AIM: To investigate the association between dyslipidemia and macular hard exudates(HEs)in non-proliferative diabetic retinopathy(NPDR)secondary to type 2 diabetes mellitus(T2DM).METHODS: NPDR patients attending the outpatient ophthalmology clinic from January 2021 to December 2023 were selected and divided into three groups according to the severity of macular HEs. Group A: None or minimal HEs; Group B: Definite HEs; Group C: Prominent HEs. Total cholesterol(TC), triglycerides(TG), low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C), lipoprotein(a)[Lp(a)] levels and other lipid-related indicators were routinely measured. The correlation between these indicators and HEs was analyzed.RESULTS:Group A(24 eyes)consisted of 9 males and 15 females with the mean age of 54.71±6.15 y, group B(52 eyes)consisted of 20 males and 32 females with the mean age of 55.08±6.27 y, group C(14 eyes)consisted of 9 males and 5 females with the mean age of 53.93±6.08 y. The concentration of TC, TG, LDL-C and Lp(a)was highest in group C, followed by group B and lowest in group A with statistically significant differences(P<0.001). There were no statistically significant differences between the three groups for fasting plasma glucose(FPG), glycated hemoglobin A1c(HbA1c), creatinine(Cr), and HDL-C(P>0.05). The results of multivariate Logistic regression analysis showed that elevated levels of TC, TG, LDL-C, and Lp(a)were associated with the presence of macular HEs. Receiver operating characteristiccurve analysis showed that the area under the curve(AUC)for TC, TG, LDL-C, Lp(a), and their combination in predicting macular HEs in NPDR were 0.785, 0.718, 0.784, 0.742, and 0.911, respectively, with the combined model demonstrating the highest predictive performance.CONCLUSION: Dyslipidemia is closely associated with the development and progression of macular HEs in patients with NPDR and T2DM. The levels of TC, TG, LDL-C, and Lp(a)were correlated with the severity of macular HEs, suggesting that dyslipidemia may be involved in the pathological process of macular HEs formation.

Objective To explore the effects of robot assisted training (RAT) combined with neural mobi-lization (NM) training on the recovery of upper limb functions in stroke patients. Methods A total of 110 stroke patients who met the inclusion criteria were selected as the subjects and randomly divided into a control group (n=28),RAT group (n=27),NM group (n=28),and combination group (n=27). All patients underwent routine upper limb occupational therapy. Additionally,the patients in the RAT group were treated with upper limb rehabilitation robots,those in the NM group underwent neural mobilization for treatment,those in the combination group were managed with robot-assisted training for upper limb rehabilitation and neural mobilization. Before treat-ment and 4 weeks after treatment,the modified Ashworth scale (MAS),Fugl-Meyer assessment upper extremity (FMA-UE),functional test for the hemiplegic upper extremity Hong Kong version (FTHUE-HK),and modified Barthel index (MBI) were used to assess the effects. The surface electromyographic signals of the biceps and triceps at the maximum isometric voluntary contraction (MIVC) position during elbow flexion and extension were measured,the integrated electromyographic values (iEMG) were recorded and the synergistic contraction rate (CR) was calculated. Results There was no statistically significant difference (P>0.05) between the four groups in the general information and pre-treatment assessments of MAS,FMA-UE,FTHUE-HK,MBI,iEMG,and CR. After 4 weeks,significant improvements were observed in all indicators compared to the pre-treatment assessments (P<0.05),with the exception of the triceps brachii CR,biceps brachii CR,and elbow extension MIVC biceps brachii iEMG in the control group.Among the group comparisons,all indicators showed statistically significant differences in mean or distribution (P<0.05),except for MAS and triceps brachii CR. The RAT group,NM group,and combination group all demonstrated significant improvements compared to the control group (P<0.05). Nota-bly,the combination group exhibited a greater degree of improvement than the RAT and NM groups. Conclusion RATcombined with NM can reduce upper limb muscle tone in stroke patients. This approacheffectively promotes the establishment of normal movement patterns,improve upper limb motor function,and enhance activities of daily living. This combination is effective and worthy of further clinical promotion and application.

Objective To explore the effects of robot assisted training (RAT) combined with neural mobi-lization (NM) training on the recovery of upper limb functions in stroke patients. Methods A total of 110 stroke patients who met the inclusion criteria were selected as the subjects and randomly divided into a control group (n=28),RAT group (n=27),NM group (n=28),and combination group (n=27). All patients underwent routine upper limb occupational therapy. Additionally,the patients in the RAT group were treated with upper limb rehabilitation robots,those in the NM group underwent neural mobilization for treatment,those in the combination group were managed with robot-assisted training for upper limb rehabilitation and neural mobilization. Before treat-ment and 4 weeks after treatment,the modified Ashworth scale (MAS),Fugl-Meyer assessment upper extremity (FMA-UE),functional test for the hemiplegic upper extremity Hong Kong version (FTHUE-HK),and modified Barthel index (MBI) were used to assess the effects. The surface electromyographic signals of the biceps and triceps at the maximum isometric voluntary contraction (MIVC) position during elbow flexion and extension were measured,the integrated electromyographic values (iEMG) were recorded and the synergistic contraction rate (CR) was calculated. Results There was no statistically significant difference (P>0.05) between the four groups in the general information and pre-treatment assessments of MAS,FMA-UE,FTHUE-HK,MBI,iEMG,and CR. After 4 weeks,significant improvements were observed in all indicators compared to the pre-treatment assessments (P<0.05),with the exception of the triceps brachii CR,biceps brachii CR,and elbow extension MIVC biceps brachii iEMG in the control group.Among the group comparisons,all indicators showed statistically significant differences in mean or distribution (P<0.05),except for MAS and triceps brachii CR. The RAT group,NM group,and combination group all demonstrated significant improvements compared to the control group (P<0.05). Nota-bly,the combination group exhibited a greater degree of improvement than the RAT and NM groups. Conclusion RATcombined with NM can reduce upper limb muscle tone in stroke patients. This approacheffectively promotes the establishment of normal movement patterns,improve upper limb motor function,and enhance activities of daily living. This combination is effective and worthy of further clinical promotion and application.

Humans ; Synovial Fluid ; MicroRNAs/genetics* ; Exosomes/genetics* ; Osteoarthritis/genetics* ; Synovial Membrane

Speech expression is an important high-level cognitive behavior of human beings. The realization of this behavior is closely related to human brain activity. Both true speech expression and speech imagination can activate part of the same brain area. Therefore, speech imagery becomes a new paradigm of brain-computer interaction. Brain-computer interface (BCI) based on speech imagery has the advantages of spontaneous generation, no training, and friendliness to subjects, so it has attracted the attention of many scholars. However, this interactive technology is not mature in the design of experimental paradigms and the choice of imagination materials, and there are many issues that need to be discussed urgently. Therefore, in response to these problems, this article first expounds the neural mechanism of speech imagery. Then, by reviewing the previous BCI research of speech imagery, the mainstream methods and core technologies of experimental paradigm, imagination materials, data processing and so on are systematically analyzed. Finally, the key problems and main challenges that restrict the development of this type of BCI are discussed. And the future development and application perspective of the speech imaginary BCI system are prospected.
Brain ; Computers ; Humans ; Imagery, Psychotherapy ; Speech ; Technology

Objective:To investigate the role of microchromosome maintenance protein 5 (MCM5) in promoting malignant progression and its mechanism in glioblastoma.Methods:(1) Three freshly excised brain tissues from non-tumor patients and 3 grading IV glioblastoma tissues were collected in our hospital from September 2020 to September 2021; mass spectrometry and quantitative proteomic analysis were performed to screen differentially expressed proteins for functional enrichment analysis. (2) The target protein MCM5, which was highly expressed in glioblastoma, was screened on the basis of proteomics, and its expression in glioblastoma was verified using The Cancer Genome Atlas (TCGA) database and further validated at the mRNA level in the collected clinical specimens. (3) U251 cells were divided into negative control group, knockdown group-1 (si-1 group) and knockdown group-2 (si-2 group) by siNRA transfection. The regulation role of MCM5 in malignant phenotype of glioblastoma was detected by CCK-8 assay, clone formation assay, 5-ethynyl-2'-deoxyuridine (EdU)staining, Transwell invasion assay and flow cytometry. (4) The transcriptome data of glioma patients from TCGA database were used to explore the possible molecular mechanisms of MCM5 regulation in the malignant process of glioblastoma by gene set enrichment analysis (GSEA) algorithm.Results:(1) In clinical samples of glioblastoma, 322 up-regulated proteins and 94 down-regulated proteins were screened out; MCM5 was highly expressed in these 3 glioblastoma samples. (2) Based on TCGA database, results of 163 patients with glioblastoma and 207 patients with non-tumor brain tissues showed that MCM5 expression was statistically up-regulated in glioblastoma ( t=3.340, P<0.001). Real-time quantitative PCR results of 3 glioblastoma tissues and 3 non-tumor brain tissues clinically collected in our hospital also indicated that significantly increased MCM5 expression in glioblastoma was noted as compared with that in the non-tumor brain tissues ( t=3.876, P<0.001). (3) As compared with the negative control group, the si-1 and si-2 groups had significantly decreased MCM5 mRNA and protein expressions, significantly lower proliferation rate 5 d after inoculation, statistically decreased number of cell clones, significantly decreased proportion of EdU positive cells, and significantly increased proportion of cells at G1 phase, and significantly impaired migration ability ( P<0.05). (4) GSEA analysis showed that mRNA in MCM5 high expression group was enriched in DNA damage repair gene, E2F target gene, MYC target gene, epithelial-mesenchymal transformation (EMT), nterleukin 6-Janus kinase-signal transduction and transcription activation factor 3 (IL6-JAK-STAT3), interferon, KRAS, NOTCH, transforming growth factor-β (TGF-β), Wnt/β-Catenin and other characteristic genes. Conclusion:MCM5 is highly expressed in glioblastoma, and MCM5 regulates the malignant progression of glioblastoma through multiple mechanisms including E2F, MYC, EMT, and Wnt/β-Catenin.

Objective:To observe the safety and efficacy of one-stage bilateral temporal lobe lesions resection in patients with severe bilateral radiation-induced temporal lobe injury after radiotherapy for nasopharyngeal carcinoma.Methods:Clinical data of 12 patients with severe bilateral radiation-induced temporal lobe injury after radiotherapy for nasopharyngeal carcinoma underwent one-stage bilateral temporal lobe lesions resection in our hospital from January 2013 to December 2017 were retrospectively analyzed. Karnofsky Performance Scale (KPS) scores were used as predictors of surgical outcomes before and two weeks after surgery. Imaging changes of radiation-induced brain injury lesions after surgery before and 3 months after surgery, surgical-related complications, and death were observed.Results:All 12 patients (100%) had improved postoperative KPS scores, which showed significant difference as compared with the preoperative KPS scores ( P<0.05). Two patients had pulmonary infection after operation, one patient had poor wound healing, and one patient had intracranial infection; all of them recovered after expectant treatment. None of the 12 patients had new neurological symptoms after surgery. During the follow-up period, the postoperative cranial MR imaging showed that the lesions were completely removed, and the leukoencephalopathy was alleviated or completely subsided. Conclusion:One-stage bilateral temporal lobe lesions resection is feasible for bilateral radiation-induced temporal lobe injury after radiotherapy for nasopharyngeal carcinoma.

Objective To investigate the value of serum high sensitive C reactive protein(hs-CRP) in the risk stratification and prognosis evaluation in the patients with coronary heart disease and PCI operation.Methods One hundred and sixty-three cases of coronary heart disease and undergoing PCI in this hospital from March 2013 to September 2015 were selected and performed the coronary angiography examination before operation.Then the patients were divided into 3 groups according to the hs-CRP level.The Gensini score was used to judge the blood vessel stenosis degree.The patients were followed up within six months after surgery.The major cardiovascular events were recorded and the relationship between the hs-CRP level with the number of diseased vessels,Gensini score,MACE and other coronary heart disease risk factors was analyzed.Results Hypertension and hs-CRP level had statistically significant difference among 3 groups(P＜0.05);preoperative hs-CRP level showed positive correlation with hs-cTnT level (r =0.44,P＜ 0.001),while the hs-CRP was negatively correlated with the HDL-C level (r =-0.18,P =0.003);with the Gemini score elevation,the hs-CRP level was similarly elevated,the hs-CRP levels in the patients with severe,moderate and mild vascular stenosis evaluated by Gensini's score were(17.11±9.58),(10.02±3.59),(4.11±1.62)mg/L respectively,the difference among them had statistical significance(F=37.21,P＜0.05).Within postoperative six months,the MACE occurrence rates in 3 groups were 32.1％,52.9 ％ and 59.2 ％ respectively,the differences among the three groups were statistically significant(x2 =13.523,P =0.001),and the target lesion blood supply reconstruction rate had statistically significant difference(x2 =7.522,P =0.022).The hsCRP level was an independent risk factor of MACE occurrence(OR =2.06,95 ％ CI:1.31-3.42,P=0.005).Conclusion Serum hs-CRP is an independent risk factor for cardiovascular events occurrence after PCI surgery in the patients with coronary heart disease.

Objective To investigate the effect of micro RNA (miR)-125a-3p on proliferation and apoptosis of glioma cells and its role in MAPK signaling pathway. Methods (1) The miR-microarray data from the Cancer Genome Atlas (TCGA, https:// cancergenome.nih.gov/) database were downloaded, and the miR-125a-3p expressions in 565 gliomas tissues and 10 normal brain tissues were compared. (2) Clinical collection of 30 glioma specimens surgically resected in our hospital from April 2015 to April 2018, was performed, including 7 of low-grade glioma and 23 of high-grade glioma;8 normal brain tissues needed craniocerebral trauma excision were collected at the same time period;reverse transcription (RT)-real-time quantitative (q) PCR was used to detect the miR-125a-3p expressions in glioma tissues and normal brain tissues. (3) The normal brain glial cells HA1800 and glioma cells (U251, U138, U87, U373, and T98G) were routinely cultured in vitro; RT-qPCR was used to detect the miR-125a-3p expression in normal brain glial cells and glioma cell lines. (4) The cultured glioma cell lines U251 and U373 at logarithmic phase were divided into miR-125a-3p group and negative control group;and miR-125a-3p mimic or nonsense sequence were transfected using LipofectamineTM 2000;72 h after transfection, the miR-125a-3p expression was detected by RT-qPCR; the proliferation rate was detected by clone formation after transfection; the apoptosis rate was detected by flow cytometry 72 h after transfection; the cleaved-caspase-3, cleaved-caspase-9, cleaved-caspase-7, P38 and P-P38/MAPK protein expressions were detected by Western blotting. Results (1) In TCGA database, the miR-125a-3p expression in glioma brain tissues was statistically lower as compared with that in normal brain tissues (P<0.05). (2) The miR-125a-3p expressions in clinically collected normal brain tissues, low-grade glioma specimens and high-grade glioma specimens were decreased successively, enjoying statistically significant differences (P<0.05). (3) As compared with normal glial cells, the miR-125a-3p expressions in glioma cell lines were significantly lower (P<0.05), of which, U251 and U373 enjoyed the most obvious decrement. (4) As compared with the blank control group, the miR-125a-3p group had significantly increased miR-125a-3p expression, significantly decreased colony forming efficiency, significantly increased proliferation rate, significantly increased expressions of apoptosis-related proteins cleaved-caspase-3, cleaved-caspase-9, and cleaved-caspase-7, and statistically increased phosphorylated-P38/MAPK expressions (P<0.05). Conclusion The miR-125a-3p expression is low in glioma tissues and cells; miR-125a-3p over-expression can inhibit the proliferation of glioma cells and promote apoptosis through MAPK signaling pathway, which may provide a new potential target for treatment of glioma.

Objective To investigate the expression and biological value of heme oxygenase I (HO-1) in gliomas. Methods Fifty-six patients with gliomas, admitted to and accepted surgery in our hospital from January 2010 to January 2015, were chosen in our study; WHO grade I was noted in 4 patients, grade Ⅱ in 16, grade Ⅲ in 10, and grade IV in 26 patients; patients with grade I and Ⅱ were as low-grade glioma group and patients with grade Ⅲ and IV were as high-grade glioma group. The HO-1 expression in the two groups was detected by immunohistochemistry. R-langrage survival tool was used to analyze the relation between HO-1 expression and prognosis of 1107 patients with gliomas selected from The Cancer Genome Atlas (TCGA) database. Results Significant differences of HO-1 expression were observed in different grades of gliomas (P<0.05), and HO-1 high-expression rate in the high-grade gliomas (75%) was significantly higher than that in the low-grade group (30%, P<0.05). HO-1 protein expression level in the high-grade gliomas was significantly higher than that in the low-grade group (P<0.05). Moreover, area under the curve (AUC) of the receiver operating characteristic curve was suggested that the HO-1 could be an ideal determine factor (AUC=0.747, P=0.002). Log rank analysis indicated that the accumulate survival rate in patients with low HO-1 expression was significantly higher than that in patients with high HO-1 expression (P<0.05). TCGA database analysis showed that simultaneous survival rate in patients with low HO-1 expression was significantly higher than that in patients with high HO-1 expression (P<0.05). Conclusion Expression of HO-1 is correlated with the malignant degrees and prognoses of gliomas, and it has potential to be a novel biological marker for the diagnosis and treatment of gliomas; furthermore, HO-1 could also be a target for the study and treatment of gliomas.