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OBJECTIVES@#To study the clinical features of children with autoimmune encephalitis (AE) secondary to epidemic encephalitis B (EEB).@*METHODS@#A retrospective analysis was performed on the medical data of five children with EEB with "bipolar course" who were treated in Children's Hospital Affiliated to Zhengzhou University from January 2020 to June 2022.@*RESULTS@#Among the five children, there were three boys and two girls, with a median age of onset of 7 years (range 3 years 9 months to 12 years) and a median time of 32 (range 25-37) days from the onset of EEB to the appearance of AE symptoms. The main symptoms in the AE stage included dyskinesia (5/5), low-grade fever (4/5), mental and behavioral disorders (4/5), convulsion (2/5), severe disturbance of consciousness (2/5), and limb weakness (1/5). Compared with the results of cranial MRI in the acute phase of EEB, the lesions were enlarged in 3 children and unchanged in 2 children showed on cranial MRI in the AE stage. In the AE stage, four children were positive for anti-N-methyl-D-aspartate receptor antibody (one was also positive for anti-γ-aminobutyric acid type B receptor antibody), and one was negative for all AE antibodies. All five children in the AE stage responded to immunotherapy and were followed up for 3 months, among whom one almost recovered and four still had neurological dysfunction.@*CONCLUSIONS@#EEB can induce AE, with anti-N-methyl-D-aspartate receptor encephalitis as the most common disease. The symptoms in the AE stage are similar to those of classical anti-N-methyl-D-aspartate receptor encephalitis. Immunotherapy is effective for children with AE secondary to EEB, and the prognosis might be related to neurological dysfunction in the acute phase of EEB.
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Masculino , Femenino , Humanos , Niño , Recién Nacido , Encefalitis Antirreceptor N-Metil-D-Aspartato , Estudios Retrospectivos , Enfermedad de Hashimoto/terapia , Encefalitis por ArbovirusRESUMEN
Objective:To analyze the clinical phenotype of adult patients with epidemic encephalitis B (encephalitis B) in Ningxia Hui Autonomous Region, and to explore the influence of related factors of the development of encephalitis B.Methods:The medical records of confirmed patients with encephalitis B admitted to the General Hospital of Ningxia Medical University from August to November 2018 were collected, and the general data of patients and the results of laboratory indexes such as blood routine examination and cerebrospinal fluid routine examination were analyzed. Logistic regression analysis and survival curve were used to evaluate the risk factors of the development of encephalitis B.Results:Totally 97 patients with encephalitis B were included, 32 of them died, with a case fatality rate of 32.99%. There were 63 males and 34 females, and the age of onset was (59.13 ± 14.70) years old. There were statistically significant differences in case distribution rate between different sexes and ages (χ 2 = 97.00, 291.00, P < 0.001). The most common clinical type was extremely severe (43 cases), followed by mild (27 cases), severe (15 cases) and ordinary (12 cases). The results of laboratory tests showed that the number of neutrophils, lymphocytes and monocytes in the blood of patients increased; and the white blood cells number in cerebrospinal fluid increased significantly, while neutrophils ratio increased slightly. There were significant differences in cerebrospinal fluid glucose level and neutrophil ratio among patients with different clinical types of encephalitis B ( H = 4.21, 2.74, P < 0.05). There were statistically significant differences in death, hypertension, cerebrovascular diseases, and pulmonary infection among patients with different clinical types of encephalitis B (χ 2 = 34.22, 16.97, 9.91, 15.59, P < 0.05). Logistic regression analysis showed that hypertension [ OR (95% CI) = 5.544 (1.450-21.191)] and pulmonary infection [ OR (95% CI) = 6.490 (1.887-22.325)] were risk factors for the development of encephalitis B patients ( P = 0.012, 0.003). Pulmonary infection was the influencing factor for the death of encephalitis B patients (χ 2 = 18.88, P < 0.001). The survival curve showed that the survival status of encephalitis B patients with cerebrovascular disease and pulmonary infection was significantly worse than that of patients without comorbidity or complications (χ 2 = 6.45, 20.33 , P < 0.05). Conclusions:The majority of encephalitis B patients in this outbreak are the elderly people, and the patient's nervous system has inflammatory reaction. Complicated pulmonary infection is an important factor for the aggravation and death of encephalitis B patients.
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Objective@#To analyze the epidemiological and spatial-temporal distribution of Brucellosis, epidemic encephalitis B and hemorrhagic fever with renal syndrome (HFRS) in Gansu province during 2014-2018 so as to provide evidence for the prevention and control of those diseases.@*Methods@#A database was established in Gansu province from 2014 to 2018, using the geographical information system. A spatial distribution map was drawn, with trend analysis and space-time clustering used to study the 3-dimention of the diseases, by using both ArcGIS 10.5 and SaTScan 9.6 softwares.@*Results@#Results from the trend surface analysis showed that the incidence of Brucellosis decreased gradually from north to south parts while the U type curve could reflect the distribution from the east to the west areas. Incidence of epidemic encephalitis B decreased significantly from south to north areas in the province, with incidence higher in the eastern than in the mid-west region. Difference on the incidence of HFRS was not significantly visible in the eastern and western regions, while the incidence was slightly higher in the southern than the northern parts of the province. Spatial and space-time clustering did exist among the 3 diseases in Gansu from 2014 to 2018. The areas with clusters of Brucellosis appeared in the eastern parts during 2014-2015, including 19 counties. The areas with secondary clusters of Brucellosis were seen in the Hexi district, including 4 counties, during 2017-2018. The areas with high incidence of epidemic encephalitis B were clustered in the middle and southeast areas, including 32 counties, during 2017-2018. Areas with most clusters of HFRS appeared in Min county of Dingxi city in 2018, with the areas of secondary clusters in 8 counties of the eastern areas in 2018.@*Conclusions@#The overall incidence rates of the 3 natural focus diseases were in a upward trend and showing obvious characteristics on spatial clustering. According to the distributive characteristics, effective measures should be developed accordingly.
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Objective@#To evaluate the quality of Japanese Encephalitis (JE) case reports based on the establishment of surveillance on acute meningitis and encephalitis syndrome (AMES) in Baoji.@*Methods@#A surveillance network on AMES cases was set up in Baoji city of Shaanxi province between July 2013 and December 2016. All the cases met the surveillance definition of AMES cases were conducted a questionnaire, collected serum and/or cerebrospinal fluid (CSF) specimens to test JE immunoglobulin M antibodies by using enzyme-linkedimmunosorbent assay methods.The information of the incidence of JE in Shaanxi and Baoji from 2009 to 2016 originated from the China information system for disease control and prevention. Chi square test was used to compare the difference in JE incidence in Baoji, Shaanxi before and after the implementation of AMES monitoring project.@*Results@#75 out of 855 collected cases were laboratory confirmed as JE, Including 42 suspected JE cases and 33 other suspected cases diagnosed after hospitalization. Except 1 case occurring in December, all the other cases occurred between July and October, especially in August with a peak of 55 cases (73.3%), and 6 cases (8.0%) in July, 11 cases (14.7%) in September, 2 cases (2.7%) in October. The proportion of patients aging 0-6, 7-14 and ≥15 years old were respectively 4.0% (3 cases), 8.0% (6 cases) and 88.0% (66 cases). The biochemical test showed the cerebrospinal fluid in 13 cases (17.3%) were slightly turbid, the white blood cell in 31 cases (41.3%) elevated, the glucose levels in 24 cases (32.0%) were abnormal, and the chloride level in 23 cases (30.7%) were abnormal. A total of 103 cases of JE were diagnosed in Baoji from 2009 to 2016, with an average annual incidence rate at 0.34/100 000. The average incidence of JE in 2009-2012 and 2013-2016 was 0.21/100 000 and 0.48/100 000 respectively. From 2013 to 2016, the proportion of JE cases in Baoji, Shaanxi was 19.3% (71/369), and it was 8.9% (32/362) between 2009 and 2012 (χ2=4.15, P=0.040).@*Conclusion@#The AMES surveillance project improved the quality of the JE case report in Baoji. Changes appeared in biochemistrical and epidemiological characteristics of cerebrospinal fluid. The incidence of JE was seriously underestimated in Shaanxi province and therefore the sensitivity of Japanese encephalitis surveillance cases should be further improved.
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Objective To analyze morbidity,mortality and epidemiological characteristics of epidemic encephalitis B (Japanese encephalitis) from 2002 to 2013 in Zunyi.Methods The descriptive and statistical analysis of the incidence and death of epidemic encephalitis B from 2002 to 2013 in Zunyi was carried out.Results The morbidity and mortality were on a downward trend of epidemic encephalitis B in Zunyi from 2002 to 2013;most of the death and incidence cases occurred in July and August from children living scattered and students under age 15;after immunization expansion,the incidence of encephalitis B showed significant differences between ages,occupations,and time points (P<0.05);in the regional distribution of epidemic encephalitis B,incidence and mortality had significant differences (P<0.05).Conclusion Promising results might be generally obtained after expansion of encephalitis B immunization.However,there is a tendency of shifting back in terms of onset age and month.Therefore,comprehensive prevention measures should be implemented according to the epidemiological features of epidemic encephalitis B.
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Objective To investigate the clinical therapeutic effect of Chaishi fever particles on patients with epidemic encephalitis B and to study the machanism of anti-inflammatory.Methods One hundred and twenty one patients with epidemic encephalitis B admitted to the Second Clinical Medical College of Henan University of Chinese Medicine from January 2014 to May 2017 were enrolled, and they were divided into a routine treatment group (60 cases) and a traditional Chinese medicine (TCM) treatment group (61 cases) by random number table. The patients in routine treatment group were given symptomatic support and comprehensive treatment for 15 days, while those in the TCM treatment group were given as that of routine group with the addition of Chaishi fever particles 8 g, 4 times every day, orally taken for consecutive 15 days. The levels of tumor necrosis factor-α (TNF-α), interleukin (IL-1β, IL-10) in the serum of two groups were determined by enzyme-linked immunosorbent assay (ELISA), and the clinical therapeutic effect, complications and sequelae in two groups after treatment were observed.Results Compared with the routine treatment group, after treatment the time of body temperature recovering normal (days: 5.8±1.2 vs. 7.5±1.7), the coma time (days: 5.5±1.3 vs. 6.8±1.6), the remission time of convulsion (days: 5.2±1.4 vs. 6.5±1.5), and the length of stay in hospital (days: 22.6±1.9 vs. 25.2±1.8 ) were significantly shorter in TCM treatment group (P < 0.05). After treatment, the levels of serum tumor TNF-α and IL-1β were decreased, IL-10 was increased in both groups, moreover, compared with the routine treatment group, the changes were more obvious in TCM treatment group [TNF-α (μg/L): 11.4±3.6 vs. 14.6±3.5, IL-1β (μg/L): 22.3±6.2 vs. 26.2±5.6, IL-10 (μg/L): 225.2±19.2 vs. 186.2±21.5, allP < 0.05]. In addition, compared with the routine treatment group, the total effective rate was higher [98.3% (60/61) vs. 90.0% (54/60),P < 0.05], and the incidence of sequelae was lower [1.64% (1/61) vs. 13.3% (8/60),P < 0.05] in TCM treatment group.Conclusion The Chaishi fever particles can effectively treat the patients with epidemic encephalitis B and the action is related to the inhibition of inflammatory reaction.
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Objective Through the 2003 -2012 epidemic encephalitis B cases analysis ,to study the prevalence of epidemic en-cephalitis B in Shaoguan ,and to provide the scientific basis for the prevention and control epidemic encephalitis B .Methods Active surveillance of suspected cases ,retrospective analysis of laboratory confirmed cases related materials were done .Results There were 47 cases who suffered from epidemic encephalitis B in Shaoguan from 2003 to 2012 ,and 2 death cases occurred .Epidemic en-cephalitis B incidence in years was (0 -0 .531) /10 million .There was a morbidity peak in June and July ,which accounted for 87 .23% of the total incidence ,20 cases occurred in June(42 .55% )and 21 cases occurred in July(44 .68% ) .Men suspected cases in 130 cases ,31 laboratory confirmed cases .Women suspected cases in 86 cases ,16 laboratory confirmed cases .The positive cases of male was more than female .In 47 epidemic encephalitis B cases ,0- <4 years old 6 cases ,4- <7 years old 22 cases ,7- <20 years old 17 cases ,≥ 20 years old 2 cases .Most of the patients were preschool children and students ,accounting for 82 .97% .There were 32 cases with no or uncertain history of vaccination ,accounting for 68 .08% of the total cases .15 cases had history of immunity ,ac-counting for 31 .92% of the total cases .Conclusion Prevention of epidemic encephalitis B should pay more attention to epidemic en-cephalitis B vaccination .Mosquito control work of rural and peri-urban areas should be strengthened .
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Objective ToanalyzetheepidemiccharacteristicsofepidemicencephalitisBinGuangxiZhuangminority autonomousregionduring2005-2012andtoevaluatethecontrolstrategies.Methods Descriptiveepidemiological methods were used to compare epidemic characteristics before and after conducting the national expanded program of immunization.Then all the strategies conducted by local department including seasonal vaccination enhancing,ordinary vaccination,emergencyvaccination,regularvaccinationandmonitorsystemestablishingwereevaluated.Results During 2005 -2012,a total of 1 135 cases were recorded with the annual average incidence of 0.29/100000 and this rate declined every year by 16.80%.Additionally,the incidence rate was seasonal.The peak day (July 1 st)of incidence and the peak period (June 2nd-July 29th)of epidemic were delayed after conducting the expanded program of immunization.The scope of epidemic-stricken area was narrowed down.However,the incidence was still high (1.11 ~1.79/100,000)in the groupofchildrenaged5-7years.Conclusion TheoutbreakandepidemicofepidemicencephalitisBwereterminated owing to the establishment of monitor system and immunity strategy.The epidemic circle was broken and the incidence rate dropped to its lowest level in history.
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Objective To explore the clinical regularity of drugs on epidemic encephalitis B with text mining technique. Methods The data set on epidemic encephalitis B was downloaded from CBM database. The regularities of Chinese herbal medicine, Chinese patent medicine (CPM), western medicine and the combination of CPM and western medicine on epidemic encephalitis B were mined by data slicing algorithm. The results are showed visually with Cytoscape 2.8 software. Results The main function of herbal pieces was focused on clearing heat and removing toxicity. The herbal pieces such as Rehmanniae Radix Isatidis Raxis, Isatids Folium, Paeoniae Radis rubra and Scutellariae Radix were most often used. Angong Niuhuang Wan and Qingkailing Injection were usually used as CPM. For western medicine, antiviral drugs such as interferon and ribavirin were often used, and they were often used together with brain cells nutrition medicine, hormone, immunopotentiator and so on, and they were also frequently used together with CPM such as Angong Niuhuang Wan and Qingkailing Injection. Conclusion Text mining approach provides an important method in exploring the medication regularity for diseas, and provide refenrence for clinical use.
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Objective To explore the essential of cerebroprotein hydrolysate injection in the manage-ment of epidemic encephalitis B.MethodsTwo hundred and thirty-two patients with epidemic ence-phalitis B were randomly divided into two groups,one hundred and twenty-six patients in treating group,and one hundred and six patients in controlled group.Beside the conventional and symptomatic therapy,the patients in treating group received the management of cerebroprotein hydrolysate injection 10 mL+5% glucose solution 250 mL,iv drip,qd for 5 d and those in controlled group received the management of interferon?1b 1 MIU,sc,qd for 5 d.ResultsThe total clinical effective rates in treating group and controlled group were 94.6% and 82.6% respectively,there were remark-ably differences between two groups(P
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Objectives In order to study the endogenous opioid polypeptides involved in pathogenesis of epidemic encephalitis-B and the clinical therapeutic efficacy.Methods ①Leucine-enkephalin,?-endophin and Dynorphin levels in plasma and and CSF of patients with epidemic encephalitis-B during critical stage and convalescent stage were measured by radio-immunoassay.②Naloxone therapeutic efficacy in patients with epidemic encephalitis-B were investigated.Results Opioid polypeptides levels In plasma and CSF were significantly higher in critical stage and dropped to normal levels in convalescent stage.③We demonstrated that endogenous opioid polypeptides special antagnoist agent-Naloxone was a very important therapy agent for epidemic encephalitis-B patients.Therapy group efficacy was significantly better than control group.Conclusions These results demonstrate that endogenous opioid polypeptides involves in the physiopathologic changes of epidemic encephalitis-B.
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0.05).The results of electrocardiography and the laboratory ex-amination showed that neither ANWin cluding natural Calculus Bovis nor A NWincluding in -vitro cultured Calc ulus Bo-vis had obviously toxic and side effe cts in treating epidemic encephalitis B.Conclusion ANW including in -vitro cul-tured Calculus Bovis has an markedly effect in the treatment of epidemic e ncephalitis B.
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Objective:To evaluate the role of beta-2-microglobulin in the development of eqidemic encephalitis B.Methods:Forty-eight cases of epidemic encephalitis B children were divided into medium and severe types and beta-2-microglobulin was measured in their serum and cerebrospinal fluid(CSF) by radio-immunoassay(RIA).Twelve cases of control study was taken simultaneously.Results:At initial period,the serum and CSF concentrations of beta-2-microglobulin in forty-eight cases of epidemic encephalitis B patients were higher than that of the controls( P
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Objective To study the severity of systemic inflammatory response to type B epidemic encephalitis and blood tumor necrosis factor complicated with respiratory failure.Methods Fourteen children with type B epidemic encephalitis were divided into two groups;6 cases in group one with respiratory failure were given mechanical ventilation and the other 8 cases had normal respiration.Breat-hing pattern,respiratory rate,GCS scores,daily dosage of sedatives were observed before endotracheal intubation;while heart rate,temperature,WBC,CRP,TNF were measured.Results Patients in respiratory failure group were given a small dosage of Luminal;there was no significant difference in GCS between two groups treated with compound Wintermin.The heart rate,temperature,WBC,CRP,TNF levels in respiratory failure group were significantly higher than those in normal respiratory group.Conclusions The severity of systemic inflammatory response is more severe in epidemic type B encephalitis with respiratory failure than the controls.Significant increase in blood TNF may be an important factors to cause peripheral respiratory failure.