Objective To analyze the clinical manifestations as well as correlation between clinical manifestations and the new neuroimage characteristics(pontine"cross sign"and"putaminal slit")for correct diagnosis of multiple system atrophy(MSA).Methods Eleven patients with MSA based on Gilman diagnostic criteria were retrospectively analyzed for clinical manifestations and brain MRI findings.Results Eleven patients were probably diagnosed as MSA,among which 8 patients were MSA-C(olivopontoeerebellar atrophy,OPCA),2 patients were MSA-P(striatonigral degeneration,SND),one patient was MSA-A(Shy- Drager syndrome,SDS).Five years after onset,MRI of MSA-A showed stage 0"cross sign"and "putaminal slit".In 8 patients with MSA-C,2 patients reached stage Ⅰ 3 years after onset,one patient reached stage Ⅱ 2 years after onset,3 patients respectively did stage Ⅲ 1 year,3 years,and 5 years after onset,2 patients reached Ⅳ stage 2 years,and 7 years after onset respectively.As for putaminal slit,all of these patients were in stage 0.One patient with MSA-P reached stage 0"cross sign"and stage Ⅰ "putaminal slit"6 years after onset;another patient showed stage Ⅳ"cross sign"and stage Ⅱ"putaminal slit"9 years after onset,which was high slit intensity on both sides,however much stronger in the fight side than in the left side.Conclusion Both"cross sign"and"putaminal slit"are neuroimage characteristics for early diagnosing MSA-C,while"putaminal slit"for MSA-P.

ObjectiveTo study the level of temperament and self-esteem of children aged 8～12 in Beijing city,as well as their interaction and influenced factor.Methods203 school children aged 8～12 were assessed with Carey's temperament questionnaire(8～12:MCTQ) and The Self-Esteem Scale(SES).ResultsTemperament and self-esteem of school children aged 8～12 were associated with the parental behavior,especially with work style of their fathers.The rhythmicity was found to be negative correlated to the self-esteem scores,and the intensity of reaction was found to be positive correlated to the self-esteem scores.ConclusionParents' behavior and family environment were important to the temperament and self-esteem of school children.

Objective To explore the pathologic changes in the brain areas corresponding to specific cognitive function and underlying mechanism of cognitive impairment in patients with epilepsy by DTI study.Methods Forty-four Patients and 20 control subjects received the test of Wechsler Adult Intelligence Scale and the Diffusion-Tensor Imaging examination.Mean diffusivity (MD) and fractional anisotropy (FA) in the normal appearing white matter of interested area were measured.T test was employed to compare the MD and FA between patients and healthy controls,patients with normal and impaired FIQ respectively.The relationships between FIQ and DTI value were analyzed by Bivariate correlations.Results VIQ (100.52?17.63),PIQ (95.10?16.72) and FIQ (98.19?17.76) of the patients with epilepsy were significantly lower than those of health controls (VIQ,PIQ and FIQ were 109.77?13.54,108.11? 12.17 and 109.81?10.57,respectively).Significant reduction of FA in both side of posterior limb of internal capsule (P

Objective To analyze the characteristics,electroencephalographic(EEG)features,neuroimaging findings,therapeutic effects and prognoses of 114 cases of idiopathic nocturnal frontal lobe epilepsy (NFLE). Methods The clinical data of 114 patients with idiopathic NHLE admitted in the epilepsy outpatient department from June,1999 to January,2007 were collected and analyzed. Results Idiopathic NFLE was clinically characterized by nocturnal clustered,postural or dystonic seizures and complex motor activities.The interictal routine EEG in 22.9% and dynamic EEG in 28% of the cases in wakefuIness and the interictal dynamic EEG in 38% of tbe cases in sleep showed frontal lobe epileptiform discharge,which was found in the EEG during seizure attacks in66.7% of the cases.Drug therapy was effeclive in 79.8% of the cases.with 29.7% of the cases showing complete seizure control. Conclusions Idiopathic NFLE has distinct clinical features wim relatively low rate of EEG abnormality during seizure attack or the interictal period.Frontal lobe epilepsy is more likely to occur in sleep,and sleep EEG is therefore of much importance in the diagnosis of idiopathic NFLE.

OBJECTIVETo investigate the mRNA expressions of the TNF adapter proteins, including TNF receptor-associated death domain protein (TRADD), Fas-associated death domain protein (FADD), receptor-interacting protein 1 (RIP-1) and TNF receptor-associated factor-2 (TRAF-2) in peripheral blood mononuclear cells (PBMCs) of lupus nephritis (LN) patients of various TCM asthenia syndromes. Methods Fifty-one inpatients with LN were differentiated according to TCM syndrome differentiation, 13 cases of yin-deficiency with inner heat syndrome (A); 26 cases of both qi-yin deficiency syndrome (B), 12 cases of Pi-Shen yang-deficiency syndrome (C). Peripheral venous blood samples from the 51 LN patients and 17 healthy subjects were collected to separate PBMCs. The mRNA expressions of TNF adapter molecules (TRADD, FADD, RIP-1 and TRAF-2), as well as Caspase-3 and interleukin-1beta (IL-1beta) were analyzed by quantitative real-time PCR and the differences among them were compared.

RESULTS(1) As compared with the healthy subjects, expression of TRADD mRNA in patients of syndrome A, B and C was lowered to 0.54, 0.32, and 0.38-fold, respectively (P < 0.05, P < 0.01), showing insignificant difference among the three syndromes; (2) FADD mRNA lowered to 0.79, 0.62, and 0.72-fold respectively, only with significance shown in syndrome B (P < 0.05); (3) RIP-1 mRNA lowered to 0.79, 0.50, and 0.60-fold respectively with significance shown in syndrome B and C (P < 0.01, P < 0.05), and insignificant difference was shown among the three syndromes; (4) TRAF-2 lowered to 0.70, 0.52, and 0.50-fold respectively (P < 0.01, P < 0.01, P = 0.07), significance shown in syndrome B and C (P < 0.01), but with insignificant difference among the three; (5) Caspase-3 elevated in all patients of the three syndromes (all P < 0.01); (6) IL-1beta in syndrome A was apparently lower ed to the normal range and also lower than that in the other two syndromes (both P < 0.05).

CONCLUSIONSExpressions of TRADD, FADD, RIP-1 and TRAF-2 mRNA decreased in all the patients of various TCM asthenia syndromes, the decrement in patients of syndrome B and C was lesser than that in syndrome A. These abnormal low expressions of signal proteins might be the substantial bases for asthenia syndromes of LN patients, and the apoptotic signal mediated by them may involve in the formation of asthenia syndrome in LN.

Adaptor Proteins, Signal Transducing ; genetics ; metabolism ; Adolescent ; Adult ; Case-Control Studies ; Child ; Fas-Associated Death Domain Protein ; genetics ; metabolism ; Female ; Humans ; Leukocytes, Mononuclear ; metabolism ; Lupus Nephritis ; blood ; Male ; Medicine, Chinese Traditional ; Middle Aged ; RNA, Messenger ; genetics ; metabolism ; Receptor-Interacting Protein Serine-Threonine Kinases ; genetics ; metabolism ; TNF Receptor-Associated Death Domain Protein ; genetics ; metabolism ; TNF Receptor-Associated Factor 2 ; genetics ; metabolism ; Tumor Necrosis Factor-alpha ; blood ; metabolism ; Yang Deficiency ; blood ; Yin Deficiency ; blood ; Young Adult

Objective To evaluate the therapeutic effects and safety of amitrine bismesylate in patients with mild vascular dementia.Methods An open multicenter self-controlled trial was carried out with 128 mild vascular dementia patients clinically diagnosed.Patients were treated with amitrine bismesylate in a dose of 2 tablets per day for 12 weeks.The neuro-psychologieal scale of MMSE,ADAS-cog,CDR, ADL were used to evaluate patients′cognitive condition before therapy and 6,12 weeks after treatment.The adverse effects,such as nausea and vertigo and so on,were monitored at the same time to evaluate the safety of this drug.Results After 3 months of treatment,the MMSE score(16.98 before therapy and 17.97 after treatment,P

Objective To study the discharges regularity of ambulatory electroencephalogram (ambulatory,EEG,AEEG)during sleep and hyperventilation(HV)-induced EEG. Methods Features of epileptiform discharges of AEEG and HV-induced EEG were evaluated comparatively in 65 cases with frontal lobe epilepsy. Results The epileptiform discharge rate of HV-induced EEG was evidently lower than that of AEEG during the shallow sleep period (non-rapid-eye-movement phase 1 and 2,NREM phase 1 and 2),which had statistical significance(P＜0.01);however,the rate of HV-induced EEG had no significant difference from that of AEEG during the awake period and deep sleep period(NREM phase 3 and 4)(P＞0.05). Conclusions The epileptiform discharge rate of AEEG during the shallow sleep period is obviously higher than that of HV-induced EEG in patients with frontal lobe epilepsy,and thus sleep EEG is helpful to enhance the diagnostic rate of epileptiform discharges in these patients.

Objective To investigate the diagnostic values of interleukin-8 (IL-8), matrix metalloproteinase-9 (MMP-9) and interferon gamma (INF-γ) levels in patients with tuberculous meningitis and viral meningitis by detecting the contents of these biomarkers in the cerebrospinal fluid (CSF). Methods Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of IL-8,MMP-9 and INF-γ in the CSF of patients with tuberculous meningitis (n=20),viral meningitis (n=15) and noninfectious neurologic diseases (n=20) who admitted to our hospital from August 2010 to November 2011. Results The IL-8,MMP-9 and INF-γlevels in the samples from the tuberculous meningitis patients were significantly higher than those from either viral meningitis or noninfectious neurologic diseases (P＜0.05).The contents of IL-8 and MMP-9 in patients with viral meningitis were significantly higher than those in patients with noninfectious neurologic diseases (P＜0.05),while that of INF-γ showed no significant difference between the 2 groups (P＞0.05). Conclusion Detection of IL-8,MMP-9 and INF-γ in CSF is useful in the diagnosis of tuberculous meningitis; IL-8 and MMP-9 participate in the progress of viral meningitis; the detective value of high concentration of INF-γ in CSF is more significant in diagnosis of tuberculous meningitis than that of IL-8 and MMP-9.

OBJECTIVETo improve the differential diagnosis of tuberculous meningitis (TBM) and reduced potential misdiagnosis of TBM.

METHODSThe clinical data of 47 misdiagnosed cases of TBM between January, 1994 and June, 2009 were investigated retrospectively. The clinical presentations and causes for the misdiagnoses were analyzed.

RESULTSThe 47 patients with misdiagnosed TBM included 28 male and 19 female patients with a mean age of 36.84∓16.41 years. Eight patients had an acute onset, 10 had a subacute onset, and 29 had chronic disease. The initial symptoms, in the descending order of their frequencies, included fever and headache (87.2%), anergia and dyskinesia (27.7%), cerebral nerve damage (23.4%), decreased level of consciousness (14.9%), and urinary and fecal incontinence (2%). Meningeal irritation was present in 25 cases and positive Babinksi sign was found in 19 cases. Elevated intracranial pressure occurred in 51.1% of the cases, and 16 cases showed papilloedema. Non-purulent CSF with elevated protein was found in 86.7%, decreased glucose in 50%, and decreased chlorinate in 53.3% of the cases. Eight out of 23 cases showed a positive result of PPD test. MRI identified abnormitis with meningeal enhancement in 15 cases, hydrocephalus in 7 cases and infarction in 14 cases. Tuberculoma was found in 2 cases, and spinal cord lesions were found 4 cases. All the patients received anti-tuberculosis therapy, which resulted in symptomatic improvement in 39 cases, fluctuated condition in 2 cases; 5 patients discontinued the treatment and 1 died.

CONCLUSIONEarly TBM often presents with atypical features and its differential diagnosis can be difficult. CSF monitoring and careful inspection of the radiographic data can be helpful in the diagnosis of suspected cases, for which early anti-TB treatment is an important means to reduce misdiagnosis.

Adult ; Diagnosis, Differential ; Diagnostic Errors ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Tuberculosis, Meningeal ; cerebrospinal fluid ; diagnosis ; Young Adult

Objective:To explore the potential mechanism of Tianshui Dichang Decoction in the treatment of ulcerative colitis through network pharmacology and experimental verification.Methods:The active components and targets of Tianshui Dichang Decoction were screened by TCMSP. The related targets of ulcerative colitis were screened by OMIM, GeneCard and TTD databases, and the effective component targets of Tianshui Dichang Decoction were intersected with the potential targets of ulcerative colitis. The PPI network was constructed by STRING database to screen the core targets, and the "Chinese materia medica-disease-active components-target" network was constructed by Cytoscape 3.8.0 software. GO function and KEGG pathway enrichment analysis were carried out using Metascape database. 48 mice were divided into control group, model group, mesalazine group (0.3 g/kg) and Tianshui Dichang Decoction low-, medium-, and high-dosage groups (7.5,15 and 30 g/kg) according to random number table method, with 8 mice in each group. Except the control group, the ulcerative colitis model was established in other groups. After 7 days of intervention with corresponding drugs, the disease activity index (DAI) was scored, the pathological changes of colon were observed by HE staining, and the expressions of IL-6, STAT3mRNA and protein in colon tissue were detected by PCR and Western blot methods.Results:Totally 127 active components in Tianshui Dichang Decoction and 560 targets of ulcerative colitis were obtained. 89 intersecting targets of Tianshui Dichang Decoction and ulcerative colitis were obtained, and the core targets included IL6, TNF, IL1B, AKT1, TP53, VEGFA, JUN, PTGS2, CXCL8, CCL2, STAT3, MMP9 and so on. Oxidative stress response, lipopolysaccharide metabolism, bacterial response, signal transduction and other biological processes were mainly involved, mainly through the cancer pathway, IL17, TNF, MAPK and other signal pathways to play a role in the treatment of ulcerative colitis. The results of experimental verification showed that the DAI score, the expressions of IL-6 and STAT3 protein in colon tissue of Tianshui Dichang Decoction medium- and high-dosage groups.decreased ( P<0.05). The levels of IL-6 and STAT3 mRNA in colon tissue decreased in the Tianshui Dichang Decoction low-, medium- and high-dosage groups.groups ( P<0.05). Conclusion:Tianshui Dichang Decoction has a certain therapeutic effect on UC through component-multitarget-signal pathway, and its mechanism is related to regulating IL-6/STAT3 signal pathway and inhibiting intestinal mucosal inflammation.