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BackgroundHemiplegic shoulder pain (HSP) is a common complication in patients with stroke. The pathogenesis of HSP is complex, and muscle hypertonia, especially the hypertonia of internal rotation muscles of the shoulder, may be one of the important causes of shoulder pain. However, the relationship between muscle stiffness and HSP has not been well studied. The purpose of this study is to explore the correlations between the stiffness of internal rotation muscles and clinical symptoms in patients with HSP.MethodsA total of 20 HSP patients and 20 healthy controls were recruited for this study. The stiffness of internal rotation muscles was quantified using shear wave elastography, and Young's modulus (YM) of the pectoralis major (PM), anterior deltoid (AD), teres major ™, and latissimus dorsi (LD) were measured. Muscle hypertonia and pain intensity were evaluated using the Modified Ashworth Scale (MAS) and Visual Analog Scale (VAS), respectively. The mobility of the shoulder was evaluated using the Neer score. The correlations between muscle stiffness and the clinical scales were analyzed.ResultsYM of internal rotation muscles on the paretic side was higher than that of the control group in the resting and passive stretching positions (P < 0.05). YM of internal rotation muscles on the paretic side during passive stretching was significantly higher than that at rest (P < 0.05). YM of PM, TM, and LD during passive stretching were correlated with MAS (P < 0.05). In addition, the YM of TM during passive stretching was positively correlated with VAS and negatively correlated with the Neer score (P < 0.05).ConclusionIncreased stiffness of PM, TM, and LD was observed in patients with HSP. The stiffness of TM was associated with pain intensity of the shoulder and shoulder mobility.

BACKGROUND: Predictors of recurrence in patients with lymph node-negative gastric cancer (GC) who have undergone curative resection have been widely investigated, but not the effects of predictors on timing of recurrence. OBJECTIVE: Determine the factors associated with early and late recurrence in patients with node-negative GC. DESIGN: Retrospective cohort. SETTING: Academic tertiary care center. PATIENTS AND METHODS: The study included patients with node-negative GC after curative resection between 2008 and 2018 at two institutions. Early and late recurrences were determined using a minimum P value approach to evaluate the optimal cutoff for recurrence-free survival (RFS). A competing risk model and landmark analysis were used to analyze factors associated with early and late recurrences. MAIN OUTCOME MEASURES: Recurrence-free survival and factors associated with survival. SAMPLE SIZE: 606. RESULTS: After a median follow-up of 70 months, 50 (8.3%) patients experienced recurrent disease. The optimal length of RFS for distinguishing between early (n=26) and late recurrence (n=24) was 24 months (P=.0013). The median RFS in the early and late recurrence groups was 11 and 32 months, respectively. Diffuse tumors (hazard ratio 3.358, P=.014), advanced T stage (HR 8.804, P=.003), perineural invasion (HR 10.955, P

BackgroundCervicogenic headache (CEH) is a secondary headache caused by lesions of the cervical spine and surrounding soft tissues. Cervical muscle dysfunction may be related to the onset of CEH. However, whether cervical muscle stiffness changes in patients with CEH has not been well studied. The purpose of this study was to explore changes in superficial cervical extensor muscle stiffness in patients with CEH using shear wave elastography (SWE).MethodsIn this study, 19 patients with CEH and 20 healthy controls were recruited. Superficial cervical extensor muscle stiffness was obtained from SWE, and the SuperLinear SL10-2 MHz linear array probe in the musculoskeletal muscle mode was chosen as the transducer. Regions of interest in the trapezius (TRAP), splenius capitis (SPL), semispinalis capitis (SCap), and semispinalis cervicis (SCer) were manually segmented. Correlations between superficial cervical extensor muscle stiffness and visual analog scale (VAS) scores, age, and body mass index (BMI) were analyzed using Pearson's correlation. Receiver operating characteristic (ROC) curve was used to investigate the diagnostic ability of superficial cervical extensor stiffness for CEH.ResultsSuperficial cervical extensor muscle stiffness on the headache side of patients with CEH was higher than that on the non-headache side and in healthy controls (p < 0.05). Increased stiffness was also observed in SCer on the non-headache side of patients with CEH compared to healthy controls (p < 0.01). In patients with CEH, SCer stiffness was positively correlated with VAS scores (r = 0.481, p = 0.037), but no correlation was found between other muscles and VAS scores (p > 0.05). The areas under the curve of TRAP, SPL, SCap, and SCer in diagnosing CEH were 0.766, 0.759, 0.964, and 1.000, respectively.ConclusionsIncreased stiffness was observed in the superficial cervical extensor muscles on the headache side of patients with CEH. SCer stiffness was correlated with headache intensity in patients with CEH and may provide clues for the diagnosis of CEH.

As one of calmodulin families, calmodulin-like (CMLs) regulate plant growth and development, hormone regulation, stresses, which have great significance to the further study of calmodulin-like protein involved in pollen germination and growth. In this study, to explore the interaction between CMLs and NPG1 related genes in pollen development of Brassica oleracea L. var. capitata, and to explore the function of CMLs in pollen development and germination, 12 CMLs genes related to pollen development and germination, and pollen germination genes NPG1, NPGR1, and NPGR2 were cloned from "ZG". Interactions between them were detected by yeast two-hybrid test. and the relative expression levels of NPG1, NPGR1, and NPGR2 after different pollination time was detected. The results showed that the open reading frames (ORFs) of 12 CMLs genes ranged from 447 bp to 1095 bp, among which CML20, CML48, CML49, and CML50 contained 4 introns, CML21 contained 2 introns, and the others contained no introns. All of them contained no signal peptide and transmembrane domain, all of them were extracellular proteins and hydrophilic proteins which contain 2--4 EF-hands, with amino acids range of 148--364 aa. Subcellular localization was mainly located in cell membrane, vacuole, and nucleus. NPG1, NPGR1, and NPGR2 were clustered on different evolutionary branches, which were the closest to Brassica rape and Brassica napus, and closer to Arabidopsis thaliana. Yeast two-hybrid showed that CML13, CML21, CML24, CML42 could not interact with NPG1, NPGR1, and NPGR2 in vitro, CML15, CML20, CML25, CML39, CML41, CML48, and CML49 could interact with NPG1, NPGR1, and NPGR2, CML50 could interact with NPGR1 and NPGR2, but not with NPG1. The relative expression level of NPG1 increased significantly after pollination, while the relative expression levels of NPGR1 and NPGR2 didn't change significantly. The relative expression levels of CMLs genes were varied at different pollination times, and CML15, CML20, CML39, CML41, and CML49 were a trend of first increasing and then decreasing. In conclusion, several CMLs proteins were screened which can interact with NPG1 and NPGRs, indicating that CMLs can participate in the process of pollen germination and pollen tube elongation, and it was expected to provide references for the research on the mechanism of Ca2+ signaling system participating in pollen germination and pollen tube elongation. [ABSTRACT FROM AUTHOR]

Background: The majority of heart failure (HF) in hypertrophic cardiomyopathy (HCM) manifests as a phenotype with preserved left ventricular (LV) ejection fraction; however, the exact contribution of left atrial (LA) phasic function to HF with preserved ejection fraction (HFpEF) in HCM remains unresolved. Purpose: To define the association between LA function and HFpEF in HCM patients using cardiac magnetic resonance imaging (MRI) feature tracking. Study Type: Retrospective. Population: One hundred and fifty‐four HCM patients (HFpEF vs. non‐HF: 55 [34 females] vs. 99 [43 females]). Field Strength/Sequence: 3.0 T/balanced steady‐state free precession. Assessment: LA reservoir function (reservoir strain [εs], total ejection fraction [EF]), conduit function (conduit strain [εe], passive EF), booster‐pump function (booster strain [εa] and active EF), LA volume index, and LV global longitudinal strain (LV GLS) were evaluated in HCM patients. Statistical Tests: Chi‐square test, Student's t‐test, Mann–Whitney U test, multivariate linear regression, logistic regression, and net reclassification analysis were used. Two‐sided P < 0.05 was considered statistically significant. Results: No significant difference was found in LV GLS between the non‐HF and HFpEF group (−10.67 ± 3.14% vs. −10.14 ± 4.01%, P = 0.397), whereas the HFpEF group had more severely impaired LA phasic strain (εs: 27.40 [22.60, 35.80] vs. 18.15 [11.98, 25.90]; εe: 13.80 [9.20, 18.90] vs. 7.95 [4.30, 14.35]; εa: 13.50 [9.90, 17.10] vs. 7.90 [5.40, 14.15]). LA total EF (37.91 [29.54, 47.94] vs. 47.49 [39.18, 55.01]), passive EF (14.70 [7.41, 21.49] vs. 18.07 [9.32, 24.78]), and active EF (27.19 [17.79, 36.60] vs. 36.64 [26.63, 42.71]) were all significantly decreased in HFpEF patients compared with non‐HF patients. LA reservoir (β = 0.90 [0.85, 0.96]), conduit (β = 0.93 [0.87, 0.99]), and booster (β = 0.86 [0.78, 0.95]) strain were independently associated with HFpEF in HCM patients. The model including reservoir strain (Net Reclassification Index [NRI]: 0.260) or booster strain (NRI: 0.325) improved the reclassification of HFpEF based on LV GLS and minimum left atrial volume index (LAVImin). Data Conclusion: LA phasic function was severely impaired in HCM patients with HFpEF, whereas LV function was not further impaired compared with non‐HF patients. Level of Evidence: 4 Technical Efficacy: Stage 3 [ABSTRACT FROM AUTHOR]