关键词： Autoimmunity   Neuroimmunology   Biomedicine   general   Immunology  

摘要： The realization that autoantibodies can contribute to dysfunction of the brain has brought about a paradigm shift in neurological diseases over the past decade, offering up important novel diagnostic and therapeutic opportunities. Detection of specific autoantibodies to neuronal or glial targets has resulted in a better understanding of central nervous system autoimmunity and in the reclassification of some diseases previously thought to result from infectious, 'idiopathic' or psychogenic causes. The most prominent examples, such as aquaporin 4 autoantibodies in neuromyelitis optica or NMDAR autoantibodies in encephalitis, have stimulated an entire field of clinical and experimental studies on disease mechanisms and immunological abnormalities. Also, these findings inspired the search for additional autoantibodies, which has been very successful to date and has not yet reached its peak. This Review summarizes this rapid development at a point in time where preclinical studies have started delivering fundamental new data for mechanistic understanding, where new technologies are being introduced into this field, and - most importantly - where the first specifically tailored immunotherapeutic approaches are emerging.

关键词： COVID-19   SARS-CoV-2   encephalitis   blindness   neurology  

摘要： Background: There are growing reports of the neurological involvement among patients with coronavirus disease 2019 (COVID-19). Headache, confusion, and anosmia after olfactory nerve disruption are the most prevalent presentation of the neurological involvement related to COVID-19. However, small numbers of the central nervous system involvement have been reported. Case Report: A 49-year-old man was referred to our hospital with abrupt vision loss. Three weeks earlier he was admitted to the hospital based on his respiratory symptoms and was diagnosed with COVID-19 infection. Initial brain magnetic resonance imaging indicated diffuse restricted bilateral foci in both parietal and occipital lobes in favor of acute infarction. Diffuse weighted imaging demonstrated restricted bilateral hyperintense signals in parietal and occipital region. Occipital cortex biopsy showed brain tissue with focal infiltration of foamy macrophages mixed with reactive astrocytes and no plasma cell infiltration. Considering all of the evidence, post-COVID-19 encephalitis diagnosis was considered for the patient, and methyl prednisolone pulse therapy and intravenous immunoglobulin were initiated. Why Should an Emergency Physician Be Aware of This?: Although there are growing reports of neurological involvement among patients, blindness is rarely observed as a complication of post-COVID-19 encephalitis. To our knowledge, this is the first case of post-COVID-19 encephalitis that presented with bilateral vision loss primarily. This case may raise physicians' awareness of neurological complications of COVID-19. (C) 2021 Elsevier Inc. All rights reserved.

关键词： aortic calcification   coronary artery bypass   neuroprotection   neuroprotective device   perioperative stroke  

摘要： Patients with severely calcified aorta undergoing conventional cardiac surgery are at increased risk for postoperative neurologic deficits. Implementation of cerebroprotective devices may substantially reduce or even eliminate the risk of the adverse neurologic events, thus enabling surgical therapy, especially when interventional treatment cannot be considered an alternative option.

关键词： Biomarker   MiRNA   MiRNA-124a   Neurological deficit   Congenital heart disease   Pediatric cardiac surgery  

摘要： Brain injury is a major source of patient morbidity after cardiac surgery in children. New early accurate biomarkers are needed for the diagnosis of patients at risk for cerebral postoperative damage. Specific circulating miRNAs have been found as suitable biomarkers for many diseases. We tested whether miRNA-124a reflects neurological injury in pediatric patients following heart surgery. Serum samples were obtained from 34 patients before and six hours after heart surgery. MiRNAs-124a was quantified by RQ-PCR. MiRNA-124a levels six hours after heart surgery correlated with the neurological outcome of the patients. In children with neurological deficits, miRNA-124a levels increased while in those with no neurological deficits the levels decreased. MiRNA-124a was able, at six hours after the operation, to identify patients who are at risk for the appearance of neurological deficits. Circulating miRNA-124a is a potential biomarker for the appearance of neurological deficits in pediatric patients following heart surgery.

关键词： Neurological impairment   Functional feeding disorders   Nutrition   DDS   GMFCS   Gastrointestinal complications  

摘要： Background: Deficits in nutritional status and functional feeding disorders are common in Neurologically Impaired Paediatric Patients (NIPP). Interventions addressing these problems could offer better overall health status and quality of life in this group of patients, but the extent of their effectiveness is yet to be determined. Recent guidelines concerning the nutritional care of NIPP have been published from ESPGHAN but compliance to them has not been assessed. Aim: The study aimed to assess the phenotypic profile of a group of NIPP attending the outpatient clinic of a pediatric department, and to implement, for the first time to our knowledge, an individualized nutritional intervention protocol following ESPGHAN guidelines 2017 as well as to assess the impact on phenotypic parameters and nutritional status. Patients and methods: 68NIPP and their caregivers aged 1m-17 years (83.8% suffering from cerebral palsy (CP) were invited to assess their phenotypic parameters and to implement in a nutrition intervention protocol in order to improve their dietary intake and nutritional status. Anthropometry (weight, height, triceps skinfold thickness, mid upper arm circumference) was expressed as z-scores for age and sex using WHO Anthro software and classified following the WHO criteria. Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), Dysphagia Disorder Survey (DDS), Saliva Severity Scale (SSS), gastrointestinal complications, energy and nutrient intake were assessed at the beginning (zero point), after 6 (point 1) and 12 (point 2) months period. Intake to Requirement ratio (I/R) was derived. At zero point, following the baseline evaluation, caregivers were advised and educated on nutrition protocol and customized nutrition plans were handed out. The impact of the nutritional intervention on the phenotypic parameters was recorded on follow up visits (points 1, 2).The primary outcomes analyzed were anthropometric parameters (

关键词： TCONS_00041002   Neonatal ischemic hypoxic encephalopathy   Cell apoptosis   Neuron survival  

摘要： It has been reported that Neonatal hypoxic-ischemic encephalopathy (HIE) could induce apoptosis in neonates and result in cognitive and sensory impairments, which are associated with poor developmental outcomes. Despite the improvement in neonatology, there is still no clinically effective treatment for HIE presently. Long non-coding RNAs (lncRNAs) play important roles in cellular homeostasis. Nevertheless, their effects in developing rat brains with HI is little known. Here, we established HIE model in neonate rats and explored the expression and function of lncRNAs in HI, and found the expression of 19 lncRNAs was remarkably changed in the brains of HI rats, compared to the sham group. Among them, three lncRNAs (TCONS_00041002, TCONS_00070547, TCONS_00045572) were enriched in the apoptotic process via gene ontology (GO) and pathway analysis, which were selected for the further qRT-PCR verification. Through lentivirus-mediated overexpression of these three lncRNAs, we found that overexpression of TCONS_00041002 attenuated the cell apoptosis, and increased the vitality of neurons after oxygen-glucose deprivation (OGD), therefore reduced the brain infarction and further promoted the neuron survival as well as improved the neurological disorders in the rats subjected to HIE. What's more, ceRNA network prediction and co-expression verification showed that the expression of TCONS_00041002 was positively associated with Foxe1, Pawr and Nfkbiz. Altogether, this study has exhibited that lncRNA TCONS_00041002 participates in the cell apoptosis and neuronal survival of HIE and represents a potential new target for the treatment of HIE.

摘要： There are neural stem cells in the brain that give rise to adult-born neurons—a process called adult neurogenesis (ANG). ANG occurs in the dentate gyrus, a subregion of the hippocampus important for learning, memory, and emotions (1). There is a decline in ANG with age, which has been associated with cognitive decline; a more notable drop in ANG occurs in patients with Alzheimer’s disease (AD), which correlates with disease severity (2–4). On page 1106 of this issue, Terreros-Roncal et al. (5) collected brains from patients who died of neurological diseases that were implicated from animal models and human postmortem pathological assessments to have disrupted hippocampal function and dysregulated ANG. They observed a disruption of ANG homeostasis in brains from patients with Huntington’s disease, frontal temporal dementia, Parkinson’s disease, and amyotrophic lateral sclerosis (ALS). This study shows a pattern of disrupted ANG in neurological diseases that deserves further attention to potentially reveal therapeutic targets.

关键词： Neurological diseases   neurodegenerative diseases   fluorescence   scattering   absorption   brain   spectroscopy   microscopy  

摘要： Neurological diseases are a category of disease that deals with any damageable changes in the nervous system. Neurodegenerative diseases like Alzheimer's disease (AD), Parkinson's disease (PD), amyotrophic lateral sclerosis (ALS), and a few others also come under this category. Detection of the cause of such diseases can be mainly studied by digging deep into the anatomical and physiological features of the nervous system. Hence, various imaging techniques have been profusely developing recently that aim to discover the anatomical as well as physiological changes in the brain and spinal cord that lead to specific neurological diseases. This review discusses some of the spectroscopic and microscopy techniques that are beneficial in diagnostic procedures of neurological diseases. Listed down techniques are mainly categorized based on fluorescence, scattering, and infrared absorption principle and include the information on resolution, magnification, and penetration depth of each technique, respectively. In this review, the applications of confocal fluorescence microscopy, two-photon fluorescence microscopy, harmonic generation microscopy including second harmonic generation (SHG), third harmonic generation (THG), coherent Raman scattering including coherent anti-Stokes Raman scattering (CARS) and stimulated Raman scattering (SRS), fluorescence and near-infrared spectroscopy are discussed with an advantage in diagnosis but a few being more advantageous than others.

关键词： In vitro fertilization   Stroke   eNOS   Epigenetic  

摘要： Background and purpose: Assisted reproductive technologies (ART) induce premature vascular aging in human offspring. The related alterations are well-established risk factors for stroke and predictors of adverse stroke outcome. However, given the young age of the human ART population there is no information on the incidence and outcome of cerebrovascular complications in humans. In mice, ART alters the cardiovascular phenotype similarly to humans, thereby offering the possibility to study this problem. Methods: We investigated the morphological and clinical outcome after ischemia/reperfusion brain injury induced by transient (45 min) middle cerebral artery occlusion in ART and control mice. Results: We found that stroke volumes were almost 3-fold larger in ART than in control mice (P < 0.001). In line with these morphological differences, neurological performance assessed by the Bederson and RotaRod tests 24 and 48 h after artery occlusion was significantly worse in ART compared with control mice. Plasma levels of TNF-alpha, were also significantly increased in ART vs. control mice after stroke (P < 0.05). As potential underlying mechanisms, we identified increased blood-brain barrier permeability evidenced by increased IgG extravasation associated with decreased tight junctional protein claudin-5 and occludin expression, increased oxidative stress and decreased NO-bioactivity in ART compared with control mice. Conclusions: In wildtype mice, ART predisposes to significantly worse morphological and functional stroke outcomes, related at least in part to altered blood-brain barrier permeability. These findings demonstrate that ART, by inducing premature vascular aging, not only is a likely risk factor for stroke-occurrence, but also a mediator of adverse stroke-outcome. Translational perspective: This study highlights that ART not only is a likely risk factor for stroke-occurrence, but also a mediator of adverse stroke-outcome. The findings should raise awareness in t

关键词： 神经病学   PBL   CBL   临床见习  

摘要： 探讨基于问题导向教学法(PBL)联合案例教学法(CBL)对临床医学专业学生在神经病学见习中的应用效果及评价。方法:选取在我科见习的2017级临床医学专业50名本科生作为研究对象,采取随机分组的形式,分为对照组和实验组。每组各25名学生。其中对照组采用传统教学模式(LBL),实验组采用PBL加CBL教学模式。实验结束后进行考试和问卷调查,比较两组教学模式下的教学效果。结果:PBL联合CBL教学模式组的理论考试成绩、临床思维和技能考核成绩高于LBL教学模式组,两者差异有统计学意义(P<0.05)。同时实验组在实习效果的总体评价、参与教学的积极性、解剖与临床相互转化方面均高于对照组(P<0.05)。结论:PBL联合CBL的教学模式,可提升见习学生的参与度和主动性,有助于提高学习成绩和见习效果,值得进一步推广和应用。