Identifying the brain regions associated with acute spasticity in patients diagnosed with an ischemic stroke

Spasticity is a common impairment found in patients that have been diagnosed with a stroke. Little is known about the pathophysiology of spasticity at the level of the brain. This retrospective study was performed to identify an association between the area of the brain affected by an ischemic stroke and the presence of acute spasticity. Physical and occupational therapy assessments from all patients (n?=?441) that had suffered a stroke and were admitted into a local hospital over a 4-year period were screened for inclusion in this study. Subjects that fit the inclusion criteria were grouped according to the presence (n?=?42) or absence (n?=?129) of acute spasticity by the Modified Ashworth Scale score given during the hospital admission assessment. Magnetic resonance images from 20 subjects in the spasticity group and 52 from the control group were then compared using lesion density plots and voxel-based lesion–symptom mapping. An association of acute spasticity with the gray matter regions of the insula, basal ganglia, and thalamus was found in this study. White matter tracts including the pontine crossing tract, corticospinal tract, internal capsule, corona radiata, external capsule, and the superior fronto-occipital fasciculus were also found to be significantly associated with acute spasticity. This is the first study to describe an association between a region of the brain affected by an infarct and the presence of acute spasticity. Understanding the regions associated with acute spasticity will aid in understanding the pathophysiology of this musculoskeletal impairment at the level of the brain.     

A Comparison of Bone Mineral Density and Its Predictors in HIV-Infected and HIV-Uninfected Older Men

ObjectiveBone health in older individuals with HIV infection has not been well studied. This study aimed to compare bone mineral density (BMD), trabecular bone score (TBS), and bone markers between HIV-infected men and age- and body mass index (BMI)-matched HIV-uninfected men aged ≥60 years. We investigated the associations of risk factors related to fracture with BMD, TBS, and bone markers in HIV-infected men.MethodsThis cross-sectional study included 45 HIV-infected men receiving antiretroviral therapy and 42 HIV-uninfected men. Medical history, BMD and TBS measurements, and laboratory tests related to bone health were assessed in all the participants. HIV-related factors known to be associated with bone loss were assessed in the HIV-infected men.ResultsThe mean BMD, TBS, and osteopenia or osteoporosis prevalence were similar among the cases and controls. The HIV-infected men had significantly higher mean N-terminal propeptide of type 1 procollagen and C-terminal cross-linking telopeptide of type I collagen levels. Stepwise multiple linear regression analysis demonstrated that low BMI (lumbar spine, P = .015; femoral neck, P = .018; and total hip, P = .005), high C-terminal cross-linking telopeptide of type I collagen concentration (total hip, P = .042; and TBS, P = .010), and low vitamin D supplementation (TBS, P = .035) were independently associated with low BMD and TBS.ConclusionIn older HIV-infected men with a low fracture risk, the mean BMD and TBS were similar to those of the age- and BMI-matched controls. The mean bone marker levels were higher in the HIV group. Traditional risk factors for fracture, including low BMI, high C-terminal cross-linking telopeptide of type I collagen level, and low vitamin D supplementation, were significant predictors of low BMD and TBS.     

Biology and epidemics of Candidatus Liberibacter species,psyllid‐transmitted plant‐pathogenic bacteria

Candidatus Liberibacter species are Gram‐negative bacteria that live as phloem‐limited obligate parasites in plants, and are associated with several plant diseases. These bacteria are transmitted by insects called psyllids, or jumping plant lice, which feed on plant phloem sap. Citrus huanglongbing (yellow shoot) or citrus greening disease is associated with three different species of Ca. Liberibacter – Ca. L. asiaticus, Ca. L. africanus and Ca. L. americanus – all originally found on different continents. Ca. L. asiaticus is the most severe pathogen, spread by Asian citrus psyllid Diaphorina citri and causing devastating epidemics in several countries. Ca. L. africanus occurs in Africa where it is spread by the African citrus psyllid Trioza erytreae. Ca. Liberibacter solanacearum is associated with diseases in several solanaceous plants, and transmitted by potato psyllid Bactericera cockerelli. Zebra chip disease is causing large damage in potato crops in North America. In Europe Ca. Liberibacter solanacearum is associated with diseases of the Apiaceae family of plants, carrot and celery, and transmitted by psyllids Trioza apicalis and Bactericera trigonica. When Ca. Liberibacter is suspected as the disease agent, the diagnosis is confirmed by DNA‐based detection methods. Ca. Liberibacter‐associated plant diseases can be controlled by using healthy plant propagation material, eradicating symptomatic plants, and by controlling the psyllid populations spreading the disease.     

连续性血浆滤过吸附对严重感染合并MODS患者炎症因子水平的影响

目的:探讨连续性血浆滤过吸附对严重感染合并多脏器功能障碍综合征(MODS)患者炎症因子水平的影响。方法:研究对象选取我院2013年3月-2016年3月收治严重感染合并MODS患者共160例,以随机数字表法分为对照组(80例)和观察组(80例),患者均先给予高容量血液滤过(HVHF)治疗,观察组加用连续性血浆滤过吸附辅助治疗,比较两组患者治疗前后平均动脉压(MAP)、心率(HR)、血氧饱和度(SpO_2)、碳酸氢根(HCO_3~-)、肌酐(Scr)、总胆红素(TBi L)、急性生理与慢性健康II(APACHE Ⅱ)评分、肿瘤坏死因子α(TNF-α)、超敏C反应蛋白(hs-CRP)及白介素6(IL-6)水平。结果:两组治疗后MAP、Scr、TBi L、TNF-α、IL-6、hs-CRP及APACHE Ⅱ评分均有所降低,而HR、SpO_2、HCO_3~-水平均上升,且观察组以上各指标改善更明显,差异均有统计学意义(P0.05)。结论:连续性血浆滤过吸附辅助治疗严重感染合并MODS可有效稳定生命体征,改善生化指标,延缓病情进展,并有助于降低机体炎症反应水平。     

Association between light exposure at night and manic symptoms in bipolar disorder: cross-sectional analysis of the APPLE cohort

ABSTRACT

Previous studies have found that keeping the room dark at night was associated with a decrease in manic symptoms for patients with bipolar disorder (BD). However, the association between light at night of real-life conditions and manic symptoms is unclear. We investigated the association between bedroom light exposure at night and manic symptoms in BD patients. One-hundred and eighty-four outpatients with BD participated in this cross-sectional study. The average light intensity at night during sleep was evaluated using a portable photometer for seven consecutive nights. Manic symptoms were assessed using the Young Mania Rating Scale (YMRS), and scores ≥5 were treated as a “hypomanic state.” The median (interquartile range) YMRS score was 2.0 (0–5.0), and 52 (28.2%) participants were in a hypomanic state. The prevalence of a hypomanic state was significantly higher in the participants with an average light intensity at night exposure of ≥3 lux than in those with <3 lux (36.7% versus 21.9%; P = .02). In multivariable logistic regression analysis adjusted for BD type, depressive symptoms, sleep duration, and daytime physical activity, the odds ratio (OR) for a hypomanic state was significantly higher for the participants with an average light intensity at night exposure of ≥3 lux than for those with <3 lux (OR: 2.15, 95% confidence interval: 1.09–4.22, P = .02). This association remained significant at the cutoff value of YMRS score ≥6 (OR: 2.51, 95% confidence interval: 1.15–5.46; P = .02). The findings of this study indicate bedroom light exposure at night is significantly associated with manic symptoms in BD patients. Although the results of this cross-sectional investigation do not necessarily imply causality, they may serve to inform beneficial nonpharmacological intervention and personalized treatment of BD patients.     

武汉市石榴红农场休闲景观的游憩价值和存在价值估算

都市休闲农业将传统农业与旅游业结合,利用农田景观、自然生态及环境资源,融合农业生产、农村文化及农家生活等人文景观,为人们提供休闲、娱乐和游憩等多重功能.价值估算在对武汉市石榴红农场及182位样本游客调查的基础上,应用旅游成本法和条件价值评估法估算休闲农地景观的游憩价值和存在价值.研究结果表明:(1)从传统的种植单位转型为以休闲度假、农事体验、农业观光为主的农业园区,石榴红休闲农场的经营效益明显,单位用地效益较传统蔬菜种植收益 (22990.26元/(hm2·a)) 净增1.6倍,但其带给消费者的更多的是目前无法通过市场配置的非市场价值.(2)利用TCM评价出石榴红农场2006年的总游憩价值在5057.99×104元,人均消费者剩余(consumer surplus, CS)2809.99元,约为游客平均游玩费用的36.71倍;农地景观单位游憩价值334905元/(hm2·a),是休闲农业经济产值(60000元/ (hm2·a))的5.58倍,游憩价值是农地景观价值构成中的重要组成.(3)从游客的支付意愿(willingness to pay, WTP)出发,应用CVM估算出石榴红休闲农地景观保存价值达117.92×104元/a,土地年均存在价值7808元/hm2.(4)农地景观的游憩价值及存在价值等非市场效益显著,然而在现行资源价值核算体系中却往往因缺失交易机制而被遗漏,意味着在土地分配决策与消费实践中,如果只单纯考虑经济产值,土地用途转换过程中将造成大量的社会福利损失.     

布地奈德福莫特罗治疗支气管哮喘患者的临床疗效及对患者血清炎性因子水平的影响

目的:探讨布地奈德福莫特罗吸入治疗对慢性支气管哮喘患者的临床疗效及其对患者血清炎性因子水平、肺功能和生活质量的影响。方法:选择2014年2月至2016年2月于我院呼吸内科就诊并确诊为慢性支气管哮喘患者123例,根据随机数字表法分为观察组65例和对照组58例。比较两组患者治疗前后血清白介素17(IL-17)、白介素33(IL-33)、基质金属蛋白酶9(MMP-9)、肺功能、生活质量评分的变化、临床疗效有效率及不良反应的发生情况。结果:观察组的总有效率为92.3%(60/65),显著高于对照组(81.03%,P0.05)。治疗后,两组患者的血清IL-17、IL-33水平与治疗前相比均显著降低(P0.05),且观察组显著低于对照组(P0.05);两组血清MMP-9水平与治疗前相比差异均无统计学意义(P0.05);观察组患者的第一秒用力呼吸容积(FEV1)、峰值呼气流速(PEF)与第一秒用力呼气容积与用力肺活量比值(FEV1/FVC)水平均明显增加,且观察组上述指标明显高于对照组(P0.05);圣.乔治呼吸问卷(SGRQ)评分结果显示观察组患者的生活质量显著高于对照组患者。结论:布地奈德福莫特罗吸入治疗对慢性支气管哮喘临床效果显著,可显著控制炎症反应,改善肺功能,显著提升患者生活质量。     

甲状腺功能减退症患者心理健康状况及影响因素分析

目的:研究甲状腺功能减退症患者的心理健康状况及其影响因素,为预防、改善甲减患者心理健康状况提供参考依据。方法:选取2014年1月-2016年1月来我院治疗的226例甲减患者作为甲减组,另从杨浦区多个社区随机抽取同期254例健康者作为健康组,采用SCL-90症状自评量表、社会支持评定量表(SSRS)及一般情况调查问卷对两组研究对象进行调查,采用Logistic回归分析甲减患者的影响因素。结果:两组性别、年龄及职业之间的差异无统计学意义(P0.05),而文化程度、经济收入的差异具有统计学意义(P0.05);甲减组患者强迫症状、抑郁、焦虑、精神病性评分及总分均高于健康组(P0.05);甲减组患者中焦虑、抑郁、人际关系敏感所占比重较高,分别为30.97%,26.11%,26.11%;与健康组相比,甲减组患者SSRS评分中主观支持、客观支持、支持利用度评分及总分均明显降低(P0.05);多因素Logistic回归分析显示社会支持、文化程度为小学、经济收入30000元/年是甲减患者心理健康的影响因素(P0.05)。结论:甲减患者心理状况较差,存在较严重的焦虑和抑郁情况,在治疗同时应注意健康教育和心理关怀,尤其是对收入低、文化程度低或社会支持程度低的患者,应给予及时的心理治疗,可提高患者的生活质量。