BACKGROUND: Previous studies have indicated that hyperhomocysteinemia can induce atherosclerosis by enhancing oxidative stress, whereas Ginkgo biloba extract (GbE) can scavenge oxygen-derived free radicals.OBJECTIVE: To observe the role of reactive oxygen species (ROS) and nuclear factor-kappa B (NF-κB) in the expression of cell adhesion molecules (CAMs) induced by homocysteine (Hcy), and investigate the effect of GbE.DESIGN: A randomized controlled animal trial.SETTING: Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology.MATERrALS: Twenty-four healthy male rabbits of 6 months old. Dl-methionine (Sigma Chemical, Co.,Ltd.); GbE (Guizhou Yibai Pharmaceutical Company; powder).METHODS: The experiment was accomplished in the Laboratory of Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology from March 2003 to April 2004. ① After adaptive feeding for 2 weeks, the rabbits were randomly divided into three groups: Model group (n =12): The rabbits were treated with subcutaneous injection of dl-methionine (80 mg/kg per day); GbE group (n =8): The rabbits were administrated with GbE (mixed with feed, 50 m/kg per day) at 1 hour before the subcutaneous injection of dl-methionine; Control group (n=4): The rabbits were injected with equivalent sodium chloride. They were administrated for 7 weeks continuously. ②Histological changes were observed under light and electron microscopes: ROS level was determined with colorimetries (721 visible spectrophotometer); The expressions of CAMs and NF-κB in endothelial cells were detected with immunohistochemical methods; The concentration of plasma Hcy was measured with high-performance liquid chromatography.MAIN OUTCOME MEASURES: Histological changes, ROS level and expressions of CAMs and NF-κB in endothelial cells.RESULTS: All the 24 rabbits were involved in the analysis of results. ① ROS level: After administration, the ROS level in the model group was obviously increased (2.92±0.20,2.48±0.26, P ＜ 0.05), whereas those in the GbE group and control group (2.41±0.23, 2.43±0.20) had no obvious differences as compared with those before administration (2.31±0.27,2.47±0.32, P ＞ 0.05). ② Histological changes: Aortas of rabbits in the model group presented initial changes of atherosclerosis, including shedding or necrosis of endothelial cells and nuclear pyknosis or standing in a clutter of smooth muscle cells. There were scarcely any changes in the GbE group and control group. ③ Expressions of CAMs and NF-κB in endothelial cells: After treatments, the expressions of vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1) and NF-κB in the model group were obviously higher than those in the control group (P ＜0.05), and there were no significant differences between the GbE group and control group (P ＞ 0.05). ④ Concentration of plasma Hcy: After 7 weeks, the concentration of plasma Hcy was higher in the model group and GbE group than in the control group [(25.01±6.80), (26.71±2.36), (16.85± 1.64) μmol/L, P ＜ 0.05].CONCLUSION: Hcy-induced oxidative stress plays an important role in NF-κB activation. GbE might suppress the activation of NF-κB and expression of CAMs by reducing ROS.

Objective To study the characteristics and regularities of somatotype growth of Yugu adolescents.Methods The somato-type growth of 989 Yugu adolescents(male:512,female:477)in Sunan was evaluated by the Heath-Carter method.Results The average somatotype of YuGu adolescents in males was mesomorphic ectomorph(3.0-3.6-3.7),and in females,the average somatotype was ectomorphic endomorph(3.8-2.9-3.6).The somatotypes develop from central,endomorphic ectomorph to mesomorphic ectomorph in the male,however,in the female from central,ectomorphic endomorph,endomorphic ectomorph,to mesomorphic endomorph.Conclusion The somatotypes of Yugu adolescents are very different between males and females.In the male group,the somatotypes of the 7-12 year-old group of Yugu adolescents are similar to the Mongolia,Han ethnic,Zhuang ethnic and Hungary.The somatotypes of 13-17 year-old group are similar to Tibetan,Zhuang ethnic,Han ethnic and Daur.However for the female group,the somatotypes of the 7-9 year-old group are similar to Hungary,and the 10-17 year-old group are similar to Tibetan,Zhuang ethnic,Han ethnic and Finn.

Objective To firstly report the clinical features,diagnosis and treatment response of patients with anti-γ-aminobutyric acid type A receptor (GABAAR) encephalitis in China,thus raising neurologists' awareness of this emerging type of autoimmune encephalitis.Methods Specific anti-GABAAR autoantibodies in the serum and cerebrospinal fluid (CSF) of patients with suspected autoimmune encephalitis but negative for commercial available antibody tests were detected by live cell-based assay (CBA).The clinical features,laboratory examinations and treatment of two cases of autoimmune encephalitis with anti-GABAAR autoantibodies were analyzed,who admitted to Huashan Hospital,Fudan University between 2013 and 2014.Results By using live CBA,serum and CSF of the two patients diagnosed with possible autoimmune encephalitis both contained autoantibodies targeted to the GABAAR.These two patients had onset symptom of seizure or refractory seizures.Memory impairment,psychiatric symptoms and decreased consciousness were also presented.One patient was combined with mass in anterior superior mediastinum.Both patients had multifocal cortical and subcortical T2 /fluid attenuated inversion recovery-weighted images hyperintensity signal on brain magnetic resonance imaging.The two patients had poor response to antiepileptic drugs,but showed noticeable recovery with sufficient immunotherapeutic treatments.Conclusions Anti-GABAAR encephalitis is characterized by prominent epilepsy and multifocal abnormalities on brain magnetic resonance imaging.Autoantibodies specifically against GABAAR could be detected by CBA in this group of patients.Early diagnosis and immunotherapy are critical to improve clinical symptoms and outcomes of the disease.

Objective:To analyze the clinical characteristics of patients with double-positive anti-myelin oligodendrocyte glycoprotein (MOG) antibody and anti-N-methyl-D-aspartate receptor (NMDAR) antibody, so as to raise awareness of such diseases and improve the prognosis.Methods:Eighteen patients (double positive group) with positive serum anti-MOG antibody and cerebrospinal fluid anti-NMDAR antibody in Huashan Hospital, Fudan University from March 2017 to March 2020 were retrospectively analyzed. Using the SPSS software for simple random sampling, anti-MOG group(20 cases) and anti-NMDAR group (20 cases) were randomly selected at the same time for comparison. The anti-MOG group referred to the patients only with positive serum anti-MOG antibody. While the anti-NMDAR group referred to the patients whose cerebrospinal fluid anti-NMDAR antibody was positive. The clinical characteristics, laboratory examination results, radiological characteristics and prognosis of the three groups were collected and analyzed.Results:There was no statistically significant difference in demographic data among the three groups ( P>0.05). The symptoms of patients in the double-positive group were divided into two categories by cluster analysis, which corresponded to the symptom groups obtained by cluster analysis of the anti-MOG group and the anti-NMDAR group, and the same result was verified by correspondence analysis. Compared with the anti-MOG group, the incidence of epilepsy (10/18 vs 3/20, P=0.016), psychosis and behavior change (8/18 vs 0/20, P=0.001), visual disturbances (8/18 vs 17/20, P=0.016), dysarthria/dysphagia (8/18 vs 1/20, P=0.007) was significantly different in the double-positive group ( P<0.017). Compared with the anti-NMDAR group, the incidence of ataxia (8/18 vs 19/20, P=0.001), psychosis and behavior change (12/18 vs 1/20, P<0.001) was significantly different in the double-positive group. There was no statistically significant difference in the combination rate of thyroid peroxidase antibody, thyroglobulin antibody and antinuclear antibody between two groups, and the cerebrospinal fluid pressure, white blood cell count, protein, glucose, chloride and positive rate of oligoclonal band were also not statistically different between two groups ( P>0.017; P<0.017 indicates statistically significant difference by Bonferroni corrected multiple comparisons). Compared with the anti-NMDAR group, whether the brain magnetic resonance imaging had lesions was different in double positive group (18/18 vs 8/20, P<0.001). The initial modified Rankin Scale (mRS) scores before treatment were different among the double positive group, anti-MOG group and anti-NMDAR group (3.72±0.96, 2.75±0.97, 3.95±0.76, respectively, F=10.004, P<0.001), but there was no statistically significant difference in the scores after six-month treatment (1.22±1.44, 0.40±0.75, 1.20±1.24, respectively, F=3.153, P=0.051), and the recurrence rate of the disease was different among the three groups (8/18, 14/20, 5/20, respectively, χ2=10.004, P=0.017). Conclusions:Anti-MOG antibodies and anti-NMDAR antibodies could exist at the same time, showing clinical phenotype overlap, which was a new syndrome called the overlapping syndrome of myelin oligodendrocyte glycoprotein antibody-associated disease and NMDAR encephalitis, MNOS. The condition of MNOS patients was more severe than that of patients with MOG antibody-associated disease (MOGAD), but patients with MNOS, MOGAD, and anti-NMDAR encephalitis all responded well to immunosuppressive therapy. It was suggested that early second-line immunotherapy should be given to reduce the recurrence rate in patients with MNOS and MOGAD.

Objective To investigate the translation and rotation of healthy elbow joints during active flexion and extension, so as to provide references for the treatment of elbow instability and injuries. Methods Ten healthy subjects with no history of upper extremity trauma were recruited. Dual fluoroscopic imaging system (DFIS) was applied to quantify six-degree-of-freedom (6-DOF) kinematics of humeroulnar and humeroradial joint from full extension to maximum flexion in supination position. Correlation analysis was used to evaluate the relationship between the 6-DOF kinematics of the elbow joint. Results Valgus angle of humeroulnar joint gradually decreased from 15.2°±3.1° to 5.3°±2.3° with the flexion increasing. Valgus angle of humeroradical joint gradually decreased from 19.7°±4.2° to 8.2°±2.4° from full extension to maximum flexion. The valgus angle of humeroulnar and humeroradial joint was linearly related to the flexion angle during flexion and extension. The internal rotation of humeroulnar joint was quadratic nonlinearly related to the flexion angle during motion. The maximum internal rotation of the ulnar was 4.0°±4.9° at 110° flexion, and the maximum external rotation was 5.1°±4.2°. The internal rotation of humeroulnar joint gradually increased from 3.2°±16.0° to 27.2°±18.0°. Conclusions During normal flexion and extension of the elbow, the valgus angle of humeroulnar joint decreased linearly, while the internal and external rotation angle showed a nonlinear change, which first rotated internally and then rotated externally. The valgus angle of humeroradial joint decreased linearly and the internal rotation angle increased linearly. Therefore, humeroulnar joint is not a hinge joint during elbow flexion and extension. There is a kinematic difference between humeroulnar joint and humeroracial joint. For clinical treatment of complex elbow injuries, elbow instability and elbow replacement, different motion characteristics in joints should be considered to improve the outcome after surgery.