OBJECTIVE:To systematically evaluate the efficacy of transcranial direct current stimulation on the motor function of patients with Parkinson's disease,and to compare the efficacy of transcranial direct current stimulation at different targets on the motor function of patients with Parkinson's disease,so as to provide a theoretical basis for the target selection of transcranial direct current stimulation in clinical practice. METHODS:Cochrane Library,PubMed,Web of Science,CNKI,VIP,WanFang Data were retrieved for randomized controlled trials on the improvement of motor function in patients with Parkinson's disease by transcranial direct current stimulation published from the database inception to January 2023.The keywords were"Parkinson,transcranial direct current stimulation"in English and Chinese.The quality of the included studies was evaluated using the Cochrane 5.1.0 risk of bias assessment tool and the PEDro scale.Meta-analysis of outcome indicators was performed using RevMan 5.4 and Stata 17.0 software. RESULTS:Fifteen randomized controlled trials were finally included,and the PEDro scale showed that all were high-quality or very high-quality studies.Meta-analysis showed that transcranial direct current stimulation significantly improved Unified-Parkinson Disease Rating Scale part III score[mean difference(MD)=-2.49,95%confidence interval(CI):-4.42 to-0.55,P<0.05),step frequency score(MD=0.07,95%CI:0.03-0.11,P<0.05)and step speed score(MD=0.02,95%CI:0.00-0.05,P<0.05),but not for Berg Balance Scale scores(MD=2.57,95%CI:-0.74 to 5.87,P>0.05).Network Meta-analysis probability ranking:In terms of Unified-Parkinson Disease Rating Scale part III scores,the probability ranking results of target stimulation efficacy were dorsal lateral prefrontal cortex(52.4%)>primary motor cortex(45.8%)>central point of the brain(1.8%)>conventional rehabilitation(0%);in terms of gait frequency scores,the probability probability ranking results of target stimulation efficacy were cerebellum(50.1%)>central point of the brain(45.8%)>dorsal lateral prefrontal cortex(3.9%)>primary motor cortex(0.2%)>conventional rehabilitation(0%);in terms of gait speed scores,the probability ranking results of target stimulation efficacy were cerebellum(64.8%)>dorsal lateral prefrontal cortex(23.8%)>central point of the brain(9.4%)>primary motor cortex(1.7%)>conventional rehabilitation(0.4%);in terms of Berg Balance Scale scores,the probability ranking results of target stimulation efficacy were cerebellum(77.4%)>dorsal lateral prefrontal cortex(20.7%)>central point of the brain(0.7%)>conventional rehabilitation(0.2%). CONCLUSION:Transcranial direct current stimulation significantly improves motor function of patients with Parkinson's disease,with better motor coordination in the dorsolateral prefrontal cortex and better walking and balance in the cerebellum.

Objective:To assess the left ventricular myocardial function in non-ST-segment-elevation acute coronary syndrome (NSTE-ACS) patients with normal wall motion and left ventricular ejection fraction (LVEF) after percutaneous coronary intervention(PCI) by noninvasive myocardial work technology, and to explore the evolution of left ventricular myocardial function recovery.Methods:A total of 92 NSTE-ACS patients from July to December 2019 in Beijing Chao Yang Hospital with normal wall motion and LVEF (>55%) after PCI were recruited. Echocardiography was performed 1 day before PCI, 1 day, 2 weeks, 1 month, and 3 months after PCI. Global longitudinal strain (GLS) was analyzed, and Brachial cuff systolic pressure was used as left ventricular pressure to construct a non-invasive left ventricular pressure-strain loop. Global myocardial work index (GWI), global constructive work (GCW), global waste work (GWW), global myocardial work efficiency (GWE) among groups were compared and their correlations with strain parameters were explored.Results:GWI, GCW, GWE were improved ( P<0.05) at 1 day after PCI, GLS improved ( P<0.05) and GWW decreased ( P<0.05) at 2 weeks, LVEF improved ( P<0.05) at 1 month. Baseline GWI and GCW had a moderately negative correlation with GLS ( r=-0.67, -0.66; both P<0.05); GWW had a moderately positive correlation with mechanical dispersion(MD) and postsystolic shortening index(PSI) ( rs=0.45, 0.50; both P<0.05); GWE had a moderately negative correlation with GLS, MD and PSI ( rs=-0.47, -0.55, -0.56; all P<0.05). Conclusions:Left ventricular myocardial function gradually improves in NSTE-ACS patients with normal wall motion and LVEF after PCI. Myocardial work parameters changes are more sensitive than GLS and LVEF, and can assess early left ventricular myocardial function changes after PCI.

Objective:The investigation and research on the application status of Hepatic Venous Pressure Gradient (HVPG) is very important to understand the real situation and future development of this technology in China.Methods:This study comprehensively investigated the basic situation of HVPG technology in China, including hospital distribution, hospital level, annual number of cases, catheters used, average cost, indications and existing problems.Results:According to the survey, there were 70 hospitals in China carrying out HVPG technology in 2021, distributed in 28 provinces (autonomous regions and municipalities directly under the central Government). A total of 4 398 cases of HVPG were performed in all the surveyed hospitals in 2021, of which 2 291 cases (52.1%) were tested by HVPG alone. The average cost of HVPG detection was (5 617.2±2 079.4) yuan. 96.3% of the teams completed HVPG detection with balloon method, and most of the teams used thrombectomy balloon catheter (80.3%).Conclusion:Through this investigation, the status of domestic clinical application of HVPG has been clarified, and it has been confirmed that many domestic medical institutions have mastered this technology, but it still needs to continue to promote and popularize HVPG technology in the future.

Objective:To evaluate the global and segmental myocardial work in patients with cardiac amyloidosis (CA) by left ventricular pressure-strain loop (PSL) noninvasively.Methods:Eighteen patients with CA in Beijing Chao-Yang Hospital from March 2018 to December 2020 were included as CA group, 20 healthy subjects were selected as control group. The global longitudinal strain (GLS) and mechanical dispersion (MD) of left ventricle were analyzed by two-dimensional speckle tracking imaging. The left ventricular PSL was used to assess global work index (GWI), global constructive work (GCW), global waste work (GWW), and global work efficiency (GWE). The mean value of left ventricular basal, mid and apical myocardial work index (MWI), constructive work (CW), waste work (WW) and work efficiency (WE) were calculated and compared between the two groups.Results:①Compared with the control group, GLS was decreased and MD was increased in CA group (all P<0.05). ②GWI, GCW, GWW and GWE were decreased in CA group compared with the control group (all P<0.05). ③In CA group, the MWI, CW and WE of the basal, mid and apical segments were lower than those of control group (all P<0.05), WW of the basal and mid segments were lower than those of apical segment(all P<0.05). The impairment of MWI, WW and WE in basal and mid segment were more significant than those of apical segment (all P<0.05). ④GWI, GCW and GWE were positively correlated with GLS ( r=0.854, 0.816, 0.748; all P<0.001) and LVEF ( r=0.674, 0.634, 0.650; all P<0.01), and negatively correlated with MD ( r=-0.657, -0.672, -0.710, all P<0.01). GWI and GCW were negatively correlated with E/e′ ( r=-0.493, -0.539; all P<0.05). Conclusions:The global, basal, mid and apical left ventricular myocardial work indices are decreased in CA patients. MWI, CW and WE show an apical sparing pattern. Quantitative assessment of myocardial work by PSL may provide more valuable information for CA patients.

Objective:To assess global myocardial work in non-ST-segment-elevation acute coronary syndrome (NSTE-ACS) patients with no obvious regional wall motion abnormalities and preserved left ventricular ejection fraction (LVEF) by noninvasive left ventricular (LV) pressure-strain loops, and to explore its diagnostic value in patients with NSTE-ACS.Methods:A total of 169 NSTE-ACS patients with normal wall motion abnormalities and LVEF (>55%) were recruited in Beijing Chao Yang Hospital, Capital Medical University from June to December 2019. The patients were divided into two groups according to the degree of coronary stenosis, including severe coronary artery stenosis group ( n=121), and no severe stenosis group ( n=48). The patients of severe coronary artery stenosis group were further subdivided into single-vessel severe stenosis group ( n=52) and multi-vessel severe stenosis group ( n=69). Global longitudinal strain (GLS) analysis was performed by speckle tracking echocardiography before coronary angiography. Brachial cuff systolic pressure was used as left ventricular pressure to construct a non-invasive left ventricular pressure-strain loop. Global myocardial work index (GWI), global constructive work (GCW), global waste work (GWW) and global myocardial work efficiency (GWE) was computed by LV pressure-strain loops with a proprietary algorithm between groups. ROC curve analysis was used to determine the optimal cutoff value of the parameters to detect severe coronary artery stenosis. Independent factors affecting left ventricular myocardial function were assessed by Logistic regression analysis. Results:GLS, GWI, GCW and GWE were significantly reduced, and GWW was increased in severe coronary artery stenosis group than in no severe stenosis group(all P<0.05). GLS was significantly reduced in multi-vessel severe stenosis group ( P<0.05) but not in single-vessel severe stenosis group ( P=0.32). GWE was an independent factor affecting myocardial function in severe coronary artery stenosis group, GWE<96% had a area under the curve (AUC)=0.83 (74% for sensitivity, 81% for specificity) to identify severe coronary artery stenosis, and was superior to GLS (AUC=0.66, P<0.05) and GWI (AUC=0.70, P<0.05). Conclusions:In NSTE-ACS patients with severe coronary artery stenosis, no obvious regional wall motion abnormalities and preserved LVEF, LV global myocardial function is impaired based on noninvasive pressure-strain loops, GWI, GCW, and GWE are reduced, and GWW is increased, and GWE is a more sensitive index than GLS and GWI to predict severe coronary artery stenosis in NSTE-ACS patients.

BACKGROUND:Foreign studies have found that the magnesium alloy stent is safe and effective, but there are few studies on the degradation performance of magnesium alloy stents in China.OBJECTIVE:To investigate the degradation of degradable AZ31 magnesium alloy stent in the rabbit abdominal aorta and the effect of degradation process on vascularization.METHODS:Twenty-eight rabbits were enrolled, and the degradable AZ31 magnesium alloy stent was implanted into the rabbit abdominal aorta. Postoperative abdominal aortic X-ray examination and histological observation were done at 30, 60, 90, 120 days after implantation.RESULTS AND CONCLUSION:(1) X-ray examination: 30 days after implantation, the stent expanded completely with structural integrity; 60 days after implantation, the stent deformation, partial stent fracture, and lose of support were found; 90 days after implantation, only a small amount of support rod residues were found, and the majority of the stent was degraded; and 120 days after implantation, there was no support rod residual, and the stent was degraded completely. (2) Histological observation: 60 days after implantation, the number of residual support rods was less than that 30 days after implantation (P< 0.05), the number value at 90 days after implantation was lower than that at 30 and 60 days after implantation (P< 0.05), and the number value at 120 days after implantation was lower than that at 30, 60, 90 days after implantation (P < 0.05), indicating that the number of residual support rods was negatively correlated with post-implantation days. The time for complete stent degradation was 124.8 days. The intimal area at 90 days after implantation was higher than that at 30, 60, 120 days after implantation (P < 0.05), while the lumen area was smaler than that at 30, 60, 120 days after implantation (P < 0.05). There was no significant difference in the intimal area and lumen area at latter three time points after implantation. To conclude, the degradation of the degradable AZ31 magnesium alloy stent in the rabbit abdominal aorta can be completed within 124.8 days, and at 90 days after the stent is implanted, vascular intimal hyperplasia and lumen stenosis are most serious, and then gradualy reduced.

AIM:Toinvestigatetheeffectofrhynchophylline(Rhy)onbloodpressure,cardiachypertrophy and myocardial fibrosis in spontaneously hypertensive rats ( SHR) .METHODS:Spontaneously hypertensive rats were ran-domly divided into model group , high dose (10 mg? kg-1? d-1 ) and low dose (2.5 mg? kg-1? d-1 ) group of rhyncho-phylline, captopril group (17.5 mg? kg -1? d-1).Wistar-Kyoto rats were used as normal control.Respectively, systolic blood pressure was measured by tail cuff every 2 weeks.After 10 weeks, heart weight index and left ventricular weight in-dex were calculated .The myocardial hydroxyproline and plasma angiotensin Ⅱwere detected .Moreover , basic myocardial histopathological changes and myocardial collagen fibres were observed by HE staining and Masson staining , respectively . The protein expression of TGF-β1 and Smad3 in the myocardium was measured by the methods of immunohistochemistry and Western blot .RESULTS:Compared with SHR model group , Rhy significantly reduced blood pressure ( P<0.05 ) , the levels of HYP in the myocardium (P<0.05) and the levels of AngⅡin the plasma (P<0.01).The pathological dama-ges of the myocardial tissues and collagen deposition were attenuated .The protein expression of TGF-β1 and Smad3 was sig-nificantly reduced by the treatment with Rhy (P<0.01).CONCLUSION:Rhynchophylline reduces blood pressure and adjusts to improve ventricular remodeling of SHR .The mechanism may be involved in the TGF-β1/Smad pathway and re-ducing AngⅡcontent.

Objective: To explore the clinical response on cardiac resynchronization therapy (CRT) in patients of chronic heart failure (CHF) with different QRS wave morphology. Methods: A total of 52 CHF patients received CRT in our hospital and the Seventh People's Hospital of Zhengzhou City from 2010-03 to 2013-07 were retrospectively studied. The patients were divided into 3 groups: True-complete left bundle branch block (t-CLBBB) group,n=20, Classic LBBB (CLBBB) group,n=15 and IVCD group,n=17. The general clinical condition, the indexes of echocardiography at 6 months of follow-up study including left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), NYHA classiifcation and 6-MWT were examined and compared among different groups. Results: In general clinical condition, the ratio of non-ischemic heart disease patients in t-CLBBB group was higher than those in CLBBB group and IVCD group, allP<0.05. By 6 months follow-up study, LVEDD in t-CLBBB group (62.6 ± 8.9) mm was lower than those in CLBBB group (70.0 ± 8.9) mm and IVCD group (72.8 ± 8.0) mm, LVEF was higher in t-CLBBB group (38.5 ± 6.2) % than those in CLBBB group (31.7 ± 6.7) % and IVCD group (30.1 ± 6.7) %. NYHA classiifcation in t-CLBBB group (2.00 ± 0.45) grade was lower than those in CLBBB group (2.73 ± 0.80) grade and IVCD group (3.12 ± 0.78) grade . 6-MWT in t-CLBBB group (302.0 ± 57.9) m was longer than those in CLBBB group (257.3 ± 59.0) m and IVCD group (220.2 ± 57.9) m, allP<0.05. Conclusion: CRT is an effective method for treating CHD patients, different QRS morphology may have different response, the patients with t-CLBBB would make better response.

BACKGROUND:Isobaric tags for relative and absolute quantitation (iTRAQ) mass spectrometry technology studys the information of relevant protein according to the ion signal shows different mass-to-charge ratio in the tandem mass spectrometry analysis. OBJECTIVE:To establish the protein spectrum of differential proteins in cerebrospinal fluid of acute spinal cord injury rat model, study the secondary injury mechanism and find an effective method of treating acute spinal cord injury from molecular level. METHODS:Acute spinal cord injury was produced in Sprague-Dawley rats and iTRAQ technology was applied to analyze the differential proteins in cerebrospinal fluid of acute spinal cord injury rat model. RESULTS AND CONCLUSION:Total 722 proteins have been identified in this study, including 107 differentialy expressed proteins, 63 downregulated proteins and 44 upregulated proteins. There were 19 proteins related to neurogenesis, including 14 up-regulation proteins and 5 down-regulation proteins. Seven proteins contributed to the regulation of neurogenesis. The differential proteins and growth factor identified in this study can be taken as the biomarkers of acute spinal cord injury or indicators of clinical monitoring of the progression, target treatment and efficacy assessment after acute spinal cord injury.

Objective: To evaluate the short-term effect of thrombus aspiration catheters combining tiroifban medication for myocardial tissue reperfusion recovery in patients with acute ST-elevation myocardial infarction (STEMI).
Methods: A total of 105 STEMI patients with percutaneous coronary intervention (PCI) in our hospital from 2011-05 to 2013-05 were studied, there were 73 male and 32 female with the mean age of (58.39 ± 10.37) years. The patients were randomly divided into 2 groups, Group A, the patients received thrombus aspiration catheters with intravenous tiroifban, n=53 and Group B, the patients received tiroifban and PCI, n=52. The basic clinical features, myocardial tissue perfusion level, major adverse cardiovascular events (MACE) at post operative and in-hospital period were recorded, the cardiac function was examined by echocardiography at 6 months after PCI in both groups.
Results: The basic clinical features were similar between 2 groups. The thrombolysis in myocardial infarction trial (TIMI) 3 lfow rate was higher in Group A than that in Group B (92.45% vs 55.77%), P=0.000. TIMI 2 and TIMI 0~1 lfow rates were lower in Group A than that in Group B (7.55%vs 26.92%), P=0.008 and (0%vs 17.31%), P=0.002. The adjusted TIMI frame was lower in Group A (27.26±5.50) vs (38.98±5.42), P<0.001. The echocardiography at 6 months after PCI indicated that Group A had higher LVEF than that in Group B (0.55±0.06) vs (0.47±0.06), P<0.001;lower left ventricular end diastolic diameter (50.77±5.45) vs (54.76±5.34), P<0.001;less angina and target vessel revascularization (16.98%vs 40.38%), P=0.008 and (9.43%vs 17.31%), P=0.008. The incidence of MI, acute heart failure, cardiac death and non-target vessel revascularization were similar between 2 groups, P>0.05.
Conclusion:Thrombus aspiration catheters combining tiroifban medication may obviously improve the myocardial tissue reperfusion and the short-term cardiac function in STEMI patients after PCI, it could reduce the incidence of no-relfow without increasing MACE.