BackgroundIt has reached a consensus that patients with amyotrophic lateral sclerosis (ALS) could display cognitive impairment characterized by executive dysfunction or even dementia, but cognitive spectrum of Chinese patients with ALS still waits to be documented.MethodsA total of 106 incident patients with sporadic ALS were enrolled and comprehensive neuropsychological tests covering memory, executive function, attention, language, and visuospatial function were administered to them. Neuropsychological performances of 76 age- and education- matched healthy controls were used for the purpose of classification and comparison.Results106 patients were categorized into 4 subtypes:84 (79.2%) ALS with normal cognition (ALS-NC), 12 (11.3%) ALS with executive cognitive impairment (ALS-ECI), 5 (4.7%) ALS with non-executive cognitive impairment (ALS-NECI), and 5 (4.7%) ALS with frontotemporal lobe degeneration (ALS-FTLD). Under the same criteria, 2 (2.6%) and 1 (1.3%) healthy controls were diagnosed as ECI and NECI, respectively. The proportion of ECI was significantly higher in non-demented ALS than that in healthy controls, but it was not for NECI. Patients with ALS-FTLD had significantly severer bulbar function and older age than those with ALS-NC.ConclusionComorbid FTLD occurred in around 5% of Chinese sporadic ALS cases. Different genetic background and unique age distribution of Chinese ALS patients might be the reasons for the relatively low rate of comorbid FTLD. Cognitive dysfunction, predominant but not exclusive in executive area, was present in around 16% of non-demented ALS patients.
The aim of the present study was to assess the immediate and long-term results of preoperative brachytherapy and chemotherapy followed by radical surgery compared with those of standard chemoirradiation in patients with stage IB2-IIA cervical cancer. The medical records of 70 patients with stage IB2 and IIA cervical cancer who were treated between June 2006 and June 2010 were reviewed. The patients received either standard chemoirradiation (CRT) treatment (n=20) or neoadjuvant brachytherapy with one cycle of chemotherapy followed by radical hysterectomy [operation (OT) group; n=50]. Further adjuvant chemoirradiation was administered to patients with high-risk disease. Early and late complications as well as survival were compared between the two groups. No serious operative complications occurred in the OT group. In the CRT group, the incidence of symptomatic vaginal stenosis, as well as that of proctitis and cystitis, was higher compared with that in the OT group (35 vs. 4% and 20 vs. 2%, repectively). The median follow-up period was 52 months (range, 11-84 months). In the CRT group, the 3-year overall and disease-free survival rates were 95% [95% confidence interval (CI): 76.14-86.46] and 90% (95% CI: 59.94-73.66), respectively, whereas in the OT group, the respective rates were 90% (95% CI: 72.93-83.07) and 90% (95% CI: 71.84-82.96). In conclusion, the survival of patients with stage IB2-IIA cervical cancer treated with preoperative brachytherapy and chemotherapy followed by radical surgery was similar to that of patients treated with chemoirradiation, but with a more favorable side effect profile. Thus, this tri-modal treatment option requires further evaluation in prospective randomized studies.
This study investigated whether 3,4-Dihydroxyacetophenone (DHAP) could improve endothelial function in streptozotocin-induced type 2 diabetic rats. Sprague-Dawley rats were randomly divided into control, diabetic, and diabetic DHAP-treated animals. After treatment with DHAP for 8 weeks, endothelial function was determined by measuring endothelium-dependent vasodilatation (EDV) of the thoracic aorta. Endothelial nitric oxide synthase (eNOS) activity and nitric oxide (NO) production in endothelial cells and nuclear transcription factor kappa B (NF-κB) expression and superoxide anion production in the aorta were determined. DHAP treatment reduced serum levels of triglycerides, cholesterol, malondialdehyde, and tumor necrosis factor α, and enhanced serum adiponectin levels. Endothelium-dependent vasodilatation was significantly attenuated in rats with diabetes and increased significantly after DHAP treatment. NO levels and eNOS activity in endothelial cells were significantly reduced, and NF-κB activation and superoxide production increased in rats with diabetes compared with the control group. DHAP treatment enhanced NO levels and eNOS activity and decreased NF-κB activation and superoxide production. These findings suggest that DHAP could improve endothelial function in streptozotocin-induced type 2 diabetic rats. The mechanism may be related to the enhancement of eNOS activity and NO production by reducing plasma lipid levels, oxidative stress, and inflammatory activity.
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