Adults with severe Japanese encephalitis: a retrospective analysis of 9 cases in Linyi, China.

OBJECTIVE: Japanese encephalitis (JE) is a critical problem of public health worldwide; however, there is limited data about the clinical features and indicators of outcome in adults with severe Japanese encephalitis. METHODS: The clinical manifestations and laboratory study on brain neuroimaging of patients with severe JE were statistically analyzed retrospectively. All patients were followed up for 6 months after discharge. The patients were grouped into good outcome and poor outcome according to the results of the follow-up. RESULTS: This retrospective study consists of 9 adults with severe JE, including 5 cases with poor outcome, defined as the modified Rankin Scale (mRS) scores of greater than or equal to 4 points, and remained ventilator dependent. Typical clinical manifestations of JE include fever (100%), altered consciousness (100%), headache (66.7%), flaccid weakness (66.7%), and status epilepticus (44.4%). Serological examination revealed that a higher percentage of neutrophils and a lower percentage of lymphocytes at admission may be associated with a poor outcome. Abnormal neuroimaging of the thalamus (85.7%), hippocampal (71.4%), midbrain (28.6%), and basal ganglia (14.3%) was found. 42.9% of patients left severe irreversible disability, and the most prominent were mental symptoms (71.4%) and memory or understanding disorder (57.1%). CONCLUSION: Our data suggest that respiratory failure is one of the important causes of early death. Serologic examination, coma, and status epilepticus may indicate a poor outcome for severe JE. Additionally, the hippocampus is the second most common lesion in the adults with severe JE. A large-scale clinical trial is required to further confirm these conclusions.

Highly Porous Microcarriers for Minimally Invasive In Situ Skeletal Muscle Cell Delivery.

Microscale cell carriers have recently garnered enormous interest in repairing tissue defects by avoiding substantial open surgeries using implants for tissue regeneration. In this study, the highly open porous microspheres (HOPMs) are fabricated using a microfluidic technique for harboring proliferating skeletal myoblasts and evaluating their feasibility toward cell delivery application in situ. These biocompatible HOPMs with particle sizes of 280-370 µm possess open pores of 10-80 µm and interconnected paths. Such structure of the HOPMs conveniently provide a favorable microenvironment, where the cells are closely arranged in elongated shapes with the deposited extracellular matrix, facilitating cell adhesion and proliferation, as well as augmented myogenic differentiation. Furthermore, in vivo results in mice confirm improved cell retention and vascularization, as well as partial myoblast differentiation. These modular cell-laden microcarriers potentially allow for in situ tissue construction after minimally invasive delivery providing a convenient means for regeneration medicine.

Alterations of Hippocampal Myelin Sheath and Axon Sprouting by Status Convulsion and Regulating Lingo-1 Expression with RNA Interference in Immature and Adult Rats.

Seizure-induced brain damage is age-dependent, as evidenced by the different alterations of neural physiopathology in developing and mature brains. However, little is known about the age-dependent characteristics of myelinated fiber injury induced by seizures. Considering the critical functions of oligodendrocyte progenitor cells (OPCs) in myelination and Lingo-1 signaling in regulating OPCs' differentiation, the present study aimed to explore the effects of Lingo-1 on myelin and axon in immature and adult rats after status convulsion (SC) induced by lithium-pilocarpine, and the differences between immature and adult brains. Dynamic variations in electrophysiological activity and spontaneous recurrent seizures were recorded by electroencephalogram monitoring after SC. The impaired microstructures of myelin sheaths and decrease in myelin basic protein caused by SC were observed through transmission electron microscopy and western blot analysis respectively, which became more severe in adult rats, but improved gradually in immature rats. Aberrant axon sprouting occurred in adult rats, which was more prominent than in immature rats, as shown by a Timm stain. This damage was improved or negatively affected after down or upregulating Lingo-1 expression. These results demonstrated that in both immature and adult brains, Lingo-1 signaling plays important roles in seizure-induced damage to myelin sheaths and axon growth. The plasticity of the developing brain may provide a potential window of opportunity to prevent the brain from damage.

Design and Development of a Novel Chalcone Derivative as an Anticholinesterase Inhibitor for Possible Treatment of Dementia.

BACKGROUND Cognitive decline (e.g., memory loss), which mainly occurs in the elderly, is termed dementia. In the present study, we intended to explore the cholinesterase inhibitory activity of some novel synthesized chalcones, together with their effect on ß-amyloid anti-aggregation. MATERIAL AND METHODS A novel class of chalcone derivatives have been synthesized and characterized by FT-IR, ¹H-NMR, ¹³C-NMR, and mass and elemental analysis. These derivatives were later used for the determination of acetylcholinesterase (AChE) inhibitory and b-amyloid anti-aggregation activity. RESULTS The results of the study showed that among the developed compounds, 8g inhibits AChE more prominently than BuChE, as suggested by a selectivity index (SI) of 2.88. Furthermore, the most potent compound, 8g, showed considerable action in inhibition of ß-secretase and Aß aggregation, but not as prominent as that of curcumin as a standard. CONCLUSIONS In conclusion, our study revealed a novel class of chalcone derivatives as a selective inhibitor of AChE with considerably action against ß-secretase and Aß aggregation. Our results may be useful in developing AD drug therapy and warrant further investigation to generate more advanced analogues.

Estradiol prevents Aß 25 35-inhibited long-term potentiation induction through enhancing survival of newborn neurons in the dentate gyrus.

AIM AND METHODS: Estradiol (E2) is reported to attenuate ß-amyloid (Aß) accumulation and slow the progression of Alzheimer's disease (AD). This study explored the beneficial effect of E2 in AD using histological examination and electrophysiological recording technique in AD model mice created by intracerebroventricular injection of ß-amyloid 25-35 (Aß 25-35). RESULTS: Infusion of Aß 25-35 reduced the number of newborn neurons in the 2nd week after birth, a critical period for neurite growth, and impaired high-frequency stimulation-dependent long-term potentiation (LTP) induction in perforant path-granular synapses of hippocampal dentate gyrus (DG). Administration of E2 from the 2nd to 4th week after cell birth in Aß 25-35-mice ameliorated the impairment of newborn neurons and LTP induction in DG. Acute application of E2 failed to increase the newborn neurons and rescue LTP induction in the DG of Aß 25-35-mice. CONCLUSIONS: The effect of E2 in Aß 25-35-impaired LTP induction depends on its neuroprotection improvement.

[Clinical features of childhood purulent meningitis caused by Escherichia coli and Streptococcus pneumoniae: a comparative analysis].

OBJECTIVE: To investigate the differences in clinical features of childhood purulent meningitis (PM) caused by Escherichia coli and Streptococcus pneumoniae, and to provide help for the selection of antibiotics for PM children with unknown etiology. METHODS: A retrospective analysis was performed for the clinical data of children with PM caused by Escherichia coli (12 children) or Streptococcus pneumoniae (15 children). RESULTS: Compared with the Streptococcus pneumoniae infection group, the Escherichia coli infection group had a significantly higher proportion of children with an age of onset of <3 months and a significantly higher incidence rate of convulsion, but significantly lower incidence rates of severe fever (>39°C) and disturbance of consciousness and a significantly lower proportion of children with an increased leukocyte count at diagnosis (>12×10(9)/L). The results of routine cerebrospinal fluid test and biochemical examinations showed no significant differences between the two groups. Escherichia coli and Streptococcus pneumoniae were resistant to cephalosporins and had a sensitivity to chloramphenicol more than 90%. Escherichia coli was fully sensitive to meropenem and Streptococcus pneumoniae was fully sensitive to vancomycin. CONCLUSIONS: PM caused by Escherichia coli and Streptococcus pneumoniae has different clinical features. As for PM children with severe fever, disturbance of consciousness, and an increased leukocyte count, the probability of Streptococcus pneumoniae infection should be considered. For PM children with an age of onset of <3 months, medium- and low-grade fever, frequent convulsions, and a leukocyte count of <12×10(9)/L, the probability of Escherichia coli infection should be considered.

Multi-functional thermosensitive composite microspheres with high magnetic susceptibility based on magnetite colloidal nanoparticle clusters.

Monodisperse organic/inorganic composite microspheres with well-defined structure were prepared through the encapsulation of silica coated superparamagnetic magnetite colloidal nanoparticle clusters (CNCs) with cross-linked poly(N-isopropylacrylamide) (PNIPAM) shell. At first, the sub-micrometer-sized CNCs were fabricated by the solvothermal process, and then a silica layer was coated on the surface of CNCs through a sol-gel process, and finally, a thermoresponsive shell of PNIPAM was deposited onto the surface of the core/shell magnetic microspheres by a precipitation polymerization. The experimental results showed that the size of Fe(3)O(4) core, the thickness of SiO(2) shell, as well as volume phase transition temperature (VPTT) of PNIPAM shell could be well controlled, and this structured modulation could satisfy different requirements. The superparamagnetic behavior, high magnetization (the saturation magnetization of Fe(3)O(4)/SiO(2)/PNIPAM microspheres with a 10% cross-linking density is 41.6 emu/g), and good thermosensitivity make these composite microspheres an ideal candidate for various important applications such as in controlled drug delivery, bioseparation, and catalysis.

A novel germline PIGA mutation causes early-onset epileptic encephalopathies in Chinese monozygotic twins.

We report a case of 14-month-old male monozygotic twins showing early-onset intractable epilepsy, delayed psychomotor development, hypotonia, opisthotonus, and dysmorphism. They presented with refractory partial and secondary generalized tonic-clonic or myoclonic seizures since age of 6 months. Electroencephalograms mainly revealed fast activity in left occipital region and generalized high amplitude polyspikes and wave. Brain MRI was normal. A de novo germline hemizygous mutation, C.110 T > C (p.37 M > T), in exon 2 of PIGA was confirmed, which indicated that a novel germline mutation in PIGA leads to early-onset epileptic encephalopathies.

Risk Factors for Strangulated Ovarian Hernia in Female Infants: the Role of Ovarian Volume.

The risk factors associated with strangulated ovarian hernia (SOH) in female patients (<1 year old) were identified. A retrospective analysis was conducted regarding the data from 2006 to 2017. The patients were divided into 2 groups: SOH group (n=9) and non-SOH group (n=23). Patient demographics, clinical signs, preoperative examinations and intraoperative findings were compared between the two groups, and risk factors for SOH were tested using a binary logistic regression model. To explore whether greater ovary was more likely to be twisted, leading to SOH, all the patients were divided into ovary volume <5 cm3 and ≥5 cm3 groups and the association between ovarian volume and ovary torsion was assessed. Among a total of 32 female patients (<1 year old) with incarcerated ovarian herniation, 9 patients developed SOH. The single variate analysis revealed that times of manual reduction, ovarian volume, ovary with or without multiple cysts, ovary torsion or not and angle of ovary torsion were found to be significant factors associated with SOH. The multivariate analysis showed ovarian volume was evidenced as an independent risk factor for SOH. Furthermore, the incidence of ovary torsion was significantly higher in ovarian volume ≥5 cm3 group than in ovarian volume <5 cm3 group, indicating that larger ovary was more likely to result in ovary torsion, leading to SOH. Our study demonstrated that the odds of SOH increased with increasing ovarian volume in female patients (<1 year old) because the relatively greater ovary at this age was more likely to be incarcerated and twisted, leading to SOH.

[Study on photocatalytic decomposition of azo-dyes by ZnO/carbon nanotubes composites by UV-Vis spectroscopy].

ZnO/carbon nanotubes composites were prepared by hydrothermal treatment of the mixture of zinc nitrate and acid-treated multiwalled carbon nanotubes and characterized by transmission electron microscope (TEM) and X-ray powder diffraction (XRD). The TEM image indicated that ZnO nanoparticles with a diameter about 28 nm covered the carbon nanotubes. The XRD pattern shows that ZnO nanoparticles attached to the MWNTs exhibit a hexagonal phase. The diffraction peaks can be assigned to (100), (002), (101), (102), (110), (103), (200), (112) and (201) planes of the crystalline ZnO, respectively. The average size of the crystalline ZnO, calculated from the half-width of the (100) diffraction peak by the Scherrer equation, is 27.8 nm, which accords with the TEM observation. The ZnO/carbon nanotubes composites were used as a photocatalyst under sunlight for the decomposition of azo-dye, which was studied by UV-Vis spectroscopy. The effects of the illumination time, catalyst amount, initial dye concentration and the different structures of the dye on the photocatalytic process were investigated. It was noted that the intensity of the absorption peak corresponding to the azo-dye decreased rapidly at 400 nm during the photolysis process and the decomposition of azo-dye was a quasi-first order reaction. The decomposition rates for azo-dyes such as acid orange, Acid bright red, Acid light yellow are 0.09, 0.28 and 0.22 mg x L(-1) x min(-1), respectively, which maybe resulted from their different functional groups. It can be stated that the complete removal of color, after selection of optimum operation parameters, can be achieved in relatively short time by using ZnO/carbon nanotubes composites. After recycling 5 times, the catalyst still has more than 50% efficiency.

[Clinical effects of combination chemotherapy with irinotecan hydrochloride and cisplatin on cervical cancer: study of 46 patients].

OBJECTIVE: To evaluate the efficacy and toxicity of the combination chemotherapy of irinotecan hydrochloride plus cisplatin on cervical cancer. METHODS: Forty-six patients with cervical cancer, 43 with squamous cell carcinoma, 2 adenocarcinoma, and 1 small cell carcinoma, 41 being treated initially and 5 being recurrent cases of which 2 had undergone radiotherapy plus chemotherapy, 2 radical hysterectomy plus pelvic radiotherapy after operation, and 1 radical hysterectomy plus chemotherapy, aged 38 (22-61), were treated with irinotecan hydrochloride, 60 mg/m(2) in 250 ml normal saline administered on days 1, 8, and 15 by intravenous infusion over 60 min, plus cisplatin, 60 mg/m(2) in 500 ml 5% glucose given on day 1. This regimen was repeated every 28 days. Effectiveness evaluation was conducted after 1-2 courses for the initially treated patients and after 2-6 courses for the recurrent patients. RESULTS: Totally 79 courses of treatment were given to the 41 patients. After 1-2 courses 4 (9.8%) of the 41 stage Ib2-IIIb initially treated patients achieved complete remission, 30 (73.2%) achieved partial remission, and 7 (17.1%) remained at stationary phase with a overall effective rate of 82.9%. Of the 29 IIb and IIIb stage advanced patients who failed to receive operation originally 20 patients (69%) succeeded to be treated by radical hysterectomy after 1 to 2 courses when the tumorless space between the uterine and the pelvic wall > or = 3 cm with an operatibility rate of 69%. Of the 5 recurrent patients 1 case achieved complete remission, 2 partial remission, and 2 remained stable; none progression of disease was observed after 4-6 courses. The main toxic response and side effect included myelosuppression and diarrhea. CONCLUSION: Effective neoadjuvant chemotherapy on cervical cancer, combination therapy of irinotecan hydrochloride and cisplatin win opportunity for treatment and improves their life quality with tolerable side effects.

Establishing a Nomogram for Stage IA-IIB Cervical Cancer Patients after Complete Resection.

BACKGROUND: This study aimed to establish a nomogram by combining clinicopathologic factors with overall survival of stage IA-IIB cervical cancer patients after complete resection with pelvic lymphadenectomy. MATERIALS AND METHODS: This nomogram was based on a retrospective study on 1,563 stage IA-IIB cervical cancer patients who underwent complete resection and lymphadenectomy from 2002 to 2008. The nomogram was constructed based on multivariate analysis using Cox proportional hazard regression. The accuracy and discriminative ability of the nomogram were measured by concordance index (C-index) and calibration curve. RESULTS: Multivariate analysis identified lymph node metastasis (LNM), lymph-vascular space invasion (LVSI), stromal invasion, parametrial invasion, tumor diameter and histology as independent prognostic factors associated with cervical cancer survival. These factors were selected for construction of the nomogram. The C-index of the nomogram was 0.71 (95% CI, 0.65 to 0.77), and calibration of the nomogram showed good agreement between the 5-year predicted survival and the actual observation. CONCLUSIONS: We developed a nomogram predicting 5-year overall survival of surgically treated stage IA-IIB cervical cancer patients. More comprehensive information that is provided by this nomogram could provide further insight into personalized therapy selection.