Recurrent CNTN1 antibody-positive nodopathy: a case report and literature review.

Background: Contactin-1 (CNTN1) antibody-positive nodopathy is rare and exhibits distinct clinical symptoms such as tremors and ataxia. However, the mechanisms of these symptoms and the characteristics of the cerebral spinal fluid (CSF) remain unknown. Case presentation: Here, we report a case of recurrent CNTN1 antibody-positive nodopathy. Initially, a 45-year-old woman experiencing numbness in the upper limbs and weakness in the lower limbs was diagnosed with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Eleven years later, her symptoms worsened, and she began to experience tremors and ataxia. Tests for serum CNTN1, GT1a, and GQ1b antibodies returned positive. Subsequently, she was diagnosed with CNTN1 antibody-positive nodopathy and underwent plasmapheresis therapy, although the treatment's efficacy was limited. To gain a deeper understanding of the disease, we conducted a comprehensive literature review, identifying 52 cases of CNTN1 antibody-positive nodopathy to date, with a tremor prevalence of 26.9%. Additionally, we found that the average CSF protein level in CNTN1 antibody-positive nodopathy was 2.57 g/L, with 87% of patients exhibiting a CSF protein level above 1.5 g/L. Conclusion: We present a rare case of recurrent CNTN1 antibody-positive nodopathy. Our findings indicate a high prevalence of tremor (26.9%) and elevated CSF protein levels among patients with CNTN1 antibody-positive nodopathy.

Risk factors of neuropathic pain in multiple sclerosis: a retrospective case-cohort study.

Background: Pain is a common symptom in multiple sclerosis (MS), especially neuropathic pain, which has a significant impact on patients' mental and physical health and quality of life. However, risk factors that related to neuropathic pain, still remain unclear. Objective: The study aimed to explore the risk factors of neuropathic pain among MS patients. Materials and methods: This retrospective study examined the consecutive patients diagnosed with MS in the Department of Neurology of Guangdong Provincial Hospital of Chinese Medicine between August 2011 and October 2022. Neuropathic pain was defined as "pain arising as a direct consequence of a lesion or disease affecting the somatosensory system". Demographic and clinical features were obtained from the electronic system of the hospital. Results: Our cohort revealed that the prevalence of patients with neuropathic pain in MS was 34.1%. The results indicated that the longer the spinal lesions, the greater the neuropathic pain risks (2-4: OR, 13.3(2.1-82), >5: OR, 15.2(2.7-86.8), p for tread: 0.037). Meanwhile, multivariate regression analysis showed that cervical and thoracic lesions (OR 4.276, 95% CI 1.366-13.382, P = 0.013), upper thoracic lesions (T1-T6) (OR 3.047, 95% CI 1.018-9.124, P = 0.046) were positively correlated with neuropathic pain, while basal ganglia lesions (OR 0.188, 95% CI 0.044-0.809, P = 0.025) were negatively correlated with neuropathic pain among MS patients. Conclusion: Extended spinal lesions (≥3 spinal lesions), cervical and thoracic lesions, upper thoracic lesions were independent risk factors of neuropathic pain among MS patients. Furthermore, our study found that the longer the spinal lesions, the greater the neuropathic pain risks.

A meaningful exploration of ofatumumab in refractory NMOSD: a case report.

Objective: To report the case of a patient with refractory neuromyelitis optica spectrum disorder (NMOSD), who, despite showing poor response or intolerance to multiple immunosuppressants, was successfully treated with Ofatumumab. Case presentation: A 42-year-old female was diagnosed with NMOSD in the first episode of the disease. Despite treatment with intravenous methylprednisolone, immunoglobulin, rituximab and immunoadsorption, together with oral steroids, azathioprine, mycophenolate mofetil and tacrolimus, she underwent various adverse events, such as abnormal liver function, repeated infections, fever, rashes, hemorrhagic shock, etc., and experienced five relapses over the ensuing four years. Finally, clinicians decided to initiate Ofatumumab to control the disease. The patient received 9 doses of Ofatumumab over the next 10 months at customized intervals. Her symptoms were stable and there was no recurrence or any adverse events. Conclusion: Ofatumumab might serve as an effective and safe alternative for NMOSD patients who are resistant to other current immunotherapies.

An Effective Electrochemical Platform for Chloramphenicol Detection Based on Carbon-Doped Boron Nitride Nanosheets.

Currently, accurate quantification of antibiotics is a prerequisite for health care and environmental governance. The present work demonstrated a novel and effective electrochemical strategy for chloramphenicol (CAP) detection using carbon-doped hexagonal boron nitride (C-BN) as the sensing medium. The C-BN nanosheets were synthesized by a molten-salt method and fully characterized using various techniques. The electrochemical performances of C-BN nanosheets were studied using cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS). The results showed that the electrocatalytic activity of h-BN was significantly enhanced by carbon doping. Carbon doping can provide abundant active sites and improve electrical conductivity. Therefore, a C-BN-modified glassy carbon electrode (C-BN/GCE) was employed to determine CAP by differential pulse voltammetry (DPV). The sensor showed convincing analytical performance, such as a wide concentration range (0.1 µM-200 µM, 200 µM-700 µM) and low limit of detection (LOD, 0.035 µM). In addition, the proposed method had high selectivity and desired stability, and can be applied for CAP detection in actual samples. It is believed that defect-engineered h-BN nanomaterials possess a wide range of applications in electrochemical sensors.

Gut microbiota as predictors of the occurrence of high on-treatment platelet reactivity in acute ischemic stroke patients.

Introduction: In this study, we aimed to investigate the association between gut microbiota and high on-treatment platelet reactivity (HTPR) in patients with acute ischemic stroke (AIS). Methods: We enrolled a total of 48 AIS patients, including 19 HTPR patients and 29 non-high on-treatment platelet reactivity (NHTPR) patients, along with 10 healthy controls. Clinical and laboratory data, as well as stool samples, were collected from all participants. The composition and function of gut microbiota were assessed using 16S rRNA sequencing. Differences in the gut microbiota between the two groups were analyzed, and a diagnostic model based on the gut microbiota was established using random forest model. Results: HTPR patients exhibited a decreased microbial richness compared to NHTPR patients. Additionally, the relative abundance of unidentified_Clostridia and Ralstonia was lower in HTPR patients. Significant differences in biological functions, such as toxoplasmosis, were observed between the two groups. The combination of Ralstonia, unidentified-Clostridia, Mailhella, Anaerofustis, and Aggregatibacter showed excellent predictive ability for HTPR occurrence (AUC=0.896). When comparing AIS patients with healthy controls, alterations in the microbiota structure were observed in AIS patients, with imbalances in short-chain fatty acid-producing bacteria and pathogenic bacteria. Significant differences in biological functions, such as oxidative phosphorylation, were noted between the two groups. The combination of Alloprevotella, Terrisporobacter, Streptococcus, Proteus, and unidentified_Bacteria exhibited strong predictive power for AIS occurrence (AUC=0.994). Conclusions: This study is the first to uncover the microbial characteristics of HTPR in AIS patients and demonstrate the predictive potential of specific bacterial combinations for HTPR occurrence.

The risk factors of neuropathic pain in neuromyelitis optica spectrum disorder: a retrospective case-cohort study.

BACKGROUND: Neuropathic pain is a common complication in neuromyelitis optica spectrum disorder (NMOSD), which seriously affects the quality of life of NMOSD patients, with no satisfactory treatment. And risk factors of neuropathic pain are still uncertain. OBJECTIVE: To investigate the risk factors of neuropathic pain in a NMOSD cohort. MATERIALS AND METHODS: Our study was a retrospective case-cohort study, the patients diagnosed with NMOSD in the Department of Neurology from the Second Affiliated Hospital of Guangzhou University of Chinese Medicine from January 2011 to October 2021 were screened. Inclusion criteria were: (1) patients diagnosed as NMOSD according to the International Panel for NMO Diagnosis (IPND) criteria, (2) the aquaporin-4 immunoglobulin G antibodies (AQP4-IgG) test was performed. Patients without AQP4-IgG antibody were excluded. Clinical data, including sex, age of the first onset, symptoms of the first episode including neuropathic pain and attack types, localization of lesions of the first episode on Magnetic Resonance Imaging (MRI), Extended disability status Scale (EDSS) of the first onset, treatment of immunosuppression in the first acute phase, disease modifying therapy (DMT), treatment of neuropathic pain and APQ4-IgG status were collected from the hospital system database. Neuropathic pain was defined according to the International Association for the Study of Pain criteria and was described as "pain arising as a direct consequence of a lesion or disease affecting the somatosensory system". RESULTS: One hundred nineteen patients were screened and finally 86 patients fulfilling the inclusion and exclusion criteria were enrolled in our study. The prevalence of neuropathic pain in patients with NMOSD was 43.0%. Univariate analysis showed that the factors associated with neuropathic pain were the age at the onset, the attack type of optic neuritis, the attack type of myelitis, length of spinal cord involvement, localization of thoracic lesion, optic lesion, upper thoracic lesions, lower thoracic lesions, extended spinal cord lesions (≥ 3 spinal lesions), extended thoracic lesions (≥ 4 thoracic lesions), intravenous immunoglobulin and mycophenolate mofetil. Multivariate regression analysis showed that extended thoracic lesions (OR 20.21 [1.18-346.05], P = 0.038) and age (OR 1.35 (1-1.81) P = 0.050) were independently associated with neuropathic pain among NMOSD patients and that gender (OR 12.11 (0.97-151.64) P = 0.053) might be associated with neuropathic pain among NMOSD patients. CONCLUSION: Extended thoracic lesions (≥ 4 thoracic lesions), age and gender might be independent risk factors of neuropathic pain among patients with NMOSD. However, with a small sample size and predominantly female, caution must be applied and these results need validating in further cohorts.

High triglyceride is an independent predictor of high on-treatment platelet reactivity in ischemic stroke patients.

BACKGROUND: Previous studies have shown high triglyceride (TG) is associated with platelet hyperactivation in metabolic syndrome patients. However, limited information is available regarding this relationship on dual anti-platelet therapy (DAPT) in ischemic stroke (IS). In this study, we attempted to evaluate the association between TG and high on-treatment platelet reactivity (HTPR) in IS patients. METHODS: Ischemic stroke patients who received maintenance doses of clopidogrel and aspirin were categorized and analyzed retrospectively in this research. The platelet reactivity was assessed by Thromboelastography (TEG). If ADP-induced platelet inhibition rate (ADPi)<30%, it was defined as HTPR, else, it would be defined as normal on-treatment platelet reactivity (NTPR). Patients were divided into high-TG-level and lower-TG-level based on a TG level of 1.7mmol/L, the cutoff point of hypertriglyceridemia. A logistic regression model was applied to calculate the odds ratio (OR) and 95% confidence interval (CI). RESULTS: A total of 123 patients were included in this study and 24 (19.51%) patients were identified as HTPR. HTPR was observed in 36.2% of the patients in high-TG-level (TG≥1.7mmol/L) group while only 9.2% of the patients in the low-TG-level group (TG<1.7mmol/L) were HTPR (P<0.001 ). According to multivariate analysis, TG≥1.7mmol/L was independently associated with HTPR (OR=14.715, 2.445-88.549,P=0.003). CONCLUSIONS: High TG is an independent predictor of HTPR in IS patients. For IS patients with high TG level undergoing DAPT, platelet reactivity should be monitored to identify HTPR, which may proactively help to optimize the anti-platelet therapy.

Defect-enhanced electrochemical property of h-BN for Pb2+ detection.

A new strategy has been developed for the determination of trace lead ions (Pb2+) based on hexagonal boron nitride (h-BN) laden with point defect. The defect-laden boron nitride (D-BN) was synthesized by a thermal polymerization route, in which melamine borate was used as a precursor. The defect microstructure was confirmed by photoluminescence (PL) and x-ray diffraction (XRD) techniques. As compared with h-BN, the D-BN-modified glassy carbon electrode (GCE) showed an enhanced electrochemical response towards Pb2+ peaking at - 0.551 V (vs. SCE), which was evidenced by linear sweep anodic stripping voltammetry (LSASV) results. The point defect plays a pivotal role in the electrocatalytic reaction process, which can mediate the electronic structure and surface properties of h-BN. Accordingly, the sensor presented a low detection limit of 0.15 µg/L towards Pb2+ and a wide linear response concentration range from 0.5 to 400 µg/L (correlation coefficient = 0.995). In view of its superior selectivity, stability, and reproducibility, the proposed method was applied for Pb2+ determination in real samples and exhibited satisfactory results. This work provides insight for the construction of electrochemical sensor with high-performance by engineering defects of modifying materials. Defect-loaden h-BN exhibited enhanced electrocatalytic redox reaction towards lead ions and thus a novel Pb2+ sensor with high performances was constructed.

A voltammetric sensor for simultaneous determination of hydroquinone and catechol by using a heterojunction prepared from gold nanoparticle and graphitic carbon nitride.

An electrochemical sensor is described for the simultaneous determination of hydroquinone (HQ) and catechol (CC) based on a nanocomposite consisting of gold nanoparticles and graphitic carbon nitride (g-C3N4). The nanocomposite was synthesized via one-step thermal polymerization route and characterized by X-ray diffraction, transmission electron microscopy, and Fourier transform infrared techniques. The results confirmed the close contact between gold nanoparticles and g-C3N4. The nanocomposites exhibited the enhanced electrocatalytic redox towards HQ and CC. A glassy carbon electrode was modified with the nanocomposite to obtain a sensor that exhibited favorable analytical properties in the simultaneous detection of HQ and CC, with voltammetric peaks typically near -0.14 and - 0.02 V (vs. saturated calomel electrode). Linear responses are found between 1.0 and 320 µM for HQ (with a 0.3 µM detection limit; at S/N = 3), and between 0.1 and 320 µM for CC (with a 0.04 µM detection limit; at S/N = 3). The sensor was applied for the simultaneous determination of HQ and CC in spiked water samples, and acceptable recoveries were achieved. The superior sensing properties of the electrode are attributed to the synergy between the microstructure (heterojunction and porosity) and the π interactions between phenolic isomers and g-C3N4. Graphical abstractA novel electrochemical sensor is demonstrated for the simultaneous determination of hydroquinone and catechol based on a nanocomposite consisting of gold nanoparticles (AuNPs) and graphitic carbon nitride (g-C3N4).

[p53 gene mutations of familial breast cancer and early-onset breast cancer in part population of southern China].

OBJECTIVE: To investigate the site and characteristic of p53 gene mutations in familial or early-onset breast cancer patients in part population of southern China.
 Methods: A total of 150 patients with familial and early-onset breast cancer in parts population of southern China were enrolled. Genomic DNA was isolated from each peripheral blood sample, and the entire coding sequence and exon and intron splicing region of p53 gene were amplificated by PCR in the 150 patients. The mutation analysis were detected by denaturing high performance liquid chromatography (DHPLC) and confirmed by DNA sequence analysis.
 Results: In the 150 patients with familial and early-onset breast cancer, 6 mutations including one novel pathogenic mutation 869_888 ins20 (insert mutation) and 5 previously reported pathogenic mutations (deletion mutation 643_660del18 and 4 missense mutation 91G>A, 215C>G, 537T>G, 743G>A) were identified in p53 gene encoding region in 9 patients of breast cancer. Moreover, one same sense mutation 141G>A in exon 4, one 16 bases deletion in intron 3, and 9 single nucleotide polymorphisms in p53 gene introns were also identified. The total mutation frequency of p53 gene in 150 patients with familial breast cancer and early-onset breast cancer from part population of southern China was 6.00%, and the mutation frequency of familial breast cancer and early-onset breast cancer was 6.81% and 6.25%, respectively.
 Conclusion: The total mutation frequency of p53 gene in 150 patients with familial breast cancer and early-onset breast cancer from partpopulation of southern China is higher than the frequency previously reported. The pathogenicity of the novel mutations (insert mutation) 869_888ins20 will be confirmed by function analysis in the future study. The deletion mutation 643_660del18 enriches the p53 gene mutation database among Chinese population, which is probably the specific mutation of breast cancer in Chinese population.

[Clinical diagnosis of breast cancer with nonpalpable tumor].

OBJECTIVE: To investigate the early diagnosis of breast cancer with nonpalpable tumor. METHODS: Forty-six cases of clinical nonpalpable tumor were examined by mammography and sonography.The cases of nipple discharge were also examined by fiberoptic ductoscopy. RESULTS: Breast cancer in 46 cases was diagnosed by pathological examination. Of them, 34 diagnosed with breast cancer were found with nodus, calcification or confused structure, and so on, 5 were considered benign tumor, and 7 were not found lesion by mammography. Thirty-one cases were diagnosed with breast cancer, 6 with benign tumor, and 9 were not found occupying lesion by sonography. Occupying lesions were found in 6 cases of nipple discharge by fiberoptic ductoscopy and were finally diagnosed by biopsy. CONCLUSION: Mammography and sonography are important methods in early discovering breast cancer. Early diagnosis rate of breast cancer can be elevated by signs of early breast cancer and combined examination of mammograply and sonography.