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Objective@#To have a profound understanding of anti-N-methyl-D-aspartic receptor (anti-NMDAR) encephalitis, through the clinical analysis of 5 cases of anti-NMDAR encephalitis, and literature review.@*Methods@#This is a retrospective analysis. Five cases of anti-NMDA receptor encephalitis treated from May 2010 to June 2015, in the Department of Neurology, Beijing Friendship Hospital affiliated to Capital Medical University, were included in this study. The clinical data, including clinical manifestation, past history, radiological features, serum and cerebral spinal fluid examinations, treatment and prognosis, were analyzed.@*Results@#Among the 5 cases, 3 young female and 2 middle-to old-aged male. The clinical features of the onset was mental and behavior disorder, as well as seizure and extrapyramidal features, like facial and limbic involuntary movements or tremor. Coma and hypopnea was severe in 3 young female cases, needing assistance of mechanical ventilator, while the manifestation of 2 male patients was much mild, need not assisted respiration. 1 case had teratoma of ovary, 1 case had Vogt-Koyanagi-Harada syndrome. The anti-NMDA receptor antibody was positive in cerebraospinal fluid of all 5 cases, but in serum of 3 cases, serum and CSF Epstein-Barr virus (EBV) IgM antibody was positive in 1 case, while herpes simplex I virus (HSV-1) IgM antibody positive in another case, and anti-myelin oligodendrocyte glycoprotein (MOG) antibody was seen in serum and CSF in 1 case. The time interval from the onset to treatment was 10-37 d (18.8±9.8 d). IVIG was used in all of the 5 cases, glucocoticoid in 4 cases, and plasma exchange in 3 cases. One case with Vogt-Koyanagi-Harada syndrome, having a long time before diagnosis and treatment, died, while the other 4 cases had good prognosis, and had no relapse.@*Conclusions@#Mental and behavior disturbance is common at onset of anti-NMDAR encephalitis. The radiological and lab examination may be normal. It may be accompanied with HSV-1 or EBV infection, anti-MOG antibody may be positive in this disease. Active treatment is important.
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Objective@#To investigate the role of the activation and oxidative stress of cultured human umbilical vein endothelial cells (HUVEC) after HCMV infection.@*Methods@#HUVECs were divided into four groups: control, HCMV(+ ), after HCMV AD169 infection, and the supernatant of the culture was extracted, and the cells were lysed. The levels of vascular cellular adhesion molecule-1 (VCAM-1) in HUVEC were measured by real-time PCR. And the content of nitrogen monoxide (NO) of the supernatant was detected by nitrate reductasemethod accordingly.@*Results@#Twenty-four hours after infection, the mRNA expression of VCAM-1 in HUVECs of HCMV infected group increased obviously compared to control, and NO quantity increased accordingly and time-dependently. There was significant difference between groups(P<0.01).@*Conclusions@#HCMV increases the mRNA expression of VCAM-1 and quantity of NO, which may contribute to the formation of AS.
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<p><b>OBJECTIVE</b>This study aimed to investigate the expression of midkine (MK) and microvessel density (MVD) in patients with salivary adenoid cystic carcinoma (SACC) and its clinical significance, as well as detect the correlation between the expression of MK and MVD in SACC.</p><p><b>METHODS</b>Immunohistochemistry analysis (SP method) for MK and MVD were performed on 60 cases of SACC and 26 cases of normal salivary gland tissue. The expression of MK and MVD, as well as the correlation between the expression of MK and MVD in SACC were detected.</p><p><b>RESULTS</b>In SACC, the MK expression rate was 70.0% (42/60), and MK was not expressed in normal tissue. Statistical significance was found between SACC and normal tissue (P<0.05). The MVD values in SACC and normal salivary gland tissues were 38.73 +/- 8.96 and 11.15 +/- 3.33, respectively. These values were statistically significant (P<0.05). The expression levels of MK and MVD were unrelated to age, gender, and type in SACC (P>0.05), but correlated with tumor size, lymph node metastasis, and tumor-node-metastasis in SACC (P<0.05). The expression of MK and MVD was positively correlated with SACC (r=0.560, P<0.05).</p><p><b>CONCLUSION</b>SACC is correlated with the expression of MK protein and the increase in MVD, which may be some of the early diagnostic markers in SACC.</p>
Subject(s)
Humans , Carcinoma, Adenoid Cystic , Pathology , Cytokines , Genetics , Metabolism , Immunohistochemistry , Lymphatic Metastasis , Microvessels , Nerve Growth Factors , Salivary Gland Neoplasms , Pathology , Salivary GlandsABSTRACT
Objective A large number of traditional Chinese medicine(TCM)are widely used for the treatment of patients with cerebral hemorrhage in China. The aim of this study is to systematically review the existing clinical evidences on TCM treatment for cerebral hemorrhage. Methods Randomized controlled trails(RCTs) of TCM treatment of cerebral hemorrhage were identified, eligible studies were included, the methodological quality of inclusive trails was assessed by the modified Jadad scale. The Cochrane Collaberation’s Revman 5.20 was used for data analysis. Results 69 RCTs were available and included. Meta-analysis indicated that relative risk of overall effective rate of Sanqi, Ciwujia, Chuanxiongqin and Naoxueshu were significant difference; SMD(95% CI) of neural function defect score was SMD=-0.46, 95%CI(-0.56,-0.35)of Sanqi, Danshen, Qingkailing, Liangxuetongyufang;SMD(95%CI) of the reduce of cerebral hemorrhage was SMD = -0.98, 95% CI(-1.32, -0.63)of Danshen, Dahuang, Ciwujia, Qingkailing, Liangxue-Tongyufang. Conclusions The evidence currently available showed that the TCM which included do not increase the death rate and adverse reaction of the patients with cerebral hemorrhage, TCM could reduce neurological deficit and improve the absorption of hematoma.
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Inflammation plays a key role in the secondary brain injury after cerebral ischemia,in which microglia activation and polarization play important roles.This article reviews the roles of microglia in inflammation and the molecular mechanisms of microglia activation and polarization after cerebral ischemia.
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<p><b>OBJECTIVE</b>To investigate the risk factors for post-stroke pneumonia and assess the value of A(2)DS(2) score in predicting post-stroke pneumonia in elderly stroke patients.</p><p><b>METHODS</b>The clinical data were retrospectively collected from elderly stroke patients from January, 2007 to December, 2012. A(2)DS(2) score was then assigned using the clinical information from the medical record. The ability of the score to discriminate between patients with post-stroke pneumonia and those without was quantified using ROC analysis. The calibration of the score was analyzed using Hosmer-Lemeshow goodness-of-fit test.</p><p><b>RESULTS</b>A total of 131 elderly male stroke patients were enrolled in this study, among whom the incidence of post-stroke pneumonia was 29.01%. The independent risk factors for post-stroke pneumonia identified included moderate (P=0.0081, OR: 5.6089; 95%CI: 1.5663-20.0854) and severe (P=0.0048, OR: 44.4827; 95%CI: 3.1847-621.3126) neurological impairment, dysphagia (P=0.0005, OR: 7.5265; 95%CI: 2.4282-23.3292), and atrial fibrillation (P=0.0226, OR: 4.1778; 95%CI: 1.2221-14.2825). The incidence of post-stroke pneumonia ranged from 2.2% in patients with a A(2)DS(2) score less than 3 to 75% in those with a score higher than 8. The C-statistic of A(2)DS(2) score for predicting post-stroke pneumonia was 0.86 (95%CI: 0.784-0.911) by the ROC analysis. The A(2)DS(2) score was well calibrated to predict post-stroke pneumonia in elderly patients by Hosmer-Lemeshow test (7.083, P=0.528).</p><p><b>CONCLUSION</b>The A(2)DS(2) score can be useful for predicting post-stroke pneumonia and for routine monitoring of high-risk elderly stroke patients in the clinical setting.</p>
Subject(s)
Aged , Aged, 80 and over , Humans , Male , Atrial Fibrillation , China , Deglutition Disorders , Incidence , Pneumonia , Epidemiology , ROC Curve , Retrospective Studies , Risk Assessment , Risk Factors , Severity of Illness Index , StrokeABSTRACT
Heparanase (Hpa) is the only β-D-glucuronidase of degading heparan sulfate proteoglycans in the body of mammalian.Studies have confirmed that Hpa accelerates angiogenesis in multiple physiopathological processes; however there are still a few studies about the expression and role of Hpa after cerebral ischemia.This article mainly introduces the relation between Hpa and angiogenesis after cerebral ischemia.
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The neurovascular unit (NVU) consists of neurons,gllal cells and microvessels,etc.There were complex interactions among the various cellular components,which form as a uniform entirety preferably.Anong the various cellular components of NVU,the signal transduction occurred disorders during cerebral ischemia,resulting in neuronal and extracellular ratrix destruction,and thus occurring cerebral infarction and hemorrhagic transformation.Therefore,the treatment of ischemic sttroke should be based on the protection of the overall function of NVU.This article describes the changes and protection of NVU after cerebral ischemia.
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Objective To investigate Helicobacter pylori(Hp)infection and HLA-DQA1 allelic frequency in family members of children with recurrent abdominal pain.Methods One hundred and eighteen family members of 20 children with recurrent abdominal pain were divided into two groups:with and without recurrent abdominal pain.Serum Hp antibody was tested by dot immunogold filtration assay and immunophenotyping was determined by Western blot(immunobiot)technique.Polymerase chain reactionsequence specific primers(PCR-SSP)technique Was applied to identify HLA-DQAi allelic frequencies.Hardy-Weinberg equilibrium test was performed(P>0.05),and Chi-square test was used to compare the frequency of HLA-DQA1 alleles between the groups.Results The Hp seropositive rate in 118 members Was 100%and the Hp immunophenotyping was 96.6%.The prevalence of Hp Ⅰ and Ⅱ type was 55.1%(65/118)and41.5%(49/118).HLA-DQA1*0302 allelic frequency Was significantly higher in subjects with recurrent abdominal pain than that in subjects without one(23%vs.2%,X2=13.277,P=0.000).Conclusion There is immunogenetic difference between familial members with and without recurrent abdominal pain infected by Hp,and HLA-DQA1*0302 may be the associated gene contributing to different clinical outcomes after Hp infections.
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Objective To investigate the clinical presentation,diagnosis,and surgical management of anti-N-methyl-D-aspartate (NMDA) receptor encephalitis.Methods One case of anti-NMDA receptor encephalitis in a previously healthy 17-year-old female related to the development of NMDA receptor autoantibodies triggered by an ovarian teratoma was reported.The related literature was reviewed and the clinical feature was summarized.Results Removal of the ovarian teratoma combined with intravenous immuneglobulin and corticosteroid proved curative with eventual resolution of the paraneoplastic disease process and associated psychiatric symptoms.Conclusion Increasingly,reports of anti-NMDA receptor encephalitis associated with ovarian teratomas,as well as a novel assay to measure these antibodies suggest an etiology for this disease process that may be amenable to prompt surgical excision.
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@#ObjectiveTo investigate the incidence, types and risk factors of neurological complications in the early post-operation of renal transplantation. MethodsThe clinical course of 3169 cases of renal transplantation were reviewed, the clinical data of 102 patients with neurological complications were analyzed retrospectively.ResultsThe total incidence of neurological complications was 3.2%, which including: encephalopathy 35 (1.1%), seizure 24 (0.76%), acute stroke 15 (0.47% ), peripheral nerve disease 15 (0.47%), headache 12 (0.38%), central nervous system infection 1 (0.03%). ConclusionThere were varied of neurological complications of renal transplantation in early post-operation, in which encephalopathy and seizure were more common. Some of the complications may be related to immunosuppressive agents.
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@#Objective To analyze the instruments for post stroke fatigue, Fatigue Severity Scale (FSS)，Checklist Individual Strength (CIS) and Fatigue Impact Scale (FIS). Methods The FSS，CIS and FIS were applied in 214 cases with cerebral infarction. They were combined together at the (sub)scale level, and evaluated with Mokken Scale Analysis for Polytomous Items, for validity and reliability. Results and Conclusion Three scales were and The combined scale proved to be acceptable (H>0.5). 3 components were extracted in factor analysis, and the their total cumulative contribution was 77.504%, with reliability (α) of 0.8097，0.7094 and 0.8019 respectively. FSS put emphasis on the fatigue experiences of stroke patients, CIS on the influence of fatigue on, and FIS on the social function.
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@# Objective To introduce Checklist Individual Strength(CIS)into China,and evaluate its reliability and validity.Methods CIS was translated into Chinese language and the reverse translation was done by several experts.Validity and reliability were implemented in 214 cases with cerebral infarction.Results 4 components were extracted in factor analysis,and the total cumulative contribution was 78.984%.By correlation analysis,the twenty items were divided into 4 domains:subjective feeling of fatigue,concentration,motivation and physical activity,it was same as in the English version.Cronbach α of four domains were 0.9256,0.9072,0.7598,and 0.9157,respectively.Conclusion Psychometric properties(reliabilities and validities)of CIS Chinese version is met with satisfaction and seems to be adaptable to Chinese cerebral infarction patients.
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Objective:To study the frequency and distribution of HLA-A alleles and HLA-A*02 subtypes in the lung cancer patients in Yunnan Xuanwei area.This study aims at providing the significant genetic information for lung cancer research and treatment.Methods:Genomic DNA samples were collected from lung cancer patients and healthy donors residing in Yunnan Xuanwei area.HLA-A alleles and HlA-A*02 subtypes were typed by PCR-SSP assay.Case-control study was used to study the difference of frequency distribution between patients and normal controls.The polymorphisms of HLA-A*02 were also observed in cancer patients.Results:The positive rates of HLA-A*02 was significantly higher in cancer patients than in healthy controls (P=0.004,OR=2.432,95% CI=1.314-4.500),which were 68.75% and 47.50%,respectively.The gene frequency of HLA-A*02 was significantly higher in cancer patients than in healthy controls(P
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Abstract Objective:To study GST-? expression in breast cancer and axillary lymphnodes.Methods: The expression of GST-Tr proteinand mRNA was detected by means of immunohistochemistry and RT- PCR. Results: In normal breast tissue, cancer tissue , HE positive lymph-nodes and HE negative lymphnodes , GST-? protein expression rate is 0,60% ,77% ,43%; GST-? mRNA expression rate is 0,88% ,71%and 39% , respectively. Conclusion; GST-?gene whose expression is upregulated as tumor occurs and develops can be used as a tumor biomar-ker; GST-? expression in HE negative lymphnodes suggests the poor prognosis; drug-resistance response is more sensitive in lymphnode than inprimary cancer. The expression of GST-? gene may be regulated by RNA or before RNA transcription.