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Objective:To investigate the value of proteinuria in evaluating the severity of pre-eclampsia (PE) and assessing the maternal and neonatal outcomes of PE.Methods:The clinical records of 265 pregnant women who were diagnosed with PE at Peking Union Medical College Hospital from January 2011 to June 2021 were retrospectively analyzed. According to 24-hour urine protein (24-hUPro) results, pregnant women were divided into two groups: the non-proteinuric group (24-hUPro<0.3 g, n=10) and proteinuric group (24-hUPro≥0.3 g, n=255). The proteinuric group was further divided into 3 subgroups based on proteinuria levels: mild group (0.3 g≤24-hUPro<2.0 g, n=119), moderate group (2.0 g≤24-hUPro<5.0 g, n=59), and severe group (24-hUPro≥5.0 g, n=77). The demographic and clinical data, laboratory indicators, pregnancy complications, maternal and neonatal outcomes were compared between different groups. Results:In proteinuric subgroups, increased proteinuria was associated with earlier onset gestations, higher incidence of headache, peripheral tissue edema, serosal effusion, intrauterine growth restriction, and abnormal umbilical cord blood flow (all P<0.05). There were no significant differences in the incidence of placental abruption, eclampsia and maternal mortality among the three subgroups, but there were significant differences in the incidence of neonatal birth weight and multiple neonatal complications (all P<0.05). Compared with the proteinuric group, the non-proteinuric group showed later onset gestation (median:34.7 vs 37.6 weeks) and gestational age of delivery (median:36.0 vs 38.4 weeks), lower proportion of ocular vascular lesions [56.7% (135/238) vs 2/9], higher birth weight (median: 2 325 vs 2 750 g), and lower rate of neonatal intensive care unit occupancy [54.3%(127/234) vs 1/10;all P<0.05]. Conclusions:The proteinuria plays an important role in assessing the severity of PE and maternal and neonatal outcomes, but it is not the only indicator. The non-proteinuric PE pregnant women might still lead to severe maternal and neonatal outcomes.
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A 25-year-old woman was admitted to Peking Union Medical Hospital presented with arthralgia for 5 years, amenorrhea for 16 months, and speech disorder for 3 months. This patient has been afflicted by intermittent pain in metacarpophalangeal and proximal interphalangeal joints of both hands for 5 years. Her menstruation has been irregular 1 year ago and rapidly progressed to amenorrhea. Laboratory tests revealed postmenopausal sex hormones levels (estradiol<5 ng/L, follicle-stimulating hormone 62.5 IU/L, luteinizing hormone 58.71 IU/L) and no antral follicles were seen in gynecologic ultrasound. She was diagnosed with premature ovarian failure and treated with hormone replacement therapy, still with no ovulation. Numbness and weakness of right arm has recurrently occurred to her 4 months ago, and persistent weakness of right limbs combined with motor speech disorder occurred 1 month later. Magnetic resonance angiography was suggestive of ischemic stroke. Hormone replacement therapy was discontinued. Comprehensive laboratory tests revealed positive anti-dsDNA, anti-SSA/SSB, anticardiolipin and anti-β 2GPⅠ antibodies. Systemic lupus erythematosus (SLE), antiphospholipid syndrome (APS) was diagnosed. Since no drug with gonadal toxicity had been applied to the patient before, her amenorrhea was considered to be due to autoimmune oophoritis secondary to SLE. After treated with high-dose glucocorticoid, mycophenolate mofetil and hydroxychloroquine for 4 months, her menstruation recurred and regularly occurred till now. In some cases, amenorrhea in SLE patient might be resulted from autoimmune oophoritis associated with lupus flare, instead of use of drug with gonadal toxicity.
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Objective:Response surface methodology was used to optimize the optimal extraction conditions of red ginseng polysaccharide and to study the antioxidant activity of red ginseng polysaccharide.Methods:Supercritical CO 2 extraction method was used to extract polysaccharides from red ginseng. The effects of solid-liquid ratio, extraction time, extraction temperature and extraction pressure on the extraction of polysaccharides from red ginseng were investigated. Box-behnken Design method was used to optimize the extraction process of red ginseng polysaccharide, and Logit method was used to calculate the semi-inhibitory concentration of red ginseng polysaccharide on DPPH clearance (half maximal inhibitory concentration, IC 50). Results:The optimal extraction conditions were as follows: extraction temperature 61.12 ℃, extraction pressure 20.64 MPa, extraction time 128.37 min, solid-liquid ratio 1∶25.61 g/ml, and the extraction yield of red ginseng polysaccharide was 36.89%. The results of three groups of repeatability tests showed that the relative error of polysaccharide yield of red ginseng was in the range of 5%. When the mass concentration of red ginseng polysaccharide was 25 μg/ml, it had better antioxidant activity and IC 50 was 10.97 μg/ml. Conclusion:The optimized extraction conditions of red ginseng polysaccharide were reasonable and reliable, and the antioxidant activity of red ginseng polysaccharide was strong, which could provide reference for the follow-up research.
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Objective To investigate the possible electroencephalograph network connectivity mech-anism of working memory disorder in patients with frontal lobe epilepsy ( FLE). Methods Seventeen adult FLE patients were enrolled as the case group and 22 normal adults were selected as the control group. The behavioral data and 34-channel electroencephalographs were recorded in the working memory behavioral par-adigm. The directed transfer function was used to construct the causal connectivity brain network of theta band of working memory delay period. Two-sample t-test or tˊ-test was used to analyze the differences in be-havioral and frontal causal connectivity between the two groups. Results (1) Compared with control group, working memory behavioral data of FLE group showed significantly lower correct rate ((92. 778±4. 399)%, (96. 258±2. 470)%,tˊ=-2. 925,P<0. 01),and significantly longer reaction time ((978. 586± 65. 161) ms,(798. 671±196. 207)ms,tˊ=4. 023,P<0. 001). (2) Compared with control group,causal connectivity of FLE group showed significantly reduced whole brain ( tˊ=-6. 008, P<0. 001), Fz channel ( tˊ=-7. 703,P<0. 001),frontal region (tˊ=-14. 667,P<0. 001),frontal-temporal interval ( t=-14. 467,P<0. 001),and frontal-central interval (t=-3. 501,P<0. 001). The causal connectivity of frontal-occipital in-terval had no significant difference( t=1. 056,P=0. 281). Conclusions Working memory disorders were found in FLE patients. The abnormal causal connectivity of frontal brain network in theta band may be one of its potential neurophysiological mechanisms.
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Epilepsy is a chronic brain lesion caused by a variety of pathological factors. It is characterized by repeatability, transient and seizure, and is one of the common neurological systemic diseases in children. Seizures can induce structural changes of sleep and cause sleep disorders, and sleep disorders call induce interictal epileptiform discharges and seizures. The abnormal sleep structure of children with epilepsy is characterized by decreased total sleep time, prolonged sleep latency, prolonged latency of rapid eye movement (REM), and decreased proportion of sleep fragments and shortened sleep cycle time. Epilepsy and sleep are closely related and complex. Controlling seizures can help improve the quality of sleep. The normalization of sleep structure in children with epilepsy can help control seizures, thus improving overall quality of life and long-term prognosis.
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Systemic lupus erythematosus (SLE) is a rheumatic illness that often affects pregnancy outcome of young women of reproductive age.Preeclampsia is a common gestational complication.SLE flare during pregnancy and preeclampsia share common clinical features,such as hypertension,proteinuria,and thrombocytopenia,making differentiation between these two conditions difficultly.The signs and symptoms of new-onset SLE during pregnancy or postpartum may mimic those of preeclampsia,while SLE associated arthritis/arthralgia,alopecia,and ulceration were less commonly found comparing with those non-pregnant patients.SLE is a risk factor for preeclampsia and both affect maternal and fetal outcomes.Changes in angiogenic factors precede the onset of preeclampsia in SLE pregnancies.Low-dose aspirin may decrease the risk for preeclampsia in pregnant women with SLE.Pregnant women should be treated for SLE flare rather than for preeclampsia for the better of the mother and baby when it is difficult to differentiate between these two conditions.
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Objective To study the feature of theta oscillation during working memory (WM) dysfunction in patients with mild cognitive impairment (MCI). Methods Fifteen MCI patients (MCI group) and 15 healthy subjects for checkup (control group) in Tianjin Medical University General Hospital from January to November 2016 were recruited. The differences of behavioral results in visual WM tasks were compared between the two groups. Thirty four-channel electroencephalogram (EEG) signals were recorded simultaneously. Short-Time Fourier transform was used to calculate spatial and time-frequency distribution of power and spectral coherence of multi-channel EEGs. Results Compared with control group, MCI group showed significantly longer reaction time and lower accuracy in WM tasks (P<0.01). The analysis of EEGs revealed that the power of Fz channel was the biggest at frontal midline in both groups. And the power density of theta oscillation was lower at frontal electrode sites in MCI group than that of control group ( P<0.01), and theta coherence was significantly decreased in frontal region and between frontal-posterior regions ( P<0.05). Conclusion The absence of theta oscillaton in frontal region may be one of the important reasons of working memory dysfunction for MCI.
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OBJECTIVE:To study the contents changes of polysaccharide and 5-HMF in Polygonati rhizoma from different pro-ducing areas after different processing,and provide reference for the development of processing technology of Polygonati rhizoma from different producing areas and the quality standard of different processing products. METHODS:UV spectrophotometry and HPLC were conducted to respectively determine the contents of polysaccharide and 5-HMF,and compare the content differences of polysaccharide and 5-HMF in Polygonati rhizoma from different producing areas [Shaanxi Lueyang County,Shaanxi Huangling County,Yunnan Fumin County (genuine producing areas),Shaanxi Taibai County] by fresh-cutting,dry-cutting,steaming and steaming with wine. RESULTS:Polysaccharide of sample from Yunnan Fumin County showed the highest content in fresh-cut sam-ples(13.4%),no 5-HMF(0)was detected;polysaccharide contents were respectively 10.8%-13.4%,8.9%-10.8%,5.5%-6.9%, 5.6%-6.5% after fresh-cut,dry-cut,steamed and steamed with wine,5-HMF contents were 0,0,0.21%-0.50%,0.25%-0.72%. Compared with no processing samples (fresh-cut),polysaccharide contents in Polygonati rhizoma were decreased in turn after dry-cut,steamed and steamed with wine,5-HMF contents were increased in turn after steamed and steamed with wine. CONCLU-SIONS:It is suggested to consider origin factor in developing processing technology of Polygonati rhizoma from genuine and non-genuine producing areas. 5-HMF content determination index should be added into quality standard of processing products after steamed and steamed with wine.
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Objective To investigate the characteristic of sleep disorders in patients with frontal lobe epilepsy (FLE) through polysomnography and subjective questionnaires. Methods Eighteen FLE patients (FLE group) and 15 healthy subjects (control group) were recruited to our study. Two groups were evaluated by whole-night polysomnography, included total time in bed (TIB), total sleep time (TST), sleep efficiency (SE), sleep latency (SL), rapid eye movement (REM) latency (RL), wake after sleep onset (WASO), the percentage of non-REM (NREM) 1, 2, 3 stages and the percentage of REM occupied TST, the apnea-hypopnea index (AHI), hypopnea index, mean oxygen saturation (SpO2) and nadir oxygen saturation, periodic leg movements (PLMs) index and PLMs index of REM sleep, sleep stage shifts (SSS) and sleep stage shifts per hour (SSS/h), wake, NREM1, NREM2, NREM3 and REM sleep stage shifts (abbreviated as N1, N2, N3, REM, W) and their proportions of SSS (abbreviated as N1/SSS, N2/SSS, N3/SSS, REM/SSS, W/SSS). Data of depress and fatigue degrees, sleep quality, excessive daytime sleepiness were assessed by subjective questionnaires. Results Compared with control group, TIB [(503.22±62.33) min], WASO[(54.11±18.97) min], SSS (161.17±56.83), SSS/h (22.60±6.25), N1(42.56± 15.26) and N2 (57.28 ± 26.57), number of wake stage (25.33 ± 10.97) were significantly increased in FLE group. Meanwhile, scores of depression (9.33±5.01) and fatigue (5.72±3.36) were increased in FLE group compared with those of control group. Conclusion The sleep disorders can be found in FLE, which are related with depression and FLE seizure frequency.
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Objective To investigate the characteristic of theta oscillation in patients with frontal lobe epilepsy (FLE) by the analysis of multi-channel electroencephalographs (EEGs) during rest state and working memory(WM) maintenance. Methods The 19 FLE patients and 17 healthy subjects underwent EEG recording with 34-channel EEG machine during visual working memory task performance. The differences of behavioral results were analyzed between FLE group and controls. Short-time Fourier transform was used to calculate the power spectral density of different frequency bands in 34 channels. The theta power values during the retention period of working memory and rest state were compared between two groups. Results Compared with controls, reaction time of FLE increased significantly (P<0.01) and accuracy decreased (P<0.05). The power spectral density of theta band for FLE increased both in Fz and frontal region during rest state (P<0.01). Compared with controls, the power spectral density of theta oscillation decreased significantly in the frontal region for FLE during WM maintenance. Conclusion Our results suggest that working memory in patients with FLE was impaired. The absence of theta oscillation during the WM delayde period may provide a possible neural mechanism for the working memory dysfunction in FLE.
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The medulla oblongata is located at the lower end of the brain stem, and it has abundant blood supply. The incidence of medial medullary infarction is low in cerebrovascular diseases. Bilateral medial medullary infarction is even rare. Bilateral medial medullary infarction is mainly characterized by paralysis. The respiratory failure can occur in severe cases. Magnetic resonance diffusion imaging can present aheartorYshaped lesion. We treated 1 patient with a typicalYshaped bilateral medial medullary infarction.
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Objective Temporal lobe epilepsy (TLE),frequently accompanied by working memory dysfunction,is an important form of adult epilepsy syndrome.Study on neural mechanisms of TLE with working memory dysfunction has important scientific value and clinical significance.Theta oscillations are synchronous activity of the brain in the 4-8 Hz frequency range.It is well recognized that there is a close relationship between the theta oscillations and working memory behavior.TLE patients with working memory dysfunction were taken as the research subjects,and the theta oscillations absence in TLE with working memory behavioral disorder was carried out,which provide the reference for further research into the neural mechanisms of TLE with working memory dysfunction.Methods The 34-channel electroencephalographs (EEGs) were recorded from TLE group (18 TLE patients) and control groups (18 healthy subjects) while subjects were performing visual working memory (delayed matching-tosample) tasks.The EEGs during the 3 s delay period was analyzed as experimental data.Fourier transform was used to assess the EEGs spectrum.The channel with the strongest spectrum was selected as the feature channel.Short-time Fourier transform algosiths was employed to calculate the time-frequency representation of the feature channel for the TLE and control groups.Frequency band with the strongest spectrum was selected for control group as the feature frequency band in working memory.Then,the topographical maps of the feature frequency band spectrum were calculated for the TLE and control groups.Results Compared with the control group,the working memnory behavioral performance of the TLE group was lower:accuracy of the TLE group was significantly lower than that of the control group (P＜0.05),and reaction time of the TLE group was significantly longer than that of the control group (P＜0.001).The feature channel in working memnory was frontal midline (Fz) and the feature frequency band was theta band.The Fz spectrum of the feature frequency for TLE was lower than that for control (P＜0.05).The frontal spectrum (seven channels) of the feature frequency for TLE was lower than that of control (P＜0.01).Conclusions Theta oscillations for TLE with working memory behavioral disorder is absent,which maybe one of the possible neural mechanism of TLE with working memory dysfunction.
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Objective To investigate the clinical characteristics and causes of recurrent purulent meningitis and its treatment.Methods The clinical data of 36 children with recurrent purulent meningitis were analyzed retro-spectively at Tianjin Children′s Hospital from 1 995 to 201 4.Based on the underlying illness,the following examinations were done respectively:brainstem electric response audi -ometry(BERA),temporal bone computed tomography,head magnetic resonance imaging(MRI),spinal core MRI,and blood immunoglobulin,etc.Results There were 24 boys and 1 2 girls involved in this study.The age of the initial onset in these patients ranged from 20 months old to 1 5 years old,with the average age of 5 year and 9 months old.There were 2 to 7 episodes in these cases.The etiology was identi-fied:1 9 cases (52.78%)with congenital anatomical abnormalities,1 2 cases of congenital inner ear malformation with cerebrospinal fluid (CSF) leakage,1 case of ear -nose CSF leakage,6 cases of pilonidal sinus.Fifteen cases (41 .67%)had anatomical abnormalities,1 2 cases had head and facial trauma,1 case had nasal polyps surgery,1 case (2.77%)had a history of chronic mastoiditis,and 1 case had a history of cochlear implant surgery;1 case of congenital humoral immunodeficiency disease X -linked agammaglobulinemia -free;1 case (2.77%)had humoral immunodefi-ciency disease.The anti -infection treatment was adopted in the acute -phase and then CSF rhinorrhea repair,CSF oto-rrhea,cerebrospinal fluid leakage,repair of the inner ear,pilonidal sinus resection,supplementary intravenous immuno-globulin around once every 3 months was given respectively in the restoration -phase.Thirty -three cases revealed no recurrence up to 8 months till 1 0 years follow -up,3 cases lost -to -follow -up.Conclusions The recurrent purulent meningitis is a serious infectious disease of the central nervous system,which may result in disabled condition even life -threatening.In order to avoid purulent meningitis recurrence,the corresponding treatment should be chosen ac-cording to different causes.
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Objective To explore the mechanism of high mobility group protein 1 (HMGB1) involved in endoplasmic reticulum stress (ERS) induced by brain ischemia/reperfusion (I/R),based on I/R-HMGB1-ERS as the breakthrough point.Methods The brain of rats birthed 1-3 days was harvested,and the brain cells were cultured in vitro,which were used in the experiment when the cells were in the third passage.The cells were divided into two groups:cells in blank control group were cultured under the normal conditions without any treatment,and the cells in hypoxia/reoxygenation group were cultured with 99.9％ nitrogen for 60 minutes (hypoxia) followed by opening the bottle neck for reoxygenation 120 minutes to simulate I/R model.The HMGB1 gene was silenced by using small interfering RNA (siRNA,siRNA and transfection reagent Lipofectamine 2000 mixture gradient was transfected into the cultured cells) as HMGB1-siRNA transfection group,and blank control (without any treatment) and negative control group (transfected with control siRNA) served as controls.The mRNA and protein expressions of HMGB1 and ERS related molecules were determined by real-time reverse transcription-polymerase chain reaction (RT-PCR) and Western Blot.Results ① In cells of hypoxia/reoxygenation group,the mRNA and protein expressions of HMGB1 and ESR related proteins,including glucose regulating protein 78 (GRP78),C/EBP homologous protein (CHOP) and caspase-12,were significantly higher than those of blank control group with statistical difference (the value in blank control group was served as baseline 1,HMGB1 mRNA:3.19±0.48 vs.1,t =2.183,P =0.008;GRP78 mRNA:2.07±0.33 vs.1,t =3.292,P =0.016;CHOP mRNA:1.93±0.28 vs.1,t =2.573,P =0.021;caspase-12 mRNA:2.42±0.42 vs.1,t =2.261,P =0.027:HMGB1 protein:2.28±0.36 vs.1,t =2.042,P =0.009;GRP78 protein:1.33±0.24 vs.1,t =2.781,P =0.016;CHOP protein:1.67±0.34 vs.1,t =2.174,P =0.021;easpase-12 protein:1.36±0.44 vs.1,t =3.192,P =0.008).It was indicated that ERS related molecules involved in cell hypoxia/reoxygenation process.2② After HMGB1 gene was silenced by siRNA,the cells after hypoxia/reoxygenation showed a decrease in the mRNA and protein expressions of HMGB1 and ERS related moleculars as compared with those of blank control group and negative control group (served the value in blank control group as baseline 1,HMGB1 mRNA:0.27±0.12 vs.1,1.02 ± 0.04;GRP78 mRNA:0.16 ± 0.13 vs.1,0.96 ± 0.04;CHOP mRNA:0.47 ± 0.09 vs.1,0.98 ± 0.07;caspase-12 mRNA:0.31 ±0.11 vs.1,1.05±0.02;HMGBI protein:0.23±0.04 vs.1,1.08±0.01;GRP78 protein:0.14±0.09 vs.1,1.35±0.03;CHOP protein:0.32±0.10 vs.1,0.93±0.06;caspase-12 protein:0.27±0.09 vs.1,0.97±0.08;P ＜ 0.05 or P ＜ 0.01).It was indicated that HMGB1 involved in ERS related with GPR7,CHOP,caspase-12.Conclusion Hypoxia/reoxygenation brain intracellular HMGB1 and ERS related molecules expression levels were significantly up-regulated,and silencing HMGB1 gene can significantly inhibit the expression levels of these molecules,and I/R-HMGB 1-ERS pathway may participate in the mechanism of brain I/R injury.
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Epilepsy is one of the nervous system diseases,which is correlated with multiple pathogenic factors and caused by repeated discharge of neurons.Currently,there are more than 50 million people worldwide suffering from epilepsy with an average annual increase of 100 000 cases.The prevalence rate of sleep disorders in epilepsy patients is high,by up to two times than that of healthy subjects.Common sleep disorders in epilepsy patients include insomnia,sleep apnea,restless legs syndrome and parasomnias.The characteristics of sleep abnormalities have differences with the epilepsy syndromes.The relationship between epilepsy and sleep is complex and interactive.The mechanism of combined sleep disorders in epilepsy patients is still unclear.In this paper,the relationship between epilepsy and sleep disorders in epilepsy patients was summarized,which involves multiple aspects such as the possible mechanism of combined sleep disorders,the common features of sleep disorders,the possible mechanism of sleep abnormalities in different epilepsy syndromes and the characteristics of sleep structure,the effect of antiepileptic drugs on sleep architecture abnormalities and its role in combined sleep disorders.
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Objective To evaluate the residual risk (i.e.failure risk in detecting aneuploidies abnormalities except for chromosome 13,18,21,X and Y) of cytogenetic abnormalities using interphase fluorescence in situ hybridization (FISH) for the second-trimester amniocytes.Methods The results of interphase FISH and conventional karyotyping of 2 837 consecutive amniotic fluid specimens were analyzed retrospectively.Probes for chromosomes 13,18,21,X and Y were used.The detection rate and residual risk for interphase FISH were calculated for the following three major clinical indications for prenatal diagnosis (advanced maternal age,abnormal maternal serum screening indicating an increased risk for trisomy 18 or trisomy 21,and ultrasound abnormalities).Results Consecutive interphase FISH and karyotyping of second-trimester amniocytes for prenatal diagnosis were performed from January 1,2010 to July 31,2013.Among the 2 837 cases,85 (3.0％) cases with abnormal karyotypes were found,including 73 cases of aneuploidies involving chromosome 13,18,21,X and Y,which were considered detectable by interphase FISH; 12 cases of chromosomal anomalies,other than aneuploidies of chromosome 13,18,21,X and Y,were diagnosed after karyotyping and were not detected by interphase FISH,including six cases of balanced rearrangements,five cases of imbalanced rearrangements,and one case of pseudomosaic of trisomy 20.Of these 12 chromosomal anomalies,three cases of imbalanced rearrangements involving chromosome 21 showed positive FISH results,and the other nine cases showed negative FISH results among which four case of hereditary balanced rearrangemerts and two cases of novel balanced rearrangements.The total detection rate for interphase FISH was 89.4％ (76/85),the misdiagnosis rate of chromosome abnormalities was 14.1％(12/85),and the residual risk was 0.43％ (12/2 761) following interphase FISH of the second-trimester amniocytes.Conclusions Interphase FISH is a useful adjunct to conventional karyotyping,but should not be regarded as a replacement for karyotyping as too many structural chromosomal abnormalities will be missed.Providing patients with a detection rate and residual risk during counselling may help them understand the advantages and limitations of interphase FISH in their prenatal diagnostic evaluation.
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ABSTRACT:Objective To study the BDNF/TrkB signaling pathway in the epilepsy model of hippocampal neurons and the regulatory effect of on it.Methods The primary hippocampal neurons cultured in vitro for 7 days were randomly divided into seven groups:control group,epilepsy group,control+BDNF group,epilepsy+BDNF group,control + miR-185 ? group,epilepsy + miR-185 ? group,and epilepsy + miR-185 ? + BDNF group.We constructed miR-185 ? lentivirus vector and observed the changes of BDNF/TrkB pathway expression after transfaction of miR-185 ? by immunohistochemistry,patch clamp technique and Western blot technique.Results Compared with the control+BDNF group,the phosphorylated TrkB (pTrkB)/TrkB value was significantly lower in epilepsy+BDNF group (P < 0.05 )and control group (P < 0.001 ).Compared with the epilepsy group,the phosphorylated TrkB (pTrkB)/TrkB value was significantly higher in epilepsy+BDNF group (P <0.05).Compared with the epilepsy+miR-185 ? +BDNF group,the phosphorylated TrkB (pTrkB)/TrkB value was significantly lower in epilepsy + BDNF group and epilepsy + miR-185 ? group (P < 0.001 ).BDNF could promote the signaling conduction and miR-185 ? could remove the inhibition of BDNF/TrkB signaling.Conclusion BDNF can activate the BDNF/TrkB signaling pathway and transfection with miR-185 ? can relieve the inhibition of BDNF/TrkB signaling pathway of epileptic state by up-regulating the expression of TrkB.
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Objective To investigate the mechanism of brain derived neurotrophic factor (BDNF) regulated by differ-ent isoforms of tyrosine kinase receptor B (TrkB) in epileptic hippocampal neurons. Methods Primary hippocampal neu-rons were cultured in vitro for 7 days, and divided into two groups, ALLN (calcineurin inhibitor) group and Anisomycin (trans-lation inhibitor) group. ALLN group included control group, control+BDNF group, epilepsy group, epilepsy+BDNF group, control+ALLN group, epilepsy+ALLN group and epilepsy+ALLN+BDNF group. Anisomycin group was sub-divided into con-trol group, control+BDNF group, epilepsy group, epilepsy+BDNF group, control+Anisomycin group, epilepsy+Anisomycin group and epilepsy+Anisomycin+BDNF group. The immunofluorescent technique was used to identificate the hippocampal neurons. Epileptiform discharges were detected by electrophysiological techniques. Western blot assay was used to deter-mine the protein expression of TrkB and phosphorylated TrkB (p-TrkB) in all cell groups. Results (1) In ALLN group, the gray value of p-TrkB/TrkB was higher in control+BDNF group compared with that of control group, the value was higher in epilepsy+BDNF group than that of epilepsy group but was lower than that of control+BDNF group. The gray value of p-TrkB/TrkB was lower in epilepsy+ALLN+BDNF group than that of epilepsy+BDNF group, but no significant difference compared with that of epilepsy+ALLN group. (2) In Anisomycin group:the gray value of p-TrkB/TrkB was higher in control+BDNF group than that of control group. The gray value of p-TrkB/TrkB was higher in epilepsy+BDNF group than that of epilepsy group, but which was lower than that of control+BDNF group. The gray value of p-TrkB/TrkB was higher in epilepsy+Aniso-mycin+BDNF group than that of epilepsy+BDNF group and epilepsy+Anisomycin group. Conclusion The decreased ex-pression of TrkB.T can improve the inhibition of BDNF/TrkB signaling, and BDNF can activate BDNF/TrkB signal pathway in epileptic hippocampal neurons. The increased TrkB.FL protein level by ALLN can’t improve the inhibition of BDNF/TrkB signal pathway.
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Objective To study the effect of miR-204 on BDNF/TrkB signaling and pathogenesis on the neuron model of epilepsy. Methods Primary hippocampal neurons were cultured in vitro for 7 days, and were divided into control group, control+BDNF group, epilepsy group, epilepsy+BDNF group , control+miR204 group, epilepsy+miR204 group and ep-ilepsy+miR204+BDNF group. The epilepsy model of hippocampal neurons was established by being exposed to Mg2+free me-dia for 3 hours. The miR-204 lentivirus vector was constructed. The effect of miR-204 on BDNF/TrkB expression was detect-ed by immunohistochemistry, patch clamp and Western blot technique. Results Compared with the control group, the TrkB phosphorylation level was higher in control+BDNF group. The TrkB phosphorylation level was lower in epilepsy+BDNF group than that of control+BDNF group, but it was higher than that of epilepsy group. The TrkB phosphorylation level was higher in epilepsy+miR204+BDNF group than that of epilepsy+BDNF group and epilepsy+ miR204 group. Conclusion BDNF and miR-204 can improve the inhibitory condition of BDNF/TrkB signaling and may play an important role in alleviat-ing epilepsy disease.
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Objective To evaluate the maternal and fetal outcomes of pregnant women with lupus nephritis (LN) and the risk factors.Methods Ninety-three patients with 97 pregnancies from January 1st,1990 to December 31st,2012 in Peking Union Medical College Hospital were evaluated retrospectively.Objects of study were divided into three groups:stable lupus before pregnancy (stable group,52 cases),active lupus before pregnancy (active group,26 cases),and newly diagnosed LN during pregnancy (19 cases).Adverse maternal outcomes included exacerbated disease during pregnancy,preeclampsia,increased proteinuria and impaired renal function during pregnancy or postpartum,maternal death,thrombocytopenia and hypocomplementemia.Adverse fetal or neonatal outcomes included therapeutically termination of pregnancy,fetal loss,neonatal death,preterm labor,small gestational age and asphyxia.Statistical analysis was performed by Chi-square test or Fisher's exact test.A binary logistic regression model was used to evaluate the risk factors for adverse maternal and fetal outcomes.Results (1) Adverse maternal outcomes:There was no significant difference between exacerbated cases during pregnancies in stable group and that in active group [53.8 ％ (28/52) vs 61.5 ％ (16/26),x2 =0.417,P＞0.05].After deleting abortions before 20 weeks of gestation (5 cases in stable group and 4 cases in active group),there was no significant difference between preeclampsia incidence in stable group and that in active group [36.2％ (17/47) vs 59.1％ (13/22),x2 =3.204,P＞0.05].In nineteen newly diagnosed LN women,eighteen cases were over 20 weeks of gestation,during which preeclampsia incidence was 6/18.(2) Adverse fetal or neonatal outcomes:Therapeutically termination of pregnancy rate was higher in active group than that in stable group[42.3％(10/26) vs 7.7％(4/52),Fisher's exact test,P＜0.01].After deleting patients who required termination of pregnancy (three cases in stable group) and therapeutically termination of pregnancy (four cases in stable group and ten cases in active group),the rate of fetal loss and neonatal death was higher in active group than that in stable group [5/16 vs 6.7％(3/45),Fisher's exact test,P＜0.05].The rate of adverse fetal or neonatal outcomes was higher in active group than that in stable group [92.3％(24/26) vs50％(26/52),x2=13.483,P＜0.001].Among the nineteen newly diagnosed LN cases during pregnancy,the numbers of therapeutically termination of pregnancy and fetal loss were five and three cases respectively; among eleven live birth cases,two newborns died from severe asphyxia,and nine cases were preterm birth.(3) Binary logistic regression analysis showed that the independent risk factors for exacerbated lupus during pregnancy were hypocomplementemia (OR =0.300,95％ CI:0.104-0.863) and thrombocytopenia (OR =0.054,95％CI∶0.007-0.439).The independent risk factors for preeclampsia in LN pregnant women were thrombocytopenia (OR=0.151,95％CI:0.046-0.499) and LN recurrence or first diagnosed during pregnancy (OR=0.135,95％CI:0.027-0.679).The independent risk factors for adverse fetal or neonatal outcomes were preeclampsia (OR=0.134,95％CI:0.028-0.637) and lupus active during pregnancy (OR =0.026,95 ％ CI:0.005-0.138).Conclusions Active lupus before pregnancy is associated with poor maternal and fetal outcomes in lupus nephritis pregnancy.All pregnancies with LN should be planned,preferably after more than six months of quiescent disease.Blood pressure,renal function,proteinuria and level of platelet and serum complements should be closely monitored.