Neuritis Research Articles

The relationship between inositol phosphatase-1 and cognitive impairment induced by hippocampal neuritis in intrauterine infected mice

Objective To investigate the relationship between cognitive impairment and SH2 domain-containing inositol phosphatase-1(SHIP-1)induced by hippocampal neuritis in intrauterine infected mice. Methods Thirty C57BL/6 female mice and 15 male mice were caged in a ratio of 21.After that, the pregnant mice were divided into 2 groups.A mice model of intrauterine infection was established that intrauterine infection group (lipopolysaccharides, LPS group) induced by LPS at the concentration of 350 μg/kg and control group treated with same volume of saline(9 g/L). At 3 days postpartum, 15 mice in each group were killed for hippocampus, and the protein levels of SHIP-1, nuclear factor-κB(NF-κB) p65 and phosphorus NF-κB(NF-κBp) in the hippocampus of the newborn mice were detected by Western blott, while the levels of interleukin 1β(IL-1β) and tumor necrosis factor (TNF-α)were detected by using enzyme linked immunosoobent assay.When the remaining mice were 8 weeks old(10 in each group), Morris water maze experiments were performed respectively, which the mice were tested for evaluating learning and memory function by positioning navigation and space exploration experiments. Results The expression of SHIP-1 was significantly increased in control group(0.677±0.074) compared with LPS group(0.317±0.095, t=2.984, P=0.041), while the levels of NF-κB p65, and NF-κBp, were significantly lower in control group(0.630±0.109, 0.352±0.084) than LPS group(0.630±0.109, 0.352±0.084)(t=3.516, 5.161, P=0.025, 0.007). Moreover, LPS significantly enhanced the expression of IL-1β and TNF-α[(5.875±0.349) pg/mg, (14.256±0.784) pg/mg] compared with control group[(1.621±0.151) pg/mg, (3.984±0.255) pg/mg], and the differences were significant(t=11.190, 12.460, P=0.000, 0.000). By the average Escape Latency tests for 6 days, LPS group [at 1-6 days (58.286±1.418) s, (56.036±2.252) s, (55.071±1.856) s, (50.071±3.251) s, (52.893±2.372) s, (46.929±3.761) s] markedly impaired the learning capacity compared with the control group[(53.679±2.413) s, (47.571±3.529) s, (54.071±2.777) s, (47.250±2.864) s, (45.107±3.447) s, (42.393±3.463) s], and the difference was significant(F=4.466, P=0.001). Concurrently, in probe trains LPS group increased the time of in zone southeast latency to first [(44.080±6.313) s] compared with the control group[(25.900±6.033) s], while shortened the period of in zone platform duration and in zone SE duration[(0.040±0.040) s, (4.000±1.693) s], decreased the times of in zone SE frequency and in zone platform frequency[(0.100±0.100) times, (1.000±0.394) times] compared with the control group[(0.400±0.202) s, (14.360±5.000) s, (0.600±0.267) times, (3.400±0.763) times] (t=2.082, 1.746, 1.962, 2.794, 1.756, P=0.026, 0.049, 0.033, 0.006, 0.048). Conclusion The expression of SHIP-1 in hippocampus of newborn mice with intrauterine infection is decreased, and the inhibitory effect of SHIP-1 on the expression of downstream pro-inflammatory cytokines NF-κB, inflammatory cytokines IL-1β and TNF-α is decreased, along with cognitive impairments. Key words: Intrauterine infection; Inositol phosphatase-1; Cognitive disorder

Evaluation of the Detection Accuracy of Conventional Magnetic Resonance Imaging in Patients Diagnosed with Optic Neuritis

Introduction: Inflammation of the optic nerve is one of the most common causes of unilateral and/or bilateral blindness. The most common cause of this phenomenon is demyelinating processes which involve central nervous system and the diagnosis is suspected via clinical finding and confirmed by Magnetic Resonance Imaging (MRI). In this study we plan to investigate whether isolated conventional MRI is a reliable and sufficient diagnosing tool in approach to patients with clinical finings of optic neuritis. Methods: This retrospective study was performed in patients referred to neurology department of a private hospital in Tehran from 2012 to 2014, and underwent brain MRI after clinical diagnosis has been established. Clinical diagnosis of optic neuritis was confirmed by neuro-ophthalmological examination, visual field assessment and visual evoked potential (VEP). We have utilized SPSS program for statistical analysis, along with Student T-test and Chi-Square test. Result: Demographic analysis and data gathering were performed for all of the patients. Ninety patients were enrolled in the study, which 58 cases (64.4%) showed MRI abnormality in their neuro-imaging. In this group, supratentorial and infratentorial lesions were existed in 34 cases (58.6%) and 24 cases (41.3%) respectively. The most common affected sites of supratentorial region were periventricular region (in 17 cases), followed by juxtacortical (in 6 cases), basal ganglia (in 3 cases), corpus callosum (in 3 cases), centrum semiovale (in 2 cases) and in optic nerve in 3 patients. In patients with lesions in their infratentorial region, the most common sites were cerebellum hemispheres (in 11 cases), followed by mesencephalon (in 6 cases), pons (in 4 cases) and medulla oblongata (in 3 cases). Conclusion: We have found that conventional MRI as a single approach is not reliable in detecting enhancing plaques of white matter tracts in 35.6% of our enrolled cases who their diagnosis of optic neuritis were confirmed by visual field assessment and VEP. This issue raises the importance of addition of other enhancing technique to MRI for better localization of enhancement for multi-disciplinary approach.

Investigation of Ocular Manifestation in Patients Diagnosed with Multiple Sclerosis Based on the Manifestation and Demographic and Geographic Data

Introduction: Multiple sclerosis (MS) is an autoimmune inflammatory condition which attacks and demyelinate central nervous system neurons with variable degree which causes significant disability in these patients. In this study, we plan to investigate ocular manifestation and prevalence of these symptoms in patients diagnosed with MS. Methods: We have enrolled 100 patients with confirmed diagnosis of MS, in a retrospective study from neurology clinic of a private hospital in Tehran, from 2015 to 2016. We have reviewed the thorough neurological examination and visual assessment of these patients. Also, demographic data of these patients were recorded for further analysis. We have performed statistical analysis using SPSS version 16 and Stuent T-test and Chi-square test for variables analysis. Results: Of all patients, 85 cases were female and 15 were male, with mean age of 35.2 years. We have found atrophy of the disc followed by optic neuritis in 32% and 19% respectively. Also, retrobulbar neuritis and papillitis were among less common manifestations, counting as 13% and 8% respectively. Most of the ocular manifestation were consistent with some demographic and geographic factors, such as age (most common in patients under 34 years old), female gender and patients not living in city areas. Also, patients with their disease initially started less than 22 years showed increased frequency of nystagmus and optic disc atrophy, while defect in color vision were more common in patients with initial disease initiation after 22 years old (P value < 0.05). Conclusion: Patients with MS may have various presentations of neurological abnormalities, which ocular manifestations is one of the most important and initial warning signs. We have found that optic disc atrophy and optic neuritis are among the most common presentations of MS, and neurologists should consider demographic and geographic parameters of patients.

Clinical Characteristics of CRMP5 Neuropathy

Collapsin response-mediator protein-5 (CRMP5) has been associated with encephalitis, myelopathy, and optic neuritis. To further characterize the

Значимость оценки нейроархитектоники сетчатки при оптическом неврите

Значимость оценки нейроархитектоники сетчатки при оптическом неврите

Enhance the awareness of infectious and infection-related optic neuritis to improve early diagnosis and treatment outcomes

Infectious and infection-related optic neuritis is an important type of optic neuritis. Infectious optic neuritis is caused by direct spread of pathogenic organism to optic nerve from local infection or blood transmission. Infection-related optic neuritis is caused by pathogens-induced immune allergic reaction. They present with atypical clinical features of optic neuritis, including progressive vision loss, persistent eye pain or headache, ineffectiveness or even worse of glucocorticoid therapy. Fundus manifestations include optic disc swelling with peripapillary hemorrhage or neuro-retinitis, and the feature of concurrent uveitis. When these patients first visit ophthalmic clinics, they often lack signs of systemic infection, thus it is easy to misdiagnose them as other types of optic neuropathy and mistakenly treat them. In particular, high-dose glucocorticoid therapy can lead to very serious consequences. Therefore, how to correctly diagnose infectious and infection-related optic neuritis in the early stages are very important for ophthalmologists and need to be seriously kept in our mind. Key words: 【Keywords】Infection/etiology; Optic neuritis/diagnosis; Optic neuritis/therapy; Editorial

Analysis of clinical characteristics of demyelinating optic neuritis in children under the age of 16

Objective To observe the clinical characteristics of demyelinating optic neuritis (DON) in Chinese children under the age of 16. Methods A retrospective review of the medical charts of 42 pediatric patients with DON was conducted in this study. Twenty-two patients (52.4%) were male, and 20 patients(47.6%) were female. The patients aged from 3 to 15 years, with the mean age of (9.5±2.3) years. There were 35 bilateral patients and 7 unilateral patients. Twenty-seven patients (64.3%) had prodromal symptoms before onset. All patients underwent visual function and imaging tests, such as best corrected visual acuity (BCVA), fundus photography, visual evoked potential (VEP), visual field, MRI. The patients were tested for serum levels of antibodies for aquaporin 4 (AQP4) and myelin oligodendrocyte glycoprotein (MOG) with a cell-based assay. All patients were received corticosteroid therapy. The mean follow-up was (1.17±0.42) years. The children who had coordination ability and with BCVA≥0.3 were received examination of Humphery automatic perimeter. Data were collected on the age, gender, clinical features, neuroimaging, serological specific antibodies, treatment and vision prognosis. Results 23.8% of the children were bilateral optic neuritis in onset stages. 64.2% were recurrent optic neuritis and 83.3% exhibited bilateral diseases eventually. BCVA had decreased to ≤0.1 in 87.0%% eyes and disc swelling was observed in 77.9% eyes during the onset stages. All eyes had visual field defects and abnormal VEP exam results, with delayed latency of P100 and P2, and varying degrees of amplitude reduction. Serum AQP4 antibody and MOG antibody were tested by cell-based assay, 2/42 children (4.7%) were positive for AQP4 antibody and 5/24 children (20.8%) were positive for MOG antibody. All of anti-AQP4+ and anti- MOG+ cases relapsed. All children underwent orbital magnetic resonance imaging (MRI), 40 cases (95.2%) showed demyelination features of optic nerve, and 5 cases (11.9%) showed long segments lesion (more than 1/2 length of the optic nerve). There were 2 anti-AQP4+ cases and 3 anti- MOG+ cases from the 5 cases with long segments lesion. MRI also showed brain demyelinating lesions in 4 children (3 of them were anti- MOG+) or spinal cord demyelinating lesions in 3 children (2 of them were anti- MOG+). After treatment with glucocorticoid, visual acuity improved in all eyes, of which 84.4% with BCVA≥0.5. Forty-eight eyes of 26 children accept dynamic visual field during the course of treatment, showed the vision abnormalities associated with optic nerve damage. Conclusions Children under the age of 16 with DON can experience severe visual impairment, higher recurrence tendencies, and higher rate of disc involvement, but good response to glucocorticoid therapy. AQP4 or MOG antibodies positive might be concurrent with brain and (or) spinal cord demyelinating lesions and indicated a poorer prognosis. Key words: Optic neuritis; Demyelinating diseases; Child; Disease attributes

The commentaries of plasma exchange therapy for neuromyelitis optica related optic neuritis

Plasma exchange (PE) is a therapeutic blood component replacement method. The blood of patients is first separated into plasma and blood cell components using a blood cell separator in vitro, the plasma containing harmful pathogenic substances is then discarded and replaced with the same volume of exchange solution. Finally the separated blood cells together with the exchange solution are returned back to the blood circulation of patients. By reducing the circulating antibodies, abnormal plasma proteins or cytokines and other pathogenic molecules, PE can block the disease process. PE has a good therapeutic effect on neuromyelitis optica-related optic neuritis (NMO-ON), which shows resistant to glucocorticoid therapy for the first onset. The American Society for Apheresis guideline evaluates PE for acute optic neuritis as a recommended grade 1B, type II indication. In the implementation of PE treatment for NMO-ON and other diseases, indications and contraindications should be strictly adhered to the guideline, treatment procedures and protocols should be optimized, common adverse events and its prevention and management should be known and alerted. It is important to conduct multi-center clinical cooperation and a high standard clinical randomized controlled study, to find out the optimal time window, the best protocol, and the associated factors for the efficacy and prognosis of PE in NMO-ON. Key words: Neuromyelitis optica/therapy; Optic neuritis/therapy; Plasma Exchange; Editorial

Correlation of serum aquaporin 4 antibodies and condition and visual prognosis in patients with severe neuromyelitis optica spectral disorders

Objective To observe the correlation of serum aquaporin 4 (AQP4) antibodies and condition and visual prognosis in patients with severe neuromyelitis optica spectral disorders (NMOSD). Methods Fifty NMOSD patients with visual acuity of 20/200 or worse in at least one eye were enrolled in this retrospective analysis. There were 12 males and 38 females. The age ranged from 17 to 65 years, with the mean of (39.86±2.02) years. The patients were divided into two groups according to the serum AQP4-IgG status. The ophthalmologic examination, serum anti-nuclear antibodies (ANA), myelin oligodendrocyte glycoprotein (MOG) antibody detection and vision prognosis were compared and analyzed. Glucocorticoid therapy was delivered to 46 patients who were within 1 month of onset. The visual acuity of the patients after treatment was divided into complete recovery, partial recovery, stabilization and reduction, and the visual acuity of the two groups were analyzed. Results Among 50 patients, there were 30 (60%) seropositive patients (positive group), 20 (40%) seronegative patients (negative group). The positive group had significantly higher ratio of female to male (P=0.004), and more binocular optic neuritis (ON) (P=0.010) compared with the negative group. More recurrence ON were also found in the positive group, but without statistic difference between two groups (P=0.167). There was no difference of age, course, and vision damage degrees and abnormal orbital MRI scanning between two groups (P>0.05). Among 24 patients who underwent serum ANA detection in the positive group, 8 patients were positive. All of 18 patients who underwent serum ANA detection in the negative group were negative. The difference of the ratio of serum ANA positive patients between two groups was significant (P=0.030). Serum MOG antibody detection in the positive group was negative (0/10). Sixteen patients who underwent MOG antibody detection in negative group, 4 patients were positive. After treatment, there were 23.3%, 23.3%, 53.3% patients with vision of complete recovery, partial recovery and reduction in the positive group; 25.0%, 30.0%, 25.0% patients with vision of complete recovery, partial recovery and reduction in the negative group, respectively. There was no difference in proportion of vision with complete recovery and partial recovery between two groups (P=0.163, 0.607), but significant difference was observed in proportion of vision with stabilization and reduction between two groups (P=0.021, 0.048). Conclusions The positive serum AQP4 antibody is common in patients with severe NMOSD. The patients with AQP4 antibody in the serum are more likely combined with immunological serological markers and poor vision prognosis. Key words: Neuromyelitis optica; Visually impaired persons; Aquaporin 4

Diagnosis and management of fungal infected optic neuritis

Diagnosis and management of fungal infected optic neuritis

Therapeutic effect of ulnar nerve with or without transposition during open reduction and internal fixation of distal humerus fractures

Objective To investigate the effect of ulnar nerve with or without transposition during open reduction and internal fixation of distal humerus fractures. Methods A retrospective case control study was made on 74 cases receiving open reduction and internal fixation of distal humerus fractures between January 2008 and December 2015. There were 28 males and 46 females, with a mean age of 63.2 years (range, 32-83 years). AO fracture classification was A2 type in seven cases, A3 type in four, C1 type in 14, C2 type in 28 and C3 type in 21. According to the intraoperative management of the ulnar nerve, the patients were divided into transposition group (n=43) and non-transposition group (n=31). Two groups were compared with respect to operation time, Mayo elbow performance score (MEPS), incidence of ulnar neuritis and postoperative complications. Results Follow-up lasted for 6-24 months (mean, 11.7 months). Operation time differed significantly between transposition group [(110.9±20.8)minutes] and non-transposition group [(95.6±18.9)minutes] (P 0.05). Incidence of ulnar neuritis showed no significant difference between transposition group (9%, 4/43) and non-transposition group (7%, 2/31) (P>0.05). Postoperatively, one case of superficial wound infection and two delayed healing were noted in transposition group; one case of superficial wound infection and one delayed healing were noted in non-transposition group. There was no significant difference in incidence of postoperative complications between groups (P>0.05). Conclusions Ulnar nerve with or without transposition can both achieve satisfactory clinical effect during open reduction and internal fixation of distal humerus fractures. But non-transposition group is associated with shorter operation time without increasing the incidence of ulnar neuritis. Key words: Humeral fractures; Ulnar neuritis; Fracture fixation, internal

Clinical effect of point-to-point acupuncture with electric stimulation of direct current induction for facial nerve paralysis

Objective To observe the clinical effect of point-to-point acupuncture with electric stimulation of direct current induction for facial nerve paralysis. Methods A total of 65 patients with facial nerve paralysis were randomly divided into the observation group (n=33) and the control group (n=32). The control group received routine treatment, and observation group was received Dicang (ST4)-to-Jiache (ST6) and Yangbai (GB14)-to-Taiyang (EX-HN5) by acupuncture with electric stimulation of direct current induction combined with conventional western medicine. The treatment of both groups last 3 weeks. The House- Brackmann Scale and the BR indexe at baseline and after 3 weeks treatment were observed. Results After treatment, The clinical effect of observation group was 66.7%, which was significantly higher than control group 43.8% (U=2.175, P=0.013). After treatment, House-Brackmann facial nerve scale (Ⅰ level=15 cases, Ⅱ level=4 cases, Ⅲ level=3 cases) in the observation group was significantly better than that in the control group (Ⅰ level=5 cases, Ⅱ level=7 cases, Ⅲ level=2 cases; U=2.069, P=0.018). After treatment, R1 latency (12.28 ± 2.55 ms vs. 13.84 ± 3.07 ms, t=2.227) and R2 latency (32.28 ± 7.08 ms vs. 35.95 ± 5.11 ms, t=2.396) in the observation group were significantly shorter than those in the control group (P=0.030, P=0.020). Conclusions The point-to-point acupuncture with electric stimulation of direct current induction could reduce latency of R1 and R2 for facial nerve paralysis, and improve the clinical effect. Key words: Neuritis; Face; Pulse electroacupuncture therapy; Point ST4(Dicang); Point ST6(Jiache); Point GB14(Yangbai); Point EX-HN5(Taiyang)

Quantitative assessment of retinal and choroidal changes by enhanced depth imaging OCT in acute optic neuritis patients

Background Optic neuritis is one of the common clinical neuro-ophthalmic diseases.Spectral-domain OCT (SD-OCT) is a valuable tool in assessing the thickness changes of retina, while enhanced depth imaging (EDI) OCT can further quantitatively and morphologically evaluate the changes of retina and choroid.The pathological mechanism of optic neuritis is unclear now. Objective This study was to quantitatively measure the retinal and choroidal thickness in early optic neuritis eyes by SD-OCT and EDI OCT. Methods A prospective cohort study was carried out in Tianjin Eye Hospital from July 2015 to May 2016.Twenty eyes of 20 patients with acute optic neuritis were enrolled as optic neuritis group and 22 eyes of 20 healthy subjects with matched age and gender were included in the normal control group.The mean thickness of retinal nerve fiber layer (RNFL) and choriod in superior, inferior, nasal and temporal quadrants at 3.4 mm around optic disc was measured, and the mean thickness of RNFL, ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL) and photoreceptor layer also was measured by EDI OCT.Pattern visual evoked potential (P-VEP) and visual field were examined in all the individuals, the correlations of mean defect (MD) with the thickness of RNFL, choroid and the thickness of RNFL, GCL, IPL, INL, OPL, ONL, photoreceptor layer at macular area were evaluated. Results The RNFL thickness values were (424.00±160.30), (428.40±169.83) and (108.15±50.66)μm in superior, inferior, nasal quadrants at 3.4 mm arear around optic disc in the optic neuritis group, which were significantly higher than (265.68±26.25), (283.27±52.81) and (72.68±12.01)μm in the normal control group (t=4.571, 3.814, 3.190, all at P 0.05). The thickness of RNFL, GCL and IPL at 1 mm area around macula and the thickness of GCL, IPL, INL at 3 mm area around macula were evidently thining in the optic neuritis group compared with the normal control group (all at P 0.05), and the thickness of RNFL, GCL, IPL, INL, OPL, ONL, photoreceptor layer at macular area was significantly linear correlated with MD. Conclusions EDI OCT can reflect the RNFL edema around optic disc and thining of various layers of retina at macular area in acuter optic neuritis eyes, however, the choroidal thickess is unchanged.EDI OCT is a useful tool in quantitative evaluation of retinal and choroidal thickness of early optic neuritis. Key words: Optic neuritis; Tomography, optical coherence; Retina; Chorioid; Macula; Optical disc

Sequential bilateral retrobulbar optic neuritis in a young female

Optic neuritis (ON) is the demyelinating inflammation of the optic nerve head usually associated with multiple sclerosis. It is usually associated with sudden onset loss of vision with dyschromatopsia and retro-orbital pain. Atypical features for a demyelinating ON include the absence of pain, severe visual loss, progression of visual loss, pain for more than 2 weeks, and lack of recovery after 3 weeks. Atypical features in fundus examination include marked swelling of the nerve with retinal exudates, peripapillary hemorrhages and bilateral presentation, which may occur either simultaneously or sequentially. Atypical ON requires careful consideration and differentiation from demyelinating ON and ischemic optic neuropathy since the treatment is different. We describe a patient who presented with recurrent, sequential episode of visual loss over 2 years, without evidence of any additional neurological deficits, sarcoidosis, or systemic autoimmune disease. A diagnosis of chronic relapsing inflammatory optic neuropathy was made, and she was given intravenous steroids for 3 days, which improved the vision from hand movement close to face to 5/60 in the right eye. She was given immunosuppressants for 3 months, and oral steroids were gradually tapered. Her present vision is the right eye is 6/6 with normal intraocular pressure and color vision.

Laminectomy decompression under microscope for lumbar spinal stenosis

Objective To investigate the efficacy of laminectomy decompression under microscope for lumbar spinal stenosis. Methods A retrospective study was conducted regarding 13 patients with lumbar spinal stenosis who were admitted to Department of Neurosurgery, Xiangya Hospital, Central South University, from April 2015 to April 2016 and underwent unilateral/bilateral laminectomy decompression under microscope.Among the 13 patients of lumbar stenosis, 8 cases involved single segment, 3 invovled 2 segments and 2 involved 3 segments.The segments operated on were L2~3 in 2 cases, L3~4 in 5 cases , L4~5 in 10 cases and L5-S1 in 3 cases. The preoperative and postoperative Visual Analogue Scale (VAS) scores were used to evaluate the pain relief. Postoperative follow-up on a regular basis was conducted including examinations of magnetic resonance imaging (MRI), computed tomography (CT) and dynamic spine X-ray. Results The operation time in this group was 1.5-5.5 h , the intraoperative blood loss measured 50-400 ml, and postoperative hospital stay was 8-21 d. Back and leg pain in all patients were significantly improved after operation. The postoperative VAS score was 1.38 and decreased from preoperative 4.23. No nerve injury or cerebrospinal fluid leakage due to spinal dura tears was observed in this study. No cardiac or cerebrovascular complications occurred after surgery.Postoper-atively, chest herpes zoster in 1 case and lateral femoral cutaneous neuritis in 1 case were observed. One patient with preoperative bowel and bladder disorders began to recover after opeartion, and restored independent urination 10 days post operation. Varying degrees of ease of lower limb numbness was reported in 9 cases. Conclusions Laminectomy decompression under microscope for lumbar spinal stenosis demonstrated advantages including shorter operation time, less intraoperative blood loss and shorter hospitalization length, through which sufficient decompression and good clinical outcomes could be obtained. Further observation is needed to study its long-term effect on the stability of lumbar spine. Key words: Spinal stenosis; Microsurgery; Decompression, surgical; Treatment outcome

Research progression of the role of neuroinflammation in postoperative cognitive dysfunction

Background Postoperative cognitive dysfunction(POCD) often occurs in elderly patients who had cardiac or non-cardiac surgeries. POCD results in an increasing of morbidity and mortality and requires more healthcare resources. Recent studies suggest that neuroinflammation plays a major role in POCD. Objective Further investigation of the mechanism of neuroinflammation in POCD and preventive strategies. Content This article reviewed the impact of neuroinflammation, inflammation cytokines, anti-inflammation and inflammation suppression on POCD. Trend Prophylactic administration of anti-inflammation drugs as a preventive strategy of POCD. Key words: Neuritis; Postoperative cognitive dysfunction

Approach to the patients with insulin neuritis

Insulin neuritis (also referred to as treatment-induced neuropathy in diabetes)is considered a rare iatrogenic small fibre neuropathy caused by an abrupt improvement of hyperglycemia in patients with previously poor glycemic control. We hereby presented a case with insulin neuritis, discussing the pathogenesis, clinical manifestation, diagnosis and treatment, so as to help further understand of this disease. (Chin J Endocrinol Metab, 2016, 32: 952-955) Key words: Diabetes mellitus; Insulin; Complication; Diabetic neuropathy; Insulin neuritis; Treatment-induced neuropathy of diabetes

Autoantibodies in patients with neuromyelitis optica

Neuromyelitis optica (NMO) is an autoimmune disease of the central nervous system (CNS) which primarily involves the optic nerve and spinal cord. Aquaporin 4 (AQP4) is the main objective antigen, and its specific antibody was NMO-IgG. It was found in clinic that most of NMO-IgG-positive patients were female, whose clinical symptoms were more severe, bilateral optic neuritis (BON) or optic neuritis (ON) and myelitis were more likely to appear at the same time, and involved spinal segments were longer. Recent studies discovered that anti-aquaporin 1 (AQP1) and anti-myelin oligodendrocyte glycoprotein (MOG) antibodies existed in the serum of patients with NMO-IgG-negative. It was discovered that low proportions of women, more cases of long-segment spinal cord lesion, and rare cases of ON appeared in anti-AQP1 antibody-positive patients. Most of anti-MOG antibody-positive patients were male. ON was common, especially bilateral optic nerves involved at the same time, and thoracolumbar involvement was common. DOI: 10.3969/j.issn.1672-6731.2016.10.004

Study on resting-state fMRI based on amplitude of low-frequency fluctuation in patients with recurrent optic neuritis

Objective To investigate the distribution of abnormal neurological activity of patients with recurrent optic neuritis (ON) by resting-state functional magnetic resonance imaging (fMRI), and to explore the relationship between baseline neurological function and clinic. Methods Resting-state fMRI were collected from 35 patients with recurrent ON and 50 normal controls who were matched in sex, age and education with patients. The amplitude of low-frequency fluctuation (ALFF) difference was investigated and compared between 2 groups. The correlation of brain regions with significantly different mALFF with duration, Paced Auditory Serial Addition Test (PASAT) and vision was further explored. Results Compared to normal controls, patients with recurrent ON showed significantly decreased mALFF in left cuneus/precuneus, left superior temporal gyrus, bilateral inferior temporal gyri, bilateral lingual gyri, right middle occipital gyrus ( P < 0.01), and significantly increased mALFF in bilateral inferior frontal gyri and left medial frontal gyrus ( P < 0.01). The positive correlation between duration and mALFF in left superior temporal gyrus ( r = 0.403, P < 0.05) and right lingual gyrus ( r = 0.472, P < 0.05) was observed in recurrent ON patients. Conclusions Resting-state fMRI can detect decreased neurological function in the temporal and occipital lobes which are involved in visual processing and increased neurological function in the frontal lobe which is involved in default mode network (DMN) in recurrent ON. It will provide evidence for evaluating neurological function and predicting the prognosis of ON in the early stage. DOI: 10.3969/j.issn.1672-6731.2016.06.007

The modification research of bionic silk fibroin nerve guidance conduits by silk sericin

Objective To explore the modification of bionic silk fibroin nerve conduits (SF-NCs) by silk sericin. Methods The innovative SS/SF blended-NCs was fabricated by a vertical sequential cooling thermal induced phase separation (TIPS) processing with SF solution added sericin in proportion, its morphology was observed by Scanning electron microscopy (SEM), X-ray diffraction (XRD) and infrared spectroscopy (FTIR) were used to detect its internal molecular structure. MTT assay was used to quantitatively analyzed the PC12 cells viability co-cultured with the innovative SS/SF-NCs, SEM was used to observe the adhesion and morphology of PC12 cells seeded into the innovative SS/SF, PC12 cells were used to assess the NGF bioactivity released from the SS/SF. Results The SEM results showed that the new fabricated SS/SF-NCs had linearly oriented lamellar-like multiple-channel which distributed evenly, got great changes on the channel microstructure and their mechanical properties had been greatly improved, compared to SF-NCs. The XRD and FTIR results showed that the SS/SF-NCs had the similar internal molecular structure with natural silk. The spaces between parallel lamellar-like channels, porosities and compressive strengths of the SS/SF-NCs decreased with decreasing Sequential freezing temperature. MTT assay results showed that the viability of PC12 cell was better than the control group (P < 0.05). The SEM observation indicated that PC12 cells showed good adhesion and differentiation with neuritis outgrowth during the period of co-culture with the SS/SF-NCs. NGF release from the innovative SS/SF-NCs was prolonged over 4 weeks, and remained bioactive. Conclusion The new fabricated SS/SF-NCs modified though silk sericin, which was highly bionic the structure of peripheral nerve fasciculus, had excellent mechanical properties and could be used as another alternative of artificial nerve conduits. Key words: Nerve guidance conduits (NCs); Silk sericin/silk fibroin (SS/SF) blended; Bionic; Modification; Peripheral nerve