In nine patients with epilepsy and 24 neurologically healthy controls, concentrations of IgG and albumin in cerebrospinal fluid and serum were determined,and their corresponding IgG index and intrathecal IgG synthesis rate were calculated; and cerebrospinal fluid IgG fraction bands were detected. The results revealed that immunological abnormality involving central nervous system did exist in some patients with epilepsy. These combined detecting methods provide one of the effective means for screening some epileptic patients with immunological abnormalities involving central nervous system, and for probing their aetiology and pathogenesis.

BACKGROUND: As the second anti-Alzheimer disease drug approved by Food and Drug Administration(FDA), donepezil (Aricept) has been applied in European and American market. According to the regulation of Health Ministry of China, it needs conducting clinical trial of multiple center nationwide in order to come into Chinese market.OBJECTIVE: To evaluate the efficiency and safety of donepezil on treating mild and moderate Alzheimer disease (AD).DESIGN: Randomized, single blind and placebo control prospective study based on patients.SETTING: Neurological Department of Peking Hospital and Neurological Department of the 301 Hospital of Chinese PLA, and ect.PARTICIPANTS: Totally 188 patients with mild and moderate AD[with mini-mental state examination(MMSE) score of 10 to 24 points] from 15 big hospitals of Beijng, Shanghai and Guangzhou were conducted 12 weeks'clinical trial, among which 89 cases were of single blind and placebo control study while 99 cases were of self-controlled study. All the cases met the AD diagnostic standard of clinical neurology, linguistic dysfunction and stroke(NINCDS-ADRDA) and the 4th edition of Statistic Manual (DSM-IVR).INTERVENTIONS: Donepezil (5 rmg/tablet, ip, 5 rmg/time) or placebo with same color, shape, flavor and size with donepezil ( ip, 1 tablet/time)was taken orally for 12 consecutive weeks.MAIN OUTCOME MEASURES: MMSE, clinical dementia rating scale(CDR), activities of daily life scale(ADL), biochemical parameters, electrocardiograph(ECG) and chest x-ray were conducted once every 4 weeks before and after treatment.RESULTS: The random, single blind and placebo control study showed that the score of MMSE, CDR and ADL was greatly improved in donepezil group after 12 weeks' treatment when comparing with placebo group(P ＜ 0. 01,0.05, 0.01 ). Self-controlled study showed that the score of MMSE, CRD and ADL in donepezil group after 12 weeks' treatment increased 3.5, 0.6 and 7.1 points respectively compared with those before treatment(P ＜ 0.01,0.05, 0.01 ) . The score of MMSE was already improved in the 4th week of treatment. Among the 145 patients who took donepezil, 7 cases(4.8% )experienced side effect of mild cholinergic excitability. In the placebo group,2 of the 43 cases appeared dizziness and nausea. There was no difference between two groups( P ＞ 0.05).CONCLUSION: Donepezil can effectively treat mild and moderate AD patients and improve their cognitive functions, dementia level and daily living abilities with good tolerance and high safety.

Objective To study the immune function of the subpopulation of T helper lymphocyte(Th), including Th1 and Th2 cells in myasthenic thymus and peripheral blood (PB).Methods Enzyme-linked immunospot (ELISPOT) method is adopted to detect the acetylcholine receptor (AChR)-reactive interleukin-2(IL-2)-, interleukin-4 (IL-4)-, interleukin-10 (IL-10)-, interferon-gamma(IFN-?)-secreting cell numbers in thymus and peripheral blood (PB). Results The AChR-reactive IL-2-,IL-4-,IL-10-, IFN-?-secreting cell numbers were increased in thymus as well as the AChR-reactive IL-10-, IFN-?-secreting cell numbers in PB. There is a positive correlation between thymus and PB in MG for the AChR-reactive IL-4-, IL-10-secreting cell numbers. After treatment, the AChR-reactive IL-2-,IL-4-, IFN-?-secreting cell numbers were decreased in PB, while there were 1 case and 2 cases showing a decrease and an increase in AChR-reactive IL-10-secreting cell number, respectively.Conclusions The immune dysfunction of the Th1 and Th2 subpopulation existed in the thymus and PB of MG, and the AChR-reactive IL-4-, IL-10-secreting cell numbers might be served as parameters to evaluate the degree of the immune dysfunction in the MG thymus. The role of the IL-10 in pathogenesis of MG needs further study.

Objective To assess the diagnostic value of the single-photon-emission computed tomography (SPECT) and the magnetic resonance imaging (MRI) for Alzheimer's disease (AD) and vascular dementia (VD), and to explore the correlation between cerebral atrophy and cerebral regional blood flow and the degree of cognitive impairment in AD patients. Methods The temporal and frontal lobes and hippocampus were quantitatively detected by MRI and the cerebral regional blood flow in these regions was analysed semi-quantitatively by SPECT for 36 patients with AD, 32 with VD and 30 sex-matched non-demented elderly controls (NC). Results The hippocampal atrophy of AD and VD groups detected on MRI was significantly different from that of the NC group. Left hippocampal height was (9.27?3.43)mm in AD, (11.62?5.72)mm in VD and (12.13?2.97)mm in NC(P0.05, compared to that of NC), showing that hippocampal atrophy could not be detected by MRI. However, RAR of the left hippocampus by SPECT detection was 0.61?0.07 (P

Objective To assess the efficacy and safety of aricept in treatment of mild to moderate Alzheimer disease(AD).Methods 188 patients with AD were followed up in a multicentre,with randomized study for 12 weeks. 89 patients had a single -blind,placebo-controlled trial and 99 a self-matched trial.Results The results of randomized single-blind,placebo-controlled trial showed that the improvements in MMSE、CDR and ADL were statistically significantly greater with aricept 5 mg/d than with placebo(P value respectively 0.05).Conclusion Aricept is effective in treating patients with mild to moderate AD. It could produce improvements in cognition and ability of daily life. Aricept was well tolerated and safe.

Objective To evaluate the expression of Sp3 gene of peripheral blood mononuclear cells (PBMC) in multiple sclerosis (MS) patients and the correlation between Sp3 gene expression and clinical manifestation Methods Two pairs of primers were used to amplify cDNAs generated from 33 MS patients and 90 controls including healthy controls, other nonimmunological neurological disease controls and the other neuroimmunological diseases than MS controls Results The deficient expression of Sp3 gene in MS patients (45%, 15/33) is statistically significantly higher than that in the other 3 control groups ( P

The authors give an account of the historical development of neurological intensive care and its current status in China and put forward the view that establishment of neurological intensive care units can improve the level of neurological departments in delivering emergency treatments and give impetus to the improvement of expertise in diagnosing and treating acute neurological diseases. It will also play a key role in clinically conducting encephalic resuscitation and hibernation therapy, finely monitoring changes of intracranial physiologic indexes by electro physiological methods, further clarifying organ failure resulting from cerebral and neural failure, and promoting the study of nerve grafting and regeneration. Neurological intensive care units can serve as both the teaching base for training professional staff and the research base for advancing neurological emergency medicine.

Objective To study the effect of survivin gene expression on the lymphocyte’s proliferation and function in cultured K562 cells. Methods The constructed recombinant vector pEGFP-C1-survivin and the plasmid pTZU6+1-survivin encoding short hairpin RNA of survivin were transfected into K562 cells respectively to generate K562/survivin+ cells and K562/survivin-cells. K562/survivin+ cells were selected by G418. The survivin mRNA and protein levels in the 3 kinds of cells (K562/survivin+,K562 and K562/survivin-) were detected by semi-quantitative RT-PCR and immunohistochemistry methods. The peripheral blood mononuclear cells (PBMC) from healthy subjects were co-cultured with these 3 cells respectively in mixed lymphocyte-tumor cell culture (MLTC). Lymphocyte proliferation in the supernatant was evaluated by MTT assay. Nature killer activity was detected by flow cytometry and IFN-? level was measured by ELISA assay. Results Proliferation index in K562/survivin+ group was much lower than that in the other 2 groups (P

0.05). There was no correlation between Bcl-2 and Fas positive cells and acetylcholine receptor antibody serum titre, disease grouping, age and sex in patients with or without hyperplastic thymic and thymoma.Conclusions In MG patients, the expression of Bcl-2 in hyperplastic thymus is upregulated. There is no correlation between the expression of apoptotic genes Bcl-2 and Fas and clinic relative factors.

Objective To investigate the possible causes of the different diagnostic sensitivity of voluntary single fiber electromyography (SFEMG) and repetitive nerve stimulation(RNS) in patients with myasthenia gravis (MG). Methods The voluntary SFEMG and RNS at low rates were recorded successively from the same extensor digitorum communis (EDC) muscle on the same day in 67 patients with MG. Results The diagnostic sensitivity of SFEMG and RNS was 92.5% and 50.7%, respectively, with the former statistically significantly higher than the later. The percentage of decrement of RNS was positively correlated with 3 SFEMG parameters, i.e. the mean jitter, percentage of abnormal pairs of potential and percentage of impulse blocking. Among the 34 cases with significant decrement on RNS, 2 had no impulse blocking and the maximum decrement reached 62%, while 33 cases with normal RNS had up to 58% of impulse blocking. Conclusion The voluntary SFEMG was more sensitive than RNS in diagnosing MG even in the same muscle. The blocking phenomenon observed in voluntary SFEMG was not completely corresponding to the decrement in RNS.The possible explanations were partly because that RNS recorded the total muscle fibers response in surface of the muscle and SFEMG examined the increasing or blocking at individual motor end-plates, and partly because that the voluntary SFEMG and RNS might explored endplates belonging to different motor units.