Objective To investigate myostatin gene mRNA expression in the muscle tissue from patients with muscle weakness suffering from different illness.Methods The clinical data of our patients were all from the Muscular Disease Center,Department of Neurology,People' s Liberation Army General Hospital.A total of 75 patients suffered from muscular weakness were included consecutively.Skeletal muscle biopsies were obtained with informed consent from all 75 patients.The diagnosis was confirmed by two senior doctors for muscular disease according to the clinical feature,the results of electromyography,serum creatine kinase activity and histopathological examination.Among of them,21 cases were diagnosed as polymyositis,15 cases progressive muscular dystrophy,5 cases neurogenic amyotrophy,4 cases chronic muscle fiber damage,4 cases mitochondrial myopathy,4 cases lipid storage myopathy,4 cases myotonic dystrophy,3 cases muscular dystrophy in adults,2 cases dermatomyositis,and 2 cases inclusion body myositis.There were 2 cases characterized by pure high activity of creatine kinase.And the other 9 cases were diagnosed as non-neuromuscular disease.The expression of myostatin gene mRNA in muscle tissue was evaluated by reverse transcription polymerase chain reaction method,with glyceraldehyde-3-phosphate dehydrogenase as internal reference.Results The expression of myostatin gene mRNA was detected in 63 patients,but not in other 12 cases,and the percentage of positive expression was 84％.The expression index was with great variation,from 0 to 3.52.In positive cohort,the index was correlated positively with the duration of disease (r =0.236,P =0.041).The activities of creatine kinase in positive expression cohort were higher than that of negative one,but nonsignificantly.Conclusion The expression of myostatin gene mRNA in muscle tissue may not correlate to the entity of atrophic muscular disease because of its great variation.

Objective To investigate the clinical features, diagnosis, treatment and prognosis of polymyositis patients with cardiac involvement.Methods Clinical data of 41 polymyositis patients with cardiac involvement were analyzed retrospectively.Results In our group, the percentage of polymyositis with cardiac involvement was 38.3%, and 25 (60.1%) out of the 41 patients were asymptomatic. Their average age was older than the cases without cardiac involvement ( P

Objective To investigate the relationship between the G20210A mutation of prothrombin gene and cerebral infarclion(CI) in young patients. Methods The frequency of G20210A gene mutation of prothrombin in 40 young CI patients and 48 controls were studied by polymerase chain reaction (PCR) followed by Mnl- I and Hind-Ⅲ restriction enzyme analysis. Results No prothrombin gene G20210A mutation was found in both patients and controls. Conclusion The G20210A gene mutation of prothrombin was not the risk factor of this group of young CI patients.

This is to study the clinical features of thyrotoxic periodic paralysis (TPP) caused by Graves′ disease. Fifty-nine patients, accounting for 25.4% of 232 patients with Graves′ disease, were found to be suffering from TPP. Among them, 58 were male and one was female. 54 patients were young men (age 19～45) (91.5%). Hypokalemia was found in 53 cases (89.8%) during episodes of paralysis. The results indicate that the rate of TPP caused by Graves′ disease is 25.4%, and it occurs mainly in young men(98.3%). Hypokalemic periodic paralysis was the most common type of TPP.

Though affected by the COVID-19 epidemic in 2020, the Chinese Journal ofNeurology successfully overcame the difficulties and successfully completed the annual editing and publishing work. In 2020, editorial board meetings were held monthly to decide whether or not to publish a manuscript, 12 theme issues were published, nine guidelines and consensuses by the Chinese Society of Neurology were published, 10 continuing medical education articles by famous experts were published, and several COVID-19 related articles were quickly published. In 2021, efforts will be made to make the journal to a higher level.

Tumor markers (TMs) in blood are important tools for the diagnosis, prognosis prediction and monitoring therapeutic efficacy of malignant tumor. Measurement of TMs in pleural and peritoneal fluid has been widely used. However, the significance of common TMs associated with systemic solid tumors in cerebrospinal fluid (CSF) has been overlooked to some extent. TMs in CSF are within extremely low limits in patients without intracranial malignant diseases. Slightly elevated TMs in CSF usually indicate abnormal intrathecal synthesis. Measurement of TMs in CSF is a useful and feasible ancillary diagnostic tool for intracranial metastasis, especially for leptomeningeal metastasis.

Diabetic neuropathy is the most common neuropathy. Pathology and electrophysiology are important for early diagnosis of diabetic neuropathy. This article would review the newest progress of the pathology and electrophysiology of diabetic neuropathy.

Objective To analyze the correlative factors and cause of death within short-term in initially lucid patients with intracerebral hemorrhage (ICH).Methods 441 patients with spontaneous ICH admitted within 24 hours of onset and with Glasgow Coma Scale (GCS) score more than 9 on admission were enrolled. The demographic characteristics, clinical features at onset, CT, electrocardiograph (ECG) and laboratory findings, medical complications and 27 days outcome were recorded. Univariate and multivariate analysis were performed.Results 24 (5.4%) patients died winthin 27 days after onset, 14 (58.3%) died of brain herniation and central respiratory failure, another 10 (41.7%) of systemic complications. Multivariate analysis demonstrated that age was 75 years old or more, urinary incontinence at onset, peripheral white blood cell count more than 10.0?10 9/L on admission, blood glucose more than 7.0 mmol/L and abnormal ECG were independent correlative factors of death.Conclusions The short-term outcome of initially lucid patients with ICH is favorable in general, albeit with a relatively low mortality. Brain herniation and central respiratory failure were main cause of death, and they have independent correlative risk factors.

Objective To investigate the clinical, pathological and imaging features of sporadic Creutzfeldt-Jakob disease (CJD). Methods The clinical, pathological, electroencephalogram (EEG) and imaging data of 12 cases of CJD were analyzed retrospectively.Results (1) 7 cases of the enrolled patients were male and 5 were female. The average onset age of them was 49 years old. 3 cases were acute onset by visual loss and 9 cases were subacute onset by hypophrenia, mental and behavior disorder or cerebellar ataxia. All the cases showed dementia, myoclonus and extrapyramidal sign. (2) 9 cases showed typical triphasic wave on EEG and 1 case presented atypical triphasic wave. (3) 5 cases showed abnormal hyperintense lesions in basal ganglia on T 2-weighted images (T 2WI). 8 cases in occipital and/or frontal cortex showed the abnormal hyperintense lesions on diffusion-weighted images (DWI), and 5 of them accompanied symmetric diffuse hyperintense lesions in basal ganglia. (4) 1 case with postmortem and 6 cases with biopsy of brain showed classic pathological features of CJD.Conclusion On the base of typical clinic manifestations, EEG and DWI examinations are useful in early diagnosis of sporadic CJD.

Objective To investigate the change of serum homocysteine (Hcy) and plasma fibrinogen (Fg) levels in patients with ischemic cerebrovascular diseases (ICVD) and the correlation between Hcy and Fg.Methods Blood samples were collected from 74 patients with ICVD and 40 controls. The concentrations of Hcy, folate and Fg were determinated by means of fluorescence polarization immunoassay, electrochemiluminescence, and immunoturbidimetry, respectively. In the meantime, plasma lipid was detected by routine method.Results Both Hcy and Fg levels in the patients with ICVD increased significantly as compared with the controls (all P0.05). Multivariate logistic regression analysis indicated that hypertension, high cholesterol, high Fg and high Hcy concentrations played significiant roles in ICVD.Conclusion Both hyperhomocysteinemia and hyperfibrinogenemia are independent risk factors of ICVD.