Objective. This study was aimed at identifying the potential outcome predictors, comparing the efficacy in patients with different tremor characteristics, and summarizing the adverse effect rates (AERs) of deep brain stimulation on the ventral intermediate nucleus (VIM-DBS) for essential tremor (ET). Methods. An extensive search of articles published to date in 2019 was conducted, and two main aspects were analyzed. Improvement was calculated as a percentage of change in any objective tremor rating scale (TRS) and analyzed by subgroup analyses of patients’ tremor characteristics, laterality, and stimulation parameters. Furthermore, the AERs were analyzed as follows: the adverse effects (AEs) were classified as stimulation-related, surgical-related, or device-related effects. A simple regression analysis was used to identify the potential prognostic factors, and a two-sample mean-comparison test was used to verify the statistical significance of the subgroup analyses. Results. Forty-six articles involving 1714 patients were included in the meta-analysis. The pooled improvement in any objective TRS score was 61.3% (95% CI: 0.564-0.660) at the mean follow-up visit (20.0±17.3 months). The midline and extremity symptoms showed consistent improvement (P=0.440), and the results of the comparison of postural and kinetic tremor were the same (P=0.219). In addition, the improvement in rest tremor was similar to that in action tremor (OR=2.759, P=0.120). In the simple regression analysis, the preoperative Fahn-Tolosa-Marin Tremor Rating Scale (FTM-TRS) scores and follow-up time were negatively correlated with the percentage change in any objective TRS score (P<0.05). The most common adverse event was dysarthria (10.5%), which is a stimulation-related AE (23.6%), while the rates of the surgical-related and device-related AEs were 6.4% and 11.5%, respectively. Conclusion. VIM-DBS is an efficient and safe surgical method in ET, and the efficacy was not affected by the body distribution of tremor, age at surgery, and disease duration. Lower preoperative FTM-TRS scores likely indicate greater improvement, and the effect of VIM-DBS declines over time.

Ischemia-reperfusion injury (IRI), also called reoxygenation injury, is the outcome of inflammatory processes and oxidative damage through the induction of oxidative stress. In the clinical setting, IRI contributes to severe hepatic injury, including liver cell death by apoptosis and ferroptosis. Ferroptosis is a novel type of cell death in hepatic IRI that involves small molecules that inhibit glutathione biosynthesis or glutathione peroxidase 4 (GPX4), which is a glutathione-dependent antioxidant enzyme, causing mitochondrial damage. Currently, ferroptosis has been systematically described in neurological settings, kidney diseases and different types of cancer, while few studies have analysed the presence of ferroptosis and the regulatory mechanism of ferroptosis in hepatic IRI. Exploring the exact role played by ferroptosis in the liver following hepatic IRI in accordance with existing evidence and mechanisms could guide potential therapeutic interventions and provide a novel research avenue. Contents1. Introduction 2. Hepatic IRI 3. Brief overview of ferroptosis 4. The ferroptotic signalling pathway 5. Ferroptosis in hepatic IRI 6. Other types of regulated cell death 7. Current therapeutic strategies in hepatic IRI 8. Conclusions and future perspectives

Purpose Many markers of inflammation are increasingly found to have prognostic significance in some cancers. This study investigated the prognostic value of albumin/globulin (AGR), lymphocyte/monocyte ratio (LMR), and other inflammatory markers, including neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR), in patients with papillary thyroid carcinoma (PTC). Methods We retrospectively analyzed the data of 764 patients newly diagnosed with PTC (608 women, 156 men) aged 10-83 years. Univariate and multivariate analyses were used to analyze recurrence rates and assess potential prognostic factors. Furthermore, we used random survival forests to construct a random survival forest score (RSFscore). The correlations between various inflammatory factors and traditional prognostic factors were analyzed. We also compared the areas under the curve (AUCs) of the RSFscore and 4 inflammation-based markers. Results AGR, NLR, PLR, and LMR were strongly associated with invasive clinicopathological features (tumor size, lesions, lymph node metastasis, and lymph node metastasis rate) and postoperative recurrence. In the multivariate analysis, AGR and LMR were independent prognostic markers for recurrent PTC. Higher NLR and PLR values indicated a higher risk of recurrence, while higher LMR and AGR values suggested a lower recurrence risk. The predictive power of the combined indicators was stronger than that of single indicators alone. Conclusion Compared to the analysis of a single indicator, the combination of inflammatory markers was more helpful in determining the risk of PTC recurrence, which has an important impact on predicting patients’ cancer-free survival and quality of life.

Malignant tumors are often exposed to hypoxic and glucose-starved microenvironments. AMP-activated protein kinase (AMPK) is an energy sensor that is stimulated during energy-deficient conditions and protects cells from hypoxic injury by regulating metabolism. AMPK-related protein kinase 5 (ARK5) is a member of the catalytic sub-unit of the AMPK family and has an important role in energy regulation and hypoxia. ARK5 is regulated by Akt and liver kinase B1 and is associated with numerous tumor-related molecules to exert the negative effects of tumors. Studies have revealed ARK5 overexpression in cases of tumor invasion and metastasis and a positive association with the degree of cancer cell malignancy, which is regarded as a key element in determining cancer prognosis. Furthermore, ARK5 downregulation improves drug sensitivity through the epithelial-mesenchymal transition pathway, indicating that it may be a potential therapeutic target. In other non-cancer conditions, ARK5 has various roles in neurodegenerative diseases (Alzheimer's and Huntington's disease), renal disorders (diabetic nephropathy and renal fibrosis) and physiological processes (striated muscle generation). In the present review, the upstream and downstream molecular pathways of ARK5 in cancer and other diseases are described and potential therapeutic strategies are discussed.