[Clinical analysis of 8 cases with anti-GQ1b antibody syndrome].

Objective: To investigate the clinical characterization, treatment and prognosis of anti-GQ1b antibody syndrome. Methods: The clinical data of 8 patients with positive serum anti-GQ1b antibody from the Department of Neurology of Nanjing Brain Hospital between June 2016 and July 2018 were analyzed retrospectively. Their serums were tested by immunoblotting. Relevant literatures were reviewed to investigate possible pathogenesis. Results: Of the 8 cases, 4 cases were male, 4 cases were female; their age ranged from 16 to 76 (47±21) years old. Seven of them were with acute onset, the time course of the disease ranged from 2 to 15 (7±4) days. Six cases had a history of influenza prior to the onset of the presenting symptoms. In terms of the clinical manifestations of the eight patients, two were affected with Guillain-Barre syndrome (GBS), two with Cavernous sinus syndrome, one with Miller Fisher syndrome, one with both GBS and spinal cord demyelination, one with Bulbar paralysis, and one with chronic inflammatory demyelinating polyneuropathy (CIDP). The anti-GQ1b antibody IgG in serum was positive in 6 patients, two of whom were combined with positive IgG of anti-GD1b antibody in serum. The anti-GQ1b antibody IgM in serum was positive in 1 patient, and the anti-GQ1b antibody IgM and anti-GT1b antibody IgM in cerebrospinal fluid (CSF) were both positive in the other patient. In terms of the treatment, 3 patients (3/8) received vitamin B treatment only, 2 patients (2/8) received steroid plus vitamin B treatment, 2 patients (2/8) received intravenous immunoglobulin (IVIG) plus vitamin B treatment, and 1 patient (1/8) received steroid plus IVIG treatment. During the 8-33 months' follow-up after discharge, 6 patients were significantly improved in their symptoms, one with mild diplopia, one with limbs weakness, numbness and difficulty in walking. The symptoms of one patient (case 3) fluctuated twice and recovered again after treatment. Conclusions: The disease spectrum of anti-GQ1b antibodies syndrome is broad, and main symptom is ophtalmoplegia. Immunotherapy with IVIG and steroid would be beneficial to prognosis.

[Quantitative EEG and event-related potential P300 analysis oxiracetam injection curative effect in the treatment of delayed encephalopathy after acutecarbon monoxide poisoning].

Objective: oevaluateclinical curative effect of oxiracetam injection in the treatment of delayed encephalopathy after acute carbon monoxide poisoning (DEACMP) . Methods: Methods 52 patients with DEACMP were randomly divided into the observation group and the control group, 27 cases in the observation group and 25 cases in the control group. The 2 groups were adopted the treatment to improve the cerebral microcirculation and other symptomatic, the observation group on the basis of treatment for the treatment of oxiracetam Injection. Quantitative electroencephalogram (QEEG) and event-related potential P300 were used to evaluate the therapeutic effects of the 2 groups before and after treatment. Results: After treatment, QEEG value and event related potential P300 in observation group were decreased with statistically significant, respectively (P<0.05) , compared with the control group after treatment, the observation group excepted the occipital lobe, left parietal lobe, left around central and other indicators, QEEG and P300 oflatent period was shortened while the bank widens with statistical significance (P<0.05) . Conclusion: Olathe injection of DEACMP patients recovery have certain curative effect.

Label-free identification of the microstructure of rat spinal cords based on nonlinear optical microscopy.

The spinal cord is a vital link between the brain and the body and mainly comprises neurons, glial cells and nerve fibres. In this work, nonlinear optical (NLO) microscopy based on intrinsic tissue properties was employed to label-freely analyze the cells and matrix in spinal cords at a molecular level. The high-resolution and high-contrast NLO images of unstained spinal cords demonstrate that NLO microscopy has the ability to show the microstructure of white and grey matter including ventral horn, intermediate area, dorsal horns, ventral column, lateral column and dorsal column. Neurons with various sizes were identified in grey matter by dark spots of nonfluorescent nuclei encircled by cytoplasm-emitting two-photon excited fluorescence signals. Nerve fibres and neuroglias were observed in white matter. Besides, the spinal arteries were clearly presented by NLO microscopy. Using spectral and morphological information, this technique was proved to be an effective tool for label-freely imaging spinal cord tissues, based on endogenous signals in biological tissue. With future development, we foresee promising applications of the NLO technique for in vivo, real-time assessment of spinal cord diseases or injures.

Correlation between genetic susceptibility of tuberculosis and macrophage migration inhibitory factor.

This paper aims to study the relationship between genetic susceptibility of tuberculosis and macrophage migration inhibitory factor (MIF) and provide theoretical basis and foundation for further studies on pathogenesis and treatment of tuberculosis. Enzyme Linked Immuno Sorbent Assay (ELISA) was applied to detect the difference of MIF protein expression level in peripheral serum of the test subjects, and analyze the difference of MIF protein expression levels of different genotypes and alleles at -794CATT locus and -173G/C locus. The results showed that MIF protein expression level in serum of patients in the tuberculosis group was higher than that of the healthy control group (p < 0.05). The MIF protein expression level of genotype (5/5+5/6+6/6) and (7/X+8/X) at -794CATT locus of the tuberculosis group was higher than that of the healthy control group (p < 0.05), and MIF protein expression level of genotype GG and (GC+CC) at -173G/C locus of the tuberculosis group was higher than that of the healthy control group (p < 0.05). Therefore, macrophage migration inhibitory factor is an important cell factor which plays a regulating role in the immune system, as it can inhibit macrophage migration and promote the gathering, infiltration and proliferation of macrophages at inflammatory sites. Furthermore, it can secrete some cell factors which play a central role in immunological regulation.

Differentiating the extent of cartilage repair in rabbit ears using nonlinear optical microscopy.

Nonlinear optical microscopy (NLOM) was used as a noninvasive and label-free tool to detect and quantify the extent of the cartilage recovery. Two cartilage injury models were established in the outer ears of rabbits that created a different extent of cartilage recovery based on the presence or absence of the perichondrium. High-resolution NLOM images were used to measure cartilage repair, specifically through spectral analysis and image texture. In contrast to a wound lacking a perichondrium, wounds with intact perichondria demonstrated significantly larger TPEF signals from cells and matrix, coarser texture indicating the more deposition of type I collagen. Spectral analysis of cells and matrix can reveal the matrix properties and cell growth. In addition, texture analysis of NLOM images showed significant differences in the distribution of cells and matrix of repaired tissues with or without perichondrium. Specifically, the decay length of autocorrelation coefficient based on TPEF images is 11.2 ± 1.1 in Wound 2 (with perichondrium) and 7.5 ± 2.0 in Wound 1 (without perichondrium), indicating coarser image texture and faster growth of cells in repaired tissues with perichondrium (p < 0.05). Moreover, the decay length of autocorrelation coefficient based on collagen SHG images also showed significant difference between Wound 2 and 1 (16.2 ± 1.2 vs. 12.2 ± 2.1, p < 0.05), indicating coarser image texture and faster deposition of collagen in repaired tissues with perichondrium (Wound 2). These findings suggest that NLOM is an ideal tool for studying cartilage repair, with potential applications in clinical medicine. NLOM can capture macromolecular details and distinguish between different extents of cartilage repair without the need for labelling agents.

Correlation between culprit vessel/tirofiban and reperfusion bradyarrhythmia in patients with ST-segment elevation myocardial infarction after emergency PCI.

OBJECTIVE: To evaluate the correlation between culprit vessel/tirofiban and reperfusion bradyarrhythmia in patients with ST-segment elevation myocardial infarction (STEMI) after emergency percutaneous coronary intervention (PCI). PATIENTS AND METHODS: A total of 123 STEMI patients undergoing emergency PCI in our hospital from September 2018 to September 2019 were selected and divided into the reperfusion arrhythmias (RA) group (50 cases) and non-RA group (NRA, 73 cases) according to whether RA occurring during PCI. The baseline data such as age and underlying disease were statistically analyzed. Then, the differences were compared between the two groups. According to whether reperfusion bradyarrhythmia (RB) occurring during PCI, 123 STEMI patients were divided into the RB group (63 cases) and non-RB group (60 cases). The relation between culprit vessel/tirofiban and RB was analyzed. ROC curves analysis and multivariate logistic regression were conducted for the risk factors of RA and RB. RESULTS: Among 123 patients with STEMI after PCI treatment, 73 patients had RA (59.35%), including RB 63 cases and tachyarrhythmia 10 cases. Results of single factor analysis showed that there was statistical significance in 3 factors including the patient age, infarction area and vascular blood flow TIMI classification between RA group and NRA group (p<0.05). ROC curve analysis indicated that the continuous variable patent ages had predictive value in the prevalence of RA, which resulting in an AUC 0.624 and a cut-off pointed age 57 (sensitivity 72.60, specificity 52.00). Multivariate regression analysis showed that the patient age (>57 years old), infarction area in inferior wall and grade 0 lesion vascular blood flow TIMI classification in RA group was significantly higher than that in NRA group (p<0.05). Tirofiban was not associated with RB in STEMI patients treated with emergency PCI, while culprit vessel was statistically significant between RB group and NRB group (p<0.05). Multivariate regression analysis indicated that culprit vessel of the right coronary artery and grade 0 lesions vascular blood flowed TIMI classification was independent risk factors to occurring RB in the STEMI patients with emergency PCI. CONCLUSIONS: Tirofiban was not associated with RB in STEMI patients treated with emergency PCI. However, it may increase the risk of RB development when the culprit vessel is the right coronary artery. Therefore, timely corresponding treatments and reduction of reperfusion damage are of great significance for those patients.

Chitosan ducts fabricated by extrusion-based 3D printing for soft-tissue engineering.

Three kinds of methods based on extrusion and 3D printing and different acidic solutions (formic acid (FA), acetic acid (AA), glycolic acid (GA) and lactic acid (LA)) were applied for manufacturing the CS ducts. The tensile properties and preliminary cytotoxicity were measured for selecting the optimal ratio of CS slurry. The 3D printability of CS slurry was also studied. The tensile strength, Young's modulus, and fracture strain were tested for evaluating the degree of mechanical matching to soft-tissue. The optimal solvent to CS was 30 wt.% GA solution. The CS slurry possessing shear-thinning properties was suitable for 3D printing. The tensile strength, Young's modulus, and fracture strain of the CS rods were 10.98 ±â€¯0.61 MPa, 12.38 ±â€¯1.19 MPa, and 146.03 ±â€¯15.05 %, correspondingly. The CS ducts manufactured by 3D printing had an excellent mechanical matching to soft-tissue, outstanding biocompatibility and have great potential for soft-tissue restorations.

Shunt implantation in a special sub-group of post-traumatic hydrocephalus--patients have normal intracranial pressure without clinical representations of hydrocephalus.

BACKGROUND: Post-traumatic hydrocephalus (PTH) is a frequent complication secondary to traumatic brain injury (TBI) and controversy remains over whether to perform a shunt placement for patients with normal pressure hydrocephalus when the patient is too injured to display symptoms or has atypical symptoms. METHOD: A hospital-based retrospective study was performed in patients who developed normal pressure hydrocephalus, without atypical symptoms, from January 2004 to June 2007. Information regarding patients' demographics, TBI, hydrocephalus and outcome was collected. RESULTS: A total of 31 patients were involved in this study. At the 12-month follow-up, 20 patients (64.5%) showed clear improvement. Among the 10 patients who developed PTH after decompressive craniectomy, cranioplasty was performed after shunt implantation and clinical improvement was observed in nine patients. Additionally, in this series, the patients' age and the severity of hydrocephalus, assessed by CT imaging before shunt placement, significantly correlated with improvement. CONCLUSION: Although the effect was not definitively established, many patients in the sub-group of PTH patients described here would benefit from shunt placement, especially when they simultaneously have large cranial defects after surgical decompression and underwent cranioplasties after shunt placement. Additionally, younger patients and those with less severe hydrocephalus before shunt placement may expect a better outcome after shunt placement.

Classification and prediction of outcome in traumatic brain injury based on computed tomographic imaging.

Traumatic brain injury (TBI) is a common and potentially devastating problem. The classification of TBI is necessary for accurate diagnosis and the prediction of outcomes. The increased use of early sedation, intubation and ventilation in more severely injured patients has decreased the value of the Glasgow Coma Scale for the purposes of classification. An alternative is the classification of TBI according to morphological criteria based on computed tomography (CT) investigations. This article reviews the current classification and prediction of outcomes in TBI based on CT imaging. Classifications based on the presence or absence of intracranial local lesions, diffuse injury, signs of subarachnoid or intra-ventricular haemorrhage and fractures or foreign bodies are considered, and their predictive value is discussed. Future studies should address the complicated issue of how optimally to combine CT characteristics for prognostic purposes and how to improve on currently used CT classifications to predict outcomes more accurately.

Contralateral subdural effusion secondary to decompressive craniectomy performed in patients with severe traumatic brain injury: incidence, clinical presentations, treatment and outcome.

OBJECTIVE: This study was performed to better understand postoperative contralateral subdural effusion, an uncommon but serious complication secondary to decompressive craniectomy in patients with head trauma. SUBJECTS AND METHODS: Data from medical records of 169 patients who underwent decompressive craniectomy after head trauma between 2003 and 2006 were collected. The data included demographics, clinical presentations, treatment and outcome. RESULTS: Of the 169 patients, 11 (6.5%) had contralateral subdural effusion. On the average, this complication was found 14 days after decompressive craniectomy. Of the 11 patients, conservative treatment was effective in 7 with a gradual resolution which lasted 52.7 days on average. The effusion in the remaining 4 patients led to progressive deterioration of clinical presentation, and surgical intervention was necessary: subduroperitoneal shunting in 3 cases and burr hole drainage in the remaining 1 case. CONCLUSIONS: Our findings confirmed that postoperative contralateral subdural effusion was not an uncommon complication secondary to decompressive craniectomy. Most contralateral subdural effusions resolved spontaneously after conservative management, but surgical management may be necessary if the patients develop deteriorating clinical manifestations or the subdural effusion has an apparent mass effect.

Upregulation of circHIPK3 promotes the progression of gastric cancer via Wnt/ß-catenin pathway and indicates a poor prognosis.

OBJECTIVE: To elucidate the regulatory effect of circular RNA HIPK3 (circHIPK3) on the progression of gastric cancer (GC) by regulating the Wnt/ß-catenin pathway. We aim to reveal whether the abnormal expression of circHIPK3 could predict the poor prognosis of GC. PATIENTS AND METHODS: CircHIPK3 level in GC tissues and paracancerous tissues was determined by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). Its level in GC cell lines (BGC, MGC, SGC and MKN) and gastric mucosal cell line (GES) was examined as well. The correlation between the circHIPK3 level and overall survival of GC was analyzed by the Kaplan-Meier method. Regulatory effects of circHIPK3 on the proliferative ability of GC cells were evaluated by Cell Counting Kit-8 (CCK-8) and colony formation assay, respectively. Migratory changes influenced by circHIPK3 were explored through wound healing assay. The expression levels of relative genes in the Wnt/ß-catenin pathway were detected in GC cells with circHIPK3 knockdown. Finally, the Wnt/ß-catenin pathway inhibitor PNU-74654 was applied for detecting its influence on cellular behaviors of GC cells. RESULTS: CircHIPK3 level was higher in GC tissues relative to paracancerous tissues. Identically, its level was higher in GC cells compared with that of GES cells. The expression level of circHIPK3 was negatively correlated to the overall survival of GC patients. Silence of circHIPK3 weakened proliferative and migratory abilities of GC cells. In addition, circHIPK3 knockdown markedly downregulated levels of WNT1, TCF4 and ß-catenin. Application of PNU-74654 weakened the abilities of GC cells to proliferate and migrate. CONCLUSIONS: CircHIPK3 promotes GC cells to proliferate and migrate by regulating the Wnt/ß-catenin pathway. Upregulation of circHIPK3 indicates poor prognosis of GC patients.

Long non-coding RNA XIST promotes hepatocellular carcinoma progression by sponging miR-200b-3p.

OBJECTIVE: Recent studies have proved that long noncoding RNAs (lncRNAs) act as an important role in many diseases. In this research, lncRNA XIST was explored to identify how it functions in the development of hepatocellular carcinoma (HCC). PATIENTS AND METHODS: Real Time-quantitative Polymerase Chain Reaction (RT-qPCR) was utilized to detect XIST expression in HCC patients. Then, we conducted Cell Counting Kit-8 (CCK-8) assay and colony formation assays in vitro. Furthermore, mechanism assays and the interaction between XIST and miR-200b-3p were conducted. RESULTS: By comparing with XIST expression in adjacent tissues, the XIST expression level was significantly higher in HCC samples. Moreover, functional assays showed that the cell growth ability of HCC cells was inhibited after XIST was silenced in vitro, and tumor formation was inhibited after XIST was silenced in vivo. Further experiments showed that miR-200b-3p was directly targeted by XIST. CONCLUSIONS: Above results suggest that XIST could enhance the cell growth ability of HCC by targeting miR-200b-3p, which suggest that XIST may be a potential therapeutic target in HCC.

The prognostic relevance of preoperative transcatheter arterial chemoembolization (TACE) and PCNA/VEGF expression in patients with Wilms' tumour.

BACKGROUND: Wilms' tumour is the most frequent renal tumour in children. Based on the SIOP strategy, children with Wilms' tumour may benefit from preoperative chemotherapy, but few publications address the effect of preoperative transcatheter arterial chemoembolization (TACE) on patients with Wilms' tumours. The aims of this study were to investigate the prognostic relevance of preoperative TACE followed by tumour resection, proliferating cell nuclear antigen (PCNA) and vascular endothelial growth factor (VEGF) expression in patients with Wilms' tumours. MATERIALS AND METHODS: Two therapeutic strategies including tumour resection only and TACE, followed by tumour resection were conducted in a cohort of 44 patients with Wilms' tumours. Clinical and follow-up data was analysed. Immunohistochemistry staining was used to explore PCNA and VEGF expression in the Wilms' tumour. RESULTS: Two years tumour-free survival of the patients in the TACE group was significantly higher than that of the patients in the control group (P < 0.001) and recurrence and cases of death within one year in the TACE group was markedly lower than that in the control group (P < 0.001). Fifty-five percent of patients in the control group were PCNA-positive vs. 4.17% of patients in the TACE group (P < 0.001). Fifty percent of patients in the control group were VEGF-positive vs. 29.17% of patients in the TACE group (P > 0.05). CONCLUSIONS: Patients with Wilms' tumours benefited from preoperative TACE treatment. PCNA expression was significantly lower in patients in the TACE group than those in the control group. There was no significant difference on VEGF expression between the patients in TACE and control groups.

Surgical complications secondary to decompressive craniectomy in patients with a head injury: a series of 108 consecutive cases.

BACKGROUND: Decompressive craniectomy is an important method for managing refractory intracranial hypertension in patients with head injury. We reviewed a large series of patients who underwent this surgical procedure to establish the incidence and type of postoperative complications. METHODS: From 1998 to 2005, decompressive craniectomy was performed in 108 patients who suffered from a closed head injury. The incidence rates of complications secondary to decompressive craniectomy and risk factors for developing these complications were analysed. In addition, the relationship between outcome and clinical factors was analysed. FINDINGS: Twenty-five of the 108 patients died within the first month after surgical decompression. A lower GCS at admission seemed to be associated with a poorer outcome. Complications related to surgical decompression occurred in 54 of the 108 (50%) patients; of these, 28 (25.9%) patients developed more than one type of complication. Herniation through the cranial defect was the most frequent complication within 1 week and 1 month, and subdural effusion was another frequent complication during this period. After 1 month, the "syndrome of the trephined" and hydrocephalus were the most frequent complications. Older patients and/or those with more severe head trauma had a higher occurrence rate of complications. CONCLUSIONS: The potential benefits of decompressive craniectomy can be adversely affected by the occurrence of complications. Each complication secondary to surgical decompression had its own typical time window for occurrence. In addition, the severity of head injury was related to the development of a complication.

The correlation between cognitive impairment and ambulatory blood pressure in patients with cerebral small vessel disease.

OBJECTIVE: The present study was aimed to analyze the correlation between cognitive impairment and ambulatory blood pressure in patients with cerebral small vessel disease (CSVD). PATIENTS AND METHODS: 108 patients with CSVD received in our hospital were selected. Assessment of cognitive impairment was by the Montreal Cognitive Assessment (MoCA). 39 cases were established as the impairment group and 69 cases were established as the normal group. 24 h ambulatory blood pressure was monitored, and changes in ambulatory blood pressure parameters between the two groups were compared. Also, the correlation between blood pressure parameters and MoCA score were analyzed. RESULTS: Comparisons of ambulatory systolic blood pressure, ambulatory pulse pressure and the ratios of night blood pressure reduction of patients in both groups showed statistical differences (p < 0.05), while the changes in diastolic blood pressure showed no statistical differences (p > 0.05). The comparison of the blood pressure curves in both groups showed statistical differences (p < 0.05). The ambulatory systolic blood pressure, ambulatory pulse pressure and the ratio of night blood pressure reduction of patients with CSVD showed prominently negative correlations with MoCA score (p < 0.05). CONCLUSIONS: Cognitive impairment and the ambulatory blood pressure of patients with CSVD are intimately correlated. The rise of ambulatory systolic blood pressure, pulse pressure, and the decline of blood pressure may represent risk factors for cognitive impairment in patients with CSVD. Improving blood pressure management will reduce the incidence of cognitive impairment caused by CSVD.

Effects of selective brain cooling in patients with severe traumatic brain injury: a preliminary study.

We prospectively investigated non-invasive selective brain cooling (SBC) in patients with severe traumatic brain injury. Sixty-six in-patients were randomized into three groups. In one group, brain temperature was maintained at 33 - 35 degrees C by cooling the head and neck (SBC); in a second group, mild systemic hypothermia (MSH; rectal temperature 33 - 35 degrees C) was produced with a cooling blanket; and a control group was not exposed to hypothermia. Natural rewarming began after 3 days. Mean intracranial pressure 24, 48 or 72 h after injury was significantly lower in the SBC group than in the control group. Mean serum superoxide dismutase levels on Days 3 and 7 after injury in the SBC and MSH groups were significantly higher than in the control group. The percentage of patients with a good neurological outcome 2 years after injury was 72.7%, 57.1% and 34.8% in the SBC, MSH and control groups, respectively. Complications were managed without severe sequelae. Non-invasive SBC was safe and effective.

Enlargement of post-traumatic intracerebral haematoma: incidence and time course.

We retrospectively assessed the incidence and time course of enlargement in post-traumatic intracerebral haematoma (PTICH). Computed tomography (CT) scans from 165 patients who underwent a scan within 72 h and a repeat scan within 120 h of the onset of trauma were examined. A semi-automated method using region deformation-based segmentation was used to calculate the haematoma volume. The presence of haematoma enlargement was also determined based on a consensus by five observers. Seventy cases (42%) showed enlargement of the haematoma. The frequency of haematoma enlargement decreased as the interval between the onset of trauma and the initial scan increased. The discriminant value of the ratio of the haematoma volume in the second scan to that in the initial scan was ascertained, and the cut-off value for haematoma enlargement was determined to be 1.45. The radiographic criterion for enlargement in PTICH on CT scan was, therefore, defined as a > or = 1.45 times increase in haematoma volume.

Dormancy and germination: How does the crop seed decide?

Whether seeds germinate or maintain dormancy is decided upon through very intricate physiological processes. Correct timing of these processes is most important for the plants life cycle. If moist conditions are encountered, a low dormancy level causes pre-harvest sprouting in various crop species, such as wheat, corn and rice, this decreases crop yield and negatively impacts downstream industrial processing. In contrast, a deep level of seed dormancy prevents normal germination even under favourable conditions, resulting in a low emergence rate during agricultural production. Therefore, an optimal seed dormancy level is valuable for modern mechanised agricultural systems. Over the past several years, numerous studies have demonstrated that diverse endogenous and environmental factors regulate the balance between dormancy and germination, such as light, temperature, water status and bacteria in soil, and phytohormones such as ABA (abscisic acid) and GA (gibberellic acid). In this updated review, we highlight recent advances regarding the molecular mechanisms underlying regulation of seed dormancy and germination processes, including the external environmental and internal hormonal cues, and primarily focusing on the staple crop species. Furthermore, future challenges and research directions for developing a full understanding of crop seed dormancy and germination are also discussed.