Objective:To detect expression levels of complement regulatory proteins CD55 and CD59 in the peripheral blood of patients with Stevens-Johnson syndrome (SJS) /toxic epidermal necrolysis (TEN), and to preliminarily analyze their potential roles in the occurrence of SJS/TEN.Methods:Hospitalized patients with SJS/TEN (SJS/TEN group) were collected from the Department of Dermatology of the First Affiliated Hospital of Anhui Medical University and the Second Affiliated Hospital of Anhui Medical University from December 2017 to December 2022. Meanwhile, patients with maculopapular exanthema (MPE) and healthy physical examinees were also collected and served as the mild group and healthy control group, respectively. Flow cytometry was performed to determine the proportions of CD4 + T lymphocytes and CD8 + T lymphocytes in peripheral blood mononuclear cells (PBMCs). The expression levels of inflammatory cytokines tumor necrosis factor (TNF) -α, interleukin (IL) -6, IL-17, IL-10, interferon (IFN) -γ, IL-2, and IL-4 were detected using flow cytometric bead array technology. The mRNA expression levels of CD55 and CD59 in PBMCs were detected by real-time fluorescence-based quantitative PCR (qRT-PCR). Flow cytometry was also performed to determine the protein expression of CD55 and CD59 on the surface of CD8 + T lymphocytes. Statistical analyses were carried out using one-way analysis of variance and Tukey's test. Results:Totally, 13 patients with SJS/TEN, 27 patients with MPE, and 40 healthy controls were collected. Among the SJS/TEN patients, there were 8 males and 5 females, with their age being 18 to 84 (47.15 ± 19.99) years, and disease duration being 7.74 ± 2.63 days. No significant differences were observed in the gender distribution or age among the 3 groups (both P > 0.05). The proportions of CD4 + T lymphocytes did not differ among the 3 groups ( F = 3.84, P = 0.051). The proportions of CD8 + T lymphocytes in the peripheral blood were significantly higher in the SJS/TEN group (25.60% ± 4.57%) than in the healthy control group (16.20% ± 6.28%; q = 4.59, P = 0.018). The expression levels of inflammatory cytokines TNF-α, IL-6, IL-10, IL-17, and IFN-γ were significantly higher in the SJS/TEN group than in the healthy control group and mild group (all P < 0.001). In addition, the mRNA expression of CD55 ( F = 9.46, P < 0.001) and CD59 in PBMCs ( F = 15.14, P < 0.001) was significantly lower in the SJS/TEN group than in the mild group and healthy control group. The protein expression levels of CD55 ( F = 51.51, P < 0.001) and CD59 ( F = 31.59, P < 0.001) on the surface of CD8 + T lymphocytes were also significantly lower in the SJS/TEN group than in the other two groups and the healthy control group, respectively. Conclusion:Complement regulatory proteins CD55 and CD59 were downregulated in SJS/TEN patients, which may be associated with the activation of CD8 + T lymphocytes and excessive inflammatory responses.

Objective To study the relationship of CSF and serum FGF-2 level with clinical parameters in MND patients.Methods Ninety-one MND patients served as a MND group and 40 noninflammtory nervous system disease patients served as a control group.Their CSF and serum FGF-2 level were measured by ELISA.The neurological deficit in ALS patients was assessed according to the modified ALSFRS-r,the progression of MND was assessed according to the DPR.The ALS patients were followed up,during which their survival time was recorded.Results The serum FGF-2 level was significantly higher in MND group than in control group (P＜0.01).The CSF,FGF-2 level were significantly higher in ALS patients of MND group than in those of control group (319.2±105.9 ng/L vs 241.7±34.3 ng/L,P＜0.01).The CSF and serum FGF-2 level were positively correlated with the duration of MND and negatively correlated with the DRP in ALS patients (P＜0.01).Survival analysis of MND patients indicated that the survival time of PMA patients was longer than that of PLS,ALS and PBP patients (P=0.000).The cumulative survival rate of ALS patients with a high serum FGF-2 level was significantly higher than that of those with a low serum FGF-2 level (P=0.002).Conclusion The CSF and serum FGF-2 level are higher in some MND patients and can be used as one of the biomarkers for evaluating the progression and predicting surrival.

Objective To study the clinical significance of serum hs-CRP level in smokers with carotid atherosclerosis (CA) and analyze its difference in subtypes of CA.Methods Two hundred and ninety-eight smokers with CA served as a smoker group and 120 non-smokers with CA served as a non-smoker group,50 healthy smokers without CA served as control group 1 and 50 healthy non-smokers served as control group 2.Their serum hs-CRP level was measured by colloid-enhanced immunoturbidimetry.Smokers were divided into stable plaque group and unstable plaque group.Effect of smoking on serum hs-CRP level in CA patients was analyzed.Results The serum hs-CRP level was significantly higher in smoker group and control group 1 than in non-smoker group and control group 2 (7.26±4.24 mg/L vs 3.56±2.28 mg/L,4.34±2.74 mg/L vs 3.17± 1.68 mg/L,P＜0.05).The smoking index was positively related with the serum hs-CRP level (r=0.395,P＜0.01).The number of daily smoked cigarettes was significantly greater in unstable plaque group than in stable plaque group (P＜0.05).The recurrence rate of ischemic stroke was significantly higher in smokers with a high serum hs-CRP level than in those with a low serum hs-CRP level (11.36％ vs 2.00％,P＜0.01).Conclusion Smoking can increase the serum hs-CRP level in CA patients,which is closely related with the stability of plaques and the recurrence of ischemic stroke.

Objective To study any functional changes in the trigeminal nociceptive system in cases of migraine with aura (MWA) using painful heat-evoked potentials (CHEPs),and to explore the value of CHEP in evaluating the trigeminal small nerve fibers of patients with MWA.Methods Sixty patients with MWA were recruited as the MWA group,and 60 healthy persons were selected as a normal control group.Thermal stimulation at 51 ℃ was applied to the skin above the patients' right and left eyebrows.The N wave latencies and N-P amplitudes of the CHEPs were recorded at the vertex (Cz) of the head.The intensity of the stimulus was graded using a visual analogue scale (VAS).Results In the control group the simulation produced no significant differences in the N550 or P750 latencies or in the N-P amplitudes.In the MWA group no significant differences were observed when the headache side was stimulated,but the N550 and P750 latencies were both significantly shorter than those of the control group and the N-P amplitude was significantly greater than that of the control group.The average VAS score on both sides in the patients with migraine was significantly higher than those of the control group.However,there was no significant difference in average VAS scores between the headache and non-headache sides of the patients with migraine.Conclusions CHEP is a reliable method for detecting any pathological changes in the trigeminal small nerve sensory pathway.Increased cutaneous allodynia in acute migraine attacks is detectable using CHEPs.

Objective To explore the value of ocular vestibular evoked myogenic potential in treating brainstem infarctions through comparing the characteristics ocular vestibular evoked myogenic potential (oVEMP) and brainstem auditory evoked potential (BAEP) in patients with brainstem infarctions.Methods A total of 60 patients with brainstem infarctions were enrolled in a brainstem infarction (BI) group, while another sixty healthy volunteers were selected as the control group.All patients underwent oVEMP and BAEP tests via air-conducted stimuli.Results The oVEMPs were elicited reliably and stably in 58 of the control group, and 42 of the BI group, with the bilateral N1 and P1 latencies of oVEMP significantly prolonged [N1 (left) : 11.85 ± 0.82 ms, N1 (right) : 11.91 ± 0.86 ms, P1 (left) : 15.52 ± 1.61 ms, P1 (right) : 15.63 ± 1.64 ms respectively] and the bilateral N1-P1 amplitudes of oVEMP significantly reduced [1.23 ±0.42 μV (left) and 1.58 ± 0.70 μV (right) respectively].Moreover, no recordable oVEMPs was elicited in the other 18 patients, among which found 13 prolonged N1 latencies, 10 prolonged P1 latencies, 6 prolonged N1 and P1 latencies and 8 reduced N1-P1 amplitudes of oVEMP.Altogether, 45 abnormal oVEMPs were found, with an abnormal rate of 75％.The average peak latencies of Ⅴ waves [(5.98 ± 0.37) ms] and interpeak latencies of Ⅲ-Ⅴ and Ⅰ-Ⅴ waves [2.93 ± 0.34 ms and 4.96 ± 0.39 ms respectively] in the BI group were significantly prolonged compared to the controls (P＜ 0.01).The amplitude ratio of Ⅴ/Ⅰ (0.48 ± 0.10) in the BI group was significantly reduced compared to the controls (P ＜ 0.05).Forty-two abnormal BAEPs were found, with an abnormal rate of 75％ , including 17 prolonged latency of Ⅴ waves, 6 prolonged latency of Ⅲ waves, 15 prolonged interpeak latencies of Ⅲ-Ⅴ waves, 9 prolonged interpeak latencies of Ⅰ-Ⅴ waves, 11 cases of Ⅲ-Ⅴ interpeak latency larger than Ⅰ-Ⅲ interpeak latencies, 13 cases of the amplitude ratio of Ⅴ / Ⅰ smaller than 0.5 and 3 case of unclear waves.There were no significant differences in abnormal rate when using the oVEMP (42/60 and 75％) and BAEP (45/60 and 70％) testing However, the abnormal rate was 91.7％ when combining oVEMP with BAEP testing, significantly higher than that when only conducting BAEP testing.Conclusion Patients with brainstem infarctions have abnormalities in oVEMP.Combined with MRI and other electrophysiological testing, oVEMP may contribute to the diagnosis of brainstem infarctions.

Objective To analyze the correlation of plasma homocysteine (Hcy) level with hemodynamic parameters and high density lipoprotein cholesterol (HDL-C) level in patients with lacunar infarction and its significance in lacunar infarction.Methods Transcranial Doppler examination was performed in 120 patients with lacunar infarction admitted to our hospital from February 2012 to March 2013 and 100 healthy controls; systolic flow velocity (SFV),distalotic flow velocity (DFV),mean flow velocity (MFV) and pulsatility index (PI) were assessed at the middle cerebral artery (MCA) and basilar artery (BA).Serum creatinine,total cholesterol,triglycerides,HDL-C,and low-densitylipoprotein cholesterol (LDL-C) levels were detected using enzymatic colorimetric method.Plasma Hcy level was measured by circulating enzymatic method.Results Blood flow velocity indexes,such as SFV,DFV,MFV and PI in the MCA of lacunar cerebral infarction patients,were significantly higher than those in their BA and the MCA blood of control group,with statistically significant differences (P＜0.05); blood flow velocity indexes,such as MFV and PI in the BA of lacunar cerebral infarction patients,were higher than those in the BA of the control group,with significant differences (P＜0.05).Lacunar cerebral infarction patients had significantly higher levels of Hcy,total cholesterol,LDL-C,tdglycerides,and HDL-C as compared with control group,with statistical differences (P＜0.05).Linear correlation analysis showed that PI of MCA and BA and Hcy level were positively correlated in lacunar infarction patients (r=0.530,P=0.020; r=0.450,P=0.010); and HDL-C and Hcy levels had negative correlation (r=-0.308,P=0.010).Conclusion A significant association between plasma Hcy and PI of cerebral arteries and serum HDL-C level indicates that Hcy plays a role in the increase of distal arterial resistance in lacunar infarction.

Objective To observe the effects of low frequency electrical nerve stimulation on sensory and motor functioning in patients with hemiplegia and hemianesthesia caused by acute cerebral infarction.Methods Sixty-one acute cerebral infarction patients with both hemiplegia and hemianesthesia were randomly divided into a treatment group and a control group.Thirty patients in the control group received conventional treatment.Thirty-one patients in the treatment group were treated with low frequency electrical stimulation of the peripheral nerves of the affected extremities in addition to the conventional treatment.Sensory function,motor function and performance in the activities of daily living(ADL)were evaluated before and 14 days after treatment.Results Sensory function,motor function and ADL performance in both groups improved significantly over the 14 days.Furthermore,the difference between the two groups after treatment was significant.Conclusion Low frequency electrical nerve stimulation can improve sensory function,motor function and ADL performance in acute cerebral infarction patients with both hemiplegia and hemianesthesia.

BACKGROUND: Now, progress has been made in understanding the pathomechanisms, protection of injured neurons,regeneration of oligodendrocytes and transplantation of neural stem cells. This paper is aimed to introduce the decade progression, latest research and novel therapies in the area of spinal cord injury internationally.DATA SOURCES: Related articles published from January 1987 to October 2006 were chosen from the America Medline Database, and the language was limited to English, with the search keywords of "spinal cord injury; neural stem cells;axon; neurotrophic factor and animal model".STUDY SELECTION: After the primary trial, the full versions of the articles related to neural stem cell and neurotrophic factor were reviewed according to the following criterias: ① experiments investigating the mechanisms and novel therapies of spinal cord injury. ②papers revealing the axon regeneration, function of growth cone, targets for inducting the regeneration direction as well as synapse and function rebuild. ③ papers reporting neurotrophic factor and endogenous stem cell therapies. Excluded criteria: ①papers with lower impact factor in SCl or studies with similar results.②papers without English abstract.DATA EXTRACTION: A total of 1 166 papers were found in Medline, 101 papers accord with the above criteria, 61 papers were cited in this review, including 12 papers for the mechanism of spinal cord injury, 14 papers for axon regeneration, 8 papers for the function of growth cone, 8 papers for the oligodendrocytes, 7 papers for neural stem cells and the left 12 papers for neurotrophic factor. Other articles were deleted.DATA SYNTHESIS: ①Base of functional recovery after spinal cord injury: The regeneration and elongation of damaged axons; The capacity of axons to penetrate the scar; Re-growth in the direction of appropriate target .regions; Cessation of axonal growth, formation of terminal arbors and formation of synaptic contacts with target neurons; The restoration of functional neurotransmission and the recovery of function.②Neuropathological analysis of spinal cord injury: the primary and secondary damage after spinal cord injury.③Molecular biological mechanism of spinal cord injury: The growth cone is important for the establishment of neural circuitry during neural development and regeneration in the adult CNS after injury; Central nerve system myelin protein is inhibitory for axonal growth; cell membrane and intracellular signal transmission. ④The important cells and cytokine of spinal cord injury: oligodendrocyte, leukemia inhibitory factor,minocycline and endogenous neural stem cells. ⑤Animal models of spinal cord injury: The most common models are total transactions, partial transections and contusions. ⑤Prospect of researches on spinal cord injury: The therapy of neurotrophic factor and neural stem cell has been transformed to clinical practice, for example, the leukaemia inhibitory factor has been applied on clinical experiment at Ⅳ phase, and the research of the induction and proliferation of ndogenous stem cells has been paid much more attention.CONCLUSION: The regeneration of spinal cord after injury is becoming possible using the therapies of neurotrophic actor and neural stem cell. It would be an ideal direction in the near future to investigate the mechanisms of axon regeneration induced by neurotrophic factor intervention in the research areas of spinal cord injury. It would also play a vital role to reveal the proliferation and differentiation of endogenous neural stem cells in repairing the injury of spinal cord.

OBJECTIVE: To introduce the research progression of fMRI in brain functional localization in China or abroad in the recent 15 years, so as to further comprehend the effect and value of fMRI.DATA SOURCES: A computer-based online search of Medline database was undertaken to identify English articles about fMRI published from 1990 to 2005 with the keywords "functional magnetic resonance imaging (fMRI), brain".STUDY SELECTION: The articles about experimental studies of fMRI articles irrelative to motor function, sensory function, hearing function, visuEnglish title.DATA EXTRACTION: Totally 6 144 relevant articles were collected, 18 articles were involved according to the inclusive criteria, and the others were excluded. cles about sensory function, including 1 about simple tactile stimulation,ry function, including 2 about simple visual stimulation, and 1 about binoction, including about hearing stimulation by various methods, and 1 about comparison between normal and abnormal subjects by the same stimulation.language function, 1 about visual language function, and 1 about listening basic principle.CONCLUSION: fMRI was more accurate, convenient and direct than other methods. It can not only show localization, size and dimension of the activated areas in different cerebral regions, but also show accurate anatomical position. Many aspects still need to be consummated, for example, exploration of the stimulating method, design of advanced hardware, post processing of the image and the effect of visualization. With the development of hardware, software and the endless endeavor of scientists, fMRI dooms to play an important role in illustrating the function of human brain.

OBJECTIVE To provide the evidence in decreasing the rate of hospital-acquired infection by studying the patients in NICU and analyzing the bacteria strains isolated from these patients.METHODS We studied 512 cases from 1027 patients in NICU of Department of Neurology,813 isolated bacteria strains and their sensitivities to antibiotics were investigated.RESULTS NICU patients had a relatively high rate of hospital-acquired infection(49.85%),respiratory and urinary systems were the most common affected.Klebsiella pneumoniae was the top one species in Gram-negative bacteria(62.61%).Pseudomonas aeruginosa was the top one species in Gram-positive bacteria(28.16%).CONCLUSIONS Laboratory examination,appropriate antibiotics and precise medical behavior are the most important factors in preventing the hospital-acquired infection in NICU.