摘要
Objective:To analyze the clinical presentations and diagnostic and treatment process of one patient with autoimmune encephalitis(AE)with double positive anti-N-methyl-D-aspartate receptor(NMDAR)and anti-γ-aminobutyric acid B receptor(GABABR)secondary to herpes simplex virus encephalitis(HSVE),and to improve the clinicians'awareness of this disease.Methods:The clinical data of one AE patient with double positive anti-NMDAR and anti-GABABR secondary to HSVE were collected,the diagnostic and therapeutic processes were summarized,and the relevant literatures were reviewed.Results:The patient,a 36-year-old male,developed a headache followed by limb convulsions,and progressed to disturbed consciousness.After admission,the routine biochemistry of the cerebrospinal fluid(CSF)was abnormal,and the herpes simplex virus-1(HSV-1)IgG antibody showed positive in the CSF;both CSF and serum tests for NMDAR antibodies were positive;the head magnetic resonance imaging(MRI)results showed abnormal signals in the right occipital white matter,leading to the diagnosis of HSVE secondary to anti-NMDAR encephalitis.Several months later,the patient experienced psychiatric behavior abnormalities,cognitive dysfunction,and sleep disorders,and both the serum NMDAR and GABABR antibodies showed positive results,prompting the diagnosis of HSVE secondary anti-NMDAR encephalitis and anti-GABABR encephalitis.After treatment with steroid pulse therapy and intravenous immunoglobulin(IVIG),the patient's condition was improved and the patient was discharged.At one-year follow-up,the patient's psychiatric symptoms had completely resolved,leaving mild cognitive impairment.Conclusion:If the clinical symptoms of the patients recovering from antiviral treatment for HSVE is worsened,secondary AE should be highly suspected;it is important to complete autoimmunity antibody testing as soon as possible for the early diagnosis and treatment to improve the prognosis of the patient.
摘要
OBJECTIVE To study the improvement effect and possible mechanism of N-butylphthalide on inflammatory injury of bone marrow mesenchymal stem cells （BMSCs） in rats. METHODS BMSCs of rats were divided into control group， model group， N-butylphthalide low-concentration， medium-concentration and high-concentration groups （10， 20， 50 μmol/L）. BMSCs were cultured in vitro and lipopolysaccharide （the final concentration of 10 mg/L） was used to establish the inflammatory injury model. After the intervention of N-butylphthalide， the survival rate， apoptotic rate， the contents of tumor necrosis factor α （TNF- α）， interleukin 1β （IL-1β） and IL-6 in cell culture medium， the mRNA expression of nuclear factor-κB（NF-κB） p65， and the protein expressions of caspase-3， B-cell lymphoma 2 （Bcl-2）， Bcl-2 related X protein （Bax） and NF-κB p65 in cells were detected. RESULTS Compared with control group， the survival rate and protein expression of Bcl-2 were decreased significantly in model group （P＜0.05）； the apoptotic rate， contents of TNF-α， IL-1β and IL-6， the mRNA expression of NF-κB p65， and the protein expressions of caspase-3， Bax and NF-κB p65 were increased significantly （P＜0.05）. Compared with model group， above indexes were significantly reversed in all concentration groups of N-butylphthalide （P＜0.05）， in concentration-dependent manner. CONCLUSIONS N-butylphthalide can ameliorate the inflammatory injury of BMSCs induced by lipopolysaccharide， and its mechanism may be related to the inhibition of NF-κB signaling pathway.
摘要
Objective To analyze the clinical features, laboratory findings, electroencephalography (EEG) and neuroimaging of the neurosyphilis presented with parkinsonism as the principal manifestation to improve the diagnosis of neurosyphilis. Methods Eight eurosyphilis patients were from department of neurology of Hainan provincial people’s hospital from early July 2010 to December 2014. We retrospectively analyzed the clinical manifestation, laboratory exami?nations, neuroimaging examinations, diagnosis and treatment outcomes of 8 cases neurosyphilis who presented with par?kinsonism as principal manifestation. Results Myotonia and bradykinesia were principal symptoms in these 8 cases. Limb tremor, posture disorder, abnormal mental behavior and cognitive impairment occurred in some patients. Serum treponema pallidum particle agglutination (TPPA) and toluidine red untreated serum test (TRUST)were positive in 8 cas?es. Cerebrospinal fluid (CSF) protein and cell counts were elevated in all the patients. CSF-TPPA and TRUST were posi?tive in all the patients. The MRI showed that cerebral infarction in basal ganglia, cerebral atrophy in temporal lobe and hippocampus and ventricular enlargement in all the patients. EEG showed abnormal activity in all the patients. After treatment with a large dose of penicillin, clinical symptoms were obviously improved;the titer of serum and CSF TRUST decreased;and scores of UPDRS decreased in all the patients. Conclusions There is a wide variation in the clinical man?ifestation of the neurosyphilis. When patients present with Parkinsonism, we should comprehensively analyze the laborato?ry examinations, EEG and neuroimaging to rule out the possibility of neurosyphilis.
摘要
Objective To investigate the effect of nuclear-transcription factor-κB signal transduction pathway on differentiation of rat marrow mesenchymal stem cells (MSCs) into neurons.Methods The MSCs were purified at least four generations in vitro.And then,the MSCs were assigned into three groups:non-serum control group (group A),fasudil treatment group (group B) and fasudil and lipopolysaccharide treatment group (group C).Cells in group A were added serum-free DMEM,those in group B were added induced liquid (DMEM 900 μL+fetal bovine serum 100 μL that contains final concentration of 200 μmol/L of fasudil),and those in group C were added induced liquid (DMEM 900 μL+fetal bovine serum 100 μL that contains final concentration of 200 μmol/1 of fasudil and final concentration of 1000 μg/L of lipopolysaccharide).All the MSCs were induced into neurons for 6 h.The morphology of MSCs was observed under inverted fluorescence microscope.The expressions of neuronspecific enolase (NSE),microtubule-associated protein (MAP)-2,cyclin D1 and glial fibrillary acidic protein (GFAP) in neurons were detected by immunocytochemical method.The mRNA expressions ofcyclin D1 and MA P-2 in neurons were detected by real time-PCR.The protein expressions ofcyclin D1 and MAP-2 were detected by Western blotting.Results (1) The MSCs of group A kept flat and the neurites were scarce;the MSCs of group B and C could differentiate into neurons,and the speed of MSCs of group B differentiating into neurons was faster than that in group C;there was typical neural network in group B and the neural network in group C was scarcer than group B.(2) As compared with those in group A,higher expression levels of NSE and MAP-2,and lower cyclin D1 expression level in group B and group C were noted (P＜0.05);the expression percentage of GFAP was lower than 1％ in both three groups.(3) As compared with group A,group B and group C had significantly lower cyclin D1 protein and mRNA expressions and significantly higher MAP-2 protein and mRNA expressions (P＜0.05).Conclusion The NF-κB signal transduction pathway,by regulating the expression of cyclin D1,participates in the neuronal differentiation of rat marrow mesenchymal stem cells induced by fasudil.