Objective To explore the dynamic changes of inflammatory cytokines and C-reactive protein(CRP)in patients with acute cerebral hemorrhage and its prognostic value.Methods TNF-α, IL-1β, IL-6, IL-8 and CRP were measured in 120 healthy persons and 120 patients after the onset of acute cerebral hemorrhage at 24 h, 3, 7 and 14 d.Correlation analyzes were performed respectively between bleeding quantity or serious degree in patients with acute cerebral hemorrhage and the above indicators.Receiver operating characteristic curve was emploied to analysis its clinical prediction significance to the deterioration of acute cerebral hemorrhage.Results Different periods of serum TNF-α,IL-1β, IL-6, IL-8, and CRP in patients with acute cerebral hemorrhage were higher than those in healthy controls(P<0.05).There was a positive correlation between brain bleeding quantity or severity and the contents of TNF-α, IL-1β, IL-6, IL-8, and CRP in patients with acute cerebral hemorrhage(P<0.05).The inflammatory cytokines and CRP in the patients had its clinical prediction significance to the deterioration of acute cerebral hemorrhage.Conclusion The serum levels of inflammatory cytokines and CRP is involved in cerebral hemorrhage in the pathophysiological process,and these indicators have important predictive value for patients.

Objective To explore the effect of miniAd-ATP7B-GFP on the copper metabolism of skin fibroblasts of Wilson′s disease ( WD ) patients under high concentration copper medium.Methods Firstly, mini-adenovirus carrier containing human ATP7B gene was built and the mutations of 8 WD patients were detected.Fibroblasts from primary culture of skin of WD patients and normal human were cultivated 72 h in basic medium and medium with the copper concentration of C1(22.3μmol/L), C2(89.2μmol/L), C3 (156.1 μmol/L), C4 (245.3 μmol/L).Then the concentration of copper and protein was detected and copper/protein ratio was calculated.Secondly, miniAd-GFP ( miniAd-GFP group) and miniAd-ATP7B-GFP ( miniAd-ATP7B-GFP group ) were added into WD patients skin fibroblasts respectively, Wilson non-transfection group and normal group were set up as control, and C4 medium was used to culture the cells of four groups for 72 h and 96 h.Then the concentration of copper and protein was detected and copper/protein ratio was calculated.Results Five kinds of mutations were detected from 8 WD patients.The copper/protein ratio of WD patients and normal human in basic medium and the C1 -C3 groups had no statistically significant difference, but in C4 group (WD (1 871.6 ±209.2) ng/mg, normal group (1 267.2 ±188.3) ng/mg) the difference was statistically significant (t=6.075, P<0.01).C3((816.3 ±113.9) ng/mg) and C4 groups had statistically significant difference compared with the basic medium group ( ( 159.2 ± 38.6) ng/mg;WD:χ2 =31.493, normal group:χ2 =30.708, both P<0.01).The copper/protein ratio of 96 h group was higher than 72 h group.Compared with WD non-transfection (96 h:(2 731.2 ±188.7) ng/mg,72 h:(1 901.7 ±219.5) ng/mg) and normal groups, miniAd-ATP7B-GFP group had statistically significant difference both in 96 h ( ( 2 071.0 ±171.8 ) ng/mg ) and 72 h groups ( ( 1 495.5 ±161.4 ) ng/mg;72 h:F=20.130, 96 h: F=51.496,P<0.01).Conclusion MiniAd-ATP7B-GFP has partial improvement on copper metabolism of skin fibroblasts of WD patients under high concentration copper medium.

Objective To explore the effect of Tanshinone IIA on apoptosis and expression of Drp-1 and TRPM7 in a rat model of focal cerebral ischemia and reperfusion. Methods Rats were pretreated with high or low dose of tanshinone IIA before 2 h-focal cerebral ischemia plus 24 h-reperfusion. Cerebral blood flow in the middle cerebral artery was moni-tored during reperfusion. TTC, TUNEL and western blotting were used to detect the volume of cerebral infarction, apopto-sis and the protein expression of Drp-1 as well as TRPM7, respectively. Results Compared with control group, pretreat-ment with Tanshinone IIA could significantly down-regulate the expression of protein Drp-1 and TRPM7 (P<0.05), attenu-ate apoptosis (P<0.05), and reduce the volume of ischemia infarction. The volumes of right middle cerebral artery blood flow were(31.80%± 2.49%),(54.8%± 3.27%), and(58.8%± 3.03%)in controls, low-dose and high dose of tanshinone, respectively. Both low-dose and high-dose tanshinones improved cerebral blood flow. (tanshinone vs. control;all P<0.05). However, there was no statistical difference between low-dose and high-dose Tanshinone IIA groups in all measured out-comes (P>0.05). Conclusions Tanshinone IIA can inhibit ischemia-induced neuronal apoptosis and mitochondrial fission probably through improving cerebral artery blood flow and reducing the overexpression of Drp-1,TRPM7.

Objective To analyze the clinical features, diagnosis, treatment and prognosis of neurosyphilis. Methods Clinical data on and laboratory findings in 18 cases with neurosyphilis collected in the Affiliated Provincial Hospital, Anhui Medical University from 2006 to 2008 were retrospectively studied.Results Among the 18 patients, 3 sufferred from asymptomatic neurosyphilis, 1 from meningeal syphilis, 7 from meningovascular syphilis, 5 from paralytic dementia, and 2 from intracranial space-occupation. Toluidine red unheated serum reagin test (TRUST) and Treponema pallidum particle agglutination test (TPPA) of sera were positive in all the patients; cerebrospinal fluid (CSF) TRUST was positive in 16 patients, and CSF TPPA in all patients. An increase was observed in CSF leukocyte count in 7 patients and in CSF protein in 13 patients.The findings on cerebral magnetic resonance imaging (MRI) mainly included demyelination, brain atrophy,cerebral infarction, etc. All the patients, except 2 with a TRUST titer of 1:4, experienced a 4-fold decrease in TRUST titer within a 3-month follow up. Clinical symptoms of neurosyphilis improved in all patients except 1 with paralytic dementia. Conclusions The diversity of clinical manifestations usually leads to the misdiagnosis of neurosyphilis, which should be diagnosed based on comprehensive analysis of clinical characteristics as well as laboratory and imaging findings. Early diagnosis and treatment are beneficial to its prognosis.

Objective To investigate the characteristics of prospective memory in patients with Parkinson's disease (PD) and emotional apathy.Methods Included in this study were 62 PD patients who had sought medical attention at our department from January 2015 to January 2017.They were divided into an emotional apathy group and a normal emotion group according to the emotional indifference scale.Also included in this study were another 35 healthy controls matched for demographic data.Their neurological function status,severity of illness and demographic data were assessed using the Unified Parkinson's Disease Rating Scale and the General Questionnaire.The neuropsychological tests and experimental paradigms of event-based prospective memory (EBPM) and time-based prospective memory (TBPM) were used to assess their cognitive function and prospective memory.Comparisons were done between the 3 groups in the above measurements.Results (1) Neuropsychological tests demonstrated that the 2 groups of PD patients had significantly lower MoCA scores and significantly higher HAMA and Stroop scores than the healthy control group (P＜0.05).The emotional apathy group had significantly higher HAMA,Stroop and digit span test (DST) scores than the normal emotion group (P＜0.05).(2) In EBPM task,the emotional apathy group scored significantly lower than the normal emotion group and the 2 groups of PD patients scored significantly lower than the healthy control group (P＜0.05).In TBPM task,the emotional apathy group scored significantly lower than the normal emotion group and the healthy control group (P＜0.05).(3) The correlation analysis showed that the EBPM scores were negatively correlated with the HAMD,Stroop and DST scores in the emotional apathy group (r=-0.352,P=0.048;r=-0.515,P=0.003;r=-0.524,P=0.002).Conclusion Prospective memory impairment may be more severe in PD patients with emotional apathy,suggesting an impact of their emotional apathy on their prospective memory.

Objective:To investigate the relationship between the concentration of soluble platelet-derived growth factor receptor β (sPDGFRβ) in the cerebrospinal fluid (CSF) of patients with Alzheimer′s disease (AD) and the degree of cognitive impairment and cerebrospinal fluid biomarkers.Methods:A total of 50 patients with AD in the Department of Neurology of Provincial Hospital Affiliated to Anhui Medical University from September 2018 to August 2020 were selected as AD group, and 33 patients with normal cognition who had no significant difference in age and gender in the same period served as control group. The neuropsychological evaluation was conducted. According to the Clinical Dementia Rating scale scores, the AD patients were divided into mild AD group and moderate to severe AD group.The clinical data and cognitive function of the three groups were compared. And the level of CSF sPDGFRβ, CSF amyloid-β (Aβ) 1-40, CSF Aβ 1-42, CSF total tau protein (T-tau), CSF phosphorylated tau protein (P-tau) were measured by enzyme linked immunosorbent assay in each group. According to whether apolipoprotein E4 (ApoE4) gene was carried, the patients with AD were divided into ApoE4 + group and ApoE4 - group. Differences among the three groups were compared and the correlation analysis was carried out. Results:The levels of sPDGFRβ in the CSF of the mild AD group [(219.301±69.711) pg/ml] and the moderate to severe AD group [(235.358±86.187) pg/ml] were significantly higher than that of the control group [(184.878±52.944) pg/ml, F=3.90, P=0.024], while there was no significant difference in the level of CSF sPDGFRβ between the ApoE4 + group [(219.493±76.745) pg/ml] and the ApoE4 - group [(222.802±81.665) pg/ml, t=-0.13, P=0.900]. And the level of sPDGFRβ in the CSF in the mild AD group was positively correlated with the level of CSF P-tau ( r=0.43, P=0.019), but not correlated with Aβ 1-42, T-tau, Mini-Mental State Examination scores or Montreal Cognitive Assessment scores, whereas no significant correlation was found in the control group and the moderate to severe AD group. Conclusions:Expression of sPDGFRβ in CSF of AD patients is increased, and may relate to P-tau. Pericyte injury may be involved in the phosphorylation of tau protein in the brain of AD patients.

Objective　To investigate the relationship between cognitive impairment of Alzheimer’s disease and serum Uric acid (UA) and Homocysteine (Hcy) concentrations in the patients.Method　We collected 39 cases of geriatric cognitive impairment hospitalized in the department of neurology of anhui provincial hospital from September 2018 to May 2019,and 22 normal control cases with no significant differences in age,gender and education level，the levels of serum uric acid and homocysteine were measured in both groups,and neuropsychological tests including MMSE and MoCA were conducted.Results　The MMSE score (17.54±4.71) and MoCA score (11.41±4.48) of the case group were lower than that of the control group MMSE score (27.82±1.84) and MoCA score (23.27±3.23),the difference between the two groups was statistically significant (t=9.801,P<0.05,t=10.895,P<0.05) in the case group,UA was 325.16±80.19,Hcy was 14.37±7.37,in the control group,UA was 258.47±71.06,and Hcy was 8.91±2.61.The differences between the two groups were statistically significant (t=-3.246,P<0.05,Z=4.316,P<0.05);Hcy level was negatively correlated with MMSE and MoCA(R=-0.490,P<0.05).The UA value in the case group was positively correlated with MMSE and MoCA (R=0.573,P<0.05,R=0.624,P<0.05).Conclusion　Hyperhomocysteine is a risk factor for cognitive impairment,which is positively correlated with cognitive function.UA is positively correlated with patients cognitive function,especially with visual space and executive ability,and uric acid level may be related to the disease process of cognitive impairment.

Objective　To explore the relationship between the blood metabolic indexes and the occurrence and development of Alzheimer’s disease (AD) and to find the correlation with cerebrospinal fluid biomarkers.Methods　A total of 66 patients diagnosed with AD from September 2018 to July 2020 and 36 normal controls with no difference in age and gender were enrolled in this study.The levels of serum metabolic indexes were detected in all subjects.The levels of tau protein and amyloid protein (Aβ) in cerebrospinal fluid were measured and compared.and the correlation between tau protein and metabolic indexes was analyzed.Results　The levels of homocysteine (Hcy)，high density lipoprotein cholesterol (HDL-C)，folic acid and Vitamin B12 (VitB12) in AD group were significantly different from those in control group (P<0.05);after adjustment of multivariate regression analysis.HDL-C and VitB12 were significantly correlated with the occurrence of AD;the levels of HCY,HDL-C.folic acid and VitB12 were significantly correlated with cognitive score in Pearson correlation analysis (P<0.05).The level of tau protein in cerebrospinal fluid was significantly higher than that in the control group.and the concentration of Aβ42 was significantly lower than that in the control group.Pearson correlation analysis showed that HDL-C was positively correlated with tau protein level.and VitB12 was positively correlated with Aβ42 (P<0.05).Conclusion　This study shows that the degree of cognitive impairment in AD patients is positively correlated with HCY and HDL-C levels.and the levels of folic acid and VitB12 are negatively correlated with the severity of cognitive impairment in AD patients.Which may be protective factors of AD.

Objective　 To explore the clinical features,diagnosis and treatment status of serotonin syndrome (SS) in China by analyzing the case report of serotonin syndrome.Methods　We studied all case report of serotonin syndrome by database retrieval.The clinical features,treatment and outcome were analyzed statistically.Results　A total of 41 patients with serotonin syndrome were collected,the most common clinical features were the increase of blood pressure or heart rate (97.6%),sweating (92.7%),tremor (80.5%),Secondly were myoclonus or myotonia (73.2%),fever (58.6%),agitation or delirium (61%),and disturbance of consciousness (58.5%).Conclusion　Selective 5-hydroxytryptamine reuptake inhibitors are still the most common drugs leading to serotonin syndrome.The most common features were autonomic nervous system disorders,followed by neuromuscular symptoms,mental or consciousness changes.At present,the prevention and diagnosis of serotonin syndrome have not been given enough attention in our country.Early detection and early intervention have a positive effect on reducing the clinical adverse outcome.