mTOR-dependent loss of PON1 secretion and antiphospholipid autoantibody production underlie autoimmunity-mediated cirrhosis in transaldolase deficiency

Transaldolase deficiency predisposes to chronic liver disease progressing from cirrhosis to hepatocellular carcinoma (HCC). Transition from cirrhosis to hepatocarcinogenesis depends on mitochondrial oxidative stress, as controlled by cytosolic aldose metabolism through the pentose phosphate pathway (PPP). Progression to HCC is critically dependent on NADPH depletion and polyol buildup by aldose reductase (AR), while this enzyme protects from carbon trapping in the PPP and growth restriction in TAL deficiency. Although AR inactivation blocked susceptibility to hepatocarcinogenesis, it enhanced growth restriction, carbon trapping in the non-oxidative branch of the PPP and failed to reverse the depletion of glucose 6-phosphate (G6P) and liver cirrhosis. Here, we show that inactivation of the TAL-AR axis results in metabolic stress characterized by reduced mitophagy, enhanced overall autophagy, activation of the mechanistic target of rapamycin (mTOR), diminished glycosylation and secretion of paraoxonase 1 (PON1), production of antiphospholipid autoantibodies (aPL), loss of CD161+ NK cells, and expansion of CD38+ Ito cells, which are responsive to treatment with rapamycin in vivo. The present study thus identifies glycosylation and secretion of PON1 and aPL production as mTOR-dependent regulatory checkpoints of autoimmunity underlying liver cirrhosis in TAL deficiency.

Difference in the recruitment of intrinsic foot muscles in the elderly under static and dynamic postural conditions

Background

The effect of foot, especially intrinsic muscles, on postural control and its related mechanisms remain unclear due to the complex structure. Therefore, this study aims to investigate the activation of intrinsic foot muscles in the elderly under static and dynamic postural tasks.

Methods

Twenty-one elderly participants were included to perform different postural tests (sensory organization test (SOT), motor control test (MCT), limit of stability test (LOS), and unilateral stance test) by a NeuroCom Balance Manager System. The participants were instructed to maintain postural stability under conditions with combined different sensory inputs (vision, vestibular, and proprioception) in SOT as well as conditions with translation disturbance in MCT, and to perform an active weight-shifting tasks in LOS. During these tasks, muscle activation were simultaneously acquired from intrinsic foot muscles (abductor halluces (AbH) and flexor digitorum brevis (FDB)) and ankle muscles (anterior tibialis, medial head of gastrocnemius, lateral head of gastrocnemius, and peroneus longus). The root-mean-square amplitude of these muscles in postural tasks was calculated and normalized with the EMG activity in unilateral stance task.

Results

The activation of intrinsic foot muscles significantly differed among different SOT tasks (p < 0.001). Post-hoc tests showed that compared with that under normal condition 1 without sensory interference, EMGs increased significantly under sensory disturbance (conditions 2-6). By contrast, compared with that under the single-sensory disturbed conditions (conditions 2-4; 2 for disturbed vision, 3 for disturbed vestibular sensation, 4 for disturbed proprioception), activation was significantly greater under the dual-sensory disturbed postural tasks (conditions 5 and 6; 5 for disturbed vision and proprioception, 6 for disturbed vestibular sensation and proprioception). In MCT, EMGs of foot muscles increased significantly under different translation speeds (p < 0.001). In LOS, moderate and significant correlations were found between muscle activations and postural stability parameters (AbH, r = 0. 355-0.636, p < 0.05; FDB, r = 0.336-0.622, p < 0.05).

Conclusion

Intrinsic foot muscles play a complementary role to regulate postural stability when disturbances occur. In addition, the recruitment magnitude of intrinsic foot muscles is positively correlated with the limit of stability, indicating their contribution to increasing the limits of stability in the elderly.

Effect of whole-body vibration on neuromuscular activation and explosive power of lower limb: A systematic review and meta-analysis

OBJECTIVE

The review aimed to investigate the effects of whole-body vibration (WBV) on neuromuscular activation and explosive power.

METHODS

Keywords related to whole-body vibration, neuromuscular activation and explosive power were used to search four databases (PubMed, Web of Science, Google Scholar and EBSCO-MEDLINE) for relevant studies published between January 2000 and August 2021. The methodology of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses was used. The eligibility criteria for the meta-analysis were based on PICOST principles. Methodological assessment used the Cochrane scale. Heterogeneity and publication bias were assessed by I2 index and funnel plots, respectively. The WBV training cycle is a random effect model. Publication bias was also assessed based on funnel plots. This study was registered in PROSPERO (CRD42021279439).

RESULTS

A total of 156 participants data in 18 studies met the criteria and were included in the meta-analysis for quantitative synthesis. Results of the meta-analysis showed significant improvements in lower limb neuromuscular activation immediately after WBV compared with the baseline (SMD = 0.51; 95% CI: 0.26, 0.76; p<0.001), and no significant heterogeneity was observed (I2 = 38%, p = 0.07). In addition, the highest increase in lower limb explosive power was observed (SMD = 0.32; 95% CI: 0.11, 0.52; p = 0.002), and no significant heterogeneity (I2 = 0%, p = 0.80) was noted.

CONCLUSIONS

WBV training could improve neuromuscular activation and explosive power of the lower limb. However, due to different vibration conditions, further research should be conducted to determine standardized protocols targeting performance improvement in athletes and healthy personnel experienced in training.

Electroencephalographic Measurement on Post-stroke Sensory Deficiency in Response to Non-painful Cold Stimulation

Background

Reduced elementary somatosensation is common after stroke. However, the measurement of elementary sensation is frequently overlooked in traditional clinical assessments, and has not been evaluated objectively at the cortical level. This study designed a new configuration for the measurement of post-stroke elementary thermal sensation by non-painful cold stimulation (NPCS). The post-stroke cortical responses were then investigated during elementary NPCS on sensory deficiency via electroencephalography (EEG) when compared with unimpaired persons.

Method

Twelve individuals with chronic stroke and fifteen unimpaired controls were recruited. A 64-channel EEG system was used to investigate the post-stroke cortical responses objectively during the NPCS. A subjective questionnaire of cold sensory intensity was also administered via a numeric visual analog scale (VAS). Three water samples with different temperatures (i.e., 25, 10, and 0°C) were applied to the skin surface of the ventral forearm for 3 s via glass beaker, with a randomized sequence on either the left or right forearm of a participant. EEG relative spectral power (RSP) and topography were used to evaluate the neural responses toward NPCS with respect to the independent factors of stimulation side and temperature.

Results

For unimpaired controls, NPCS initiated significant RSP variations, mainly located in the theta band with the highest discriminative resolution on the different temperatures (P < 0.001). For stroke participants, the distribution of significant RSP spread across all EEG frequency bands and the temperature discrimination was lower than that observed in unimpaired participants (P < 0.05). EEG topography showed that the NPCS could activate extensive and bilateral sensory cortical areas after stroke. Significant group differences on RSP intensities were obtained in each EEG band (P < 0.05). Meanwhile, significant asymmetry cortical responses in RSP toward different upper limbs were observed during the NPCS in both unimpaired controls and participants with stroke (P < 0.05). No difference was found between the groups in the VAS ratings of the different temperatures (P > 0.05).

Conclusion

The post-stroke cortical responses during NPCS on sensory deficiency were characterized by the wide distribution of representative RSP bands, lowered resolution toward different temperatures, and extensive activated sensory cortical areas.

Analysis of mutation status and homologous recombination deficiency in tumors of patients with germline BRCA1 or BRCA2 mutations and metastatic breast cancer: OlympiAD

BACKGROUND

Presence of a germline BRCA1 and/or BRCA2 mutation (gBRCAm) may sensitize tumors to poly(ADP-ribose) polymerase (PARP) inhibition via inactivation of the second allele, resulting in gene-specific loss of heterozygosity (gsLOH) and homologous recombination deficiency (HRD). Here we explore whether tissue sample testing provides an additional route to germline testing to inform treatment selection for PARP inhibition.

PATIENTS AND METHODS

In this prespecified exploratory analysis, BRCA1 and/or BRCA2 mutations in blood samples (gBRCAm) and tumor tissue (tBRCAm) were analyzed from patients with human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer and known gBRCAm, enrolled in the phase III OlympiAD trial. The frequency and nature of tBRCAm, HRD score status [HRD-positive (score ≥42) versus HRD-negative (score <42) using the Myriad myChoice® CDx test] and rates of gsLOH were determined, and their impact on clinical efficacy (objective response rate and progression-free survival) was explored.

RESULTS

Tissue samples from 161/302 patients yielded tBRCAm, HRD and gsLOH data for 143 (47%), 129 (43%) and 125 (41%) patients, respectively. Concordance between gBRCAm and tBRCAm was 99%. gsLOH was observed in 118/125 (94%) patients [BRCA1m, 73/76 (96%); BRCA2m, 45/49 (92%)]. A second mutation event was recorded for two of the three BRCA1m patients without gsLOH. The incidence of HRD-negative was 16% (21/129) and was more common for BRCA2m (versus BRCA1m) and/or for hormone receptor-positive (versus triple-negative) disease. Olaparib antitumor activity was observed irrespective of HRD score.

CONCLUSIONS

gBRCAm identified in patients with HER2-negative metastatic breast cancer by germline testing in blood was also identified by tumor tissue testing. gsLOH was common, indicating a high rate of biallelic inactivation in metastatic breast cancer. Olaparib activity was seen regardless of gsLOH status or HRD score. Thus, additional tumor testing to inform PARP inhibitor treatment selection may not be supported for these patients.

Effects of intrinsic-foot-muscle exercise combined with the lower extremity resistance training on postural stability in older adults with fall risk: study protocol for a randomised controlled trial

BACKGROUND

Falls are one of the most common accidents in older adults, often leading to injury, disability and quality-of-life declines. Foot core function contributes to postural stability in most static postures and dynamic activities. As efficient foot core training, the intrinsic-foot-muscle exercise has been proposed to improve postural control. However, the effects of the exercise on postural stability in the elderly remain unclear. Therefore, this study attempts to investigate the effect of 12-week intrinsic-foot-muscle exercise on postural stability in older adults with fall risk.

METHODS

We will conduct a prospective, single-blind randomised controlled trail on 120 older adults with fall risk. Participants will be randomly assigned to an intrinsic-foot-muscle exercise combining the lower extremity resistance training group (IFM group), an extrinsic-foot-muscle exercise combining the lower extremity resistance training group (EFM group) and a control group. The control group will perform lower extremity resistance training. The IFM and EFM groups will be given additional short-foot exercise or towel-curl exercise training, respectively. After the intervention, participants will be followed up for another 12 weeks with no active intervention. The outcome measures will include the postural stability measurements, self-reported postural stability, number of falls, intrinsic-foot-muscle strength and foot arch function. Furthermore, adverse events will be recorded and analysed. If any participant withdraws from the trial, an intention-to-treat analysis will be performed.

DISCUSSION

The trial is designed to investigate the efficacy of a 12-week intrinsic foot muscle training combined with the lower extremity resistance training on postural stability outcomes in elderly people with fall risk. The trial will also examine the comprehensive outcomes of postural stability during static standing and dynamic movements. The function of intrinsic foot muscle to support the arch will also be evaluated. Important features of this trial mainly include intervention setting, outcome measure selection and study duration. The results of this study will determine the effectiveness and provide scientific evidence to establish comprehensive fall prevention intervention.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR2000033623. Registered on 7 June 2020. http://www.chictr.org.cn/showproj.aspx?proj=54741.

Tongxin formula protects H9c2 cardiomyocytes from cobalt chloride-induced hypoxic injury via inhibition of apoptosis

In this study, the effect of the Tongxin formula (TXF) on the apoptosis of H9c2 cardiomyocytes induced by cobalt chloride (CoCl₂) was investigated, and the potential mechanism was explored. A hypoxic injury model of H9c2 cardiomyocytes was established using CoCl₂. The cell viability was measured using a Cell Counting Kit-8 assay. The lactate dehydrogenase (LDH) release and caspase-3 activity were measured using spectrophotometry. The apoptosis was measured via Annexin V-FITC/PI staining and flow cytometry. The changes in the mitochondrial membrane potential were examined using immunofluorescence microscopy following the loading of JC-1 probes. The expressions of apoptosis-related proteins and key proteins in the phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) pathway were examined via immunoblotting. The different TXF concentrations studied significantly improved the percentage of viability of cardiomyocytes with hypoxic injury, and the LDH release, apoptotic rate, caspase-3 activity, and levels of cleaved caspase-3 protein were reduced in the injured cells. Additionally, the TXF group had increased mitochondrial membrane potential, upregulated expression of Bcl-2 and p-Akt proteins, and significantly reduced expression of cleaved caspase-3 protein in the cells with hypoxic injury. Moreover, in the TXF group, the treatment significantly reduced the BAX protein expression, but the difference was not statistically significant compared with the CoCl2 group. In this study, TXF regulated the expression of apoptosis-related proteins, inhibited apoptosis, increased the mitochondrial membrane potential, and alleviated damage to the mitochondrial membrane, thereby protecting the cardiomyocytes from hypoxic injury. The underlying mechanism could be related to activation of the PI3K/Akt signaling pathway and upregulation of the Bcl-2 protein.

Effects of overground surfaces on running kinematics and kinetics in habitual non-rearfoot strikers

This study aimed to investigate the effects of different overground surfaces on running biomechanics of non-rearfoot strikers. Thirty-one male habitual non-rearfoot strikers were required to run at 3.3 ± 0.2 m/s on a customized runway with artificial grass, concrete, or synthetic rubber surfaces in a random order. Vertical loading rates, three-dimensional ground reaction forces (GRFs), and lower-limb joint angles and moments were compared among surfaces. Regarding kinematics, significances were only detected in maximum knee flexion angle, with greater values when running on artificial grass compared to synthetic rubber or concrete. Regarding kinetics, changes were demonstrated in GRF peaks and lower-limb joint moments. GRF peaks were significantly greater when running on synthetic rubber or artificial grass compared to concrete; lower-limb joint moments were significantly lower when running on synthetic rubber compared to concrete; these changes were inconsistent when running on artificial grass compared to concrete. Significant differences were demonstrated in running kinetics when habitual non-rearfoot strikers ran on different overground surfaces. Running on artificial grass or synthetic rubber caused greater GRFs than running on concrete. However, only synthetic rubber could reduce joint loads.

Androgen deprivation-induced elevated nuclear SIRT1 promotes prostate tumor cell survival by reactivation of AR signaling

The NAD⁺-dependent deacetylase, Sirtuin 1 (SIRT1) is involved in prostate cancer pathogenesis. However, the actual contribution is unclear as some reports propose a protective role while others suggest it is harmful. We provide evidence for a contextual role for SIRT1 in prostate cancer. Our data show that (i) mice orthotopically implanted with SIRT1-silenced LNCaP cells produced smaller tumors; (ii) SIRT1 suppression mimicked AR inhibitory effects in hormone responsive LNCaP cells; and (iii) caused significant reduction in gene signatures associated with E2F and MYC targets in AR-null PC-3 and E2F and mTORC1 signaling in castrate-resistant ARv7 positive 22Rv1 cells. Our findings further show increased nuclear SIRT1 (nSIRT1) protein under androgen-depleted relative to androgen-replete conditions in prostate cancer cell lines. Silencing SIRT1 resulted in decreased recruitment of AR to PSA enhancer selectively under androgen-deprivation conditions. Prostate cancer outcome data show that patients with higher levels of nSIRT1 progress to advanced disease relative to patients with low nSIRT1 levels. Collectively, we demonstrate that lowering SIRT1 levels potentially provides new avenues to effectively prevent prostate cancer recurrence.

Impairments of cortico-cortical connectivity in fine tactile sensation after stroke

Background

Fine tactile sensation plays an important role in motor relearning after stroke. However, little is known about its dynamics in post-stroke recovery, principally due to a lack of effective evaluation on neural responses to fine tactile stimulation. This study investigated the post-stroke alteration of cortical connectivity and its functional structure in response to fine tactile stimulation via textile fabrics by electroencephalogram (EEG)-derived functional connectivity and graph theory analyses.

Method

Whole brain EEG was recorded from 64 scalp channels in 8 participants with chronic stroke and 8 unimpaired controls before and during the skin of the unilateral forearm contacted with a piece of cotton fabric. Functional connectivity (FC) was then estimated using EEG coherence. The fabric stimulation induced FC (SFC) was analyzed by a cluster-based permutation test for the FC in baseline and fabric stimulation. The functional structure of connectivity alteration in the brain was also investigated by assessing the multiscale topological properties of functional brain networks according to the graph theory.

Results

In the SFC distribution, an altered hemispheric lateralization (HL) (HL degree, 14%) was observed when stimulating the affected forearm in the stroke group, compared to stimulation of the unaffected forearm of the stroke group (HL degree, 53%) and those of the control group (HL degrees, 92% for the left and 69% for the dominant right limb). The involvement of additional brain regions, i.e., the distributed attention networks, was also observed when stimulating either limb of the stroke group compared with those of the control. Significantly increased (P < 0.05) global and local efficiencies were found when stimulating the affected forearm compared to the unaffected forearm. A significantly increased (P < 0.05) degree of inter-hemisphere FC (interdegree) mainly within ipsilesional somatosensory region and a significantly diminished degree of intra-hemisphere FC (intradegree) (P < 0.05) in ipsilesional primary somatosensory region were observed when stimulating the affected forearm, compared with the unaffected forearm.

Conclusions

The alteration of cortical connectivity in fine tactile sensation post-stroke was characterized by the compensation from the contralesional hemisphere and distributed attention networks related to involuntary attention. The interhemispheric connectivity could implement the compensation from the contralateral hemisphere to the ipsilesional somatosensory region. Stroke participants also exerted increased cortical activities in fine tactile sensation.

Comparison of whole-body vibration training and quadriceps strength training on physical function and neuromuscular function of individuals with knee osteoarthritis: A randomised clinical trial

Background

Knee osteoarthritis (KOA) is one of the leading causes of global disability, which causes knee pain, stiffness and swelling. Impaired neuromuscular function may cause joint instability, alignment changes and knee stress, which leads to the progression of KOA. Whole-body vibration (WBV) training is considered to improve pain and functional mobility effectively. However, few studies have investigated the therapeutic effect of WBV on neuromuscular function in KOA.

Material and methods

A single-blinded, randomised, controlled trial was performed on 81 participants diagnosed with KOA. The participants were randomised into three groups: (1) WBV group, in which participants performed strength training (ST) with vibration exposure for 8 weeks; (2) ST group, in which participants performed ST without vibration for 8 weeks; and (3) health education (HE) group, in which participants received a HE for 8 weeks. The visual analogue scale for knee pain, isokinetic muscle strength test, proprioception test, Timed Up and Go test (TUG) and 6-min Walk Distance test (6MWD) were performed before and after the interventions.

Results

No significant difference was found on pain, proprioception, TUG and 6MWD. A significant interaction effect was found in isokinetic muscle strength between groups. Further analysis showed that compared with the HE group, the WBV group exhibited significantly greater improvement in isokinetic muscle strength (peak torque [PT] of extensors, p < 0.01, 95% CI = 0.11-0.33 Nm/kg; PT of flexors, p = 0.01, 95% CI = 0.02-0.19 Nm/kg; peak work [PW] of extensors, p < 0.01, 95% CI = 0.12-0.75 W/kg). In addition, compared with the ST group, the muscle strength of the WBV group (PT of extensors, p < 0.01, 95% CI = 0.10-0.32 Nm/kg; PW of extensors, p < 0.01, 95% CI = 0.09-0.71 W/kg) improved significantly.

Conclusion

Our findings suggested that adding WBV training to ST might benefit muscle strength around the knee joint in patients with KOA.

Technical validation of a new microfluidic device for enrichment of CTCs from large volumes of blood by using buffy coats to mimic diagnostic leukapheresis products

Diagnostic leukapheresis (DLA) enables to sample larger blood volumes and increases the detection of circulating tumor cells (CTC) significantly. Nevertheless, the high excess of white blood cells (WBC) of DLA products remains a major challenge for further downstream CTC enrichment and detection. To address this problem, we tested the performance of two label-free CTC technologies for processing DLA products. For the testing purposes, we established ficollized buffy coats (BC) with a WBC composition similar to patient-derived DLA products. The mimicking-DLA samples (with up to 400 × 106 WBCs) were spiked with three different tumor cell lines and processed with two versions of a spiral microfluidic chip for label-free CTC enrichment: the commercially available ClearCell FR1 biochip and a customized DLA biochip based on a similar enrichment principle, but designed for higher throughput of cells. While the samples processed with FR1 chip displayed with increasing cell load significantly higher WBC backgrounds and decreasing cell recovery, the recovery rates of the customized DLA chip were stable, even if challenged with up to 400 × 106 WBCs (corresponding to around 120 mL peripheral blood or 10% of a DLA product). These results indicate that the further up-scalable DLA biochip has potential to process complete DLA products from 2.5 L of peripheral blood in an affordable way to enable high-volume CTC-based liquid biopsies.

Neuro-perceptive discrimination on fabric tactile stimulation by Electroencephalographic (EEG) spectra

The precise evaluation of sensory perceptions during fabric-skin interactions is still poorly understood in neuroscience. This study aims to investigate the cortical sensory response to fabric stimuli with different textiles by Electroencephalographic (EEG) spectral intensities, and evaluate the relationships between EEG frequency bands, traditional subjective questionnaires, and the materials' physical properties. Twelve healthy adult participants were recruited to test three fabrics with different textile compositions of 1) cotton, 2) nylon, and 3) polyester and wool. The physical properties of the fabrics were quantitatively evaluated by a Fabric Touch Tester (FTT). Subjects were invited to rate the sensory perception of the fabric samples via a subjective questionnaire and objective EEG recording. Significant differences in the EEG relative spectral power of Theta and Gamma bands were acquired in response to the different fabric stimuli (P<0.05). The Theta and Gamma powers demonstrated a significant correlation with the most of the subjective sensations evaluated by questionnaire and the fabrics' physical properties by FTT (P<0.05). The EEG spectral analysis could feasibly be used for the discrimination of fabric stimuli with different textile compositions and further indicates sensory perceptions during fabric stimulation. This finding may provide evidence for further exploratory research of sensory perceptions via EEG spectral analysis, which could be applied to the study of brain generators of skin tactility in future prostheses and the automatic detection of sensory perception in industries.

Evaluating Postural Control and Lower-extremity Muscle Activation in Individuals with Chronic Ankle Instability

Computerized dynamic posturography (CDP) is an objective technique for the evaluation of postural stability under static and dynamic conditions and perturbation. CDP is based on the inverted pendulum model that traces the interrelationship between the center of pressure and the center of gravity. CDP can be used to analyze the proportions of vision, proprioception, and vestibular sensation to maintain postural stability. The following characters define chronic ankle instability (CAI): persistent ankle pain, swelling, the feeling of "giving way," and self-reported disability. Postural stability and fibular muscle activation level in individuals with CAI decreased due to lateral ankle ligament complex injuries. Few studies have used CDP to explore the postural stability of individuals with CAI. Studies that investigate postural stability and related muscle activation by using synchronized CDP with surface electromyography are lacking. This CDP protocol includes a sensory organization test (SOT), a motor control test (MCT), and an adaption test (ADT), as well as tests that measure unilateral stance (US) and limit of stability (LOS). The surface electromyography system is synchronized with CDP to collect data on lower limb muscle activation during measurement. This protocol presents a novel approach for evaluating the coordination of the visual, somatosensory, and vestibular systems and related muscle activation to maintain postural stability. Moreover, it provides new insights into the neuromuscular control of individuals with CAI when coping with real complex environments.

Measurement of sensory deficiency in fine touch after stroke during textile fabric stimulation by electroencephalography (EEG)

Objective

Sensory deficiency of fine touch limits the restoration of motor functions after stroke, and its evaluation was seldom investigated from a neurological perspective. In this study, we investigated the cortical response measured by electroencephalography (EEG) on the fine touch sensory impairment during textile fabric stimulation after stroke.

Approach

Both participants with chronic stroke (n = 12, stroke group) and those unimpaired (n = 15, control group) were recruited. To investigate fine touch during textile fabric stimulations, full brain EEG recordings (64-channel) were used, as well as the touch sensation questionnaires based on the American Association of Textile Chemists and Colorists (AATCC) Evaluation Procedure 5. During the EEG measurement, relative spectral power (RSP) and EEG topography were used to evaluate the neural responses toward the fabric stimuli. In the subjective questionnaire, the fine touch for fabric stimuli was rated and represented by 13 different sensation parameters. The correlation between the fine touch evaluated by the EEG and the questionnaire was also investigated.

Main results

The neural responses of individuals with fine touch impairments after stroke were characterized by a shifted power spectrum to a higher frequency band, enlarged sensory cortical areas and higher RSP intensity (P < 0.05). Asymmetric neural responses were obtained when stimulating different upper limbs for both unimpaired participants and stroke participants (P < 0.05). The fine touch sensation of the stroke participants was impaired even in the unaffected limb. However, as a result of different neural processes, the correlation between the EEG and the questionnaire was weak (r < 0.2).

Significance

EEG RSP was able to capture the varied cortical responses induced by textile fabric fine touch stimulations related to the fine touch sensory impairment after stroke.

Single-site laparoscopic percutaneous extraperitoneal closure (SLPEC) of hernia sac high ligation using an ordinary taper needle: a novel technique for pediatric inguinal hernia

PURPOSE

Laparoscopic high ligation of the internal inguinal ring is an alternative procedure for treatment of pediatric inguinal hernia (PIH), with a major trend toward increasing use of extracorporeal knotting and decreasing use of working ports. We have utilized this laparoscopic technique to treat the entire spectrum of PIH (including incarcerated cases) for more than 17 years, and the technique continues to evolve and improve. We herein report our latest modification of this minimally invasive technique, namely single-site laparoscopic percutaneous extraperitoneal closure (SLPEC) of hernia sac high ligation using an ordinary taper needle, and evaluate its safety and efficacy.

METHODS

From July 2016 to July 2019, 790 children with indirect PIH were treated by laparoscopic surgery. All patients underwent high ligation surgery with a modified single-site laparoscopic technique mainly performed by extracorporeal suturing with an ordinary closed-eye taper needle (1/2 arc 11 × 34). The clinical data were retrospectively analyzed.

RESULTS

All surgeries were successful without serious complications. A contralateral patent processus vaginalis (CPPV) was found intraoperatively and subsequently repaired in 190 patients (25.4%). The mean operative time was 15 min (8-25 min) for 557 unilateral hernias and 21 min (14-36 min) for 233 bilateral hernias. The mean postoperative stay was 20 h. Minor complications occurred in five patients (0.63%) and were managed properly, with no major impact on the final outcomes. No recurrence was noted in the patients who were followed up for 6-42 months. No obvious scar was present postoperatively.

CONCLUSION

Modified SLPEC of hernia sac high ligation using an ordinary taper needle for repair of indirect PIH is a safe, reliable, and minimally invasive procedure with satisfactory outcome, with no special device being needed. It is easy to learn and perform and is worthy of popularization in the clinical setting.

Effects of Taichi exercise on knee and ankle proprioception among individuals with knee osteoarthritis

The study aimed to investigate the effects of 24 weeks Taichi intervention on knee and ankle proprioception amongst individuals with knee osteoarthritis (KOA). Ninety-two patients with KOA were included in the current study, involving 52 participants in the intervention group and 40 participants in the control group. The intervention group performed Taichi exercise for 24 weeks, the control group accepted the health education lectures. The main outcome of this study was the proprioception of the knee and ankle which was measured by an electric-driven movable frame. Between- and within-group differences were evaluated through the repeated-measurement ANOVA. For the Taichi group, the differences in the changes in ankle proprioception were significant on ankle plantarflexion (p = 0.03), ankle dorsiflexion (p = 0.043), ankle varus (p = 0.019) and knee flexion (p = 0.01) between the baseline and post-test measures. Twenty-four weeks Taichi exercise may improve the ankle and knee proprioception of patients with KOA.

Effect of adding whole-body vibration training to squat training on physical function and muscle strength in individuals with knee osteoarthritis

OBJECTIVES

This study aims to investigate the effects of adding whole-body vibration (WBV) exercise to squat training (ST) on the physical function and muscle strength of patients with knee osteoarthritis (KOA).

METHODS

41 participants completed the intervention and measurements (ST group; n=21, age=65.00±4.39 years, BMI=23.01±2.95 kg/m²; WBV+ST group; n=20, age=64.10±4.95 years, BMI=24.79±3.12 kg/m²). The supervised eight-week intervention was performed three times per week with the intensity and duration increased gradually. Visual analog scale, Timed Up and Go test (TUG), 6-min Walk Distance test, and isokinetic measurements were performed at baseline and post-intervention.

RESULTS

The peak torque (PT) of the extensors at 180°/s increased significantly in the WBV+ST group compared with the ST group (p = 0.046). The peak work of the extensors and the PT of the flexors at 180°/s improved only in the WBV+ST group (p<0.0125). However, no significant changes in these variables were found between groups (p>0.05).

CONCLUSIONS

Adding 8 weeks of WBV training to ST can more effectively improve the muscular strength of knee extensors compared with ST in patients with KOA.

RAD51 foci as a functional biomarker of homologous recombination repair and PARP inhibitor resistance in germline BRCA-mutated breast cancer

Background

BRCA1 and BRCA2 (BRCA1/2)-deficient tumors display impaired homologous recombination repair (HRR) and enhanced sensitivity to DNA damaging agents or to poly(ADP-ribose) polymerase (PARP) inhibitors (PARPi). Their efficacy in germline BRCA1/2 (gBRCA1/2)-mutated metastatic breast cancers has been recently confirmed in clinical trials. Numerous mechanisms of PARPi resistance have been described, whose clinical relevance in gBRCA-mutated breast cancer is unknown. This highlights the need to identify functional biomarkers to better predict PARPi sensitivity.

Patients and methods

We investigated the in vivo mechanisms of PARPi resistance in gBRCA1 patient-derived tumor xenografts (PDXs) exhibiting differential response to PARPi. Analysis included exome sequencing and immunostaining of DNA damage response proteins to functionally evaluate HRR. Findings were validated in a retrospective sample set from gBRCA1/2-cancer patients treated with PARPi.

Results

RAD51 nuclear foci, a surrogate marker of HRR functionality, were the only common feature in PDX and patient samples with primary or acquired PARPi resistance. Consistently, low RAD51 was associated with objective response to PARPi. Evaluation of the RAD51 biomarker in untreated tumors was feasible due to endogenous DNA damage. In PARPi-resistant gBRCA1 PDXs, genetic analysis found no in-frame secondary mutations, but BRCA1 hypomorphic proteins in 60% of the models, TP53BP1-loss in 20% and RAD51-amplification in one sample, none mutually exclusive. Conversely, one of three PARPi-resistant gBRCA2 tumors displayed BRCA2 restoration by exome sequencing. In PDXs, PARPi resistance could be reverted upon combination of a PARPi with an ataxia-telangiectasia mutated (ATM) inhibitor.

Conclusion

Detection of RAD51 foci in gBRCA tumors correlates with PARPi resistance regardless of the underlying mechanism restoring HRR function. This is a promising biomarker to be used in the clinic to better select patients for PARPi therapy. Our study also supports the clinical development of PARPi combinations such as those with ATM inhibitors.

Effects of whole body vibration exercise on neuromuscular function for individuals with knee osteoarthritis: study protocol for a randomized controlled trial

Background

Knee osteoarthritis (KOA) is a leading cause of public disability. Neuromuscular function contributes to the development and/or progression of KOA. Whole body vibration (WBV) exercise improve the neuromuscular function of patients with neurological disorders and even that of older patients with limited exercise options. Therefore, WBV exercise may offer an efficient and alternative treatment for individuals with KOA. However, the effects of WBV training on the neuromuscular function of individuals with KOA remain unclear. Therefore, this study attempts to investigate the effect of a 12-week WBV exercise on the neuromuscular function of individuals with KOA.

Methods/design

We will conduct a prospective, single-blind randomized controlled trial on 180 KOA patients. Participants will be randomly assigned to the WBV exercise, lower extremity resistance training, and health education groups. The WBV exercise group will participate in a 12-week WBV training. The lower extremity resistance training group will undergo a 12-week lower extremity resistance training of both lower limbs. The control group will receive health education for 12 weeks. After the intervention, the participants will be followed up for 3 months with no active intervention. Primary outcome measures will include anthropometric measurements, gait analysis during walking and stair climbing, muscle strength test of the knee and ankle, proprioception test of the knee and ankle, and neuromuscular response of the leg muscles. Secondary outcome measures will include self-reported pain and physical functional capacity, and physical performance measures. Furthermore, adverse events will be recorded and analyzed. If any participant withdraws from the trial, intention-to-treat analysis will be performed.

Discussion

Important features of this trial mainly include intervention setting, outcome measure selection, and study duration. This study is intended for estimating the effect of WBV intervention on neuromuscular control outcomes. Study results may provide evidence to support the beneficial effects of WBV exercise on the physical performance and neuromuscular control of individuals with KOA to fill the research gap on the efficacy of WBV.

Trial registration

Chinese Clinical Trial Registry, ID: ChiCTR-IOR-16009234. Registered on 21 September 2016.

Electronic supplementary material

The online version of this article (doi:10.1186/s13063-017-2170-6) contains supplementary material, which is available to authorized users.

Thyroid abnormalities following the use of cytotoxic T-lymphocyte antigen-4 and programmed death receptor protein-1 inhibitors in the treatment of melanoma

CONTEXT

Checkpoint inhibitors are emerging as important cancer therapies but are associated with a high rate of immune side effects, including endocrinopathy.

OBJECTIVE

To determine the burden of thyroid dysfunction in patients with melanoma treated with immune checkpoint inhibitors and describe the clinical course.

DESIGN AND PATIENTS

Consecutive patients with melanoma treated with either ipilimumab, nivolumab, pembrolizumab or the combination of ipilimumab and nivolumab were identified. Baseline thyroid function tests were used to exclude those with pre-existing thyroid abnormalities, and thyroid function tests during treatment used to identify those with thyroid dysfunction.

RESULTS

Rates of overt thyroid dysfunction were in keeping with the published phase 3 trials. Hypothyroidism occurred in 13·0% treated with a programmed death receptor-1 (PD-1) inhibitor and 22·2% with a combination of PD-1 inhibitor and ipilimumab. Transient subclinical hyperthyroidism was observed in 13·0% treated with a PD-1 inhibitor, 15·9% following a PD-1 inhibitor, and 22·2% following combination treatment with investigations suggesting a thyroiditic mechanism rather than Graves' disease, and a high frequency of subsequent hypothyroidism. Any thyroid abnormality occurred in 23·0% following ipilimumab, 39·1% following a PD-1 inhibitor and 50% following combination treatment. Abnormal thyroid function was more common in female patients.

CONCLUSION

Thyroid dysfunction occurs commonly in patients with melanoma treated with immune checkpoint inhibitors, with rates, including subclinical dysfunction, occurring in up to 50%.

Validation of daily increment deposition and early growth of mud carp Cirrhinus molitorella

In this study, laboratory reared Cirrhinus molitorella from hatching through to the juvenile stage were used to validate daily increment deposition. Lapilli were suitable for ageing C. molitorella. The slope of the linear relationships between increment counts and age was not significantly different from 1 (n = 258, P > 0·05), indicating that growth increments are deposited daily. The first increment following the first-feeding check formed 3 days post hatch (dph). One hundred and twenty-three juveniles, ranging from 36·4 to 84·7 mm in body length (L_B ), were collected in the Pear River estuary from July to January in both 2014 and 2015 and used to estimate growth rate. The core in the lapillus, consisting of a single primordium, a diffuse area and the first-feeding band, was followed by 20 narrow and poorly contrasted daily increments. Thereafter, increments were wide and well-defined, and, finally became less distinct, but still homogenous after c. 53 dph. The mean increment width increased to the 29th increment and stayed relatively constant up to the 35th increment and then, gradually declined to the edge of the otolith. Wild juveniles were aged from 69 to 178 dph and hatched from the 15 February to 2 September. Growth rate was estimated from the adjusted linear regression of L_B on age: L_B = 4·37 + 0·44A (r² = 0·60), where A = age. The radius of the core and the regularity and resolution of the increments showed some differences between reared and wild fish. These results are of value for the further study of early life traits and recruitment of C. molitorella.

Study on female breast cancer imaging screening consultation network in Guangdong Province, China

OBJECTIVE

This study aimed to construct breast cancer image screening consultation network (BISCN) that connects all levels of medical institutions in Guangdong Province.

MATERIALS AND METHODS

Fourteen hospitals in different cities and counties (districts) of Guang-dong were selected for breast cancer screening with imaging (breast X-ray, ultrasound, and MRI). "Breast Imaging Reporting and Data System (BI-RADS)" was taken as reference to build up image data base of breast cancer screening and BISCN that is an internet-based network platform. BISCN quality control was performed to improve the diagnostic accuracy and collaboration of members. In 2011, the BISCN members underwent breast imaging diagnosis training and conducted a questionnaire survey.

RESULTS

BISCN allowed quick, synchronous, and accurate communication and feedback of diagnostic imaging in breast cancer among all levels of medical institutions and improved the ability of breast cancer screening in the province, as well as the detection rate of early breast cancer throughout the province, especially in the grassroot units. The survey results showed that the trainees' understanding situation of the training contents before training was 2.02 ± 1.75 points. Through the study, the participants considered that the teaching contents could solve the daily diagnose problems (2.91 ± 0.70 points), the post-training scores were improved (2.88 ± 1.23 points), and highly satisfactory with the teaching contents (2.81 ± 0.53 points). All students passed the examination and were qualified for the future.

CONCLUSIONS

BISCN is of good feasibility in construction and applicability in management by raising diagnosis level of breast cancer in Guangdong Province.

Proliferation inhibition and CD4/CD8 thymocyte subset skewing by in vivo exposure of C57BL/6 mice to Ah receptor-binding 3,3',4,4'-tetrachlorobiphenyl

3,3',4,4'-Tetrachlorobiphenyl (TCB) and other Ah receptor-binding xenobiotics lead to thymus atrophy and immunosuppression, the former possibly causing the latter. In order to better understand the TCB-induced events in the murine thymus, we analyzed the effects of TCB on the proliferation capacity and maturation kinetics of different thymocyte subsets in 2-week-old C57BL/6 mice (i.e. of the Ahb-1 'dioxin-sensitive' genotype). Mice were injected with a single dose of TCB, and the development of thymocytes was followed up for 10 days using flow cytometric surface marker analysis combined with measurement of DNA content by 7-amino-actinomycin D staining. Already 2 days after exposure to TCB, fewer of the more immature thymocytes (CD4-CD8-, CD4-CD8+ alpha beta TCR-) were proliferating than in thymi from control animals. Eventually this led to a severe decrease in thymus cellularity. Moreover, a shift towards the CD4-CD8+ mature subpopulation was observed. The effects were reversible, and proliferation and CD4/CD8 subset distribution returned to normal levels within the observation period. The results are in good agreement with the data obtained previously in vitro with fetal thymus organ cultures.

A region of barley chromosome 6H harbors multiple major genes associated with net type net blotch resistance

Net type net blotch (NTNB), caused by Pyrenophora teres f. teres Drechs., is prevalent in barley growing regions worldwide. A population of 118 doubled haploid (DH) lines developed from a cross between barley cultivars 'Rika' and 'Kombar' were used to evaluate resistance to NTNB due to their differential reaction to various isolates of P. teres f. teres. Rika was resistant to P. teres f. teres isolate 15A and susceptible to isolate 6A. Conversely, Kombar was resistant to 6A, but susceptible to 15A. A progeny isolate of a 15A x 6A cross identified as 15A x 6A#4 was virulent on both parental lines. The Rika/Kombar (RK) DH population was evaluated for disease reactions to the three isolates. Isolate 15A induced a resistant:susceptible ratio of 78:40 (R:S) whereas isolate 6A induced a resistant:susceptible ratio of 40:78. All but two lines had opposite disease reactions indicating two major resistance genes linked in repulsion. Progeny isolate 15A x 6A#4 showed a resistant:susceptible ratio of 1:117 with the one resistant line also being the single line that was resistant to both 15A and 6A. An RK F(2) population segregated in a 1:3 (R:S) ratio for both 15A and 6A indicating that resistance is recessive. Molecular markers were used to identify a region on chromosome 6H that harbors the two NTNB resistance genes. This work shows that multiple NTNB resistance genes exist at the locus on chromosome 6H, and the recombinant DH line harboring the resistance alleles from both parents will be useful for the development of NTNB-resistant barley germplasm.

Chromosomal microarray mapping suggests a role for BSX and Neurogranin in neurocognitive and behavioral defects in the 11q terminal deletion disorder (Jacobsen syndrome)

We performed a prospective analysis on 14 11q- patients to determine the relationship between the degree of cognitive impairment and relative deletion size. Seventeen measures of cognitive function were assessed. All nine patients with a deletion of at least 12.1 Mb had severe global cognitive impairment, with full-scale IQ <50, whereas all five patients with smaller deletions, <or=11.8 Mb, demonstrated mild cognitive impairment, with a full-scale IQ of 63 or higher (p < 0.001). Among these five patients, the two patients with the larger deletions (11.4, 11.8 Mb) had a selective impairment in freedom from distractability compared to the three patients with smaller deletions (<or=9.1 Mb). We propose the presence of a proximal critical region that contains a gene for global cognitive function and a distal critical region that contains a gene essential for auditory attention, which may be necessary for optimizing intellectual function. The proximal critical region is 300 kb and contains three annotated genes. One of these genes, BSX, encodes a brain-specific homeobox protein that in gene-targeted mice has been shown previously to have a role in regulating locomotory behavior via BSX-expressing neurons in the hypothalamus. The distal critical region, approximately 2.2 Mb, contains 18 annotated genes. One gene in this region, Neurogranin, has been demonstrated previously in mice to be critical for synapse plasticity and long-term potentiation. Taken together, our results implicate the presence of at least two loci in distal 11q that when deleted, cause global and selective deficits in neurocognitive function. These findings have important implications for genetic counseling and potential gene-specific therapies.