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Objective:To analyze the clinical features and auxiliary examination results of sporadic Creutzfeldt-Jakob disease (sCJD) with restless leg syndrome (RLS) as the first symptom.Methods:The clinical features and auxiliary examination results of one case of sCJD who received treatment in Sichuan Mianyang 404 Hospital were analyzed based on relevant literature.Results:A 59-year-old woman of Han nationality who had sCJD with restless leg-like manifestation of the left lower limb for 18 days was included in this study. The patient was first treated in orthopedic department, but her symptom did not improve after treatment. Twenty days later, she was transferred to neurology department for further treatment. Her daily life and activities were not affected. Head magnetic resonance imaging, electroencephalography, cerebrospinal fluid routine examination and biochemical test results were normal. Five days later, the patient had mild left-sided ataxia, which then progressed rapidly, followed by right-sided ataxia, left-leg spasticity and adduction, involuntary movement, myoclonia, cognitive decline, akinetic mutism, repeated hyperthermia, repeated complex partial seizures. Two weeks later, head magnetic resonance imaging examination revealed hyperintense signal of the cingulate gyrus, frontal cortex and right island cortex on DWI, with cerebellar atrophy and three-phase electroencephalography wave. Four weeks later, CSF14-3-3 protein was positive, and no related genetic mutation in the prion protein gene was found. The duration from onset to death was about 8 months.Conclusion:sCJD is a common subtype of prion protein disease, and the condition can be stabilized for more than 1 month after the onset of RLS. There is no specificity in early clinical and auxiliary examinations, and neither dobutazine treatment nor neurotrophic treatment is effective. The disease progresses rapidly after 1 month, head MRI and EEG reexamination can reveal clues, and CSF14-3-3 protein can assist clinical diagnosis.
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Objective To investigate the effect of doxycycline on the Th1/Th2 cell balance in experimental allergic encepha-lomyelitis(EAE)rats.Methods Forty female Wistar rats were randomly divided into the EAE control group,low,medium and high does DOX treatment groups,10 cases in each group.The onset situation in rats was observed.The IL-4 and IFN-γlevels secreted by peripheral blood mononuclear cells (PBMC)at the peak stage were detected.The levels of IL-1β,IL-10,TNF-αin brain tissue,and the albumin content in cerebrospinal fluid and serum were detected.The QA value was calculated.Results In each DOX group,the clinical symptoms of rats were alleviated compared with the EAE control group.In each DOX group,the PBMC secreting IFN-γlev-el and IFN-γ/IL-4 ratio in the onset peak stage were lower than those in the EAE control group,while the IL-4 level was higher than that in the EAE control group(P 0.05),but the difference between other DOX groups had statistical significance(P <0.01).The IL-1βand TNF-αlevels of brain tissue and QA value during onset peak stage in various doses DOX groups were decreased compared with the EAE control group,while the IL-10 level was increased compared with the EAE control group(P <0.05).With the DOX dose increasing,the levels of IL-1β,TNF-αand QA value in various doses DOX groups became lower,the IL-10 level became high-er,there was statistically significant difference among various doses DOX groups (P <0.05 ).Conclusion DOX can obviously alle-viate the clinical symptoms of EAE rats,its mechanism may be related with that DOX could decrease the level of Th1 cytokine and increase the level of Th2 cytokine,correct the Th1/Th2 cell balance,thus protect the blood brain barrier(BBB).
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OBJECTIVE:To observe the efficacy and safety of carbamazepine combined with topiramate in the treatment of par-tial epilepsy. METHODS:130 patients with partial epilepsy were randomly divided into observation group and control group. Con-trol group was orally treaed with carbamazepine 100 mg,3 times a day. Based on the treatment of control group,observation group was orally treaed with topiramate initial dose of 25 mg,once a day,and then increased 25 mg every week,the maximum dose was no more than 200 mg,once a day. After 6 months,the efficacy was evaluated,frequency of epileptic seizures,EEG epileptiform discharges wave and incidence of adverse reactions were observed. RESULTS:The total effective rate in observation group was sig-nificantly higher than control group(P0.05). CONCLUSIONS:Carbamazepine combined with topiramate has better efficacy than carbamazepine alone in the treatment of partial epilepsy,with similar safety.
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Objective To investigate the serum neuron-specific enolase (NSE) and high sensitivity C-reactive protein (hs-CRP) on neonatal hypoxic-ischemic encephalopathy (HIE) in children with illness and prognosis of assessed value. Method The serum NSE, hs-CRP levels of 40 patients with HIE (HIE group) of the acute stage and convalescence, and 20 healthy neonates (control group ) were measured and the clinical sub-degree relationships were analyzed. Results The serum NSE, hs-CRP levels in HIE group of the acute stage [ (32.88 ± 12.61 ) μ g/L, (6.43 ± 2.07) mg/L] were significantly higher than those in control group [(8.62 ± 3.58) μ g/L, (2.61 ± 0.95) mg/L](P ＜ 0.01 ). The serum NSE, hs-CRP levels in HIE group of the severe acute stage were significantly higher than those of the mild and light acute stage (P＜0.01 ). The more severe disease, the more higher NSE, hs-CRP. Conclusion The serum NSE, hs-CRP reflect the brain neuronal damage or necrosis of the objective indicators that could be used as early objective indicators to judge the pathogenetic condition and prognosis of HIE.
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Objective To investigate the levels of serum neuron-specific enolase (NSE) and C-reactive protein ( CRP ) in patients with acute cerebral infarction, and its value on prognosis. Methods The levels of serum NSE and CRP were compared in 92 acute cerebral infarction patients (observation group) and 45 healthy (control group). The relationship between the levels of NSE, CRP and the degree of neurological damage and infarction location were analyzed. Results The levels of serum NSE and CRP were significantly higher in observation group than those in control group (P< 0.01). In observation group, the levels of serum NSE and CRP were higher in heavy patients [ (35.63 ± 7.12) μg/L, (13.82 ± 3.57) mg/L] than those in mild or medium patients [(17.24 ± 5.32) μg/L, (5.61 ± 2.35) mg/L and (26.08 ±5.91) μg/L, (9.07 ±2.14) mg/L,respectively](P<0.01). There was no significant difference in the levels of serum NSE and CRP in different infarction location(P > 0.05 ). Conclusion The level of serum NSE and CRP is an index in reflecting the degree of neurological damage, and they can be used in evaluating patient's condition and prognosis.