retrospective cohort

BackgroundIncreased postoperative serum amylase has been recently reported to be associated with increased postoperative morbidity, but studies on postoperative serum lipase are limited. The aim of this study was to evaluate the value of postoperative serum lipase in predicting clinically relevant postoperative pancreatic fistula (CR-POPF) after pancreaticoduodenectomy (PD).MethodA retrospective analysis was performed on 212 patients who underwent PD from September 2018 and March 2021, focusing on the association between postoperative day (POD) 1 serum lipase and CR-POPF.ResultsOverall, 108 (50.9%) patients had elevated serum lipase levels (>68 U/L) on POD 1. Patients with elevated serum lipase exhibited a significantly higher incidence of CR-POPF (37.0% vs. 6.7%, p < 0.001). Receiver operating characteristic (ROC) analyses showed improved diagnostic accuracy for POD 1 serum lipase compared with POD 1 serum amylase in predicting CR-POPF (AUC: 0.801 vs. 0.745, p = 0.029). Elevated serum lipase on POD 1 and elevated serum CRP on POD 3 were identified as independent predictors of CR-POPF. A simple early postoperative model, consisting of POD 1 serum lipase levels and POD 3 serum CRP levels, showed good discrimination (AUC 0.76, 95% CI 0.69–0.83) to identify the onset of CR-POPF.ConclusionSerum lipase on POD 1 outperformed serum amylase on POD 1 in predicting CR-POPF after PD. The combination of POD 1 serum lipase and POD 3 serum CRP provides a reliable predicting model for CR-POPF.     

Haptoglobin therapy for acute favism: a Japanese boy with glucose-6-phosphate dehydrogenase Guadalajara

Summary. We report the case of a 2-year-old Japanese boy with acute favism who was treated with human haptoglobin products. He had been exhibiting chronic nonspherocytic haemolytic anaemia until the diagnosis of glucose-6-phosphate dehydrogenase (G6PD) deficiency when 14 months old. He suffered a favic crisis at 24 months of age, when the administration of haptoglobin was effective for relieving bilirubinaemia and haemoglobinuria. Serum-free Hb rapidly decreased to normal levels despite the sustained level of serum lactate dehydrogenase. His G6PD gene was G6, Guadalajara. This is the first application of haptoglobin therapy for acute favism and the first reported case of Japanese G6PD deficiency with typical favic crisis. Haptoglobin treatment might be helpful for managing the haemolytic crisis in the disease.     

Prognostic impact of preoperative NLR and CA19-9 in pancreatic cancer

BackgroundRecently, several preoperative proinflammatory markers and nutritional factors such as neutrophil-to-lymphocyte ratio (NLR) and prognostic nutrition index (PNI) have been reported as significant predictor for poor prognosis of various malignant tumors. In this study, we evaluated the prognostic values of these preoperative parameters in patients with resectable pancreatic head cancer.MethodsWe retrospectively reviewed consecutive patients who underwent PD for pancreatic head cancer between 2007 and 2012. A total of 46 patients were enrolled in this analysis. Preoperative parameters such as CRP, CA19-9, NLR and PNI at the time of presentation were recorded as well as overall survival. Cancer specific survival was assessed using Kaplan–Meier method. Univariate and multivariate Cox regression models were applied to evaluate the prognostic relevance of preoperative parameters. The correlations between CA19-9 values, NLR and pathological findings, first recurrence site were respectively reviewed.ResultsIn multivariable analysis preoperative high NLR (≧2.7) and high CA19-9 (≧230) were independent prognostic factors for poor survival (P value: 0.03 and 0.025, respectively). Kaplan–Meier survival analysis demonstrated the overall 2-year survival rate in patients with high NLR or high CA19-9 were 37.5% compared with 89.9% in patients with low NLR and low CA19-9.ConclusionPreoperative NLR and serum CA19-9 offer significant prognostic information associated with overall survival following PD in the patients with pancreatic head cancer.     

右房射频消融术治疗心房扑动

对５例阵发性心房扑动（简称房扑）患者行右房射频消融术。３例单型房扑消融成功，２例复合型房扑／房颤失败。３例成功者随访６个月无复发。房扑与右房内大折返运动有密切关系。射频消融结果与右房结构、房扑的类型及折返运动有关。右房射频消融的远期效果仍有待研究     

CKS1B promotes cell proliferation and invasion by activating STAT3/PD‐L1 and phosphorylation of Akt signaling in papillary thyroid carcinoma

ObjectiveTo investigate role of GKS1B and its relationship between STAT3/PD‐L1 and p‐Akt in papillary thyroid carcinoma (PTC).MethodsExpression of GKS1B and PD‐L1 was determined in PTC cell lines. GKS1B was overexpressed or knocked down by transfection with overexpression plasmids or si‐CKS1B. STAT3 inhibitor WP1066 was used to suppress STAT3, and PD‐L1 inhibitor Pembrolizumab was used to block PD‐L1. Cell viability and invasion were evaluated by MTT and transwell assay, respectively. The expression of STAT3, p‐STAT3, Akt, and p‐Akt was measured using Western blotting.ResultsBoth protein levels and mRNA levels of CKS1B and PD‐L1 were remarkably up‐regulated in PTC cell lines. Knockdown of CKS1B significantly inhibited cell viability and invasion of PTC cells and suppressed STAT3/PD‐L1 signaling and Akt phosphorylation, while overexpression of CKS1B led to opposite results. Inhibition of STAT3 or PD‐L1 reversed the effects of overexpressed CKS1B on PTC cells.ConclusionThe overexpression of CSK1B could promote cell viability and invasion of PTC cells through activation of STAT3/PD‐L1 signaling and Akt phosphorylation.