Objective:To investigate the clinical features of nontuberculous mycobacteria (NTM) disease patients with positive anti-interferon γ (IFN-γ) autoantibody.Methods:Forty-three adult human immunodeficiency virus-uninfected patients with NTM disease hospitalized in Huashan Hospital, Fudan University and Jing′an Branch, Huashan Hospital, Fudan University from July 2021 to August 2023 were included. Clinical data and NTM strain information of the patients were collected. The plasma levels of anti-IFN-γ autoantibodies were detected by enzyme-linked immunosorbent assay, and the patients were divided into antibody positive group and antibody negative group. The clinical characteristics and laboratory examination results between the two groups were compared. The independent sample t test, Mann-Whitney U test and chi-square test were used for statistical analysis. Multivariate logistic regression analysis was used to determine the correlation factors of positive anti-IFN-γ autoantibodies. Results:Among the 43 patients, 13 cases (30.2%) were positive for anti-IFN-γ autoantibodies and 30 cases (69.8%) were negative. The proportions of patients with NTM disseminated infection (9/13 vs 30.0%(9/30))and combined bacterial infection (5/13 vs 6.7%(2/30)) in antibody positive group were both higher than those in antibody negative group, and the differences were both statistically significant ( χ2=5.74 and 6.73, respectively, both P<0.05). The white blood cell count, platelet count, the proportion of platelet count >350×10 9/L of antibody positive patients were all higher than those of antibody negative group, while the white sphere ratio was lower than that of antibody negative group, with statistical significance ( t=2.42, 3.02, χ2=9.77 and t=3.66, respectively, all P<0.05). Erythrocyte sedimentation rate, C-reactive protein, procalcitonin, globulin, immunoglobulin G, immunoglobulin A and immunoglobulin M in antibody positive patients were all higher than those in antibody negative group, and the differences were all statistically significant ( U=99.50, 112.00, 115.50, 61.50, 76.50, 99.00 and 83.00, respectively, all P<0.05). Mycobacterium abscessus complex (seven cases and 11 cases, respectively) and Mycobacterium avium complex (five cases and 13 cases, respectively) were the main isolated strains in antibody positive and antibody negative patients. Multivariate logistic regression analysis showed that combined with bacterial infection (odds ratio ( OR)=21.83, 95% confidence interval ( CI) 1.94 to 245.71), NTM disseminated infection ( OR=7.64, 95% CI 1.10 to 53.26), platelet count>350×10 9/L ( OR=14.31, 95% CI 1.91 to 107.04) were risk factors for anti-IFN-γ autoantibodies positive (all P<0.05). Conclusions:Patients with positive anti-IFN-γ autoantibodies have higher probability of having elevated levels of systemic inflammation. Anti-IFN-γ autoantibody test is recommended for patients with NTM disease who present with co-bacterial infection, NTM disseminated infection, or elevated platelet count (>350×10 9/L).

N-cadherin,also known as Neural-cadherin/Cadherin-2,is a calcium-dependent transmembrane glycoprotein that plays a crucial role in cell-to-cell adhesion,cell sorting,nerve development and a variety of physiological and pathological processes. In recent years,with the rapid development of molecular biology and cell biology,the functional research of N-cadherin has made remarkable progress,providing essential clues for understanding tumor metastasis and neurodegenerative diseases. In this paper,the main progress in N-cadherin functional research in recent years is reviewed,including its molecular structure,biological function,signal transduction mechanism and its role in diseases. Finally,the clinical application prospect and future research direction of N-cadherin are summarized. It is expected to provide some theoretical reference for future research and clinical application of N-cadherin as a new target for the treatment of diseases.

Objective:To establish and verify a diagnostic model for distinguishing multiple sclerosis (MS) from other neurological diseases with similar symptoms by usingcerebrospinal fluid oligoclonal band (CSF-OCB)combined with IgG intrathecal synthesis indicators and biochemical markers.Methods:Multiple sclerosis (MS) patients admitted to the Neurology Department of Beijing Tiantan Hospital affiliated with Capital Medical University from January 2014 to December 2022 were selected as the case group, while patients with similar neurological symptoms were selected as the control group. Using the case-control study design, a retrospective analysis was conducted on the detection of age, gender, oligoclonal bands in cerebrospinal fluid, IgG intrathecal synthesis indicators and biochemical indicators for all study subjects. The differential diagnosis model was determined by the multiple logistic regression analysis, and the receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficiency of the differential diagnosis model for neurological diseases with similar symptoms to MS and other conditions.Results:This study included 167 patients in the case group and 335 patients in the control group, of which 128 patients in the case group and 265 patients in the control group were used to construct the model, and 39 patients in the case group and 70 patients in the control group were used for model validation. The differential diagnostic model constructed by a multivariate logistic regression model was Y=0.871×CSF-OCB-0.051×CSFprotein-0.231×CSFchloride+1.183×gender-0.036×LDH+35.770. The model showed that the area under the curve, sensitivity and specificity were respectively 0.916, 87.3% and 87.6%. The Delong test results showed that the diagnostic efficacy of the model was significantly different from OCB, IgG intrathecal synthesis indicators, and OCB combined with IgG intrathecal synthesis indicators ( P<0.05). The new model validation showed that the actual diagnostic consistency rate for the MS group was 84.6%, while the actual diagnostic consistency rate for the control group was 90.0%. Conclusion:This study combines OCB, IgG intrathecal synthesis indicators, and biochemical indicators to establish a diagnostic prediction model for neurological diseases with similar clinical symptoms in MS. This model may have good differential diagnostic value and can better assist clinical diagnosis in the early stages of disease progression in MS patients.

Objective:To establish and verify a diagnostic model for distinguishing multiple sclerosis (MS) from other neurological diseases with similar symptoms by usingcerebrospinal fluid oligoclonal band (CSF-OCB)combined with IgG intrathecal synthesis indicators and biochemical markers.Methods:Multiple sclerosis (MS) patients admitted to the Neurology Department of Beijing Tiantan Hospital affiliated with Capital Medical University from January 2014 to December 2022 were selected as the case group, while patients with similar neurological symptoms were selected as the control group. Using the case-control study design, a retrospective analysis was conducted on the detection of age, gender, oligoclonal bands in cerebrospinal fluid, IgG intrathecal synthesis indicators and biochemical indicators for all study subjects. The differential diagnosis model was determined by the multiple logistic regression analysis, and the receiver operating characteristic (ROC) curve was used to analyze the diagnostic efficiency of the differential diagnosis model for neurological diseases with similar symptoms to MS and other conditions.Results:This study included 167 patients in the case group and 335 patients in the control group, of which 128 patients in the case group and 265 patients in the control group were used to construct the model, and 39 patients in the case group and 70 patients in the control group were used for model validation. The differential diagnostic model constructed by a multivariate logistic regression model was Y=0.871×CSF-OCB-0.051×CSFprotein-0.231×CSFchloride+1.183×gender-0.036×LDH+35.770. The model showed that the area under the curve, sensitivity and specificity were respectively 0.916, 87.3% and 87.6%. The Delong test results showed that the diagnostic efficacy of the model was significantly different from OCB, IgG intrathecal synthesis indicators, and OCB combined with IgG intrathecal synthesis indicators ( P<0.05). The new model validation showed that the actual diagnostic consistency rate for the MS group was 84.6%, while the actual diagnostic consistency rate for the control group was 90.0%. Conclusion:This study combines OCB, IgG intrathecal synthesis indicators, and biochemical indicators to establish a diagnostic prediction model for neurological diseases with similar clinical symptoms in MS. This model may have good differential diagnostic value and can better assist clinical diagnosis in the early stages of disease progression in MS patients.

Objective To observe the effect of Bushen Huoxue Decoction(BSHX)on PI3K/Akt/mTOR signaling pathway and explore its possible mechanism in improving synaptic plasticity in a vascular dementia(VD)rat model.Methods Sprague-Dawley rats were randomly divided into sham operation group(Sham group),model group(VD group),Bushenhuoxue decoction group(BSHXD group),nimodipine group(NMDP group),with 10 rats in each group.The VD model of rats was established by two-vessel(2-VO)occlusion method.Rats in BSHXD group were given BSHXD at a weight of 10.14 g·kg-1,while rats in the NMDP group were given nimodipine decoction at 11 mg·kg-1.The SHAM group and the VD group were given saline at a weight of 10 mL·kg-1 once a day for 4 weeks.Morris water maze was used to observe the spatial learning and memory ability of rats in each group.Nissl staining was used to observe the damage of Nissl bodies and neurons in CA1 area of hippocampus of rats.The expression of synaptophysin(SYN)and postsynaptic density protein 95(PSD-95)in hippocampal CA1 region was detected by immunohistochemistry.Golgi-Cox staining method was used to observe the number changes of dendritic branches and spines of hippocampal neurons.Transmission electron microscopy(TEM)observed the ultrastructural change of synapses.The protein and mRNA expressions of phosphatidylinositol 3-kinase(PI3K),serine-threonine kinase(AKT)and mammalian target of rapamycin(mTOR)in rat hippocampus were detected by Western blot and Reverse transcription quantitative PCR(RT-qPCR).Results Compared with the control group,the learning and memory ability of VD rats decreased.These rats showed abnormal synaptic ultrastructure of hippocampal neurons and neuronal cell damage,and this was accompanied by a decrease in the density of dendrite branches and dendritic spines of neurons.The expression of both SYN and PSD-95 proteins in the hippocampus decreased(P<0.05),and synaptic plasticity was damaged.Both mRNA and protein expression of PI3K,Akt,and mTOR in the hippocampus decreased in the VD rats(P<0.05).Also observed in VD rats was that administration of BHSX mitigated the learning and memory impairment observed in these animals,improved the morphology and synaptic ultrastructure of hippocampal neurons,increased the mRNA and protein expression levels of PI3K,Akt,mTOR,and increased the protein levels of SYN and PSD-95(P<0.05).Conclusion BSHX can alleviate the learning and memory impairment of VD rats and increase the protein expression levels of synapse-related proteins.These effects may be related to the promotion of synaptic plasticity by BSHX through activation of PI3K/Akt/mTOR signaling.

Objective To analyze the distribution characteristics and application value of liver,renal func-tion indexes and autoantibody-related indexes of neuromyelitis optica spectrum disorder(NMOSD).Methods The liver,renal function and autoantibody-related indexes data of patients diagnosed with NMOSD and multiple sclerosis(MS)in Beijing Tiantan Hospita,Capital Medical University from June 2015 to June 2023,as well as gender and age-matched controls underwent routine physical examination were retrospectively collected.A total of 95 patients with NMOSD(NMOSD group),230 patients with MS(MS group),and 244 healthy controls(routine physical examination group)were selected to evaluate the diagnostic value of each index for NMOSD.Results Compared with MS group,the levels of alanine aminotransferase,as well as the positive rates of α-hydroxybutyrate dehydrogenase,y-glutamyltransferase,anti-SS-A antibody,anti-SS-B anti-body,anti-ribosomal P protein antibody and Ro-52 antibody were significantly increased in NMOSD group,while the levels of albumin,indirect bilirubin and total bilirubin were significantly decreased,and the differ-ences were statistically significant(P＜0.05).The difference index between NMOSD and conventional physi-cal examination group was similar to that of MS group.The seven indexes,a-hydroxybutyrate dehydrogenase,albumin,globulin,direct bilirubin,indirect bilirubin,total bile acid and uric acid alkalinity could be used for the diagnosis of NMOSD.The area under the curve of combined diagnosis of NMOSD was 0.969,and the sensitiv-ity and specificity were 92.6％and 92.9％.Conclusion Multiple indexes of liver and kidney function in NMOSD patients are different from those in MS patients and healthy subjects underwent routine physical ex-amination,and the positive rate of some autoantibody indexes in NMOSD patients is higher than that in MS patients.Liver,renal function and autoantibody-related indexes can be used clinically to assist diagnosis,and the combined application of multiple indexes can further enhance its diagnostic value.

The prevention and treatment of COVID-19 in China is now at a key stage. The tasks faced by the medical organs are fighting against the COVID-19 while providing the medical services orderly. As a Specialist medical institution nationwide, ophthalmic hospitals are resuming receiving patients and performing operations gradually, including precision interruption of the epidemic, prevention of the secondary virus transmission, and avoidance of nosocomial cross infection among health care providers are required. We explored a multifaceted management for the prevention and control of epidemic, with a special focus on the individual protection for patients and medical staffs. A preliminary positive effect can be observed as a result. The main measures taken cover two aspects. On the one hand, 2019-nCoV ribonucleic acid (RNA) detection and hematological indices inspection including C-reactive protein (CRP) and serum amyloid A (SAA) are listed as routine tests of preoperative screening for ocular surgical patients. These tests are required to be completed upon the admission to avoid the possibility of accepting any asymptomatic infected individual and to reduce the risk of nosocomial cross infection. On the other hand, the 2019-nCoV RNA detection is also provided to high-risk employees who visited affected area recently. This assists in obtaining guarantee in both safety and quality of medical services provided, but also helps in lessening the mental and spiritual stress for medical staffs. It is expected that these measures can contribute to the work of our peers of ophthalmology in the prevention and control of COVID-19 and to the safe environment where the medical services are provided, and provide a reference for other outbreak of virus-causing disease.

Objective:Under different diagnostic scenarios, we tried to establish a tuberculosis dynamic model, to predict the incidence burden and to provide evidence for developing the prevention and control programs of tuberculosis.Methods:A systematic dynamic model was established to fit the annual incidence rates of tuberculosis data from the China CDC, between 2005 and 2018. Basic reproductive number ( R0) was calculated. Impact of different diagnostic scenarios on tuberculosis burden was explored by numerical changes in diagnosis-related parameters. Results:Results from the Chi-square test indicated that the model accuracy appeared as: χ2=1.102 ( P=1.000). Also, the computed result showed that R0=0.063<1, indicating that tuberculosis would gradually be disappearing in China. Approaches that including 'reducing the delayed diagnosis time’or 'improving the timely medical treatment’would end the fluctuations of the number of infectious and hospitalized patients and thus leading to continuous reduction in the number of these patients, in a long run. Conclusions:This model fitted well for the trend of tuberculosis incidence rates between 2005 and 2018. Reducing the delay time in diagnosis and improving the rate of timely medical treatment could effectively reduce the long-term burden of tuberculosis. Improvement of this model would be further explored.

Carotid atherosclerosis,especially unstable carotid plaque,is closely related to stroke.Serum biomarkers have unique value for screening and identifying high-risk carotid plaque.This article reviews the serum biomarkers of unstable carotid plaque.

Objective To present the changing of the parameters of orbital volume after endoscopic transethmoid medial orbital wall decompression combined with the endoscopic transethmoid intraconal fat-removal orbital decompression in thyroid associated ophthalmopathy (TAO).Methods A retrospective chart was reviewed in 11 patients (20 eyes) receiving orbital decompression for the treatment of exophthalmos secondary to TAO from September 2014 to August 2015. All patients diagnosed TAO were in stable and inactive phase at least for 6 months. High-resolution computed tomography (HRCT) scan were performed in all patients before and 3-month after surgery. CT scan of orbit and computer-aided measurement software were used to measure the exophthalmos. Changing of the parameters of orbital volume were recorded for analysis its relationship with the amount of proptosis reduction.Results The exophthalmos was signiifcantly decreased after surgery. Medial rectus volume, fat volume and orbital volume were larger postoperatively. The changing of rectus volume and fat volume both had negative correlationship with the amount of proptosis.Conclusions The thickening of medial rectus 3-month postoperative may due to the removing of medial wall of orbit during the surgery. The stimulation of the surgery may be another reason. The changing of rectus volume and fat volume both had negative correlationship with the amount of proptosis.