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
Cerebral microbleed (CMB) is a type of cerebral small vessel disease (CSVD). Recently studies have found that there is a certain relationship between CMB and cognitive impairment. This article mainly reviews the etiology of CMB, the relationship between CMB and cognitive impairment, CMB and cognitive disorders and the possible mechanism of CMB-related cognitive impairment, in order to improve the understanding of cognitive impairment caused by CMB.
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 study the clinical characteristics and treatment of esophageal injury caused by button battery foreign bodies in children, then improve the diagnosis and management level of this hazardous problem of children. Methods 15 patients with esophageal injury caused by button battery foreign bodies were retrospectively analyzed the clinical characteristics, treatment and prognosis. Results 12 button battery foreign bodies were removed successfully with rigid esophagoscope, 3 with electronic gastroscope. 12 cases occurred serious esophageal lesions, 10 patients were fully recovered after nasal feeding, anti-inflammatory and supporting therapy. Serious complication such as esophageal perforation occurred in 2 cases, one of them occurred tracheo-esophageal fistula. Conclusion Button battery embedded in the esophagus is easy to cause serious esophagus injury, early detection is the key of the management, and its prompt removal is mandatory. Button battery have a distinctive appearance on radiography, chest radiographs can be used as the first choice of diagnosis. The reasonable treatment can obtain better curative results and avoid serious complications according to the course of the disease and esophageal damage degree. Physicians must recognize the hazardous potential and serious implications such as esophageal perforation and tracheo-esophageal fistula.
摘要
Objective To investigate the potential effects of Lactobacillus acidophilus strain L6 on prevention and treatment of Helicobacter pylori (H. pylori) infection in animal models. Methods A total of 200 hundred C57BL/6 mice were used in the study. ① Sixty mice were divided into control group (infected with H. pylori) and prevention group (previously treated with L6 and followed by infection with H. pylori) with 30 each. The incidence of H. pylori infection was compared between two groups.② Sixty mice were divided into control group (infected with H. pylori) and treatment group (infected with H. pylori for 4 weeks and followed by treatment with L6) with 30 each. Thechanges of H. pylori infection was compared between tow groups. ③ Eighty mice previously infected with H. pylori were orally administrated with L6 in the water supply over a period of 9 months. Of which, 40 H. pylori negative mice were either continuously or discontinuously treated with L6. The re-infection of H. pylori was compared between two groups. The H. pylori infection, gastric mucosal inflammatory and serum anti-H. pylori-lgG titer was measured by using urea breath test, histopathology and ELISA, respectively. Results The positive rate of H. pylori infection was 100% in control group and 20% in prevention group (pre-treated with L6 for 1 week). Whereas there was no H. pylori infection in the rest mice of prevention group pre-treated with L6 for 2 or 4 weeks. There was significant difference in H. pylori infection between two groups (P<0. 05).The serum anti-H. pylori IgG titer was lower in treatment group than in control group (P<0. 05).The reinfection of H. pylori in mice continuously treated with L6 was significantly lower than those discontiously treated with L6 (P<0. 05). Conclusions Preventively feeding L6 can significantly reduce the H. pylori infection in C57BL/6 mice, whereas the inhibition of H. pylori re-infection can also be achieved with long-term administration of L6.
摘要
Objective To analyze the synergistic effects between H.pyloriinfection and non-steroidal anti-inflammatory drugs use in peptic ulcer patients and upper gastrointestinal bleeding patients induced by peptic ulcer.Methods The peptic ulcer group consisted of 803 peptic ulcer patients,208 patients with gastrointestinal hemorrhage,and they were compared with 2 061 patients with non-peptic ulcer.Results H.pyloriinfection and NSAIDs use could increase the risk of peptic ulcer,and NSAIDs use in coordination with H.pyloriinfection in gastric ulcer morbility,but it's not significant coordination in the duodenal ulcer mortility.Pure NSAIDs use could increase the risk of bleeding gastric and duodenal ulcer,but pure H.pyloriinfection didn't increase the risk of bleeding peptic ulcer obviously,but the risk of bleeding peptic ulcer was not different in the patients of occasional,frequent and long-term NSAIDs use.Conclusion Detection of H.pyloriin the patients with long-term NSAIDs use is necessary,and eradication is needed in the patients infected with H.pylori.The NSAIDs use in peptic ulcer patients complicated with upper gastrointestinal bleeding should be payed attention and given timely treatment.