High-frequency rTMS over bilateral primary motor cortex improves freezing of gait and emotion regulation in patients with Parkinson’s disease: a randomized controlled trial

BackgroundFreezing of gait (FOG) is a common and disabling phenomenon in patients with Parkinson’s disease (PD), but effective treatment approach remains inconclusive. Dysfunctional emotional factors play a key role in FOG. Since primary motor cortex (M1) connects with prefrontal areas via the frontal longitudinal system, where are responsible for emotional regulation, we hypothesized M1 may be a potential neuromodulation target for FOG therapy. The purpose of this study is to explore whether high-frequency rTMS over bilateral M1 could relieve FOG and emotional dysregulation in patients with PD.MethodsThis study is a single-center, randomized double-blind clinical trial. Forty-eight patients with PD and FOG from the Affiliated Hospital of Xuzhou Medical University were randomly assigned to receive 10 sessions of either active (N = 24) or sham (N = 24) 10 Hz rTMS over the bilateral M1. Patients were evaluated at baseline (T0), after the last session of treatment (T1) and 30 days after the last session (T2). The primary outcomes were Freezing of Gait Questionnaire (FOGQ) scores, with Timed Up and Go Test (TUG) time, Standing-Start 180° Turn (SS-180) time, SS-180 steps, United Parkinson Disease Rating Scales (UPDRS) III, Hamilton Depression scale (HAMD)-24 and Hamilton Anxiety scale (HAMA)-14 as secondary outcomes.ResultsTwo patients in each group dropped out at T2 and no serious adverse events were reported by any subject. Two-way repeated ANOVAs revealed significant group × time interactions in FOGQ, TUG, SS-180 turn time, SS-180 turning steps, UPDRS III, HAMD-24 and HAMA-14. Post-hoc analyses showed that compared to T0, the active group exhibited remarkable improvements in FOGQ, TUG, SS-180 turn time, SS-180 turning steps, UPDRS III, HAMD-24 and HAMA-14 at T1 and T2. No significant improvement was found in the sham group. The Spearman correlation analysis revealed a significantly positive association between the changes in HAMD-24 and HAMA-14 scores and FOGQ scores at T1.ConclusionHigh-frequency rTMS over bilateral M1 can improve FOG and reduce depression and anxiety in patients with PD

Symptom clusters in patients with hypertensive cerebral haemorrhage during the acute phase and their correlation with prognostic quality of life

Objective To explore the composition of symptom clusters in the acute phase of patients with hypertensive cerebral haemorrhage and to analyse their correlation with prognostic quality of life. Methods From July 2021 to June 2022, 396 patients with hypertensive cerebral haemorrhage hospitalised in neurosurgery departments of two tertiary care hospitals in Tangshan City were selected and surveyed using the General Information Questionnaire, the Memory Symptom Assessment Scale and the Stroke-Specific Quality of Life Scale. An exploratory factor method was used to extract symptom clusters and Biased correlation analysis was applied to analyse the correlation between symptom clusters and quality of life. Results Symptoms with a higher incidence in the acute phase in patients with hypertensive cerebral hemorrhage included loss of appetite (77.3%), low energy/weakness (74.0%), pain (72.9%), weight loss (71.5%), and feeling nervous (70.7%); symptoms with a higher degree of severity included loss of appetite (2.01±1.22), low energy/weakness (2.00±1.32), pain (1.97±1.30), vomiting/nausea (1.83±1.21), difficulty concentrating (1.81±1.30); symptoms with higher levels of distress included pain (2.27±1.53), vomiting/nausea (2.20±1.48), vomiting (1.98±1.59), low energy/weakness (1.96±1.30), dizziness (1.81±1.40). A total of six symptom clusters were extracted by the exploratory factor method, namely digestive symptom cluster, psychological symptom cluster, pain-fatigue related symptom cluster, physical-cognitive impairment symptom cluster, speech-swallowing disorder symptom cluster and pneumonia related symptom cluster, all of which were negatively correlated with prognostic quality of life with correlation coefficients of-0.261,-0.388,-0.335,-0.513,-0.304,-0.273. Conclusion The presence of six symptom clusters in the acute phase of hypertensive cerebral haemorrhage patients, all of which were negatively associated with prognosis of quality of life, suggests that medical staff should identify or predict symptom clusters in a timely and accurate manner and optimise symptom management strategies to improve patients ‘ prognosis of quality of life

High Selectivity and Reusability of Biomass-Based Adsorbent for Chloramphenicol Removal

Recently, biomass-based materials have attracted increasing attention because of their advantages of low cost, environment-friendly and nonpollution. Herein, the feasibility of using corn stalk biomass fiber (CF) and Fe3O4 embedded chitosan (CS) as a novel biomass-based adsorbent (CFS) to remove chloramphenicol (CAPC) from aqueous solution. Structure of CFS was characterized by using X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FT-IR), Brunauer–Emmett–Teller (BET), scanning electron microscopy (SEM) and zeta potential techniques. The effects of solution pH, adsorption time and ion strength on the adsorption capacity were examined. Adsorption isotherms obtained from batch experiments were better fitted by Langmuir model compared with Freundlich model, Dubinin–Radushkevich model and Temkin model. Adsorption kinetic data matched well to the pseudo-second order kinetic model. CAPC adsorption was endothermic, spontaneous, and entropy-increasing nature on CFS. In addition, the CFS could be separated by an external magnetic field, recycled, and reused without any significant loss in the adsorption capacity of CAPC. Based on these excellent performances, there is potential that CFS can be considered as a proficient and economically suitable material for the CAPC removal from the water environment

Deficient mismatch repair and RAS mutation in colorectal carcinoma patients: a retrospective study in Eastern China

Objectives To investigate the frequency and prognostic role of deficient mismatch repair (dMMR) and RAS mutation in Chinese patients with colorectal carcinoma. Methods Clinical and pathological information from 813 patients were reviewed and recorded. Expression of mismatch repair proteins was tested by immunohistochemistry. Mutation analyses for RAS gene were performed by real-time polymerase chain reaction. Correlations of mismatch repair status and RAS mutation status with clinicopathological characteristics and disease survival were determined. Results The overall percentage of dMMR was 15.18% (121/797). The proportion of dMMR was higher in patients <50 years old (p < 0.001) and in the right side of the colon (p < 0.001). Deficient mismatch repair was also associated with mucinous production (p < 0.001), poor differentiation (p < 0.001), early tumor stage (p < 0.05) and bowel wall invasion (p < 0.05). The overall RAS mutation rate was 45.88%, including 42.56% (346/813) KRAS mutation and 3.69% (30/813) NRAS mutation (including three patients with mutations in both). KRAS mutation was significantly associated with mucinous production (p < 0.05), tumor stage (p < 0.05) and was higher in non-smokers (p < 0.05) and patients with a family history of colorectal carcinoma (p < 0.05). Overall, 44.63% (54/121) dMMR tumors harbored KRAS mutation, however, dMMR tumors were less likely to have NRAS mutation. Moreover, dMMR, KRAS and NRAS mutation were not prognostic factors for stage I–III colorectal carcinoma. Conclusions This study confirms that the status of molecular markers involving mismatch repair status and RAS mutation reflects the specific clinicopathological characteristics of colorectal carcinoma

Atmospheric Hydrogen Peroxide (H 2 O 2 ) at the Foot and Summit of Mt. Tai: Variations, Sources and Sinks, and Implications for Ozone Formation Chemistry

International audienceHydrogen peroxide (H 2 O 2) acts as a terminal sink for atmospheric HO x radicals (OH and HO 2), playing a key role in tropospheric O 3 formation. However, there are few field measurements of atmospheric H 2 O 2 to assess its role in O 3 formation, especially for the seriously polluted region of the North China Plain. In this study, H 2 O 2 concentrations were measured at the foot of Mt. Tai from May to July 2018 and the summit of Mt. Tai from May to June 2019, with average values of 0.93 ± 1.01 and 2.05 ± 1.20 ppb, respectively. H 2 O 2 exhibited a pronounced diurnal variation with a noon-peak at the foot of Mt. Tai, which could be well reproduced by a gas-phase box model with H 2 O 2 dry deposition velocity of 3 cm s −1 included, indicating H 2 O 2 was mainly photochemically produced. Modeling analysis showed H 2 O 2 production at the foot was most sensitive to alkenes and aromatics, while the source and sink for H 2 O 2 were dominated by HO 2 recombination and dry deposition, respectively. Compared with the summer-measurement in 2007, the remarkable elevation of H 2 O 2 at the summit might be ascribed to volatile organic compounds (VOCs) increase and SO 2 decline. Both H 2 O 2-O 3 correlation and H 2 O 2 / NO z ratio suggested O 3 formation at the foot of Mt. Tai was mainly VOC-sensitive in the early morning and shifted to NO x-sensitive thereafter. Therefore, reduction of VOCs emission especially for the reactive species of alkenes and aromatics in the morning as well as NO x emission around noontime will be effective for mitigating the serious O 3 (as well as H 2 O 2) pollution in Tai'an city. YE ET AL

Endothelial deletion of PTBP1 disrupts ventricular chamber development

Alternative splicing crucially affects various biological processes, however, its function in heart development is largely unknown. Here, the authors show an essential role of alternative splicing factor PTBP1 in ventricular chamber development