Correlation of serum antibody titers with clinical features and prognosis of anti leucine-rich glioma inactivated 1 antibody encephalitis / 中华神经科杂志

Objective:To analyze the relationship between serum antibody titers, clinical characteristics, and prognosis in patients with encephalitis induced by anti leucine-rich glioma inactivated 1 (LGI1) antibody.Methods:Clinical data of 20 patients diagnosed with encephalitis in the Department of Neurology, First Hospital of Shanxi Medical University from February 2015 to February 2021 were collected and retrospectively analyzed. Patients were divided into 2 groups based on their serum anti LGI1 antibody titers, namely the high titer group (1∶100, 1∶320) and the low titer group (1∶10, 1∶32). The clinical characteristics, laboratory test results, and prognosis of the 2 groups of patients were compared. Relusts The age of the 20 patients with anti LGI1 antibody encephalitis ranged from 27 to 69 (53.5±11.2) years, with a male to female ratio of 1∶1. There were 9 patients in the low titer group and 11 patients in the high titer group. There was no statistically significant difference in the types and quantities of clinical symptoms between the 2 groups. Patients in the high titer group were more prone to abnormal lesions on cranial magnetic resonance imaging (10/11 vs 3/9, P=0.014). There was no statistically significant difference between the 2 groups in the presence or absence of cerebrospinal fluid anti LGI1 antibodies (9/11 vs 4/9, P=0.160). During the follow-up, it was found that 1/20 patient died of pulmonary embolism, 7/20 of patients were able to recover to their predisease state, and 9/20 of patients had residual memory impairment. In the high titer group, 3/11 of patients experienced recurrence, while there was no recurrence in the low titer group. There was no statistically significant difference in the neurological prognosis between the 2 groups at 3 months of discharge and follow-up (the number of patients whose modified Rankin Scale score≤2: 10/10 vs 8/9, P=0.474). Conclusions:Patients with high serum anti LGI1 antibody titers are more likely to develop intracerebral lesions. Higher antibody titers may be associated with a higher risk of disease recurrence. There was no significant correlation between serum antibody titers and neurological outcomes.

Diagnostic value of 18F-fulorodeoxyglucose marked positron emission computed tomography in anti- N-methyl-daspartate receptor encephalitis and viral encephalitis / 中华神经医学杂志

The clinical manifestations of anti- N-methyl-daspartate (NMDA) receptor encephalitis and viral encephalitis are similar but the treatments and prognoses are different, so the early differentiation of the two diseases is very important. Early diagnosis is affected by delayed antibody detection and false negative detection, while routine auxiliary tests lack specificity; therefore, they have limited value in identification. The 18F-fulorodeoxyglucose (FDG) marked positron emission computed tomography (PETCT) is highly sensitive to abnormal cerebral metabolism in the early stage of anti-NMDA receptor encephalitis, showing a characteristic metabolic pattern of frontal or temporal lobe increase metabolism and occipital decrease metabolism. The number of patients who underwent 18F FDG PETCT examination for viral encephalitis was small; different kinds of viral encephalitis show different brain metabolism, but there was no characteristic hypometabolism of the occipital lobe. This paper reviews the cerebral metabolic characteristics of 18F-FDG PETCT in anti-NMDA receptor encephalitis and viral encephalitis.

Recent advance in cerebrospinal fluid biomarkers in patients with anti- N-methyl- D-aspartic acid receptor encephalitis / 中华神经医学杂志

Anti- N-methyl- D-aspartic acid (NMDA) receptor encephalitis is an autoimmune encephalitis. Most patients have a good prognosis, but a small number of patients have memory impairment and other sequelaes. Early immunotherapy is a key factor for good prognosis of patients with this disease. However, a key problem in the treatment of this disease is the lack of biomarkers for disease monitoring and prognosis assessment. Therefore, it is positive for guiding the diagnosis and treatment and evaluating the prognosis to find biomarkers that can reflect the disease. Here, biological factors abnormally elevated in cerebrospinal fluid of patients with anti-NMDA receptor encephalitis are reviewed, and biological factors with potential as biomarkers are summarized.

Recent advance in imaging features of anti- N-methyl- D-aspartic acid receptor encephalitis / 中华神经医学杂志

Anti- N-methyl- D-aspartic acid (NMDA) receptor encephalitis is an autoimmune encephalitis mediated by anti-NMDA receptor antibody. At present, the diagnosis of the disease depends mainly on typical clinical symptoms and detection of specific antibodies in cerebrospinal fluid. Early and timely treatment can curb the disease progression and improve the prognosis of the disease. However, because of the atypical clinical manifestations of patients and long waiting time for antibody detection, early identification is difficult. Imaging equipment is more popular in primary hospitals in China, and it is easier to perform imaging examination for suspected patients in the early stage; therefore, this article aims to review the imaging characteristics and current imaging research progress of anti-NMDA receptor encephalitis in recent years, so as to improve clinicians' understanding and early recognition of this disease.

Recent advance in epilepsy associated with autoimmune encephalitis / 中华神经医学杂志

Autoimmune encephalitis (AE) is a novel form of encephalitis associated with antibodies to cell-surface or synaptic proteins. Epileptic seizures act as the predominant manifestation of AE which are triggered by interaction between kinds of antibodies and antigens on cell-surface or intracellular. Patients with AE-related epilepsy are insensitive to antiepileptic drugs but sensitive to immunotherapy. Early initiation of immunotherapy can significantly improve the prognosis. To date, there are few reports on the treatment plan of antiepileptic drug to the patients with AE-related epilepsy. In this review we report the most relevant data about the morbidity, pathogenesis and treatment of AE-related epilepsy with aim of providing better treatment options.

Treatment of aseptic ulnar diaphyseal nonunion with locking compression plate and autogenous iliac bone graft / 中国骨伤

OBJECTIVE@#To investigate the clinical results of locking compression plate combined with autologous iliac bone graft in the treatment of aseptic ulnar nonunion.@*METHODS@#From March 2009 to July 2017, 22 patients with aseptic ulnar diaphyseal nonunion with complete follow-up data were treated with surgery, including 12 males and 10 females, aged from 16 to 58 (39.7±9.9) years old and ranging in course of disease from 10 to 192 (39.4±55.7) months. There were 15 atrophic nonunions, 5 hypertrophic nonunions and 2 synovial pseudo-articular nonunions. After debridement of the nonunion, locking compression plate was used to fix the nonunion and autogenous iliac bone graft was given. Bone healing rate, surgical complications and clinical results were evaluated.@*RESULTS@#All the patients were followed up, and the duration ranged from 13 to 42 months, with a mean of (22.5±8.2) months, and 1 patient did not heal. Visual analogue pain scores ranged from 0 to 3 (0.9±0.9). Pronation of forearm was 47 to 86 (69.0±14.7) degrees, supination was 35 to 85 (63.0±9.4) degrees, wrist flexion was 20 to 80 (51.0±10.2) degrees, wrist flexion was 32 to 88 (71.0±11.7) degrees, elbow flexion contracture was 0 to 25 (9.0±5.6) degrees, further flexion was 105 to 150 (134.0±13.9) degrees, and grip strength was 87% on the opposite side. According to the Anderson scoring system, 8 cases were excellent, 11 were satisfied, 2 were not satisfied, and 1 was failed.@*CONCLUSIONS@#LCP combined with autologous iliac bone graft can effectively treat aseptic ulna diaphyseal nonunion.

Effects of 17beta-estradiol on distribution of primordial germ cell migration in male chicks / 亚洲男科学杂志(英文版)

<p><b>AIM</b>To assess whether exogenous estradiol has any effect on migration of primordial germ cells (PGCs) in the chick.</p><p><b>METHODS</b>Fertilized eggs were treated with 17beta-estradiol (E(2)) (80 microg/egg) at stage X (day 0 of incubation), stages 8-10 (incubation 30 h) and 13-15 (incubation 55 h). Controls received vehicle (emulsion) only. Changes in PGC number were measured on different days according to developmental stages.</p><p><b>RESULTS</b>In male right gonads, but not in female left gonads, at stages 28-30 (incubation 132 h) significant decreases in the mean number of PGCs aggregating were observed compared with the controls (P < 0.05) while the total PGC number in the right and left gonads at each stage did not change (P > 0.05).</p><p><b>CONCLUSION</b>The present study provides evidence that E(2) has significant effects on the localization of PGCs in male right, but not female left, gonads of chicken embryos at stages 28-30, compared with controls.</p>