Objective To study the effect of chronic low dose soman on learning and memory and long term potentiation(LTP) of hippocampal slices. Methods Rat model was established by consecutive subcutaneous injection of soman(6-10 ?g?kg 1 , s. c, sig?14) for 14 days for Morris water maze test. Long term potential of synaptic transmission was observed in CA1 region by tetanization of the Schaffer commissural pathway in rat hippocampal slices. Results In the Morris water maze, latency to find a hidden platform was longer and the times of crossing the situation of platform and the time percent of swimming in northeast obviously decreased. In the experiment on hippocampal slice of rats in vitro by microelectrode method, the generation of long term potentiation was inhibited. Conclusion Chronic low dose soman may cause an evident learning and memory disturbance and decrease hippocampal synaptic plasticity.

Objective:To check the effect of immunosuppressants as adjuvants for DNA vaccine to prevent autoimmune disease.Methotis:Three immunosuppressants,Cyclosporin A(CsA),Tacrolimus(FK506)and Mycophenolate Mofetil(MMF)Were combined with DNA vaccine of Multiple Sclerosis(MS)and injected intramuscuarly.The splenocytes of immunized mice were checked for regulatory T cells(Treg),T cell proliferation and maturation of dendritic cells(Dcs)as well as release of intereleukin 10(IL-10).The immunized mice were induced as EAE animal model to check the preventive effect of FK506 as adjuvant.Results:More Treg cells Were induced in the mice immunized with FK506 and DNA vaccine and also T cell proliferation Was suppressed.DCs maturation Was blocked and high level of IL-10 in DCs Was induced in mice treated with FK506 and DNA vaccine.The clinic scores of EAE were significantly decreased in mice treated with FK506 and DNA vaccine compared with other control groups.Conclusion:FK506 as adjuvant of DNA vaccine can stimulate Treg cells and immune tolerance,then prevent from the autoimmune disease.

Objective To summarize the experience on treatment for 15 cases of acute pulmonary embolism(PE).Methods Fifteen acute PE patients admitted from June 2009 to May 2011 were analyzed retrospectively.All patients were diagnosed as PE and deep vein thrombosis,and treated with placement of inferior vena caval filters(IVC).Five patients with main pulmonary artery embolism accepted intrapulmonary arterial interventional therapy of thrombus fragmenlation and suction and catheter-directed thrombolysis (CDT).Ten patients with embolization on pulmonary artery branch and acute iliofemoral vein thrombus accepted therapy of peripheral thrombolysis.During postoperative course improvement was observed on the clinical symptoms,occurrence of complications,Miller index,change of mean pulmonary arterial pressure (mPAP) and arterial partial pressure of oxygen(PO2),as well as the patency of pulmonary artery.Result Five main pulmonary artery embolization patients gained complete patency of pulmonsnary artery,and the clinical symptoms immediately improved.Miller index reduced from (0.51 ± 0.04) to (0.27 ± 0.38),mPAP decreased from (55.3 ± 3.1 ) mm Hg to ( 32.7 ± 2.2 ) mm Hg,and PO2 elevated from ( 40 ±3 ) mm Hg to ( 63 ± 4) mm Hg,showing a significant difference ( P ＜ 0.01 ).Ten patients with pulmonary artery branch embolization gained patency of pulmonary artery branch,iliofemoral venous thrombosis cleared,and clinical symptoms significantly improved.All patients recovered after two weeks of intravenous thrombolytic,anticoagulation and antiplatelet therapy.During three to twelve months' follow up,the therapeutic effects persisted and there was no recurrence.Conclusions Emergency intrapulmonary arterial interventional therapy of acute PE has remarkable effectiveness,safety and feasibility,improving pulmonary obstruction and clinical symptoms.

To investigate the clinical characteristics of primary Sj-gren's Syndrome （pSS） patients with central nervous system（CNS） damage as the initial manifestation.Methods Fifteen pSS patients with CNS damage as the initial manifestation were recruited.Clinical manifestations，laboratory results and imaging findings were retrospectively analyzed.Descriptive statistics was used for statistical analysis.Results Among the 15 patients，the ratio of male to female was 1∶4，and the first onset age was （45.53±16.19） years old.The diagnosis was confirmed after an average of 32.37 months.The initial symptoms included headache （6.67%），dizziness （20%），vomiting （20%），slurred speech （6.67%），facial paralysis （6.67%），hemilateral limb weakness （26.67%），numbness and weakness of both lower limbs （13.33 %） or the limbs （46.67%），chest and back pain（26.67%），blurred vision （6.67%）.The lesions involved the cerebral hemisphere （33.33%），brain stem （53.33%），cerebellum （6.67%），spinal cord （53.33%），and optic nerve （6.67%），presenting as cerebral infarction（33.33%），SAH（6.67%），transverse myelitis（6.67%），bulbar lesion（6.67%），neuromyelitis optica spectrum disorder （NMOSD）（53.33%） and NMOSD complicated with cerebral infarction in 1 case （6.67%）.CNS symptoms recurred in 3 cases （20%） before pSS was diagnosed.At the time of diagnosis，the positive rate of autoimmune antibodies was anti-SSA antibody 100%，anti-nuclear antibody 100%，anti-SSB antibody 73.33%，anti-R0-52 antibody 80%，anti-ds-DNA antibody 6.67%，respectively.The positive rate of RF was 20%.The increase rate of IgG and IgA were 20%，and the decrease rate of complement C3 was 20%.The cerebrospinal fluid study showed：CSF pressure （80-240） mmH-2O，white blood cells cout （4-130）×106/L，protein （0.27-1.46） g/L；CSF IgG increased in 5 cases，and IgM increased in 2 cases，and IgA increased in 4 cases.Conclusion CNS damage can be the initial manifestation of pSS.The lack of timely screening and monitoring of autoimmune antibody is an important reason for the delayed diagnosis of pSS.For unexplained CNS lesions，especially those presenting as recurrent demyelinating events or cerebral infarction，autoimmune antibodies such as anti-SSA and SSB should be examed actively，while the symptoms such as dry eyes and dry mouth should be questioned.It is important for early diagnosis.

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 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 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.