Research progress in the protective efficacy of human papillomavirus vaccines in males / 中华微生物学和免疫学杂志

Human papillomavirus (HPV) is one of the most common sexually transmitted pathogens. It can cause a variety of diseases such as condyloma acuminatum, anal cancer, penile cancer and oropharyngeal cancer in men, resulting in a high disease burden. With the development of society, the application of HPV vaccines in males has attracted more attention. Currently, there are many clinical trials and real-world research results of HPV vaccines applied to boys and men worldwide, and many countries have introduced HPV vaccination for underage boys into their national immunization programs. This article intended to review the research progress in the efficacy of HPV vaccines in male population.

Effectiveness of HPV vaccines in real-world study / 中华微生物学和免疫学杂志

Human papillomavirus (HPV) is an epitheliotropic virus. High-risk HPV infections lead to precancerous lesions which may progress to cancer in the cervix, vagina and vulva, while low-risk HPV infections cause benign lesions such as genital warts and recurrent respiratory papillomas. HPV infection remains one of the major public health problems threatening human health. To date, six prophylactic preventive HPV vaccines have been licensed, and the effectiveness of HPV vaccination has gradually appeared in some countries with earlier vaccination. HPV vaccination has been proved to be effective in protecting against diseases related to HPV infection, which leads to significant reductions in the incidence of vaccine-type HPV-related infection, high cervical lesions, anogenital warts, recurrent respiratory papillomatosis and other relevant diseases. The herd protection effect of the vaccines is outstanding. Meanwhile, a bivalent HPV vaccine has been demonstrated for the cross-protection against HPV infections of non-vaccine types (HPV31/33/45) in real-world vaccination practice.

A review of the safety and efficacy of current COVID-19 vaccines / 医学前沿

Vaccination is the most effective and feasible way to contain the Coronavirus disease 2019 (COVID-19) pandemic. The rapid development of effective COVID-19 vaccines is an extraordinary achievement. This study reviewed the efficacy/effectiveness, immunogenicity, and safety profile of the 12 most progressed COVID-19 vaccines and discussed the challenges and prospects of the vaccine-based approaches in a global crisis. Overall, most of the current vaccines have shown safety and efficacy/effectiveness during actual clinical trials or in the real-world studies, indicating a development of pandemic control. However, many challenges are faced by pandemic control in terms of maximizing the effect of vaccines, such as rapid vaccine coverage, strategies to address variants with immune escape capability, and surveillance of vaccine safety in the medium- and long-terms.

A live attenuated influenza virus-vectored intranasal COVID-19 vaccine provides rapid, prolonged, and broad protection against SARS-CoV-2 infection

Remarkable progress has been made in developing intramuscular vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); however, they are limited with respect to eliciting local immunity in the respiratory tract, which is the primary infection site for SARS-CoV-2. To overcome the limitations of intramuscular vaccines, we constructed a nasal vaccine candidate based on an influenza vector by inserting a gene encoding the receptor-binding domain (RBD) of the spike protein of SARS-CoV-2, named CA4-dNS1-nCoV-RBD (dNS1-RBD). A preclinical study showed that in hamsters challenged 1 day and 7 days after single-dose vaccination or 6 months after booster vaccination, dNS1-RBD largely mitigated lung pathology, with no loss of body weight, caused by either the prototype-like strain or beta variant of SARS-CoV-2. Lasted data showed that the animals could be well protected against beta variant challenge 9 months after vaccination. Notably, the weight loss and lung pathological changes of hamsters could still be significantly reduced when the hamster was vaccinated 24 h after challenge. Moreover, such cellular immunity is relatively unimpaired for the most concerning SARS-CoV-2 variants. The protective immune mechanism of dNS1-RBD could be attributed to the innate immune response in the nasal epithelium, local RBD-specific T cell response in the lung, and RBD-specific IgA and IgG response. Thus, this study demonstrates that the intranasally delivered dNS1-RBD vaccine candidate may offer an important addition to fight against the ongoing COVID-19 pandemic, compensating limitations of current intramuscular vaccines, particularly at the start of an outbreak.

Clinical characteristics of movement disorders in patients with anti-N-methyl-D-aspartate acid receptor encephalitis / 中华神经科杂志

Objective:To explore the clinical characteristics, therapeutic effect and prognosis of movement disorders in anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis.Methods:The prospectively collected data of hospitalized 163 patients with anti-NMDAR encephalitis admitted to Xuanwu Hospital, Capital Medical University from June 2012 to October 2019 were analyzed. According to the presence of movement disorders, the patients were divided into movement disorders group (75 cases, 46.0%) and non-movement disorders group (88 cases, 54.0%). Patients were followed up for six months and 12 months after immunotherapy. The clinical manifestations, auxiliary examinations, treatment and prognosis of the two groups were compared.Results:Among 163 patients with anti-NMDAR encephalitis, 91 patients (55.8%) were male and 72 patients (44.2%) were female, with an age of 26(19, 34) years. In the 75 patients of the movement disorders group, 50 patients (66.7%) presented with orofacial dyskinesia, 45 patients (60%) with limb stereotypies, 28 patients (37.3%) with choreoathetosis, nine patients (12.0%) with ballism, seven patients (9.3%) with bradykinesia, five patients (6.7%) with tremor, and 13 patients (17.3%) with status dystonicus. Compared with the non-movement disorders group, the movement disorders group had a higher proportion of ovarian teratoma (14.7% vs 3.4%), modified Rankin Scale score of 3-5 before immunotherapy (76.0% vs 33.0%), abnormal electroencephalogram (89.3% vs 77.3%), increased lumbar puncture pressure (53.3% vs 34.1%), cerebrospinal fluid (CSF) pleocytosis (73.3% vs 51.1%), strong positive NMDAR antibody of CSF (44.0% vs 25.0%), admitting to intensive care unit (60.0% vs 9.1%), treated with intravenous immunoglobulin (80.0% vs 40.9%), plasma exchange (36.0% vs 3.4%), and immunosuppressive therapy (37.2% vs 17.0%); had shorter days from the onset to the beginning of immunotherapy [20(10, 33) d vs 35(15, 77) d]; had longer days from the beginning of immunotherapy to the improvement [34(20, 60) d vs 20(15, 35) d]; and there were significant differences of above items between the two groups ( P<0.05). There was no significant difference in the prognosis and relaps between the two groups at six and 12 months after immunotherapy. Conclusions:Nearly a half of patients with anti-NMDAR encephalitis had movement disorders with multiple phenotypes. The severity of movement disorders was related to the severity of the disease. After active immunotherapy and symptomatic treatment, movement disorders improved with the improvement of primary disease in majority of patients.

A survey on the enteral nutrition practices in patients with neurological diseases in the tertiary hospitals of northern China in 2020 / 中华临床营养杂志

Objective:To investigate the enteral nutrition (EN) practices in patients with neurological diseases in the tertiary hospitals of northern China in 2020.Methods:A questionnaire survey was conducted among clinicians in 123 tertiary hospitals of northern China, which admitted patients with neurological diseases and implemented EN practices, in June 2020. The selected departments included neurology, neurological intensive care unit (ICU), neurosurgery ICU, and general ICU. The indicators for evaluation included: the equipment and personnel for EN practices, the application of screening, assessment and implementation methods of EN management, the timing of EN support, the route and methods of EN infusion, and the monitoring of nutrition-related indicators.Results:Concerning the EN practices in the 123 tertiary hospitals of northern China, 82.9% were equipped with weight measuring instruments, 85.4% with EN infusion pumps, 74.8% applied nutrition risk screening 2002 (NRS 2002) or nutrition risk in critically ill (NUTRIC) score scale to evaluate the nutritional status of patients, 71.5% applied nutrition assessment scales, 74.8% elevated the head of the bed to ≥ 30 degrees during EN infusion. Only 30.1% were equipped with an indirect calorimetry instruments (metabolic cart), 31.7% had their own standard operating procedures for nutrition management, 46.3% had a percutaneous endoscopic gastrostomy (PEG) or percutaneous endoscopic jejunostomy (PEJ) devices, 46.3% had a nutrition support team, 48.0% started EN practices within 48 hours, 57.7% started EN infusion based on Water Swallow Test, and 58.5% stopped EN infusion based on Water Swallow Test.Conclusions:The EN equipments in practices for patients with neurological diseases in tertiary hospitals of northern China were basically adequate, the evaluation and monitoring of EN related indicators were basically consummate. However, there were still some deficiencies warranting further improvement.

The prevalence of antibodies to SARS-CoV-2 among blood donors in China

ObjectivesThe prevalence of antibodies to SARS-CoV-2 among blood donors in China remains unknown. To reveal the missing information, we investigated the seroprevalence of SARS-CoV-2 antibodies among blood donors in the cities of Wuhan, Shenzhen, and Shijiazhuang of China. DesignCross-sectional study SettingThree blood centers, located in the central, south and north China, respectively, recruiting from January to April 2020. Participants38,144 healthy blood donors donated in Wuhan, Shenzhen and Shijiazhuang were enrolled, who were all met the criteria for blood donation during the COVID-19 pandemic in China. Main outcome measuresSpecific antibodies against SARS-CoV-2 including total antibody (TAb), IgG antibody against receptor-binding domain of spike protein (IgG-RBD) and nucleoprotein (IgG-N), and IgM. Pseudotype lentivirus-based neutralization test was performed on all TAb-positive samples. In addition, anonymous personal demographic information, including gender, age, ethnicity, occupation and educational level, and blood type were collected. ResultsA total of 519 samples from 410 donors were confirmed by neutralization tests. The SARS-CoV-2 seroprevalence among blood donors was 2.29% (407/17,794, 95%CI: 2.08% to 2.52%) in Wuhan, 0.029% (2/6,810, 95%CI: 0.0081% to 0.11%) in Shenzhen, and 0.0074% (1/13,540, 95%CI: 0.0013% to 0.042%) in Shijiazhuang, respectively. The earliest emergence of SARS-CoV-2 seropositivity in blood donors was identified on January 20, 2020 in Wuhan. The weekly prevalence of SARS-CoV-2 antibodies in Wuhans blood donors changed dynamically and were 0.08% (95%CI: 0.02% to 0.28%) during January 15 to 22 (before city lockdown), 3.08% (95%CI: 2.67% to 3.55%) during January 23 to April 7 (city quarantine period) and 2.33% (95%CI: 2.06% to 2.63%) during April 8 to 30 (after lockdown easing). Female and older-age were identified to be independent risk factors for SARS-CoV-2 seropositivity among donors in Wuhan. ConclusionsThe prevalence of antibodies to SARS-CoV-2 among blood donors in China was low, even in Wuhan city. According to our data, the earliest emergence of SARS-CoV-2 in Wuhans donors should not earlier than January, 2020. As most of the population of China remained uninfected during the early wave of COVID-19 pandemic, effective public health measures are still certainly required to block viral spread before a vaccine is widely available.

Serology characteristics of SARS-CoV-2 infection since the exposure and post symptoms onset

BackgroundTimely diagnosis of SARS-CoV-2 infection is the prerequisite for treatment and preventive quarantine. The serology characteristics and complement diagnosis value of antibody test to RNA test needs to be demonstrated. MethodA patient cohort study was conducted at the first affiliated hospital of Zhejiang University, China. Serial plasma of COVID-19 patients and were collected and total antibody (Ab), IgM and IgG antibody against SARS-CoV-2 were detected. The antibody dynamics during the infection were described. ResultsThe seroconversion rate for Ab, IgM and IgG in COVID-19 patients was 98.8% (79/80), 93.8% (75/80) and 93.8% (75/80), respectively. The first detectible serology marker is total antibody and followed by IgM and IgG, with a median seroconversion time of 15, 18 and 20 day post exposure (d.p.e) or 9, 10 and 12 days post onset, separately. The antibody levels increased rapidly since 6 d.p.o and accompanied with the decline of viral load. For patients in the early stage of illness (0-7d.p.o),Ab showed the highest sensitivity (64.1%) compared to the IgM and IgG (33.3% for both, p<0.001). The sensitivities of Ab, IgM and IgG detection increased to 100%, 96.7% and 93.3% two weeks later, respectively. ConclusionsTypical acute antibody response is induced during the SARS-CoV-2 infection. The serology testing provides important complementation to RNA test for pathogenic specific diagnosis and helpful information to evaluate the adapted immunity status of patient. It should be strongly recommended to apply well-validated antibody tests in the clinical management and public health practice to improve the control of COVID-19 infection. Take-Home MessageAntibody responses are induced after SARS-CoV-2 infection and complement diagnosis value of antibody test to RNA test was observed. Antibody tests are critical tools in clinical management and control of SARS-CoV-2 infection and COVID-19.

Antibody responses to SARS-CoV-2 in patients of novel coronavirus disease 2019

BackgroundThe novel coronavirus SARS-CoV-2 is a newly emerging virus. The antibody response in infected patient remains largely unknown, and the clinical values of antibody testing have not been fully demonstrated. MethodsA total of 173 patients with confirmed SARS-CoV-2 infection were enrolled. Their serial plasma samples (n = 535) collected during the hospitalization period were tested for total antibodies (Ab), IgM and IgG against SARS-CoV-2 using immunoassays. The dynamics of antibodies with the progress and severity of disease was analyzed. ResultsAmong 173 patients, the seroconversion rate for Ab, IgM and IgG was 93.1% (161/173), 82.7% (143/173) and 64.7% (112/173), respectively. Twelve patients who had not seroconverted were those only blood samples at the early stage of illness were collected. The seroconversion sequentially appeared for Ab, IgM and then IgG, with a median time of 11, 12 and 14 days, respectively. The presence of antibodies was < 40% among patients in the first 7 days of illness, and then rapidly increased to 100.0%, 94.3% and 79.8% for Ab, IgM and IgG respectively since day 15 after onset. In contrast, the positive rate of RNA decreased from 66.7% (58/87) in samples collected before day 7 to 45.5% (25/55) during days 15 to 39. Combining RNA and antibody detections significantly improved the sensitivity of pathogenic diagnosis for COVID-19 patients (p < 0.001), even in early phase of 1-week since onset (p = 0.007). Moreover, a higher titer of Ab was independently associated with a worse clinical classification (p = 0.006). ConclusionsThe antibody detection offers vital clinical information during the course of SARS-CoV-2 infection. The findings provide strong empirical support for the routine application of serological testing in the diagnosis and management of COVID-19 patients.

Association of PLCB1 gene polymorphism with the risk of central precocious puberty in Chinese Han girls / 中国学校卫生

Objective@#To investigate the association between mutation of PLCB1, the downstream gene of KISS1/GPR54 pathway, and the risk of central precocious puberty (CPP) in Chinese Han girls.@*Methods@#Totally 169 pairs of CPP girls on their first visit to hospital and age-matched controls (± 3 months) were recruited. The genotypes of rs6140544, rs11476922, rs3761170 and rs2235613 were determined and the effect of loci variations on CPP was investigated.@*Results@#After adjusting for confounding factors (BMI, maternal age at menarche, maternal age at birth, and time for bed), rs2235613 variation was significantly negative associated with CPP in recessive models(OR=0.46，95%CI=0.24-0.91), and mutation in rs3761170 increased the risk of CPP in dominant models (OR=1.99，95%CI=1.01-3.93).@*Conclusion@#The study suggests that mutation in rs3761170 increases the risk of CPP and rs2235613 variation may have a protective effect on the risk of CPP.

Introduction of papillomavirus rapid interface for modelling and economics (PRIME) and an example of China′s data analysis / 中华预防医学杂志

Cervical cancer has become an important disease that jeopardizes women′s health, causing hundreds of thousands of new cases annually. Human papillomavirus (HPV) is the leading cause for cervical cancer. Since the world′s first HPV vaccine was licensed in 2006, 92 countries around the world have introduced them in national immunization programs. The WHO recommends that scientific economic evaluation should be achieved before the introduction, but this is more difficult for low-and middle-income countries. Therefore, this article introduces a mathematical model recommended by WHO in 2014 to quickly and easily accomplish economic evaluation of HPV vaccine -the PRIME, and take the China′s 2018 data published by International Agency for Research on Cancer (IARC) as an example. The evaluation result shows that the introduction of HPV vaccine in Chinese 12-year-old women is cost-effective.

Progress in clinical research of varicella vaccines / 中华微生物学和免疫学杂志

Varicella(chickenpox)is an acute infectious disease with high incidence in children. It is mainly transmitted through the airborne route and vaccination is the best measure for the prevention and control. Data from post-marketing studies show the effectiveness of varicella vaccines is 80%-85%, and two-dose regimen is significantly more effective than one-dose. After inclusion of varicella vaccines into the national immunization programme, there has been a clear decrease in varicella morbidity. Despite the lack of direct evidence, there remains the risk that varicella-zoster virus might latent in the dorsal route ganglia after vaccination. Therefore, more safe and effective novel varicella vaccines are under development. This paper reviewed the progress in varicella vaccine development and their long-term efficacy and safety.

Mechanism of inflammatory reaction to vaccination and its effects on immunogenicity / 中华微生物学和免疫学杂志

Vaccination, one of the greatest inventions of mankind, prevents millions of people from infectious diseases and death each year. With the continuous improvement in immunization coverage, the safety of vaccines has attracted widespread attention. Common adverse reactions to vaccinations are mainly caused by inflammation, but the immune responses and biological damages following immunization are so complicated that the possible mechanisms have not been completely unveiled. Exploring the relationship be-tween inflammation and immunogenicity after vaccination is of great significance for the monitoring and man-agement of vaccines after marketing. This article reviewed the mechanism of inflammatory responses after vaccination and its potential impact on immunogenicity.

Clinical characteristics and prognosis of brain-heart interaction in patients with acute severe stroke / 中华危重病急救医学

To investigate and analyze the clinical characteristics and prognosis of brain-heart interaction (BHI) in patients with acute severe stroke. Methods The patients with acute severe stroke admitted to Neurointensive Care Unit of Xuanwu Hospital, Capital Medical University from January 1st, 2015 to December 31st, 2017 were enrolled. The clinical data, indicators related to BHI and prognosis were collected. Patients were divided into BHI group and non-BHI group according to the presence or absence of BHI. The differences of each index were compared between two groups. The independent risk factors of BHI were analyzed using multivariate Logistic regression analysis. In addition, subgroup analysis was performed for patients in the BHI group based on the presence or absence of Takotsubo syndrome (TTS), and multivariate Logistic regression was used to analyze independent risk factors for TTS. Results 119 patients with acute severe stroke were analyzed, BHI occurred in 91 cases (76.5%), and 17 cases (14.3%) TTS were included in the BHI group. Compared with non-BHI group, BHI group had lower rates of cerebrovascular disease history (20.9% vs. 42.9%, P = 0.020), lower smoking history (25.3% vs. 50.0%, P = 0.013), lower statin use (16.5% vs. 50.0%, P = 0.000), lower total cholesterol [TC (mmol/L): 3.97±1.05 vs. 4.43±0.88, P =0.039], and lower low density lipoprotein [LDL (mmol/L): 2.30±0.76 vs. 3.00±0.84, P = 0.000]. Multivariate Logistic regression showed that the use of statins [odds ratio (OR) = 0.222, 95% confidence interval (95%CI) = 0.075-0.658, P =0.007] and the history of cerebrovascular diseases (OR = 0.321, 95%CI = 0.113-0.912, P = 0.033) were protective factors of BHI. Compared with non-TTS subgroup, TTS subgroup had a lower percentage of diabetes history (0% vs. 37.8%, P = 0.002), lower glycated hemoglobin [HbA1c: 0.055 (0.050, 0.056) vs. 0.064 (0.056, 0.075), P = 0.000], higher TC (mmol/L: 4.70±1.16 vs. 3.80±0.95, P = 0.001), first day mean arterial pressure [MAP (mmHg, 1 mmHg = 0.133 kPa):114 (98, 122) vs. 103 (94, 108), P = 0.042], third day diastolic blood pressure [DBP (mmHg): 82 (77, 94) vs. 67 (59, 86), P = 0.002], and third day MAP [mmHg: 106 (95, 114) vs. 94 (80, 106), P = 0.015]. Multivariate Logistic regression analysis showed that increased MAP on the third day of admission was an independent risk factor for TTS (OR = 11.833, 95%CI = 1.113-125.779, P = 0.040), increased HbA1c was protective factor of TTS (OR = 0.022, 95%CI = 0.001-0.345, P = 0.006). The rate of poor outcome at discharge of all the BHI patients were higher than those of the non-BHI patients (34.1% vs. 14.3%, P = 0.045). Conclusions Acute severe stroke patients with high incidence of acquiring BHI and having BHI is associated with poor outcome after discharge. Using statins, ischemic preconditioning and control blood pressure, the occurrence of BHI can be reduced and might be beneficial to patients.

Progress in clinical research of varicella vaccines / 中华微生物学和免疫学杂志

Varicella( chickenpox) is an acute infectious disease with high incidence in children. It is mainly transmitted through the airborne route and vaccination is the best measure for the prevention and control. Data from post-marketing studies show the effectiveness of varicella vaccines is 80％-85％, and two-dose regimen is significantly more effective than one-dose. After inclusion of varicella vaccines into the na-tional immunization programme, there has been a clear decrease in varicella morbidity. Despite the lack of direct evidence, there remains the risk that varicella-zoster virus might latent in the dorsal route ganglia after vaccination. Therefore, more safe and effective novel varicella vaccines are under development. This paper reviewed the progress in varicella vaccine development and their long-term efficacy and safety.

Mechanism of inflammatory reaction to vaccination and its effects on immunogenicity / 中华微生物学和免疫学杂志

Vaccination, one of the greatest inventions of mankind, prevents millions of people from infectious diseases and death each year. With the continuous improvement in immunization coverage, the safety of vaccines has attracted widespread attention. Common adverse reactions to vaccinations are mainly caused by inflammation, but the immune responses and biological damages following immunization are so complicated that the possible mechanisms have not been completely unveiled. Exploring the relationship between inflammation and immunogenicity after vaccination is of great significance for the monitoring and management of vaccines after marketing. This article reviewed the mechanism of inflammatory responses after vaccination and its potential impact on immunogenicity.

The impact of male circumcision on the natural history of genital HPV infection: a prospective cohort study / 中华预防医学杂志

Objective@#To analyze the correlation between circumcision and incidence and clearance of male genital HPV infection.@*Methods@#From May to July 2014, 18-55 year old men who had sexual behavior history were recruited from the general population in Liuzhou, Guangxi to set up a cohort. Totally, 113 circumcised and 560 uncircumcised men were enrolled and interviewed using a questionnaire (including information on demographic characteristics and sexual behaviors), then they were followed-up with 6-month interval for 2 times. On each visit, specimens of male external genitalia were collected and genotyped for HPV DNA. The differences of incidence and clearance of genital HPV infections between circumcised and uncircumcised men were analyzed by Log-rank test. Cox regression was used to analyze the relationship between circumcision and incidence and clearance of HPV infection.@*Results@#The median age (P25, P75) of circumcised and uncircumcised men were 28 (24, 35) and 32 (24, 31), respectively. The incidences of any HPV infections were 9.1 (95%CI: 2.4-15.7) and 8.4 (95% CI: 5.6-11.2) per 1 000 person-months (χ2=0.10, P=0.758), respectively. The clearance of circumcised men [136.3 (95%CI: 70.0-202.7) per 1 000 person-months] was higher than that in uncircumcised men [89.6 (95%CI: 65.9-113.3) per 1 000 person-months] (χ2=8.19, P=0.004). In multivariate COX regression analysis, compared with uncircumcised men, circumcised men had higher possibility to clear any HPV infections (HR: 2.41, 95%CI: 1.30-4.46). Compared with men having one sexual partner, people having more than 4 sexual partners had lower possibility to clear any HPV infections (HR: 0.49, 95%CI: 0.25-0.96). Compared with 18-25 years old men, men aged 26-35 years old had higher possibility to clear high-risk HPV infections (HR: 2.14, 95%CI: 1.08-4.23).@*Conclusion@#Circumcised and uncircumcised men had similar incidence of genital HPV infection, whereas, men conducted circumcision and having fewer sexual partners could increase the clearance of genital HPV infections.

Comparison of the accuracy of predicting poor outcome of coma after cardiopulmonary resuscitation with two kinds of electroencephalogram techniques / 中华危重病急救医学

Objective To compare the accuracy of electroencephalography (EEG) grading scale with amplitude-integrated electroencephalography (aEEG) in predicting poor outcomes (3-month), who sustained coma after cardiopulmonary resuscitation (CPR) in adults. Methods A retrospective study was conducted. The patients with post-anoxic coma admitted to intensive care unit (ICU) of Tongren Hospital, Capital Medical University from March 2010 to June 2017 were enrolled. EEG was registered and recorded at least once within 7 days of coma after CPR, while not being subjected to therapeutic hypothermia. General data, Glasgow coma scale (GCS), EEG grading and aEEG model were collected. According to Glasgow prognosis score (GOS) of 3-month outcome, patients were divided into poor prognosis group (GOS 1-2) and good prognosis group (GOS 3-5), and the differences of related indexes between the two groups were compared. The predictive ability of aEEG model and EEG grading for brain function prognosis was evaluated by receiver operating characteristic (ROC) curve. Results Fifty-four patients were included, with 31 males and 23 females, and age of (53.9±19.3) years. Among the EEG Young grades, 17 cases (31.5%) were grade 1, 4 cases (7.4%) were grade 2-5, and 33 cases (61.1%) were grade 6. Among the aEEG model grades, 26 cases (48.1%) had slow wave pattern grade 1, 23 cases (42.6%) had suppressed mode grade 4, 4 cases (7.4%) had status epilepticus mode grade 2, and 1 case (1.9%) had burst suppression mode grade 3. Thirty-six patients had poor prognosis 3-month after onset, 26 of them died and 10 had persistent vegetative state. The prognosis was good in 18 cases, including 16 cases with severe neurological disability and 2 cases with moderate neurological disability. There was no significant difference in gender, age, anoxic time between two groups with different prognosis, while the degree of consciousness disorder in poor prognosis group was more severe than that in good prognosis group (GCS score: 4.1±1.7 vs. 5.0±2.1, P < 0.05). The consistency test showed that different physicians had good consistency in EEG grading and aEEG model (Kappa values were 0.917 and 0.932, respectively). It was shown by ROC curve analysis that the area under ROC curve (AUC) of aEEG model and EEG grading for predicting poor prognosis of coma patients after CPR were 0.815 and 0.720, respectively (both P < 0.01); when the cut-off value of aEEG was 2.5, the sensitivity was 79.3%, the specificity was 77.4%, the positive likelihood ratios (PLR) was 3.508, and the negative likelihood ratios (NLR) was 0.267; when the cut-off value of EEG grading was 4.5, the sensitivity was 82.8%, the specificity was 61.3%, the PLR was 2.140, and NLR was 0.281. Conclusions aEEG model was more accurate in prognosticating poor outcomes (3-month) in patients with post-anoxic coma, when compared to EEG grading. Its operation was simple, so aEEG is very suitable in ICU.

GFAP-Positive Progenitor Cell Production is Concentrated in Specific Encephalic Regions in Young Adult Mice / 神经科学通报·英文版

Previous genetic fate-mapping studies have indicated that embryonic glial fibrillary acidic protein-positive (GFAP) cells are multifunctional progenitor/neural stem cells that can produce astrocytes as well as neurons and oligodendrocytes throughout the adult mouse central nervous system (CNS). However, emerging evidence from recent studies indicates that GFAP cells adopt different cell fates and generate different cell types in different regions. Moreover, the fate of GFAP cells in the young adult mouse CNS is not well understood. In the present study, hGFAP-Cre/R26R transgenic mice were used to investigate the lineage of embryonic GFAP cells in the young adult mouse CNS. At postnatal day 21, we found that GFAP cells mainly generated NeuN neurons in the cerebral cortex (both ventral and dorsal), hippocampus, and cerebellum. Strangely, these cells were negative for the Purkinje cell marker calbindin in the cerebellum and the neuronal marker NeuN in the thalamus. Thus, contrary to previous studies, our genetic fate-mapping revealed that the cell fate of embryonic GFAP cells at the young adult stage is significantly different from that at the adult stage.

Characteristics of electroencephalogram in patients with anti-N-methyl-D-aspartate receptor encephalitis / 中华神经科杂志

Objective To investigate the characteristics of electroencephalogram (EEG) in patients with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. Methods In this retrospective study, patients with anti-NMDAR encephalitis who admitted to Xuanwu Hospital of Capital Medical University from January 2012 to June 2015 were enrolled. All patients accepted EEG monitoring at least once, and tumor screening, symptomatic therapy, as well as immunotherapy. Outcomes were assessed by modified Rankin Scale (mRS) 6 and 12 months after immunotherapy, and mRS score 0-2 was defined as favorable outcome. Results Forty-one patients aged (27±12) (13-58) years were enrolled, 19 of whom were male. All patients received EEG monitoring 55 times totally. Among 41 patients in disease peak period, 39 patients (95.1%) had abnormal EEG, 2 patients had normal EEG. The abnormality of brain MRI scan accounted for 51.2%. Abnormal EEG included diffuse slowing (12 patients, 29.3%), epileptic discharges (9 patients, 22.0%), rhythmic delta activity (6 patients, 14.6%), extreme delta brush (EDB) (6 patients, 14.6%), focal slowing (4 patients, 9.8%), and rhythmic delta frequency activity without EDB (2 patients, 4.9%). Clinical items did not show statistically significant difference between the patients with EDB and those without EDB. The patients with normal EEG, epileptic discharges, rhythmic delta activity, or rhythmic delta frequency activity without EDB all had favorable outcomes after 12 months′ treatments. Conclusions The great majority of patients with anti-NMDAR encephalitis had abnormal EEG. EEG could sensitively reflect the changes of brain function and could be helpful in early diagnosis and treatment of this disease. The most common electrographic pattern was found to be diffuse slowing in patients with anti-NMDAR encephalitis. EEG of some patients showed EDB.