1.Undiagnosed 33-Year-Old Filipino male HIV case presenting initially as stroke in the young: A case report.
Samantha Karla Dv INONCILLO ; Joseree-ann S. CATINDIG ; Maria Rhona M. BERGANTIN
Journal of Medicine University of Santo Tomas 2026;10(1):1913-1917
Cerebrovascular disease is uncommon in patients with HIV, occurring in up to 1.9% of patients, 0.2% were presenting with transient ischemic attacks. The central nervous system is the first part of the body to be affected by the human immunodeficiency virus. This case report is a unique presentation of a 33-year-old male who presented with focal neurologic deficits that lasted for one hour with a background of promiscuous history. The patient was positive for HIV screening test and CD4 count and was started on a combination of antiretroviral therapy. This is the first documented case report in the Philippines. This case report demonstrates the need for a high index of suspicion for early detection of the cause in HIV-positive patients with recurrent transient ischemic attacks, given the high morbidity and mortality that is associated with this condition if delayed or undiagnosed.
Human ; Male ; Adult: 25-44 Yrs Old ; Neurologic Manifestations ; Cerebrovascular Disorders ; Nervous System ; Central Nervous System ; Cd4 Lymphocyte Count
2.From Physiology to Pathology of Astrocytes: Highlighting Their Potential as Therapeutic Targets for CNS Injury.
Yimin YUAN ; Hong LIU ; Ziwei DAI ; Cheng HE ; Shangyao QIN ; Zhida SU
Neuroscience Bulletin 2025;41(1):131-154
In the mammalian central nervous system (CNS), astrocytes are the ubiquitous glial cells that have complex morphological and molecular characteristics. These fascinating cells play essential neurosupportive and homeostatic roles in the healthy CNS and undergo morphological, molecular, and functional changes to adopt so-called 'reactive' states in response to CNS injury or disease. In recent years, interest in astrocyte research has increased dramatically and some new biological features and roles of astrocytes in physiological and pathological conditions have been discovered thanks to technological advances. Here, we will review and discuss the well-established and emerging astroglial biology and functions, with emphasis on their potential as therapeutic targets for CNS injury, including traumatic and ischemic injury. This review article will highlight the importance of astrocytes in the neuropathological process and repair of CNS injury.
Astrocytes/drug effects*
;
Humans
;
Animals
;
Central Nervous System/pathology*
;
Central Nervous System Diseases/physiopathology*
3.The Role of Intravenous Anesthetics for Neuro: Protection or Toxicity?
Kaixin WANG ; Yafeng WANG ; Tianhao ZHANG ; Bingcheng CHANG ; Daan FU ; Xiangdong CHEN
Neuroscience Bulletin 2025;41(1):107-130
The primary intravenous anesthetics employed in clinical practice encompass dexmedetomidine (Dex), propofol, ketamine, etomidate, midazolam, and remimazolam. Apart from their established sedative, analgesic, and anxiolytic properties, an increasing body of research has uncovered neuroprotective effects of intravenous anesthetics in various animal and cellular models, as well as in clinical studies. However, there also exists conflicting evidence pointing to the potential neurotoxic effects of these intravenous anesthetics. The role of intravenous anesthetics for neuro on both sides of protection or toxicity has been rarely summarized. Considering the mentioned above, this work aims to offer a comprehensive understanding of the underlying mechanisms involved both in the central nerve system (CNS) and the peripheral nerve system (PNS) and provide valuable insights into the potential safety and risk associated with the clinical use of intravenous anesthetics.
Animals
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Humans
;
Anesthetics, Intravenous/adverse effects*
;
Neuroprotective Agents/pharmacology*
;
Propofol
;
Neurotoxicity Syndromes/prevention & control*
;
Central Nervous System/drug effects*
;
Dexmedetomidine
4.Research progress on molecular mechanism and future perspectives of leonurine.
Ran WANG ; Aiying LI ; Zongran PANG
Frontiers of Medicine 2025;19(4):612-625
Leonurus japonicas Houtt., has been recorded as "light body and long life" properties in the oldest classical medicinal book Shennong Bencao Jing thousands of years ago. Herba leonuri, also named Chinese Motherwort or Siberian Motherwort, has the effects of activating blood circulation, regulating menstruation, diuresis and detumescence, clearing heat and detoxifying, and is known as the "sacred medicine of gynecology." It has been well known by doctors and usually used in the treatment of common gynecological diseases in clinic. Leonurine is a very important alkaloid in Herba leonuri, which has many biological activities such as anti-oxidation, anti-inflammation, and anti-apoptosis. Diseases of the cardiovascular system and central nervous system are "major health threats" that threaten human life and health worldwide, however, many drugs have certain side effects right now. This paper reviews the potential molecular therapeutic effects of leonurine on cardiovascular system and central nervous system diseases, highlights the current findings of research progress, and focuses on the therapeutic effects of leonurine in various diseases. At present, leonurine is in the stage of clinical experiment, and we hope that our summary can provide guidance for its future molecular mechanism study and clinical application.
Humans
;
Gallic Acid/therapeutic use*
;
Leonurus/chemistry*
;
Cardiovascular Diseases/drug therapy*
;
Animals
;
Central Nervous System Diseases/drug therapy*
5.Advances in the Studies of MicroRNA-1976 in Aberrant Cell Cycle Diseases.
Hao-Yu JI ; Hao CHEN ; Liang SHI ; Meng ZHANG ; Ting CHEN ; Ying-Ming KONG ; Rong-Ke FENG
Acta Academiae Medicinae Sinicae 2025;47(4):644-650
Most tumor cells and healthy neurons are at rest during G0 phase.Once the cell cycle is abnormally re-entered under certain conditions,the proliferation of tumor cells and the degenerative necrosis of neurons can be initiated.From the perspective of the cell cycle,cancer and central nervous system diseases,two seemingly different disease types,have a common pathogenesis.This type of diseases is named aberrant cell cycle diseases.As a newly discovered microRNA(miR),miR-1976 is closely related to the regulation of the cell cycle.This review summarizes the progress in the research on miR-1976 in cancer and central nervous system diseases,aiming to provide a reference for the clinical application of miR-1976 in aberrant cell cycle diseases in the future.
MicroRNAs/genetics*
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Humans
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Cell Cycle/genetics*
;
Neoplasms/genetics*
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Central Nervous System Diseases/genetics*
6.Dural arteriovenous fistula in a neonate presenting with respiratory distress.
Yue DU ; Jing-Hua ZHANG ; Jun-Liang LI ; Zhou-Ping WANG ; Mei-Gui WU
Chinese Journal of Contemporary Pediatrics 2025;27(4):500-504
The patient, a 20-day-old male, was admitted due to respiratory distress that had persisted for 20 days after birth. The main clinical manifestations included gradually worsening respiratory distress and edema. The patient received treatment including mechanical ventilation and diuretics. Echocardiography indicated cardiomegaly, pulmonary hypertension, and heart failure. A comprehensive systemic examination revealed a significant blowing vascular murmur upon auscultation over the anterior fontanelle and bilateral temporal regions. Further imaging studies including cranial magnetic resonance imaging, magnetic resonance angiography, and magnetic resonance venography showed marked dilation of the superior sagittal sinus, transverse sinus, and sigmoid sinus, leading to a definitive diagnosis of dural arteriovenous fistula. After a multidisciplinary consultation, the patient underwent cerebral angiography and partial embolization of the left parietal arteriovenous fistula. Postoperatively, the patient was treated with positive inotropes, diuretics, and fluid restriction. Ultimately, the patient was weaned off the ventilator and discharged in improved condition. This article reports a case of neonatal dural arteriovenous fistula presenting with respiratory distress and discusses the multidisciplinary approach to managing this condition, which aids in early disease recognition and guides clinical decision-making.
Humans
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Male
;
Infant, Newborn
;
Central Nervous System Vascular Malformations/diagnosis*
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Respiratory Distress Syndrome, Newborn/etiology*
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Embolization, Therapeutic
7.Granulomatous primary central nervous system vasculitis in a child.
Ya-Nan ZHANG ; Chang-Hong DING ; Shu-Hong REN ; Wei-Hua ZHANG ; Fang LIU ; Nan ZHANG ; Yu-Juan ZHANG
Chinese Journal of Contemporary Pediatrics 2025;27(9):1140-1142
A 14-year-old boy was admitted to the hospital due to a single episode of afebrile seizure and four hours of impaired consciousness. Three months prior to admission, he had a history of bilateral uveitis. Cerebrospinal fluid analysis revealed a mild elevation in white blood cell count. Cranial magnetic resonance imaging and contrast-enhanced scans showed multiple abnormal signals in both cerebral hemispheres, with punctate and nodular enhancement. Susceptibility-weighted imaging revealed multiple punctate hemorrhages within lesions in the bilateral frontal and left parietal lobes, suggestive of vasculitis. Brain biopsy demonstrated inflammatory granulomatous lesions. No secondary causes were identified, and the final diagnosis was granulomatous primary central nervous system vasculitis. The patient's condition improved after treatment with methylprednisolone sodium succinate and mycophenolate mofetil. This report describes a rare case of granulomatous central nervous system vasculitis in a child and provides valuable insights for the diagnosis and treatment of this disease.
Humans
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Male
;
Vasculitis, Central Nervous System/diagnosis*
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Adolescent
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Magnetic Resonance Imaging
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Granuloma/diagnosis*
8.Clinical Features, Prognostic Analysis and Predictive Model Construction of Central Nervous System Invasion in Peripheral T-Cell Lymphoma.
Ya-Ting MA ; Yan-Fang CHEN ; Zhi-Yuan ZHOU ; Lei ZHANG ; Xin LI ; Xin-Hua WANG ; Xiao-Rui FU ; Zhen-Chang SUN ; Yu CHANG ; Fei-Fei NAN ; Ling LI ; Ming-Zhi ZHANG
Journal of Experimental Hematology 2025;33(3):760-768
OBJECTIVE:
To investigate the clinical features and prognosis of central nervous system (CNS) invasion in peripheral T-cell lymphoma (PTCL) and construct a risk prediction model for CNS invasion.
METHODS:
Clinical data of 395 patients with PTCL diagnosed and treated in the First Affiliated Hospital of Zhengzhou University from 1st January 2013 to 31st December 2022 were analyzed retrospectively.
RESULTS:
The median follow-up time of 395 PTCL patients was 24(1-143) months. There were 13 patients diagnosed CNS invasion, and the incidence was 3.3%. The risk of CNS invasion varied according to pathological subtype. The incidence of CNS invasion in patients with anaplastic large cell lymphoma (ALCL) was significantly higher than in patients with angioimmunoblastic T-cell lymphoma (AITL) (P <0.05). The median overall survival was significantly shorter in patients with CNS invasion than in those without CNS involvement, with a median survival time of 2.4(0.6-127) months after diagnosis of CNS invasion. The results of univariate and multivariate analysis showed that more than 1 extranodal involvement (HR=4.486, 95%CI : 1.166-17.264, P =0.029), ALCL subtype (HR=9.022, 95%CI : 2.289-35.557, P =0.002) and ECOG PS >1 (HR=15.890, 95%CI : 4.409-57.262, P <0.001) were independent risk factors for CNS invasion in PTCL patients. Each of these risk factors was assigned a value of 1 point and a new prediction model was constructed. It could stratify the patients into three distinct groups: low-risk group (0-1 point), intermediate-risk group (2 points) and high-risk group (3 points). The 1-year cumulative incidence of CNS invasion in the high-risk group was as high as 50.0%. Further evaluation of the model showed good discrimination and accuracy, and the consistency index was 0.913 (95%CI : 0.843-0.984).
CONCLUSION
The new model shows a precise risk assessment for CNS invasion prediction, while its specificity and sensitivity need further data validation.
Humans
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Lymphoma, T-Cell, Peripheral/pathology*
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Prognosis
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Retrospective Studies
;
Central Nervous System Neoplasms/pathology*
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Neoplasm Invasiveness
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Male
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Female
;
Central Nervous System/pathology*
;
Middle Aged
;
Adult
9.The Efficacy and Safety of Modified Thiotepa-Based Conditioning Followed by Autologous Stem Cell Transplantation in Primary CNS Lymphomas.
Yan LI ; Ping YANG ; Fang BAO ; Sen LI ; Lan MA ; Fei DONG ; Ji-Jun WANG ; Hong-Mei JING
Journal of Experimental Hematology 2025;33(5):1435-1442
OBJECTIVE:
To explore and evaluate the efficacy and safety of a modified thiotepa-based conditioning regimen combined with autologous hematopoietic stem cell transplantation (ASCT) for the treatment of primary central nervous system lymphoma (PCNSL).
METHODS:
In a retrospective, single center, single arm study, we collected data of 28 patients with PCNSL who underwent high-dose chemotherapy followed by autologous stem cell transplantation (HDC-ASCT) at our center from March 2021 to December 2024. The clinical characteristics of the patients, the conditioning regimen details, treatment-related toxicities and adverse reactions, post-transplant disease remission status, and survival outcomes were analyzed.
RESULTS:
A total of 28 patients were included. Among them, 19 patients received ASCT as first-line consolidation therapy in complete response (CR) or partial response (PR) status, and 9 patients with relapsed/refractory disease underwent salvage ASCT. The median time to neutrophil engraftment was 9 days (range: 5-11 days), and the median time to platelet engraftment was 10 days (range: 6-13 days). All patients achieved CR at the initial efficacy evaluation post-ASCT. The main complications during the transplantation period were febrile neutropenia (26 cases) and grade 3 diarrhea (9 cases). No transplantation-related mortality occurred. Post-ASCT, 19 patients received maintenance therapy, which was demonstrated to be safe and effective. Three patients relapse, and one patient died. The median progression-free survival (PFS) and overall survival (OS) of patients were not reached. The estimated 1-year and 2-year cumulative PFS rates were 88.4% and 66.3%, respectively, while the 1-year and 2-year OS rates were both 94.1%.
CONCLUSION
The modified thiotepa-based conditioning regimen combined with ASCT is safe and effective for the treatment of PCNSL.
Humans
;
Thiotepa/therapeutic use*
;
Retrospective Studies
;
Transplantation, Autologous
;
Transplantation Conditioning/methods*
;
Central Nervous System Neoplasms/therapy*
;
Hematopoietic Stem Cell Transplantation
;
Female
;
Male
;
Middle Aged
;
Adult
;
Lymphoma/therapy*
;
Treatment Outcome
;
Aged
10.Structure of myelin in the central nervous system and another possible driving force for its formation-myelin compaction.
Qi SHAO ; Simin CHEN ; Tian XU ; Yuyu SHI ; Zijin SUN ; Qingguo WANG ; Xueqian WANG ; Fafeng CHENG
Journal of Zhejiang University. Science. B 2025;26(4):303-316
Myelin formation is considered the last true "invention" in the evolution of vertebrate nervous system cell structure. The rapid jumping pulse propagation achieved by myelin enables the high conduction speed that is the basis of human movement, sensation, and cognitive function. As a key structure in the brain, white matter is the gathering place of myelin. However, with age, white matter-associated functions become abnormal and a large number of myelin sheaths undergo degenerative changes, causing serious neurological and cognitive disorders. Despite the extensive time and effort invested in exploring myelination and its functions, numerous unresolved issues and challenges persist. In-depth exploration of the functional role of myelin may bring new inspiration for the treatment of central nervous system (CNS) diseases and even mental illnesses. In this study, we conducted a comprehensive examination of the structure and key molecules of the myelin in the CNS, delving into its formation process. Specifically, we propose a new hypothesis regarding the source of power for myelin expansion in which membrane compaction may serve as a driving force for myelin extension. The implications of this hypothesis could provide valuable insights into the pathophysiology of diseases involving myelin malfunction and open new avenues for therapeutic intervention in myelin-related disorders.
Myelin Sheath/metabolism*
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Humans
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Central Nervous System/metabolism*
;
Animals


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