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Influence of reminiscence therapy on mental health and quality of life in elderly patients with unresectable, metastatic gastrointestinal cancer. 回忆疗法对患有无法切除的转移性胃肠癌的老年患者的心理健康和生活质量的影响。
IF 1.9 4区 医学 Q2 BIOLOGY Pub Date : 2024-05-20 eCollection Date: 2024-01-01 DOI: 10.1590/1414-431X2024e13344
Yu Liang, Limin Zhang

Reminiscence therapy (RT) attenuates psychological disorders in cancer patients. This study aimed to evaluate the effect of RT on anxiety, depression, spiritual well-being, and quality of life in elderly patients with unresectable, metastatic gastrointestinal cancer. A total of 222 elderly patients with unresectable, metastatic gastrointestinal cancer were randomized into RT group (RT plus usual care, n=112) or control group (usual care, n=110) with a 6-month intervention. Hospital Anxiety and Depression Scale for Anxiety (HADS-A) and Depression (HADS-D), Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp), and Quality of Life Questionnaire-Core 30 (QLQ-C30) were evaluated at month (M)0, M1, M3, and M6. Concerning the primary outcome, HADS-A score at M6 decreased in the RT group compared to the control group (P=0.005). As to secondary outcomes, the RT group showed decreased HADS-A scores at M3, anxiety rate at M3, HADS-D scores at M3 and M6, depression rate at M6, as well as greater FACIT-Sp scores at M1, M3, and M6 vs the control group (all P<0.050). Additionally, QLQ-C30 global health score was elevated at M1 (P=0.046) and M6 (P=0.005), functions score was greater at M6 (P=0.038), and symptoms score was lower at M3 (P=0.019) in the RT group than in the control group. Subgroup analysis revealed that the addition of RT was more effective for patients with anxiety or depression at baseline. In summary, RT alleviated anxiety and depression, and improved the spiritual well-being and quality of life within 6 months in elderly patients with unresectable, metastatic gastrointestinal cancer.

回忆疗法(RT)可减轻癌症患者的心理障碍。本研究旨在评估回忆疗法对不可切除的转移性胃肠癌老年患者的焦虑、抑郁、精神健康和生活质量的影响。研究人员将 222 名无法切除的转移性胃肠癌老年患者随机分为 RT 组(RT 加常规护理,人数=112)或对照组(常规护理,人数=110),进行为期 6 个月的干预。在第 0 个月、第 1 个月、第 3 个月和第 6 个月对医院焦虑抑郁量表(HADS-A)和抑郁量表(HADS-D)、慢性疾病治疗功能评估-精神健康量表(FACIT-Sp)和生活质量问卷-核心 30(QLQ-C30)进行评估。在主要结果方面,与对照组相比,RT 组在 M6 时的 HADS-A 评分有所下降(P=0.005)。至于次要结果,与对照组相比,RT 组在 M3 时的 HADS-A 评分、M3 时的焦虑率、M3 和 M6 时的 HADS-D 评分、M6 时的抑郁率以及 M1、M3 和 M6 时的 FACIT-Sp 评分均有所下降(均为 P=0.005)。
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引用次数: 0
The essential role of adenine nucleotide translocase 4 on male reproductive function in mice. 腺嘌呤核苷酸转位酶 4 对小鼠雄性生殖功能的重要作用
IF 1.9 4区 医学 Q2 BIOLOGY Pub Date : 2024-05-20 eCollection Date: 2024-01-01 DOI: 10.1590/1414-431X2024e13590
Fengyuan Yang, Xiali Yang, Hui Zhu, Xinbo Wang, Xin Liao, Yinxu Fu, Ting Fu, Xiandan Chen, Aliaksei Sysa, Jianxin Lyu, Huaibin Zhou

Adenine nucleotide translocator 4 (Ant4), an ATP/ADP transporter expressed in the early phases of spermatogenesis, plays a crucial role in male fertility. While Ant4 loss causes early arrest of meiosis and increased apoptosis of spermatogenic cells in male mice, its other potential functions in male fertility remain unexplored. Here, we utilized Ant4 knockout mice to delineate the effects of Ant4-deficiency on male reproduction. Our observations demonstrated that Ant4-deficiency led to infertility and impaired testicular development, which was further investigated by evaluating testicular oxidative stress, autophagy, and inflammation. Specifically, the loss of Ant4 led to an imbalance of oxidation and antioxidants. Significant ultrastructural alterations were identified in the testicular tissues of Ant4-deficient mice, including swelling of mitochondria, loss of cristae, and accumulation of autophagosomes. Our results also showed that autophagic flux and AKT-AMPK-mTOR signaling pathway were affected in Ant4-deficient mice. Moreover, Ant4 loss increased the expression of pro-inflammatory factors. Overall, our findings underscored the importance of Ant4 in regulating oxidative stress, autophagy, and inflammation in testicular tissues. Taken together, these insights provided a nuanced understanding of the significance of Ant4 in testicular development.

腺嘌呤核苷酸转运体4(Ant4)是一种在精子发生早期阶段表达的ATP/ADP转运体,在男性生育中起着至关重要的作用。虽然Ant4缺失会导致雄性小鼠减数分裂早期停止和生精细胞凋亡增加,但它在雄性生育能力中的其他潜在功能仍有待探索。在这里,我们利用Ant4基因敲除小鼠来阐明Ant4缺失对雄性生殖的影响。我们的观察结果表明,Ant4缺失会导致不育和睾丸发育受损,并通过评估睾丸氧化应激、自噬和炎症对其进行了进一步研究。具体来说,Ant4缺失导致氧化和抗氧化失衡。在Ant4缺失小鼠的睾丸组织中发现了明显的超微结构改变,包括线粒体肿胀、嵴缺失和自噬体积累。我们的结果还显示,Ant4缺陷小鼠的自噬通量和AKT-AMPK-mTOR信号通路受到了影响。此外,Ant4 缺失会增加促炎因子的表达。总之,我们的发现强调了Ant4在调节睾丸组织氧化应激、自噬和炎症中的重要性。总之,这些发现让我们对Ant4在睾丸发育过程中的重要性有了细致入微的了解。
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引用次数: 0
Tolerability of glutamine supplementation in older adults: a double-blind placebo-controlled randomized clinical trial. 老年人补充谷氨酰胺的耐受性:双盲安慰剂对照随机临床试验。
IF 1.9 4区 医学 Q2 BIOLOGY Pub Date : 2024-05-20 eCollection Date: 2024-01-01 DOI: 10.1590/1414-431X2024e13468
T C M de Nóbrega, M A R C P da Silva, E M Rampani, R Curi, R B Bazotte

In this double-blind placebo-controlled randomized investigation, we assessed the tolerability of glutamine in older adults recruited from three daycare centers. The relevance of studying glutamine supplementation in elderly patients lies in its potential to provide a well-tolerated intervention. Glutamine, a crucial amino acid, plays a vital role in various physiological processes, including immune function and protein synthesis. Understanding its impact on older adults is essential, given the potential implications for their health and well-being. Participants received a daily dose of 12.4 g of oral effervescent glutamine (EGln group) or maltodextrin (placebo group) for 60 days. Fifteen patients from each group completed the study. The mean ages were 77.0±9.1 and 79.0±6.9 years for the EGln and placebo groups, respectively. We evaluated body mass index, aminogram, hemogram, plasma levels of glucose, prealbumin, albumin, urea, creatinine, uric acid, C-reactive protein, vitamin D, calcium, sodium, potassium, and the plasma activities of aspartate aminotransferase and alanine aminotransferase. Notably, we quantified a broad array of inflammatory markers and growth factors providing a holistic understanding of the potential effects of glutamine supplementation. The results demonstrated that oral glutamine did not induce significant changes in any evaluated parameters, and no adverse effects were reported. This finding suggested that the dosage of glutamine used in this study was well-tolerated and safe. This information contributes to the broader understanding of glutamine supplementation, emphasizing its safety and supporting its potential as a viable intervention for maintaining health in aging individuals.

在这项双盲安慰剂对照随机调查中,我们评估了从三个日托中心招募的老年人对谷氨酰胺的耐受性。对老年患者补充谷氨酰胺进行研究的意义在于,它有可能提供一种耐受性良好的干预措施。谷氨酰胺是一种重要的氨基酸,在免疫功能和蛋白质合成等各种生理过程中发挥着重要作用。鉴于谷氨酰胺对老年人健康和福祉的潜在影响,了解谷氨酰胺对老年人的影响至关重要。参与者每天服用 12.4 克泡腾谷氨酰胺口服液(EGln 组)或麦芽糊精(安慰剂组),连续服用 60 天。每组各有 15 名患者完成了研究。EGln 组和安慰剂组的平均年龄分别为 77.0±9.1 岁和 79.0±6.9 岁。我们评估了体重指数、氨基转移图、血红蛋白、血浆中葡萄糖、前白蛋白、白蛋白、尿素、肌酐、尿酸、C 反应蛋白、维生素 D、钙、钠、钾的水平,以及血浆中天冬氨酸氨基转移酶和丙氨酸氨基转移酶的活性。值得注意的是,我们对一系列炎症标志物和生长因子进行了量化,从而全面了解了谷氨酰胺补充剂的潜在作用。结果表明,口服谷氨酰胺不会引起任何评估参数的显著变化,也没有不良反应的报告。这一结果表明,本研究中使用的谷氨酰胺剂量具有良好的耐受性和安全性。这些信息有助于人们更广泛地了解谷氨酰胺补充剂,强调其安全性,并支持其作为维持老年人健康的可行干预措施的潜力。
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引用次数: 0
Electro-acupuncture modulated miR-214 expression to prevent chondrocyte apoptosis and reduce pain by targeting BAX and TRPV4 in osteoarthritis rats. 电针通过靶向BAX和TRPV4调节miR-214的表达,防止骨关节炎大鼠软骨细胞凋亡并减轻疼痛
IF 1.9 4区 医学 Q2 BIOLOGY Pub Date : 2024-05-20 eCollection Date: 2024-01-01 DOI: 10.1590/1414-431X2024e13238
Jia He, Jia Zuo, Xiaochen Fan, Zhe Li

Osteoarthritis (OA) is a highly prevalent joint disorder characterized by progressive degeneration of articular cartilage, subchondral bone remodeling, osteophyte formation, synovial inflammation, and meniscal damage. Although the etiology of OA is multifactorial, pro-inflammatory processes appear to play a key role in disease pathogenesis. Previous studies indicate that electroacupuncture (EA) exerts chondroprotective, anti-inflammatory, and analgesic effects in preclinical models of OA, but the mechanisms underlying these potential therapeutic benefits remain incompletely defined. This study aimed to investigate the effects of EA on OA development in a rat model, as well as to explore associated molecular mechanisms modulated by EA treatment. Forty rats were divided into OA, EA, antagomiR-214, and control groups. Following intra-articular injection of monosodium iodoacetate to induce OA, EA and antagomiR-214 groups received daily EA stimulation at acupoints around the knee joint for 21 days. Functional pain behaviors and chondrocyte apoptosis were assessed as outcome measures. The expression of microRNA-214 (miR-214) and its downstream targets involved in apoptosis and nociception, BAX and TRPV4, were examined. Results demonstrated that EA treatment upregulated miR-214 expression in OA knee cartilage. By suppressing pro-apoptotic BAX and pro-nociceptive TRPV4, this EA-induced miR-214 upregulation ameliorated articular pain and prevented chondrocyte apoptosis. These findings suggested that miR-214 plays a key role mediating EA's therapeutic effects in OA pathophysiology, and represents a promising OA treatment target for modulation by acupuncture.

骨关节炎(OA)是一种高发的关节疾病,其特点是关节软骨逐渐退化、软骨下骨重塑、骨质增生形成、滑膜炎症和半月板损伤。虽然 OA 的病因是多因素的,但促炎过程似乎在疾病发病机制中起着关键作用。先前的研究表明,电针(EA)可在 OA 临床前模型中发挥软骨保护、抗炎和镇痛作用,但这些潜在疗效的机制仍未完全明确。本研究旨在研究 EA 对大鼠模型 OA 发育的影响,并探索 EA 治疗调节的相关分子机制。40 只大鼠被分为 OA 组、EA 组、antagomiR-214 组和对照组。在关节内注射碘乙酸钠诱导 OA 后,EA 组和 antagomiR-214 组每天对膝关节周围的穴位进行 EA 刺激,持续 21 天。评估结果包括功能性疼痛行为和软骨细胞凋亡。研究还检测了microRNA-214(miR-214)及其参与细胞凋亡和痛觉的下游靶标BAX和TRPV4的表达。结果表明,EA 治疗可上调 OA 膝关节软骨中 miR-214 的表达。通过抑制促凋亡的 BAX 和促痛觉的 TRPV4,EA 诱导的 miR-214 上调可改善关节疼痛并防止软骨细胞凋亡。这些研究结果表明,miR-214在介导EA对OA病理生理学的治疗作用中起着关键作用,是针灸治疗OA的一个很有前景的靶点。
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引用次数: 0
Pseudogene CSPG4P12 inhibits colorectal cancer progression by attenuating epithelial-mesenchymal transition. 伪基因CSPG4P12通过抑制上皮-间质转化抑制结直肠癌的进展。
IF 1.9 4区 医学 Q2 BIOLOGY Pub Date : 2024-05-20 eCollection Date: 2024-01-01 DOI: 10.1590/1414-431X2024e13645
Qinqin Song, Hongxue Xu, Hongjiao Wu, Jing Dong, Shanshan Ji, Xuemei Zhang, Zhi Zhang, Wanning Hu

Colorectal cancer is one of the most common malignant cancers. Pseudogenes have been identified as oncogenes or tumor suppressor genes in the development of various cancers. However, the function of pseudogene CSPG4P12 in colorectal cancer remains unclear. Therefore, the aim of this study was to investigate the potential role of CSPG4P12 in colorectal cancer and explore the possible underlying mechanism. The difference of CSPG4P12 expression between colorectal cancer tissues and adjacent normal tissues was analyzed using the online Gene Expression Profiling Interactive Analysis 2 (GEPIA2) database. Cell viability and colony formation assays were conducted to evaluate cell viability. Transwell and wound healing assays were performed to assess cell migration and invasion capacities. Western blot was used to measure the expression levels of epithelial-mesenchymal transition-related proteins. Colorectal cancer tissues had lower CSPG4P12 expression than adjacent normal tissues. The overexpression of CSPG4P12 inhibited cell proliferation, invasion, and migration in colorectal cancer cells. Overexpressed CSPG4P12 promoted the expression of E-cadherin, whereas it inhibited the expression of vimentin, N-cadherin, and MMP9. These findings suggested that CSPG4P12 inhibits colorectal cancer development and may serve as a new potential target for colorectal cancer.

大肠癌是最常见的恶性癌症之一。在各种癌症的发病过程中,假基因已被确定为致癌基因或抑癌基因。然而,假基因 CSPG4P12 在结直肠癌中的功能仍不清楚。因此,本研究旨在调查 CSPG4P12 在结直肠癌中的潜在作用,并探讨其可能的内在机制。利用在线基因表达谱交互式分析 2(GEPIA2)数据库分析了结直肠癌组织与邻近正常组织之间 CSPG4P12 表达的差异。细胞存活率和集落形成试验用于评估细胞存活率。透孔试验和伤口愈合试验用于评估细胞迁移和侵袭能力。采用 Western 印迹法测定上皮-间质转化相关蛋白的表达水平。结直肠癌组织的 CSPG4P12 表达低于邻近的正常组织。过表达 CSPG4P12 可抑制结直肠癌细胞的增殖、侵袭和迁移。过表达的 CSPG4P12 可促进 E-cadherin 的表达,而抑制波形蛋白、N-cadherin 和 MMP9 的表达。这些研究结果表明,CSPG4P12可抑制结直肠癌的发展,并可能成为结直肠癌的一个新的潜在靶点。
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引用次数: 0
Coenzyme Q10 prevents RANKL-induced osteoclastogenesis by promoting autophagy via inactivation of the PI3K/AKT/mTOR and MAPK pathways. 辅酶Q10通过使PI3K/AKT/mTOR和MAPK途径失活来促进自噬,从而防止RANKL诱导的破骨细胞生成。
IF 2.3 4区 医学 Q2 BIOLOGY Pub Date : 2024-05-03 eCollection Date: 2024-01-01 DOI: 10.1590/1414-431X2024e13474
Delu Zheng, Chenli Cui, Chengsong Ye, Chen Shao, Xiujing Zha, Ying Xu, Xu Liu, Can Wang

Coenzyme Q10 (CoQ10) is a potent antioxidant that is implicated in the inhibition of osteoclastogenesis, but the underlying mechanism has not been determined. We explored the underlying molecular mechanisms involved in this process. RAW264.7 cells received receptor activator of NF-κB ligand (RANKL) and CoQ10, after which the differentiation and viability of osteoclasts were assessed. After the cells were treated with CoQ10 and/or H2O2 and RANKL, the levels of reactive oxygen species (ROS) and proteins involved in the PI3K/AKT/mTOR and MAPK pathways and autophagy were tested. Moreover, after the cells were pretreated with or without inhibitors of the two pathways or with the mitophagy agonist, the levels of autophagy-related proteins and osteoclast markers were measured. CoQ10 significantly decreased the number of TRAP-positive cells and the level of ROS but had no significant impact on cell viability. The relative phosphorylation levels of PI3K, AKT, mTOR, ERK, and p38 were significantly reduced, but the levels of FOXO3/LC3/Beclin1 were significantly augmented. Moreover, the levels of FOXO3/LC3/Beclin1 were significantly increased by the inhibitors and mitophagy agonist, while the levels of osteoclast markers showed the opposite results. Our data showed that CoQ10 prevented RANKL-induced osteoclastogenesis by promoting autophagy via inactivation of the PI3K/AKT/mTOR and MAPK pathways in RAW264.7 cells.

辅酶Q10(CoQ10)是一种强效抗氧化剂,与抑制破骨细胞生成有关,但其潜在机制尚未确定。我们探索了这一过程的分子机制。RAW264.7 细胞接受 NF-κB 配体受体激活剂(RANKL)和 CoQ10 处理后,破骨细胞的分化和活力得到了评估。用 CoQ10 和/或 H2O2 及 RANKL 处理细胞后,检测了活性氧(ROS)、参与 PI3K/AKT/mTOR 和 MAPK 通路的蛋白质以及自噬的水平。此外,在使用或不使用这两种途径的抑制剂或有丝分裂激动剂对细胞进行预处理后,还对自噬相关蛋白和破骨细胞标志物的水平进行了测定。CoQ10 能明显降低 TRAP 阳性细胞的数量和 ROS 水平,但对细胞活力没有明显影响。PI3K、AKT、mTOR、ERK和p38的相对磷酸化水平明显降低,但FOXO3/LC3/Beclin1的水平明显升高。此外,FOXO3/LC3/Beclin1的水平在抑制剂和有丝分裂激动剂的作用下明显升高,而破骨细胞标志物的水平则显示出相反的结果。我们的数据表明,CoQ10通过抑制RAW264.7细胞中的PI3K/AKT/mTOR和MAPK通路来促进自噬,从而阻止了RANKL诱导的破骨细胞生成。
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引用次数: 0
Giant uterine tumor and miscarriage: how to proceed? 巨大子宫肿瘤和流产:如何处理?
IF 2.3 4区 医学 Q2 BIOLOGY Pub Date : 2024-05-03 eCollection Date: 2024-01-01 DOI: 10.1590/1414-431X2024e13549
E A Hase, L L Iervolino, H A Antico, N Bozzini, R P V Francisco

Expanding uterine masses can be the cause of pregnancy loss and add technical difficulties to uterus evacuation due to the intense anatomical distortion of the endocervical canal and uterine cavity. The literature is scarce in the peculiarities of the management of missed abortions in uterus with important distorted anatomies. We report a case of a primigravida patient who presented a rapid and expressive increase of abdominal volume due to a giant uterine mass, evolving to miscarriage. Ultrasound can be a useful tool, allowing visualization of the endocervical path and uterine cavity, helping to perform uterine evacuation in the presence of anatomical distortion without compromising the reproductive future. To the best of our knowledge, no such case has been previously reported.

由于宫颈内口和宫腔在解剖学上的严重变形,膨大的子宫肿块可能是导致妊娠失败的原因,并给子宫排空增加了技术难度。关于解剖结构严重扭曲子宫的漏诊流产的特殊处理方法的文献很少。我们报告了一例初产妇患者,她因巨大子宫肿块导致腹部体积急剧增大,最终导致流产。超声波是一种有用的工具,它可以显示宫颈内口和宫腔的情况,有助于在解剖结构变形的情况下进行子宫排空,而不会影响未来的生育。据我们所知,此前还没有此类病例的报道。
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引用次数: 0
Moderate physical exercise and ATP modulate the P2X7 receptor and improve cisplatin-induced gastric emptying delay in rats. 适度运动和 ATP 可调节 P2X7 受体并改善顺铂诱导的大鼠胃排空延迟。
IF 2.3 4区 医学 Q2 BIOLOGY Pub Date : 2024-05-03 eCollection Date: 2024-01-01 DOI: 10.1590/1414-431X2024e13234
Y A Gomes, W L L Santos, C S Pinheiro, J S Severo, J C C Oliveira Júnior, A C A da Silva, B L B Dos Santos, C H L Rocha, A A Dos Santos, M T B da Silva

Patients undergoing chemotherapy with cisplatin commonly present gastrointestinal effects such as constipation and gastric emptying (GE) delay. Both the purinergic system and physical exercise modulate the gastrointestinal (GI) tract. In the current study, we investigated the role of ATP, physical exercise, and P2X7 receptor blocking on GE delay induced by cisplatin in rats. Male rats were divided into the following groups: control (C), cisplatin (Cis), exercise (Ex), Brilliant Blue G (BBG), ATP, Cis+Ex, Cis+ATP, Cis+BBG, Cis+Ex+BBG, Cis+Ex+BBG+ATP, and Cis+ATP+BBG. GE delay was induced by treatment with 1 mg/kg cisplatin (1 time/week for 5 weeks, ip). The moderate physical exercise was swimming (1 h/day, 5 days/week for 5 weeks). At the end of the treatment or exercise and 30 min before the GE assessment, some groups received BBG (50 mg/kg, sc) or ATP (2 mg/kg, sc). Then, GE was assessed after a 10-min postprandial period. Chronic use of Cis decreased GE delay (P<0.05) compared to the control group. Both exercise and ATP prevented (P<0.05) GE delay compared to Cis. The pretreatment with BBG significantly inhibited (P<0.05) the effect of exercise and ATP. On the other hand, the association between exercise and ATP reversed (P<0.05) the effect of the BBG and prevented GE delay. Therefore, we suggest that both exercise and treatment with ATP activate P2X7 receptors and prevent GE delay induced by cisplatin in rats.

接受顺铂化疗的患者通常会出现胃肠道反应,如便秘和胃排空(GE)延迟。嘌呤能系统和体育锻炼都能调节胃肠道。在本研究中,我们探讨了 ATP、体育锻炼和 P2X7 受体阻断对顺铂诱导的大鼠胃排空延迟的作用。雄性大鼠被分为以下几组:对照组(C)、顺铂组(Cis)、运动组(Ex)、亮蓝 G 组(BBG)、ATP 组、Cis+Ex 组、Cis+ATP 组、Cis+BBG 组、Cis+Ex+BBG 组、Cis+Ex+BBG+ATP 组和 Cis+ATP+BBG 组。1毫克/千克顺铂(1次/周,连续5周,ip)诱导GE延迟。适度的体育锻炼是游泳(每天 1 小时,每周 5 天,共 5 周)。在治疗或运动结束后、GE评估前30分钟,部分组接受BBG(50毫克/千克,皮下注射)或ATP(2毫克/千克,皮下注射)。然后,在餐后 10 分钟后对 GE 进行评估。长期服用 Cis 会减少 GE 延迟(P
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引用次数: 0
Acupuncture for generalized anxiety disorder: a study protocol for a randomized controlled trial. 针灸治疗广泛性焦虑症:随机对照试验的研究方案。
IF 2.3 4区 医学 Q2 BIOLOGY Pub Date : 2024-05-03 eCollection Date: 2024-01-01 DOI: 10.1590/1414-431X2024e13389
Xiayun Zhou, Guoao Shi, Ruiming Chen, Lingsan Hu, Zhongxian Li, Yifu Zhou, Pan Zhang, Xiang Ji, Min Peng, Kengyu Chen, Luda Yan, Peng Zhou

During the COVID-19 outbreak, there was a sharp increase in generalized anxiety disorder (GAD). Acupuncture therapy has the advantages of accurate clinical efficacy, safety and reliability, few adverse reactions, and no dependence, and is gradually becoming one of the emerging therapies for treating GAD. We present a study protocol for a randomized clinical trial with the aim of exploring the mechanism of brain plasticity in patients with GAD and evaluate the effectiveness and reliability of acupuncture treatment. Transcranial magnetic stimulation (TMS) will be used to assess cortical excitability in GAD patients and healthy people. Sixty-six GAD patients meeting the inclusion criteria will be randomly divided into two groups: TA group, (treatment with acupuncture and basic western medicine treatment) and SA group (sham acupuncture and basic western medicine treatment). Twenty healthy people will be recruited as the control group (HC). The parameters that will be evaluated are amplitude of motor evoked potentials (MEPs), cortical resting period (CSP), resting motor threshold (RMT), and Hamilton Anxiety Scale (HAMA) score. Secondary results will include blood analysis of γ-aminobutyric acid (GABA), glutamate (Glu), glutamine (Gln), serotonin (5-HT), and brain-derived nerve growth factor (BDNF). Outcomes will be assessed at baseline and after the intervention (week 8). This study protocol is the first clinical trial designed to detect differences in cerebral cortical excitability between healthy subjects and patients with GAD, and the comparison of clinical efficacy and reliability before and after acupuncture intervention is also one of the main contents of the protocol. We hope to find a suitable non-pharmacological alternative treatment for patients with GAD.

在 COVID-19 爆发期间,广泛性焦虑症(GAD)患者急剧增加。针灸疗法具有临床疗效确切、安全可靠、不良反应少、无依赖性等优点,逐渐成为治疗 GAD 的新兴疗法之一。我们介绍一项随机临床试验的研究方案,旨在探索 GAD 患者大脑可塑性的机制,并评估针灸治疗的有效性和可靠性。经颅磁刺激(TMS)将用于评估 GAD 患者和健康人的大脑皮层兴奋性。符合纳入标准的 66 名 GAD 患者将被随机分为两组:TA组(针灸治疗和基本西医治疗)和SA组(假针灸和基本西医治疗)。对照组(HC)为 20 名健康人。评估参数包括运动诱发电位(MEPs)振幅、皮层静息期(CSP)、静息运动阈值(RMT)和汉密尔顿焦虑量表(HAMA)评分。次要结果将包括γ-氨基丁酸(GABA)、谷氨酸(Glu)、谷氨酰胺(Gln)、5-羟色胺(5-HT)和脑源性神经生长因子(BDNF)的血液分析。结果将在基线和干预后(第 8 周)进行评估。该研究方案是首个旨在检测健康受试者与 GAD 患者大脑皮层兴奋性差异的临床试验,针灸干预前后的临床疗效和可靠性比较也是该方案的主要内容之一。我们希望能为 GAD 患者找到一种合适的非药物替代治疗方法。
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引用次数: 0
Crescentic glomerulonephritis due to linear IgA anti-glomerular basement membrane disease: report of a rare case. 线性 IgA 抗肾小球基底膜病引起的新月体肾小球肾炎:一例罕见病例的报告。
IF 2.3 4区 医学 Q2 BIOLOGY Pub Date : 2024-05-03 eCollection Date: 2024-01-01 DOI: 10.1590/1414-431X2024e13466
A G Monich, R F Romani, J L S Carneiro

Anti-glomerular basement membrane (GBM) disease is a rare and severe vasculitis that affects the glomerular and pulmonary capillaries and has an incidence of less than 2 cases per million individuals per year. Anti-GBM disease is mediated by autoantibodies against the α3 chain of type IV collagen. In the majority of cases, the autoantibodies are of the immunoglobulin G (IgG) class, with rare cases being mediated by immunoglobulin M (IgM) or immunoglobulin A (IgA); there are less than 15 IgA-mediated cases reported in the literature worldwide. The classic form of this disease manifests with rapidly progressive glomerulonephritis (RPGN), with or without pulmonary hemorrhage, and the diagnosis consists of identifying high titers of autoantibodies in the serum and/or deposited in the tissues. IgA antibodies are not identified in routine immunoassay tests, and renal biopsy with immunofluorescence is essential for diagnosis. We present a case of RPGN due to anti-GBM disease with linear IgA deposition, whose diagnosis was made exclusively by renal biopsy and with an unfavorable prognosis.

抗肾小球基底膜病(GBM)是一种罕见的严重血管炎,会影响肾小球和肺毛细血管,发病率每年每百万人中不到 2 例。抗 GBM 病是由针对 IV 型胶原 α3 链的自身抗体介导的。在大多数病例中,自身抗体属于免疫球蛋白 G(IgG)类,极少数病例由免疫球蛋白 M(IgM)或免疫球蛋白 A(IgA)介导;全球文献中报道的 IgA 介导的病例不到 15 例。这种疾病的典型表现为快速进展性肾小球肾炎(RPGN),伴有或不伴有肺出血,诊断包括在血清和/或组织中发现高滴度的自身抗体。常规免疫测定无法识别 IgA 抗体,因此必须进行肾活检和免疫荧光检查才能确诊。我们报告了一例抗 GBM 病导致的 RPGN,其 IgA 呈线性沉积,完全通过肾活检确诊,预后不良。
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Brazilian Journal of Medical and Biological Research
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