Serotonin receptor 2B induces visceral hyperalgesia in rat model and patients with diarrhea-predominant irritable bowel syndrome.

BACKGROUND: Serotonin receptor 2B (5-HT2B receptor) plays a critical role in many chronic pain conditions. The possible involvement of the 5-HT2B receptor in the altered gut sensation of irritable bowel syndrome with diarrhea (IBS-D) was investigated in the present study. AIM: To investigate the possible involvement of 5-HT2B receptor in the altered gut sensation in rat model and patients with IBS-D. METHODS: Rectosigmoid biopsies were collected from 18 patients with IBS-D and 10 patients with irritable bowel syndrome with constipation who fulfilled the Rome IV criteria and 15 healthy controls. The expression level of the 5-HT2B receptor in colon tissue was measured using an enzyme-linked immunosorbent assay and correlated with abdominal pain scores. The IBS-D rat model was induced by intracolonic instillation of acetic acid and wrap restraint. Alterations in visceral sensitivity and 5-HT2B receptor and transient receptor potential vanilloid type 1 (TRPV1) expression were examined following 5-HT2B receptor antagonist administration. Changes in visceral sensitivity after administration of the TRPV1 antagonist were recorded. RESULTS: Here, we observed greater expression of the 5-HT2B receptor in the colonic mucosa of patients with IBS-D than in that of controls, which was correlated with abdominal pain scores. Intracolonic instillation of acetic acid and wrap restraint induced obvious chronic visceral hypersensitivity and increased fecal weight and fecal water content. Exogenous 5-HT2B receptor agonist administration increased visceral hypersensitivity, which was alleviated by successive administration of a TRPV1 antagonist. IBS-D rats receiving the 5-HT2B receptor antagonist exhibited inhibited visceral hyperalgesia.Moreover, the percentage of 5-HT2B receptor-immunoreactive (IR) cells surrounded by TRPV1-positive cells (5-HT2B receptor I+) and total 5-HT2B receptor IR cells (5-HT2B receptor IT) in IBS-D rats was significantly reduced by the administration of a 5-HT2B receptor antagonist. CONCLUSION: Our finding that increased expression of the 5-HT2B receptor contributes to visceral hyperalgesia by inducing TRPV1 expression in IBS-D patients provides important insights into the potential mechanisms underlying IBS-D-associated visceral hyperalgesia.

Incidence and risk factors of unplanned retreatment following dental general anesthesia in children with severe early childhood caries.

Objective: This study aimed to retrospectively describe the unplanned retreatment of dental general anesthesia (DGA) in children with severe early childhood caries (S-ECC) and explore potential factors that may influence the outcome of DGA treatment. Methods: Medical records of children with S-ECC who received DGA treatment were screened, and necessary data were extracted. The Kaplan-Meier method and Cox proportional hazards model were used to estimate the DGA survival rate and explore the potential factors affecting the success rate of DGA treatment. Results: Medical records of 852 children were included; 509 (59.7%) children with 1,212 (10.7%) teeth underwent unplanned retreatment. Restoration failure (30.12%) and new caries (29.46%) accounted for the most significant proportion of all failures. The median survival times were 510 and 1,911 days at the child and tooth levels, respectively. Unplanned retreatment risk was associated with the age of S-ECC children, frequency of follow-up, and fluoride application (hazard ratio = 0.97, 0.78, 0.69, P < 0.001). Conclusion: The treatment outcome of DGA administered to children with S-ECC was satisfactory at the tooth level from the perspective of the incidence of unplanned retreatment. Restoration failure was the main reason for the high unplanned retreatment rate. Strategies for a better outcome of DGA include improving the professional knowledge and skills of pediatric dentists and enhancing compliance of parents/patients. Health education and regular topical fluoride application may improve the success rate of DGA treatment.

Metabolic perspective of astrocyte dysfunction in Alzheimer's disease and type 2 diabetes brains.

The term type III diabetes (T3DM) has been proposed for Alzheimer's disease (AD) due to the shared molecular and cellular features between type 2 diabetes (T2DM) and insulin resistance-associated memory deficits and cognitive decline in elderly individuals. Astrocytes elicit neuroprotective or deleterious effects in AD progression and severity. Patients with T2DM are at a high risk of cognitive impairment, and targeting astrocytes might be promising in alleviating neurodegeneration in the diabetic brain. Recent studies focusing on cell-specific activities in the brain have revealed the important role of astrocytes in brain metabolism (e.g., glucose metabolism, lipid metabolism), neurovascular coupling, synapses, and synaptic plasticity. In this review, we discuss how astrocytes and their dysfunction result in multiple pathological and clinical features of AD and T2DM from a metabolic perspective and the potential comorbid mechanism in these two diseases from the perspective of astrocytes.

P2X7 receptor as the regulator of T-cell function in intestinal barrier disruption.

The intestinal mucosa is a highly compartmentalized structure that forms a direct barrier between the host intestine and the environment, and its dysfunction could result in a serious disease. As T cells, which are important components of the mucosal immune system, interact with gut microbiota and maintain intestinal homeostasis, they may be involved in the process of intestinal barrier dysfunction. P2X7 receptor (P2X7R), a member of the P2X receptors family, mediates the effects of extracellular adenosine triphosphate and is expressed by most innate or adaptive immune cells, including T cells. Current evidence has demonstrated that P2X7R is involved in inflammation and mediates the survival and differentiation of T lymphocytes, indicating its potential role in the regulation of T cell function. In this review, we summarize the available research about the regulatory role and mechanism of P2X7R on the intestinal mucosa-derived T cells in the setting of intestinal barrier dysfunction.

Extraction of Next-to-Next-to-Leading-Order Parton Distribution Functions from Lattice QCD Calculations.

We present for the first time complete next-to-next-to-leading-order coefficient functions to match flavor nonsinglet quark correlation functions in position space, which are calculable in lattice QCD, to parton distribution functions (PDFs). Using PDFs extracted from experimental data and our calculated matching coefficients, we predict valence-quark correlation functions that can be confronted by lattice QCD calculations. The uncertainty of our predictions is greatly reduced with higher order matching coefficients. By performing Fourier transformation, we also obtain matching coefficients for corresponding quasi-PDFs and pseudo-PDFs. Our method of calculations can be readily generalized to evaluate the matching coefficients for sea-quark and gluon correlation functions, making the program to extract partonic structure of hadrons from lattice QCD calculations comparable with and complementary to that from experimental measurements.

The value of the atherogenic index of plasma in non-obese people with non-alcoholic fatty liver disease: a secondary analysis based on a cross-sectional study.

BACKGROUND AND OBJECTIVES: The atherogenic index of plasma (AIP) is elevated in fatty liver disease, but its value in non-obese people with non-alcoholic fatty liver disease (NAFLD) is unclear. This study aimed to investigate the relationship between AIP and NAFLD as well as to determine whether AIP might be used as an indicator of NAFLD in non-obese individuals. METHODS: The present study involved non-obese Chinese and Japanese participants. Risk factors are evaluated using univariate and multivariate analysis. The performance of risk factors was compared according to the area under the receiver operating characteristic curve. RESULTS: In the unadjusted model, the odds ratio (OR) for every 1 standard deviation (SD) increase in AIP was 52.30. In adjusted models I and II, the OR for every 1 SD increase in AIP was 36.57 and 50.84, respectively. The area under the receiver operating characteristic curve for AIP was 0.803 and 0.802 in the development and validation groups, respectively. The best cut-off value of AIP for discrimination between NAFLD and non-NAFLD was 0.005 in the Chinese group and - 0.220 in the Japanese group. CONCLUSIONS: AIP and NAFLD are positively correlated in Chinese and Japanese populations. Therefore, AIP can be used as a new screening indicator for non-obese people with NAFLD in different nations.

Load distribution measurement instrument for oscillating follower cam mechanism.

Cam mechanism is widely applied in industry because it can help achieve various complex motions of the follower via the cam contour design. However, its performance is significantly affected by the wear condition. This study proposes a load distribution measurement instrument to assist the study on friction and wear regularities of oscillating follower cam mechanisms through obtaining the normal pressure (F) and friction force (Ff) distributions along the cam profile. In the instrument, F and Ff are automatically calculated via a MATLAB program based on the geometry and the measured rotary resistance torque and rotary angle of the cam. The latter two parameters are obtained through a static torque sensor and a rotary encoder built in servo motor in real time, respectively. An experimental test was conducted and the cam morphology after service was observed using scanning electron microscopy. Results show that the wear condition of the cam is significantly related to the corresponding F and Ff. Complex load parameters of oscillating follower cam mechanisms can be provided by this instrument, which is crucial in understanding the friction and wear behaviors of cams and finding the vulnerable position.

Multiplicative Renormalizability of Operators defining Quasiparton Distributions.

Extracting parton distribution functions (PDFs) from lattice QCD calculation of quasi-PDFs has been actively pursued in recent years. We extend our proof of the multiplicative renormalizability of the quasiquark operators of Ishikawa et al. [Phys Rev. D 96, 094019 (2017)] to quasigluon operators, and demonstrated that quasigluon operators could be multiplicatively renormalized to all orders in perturbation theory, without mixing with other operators. We find that using a gauge-invariant UV regulator is essential for achieving this proof. With the multiplicative renormalizability of both quasiquark and quasigluon operators, and QCD collinear factorization of hadronic matrix elements of there operators into PDFs, extracting PDFs from lattice QCD calculated hadronic matrix elements of quasiparton operators could have a solid theoretical foundation.

Effect of frequency on fretting wear behavior of Ti/TiN multilayer film on depleted uranium.

The Ti/TiN multi-layer film was prepared on the depleted uranium (DU) substrate by cathodic arc ion plating equipment. The character of multi-layer film was studied by SEM, XRD and AES, revealed that the surface was composed of small compact particle and the cross-section had a multi-layer structure. The fretting wear performance under different frequencies was performed by a MFT-6000 machine with a ball-on-plate configuration. The wear morphology was analyzed by white light interferometer, OM and SEM with an EDX. The result shows the Ti/TiN multi-layer film could greatly improve the fretting wear performance compared to the DU substrate. The fretting wear running and damaged behavior are strongly dependent on the film and test frequency. The fretting region of DU substrate and Ti/TiN multi-layer under low test frequency is gross slip. With the increase of test frequency, the fretting region of Ti/TiN multi-layer change from gross slip to mixed fretting, then to partial slip.

Decreased glucagon-like peptide-1 correlates with abdominal pain in patients with constipation-predominant irritable bowel syndrome.

BACKGROUND AND OBJECTIVE: The glucagon-like peptide-1 (GLP-1) analog, ROSE-010, plays a critical role in alleviating abdominal pain in patients with irritable bowel syndrome (IBS); however, the underling mechanism is unclear. In the present study, we determined the serum GLP-1 level in patients with constipation-predominant IBS (IBS-C). The relationship between GLP-1 and abdominal pain was investigated. In addition, the expression of the GLP-1 receptor in the colon was determined. METHODS: Rectosigmoid biopsies were gathered from 38 patients with IBS-C who met the Rome III criteria, and 22 healthy controls. Abdominal pain was quantified by a validated questionnaire. Serum GLP-1 was measured by ELISA and correlated with abdominal pain scores. The presence of the GLP-1 receptor in the colonic mucosa was assessed by immunohistochemistry. RESULTS: Serum GLP-1 was substantially decreased in patients with IBS-C. Decreased serum GLP-1 had a negative correlation with the abdominal pain scores. Biopsies from patients with IBS-C revealed a significant down-regulation of the GLP-1 receptor in colonic mucosa compared with control subjects. CONCLUSIONS: Decreased serum GLP-1 correlates with abdominal pain in patients with IBS-C. Decreased expression of GLP-1 and GLP-1 receptor may be the basis for alleviation of abdominal pain in patients with IBS-C by ROSE-010.

Daidzein increases OPG/RANKL ratio and suppresses IL-6 in MG-63 osteoblast cells.

Daidzein is a major dietary source of isoflavones found in Leguminosae, and belongs to the family of diphenolic compounds. The estrogenic effects of daidzein to prompt bone formation and prevent bone resorption have been observed in animal models and cultured cells. In our study, we studied the effects of daidzein, raloxifene and E2 on expression of the osteoblast-produced bone regulatory factors OPG, RANKL and IL-6 in human osteoblastic MG-63 cells. Results suggest that treatment with daidzein, raloxifene and E2 increased the levels of OPG and decreased those of RANKL and IL-6. The effects of daidzein on OPG and RANKL expression are mediated by both ERα and ERß but those on IL-6 production primarily by ERα. Moreover, daidzein may promote activation of the classic estrogen response element (ERE) pathway through increasing ERα, ERß and steroid hormone receptor coactivator (SRC)-1 expression. E2 was also able to enhance transcription derived from the ERE, while raloxifene has no effect on it. Raloxifene increased ERα protein and gene expression levels but had no effect on ERß protein and gene expression at 0.1µM. E2 was found significantly increased the protein and mRNA levels of SRC-1, while raloxifene has no effect on it compared with control. This ability of daidzein to affect osteoblastic cells makes it a good candidate for the treatment of bone loss in postmenopausal women.

[Characteristics and Pollution Source Analysis of Nutrients in Tributary Outlets of Xitiaoxi Watershed].

The input of tributary is the important source of nutrients to the main stream, and it is the key area for water pollution control of watershed. In order to explore the sources of nutrient and seek the effective measures to control the river pollution, the spatial and temporal variations of aquatic parameters and the output of nutrient flux in the tributary outlets of Xitiaoxi watershed were analyzed. The quantitative analysis concerning the contribution of pollution sources from 10 typical tributaries was carried out, using the PMF analytical model. The results showed that the TN and TP concentrations were higher in the middle and lower reaches. In the temporal scale, the concentrations of nutrients in the dry season were higher than those in the wet season. In the dry season, average concentrations of TN and TP were 4.25 mg·L-1 and 0.11 mg·L-1, respectively, compared to the corresponding values of 3.15 mg·L-1 and 0.09 mg·L-1 in wet season. Because of the differences of surrounding lands, the sources of nitrogen and phosphorus forms were various. The results of PMF(Positive Matrix Factorization) method identified the three nutrient sources as agricultural source, aquaculture source and municipal source. In different seasons and river reaches, the contribution rates of three sources were different. Agricultural source contributed nutrient largely to the tributaries in the upstream reaches, and the aquaculture source was the main contributor in the middle reaches, while the municipal source contributed more nutrient in the wet season than in the dry season. Therefore, to better improve water quality of Xitiaoxi watershed, the surrounding environment of tributary and the characteristics of nutrients in spatial and temporal variations should be considered.

Complete genome sequence of a benzo[a]pyrene-degrading bacterium Altererythrobacter epoxidivorans CGMCC 1.7731(T).

Altererythrobacter epoxidivorans CGMCC 1.7731(T) is a Gram-negative bacterium isolated from marine sediments. It is able to utilize benzo[a]pyrene as sole carbon and energy source. Here, we describe the complete genome sequence and annotation of A. epoxidivorans CGMCC 1.7731(T). The genome has a size of 2,786,256 bp (61.50 mol% G+C content), which consists of 2773 coding genes, 43 tRNA genes and 3 rRNA genes. According to the genome information, strain A. epoxidivorans CGMCC 1.7731(T) encodes 22 genes related to degradation of benzo[a]pyrene. These genes may have potential in bioremediation of PAH-polluted environments.

[Distributions of phosphorus fractions in suspended sediments and surface sediments of Tiaoxi mainstreams and cause analysis].

Phosphorus is a primary nutrient showing the water quality status of river and inducing eutrophication, and a different phosphorus fraction can make diverse contributions to water quality. Four phosphorus forms of suspended sediments and surface sediments in Tiaoxi mainstreams were measured using a sequential extraction procedure, and the distributions of their forms were discussed. The results showed that the tropic status of Xitiaoxi River was inferior to that of Dongtiaoxi River as a whole, and the water quality in the middle reach of Dongtiaoxi River was better than that in the upper and lower reaches. The contents of nutrient elements in suspended sediments were significantly higher than those in surface sediment, which indicated an enrichment of nutrient in fine sediment. The percentages of the loosely absorbed phosphorus ( NH4Cl-P), the reductant phosphorus (BD-P) and the metal oxide bound phosphorus (NaOH-P) in the suspended sediment were higher than those in surface sediment, while the percentage of the calcium bound phosphorus (HCl-P) showed a reverse trend. Correlation analyses between phosphorus forms and chemical compositions of suspended sediments and surface sediments were performed. The results showed the phosphorus forms in suspended sediments and surface sediments of Xitiaoxi River had weak relationships with mineral components, while those in the Dongtiaoxi River had strong relationships with mineral, especially OM and clay mineral. The cause was associated with the geological setting and material sources in Tiaoxi watershed.

Chryseobacterium profundimaris sp. nov., a new member of the family Flavobacteriaceae isolated from deep-sea sediment.

A Gram-stain negative, strictly aerobic, rod-shaped, non-motile bacterium, designated strain DY46(T), was isolated from Atlantic Ocean sediment. The isolate was found to grow in medium containing 0-3.0 % (w/v) NaCl (optimally at 0-1.0 %), at 4-37 °C and pH 5.0-8.0. Chemotaxonomic analysis detected MK-6 as the sole isoprenoid quinone. The major fatty acids were identified iso-C15:0, iso-C17:0 3-OH, iso-C17:1 ω9c and summed feature 3 (comprising iso-C15:0 2-OH and/or C16:1 ω7c). The DNA G + C content was determined to be 40.7 mol %. Phylogenetic analyses based on the 16S rRNA gene sequence indicated that strain DY46(T) falls within the cluster comprising Chryseobacterium species. The levels of 16S rRNA gene sequence similarity between strain DY46(T) and the type strains of the Chryseobacterium species with validly published names ranged from 92.4 to 99.1 %, the high values (>97 %) being with Chryseobacterium takakiae A1-2(T) (99.1 %), C. taiwanense BCRC 17412(T) (98.0 %), C. taeanense PHA3-4(T) (97.3 %), C. hispalense DSM 25574(T) (97.3 %), C. camelliae THG C4-1(T) (97.2 %), C. gregarium DSM 19109(T) (97.1 %) and C. wanjuense R2A10-2(T) (97.0 %). The DNA-DNA relatedness values between strain DY46(T) and the type strains of the above closely related species were 47, 57, 24, 34, 6, 40 and 21 %, respectively. On the basis of phenotypic and genotypic characteristics, strain DY46(T) represents a novel member within the genus Chryseobacterium, for which the name Chryseobacterium profundimaris is proposed. The type strain is DY46(T) (=CGMCC 1.12663(T) = JCM 19801(T)).

Novosphingobium marinum sp. nov., isolated from seawater.

A Gram-stain-negative, aerobic, short rod-shaped bacterium, strain LA53(T), was isolated from a deep-sea water sample collected from the eastern Pacific Ocean. Strain LA53(T) grew in the presence of 0-7.0 % (w/v) NaCl and at 15-37 °C; optimum growth was observed with 1.0-2.0 % (w/v) NaCl and at 35 °C. Chemotaxonomic analysis showed ubiquinone-10 as the predominant respiratory quinone, C18 : 1ω7c and summed feature 3 (iso-C15 : 0 2-OH and/or C16 : 1ω7c) as major fatty acids, and diphosphatidylglycerol, phosphatidylcholine, phosphatidylethanolamine, phosphatidylglycerol and sphingoglycolipid as major polar lipids. The genomic DNA G+C content was 57.7 mol%. Phylogenetic analyses revealed that strain LA53(T) belongs to the genus Novosphingobium. 16S rRNA gene sequence similarities between strain LA53(T) and the type strains of species of the genus Novosphingobium with validly published names ranged from 93.1 to 96.3 %. In addition, strain LA53(T) could be differentiated from Novosphingobium pentaromativorans DSM 17173(T) and Novosphingobium indicum DSM 23608(T) as well as the type strain of the type species of the genus, Novosphingobium capsulatum DSM 30196(T), by some phenotypic characteristics, including hydrolysis of substrates, utilization of carbon sources and susceptibility to antibiotics. On the basis of phenotypic and genotypic data, strain LA53(T) represents a novel species within the genus Novosphingobium, for which the name Novosphingobium marinum sp. nov. is proposed. The type strain is LA53(T) ( = CGMCC 1.12918(T) = JCM 30307(T)).

Efficacy and safety of immunosuppressive therapy in the treatment of seronegative hepatitis associated aplastic anemia.

OBJECTIVE: To investigate the clinical characteristics of seronegative hepatitis-associated aplastic anemia (AA) (SNHAA) and hepatitis B virus (HBV) infection complicating AA (HBVAA), and thereby compare the efficacy of immunosuppressive therapy (IST). METHODS: An analysis was conducted on the clinical data of ten patients with SNHAA out of 332 cases of AA from our center at AA diagnosis, and on the efficacy of IST. This was compared to 22 cases of HBVAA at AA onset as well as the associated IST outcomes. RESULTS: Nine patients with SNHAA developed severe aplastic anemia, with a median age of 18 years. After IST, six (60%) of the SNHAA patients achieved complete remission and two achieved partial remission. The patients with HBVAA had a total response rate of 82.3%. The disease recurred in two HBVAA patients. No statistically significant differences were observed in response rate, mortality, and recurrence rate between both groups. As compared with HBVAA, patients with SNHAA had a shorter interval from the acute episode of hepatitis to AA onset (4 months versus 92 months, P=0.00), a quicker response to IST (2.5 months versus 4.5 months, P=0.018), a lower proportion of bone marrow hematopoietic tissues (20.6% versus 23.6%, P=0.03), and lower white blood cell and absolute neutrophil count (0.8 × 10(9)/L versus 1.23 × 10(9)/L and 0.26 × 10(9)/L versus 0.58 × 10(9)/L, P=0.026 and P=0.0009, respectively). No significant liver damage or hepatitis B fulminant infection was observed in either group during the follow-up. CONCLUSION: The prevalence of SNHAA is 3.01%. SNHAA often presents as severe AA and responds to IST quickly. Neither hepatitis prior to AA nor AA complicating HBV infection have been shown to influence the early efficacy of IST and adverse events, and HBV may not be the causative agent of AA.

Oceanicola antarcticus sp. nov. and Oceanicola flagellatus sp. nov., moderately halophilic bacteria isolated from seawater.

Two Gram-stain-negative, aerobic, moderately halophilic, rod-shaped bacteria (strains Ar-45(T) and DY470(T)) were isolated from seawater collected from the Southern Ocean and the Pacific Ocean, respectively. Growth of strain Ar-45(T) was observed with between 0.5 and 10.0 % (w/v) NaCl (optimally with 0.5-3.0 %) and between pH 5.5 and 9.5. Strain DY470(T) grew in the presence of 0.5-7.5 % (w/v) NaCl (optimally with 2.0 %) and at pH 5.5-8.5. Chemotaxonomic analysis showed Q-10 as the respiratory quinone for both strains. The major fatty acids (>5 %) of strain Ar-45(T) were C16 : 0, C19 : 0 cyclo ω8c and C18 : 1ω7c, while those of strain DY470(T) were C18 : 1ω7c, C16 : 0 and 11-methyl C18 : 1ω7c. The DNA G+C contents of the two strains were 62.0 and 61.8 mol%, respectively. Phylogenetic analyses based on 16S rRNA gene sequences showed that strains Ar-45(T) and DY470(T) were related most closely to the genus Oceanicola, with sequence similarities of 97.4-94.0 and 97.7-94.7 %, respectively. The DNA-DNA hybridization value between strain Ar-45(T) and Oceanicola marinus LMG 23705(T) was 22.0 %. Levels of DNA-DNA relatedness between strain DY470(T) and Oceanicola nitratireducens LMG 24663(T) and Oceanicola batsensis DSM 15984(T) were 32.5 and 26.1 %, respectively. Based on phylogenetic, chemotaxonomic and phenotypic data, strains Ar-45(T) and DY470(T) are considered to represent two novel species of the genus Oceanicola, for which the names Oceanicola antarcticus (type strain Ar-45(T) = CGMCC 1.12662(T) = LMG 27868(T)) and Oceanicola flagellatus (type strain DY470(T) = CGMCC 1.12664(T) = LMG 27871(T)) are proposed.

High quality draft genome sequence of the heavy metal resistant bacterium Halomonas zincidurans type strain B6(T).

Halomonas zincidurans strain B6(T) was isolated from a deep-sea heavy metal rich sediment from the South Atlantic Mid-Ocean Ridge. The strain showed significant resistance to heavy metals, especially to zinc. Here we describe the genome sequence and annotation, as well as the features, of the organism. The genome contains 3,325 protein-coding genes (2,848 with predicted functions), 61 tRNA genes and 6 rRNA genes. H. zincidurans strain B6(T) encodes 31 genes related to heavy metal resistance. And HGT may play an important role in its adaption to the heavy metal rich environment. H. zincidurans strain B6(T) may have potential applications in the bioremediation of heavy metal-contaminated environments.

Valproic acid-associated low fibrinogen and delayed intracranial hemorrhage: case report and mini literature review.

A 41-year-old male had suffered from gradual hearing loss in his right ear for 2 years. Head computed tomography and magnetic resonance imaging scans showed a neoplasm in the cerebellopontine angle region, which was confirmed by the diagnosis of acoustic neurilemmoma by pathological findings after surgery. Following surgery, he routinely received valproic acid (VPA) to prevent seizures. However, the patient presented with hypofibrinogenemia and cerebral hemorrhage after taking VPA for 12 days. The hypofibrinogenemia recurred when VPA was re-administered. After withdrawal of VPA, his fibrinogen concentration rose to normal within several days. As far as we are aware, this is the first case of cerebral hemorrhage due to VPA to have been reported. Herein, as well as reporting on this case, a mini review of the relevant literature is also presented.