关键词： diffuse large B-cell lymphoma   DLBCL   CD19   cytokines   ABCL   aggressive B-cell lymphoma  

关键词： Motor axon regeneration   Collagen scaffold   Complete spinal cord transection   Locomotor recovery   Neuronal regeneration  

摘要： Many studies have shown that rodents exhibit a certain degree of spontaneous motor function recovery even if they suffer from spinal cord complete transection injury. However, the characteristics of spontaneous locomotor recovery and its associated neurobiological mechanisms are unclear. In this study, we observed that spontaneous locomotor function recovery of hind limbs could also be detected in a canine thoracic (T8) spinal cord complete transection model. In addition, the spontaneous locomotor recovery of canines could be further promoted by chronic implantation of Taxol- or human bone marrow mesenchymal stem cell-modified bio-scaffolds. Moreover, functional bio-scaffolds implantation promoted locomotor outcome could be significantly weakened (drop to the spontaneous recovery level) but not totally abolished by resection in the lesion site. The neurological mechanism for functional bio-scaffolds improved locomotor outcome was primarily dependent on the formation of neuronal bridging but not the long-distance regeneration of descending motor axons throughout the lesion gap. Besides that, we found that spontaneously achieved locomotor recovery of hind limbs was unable to be weaken by repetitive resection of the lesion area, indicating the mechanism for spontaneous locomotor recovery was independent on functional neurological bridging throughout the lesion gap.

关键词： Adverse effects   Cancer immunotherapy   Immunotherapy   Risk factors   Tumour biomarkers  

摘要： Paraneoplastic neurological syndromes (PNSs) comprise a group of disorders that can affect any part of the nervous system in patients with cancer and frequently result from autoimmune responses triggered by the ectopic expression of neuronal proteins in cancer cells. These disorders are rare, although the introduction of immune-checkpoint inhibitors (ICIs) into cancer treatment algorithms has renewed interest in PNSs. ICIs are associated with a considerably increased incidence of immunological toxicities compared with traditional anticancer therapies, including neurological immune-related adverse effects (nirAEs) that can manifest as PNSs. Theoretically, the use of ICIs might increase the risk of PNSs, in particular, in patients with the types of cancer that are most frequently associated with these disorders (such as small-cell lung cancer), emphasizing the importance of their prompt diagnosis and treatment to prevent irreversible neurological deficits. To facilitate the recognition of these disorders in the context of immune-checkpoint inhibition, we provide an overview of PNSs, including the main syndromes, types of neuronal autoantibodies and associated immunological mechanisms. We also review the scenarios in which nirAEs fulfil the criteria for PNSs and examine their frequency and clinical presentations. Finally, we provide recommendations for the prevention and management of PNSs that can occur during ICI therapy.

关键词： Catatonia   Extrapyramidal disorder   Parkinsonism   Major depression   Schizophrenia  

摘要： Catatonia is a well-described clinical syndrome characterized by features that range from mutism, negativism and stupor to agitation, mannerisms and stereotype. Causes of catatonia may range from organic brain disorders to psychiatric conditions. Despite a characteristic syndrome, catatonia is grossly under diagnosed. The reason for missed diagnosis of catatonia in neurology setting is not clear. Poor awareness is an unlikely cause because catatonia is taught among conditions with deregulated consciousness like vegetative state, locked-in state and akinetic mutism. We determined the proportion of catatonia patients correctly identified by neurology residents in neurology emergency. We also looked at the alternate diagnosis they received to identify catatonia mimics. Twelve patients (age 22-55 years, 7 females) of catatonia were discharged from a single unit of neurology department from 2007 to 2017. In the emergency department, neurology residents diagnosed none of the patients as catatonia. They offered diagnosis of extrapyramidal syndrome in 7, meningitis in 2, and conversion reaction, acute psychosis/encephalopathy and non-convulsive status epilepticus in one each. Their final diagnosis at discharge was catatonia due to general medical condition in 6 (progressive supranuclear palsy in 2, post-status epilepticus, uremic encephalopathy, glioblastoma multiforme and tuberculous meningitis in one each), catatonia due to major depression in 4, schizophrenia and idiopathic catatonia in one each. Extrapyramidal syndrome appeared as common mimic of catatonia. The literature reviewed also revealed the majority of organic catatonia secondary to causes that are usually associated with extrapyramidal features. Therefore, we suggest that neurologists should consider catatonia in patients presenting with extrapyramidal syndromes.

关键词： Out-of-hospital cardiac arrest   Outcome   Machine learning analysis  

摘要： Background: This study aimed to train, validate and compare predictive models that use machine learning analysis for good neurological recovery in OHCA patients. Methods: Adult OHCA patients who had a presumed cardiac etiology and a sustained return of spontaneous circulation between 2013 and 2016 were analyzed;80 degrees. of the individuals were analyzed for training and 20% were analyzed for validation. We developed using six machine learning algorithms: logistic regression (LR), extreme gradient boosting (XGB), support vector machine, random forest, elastic net (EN), and neural network. Variables that could be obtained within 24 hours of the emergency department visit were used. The area under the receiver operation curve (AU ROC) was calculated to assess the discrimination. Calibration was assessed by the Hosmer-Lemeshow test. Reclassification was assessed by using the continuous net reclassification index (NRI). Results: A total of 19,860 OHCA patients were included in the analysis. Of the 15,888 patients in the training group, 2228 (14.05) had a good neurological recovery;of the 3972 patients in the validation group, 577 (14.5%) had a good neurological recovery. The LR, XGB, and EN models showed the highest discrimination powers (AUROC (95% CI)) of 0.949 (0.941-0.957) for all), and all three models were well calibrated (Hosmer-Lemeshow test: p>0.05). The XGB model reclassified patients according to their true risk better than the LR model (NRI: 0.110), but the EN model reclassified patients worse than the LR model (NRI: -1.239). Conclusion: The best performing machine learning algorithm was the XGB and LR algorithm.

关键词： Functional Neurological Disorder   Conversion Disorder   Education   Neuropsychiatry  

摘要： Objectives of this study were to identify the knowledge and support needs for a wide range of health professions who come in contact with patients with Functional Neurological Disorders (FND) in Australia. Invitations to an anonymous online survey (36 items) were sent to health professionals (practicing in the fields of neurology, psychiatry, psychology, general practice, nursing and physiotherapy) who are involved in the care of patients suffering from FND. Potential participants were invited via professional and hospital databases, advertising in professional newsletters as well as direct emails. A total of 538 health professionals completed the questionnaire. Most participants did not feel well educated about FND with only 14% of General practitioners (GPs) reporting 'good' knowledge. Neurologists, GPs and nurses reported lower clinical interest and greater negative attitude towards FND than psychiatrists, psychologists and physiotherapists. Many health professionals do not feel confident discussing the possibility of a Functional Neurological Disorder with a patient. Seeing more patients per year was significantly correlated with greater knowledge (r = 0.54) and confidence diagnosing (r = 0.49) FND. It was also significantly related to confidence in discussing the diagnosis of FND with a patient (r = 0.44). These factors were not significantly related to years of practice. Although patients suffering from Functional Neurological Disorders are commonly seen by many health professionals in clinic practice, there is little training in this area and self-perceived knowledge in Australia is generally poor. There is, however, clear interest in this area and our findings suggest that improved teaching and education of health professionals about FND and its management could potentially have a significant impact towards better patient care. Crown Copyright (C) 2019 Published by Elsevier Ltd. All rights reserved.

关键词： 3D printing technology   spinal cord injury   chitosan   scaffold   axonal regeneration   diffusion tensor imaging  

摘要： Spinal cord injury (SCI) is a disaster that can cause severe motor, sensory, and functional disorders. Implanting biomaterials have been regarded as hopeful strategies to restore neurological function. However, no optimized scaffold has been available. In this study, a novel 3D printing technology was used to fabricate the scaffold with designed structure. The composite biomaterials of collagen and chitosan were also adopted to balance both compatibility and strength. Female Sprague-Dawley rats were subjected to a T8 complete-transection SCI model. Scaffolds of C/C (collagen/chitosan scaffold with freeze-drying technology) or 3D-C/C (collagen/chitosan scaffold with 3D printing technology) were implanted into the lesion. Compared with SCI or C/C group, 3D-C/C implants significantly promoted locomotor function with the elevation in Basso-Beattie-Bresnahan (BBB) score and angle of inclined plane. Decreased latency and increased amplitude were observed both in motor-evoked potential and somatosensory-evoked potential in 3D-C/C group compared with SCI or C/C group, which further demonstrated the improvement of neurological recovery. Fiber tracking of diffusion tensor imaging (DTI) showed the most fibers traversing the lesion in 3D-C/C group. Meanwhile, we observed that the correlations between the locomotor (BBB score or angle of inclined plane) and the DTI parameters (fractional anisotropy values) were positive. Although C/C implants markedly enhanced biotin dextran amine (BDA)-positive neural profiles compared with SCI group, rats implanted with 3D-C/C scaffold displayed the largest degree of BDA profiles regeneration. Collectively, our 3D-C/C scaffolds demonstrated significant therapeutic effects on rat complete-transected spinal cord model, which provides a promising and innovative therapeutic approach for SCI. (c) 2019 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 107A: 1898-1908, 2019.

关键词： Cryopreservation   Meningeal scaffolds   Acellularization   Human neurological constructs   Tissue engineering   Spinal cord injury  

摘要： Spinal cord injury (SCI) is one of the most precarious conditions which have been one of the major reasons for continuous increasing mortality rate of SCI patients. Currently, there is no effective treatment modality for SCI patients posing major threat to the scientific and medical community. The available strategies don't mimic with the natural processes of nervous tissues repair/regeneration and majority of the approaches may induce the additional fibrotic or immunological response at the injury site and are not readily available on demand. To overcome these hurdles, we have developed a ready to use bioengineered human functional neurological construct (BHNC) for regenerative applications in SCI defects. We used cryopreserved meningeal tissues (CMT) for bioengineering these neurological constructs using acellularization and repopulation technology. The technology adopted herein generates intact neurological scaffolds from CMT and retains several crucial structural, biochemical and mechanical cues to enhance the regenerative mechanisms. The neurogenic differentiation on CMT scaffolds was almost similar to the freshly prepared meningeal scaffolds and mimics with the natural nervous tissue developmental mechanisms which offer intact 3D-microarchitecture and hospitable micro-environment enriched with several crucial neurotrophins for long-term cell survival and function. Functional assessment of developed BHNC showed highly increased positive staining for pre-synaptic granules of Synapsis-1 along with MAP-2 antibody with punctuate distribution in axonal regions of the neuronal cells which was well supported by the gene expression analysis of functional transcripts. Given the significant improvement in the field may enable to generate more such ready to use functional BHNC for wider applicability in SCI repair/regeneration.