Optimal Blood Pressure Control Target for Older Patients with Hypertension: A Systematic Review and Meta-Analysis

Objective: This study evaluated the optimal systolic blood pressure (SBP) target for older patients with hypertension.Method: A Bayesian network meta-analysis was conducted. The risk of bias of the included studies was assessed by using a modified version of the Cochrane risk of bias. The trial outcomes comprised the following clinical events: major adverse cardiovascular events (MACE), cardiovascular mortality, all-cause mortality, myocardial infarction, heart failure and stroke.Results: A total of six trials were included. We reclassified all treatment therapies into three conditions according to the final achieved SBP after intervention (<130 mmHg, 130–139 mmHg and ≥140 mmHg). Our results demonstrated that anti-hypertensive treatment with an SBP target <130 mmHg, compared with treatment with an SBP target ≥140 mmHg, significantly decreased the incidence of MACE (OR 0.43, 95%CI 0.19–0.76), but no statistical difference was found in other comparisons. Although the results showed a trend toward more intensive anti-hypertension therapy having better effects on preventing cardiovascular mortality, all-cause mortality, myocardial infarction, heart failure, and stroke, no significant differences were found among groups.Conclusions: Our meta-analysis suggested that SBP <130 mmHg might be the optimal BP control target for patients ≥60 years of age; however, further evidence is required to support our findings

The clinical and EEG features and mutation analysis in a Chinese patient with severe hypoplasia of the cerebellum and pons

Abstract We report here a Chinese female infant with severe hypoplasia of the cerebellum and pons, and heterozygous mutation (c.18G &gt;T, p.E6D) in the TSEN54 gene. This mutation was not present in her parents and the 100 Chinese controls, which proved to be a de novo missense mutation. MR imaging of the patient revealed severe hypoplasia of the bilateral cerebellar hemispheres and vermis with moderate flattening of the pons. A video EEG during hospitalization demostrated abnormal background activities and generalized burst and attenuation patterns during interictal stage. The spasms and tonic spasms occurred frequently in clusters with generalized voltage attenuation

Cerebral Blood Volume Changes During Radiotherapy May Predict Pseudoprogression versus Disease Progression for Patients with High Grade Glioma

https://openworks.mdanderson.org/sumexp21/1040/thumbnail.jp

Targeting immunosuppressive classical monocytes prevents immunotherapy resistance

View full abstracthttps://openworks.mdanderson.org/leading-edge/1053/thumbnail.jp

Shared Nearest Neighbors Approach and Interactive Browser for Network Analysis of a Comprehensive Non-Small-Cell Lung Cancer Data Set

View full abstracthttps://openworks.mdanderson.org/leading-edge/1000/thumbnail.jp

Observing Colloidal Fluids in Shear Flow Using Custom Light-Sheet Microscopy

We study liquid-liquid phase separation (LLPS) with a colloid-polymer system subjected to shear. Our colloid-polymer mixture consists of temperature-responsive PNIPAM microgel particles and polymers acting as a depletant. This mixture separates into two phases: a colloid-poor, or \u27gas\u27 phase, and a colloid-rich, or \u27liquid\u27 phase. We observe the process of phase separation using a custom-built light-sheet microscope, which allows for simultaneously acquiring optically-sectioned images of our sample and shearing the sample in a Couette geometry. We measure the size and shape of elongated liquid domains that have been deformed due to flow as a function of shear rate. The temperature-responsive feature of our colloidal particles allows us to further explore the kinetics of phase separation under shear flow. We hope our study of phase separation under shear can provide fundamental insights into hydrodynamics and thermodynamics and provide novel strategies for structuring soft materials

Supplementation of black rice pigment fraction improves antioxidant and anti-inflammatory status in patients with coronary heart disease

Black rice and its pigment fraction have shown anti-atherogentic activities in several animal models, but whether their beneficial effects will recur in humans remains unknown. The aim of the present study is to investigate the influence of black rice pigment fraction (BRF) supplementation on selected cardiovascular risk factors in patients with coronary heart disease (CHD). Sixty patients with CHD aged 45 -75 years were recruited from the Second Affiliated Hospital of Sun Yat-Sen University in Guangzhou, China and randomly divided into two groups. In the test group, the diet was supplemented with 10 grams of BRF derived from black rice for 6 months; While in the placebo group, the diet was supplemented with 10 grams of white rice pigment fraction (WRF) derived from white rice. At baseline, plasma antioxidant status and the levels of inflammatory biomarkers and other measured variables were similar between two groups. After 6 months&apos; intervention, compared to WRF supplementation, BRF supplementation greatly enhanced plasma total antioxidant capacity (TAC) (p=0.003), significantly reduce plasma levels of soluble vascular cell adhesion molecule-1 (sVCAM-1) (p=0.03), soluble CD40 ligand (sCD40L) (p=0.002) and high sensitive C-reactive protein (hs-CRP) (p=0.002) in the test group . No significant changes were observed in plasma total superoxide dismutase (T-SOD) activity, lipids level and carotid artery intima-media thickness (IMT) between two groups. These results may suggest that BRF could exert cardioprotective effects on patients with CHD by improving plasma antioxidant status and inhibiting inflammatory factors

Person-Centered Dementia Care in China: A Bilingual Literature Review

We conducted a bilingual literature review of the existing studies focusing on person-centered dementia care in China. We synthesized key findings from included articles according to three overarching themes: Chinese cultural relevance of person-centered care (PCC), perceived needs for PCC for older adults in China, implementation and measurement of PCC in China , and person-centered dementia care model . We also drew on frameworks, theories, and other contents from the examined articles to develop a person-centered dementia care model with specific relevance to China. The model is a good starting point to help us operationalize globally relevant core principles of PCC in the specific sociocultural context of China. The framework will be informed by more empirical studies and evolve with the ongoing operationalization of PCC. Although PCC is a new concept and has not been vigorously or systematically studied in China, it is attracting increasing attention from Chinese researchers. More empirical studies are needed to link PCC to measurable outcomes, enrich the framework for applying PCC, and construct assessment and evaluation systems to facilitate the provision of PCC across countries and cultures. Global consortia and collaborations with multidisciplinary expertise to develop a PCC common data infrastructure that is internationally relevant for data sharing and comparison are needed

Clinical and Associated Immunological Manifestations of HFMD Caused by Different Viral Infections in Children

Hand, foot, and mouth disease (HFMD), with vesiculae on the hands, feet and mouth, is an infectious disease caused by many viral pathogens. However, the differences of immune response induced by these pathogens are unclear. We compared the clinical manifestations and the levels of immunologic indicators from 60 HFMD patients caused by different viral pathogens to analyze the differences in the immune response. It was shown that Th2 cytokines (IL-4 and IL-10) increased significantly in EV71-infected children; Th1 cytokines (IL-2 and IFN-γ) rose in CA16-infected children; both Th1 and Th2 cytokines elevated in non-EVG-infected children; only individual cytokines (such as IL-10) went up in EVG-infected children. Meanwhile, the antibodies induced by viral infection could not cross-interfere between the different pathogens. These differences might be due to variations in the immune response induced by the individual pathogens or to the pathogenesis of the infections by the individual pathogens

Revision surgery versus biologic treatment with omalizumab in recurrent chronic rhinosinusitis with nasal polyps: An analysis of cost-utility and clinical outcomes

Background: Both revision surgery and omalizumab are recommended therapies for the treatment of recurrent chronic rhinosinusitis with nasal polyps (CRSwNP) and can improve patients' clinical symptoms and quality of life (QoL). The aim of this study was to compare the improvement in sinus-related symptoms, QoL, economic cost, and duration cost between treatment with revision-surgery and treatment with omalizumab. Methods: This was a prospective study of patients with recurrent CRSwNP. All patients were asked to complete a 22-item sino-nasal outcome test (SNOT-22), a visual analog scale (VAS), and a 36-item short-form (SF-36) questionnaire at baseline and 6 months after the treatments. Patients were required to document economic costs and duration costs within 6 months and report them at each visit. Results: A total of 44 patients who received the treatment of revision surgery or omalizumab were enrolled in this study. After six months of treatment, the improvements in total SNOT-22 and SF-36 in 8 domains were not different between the 2 treatments. The improvements in rhinologic symptoms, extranasal rhinologic symptoms, and ear/facial symptoms according to the SNOT-22 (P value = 0.0288, 0.0016, and 0.0347, respectively) and the improvements in nasal congestion, loss of smell, and overall symptoms assessed by the VAS (P value = 0.0057, 0.0206, and 0.0122, respectively) were better in the revision surgery group than in the omalizumab group. The economic cost and the total duration cost were obviously lower in the omalizumab group (¥18836 and 1 day) than in the revision surgery group (¥29824 and 23 days). Conclusions: Both revision surgery and omalizumab treatments can improve the clinical symptoms and QoL of patients with recurrent CRSwNP. Patients who underwent revision surgery experienced better improvement in sinus-related symptoms. However, omalizumab treatment clearly showed a benefit in terms of economic cost and duration cost of disease-related care