Olanzapine vs. magnesium valproate vs. lamotrigine in anti-N-methyl-D-aspartic acid receptor encephalitis: a retrospective study.

BACKGROUND: This study aimed to compare the impact of olanzapine, magnesium valproate, and lamotrigine as adjunctive treatments for anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. And it is expected to add supporting points related to the rebalance of neurotransmitters in the brain through adjuvant therapy in the clinical management of anti-NMDAR encephalitis. METHODS: This retrospective study included patients diagnosed with anti-NMDAR encephalitis who received standardized immunotherapy at Hunan Brain Hospital between January 2018 and December 2020. RESULTS: Compared to the olanzapine group, both the magnesium valproate and lamotrigine groups showed lower scores on the positive and negative symptom scale (PANSS) total score after 3 weeks of treatment (all P < 0.05). The Montreal Cognitive Assessment Scale (MoCA) scores in the magnesium valproate and lamotrigine groups were significantly higher than in the olanzapine group after 3 weeks and 3 months of treatment (all P < 0.05). After 3 months of treatment, the proportions of patients with a modified Rankin scale score (mRS) of 0-1 in the magnesium valproate and lamotrigine groups were significantly higher than in the olanzapine group (all P < 0.05). The electroencephalogram (EEG) abnormality ranks at 3 months were significantly lower in the magnesium valproate and lamotrigine groups compared with the olanzapine group (all P < 0.05). Furthermore, the Glx/Cr ratio significantly decreased after 3 months of treatment (all P < 0.05) in the magnesium valproate and lamotrigine groups, while the Glx/Cr ratio in the olanzapine group showed no significant change (P > 0.05). CONCLUSION: Compared with olanzapine, the addition of magnesium valproate or lamotrigine to immunotherapy might be associated with a lower PANSS score, higher MoCA score, and lower mRS score. The improvement of neurological functions and cognitive function may be related to the decreased Glx/Cr ratio.

Autoantibodies Targeting Unknown Epitope Autoimmune Encephalitis and the Effect of Modified Electroconvulsive Therapy: Report of Three Cases.

Objective: Generally autoimmune encephalitis (AE) cases present with central nervous system symptoms. Many types of autoantibodies are associated with autoimmune encephalitis, with anti-N-methyl-D-aspartate receptor being the most commonly reported. However, autoimmune encephalitis cases with autoantibodies targeting unknown epitopes are increasingly recognized. This article aims to summarize the clinical experience and assess the feasibility of modified electroconvulsive therapy (MECT) as an adjunctive treatment method for autoimmune encephalitis patients with poor response to first-line immunotherapy and mainly displaying psychiatric symptoms. Methods: This work reports three cases of which two have been diagnosed as autoantibodies targeting unknown epitope autoimmune encephalitis while one has been diagnosed as anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis and all were effectively treated with MECT. Results: All three cases that otherwise failed to respond to standard immunotherapy for controlling psychiatric symptoms exhibited excellent clinical outcomes following MECT. The underlying mechanism of action of MECT is unclear and whether such an effect involves a neurotransmitter rebalance in the brain remains uncertain. At present, we have observed only a small number of clinical cases, warranting further research among a larger number of clinical cases and more systematic multicenter retrospective analysis. Conclusions: It should be noted that, while our experience supports the utility of MECT in the treatment of certain cases of AE, this option should be regarded as an adjuvant therapy after standard immunosuppressive therapy. Clinicians must be aware that patients should be provided with psychiatric or neurological services for timely diagnosis along with timely and appropriate treatment.

Boll-leaf system gas exchange and its application in the analysis of cotton photosynthetic function.

Estimating the boll development and boll yield from single-leaf photosynthesis is difficult as the source-sink relationship of cotton (Gossypium hirsutum L.) is complicated. As the boll-leaf system (BLS), which includes the main-stem leaf, sympodial leaf, and non-leaf organs, is the basic unit of the cotton source-sink relationship and yield formation, the concept of "BLS photosynthesis" is introduced in this study. We speculate that the characteristics of BLS gas exchange can more accurately reflect the photosynthetic function of the system, thus revealing the law of photosynthesis in the process of boll development. The results showed that the photosynthetic rate of single leaves measured by a BLS chamber was consistent with that measured by a standard single-leaf chamber. BLSs exhibited typical light response curves, and the shape of the curves was similar to those of single leaves. The light compensation point and respiration rate of BLSs were higher than those of single leaves, while the apparent quantum efficiency of BLSs was lower. Compared with single leaves, the duration of the photosynthetic function of BLSs was longer. Increasing plant density decreased the gas exchange rate per unit BLS more significantly under field conditions. There was a better linear correlation between the net CO2 assimilation rate, respiration rate of BLSs and boll biomass. Therefore, we think that the gas exchange of BLSs can better reveal the changes in photosynthetic function of BLSs and boll development. This provides a new basis for analyzing the mechanism and regulation of cotton yield formation.

Nitrogen vacancy mediated exciton dissociation in carbon nitride nanosheets: Enhanced hydroxyl radicals generation for efficient photocatalytic degradation of organic pollutants.

Polymeric materials are promising candidates as photocatalysts for environmental purification, however their catalytic performance are still unsatisfactory mainly due to the strong Coulomb interactions between electron and hole that leads to fast charge recombination. Herein, taking graphitic carbon nitride as an example, we verify that installing carbon nitride nanosheets with nitrogen vacancy could break the intrinsic electronic state distribution, forming energy disordered interfaces around the vacancies with the energy difference as large as 0.35 eV. Such a large energy difference is found energetic enough to overcome the strong Coulomb interactions between electron and hole for hot electron and hole generation, as a result showing high electron-hole separation efficiency. Benefited from these advantages, the as prepared material shows remarkable photocatalytic performance toward organic pollutants degradation. The improved catalytic performance is originated from the promoted exciton dissociation that leads to ultra high hydroxyl radical generation. This study offers a new understanding of the excitonic effects for designing advanced polymeric photocatalyst for energy and environment related applications.