BACKGROUNDDiagnosis and treatment for respiratory symptoms (RSs) of gastroesophageal reflux disease (GERD) is more difficult than that for common esophageal symptoms. The goal of this study was to evaluate the efficacy and safety of radiofrequency (RF) treatment on RSs of GERD in a preliminary 12-month follow-up observation.

METHODSFrom April 2006 to October 2008, 505 GERD patients with mainly respiratory presentations such as wheezing, chronic cough or hoarseness, were treated by endoscopic RF. A questionnaire was completed before and after treatment, using a six-point scale ranging from 0 to 5 to assess symptom severity and frequency. The symptom score was the sum of frequency and severity.

RESULTSSymptom scores were significantly improved at the end of the follow-up period. The mean heartburn score decreased from 5.31 to 1.79. The mean regurgitation score decreased from 5.02 to 1.64; mean cough score decreased from 6.77 to 2.85; mean wheezing score decreased from 7.83 to 3.07; and mean hoarseness score decreased from 5.13 to 1.81 (P < 0.01). No major complications or deaths occurred. Minor complications included temporary post-procedural retrosternal unease or pain (n = 106; 21.0%), mild fever (n = 86; 17.0%), transient nausea/vomiting (n = 97; 19.2%), and transient dysphagia (n = 42; 9.3%). Thirty-five (6.9%) patients had recurrence of symptoms. Endoscopic RF treatment was repeated in six patients, and laparoscopic fundoplication was performed in seven.

CONCLUSIONEndoscopic RF is an effective and safe means to treat RSs in patients with GERD.

Adult ; Aged ; Cough ; surgery ; Esophagogastric Junction ; physiopathology ; radiation effects ; Esophagoscopy ; methods ; Female ; Gastroesophageal Reflux ; physiopathology ; surgery ; Heartburn ; surgery ; Hoarseness ; surgery ; Humans ; Male ; Middle Aged ; Radio Waves ; Treatment Outcome ; Young Adult

Exosomes are nanoscale vesicles produced and secre-ted into extracellular fluid by all cells. They mediate cell com-munication through carrying and transferring informational car-goes ( proteins, nucleic acids, lipids and so on ) to recipient cells. In central nervous system, exosomes can be released from all cell types including neurons, neural stem cells and neuroglia cells. These exosomes shuttle nucleic acids ( miRNAs, mRNAs and so on) and play an important role in nervous system devel-opment and function as well as diseases including Alzheimer's disease and drug addiction. Furthermore, the functional effects and targeting characteristics of exosomes-shuttle-RNAs suggest that exosomes-shuttle-RNAs can be diagnostic and therapeutic targets. In this review, we elaborate the effects, functions and mechanisms of exosomes-shuttle-RNAs in order to gain a new recognition of CNS development and diseases.

Objective To analysis the clinical efficacy of alteplase com-bined with butylphthalide sodium chloride injection on patients with acute cerebral infarction and its effect on the expression of serum stress factors. Methods A total of 142 patients with acute cerebral infarction were ran-domly divided into treatment group and control group, with 71 cases each.Patients in two groups were all treated with butylphthalide sodium chloride injection100 mL each time, twice a day, with over 6 h interval, injection time was 50-70 min.Alteplase was added in treatment group on the basis of control group, 5 mg alteplase was dissolved in 10 mL 0.9%NaCl for intravenous injection within 10 seconds.The remaining 45 mg was dissolved 0.9% NaCl in 100 mL for intravenous injection within 60 min, the injections were proceeded once a day.The course was 2 weeks of the two groups.The clinical efficacy and the changes of neu-rological function and expression of stress factor of the 2 groups were compared.Results The total effective rate in treatment group was 95.8%, and 83.1% in control group ( P<0.05 ) .Cerebral infarction volume and US National institutes of health stroke scale ( NHISS ) significantly reduced at 1 and 2 weeks after treatment in both groups, Barthel index ( BI) significantly increased ( P<0.05).The improvement in the treatment group was more obvious (P<0.05).Interleukin -6 (IL-6), IL-8, IL-10, C-reaction protein significantly decreased (P<0.05) after 1 and 2 weeks treatment in both groups, treat-ment group obviously decreased( P<0.05).Conclusion Alteplase combined with butylphthalide sodium chloride in-jection could reduce the expression of serum stress factor in patients with acute cerebral infarction, and could control the volume of cerebral infarction and improve the neural function.

Objective To detect the expression of microRNA (miR)-181 a-5 p in serum exosomes of methamphetamine-dependent rats and healthy rats,and to predict target gene of miR-181a-5p and related bioinformatics analysis.Methods The conditioned place preference (CPP) model was established by methamphetamine:male SD rats were randomly divided into two groups(ten rats in each group):normal group (0.9％ NaCl),and experimental group (methamphetamine 2 mg· kg-1).The experimental group was subcutaneously injected methamphetamine at 8 am,injected saline at 4 pm for four days.The normal group was injected subcutaneously with equal volume of normal saline.In the morning,after the experimental group(normal group)were injected subcutaneously with methamphetamine(saline),they were immediately put in the white side for one hour.In the afternoon,after rats were injected subcutaneously with saline,they were immediately put in the black side for one hour.This training was carried out continuously for 4 days.After 1 day of the last subcutaneous injection of methamphetamine (saline),the conditioned place preference was measured.The residence time and movement distance in the white side were recorded within 15 main.The expression of miR-181a-5p in rats' serum exosomes was detected by RT-qPCR technique.The miR-181a-5p target gene was predicted by Target Scan,miRanda and miRBD.The target gene was analyzed by Gene Ontology (GO) analysis and Kyoto Encyclopedia of Genomes and Genes pathways (KEGG pathways)with DAVID DataBase.The target gene protein was carried out interactive analysis by STRING online analysis software.Results After CPP training,the residence time (s)and the moving distance (cm)of normal group in the white side were 202.67 ± 28.24 and 3349.26 ± 412.28 respectively;the experimental group were 460.47 ± 66.71 and 4475.97 ± 585.74 respectively.Compared with the normal group,the residence time and the moving distance of the experimental group were significandy increased in the white side(P ＜ 0.01).The expression of miR-181a-5p in serum exosomes in the normal group and the experimental group was 3.39 ± 1.79,10.23 ± 4.32 respectively.Compared with the normal group,the expression of miR-181a-5p in the experimental group had increased significantly(P ＜0.01).The 108 miR-181a-5p target genes were predicted to be rich in biological processes such as neuronal generation and differentiation,gene expression regulation and glutamate transport,and involved in the pathogenesis of protein processing in endoplasmic reticulum.MiR-181a-5p target gene encodes a complex interaction between proteins,including RAD23B,ATXN3,PRKCD,MAP2K1,NCBP1,GABRA1 and so on.They played a core position in the protein-protein interaction (PPI)network.Conclusion miR-181 a-5p may regulate the downstream target protein and participate in the development of methamphetamine addiction by regulating gene expression,glutamate transport and participate in the pathway of protein processing in endoplasmic reticulum.

Background: and Purpose Symptomatic intracranial hemorrhage (sICH) following endovascular thrombectomy (EVT) is a severe complication associated with adverse functional outcomes and increased mortality rates. Currently, a reliable predictive model for sICH risk after EVT is lacking. Methods: This study used data from patients aged ≥20 years who underwent EVT for anterior circulation stroke from the nationwide Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke (TREAT-AIS). A predictive model including factors associated with an increased risk of sICH after EVT was developed to differentiate between patients with and without sICH. This model was compared existing predictive models using nationwide registry data to evaluate its relative performance. Results: Of the 2,507 identified patients, 158 developed sICH after EVT. Factors such as diastolic blood pressure, Alberta Stroke Program Early CT Score, platelet count, glucose level, collateral score, and successful reperfusion were associated with the risk of sICH after EVT. The TREAT-AIS score demonstrated acceptable predictive accuracy (area under the curve [AUC]=0.694), with higher scores being associated with an increased risk of sICH (odds ratio=2.01 per score increase, 95% confidence interval=1.64–2.45, P<0.001). The discriminatory capacity of the score was similar in patients with symptom onset beyond 6 hours (AUC=0.705). Compared to existing models, the TREAT-AIS score consistently exhibited superior predictive accuracy, although this difference was marginal. Conclusions The TREAT-AIS score outperformed existing models, and demonstrated an acceptable discriminatory capacity for distinguishing patients according to sICH risk levels. However, the differences between models were only marginal. Further research incorporating periprocedural and postprocedural factors is required to improve the predictive accuracy.

Background: and Purpose Symptomatic intracranial hemorrhage (sICH) following endovascular thrombectomy (EVT) is a severe complication associated with adverse functional outcomes and increased mortality rates. Currently, a reliable predictive model for sICH risk after EVT is lacking. Methods: This study used data from patients aged ≥20 years who underwent EVT for anterior circulation stroke from the nationwide Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke (TREAT-AIS). A predictive model including factors associated with an increased risk of sICH after EVT was developed to differentiate between patients with and without sICH. This model was compared existing predictive models using nationwide registry data to evaluate its relative performance. Results: Of the 2,507 identified patients, 158 developed sICH after EVT. Factors such as diastolic blood pressure, Alberta Stroke Program Early CT Score, platelet count, glucose level, collateral score, and successful reperfusion were associated with the risk of sICH after EVT. The TREAT-AIS score demonstrated acceptable predictive accuracy (area under the curve [AUC]=0.694), with higher scores being associated with an increased risk of sICH (odds ratio=2.01 per score increase, 95% confidence interval=1.64–2.45, P<0.001). The discriminatory capacity of the score was similar in patients with symptom onset beyond 6 hours (AUC=0.705). Compared to existing models, the TREAT-AIS score consistently exhibited superior predictive accuracy, although this difference was marginal. Conclusions The TREAT-AIS score outperformed existing models, and demonstrated an acceptable discriminatory capacity for distinguishing patients according to sICH risk levels. However, the differences between models were only marginal. Further research incorporating periprocedural and postprocedural factors is required to improve the predictive accuracy.

Background: and Purpose Symptomatic intracranial hemorrhage (sICH) following endovascular thrombectomy (EVT) is a severe complication associated with adverse functional outcomes and increased mortality rates. Currently, a reliable predictive model for sICH risk after EVT is lacking. Methods: This study used data from patients aged ≥20 years who underwent EVT for anterior circulation stroke from the nationwide Taiwan Registry of Endovascular Thrombectomy for Acute Ischemic Stroke (TREAT-AIS). A predictive model including factors associated with an increased risk of sICH after EVT was developed to differentiate between patients with and without sICH. This model was compared existing predictive models using nationwide registry data to evaluate its relative performance. Results: Of the 2,507 identified patients, 158 developed sICH after EVT. Factors such as diastolic blood pressure, Alberta Stroke Program Early CT Score, platelet count, glucose level, collateral score, and successful reperfusion were associated with the risk of sICH after EVT. The TREAT-AIS score demonstrated acceptable predictive accuracy (area under the curve [AUC]=0.694), with higher scores being associated with an increased risk of sICH (odds ratio=2.01 per score increase, 95% confidence interval=1.64–2.45, P<0.001). The discriminatory capacity of the score was similar in patients with symptom onset beyond 6 hours (AUC=0.705). Compared to existing models, the TREAT-AIS score consistently exhibited superior predictive accuracy, although this difference was marginal. Conclusions The TREAT-AIS score outperformed existing models, and demonstrated an acceptable discriminatory capacity for distinguishing patients according to sICH risk levels. However, the differences between models were only marginal. Further research incorporating periprocedural and postprocedural factors is required to improve the predictive accuracy.