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Objective:To provide insight into the clinical characteristics, therapy and prognosis of patients with radiation-induced brainstem injury after radiotherapy.Methods:From August 2013 to September 2021, 13 patients with radiation-induced brainstem injury were included in this study at Sun Yat-sen Memorial Hospital, and the general information and strategy of radiotherapy were collected. A retrospective analysis was adopted to investigate the clinical and radiological characteristics, treatment and clinical outcomes.Results:There were 13 cases in total, including 4 females and 9 males. The onset age of enrolled patients ranged from 29 to 66 years with an average of (48.15±10.23) years. The median dose targeted at tumor area was 70 Gy with in 33 fractions. The median interval between radiotherapy and the diagnosis of radiation-induced brainstem injury was 24 months. The common clinical manifestations included dysphagia, bucking dysarthria, dizziness and problem with balance. The MRI radiological features were hypointense on T1WI, hyperintense on T2WI, and irregularly enhanced with contrast. The median follow-up was 45 months. Seven cases got improvements, while 3 had no obvious efficacy and 3 cases died. No significant differences in prognosis were observed between those received traditional glucocorticoid and those received bevacizumab treatment( P=0.079). Conclusions:The common symptoms of radiation-induced brainstem injury were symptoms of posterior cranial nerves injury and ataxia. Lesions mostly happened in pons and medulla, with hypointense on T1WI and hyperintense on T2WI. Half of the patients have improved after treatment. There was no significant difference in prognosis between glucocorticoid and bevacizumab treatment.
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Objective To investigate the characteristics,treatment and prognosis of radiation-induced sympathetic chain injury.Methods We observed 6 cases with radiation-induced sympathetic chain injury and re-viewed the clinical features,treatment and prognosis of these patients. Results The median age of these 6 cases was 50 and the interval between radiotherapy to onset was 7.7 years.Dizziness was the first and most common symp-tom and dramatic fluctuation of blood pressure was the most common physical sign.Steroids might be considered for the treatment of radiation-induced sympathetic nerve injury. However,the therapeutic effect still needs to be proved.Conclusions Sympathetic nerve injury is an uncommon but dramatic symptom in NPC patients after radio-therapy.
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Objective To examine serum levels of complement component 3(C3), complement component 4(C4), high sensitivity C reactive protein (hs-CRP), and uric acid (UA) in schizophrenia (SZ) patients and study their clinical significance. Methods One hundred forty-four SZ patients were recruited as SZ group. According to use of antipsychotics within four weeks, patients were divided into drug group (77 cases) and non-drug group (67 cases). One hundred forty-seven healthy subjects from health checkup center in the second XiangYa hospital during the same period were selected as control group. The concentrations of serum C3, C4, hs-CRP, and UA from SZ patients and healthy subjects were measured using immuno-scatter turbidmetry, latex-enhanced immunoturbidimetric assay, urea oxidase method, respectively. Results The serum levels of complement C3 and C4 were lower in SZ patients than in control group [(0.99±0.17) g/L vs. (1.03±0.17) g/L、(0.21±0.05) g/L vs. (0.23±0.05) g/L], and the serum levels of UA in serum of was higher in SZ patients than in control group [(351.61±95.90) μmol/L vs. (300.28±39.57) ?mol/L]. The differences had statistical significance (P<0.05, P<0.05, and P<0.001, respectively). The serum levels of C3, C4, hs-CRP, and UA were higher in drug group than in no-drug group [(1.04±0.19) g/L vs. (0.95±0.15) g/L、(0.22±0.06) g/L vs. (0.20±0.05) g/L、1.08(0.33, 5.04) mg/L vs. 0.47(0.28, 1.29) mg/L、(374.54±108.33)μmol/L vs. (331.61±79.03)μmol/L], and the differences had statistical significance (P<0.01).The concentrations of serum hs-CRP and UA were higher in drug group than in control group[1.08(0.33, 5.04) mg/L vs. 0.61(0.33, 1.26) mg/L、(374.54±108.33) μmol/L vs. (300.28±39.57) μmol/L], and differences had statistical significance (P<0.001). Conclusion The serum levels of C3, C4, hs-CRP, and UA in SZ Patients will be of guiding significance for clinical diagnosis of SZ and efficacy evaluation of antipsychotic drugs.
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Objective To evaluate the efficacy and safety of donepezil in the treatment of cognitive dysfunction caused by radiation-induced encephalopathy.Methods A total of fifty-five patients with radiation-induced cognitive impairment were divided into treatment group with extra donepezil 5-10 mg/d combined with conventional therapy and control group with conventional treatment for 16 weeks.The cognitive function was assessed according to Montreal cognitive assessment (MoCA) and mini-mental state examination (MMSE) before and 16 weeks after treatment.Results After 16 weeks of treatment,the patients in treatment group displayed significantly greater improvement in cognitive function.In treatment group,the scores of patients after donepezil therapy in MoCA and MMSE were obviously higher than the control group (t =5.40,3.88,P ＜ 0.01).The scores in the visual space and executive function,naming,attention,abstract thinking,delayed memories also had improved,which suggested the statistically significant difference(t=-3.55,-3.08,-3.21,-2.58,-3.65,P＜0.05).The scores of control group unchanged accordingly.Conclusions Donepezil combined with conventional treatment was signally effective in the therapy of cognitive dysfunction caused by radiation-induced encephalopathy.
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Objective To investigate the clinical significance of plasma neuropeptide Y (NPY)and oxytocin (OXT) and the mRNA level of OXT gene in first-episode schizophrenia (FES) patients and healthy controls (HC).Methods The plasma concentration of NPY and OXT in 55 FES patients and 33 HC were measured by enzyme linked immunosorbent assay (ELISA) and the mRNA level of OXT gene were performed by real-time quantitative polymerase chain reaction (RT-qPCR).Results The NPY levels in FES patients ((1386.88±254.57) pg/ml) were significantly higher than that in HC ((1 140.62±266.63)pg/ml)(P＜0.01),and both the males and females in FES patients ((1 489.97±231.06)pg/ml and (1 279.97±236.30) pg/ml) were higher than their counterparts in HC ((1 305.40 ± 238.80) pg/ml and (965.55 ±165.45) pg/ml) (P＜0.05,P＜0.01).The OXT level in FES patients ((553.26± 180.49) pg/ml) was lower than that in HC ((696.27±280.77) pg/ml) with significant difference (P＜0.05),especially the females FES patients ((597.49±178.63)pg/ml vs (785.51±329.60)pg/ml);but the mRNA expression of OXT gene in FES patients (0.2075 (0.1653,0.3388)) were significantly higher than that in HC (0.1615 (0.1321,0.2200)) (P＜0.05),and there were no differences between the females of the two groups (P＞0.05).Conclusion The FES patients presented abnormal expression of NPY and OXT,and the concentration changes of plasma NPY and OXT will provide referential significance for the diagnosis of schizophrenia(SZ).
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Objective To investigate the clinical significance of plasma neuropeptide Y (NPY)and oxytocin (OXT) and the mRNA level of OXT gene in first-episode schizophrenia (FES) patients and healthy controls (HC).Methods The plasma concentration of NPY and OXT in 55 FES patients and 33 HC were measured by enzyme linked immunosorbent assay (ELISA) and the mRNA level of OXT gene were performed by real-time quantitative polymerase chain reaction (RT-qPCR).Results The NPY levels in FES patients ((1386.88±254.57) pg/ml) were significantly higher than that in HC ((1 140.62±266.63)pg/ml)(P＜0.01),and both the males and females in FES patients ((1 489.97±231.06)pg/ml and (1 279.97±236.30) pg/ml) were higher than their counterparts in HC ((1 305.40 ± 238.80) pg/ml and (965.55 ±165.45) pg/ml) (P＜0.05,P＜0.01).The OXT level in FES patients ((553.26± 180.49) pg/ml) was lower than that in HC ((696.27±280.77) pg/ml) with significant difference (P＜0.05),especially the females FES patients ((597.49±178.63)pg/ml vs (785.51±329.60)pg/ml);but the mRNA expression of OXT gene in FES patients (0.2075 (0.1653,0.3388)) were significantly higher than that in HC (0.1615 (0.1321,0.2200)) (P＜0.05),and there were no differences between the females of the two groups (P＞0.05).Conclusion The FES patients presented abnormal expression of NPY and OXT,and the concentration changes of plasma NPY and OXT will provide referential significance for the diagnosis of schizophrenia(SZ).
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Objective To evaluate the effectiveness and safety of mouse nerve growth factor in treating dysphagia in patients with nasopharyngeal carcinoma after radiotherapy.Methods Fifty-eight post-radiotherapy nasopharyngeal carcinoma patients with dysphagia were randomly divided into an observation group and a control group.Both groups received routine treatment,but the observation group was additionally injected with mouse nerve growth factor intramuscularly every day for four weeks.Before and after the 4 weeks of treatment,both groups were evaluated using Kubota's water drinking test,videofluoroscopy and the brief version of the WHO's Quality of Life scale.Results After 4 weeks,the patients in the observation group displayed significantly greater improvement in swallowing compared with the control group.There was a significant difference in the groups' average scores on the drinking water test and in the videofluoroscopy results.Moreover,the patients in the observation group had significantly higher quality of life scores than those in the control group,on average.Conclusions Mouse nerve growth factor may have a rapid and safe therapeutic effect on dysphagia induced by radiation.No obvious adverse reactions were observed.
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Objective To evaluate the efficacy of pregabalin on painful radiation-induced brachial plexus injury.Methods A total of forty-five patients with painful radiation-induced brachial plexus injury were assigned to treatment group with pregabalin 150-600 mg/d combined with conventional therapy, and to control group with conventional treatment for 12 weeks.The visual analogue scale (VAS) and neuropathic pain symptom inventory (NPSI) were evaluated.The response rate (proportion of subjects with at least a 30％ to 50％ reduction in visual analogue scale) was evaluated as the primary endpoint.Results The response rate of the pregabalin group(36.4％) was significantly higher than that of the control group (9.1％) (x2 =4.98, P ＜ 0.05).Although hospital anxiety and depression level, clinical global impression of change, and clinical global impression of change (CGIC) did not differ significantly between pregabalin group and control group (P ＞ 0.05), improvements in neuropathic pain symptom inventory (NPSI), patient global impression of change (PGIC) and the sleep interference score(t =-6.62,-5.65,-6.16, P ＜ 0.05)suggested some utility in the management of radiation-induced brachial plexus.Conclusions Pregabalin treatment combined with conventional treatment exerts efficacy on patients with painful radiation-induced brachial plexus and patients are well tolerated.
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Objective To observe the clinical efficacy of electroacupuncture in treating deglutition disorders after radiotherapy of nasopharyngeal carcinoma. Method Forty nasopharyngeal carcinoma patients with deglutition disorders after radiotherapy were randomized into a treatment group and a control group, 20 in each group. The control group was intervened by nourishing nerve, improving microcirculation, promoting nerve growth factor, and physical rehabilitation. Based on the treatment given to the control group, the treatment group was additionally intervened by electroacupuncture. Water drinking test was adopted to evaluate the deglutition function before and after intervention, and the clinical efficacy was compared. Result After intervention, there was no significant difference in comparing the deglutition function between the two groups (P>0.05). The total effective rate was 80.0%in the treatment group versus 50.0% in the control group, and the difference was statistically significant (P<0.05). Conclusion Electroacupuncture is an effective method in treating deglutition disorder after radiotherapy of nasopharyngeal carcinoma.
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Objective To explore the effects and safety of bevacizumab monotherapy on radiationinduced brain necrosis in patients with head and neck cancer.Methods Twenty-three patients with radiation-induced brain necrosis received intravenous injection of bevacizumab 5 mg/kg every 2 weeks for 4 cycles.Before and 2 weeks after the treatment LENT/SOMA scoring system,Montreal Cognitive Assessment (MoCA),and MRI were used to evaluate the scores of subjective and objective items,cognitive scores,and the extent of edema.Adverse effects were observed.Results Two patients suffered from grade 2 rhinorrhagia after the first dose and had to give up the therapy.Twenty-one patients received the full dose of bevacizumab and showed improvement in clinical signs and symptoms.The MoCA score after treatment was significantly higher than that before treatment (t =3.166,P ＜ 0.05).MRI T2-weighted image showed that the volume of brain edema was decreased by (53.9 ± 22.13)％ on average (Z =-5.645,P ＜0.05).One patient showed mild exacerbation of the extent of focus on MRI after the second cycle therapy but still showed significant improvement at the end of four cycles.Of the 21 cases that successfully finished the whole treatment,one suffered from grade 2 rash and one had mild intracranial hemorrhage,however,no grade 3 to 5 adverse reactions were observed.Conclusions Bevacizumab monotherapy may have a rapid and safe therapeutic effect on radiation necrosis.
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Objective To identify etiological factors for non-ulcer dyspepsia (NUD) in elderly patients presenting to the emergency department.Methods A total of 97 elderly patients with NUD presenting to the emergency department from January 2011 to December 2013 were enrolled in the NUD group and 116 elderly people undergoing annual physical examinations served as the control group.Clinical data,including Helicobacter pylori (HP) infection,unhealthy living habits,anxiety,depression and regular intake,were collected and compared between the two groups.Results Compared with the control group,the NUP group showed a higher HP infection rate [70.1％ (68/97)vs.54.3％ (63/116),x2 =5.565,P＜0.05],a higher incidence of unhealthy living habits (unhealthy dietary habits,smoking,drinking,and lack of regular exercise) (P＜0.05),a higher incidence of suspect anxiety/anxiety and a higher incidence of regular intake [30.9％ (30/97) vs 10.3％ (12/116),x2=14.138,P＜0.05].SerumpepsinogenⅠ(PGⅠ) [(178.7±13.6) μg/L vs.(125.2±10.5)μg/L,t=1.971,P＜0.01] and serum pepsinogen Ⅱ(PG Ⅱ) [(28.8±5.3) μg/L vs.(14.7±3.8)μg/L,t=1.960,P＜0.01] levels were also higher in the elderly NUD patients than in the control group.Conclusions HP infection,unhealthy living habits,anxiety and/or depression,and regular intake are closely associated with NUD in the elderly.Serum PGⅠ and PGⅡ could be used as markers in screening for malignant lesions in elderly patients with dyspepsia.
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Objective:To explore the clinical measurements for preventing and curing epistaxis in patients irradiated for nasopharyngeal carcinoma by analyzing the related factors. Methods:Thirty patients irradiated for nasopharyngeal carcinoma and consequently presented epistaxis were retrospectively reviewed by analyzing the clinical characteristics and measurements. Literature review was also performed. Results:Twenty-two cases were successfully rescued, and eight cases died (mortality rate:26.6%). Twenty-five cases underwent inflation sponge packing hemostasis, whereas three cases underwent endoscopic hemostasis with cauterization. Five patients underwent digital subtraction angiography (DSA) and selective arterial embolization. For patients who underwent one irradiation course, the epistaxis latent period ranged from 3 to 12 years, and the amount of bleeding ranged from 200 mL to 1 200 mL. For patients who underwent more than one irradiation course, the epistaxis latent period ranged from 6 months to 3 years, and the amount of bleeding ranged from 300 mL to 8 000 mL. Conclusion:Packing through choanal atresia by using inflation sponge, cautery under endoscopy, DSA, and selective arterial embolization are useful and effective measurements for hemostasis. The epistaxis latent period and volume are related to the age, tumor stage, and ir-radiation course of the patients. Patients with advanced age, tumor stage, and more than one irradiation course have short latent period and high amount of bleeding.
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OBJECTIVE@#To observe the change of serum homocysteine (Hcy) and anti-citrullinated peptide (CCP) antibody concentration in depression rat model induced by chronic unpredictable mild stress (CUMS), and to explore the immunologic mechanism of depression and the relation between depression and its autoimmunity.@*METHODS@#Sixty adult male SD rats were randomly divided into 2 groups, 30 rats in each group, which were divided into 3 subgroups: a normal control group, a model group and a fluoxetinetreated group. The depression rat model was established under CUMS and seperated feeding, after which, open field, sugar consumption and forced swimming test were applied in the first group. After the blood was taken in the second group of rats through heart puncture, the level of serum Hcy was detected by enzymatic cycling assay and serum anti-CCP antibody by ELISA.@*RESULTS@#Compared with the control group and the fluoxetine treatment group, spontaneous activity and sucrose consumption and preference percentage of the rats in the model group significantly reduced, while the immobility time in forced swimming test and the level of Hcy and anti-CCP antibody in the rat serum significantly increased.@*CONCLUSION@#Immunity inflammation and autoimmune reaction exist in CUMS depression model rats, and fluoxetine treatment can improve these immune response.
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Animals , Male , Rats , Autoantibodies , Blood , Depression , Drug Therapy , Allergy and Immunology , Disease Models, Animal , Fluoxetine , Therapeutic Uses , Homocysteine , Blood , Peptides, Cyclic , Allergy and Immunology , Metabolism , Rats, Sprague-Dawley , Stress, Physiological , Allergy and ImmunologyABSTRACT
Objective To explore the related neurobiochemical mechanism by comparing the concentration change of dopamine (DA),dihydroxy-phenyl acetic acid (DOPAC),glutamate (Glu),and γ-aminobutyric acid (GABA) in the brain tissues in schizophrenia (SZ) developmental model rats and chronic medication model rats.Methods A total of 60 neonatal male Spragur-Dawley (SD) rats were randomly assigned to 3 groups at the postnatal day 6:an SZ developmental rat model group (subcutaneous injection with MK-801 at the postnatal day 7-10,0.1 mg/kg,Bid),a chronic medication model group (intraperitoneal injection at the postnatal day 47-60,0.2 mg/kg,Qd),and a normal control group (injection with O.9％ normal saline during the corresponding periods).DA,DOPAC,Glu,and GABA of the tissue homogenate from the medial prefrontal cortex (mPFC) and hippocampus were examined with Coularray electrochemic detection by high performance liquid chromatogram technique.The utilization rate of DA and Glu was calculated.Results Compared with the normal control group,the concentration of DA and DOPAC in the mPFC and the hippocampus in the SZ developmental model group significantly decreased ( P ＜ 0.05 ),and the GABA concentration and Glu utilization rate in the mPFC also decreased (P ＜ 0.05 ).Compared with the chronic medication model group,the DA concentration of the mPFC in the SZ developmental group decreased ( P ＜ 0.05 ),and the DOPAC concentration and the utility rate of DA in the hippocampus also decreased (P ＜0.01,P ＜0.05,respectively).Conclusion The activities of DA,Glu and GABA system decrease in the mPFC and the DA system function reduces in the hippocampus of SZ developmental rats.
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Objective To evaluate the effect of rehabilitation training on dysphagia and trismus in patients with nasopharyngeal carcinoma after radiotherapy.Methods Fony-three post-radiotherapy nasopharyngeal carcino-ma patients were divided into a rehabilitation group and a control group.Both groups were subjected to routine treat-ment,while the rehabilitation group received rehabilitation training in addition.The patients were assessed with a wa-ter-swallowing test of swallowing.Late effects of normal tissues/subjective and objective medical analysis(LENT/SOMA)scored and inter-incisor distance were measured to assess trismus before and after treatment.Results The rehabilitation group displayed significant improvement in swallowing as well as increased inter-incisor distance.Con-clusions Rehabilitation training can improve swallowing,prevent or delay trismus and improve the quality of life of patients.
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OBJECTIVE To analyze the significance of serum infectious markers in different sources and investigate the prevetion strategy of nosocomial infection in clinical laboratory. METHODS The serum infectious markers(HBsAg,anti-HCV,anti-HIV and syphilis antibody) were detected in outpatient,inpatient and physical check-up people from Jun 2007 to Jun 2008. RESULTS The total percentage of HBsAg,anti-HCV,anti-HIV or syphilis antibody positive in outpatient,inpatient and physical check-up people was 43.30%,13.56% and 7.26%,respectively.The positive rate of HBeAg in outpatient,inpatient and physical check-up people was 12.29%,1.78% and 0.71%,respectively.The average infection rate of syphilis was 1.75% in inpatients,but in inpatients above 60 years old it could be 3.75%.Twenty-one cases were reconfirmed of HIV positive by the reconfirmation laboratory of CDC in Human Province. CONCLUSIONS The positive rates of four serum infectious markers in outpatient or inpatient are markedly higher than that in physical check-up people(? 2=10 117.6,P
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BACKGROUND: Changes of leukocytes are related with some postoperative complications after renal transplantation. OBJECTIVE: To observe dynamically the level of white blood cell (WBC) and its morphological changes using automatic blood cell analyzer to evaluate its relationship with infection, immunosuppressive intoxation and acute rejection. DESIGN, TIME AND SETTING: Observation and controlled trial was performed at Second Xiangya Hospital, Central South University from June 2004 to October 2005. PARTICIPANTS: Sixty-eight patients who received renal transplantation were selected. According to clinical symptoms and laboratory biochemical indexes, X-ray, B ultrasound, and renal puncture biopsy, the patients were divided into stable group (n=36), infection group (n=9), intoxation group (n=6) and acute rejection group (n=13). METHODS: The blood routine was tested with Sysmex XE-2100 automatic blood analyzer following renal transplantation and WBC manual differentiation was done to observe peripheral blood morphology, their liver function. In addition, renal and liver functions were detected by automatic biochemical system 7600A. MAIN OUTCOME MEASURES: WBC count and its morphological changes in peripheral blood and liver and renal function after renal transplantation. RESULTS: WBC count of the stable group and intoxation group was normal, and that of the acute rejection group and infection group were significantly higher than the stable group (P
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BACKGROUND: At present, the researches on murine model of acute radiation encephalopathy are still in investigation, and mature model making method is not clear.OBJECTIVE: To establish a murine model of acute radiation encephalopathy in order to provide a good foundation for further researches of radiation encephalopathy(REP) mechanism and therapy.DESIGN: Randomized controlled study based on the experimental animals.SETTING: Animal laboratory in a university hospital. The Second Affiliated Hospital of Sun Yat-sen University.MATERIALS: The experiment was completed in the Laboratory of the Second Affiliated Hospital of Sun Yat-sen University from June 2001 to August 2002. Totally 30 female and 30 male SD rats, weighted(300 ± 30) g, were selected from the Animal Experiment Center of Sun Yat-sen University, and randomly divided into blank control group with 20 rats and experimental group with 40 rats.METHODS: Fourty rats' brain received 60Co γ-ray irradiation with the dosage of 7 Gy/time per day for 6 consecutive days with the total dosage of 42 Gy. The amount of ingestion and drinking, general activities, central nervous system(CNS) symptoms and signs were recorded every day. The hairs and skin of irradiated field and weight were checked and recorded weekly. On the 3rd, 7th, 14th, 30th days after radiation, the brain tissue was collected and the histopathologic changes were examined.Histopathologic changes after radiation.RESULTS: Since the third day, the ingestion and drinking amount of irradiated rats were decreased. The general activities were increased for the first two days, but decreased without abnormal nervous signs on the 3rd day. The rats in experimental group had a slower weight gain than those of control group, and the difference between them was of no statistical significance. All rats had slight alopecia and neuronal necrosis 2 weeks after irradiation.CONCLUSION: The irradiation method is reliable, practical and good for modeling REP process, which can be used in preventing or reducing the harm effect of radiation therapy on brain tissue.
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BACKGROUND: Memory loss is the main presentation during the earlier stage of radiative eneephalopathy, and it was reported that ganglioside (GM1) played important role in neural rehabilitation, particular in the improvement of memory.OBJECTIVE: To study the improving effect of GM1 on spatial learning and memory retardation in rats following radiative encepholopathy. DESIGN: Randomized control and comparative observing study based on the experimental animals.SETTING: Department of Neurology and Department of Radiation of Second Affiliated Hospital of Sun Yat-sen University.MATERIALS: This study was carried out at the Laboratory of the Second Hospital Affiliated to Sun Yat-sen University between March 2001 and May 2002. Tctally 80 SD rats were randomly selected and divided into control group, GM1 treatment group, physiological saline group and non-intervention group with 20 rats in each group.INTERVENTIONS: Rats in GM1 group, physiological saline group and non-intervention group subjected to head 60Coγ irradiation of 7Gy each time after anesthesia, once a day for consecutive 6 days, and the total dosage was 42Gy while rats in control group did not receive irradiation after anesthesia. Rats in GM1 and physiological saline(PS) group were given intraperitoneal injection of GM1 and physiological saline of 30 mg/kg respectively at 1 hour after each time of radiation, once a day for consecutive 6 days but not in control group and non-intervention group. Evaluation: ①After irradiation, morris water labyrinth navigation test was used to assess the capability of learning and memory of rats by the time for reaching platform (latency); ② Spatial searching test was used to detect their spatial memory after learning how to reach the platform by recording the way of rats searching the platform in 120 s and calculating the percentage of swimming distance in platform quadrant in the total distance; ③ After labyrinth test, brains were taken out of the rats in GM1 group, PS group and non-intervention group for observing the histological and pathological changes in rat brains.RESULTS: ① The latency become stable form onset of the 4th day in each group. On the 5th day, the searching platform latency in GM1 group was(13.6±1.4) s, shorter than(17.1±2.9) s of PS group and [(15.8±2.2) s, (P＜0.05)] of non-intervention group; ② Rats in GM 1 and control group were found capable of searching platform according to their spatial memory, presented by swimming trail most located in platform quadrant while rats in PS and non-intervention groups were found mostly swimming around the pool with moving trails distributed randomly. The percentage of swimming distance in platform quadrant was found higher in GM 1 treatment group than in the PS group and non-intervention group, but lower than that in the control group; ③ Histological examination revealed slight neuronal degeneration in PS group, part of which was changes of vacuolar degeneration with cell shrank, chromosome concentrated and nuclei gathered aside, and the number of astrocytes also decreased; the pathological changes in non-intervention group and PS group were similar; in GM1 group, part neurons became smaller with peripalsm turning red but the pathological changes, such as the number of cells,neuclei shrank and gathered aside, and vacuolar changes were less than those of the former two groups.ONCLUSION: Radiative encephalopathy would result in obvious learning nd memory impairments in rats but histological and pathological changes due o brain radiation injury can be attenuated with the treatment of GM1, implying that GM1 may play important role in the improvement of radiation-induced spatial learning and memory loss.
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BACKGROUND:Severe acute respiratory syndrome (SARS),an acute infection with a mutant coronavirus,is characterized by acute pulmonary inflammatory injury accompanied by possible multiple organ injuries. Besides somatic symptoms,affective disorder constitutes an obvious neuropsychiatric symptom in SARS patients.OBJECTIVE:To analyze the clinical features of SARS with neuropsychiatric involvement.DESIGN:A retrospective case analysis.SETTING:Department of Neurology,Department of Respiratory Diseases and Department of Radiology of Affiliated Hospital of Sun Yat-sen University.PARTICIPANTS:Totally 325 SARS patients treated in the Second Affiliated Hospital of Sun Yat-sen University and the 8th People's Hospital of Guangzhou from February 2003 to May 2003 were involved,including 173cases who developed neuropsychiatric symptoms.METHODS:The clinical data of 325 of SARS including 173 cases with neuropsychiatric symptoms were retrospectively analyzed.MAIN OUTCOME MEASURES:Clinical neuropsychiatric symptoms,ophthalmoscopic examination,and pathological findings in autopsy.RESULTS: ①The incidence of neuropsychiatric involvement was about 53.2% in SARS patients. The manifestations consisted mostly of headache (67.1%),dizziness(28.9%),conscious-ness disturbance(10.4%),mental disorder(4.6%), local orientational disorder(0.6%),seizures(1.2%),and affective disorders (30.6%);anxiety occurred in 20.2%,depression in 6.4%,suicidal tendency in 1.2%,and phobia in 7.5% of the patients with neuropsychiatric involvement. ②Among the 325 patients,56 were in critical condition of whom 47 had accompanying neuropsychiatric impairment,with significantly greater incidence than that in mild cases (P＜0.01). ③Ophthalmoscopic examination performed in 4 patients showed blurred margin of the optic disc with retinal venous congestion. ④Autopsy in 2 cases identified edema of the perivascular tissue and vascular wall of the small veins with mononuclear cell and lymphocyte infiltration,neuron degeneration and demyelination in focal brain tissues.CONCLUSION:The manifestations of neuropsychiatric involement can vary in association with the severity of SARS,and the typical pathological changes include edema,neuronal demyelination etc.in the brain.