Objective To analyze the clinical data of patients with neurosyphilis(NS)and explore factors influencing their activity of daily living(ADL).Methods The clinical data of 90 patients with NS was retrospectively analyzed,and the ADL scores at admission were assessed by using the Barthel index(BI).The patients were divided into no-dependency,mild-dependency,and moderate-to-severe-dependency groups.The influencing factors of ADL were explored through comparative analysis and multiple linear regression analysis.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of clinical indicators for poor ADL recovery(BI score≤60)at discharge in patients.Results Among the 90 NS patients,the average age was 54.17±12.45 years,with 70 males(77.78%).The most common clinical manifestation was abnormal mental behavior(44.44%),followed by limb sensory or motor disorders(25.56%)and dysarthria(16.67%).Based on the BI scores,41 patients(45.6%)were independent,31 patients(34.4%)had mild dependence,and 18 patients(20.0%)had moderate to severe dependence.The comparison results of the three groups showed that the neutrophil-to-lymphocyte ratio(NLR)was gradually increased[2.80(1.97,4.73)vs.3.80(2.28,4.89)vs.5.37(3.76,7.20)]which was higher in the moderate-to-severe-dependency group than in the independent and the mildly-dependent group(P<0.05);cerebrospinal fluid protein concentration[427(341,644)mg/L vs.553(425,830)mg/L vs.933(641,1706.5)mg/L]was gradually increased and there were significant differences in pairwise comparisons(P<0.05).Multiple linear regression analysis showed that NLR(β=-0.242,P=0.018)and cerebrospinal fluid protein concentration(β=-0.461,P<0.001)were negatively correlated with ADL at admission.The area under curve(AUC)for cerebrospinal fluid protein concentration in predicting poor ADL recovery at discharge was 0.806(95%CI:0.708-0.883,P<0.001),with an optimal cutoff value of 620 mg/L,sensitivity of 86.7%,and specificity of 69.4%.Conclusion The main clinical manifestations of NS patients are psychiatric/behavioral abnormalities.Elevated NLR and cerebrospinal fluid protein concentration may be associated with the decreased ADL.Early active intervention of inflammatory response and cerebrospinal fluid protein abnormalities may provide a new way to improve the prognosis of patients.

Objective To analyze the clinical data of patients with neurosyphilis(NS)and explore factors influencing their activity of daily living(ADL).Methods The clinical data of 90 patients with NS was retrospectively analyzed,and the ADL scores at admission were assessed by using the Barthel index(BI).The patients were divided into no-dependency,mild-dependency,and moderate-to-severe-dependency groups.The influencing factors of ADL were explored through comparative analysis and multiple linear regression analysis.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of clinical indicators for poor ADL recovery(BI score≤60)at discharge in patients.Results Among the 90 NS patients,the average age was 54.17±12.45 years,with 70 males(77.78%).The most common clinical manifestation was abnormal mental behavior(44.44%),followed by limb sensory or motor disorders(25.56%)and dysarthria(16.67%).Based on the BI scores,41 patients(45.6%)were independent,31 patients(34.4%)had mild dependence,and 18 patients(20.0%)had moderate to severe dependence.The comparison results of the three groups showed that the neutrophil-to-lymphocyte ratio(NLR)was gradually increased[2.80(1.97,4.73)vs.3.80(2.28,4.89)vs.5.37(3.76,7.20)]which was higher in the moderate-to-severe-dependency group than in the independent and the mildly-dependent group(P<0.05);cerebrospinal fluid protein concentration[427(341,644)mg/L vs.553(425,830)mg/L vs.933(641,1706.5)mg/L]was gradually increased and there were significant differences in pairwise comparisons(P<0.05).Multiple linear regression analysis showed that NLR(β=-0.242,P=0.018)and cerebrospinal fluid protein concentration(β=-0.461,P<0.001)were negatively correlated with ADL at admission.The area under curve(AUC)for cerebrospinal fluid protein concentration in predicting poor ADL recovery at discharge was 0.806(95%CI:0.708-0.883,P<0.001),with an optimal cutoff value of 620 mg/L,sensitivity of 86.7%,and specificity of 69.4%.Conclusion The main clinical manifestations of NS patients are psychiatric/behavioral abnormalities.Elevated NLR and cerebrospinal fluid protein concentration may be associated with the decreased ADL.Early active intervention of inflammatory response and cerebrospinal fluid protein abnormalities may provide a new way to improve the prognosis of patients.

Objective To analyze the clinical,laboratory and brain MRI features of patients with neurosyphilis(NS).Methods Eighty-five NS patients admitted to the Department of Neurology in Nanjing Second Hospital from November 2018 to November 2022 were retrospectively analyzed.According to the results of brain MRI,the patients were divided into two groups:normal brain MRI + unilateral lesions group and bilateral lesions group(more severe group).ROC were plotted and the areas under the curves(AUC)were calculated to evaluate the diagnostic value of clinical indicators for severe NS on MRI.Results Compared with normal brain MRI + unilateral lesions group,the mean age(P = 0.000),the rate of male(P = 0.008)and the rate of symptomatic NS(P = 0.006)were significantly higher in bilateral lesions group.Moreover,hypersensitive C-reactive protein(P = 0.028),basophil(P = 0.003),fibrinogen(P = 0.011),CSF tolulized red unheated serum test titer(P = 0.004),CSF protein concentration(P =0.000),CSF adenosine deaminase(P =0.003),and CSF white blood cell count(P =0.049)were significantly increased in patients with NS in bilateral brain lesions group.Multivariate regression analysis suggested that age(OR =1.085,P =0.019)and CSF protein concentration(OR =1.004,P =0.023)were risk factors for NS patients with bilateral brain lesions on MRI.The clinical model was established by age,CSF protein concentration,and basophil,the AUC for predicting NS patients with bilateral brain lesions could reach 0.83(95%CI:0.73-0.91,P＜0.01).Conclusions Clinical,laboratory and brain MRI examination should be integrated during the diagnosis and treatment of NS.Elderly patients and patients with high CSF protein concentration suggest severe disease,and reduction of CSF protein concentration is expected to improve the condition of NS patients.

Objective To study the expressions of P53,vascular endothelial growth factor (VEGF) and proliferating cell nuclear antigen (PCNA) in astrocytomas and their relationships with prognosis of these patients.Methods Immunohistochemical SP method was employed to detect the P53,VEGF and PCNA expression in 126 cases of human brain astrocytomas of different grades,collected in our hospital from May 2002 to May 2010; their correlations and their significance in the prognosis in these patients were analyzed.Results P53,VEGF,and PCNA expressed differently in astrocytomas of different grades,enjoying a positive relation with grades (P＜0.05); positive correlations of between P53 expression and both VEGF and PCNA expressions (r=0.608,P=0.000; r=0.432,P=0.001).In patients with the same grade of astrocytoma,those having positive P53 expression enjoyed poorer prognosis and lower survival rate with significant difference (P＜0.05); while VEGF and PCNA expressions had no correlation with the progonosis.Conclusion The expressions of PCNA,VEGF and P53 are closely associated with grade of the astrocytomas,and only P53 expression is an indicator of poor prognosis.