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Comparison of clinical manifestations and electrophysiological features in patients with chronic inflamma-tory demyelinating polyneuropathy and Type-I Charcot Marie Tooth Disease

Jingjie LIU ; Ping HAN ; Zhen GAO ; Fuhua GONG ; Xiaolin MA ; Li XIANG

Chinese Journal of Nervous and Mental Diseases.2016;42(8):493-497. doi:10.3969/j.issn.1002-0152.2016.08.010

Objectives To compare clinical manifestations and electrophysiological features in patients with chron?ic inflammatory demyelinating polyneuropathy (CIDP) and Type-I Charcot Marie Tooth Disease (CMT-I) for guiding dif?ferential diagnosis. Methods Data including clinical manifestations and electrophysiological indexes was collected from thirty-one CIDP cases and 28 CMT-I cases. Correlation analysis was used to assess the association of the severity of electrophysiology with the severity of clinical symptoms. Results There were statistically significant differences in onset site, sensory dysfunction, foot deformity and cerebrospinal fluid protein between these two groups (P<0.05). There were significant differences in indexes of nerve conduction and needle electromyography between these two groups (P<0.05). The severity of clinical symptoms was not related with the severity of electrophysiology in CMT-I group (r=0.27,P>0.05). Conclusions Differential diagnoses of CIDP and CMT-I can be made based on clinical manifestations and electro?physiological features.

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Clinical manifestations and microemboli signals in patients with hypercoagulability related multiple acute cerebral infarcts within non-single arterial territories

Wei SUN ; Yajun YAO ; Haiying XING ; Qing PENG ; Junlong SHU ; Xi MEN ; Ran LIU ; Ke XU ; Yining HUANG

Chinese Journal of Nervous and Mental Diseases.2016;42(8):488-492. doi:10.3969/j.issn.1002-0152.2016.08.009

Objective To investigate the clinical features and TCD-detected microembolic signals in patients with hypercoagulability related multiple acute cerebral infarcts within non-single arterial territories, and to explore the possi?ble underlying mechanisms. Methods A retrospective review was conducted on all clinical, laboratory, radiological and TCD monitoring records from patients with hypercoagulability related multiple acute cerebral infarcts within non-single arterial territories, who admitted to the neurology department in our hospital. Results The data from twenty-two cases were finally included in this study. All patients presented with acute-onset localized neurological dysfunction, e.g. hemi?paresis, aphasia, hemiparesthesia, dysarthria, hemianopsia and cortical blindness. Their hypercoagulability related diseas?es included 10 cases of systemic malignancy, 5 moderate to severe hyperhomocystynemia (HCY>50μmol/L), 2 nephrot?ic syndrome, 2 antiphospholipid syndrome, 1 ulcerative colitis, 1 polycythemia vera,1 paroxysmal nocturnal hemoglobin?uria. In 18 cases, the hypercoagulability related diseases were diagnosed after their initial stroke onset. DWI showed mul?tiple disseminated acute cerebral infarcts in non-single arterial territories involving bilateral anterior or anterior plus pos?terior cerebral circulation simultaneously. Foci involved lobar cortex/subcortex of cerebral hemisphere in 22 cases, deep cerebral hemisphere in 12 cases, cerebellum foci in 10 cases,brainstem foci in 2 cases. TCD revealed microembolic sig? nals in ten of 22 patients monitored. Conclusions Patients with multiple acute cerebral infarcts involving non-single arte?rial territories, should be screened for hypercoagulability as in that hypercoagulability and microembolism might be in?volved in the etiology of cerebral infarction.

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Predictors for sever Guillain-Barré syndrome

Chunge XIE ; Limin WANG ; Xuetao HE ; Jieling CHEN

Chinese Journal of Nervous and Mental Diseases.2016;42(8):484-487. doi:10.3969/j.issn.1002-0152.2016.08.008

Objectives To explore different factors (clinical presentations and laboratory investigations ) between the severe and mild Guillain-Barré syndrome (GBS) in southeast China ,and to find the predictors of severe GBS. Meth?ods Retrospective analysis was conducted on 101 cases of patients with GBS admitted to our Hospital from Jan. 2006 to Nov. 2015, who were divided into mild and severe groups according to Hughes scale. The different factors were compared between these two groups such as age, sex, precursor infection factors, the initial symptoms, bulbar dysfunction, cranial nerves involvement, autonomic nervous dysfunction, peripheral nerve axonal damage to find the predictors for the severe GBS. Results Severe GBS more frequently presented with non-paresthesia as initial symptom (P<0.001) , bulbar dysfunc?tion (P<0.001), cranial nerves involvement (P=0.025), autonomic nervous dysfunction (P=0.018), motion system involve?ment (P = 0.004) and peripheral nerve axonal damage (P<0.001). After multivariable logistic regression analysis, we found that the axon damage(P=0.008, OR=4.632), bulbar dysfunction(P=0.010, OR=10.420), and cranial nerves in?volvement(P=0.047, OR=0.076)were the independent risk factors for sever GBS. Conclusion Axon damage, bulbar dys?function, and cranial nerves involvement might be significant predictors of sever GBS.

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The analysis of failure cause of valproate monotherapy for newly diagnosed generalizedepilepsy in children

Zhi JIANG ; Liming YANG ; Zeshu NING ; Bo CHEN ; Jie ZHANG ; Feng GUO

Chinese Journal of Nervous and Mental Diseases.2016;42(8):479-483. doi:10.3969/j.issn.1002-0152.2016.07.007

Objectives To investigate the failure cause of valproate monotherapy for newly diagnosed generalized epilepsy in children and to investigate the factors related to the failure. Methods The newly diagnosed cases of general?ized epilepsy were recruited and given valproate monotherpy. After 2 years of treatment and regular follow-up, they were divided into control group and poor effect group.according to their response to the treatment. The clinic data and electro?encephalogram were collected. The reasons of treatment failure were studied using Logistic regression analysis. Results There were 231 patients who had completed this study in all. After 2 years, 62 cases had switched to other drugs because of poor efficacy. Efficacy of was satisfactory in 169 cases of children. There were 3 cases of poor compliance, and one case switched to other drug due to side effect. There were statistically significant (P<0.05) in the abnormal electroenceph?alogram (EEG) rate (poor effects group 90.32%vs. control group 61.54%), abnormal cranial magnetic resonance imaging (MRI) rate (poor effects group 45.16%vs. control grou p23.08%) and the first age of onset [poor effects group 0.50(0.42, 2.50)year vs. control group 0.75(1.50, 5.16)year] between the good effects group and poor effects group. Univariate anal?ysis showed that mental retardation,birth asphyxia,abnormal bain MRI,the first episode of age were statistically signifi? cant different between these two groups (P<0.05). Further multivariate regression analysis showed that the low first onset age (OR=2.124 P=0.004)、mentalretardation (OR=10.535,P=0.000, abnormal brain MRI(OR=1.603,P=0.020), asphyxia at birth(OR=1.913 P=0.027)were independent risk factors for the poor efficacy of valproate. Conclusions The main rea?sons for the failure of valproate monotherpy in children with generalizedepilepsy are poor efficacy,bad compliance, ad?verse reactions. The risk factors of poor efficacy are the low first onset age, mental retardation, abnormal brain MRI and asphyxia at birth etc.

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The clinical study on the relationship between silent cerebral ischemia and cognitive impairment in inpa-tiens older than sixty with nonvalvula atrial fibrillation

Jiming LI ; Weiliang LUO

Chinese Journal of Nervous and Mental Diseases.2016;42(8):473-478. doi:10.3969/j.issn.1002-0152.2016.08.006

Objectives The aim of this study was to study the relationship between silent cerebral ischemia (SCI) and mild cognitive impairment(MCI)in inpatients with nonvalvula atrial fibrillation (NAF) and those with sinus rhythm (SR) older than sixty. Methods Ninety-eight inpatients were enrolled from November 2014 to November 2015 in Hui?zhou Municipal Central Hospital: 45 patients with NAF and 53 with SR. All general clinical data was collected. The Montreal Cognitive Assessment (MoCA) and brain MRI were used to assess the cognitive performance of patients within 1 weeks of admission. Results The MoCA scores were lower in patients with NAF than in those with SR[16(10,20) vs. 20 (15,23),P=0.006]. At least one foci of SCI was present in patients 80%with NAF and 52.8%with SR (NAF vs. SR, P=0.018).The rates of SCIs in the cortex/subcortex were higher in the NAF group than in the SR group (25.2%vs. 12.4%, P=0.017). Multivariate analysis showed that MoCA score were related to the degree of education in NAF patients and were related to age and education level in SR patients. Conclusions NAF is an independent risk factor for cognitive impair?ment in NAF patient and associated with the SCI present. Educational level is a factor affecting the cognitive function with elderly patients.

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The Expression of Speckle-type POZ protein-like(SPOPL)in Brain Glioma

Bin XU ; Nu ZHANG ; Yuanjun HU ; Yibing YANG ; Sheng YAN ; Jinlong LIU ; Zhibo XIA

Chinese Journal of Nervous and Mental Diseases.2016;42(8):469-472. doi:10.3969/j.issn.1002-0152.2016.08.005

Objective To explore the expression of Speckle-type POZ protein-like(SPOPL)in human glioma tis?sues and its relationship with clinical pathological parameters and prognosis. Methods Immunohistochemical and west?ern blotting method were used to detect SPOPL expression in glioma tissues and tumor peripheral tissues in 68 cases of glioma patients including 32 cases of low grade gliomas (WHO I- II), and 36 cases of high grade gliomas (WHO III-IV). T test,χ2 test, Kaplan-Meier method and the Cox regression model were used to analyze the relationship between the expression and clinical indicators. Results The expression of SPOPL was significantly lower in gliomas than in tumor pe?ripheral tissues (t=-8.754, P<0.05), the expression of SPOPL was lower in high pathological grade tissues than in low grade of glioma tissues (t=-13.552, P<0.05). SPOPL expression was associated with pathological grade ( χ2=4.023, P<0.05). Cox regression model showed that the tumor pathological grade and different SPOPL protein expression were inde?pendent risk factors for the prognosis of patients with glioma. Conclusions SPOPL may be a biomarkers of human brain gliomas and can help to evaluate the prognosis of brain glioma.

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Risk factors for postoperative provisional paralysis of parasagittal meningioma in the eloquent area

Decai XU ; Jian LI ; Yongxuan ZHAO ; Jun MA ; Houyin LIU ; Hexian SU

Chinese Journal of Nervous and Mental Diseases.2016;42(8):465-468. doi:10.3969/j.issn.1002-0152.2016.08.004

Objective The aim of the study was to investigate the related factor of postoperative provisional paraly?sis of parasagittal meningioma in the eloquent area. Methods A retrospective review was conducted on ninety-six pa?tients with parasagittal meningioma in the eloquent area treated by surgery from May 2005 to December 2015. Accord?ing to the diagnostic criteria for postoperative provisional paralysis, patients were divided into postoperative provisional paralysis group(n=31)and non- postoperative provisional paralysis group(n=65). Univariate and multivariate logistic regression methods were used to analyze the data including age, size of tumor,preoperative epilepsy, preoperative periph?eral edema, complete the occlusion of superior sagittal sinus(SSS) by tumor, incision of SSS during surgery, drainage vein damage during surgery. Results Univariate analysis showed that there were significant differences(P<0.05)between these two groups in age(χ2=14.943,P=0.000), preoperative peripheral edema(χ2=4.435,P=0.049), the complete occlu?sion of SSS by tumor(χ2=5.248,P=0.028), incision of SSS during surgery(χ2=5.773,P=0.026), drainage vein damage during surgery(χ2=11.441,P=0.002). Multivariate analysis showed that the factors related to postoperative provisional paralysis were age(OR=8.709,P=0.028), drainage vein damage during surgery(OR=16.242,P=0.012)and complete oc?clusion of SSS by tumor(OR=0.053,P=0.025). Conclusion Age and the drainage vein damage during surgery are the risk factors of postoperative provisional paralysis and complete occlusion of SSS by tumor is the protective factor for the oc? currence of postoperative provisional paralysis.

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The study of plasma levels of sCD40 and sCD40L in Alzheimer’s disease and mild cognitive impairment

Ling LI ; Xiaomei ZHONG ; Haishan SHI ; Le HOU ; Xinni LUO ; Yanhua WANG ; Guoyan HU ; Xinru CHEN ; Wenru ZHANG ; Ben CHEN ; Qi PENG ; Yuping NING

Chinese Journal of Nervous and Mental Diseases.2016;42(8):460-464. doi:10.3969/j.issn.1002-0152.2016.08.003

Objective To explore the plasma levels of soluble CD40 (sCD40) and soluble CD40 ligand (sCD40L) in the patients with Alzheimer’s disease (AD) and those with amnestic mild cognitive impairment (aMCI). Methods The levels of plasma sCD40 and sCD40L were measured in 20 patients with AD, 35 patients with aMCI, and 32 cognitively normal controls (NC) using commercially available ELISAs. The cognitive function of AD and aMCI patients was mea?sured by mini-mental state examination (MMSE). Results There were significant differences in plasma sCD40 among AD, aMCI and NC groups (P<0.05) as the medians (the upper and lower quartiles) of plasma levels were 123.3 (97.4, 149.5) pg/mL, 102.9 (63.6, 124.0) pg/mL and 70.66 (51.0, 90.8) pg/mL, respectively. There were significant differences in plasma sCD40L among AD, aMCI and NC groups (P<0.05) as plasma levels were 537.0 (316.0, 1134.0) pg/mL, 316.0 (190.0,546.0) pg/mL and 167.0 (107.5,478.0) pg/mL. A negative correlation between the plasma concentrations of sCD40L and the MMSE scores was found in aMCI patients (r=-0.736, P<0.001). Conclusions There are relevant chang?es of plasma sCD40 and sCD40L levels in patients with AD and aMCI. The present results suggest that plasma levels of sCD40 and sCD40L may be appropriate biomarkers for AD patients and indicate that CD40-CD40L signaling may be in?volved in AD pathophysiology.

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Association study between G-protein β3 subunit gene polymorphism and olanzapine-induced weight gain

Wenyue ZHANG ; Xiaofei QI ; Chenxi BAO ; Zhenghui YI ; Qiang ZHU ; Zhong YANG ; Ying WEI ; Junfeng MA ; Zhongtao LU

Chinese Journal of Nervous and Mental Diseases.2016;42(8):454-459. doi:10.3969/j.issn.1002-0152.2016.08.002

Objective To explore the relationship between G-protein β3 subunit (GNB3) gene C825T polymor?phism and the weight gain of schizophrenics treated with olanzapine. Methods Ninety schizophrenics of first time hospi?talization were collected and treated with olanzapine for 12 weeks. The changes of body weight and body mass index (BMI) were detected before and after 12-week olanzapine treatment. The GNB3 gene C825T polymorphism in patients was determined by polymerase chain reaction (PCR) and DNA sequencing technique. The correlation of GNB3 gene C825T polymorphism and change of clinical parameters was analyzed. Results Body weight and BMI in patients were all increased significantly after treatment (all P<0.01). Weight gain rate (WGR) and increase of BMI in the TT genotype group were higher than those in the CC genotype group (all P<0.01). WGR and increase of BMI in the T-allele carrier (TT and CT genotypes) were higher than those in the T-allele non-carrier (CC genotype) (all P<0.01). There was signifi?cant difference in distribution of genotypes between WGR ≥7% group (CC 15.69%, CT 54.90%, TT 29.41%) and WGR <7% group (CC 38.46%, CT 43.59%, TT 17.95%) (P<0.05). The frequency of T-allele in the WGR≥7% group (63.33%) was higher than that in the WGR<7%group (39.74%) (P<0.05). Multi-variable linear regression indicated that TT genotype (contrasted with CC genotype) was an influential factor for change of body weight after treatment with olan?zapine (β=1.83, standardized β=0.29, P<0.01). Conclusions The GNB3 gene C825T polymorphism is associated with olanzapine-induced weight gain.

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Alteration of oxidative stress in peripheral blood of first-episode schizophrenia

Yangyang CHAO ; Weiyong SHENG ; Jin ZHAO ; Yuzhong SHI

Chinese Journal of Nervous and Mental Diseases.2016;42(8):449-453. doi:10.3969/j.issn.1002-0152.2016.08.001

Objective To explore the status of oxidative stress (OS) in the first-episode schizophrenia patients (FEP) and to examine the effects of antipsychotic drugs on oxidative stress of FEP. Methods The plasma total superox?ide dismutase (T-SOD), glutathione peroxidase (GSH-Px), catalase (CAT) and total antioxidant capacity (T-AOC) were measured in forty-seven FEP (case group) and forty-three healthy volunteers (control group) before and after treatment. Eighteen cases completed 6-week treatment with risperidone (risperidone group) and twenty-five cases completed 6-week treatment with olanzapine (olanzapine group). Results The activity of T-SOD and GSH-Px were lower (P<0.05) and CAT was higher (P<0.05 ) while there was no significant difference in T-AOC (P>0.05) in FEP compared to the control group. Risperidone and olanzapine significantly improved T-SOD and T-AOC, respectively (P<0.05). There was no significant difference between the two groups in the changes of oxidative stress indicators after treatment (P>0.05). Conclusion FEP has alterations of antioxidant enzymes, which may be related to the pathogenesis of schizo?phrenia. Antipsychotics risperidone and olanzapine may improve the oxidative stress in FEP.

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