Stage-matched intervention could not only facilitate intention formation and enhance treatment self-efficacy but significantly improve CPAP adherence in OSA patients for the 3-month treatment.

Background:Ancient medical practitioners used to encourage dietary supplements and herbal medicine for the treatment of type 2 diabetes mellitus (T2DM). Ginger (Zingiber officinale), is a nontoxic spice with negligible side effects, and is considered safe by the food and drug administration. In this analysis, we aimed to systematically compare fasting blood sugar (FBS) and glycated hemoglobin (HbA1c) at baseline versus at follow-up in T2DM patients who consumed and who did not consume ginger.Methods:A literature search was carried out through MEDLINE, Embase, the Cochrane Central, and www.ClinicalTrials.gov for English-published trials comparing glucose parameters in T2DM patients who were assigned to ginger consumption versus a control group. All the participants were patients with T2DM who were either assigned to ginger therapy (1600– 4000 mg daily) or to a control group. FBS and HbA1c were assessed in the ginger and control groups, respectively, from baseline to follow-up to observe any significant change. Weight mean difference (WMD) with 95% confidence intervals (CI) was calculated to represent the analysis which was carried out by the RevMan 5.3 software.Results:Eight randomized trials consisting of a total number of 454 participants with T2DM were included in this analysis. At first, FBS was compared in patients with T2DM from baseline prior to ginger consumption until follow-up after ginger consumption. The results showed no significant difference in FBS (WMD: 1.38, 95% CI: [−0.53–3.30]; P = .16). For the T2DM patients who did not consume ginger, no significant difference in FBS was observed (WMD: −0.27, 95% CI: [−5.09–4.54]; P = .91). However, a significantly improved HbA1c from baseline to follow-up was observed in those participants with ginger consumption (WMD: 0.46, 95% CI: [0.09–0.84]; P = .02) whereas in the control group, no significant difference in HbA1c was observed (WMD: −0.23, 95% CI: [−0.60–0.14]; P = .22).Conclusion:This analysis involving patients with T2DM showed no significant difference in FBS with ginger consumption. However, dietary ginger significantly improved HbA1c from baseline to follow-up showing that this natural medicine might have an impact on glucose control over a longer period of time in patients with T2DM.

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BackgroundSeveral studies have assessed the effects of computer-based cognitive programs (CCP) in the management of age-related cognitive decline, but the role of CCP remains controversial. Therefore, this systematic review evaluated the evidence on the efficacy of CCP for age-related cognitive decline in healthy older adults.MethodsSix electronic databases (through October 2014) were searched. The risk of bias was assessed using the Cochrane Collaboration tool. The standardized mean difference (SMD) and 95% confidence intervals (CI) of a random-effects model were calculated. The heterogeneity was assessed using the Cochran Q statistic and quantified with the I2 index.ResultsTwelve studies were included in the current review and were considered as moderate to high methodological quality. The aggregated results indicate that CCP improves memory performance (SMD, 0.31; 95% CI 0.16 to 0.45; p < 0.0001) and processing speed (SMD, 0.50; 95% CI 0.14 to 0.87; p = 0.007) but not executive function (SMD, -0.12; 95% CI -0.33 to 0.09; p = 0.27). Furthermore, there were long-term gains in memory performance (SMD, 0.59; 95% CI 0.13 to 1.05; p = 0.01).ConclusionCCP may be a valid complementary and alternative therapy for age-related cognitive decline, especially for memory performance and processing speed. However, more studies with longer follow-ups are warranted to confirm the current findings.

Edited by Laszlo NagyKeywords: FAM19A3 Microglia Cerebral ischemia Polarization Middle cerebral artery occlusion a b s t r a c tIn this study, we have identified FAM19A3 as a gene that is significantly upregulated in the microglia in the middle cerebral artery occlusion (MCAO) mouse model. FAM19A3 expression and secretion were promoted by M2 stimuli, and this indicated that FAM19A3 might be an M2-type gene. Indeed, recombinant FAM19A3 promoted M2 polarization and inhibited M1 polarization of microglia in vitro. Similarly, recombinant FAM19A3 promoted M2 polarization of microglia and macrophages in vivo, and attenuated cerebral ischemia in the MCAO mouse model. Thus, the newly-identified secreted protein FAM19A3 modulates the microglia/macrophage polarization dynamics and ameliorates cerebral ischemia.

Aims:  Adenosine triphosphate (ATP) during the enzymatic production of glutathione is necessary. In this study, our aims were to investigate the reason for low glutathione production in Escherichia coli coupled with an ATP regeneration system and to develop a new strategy to improve the system. Methods and Results:  Glutathione can be synthesized by enzymatic methods in the presence of ATP and three precursor amino acids (l‐glutamic acid, l‐cysteine and glycine). In this study, glutathione was produced from E. coli JM109 (pBV03) coupled with an ATP regeneration system, by using glycolytic pathway of Saccharomyces cerevisiae WSH2 as ATP regenerator from adenosine and glucose. In the coupled system, adenosine used for ATP regeneration by S. cerevisiae WSH2 was transformed into hypoxanthine irreversibly by E. coli JM109 (pBV03). As a consequence, S. cerevisiae WSH2 could not obtain enough adenosine for ATP regeneration in the glycolytic pathway in spite of consuming 400 mmol l−1 glucose within 1 h. By adding adenosine deaminase inhibitor to block the metabolism from adenosine to hypoxanthine, glutathione production (8·92 mmol l−1) enhanced 2·74‐fold in the coupled system. Conclusions:  This unusual phenomenon that adenosine was transformed into hypoxanthine irreversibly by E. coli JM109 (pBV03) revealed that less glutathione production in the coupled ATP regeneration system was because of the poor efficiency of ATP generation. Significance and Impact of the Study:  The results presented here provide a strategy to improve the efficiency of the coupled ATP regeneration system for enhancing glutathione production. The application potential can be microbial processes where ATP is needed.

This study was conducted to investigate the relationship between the pattern of pathological plantar response (Babinski sign), and the focus of the lesions of pyramidal tract. We examined 107 subjects with definite lesions of the pyramidal tract recruited from inpatients at the Neurology Department of the Xuanwu Hospital of Capital Medical University (Beijing, China). We found that patients with sub-cortical lesions (corona radiata to spinal cord) showed different patterns of Babinski sign than those with lesions within the primary motor cortex. Specifically, dorsiflexion of the big toe without recruitment of the other toes was seen in 71.4 % of patients with cortical pyramidal tract lesions, while 93 patients with lesions lower than cortex (corona radiata to spinal cord) showed movement of other toes in addition to the big toe, which showed movement due to contraction of the extensor hallucis longus tendon in all patients. There were no differences in patterns of Babinski sign between the different sub-cortical lesion foci. We conclude that the patterns of Babinski sign can be used to predict cortical lesions of the pyramidal tract.

Background We aimed to investigate the clinical features and prognosis of posterior reversible encephalopathy syndrome (PRES) in children. Methods Clinical data of children with PRES diagnosed at the Children's Hospital of Chongqing Medical University from June 2015 to May 2019 were retrospectively analyzed. Results The study enrolled 47 patients with a mean age at diagnosis of 8.79 ± 3.72 years (range, 2–15 years). PRES causes included renal disorder (29/47), hematological disease (13/47), and hypertension (5/47). PRES manifested as seizure (43/47), headache (28/47), visual impairment (18/47), dizziness (18/47), vomiting (18/47), and mental and behavioral abnormalities (17/47). Forty‐six children had hypertension (46/47) at PRES onset. Magnetic resonance imaging (MRI) mainly involved the parietal and occipital lobes (42/47), 38 cases were mild (38/47), seven were moderate (7/47), and two were severe (2/47). The clinical symptoms of 41 patients (41/47) were relieved within 1–2 weeks. Thirty‐seven children were followed up for 7–54 months (modified Rankin Scale). Twenty‐five children had favorable outcomes (25/37). Twelve children had adverse outcomes (12/37), including epilepsy, disorders of consciousness, visual impairment, and mental decline. Analysis of single factors revealed that severity on MRI, length of in‐hospital stay, and mental and behavioral abnormalities were related to adverse outcomes after PRES. Analysis of multiple factors revealed that severity on MRI and length of in‐hospital stay were independent risk factors for PRES. Conclusion Pediatric PRES is a clinical radiographic syndrome with multiple etiologies. Most patients have a good prognosis. Severity on MRI and length of in‐hospital stay are independent risk factors.