Therapeutic Effect In Patients Research Articles

Brief Report: Tepotinib as a Treatment Option in MET Exon 14 Skipping-Positive Lung Cancers—Investigating Discordance Between ArcherMET and the Oncomine Dx Target Test

IntroductionNSCLC is a leading cause of cancer-related mortality worldwide. Specific genetic alterations, such as MET exon 14 (METex14) skipping, have been identified in NSCLC, allowing targeted therapy. Tepotinib, a highly selective MET inhibitor, has displayed promise in patients with advanced NSCLC. Nevertheless, challenges arise when identifying treatment strategies for patients with discordant results regarding METex14 skipping detection between diagnostic tests. MethodsWe investigated patients with NSCLC and discordant results for METex14 skipping between the Oncomine Dx Target Test (ODxTT) and ArcherMET. Clinical response, adverse events, and the duration of tepotinib treatment were assessed, and statistical analysis was performed. ResultsAmong the 19 patients deemed METex14 skipping positive by ODxTT, only 10 had concordant results with ArcherMET. The number of METex14 skipping reads detected by ODxTT was significantly lower in discordant cases. Of the 19 patients, 14 received tepotinib, and comparable response and disease control rates were observed in both concordant and discordant cases. The duration of treatment did not significantly differ between the two groups. ConclusionsOur findings suggest that tepotinib has comparable therapeutic effects in patients with METex14 skipping-positive NSCLC irrespective of the concordance of results between ODxTT and ArcherMET. Tepotinib is a possible treatment option for patients with METex14 skipping, even in patients with discordant test results.

Rehabilitation of burnout patients: medical and psychological aspects

Abstract. Rationale: Determining the therapeutic effects of rehabilitation technologies in patients with burnout is a topical scientific and practical task. Purpose of the study: to determine the therapeutic effects of combinations of rehabilitation technologies in patients with burnout. Methods: 208 patients aged 31.9 (18–52.0) years with burnout (ICD-10 code Z73.0) were studied. The patients were prescribed a set of physical exercises, a course of audiovisual polysensory relaxation, transcranial magnetic therapy, non-selective chromotherapy, therapeutic massage, contrast showers (baths), climatotherapy, clinical nutrition, and psychotherapy. The total duration of the course was 20–30 days. Clinical, instrumental, psychophysical, and integral methods of assessing the condition of patients were used. Results: the study revealed significant dynamics of indicators of subjective well-being: interest in professional activity, attention to detail, psychophysiological status, heart rate, systolic arterial pressure, vital capacity, double product and the Martinet-Kushelevsky test, adaptive potential, and vegetative regulation. The rehabilitation course caused a significant improvement in integral health indicators: the level of somatic health increased from 1.75 ± 0.52 to 2.9 ± 0.58 points (p < 0.001) and physical performance indicators PWC-170 — from 866.6 ± 10.2 to 1,031.1 ± 11.8 mcg/s (p < 0.001). Conclusion: the complex of syndrome and pathogenetically conditioned rehabilitation technologies forms pronounced actoprotective and psychorelaxing therapeutic effects in patients with burnout.

Impact of Pharmacist-led Interventions on Medication Adherence and Inhalation Technique in Adult Patients with COPD and Asthma

Introduction: Inhalation technique and medication adherence are essential prerequisites for achieving optimal therapeutic effects in patients with chronic obstructive pulmonary disease (COPD) and asthma. Although there are various effective treatments for respiratory disorders, disease control in these patients is still sub-optimal because of incorrect inhalation techniques and poor medication adherence. Pharmacist-led interventions have demonstrated a positive impact on improving inhalation technique, better medication adherence, and thus subsequently improving the quality of life of patients. Methods: Search engines such as PubMed, Google Scholar, and Science Direct were used to identify the relevant information using keywords: Chronic Obstructive Pulmonary Disease, Asthma, Pharmaceutical care, Pharmacist Intervention, Medication Adherence and Inhalation Technique. The relevant articles that were published between 2005 to 2021 were included and reviewed for the Pharmacist-led interventions to improve medication adherence, inhalation technique, and quality of life of patients with COPD and asthma. Results: Of the 300 articles screened, a total of 14 articles met the inclusion criteria and were included for review. Pharmacist-led interventions help to improve the medication adherence, inhalation technique, and quality of life of patients with COPD and asthma. Similarly, the articles mentioned in this review found that the interventions provided by the pharmacist to COPD and asthma patients were cost-effective in terms of reducing hospitalization rates and severe exacerbation rates. Conclusion: Our review concluded that the pharmacists’ interventions have a significant improvement in medication adherence and inhalation techniques with the enhancement of therapeutic effects in adult patients with COPD and asthma.

Outcome of Post Functional Endoscopic Sinus Surgery Nasal Irrigation with Normal Saline Versus Normal Saline with Budesonide in Patients with Sinonasal Polyposis: A Randomized Control Trial.

Chronic rhinosinusitis(CRS) is a condition characterized by inflammation of the lining of nose and sinuses lasting for 12weeks or more. CRS with nasal polyp nasal polyp(CRSwNP) is seen in 0.5-4% of the population and is present in about 20% of patients with CRS. Functional endoscopic sinus surgery aids in restoring the ventilation and drainage of paranasal sinuses. Postoperatively, various solutions are used to irrigate the sinus cavity for pharmaceutical and mechanical lavage. Hence, it is imperative to compare different solutions to choose the best to give a favorable outcome. A total of 24 postoperative CRSwNP patients were randomly divided into two groups. Group A received routine post-FESS medication as per the institute guidelines. Group B received budesonide nasal irrigation in addition to regular care. Both groups were evaluated endoscopically at 1, 4, and 12weeks after the surgery. Pre and postoperative quality of life were compared. Endoscopic Lund-Kennedy scoring (objective measurement) and Sino-Nasal Outcome Test 22 score were used to compare the two groups. The mean preoperative Sino Nasal Outcomes Test 22 score(SNOT-22) was 46.58 ± 6.18 in group A and 50.5 ± 5.7 in group B. It was reduced to 15.00 ± 2.00 and 9.75 ± 1.95 postoperatively in both groups respectively at the end of 3months. Postoperatively, the mean endoscopic score was 2.36 ± 0.80 in group A and 1.18 ± 0.40 in group B at the end of 3months. In conclusion, saline plus budesonide nasal irrigation is a better option when compared to saline only irrigation in terms of efficacy and therapeutic effect in patients undergoing FESS for CRSwNP, hence, it should be advocated in regular clinical practice.

Serum neuroactive metabolites of the tryptophan pathway in patients with acute phase of affective disorders.

Many studies showed disrupted tryptophan metabolism in patients with affective disorders. The aims of this study were to explore the differences in the metabolites of tryptophan pathway (TP) and the relationships between TP metabolites and clinical symptoms, therapeutic effect in patients with bipolar disorder with acute manic episode (BD-M), depressive episode (BD-D) and major depressive disorder (MDD). Patients with BD-M (n=52) and BD-D (n=39), MDD (n=48) and healthy controls (HCs, n=49) were enrolled. The serum neuroactive metabolites levels of the TP were measured by liquid chromatography-tandem mass spectrometry. Hamilton Depression Scale-17 item (HAMD-17) and Young Mania Rating Scale (YMRS) were used to evaluate depressive and manic symptoms at baseline and after 8 weeks of antidepressants, mood stabilizers, some also received antipsychotic medication. The levels of tryptophan (TRP) and kynurenic acid (KYNA) were significantly lower and the ratios of tryptophan/kynurenine (TRP/KYN), 5-hydroxytryptamine/tryptophan (5-HT/TRP), quinolinic acid/kynurenic acid (QUIN/KYNA) were higher in BD-M, BD-D, MDD vs. HC. The levels of QUIN and the ratios of QUIN/KYNA were higher in BD-M than in BD-D, MDD, and HCs. The 5-hydroxyindoleacetic acid (5-HIAA) levels of patients with MDD were significantly higher than those in BD-M and BD-D. Binary logistic regression analysis showed the lower peripheral KYNA, the higher the QUIN level, and the higher the risk of BD-M; the lower peripheral KYNA and the higher KYN/TRP and 5-HT/TRP, the higher the risk of BD-D; and the lower the peripheral KYNA level and the higher the KYN/TRP and 5-HT/TRP, the higher the risk of MDD. Correlation analysis, showing a significant association between tryptophan metabolites and improvement of clinical symptoms, especially depression symptoms. Patients with affective disorders had abnormal tryptophan metabolism, which involved in 5-HT and kynurenine pathway (KP) sub-pathway. Tryptophan metabolites might be potential biomarkers for affective disorders and some metabolites have been associated with remission of depressive symptoms.

Diagnosis and treatment of recurrent patellar dislocation with knee extensor device combined with rearrangement.

This study aimed to investigate the clinical effects of combining knee extension mechanism (EM) with rearrangement in the treatment of recurrent patellar dislocation (RPD). Eighty-four patients with RPD admitted to the First Affiliated Hospital of Kunming Medical University were included. In this work, all patients received routine computed tomography (CT) examinations. In addition, the evaluation factors of EM combined with rearrangement therapy in RPD patients were analyzed using logistic regression. Lysholm and Kujula scores, femoral canal width, patellar canal width, patellar tilt angle (PTA), and lateral patellar displacement (LPD) were significantly increased at 1 and 3 years after treatment (p < 0.05). LPA was significantly decreased, while the tibial tuberosity trochlear groove of the femur (TT-TG) demonstrated no considerable differences (p > 0.05). The good rate of the short-term Insall-Salvati index was 78.6%, and that of the long-term Insall-Salvati index was 76.1%. The combination of the knee extension device and rearrangement therapy has a higher rate of short-term and long-term Insall-Salvati index (ISI) excellence. In addition, the range of motion of the knee joint increased significantly, and the Q Angle decreased significantly (p < 0.05). Logistic regression analysis showed that age and ISI were highly correlated with the evaluation of therapeutic effects in patients with RPD. EM combined with rearrangement in the treatment of RPD had positive short-term and long-term efficacy, high application value, and age, which can be popularized in clinical applications and have positive diagnostic value.

Abstract 1912: Targeting Trop-2 with sacituzumab govitecan (IMMU-132) suppresses the tumor growth in diffuse large B cell lymphoma

Abstract Introduction: Sacituzumab govitecan (SG), also termed IMMU-132, is an antibody-drug conjugate, linking an anti-Trop-2 antibody and the topoisomerase I inhibitor, SN-38. Clinically, SG has shown promising therapeutic effects in patients with human epidermal growth factor receptor 2 (HER2)-negative metastatic breast cancer. However, the efficacy of SG in diffuse large B-cell lymphoma (DLBCL) remains unexplored. In this study, we sought to determine whether SG can efficiently inhibit cell proliferation and tumor growth of DLBCL by using both in vitro and in vivo models. Methods: We examined the cytotoxicity of SG in the activated B-cell like (ABC)-subtype-DLBCL cell lines, Riva (Ri-1), HBL-1, and SU-DHL-2, and the germinal center B-cell (GCB)-subtype-DLBCL cell lines, SU-DHL-4, SU-DHL-5, and SU-DHL-6 by MTT assay. We assessed the distributions of cell cycle phase and apoptosis in the aforementioned DLBCL cell lines treated with SG for 24 h or 48 h using flow cytometry and Annexin V staining. We confirmed apoptosis (cleavage of poly ADP-ribose polymerase [PARP] and caspase-3) and detected DNA damage (γH2AX and 53BP1)-related protein expression in SU-DHL-2 and SU-DHL-6 cell lines treated with SG at various concentrations for 48 h using western blotting, compared to untreated cells. To examine the anti-tumor effect of SG in vivo, NOD-SCID nude mice of Riva-xenograft mouse models were randomized into a control group and an SG-treated group. Results: Flow cytometry and western blotting revealed overexpression of Trop-2 on the surface of untreated ABC-DLBCL and GCB-DLBCL cell lines. In this study, we showed that SG treatment reduced cell viability in all six DLBCL cell lines with nanomolar IC50 values. Exposing SG to DLBCL cells significantly increased cell cycle arrest at the G2/M and sub-G1 phases of all six DLBCL cell lines. Annexin V staining revealed that SG induced apoptosis in all six DLBCL cell lines. Western blotting confirmed apoptosis induction by showing a dose-dependent upregulation of cleaved PARP and cleaved caspases-3 by SG treatment, along with decreased expression of survivin in both SU-DHL-2 and SU-DHL-6 cells. SG also upregulated the expression of γH2AX and 53BP1 in both SU-DHL-2 and SU-DHL-6 cells. Furthermore, we found that tumor growth of Riva cells in vivo was significantly reduced by treatment with SG when compared with untreated control. Conclusion: SG suppresses tumor growth of ABC-DLBCL and GCB-DLBCL cells in both in vitro and in vivo models by inducing cell cycle arrest, apoptosis, and DNA damage. These findings provide a rationale for transitioning SG to clinical trials for treating patients with relapsed or refractory DLBCL. Citation Format: Jakie Ting, Ming-Feng Wei, Hsiao-Wei Lee, Keng-Hsueh Lan, Ann-Lii Cheng, Sung-Hsin Kuo. Targeting Trop-2 with sacituzumab govitecan (IMMU-132) suppresses the tumor growth in diffuse large B cell lymphoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 1912.

Impact of NOTCH1 expression in primary breast adenoid cystic carcinoma

AimsAdenoid cystic carcinoma (AdCC) originates from salivary-type like glands in the head and neck, lung, and breast. AdCC shows chromosomal translocation, resulting in MYB::NFIB fusion and overexpression of MYB. Recently,...

Therapeutic utility of human umbilical cord-derived mesenchymal stem cells-based approaches in pulmonary diseases: Recent advancements and prospects.

Pulmonary diseases across all ages threaten millions of people and have emerged as one of the major public health issues worldwide. For diverse disease conditions, the currently available approaches are focused on alleviating clinical symptoms and delaying disease progression but have not shown significant therapeutic effects in patients with lung diseases. Human umbilical cord-derived mesenchymal stem cells (UC-MSCs) isolated from the human UC have the capacity for self-renewal and multilineage differentiation. Moreover, in recent years, these cells have been demonstrated to have unique advantages in the treatment of lung diseases. We searched the Public Clinical Trial Database and found 55 clinical trials involving UC-MSC therapy for pulmonary diseases, including coronavirus disease 2019, acute respiratory distress syndrome, bronchopulmonary dysplasia, chronic obstructive pulmonary disease, and pulmonary fibrosis. In this review, we summarize the characteristics of these registered clinical trials and relevant published results and explore in depth the challenges and opportunitiesfaced in clinical application. Moreover, the underlying molecular mechanisms involved in UC-MSC-based therapy for pulmonary diseases are also analyzed in depth. In brief, this comprehensive review and detailed analysis of these clinical trials can be expected to provide a scientific reference for future large-scale clinical application.

Efficacy of Daiwenjiu ointment on the treatment of cervical spondylosis with nerve root type caused by cold dampness obstruction

Objective This study aimed to assess the clinical efficacy of Daiwenjiu ointment in the treatment of cervical spondylosis with cold dampness obstruction nerve root type. Methods A retrospective analysis was conducted on a cohort of 110 patients diagnosed with cervical spondylotic radiculopathy. Based on the treatment method, the patients were divided into two groups. The control group received electroacupuncture treatment, while the observation group received a combination of Daiwenjiu ointment and electroacupuncture treatment. The outcome measures included Japanese Orthopedic Association (JOA) scores for cervical spine function, Simplified McGill Pain Questionnaire (SF-MPQ) scores, and changes in serum inflammatory factors TNF-α and IL-1β. Results Following treatment, the JOA score in the observation group increased from 9.45 ± 1.35 to 14.82 ± 1.29 after treatment, indicating better recovery of cervical spine function compared to the control group (p < 0.001). The SF-MPQ score in the observation group decreased to 18.25 ± 3.80 after treatment, while it remained at 30.20 ± 4.30 in the control group. This difference between the groups was statistically significant (p < 0.001). Furthermore, the observation group demonstrated a significant decrease in serum levels of TNF-α and IL-1β after treatment compared to the control group (p < 0.001). Conclusion Daiwenjiu ointment exhibits significant therapeutic effects in patients with cold dampness obstruction nerve root type cervical spondylosis. It effectively improves cervical function, reduces pain, and downregulates inflammatory cytokine levels.

CACA guidelines for holistic integrative management of urothelial carcinoma

Bladder urothelial carcinoma (UC) is the most common malignant tumor of the urinary system. It has the characteristics of high recurrence rate and poor prognosis. It is a malignant disease that threatens the safety of human life. The incidence rate has gradually increased in recent years. UC has the following characteristics: non-specific clinical symptoms, difficult preoperative qualitative diagnosis, unsatisfactory clinical treatment effect and poor prognosis. Therefore, a clear diagnosis plays a decisive role in the selection and formulation of surgical plans, and reasonable treatment is the key to improving the prognosis of patients and increasing their long-term survival rate. Based on the research evidence of diagnosis, evaluation, and treatment and the clinical experience of experts, the Cancer Nutrition Professional Committee of the Chinese Anti-Cancer Association formulated the "Guidelines for the Diagnosis and Treatment of Bladder Urothelial Carcinoma" for the reference of clinicians. It is hoped that this guideline can provide clinicians with the best and effective reference for clinical diagnosis and treatment, so as to achieve the best therapeutic effect for patients with UC in our country.

Therapeutic effects of rehabilitation technologies in patients with functional asthenia

Relevance: determining the therapeutic effects of a complex of pathogenetically determined rehabilitation technologies in patients with functional asthenia is an urgent scientific and practical task. The aim of the study was to determine the therapeutic effects of combinations of rehabilitation technologies in patients with functional asthenia. Methods: 24 patients aged 29.3 (21.5–35.0) years with functional asthenia (ICD-10 code: R53) were studied. The patients were prescribed a set of physical exercises, a course of audiovisual polysensory relaxation, carbon dioxide baths, climatotherapy, clinical nutrition, and psychotherapy. The total duration of the course was 30 days. Clinical, instrumental, psychophysical, and integral methods of assessing the condition of patients were used. Results: an improvement in clinical status indicators and a decrease in signs of asthenia with an improvement in mood, well-being, cheerfulness, and self-confidence were noted. The rehabilitation course caused a pronounced oxygen capacity of tissues, an increase in adaptation reserves, an improvement in vegetative regulation and the level of somatic health, and a significant increase in physical performance in patients with functional asthenia. Conclusion: а complex of physical exercises, audiovisual polysensory relaxation, carbon dioxide baths, climatotherapy, clinical nutrition, and psychotherapy forms pronounced actoprotective and psychocorrective therapeutic effects in patients with functional asthenia.

Comprehensive molecular analyses of a 7-m6A-related lncRNAs signature for prognosis, tumor immunity and therapeutic effect in patients with hepatocellular carcinoma.

Hepatocellular carcinoma is the most common form of liver tumor. m6A modification and noncoding RNA show indispensable roles in HCC. We sought to establish and verify an appropriate m6A-related long noncoding RNA prognostic tool for predicting hepatocellular carcinoma progression. We extracted the RNA expression levels and the clinicopathologic data from GTEx and TCGA databases. Multivariate Cox regression analysis and receiver operating characteristic curves were performed to test the model's predictive ability. We further built a nomogram for overall survival according to the risk score and clinical features. A competing endogenous RNA network and Gene Ontology assessment were implemented to identify related biological mechanisms and processes. By bioinformatics analysis, a risk model comprising GABPB1-AS1, AC025580.1, LINC01358, AC026356.1, AC009005.1, HCG15, and AC026368.1 was built to offer a prognostic prediction for hepatocellular carcinoma independently. The prognostic tool could better prognosticate hepatocellular carcinoma patients' survival than other clinical characteristics. Then, a nomogram with risk score and clinical characteristics was created, which had strong power to calculate the survival probability in hepatocellular carcinoma. The immune-associated processes involving the differentially expressed genes between the two subgroups were displayed. Analyses of prognosis, clinicopathological characteristics, tumor mutation burden, immune checkpoint molecules, and drug response showed significant differences among the two risk subtypes, hinting that the model could appraise the efficacy of immunotherapy and chemotherapy. The tool can independently predict the prognosis in patients with hepatocellular carcinoma, which benefits drug selection in hepatocellular carcinoma patients.

Salvage therapy for refractory sudden sensorineural hearing loss (RSSNHL): a systematic review and network meta-analysis.

Approximately 30-50% of sudden sensorineural hearing loss (SSNHL) patients show poor response to systemic steroid therapy. Additionally, the most appropriate treatment for patients with refractory sudden sensorineural hearing loss (RSSNHL) is unknown. This study aimed to explore the best treatment for RSSNHL. Using a frequentist contrast-based model and PRISMA guidelines, this study compared five salvage regimes: intratympanic injection of steroids (ITS), hyperbaric oxygen (HBO) therapy, post auricle steroid injection (PSI), ITS combined with HBO therapy, and continued systemic steroids. We searched the PubMed, EMBASE, Web of Science, and Cochrane Library databases for randomised controlled trials and cohort studies comparing treatment regimens for RSSNHL. Compared with the control group (no additional treatment), PSI and ITS demonstrated significant improvements. The mean hearing gain was greater after PSI (11.1 dB [95% CI, 4.4-17.9]) than after ITS (7.7 dB [95% CI, 4.8-10.7]). When a restricted definition of RSSNHL was used, the ITS + HBO therapy showed the largest difference in improvement for pure tone average compared with the control group (14.5 dB [95% CI, 4.2-25.0]). The administration of either PSI or ITS leads to the greatest therapeutic effect in patients with RSSNHL. However, a consensus on the definition of RSSNHL is needed.

Comparison of Nuclear Medicine Therapeutics Targeting PSMA among Alpha-Emitting Nuclides.

Currently, targeted alpha therapy (TAT) is a new therapy involving the administration of a therapeutic drug that combines a substance of α-emitting nuclides that kill cancer cells and a drug that selectively accumulates in cancer cells. It is known to be effective against cancers that are difficult to treat with existing methods, such as cancer cells that are widely spread throughout the whole body, and there are high expectations for its early clinical implementation. The nuclides for TAT, including 149Tb, 211At, 212/213Bi, 212Pb (for 212Bi), 223Ra, 225Ac, 226/227Th, and 230U, are known. However, some nuclides encounter problems with labeling methods and lack sufficient preclinical and clinical data. We labeled the compounds targeting prostate specific membrane antigen (PSMA) with 211At and 225Ac. PSMA is a molecule that has attracted attention as a theranostic target for prostate cancer, and several targeted radioligands have already shown therapeutic effects in patients. The results showed that 211At, which has a much shorter half-life, is no less cytotoxic than 225Ac. In 211At labeling, our group has also developed an original method (Shirakami Reaction). We have succeeded in obtaining a highly purified labeled product in a short timeframe using this method.

Pitavastatin calcium significantly improves glucose and lipid metabolism of patients with coronary atherosclerosis and reduces the occurrence of adverse cardiovascular events

Purpose: To determine the efficacy of pitavastatin calcium and atorvastatin calcium on coronary atherosclerosis (CA) and compare the influence of the two schemes on adverse cardiovascular events.&#x0D; Methods: The medical records of 198 patients with CA admitted at Affiliated Hospital of Jiangsu University, China from August 2019 to May 2011 were analyzed retrospectively. The patients were grouped into pitavastatin calcium group (n = 102) and atorvastatin calcium group (n = 96). The efficacy, incidence of adverse cardiovascular events, as well as changes in blood lipid metabolism and blood glucose metabolism indices before and after therapy were recorded and compared.&#x0D; Results: Compared with atorvastatin calcium group, pitavastatin calcium group yielded a significantly higher overall response rate (ORR, p &lt; 0.05) and presented a significantly lower total incidence of cardiovascular adverse events (p &lt; 0.05). After therapy, pitavastatin calcium group displayed significantly lower triglyceride, total cholesterol and low-density lipoprotein-cholesterol levels (p &lt; 0.05), and also presented significantly higher high-density lipoprotein-cholesterol levels (p &lt; 0.05) in contrast to atorvastatin calcium group. Furthermore, pitavastatin calcium group presented significantly lower fasting blood glucose and glycosylated hemoglobin levels than atorvastatin calcium group (p &lt; 0.05).&#x0D; Conclusion: Compared with atorvastatin calcium, pitavastatin calcium displays a better therapeutic effect in patients with CA, lowers the incidence of adverse cardiovascular events and improves glucose and lipid metabolism of patients. Future studies will focus on longer follow-up sessions to better understand the impact of the drugs on patient’s prognosis.

Increased Cerebrospinal Fluid Adenosine 5'-Triphosphate Levels in Patients with Guillain-Barré Syndrome and Chronic Inflammatory Demyelinating Polyneuropathy.

Extracellular adenosine 5'-triphosphate (ATP) acts as a signaling molecule in the peripheral nerves, regulating myelination after nerve injury. The present study examined whether the cerebrospinal fluid (CSF) ATP levels in patients with Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyneuropathy (CIDP) are related to disease severity. CSF ATP levels in 13 patients with GBS and 18 patients with CIDP were compared with those in a control group of 16 patients with other neurological diseases (ONDs). In patients with CIDP, CSF ATP levels were compared before and after treatment. The correlations between CSF ATP levels and other factors, including clinical data and CSF protein levels, were also evaluated. Median CSF ATP levels were significantly higher in patients with GBS and CIDP than in those with ONDs. When patients with CIDP were classified into two groups depending on their responsiveness to immunotherapy, median CSF ATP levels were significantly higher in good responders than in ONDs. CSF ATP levels tended to decrease after treatment in patients with CIDP. In patients with CIDP, there is a negative correlation between CSF ATP and CSF protein levels. CSF ATP levels were increased in patients with GBS and CIDP. In particular, CSF ATP levels tended to decrease following treatment in patients with CIDP. CSF ATP levels may be useful biomarkers for the diagnosis or monitoring of therapeutic effects in patients with GBS and CIDP.

Application of noninvasive neuromodulation and light therapy in post-stroke depression: a narrow review

Post-stroke depression is closely related to the poor prognosis of stroke, resulting in prolonged hospital stay, neurological dysfunction, and increased mortality. Post-stroke depression has a complex pathogenesis, and cannot be explained by a single pathophysiological mechanism; therefore, no treatment is definitely effective. Currently, the commonly used treatment methods include drug therapy, psychotherapy and noninvasive neuromodulation therapy, such as repetitive transcranial magnetic stimulation, and transcranial direct current stimulation. However, simple drugs have poor efficacy and are often accompanied by side effects. Although repetitive transcranial magnetic stimulation and transcranial direct current stimulation combined with drug therapy enhance drug efficacy, their application is limited in some cases. Light therapy can regulate the central nervous system through the light-sensitive retinal nerve pathway, which has been proven to have therapeutic effects in patients with depression. Light therapy has the advantages of no obvious side effects and a wider range of adaptation. This review summarizes the current research status of noninvasive neuromodulation and light therapy in post-stroke depression and explores the possibility of widespread application of physical factors modulation for post-stroke depression.

Effect of Vitreous Reflux after Intravitreal Aflibercept Injection for Macular Edema with Branch Retinal Vein Occlusion: A Real-World Study.

This study aimed to evaluate the therapeutic effect of vitreous reflux (VR) after intravitreal aflibercept injection (IVAI) for macular edema (ME) following naïve branch retinal vein occlusion (BRVO). Eighty patients with ME following BRVO were divided into three groups according to the conjunctival bleb diameter after IVAI as follows: group A (no VR), group; B (<3 mm VR), and group C (>3 mm VR). Each patient received single IVAI. The treatment response was evaluated with the best-corrected visual acuity (BCVA) and optical coherence tomography measurements of the retinal foveal thickness (RFT) before treatment and 1 month after the first injection. RFT >375 μm was defined as recurrence and received additional IVAI. The recurrence rate of ME and total numbers of IVAI were investigated at 12 months. The BCVA values at 1 month were 0.17 ± 0.29 in group A (n = 41), 0.18 ± 0.17 in group B (n = 18), and 0.19 ± 0.26 in group C (n = 21). The RFT at 1 month were 270 ± 45 μm in group A, 279 ± 24 μm in group B, and 290 ± 43 μm in group C, respectively. ME recurred in 29 out of 41 patients in group A, 15 out of 18 in group B, and 14 out of 21 in group C. The total numbers of IVAI were 2.50 ± 1.24 in group A, 2.59 ± 1.06 in group B, and 2.29 ± 1.27 in group C, respectively. In the above mentioned comparisons, no significant differences were found following an IVAI (P > 0.05). VR after IVAI did not affect the therapeutic effect in patients with ME following BRVO. Thus, we do not need to pay excess attention to VR in the case of IVAI.

A prospective cohort study of periostin as a serum biomarker in patients with idiopathic pulmonary fibrosis treated with nintedanib

This study investigated the utility of periostin, a matricellular protein, as a prognostic biomarker in patients with idiopathic pulmonary fibrosis (IPF) who received nintedanib. Monomeric and total periostin levels were measured by enzyme-linked immunosorbent assay in 87 eligible patients who participated in a multicenter prospective study. Forty-three antifibrotic drug-naive patients with IPF described in previous studies were set as historical controls. Monomeric and total periostin levels were not significantly associated with the change in forced vital capacity (FVC) or diffusing capacity of the lungs for carbon monoxide (DLCO) during any follow-up period. Higher monomeric and total periostin levels were independent risk factors for overall survival in the Cox proportional hazard model. In the analysis of nintedanib effectiveness, higher binarized monomeric periostin levels were associated with more favorable suppressive effects on decreased vital capacity (VC) and DLCO in the treatment group compared with historical controls. Higher binarized levels of total periostin were associated with more favorable suppressive effects on decreased DLCO but not VC. In conclusion, higher periostin levels were independently associated with survival and better therapeutic effectiveness in patients with IPF treated with nintedanib. Periostin assessments may contribute to determining therapeutic strategies for patients with IPF.