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@#To assess the efficacy and safety of pregabalin during short-term treatment in adults with neuropathic pain. We searched the PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, and Clinical Trials databases. Twelve eligible articles were finally selected. Efficacy outcomes included change in Daily Pain Rating Scale score (DPRS; 0 = ‘no pain’ to 10 = ‘worst possible pain’) and sleep interference score (0 = ‘pain does not interfere with sleep’ to 10 = ‘completely interferes’). Safety was based on adverse events, serious adverse events (SAEs) and the incidence of treatment emergent adverse events (TEAEs) .The authors used the Cochrane Collaboration’s Risk of Bias Tool to assess the risk of bias in included trials. Review Manager 5.3 was used for all statistical analyses. Data from 12 articles including 3,169 patients (pregabalin, n = 1,677; placebo, n =1,492) were analyzed. Mean changes in the daily pain rating scale score [MD=-0.65, 95%CI(-0.88,-0.41), P<0.001] and daily sleep interference score in patients that received pregabalin were compared to those that received placebo [MD=-0.81, 95%CI(-1.16,-0.46), P<0.001]. The incidence of any TEAE was significantly increased in patients that received pregabalin [OR=1.70, 95%CI (1.44,2.01), P<0.001]. Serious adverse events (SAEs) rate in the pregabalin group was higher than the placebo group [OR=2.09, 95%CI (1.49,2.93), P<0.001], while there was no significant difference in the incidence rate of discontinuation [OR=1.29, 95%CI (0.79,2.11), P = 0.31]. Comparative results revealed pregabalin (150-600 mg/day) significantly reduced the symptoms of neuropathic pain in adults and its safety was acceptable
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@#Toxoplasmosis is a worldwide zoonosis caused by an intracellular protozoan parasite, Toxoplasma gondii. We report here a diabetic patient who was diagnosed as toxoplasmosis with multiple cranial nerve palsies and cavernous sinusitis. A 37-year-old male presented with an 11-day history of gingival pain, one day history of ptosis and diplopia. He has been having diabetes mellitus for 6 years, and has a history of contact with cats. After admission, his symptoms worsened with right 3rd to 7th cranial nerve palsies. The brain magnetic resonance imaging (MRI) showed cavernous sinusitis in the right sellar region. Serology for toxoplasma was positive for IgM and negative IgG. The patient was treated with oral clindamycin (900 mg/day) and dexamethasone (15 mg/day). The right visual acuity and lid-conjunctival swelling improved after 3 days. At follow-up after a month, the movement of the right eye significantly improved. This case demonstrate the rare occurrence of multiple cranial nerve (3rd to 7th) palsies from toxoplasmosis cavernous sinusitis, which is a potentially treatable condition.
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@#Post-stroke depression often seriously affects the prognosis and quality of life of patients and many clinical trials had shown that Chai Hu Shu Gan San (柴胡疏肝散) combined with selective serotonin reuptake inhibitors (SSRIs) had good efficacy and minor side effects. We aimed to conduct this metaanalysis to evaluate the efficacy and safety of Chai Hu Shu Gan San as an adjuvant drug for SSRI in treating post-stroke depression. We searched PubMed, EMBASE, Cochrane Library, Wanfang, China Biology Medicine disc (CBM), Chongqing VIP, and CNKI (China National Knowledge Infrastructure) from their date of foundation to December 15, 2018. Literature screening, data extraction and quality assessment were conducted by two authors independently. The data synthesis and analysis were performed by using Review Manager (RevMan) 5.3 software and sensitivity analysis was conducted to assess the robustness of the results. Finally, a total of 22 articles were included. The meta-analysis confirmed the advantages of the combination of SSRI and Chai Hu Shu Gan San, mainly from four aspects: the Hamilton Depression (HAMD) scale score (MD=3.66; 95% DI=2.33-4.98; p<0.001), the Modified Edinburgh Scandinavian Stroke Scale (MESSS) score (MD=4.87; 95% CI=2.32-7.43; p<0.001), the efficacy rate (OR=3.50; 95% CI =2.61-4.69; p<0.001) and the incidence of adverse reactions (OR=0.28; 95% CI=0.17-0.46; p<0.001). No significant publication bias was observed, and sensitivity analysis suggested a good stability of the results. According to the present evidence, we concluded that Chai Hu Shu Gan Sa
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Hereditary spastic paraplegia is a heterogeneous group of genetic neurodegenerative disorders of the nervous system. It is classified into four subtypes based on the mode of inheritance; and among them, most autosomal recessive hereditary spastic paraplegia cases are due to type SPG11 and SPG15 gene mutations. Autosomal recessive hereditary spastic paraplegia cases with SPG30 gene mutation have never been reported in China. Herein, we present our experience with a case of hereditary spastic paraplegia with SPG30 gene mutation in our hospital from North East China. In this patient we detected a missense mutation of c.499 C>T (p.Arg167Cys) in gene KIF1A, a causative gene of type SPG30.
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Background & Objectives: Multiple sclerosis (MS), neuromyelitis optica (NMO) and acute transverse myelitis (ATM) are common diseases in neurology; however their corresponding cervical spinal cord involvements are still ambiguous. The purpose of this study was to demonstrate the utility of diffusion tensor imaging (DTI) and diffusion tensor tractography (DTT) in identifying the injury in cervical spinal cord. Methods: Nine patients and nine healthy volunteers were enrolled in this study. Conventional sequences and DTI scan were performed on each participant. Results: The average fractional anisotrophy (FA) values of the cervical cord in patients with acute cerebral type MS, acute or stationary cerebrospinal type MS, acute NMO, or acute ATM were all significantly decreased relative to the control group (p <0.05). As to the cerebrospinal type MS, the changes in acute-stage patients were more apparent (p <0.05). The average FA value of the cervical cord in acute NMO was decreased more extensively, involving the normal-appearing spinal cord (p <0.05). In patients with MS or NMO, The lesions showed significantly hypointense on FA images and directionally encoded color (DEC) images, nevertheless the pathological areas on DTI images were no significantly different from those on routine sequences. On DTT, the fiber tracts in the lesion-involved regions were all sparser than that in control regions, nevertheless interruption or impairment of fiber tracts could only be noted in NMO patients. Bilateral differences of average FA values in the cervical cord was noted in one case with ATM and another case with MS (p <0.05), and the decrease of FA values was significant in the main side of clinical presentations. Conclusion: DTI and DTT may be a sensitive measure for early cervical injury in MS, NMO and ATM
Subject(s)
Spinal Cord DiseasesABSTRACT
A 26-year-old girl was admitted to the Neurological Department of The First Teaching Hospital of Jilin University with complaints of rapidly deteriorating speech clumsiness for 18 days
Five Days before her attack she had undergone intramuscular pituitrin therapy on account of recurrent haemoptysis. Cranial MRI revealed multiple abnormal signals in bilateral hemisphere and symmetric abnormal signal in bilateral caudate nucleus and putamen
Serum electrolyte analysis revealed mild hyponatremia
The abnormal signals in bilateral hemisphere almost disappeared after 7 days of cerebral circulation ameliorating and serum electrolyte turbulence correcting therapy, whereas the symmetric abnormal signals in bilateral caudate nucleus and putamen still existed. A diagnosis of delayed encephalopathy was made and we presume the encephalopathy was associated with pituitrin therapy
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A 40- year-old Male was admitted to the first hospital of Jilin University with the complaint of 4 days of fever and headache and aggravation of weakness in his lower extremities accompanied with dysuria and disturbance of consciousness for one day. He had tachycardia, tachypnea and elevated white blood cell counts. General status of the patient got better day by day, while weakness and pain in his lower extremities had developed and gradually quadriplegia arose. When intensive care unit history, weaning difficulty from mechanical ventilator, clinical manifestations in intensive care unit associated with SIRS, symmetrical paresis pronounced in distal lower extremities, absence of deep tendon reflexes, evidence of distal sensory impairment, presence of electrophysiologic results indicating axonal sensorimotor polyneuropathy and muscle and nerve biopsy results were taken into consideration, he was diagnosed as critical illness polyneuropathy
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Objective To explore the effects of Buchang Naoxintong on cognitive function and apoptosis of cranial nerve cells in vascular dementia rats induced by chronic ischemia and their mechanisms.Methods The permanent occlusion of bilateral common carotid arteries in Wistar rats was adopted to set up the chronic fore-brain ischemia model.Model rats were randomly divided into model control groups and drug groups at 1 and 2 month,unoperated Wistar rats were divided into normol control groups at 1 and 2 month,six rats in each group.The cognitive function was assessed by Morris water labyrinth.The morphologic changes of cranial nerve cells were observed with HE staining.The apoptosis was examined by methods of TUNEL,the expression of Bcl-2 protein was detected by immnunohistochemistry method.Results Compared with model control group,escape incubation periods in drug group at 1 and 2 month were shorter(P
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Objective To study the protective effects of antipsychotic drugs Venlafaxine and Olanzapine on pheochromocytoma(PC12) cells after serum withdrawal.Methods The cells were cultivated in serum-free medium.Venlafaxine and Olanzapine were added in the medium.Morphological observation,MTT assays and LDH assays were used to study the protective effects of Venlafaxine and Olanzapine.Results Venlafaxine and Olanzapine prevented PC12 cells from the damage in serum-free medium,elevated PC12 cell survival rates,reduced the LDH release and kept cell membrane intact.The greatest effects were observed at concentrations of 100 ?mol?L~(-1) Olanzapine and 20 ?mol?L~(-1) Venlafaxine(P
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Objective To explore the expression of interleukin-8(IL-8) in the brain tissue and serum and effect of Dexamethason in rats with local cerebral ischemic.Methods The rats were randomly divided into blank control group,shamoperated group,ischemic group and Dexamethasone group.The latter two groups were divided into 1 h,2 h,4 h,8 h,12 h,24 h,48 h,72 h after oppration groups,respectively,12 rats in each group.The cerebral ischemical models were made by thread-embolism.The expression of IL-8 in brain tissue and serum at each time point were detected by ELISA method.Results In the ischemic group and Dexamethasone group,the expression of IL-8 of the brain tissue and serum were increased gradually in 1 h after ischemia,and reached the perk in 24 h and 4 h respectively.Which were significantly lower than those in the blank control group or shamoperated group(all P