Minimum clinically important difference of the health-related quality of life scales in adult spinal deformity calculated by latent class analysis: is it appropriate to use the same values for surgical and nonsurgical patients?

BACKGROUND CONTEXT

Health-related quality of life (HRQOL) parameters have been shown to be reliable and valid in patients with adult spinal deformity (ASD). Minimum clinically important difference (MCID) has become increasingly important to clinicians in evaluating patients with a threshold of improvement that is clinically relevant.

MCPH1在电离辐射诱导食管癌细胞DNA损伤通路中的作用

目的:研究MCPH1在电离辐射诱导食管癌细胞DNA损伤通路中的作用。方法:应用已构建的沉默MDC1的食管癌ECA109细胞株接受8 Gy电离辐射后1 h,检测相关因子核内斑点形成情况。构建沉默MCPH1的食管癌ECA109细胞株,检测此细胞株接受同样照射条件后相关因子核内斑点的形成情况。结果:成功构建沉默MCPH1的食管癌ECA109细胞;电离辐射使MDC1、MCPH1与γ-H2AX蛋白相互作用。沉默MDC1不影响γ-H2AX和MCPH1核内斑点的形成;沉默MCPH1使电离辐射导致的MDC1核内斑点减少,不影响γ-H2AX核内斑点的形成。结论:MCPH1在电离辐射诱导的DNA损伤通路中可能位于H2AX下游、MDC1上游,可以调控MDC1核内斑点形成。     

Longitudinal Recovery and Reduced Costs After 120 Sessions of Locomotor Training for Motor Incomplete Spinal Cord Injury

Objective

To determine the impact of long-term, body weight–supported locomotor training after chronic, incomplete spinal cord injury (SCI), and to estimate the health care costs related to lost recovery potential and preventable secondary complications that may have occurred because of visit limits imposed by insurers.

Validity and Reliability of Outcome Measures Assessing Dexterity,Coordination, and Upper Limb Strength in Autosomal Recessive Spastic Ataxia of Charlevoix-Saguenay

Objective

To document in adults affected by autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) the intra- and interrater reliability, standard error of measurement, agreement, minimal detectable change, and construct validity of the 9-Hole Peg Test (NHPT), the Standardized Finger-to-Nose Test (SFNT), and grip strength.

芪三酚与人乳腺癌MDC1基因关系的研究

目的探讨芪三酚（Res）对人乳腺癌MDA—MB-231细胞增殖抑制的相关效应及其与MDCl基因的关系。方法以人乳腺癌MDA—MB-231细胞株为研究对象,采用MTS方法测定细胞增殖,应用吖啶橙荧光染色观察Res对乳腺癌MDA—MB-231细胞的影响,用RT-PCR与免疫印迹方法测定MDCl基因与蛋白表达水平,用小RNA干扰MDCl基因后,用流式细胞仪检测细胞的凋亡并观察其对Res的敏感性影响。结果40μmol／L以上的Res可显著抑制乳腺癌MDA—MB-231细胞的增殖（P〈0．05）,给予0、60、120μmol／LRes能明显降低MDCl基因和蛋白的表达（P〈0．05）。用小RNA干扰MDC1基因后,流式细胞术分析显示,实验组（MDCl．siRNA）的细胞凋亡率[（45．13±6．2）％]较阴性对照组[（24．34±2．6）％]和未处理组[（17．69±4．9）％]明显上升（P〈0．05）,MTS结果显示MDCl基因干扰后细胞对Res的敏感性增加。结论40μmol／L以上的Res可以抑制MDA-MB-231细胞的增殖,Res可以有效降低MDC基因和蛋白的表达并促进细胞的凋亡。用小RNA干扰MDCl基因（MDCl-siRNA）后,MDA-MB-231细胞对Res的敏感性增加。     

Responsiveness and Predictive Validity of the Participation Measure–3 Domains, 4 Dimensions in Survivors of Stroke

ObjectivesTo examine the responsiveness and predictive validity of the Participation Measure–3 Domains, 4 Dimensions (PM-3D4D) in people receiving outpatient rehabilitation following stroke.DesignProspective cohort observational study.SettingOutpatient rehabilitation settings.ParticipantsVolunteer patients (N=269) with stroke (mean age ± SD [y], 55.36±12.46; 70.26% male).InterventionsNot applicable.Main Outcome MeasuresThe PM-3D4D was designed to measure 3 domains (Productivity, Social, and Community) and 4 dimensions (Diversity, Frequency, Desire for change, and Difficulty) of participation in individuals with rehabilitation needs. All participants completed the PM-3D4D, the Participation Assessment with Recombined Tools-Objective (PART-O), the Participation Measure for Post-Acute Care (PM-PAC), and the EuroQol-5-Dimension (EQ-5D) at the baseline assessment and again following 3 months of outpatient rehabilitation.ResultsSignificant mean changes in scores were observed for most of the PM-3D4D subscales, with the largest score change observed in the Difficulty subscale (standardized response mean=0.57～0.88). The minimal detectable change and meaningful clinically important differences were calculated for each subscale. The Frequency and Difficulty dimensions of the PM-3D4D demonstrated significantly greater responsiveness than the PART-O and PM-PAC, respectively. The baseline PM-3D4D scores, except for Desire for change subscales, were significantly correlated with the PART-O, PM-PAC, and EQ-5D scores after 3 months of rehabilitation.ConclusionsThis study provides evidence supporting the responsiveness and predictive validity of the PM-3D4D in survivors of stroke. Among all subscales of the PM-3D4D, the Difficulty dimensional scale demonstrated the greatest responsiveness. The Desire for change dimension of the PM-3D4D showed less responsiveness, and we recommend that it be used as a goal-setting tool rather than an outcome measure. The PM-3D4D can potentially be used to predict participation outcomes and the health-related quality of life following rehabilitation interventions.     

Chylothorax after Myocardial Revascularization with Internal Mammary Graft

Chylothorax following an intrapericardial cardiac operation is rare, and we are aware of only 12 reported cases. Nine followed median sternotomy for treatment of congenital heart disorders or acquired valvular disease; more than expected were reoperations (23%). This report documents that this complication may also occur following myocardial revascularization with internal mammary graft and describes the anatomy that makes this possible. This rare complication is important because of the high morbidity of prolonged tube drainage and the fact that nearly half of the affected patients underwent reoperation (5 of 13). Dilated lymphatics exuding chyle have been found at operations undertaken to control lymph fistulas and were located in anterior thymic tissue previously divided by electrocautery. Awareness of the significance of lymph encountered during cardiac operations, particularly during reoperation and near the origin of the internal mammary artery, may alert the surgeon that the stage is set for a disabling complication. Electrocautery may be an unreliable means of control as lymph contains little coagulable material; suture is recommended instead.     

Preventive effect of silymarin against taurolithocholate-induced cholestasis in the rat

Increased amounts of monohydroxylated bile salts (BS) have been found in neonatal cholestasis, parenteral nutrition-induced cholestasis and Byler's disease, among others. We analyzed whether the hepatoprotector silymarin (SIL), administered i.p. at the dose of 100mg/kg/day for 5 days, prevents the cholestatic effect induced by a single injection of the model monohydroxylated BS taurolithocholate (TLC, 30 micromol/kg, i.v.) in male Wistar rats. TLC, administered alone, reduced bile flow, total BS output, and biliary output of glutathione and HCO(3)(-) during the peak of cholestasis (-75, -67, -81, and -80%, respectively, P<0.05). SIL prevented partially these alterations, so that the drops of these parameters induced by TLC were of only -41, -25, -60, and -64%, respectively (P<0.05 vs. TLC alone); these differences between control and SIL-treated animals were maintained throughout the whole (120 min) experimental period. Pharmacokinetic studies showed that TLC decreased the intrinsic fractional constant rate for the canalicular transport of both sulfobromophthalein and the radioactive BS [14C]taurocholate by 60 and 68%, respectively (P<0.05), and these decreases were fully and partially prevented by SIL, respectively. SIL increased the hepatic capability to clear out exogenously administered TLC by improving its own biliary excretion (+104%, P<0.01), and by accelerating the formation of its non-cholestatic metabolite, tauromurideoxycholate (+70%, P<0.05). We conclude that SIL counteracts TLC-induced cholestasis by preventing the impairment in both the BS-dependent and -independent fractions of the bile flow. The possible mechanism/s involved in this beneficial effect will be discussed.