Study Design Meta-analysis. Objectives This study aimed to evaluate the effect of transcutaneous electrical nerve stimulation in people with pain after spinal cord injury by meta-analysis. Methods Reviewed PubMed, Embase, Cochrane library, as well as China National Knowledge Infrastructure (CNKI), Wanfang, and Vip databases to search the randomized controlled trials of pain after spinal cord injury through transcutaneous electrical nerve stimulation from the beginning of the library to March 2021, and analyze the literature with RevMan 5.3 software and the bias in the literature with STATA 12.0 software. Results There are six randomized controlled trials in the study with 165 cases. 83 cases in the test group were given transcutaneous electrical nerve stimulation, and 82 cases in the control group used sham stimulation or other treatments. Meta-analysis results showed the experimental group’s visual analog scale (MD = −1.52, 95%CI, −2.44 to −0.60, P = 0.001) and short-form McGill pain questionnaire scores (MD = −0.70, 95% CI, −1.03 to −0.25, P = 0.002) were lower than those of the control group. Conclusions Transcutaneous electrical nerve stimulation has some clinical therapeutic effects on persons with pain after spinal cord injury, but due to the lack of literature, the sample size is not large, and clinical trials need to be further improved later.
Background: PPM1M is a member of the metal-dependent protein phosphatase family, and its role in the immunization process has not been studied in depth. In this study, we investigated the role of PPM1M in pan-cancer. Methods: Samples of cancer and normal tissues were obtained from the cancer genome atlas and genotype-tissue expression. Kaplan–Meier survival curves and Cox regression were used to analyze the effect of PPM1M on prognosis. Functional and pathway enrichment analyses were performed using the R package “clusterProfiler” to explore the role of PPM1M . The Sanger Box database was used to analyze the relationship between PPM1M and tumor immune checkpoint, tumor mutational burden, and microsatellite instability. The Tumor Immune Estimation Resource 2 database and CIBERSORT method were used to analyze the relationship between PPM1M and tumor-infiltrating immune cells. Finally, the cBioPortal database was used to analyze the genomic variation in PPM1M. Results: Among the variety of tumors, the expression of PPM1M was higher in normal tissues than in cancerous tissues. The expression of PPM1M is closely associated with patient prognosis, tumor immune checkpoint, tumor mutational burden, and microsatellite instability. PPM1M is closely associated with the infiltration of immune cells into the tumor microenvironment. In addition, PPM1M is involved in the regulation of several immune-related pathways. Conclusion: In pan-cancer, PPM1M affects patient prognosis and may be a potential immunological biomarker. Furthermore, PPM1M may be a potential therapeutic target in tumor immunology.
Complex coronary heart disease (CHD) has become a hot spot in medicine due to its complex coronary anatomy, variable clinical factors, difficult hemodynamic reconstruction, and limited effect of conservative drug treatment. Identifying complex CHD and selecting optimal treatment methods has become more scientific as revascularization technology has improved, and coronary risk stratification scores have been introduced. SYNTAX and its derivative scores are a decision-making tool that could quantitatively describe the characteristics of coronary lesions in patients based on their complexity and severity, could assist clinicians in rationalizing the selection of hemodynamic reconstruction treatment strategies, and have outstanding value in evaluating the prognosis of patients with complex CHD undergoing revascularization treatment. The authors hope that describing the practical application of SYNTAX and its derivative scores in complex CHD will deepen the understanding of the relationship between the choice of different revascularization strategies and SYNTAX and its derived scores in complex CHD and provide a further reference for clinical treatment of complex CHD.
Background: In recent years, non-invasive brain stimulation (NIBS) has often been used for therapeutic effects on motor functions. However, there is no clear evidence for the efficacy of NIBS in populations with spinal cord injury (SCI). This study aims to conduct a meta-analysis to summarize the existing evidence on the effectiveness and safety of NIBS for motor dysfunction after a spinal cord injury to obtain new insights. Methods: Two investigators systematically screened English articles from PubMed, MEDLINE, Embase, and Cochrane Library for eligible Randomized and prospective controlled trials regarding the effects of NIBS in motor function recovery after SCI. Studies with at least three sessions of NIBS were included. We assessed the methodological quality of selected studies as described in the evidence-based Cochrane Collaboration’ tool. A meta-analysis of the motor function was performed by pooling thestandardized mean difference (SMD)with 95% confidence intervals (CI). Results: A total of 14 studies involving 225 patients were included. Nine studies used repetitive transcranial magnetic stimulation (rTMS) and 5 studies used transcranial direct current stimulation (tDCS). The meta-analysis showed that NIBS could improve the lower extremity strength (SMD = 0.58, 95% CI= 0.02 to 1.14, P = 0.004), balance (SMD = 0.64, 95% CI= 0.05 to 1.24, P= 0.03) and decrees the spasticity (SMD = -0.64, 95% CI=-1.20 to-0.03, P =0.04); while functional mobility of the NIBS group was not statistically significant than that of the control group (upper extremity strength: P=0.07; spasticity: P=0.12). The motor function of upper extremity strength in the NIBS group did not reach statistical significance when compared with the sham group. Only one patient reported seizures occurred during stimulation; no other serious adverse events were reported. Conclusion: NIBS appears to have a positive effect on motor function of the lower extremity in SCI patients. However, the marginal p-value and a high heterogeneity suggest that these results should be interpreted with caution. Further high-quality clinical trials are needed to support or refute the use and optimize the stimulation parameters of NIBS in clinical practice.
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