Therapy of myasthenia gravis: looking forward to the era of targeted immunotherapy / 中华神经科杂志

Myasthenia gravis is mainly acetylcholine receptor antibody-mediated, T cells-dependent and complement participated acquired autoimmune disease characterized by impairment of the neuromuscular transmission. The main clinical feature of the disease is the presence of fatigability or muscle weakness. Most patients can be successfully managed with nonspecific immunotherapies such as corticosteroid and non-steroidal immunosuppressants. However, the side effects caused by long-term corticosteroid therapy are still a hurdle in the treatment of myasthenia gravis (MG). Oral non-steroidal immunosuppressants, as add-on therapy, can greatly reduce the relapse of the disease, but some drugs have a slow onset of action and the potential for significant toxicity, and even increase the risk of infection and neoplasms with long-term treatment. Despite these therapies, a minority of patients can be refractory because of incompletely responding or not well tolerated to available therapies. Thus, the need to avoid the use of corticosteroids, or at least reduce their use as much as possible should concern all patients with MG. Targeted immunotherapy is a therapeutic monoclonal antibody or antibody fragment targeting immune cells, complement, neonatal Fc receptor and cytokines. Recently, targeted immunotherapy has completed phase Ⅱ and Ⅲ clinical trials in patients with MG, and some of them have been approved by Food and Drug Administration. These promising biologics showed efficacy in symptoms persistent improvement, steroids reduction and were well tolerated, now evolving into powerful tools changing the algorithm of MG. This paper summarizes the results of clinical trials of new biologics in MG and looks forward to the prospect of MG treatment.

Diagnosis and treatment of myasthenia gravis / 中华神经科杂志

Myasthenia gravis (MG) is mainly acetylcholine receptor antibody-mediated acquired autoimmune disease that affects the postsynaptic membrane at the neuromuscular junction. The predominant manifestation is muscle weakness. Extraocular muscles are frequently affected in the early stage of disease with typical symptoms of intermittent drooping of the upper eyelid (ptosis) and double vision (diplopia), which is easy to be misdiagnosed as an ophthalmic disease. When the weakness of the face, bulbar, neck and limb muscles occur, it needs to be differentiated from a variety of diseases. Other clinical disorders can present in a similar fashion and may be mistakenly labeled as MG. This paper summarizes the epidemiology, etiology, pathogenesis, clinical manifestations, classification, auxiliary examination, diagnosis, differential diagnosis, and treatment progress of MG, which can be used as a reference for clinicians and neurologists.

Evidence and controversy for thymectomy in myasthenia gravis / 中华神经科杂志

Myasthenia gravis (MG) is an acquired autoimmune disease mediated by antibodies against components expressed in the neuromuscular junction. The thymus plays an important role in the development of MG. More than 80% of patients with MG demonstrate histological abnormalities of thymus, such as follicular hyperplasia or thymoma. Although thymectomy is standard treatment for patients with MG who have thymoma, whether the procedure is of any clinical benefit in patients without thymoma has been questioned for more than 40 years. In the 2016 issue of the New England Journal of Medicine, the results of the first randomized trial to assess the role of thymectomy in the treatment of MG, the Thymectomy Trial in Non-Thymomatous Myasthenia Gravis Patients Receiving Prednisone Therapy (MGTX) was reported. The MGTX trial conclusively proved that thymectomy improved clinical outcomes over a three-year period in patients with non-thymomatous MG, which provided Class Ⅰ evidence supporting the use of thymectomy in patients with non thymomatous MG. However, there are still debates on the selection of patients for surgery, and surgical approaching techniques. In addition, the benefit of the thymectomy remains less clear in other subgroups of MG. In the future, randomized controlled trials are required to resolve those controversies and to maximize the benefit of thymectomy in the treatment of MG.

CHRNB1 gene mutations-related congenital myasthenic syndromes in a Chinese family / 中华神经科杂志

Objective:To analyze the clinical, neurophysiological and genetic features of CHRNB1 gene mutations-related congenital myasthenic syndromes (CMS), and to facilitate the recognition and differential diagnosis of this disorder.Methods:The clinical characteristics and laboratory features of the proband in a family with CHRNB1 gene mutations-related CMS were recorded, and the neurophysiological testing and high-throughput sequencing for the proband were performed. In addition, the response to the treatment and prognosis of the proband were reported.Results:The proband is a 16-year-old female who had bilateral eyelid ptosis at the age of 4, presented with limb weakness at the age of 12. Her father has the similar symptoms and other family members are not affected similarly. Serum creatine kinase and thyroid function were normal. Needle electromyography results demonstrated no myopathic disorders. All myasthenia gravis-related antibodies tests including anti-acetylcholine receptor antibody were negative and she failed to respond to pyridostigmine. There was a decremental response of the compound muscular action potential on 5 Hz repetitive nerve stimulation. Brain magnetic resonance imaging and chest CT were unremarkable. The proband was found a heterozygous mutation (c.865G>A (NM_000747)) in CHRNB1 gene exon 8 through high throughput sequencing. She started a 60 mg/d treatment of fluoxetine and showed beneficial response at one-year follow-up.Conclusions:The clinical presentation of CHRNB1 gene mutation-related slow-channel CMS is similar to autoimmune myasthenia gravis, and is likely to be misdiagnosed. High-throughput sequencing accelerates the diagnosis.

Changes in circulating follicular helper T cells and regulatory follicular T cells in patients with neuromyelitis optica spectrum disorder / 实用医学杂志

Objective To study the changes and significance of the frequencies of circulating follicular helper T cells (cTfh) and circulating regulatory follicular T cells (cTfr) as well as the cTfh/cTfr ratio in neuromyelitis optica spectrum disorder (NMOSD).Methods The frequencies of cTfh,cTfr and B cells in patients with NMOSD and health controls(HCs) were measured by flow cytometry.Enzyme-linked immunosorbent assay was used to detect the level of IL-21 and AQP4-Ab in patients and HCs.Results The frequencies of cTfh and B cells,the cTfh/cTfr ratio and the plasma level of IL-21 werc significantly higher in the relapsing patients than those in the remitting patients and HCs(P ＜ 0.05),and the cTfr level in the relapsing patients was lower than that in the remitting patients and healthy population (P ＜ 0.05).But no statistical differences were observed in the above indexes between the remitting paticnts and HCs.There was also no significant difference in AQP4-Ab level between the patients with relapse and remission (P ＞ 0.05).The frequency of cTfh in the patients wasc positively correlated with the level of B cells and IL-21(P ＜ 0.05),and the frequency of cTfr was negatively correlated with B cells and IL-21 (P ＜ 0.05).The ratio of cTfh/cTfr was positively correlated with B cell frequency and IL-21 level (P ＜ 0.05).AQP4-Ab level had no correlation with the frequencies of cTfh cells and B cells,cTfh/cTfr ratio and IL-21 concentration (P ＞ 0.05).Conclusion The changes in the frequencies of cTfh and cTfr as well as the imbalanced cTfh/cTfr ratio may promote the activation of humoral immunein NMOSD and participate in the pathogenesis of this disease.

A report of atypical hypomyelinating leukodystrophy with atrophy of the basal ganglia and cerebellum caused by a de novo mutation in tubulin beta 4A (TUBB4A) gene and literature review / 中华内科杂志

Objective To explore the clinical symptoms and neuroimaging features of a patient with atypical hypomyelinating leukodystrophy with atrophy of the basal ganglia and cerebellum (H-ABC) caused by a novel TUBB4A mutation.Methods We analyzed the clinical data, imaging features and the result of genetic testing of a case diagnosed as atypical H-ABC.Results The initial symptoms were progressive spasticity, mild cerebellar ataxia and mild cognitive impairment.MRI showed regional blurring of slight high signal on T2-weight and FLAIR image in white matter of the bilateral midbrain ventral, internal capsule, posteior horn of lateral ventricle and centrum semiovale, with normal bilateral cerebellar and caudoputamen nucleus.Compared with normal subjects of the same age and gender, hypometabolism was found by 18F-FDG-PET in brainstem, cerebellar and caudoputamen nucleus in the patient.Genetic testing revealed a de novo pathogenic exome missense heterozygous mutations c.70G>A in TUBB4A, which was not reported in the human gene mutation database (HGMDpro) and was assessed to be a pathogenic mutation by pathogenic mutation prediction software.Conclusions The diversity of TUBB4A gene mutations may cause different functional and/or structural impairment in subcortical white matter, cerebellar and caudoputamen nucleus, leading to atypical symptoms and neuroimaging features.Genetic testing for pathogenic mutation in TUBB4A gene is a key for the diagnosis of H-ABC.

Characteristics of clinical presentation and neuropathology in idiopathic hypereosinophilic syndrome encephalopathy / 中华神经科杂志

Objective To discuss the mechanism and characteristics of clinic presentation and neuropathology in idiopathic hypereosinophilic syndrome (IHES) encephalopathy. Methods IHES encephalopathy was diagnosed by clinical presentations,lab examinations,neurologic images,marrow and brain biopsy,then treated with corticosteroids and continuous follow-up. Results The IHES patient presented progressive limbs weakness and cognitive deficit with elevated eosinophil count. Results of lab examinations and bone marrow biopsy ruled out secondary eosinophilia and clonal eosinophilia such as eosinophilic leukemia.Brain magnetic resonance imaging (MRI) study showed multiple lesions in right frontal lobe, bilateral parietal and occipital lobe, presenting hypointensity in T1 weighted images,hyperintensity in T2 and fluid-attenuated inversion recovery weighed images. Brain biopsy showed proliferation of vascular membrane,small vessels stenosis,ischemia-induced morphological change and necrosis of neurons in the lesions.The patient was continuously treated with corticosteroids,and the situation was stabilized with follow-up.Conclusions IHES encephalopathy should be paid more attention in clinical practice of neurologists for its rarity. Brain vascular damages caused by elevated eosinophil may be an important pathophysiological mechanism of IHES encephalopathy,and corticosteroids or hydroxycarbamide should be used for the treatment.

Clinical and neuroimaging features of reversible posterior leukoencephalopathy syndrome / 中国神经精神疾病杂志

Objective To investigate the clinical and neuroimaging characteristics of patients with reversible posterior leukoencephalopathy syndrome (RPLS). Methods The etiology, clinical manifestations, neuroimaging features, treatment, and prognosis were retrospectively analyzed in 8 patients (5 males and 3 females) with RPLS. Results The causes of RPLS included systemic lupus erythematosus (2 cases) eclampsia (one case), primary hypertension (one case), fungal encephalitis (one case), multiple myeloma (one case), renal transplantation (one case), immunosuppressant (three cases), chemotherapy (one case) and antifungal agent (one case). The clinical manifestations of these patients included headaches, seizures, visual abnormalities, and consciousness or mental disorders. Magnetic resonance imaging (MRI) of the head mainly showed symmetrical abnormalities in the posterior regions of the brain, as evidenced by low or equal signal on T_1WI, and high signal on T_2WI and FLAIR images. After treatment with antihypertensive agents, dehydration therapy, and heteropathy for 2～3 weeks, the neurological deficits of the patients were almost resolved and the initial lesions disappeared completely or almost completely in all patients at the follow-up MRI. Conclusions RPLS is a clinical entity characterized by reversible white matter damage in posterior brain. Prompt diagnosis and treatment may result in reversible resolution of its clinical symptoms and neuroradiological lesions.

Clinical analysis of two patients with rhythmic movement disorder / 中华神经科杂志

Objective To investigate the clinical features and the possible pathogenesis of rhythmic movement disorder (RMD) by analyzing 2 patients with RMD and reviewing the literature. Methods By using overnight polysomnogram (PSG) and sleeping video monitoring, the movement patterns, sleep architecture, and sleep quality of 2 patients who met the RMD diagnostic criteria were examined. Results Two male patients were 15-years old. The onset age of patient 1 was 3-years old, and patient 2 was 10-years old. All abnormal movements occurred in sleep, which presented with repetitive, stereotyping and rhythmical movements. Multiple patterns of abnormal sleeping movement were observed in 2 patients: head hypsokinesis, thoracic and waist hyperextension, and pendular movement of bilateral upper extremities. In the sitting position, the patient exhibited kneeling position, and fore-and-aft or lateral rhythmical swing of the upper body accompanied with head-banging. In the prone position, the patient behaved head backward hyperextension, and horizontal and fluctuating pendular movement of the body, which was just like the auto-erotic situation. In the lateral sleep position, the patient supported their head by using the right hand accompanied with fore-and-aft pendular movement of the head and the upper body. These symptoms mentioned above emerged immediately when the patient fell asleep, and continuously existed in all sleep period including non-rapid eye movement and rapid eye movement. All of the symptoms disappeared once the patient woke. The abnormal movement frequency was 0.1-2.0 Hz. In addition, the sleep architecture and quality were severely influenced by RMD in patient 2. Clonazepam might markedly ameliorate the symptoms and sleep quality. Conclusions Multiple abnormal movement patterns may exist in the RMD patients, and these abnormal movements could last during the whole sleep period. PSG and sleeping video monitoring should be undertaken for the suspected RMD patients, which are very useful for the definite diagnosis of RMD.

Restless legs syndrome:23-cases report / 中华神经科杂志

Objective To investigate the clinical features of restless legs syndrome(RLS),its possible pathogenesis.and the effects of benserazide on the patients with RLS.Methods Twenty-three patients who met the primary diagnostic criteria of RLS were retrospectively analyzed.Results Twenty-three middle-aged or elderly patients aged 56 years in average had an average onset age of 52 years.Insomnia and daytime sleepiness were mostly common complains for these patients.Based on the diagnostic criteria of International RLS study group(IRLSSG),the average IRLSSG score was 25,and 16 cases(69%)of the patients were severe(21-30).Polysomnographic examination showed that 18 cases(78%)had periodic limb movement.in which the PLM index of 11 cases(61%)patients Was moderate(25-49).PLM-arousal index of all patients was increased.that of 16 cases(67%)patients being moderate.After treatment by levodopa/benserazide 100/25 mg at bedtime each night for 4 weeks,most of patients'subjective symptoms improved markedly.and the IRLSSG score Was obviously decreased.with an average score of 13,and 5 patients became completely normal.Among patients with periodic legs movement.the PLM index became normal in 5 patients and became mild in others.In addition.the PLM-arousal index in all patients Was markedly decreased.with that of 11 patients becoming normal.The sleep latency of 19 patients became normal.On the other hand,6 patients(26%)had transient headache,nausea,and lethargy.Conclusions Patients with discomfortable feeling of lower extremity which is mitigated after movement.and legs movement during sleep should be check up as early as possible.Benserazide may be considered as an effeetive medication for patients with RLS.

Neuroprotective effect of repetitive magnetic stimulation on primarily cultured hippocampus neurons in rats / 中国组织工程研究

BACKGROUND: Much has been studied on the neuroprotective effect of repetitive transcranial magnetic stimulation.OBJECTIVE: To observe the effects of repetitive transcranial magnetic stimulation on the morphology and vitality of rat hippocampus neurons in vitro in order to verify its protective effect on neurons.DESIGN: A completely randomized controlled experiment with animals as subjects.SETTING: Institute of neuroscience of a military medical university of Chinese PLA.MATERIALS: The experiment was conducted at the Institute of Neuroscience, Fourth Military Medical University of Chinese PLA, from April to June 2004. Primary cultured hippocampus neurons of neonatal SD rats were used in the experiment. The cells were randomly assigned to control group,repetitive transcranial magnetic stimulation group, H2O2 group and repetitive transcranial magnetic stimulation-H2O2 group, each group having 10 wells.METHODS: Hippocampus neurons of the rats were cultured by common culture method. Repetitive transcranial magnetic stimulation group and repetitive transcranial magnetic stimulation-H2O2 group were treated with 1 Hz 100 mT repetitive magnetic stimulation for 1 000 times 48 hours after being seeded, whereas the control group and H2O2 group were left untreated. H2O2group and repetitive transcranial magnetic stimulation-H2O2 group were incubated with 100 μmol/L H2O2 56 hours after being seeded. Seventy-two hours after being seeded, the cellular morphology of repetitive transcranial magnetic stimulation group and control group was observed under an inverted phase contrast microscope. Cell vitality was assayed with 3-(4, 5)-dimethythioazol-2-yl-2, 5-diphenyl-tetrazoliumbromide method (MTT).MAIN OUTCOME MEASURES: The morphology and viability of the neurons in repetitive transcranial magnetic stimulation group and control group.RESULTS: Seventy-two hours after being seeded, the cellular morphology of repetitive transcranial magnetic stimulation group and control group was observed under an inverted phase contrast microscope. Cells clustered and had good refractive power. The cell body was satiated and took round, fusiform or conical shape. Processes were obvious(mostly 20-30 μm) and formed intensive neural network. The two groups did not differ significantly in morphological alteration. MTT metabolic rate: It was higher in repetitive transcranial magnetic stimulation group[ ( 104.43 ± 2.76) % ] than in control group[ (100. 00 ± 3.20) % ] ( F = 1. 344, P ＜ 0.05); it was higher in repetitive transcranial magnetic stimulation-H2O2 group[ (52.61 ± 2.64) % ] than in H2O2 group[ (46. 28 ± 2.04) % ] ( F = 1. 675, P ＜ 0.05).CONCLUSION: After repetitive transcranial magnetic stimulation, the morphology of hippocampus neurons cultured in vitro does not change obviously, but cell vitality and ability of anti-oxidation are increased remarkably, which does not cause obvious harm to the cultured cells and may have some neuroprotective effects.

PROGRESS OF TREATMENT OF WRIST DISORDER BY LIMITED INTERCARPAL ARTHRODESIS / 中国修复重建外科杂志

Objective　To review the recent progress in the treatment of wrist disorder by limited intercarpal arthrodesis and the related experimental study. Methods　Recent original articles related to limited intercarpal arthrodesis, including clinical practice and experimental study, were extensively retrieved and carefully analyzed. Results　Limited intercarpal arthrodesis could relieve pain and stabilize the wrist joint with partial motion. Conclusion　 With suitable indication and well selected operation approach, the limited intercarpal arthrodesis should be the optimal surgical intervention than total carpal athrodesis in the treatment of wrist disorder.

Effects of phenytoin and gabapentin on veratridine-induced epileptiform discharge in rats' hippocampal CA1 neurones / 解放军医学杂志

Objective To observe the effects of phenytoin and gabapentin in therapeutic dosage on low-dose veratridine-induced epileptiform discharge in rats' hippocampal CA1 neurons,and explore the involved mechanisms.Methods By means of whole-cell patch clamp technique,the epileptiform discharge model of rats' hippocampal CA1 neurons was constructed with extracellular perfusion of 0.5?mol/L veratridine,and the model should be regarded as successfully estabilshed if bursting discharge emerged within 30min perfusion.The effects of phenytoin(2.5,5,10 and 15?mol/L) and gabapentin(2.5,5 and 10?mol/L) on the epileptiform activity were observed under the voltage-clamp configuration,and the current changes for 1 hour in CA1 neurons was also observed.Results Nine-sixteen minutes after veratridine perfusion,the huge,rhythmic slow oscillation emerged,with 100～200Hz high-frequency discharge,in the hippocampal CA1 neurons,which was similar to the paroxysmal depolarization shifts(PDS),implying that the epileptiform activity was reproduced.Therapeutic dose of phenytoin blocked the veratridine-induced epileptiform activity.The bursting interval of the epileptiform activity was prolonged along with the increased phenytoin concentration,and the duration of bursting was not shortened.1h current decreased gradually in the generation of veratridine-induced epileptiform activity.Therapeutic dose of gabapentin did not block the epileptiform activity in this model.Conclusions In the epileptiform discharge model of rats' hippocampal CA1 neurons,phenytoin can block the epileptic activity in a dose-dependent manner,and the effect may be related to the inhibition of 1h currents.Gabapentin shows no influence on the epileptiform activity,and the possible mechanism may be its ineffectiveness to the persistent sodium currents,and vertridine-induced epileptiform activity does not enhance the 1h currents.

Cytological mechanism of epileptoid activities of rats hippocampus pyramidal cells induced by low dose of veratrine / 解放军医学杂志

Objective To observe the effects of low dose of veratrine on the discharges of rat hippocampus pyramidal neurons,and to elucidate its possible cytological mechanism.Methods The discharge features of hippocampus CA1 pyramidal neurons of 14-day-aged healthy Sprague-Dawley rats induced by low dose(0.3～0.8?mol/L)of veratrine were observed by slice patch-clamp technique.Presynap- tic stimulation was given to Schaffer collaterals.Presynaptic receptor inhibitors such as 6-cyano-7-nitroquinoxaline-2,3-dione(CNQX, 5?mol/L),DL-2-amino-5-phosphonopentanoic acid(AP-5,12.5?mol/L),bicuculline(Bic,10?mol/L)and tetrodotoxin(TTX,40～80nmol/L)were used to investigate the influence on veratrine-induced epilepsy andⅠ-Ⅴcurves were plotted under these conditions.Elec- trophysiological mechanism of veratrine-induced epilepsy was elucidated on the basis of these experiments,Results After a perfusion with low dose of veratrine,the pyramidal neurons were found to discharge relatively fixed-mode slow wave epileptoid bursts accompanied with hyperpolarization of membrane potential.These epileptoid bursts were not blocked by a mixture of CNQX,AP-5 and Bic,but by low dose of TTX.After a perfusion with veratrine,Ⅰ-Ⅴrelationship tended to be nonlinear and the depolarization rectification was enhanced,which were reversed by administration of low dose of TTX.The subthreshold TTX-sensitive persistent sodium current of CA1 pyramidal cells was enhanced by veratrine in a voltage-dependent manner.Conclusion Inducing slow wave epileptoid bursts,the low dose of veratrine can remarkably change the discharge features of CA1 pyramidal neurons.Such epileptoid activities were not influenced by the synaptic receptor inhibitors,and were obviously related to the persistent sodium current.

Spinal Clinically Isolated Syndromes:Clinical and MRI Analysis / 实用放射学杂志

Objective To evaluate the clinical manifestations and magnetic resonance imaging(MRI) features of the clinically isolated syndrome(CIS) of the spinal cord.Methods MRI features and expanded disability status scale(EDSS) score in 63 patients with multiple sclerosis(MS) showed early clinical manifestations of spinal CIS were retrospectively analysed.Results 52.9% of MS patients in the early performance was the spinal CIS,88.9% was acute or subacute onset,42.9% of the initial symptoms was isolated sensory dysfunction,and 54.9% had cervical spinal cord involvement.The first MRI positive rate was 91.1% and 35.3% presented with "multifocal" plagues.81.7% of the MRI lesions were not more than two vertebral segments,and 89.0% in the axial diameter of the spinal cord did not exceed 1/2.The number,volume and area of MRI lesions at baseline confirmed the positive correlation with EDSS at diagnosis of MS.Corticosteroid therapy before and after the EDSS score was of a significant difference(P= 0.003).Conclusion Spinal CIS often occurs in cervical spinal cord with acute or subacute onset,and incomplete spinal cord injury.MRI may detect "multifocal" plagues.Quantitative MRI is valuable for the assessment of prognosis.Early intravenous corticosteroid therapy can be an effective way to ease symptoms.

Microsurgical repair of blood vesseles wounded with firearm in limbs / 中华显微外科杂志

Objective To analyses the efficacy of treatment of blood vessels wounded with firearm in limbs by microsurgical technique Methods From March 1979 to October 2000,560 cases whose blood vessels were wounded with firearm in limbs were repaired by microsurgical technique Results Five hundred and twenty cases were good,17 cases were disable,15 cases were amputated limds,and 8 cases died Conclusions The majority of blood vessels wounded with firearm in limbs can be obtained good results being repaired by microsurgical technique

Microsurgical treatment of peripheral nerves injuries by firearm / 中华显微外科杂志

Objective Peripheral nerve injuries are common in firearm injuries The outcomes of peripheral nerves injuries by firearm treated with microsurgical techniques were discussed Methods All 314 cases of firearm injuries of peripheral nerves were treated with five types of microsurgical techniques Results The outcome was good in a 2 year follow up The recovery rate for nerve function was 79 4% in upper extremity,and 62 6% in lower extremity Conclusions Microsurgical techniques are effective methods for treatment of firearm injuries of peripheral nerve

Microsurgical repair of soft tissue defects in the firearm wound / 中华显微外科杂志

Objective To summarize the experience of microsurgical repair of soft tissue defects in 136 cases with firearm wound,to probe into repairing defect methods in different parts and to improve repairing results Methods According to the location,area of soft tissue defects or special needs,dorsalis pedis flap,latissimus dorsi flap,thoracoumbilical flap,forearm flap,lateral leg flap,tensor fascia lata flap or compound tissue flap were used to repair 136 cases with soft tissue defects in the firearm wound Results All 136 cases with soft tissue defects were repaired successfully Conclusions Microsurgical technique is a good method to repair soft tissue defects and reconstruct function in the firearm wound

Changes and correlation between the concentration of complement and titer of anti-acetylcholine receptor antibody in the sera of patients with myasthenia gravis / 临床神经病学杂志

0.05).Conclusions The serum concentration of C_3 rises and the titer of AChRAb decreases in MG patients after treatment with glucocorticoid. There is no correlation between C_3 concentration and titer of AChRAb. The complement possibly cooperates with AChRAb in pathogenesis of MG.

Effects of repetitive transcranial magnetic stimulation on GFAP and OX-42 expression in hippocampus and dentate gyrus in rats / 临床神经病学杂志

Objective To observe the effects of repetitive transcranial magnetic stimulation (rTMS) on the expression of glial fibrillary acidic protein (GFAP) and OX-42 in hippocampus and dentate gyrus in rats.Methods The rats were treated with 1 Hz, 100 mT TMS 10 min once a day for 14 days, and then the expression of GFAP and OX-42 in hippocampus and dentate gyrus were investigated by ABC technique of immunohistochemistry.Results Compared with the control group, there were no significant difference in the expression of GFAP and OX-42 between the two groups.Conclusion rTMS using our parameters does not cause brain injury in rats.