Search

Objective To explore the effect of myofascial release technique in the treatment of stage Ⅲ lymphedema after breast cancer surgery. Methods The clinical data of breast cancer-related stage Ⅲ lymphedema patients treated in the Department of Rehabilitation Medicine of Peking Union Medical College Hospital from January 2016 to December 2021 were retrospectively collected. According to different treatment methods, the patients were divided into manual therapy group and conventional therapy group. The conventional therapy group was treated with conventional bandage compression combined with exercise training, while the manual therapy group was treated with myofascial release technique before bandage compression and exercise training. Both groups were treated 2-3 times a week, 25-30 times in total. Limb volume, pain, range of motion (ROM), and limb function were evaluated before treatment, at the end of treatment, and 3 months after treatment, with limb volume as the primary outcome index. Results A total of 79 breast cancer patients with stage Ⅲ lymphedema who met the inclusion and exclusion criteria were enrolled, including 39 in the conventional therapy group and 40 in the manual therapy group. There was no significant difference in limb volume, visual analogue scale (VAS) score, flexion and abduction ROM, and disability arm shoulder hand (DASH) score between the two groups before treatment (all P > 0.05). Compared with the conventional therapy group, the affected limb volume in the manual therapy group was reduced at the end of treatment[(2511.70±437.08)cm3 vs. (2823.58±537.60)cm3, P=0.006] and 3 months after treatment[(2492.91±446.52)cm3 vs. (2813.90±533.87)cm3, P=0.005], and VAS and DASH scores were decreased (all P < 0.05), while the anteriorflexion and abduction ROM of the affected limb were increased 3 months after treatment (all P < 0.05). Linear regression analysis showed that in the manual therapy group the mean reduction of limb volume after treatment was 156.260 cm3(95% CI: 124.264-188.255, P < 0.001) more than that in the conventional therapy group; the mean reduction of VAS score was 0.557(95% CI: 0.163-0.951, P=0.006) more than that in the conventional therapy group; and the mean reduction of DASH score was 16.590(95% CI: 12.270-20.911, P < 0.001) more than that in the conventional therapy group; the average increase of anteriorflexion ROM was 7.390(95% CI: 2.016-12.763, P=0.007) more than that in the conventional therapy group, and the average increase of abduction ROM was 12.737(95% CI: 6.320-19.153, P < 0.001) more than that in the conventional therapy group. Conclusions Myofascial relaxation may be associated with the reduction of the volume of stage Ⅲ lymphedema in patients with breast cancer. It can relieve pain and restore joint function to a certain extent.

A young male diagnosed with severe hemophilia A since childhood, was presented with recurrent joint and urinary bleeding. Annualized bleed rates dropped below five with low dose prophylactic medication.Bleeding in the right knee joint recently aggravated. Due to coexisting HIV infection and advanced hemophilic arthritis, the patient was managed by a multi-disciplinary team(MDT).Total knee arthroplasty was performed by an experienced surgeon using modern prosthesis design and intraoperative navigation technologies.Physical and rehabilitation therapy was provided during the postoperative period, and joint function improved. The MDT managed the young patient with HIV infection and advanced hemophilic arthritis. The patient was diagnosed with osteoporosis thought to have been caused by hemophilia, HIV infection and antiviral drugs; and he received treatment. The treatment of this patient reflects the importance of multidisciplinary cooperation in the management of difficult and rare diseases.

Background: Split-hand/foot malformation (SHFM) is a congenital disability characterized by the absence or hypoplasia of the central ray of the hands and/or feet. This study reports a causative variant in the TP63 gene in a Chinese family exhibiting limb anomalies associated with SHFM4. Methods: Enrolled in this study was a Chinese family with limb anomalies without any other clinical features. Karyotype analysis and chromosomal microarray analysis (CMA) were conducted to identify chromosomal abnormalities. Whole exome sequencing (WES) was utilized to investigate sequence variants, while RNA sequencing assessed differentially expressed genes, with findings confirmed through quantitative PCR (qPCR). Results: Karyotype analysis and CMA revealed no chromosomal abnormalities in the family. Subsequently, WES identified a rare heterozygous variant of NM_003722.5: c.956G > A (p.Arg319His) in the TP63 gene in the proband, which was inherited from her father who also presented with limb deformities. However, both of the sister and grandfather of the proband had the same variant but exhibited normal limb morphology. RNA sequencing results demonstrated an increased expression level of TP63 and its downstream genes (PERP, CDH3, and DLX5) compared with the controls, indicating an enrichment of cell adhesion molecules the differentially expressed genes in the patient. However, significant differences were noted only for the CDH3 and DLX5 genes in qPCR analysis (p<0.05). Conclusion: This study identifies, for the first time, the TP63 gene variant c.956G > A (p.Arg319His) as a causative factor for SHFM4 in Chinese individuals with incomplete penetrance. In addition, we hypothesize that the p.Arg319His variant functions as a gain-of-function variant, leading to the upregulation of cell adhesion target genes. Such upregulation then disrupts the p63-Dlx signaling pathway and causes AER stratification failure. [ABSTRACT FROM AUTHOR]

AIM: This study aims to investigate the role of dynamin-related protein 1 (Drp1) in the A1 type activation of astrocytes and elucidate the underlying mechanism of abnormal astrocyte activation. METHODS: Rat astrocyte line CTX-TNA2 was divided into control group, astrocyte-conditioned medium (ACM) group, and 5, 10 and 25 μmol/L mitochondrial division inhibitor-1 (Mdivi-1; a selective inhibitor of Drp1) +ACM group. The cells in ACM group were exposed to ACM containing interleukin-1α (IL-1α), tumor necrosis factor-α (TNF-α) and complement 1q (C1q) for 24 h to induce type A1 activation, while those in Mdivi-1+ACM group were pre-treated with various concentrations of Mdivi-1 for 2 h before stimulation with ACM for 24 h. RT-qPCR was used to detect the expression levels of A1 type activation- related indicators IL-1β, TNF-α and IL-10 mRNA in each group. Immunofluorescence was utilized to assess the expression levels of A1 type activation marker molecules C3, inducible nitric oxide synthase (iNOS) and S100 calcium binding protein A10 (S100A10) . The level of mitochondrial reactive oxygen species (ROS) was measured using MitoSOX Red staining and flow cytometry analysis. The mitochondrial morphology was observed using the MICA full-field imaging analysis platform. Lastly, the expression level of mitochondrial fission protein 1 (FIS1) and the activation level of Drp1 in each group were evaluated through immunoblotting analysis. RESULTS: The RT-qPCR and immunofluorescence results indicated that the ACM group exhibited significantly elevated levels of IL-1β and TNF-α mRNA, and C3 protein expression compared with control group, along with increased iNOS protein expression and reduced IL-10 mRNA and S100A10 protein expression (P<0. 05) . Interventions with 10 and 25 μmol/L Mdivi-1 effectively inhibited the rise in IL-1β and TNF-α mRNA, and C3 and iNOS protein expression induced by ACM, while promoting S100A10 expression. MitoSOX Red staining revealed a significant increase in mitochondrial ROS levels in astrocytes stimulated by ACM, which was effectively reversed by Mdivi-1 intervention. The MICA full-field imaging analysis platform demonstrated that ACM induced the formation of round-shaped mitochondria in astrocytes, while 10 and 25 μmol/L Mdivi-1 interventions facilitated the restoration of their tubular shape. Additionally, Western blot results confirmed that Mdivi-1 intervention effectively reversed the activation of Drp1 and FIS1. CONCLUSION: The Drp1-mediated mitochondrial fission represents one of the intrinsic molecular mechanisms underlying A1 type activation of astrocytes, and Mdivi-1, as a selective inhibitor of Drp1, can effectively inhibit abnormal astrocyte activation. [ABSTRACT FROM AUTHOR]

Under the background of rapid urbanization,rapid economic development and industrialization level improvement,the lake water quality is deteriorating,with increasingly serious eutrophication.So it is of great significance to strengthen the monitoring and control of lake water quality.Taking Dongping Lake as the research object,this paper quantitatively analyzes the dynamic change of Potamogeton crispus in Dongping Lake by remote sensing method,with purpose to reveal the seasonal biomass dynamics of Potamogeton crispus in Dongping Lake,clarify its impact on the total phosphorus of Dongping Lake,and provide scientific support for water quality control,especially total phosphorus control.The results show that:The vegetation in the lake water in 2018 was less than that in 2017 by visual interpretation,and showed a decline trend in concentric way from the center of the lake,which indicated that the local government and environmental protection departments has spared no efforts in governance;The dry matters in 2018 were less than those in 2017.It is a great contribution to total phosphorus of lake water by the death of Potamogeton crispus.

By preparing the 18Ni300 laser clad layers at different energy densities, the pores of the laser clad layers were measured and analyzed by using the image method, and the effect of energy density on the porosity was explored by combining the experimental data. The experimental results show that the cross-sectional pores of the laser clad layers are regular in shape and do not intersect with each other, and most of the pores are gathered at the top edge of the fused cladding layer. The influence of process parameters on the morphology of the laser clad layer is obvious. The study shows that the influence of process parameters on porosity is in the order of laser power, scanning speed, and powder feeding voltage; combined with the analysis of variance table and response surface diagram, the interaction between the parameters is obvious, and combined with the change, it can achieve the purpose of reducing porosity. Porosity first increases and then decreases with the increase in the energy density, and the distribution of the energy density and porosity is divided into regions, and larger porosity can be avoided by selecting the regions. The hardness of the laser clad layer can be increased by the choice of energy density. The laser clad layer with good test results was observed to contain Co, α-Fe, and Fe7Ni3 intermetallic compounds. The microstructure is transformed from fine grains at the top to columnar dendrites at the bottom. [ABSTRACT FROM AUTHOR]