Optimal Sequential Strategies for Antibody-Drug Conjugate in Metastatic Breast Cancer: Evaluating Efficacy and Cross-Resistance.

BACKGROUND: The optimal sequential strategy for antibody-drug conjugates (ADCs) in breast cancer remains uncertain. This study aimed to evaluate the efficacy and potential resistance of second ADC (ADC2) following the first ADC (ADC1) in human epidermal growth factor receptor 2 (HER2)-positive and HER2-low MBC. METHODS: This retrospective, multicenter, real-world study enrolled patients with MBC who received at least 2 different types of ADCs in 3 hospitals in China between July 1, 2017 and May 1, 2023. Outcomes included the objective response rate (ORR) for ADC1 and ADC2, progression free survival 2 (PFS2), defined as the time from initiation of ADC2 to progression, and overall survival (OS). RESULTS: Seventy-nine female patients were included, 64 of whom had HER2-positive disease. The ORR for ADC2 with similar payload of ADC1 was found to be 5.3%. When switching to a different payload, the ORR of ADC2 increased to 22.6%. The PFS2 for ADC2 remained similar regardless of whether the payload was similar or different. Switching to different payload showed a higher ORR in patients with rapid progression and a durable response longer than 6 months (41.2% vs 15.0%). Specifically, significantly longer PFS2 and OS were seen in patients treated with trastuzumab deruxtecan (T-Dxd) compared to those treated with disitamab vedotin (RC48) after progression from trastuzumab emtansine (T-DM1; median PFS2 5.37 months vs 3.30 months, HR = 0.40, 95% CI 0.17-0.93, P = .034; median OS 50.6 months vs 20.2 months, HR = 0.27, 95% CI 0.08-0.91, P = .034). For patients who progressed after T-Dxd, the median PFS2 was 6.05 months for those treated with RC48 versus 0.93 months for those treated with T-DM1 (HR = 0.03, 95% CI 0.002-0.353, P = .0093). Genomic analysis revealed that alternation of retinoblastoma1 was significantly associated with superior PFS. CONCLUSION: The alternation of payload achieves different responses in different settings. T-Dxd followed by RC48 may be a potentially beneficial strategy in HER2-positive disease. Further research is needed to elucidate the mechanism of cross-resistance.

Opportunistic use of lumbar computed tomography and magnetic resonance imaging for osteoporosis screening.

Compared with the healthy patients, patients with osteoporosis had a lower Hounsfield unit (HU) value and a higher vertebral bone quality (VBQ) score. Both the HU value and VBQ score can simply distinguish patients with osteoporosis (OP), with a cutoff value of HU value < 97.06 and VBQ score > 3.08. INTRODUCTION: The purpose of this study is to determine whether the opportunistic use of computed tomography (CT) or magnetic resonance imaging (MRI) is effective for identifying spine surgical patients with OP. METHODS: We retrospectively evaluated 109 lumbar spine surgery patients who received lumbar quantitative CT (QCT) and MRI. Using the area under the curve, the CT-based HU value and MRI-based VBQ score were calculated. Then, based on the QCT results, receiver operating characteristic (ROC) curves were constructed to determine the diagnostic performance of the HU value and VBQ score. RESULTS: The HU value was significantly lower in the OP group, and the VBQ score was significantly higher in the OP group. Using the area under the curve, the diagnostic performance of the HU value and VBQ score for OP were 0.959 and 0.880, respectively. The diagnostic threshold values determined with optimal sensitivity and specificity were an HU value of 97.06 and a VBQ score of 3.08. CONCLUSION: Opportunistic use of CT and MRI can simply distinguish patients with OP, which are expected to be potential alternatives to T-score for the osteoporosis screening.

Phosphate solubilization and plant growth properties are promoted by a lactic acid bacterium in calcareous soil.

On the basis of good phosphate solubilization ability of a lactic acid bacteria (LAB) strain Limosilactobacillus sp. LF-17, bacterial agent was prepared and applied to calcareous soil to solubilize phosphate and promote the growth of maize seedlings in this study. A pot experiment showed that the plant growth indicators, phosphorus content, and related enzyme activity of the maize rhizospheric soils in the LF treatment (treated with LAB) were the highest compared with those of the JP treatment (treated with phosphate solubilizing bacteria, PSB) and the blank control (CK). The types of organic acids in maize rhizospheric soil were determined through LC-MS, and 12 acids were detected in all the treatments. The abundant microbes belonged to the genera of Lysobacter, Massilia, Methylbacillus, Brevundimonas, and Limosilactobacillus, and they were beneficial to dissolving phosphate or secreting growth-promoting phytohormones, which were obviously higher in the LF and JP treatments than in CK as analyzed by high-throughput metagenomic sequencing methods. In addition, the abundance values of several enzymes, Kyoto Encyclopedia of Genes and Genomes (KEGG) orthology, and Carbohydrate-Active Enzymes (CAZys), which were related to substrate assimilation and metabolism, were the highest in the LF treatment. Therefore, aside from phosphate-solubilizing microorganisms, LAB can be used as environmentally friendly crop growth promoters in agriculture and provide another viable option for microbial fertilizers. KEY POINTS: • The inoculation of LAB strain effectively promoted the growth and chlorophyll synthesis of maize seedlings. • The inoculation of LAB strain significantly increased the TP content of maize seedlings and the AP concentration of the rhizosphere soil. • The inoculation of LAB strain increased the abundances of the dominant beneficial functional microbes in the rhizosphere soil.

Angular uniformity improvement of diffractive waveguide display based on region geometry optimization.

Augmented reality (AR) near-eye displays have significantly progressed due to advances in nanostructure fabrication. However, for diffractive waveguide AR displays requiring exit pupil expansion, the angular uniformity of each exit pupil position still needs to improve. In this paper, an angular uniformity improvement method based on region geometry optimization is proposed. This optimization method essentially introduces the interaction number of the light with the grating as one of the variables to manipulate the energy distribution. This distribution is obtained by the rigorous coupled wave analysis (RCWA) method and ray tracing process and is further optimized by a multi-objective genetic algorithm. A model is built, and the feasibility of the proposed method is verified. The diffractive waveguide system has a 10m m×10m m exit pupil size at the eye relief of 25 mm and a field of view (FOV) of 21∘×12∘. After the optimization, the overall optical efficiency of the central field and the angular uniformity at the center exit pupil position increased from 0.9% and 66% to 3.1% and 80%, respectively.

Histone Methyltransferase SUV39H2 Supports Nasopharyngeal Carcinoma Cell Metastasis by Regulation of SIRT1.

Nasopharyngeal carcinoma (NPC) is a malignant tumor with high metastatic features originating from the nasopharynx. However, the underlying mechanism of Suppressor of variegation 3-9 homolog 2 (SUV39H2) in NPC remains poorly understood. RT-qPCR was carried out to examine SUV39H2 and SIRT1 expression in NPC tissues and cells. Kaplan-Meier method was utilized to evaluate the association between SUV39H2 level and overall survival. The function of SUV39H2 and SIRT1 in NPC cell viability, metastasis, and apoptosis was tested through CCK-8, transwell, and flow cytometry experiments. Here, it was uncovered that SUV39H2 level was augmented in NPC tissues and cells. Moreover, SUV39H2 expedited NPC cell viability, metastasis, and inhibited apoptosis, while SIRT1 addition reversed these impacts. Besides, SUV39H2 induced H3K9me3 enhancement to repress SIRT1 transcription via binding to SIRT1 promoter. Collectively, our results demonstrated upregulated SUV39H2 aggravated NPC tumorigenesis through SIRT1, which may offer a potential therapeutic target for NPC.

Prevalence and risk factors of osteoporotic fracture among the elderly population in China: a multicenter cross-sectional study.

PURPOSE: Prevalence of osteoporotic fracture (OPF) is increasing with ageing, resulting in a significant financial burden for healthcare. However, research on the nationwide epidemiological data of OPF in Chinese elderly is still scarce. The aim of this study was to investigate the prevalence and risk factors of OPF in Chinese population aged 60 years or order. METHODS: A cross-sectional survey was conducted in an elderly Chinese population in five centres. Questionnaire investigation and imaging examination were taken in all participants to identify OPF prevalence and risk factors. Diagnosis of OPF was determined based on imaging of vertebral fractures or history of fall-related fractures. We then used multivariate logistic regression model to analyze the associations between the potential risk factors and OPF. RESULTS: The overall prevalence of OPF in population aged 60 years or older was 24.7% (1,071/4,331), showing an increasing trend with age (P < 0.001). The prevalence of OPF was geographically distinct (P < 0.001), but similar between men and women (P > 0.05). Up to 96.8% of OPFs consisted of vertebral fractures, especially involving T11, T12, and L1 segments. Advanced age (≥ 80), vision loss, severe hearing loss, multiple exercise forms, chronic kidney disease, osteoarthritis, and trauma-related vertebral fractures were significantly associated with risk factors, while education level and vitamin D supplementation were associated with protective factors of OPF. CONCLUSION: High prevalence of OPF is a serious threat to bone health among elderly people in China. There is an urgent need for effective strategies to diagnose, prevent, and treat OPF in elderly adults.

Design and fabricate freeform holographic optical elements on curved optical surfaces using holographic printing.

Freeform holographic optical elements (HOEs), due to the high degrees of design freedom, can be used to enhance performance of display systems. In this Letter, we propose a method for designing and fabricating freeform HOEs on curved optical surfaces that can be utilized to implement curved augmented reality (AR) displays. In our method, the phase profile of the freeform HOE laminated on a curved surface is first optimized to achieve a good image performance. Then, two recording wavefronts are optimized to produce the phase profile of the freeform HOE on the curved surface with a high uniformity of diffraction efficiency. The two recording wavefronts used for a curved substrate are converted into two wavefronts for a planar substrate based on a conversion relationship between the curved HOE and the planar HOE. A home-built holographic printer is used to fabricate freeform HOEs on a flat substrate, and then the freeform HOEs are laminated onto a curved optical surface. Two interesting AR display systems are presented to demonstrate the effectiveness of the proposed design and fabrication method.

Effects of Schroth 3D Exercise on Adolescent Idiopathic Scoliosis: A Systematic Review and Meta-Analysis.

(1) Background: This meta-analysis aims to systematically assess the effect size of Schroth three-dimensional exercise training on adolescent idiopathic scoliosis, especially for Cobb angles, angles of trunk rotation, and quality of life. (2) Methods: Randomized controlled trials (RCTs) focused on the effect of Schroth exercise on patients with adolescent idiopathic scoliosis (AIS) were retrieved from six databases, including PubMed, Embase, Cochrane Library, Web of Science, CNKI, and Wanfang. All publications until July 2023 were searched. Two researchers screened and evaluated the literature. Review manager (RevMan 5.3) statistical software was used for meta-analyses, and subgroup analysis and sensitivity analysis of the literature with high heterogeneity were further conducted. (3) Results: In total, 14 studies were included, including 538 adolescent idiopathic scoliosis patients. Compared with conventional physical therapy, Schroth 3D exercise training is more effective at reducing the Cobb angle (WMD = -3.32, 95%CI [-4.15, -2.50], p < 0.001) and improving the trunk rotation angle (WMD = -2.24, 95%CI [-3.00, -1.48], p < 0.001), quality of life (SMD = 2.80, 95%CI [1.53, 4.06], p < 0.001), and WRVAS (WMD = -2.92, 95%CI [-3.25, -2.60], p < 0.001), as well as enhancing the strength of the lumbar extensor (SMD = 1.79, 95%CI [1.46, 2.12], p < 0.001). (4) Conclusion: Compared with traditional therapy, Schroth 3D exercises are more effective at decreasing the Cobb angle and ATR in adolescent idiopathic scoliosis, improving patients' quality of life, as well as enhancing the strength of the lumbar extensor.

Potential impact of relational job design on future intentions of episodic volunteers in major sport events.

Introduction: Based on Social Identity Theory, this study hypothesized the parallel mediating roles of organizational commitment, and commitment to beneficiaries, in the relationship between relational job design and future volunteer intentions among episodic volunteers at a mega sport event. Perceived organizational support was tested as a moderator of this relationship. Methods: Participants were 617 episodic volunteers (35.7% male and 64.3% female) at the 7th CISM Military World Games in Wuhan, China, who completed online questionnaires. Results: Regression-based analyses indicated that relational job design positively predicted future volunteer intentions through organizational commitment. Although the results did not indicate a mediating role of commitment to beneficiaries, relational job design was still shown to positively predict commitment to beneficiaries. Furthermore, the association between relational job design and commitment to beneficiaries was moderated by perceived organizational support, such the effect was stronger when perceived organizational support was high. Discussion: The results have practical implications for strengthening episodic volunteers' intentions to participate in future mega sport events, creating a legacy of volunteerism.

Emotion recognition based on microstate analysis from temporal and spatial patterns of electroencephalogram.

Introduction: Recently, the microstate analysis method has been widely used to investigate the temporal and spatial dynamics of electroencephalogram (EEG) signals. However, most studies have focused on EEG at resting state, and few use microstate analysis to study emotional EEG. This paper aims to investigate the temporal and spatial patterns of EEG in emotional states, and the specific neurophysiological significance of microstates during the emotion cognitive process, and further explore the feasibility and effectiveness of applying the microstate analysis to emotion recognition. Methods: We proposed a KLGEV-criterion-based microstate analysis method, which can automatically and adaptively identify the optimal number of microstates in emotional EEG. The extracted temporal and spatial microstate features then served as novel feature sets to improve the performance of EEG emotion recognition. We evaluated the proposed method on two publicly available emotional EEG datasets: the SJTU Emotion EEG Dataset (SEED) and the Database for Emotion Analysis using Physiological Signals (DEAP). Results: For the SEED dataset, 10 microstates were identified using the proposed method. These temporal and spatial features were fed into AutoGluon, an open-source automatic machine learning model, yielding an average three-class accuracy of 70.38% (±8.03%) in subject-dependent emotion recognition. For the DEAP dataset, the method identified 9 microstates. The average accuracy in the arousal dimension was 74.33% (±5.17%) and 75.49% (±5.70%) in the valence dimension, which were competitive performance compared to some previous machine-learning-based studies. Based on these results, we further discussed the neurophysiological relationship between specific microstates and emotions, which broaden our knowledge of the interpretability of EEG microstates. In particular, we found that arousal ratings were positively correlated with the activity of microstate C (anterior regions of default mode network) and negatively correlated with the activity of microstate D (dorsal attention network), while valence ratings were positively correlated with the activity of microstate B (visual network) and negatively correlated with the activity of microstate D (dorsal attention network). Discussion: In summary, the findings in this paper indicate that the proposed KLGEV-criterion-based method can be employed to research emotional EEG signals effectively, and the microstate features are promising feature sets for EEG-based emotion recognition.

Revealing brain's cognitive process deeply: a study of the consistent EEG patterns of audio-visual perceptual holistic.

Introduction: To investigate the brain's cognitive process and perceptual holistic, we have developed a novel method that focuses on the informational attributes of stimuli. Methods: We recorded EEG signals during visual and auditory perceptual cognition experiments and conducted ERP analyses to observe specific positive and negative components occurring after 400ms during both visual and auditory perceptual processes. These ERP components represent the brain's perceptual holistic processing activities, which we have named Information-Related Potentials (IRPs). We combined IRPs with machine learning methods to decode cognitive processes in the brain. Results: Our experimental results indicate that IRPs can better characterize information processing, particularly perceptual holism. Additionally, we conducted a brain network analysis and found that visual and auditory perceptual holistic processing share consistent neural pathways. Discussion: Our efforts not only demonstrate the specificity, significance, and reliability of IRPs but also reveal their great potential for future brain mechanism research and BCI applications.

A bird's eye view of the potential role of NFKBIA in pan-cancer.

In the 21st century, cancer remains a serious threat to people's health and has become a prominent public health problem. NFKBIA is involved in the pathological process of many diseases including cancer, but its specific role in pan-cancer has not yet been fully elucidated. This study aims to deepen the understanding of cancer pathology by analyzing the potential functions of NFKBIA in pan-cancer. We used TCGA data to analyze differences of expression of NFKBIA in pan-cancer. We explored the prognostic value, clinical relevance, immune relevance, potential biological function, and diagnosis and treatment value of NFKBIA in pan-cancer through bioinformatics analysis. This study found that in pan-cancer, NFKBIA exhibits differences in expression, which correlate with the prognosis, diagnosis, treatment value and clinical and immune parameters. We have identified that Aspirin, Astaxanthin and Bardoxolone methyl are expected to play a potential therapeutic role in pan-cancer. The results of this study will help to improve our understanding of the role and potential mechanism of NFKBIA in cancer pathology, which may provide guidance for cancer-related research and clinical diagnosis and treatment.

EEG analysis in patients with schizophrenia based on microstate semantic modeling method.

Introduction: Microstate analysis enables the characterization of quasi-stable scalp potential fields on a sub-second timescale, preserving the temporal dynamics of EEG and spatial information of scalp potential distributions. Owing to its capacity to provide comprehensive pathological insights, it has been widely applied in the investigation of schizophrenia (SCZ). Nevertheless, previous research has primarily concentrated on differences in individual microstate temporal characteristics, neglecting potential distinctions in microstate semantic sequences and not fully considering the issue of the universality of microstate templates between SCZ patients and healthy individuals. Methods: This study introduced a microstate semantic modeling analysis method aimed at schizophrenia recognition. Firstly, microstate templates corresponding to both SCZ patients and healthy individuals were extracted from resting-state EEG data. The introduction of a dual-template strategy makes a difference in the quality of microstate sequences. Quality features of microstate sequences were then extracted from four dimensions: Correlation, Explanation, Residual, and Dispersion. Subsequently, the concept of microstate semantic features was proposed, decomposing the microstate sequence into continuous sub-sequences. Specific semantic sub-sequences were identified by comparing the time parameters of sub-sequences. Results: The SCZ recognition test was performed on the public dataset for both the quality features and semantic features of microstate sequences, yielding an impressive accuracy of 97.2%. Furthermore, cross-subject experimental validation was conducted, demonstrating that the method proposed in this paper achieves a recognition rate of 96.4% between different subjects. Discussion: This research offers valuable insights for the clinical diagnosis of schizophrenia. In the future, further studies will seek to augment the sample size to enhance the effectiveness and reliability of this method.

Fermentation properties and functional stability of dough starter Jiaozi and Laomian after frozen storage.

Purpose: This study aims to investigate the effects of frozen storage on the stability of traditional dough starters in China. Methods: The microbial community structure and abundance of related metabolic genes in different fermented sourdough prepared by Jiaozi (JZ) and Laomian (LM) starters before and after frozen storage at -20°C for half a year were analyzed using the shotgun metagenomic sequencing method, and differences in characteristics of texture in steamed bread were also compared by formal methods. Results: The fermentation ability (FA) and metabolic activities of yeast in the JZH sourdough (started by JZ which was stored at -20°C for half a year) were better than those of LMH sourdough (started by LM which was stored at -20°C for half a year). The dominant genera of Acetobacter were found to be increased in the JZH0 sourdough (started by JZH and fermented for 0 h) and those of Lactobacillus were found to be decreased. Lactobacillus (98.72%), Pediococcus (0.37%), Saccharomyces (0.27%), and Acetobacter (0.01%), were dominant in sourdough LMH0 (started by LMH and fermented for 0 h). The abundances of "oxidative phosphorylation-related enzymes" and the "biosynthesis of glutamate"-related enzymes and genes related to "biosynthesis of glutamate" and "unsaturated fatty acid" were higher in JZH0 than in the JZ0 sourdough (started by JZ without being frozen and fermented for 0 h). The good FA of yeast, the acid production capacity of bacteria in the sourdough, and the quality of the JZH steamed bread (made by the JZH starter) indicated the better freezing tolerance of the microorganisms in JZ than in LM. Conclusion: The conclusion of this study suggests the better application potential of the JZ as the fermentation starter in actual production.

Predictive Value of Fidgety Movement Assessment and Magnetic Resonance Imaging for Cerebral Palsy in Infants.

BACKGROUND: The early prediction of cerebral palsy (CP) could enable the follow-up of high-risk infants during the neuroplasticity period. This study aimed to explore the predictive value of fidgety movement assessment (FMA) and brain magnetic resonance imaging (MRI) for the development of CP in clinic rehabilitation setting. METHODS: This retrospective observational study included infants who underwent FMA and brain MRI at age nine to 20 weeks at Children's Hospital, Zhejiang University School of Medicine, between March 2018 and September 2019. The area under the receiver operating characteristic curve (AUC), sensitivity, specificity, and accuracy of FMA and MRI for predicting the development of CP were assessed. RESULTS: A total of 258 infants (169 males, gestational age 37.4 ± 3.0 weeks, birth weight 2987.9 ± 757.1 g) were included. Fifteen children had CP after age two years. The diagnostic value of FMA and brain MRI combination showed 86.7% sensitivity (95% confidence interval [CI]: 58.4% to 97.7%), 98.4% specificity (95% CI: 95.6% to 99.5%), and 97.7% accuracy (95% CI: 95.0% to 99.1%); the combination diagnostic value also showed a significantly higher AUC for predicting CP after age two years than FMA alone (AUC: 0.981 vs 0.893, P = 0.013). CONCLUSIONS: The diagnostic value of FMA and brain MRI combination during infancy showed a high predictive value for CP development in clinical rehabilitation setting.

Improvement of the freezing resistance characteristics of yeast in dough starter.

Improving the freezing resistance of yeast in dough starters is one of the most effective methods to promote the healthy development of frozen dough technology. When the dough starter was composed of yeast, lactic acid bacteria and acetic acid bacteria, the microbial proportion was 10:1:5, and the ratio of wheat flour to corn flour was 1:1. The proline contents of the starters and the survival rates and fermentation capacity of yeast significantly increased compared with those of the starter composed of yeast and wheat flour only (P < 0.05). Laser confocal microscopy observation showed that the cell membrane damage of yeast obviously decreased. Low-field nuclear magnetic resonance method revealed that the water distribution state of starters changed. Adding corn flour and acetic acid bacteria to dough starter in appropriate proportions improves yeast freezing resistance.

A novel multi-feature fusion attention neural network for the recognition of epileptic EEG signals.

Epilepsy is a common chronic brain disorder. Detecting epilepsy by observing electroencephalography (EEG) is the main method neurologists use, but this method is time-consuming. EEG signals are non-stationary, nonlinear, and often highly noisy, so it remains challenging to recognize epileptic EEG signals more accurately and automatically. This paper proposes a novel classification system of epileptic EEG signals for single-channel EEG based on the attention network that integrates time-frequency and nonlinear dynamic features. The proposed system has three novel modules. The first module constructs the Hilbert spectrum (HS) with high time-frequency resolution into a two-channel parallel convolutional network. The time-frequency features are fully extracted by complementing the high-dimensional features of the two branches. The second module constructs a grayscale recurrence plot (GRP) that contains more nonlinear dynamic features than traditional RP, fed into the residual-connected convolution module for effective learning of nonlinear dynamic features. The third module is the feature fusion module based on a self-attention mechanism to assign optimal weights to different types of features and further enhance the information extraction capability of the system. Therefore, the system is named HG-SANet. The results of several classification tasks on the Bonn EEG database and the Bern-Barcelona EEG database show that the HG-SANet can effectively capture the contribution degree of the extracted features from different domains, significantly enhance the expression ability of the model, and improve the accuracy of the recognition of epileptic EEG signals. The HG-SANet can improve the diagnosis and treatment efficiency of epilepsy and has broad application prospects in the fields of brain disease diagnosis.

Nerve-tumor crosstalk in tumor microenvironment: From tumor initiation and progression to clinical implications.

The autonomic nerve system (ANS) innervates organs and tissues throughout the body and maintains functional balance among various systems. Further investigations have shown that excessive activation of ANS not only causes disruption of homeostasis, but also may promote tumor formation. In addition, the dynamic interaction between nerve and tumor cells in the tumor microenvironment also regulate tumor progression. On the one hand, nerves are passively invaded by tumor cells, that is, perineural invasion (PNI). On the other hand, compared with normal tissues, tumor tissues are subject to more abundant innervation, and nerves can influence tumor progression through regulating tumor proliferation, metastasis and drug resistance. A large number of studies have shown that nerve-tumor crosstalk, including PNI and innervation, is closely related to the prognosis of patients, and contributes to the formation of cancer pain, which significantly deteriorates the quality of life for patients. These findings suggest that nerve-tumor crosstalk represents a potential target for anti-tumor therapies and the management of cancer pain in the future. In this review, we systematically describe the mechanism by which nerve-tumor crosstalk regulates tumorigenesis and progression.

A case report of lymphoproliferative disease in brain following therapies with mycophenolate Mofetil and Fingolimod and literature review.

Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is an autoimmune disorder. With the method of indirect immunofluorescence assay (IIF), more anti-NMDAR encephalitis patients have been discovered when its first onset. But it was rare that anti-NMDAR encephalitis overlapped with multiple sclerosis (MS) documented in literatures. Here, we present a case who initially developed anti-NMDAR encephalitis and MS. Furthermore, we concluded the characteristics of patients who were diagnosed as anti-NMDAR encephalitis overlapping with MS. Additionally, due to the relapsing process, mycophenolate mofetil and sequentially fingolimod for the treatment were taken, which subsequently led to the development of a lymphoproliferative disease in his brain and other organs. This case illustrates the complex role of immunosuppressive agents.