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To investigate the risk factors of poor prognosis and recurrence in patients with anti-NMDAR encephalitis. A single center, observational cohort study was used to retrospectively analyze 44 patients with anti NMDAR encephalitis hospitalized in the Department of Neurology of Beijing Tong Ren Hospital from January 2014 to October 2020. The results showed that the interval from onset to immunotherapy in the poor prognosis group was significantly longer than that in the good prognosis group (t=2.045,P=0.047), and the course of disease in the poor prognosis group was significantly longer than that in the good prognosis group (t=4.127,P=0.000 2). The number of patients with clinical manifestations of dyskinesia was significantly increased (Fisher exact test: P=0.014). The patients with abnormal brain MRI in the poor prognosis group were significantly more than those in the good prognosis group (Fisher exact test: P=0.017), and the patients with slow wave>50% in the poor prognosis group were significantly more than those with slow wave <50% (Fisher exact test: P<0.001). Patients with the first onset of immunotherapy time <3 months, long course of disease, high intracranial pressure, and high cerebrospinal fluid protein are prone to relapse. Bivariate logistic regression analysis showed that patients with dyskinesia, abnormal brain MRI, and slow wave EEG more than 50% were risk factors for poor prognosis (OR values were 4.687, 4.978, and 24.500, respectively; P values were 0.018, 0.016, and 0.000, respectively). The time of first-line immunotherapy for the first onset<3 months was the risk factor for recurrence (OR 17.231, P=0.010). In conclusion, dyskinesia, abnormal brain MRI and slow wave of EEG more than 50% may be the risk factors for poor prognosis of patients. The duration of immunotherapy less than 3 months after the first onset might be the risk factor for recurrence.
Subject(s)
Humans , Anti-N-Methyl-D-Aspartate Receptor Encephalitis/cerebrospinal fluid , Retrospective Studies , Neoplasm Recurrence, Local , Risk Factors , DyskinesiasABSTRACT
OBJECTIVE To investigate the developmental toxicity of a new disinfectant trichloroiso-cyanuric acid (TCCA) on zebrafish embryos and larvae. METHODS Zebrafish embryos of 2 h post fertilization (hpf) were exposed to TCCA:①The embryos were exposed to a culture medium containing TCCA 0, 50, 100, 150, 200, 250 and 300 mg·L-1 for 48 h before 50%lethal concentration (LC50) was calcu-lated. ② The embryos were exposed to a culture medium containing TCCA 0, 10.4, 20.8 and 41.7 mg · L-1 for 96 h. The mortality, malformation rate and heart rate of embryos and larvae were measured at 48, 72 and 96 h after TCCA exposure. The expression of superoxide dismutase (SOD) was detected at 2, 4 and 6 h after TCCA exposure. The pathological changes in the head of zebrafish larvae were observed 7 d after exposure by HE staining. RESULTS LC50 of 48 h after TCCA exposure was 166.9 mg · L-1. Compared with normal control group, the mortality and malformation rate of zebrafish embryos were significantly increased (P<0.05) in TCCA 41.7 mg · L-1 group, but the heart rate was decreased significantly (P<0.05) in each dose of TCCA group at 96 h after TCCA exposure. At 72 h after TCCA exposure, the mortality rate of zebrafish embryos was significantly increased (P<0.05) in TCCA 41.7 mg·L-1 group, the malformation rate of zebrafish embryos was increased (P<0.05) and the heart rate of zebrafish embryos was decreased (P<0.05) in 20.8 and 41.7 mg · L-1 groups. At 48 h after TCCA exposure, the heart rate of zebrafish embryos was decreased significantly (P<0.05) in 41.7 mg · L-1 group. The SOD activity of zebrafish embryos in 20.8 and 41.7 mg · L-1 groups was significantly lower than that of control group (P<0.05). At 7 d after exposure, the brain and ocular space of larvae were enlarged and the ocular retina layers were not obvious in any dose of TCCA groups. CONCLUSION TCCA has toxic effect on zebrafish embryonic development, which can down-regulate SOD activity in the early developmental stage of embryos and damage the retina tissue of larvae.
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Objective:To investigate the mechanism of miR-128 on the expression of AK2 protein through the STAT3 signaling pathway on the biological behavior of cervical cancer cells .Methods: The expression of AK2 and miR-128 in cervical cancer tissues and cells was detected by qPCR and Western blot .Double luciferase assay was used to detect the interaction between miR-128 and AK2.CCK-8 proliferation assay was used to detect the effect of miR-128 on the enhancement of cervical cancer cells .The effect of miR-128 on the tumorigenesis of cervical cancer cells was exa mined by tumor formation test in nude mice .Western blot was used to detect the effect of miR-128 on STAT3 signal pathway protein level .Western blot was used to detect the inhibitory effect of miR-128 on p-STAT3 by overexpressing AK2 protein.Results:The expression level of AK2 in cervical cancer tissues was higher than that in normal cervical tissues,and the expression level of miR-128 in cervical cancer C33a cells was lower.Double luciferase assay confirmed that miR-128 could directly target the expression of AK 2.CCK-8 proliferation test showed that miR-128 could inhibit the proliferation of cervical cancer cell lines .In vivo tumorigenesis test showed that the increase of miR-128 could inhibit the tumorigenesis ability of cervical cancer cells[volume(3.05±0.35)cm3 vs (0.86±0.11)cm3,P=0.031;weight(3.26±0.39)g vs (0.89±0.15)g,P=0.016 ];Western blot showed that miR-128 could inhibit the activation of p-STAT [ ( 42.12 ±6.28 )% vs ( 91.25 ±9.29 )%, P<0.05 ] ,while the overexpression of AK 2 could reverse the inhibitory effect of miR-128 on p-STAT.Conclusion: miR-128 is used to regulate the expression of AK 2 and regulate the biological behavior of cervical cancer cells through the activation of STAT 3 pathway.
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<p><b>BACKGROUND</b>Coma after cardiopulmonary resuscitation (CPR) is commonly seen in daily clinical practice. How to objectively evaluate brain function after CPR is essential to the following treatment. Coma patients after CPR had been studied prospectively at the Neuro-Intensive Care Unit of Xuanwu Hospital since 2002. In this study, we focused on the topic of how to evaluate the severity of coma after CPR.</p><p><b>METHODS</b>From April 2002 to November 2004, patients in coma 24 hours after CPR were monitored, the evaluation methods included Glasgow coma score (GCS), brain stem reflection, and spinal reflection. Laboratory evaluation included electroencephalography (EEG), brainstem auditory evoked potential (BAEP), short latency somatosensory evoked potential (SLSEP), and transcranial Doppler (TCD).</p><p><b>RESULTS</b>Twenty-four of 35 patients (68.57%) were in deep coma. The GCS was 3 except for 2 patients; EEG was evaluated not less than grade IV except for 4 patients, BAEP was evaluated as grade III except for 3 patients, and SLSEP was evaluated as grade III except for 1 patient. Twenty-four patients died within 1 month and 11 of them (45.83%) were determined as brain death. Glasgow outcome score (GOS) was evaluated as grade I. Eleven of the 35 patients survived and their consciousness changed from deep coma to coma vigil. EEG was evaluated as gradeIin 5 patients, BAEP and SLSEP were evaluated as grade I in 3 patients, and GOS was all evaluated as grade II among the 11 patients. Two patients (18.18%) regained consciousness in 35 and 90 days after cardiopulmonary resuscitation and GOS was evaluated as grade IV and III, respectively.</p><p><b>CONCLUSION</b>Combined or continuous evaluation of clinical examinations and laboratory tests can accurately and objectively determine brain function after CPR.</p>
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Brain , Cardiopulmonary Resuscitation , Coma , Electroencephalography , Evoked Potentials, Auditory, Brain Stem , Evoked Potentials, Somatosensory , Glasgow Coma Scale , Ultrasonography, Doppler, TranscranialABSTRACT
Objectives To study a special pattern of electroencephalogram (EEG),regional attenuation without Delta in massive cerebral ischemic infraction and evaluate its clinical value.Methods All the 47 cases diagnosed as massive cerebral infraction were continuously observed and evaluated in the period of 2004 to 2006 for EEG,short-latency somatosensory evoked potential (SLSEP).Glasgow coma scale (GCS) and the National Institutes of Health Stroke Scale (NIHSS) were also rated.EEG monitoring was performed every 1 to 3 day,but at least one time for patient with deteriorated condition.The outcome was evaluated with Glasgow outcome scale (GOS).Results 47 cases were performed 70 times of EEG all together,among whom 32 cases (68.1%) showed RAWOD in EEG.The positive rate of RAWOD was 76.9% within 24 hours of onset,but it was 28.6% in CT in the same time.The GCS and NIHSS of two groups had significant differences (P
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Objective To investigate an accurate,reliable and objective method to evaluate persistent vegetative state at bedside.Methods The brain function of 34 cases with persistent vegetative state as a result of acute brain injury was evaluated,involving clinical examinations and neuroelectrophysiological evaluations(EEG,BAEP,SLSEP).Results The most common cause of brain damage was anoxic encephalopathy(30/34,88.2%).The patients were in mild,moderate or deep coma with complete or partial existence of brainstem reflection,activities distributed by cerebral nerves,voluntary extremity activities,spinal cord reflection and automatic spinal cord reflection as well as partial existence of pathologic reflection.According to the Young Criteria of EEG,64.5%(20/31)and 29.0%(9/31)of the cases were in grade Ⅰ and Ⅵ respectively,6.5%(2/31)were in grade Ⅲ and Ⅳ.According to the Cant Criteria of evoked potential,34.8%(8/23),21.7%(5/23)and 43.5%(10/23)of the cases were in gradeⅠ,Ⅱ and Ⅲ of brainstem auditory evoked potential,respectively.43.5%(10/23),4.4%(12/23) and 52.2%(12/23)were in grade Ⅰ,Ⅱ and Ⅲ of short-latency somatosensory evoked potential respectively.29.4%(10/34)of 34 cases died,and 11.8%(4/34)resuscitated during 35—90 days. Conclusion Combination of multiple neuroelectrophysiological tests was an accurate,reliable and objective approach to evaluate the brain function of patients with persistent vegetative state,which provides evidence for decision-making in agrypnotic therapy.