1.Clinical and immunological mechanisms of myasthenia gravis and pregnancy
Xiaoqing LIU ; Manqiqige SU ; Sushan LUO ; Chongbo ZHAO ; Yali ZHANG
Chinese Journal of Neurology 2023;56(3):338-343
The clinical symptoms of myasthenia gravis (MG) in women are closely related to pregnancy, and the outcome of pregnancy and neonates is related to MG disease control, comorbidities and antibody types. The exacerbation of muscle weakness usually appeared in the first trimester and postpartum 0-3 months. The adverse pregnancy outcomes of MG mothers are mainly fetal arrest and abortion. Neonatal muscle weakness and congenital joint flexion are common neuromuscular lesions in childbirth. During pregnancy, the immune system of MG pregnant women is regulated by estrogen/progesterone/prolactin/glucocorticoid, and the main result is to inhibit pro-inflammatory response and promote immune tolerance. However, the specific interaction between MG and pregnancy remains to be elucidated in prospective cohort studies.
2.Efficacy and safety of vagus nerve stimulation in the treatment of refractory epilepsy.
Zhuanyi YANG ; Dingyang LIU ; Zhiquan YANG ; Xiaoyu CHEN ; Yuxiang CAI ; Jian LIU ; Junmei ZHANG ; Sushan LI
Journal of Central South University(Medical Sciences) 2021;46(10):1096-1101
OBJECTIVES:
Vagus nerve stimulation (VNS) is a neuromodulative therapeutic technique for patients with drug-resistant epilepsy who are not suitable for resection or who have experienced a failed resection. This study aims to explore the efficacy and safety of VNS in patients with refractory epilepsy, and to analyze the influential factors for the efficacy.
METHODS:
A retrospective review of clinical data were conducted for 35 patients, who were treated for refractory epilepsy through VNS surgery in the Department of Neurosurgery, Xiangya Hospital, Central South University from April 2016 to August 2019. All patients were analyzed in terms of the clinical and follow-up data.
RESULTS:
After a mean follow-up of 26 months (6-47 months), outcome was as follows: 7 patients were MuHugh class I, 13 patients were MuHugh class II, 8 patients were MuHugh class III, and 7 patients were MuHugh class IV-V. The total efficacy rate in the short duration group was significantly higher than that in the long duration group (77.8% vs 50.0%,
CONCLUSIONS
VNS is a safe and effective option in treating patients with refractory epilepsy, especially for those with short duration.
Drug Resistant Epilepsy/therapy*
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Humans
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Magnetic Resonance Imaging
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Retrospective Studies
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Seizures
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Treatment Outcome
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Vagus Nerve Stimulation
3.Mechanical Properties and Biological Characteristics of the Porous 3D-Printed β-TCP Composite Scaffolds
Chao DU ; Hao JIANG ; Yi CAO ; Zijing DU ; Danyang ZHAO ; Zhencheng YU ; Sushan ZHANG ; Dong HAN
Journal of Medical Biomechanics 2018;33(3):E234-E239
Objective To study the mechanical properties and biological characteristics of 3D-printed porous β-tricalcium phosphate [β-Ca3(PO4)2, β-TCP] scaffolds, so as to provide guidance for the design of composite scaffolds in animal experimentation. Methods Poly 1,8-octanediol citrate (POC), a kind of novel biodegradable materials, was used as the adhesive. The 3D-printed porous β-TCP scaffolds were fabricated by fused deposition modeling (FDM) technology, and Gly-Arg-Gly-Asp-Ser (GRGDS), a kind of polypeptides, was added into the scaffolds to improve the adhesive property of cells. The optical microscope and scanning electron microscope (SEM) were used to observe the micro-pore architectures of those scaffolds. The material testing machine was used to conduct compressive test on the scaffolds, and the water contact angles of the scaffolds were measured. The cell adhesion rate and proliferation rate of the scaffolds were also tested by in vitro cell experiment. The model of SD rat skull defects was repaired by the scaffolds, and the osteogenic ability in vivo was further studied. Results The GRGDS, remaining active, was evenly distributed in the composite scaffolds. The micro-pore architectures of the polypeptide modified scaffolds changed, with improvement in cell adhesion rate, while the compressive modulus, water contact angle and osteogenic ability in vivo of the scaffolds were not obviously affected. Conclusions The cell adhesion capacity of β-TCP composite scaffolds modified by polypeptide improved significantly, while the mechanical properties and hydrophilicity, osteogenic ability in vivo of the scaffolds were not affected very much. These research results provide new ideas for reconstruction of scaffolds for repairing bone defects in clinic, and a laboratory basis for further clinical application of this scaffold.