Objective:To investigate the abnormal changes of the nodal centrality of the whole-brain network in patients with narcolepsy type 1 (NT1) through the degree centrality (DC) technique of resting-state magnetic resonance and the predictive value for NT1.Methods:From September 2019 to November 2021, 18 NT1 patients who were first diagnosed and never accepted managements and 18 age-, sex-matched healthy controls recruited by advertisement in the Second Affiliated Hospital of Nanchang University were required for resting-state functional magnetic resonance imaging scans and clinical scale assessment, including Epworth Sleepiness Scale (ESS), Self-rating Anxiety Scale, Self-rating Depression Scale, Pittsburgh Sleep Quality Index, Insomnia Severity Scale and Multidimensional Fatigue Inventory-20 (MFI-20). The differences in DC values between the NT1 patients and healthy controls were analyzed using the DC method. Then, the correlation between DC values in differential brain regions and clinical characteristics of NT1 was explored through Pearson correlation analysis. The receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive value of the DC values in the differential brain regions for NT1 patients.Results:Compared with the healthy controls, the DC value of the right superior temporal gyrus was increased, while the DC values of the bilateral middle frontal gyrus and the right precuneus were decreased in the NT1 patients (all P<0.05, Gaussian random-field correction). The DC value of the right superior temporal gyrus in the NT1 patients was positively correlated with the ESS score ( r=0.82, P<0.001) and MFI-20 score ( r=0.48, P=0.040). The DC value of the right middle frontal gyrus was positively correlated with the disease course ( r=0.51, P=0.032). The ROC curve showed that the area under the curve of NT1 predicted by the DC value of the right superior temporal gyrus was 0.95. And the areas under the curve of non-NT1 predicted by the DC values of the left middle frontal gyrus, right middle frontal gyrus, and right precuneus were 0.86, 0.84 and 0.87, respectively. Conclusions:NT1 patients have abnormal resting-state DC in the default network, executive network core brain regions, and superior temporal gyrus. And the DC value in the right superior temporal gyrus may be a potential biomarker of NT1 patients.

Objective:To investigate the expression of circ_0063865 in esophageal squamous cell carcinoma(ESCC)tissues and cells and its effect on the biological properties of the cells.Methods:The loop structure and stability of circ_0063865 were identified by Sanger sequencing, back-to-back primer validation and the ribonuclease R(Rnase R)tolerance assay.The expression of circ_0063865 was detected by RNA fluorescence in situ hybridization in an ESCC tissue microarray and its clinical relevance was analyzed.The expression levels of circ_0063865 in a normal esophageal epithelial cell line and ESCC cell lines were measured by real-time quantitative polymerase chain reaction(RT-qPCR). Cell counting Kit-8, the colony formation assay, the scratch assay, the transwell invasion assay and flow cytometry were used to detect the effects of circ_0063865 on cell proliferation, migration, invasion abilities and apoptosis, respectively.Results:The loop formation of circ_0063865 was verified by Sanger sequencing, back-to-back primer and Rnase R tolerance assays.The results of RNA fluorescence in situ hybridization showed that the mean fluorescence intensity of circ_0063865 expressed in ESCC tissues was significantly higher than in its paired paracancerous normal tissues( t=2.267, P<0.05). The expression of circ_0063865 was significantly associated with lymph node metastasis( χ2=4.356, P<0.05). The average overall survival time of patients with high circ_0063865 expression ESCC was lower than that of patients with low circ_0063865 expression ESCC.RT-qPCR results demonstrated that, compared with HEEC, circ_0063865 expression was elevated in ESCC cell lines( F=18.413, P<0.05). In addition, after circ_0063865 knockdown, the proliferation, migration and invasion abilities of KYSE-30 and KYSE-150 cells were significantly decreased, and the level of apoptosis was significantly increased(both P<0.05). Conclusions:The expression of circ_0063865 in ESCC is high, and changes in its expression are significantly correlated with lymph node metastasis.Additionally, circ_0063865 can promote the proliferation, migration and invasion of ESCC cells.

Objective:To investigate the effect of combined treatment with alendronate tablets and calcitonin on insulin like growth factor-1 (IGF-1), procollagen type Ⅰ amino terminal lengthening peptide (PINP) and c-terminal telopeptide of type Ⅰ collagen (S-CTX) levels in patients with type 2 diabetes mellitus (T2DM) combined with osteoporosis (OP) .Methods:Using the principle of randomized controlled experiment, 130 patients in Xiyuan Hospital, China Academy of Chinese Medical Sciences from Feb. 2021 to Feb. 2022 were selected as study subjects and divided into control group and observation group according to the randomized envelope method in the ratio of 1:1, 65 cases each. The control group was treated with calcitonin and the observation group was treated with alendronate tablets combined with calcitonin, both were treated continuously for 6 months. The therapeutic effect, bone mineral density, blood glucose related indexes [fasting blood glucose (FPG), 2 h postmeal blood glucose (2 hPG), glycosylated hemoglobin content (HAb1c) ], 25 hydroxyvitamin D[25 (OH) D], IGF-1, PINP, S-CTX, and adverse reactions were statistically compared between the two groups.Results:The total effective rate of the observation group was 98.46%, higher than that of the control group 86.15% ( P < 0.05) ; After 6 months of treatment, the bone mineral density of left femoral neck, hip, lumbar spine L1-L4 and Wards triangle in the observation group was higher than that in the control group ( P < 0.05) ( P < 0.05) ; After 6 months of treatment, the levels of PINP (38.36 ± 3.44 vs 42.77 ± 3.86, t=6.88, P<0.001) and S-CTX (0.36 ± 0.13 vs 0.52 ± 0.13, t=7.02, P<0.001) in the observation group were lower than those in the control group, while the levels of 25 (OH) D (31.28 ± 5.96 vs 27.46± 5.18, t=3.90, P<0.001) and IGF-1 (167.82 ± 39.46 vs 150.86 ± 40.27, t=2.43, P=0.017) were higher than those in the control group; FPG, 2 hPG and HAb1c levels in the observation group were lower than those in the control group after 6 months of treatment ( P < 0.05) ; The difference was not statistically significant when comparing the incidence of adverse reactions between the two groups ( P>0.05) . Conclusion:The combined treatment of T2DM combined with osteoporosis with alendronate tablets sodium and osteopontin can further increase bone mineral density, regulate bone metabolism and improve osteoporosis symptoms, and also have a positive effect on blood glucose control.

Anti-neurexin-3α antibody-associated encephalitis is rare in clinical practice. It often has a history of pre-infection. It is characterized by abnormal mental behavior, seizures, decreased consciousness, cognitive and sleep disorders, movement disorder, central hypoventilation and autonomic nervous dysfunction. Among them, dyskinesias are mainly involuntary movements of the mouth, face and limbs, dystonia, myoclonic seizures and other manifestations of increased movement. Parkinson′s symptoms manifested as decreased movement are rarely reported. A encephalitis patient with positive anti-neurexin-3α antibody is reported, who is a young female, mainly with parkinsonism such as slow movement, unsteady walking, difficulty in starting and turning around, and inability to hold things in both upper limbs, accompanied by abnormal mental behavior and cognitive dysfunction. After treatment with methylprednisolone and intravenous immunoglobulin, the prognosis is good.

Autoimmune encephalitis is a group of inflammatory diseases related to autoantibodies that affect the central nervous system. Early diagnosis of patients with autoimmune encephalitis has certain difficulties, because the clinical manifestations caused by different types of autoantibodies can be non-specific, and the presence of multiple autoantibodies can cause variation and superposition of clinical manifestations. The article reported a case of autoimmune encephalitis patients with double positive anti-N-methyl-D-aspartate receptor and dipeptidyl-peptidase-like protein-6 antibodies, and reviewed relevant literature for clinical reference.

An increasing number of studies have recently indicated the important effects of gut microbes on various functions of the central nervous system.However, the underlying mechanisms by which gut microbiota regulate brain functions and behavioral phenotypes remain largely unknown. We therefore used isobaric tags for relative and absolute quantitation (iTRAQ)-based quantitative proteomic analysis to obtain proteomic profiles of the hippocampus in germ-free (GF), colonized GF, and specific pathogen-free (SPF) mice. We then integrated the resulting proteomic data with previously reported mRNA microarray data, to further explore the effects of gut microbes on host brain functions. We identified that 61 proteins were upregulated and 242 proteins were downregulated in GF mice compared with SPF mice. Of these, 124 proteins were significantly restored following gut microbiota colonization. Bioinformatic analysis of these significant proteins indicated that the glucocorticoid receptor signaling pathway and inflammation-related pathways were the most enriched disrupted pathways. This study provides new insights into the pathological mechanisms of gut microbiota-regulated diseases.