OBJECTIVE:

To determine the efficacy of botulinum toxin-A (BTX-A) nerve block, with and without rehabilitation, in the treatment of spastic cerebral palsy.

METHODS:

Patients (aged 1-23 years) with spastic cerebral palsy underwent nerve block with BTX-A, followed by ≥ 2 h/day rehabilitation (experimental group) or <2 h/day rehabilitation (control group). Muscle tension and motor function were evaluated pre-block using the Modified Ashworth Scale (MAS) and gross motor function measure (GMFM), respectively. MAS was assessed weekly to determine duration of action of BTX-A; GMFM was assessed at 1 year post-block.

RESULTS:

There were no significant differences between the experimental group (n = 120) and the control group (n = 124) in age, body weight, pre-block MAS or GMFM, or BTX-A duration of action. MAS was significantly improved in both groups at 1 month post-block. At 1 year post-block, GMFM was significantly improved in both groups, with a significantly greater improvement seen in the experimental group compared with the control group.

CONCLUSION:

BTX-A block improved muscle tension and motor function. Rehabilitation training, following the block, resulted in greater improvements to motor function than block alone.

OBJECTIVES:

MicroRNA-206 (miR-206) is downregulated in many human malignancies, which correlates with tumour progression. This study characterized the contribution of miR-206 to the initiation and progression of human breast cancer.

METHODS:

Consecutive primary breast cancer patients who received radical resection were enrolled. Breast cancer tissue samples were obtained during surgery. MiR-206 levels in matched pairs of cancer tissue and normal adjacent tissue (NAT) samples were examined using quantitative reverse transcription-polymerase chain reaction. The relationship between miR-206 levels and clinicopathological characteristics and overall survival was also investigated.

RESULTS:

In 128 patients with breast cancer, miR-206 was downregulated in 119 (93%) tumour tissue compared with their matched NAT samples. Decreased miR-206 was significantly associated with advanced clinical stage and lymph node metastasis. Univariate and multivariate Cox proportional hazard regression analysis revealed that a low miR-206 level was an unfavourable prognostic factor for overall survival, in patients with breast cancer.

CONCLUSIONS:

This study indicated that miR-206 may be a good candidate as a novel prognostic indicator in breast cancer patients.

OBJECTIVES:

To investigate levels of cell-division cycle 42 (Cdc42) protein, and their relationship with Golgi apparatus function in peripheral lymphocytes, in patients following ischaemic stroke.

METHODS:

Patients with acute cerebral ischaemic stroke (within 24-72 h of the onset of focal neurological symptoms) and healthy control subjects were enrolled in this prospective case-control study. The cellular location of Cdc42 in peripheral lymphocytes was demonstrated using immunofluorescence. Protein levels of Cdc42 and trans-golgi network protein 2 (TGN46) in peripheral lymphocytes were determined by immunocytochemical staining and Western blotting.

RESULTS:

A total of 38 patients with stroke and 38 control subjects were studied. The mean ± SD percentage of Cdc42-positive lymphocytes from patients with stroke was significantly lower than that in control subjects (39.53 ± 13.55% versus 66.61 ± 23.30%, respectively). Similar findings were demonstrated for TGN46. Cdc42 levels were positively correlated with TGN46 levels (r = 0.92).

CONCLUSIONS:

Acute ischaemic stroke was associated with reduced levels of Cdc42 protein. These findings might lead to the development of drugs that could have therapeutic benefits in patients with acute ischaemic stroke.

OBJECTIVES:

To investigate relationships between several protein biomarkers and clinical responses to neoadjuvant chemotherapy (NAC) in breast cancer.

METHODS:

Tumour tissue samples from female patients with locally advanced breast carcinoma (stages IIA to IIIC), treated with NAC regimens (including 5-fluorouracil, epirubicin, cyclophosphamide and docetaxel, epirubicin, cyclophosphamide) were analysed retrospectively. Immunohistochemical analysis was used to test for protein levels of oestrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor (HER)-2, protein 53 (p53) and γ-synuclein. Relationships between protein biomarkers and responses to NAC were analysed by multivariate logistic regression analysis.

RESULTS:

Data from 154 patients (median age, 51 years; range 27-75 years) were included. Multivariate logistic regression analysis showed that γ-synuclein was an independent predictor of NAC objective response rate, and a statistically significant relationship was observed between NAC regimen, γ-synuclein levels and pathological complete response rate.

CONCLUSIONS:

These study findings suggest that γ-synuclein - in combination with other markers such as ER, PR and HER-2 - may serve as a biomarker for response to NAC in breast cancer and warrants further study.

OBJECTIVE:

The aim of this study was to explore the relationships between expression of the NIN1/RPN12 binding protein 1 homologue gene (NOB1) in papillary thyroid carcinoma tissue and clinicopathological variables.

METHODS:

Expression of NOB1 in papillary thyroid carcinoma, normal thyroid and benign thyroid tumour tissue was evaluated at the mRNA and protein levels by real-time fluorescence quantitative reverse transcription-polymerase chain reaction and immunohistochemistry, respectively. Relationships between immunohistochemical scores and several clinicopathological variables were also examined.

RESULTS:

Expression of NOB1 mRNA and protein in papillary thyroid carcinomatissue was significantly higher than in normal thyroid tissue and benign thyroid tissue, while there was no significant difference between normal thyroid tissue and benign thyroid tumour tissue. A high level of NOB1 protein expression was associated with large tumour size and Union for International Cancer Control stage, but was not significantly correlated with sex or age.

CONCLUSIONS:

Compared with normal thyroid and benign thyroid tumour tissue, papillary thyroid carcinomas showed higher expression of NOB1, which indicates that the expression level of the NOB1 gene in the thyroid may play a key role in the occurrence and development of papillary thyroid carcinoma.

OBJECTIVES:

To investigate the ability of matrix metalloproteinase (MMP)-2 and CD44 variant 6 (CD44v6) protein levels to diagnose papillary thyroid cancer (PTC), compared with routine diagnostic methods using tissue sections; to explore the relationship between MMP-2 and CD44v6 protein levels and lymph node metastases (LNM) in PTC.

METHODS:

Archival PTC specimens from patients with PTC, with or without lateral cervical LNM, were included in this retrospective immunohistochemical study. MMP-2 and CD44v6 protein levels were analysed immunohistochemically using routinely prepared tissue sections.

RESULTS:

Specimens from 66 patients with PTC were reviewed retrospectively (35 patients with lateral cervical LNM; 31 patients without LNM). The percentages of samples with cells that demonstrated positive protein staining differed significantly between PTC specimens, benign thyroid nodules and adjacent normal follicular epithelium (MMP-2: 86.4%, 60.0%, and 25.7%, respectively; CD44v6: 80.3%, 37.1% and 22.9%, respectively). The level of CD44v6 protein staining was found to be significantly and positively correlated with the level of MMP-2 protein staining in PTC specimens.

CONCLUSIONS:

Both MMP-2 and CD44v6 might be useful tumour markers for predicting risk of lateral cervical LNM in patients with PTC.

OBJECTIVE:

This study investigated the influence of laparoscopic carbon dioxide (CO2) pneumoperitoneum on neonate circulation and respiration.

METHODS:

The study included neonates undergoing elective laparoscopic abdominal surgery. CO2 insufflation pressure was maintained within 8-14 mmHg for pneumoperitoneum creation. Heart rate (HR), mean arterial pressure (MAP), peripheral oxygen saturation (SpO2), partial pressure of end-tidal carbon dioxide (PETCO2) and maximum inspiratory pressure were monitored continuously. Arterial blood samples were collected: 5 min before pneumoperitoneum creation (baseline); 5, 10, and 20 min after CO2 insufflation; 10 min after CO2 exsufflation; 10 min after surgery. pH, partial pressure of CO2 (PaCO2) and arterial oxygen saturation (SaO2) were also measured.

RESULTS:

Thirty-six neonates were included. HR and MAP significantly increased after pneumoperitoneum creation, then decreased to baseline after CO2 exsufflation. PaCO2 and PETCO2 were significantly higher after pneumoperitoneum creation, whereas pH was significantly lower 20 min after pneumoperitoneum creation compared with baseline. No significant differences were observed in SpO2 and SaO2.

CONCLUSION:

CO2 pneumoperitoneum had a significant effect on neonatal circulation and respiration, suggesting that the pneumoperitoneal pressure should be limited within a certain range in neonates undergoing laparoscopic surgery.

OBJECTIVE:

To investigate the efficacy and safety of 14 days' orally administered tolvaptan as adjunctive treatment for hepatic oedema in Japanese liver cirrhosis patients with insufficient response to conventional diuretics, with the option to increase dose in those who did not respond initially.

METHODS:

This multicentre, single-arm, phase 3 study allocated patients with liver cirrhosis and persistent ascites to 7-day treatment with 7.5 mg/day tolvaptan followed by an additional 7 days' treatment. Responders at day 7 (achieving ≥1 kg body-weight reduction) continued on 7.5 mg/day tolvaptan; nonresponders (<1 kg body-weight reduction) received 15 mg/day tolvaptan. Conventional diuretic treatment continued throughout. The primary endpoint was change in body weight from baseline, as a marker of ascites volume.

RESULTS:

A total of 51 patients received 7.5 mg/day tolvaptan for 7 days, which caused a significant reduction in mean body weight (55% response rate). During the second 7-day treatment period, 30 patients received 7.5 mg/day tolvaptan and 13 patients received tolvaptan 15 mg/day: response rates were 43% and 23%, respectively. Two serious adverse events were observed. Serum sodium was within normal range.

CONCLUSIONS:

Tolvaptan therapy for 14 days (with possible dose increase as necessary), in combination with conventional diuretics, effectively reduced body weight in patients with hepatic oedema.

OBJECTIVE:

To analyse relationships between incidence of osteoporosis, age and clinical symptoms in older female patients in East China.

METHODS:

Data from females aged ≥30 years, admitted to QiLu Hospital between January 1999 and December 2011 were retrospectively assessed for osteoporosis. Correlations between osteoporosis diagnosis, age and clinical symptoms were analysed. Factors associated with osteoporosis were assessed using logistic regression.

RESULTS:

Out of 4212 patients enrolled, 1673 were assigned to the osteoporosis group and 2539 to the nonosteoporosis group. Neck, shoulder and arm pain negatively correlated with osteoporosis diagnosis. Lumbar and back pain had no correlation with osteoporosis diagnosis. In patients with osteoporosis there was no relationship between bone density and site of clinical symptoms. Bone density decreased, as age increased, in patients aged >50 years in the osteoporosis group.

CONCLUSION:

The present study revealed a relationship between epidemiological distribution of osteoporosis and associated factors in adult females suffering from pain or numbness, in East China.

OBJECTIVE:

To determine the relationship between temporomandibular dysfunction syndrome (TMDS), sex and pain severity.

METHODS:

Data were collected prospectively from consecutive patients with TMDS. Patients were divided into four subgroups according to signs and symptoms: myofascial pain; intra-articular disorders; extra-articular disorders; degenerative disorders. Intergroup sex distribution differences were evaluated, the pain severity between the four subgroups was compared, and the rates of bruxism and inco-ordination were measured. A visual analogue scale was used to rate the pain.

RESULTS:

A total of 255 patients with TMDS were included in the study. A significantly higher rate of extra-articular disorders was found in male patients. Bruxism was found to be significantly more common in females than in males. There was no significant difference in the prevalence of inco-ordination based on sex. The overall pain score was higher in females than in males, but there was no significant difference. The pain score was significantly higher in patients in the degenerative disorders subgroup, compared with other subgroups.

CONCLUSIONS:

There was no relationship between TMDS and pain and sex. Pain scores were significantly higher in the degenerative disorders subgroup, compared with other subgroups.