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Objective:To analyze the clinical features, risk factors of the prognosis and recurrence of first diagnosed acute disseminated encephalomyelitis(ADEM)in children.Methods:The clinical characteristics of 32 children with first diagnosed ADEM who were treated in the Department of Neurology of Shanghai Children′s Medical Center from January 1, 2012 to January 31, 2022 were analyzed retrospectively and followed up.Results:After follow-up, 27 of the 32 patients were diagnosed as ADEM and 4 were diagnosed as multiphasic disseminated encephalomyelitis(MDEM), 1 was diagnosed as ADEM followed by optic neuritis(ADEM-ON).Among the 27 patients diagnosed with ADEM, most of them were girls, 3~8 years old, had a history of infection before onset, occurred in summer and autumn.Common clinical symptoms included disturbance of consciousness or mental and behavior disorders(27/27, 100.0%), fever(13/27, 48.1%), paralysis(13/27, 48.1%), abnormal defecation(7/27, 25.9%), decreased vision(7/27, 25.9%)and so on.Brain MRI mainly involved subcortical white matter(20/27, 74.1%), cerebellum(10/27, 37.0%), deep nuclei such as thalamus and basal ganglia(7/27, 25.9%)and brainstem(3/27, 11.1%).In 10 cases, myelin oligodendrocyte glycoprotein(MOG)antibody tests showed positive results in 3(30.0%)and negative results in 7(70.0%).There were no significant differences in gender, age, history of infection before onset, season of onset, clinical symptoms, peripheral WBC, CRP, erythrocyte sedimentation rate, levels of WBC and protein in cerebrospinal fluid, electroencephalogram, brain and spinal cord MRI, treatment and prognosis between the MOG antibody positive and negative children(all P>0.05).16 cases (59.3%)were recovery completely, 11 cases (40.7%)were not, the rate of the infection before onset of the former was higher than the latter( P<0.05).27 cases (84.4%)had monophasic course and 5 cases (15.6%)had non-monophasic course, more of the nonmonophasic children′s brain MRI show multiple abnormal signals in the brain than the monophasic children( P<0.05). Conclusion:Children with first diagnosed ADEM require long-term clinical follow-up, and brain MRI show a higher risk of recurrence of multiple abnormal signals in the brain.The prognosis of ADEM children with a history of infection before onset is relatively good.
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Tuberous sclerosis complex(TSC)is an autosomal dominant skin-nerve syndrome with diverse clinical manifestations.Epilepsy is the most common neurological manifestation.Vigabatrin(VGB)is an inhibitory neurotransmitter γ-aminobutyric acid(GABA)analogue.It reduces the degradation of GABA by irreversibly binding to GABA transaminase, thereby increasing the level of GABA in the central nervous system and exerting anti-epileptic effects.It is suitable for the treatment of various types of epilepsy related to TSC.In recent years, the preventive effect of VGB in TSC-related epilepsy has attracted wide attention.There is a certain degree of adverse reactions during the use of VGB, the most noteworthy of which is the visual field and central nervous system changes.This article reviews the efficacy and safety of VGB in the treatment of TSC-related epilepsy.
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Myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is one of inflammatory demyelinating disorders of the central nervous system.Due to the diverse and atypical clinical manifestations, positive rate of current detection methods is not high, and early diagnosis is difficult.This review aims to elucidate the research progress of the epidemiology, pathogenesis, clinical characteristics, diagnostic criteria, biological markers, treatment and prognosis of MOGAD, in order to improve the understanding of MOGAD for clinicians, so as to identify, treat and reduce the recurrence of MOGAD as early as possible.
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Objective:To evaluate the relationship between preoperative malnutrition and postoperative pulmonary complications (PPCs) in elderly patients undergoing thoracoscopic and laparoscopic radical esophagectomy.Methods:The elderly patients who underwent elective thoracoscopic and laparoscopic radical esophagectomy in the Affiliated Hospital of Jiangnan University were enrolled.The general clinical data and nutritional status, Assess Respiratory Risk in Surgical Patients in Catalonia (ARISCAT) score, tumor pathological stage and operation-related variables based on the Gobal Leader Initiative on Malnutrition criteria were recorded.The patients were divided into 2 groups according to whether PPCs occurred during hospitalization, and the differences between the variables were compared.Logistic regression analysis was used to identify the risk factors for PPCs in elderly patients undergoing thoracoscopic and laparoscopic radical esophagectomy.The accuracy of the ARISCAT score and ARISCAT score combined with malnutrition in predicting the occurrence of PPCs was evaluated by receiver operating characteristic curve.Results:A total of 256 elderly patients undergoing thoracoscopic and laparoscopic radical esophagectomy were included, and the incidence of PPCs was 23.8%.There were no significant differences between patients with and without PPCs in FEV 1/FVC, age, American Society of Anesthesiologists physical status, chronic obstructive pulmonary disease ratio, malnutrition ratio and ratio of patients with high ARISCAT score ( P<0.05). The results of logistic regression analysis showed that increasing age, chronic obstructive pulmonary disease, malnutrition and high ARISCAT score were independent risk factors for PPCs.The area under the receiver operating characteristic curve of ARISCAT score and malnutrition combined with ARISCAT score in predicting the occurrence of PPCs was 0.722 and 0.777, respectively, and the difference was statistically significant ( P<0.05). Conclusions:Preoperative malnutrition is an independent risk factor for the occurrence of PPCs in elderly patients undergoing thoracoscopic and laparoscopic radical esophagectomy, which is helpful in improving the accuracy of ARISCAT score in predicting the occurrence of PPCs.
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Objective:To investigate the protective effect of interfering peptide TAT-GluA2CT on hippocampal neurons in the Lithium chlorine-Pilocarpine status epilepticus model and the optimal time of administration.Methods:Male SD rats (72 cases) were induced to status epilepticus by using Lithium chlorine-Pilocarpine, while a control group ( n=12) was established.The 72 rats were divided into epilepsy group ( n=12), TAT-sham peptide group ( n=12), TAT-GluA2CT peptide group ( n=48) according to the random number table method, and the TAT-GluA2CT peptide group were further divided into the pre-1 h group ( n=12), the post-2 h group ( n=12), the post-4 h group( n=12), and the post-6 h group ( n=12) according to the administration time of the TAT-GluA2CT peptide.Nissl staining and terminal dUTP nick end labeling (TUNEL) assay were performed on 6 rats each from control group, epilepsy group, TAT-shampeptide group, pre-1 h group, post-2 h group, post-4 h group, and post-6 h group to observe the morphological changes and apoptosis of neurons in the CA1 region of the rat hippocampus.Western blot and co-immunopercipitation test were used to detect the expression of GluA2[second subunit of α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) recepter] and the coupling of GluA2/transmembrane AMPA receptor regulatory protein (TARP γ-8) complex in control group, epilepsy group, pre-1 h group, post-2 h group, post-4 h group and post-6 h group.The t-test was used to compare the data differences between 2 groups, and one-way ANOVA was adopted to compare the differences between the groups. Results:Compared with the epilepsy group, the number of neurons in each TAT-GluA2CT peptide group increased significantly, and the difference was statistically significant( epilepsy group 20.07±3.51, pre-1 h group 39.40±2.39, post-2 h group 38.43±2.42, post-4 h group 30.30±2.55, and post-6 h group 27.93±3.20, F=235.28, P<0.05). Compared with the epilepsy group, the number of apoptotic cells in each TAT-GluA2CT peptide group was significantly reduced, and the difference was statistically significant(epilepsy group 31.47±3.19, pre-1 h group 7.30±3.45, post-2 h group 9.27±3.81, post-4 h group 12.86±3.08, and post-6 h group 14.43±3.13, F=248.60, P<0.05). Compared with the control group, the expression of hippocampal GluA2 decreased after epilepsy induction, and the difference was statistically significant(control group 21 626.53±2 700.58, epilepsy group 14 578.16±2 917.02, pre-1 h group 13 375.47±3 180.54, post-2 h group 15 244.10±1 390.41, post-4 h group 15 799.16±4 559.49, post-6 h group 15 722.95±1 756.01, F=3.83, P<0.05). No statistical difference was observed in the expression of GluA2 between the TAT-GluA2CT peptide group and the epilepsy group( F=0.45, P=0.77). Compared with the epilepsy group, GluA2/TARPγ-8 complex coupling was decreased in each TAT-GluA2CT peptide group, and the difference was statistically significant(epilepsy group 24 509.80±3 718.54, pre-1 h group 12 055.18±5 847.11, post-2 h group 9 630.51±5 805.17, post-4 h group 12 749.35±7 108.45, post-6 h group 11 092.98±7 330.08, F=10.68, P<0.05). Compared with the epilepsy group, the incubation period of seizures in the pre-1 h group was prolonged and the seizure rating was decreased, with statistically significant differences[epilepsy group (18.58±3.99) min, pre-1 h group (103.25±9.21) min, t=29.23, P<0.05]. Conclusions:TAT-GluA2CT peptide can attenuate the neuronal damage in hippocampus of epileptic rats.The neuroprotective effect of TAT-GluA2CT peptide was most obvious at 1 h before or 2 h after administration of Pilocarpine.
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Lung cancer ranks first in the cancerous morbidity and mortality rate around the world. With the popularity of low-dose CT scans and the aging of society, the diagnostic rate of early-staged lung cancer in the elder has increased significantly. However, it poses a serious challenge to the selection of surgical strategies for elderly patients of early-staged lung cancer due to the decline in organ function accompanying the aging, the combination of various chronic diseases and underlying senile syndrome. Inappropriate surgical strategies can significantly affect postoperative prognosis and long-term survival. Therefore, this article reviews the preoperative risk factors and surgical strategies affecting the long-term survival of elderly patients with early-stage NSCLC(non-small cell lung cancer), thus increasing the clinician’s awareness of elderly NSCLC, which is of great significance to help make reasonable surgical strategies and improve the prognosis.
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Abdominoscrotal hydrocele is rare in clinic. In the past, routine examination and diagnosis were difficult, easy to be misdiagnosed. The daily operations were mostly completed through the groin area or abdominal incision, the wound is large. The application of laparoscopy can clearly diagnose the abdominoscrotal hydrocele through "springing back ball" sign, and can cure the disease by laparoscopic resection of interperitoneal mass and closure of the internal ring. It is worthy of clinical application. In this article, we summarized and analyzed the clinical experience of 15 cases of children with abdominoscrotal hydrocele diagnosed and treated by laparoscopy, to explore the value of the laparoscopic technology in the diagnosis and treatment of the abdominoscrotal hydrocele.
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Epilepsy occurs as a result of episodic abnormal synchronous discharges in cerebral neuronal networks.It is characterized by an imbalance between excitatory and inhibitory neurotransmission.Although various non-conventional mechanisms are implicated in epileptic synchronization, glutamate excitatory neurons play an essential role.AMPA receptors mediate fast synaptic excitation within and between brain regions relevant to epilepsy, and play a role in epileptogenesis and in seizure-induced brain damage.However, direct modulation of AMPA receptors may have undesirable consequences, given its wide expression within the central nervous system and critical roles on brain circuitry development.Hippocampal CA1 region, as the main site of epilepsy, selectively regulates the high expression of AMPA receptor GluA2 subunit and transmembrane AMPA receptor regulatory protein family(TARPs)γ-8 subtype and its complex GluA2/TARPγ-8, whether it can produce anti-epileptic and avoid adverse reactions.
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Objective:To analyze the clinical features of the recurrence of febrile seizures(FS), and observe the efficacy of levetiracetam(LEV)in preventing FS recurrence.Methods:We retrospectively analyzed the clinical data of 101 cases of FS recurrence who were admitted to the Department of Neurology of our hospital from May 2017 to May 2020, and collected the information of the recurrence after discharge and adverse effects of LEV application.Cox proportional hazards model regression was applied to explore the relationship between FS recurrence and LEV prophylaxis.Results:Among 101 cases of recurrent FS, the section of 18-60 months(63/101)composed the dominant proportion, of which the episode of 18-36 months(40/101)took the biggest recurrence rate.All 101 recurrent FS cases occurred within 24 hours of fever-beginning time, and 74.3%(75/101)occurred within 3 hours of fever onset.39.6% cases(40/101)were non-high febrile seizures, of which 30.0%(12/40)even had a temperature ≤38°C at the onset.Ninty-five cases of FS were included in the retrospective cohort study.Thirty-eight cases(4 lost to follow-up)were treated with LEV, while 57 cases(7 lost to follow-up)were not treated with any anticonvulsant drugs.The recurrence rate in the prophylactic group was 17.6%(6/34), compared with 44.0%(22/50)in the control group.The recurrence rate of the prophylactic group was statistically lower than that of the control group( χ2=6.325, P=0.012). Cox regression analysis was used to explore the relationship between FS recurrence and various factors, suggesting LEV prophylaxis( OR=0.325, 95% CI 0.129-0.821)and family history of FS( OR=3.060, 95% CI 1.427-6.560)affect the recurrence of FS.Then FS family history was stratified, LEV prophylaxis still statistically reduced the recurrence of FS( OR=0.316, 95% CI 0.124-0.802). Conclusion:The risk of recurrence increases significantly after 18 months of the age.Besides, FS recurrence is relatively common in the initial episode of fever and in the stage of low fever.For children at months of high probability of recurrence, prophylactic drugs should be used in the initial episode of fever and in the stage of low fever.LEV prophylaxis therapy is effective, with mild adverse reactions.
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Objective:To investigate the clinical features of Herpes simplex virus encephalitis(HSE) with cerebral hematoma as the prominent manifestation and the significanc of metagenomic next-generation sequencing (mNGS) in the diagnosis of HSE.Methods:The clinical manifestations, diagnostic process, clinical treatment and prognosis of a case of HSE with cerebral hematoma as the prominent manifestation at Shanghai Children′s Medical Center Affiliated to Shanghai Jiaotong University School of Medicine in June 2019 were retrospectively analyzed.The relevant literatures were also searched and reviewed.Results:A 4-year-old boy presented with slight fever, headache, convulsion and vomiting was considered to have intracranial space-occupying lesions and possible intratumoral hemorrhage after undergoing imaging examination at a local hospital.The patient was checked by head CT in Shanghai Children′s Medical Center Affiliated to Shanghai Jiaotong University School of Medicine, which showed that there were many bleeding foci in the brain, indicating the possibility of complications of blood system diseases.Therefor the child was given the examination of blood routine and coagulation routine, but the results were normal, the bone marrow cytology was negative, the cerebrospinal fluid(CSF) of lumbar puncture was biochemically normal, and mNGS were 8×10 6/L.Besides, CSF smear, culture and next-generation sequencing were negative, the autoimmune encephalitis CSF testing was negative, and brain biopsy suggested inflammation.The mNGS brain tissue showed herpes simplex virus 1 was positive in two specimens, confirming the diagnosis of HSE.After 3 weeks of antiviral treatment with Aciclovir, the child′s condition improved.After a 5-month follow-up, the patient had quadriplegia and only had activities such as blinking and swallowing. Conclusions:When the intracerebral hemorrhage such as hematoma caused by encephalitis clinically can not be ruled out, the possibility of HSE should be considered, and mNGS is helpful for identifying the central ner-vous system pathogen.
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Objective:To analyze the clinical characteristics, cerebrospinal fluid (CSF) and other auxiliary examination results of febrile children with convulsions in order to provide the evidence for clinical recognition of central nervous system (CNS) infection and its etiology.Methods:The clinical data of 64 fever patients with convulsions admitted at the Department of Neurology, Shanghai Children′s Medical Center, Shanghai Jiaotong University School of Medicine were analyzed retrospectively.According to the results of the routine biochemical examination of CSF, they were divided into 2 groups as CSF normal group (44/64 cases, 69%) and CSF abnormal group (20/64 cases, 31%). Their age, gender, clinical manifestations, physical symptoms and auxiliary examination results were compared between the two groups. Logistic regression analysis was performed to explore the independent risk factors of abnormal CSF results.Twenty children with abnormal CSF results were divided into the normal glucose group (12/20 cases, 60%) and the glucose reduction group (8/20 cases, 40%) according to the glucose level of CSF.The fever duration, serum inflammation markers, CSF routine and biochemical indexes of the two groups were compared. Results:According to Logistic multivariate unconditional regression analysis, the mental state change ( OR=435.99, P=0.010), abnormal neurological signs ( OR=65.25, P=0.023) and vomiting ( OR=20.56, P=0.048) were the high risk factors of abnormal CSF results.Among the children with abnormal CSF results, in the glucose reduction and normal glucose groups, the fever duration was 12.50 (7.75-16.75) d and 4.00 (3.00-5.75) d, respectively; the level of CSF protein were 3 000 (1 745-3 000) mg/L and 648 (469-1 734) mg/L, respectively; the erythrocyte sedimentation rate (ESR) was 71.50(56.00-97.50) mm/1 h and 20.50 (12.00-26.00) mm/1 h, respectively; the procalcitonin level was 2.76(0.90-20.72) g/L and 0.23 (0.03-1.00) g/L, respectively; the C-reactive protein (CRP) level was 123.00 (33.00-177.75) mg/L and 12.50(4.25-57.75) mg/L, respectively.The fever duration, CSF protein level, ESR, procalcitonin level and CRP level were statistically different between the glucose reduction and normal glucose groups (all P<0.05). Conclusions:In fever children with convulsions, vomiting, the mental state change, and abnormal neurological signs are the high risk factors of abnormal CSF results, suggesting the possibility of CNS infections and the need of early diagnosis by CSF and other auxiliary examinations.In addition, a low level of CSF glucose in children with abnormal CSF results may be a potential and powerful clue for purulent meningitis.Timely etiological tests are required for confirmation, and antibiotics treatments should be applied as early as possible.
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Objective@#To evaluate the feasibility and accuracy of deep learning in CT image segmentation and further lesion-volume assessment of spontaneous intracerebral hemorrhage.@*Methods@#A total of 1 223 cases of spontaneous intracerebral hemorrhage including parenchymal hemorrhage, ventricular hemorrhage, subarachnoid hemorrhage and mixture hemorrhage, from April 2016 to April 2018 in Tianjin Medical University General Hospital, were retrospectively enrolled and analyzed. The patients were randomly divided into training set (905 cases), validation set (156 cases) and test set (162 cases), among each group, the number of parenchymal hemorrhage was 498, 107 and 100, respectively. The bleeding area manually outlined by physician was served as the reference standard to build the segmentation model and to evaluate the performance of the validation set. Patients were divided into 3 groups according to the volume calculated by reference standard. The volume of hematoma in group 1 was less than 5 ml, while group 2 was 5-25 ml, and group 3 was more than 25 ml. Comparison of the hematoma volume calculated by segmentation model and that calculated by ABC/2 formula was conducted in 97 simple intraparenchymal hemorrhage cases.@*Results@#In 162 cases of test set, the Dice coefficients of the segmentation model were 0.87, 0.85, 0.67 and 0.77 in parenchymal hemorrhage, intraventricular hemorrhage, subarachnoid hemorrhage and mixture hemorrhage, respectively. The estimated hematoma volume in the 97 intraparenchymal hemorrhage cases calculated by the segmentation model was (29.55±37.69) ml, and that calculated by the ABC/2 formula was (24.04±31.22) ml. Compared with reference standard, the absolute errors of three segmentation model were (0.52±0.54), (1.53±1.22) and (7.93±8.49) ml in group 1, 2 and 3 respectively. The absolute errors of the ABC/2 formula were (0.68±0.60), (3.16±2.90) and (19.31±17.23) ml in group 1, 2 and 3.@*Conclusion@#Deep learning based segmentation model improved detection of intraparenchymal hematoma volume, compared with ABC/2 formula.
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Objective To summarize the efficacy and adverse reactions of incremental corticotrophin (ACTH) therapy in the treatment of infantile spasms (IS),and to provide new clinical treatment options.Methods The clinical data of 40 children with IS who were hospitalized in the Department of Neurology,Shanghai Children's Medical Center,Shanghai Jiaotong University School of Medicine,treated with ACTH from January 2016 to January 2018 were collected and retrospectively analyzed.All the children were treated with intravenous infusion of ACTH with an initial dose 12.5 U/d for 3 days.If the spasms did not disappear,dosage of ACTH increased to 25.0 U/d for another 3 days.If the spasms could not yet be fully controlled,the dosage increased to 40.0 U/d,and the total course of treatment did not exceed 2 weeks.If the spasms disappeared at each dose stage or the course of treatment reached to 2 weeks,ACTH would be changed to Prednisone 2 mg/(kg · d) orally,which gradually decreased in 2 months.All children underwent electroencephalogram examination before and after treatment.Results Forty patients with IS were treated with ACTH increasing therapy.The disappearance rate of spasms was 40.0％ (16/40 cases) totally,with 7.5％ (3/40 cases) at the dosage phase of 12.5 U/d,16.2％ (6/37 cases) at the dosage stage of 25.0 U/d,and 22.6％ (7/31 cases) at the dosage of 40.0 U/d.The disappearance rate of hypsarrhythmia on electroencephalogram was 60.0％ (24/40 cases) generally,and 5.0％ (2/40 cases),10.8％ (4/37 cases),58.1％ (18/31 cases),respectively at above different dosage phases,while 37.5％ (15/40 cases) of the children had mild adverse reactions,mostly respiratory infections.Conclusions The short-term efficacy of the ACTH incremental therapy in the treatment of IS is positive,and the incidence of adverse reactions is low.
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The immune mechanisms are involved in the pathogenesis of many acute encephalitis and encepha-lopathies. The discovery of auto - antibodies in the central nervous system promotes the development of neurology. The more common auto - antibody - associated encephalitis syndromes in children include anti - N - methyl - D - aspartate receptor encephalitis,anti - myelin oligodendrocyte glycoprotein antibody associated demyelination,anti - gamma -aminobutyric acid (GABA)- A receptor encephalitis,antiglycine receptor encephalitis,basal ganglia encephalitis and anti - glutamic acid decarboxylase encephalitis. Other auto - antibodies described in adults are very rare or unreported in childhood cases. There is no consensus definition for the diagnosis of seronegative suspected autoimmune encephalitis in pediatrics. This paper reviews the progress of autoimmune encephalitis of children with antibody mediated and sero-logical negative in recent years.
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To investigate the efficacy of high-dose methylprednisolone pulse therapy in the treatment of Enterovirus 71 [EV71] encephalitis. To determine whether high-dose methylprednisolone pulse therapy should be used, 80 cases of pediatric patients with EV71 encephalitis were randomly divided into steroid pulse therapy group and non-steroid pulse therapy group and their clinical information was compared using statistic analysis. There was no statistical difference in the duration of fever, duration of nervous system involvement, duration of hospital stay, blood pressure, and cure rates between the two groups [p>0.05]. The heart rate, respiratory rate, white blood cell counts and blood glucose of the steroid pulse therapy group were significantly higher than those of the non-steroid pulse therapy group [p<0.05]. Highdose steroid pulse therapy to treat EV71 encephalitis can't shorten the course or improve the prognosis of the disease. In contrast, it has side effects and might aggravate disease condition or interfere with disease diagnosis. Our study suggested that there is no beneficial effect to use high-dose steroid pulse therapy for the treatment of EV71 encephalitis
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Objective To investigate hippocampal neuronal damage and dynamic change of α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptor subunit GluR2 in status epilepticus, to find out whether GluR2/glyceral dehyde-3-phosphate dehydrogenase (GAPDH) interaction has any change.Methods Male Wistar rats (62 cases) were induced to status epilepticus by using LiC1-pilocarpine.The 62 rats were divided into 1 h (6 cases),6 h (12 cases), 24 h (12 cases),72 h (12 cases)and 7 d (20 cases)after status epilepticus.At the same time, the healthy control group (12 cases) was established.Morphologic changes of hippocampus and the amount of apoptotic cells in healthy control and SE model groups at different time points (6 h, 24 h, 72 h, 7 d) (6 cases each group) after status epilepticus were quantified by adopting Nissl staining and terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end-labeling staining respectively.Expressions of GluR2 in healthy control and SE model groups at 1 h,6 h,24 h,72 h and 7 d (6 cases each group) after status epilepticus were detected by using Western blot.Co-precipitation and Western blot techniques were used to investigate whether the GluR2/GAPDH interaction in the hippocampus was increased.Results Compared with the healthy control group, the number of nerve cells in the hippocampal CA1 and CA3 regions was significantly reduced at all studied time points(F =30.866,24.043, all P ＜0.05).Apoptotic cells in hippocampal CA1 and CA3 regions were significantly increased at 24 h,72 h and 7 d after status epilepticus (F =84.762,52.574, all P ＜ 0.01).GluR2 at 1 h,6 h after status epilepticus was equal to that of the control group (P ＞ 0.05), but it was shown to be significantly down-regulated at other studied time points (F =76.506,P ＜ 0.01);when compared with the healthy control group,the GluR2/GAPDH interaction was significantly up-regulated in the hippocampus at 72 h after status epilepticus (t =7.029, P ＜ 0.05).Conclusions Status epilepticus can lead to neuronal damage in the hippocampus.Down-regulation of GluR2 and increase of the GluR2/GAPDH complex formation might be one of the mechanisms involved in hippocampal neuronal damage.
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The ketogenic diet is a high-fat,low-carbohydrate diet that imitates ketone bodies from hunger produce,is a kind of treatment for children with refractory epilepsy.Autism is a subtype of pervasive developmental disorder characterized by impaired social interaction,language barriers and stereotyped behavior.Some children may be associated with epilepsy.Early rehabilitation education and training are the main method of treatment.This review summarized ketogenic diet clinical applications for the treatment of children with autism and potential mechanisms.
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BACKGROUND:The quantity and quality of seed cel s is a critical bottleneck of the development of vascular tissue engineering. To address this issue, stem cel-derived endothelial cel s have been a hot spot in this field due to their potential in providing the ideal seed cel s. OBJECTIVE:To elucidate the effect of vascular endothelial growth factor (VEGF) supplementation combined with hypoxic culture condition on the lineage-specific differentiation of embryonic stem cel s into endothelial cel s. METHODS:Serum-free medium mTeSR?1 was applied to cultivate H9 cel s in vitro. A conditioned medium containing 50μg/L vascular endothelial growth factor was utilized to induce H9 cel s to differentiate into endothelial cel s under the hypoxic culture condition (5%O2). The cel under normal condition (5%CO2) with or without vascular endothelial growth factor served as controls. The phenotype and function of human embryonic stem cel s-derived endothelial cel s were assayed by immunofluorescence staining, quantitative RT-PCR, and low-density lipoprotein uptake experiment. RESULTS AND CONCLUSION:Compared with the control group, the H9 cel s were induced to be differentiated into endothelial-like cel s more efficiently when they were cultivated under a conditioned medium with vascular endothelial growth factor supplementation under the hypoxic condition. These differentiated cel s not only expressed some important surface markers of endothelia cel s, including kdr, pecam, but also took in low-density lipoprotein to form microvessle-like structures. This culture system supports a synergy effect of vascular endothelial growth factor and hypoxic environment that can efficiently promotes the lineage-specific differentiation of embryonic stem cel s into endothelial cel s with good phenotype and functionality.
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BACKGROUND:Constructing a three-dimensional tissue-like structure in vitro plays a critical role in modern tissue engineering and regenerative medicine. Several advances have been made in the past decade. However, it is stil a chal enge to promote microvascular-like structure formation and improve limited nutritional transportation, thereby promoting cel viability. OBJECTIVE:To explore the feasibility of constructing a three-dimensional microvascular-like structure through the co-culture technique. METHODS:Human bone marrow mesenchymal stem cel s and human endothelial cel s were co-cultured on a three-dimensional porous silk scaffold. Cel proliferation was analyzed by Pico-green DNA assay. Their growth profiles were evaluated by scanning electron microscope and laser scanning confocal microscopy, respectively. The mRNA levels of von Wil ebrand factor and CD31, two key functional markers of endothelial cel s, in the co-cultured endothelial cel s was assayed by real-time quantitative reverse transcription-PCR. RESULTS AND CONCLUSION:The three-dimensional culture system constructed by the silk scaffold and bone marrow mesenchymal stem cel s provided an ideal microenvironment for cel growth and proliferation in vitro. Moreover, this microenvironment was capable of promoting endothelial cel differentiation evidenced by their significantly improved mRNA levels of von Wil ebrand factor and CD31. Premicrovascular-like structure was also observed in the co-cultures under the confocal microscope. Thus, al the data supported that the unique co-culture system could promote endothelial cel differentiation and self-assembling in vitro. This culture system provides a robust tool for the studies addressing microvessel-based tissue engineering.
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Objective To optimize the extraction technology of Taxus x media by using the contents of Paclitaxel and 10-deacetylbaccatin(10-DAB),two representative active diterpene alkaloids of taxane type from T.x media,as evaluation standard.Methods The smashing tissue extraction(STE)of Paclitaxel and 10-DAB from T.x media,was investigated by comparing with ultrasonic extraction(UE)which was one of the modern technologies of extraction.Results STE was more efficient than UE,and the contents of 10-DAI3 and Paclitaxel in the extracts obtained by STE were higher than those by UE.Conclusion STE is a fast,high-performance,and energy-saving technology for the extraction of diterpene alkaloids of taxane type.STE also provides a simple,component-safe,workable,and highly efficient method for the extraction of active natural product.