The value of serum albumin concentration in predicting functional outcome of status epilepticus: An observational study.

OBJECTIVE: Status epilepticus (SE) is a common neurological emergency with unsatisfying prognoses, and accurate prediction of functional outcome is beneficial in clinical decision-making. The relationship between serum albumin concentration and outcome of SE patients has yet to be unveiled. METHODS: Clinical profiles of SE patients admitted to Xiangya Hospital, Central South University, from April 2017 to November 2020, were analyzed retrospectively. Outcomes of SE patients at discharge were divided into two groups based on the modified Rankin Scale (mRS): favorable outcome (mRS: 0-3) and unfavorable outcome (mRS: 4-6). RESULTS: Fifty-one patients were enrolled. Unfavorable functional outcome at discharge was reported in 60.8% (31/51). Serum albumin concentration at admission and the Encephalitis-NCSE-Diazepam resistance-Image abnormalities-Tracheal intubation (END-IT) score remained independent predictors for functional outcome of SE patients. A lower albumin concentration at admission and higher END-IT score indicated a higher chance of unfavorable outcome for SE patients. The cut-off value of serum albumin to predict unfavorable outcome was 35.2 g/L, with a sensitivity of 67.7% and specificity of 85.0%, and an area under the receiver operating characteristic curve (ROC) of .738 (95% CI: .600-.876, p = .004). The preferable END-IT score with optimal sensitivity (74.2%) and specificity (60%) was 2 and the area under the ROC was .742, with 95% CI of .608-.876 (p = .004). SIGNIFICANCE: Serum albumin concentration at admission and the END-IT score are two independent predictive factors for short-term outcome of SE patients, moreover, the serum albumin concentration is not inferior to the END-IT score in indicating functional outcome at discharge.

Spectrum of neuroimaging findings in cryptococcal meningitis in immunocompetent patients in China - A series of 18 cases.

PURPOSE: Cryptococcosis is a devastating opportunistic disease commonly encountered in organ transplant recipients and patients with acquired immunodeficiency syndrome (AIDS). Few studies have profiled the disease in immunocompetent patients. We sought to characterize the neuroimaging findings of cryptococcal meningitis among immunocompetent patients in China. MATERIALS AND METHODS: Retrospective review of all patients diagnosed with cryptococcal meningitis at our institute, on the basis of CSF culture or India Ink test, between November 2011 and February 2016, was performed. Only apparently immunocompetent patients, for whom at least one brain MRI examination was performed, were included in the analysis. The MRI results were available for all these patients before CSF diagnosis. Data related to variables such as patient demographics, clinical features, neuroimaging characteristics and CSF findings were analyzed. RESULTS: Eighteen apparently immunocompetent patients, for whom brain MRI radiographs were available, were included in the analysis. Abnormal MRI findings were observed in 16 patients. These included multiple intraparenchymal lesions with or without enhancement, prominent basal ganglia involvement, miliary distribution of parenchymal nodules, multiple dilated Virchow-Robin spaces and leptomeningeal enhancement. Six patients had ventriculomegaly. CONCLUSION: In our study, intraparenchymal findings were more common than leptomeningeal enhancement and perivascular lesions. Cryptococcal meningitis should be considered in the differential diagnosis of immunocompetent patients with brain MRI findings of prominent parenchymal involvement such as bilateral patchy lesions in basal ganglia or miliary distribution of parenchymal nodules.

Tenuigenin attenuates α-synuclein-induced cytotoxicity by down-regulating polo-like kinase 3.

BACKGROUND AND AIMS: Tenuigenin (Ten) is a Chinese herbal extract with antioxidative and antiinflammatory effects on toxin-induced cell models of Parkinson's disease (PD); however, its effects on α-synuclein toxicity-based PD models remain unknown. α-synuclein hyperphosphorylation is a key event in PD pathogenesis and potential target of therapeutic interventions. We tested whether Ten alleviates α-synuclein-induced cytotoxicity via reducing kinases that phosphorylate α-synuclein. METHODS: SH-SY5Y cells transiently transfected with wild-type or A53T mutant α-synuclein were used to evaluate the effect of Ten on the levels of α-synuclein phosphorylation-related kinases. Cells treated with 10 µM Ten for 24 h were measured for viability (proliferation and apoptosis assays) and cellular proteins harvested and fractioned. The levels of total and phosphorylated α-synuclein and five associated kinases (polo-like kinase [PLK] 1-3, casein kinase [CK] 1-2) were evaluated by Western blotting. RESULTS: Overexpression of either wild-type or A53T mutant α-synuclein decreased cell viability and increased α-synuclein phosphorylation. Ten treatment-protected cells from this α-synuclein-induced toxicity and dramatically reduced α-synuclein phosphorylation and PLK3 (but not other kinase) levels. CONCLUSION: In α-synuclein cell model of PD, Ten is effective in attenuating α-synuclein-induced toxicity and α-synuclein phosphorylation probably via targeting PLK3, suggesting it could be an efficient therapeutic drug to treat α-synuclein-related neurodegeneration.

[Callus cultivation and determination of gentiopicroside from Gentiana macrophylla].

OBJECTIVE: To explore and improve the utilization efficiency of Gentiana macrophylla resources. METHODS: The germination of Gentiona macrophylla seeds were used as explants to induce calluses; Cultured on various culture media and condition for callus induction and subculture by test; The content of gentiopicroside in callus was determined by HPLC. RESULTS: The optimum medium for callus was MS +2,4-D (1.0 mg/L) + 6-BA (0.5 mg/L), and MS +2,4-D (1.0 mg/L) +6-BA (0.5 mg/L) + NAA (0.5 mg/L) was the optimum for subculture,the optimum time of subculture was 30 d; The accumulated gentiopicroside reached the highest level with 0.78 mg/g DW when entered 28-30 d. CONCLUSION: The optimized culture method of callus of Gentiana. macrophylla is obtained; The growth curve of callus of Gentiona macrophylla turns on "S" appearance and the accumulated gentiopicroside increases along with the callus appreciation.

[Fine mapping of a pure paroxysmal kinesigenic dyskinesia family].

OBJECTIVE: To fine map the gene responsible for pure paroxysmal kinesigenic dyskinesia in a Chinese family. METHODS: Six additional markers flanking the tightly linked markers were chosen in the candidate region resulting from a whole genome-wide scanning and tested by parameter and nonparameter analysis using Linkage and Genehunter softwares to fine map the candidate region. RESULTS: Evidence for linkage of the pure paroxysmal kinesigenic dyskinesia to chromosome 3 was further confirmed. A maximum two-lod score of 2.82 at theta=0 was obtained with D3S3669. Critical recombinants place the PKD gene between D3S1314 and D3S1265. CONCLUSION: A new locus of pure paroxysmal kinesigenic dyskinesia (PKD) is localized within a 10.2 cM interval on 3q28-29, between markers D3S1314 and D3S1265.

[Clinical features and prognosis of cerebral venous thrombosis].

OBJECTIVE: To explore the diagnosis,therapy and prognosis of cerebral venous thrombosis (CVT). METHODS: Twenty-two CVT patients were reviewed. The onset age, clinical manifestations, imaging, treatment, and prognosis were analyzed. RESULTS: Their age ranged from 15 to 58 (mean 33.0+/-8.8) years. Nine were males and 13 were females (1:1.4), 41% of whom were women of childbearing age.This disease occurred rapidly, and the relative pathogeny could be found in most patients (59%), and the hypercoagulative state was the commonest one.The clinical manifestations were variable. Most patients had symptoms and signs of intracranial hypertension(86%), accompanied with or without focal neurological dysfunction and seizures. Disorders of consciousness were found in some sever conditions.The cerebrospinal fluid (CSF) pressure was significantly increased, and the quantity of proteins or white blood cells in CSF was nearly normal.The occluded dural sinus and the clot could be visualised directly by means of magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA) or digital subtraction angiogrophy (DSA).After dehydration,anticoagulation,application of adrenal cortex hormone and etilogical treatment,9 patients improved,7 nearly cured, 2 had no changes,1 had cerebral hemorrhage, and 3 died. CONCLUSION: CVT should be suspected when patients show manifestation of intracranial hypertension and/or focal neurological dysfunction and seizures. MRI and MRA are efficient choices for the early diagnosis of CVT. Early diagnosis and anticoagulation with heparin are keys to good prognosis.