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Rigidity is one of the major manifestations of Parkinson’s disease (PD), but no quantitative and objective imaging method has been developed to measure rigidity. Ultrasound shear wave elastography (SWE) can reflect the stiffness of tissue by providing a quantitative index. Thus, we conducted this study to evaluate the potential clinical value of SWE in assessing rigidity in PD. A total of 63 subjects (44 patients with rigidity-dominant PD and 19 right-dominant-hand normal controls with matched age) were enrolled, and each underwent ultrasound SWE testing. The tests were conducted on the brachioradialis (BR) and biceps brachii (BB) on the more affected side in patients with PD and on the right side in normal controls. Differences in quantitative shear wave velocity (SWV) between patients with PD and normal controls were determined. The relationship of muscle SWV with joint rigidity, UPDRSIII, disease duration, sex, and age in patients with PD was analyzed. The intraclass correlation coefficient (ICC) was used to evaluate the reliability of SWE in assessing muscle stiffness in patients with PD. The mean SWVs of the BB and BR were higher in the PD group (3.65±0.46 and 4.62±0.89 m/s, respectively) than in normal controls (2.79±0.37 and 3.26±0.40 m/s, respectively). Stiffness in BR and BB was correlated with the upper-limb joint rigidity, UPDRSIII, and disease duration but not with sex or age in the PD group. The intraobserver correlation coefficients (ICCs) for interobserver and intraobserver variations in measuring SWV were 0.85 (95% confidence interval 0.56–0.95) and 0.85 (95% confidence interval 0.58–0.95), respectively, for BR and 0.90 (95% confidence interval 0.73–0.97) and 0.86 (95% confidence interval 0.61–0.95), respectively, for BB. SWV is associated with joint rigidity and disease duration, indicating that SWE can be potentially used as an objective and quantitative tool for evaluating rigidity.

SERPINE1 protein is one important member of the serine proteinase inhibitor E superfamily that plays a crucial role in the fibrinolytic system. It has been identified which is related to chronic inflammatory lung diseases like allergic asthma and lung fibrosis. Recently, researchers have focused on the impact of SERPINE1 and its genetic polymorphisms on inflammatory diseases of the upper respiratory tract. In this review, we conclude that SERPINE1 is widely involved in the pathological process of chronic rhinosinusitis and allergic rhinitis (AR) and may play a pivotal role in tissue remodelling in chronic rhinosinusitis without nasal polyps. It is also found that the 4G allele of SERPINE1 gene is associated with the risk of upper respiratory diseases. More studies are needed to further clarify how SERPINE1 influences chronic rhinosinusitis and AR, which would be conducive to improving the therapeutic efficacy of treatments for upper respiratory diseases.

Yuqin Zeng,1– 3 Shan Cai,1– 3 Yan Chen,1– 3 Jiaxi Duan,1– 3 Yiyang Zhao,1– 3 Xin Li,4 Libing Ma,5 Qimi Liu,6 Yingqun Zhu,7 Ming Chen,8 Meiling Zhou,9 Ping Chen1– 3 1Department of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China; 2Research Unit of Respiratory Disease, Central South University, Changsha, Hunan, People’s Republic of China; 3Hunan Centre for Evidence-Based Medicine, Changsha, Hunan, People’s Republic of China; 4Division 4 of Occupational Disease, Hunan Occupational Disease Prevention and Treatment Hospital, Changsha, Hunan, People’s Republic of China; 5Department of Respiratory and Critical Care Medicine, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, People’s Republic of China; 6Department of Respiratory and Critical Care Medicine, The Second People’s Hospital of Guilin, Guilin, Guangxi, People’s Republic of China; 7Department of Respiratory and Critical Care Medicine, The Third Hospital of Changsha, Changsha, Hunan, People’s Republic of China; 8Department of Respiratory and Critical Care Medicine, No.1 Traditional Chinese Medicine Hospital of Changde City, Changde, Hunan, People’s Republic of China; 9Department of Respiratory and Critical Care Medicine, The First People’s Hospital of Huaihua City, Huaihua, Hunan, People’s Republic of ChinaCorrespondence: Ping ChenDepartment of Pulmonary and Critical Care Medicine, The Second Xiangya Hospital, Central South University, 139 Middle Ren Min Road, Changsha, Hunan 410011, People’s Republic of ChinaTel + 86-731-85295047Fax + 86-731-85295044Email pingchen0731@csu.edu.cnBackground: There is a large gap in the treatments for patients with COPD according to the Global Initiative for COPD (GOLD) recommendations. Determining the situation of therapies in the real world is necessary. This study aimed to characterize the real-world practical therapies of COPD and prognosis of patients after treatment for 1 year.Methods: This study was a multicenter prospective observational study performed using a database set up by the Second Xiangya Hospital of Center South University. Detailed usage information for pharmacotherapies and nonpharmacotherapies for patients was collected, as well as the consistency of recommendations and patient adherence. Moreover, the effect of therapies after 1 year was calculated by comparing lung function and symptoms.Results: Ultimately, 4,796 patients with COPD from 12 hospitals in China were eligible. LAMA (39.1%), LAMA + LABA/ICS (39.0%) and LABA/ICS (14.4%) were the top three inhalants. We found that 42.7% of Group A patients, 61.6% of Group B patients and 30% of Group C patients were following inappropriate therapy, especially overuse of ICS. Only 3.9% (95% CI 2.4, 5.4) of patients used oxygen therapy, and 1.8% (95% CI 1.5, 2.3) used noninvasive positive pressure ventilation at home. Among these patients, 33.2% had poor adherence. A total of 452 patients completed 1 year of follow-up. After 1 year of treatment, the lung function of FEV1/FVC decreased (P=0.001) and the mMRC score increased (P< 0.001). There was no change in CAT scores (P> 0.05).Conclusion: This study highlights a significant discrepancy between recommendations for managing patients with COPD in GOLD report, and in real-world clinical practice in China. Over-prescription of ICS and under-prescription of nonpharmacologic therapy were common. The adherence to treatment of patients was poor, and the real-life treatment effectiveness was unsatisfactory. More attention should be paid to the implementation of recommendations and standardized administration of therapies.Keywords: COPD, treatment, discrepancy, observational study

Objective(s): Apoptosis of pulmonary alveolar septal cells is a pathogenesis characteristic of chronic obstructive pulmonary disease (COPD). Endothelial cell specific molecule-1 (ESM-1) plays an important role in apoptosis of cells. Here, we aimed to determine whether ESM-1 can involve in cell apoptosis in emphysematous mice and stable COPD patients. The sample size of patients was small, so two separate models were studied.Materials and Methods: At day 0, 11, and 22, murine were injected IP with 0.3 ml of PBS/Cigarette smoke extract, and euthanized at day 28. Lung tissues from 20 stable COPD patients and 12 Controls were evaluated. Serum was obtained from 25 stable COPD patients and 12 healthy Controls. Pulmonary function, pathology, pulmonary apoptosis index (AI), expression of vascular endothelial growth factor (VEGF), hepatocyte growth factor (HGF) and ESM-1 in lung tissue, and concentration of ESM-1 in serum were tested. Results: Protein expression of ESM-1, VEGF and HGF were decreased significantly in emphysematous mice (p

Measuring transmembrane water exchange can provide potential biomarkers for tumors and brain disorders. Diffusion Magnetic Resonance Imaging (dMRI) is a well-established tool that can non-invasively measure water exchange across cell membranes. Diffusion Exchange Spectroscopy (DEXSY) is one of the dMRI-based frameworks used to estimate exchange. DEXSY provides a detailed picture of multi-site exchange processes but requires a large quantity of data. Several models based on the DEXSY framework have been proposed to reduce the acquisition time. Filter Exchange Imaging (FEXI) and curvature models are two of them that only require certain samples of the DEXSY dataset. Diffusion-Exchange Weighted (DEW) Imaging model is another data reduction method accounting for restricted diffusion within cells and can use a specific subset of the DEXSY dataset to measure exchange. Furthermore, a more general expression of the DEXSY signal, referred to as the general model, can theoretically analyze the full space or reduced DEXSY datasets and estimate exchange. However, the results of the subsampling schemes and the data reduction models have not been compared to the full space estimation. Therefore, this thesis aims to experimentally explore the feasibility of estimating exchange using these four models (the general, FEXI, curvature and DEW models) with the data acquired using a low-field benchtop MR scanner, and compare the estimates from the general model with different subsampling schemes and the data reduction models to the full space estimation. For this purpose, a double diffusion encoding (DDE) sequence was modified from an existing sequence on the benchtop MR scanner and a DEXSY experiment was conducted on this MR scanner and a yeast phantom to acquire a full space dataset. The exchange parameters estimated from the full space dataset using the general model were used as "ground truths" to evaluate the estimates from the reduced datasets analyzed using the general, FEXI and curvature models. Moreover, two alternative subsampling schemes named the shifted DEW and new trajectory schemes were proposed and employed to measure exchange. The results indicate that all the methods except the curvature sampling scheme employed with both the general and curvature models provided comparable estimates to the "ground truths". The shifted DEW and new trajectory sampling schemes performed better over others in terms of consistency with the "ground truths" and low variations between voxels, suggesting the theoretical and experimental optimization of these two subsampling schemes can be further studied and developed.

The amygdala is known to modulate hippocampal synaptic plasticity. One role could be an immediate effect of basolateral amygdala (BLA) in priming synaptic plasticity in the hippocampus. Another role could be through associative synaptic co-operation and competition that triggers events involved in the maintenance of synaptic potentiation. We present evidence that the timing and activity level of BLA stimulation are important factors for the induction and maintenance of long-term potentiation (LTP) in ventral hippocampal area CA1. A 100 Hz BLA co-stimulation facilitated the induction of LTP, whereas 200 Hz co-stimulation attenuated induction. A 100 Hz BLA co-stimulation also caused enhanced persistence, sufficient to prevent synaptic competition. This maintenance effect is likely through translational mechanisms, as mRNA expression of primary response genes was unaffected, whereas protein level of plasticity-related products was increased. Further understanding of the neural mechanisms of amygdala modulation on hippocampus could provide insights into the mechanisms of emotional disorders.

Our study focused on three aspects to determine whether bilateral substantia nigra hyperechogenicity (SN+) is asymmetrical, whether the asymmetry of SN+ is related to the clinical features and whether there is variation in SN+ asymmetry during the progression of Parkinson disease (PD). This follow-up study included 234 patients with PD, who were divided into tremor PD (TD, n = 67) and non-tremor PD (NTD, n = 167) groups based on the Unified Parkinson's Disease Rating Scale (UPDRS) Part III. All participants underwent transcranial sonography (TCS) and clinical assessment. In both the TD and NTD groups, the initial SN+ was larger than the non-initial SN+. The initial SN+ was associated with Hoehn and Yahr (Hamp;Y) stage, PD duration and initial UPDRS III, and the SN+ asymmetry index was associated with motor asymmetry index in the TD group. In the NTD group, the initial SN+ was associated only with initial UPDRS III. After a 5-year follow-up, the area of SN+ on both sides was gradually inclining to symmetry in the NTD group. Our study determined that SN+ asymmetry could reflect asymmetrical characteristics of PD. Furthermore, we inferred that the dynamic change in SN+ asymmetry might reflect a dynamic change in motor asymmetry in the NTD group.

Thanks to the superior resistance to corrosions, especially the chloride-induced pitting corrosion, titanium and its alloys are generally regarded ideal for application in the seawater environment. However in this paper, one failure case regarding leakage on the titanium tubes of the seawater heat exchangers in the recirculating cooling water system of one coastal nuclear power plant was reported. Actually, similar problem with severer extent on even a larger number of tubes in this equipment had already occurred before and been effectively solved, nevertheless it emerged again this time but merely affected several individual tubes. To avoid contamination of the moderator system, plugging was temporarily adopted for the leaked tubes, but undoubtedly root causes analysis of this failure was immediately necessitated to reduce both the safety risks and the economic losses. Hence, comprehensive investigation of the base materials, environmental media, defects morphologies and micro-area compositions etc. was carried out for identification of the failure causes, based on which the relevant mechanisms were discussed and the pertinent countermeasures were proposed. Achievement of this paper will not only help to solve the practical engineering problem for this sole nuclear equipment, but also lead to a better understanding of the degradation behaviors of titanium alloys under complex service conditions.

Amidoxime polyacrylonitrile fibers (PAO fibers) were prepared with polyacrylonitrile fibers (PAN fibers) and hydroxylamine hydrochloride through a heterogeneous reaction, which were used for low-co...

In this study, we aim to explore the status quo of self-health management of patients with bipolar disorder and influencing factors. A total of 80 patients with bipolar disorder were included and assigned into the observation group and the control group, with 40 cases per group. The patients in the control group were given general health education, and those in the observation group were given personalized education combined with peer support. It was found that there was no significant difference in gender, age, educational degree, marital status, and living state between the observation group and the control group ( P > 0.05 ). There are significant differences with regard to self-management between the two groups. The observation group showed stronger self-care ability, health education level, self-protection ability, and emotional control ability than the control group ( P < 0.05 ). Before the intervention, no significant difference in Hamilton Depression Rating Scale (HAMD) scores was observed between the observation group and the control group ( P > 0.05 ). After the intervention, the HAMD scores were lower in the observation group than in the control group ( P < 0.05 ), suggesting an alleviation in manic and depressive episodes in the observation group. It was also revealed that the observation group exhibited lower Functioning Assessment Short Test (FAST) scores in all aspects than the control group, suggesting personalized education combined with peer support could significantly improve the quality of life of patients with bipolar disorder. Self-health management ability of the patients was regarded as the dependent variable and healthy education level, health literacy, and objective support as the independent variables, and the regression model was performed. The results show that information acquisition ability, communication and interaction ability, objective social support, subjective social support, and utilization of social support can all affect the self-health management ability of patients. Personalized education combined with peer support can effectively alleviate the condition of patients with bipolar disorder, improve the degree of overall functional impairment, enhance the patient’s self-management ability, and promote their recovery. It is worthy of promotion and application. In conclusion, information acquisition ability, communication and interaction ability, objective social support, subjective social support, and utilization of social support can all affect the self-health management ability of patients.