Objective To evaluate the clinical manifestations and magnetic resonance imaging(MRI) features of the clinically isolated syndrome(CIS) of the spinal cord.Methods MRI features and expanded disability status scale(EDSS) score in 63 patients with multiple sclerosis(MS) showed early clinical manifestations of spinal CIS were retrospectively analysed.Results 52.9% of MS patients in the early performance was the spinal CIS,88.9% was acute or subacute onset,42.9% of the initial symptoms was isolated sensory dysfunction,and 54.9% had cervical spinal cord involvement.The first MRI positive rate was 91.1% and 35.3% presented with "multifocal" plagues.81.7% of the MRI lesions were not more than two vertebral segments,and 89.0% in the axial diameter of the spinal cord did not exceed 1/2.The number,volume and area of MRI lesions at baseline confirmed the positive correlation with EDSS at diagnosis of MS.Corticosteroid therapy before and after the EDSS score was of a significant difference(P= 0.003).Conclusion Spinal CIS often occurs in cervical spinal cord with acute or subacute onset,and incomplete spinal cord injury.MRI may detect "multifocal" plagues.Quantitative MRI is valuable for the assessment of prognosis.Early intravenous corticosteroid therapy can be an effective way to ease symptoms.

This paper reports a study of renal microcirculation in rabbits with glycerol-induced acute renal failure by using the microsphere technique, transmission and scanning electron-microscopy as well as morphemetry. In the initial phase of acute renal failure, there was microcir-culatory ischemia, and the changes were parallel with functional changes following glycerol injection, the renal microcirculation showed marked structureal changes. The results indicated that renal microcirculation should be given early.

To our knowledge, there has been no clinical report of artesunate in the treatment of lung cancer. This study was designed to compare the efficacy and toxicity of artesunate combined with NP (a chemotherapy regimen of vinorelbine and cisplatin) and NP alone in the treatment of advanced non-small cell lung cancer (NSCLC).

Objective To discuss the mechanism and characteristics of clinic presentation and neuropathology in idiopathic hypereosinophilic syndrome (IHES) encephalopathy. Methods IHES encephalopathy was diagnosed by clinical presentations,lab examinations,neurologic images,marrow and brain biopsy,then treated with corticosteroids and continuous follow-up. Results The IHES patient presented progressive limbs weakness and cognitive deficit with elevated eosinophil count. Results of lab examinations and bone marrow biopsy ruled out secondary eosinophilia and clonal eosinophilia such as eosinophilic leukemia.Brain magnetic resonance imaging (MRI) study showed multiple lesions in right frontal lobe, bilateral parietal and occipital lobe, presenting hypointensity in T1 weighted images,hyperintensity in T2 and fluid-attenuated inversion recovery weighed images. Brain biopsy showed proliferation of vascular membrane,small vessels stenosis,ischemia-induced morphological change and necrosis of neurons in the lesions.The patient was continuously treated with corticosteroids,and the situation was stabilized with follow-up.Conclusions IHES encephalopathy should be paid more attention in clinical practice of neurologists for its rarity. Brain vascular damages caused by elevated eosinophil may be an important pathophysiological mechanism of IHES encephalopathy,and corticosteroids or hydroxycarbamide should be used for the treatment.

Objective To explore the clinical symptoms and neuroimaging features of a patient with atypical hypomyelinating leukodystrophy with atrophy of the basal ganglia and cerebellum (H-ABC) caused by a novel TUBB4A mutation.Methods We analyzed the clinical data, imaging features and the result of genetic testing of a case diagnosed as atypical H-ABC.Results The initial symptoms were progressive spasticity, mild cerebellar ataxia and mild cognitive impairment.MRI showed regional blurring of slight high signal on T2-weight and FLAIR image in white matter of the bilateral midbrain ventral, internal capsule, posteior horn of lateral ventricle and centrum semiovale, with normal bilateral cerebellar and caudoputamen nucleus.Compared with normal subjects of the same age and gender, hypometabolism was found by 18F-FDG-PET in brainstem, cerebellar and caudoputamen nucleus in the patient.Genetic testing revealed a de novo pathogenic exome missense heterozygous mutations c.70G>A in TUBB4A, which was not reported in the human gene mutation database (HGMDpro) and was assessed to be a pathogenic mutation by pathogenic mutation prediction software.Conclusions The diversity of TUBB4A gene mutations may cause different functional and/or structural impairment in subcortical white matter, cerebellar and caudoputamen nucleus, leading to atypical symptoms and neuroimaging features.Genetic testing for pathogenic mutation in TUBB4A gene is a key for the diagnosis of H-ABC.

Eicosanoids are oxidized derivatives of 20-carbon polyunsaturated fatty acids (PUFAs). In recent years, the role and mechanism of eicosanoids in cardiovascular diseases have attracted extensive attention. Substrate PUFAs including arachidonic acid are metabolized by cyclooxygenase, lipoxygenase, cytochrome P450 oxidase enzymes, or non-enzymatic auto-oxidation. Eicosanoid metabolomics is an effective approach to study the complex metabolic network of eicosanoids. In this review, we discussed the biosynthesis and functional activities of eicosanoids, the strategies of eicosanoid metabolomics, and applications and research progress of eicosanoid metabolomics in cardiovascular diseases, which might offer new insights and strategies for the treatment of cardiovascular diseases.
Arachidonic Acid ; Cardiovascular Diseases ; Cytochrome P-450 Enzyme System ; Eicosanoids ; Humans ; Metabolomics