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Objective:To explore the epidemiology, clinical features and prognosis of pseudorabies virus (PRV) infection in human.Methods:A case of human PRV encephalitis combined with acute retinal necrosis (ARN) in the First Affiliated Hospital of Zhengzhou University in May 2020 was reported. The epidemiology, clinical features, neuroimaging, cerebrospinal fluid (CSF), next-generation sequencing (NGS), treatment and prognosis of human PRV infection were summarized and analyzed with the previous published data.Results:The present case was a 38-year-old man who developed high fever, headache, cognitive decline, recurrent epileptic seizures after butchering a pig. Brain magnetic resonance imaging showed lesions in the insular lobes, temporal lobes, cingulate gyrus, frontal lobes, basal ganglia and hippocampus, with more significant signals on the left side. Afterwards, bilateral ARN occurred and resulted in his blindness. PRV DNA was detected from the aqueous humor. By literature review, a total of 20 cases (including this case) were analyzed. Most patients (95%, 19/20) had the history of direct contact with swine. The median incubation period was 7 days. The infection normally caused encephalitis (95%, 19/20), some cases with endophthalmitis (60%, 12/20). Based on the neuroimaging of the 19 patients, the lesions in neuroimaging were mainly in limbic system, especially in insular (17/19) and temporal lobes (17/19). The basal ganglia was often involved (9/19).The PRV-DNA was detected by NGS in CSF or intraocular fluid. Antiviral drugs and adjuvant treatment, including immunoglobulin and/or corticoid therapy, were effective to only few cases. Most patients (90%, 18/20) had the sequelae of severe impairment of daily living (modified Rankin Scale scores≥3).Conclusions:The cardinal clinical characteristics of human PRV infection are progressive panencephalitis and endophthalmitis, with an unfavorable outcome. The history of exposure to sick swine and typical neuroimaging suggest PRV infection. NGS of CSF and/or intraocular fluid is the dependable diagnostic method.
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Objective:To investigate the characteristics of phosphorylated α-synuclein (p-α-syn) deposition in skin nerve fibers and its potential as a peripheral biomarker for Parkinson′s disease (PD).Methods:Fifteen PD patients and 31 age-matched healthy controls were evaluated by Small-Fiber Neuropathy and Symptoms Inventory Questionnaire (SFN-SIQ), who were recruited in the Department of Neurology, the First Affiliated Hospital of Zhengzhou University from June 1, 2017 to August 31, 2018. PD patients were divided into two subgroups according to the main clinical manifestations: bradykinesia ( n=7) and resting tremor ( n=8), and the severity of the disease was evaluated by Honhn-Yahr classification, where 0 to 2.5 indicates early stage ( n=11) and 3.0 to 5.0 indicates middle to late stage ( n=4). Three-millimeter punch biopsies were taken from cervical seven paravertebral area and distal leg of PD patients, while the skin of the distal leg of healthy control group was only taken, followed by immunohistochemistry and double immunofluorescence staining. The intraepidermal nerve fiber density (IENFD) and the deposition characteristics of p-α-syn were studied. Results:P-α-syn immuosignals were observed in 12/15 PD patients while in none of the control subjects, distributed in shape of dots or thread in the subepithelial plexus, dermis nerve tracts, and/or in the nerve fibers innervating sweat gland, muscle arrector pilorum, small blood vessels or hair follicle. The positive rate of p-α-syn deposition in a single site was 6/15 of the distal leg, 7/15 of the cervical, and the total positive rate was 12/15. The IENFD of PD group was 6.85±1.94/mm, which was significantly lower than that of control group (10.45±3.70/mm, t=-3.303, P=0.002), and was negatively correlated with the SFN-SIQ ( r=-0.561, P=0.046). There was no statistically significant difference in the positive rate of p-α-syn deposition and IENFD between patients with tremor and bradykinesia, nor between patients at stage of Hoehn-Yahr 0-2.5 and 3.0-5.0. Conclusions:Cutaneous p-α-syn deposits in the nerve fibers of PD patients, with a significant decrease in IENFD. P-α-syn deposition in skin nerves may be an intrinsic peripheral pathological change of PD, and skin biopsy immunolabelling p-α-syn merits further study as a potential peripheral biomarker of in vivo PD diagnosis.
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Objective To analyze the clinical features and prognosis of anti-leucine rich glioma inactivated protein 1 (LGI1) encephalitis.Methods Twelve encephalitis patients with anti-LGI1 antibodies were collected from the First Affiliated Hospital of Zhengzhou University from June 2015 to December 2016.The clinical manifestations,electroencephalogram,laboratory examination and imaging findings were summarized and the prognosis was observed.The modified Rankin Scale (mRS) was used for evaluation before and after treatment.Results The major clinical features included memory deficit (10/12),spatial disorientation (7/12),epilepsy with generalized tonic-clonic seizures (9/12),faciobrachial dystonic seizures (7/12),hyponatremia (5/12),mental and behavioral abnormalites (1/12),light sleep (1/12),increased sleep (3/12),aphasis (4/12),dysphagia,choking (2/12),headache (1/12),dizziness (2/12),fatigue (2/12),ataxia (2/12),bradycardia (3/12),urinary disorders (2/12),intestinal obstruction (1/12),diarrhea (1/12).Admission mRS score was found to be three in eight cases,four in four cases.The abnormal electroencephalogram was found in six cases,mainly manifested as focal or diffuse slow wave,some accompanied by epileptic wave.MRI scan of brain showed abnormal signals in four cases,mainly involved medial temporal lobe,hippocampus,basal ganglia,while one patient avoided MRI scan due to implantation of pacemaker.Two patients presented with pulmonary nodules,one case with positive thyroid antibody and increased rheumatoid factor.The follow-up after treatment showed no one died;mRS score was two in two cases,one in nine cases and zero in one case;the sequelae were memory deficit,increased sleep,faciobrachial dystonic seizures.Conclusions Anti-LGI1 encephalitis is a treatable disease,cardinal clinical features of which are seizures,cognitive disorders,hyponatremia.Immunotherapy can improve the symptoms of the disease significantly,and the prognosis is better comparatively.
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Objective To explore the clinical effect of electrochemical therapy (EchT) on hemangiomas of liver.Method 186 cases of hemangiomas of liver with,male 97 and female 89 were selected for the study.The age ranged from 31～55 years old.The electrochemical therapy instrument of model ZAY-B and the electrode made of platinum were used.Suitable manipulating technique and treating quantity of electricity were investigated for the patients.Electrodes were inserted into the tumor through a tracer directly by opening the abdominal cavity.Normal tissue of liver was protected by the spaghetti and the electrodes were connected to EchT device,then the treatment began.The therapeutic voltage was 6～8V,electic current 120～160mA.The quantity of electricity was 100～150 Coulombs per 1.0cm diameter of the tumor.The treatment could be terminated when the tumor became from soft to stiff.Result The therapeutic efficacy was evaluated 6 months after EchT.Through the follow-up of 1～5 years,103 of total 186 cases of hemangiomas of liver completely disappeared(72.5%);31 cases partially relieved (21.8%) and 8 cases were ineffective (5.6%).Conclusion EchT to treat hemangiomas of liver is safe and efficacy,with less traumatic and a quick recovery.It can be served as a new method for treating hemangiomas of liver.
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OBJECTIVE To established a viable and convenient method for human nasoseptal chondrocyte culture in vitro and study the biological characters of the chondrocyte. METHODS The chondrocytes were obtained by incomplete enzyme digestion of cartilage and were seeded with small piece of cartilage in 25 ml culture flasks coated with polylysine previously. This study determines the biologic synthesis of the chondrocytes by toluidine blue and type Ⅱcollagen immunohistochemistry reaction. The proteoglycan synthesis efficiencies of human nasoseptal chondrocytes cultured in vitro were measured by using 35S-Na2SO4 incorporation. The modified method and the conventional method in proteoglycan synthesis were also compared. RESULTS The results suggested that human nasoseptal chondrocytes cultured by modified method still show the normal structure and morphology, and maintain the function of metabolism and self duplication. With the modified method, we can get a higher cell survival rate and more cells. CONCLUSION The modified method is a viable and convenient method.