Research progress on cognitive dysfunction and brain gray matter areas changes in patients with obstructive sleep apnea hypopnea syndrome / 中华神经科杂志

Obstructive sleep apnea hypopnea syndrome (OSAHS) is a sleep breathing disorder caused by obstruction of the upper airway during sleep from various causes. At present, the diagnosis and treatment of OSAHS are insufficient. OSAHS causes cognitive decline due to excessive oxidative stress and inflammatory response caused by sleep breathing disorder, and its alteration of the brain gray matter area may be related to cognitive dysfunction. This review investigates the correlation between cognitive dysfunction and brain gray matter areas changes in OSAHS, and elucidates the underlying mechanisms, which provide a theoretical basis for early clinical diagnosis and treatment.

Research progress of white matter lesions in patients with obstructive sleep apnea hypopnea syndrome / 中华神经科杂志

White matter lesions in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) are common brain microstructural changes, the mechanism of which is still not clear, including decreased cerebral perfusion, oxidative stress, inflammatory damage, etc. At present, white matter lesions are mainly evaluated by magnetic resonance imaging. White matter lesions in patients with OSAHS are often manifested as cognitive dysfunction such as inattention, decreased executive ability and memory loss. Continuous positive airway pressure can relieve the white matter lesions and improve the cognitive function of some patients with OSAHS. Further study on the pathogenesis and early imaging characteristics of OSAHS white matter lesions is expected to provide targets and evidence for early intervention.

Effects of acute ammonia exposure on antioxidant and detoxification metabolism in clam Cyclina sinensis.

To investigate the defensive strategies of clam Cyclina sinensis in response to environmental ammonia exposure, we investigate the 96 h median lethal concentration (LC50-96 h) and the 96 h safe concentration (SC) of total ammonia nitrogen (TAN) for C. sinensis, and on the basis we examined glutamine synthetase (GS) activity, glutamine content, urea content and the antioxidant enzyme activities of super oxide dismutase (SOD) and catalase (CAT) in 96 h at three different levels of TAN as 0 (control), 73.94 (T1) and 227.04 mg/L (T2). Results showed that LC50-96 h and SC for C. sinensis were 65.79 and 6.58 mg/L, respectively. The LC50-96 h and SC of NH3 were 1.70 and 0.17 mg/L, respectively. Ammonia exposure had significantly effects on SOD and CAT activities in the hepatopancreas tissue. Both the level of SOD activity and CAT activity increased with increasing concentration of TAN. No significant differences between T1 and T2 were found in GS activity from 3 h to 96 h after exposed to ammonia, whereas they were significantly higher than those in the control. Both the level of glutamine content in T1 and T2 increased significantly from 6 h to 24 h after exposed to ammonia and they were significantly higher than those in the control. There were no significantly differences were found in the level of urea concentration between T1 and T2 from 6 h to 96 h, while they were significantly higher those in the control. In conclusion, enhancing hepatopancreas antioxidant responses as well as converting ammonia into glutamine and urea worked in combination to allow C. sinensi to defend against acute ammonia exposure.

Recent advance in pathogenesis of aquaporin-4 immunoglobulin G positive neuromyelitis optica spectrum disorder / 中华神经医学杂志

Neuromyelitis optica spectrum disorder (NMOSD) is a central nervous system inflammatory disease characterized by aquaporin-4 immunoglobulin G (AQP4-IgG). The core clinical manifestations include acute myelitis, optic neuritis and area postrema syndrome. AQP4-IgG-positive NMOSD patients have severe symptoms, frequent relapses, less complete recovery and early disability. In recent years, AQP4-IgG-positive NMOSD has gradually been recognized, but its exact mechanism is still unclear. This paper reviews the recent advance in pathogenesis of AQP4-IgG positive NMOSD.

Changes in serum inflammatory cytokine levels and intestinal flora in a self-healing dextran sodium sulfate-induced ulcerative colitis murine model.

AIMS: Whether dextran sodium sulfate (DSS)-induced ulcerative colitis (UC) animal models undergo self-healing remains unclear. Therefore, the study aim was to determine if these models have self-healing ability. MAIN METHODS: UC was induced using 4% DSS in male KM mice. Histopathological and inflammatory cytokine were evaluated. Fecal samples were analyzed by 16S rDNA gene sequencing. KEY FINDINGS: Physiological and inflammatory cytokine changed obviously on days 4-14 of establishment and returned to normal levels by day 21. The degrees of inflammation and injury in pathological sections decreased within 14 days compared with those on day 7. Interleukin (IL)-17A, IL-6, and C-reactive protein (CRP) levels fluctuated daily and were highest at 10 AM, 11 AM, and 8 PM, respectively. Intestinal flora disturbance was most obvious on days 7 and 14. The abundances of Lactobacillus and Alistipes decreased, whereas those of Streptococcus, Escherichia-Shigella, and Oscillibacter increased and mostly recovered by day 21. Lactobacillus and serum CRP level were negatively correlated with inflammation, whereas Streptococcus and Escherichia-Shigella were positively correlated with serum IL-6 level. SIGNIFICANCE: The DSS-induced UC murine model was shown to undergo self-healing. Intestinal flora disturbance in the model were obvious from days 4 to 14 and had mostly recovered by day 21.

Progress of the anoikis effector bcl-2 inhibitor of transcription 1 / 肿瘤研究与临床

bcl-2 inhibitor of transcription 1 (Bit1) is an anoikis effector that can play a role of caspase-independent apoptosis by down-regulating bcl-2 expression. Previous studies have found that Bit1 affects cell survival and apoptosis through Erk and FAK-PI3K-Akt-NF-κB pathways. It is worth noting that the expression of Bit1 has shown the obvious tumor specificity in different tumors, and it is closely related to TNM stage, differentiation and prognosis of the tumor. This review summarizes the expression, main mechanism, and significance of Bit1 in different tumors.

Risk factors for intracranial infection after external ventricular drainage by Logistic regression / 中国神经精神疾病杂志

Objective To investigate the risk factors for intracranial infection after external ventricular drainage and provide basis for preventing and controlling the drainage-associated intracranial infection. Metheds the clinical data from three hundred sixty-seven cases of ventricular hemorrhage patients were retrospectively analyzed, using Logis?tic regression to screen risk factors of intracranial infection after external ventricular drainage. Results There were 29 cases with intracranial infection and infection rate was 8.19%, 8.04% and 7.32% at ventricle drainage tube indwelling 1-week group, 2-week group and 3 week-group, respectively. Glasgow coma score (GCS) [OR= 2. 569 CI (1.792 3.378) %, P< 0.05), urokinase perfusion (OR= 2.897, 95%CI (1.297 5.061), P< 0.05), cerebrospinal fluid sampling (OR= 3.399, 95%CI (2.705 4.175), P< 0.01] and comorbidities [OR= 3.751, 95%CI (2.032 5.371), P< 0.01] were risk factors for ventricle drainage operation. Conclusion Ventricle drainage tube indwelling 3 weeks is safe. Less use of urokinase perfusion and cerebrospinal fluid sampling and active treatment of comorbidities diseases can reduce the intra?cranial infection incidence of external ventricular drainage after Intraventricular hemorrhage .

Investigation of Mild Hypothermia Treatment on Severe Traumatie Brain Injuries / 医学研究杂志

Objective To explore the prognosis of mild hypothermia treatment in cases of severe traumatic brain injuries(sTBI),improve the knowledge of mild hypothermia treatment on brain injuries.Methods Cases were divided into 2 groups:mild hypothermia treatment group and control group.Mild hypothermia was applied to the cases of sTBI in mild hypothermia group.The prognosis was divided into five grades such as good recovery(GR),moderate disability(MD),severe disability(SD),persisted vegetative state(PVS)and death(D).Results In mild hypothermia group,there were 20 GR cases,5 MD,2 SD and 3 D cases,while in control group,there were 14 GR cases,9 MD,4 SD and 3 D cases.Conclusion Mild hypothermia treatment can improve the prognosis of sTBI.

Leflunomide, a new disease-modifying drug for treating active rheumatoid arthritis in methotrexate-controlled phase II clinical trial / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of leflunomide in comparison with methotrexate (MTX) on patients with rheumatoid arthritis (RA) in China.</p><p><b>METHODS</b>Five hundred and sixty-six patients with active rheumatoid arthritis were randomly assigned to receive leflunomide at 20 mg once daily or MTX at 15 mg once weekly in a controlled trial. Five hundred and four patients completed the 12-week treatment and some patients continued the treatment for 24 weeks.</p><p><b>RESULTS</b>Both leflunomide and MTX could improve the symptoms, signs, and joint function, but there were no changes in X-ray observations of patients with rheumatoid arthritis. In the leflunomide group, the overall rates of effectiveness at 12 weeks and 24 weeks were 86.94% and 92.31% respectively; the rates of remarkable improvement were 64.95% and 79.81% respectively. In the MTX group, the overall rates of effectiveness at 12 weeks and 24 weeks were 84.04% and 83.15% respectively; the rates of remarkable improvement were 56.81% and 75.28% respectively. According to intent-to-treat analysis, the ACR 20% response rates at 12 weeks and 24 weeks in the leflunomide group were 62.54% and 67.18% respectively, compared with 60.08% and 61.32% respectively in MTX group. No statistical differences were shown in the efficacy between the two groups (P > 0.05). The adverse events in the leflunomide group were gastrointestinal symptoms, skin rash, alopecia, nervous system symptoms, decreased leukocyte count, and elevation of alanine aminotransferase (ALT). Most of these side effects were mild and transient. The incidence of adverse events in the leflunomide group was 16.84%, significantly lower than that in MTX group (28.17%, P = 0.002).</p><p><b>CONCLUSIONS</b>Leflunomide is effective in the treatment of RA with less adverse events than MTX. Its efficacy is similar to MTX, but the incidence of adverse events and the rate of withdrawal due to adverse events were lower in the leflunomide group than in MTX group.</p>