Systemic lupus erythematosus associated macrophage activation syndrome with neuropsychiatric symptoms: A report of 2 cases / 北京大学学报(医学版)

Systemic lupus erythematosus (SLE) associated macrophage activation syndrome (MAS) is clinically severe, with a high mortality rate and rare neuropsychiatric symptoms. In the course of diagnosis and treatment, it is necessary to actively determine whether the neuropsychiatric symptoms in patients are caused by neuropsychiatric systemic lupus erythematosus (NPSLE) or macrophage activation syndrome. This paper retrospectively analyzed the clinical data of 2 cases of SLE associated MAS with neuropsychiatric lesions, Case 1: A 30-year-old female had obvious alopecia in 2019, accompanied by emaciation, fatigue and dry mouth. In March 2021, she felt weak legs and fell down, followed by fever and chills without obvious causes. After completing relevant examinations, she was diagnosed with SLE and given symptomatic treatments such as hormones and anti-infection, but the patient still had fever. The relevant examinations showed moderate anemia, elevated ferritin, elevated triglycerides, decreased NK cell activity, and a perforin positivity rate of 4.27%, which led to the diagnosis of "pre-hemophagocytic syndrome (HPS)". In May 2021, the patient showed mental trance and babble, and was diagnosed with "SLE-associated MAS"after completing relevant examinations. After treatment with methylprednisolone, anti-infection and psychotropic drugs, the patient's temperature was normal and mental symptoms improved. Case 2: A 30-year-old female patient developed butterfly erythema on both sides of the nose on her face and several erythema on her neck in June 2019, accompanied by alopecia, oral ulcers, and fever. She was diagnosed with "SLE" after completing relevant examinations, and her condition was relieved after treatment with methylprednisolone and human immunoglobulin. In October 2019, the patient showed apathy, no lethargy, and fever again, accompanied by dizziness and vomiting. The relevant examination indicated moderate anemia, decreased NK cell activity, elevated triglycerides, and elevated ferritin. The patient was considered to be diagnosed with "SLE, NPSLE, and SLE-associated MAS". After treatment with hormones, human immunoglobulin, anti-infection, rituximab (Mabthera), the patient's condition improved and was discharged from the hospital. After discharge, the patient regularly took methylprednisolone tablets (Medrol), and her psychiatric symptoms were still intermittent. In November 2019, she developed symptoms of fever, mania, and delirium, and later turned to an apathetic state, and was given methylprednisolone intravenous drip and olanzapine tablets (Zyprexa) orally. After the mental symptoms improved, she was treated with rituximab (Mabthera). Later, due to repeated infections, she was replaced with Belizumab (Benlysta), and she was recovered from her psychiatric anomalies in March 2021. Through the analysis of clinical symptoms, imaging examination, laboratory examination, treatment course and effect, it is speculated that the neuropsychiatric symptoms of case 1 are more likely to be caused by MAS, and that of case 2 is more likely to be caused by SLE. At present, there is no direct laboratory basis for the identification of the two neuropsychiatric symptoms. The etiology of neuropsychiatric symptoms can be determined by clinical manifestations, imaging manifestations, cerebrospinal fluid detection, and the patient's response to treatment. Early diagnosis is of great significance for guiding clinical treatment, monitoring the condition and judging the prognosis. The good prognosis of the two cases in this paper is closely related to the early diagnosis, treatment and intervention of the disease.

Research progress of circRNA and its clinical significance in gastric cancer / 医学研究生学报

Circular RNA (circRNA) is a class of endogenous non-coding RNA molecules with a stable closed loop structure formed by reverse splicing. It is more conserved and stable than linear RNA and involves cell development, proliferation, differentiation and apoptosis. Long-term and large-scale studies show the dysregulation of circRNA is associated with the risk of invasion, staging, metastasis, and postoperative recurrence of gastric cancer. This paper reviews the structure, classification, function of circRNA and its clinical significance in gastric cancer.

Role of p53 Protein in Improving Nerve Function of Rats with Acute Cerebral Ischemia-reperfusion Injury by Electroacupuncture Pretreatment / 中国康复理论与实践

@#Objective To investigate the effect of p53 protein on the nerve function of rats with acute cerebral ischemia-reperfusion by electro-acupuncture pretreatment. Methods A total of 72 male Sprague-Dawley rats were randomly divided into sham group(n=24),model group(n=24) and electroacupuncture pretreatment group(n=24).Each group was equally divided into two hours and 72 hours subgroups. The neurological behavior was assessed with modified Neurological Severity Score (mNSS). HE staining and TUNEL assay were used to observe the injury and cell apoptosis in ischemic brain,and Western blot-ting was used to detect the expression of p-p53(ser392),p53 and microtubule associated protein 1 light chain 3 (LC3)II in ischemic area. Results Compared with the model group,the mNSS scores,the injury of brain tissue,the number of TUNEL-positive cells, and the level of p-p53 and LC3II decreased (P<0.05) in the electroacupuncture pretreatment group.Two hours after reperfusion,there was no significant difference in the level of p53 between the model group and the electroacupuncture pretreatment group(P>0.05),however,72 hours after reperfusion,the level of p53 decreased in the electroacupuncture pretreatment group(P<0.05). Conclusion Electroacupuncture pretreatment can improve neurological deficit in cerebral ischemia-reperfusion injury rats,which may be related to the involvement of p53 protein in autophagy and apoptosis.

Expression of hENTl and ERCC1 genes in tumor tissues non-small cell lung cancer

OBJECTIVE@#To investigate the expression of hENTl and ERCC1 genes in tumor tissues non-small cell lung cancer (NSCLC).@*METHODS@#Fresh non-small lung cancer specimens were transplanted into nude mice. Twenty mice were randomized into two groups: experimental group receiving gemcitabine plus cisplatin and control group receiving 0.9% physiological saline. The expressions of hENTl and ERCC1 mRNA in tumor tissue were detected by real-time fluorescent quantitative PCR. The volume of tumor, the weight of nude mice and tumor volume were respectively measured and calculated 2-3 times per week. Tissue samples were collected from NSCLC mice treated with gemcitabine plus carboplatin.@*RESULTS@#The histological examination showed that many tumor cells were well preserved in nude mice. The rate of transplanted tumor cells was 86.7%. The concomitant treatment study showed that the rate of TV, RTV, T/C in GEM + DDP group was the lowest. LBP + DOC, DDP + DOC obviously influenced the body weight. Compared with NS group, DDP group, GEM group, the survival period and the level of hENTl of DDP+GEM group increased obviously, the level of ERCC1 decreased significantly (P<0.05).@*CONCLUSIONS@#The expression of hENT1 and ERCC1 genes in tumor tissues were closely correlated with the response to chemotherapy and prognosis of patients with NSCLC treated with gemcitabine plus cisplatin.