ObjectiveTo evaluate the effect of transcranial direct current stimulation (tDCS) on the cognitive function and quality of life in patients with Parkinson's disease. MethodsRandomized controlled trials (RCTs) on tDCS for Parkinson's disease were searched in PubMed, Web of Science, Embase, Cochrane Library, CNKI, CBM, VIP and Wanfang Data from the inception to September, 2023. Control group was administered standard Parkinson's medications or placebo, physical therapy, and cognitive rehabilitation, while treatment group received tDCS additionally. The quality of the researches was evaluated using the Cochrane Risk of Bias Tool. Data synthesis and analysis were performed using RevMan 5.4 and Stata 17.0, with heterogeneity and sensitivity analyses. ResultsEight articles were included. tDCS significantly improved the scores of Montreal Cognitive Assessment (MD = 2.00, 95%CI 1.13 to 2.87, P < 0.001). However, there was no significant difference in the scores of Parkinson's Disease Questionnaire (MD = 0.73, 95%CI -5.78 to 7.23, P = 0.830), Beck Depression Inventory-Ⅱ(MD = -0.77, 95%CI -7.14 to 5.60, P = 0.810), and Unified Parkinson Disease Rating Scale-Ⅲ (MD = 1.60, 95%CI -0.77 to 3.97, P = 0.190). ConclusiontDCS may improve cognitive function of patients with Parkinson's disease.

The aim of this study was to investigate the effects of high-intensity interval training(HIIT)on lipopolysaccharide(LPS)-induced septic myocardial injury in mice and the roles of NLRP3 inflammasome and macrophage M1 polarization in the process.C57BL/6 male mice were randomly divided into 4 groups:control(CON)group,LPS(L)group,HIIT+saline injection(E)group,and HIIT+LPS(EL)group.Six weeks of HIIT intervention was followed by intraperitoneal injection of LPS,and cardiac function indexes were measured by echocardiography 12 hours post the injection.Hematoxylin-eosin(HE)staining was used to evaluate the morphology and pathological characteristics of myocardium for assessing myocardial damage score;enzyme-linked immunosorbent assay(ELISA)was used to test the content of myocardial damage indicators(AST,CK-MB,LDH);RT-PCR was used to detect the relative mRNA levels of NLRP3 inflammasome(NLRP3,Caspase-1),atrial natriuretic peptide(ANP),brain natriuretic peptide(BNP),myeloperoxidase(MPO)and macrophage M1-associated inflammasome factors(IL-1β,TNF-α,IL-6);Western blot was applied to measure the protein expression of inducible nitric oxide synthase(iNOS)and apoptosis-associated speck-like protein containing a caspase recruitment domain(ASC)in cardiac tissues;immunofluorescence staining was used to detect the protein expression of NLRP3 inflammasome,ASC,IL-18 and iNOS.Compared with the CON group,mice in the LPS group showed obvious decrease in body weight,a significant decrease in EF and FS,a significant increase in LVESD and LVEDD,obvious pathological damage in myocardial tissue,a significant increase in myocardial damage fraction,a significant increase in serum myocardial damage indexes,and a significant increase in the expression levels of BNP,MPO,NLRP3 inflammasome,iNOS,IL-1β,IL-6 and TNF-α.HIIT treatment could reverse these changes mentioned above in model mice.In conclusion,6 weeks of HIIT inhibits the activation of LPS-induced NLRP3 inflammasome and suppressed macrophage M1-type polarization,thereby combating septic myocardial injury.

Objective:To investigate the clinical and pathological characteristics of breast cancer with HER2 low expression.Methods:The data from 3 422 patients with invasive breast cancer which archived in Peking Union Medical College Hospital between April 2019 and July 2022 were retrospectively reviewed. Among them, 136 patients were treated with neoadjuvant chemotherapy. The tumor size, histological type, tumor differentiation, lymph node metastasis, Ki-67 index, the status of estrogen receptor, progesterone receptor and HER2 as well as pathological complete response (pCR) rate were collected.Results:The HER2 status of 3 286 patients without neoadjuvant therapy, 616 (616/3 286, 18.7%) score 0, 1 047 (1 047/3 286, 31.9%) score 1+, 1 099 (1 099/3 286,33.4%) score 2+ and 524 (524/3 286,15.9%) score 3+ by immunohistochemistry (IHC). Among the 1 070 IHC 2+ cases, 161 were classified as HER2 positive by reflex fluorescence in situ hybridization (FISH) assay. In our cohort, 1 956 cases of HER2-low (IHC 1+ and IHC 2+/FISH-) breast cancer were identified. Compared to the HER2 IHC 0 group, HER2-low tumors more frequently occurred in patients with hormone receptor (HR) positive ( P<0.001), Ki-67 index below 35% ( P<0.001), well or moderate differentiation ( P<0.001) and over the age of 50 ( P=0.008). However, there were no significant differences in histological type, tumor size, and lymph node metastasis between HER2-low and HER2 IHC 0 group. For patients who had neoadjuvant therapy, the pCR rate in the patients with HER2-low was lower than those with HER2 IHC 0 (13.3%, 23.9%), but there was no significant difference. Although HER2-low breast cancers showed a slightly lower pCR rate than HER2 IHC 0 tumors, no remarkable difference was observed between tumors with HER2-low and HER2 IHC 0 regardless of hormone receptor status. Conclusions:The clinicopathological features of HER2-low breast cancers are different from those with HER2 IHC 0. It is necessary to accurately distinguish HER2-low breast cancer from HER2 IHC 0 and to reveal whether HER2-low tumor is a distinct biological entity.

Objective To study the efficacy of breathing training in the patients with chronic non-spe-cific low back pain (CNLBP).Methods The databases of Pubmed,Embase,Web of Science,Cochrane Librar-y,CNKI,China Biomedical Literature Database,Wanfang Database and VIP Database were searched for obtai-ning relevant trials of respiratory-related training for treating CNLBP.The retrieval time limit was from the database establishment to October 2022.The quality assessment was performed by using the Cochrane Manual for Systematic Reviews,and the data analysis was performed by using StataSE15.1 software.Results Nine-teen articles were finally obtained,involving in 1011 cases.The meta analysis showed that the visual analogue scale (VAS) score or pain numerical scale (NRS) score in the experiment group were lower than those in the control group (MD=-1.19,95％CI:-1.51 to-0.87,P<0.05),and the Oswestry dysfunction index (ODI) score was lower than that in the control group (MD=-0.64,95％CI:-0.91 to-0.38,P<0.05). For different types of the patients,the improvement effects of VAS score for different types of patients with CNLBP from high to low were in turn postpartum patients (MD=-1.89,95％CI:-2.51 to-1.27,P<0.05),athletes (MD=-1.46,95％CI:-1.79 to-1.13,P<0.05) and general population (MD=-1.01,95％CI:-1.40 to-0.61,P<0.05).Conclusion Thebreathing training has the improvement effect for pain,dysfunction,proprioception and posture control in various populations with CNLBP.

The prevention and treatment of cardiovascular diseases have always been a focus of attention in re-lated fields.This paper discusses the application and mechanism of exogenous and endogenous supplementation with β-hy-droxybutyrate in the prevention and treatment of cardiovascular diseases such as myocardial ischemia,myocardial infarc-tion,diabetic cardiomyopathy,hypertension,myocardial inflammation,hypertrophic cardiomyopathy and heart failure.Exogenous β-hydroxybutyrate supplementation can quickly and directly provide substitute energy for the heart and thus prevent and treat heart injury.The comprehensive effect of exogenous β-hydroxybutyrate supplementation is significantly better than that of endogenous β-hydroxybutyrate.Endogenous fatty acid,obtained through a ketogenic diet,needs to be oxidized to β-hydroxybutyrate in vivo for energy supply,which is greatly influenced by glucose and lipid metabolism under the conditions of the basic disease itself.At present,ketogenic diet is not recommended for use in the prevention and treat-ment of myocardial ischemia or myocardial infarction,and in the treatment of diabetic cardiomyopathy or hypertension.

OBJECTIVE: To explore the genetic basis for three Chinese patients with McCune-Albright syndrome (MAS). METHODS: Three children who had respectively presented at Shandong Provincial Hospital in April 2019 and Peking Union Medical College Hospital in August 2020 and May 2021 were selected as the research subjects. Peripheral blood samples of the probands and their family members were taken for the extraction of genomic DNA. Potential variants were screened by whole exome sequencing (WES), and candidate variants were validated by Sanger sequencing of the patients and their family members. RESULTS: The proband from family 1 was found to harbor a heterozygous c.601C>T (p.R201C) missense variant in exon 8 of the GNAS gene, whilst the probands from families 2 and 3 were both found to harbor a heterozygous c.602G>A (p.R201H) missense variant in exon 8 of the GNAS gene. Both variants were known to be pathogenic, and all probands were found to be mosaics for the corresponding variants but with various degrees. CONSLUSION WES can effectively diagnose MAS and other somatic genetic disorders. In this study, the combined WES and Sanger sequencing have verified the degree of mosaicisms of pathogenic variants in the three MAS patients, albeit no apparent correlation was found between the degree of mosaicisms and the phenotype of patients. Above finding has provided a basis for genetic counseling and prenatal diagnosis for the affected families.
Humans ; Mutation ; Fibrous Dysplasia, Polyostotic/genetics* ; East Asian People ; Exons ; Phenotype ; Pedigree

Ketogenic diet can supplement blood ketone,provide energy for skeletal muscle,and affect the athletic performance and recovery of animals and humans after fatigue.In this paper,it was found that ketogenic diet transformed muscle fibers from Ⅱb to Ⅱa through axonal germination and nerve reinnervation,improved the quality and function of mitochondria of fast muscle and increased histone acetyltransferase to enhance skeletal muscle strength.Using ketone body to provide energy,it can reduce glycolysis and improve the ability of fatty acid oxidation in slow muscle to improve exercise endurance;It can reduce endoplasmic reticulum stress,oxidative stress and inflammatory reaction of skeletal muscle,protect the body from injury,reduce the consumption of muscle glycogen and the accumulation of lactic acid,reduce fatigue after exercise and promote recovery.It is considered that ketogenic diet has low negative effects on the body,can improve sports performance and accelerate fatigue recovery,and can be used as a diet scheme in competitive sports and rehabilitation training.

Objectives:To investigate the effects of morning blood pressure on vascular endothelial function and chronic inflammatory response in the elderly.Methods:349 elderly people aged ≥60 who underwent 24-hour ambulatory blood pressure monitoring in Gaomi Municipal Hospital from April 2018 to October 2019 were selected to detect brachial artery flow mediated vasodilation (FMD) and chronic inflammatory factors [high-sensitivity C-reactive protein (hsCRP), tumor necrosis factor-α (TNF-α) and interleukin (IL)-17] levels. According to the results of 24-hour ambulatory blood pressure monitoring, the subjects were divided into normal blood pressure group ( n=108), simple morning hypertension group ( n=114) and hypertension group ( n=127). The clinical data, 24-hour ambulatory blood pressure parameters, vascular endothelial function and inflammatory factors of the three groups were compared. The correlation between 24-hour ambulatory blood pressure parameters and FMD and inflammatory factors was analyzed by partial correlation. Results:Compared with the normal blood pressure group, the simple morning hypertension group and the hypertension group had lower FMD (all P<0.05), higher serum hsCRP and TNF-α , IL-17 levels (all P<0.05). Compared with the simple morning hypertension group, the hypertension group had lower FMD ( P<0.05), higher serum hsCRP, TNF-α and IL-17 levels (all P<0.05). After controlling for age, sex, smoking history, drinking history, total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, fasting blood glucose and 24 h average blood pressure, the morning systolic blood pressure was negatively correlated with FMD ( P<0.05), and positively correlated with serum hsCRP and TNF-α and IL-17 levels (all P<0.05); the morning diastolic blood pressure was negatively correlated with FMD ( P<0.05) and positively correlated with serum hsCRP and TNF-α levels (all P<0.05). Conclusions:Morning blood pressure level is closely related to vascular endothelial function and chronic inflammation level, and is independent of 24-hour average blood pressure. The increase of morning blood pressure may be an important risk factor for endothelial dysfunction and chronic inflammation in the elderly.

Objective: To investigate the prevalence of dyslipidemia among adults in Moyu County, Hotan Prefecture, Xinjiang Uygur Autonomous Region, so as to provide insights into the management of dyslipidemia. Methods: The physical examination data of permanent residents at ages of 18 years and older were collected from Moyu County from 2018 to 2019, including demographic features, height, body weight, blood pressure and blood biochemical parameter measurements. The epidemiological characteristics of dyslipidemia were analyzed among residents. Results: Totally 166 142 adults were investigated, with a mean age of (41.08±15.72) years. There were 77 744 men (46.76%), 34 728 obese adults (20.90%), 5 776 adults with diabetes (3.48%) and 26 294 adults with hypertension (15.83%). The levels of triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were (1.38±0.98), (4.13±1.19), (1.31±0.41) and (2.25±0.77) mmol/L, respectively. The prevalence of dyslipidemia was 29.72%, and the detection rates of high TG, high TC, low-HDL-C and high LDL-C were 9.73%, 4.59%, 19.65% and 1.99%, respectively. The prevalence of dyslipidemia was higher in men than in women (33.97% vs. 25.98%; χ2=1 264.729, P<0.001), and the prevalence increased with age (χ2=539.382, P<0.001) and body mass index (χ2=3 601.833, P<0.001). The prevalence of dyslipidemia was 35.48% among patients with hypertension (χ2=497.251, P<0.001) and 46.07% among patients with diabetes (χ2=766.142, P<0.001). There were 9 059 adults with two and more abnormal blood lipid indexes (18.35%), and the detection rates of two and more abnormal blood lipid indexes were 26.50%, 24.14% and 33.15% among patients with obesity, hypertension and diabetes, respectively. Conclusions The prevalence of dyslipidemia among adults in Moyu County is lower than the national level, and low-HDL cholesterolemia is the most common type of dyslipidemia. The prevalence of dyslipidemia is high among patients with obesity, hypertension and diabetes mellitus, in whom abnormality of multiple blood lipid indexes is measured.

Rotavirus (RV) is one of the main pathogens causing diarrhea in children under five years old, but the mechanism of RV-infected diarrhea is still unclear. The RV genome encodes six structural proteins (VP1-VP4, VP6 and VP7) and six non-structural proteins (NSP1-NSP6), among which NSP4 can interact with other non-structural proteins or structural proteins of RV to produce corresponding biological functions, and is a key factor in the formation of RV morphology, the process of infection and the pathogenesis of diarrhea. In this paper, the current domestic and foreign studies on the structure and function of NSP4 are reviewed.