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Objective:To investigate the clinical characteristics of atypical neurobrucellosis.Methods:Retrospective analysis was made on the epidemiological characteristics, clinical manifestations, laboratory and imaging findings of five cases of atypical neurobrucellosis admitted to the People's Hospital of Inner Mongolia Autonomous Region from December 2020 to June 2021.Results:The age of the five cases ranged from four to sixty-nine years old, including three females and two males. Four cases had a clear history of sheep contact. Serum F1 antibody against brucellosis was positive in all five cases, serum tube agglutination test (SAT) was positive in three cases, lumbar puncture cerebrospinal fluid (CSF) examination showed increased intracranial pressure in four cases, and bacterial smear and tuberculosis culture were negative in all of the five cases. After magnetic resonance imaging (MRI), two cases were found to have abnormal intracranial high signals, of which one case was abnormal in bilateral frontal parietal lobe and right temporal occipital lobe, showing long T1 and T2 signals and increased fluid-attenuated inversion recovery sequence(FLAIR) signal; and another case was abnormal in bilateral corona radiata, posterior limbs of internal capsule and bilateral cerebral peduncles, it showed continuous T2 and FLAIR slightly high signal intensity. One case had abnormal signal in the spinal cord, showing a small patch like long T2 signal on the right side of the spinal cord at the level of C2-3 discs. Electromyography was abnormal in one case. Among the five cases, two cases presented with brucellosis encephalitis, one case with brucellosis myelitis, one case with glossopharyngeal nerve damage caused by brucellosis, and one case with brucellosis cerebrospinal neuropathy. All five patients were treated with a combination of doxycycline, rifampicin and ceftriaxone, and three patients had a good prognosis.Conclusions:The clinical manifestations of atypical neurobrucellosis are various. Clinicians should strengthen their understanding of the disease and reduce the chance of missed diagnosis and misdiagnosis.
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Objective To analyze the clinical characteristics and prognosis of neurobrucellosis(NB).Methods Twenty-seven cases of NB patients who received treatment in Disease Prevention and Control Center of Inner Mongolia Autonomous Region and Inner Mongolia Medical University Hospital from January to December in 2016 were collected.The clinical data of these patients were recorded and systematically analyzed.Results Twenty-four cases(88.89%)had a history of exposure to cattle and sheep.Twenty-four cases(88.89%)were admitted with fever,18(66.67%)cases with sweat,16 cases(59.26%)with headache,14 cases(51.85%)with neurological symptoms of meningitis and meningoencephalitis,4 cases(14.81%)with auditory nerve damage and 3 cases(11.11%)with spinal cord damage.Elevated white blood cells were found in 2 cases(7.41%),elevated serum C-reactive protein in 3 cases(11.11%),elevated procalcitonin in 2 cases(7.41%)and elevated erythrocyte sedimentation rate in 15 cases(55.56%).All the 27 patients underwent lumbar puncture and the cerebrospinal fluid test results were abnormal,of which increased protein levels in 17 cases(62.96%),increased mononuclear cell ratio 14 cases(51.85%),increased pressure in 14 cases(51.85%),and reduced chloride levels in 14 cases(51.85%),and reduced glucose levels in 6 cases(22.22%).Positive cerebrospinal fluid culture(CSF)was found in 1 case(3.70%).There were 8 cases(29.63%)with white matter damage,5 cases(18.52%)with meningeal enhancement,3 cases(11.11%)with spinal cord lesions,2 cases(7.41%)with cerebral edema and 2 cases(7.41%)with brain abscess.There were 10 cases(37.04%)with sensory nerve damage in the extremities,4 cases(14.81%)with auditory nerve damage and 2 cases(7.41%)with motor nerve damage.All patients were treated with regular anti-Berg's disease for 6 weeks and were followed up for 1 year(every 3 months)after the treatment.Nineteen patients(70.37%)were cured,7 patients(25.93%)developed sequelae and 1(3.70%)patient died.Conclusions The analysis suggests that NB have a variety of clinical characteristics.CSF examination,imaging examination and neuro electrophysiology detection have contribution to the diagnosis of the NB.
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Objective To characterize the clinical manifestations and to evaluate the value of the electrophysio-logical examination in patients with peripheral nerves injuries caused by neurobrucellosis. Methods Electrophysiology examination was conducted in 32 patients with peripheral nerve injuries caused by neurobrucellosis and 32 normal controls who had equivalent age and gender. The results were further statistically analyzed. Results There were sig-nificant difference between patients and healthy control group in distal motor latency (DML), compound motor active potentials (CMAP) amplitude, motor nerve conduction velocity (MCV), sensory nerve action potential latency(SL),senso-ry nerve action potential (SNAP) amplitude and sensory nerve conduction velocity (SCV) ( P﹤0.05). Electrophysiology examination revealed peripheral nerve damage of limbs involving, both sensory nerve and motor nerves, of which sen-sory and motor nerve injuries accounted for 55.47% and 16.80%, respectively. Median and sural nerve injuries were most frequently affected in upper (64) and lower limbs (16). Motor and sensory nerve conduction velocity was delayed in 43 nerves (16.80%) of 256 examined motor nerves and in 142 nerves (55.47%) of 256 examined sensory nerves. The damage of the sensory nerves was more severe than those of the motor nerves and damage of nerves in the upper limbs was more severe than those in the lower limbs. Conclusion Electrophysiologoical examination provides objective basis for the diagnosis of peripheral nerve injuries in neurobrucellosis.
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To identify susceptible single nucleotide polymorphisms causing prevailing essential hypertension complicating stroke in the Mongolian population. This study was carried out at the Beijing Huada Genome Company, Beijing, and the Clinical Testing Center of Inner Mongolia Medical College, Hohhot, P. R. China from March to November 2005, and included 96 patients with hypertension [control group] with an average age of 53 +/- 11 years, and 68 patients with hypertensive stroke with an average age of 60 +/- 10 years. The gene polymorphisms were examined by the polymerase chain reaction-restriction fragment length polymorphism technique and the Sequenom system, and analyzed by multiple regression analysis. Logistic multiple regression analysis revealed significant differences between the groups for age and smoking. Genotypes and allele gene frequencies were not significantly different between the groups. The significant incidence risks were p=0.011, odds ration [OR]=3.182 for the ACE DD genotype, p=0.038, OR=6.179 for the CYP CT genotype, and p=0.042, OR=6.089 for the CYP TT genotype. All the other genotypes did not significantly correlate to hypertension and hypertensive stroke. The ACE DD, CYP CT and TT genotypes are candidates for hypertension complicating stroke in the Mongolian population. The risk of disease was lowest among the ACE II and CYP CC genotypes
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Humanos , Masculino , Feminino , Fatores de Risco , Acidente Vascular Cerebral/genética , Hipertensão/genéticaRESUMO
Objective： To investigate pathophysiologic mechanism about initiation and propagation of epilepsy in a genetically epilepsy-prone rat (GEPR) model. Methods： The hippocampal MF sprouting of P77PMC rats was examined at different stages in the course of recurrent seizures using Timm method of sulfide silver staining. Results：The three groups of P77PMC rats which experienced 30 and less than 30 times of audiogenic seizure ( AGS ) and the Wistar control group did not display MF sprouting in dentate gyrus, however, the group of P77PMC rats which experienced 50 times of AGS was found hippocampal MF sprouting into the inner molecular layer of dentate gyrus. Conclusion：Our findings suggest that hippocampal MF sprouting presented not only in limbic seizure, but also in AGS, the seizure initiated in brainstem but rapidly generalized; in AGS-prone rats, recurrent AGSs can induce MF synaptic reorganization in hippocampus.
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Objective To observe the changes and its significance of the levels of serum cytokines——interleukin-(IL)1?,IL-6,tumor necrosis factor(TNF)-? and C-reactive protein(CRP) in patients with cerebral infarction(CI).Methods The serum IL-1?,IL-6 and TNF-? level were detected by radioimmunnoassay and serum CRP level by immunoturbidimetry in 30 CI patients with DM(DMCI group),30 CI patients without DM(NDMCI group),20 patients with DM(DM group) and 20 normol controls(NC group).The situation of CI patients were assessed by modified Edinburgh-Scandinavian stroke scale(ESSS).Results The serum levels of IL-1? [(0.60?0.04)ng/ml,(0.33?0.03)ng/ml,(0.30?0.02)ng/ml],IL-6 [(231.07?7.68)pg/ml,(141.34?6.50)pg/ml,(118.92?5.82) pg/ml],TNF-?[(2.70?0.11)ng/ml,(1.85?0.11)ng/ml,(1.21?0.13) ng/ml] and CRP [(7.44?0.26),g/L,(4.67?0.21)mg/L,(4.54?0.24)mg/L] in DMCI group,NDMCI group and DM group were significantly higher than those in NC group [(0.20?0.03)ng/ml,(60.99?5.98)pg/ml,(0.70?0.10) ng/ml,(3.83?0.14) mg/L](all P