BACKGROUND:Currently, neural stem celltransplantation can be performed through three main approaches:local lesions, blood circulation, and cerebrospinal fluid.
OBJECTIVE:To review the transplantation of neural stem cells or neural precursor cells via the cerebrospinal fluid in the treatment of central nervous system diseases.
METHODS:A computer-based search of PubMed and CHKD databases was performed to retrieve articles concerning transplantation of neural stem cells via the cerebrospinal fluid, and its application and therapeutic mechanism in the treatment of central nervous system diseases in both animal experiment and clinic study published from 2000 to 2009.
RESULTS AND CONCLUSION:It is suitable for neural stem cellsurvival, proliferation, and differentiation in the cerebrospinal fluid. Transplantation of neural stem cells via the cerebrospinal fluid is effective and feasible to treat central nervous system diseases. However, some problems have not been solved, such as the source of neural stem cells, the optimal time window and celldose, the safety and the long-term effect. Further studies are needed to pave the way for the intrathecal injection of neural stem cells in the treatment of central nervous system diseases.

Objective To analyze the electrophysiological characteristics of Charcot-Marie-Tooth (CMT) disease 1A,1X,2A and myelin protein zero (MPZ)-related CMT in Chinese patients.Methods Baseline electrophysiological data from 36 CMT1A patients,78 CMT1X patients,31 CMT2A patients and 10 MPZ-related CMT patients in the Third Xiangya Hospital and Xiangya Hospital of Central South University during 2004-2018 were analyzed.Electrophysiological recordings were taken from the upper limbs (median nerve,ulnar nerve) and lower limbs (tibial nerve,peroneal nerve).Demyelination in different nerve segments was assessed by measurement of distal motor latency,motor nerve conduction velocity (MNCV),sensory nerve conduction velocity and F-wave latency,and calculation of conduction block,terminal latency index (TLI) and modified F ratio (MFR);Axonal degeneration was assessed by measuring compound motor action potential (CMAP) and sensory nerve action potential.The relationship between the gender,age at onset,duration,Overall Neuropathy Limitation Scale (ONLS) score and indexes of peripheral nerve electrophysiology was statistically analyzed.Results The peripheral nerves of CMT1A patients were characterized by uniform demyelination and axonal degeneration.MNCV ((21.39± 6.72) m/s) and CMAP amplitude (2.40 (3.50) mY) of median nerve of CMT1A patients were decreased.The peripheral nerves of CMT1X patients were also characterized by uniform demyelination and axonal degeneration.MNCV (35.20 (6.77) m/s) and CMAP amplitude (2.60 (3.79) mY) of median nerve of CMT1X patients were decreased.CMT2A patients showed axonal degeneration of the peripheral nerves and CMAP amplitude ((4.75 ±2.38) mV) of median nerve of CMT2A patients was decreased.The electrophysiological data in MPZ-related CMT patients demonstrated variability.The TLI and MFR for the median and ulnar nerves in these four subtypes were normal.MNCV (r=0.423,P=0.025) of median nerve in CMT1A patients was positively correlated with age at onset.MNCV (r=0.782,P=-0.013) of median nerve in MPZ-related CMT patients was positively correlated with age at onset.CMAP amplitude (r=0.652,P＜0.01) of median nerve in CMT2A patients was positively correlated with age at onset.Demyelination and axonal degeneration in male CMT1X patients were relatively more severe than those in female patients,and MNCV (Z=-3.300,P＜0.01) and CMAP amplitude (Z=-3.960,P＜0.01) of median nerve,MNCV (Z=-2.56,P=0.011) and CMAP amplitude (Z=-2.311,P=0.048) of ulnar nerve of male patients were lower than those of female patients.The ONLS score of CMT1A (r=-0.494,P＜0.01),CMT1X (r=-0.596,P＜0.01) and CMT2A patients (r=-0.494,P=0.012) was inversely associated with CMAP amplitude.Conclusions The electrophysiological characteristics of CMT1A,CMT1X,CMT2A and MPZ-related CMT are different.Electrophysiological examinations are the basis of clinical classification and could provide guidance for further genetic testing and diagnosis.CMAP amplitude may serve as an objective index to assess the severity of functional disability in CMT patients.

Objective:To investigate the efficacy and safety of surgery via endoscopic-assisted transcallosal approach in intraventricular hemorrhage (IVH).Methods:A retrospective study was performed; the clinical data of 68 IVH patients admitted to our hospital from October 2016 to January 2020 were analyzed. These patients were divided into endoscopic treatment group ( n=34) and drainage group ( n=34) according to the treatment methods. In the endoscopic treatment group, IVH was evacuated via endoscopic-assisted transcallosal approach; in the drainage group, external ventricular drainage and urokinase injection were performed. Gross hematoma clearance rate (clearance rate≥95%) 1, 3, and 7 d after surgery, complication incidence 7 d and 1 month after surgery, and good prognosis rate (ability of daily living [ADL] grading I-III) 3 months after surgery were compared between the two groups. Results:One, 3, and 7 d after surgery, the gross hematoma clearance rate in the endoscopic treatment group was significantly higher than that in the drainage group ( P<0.05). The recurrent hemorrhage rate within 7 d of surgery, intracranial infection rate, and percentage of patients with secondary hydrocephalus requiring shunt within 30 d of surgery in the endoscopic treatment group were significantly lower than those in the drainage group (2.9% vs. 20.6%, 2.9% vs. 23.5%, 5.9% vs. 17.6%, P<0.05). Three months after follow-up, the good prognosis rate of patients in the endoscopic treatment group was significantly higher than that in the drainage group (91.2% vs. 58.9%, P<0.05). Conclusion:Endoscopic-assisted transcallosal approach is recommended in clinical treatment of IVH, which can significantly reduce postoperative complications and improve postoperative prognosis.

OBJECTIVE： To investigate the formulation of therapy plan and pharmaceutical care for a penicillin allergic patient with necrotizing fasciitis combined with diabetes mellitus. METHODS： A penicillin allergic patient with necrotizing fasciitis combined with diabetes mellitus was admitted to Ordos central hospital on March 30， 2018. According to the disease characteristics of the patient， clinical pharmacists conducted pharmaceutical care during the treatment process from the aspects of antiinfective drugs selection， monitoring points of necrotizing fasciitis， blood glucose monitoring， effects of hypoproteinemia on antibiotic pharmacokinetics-pharmacodynamics， and assisted the physician to develop a more reasonable and effective individualized therapentic regimen. RESULTS： For diabetes mellitus， the patient adjusted Insulin lispro injection （insulin pump）， Acarbose tablets， Metformin hydrochloride tablets and Glimepiride tablets successively. For rapid atrial fibrillation with intraventricular differential conduction and ST-T changes， Metoprolol tartrate tablets were used to reduce heart rate. For necrotizing fasciitis， when choosing drugs to ensure the anti-infective effect， considering that the patient had penicillin allergic and hypoproteinemia， clinical pharmacists chose drugs with low protein binding rates and different from the mother nucleus and side chain of penicillin. Imipenem cilastatin for injection， Aztreonam for injection， Levofloxacin lactate and sodium chloride injection were used successively. Voriconazole for injection was adopted for anti-fungal treatment. Physicians adopted the suggestions of clinical pharmacists. Debridement through early thorough drainage and rational drug use， the patient’s condition was effectively controlled. CONCLUSIONS： Clinical pharmacists assist physicians to formulate and optimize whole course therapentic regimen so as to improve the safety and effectiveness of drug treatment.