[ ABSTRACT] AIM: To investigate the role of TNF-αand NF-κB in the mechanism of neuropathic pain due to chronically compressed dorsal root ganglion ( CCD) .METHODS:Based on the CCD model, von Frey filaments were used to quantify behavior test.The expression changes of TNF-αand NF-κB were determined by Western blotting, and the cor-relation between the expression of TNF-αand the 50%paw withdrawal threshold was also analyzed.Moreover, the location of TNF-αin dorsal root ganglion ( DRG) was observed with immunofluorescence double staining.RESULTS: We found 50%paw withdrawal threshold of CCD decreased at the first day after operation.The mechanical allodynia was the most ob-vious at postoperative 7~14 d and lasted longer than 35 d.The expression of TNF-αand NF-κB increased significantly in DRG after operation (P<0.01), especially at 7~14 d, and then restored gradually.Moreover, there was a correlation between the protein expression of TNF-αand the changes of neuropathic behavior ( P<0.05 ) .CONCLUSION: TNF-αand NF-κB are involved in the mechanism of mechanical allodynia after chronically compressed DRG.

Objective: To study the feasibility of the determination paracetamol in Gangmaoqing by HPLC. Methods: The paracetamol contents of the different samples of Ganmaoqing Tablets were determined by the dead stop titration and HPLC, respectively. Results: The dead stop titration was complex and the error was larger. Whereas HPLC was simple, quick with a good seperation and small error.Conclusion: HPLC is accurate and reliable and reproducible for the determination of paracetamol in Ganmaoqing Tablets.

Objective To investigate the effects of different concentrations of ozone on nigra oxidative stress and apoptosis-related protein expression in rats with Parkinson's disease (PD).Methods Thirty-two adult male SD rats aged 2-3 months and weighted 180-220 g were randomly divided into 4 groups (n=8):PD group,PD+ozone 20 group (given ozone 20 mg/L),PD+ozone 50 group (given ozone 50 mg/L) and control group; rats in the former three groups were given right striatum injection of 15 μg 6-OHDA to induce PD models,and rats in the control group were given the same volume of normal saline; four weeks after PD inducement,mixed gases of 5.0 mL of oxygen and ozone (20 mg/L and 50 mg/L,1 mg/kg) were given to rats in the PD+ozone 20 group and PD+ozone 50 group,respectively,for 15 d.Then,tissues were obtained from nigra; the activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px),and the content of malondialdehyde (MDA) were measured by using chromometry; the protein expressions of B cell lymphoma/lewkmia-2 (Bcl-2) and Bcl-2 associated X protein (Bax) were detected by using Western blotting.Results As compared with those in the control group,the GSH-Px activity was significantly decreased and the MDA content was significantly increased in PD group,PD+ozone 20 group and PD+ozone 50 group (P＜0.05); the GSH-Px activity (6.98±0.60 vs 9.37±0.41、10.04±0.59) was significantly increased and the MDA content(2.31±0.54 vs 1.85±0.29、1.79±0.39) was significantly decreased in PD+ozone 20 group and PD+ozone 50 group as compared with those in the PD group (P＜0.05).Western blotting indicated no significant differences of protein expressions of Bax and Bcl-2 among the four groups (P＞0.05).Conclusion Ozone can improve antioxidation capability of rats with PD by increasing the activity of GSH-PX,while it does not affect the expression levels of Bax and Bcl-2.

Objective To investigate the differences in the curative effects between traditional telephone follow-up and medical care combined with WeChat and medical mobile app in adult epilepsy patients with anxiety and depression,analyze the influence factors for the differences from following five aspects: medication compliance, anxiety and depression,quality of life of patients, knowledge of diseases and related behavior correction,satisfaction rate of patients to follow-up and patients' hospital readmission rate. Methods A total of 100 adult epilepsy patients with anxiety and depression in our department from February 2015 to October 2015 were investigated in the study. The patients were divided into observation group and control group by admission order alternates (50 respectively). Patients in control group received traditional telephone follow-up,while patients in observation group were managed using WeChat and medical mobile APP. Medication compliance,anxiety and depression,quality of life of patients,knowledge of diseases and related behavior correction, satisfaction rate of patients to follow-up and number of patients' hospital readmission were compared between two groups at intake time and after 6 months' follow-up. Results Among 100 epilepsy patients, 14 patients were lost and 86 patients were followed up for 6 months. At 6 months' post discharge, medication compliance of patients in observation group was significantly higher than that in control group (P<0.05). The scores of SAS and SDS in observation group were lower than those in control group, with statistically significant difference (P<0.05). The score of QOLIT-31 in observation group was significantly higher than that in control group (P<0.05). Patients in observation group performed better than patients in control group in diet habit correction, knowledge of training methods, as well as in satisfaction to follow-up and rate of patients' hospital readmission. The differences were statistically significant (P<0.05). Conclusions Medical care combined with WeChat and medical mobile APP in adult epilepsy patients with anxiety and depression can improve patients' medication compliance, relieve patients' anxiety and depression, increase quality of life of patients, enhance patients' knowledge of disease and behavior correction and raise the rate of patients' hospital readmission and satisfaction to follow-up.

Objective To investigate the clinical and imaging characteristics of myelin oligodendrocyte glycoprotein antibody-associated disease(MOGAD).Methods The clinical symptoms,MRI features,results of laboratory tests and clinical prognosis of 14 MOGAD patients who were hospitalized in our hospital from June 2016 to June 2022 were collected and retrospectively analyzed.Their clinical and imaging characteristics were summarized and discussed.Results Among the 14 enrolled patients,there were 10 males and 4 females,with a male to female ratio of 2.5∶1.Their age of first onset was＜18 years in 3 cases,18～45 years in 8 cases,and＞45 years in 3 cases.Optic neuritis(10/14,71.43％)was the most common clinical type,followed by encephalitis or meningoencephalitis(9/14,64.29％),brainstem encephalitis(5/14,35.71％)and myelitis(5/14,35.71％).Visual impairment(10/14,71.43％)was the most common clinical symptom,followed by headache in 8 cases(8/14,57.14％),fever in 6 cases(6/14,42.86％),dizziness in 6 cases(6/14,42.86％),parethesia in 5 cases(5/14,35.71％),and seizures,limb paralysis,sphincter dysfunction,ataxia,and vomit were all in 4 cases(4/14,28.57％).Four patients(4/14,28.57％)had a history of upper respiratory tract infection before MOGAD onset.There were 10 patients undergoing cerebrospinal fluid(CSF)test,and 8 of them had abnormal results,including 2 patients(2/10,20％)of increased pressure,8 patients(8/10,80％)of larger WBC count in CSF,and 5 patients(5/10,50％)of elevated total protein in CSF.MRI displayed multiple lesion involvement,and there were 7 cases(7/14,50.00％)in cortical/subcortical white matter,6 cases in brainstem(6/14,42.86％),5 cases in optic nerve(5/14,35.71％),4 cases in spinal cord(4/14,28.57％).The hippocampus,thalamus,basal ganglia,and paraventricular white matter were involved in 3 cases(3/14,21.43％),respectively,and the cerebellum and corpus callosum were in 2 cases(2/14,14.29％),respectively.MRI lesions demonstrated patchy hyperintensity on T2 WI and T2 FLAIR,with patchy,nodular and linear enhancement.Among the 10 patients undergoing visual evoked potential(VEP)test,abnormalities were detected in 9 cases(9/10,90％),and 8(8/10,80％)had bilateral visual pathway abnormalities.Eight patients(8/14,57.14％)experienced relapse and remission course.Both methylprednisolone pulse therapy and immunoglobulin modulation therapy were effective in the acute phase.Five patients with relapsed remission presented a significant reduction in recurrence after immunosuppressants.Conclusion MOGAD is manifested with various clinical features,with vision loss,headache,fever and dizziness more common.MRI lesions of MOGAD involve cerebral cortex,subcortical white matter,brainstem,and optic nerve,etc.Patchy hyperintesive signals are observed on T2WI and T2 FLAIR,and some lesions can be enhanced.Corticosteroid pulse therapy and immunoglobulin therapy show effective treatment in the acute phase,and immunosuppressants in the remission phase can reduce relapse.

Objective To explore the risk factors of depression and anxiety in adult patients with epilepsy and their relationship with quality of life.Methods From May 2022 to January 2023,patients diagnosed with epilepsy(aged≥18 years)in the department of neurology of our hospital were collected.General demographic data and disease-related information were recorded.Quality of life,depression and anxiety scales were measured in all patients.SPSS26.0 software was used for multiple linear regression analysis,multiple ordered Logistic regression analysis,rank sum test,Pearson correlation analysis,etc.Results Among the 111 patients,49.5%had depression and 43.2%had anxiety.Depression score and anxiety score were correlated with attack type,attack frequency,quality of life and right temporal lobe,and there was a significant negative correlation between life quality score and anxiety and depression score(P<0.01).Seizure frequency,seizure type and right temporal lobe were common risk factors for depression and anxiety in patients with epilepsy(P<0.05).Conclusion Epileptic depression and anxiety were affected by seizure frequency and seizure type,and this bad mood further affected the quality of life of patients.No clear link has been found between the lateralization of seizures and the presence of depression and anxiety states,and further research is needed.

By gene sequencing methods, such as targeted sequencing, whole exome sequencing (WES) and whole genome sequencing (WGS), about 1,000 epilepsy-related genes have been identified recently; and ion channel related genes are the most common genes being studied; about 25% single-gene inherited epilepsy is associated with ion channel gene variants. This article reviews the value of ion channel genes in epilepsy treatment so as to improve the understanding of epilepsy related ion channel genes and further optimize the treatment strategy of epilepsy.

Objective To observe the efficacy and side effect of Chinese style modified Atkins diet as add-on therapy in Chinese patients with intractable epilepsy to provide an easier operational choice for these patients.Methods A prospective study was performed on the clinical data of 15 patients with intractable epilepsy,admitted to our hospital from January 2010 to May 2013.On the basis of Johns Hopkins hospital operation method,other three measures were added:recommending calories and protein restriction,guaranteeing lowest fat intake,and choosing 1 g carbohydrate as one serving.All the patients were implemented with this method on the base of drugs.The efficacy,retention rate and side effect after this diet were observed.Results These patients were followed-up for 6 months to 3 years.Three patients (20％) had no attack,4 (26％) had reduced onset of ＞90％ attacks,6 (40％) had reduced 50％ -90％ of their attacks,and the other two did not enjoy good effect.The retention rate at 6 months was 66％; 33％ patients (5/15) had elevated blood lipids (including triglyceride and cholesterol).Conclusion As compared with ketogenic diet,Chinese style modified Atkins diet achieves similar effect,enjoying higher retention rate and fewer side effect,which is worth for clinical promotion.