The effects of high erucic acid rapeseed oil (HER) on fatty acid oxidation in rat livers compared with low erucic acid rapeseed oil (LER) were studied. Weanling male SD rats were fed on 20% (% by weight, similarly hereinbelow) HER or LER diet for a week or 4 weeks, or 5% HER diet for 4 weeks. The hepatic capacity for oxidation of butyric acid and palmitic acid was determined by titrating the acetone produced by the fatty acid oxidation. The results showed that feeding HER to rats led to an increse in weight of liver and the extent of this increase was positively correlated to the intake of erucic acid (C22:1, n-9 cis). Feeding HER reduced the hepatic oxidation capacity for palmitic acid, notably in 20% HER (1 wk) group. Feeding LER had not shown this effect,indicating that erucic acid plays an important role in the toxicity of rapeseed oil. In the present study it was not found that the hepatic oxidation capacity for butyric acid was influenced by the intake of HER. Therefore, we considered that the inhibitory effect of HER on oxidation of long-chain fatty acids probably resulted from that the incorporation of erucic acid into mitocho-ndrial membranes interfered with the fatty acyl-CoA transfering system on the membranes, leading the fatty acyl-CoA to be unable to enter the mitochondria and to be oxidized there, but not from that the B-oxidation system in mitochondria was directly inhibited.

Objective:To summarize the clinical characteristics and therapeutic efficacy of central nervous system (CNS) aspergillosis.Methods:The clinical manifestations, laboratory examination, neuroimaging features, treatment and prognosis of 37 cases of CNS aspergillosis diagnosed and treated in the First Medical Center of People′s Liberation Army General Hospital from January 2000 to January 2021 were retrospectively analyzed. According to the correlation between intracranial lesions and paranasal sinus lesions, they were divided into two groups: rhino-cerebral aspergillosis (RA, n=21) group and cerebral aspergillosis (CA, n=16) group. Results:Only 16.2% (6/37) of CNS aspergillosis patients had a clear background of immunosuppression, but 35.1% (13/37) were complicated with diabetes. The most common clinical manifestations were headache (73.0%, 27/37), cranial nerve involvement (59.5%, 22/37) and fever (37.8%, 14/37). Cerebrospinal fluid characteristics included increased pressure (53.8%, 14/26), increased white blood cell count (46.7%, 14/30), decreased glucose (30.0%, 9/30), increased protein (70.0%, 21/30), and high positive results of the metagenomic next-generation sequencing (mNGS) of pathogenic microorganism (7/10). Cranial magnetic resonance imaging showed that commonly involved sites were sinus, orbital apex, posterior orbit, cavernous sinus (43.2%, 16/37) and cerebral lobes (27.0%, 10/37). Treatment options included antifungal drugs alone (64.9%, 24/37), combination of drugs and surgery (27.0%, 10/37) and surgery alone (8.1%, 3/37). Compared with the CA group, RA group had fewer males [47.6% (10/21) vs 14/16, χ2=6.34, P=0.012] and older age [(54.2±19.4) years vs (38.4±18.4) years, t=2.50, P=0.017], and was more prone to headache [85.7% (18/21) vs 9/16, χ2=4.00, P=0.046) and cranial nerve involvement [81.0% (17/21) vs 5/16, χ 2=9.31, P=0.006]. The misdiagnosis rate of these patients in the early stage was 73.0% (27/37). A total of 29 patients (85.3%, 29/34) were treated with voriconazole successively, and the course of treatment was 3.0 (0.5, 10.4) months. Compared with salvage therapy, the mortality of primary therapy was lower (4/17 vs 9/12, χ2=7.54, P=0.006). All patients were followed up to December 2021, and 17 patients died, with a mortality rate of 45.9% (17/37). Conclusions:CNS aspergillosis may have no definite immunosuppressive background. Some of CNS aspergillosis patients are complicated with diabetes, and the clinical manifestations of the disease lack specificity, with high misdiagnosis rate in the early stage, no inflammatory changes in cerebrospinal fluid, and high positive rate of mNGS for pathogenic microorganism. Early and long-term application of voriconazole can significantly reduce the mortality rate.