Objective:To study the impact of third-party disability in caregivers of aphasia patients with stroke based on the concept of the International Classification of Functioning, Disability and Health (ICF), and to examine the factors influencing it.Methods:Sixty-four pairs of stroke patients with aphasia and their caregivers were recruited. The patients were assessed using a general information questionnaire and the western aphasia battery (WAB), while the caregivers were surveyed using a general information questionnaire and a family aphasia measure of life impact (FAMLI) developed based on the ICF framework. Pearson correlation analysis was performed on the WAB scores of the patients and the FAMLI scores of their caregivers, and multiple linear regression analysis was used to screen out the factors significantly influencing third-party disability among the caregivers.Results:The caregivers′ average total FAMLI score was (33.64±19.38), with significant differences reflecting the patient′s age and the course of the disease. Correlation analysis showed that the patients′ cerebral cortical quotients (CQs) and aphasia quotients were significantly and positively correlated with the FAMLI scores of their caregivers ( r-values of 0.408 and 0.395, respectively). Multiple linear regression analysis showed that a patient′s CQ score and age were significantly correlated with the FAMLI score of their caregiver (β-values of 0.326 and 0.599, respectively). Conclusion:The caregivers of stroke survivors with aphasia tend to have third-party disabilities. The patient′s age and the severity of their aphasia are important predictors of life quality for their caregivers.

Objective To investigate the effects of parecoxib sodium on pain and Toll-like receptor 4(TLR4)/p38 mitogen activated protein kinase(p38MAPK)pathway in rats with femoral fracture.Methods Sixty rats were randomly separated into sham operation group,model group,TLR4 inhibitor(TAK-242)group(3 mg/kg),parecoxib sodium group(10 mg/kg),and parecoxib sodium+TLR4 activator lipopolysaccharide group(10 mg/kg parecoxib sodium+15 mg/kg LPS),with 12 rats in each group.Except for the sham operation group,rats in all other groups were used to establish a femoral fracture model by transverse cutting of the mid femur.After 28 days of treatment in each group,X-rays were used to detect the degree of fracture healing in rats.The mechanical pain threshold(PWMT)and thermal pain threshold(PWTL)of rats were measured.ELISA was applied to detect the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and IL-10 in serum.Micro-CT method was applied to detect changes in femoral bone density(BMD),bone volume fraction(BV/TV),trabecular thickness(Tb.Th),and trabecular quantity(Tb.N)in rats.HE staining was applied to observe the pathological changes of bone tissue at the fracture site in rats.Western blot was applied to detect the expression of TLR4/p38MAPK pathway related proteins in bone tissue at the fracture site.Results Compared with the sham operation group,the fracture lines of rats in the model group were obvious,with a small amount of callus growth,the PWMT,PWTL,femoral BMD,BV/TV,Tb.Th,and Tb.N decreased,while the levels of serum IL-6,TNF-α,and IL-10,and the levels of TLR4 and p-p38MAPK/p38MAPK proteins in the bone tissue at the fracture site increased(P＜0.05).Compared with the model group,the fracture lines in the TAK-242 group and the parecoxib sodium group were blurred,and there was an increase in callus growth,the PWMT,PWTL,femoral BMD,BV/TV,Tb.Th,and Tb.N,the serum IL-10 level increased,while the serum IL-6,TNF-αlevels,the TLR4 and p-p38MAPK/p38MAPK protein levels in bone tissue at the fracture site decreased(P＜0.05).LPS could upregulate the phosphorylation levels of TLR4 and p38MAPK,and weaken the relieving effects on anti-inflammatory and pain of parecoxib sodium on fracture rats.Conclusion Paracoxib sodium may alleviate pain and accelerate fracture healing in rats with femoral fractures by inhibiting the TLR4/p38MAPK pathway and suppressing inflammatory responses.

Objective To explore the extent of third-party disability among caregivers of head and neck cancer patients with dyspha-gia and to examine the influencing factors,based on the framework of the International Classification of Func-tioning,Disability and Health.Methods From January,2023 to December,2024,54 pairs of head and neck cancer patients with dysphagia and their caregivers were included in the study.The patients were assessed using the general information questionnaire,Penetration-Aspiration Scale(PAS),Functional Oral and Intake Scale(FOIS)and Functional Assessment of Can-cer Therapy-Head and Neck(FACT-H&N).The caregivers were evaluated with the general information question-naire,Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD)and the MOS Health Survey 36-item short-form(SF-36).Results The total score of SF-36 of caregivers was(59.63±20.10).In univariate analysis,there was significant difference in the total score of SF-36 among different types of tumor(F=3.494,P<0.05).Correlation analysis showed that the scores of PAS(r=-0.371),FOIS(r=0.384)and FACT-H&N(r=0.484)of patients,and the scores of HA-MA(r=-0.378)and HAMD(r=-0.374)of caregivers were all correlated with the total score of SF-36(P<0.05).Multiple linear regression analysis showed that the score of PAS of patients(β=-0.340)and the score of HAMA of caregivers(β=-0.346)were correlated with the total score of SF-36(P<0.05).Conclusion There are third-party disabilities in caregivers of head and neck cancer patients with dysphagia,and the se-verity of the patient's swallowing and the caregiver's emotional state influence the caregiver's quality of life.

Objective To investigate the effects of parecoxib sodium on pain and Toll-like receptor 4(TLR4)/p38 mitogen activated protein kinase(p38MAPK)pathway in rats with femoral fracture.Methods Sixty rats were randomly separated into sham operation group,model group,TLR4 inhibitor(TAK-242)group(3 mg/kg),parecoxib sodium group(10 mg/kg),and parecoxib sodium+TLR4 activator lipopolysaccharide group(10 mg/kg parecoxib sodium+15 mg/kg LPS),with 12 rats in each group.Except for the sham operation group,rats in all other groups were used to establish a femoral fracture model by transverse cutting of the mid femur.After 28 days of treatment in each group,X-rays were used to detect the degree of fracture healing in rats.The mechanical pain threshold(PWMT)and thermal pain threshold(PWTL)of rats were measured.ELISA was applied to detect the levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and IL-10 in serum.Micro-CT method was applied to detect changes in femoral bone density(BMD),bone volume fraction(BV/TV),trabecular thickness(Tb.Th),and trabecular quantity(Tb.N)in rats.HE staining was applied to observe the pathological changes of bone tissue at the fracture site in rats.Western blot was applied to detect the expression of TLR4/p38MAPK pathway related proteins in bone tissue at the fracture site.Results Compared with the sham operation group,the fracture lines of rats in the model group were obvious,with a small amount of callus growth,the PWMT,PWTL,femoral BMD,BV/TV,Tb.Th,and Tb.N decreased,while the levels of serum IL-6,TNF-α,and IL-10,and the levels of TLR4 and p-p38MAPK/p38MAPK proteins in the bone tissue at the fracture site increased(P＜0.05).Compared with the model group,the fracture lines in the TAK-242 group and the parecoxib sodium group were blurred,and there was an increase in callus growth,the PWMT,PWTL,femoral BMD,BV/TV,Tb.Th,and Tb.N,the serum IL-10 level increased,while the serum IL-6,TNF-αlevels,the TLR4 and p-p38MAPK/p38MAPK protein levels in bone tissue at the fracture site decreased(P＜0.05).LPS could upregulate the phosphorylation levels of TLR4 and p38MAPK,and weaken the relieving effects on anti-inflammatory and pain of parecoxib sodium on fracture rats.Conclusion Paracoxib sodium may alleviate pain and accelerate fracture healing in rats with femoral fractures by inhibiting the TLR4/p38MAPK pathway and suppressing inflammatory responses.

Objective To explore the extent of third-party disability among caregivers of head and neck cancer patients with dyspha-gia and to examine the influencing factors,based on the framework of the International Classification of Func-tioning,Disability and Health.Methods From January,2023 to December,2024,54 pairs of head and neck cancer patients with dysphagia and their caregivers were included in the study.The patients were assessed using the general information questionnaire,Penetration-Aspiration Scale(PAS),Functional Oral and Intake Scale(FOIS)and Functional Assessment of Can-cer Therapy-Head and Neck(FACT-H&N).The caregivers were evaluated with the general information question-naire,Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD)and the MOS Health Survey 36-item short-form(SF-36).Results The total score of SF-36 of caregivers was(59.63±20.10).In univariate analysis,there was significant difference in the total score of SF-36 among different types of tumor(F=3.494,P<0.05).Correlation analysis showed that the scores of PAS(r=-0.371),FOIS(r=0.384)and FACT-H&N(r=0.484)of patients,and the scores of HA-MA(r=-0.378)and HAMD(r=-0.374)of caregivers were all correlated with the total score of SF-36(P<0.05).Multiple linear regression analysis showed that the score of PAS of patients(β=-0.340)and the score of HAMA of caregivers(β=-0.346)were correlated with the total score of SF-36(P<0.05).Conclusion There are third-party disabilities in caregivers of head and neck cancer patients with dysphagia,and the se-verity of the patient's swallowing and the caregiver's emotional state influence the caregiver's quality of life.

Objective:To study the impact of third-party disability in caregivers of aphasia patients with stroke based on the concept of the International Classification of Functioning, Disability and Health (ICF), and to examine the factors influencing it.Methods:Sixty-four pairs of stroke patients with aphasia and their caregivers were recruited. The patients were assessed using a general information questionnaire and the western aphasia battery (WAB), while the caregivers were surveyed using a general information questionnaire and a family aphasia measure of life impact (FAMLI) developed based on the ICF framework. Pearson correlation analysis was performed on the WAB scores of the patients and the FAMLI scores of their caregivers, and multiple linear regression analysis was used to screen out the factors significantly influencing third-party disability among the caregivers.Results:The caregivers′ average total FAMLI score was (33.64±19.38), with significant differences reflecting the patient′s age and the course of the disease. Correlation analysis showed that the patients′ cerebral cortical quotients (CQs) and aphasia quotients were significantly and positively correlated with the FAMLI scores of their caregivers ( r-values of 0.408 and 0.395, respectively). Multiple linear regression analysis showed that a patient′s CQ score and age were significantly correlated with the FAMLI score of their caregiver (β-values of 0.326 and 0.599, respectively). Conclusion:The caregivers of stroke survivors with aphasia tend to have third-party disabilities. The patient′s age and the severity of their aphasia are important predictors of life quality for their caregivers.

Objective To investigate the effects of perioperative goal-directed fluid therapy (GDFT) on hemodynamics, postoperative recovery, and complications in elderly patientswith gastric cancer radical surgery complicated by hypertension. Methods A total of 88 elderly patients with gastric cancer radical surgery complicated by hypertension were enrolled and randomly divided into treatment group and control group, with 44 patients in each group. The treatment group received GDFT during the perioperative period, while the control group received conventional fluid therapy. The mean arterial pressure, heart rate, and central venous oxygen saturation (ScvO₂) at different time points, as well as postoperative exhaust time, postoperative hospital stay, and postoperative complication rates were compared between the two groups. Results The time effects (F=60.488, 49.789, 39.423), intergroup effects (F=17.317, 12.969, 10.101), and interaction effects (F=26.415, 22.546, 17.294) of mean arterial pressure, heart rate, and ScvO₂ in the two groups showed statistically significant difference(P < 0.05). After surgery, the mean arterial pressure, heart rate, and ScvO₂ in the treatment group were higher than those before anesthesia and the control group (P < 0.05). The postoperative exhaust time and hospital stay in the treatment group were (2.25±0.61) and (10.29±1.96) days, respectively, which were shorter than (2.82±0.71) and (12.36±2.29) days in the control group (P < 0.05). The total incidence of postoperative complications in the treatment group was lower than that in the control group (11.36% versus 29.54%, P < 0.05). Conclusion Applying GDFT during the perioperative period for elderly patients with gastric cancer radical surgery complicated by hypertension can provide a more stable hemodynamic environment, improve tissue perfusion, accelerate postoperative recovery, and reduce postoperative complications.

OBJECTIVES: To investigate the role of mitochondrial autophagy disorder caused by deletion of E3 ubiquitin ligase Parkin in neuroinflammation in a mouse model of MPTP-induced Parkinson's disease (PD). METHODS: Wild-type (WT) male C57BL/6 mice and Parkin^-/- mice were given intraperitoneal injections with MPTP or PBS for 5 consecutive days, and the changes in motor behaviors of the mice were observed using open field test. The effects of Parkin deletion on PD development and neuroinflammation were evaluated using immunofluorescence and Western blotting. The changes of the PINK 1/Parkin signaling pathway in the midbrain substantia nigra of the mice were examined to explore the molecular mechanism of Parkin-mediated regulation of mitochondrial autophagy and its effect on neuroinflammation in PD mice. RESULTS: Compared with their WT counterparts, the Parkin^-/- mice with MPTP injections exhibited significant impairment of motor function with decreased TH⁺ neurons, increased α-synuclein (α-syn) accumulation, and increased numbers of GFAP⁺ and I-ba1⁺ cells in the midbrain substantia nigra. Parkin deletion obviously affected PINK1/Parkin-mediated mitochondrial autophagy to result in significantly increased mtDNA and upregulated expressions of STING and NLRP3 inflammatosomes in the midbrain substantia nigra of MPTP-treated transgenic mice. CONCLUSIONS Parkin deletion causes mitochondrial autophagy disorder to accelerate PD progression and exacerbates neuroinflammation in mice by affecting the PINK1/Parkin signaling pathway, suggesting the important role of Parkin in early pathogenesis of PD.
Animals ; Ubiquitin-Protein Ligases/genetics* ; Mice ; Mice, Inbred C57BL ; Male ; Parkinson Disease/genetics* ; Protein Kinases/genetics* ; Mitochondria/metabolism* ; Disease Models, Animal ; Autophagy ; Signal Transduction ; Neuroinflammatory Diseases/metabolism* ; Mice, Knockout ; alpha-Synuclein/metabolism* ; Substantia Nigra/metabolism* ; Mitophagy ; Disease Progression

Objective:To evaluate the efficacy and safety of Xiao′er Huangjin Zhike Granules in the treatment of cough caused by acute bronchitis in children, which is defined in TCM terms as a syndrome of phlegm-heat obstructing the lung.Methods:This was a block-randomized, double-blind, placebo-controlled, multicenter clinical trial.From January 2022 to September 2023, 359 children aged 3 to 7 years old diagnosed as acute bronchitis (lung-obstructing phlegm-heat syndrome) were enrolled from 21 participating hospitals and randomly assigned to the experimental group and placebo group in a 3︰1 ratio, and respectively treated with Xiao′er Huangjin Zhike Granules and its matching placebo.Cough resolution/general resolution rate after 7 days of treatment was used as the primary efficacy outcome for both groups.Results:(1)On the seventh day of treatment, the rate of cough disappearance/basically disappearance in the experimental group and placebo group were 73.95% and 57.61% retrospectively, which had statistically significance ( P=0.001).(2)After 7 days of treatment, the median duration of cough disappearance/basic disappearance were 5 days and 6 days in the two groups , with a statistically significant difference ( P=0.006).The area under the curve of cough symptom severity time was 7.20 ± 3.79 in the experimental group and 8.20±4.42 in the placebo group.The difference between the two groups was statistically significant ( P=0.039).(3) After 7 days of treatment, the difference between TCM syndrome score and baseline was -16.0 (-20.0, -15.0) points in the experimental group and -15.0 (-18.0, -12.0) points in the placebo group, with significant difference between the two groups ( P=0.004).In the experimental group, the clinical control rate, the markedly effective rate, the effective rate and the ineffective rate were 49.04%, 28.35%, 16.48% and 6.13% severally; and in the placebo group, the clinical control rate, the markedly effective rate, the effective rate and the ineffective rate were 38.04%, 26.09%, 29.35%, and 6.52% separately, which had statistically significant ( P=0.014).(4) There was no significant difference in the incidence of adverse events or adverse reactions during the trial between both groups.Moreover, while adverse reactions in the form of vomiting and diarrhea were occasionally reported, no serious drug-related adverse event or adverse reaction was reported.(5)The tested drug provided good treatment compliance, showing no statistically significant difference from the placebo in terms of compliance rate. Conclusions:Based on the above findings, it can be concluded that Xiao′er Huangjin Zhike Granules provides good safety, efficacy, and treatment compliance in the treatment of cough caused by acute bronchitis, and lung-obstructing phlegm-heat syndrome, in children.

Objective To compare the clinical efficacy of three different therapies,including transjugular intrahepatic portosystemic shunt(TIPS)treatment,endoscopic treatment and medication treatment,combined with transhepatic arterial chemoembolization(TACE)in treating primary liver cancer complicated by portal hypertension and upper gastrointestinal bleeding.Methods A total of 105 patients with primary liver cancer associated with portal hypertension and upper gastrointestinal bleeding,who were admitted to the No.980 Hospital of PLA Joint Logistics Support Forces of China to receive treatment between January 2014 and June 2020,were enrolled in this study.According to the therapeutic scheme,the patients were divided into TIPS+TACE group(TIPS group,n=25),endoscopy+TACE group(endoscopy group,n=30),and medication+TACE group(medication group,n=50).The clinical efficacy,recurrence rate of bleeding,incidence of hepatic encephalopathy,and survival rate were compared between each other among the three groups.Results The differences in the postoperative 6-month,12-month and 24-month recurrence rates of bleeding between each other among the three groups were statistically significant(all P＜0.05).In TIPS group,the portal vein pressure decreased from preoperative(38.47±9.35)mmHg(1 mmHg=0.133 kPa)to postoperative(25.24±5.68)mmHg,the difference was statistically significant(P＜0.05).After treatment,the hemoglobin level in the three groups showed varying degrees of elevation,which in the TIPS group and endoscopy group were better than that in the medication group,the differences were statistically significant(P＜0.05).In all three groups,the differences in the recurrence rate of bleeding between postoperative 6-month value,12-month value and 24-month value were statistically significant(all P＜0.05).The postoperative 6-month,12-month and 24-month recurrence rates of bleeding in the TIPS group were lower than those in the endoscopy group and the medication group,and the differences were statistically significant(P＜0.05).The postoperative 12-month and 24-month recurrence rates of bleeding in the TIPS group were lower than those in the endoscopy group,and the differences were statistically significant(P＜0.05).The postoperative 12-month and 24-month recurrence rates of bleeding in the endoscopy group were lower than those in the medication group(P＜0.05),and the difference in the postoperative 6-month recurrence rate of bleeding between the two groups was not statistically significant(P＞0.05).The postoperative 6-month and 12-month incidences of hepatic encephalopathy in the TIPS group were higher than those in the endoscopy group and the medication group,the differences were statistically significant(P＜0.05),while the differences in the postoperative 6-month and 12-month incidences of hepatic encephalopathy between the endoscopy group and the medication group were not statistically significant(P＞0.05),and the differences in the postoperative 24-month incidence of hepatic encephalopathy between each other among the three groups were not statistically significant(P＞0.05).No statistically significant difference in the 6-month mortality existed between TIPS group and endoscopy group(P＞0.05),and the 6-month mortality of both TIPS group and endoscopy group was remarkably lower than that of the medication group(P＜0.05).The postoperative 12-month mortality and 24-month mortality in TIPS group were lower than those in the endoscopy group and the medication group,and the differences were statistically significant(P＜0.05),but the differences in the postoperative 12-month mortality and 24-month mortality between the endoscopy group and the medication group were not statistically significant(P＞0.05).Conclusion For primary liver cancer associated with portal hypertension and upper gastrointestinal bleeding,TIPS combined with TACE can effectively control tumor progression and prolong survival.(J Intervent Radiol,2024,32:33-37)