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Background Para-infectious encephalopathy is an acute inflammatory encephalopathy secondary to a systemic infectious disease, including acute necrotizing encephalopathy (ANE) and mild encephalitis/encephalopathy with a reversible splenial lesion (MERS). This paper reports on 3 cases of SARS-CoV-2 related to para-infectious encephalopathy diagnosed and treated in The Ordos Central Hospital of Inner Mongolia Autonomous Region from December 2022 to February 2023, and reviews relevant literature to summarize the clinical characteristics of the disease. Methods and Results The 3 patients with SARS-CoV-2 related to para-infectious encephalopathy, including 2 cases of SARS-CoV-2 related to ANE and one case of SARS-CoV-2 related to MERS were reported. Three patients developed consciousness disorder 2-4 d after fever, and still had aphasia, mental abnormality, convulsions, etc.. SARS-CoV-2 throat swab was positive. Head MRI showed one abnormal signal of brain stem and bilateral thalamus, one abnormal signal of bilateral thalamus, and one abnormal pressure of corpus callosum. All received hormone shock therapy and (or) intravenous immunoglobulin. One died, and 2 cases were recovered. Conclusions SARS-CoV-2 related to para-infectious encephalopathy including SARS-CoV-2 related to ANE and MERS and other clinical subtypes, the former has rapid progress, severe disease, high disability rate and fatality rate and poor prognosis, while the latter has relatively mild symptoms and better prognosis. [ABSTRACT FROM AUTHOR]

An accurate diagnosis of consciousness disorder after brain injury is the basis for further treatment. The previous evaluation of consciousness disorder after brain injury is mainly based on behavior scales and imaging examination, which is limited to subjective factors and external interference and difficult to detect and evaluate in real time. The development of objective and efficient evaluation methods of consciousness disorder after brain injury is currently a hot spot in clinical research. Neurophysiological monitoring is safe, objective, simple to operate, and can be detected continuously timely. It can be used as an evaluation method for consciousness disorder after brain injury. In this paper, we summarize the application paradigms and analysis methods of evoked potential and EEG in the clinical evaluation of consciousness disorder after brain injury in recent years, in order to provide new technical ideas for improving the clinical diagnosis and treatment of consciousness disorder after brain injury. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Beijing University of Traditional Chinese Medicine is the property of Journal of Beijing University of Traditional Chinese Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Idiopathic rapid eye movement sleep behavior disorde (iRBD) is a precursor symptom of neurodegenerative diseases, and most patients will convert to neurodegenerative diseases later in the disease. Reliable biological markers are of great significance for early identification of high-risk converters and predicting phenoconversion pattern. This paper reviews the research progress of biological markers in predicting conversion to neurodegenerative diseases in iRBD from clinical symptomology, neuroelectrophysiology, neuroimaging, body fluid, pathology and gene markers, in order to select patients suitable for disease modification therapy and delay the development of neurodegenerative diseases. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD) is a common neurological degenerative disease that can cause structural and functional abnormalities of the heart. Amyloid-β protein (Aβ) and AD-related gene variants play important roles in the pathophysiological changes of the heart associated with AD. This paper reviews the structural and functional damage of the heart associated with AD and its possible mechanism of action, providing theoretical basis for a comprehensive understanding of AD and exploring new drugs and therapeutic targets. [ABSTRACT FROM AUTHOR]

Cognition disorders is a common complication of epilepsy, which seriously affects patients' activities of daily living. Timely measures can avoid further impairment of patients' cognitive function. There are many risk factors for cognition disorders in patients with epilepsy. This paper summarizes the risk factors related to cognition disorders in patients with epilepsy, and classifies them according to epileptic factors and non-epileptic factors, so as to provide a theoretical basis for accurate treatment of epilepsy. [ABSTRACT FROM AUTHOR]

Postural disorder is a common disabling movement complication of Parkinson's disease (PD), in which camptocormia is the most common disabling postural disorder, which further aggravates the movement disorder of PD, and seriously reduces the activities of daily living and quality of life of patients. This paper reviews the pathogenesis and treatment progress of PD with camptocormia, providing theoretical basis for further investigation of the pathogenesis of camptocormia in PD, and assisting the clinical diagnosis and treatment of the disease. [ABSTRACT FROM AUTHOR]

Gait disorder is one of common motor symptoms in patients with Parkinson's disease (PD), significantly affecting their quality of life and mobility. Robot - assisted gait training (RAGT) can improve the motor symptoms of PD patients, particularly in terms of lower limb motor function. It corrects abnormal spatiotemporal parameters of gait, such as gait velocity, step length, and step frequency, reduces the occurrence of freezing of gait, improves endurance, enhances balance ability, and ultimately improves quality of life. This paper focuses on the classification and construction, clinical efficacy and mechanism of exoskeleton robot, which can be used to guide the rehabilitation treatment of PD. [ABSTRACT FROM AUTHOR]

Copyright of Evaluation & Analysis of Drug-Use in Hospitals of China is the property of Evaluation & Analysis of Drug-Use in Hospitals of China Editorial Board and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Computer-assisted cognitive rehabilitation (CACR), as a good substitute or supplement for traditional cognitive rehabilitation, has been applied to the rehabilitation of post - stroke cognitive impairment (PSCI) due to its repeatability, interest and colorful training content. However, there are still some objective limitations of CACR. This paper reviews the application of CACR in PSCI rehabilitation based on some clinical randomized controlled trials, discusses its effects on cognitive dysfunction, emotional disorders, activities of daily living disorders, and provides evidence for its promotion and application. [ABSTRACT FROM AUTHOR]

Frailty is a geriatric syndrome caused by a decrease in multi - system physiological reserve and function, which reduces the elderly's ability to stress the internal and external environment and maintain homeostasis, and increases the risk of adverse health events. The incidence of frailty and pre - frailty in stroke patients is the highest and significantly higher than that in non-stroke patients, while the prevalence of cerebrovascular disease in frailty patients is also significantly increased and the prognosis is worse. This paper intends to review the potential association between frailty and cerebrovascular disease. [ABSTRACT FROM AUTHOR]

Objective This paper summarized the experience in treating middle-aged and elderly patients with brain trauma-induced coagulopathy (BTIC). Methods and Results From January 2015 to May 2019, 3 BTIC patients (50-85 years old) were diagnosed by clinical examination, laboratory coagulation test and CT scan. Trauma-induced coagulopathy (TIC) was corrected by craniotomy and decompression, and hematoma aspiration. Two cases (Case 1 and Case 2) were successfully treated while Case 3 was dead due to coagulation disorder and irreversible injury of nervous system. Conclusions Early diagnosis and early treatment could prevent the exacerbation of BTIC, even the patient over 80-year- old may be cured. However, for patients with particularly severe brain damage, there are still many difficulties, and new treatment methods need to be studied. [ABSTRACT FROM AUTHOR]

Breast cancer and lung cancer are the two most common malignancies in China. With the continuous improvement of breast cancer diagnosis and treatment technology, the survival time of breast cancer patients has been prolonged, and the number of breast cancer patients with second primary lung cancer (SPLC) has increased. In addition, breast cancer is the most common primary cancer in female patients with SPLC, and SPLC is the main cause of death in this population. More and more physicians pay attention to this clinical phenomenon. This paper summarized the risk and risk factors of SPLC in breast cancer patients, and elaborated its pathogenesis, in order to provide a theoretical basis for the clinical management of breast cancer patients and achieve accurate early intervention as soon as possible. [ABSTRACT FROM AUTHOR]

AADC deficiency is a rare autosomal recessive disease that may lead to movement disorder and/or autonomic dysfunction. The prognosis of AADC deficiency patients is poor, and most die in childhood. Gene therapy is the only method currently available to help alleviate related symptoms. Gene therapy involves the injection of adeno-associated viral (AV) vector into the basal ganglia of patients, helping transfer the AADC gene and leading to improved AADC production and higher numbers of neurotransmitters in the brain. Moreover, as patients are unable to produce catecholamine, they may also suffer from a disorder affecting the regulatory control of the autonomic nervous system, resulting in hypoglycemia, which often causes imbalances in thermoregulation and hemodynamic and functional adjustments during surgery. Furthermore, the use of analgesics and inhalational anesthetics increase the risks of hypotension and bradycardia. Thus, in addition to assessing cardiac and respiratory system functions, it is important to evaluate the patient's airway before administering anesthesia, as structural anomalies or other situations may be present that lead to difficulties in tracheal intubation. Various airway tools, anesthesia equipment, and alternative plans should thus be prepared to protect the airway and maintain vital signs. All of the abovementioned issues increase the risks of AADC deficiency patients undergoing general anesthesia. The development of gene transfection for genetic diseases is a future trend. This paper identifies possible problems and related responses in perioperative patient care during gene therapy. The authors hope that these experiences provide references for the administration of AADC and similar gene therapies in the future. [ABSTRACT FROM AUTHOR]

Copyright of Progress in Modern Biomedicine is the property of Publishing House of Progress in Modern Biomedicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Duchenne muscular dystrophy (DMD) is the most common hereditary muscular disease. This paper introduced the research status, problems, and solutions of DMD in China, and latest progress of treatment of DMD on the international. What's more, we set up the DMD medical map: training DMD experts in the hospital which was close to the address of DMD patients, in order to facilitate the DMD patients for treatment and guidance at different stages. [ABSTRACT FROM AUTHOR]

Background Focal cortical dysplasia (FCD) is a group of diseases including abnormal cortical layer, abnormal cell structure and abnormal white matter. It is one of the main causes of intractable epilepsy. In this paper, the clinical manifestations, EEG and MRI characteristics of FCD in children and adolescents were summarized in order to improve the diagnosis and treatment level of clinicians. Methods The clinical symptoms, EEG and MRI manifestations of 22 cases were retrospectively analyzed. Results Among 22 cases, 13 cases (59.09%) only showed focal seizures, 6 cases (27.27%) only showed generalized seizures, and 3 cases (13.64%) showed focal to generalized seizures. The seizure frequency of 22 patients was namely: 6 cases (27.27%) had seizures daily, 13 cases (59.09%) were more than one time/month, and 3 cases (13.64% ) were less than one time/month. EEG in 21 cases (95.45% ) showed abnormal slow waves and epileptiform discharges. MRI of 12 cases showed FCD in frontal lobe, the scalp EEG of whom showed abnormal slow waves and epileptiform discharges in focal frontal region in 7 cases (7/12), extensive slow waves and spike and slow wave complex in 2 cases (2/12), temporal sharp waves in 2 cases (2/12), and a small amount of sharp waves at midline in one case (1/12). Simple focal seizures occurred in 7 cases (7/12), generalized seizures occurred in 4 cases (4/12), and focal to generalized seizures occurred in one case (1/12). MRI of 6 cases showed FCD in parietal lobe, the scalp EEG of whom showed abnormal slow waves and epileptiform discharges in focal parietal region in 3 cases (3/ 6), epileptiform discharges in temporo - occipital region in 2 cases (2/6), and no abnormality in one case (1/ 6). Simple focal seizures occurred in 5 cases (5/6), and focal to generalized seizures occurred in one case (1/6). MRI of 2 cases showed FCD in temporal lobe, the scalp EEG of whom showed abnormal slow waves and epileptiform discharges in focal temporal region in one case (1/2) and epileptiform discharges in frontal region in one case (1/2). Generalized seizures occurred in those 2 cases. MRI of 2 cases showed FCD in insular lobe, the scalp EEG of whom showed epileptiform discharges in bilateral temporal regions in one case (1/2) and sharp waves and sharp and slow wave complex of all lead in one case (1/2). Simple focal seizures occurred in one case (1 /2) and focal to generalized seizures occurred in one case (1/2). Conclusions FCD mostly occurs in preschool and school age. Epileptic seizures are focal or generalized, other seizure type can also be seen, and the frequency is high. Head MRI is an important method for diagnosing FCD. Antiepileptic drugs (AEDs) therapy is mostly used to control epileptic seizures. Epilepsy surgeries should be considered if the curative effect of AEDs is poor. [ABSTRACT FROM AUTHOR]

Transcranial direct current stimulation (tDCS), which is a safe and noninvasive method for inducing or enhancing neural plasticity, can promote the recovery of post - stroke aphasia (PSA). This paper explores the possible mechanisms of verbal recovery in patients with PSA, and analyzes the role of bilateral hemispheres and cerebellum in speech recovery to review the research progress of application of tDCS in PSA. [ABSTRACT FROM AUTHOR]

Stroke has become the leading common cause of disability and the second most common cause of death in China. Endovascular treatment emerged in recent years as a promising treatment method with a higher recanalization rate and better functional outcome in patients with acute ischemic stroke caused by large vessel occlusion. This paper selected 4 high - quality retrospective studies by Chinese scholars regarding endovascular treatment in patients with acute ischemic stroke, which were published in foreign journals during past 3 years, and focused on study methods and results. [ABSTRACT FROM AUTHOR]

Background DMD gene point mutation, mainly nonsense mutation, always cause the most severe Duchenne muscular dystrophy (DMD). However, we also observed some cases of Becker muscular dystrophy (BMD) carrying DMD point mutation. This paper aims to explore the mechanism of DMD point mutation causing BMD, in order to enhance the understanding of mutation types of BMD. Methods Sequence analysis was performed in 11 cases of BMD confirmed by typical clinical manifestations and muscle biopsy. The exon of DMD gene was detected non - deletion or duplication by multiplex ligation - dependent probe amplification (MLPA). Results Eleven patients carried 10 mutation types without mutational hotspot. Six patients carried nonsense mutations [c.5002G>T, p.(Glu1668X); c.1615C > T, p.(Arg539X); c.7105G > T, p.(Glu2369X); c.5287C > T, p.(Arg1763X); c.9284T > G, p. (Leu3095X)]. One patient carried missense mutation [c.5234G > A, p.(Arg1745His)]. Two patients carried frameshift mutations (c.10231dupT, c.10491delC). Two patients carried splicing site mutations (c.4518 + 3A > T, c.649 + 2T > C). Conclusions DMD gene point mutation may result in BMD with mild clinical symptoms. When clinical manifestations suggest the possibility of BMD and MLPA reveals non-deletion or duplication mutation of DMD gene, BMD should be considered. Study on the mechanism of DMD point mutation causing BMD is very important for gene therapy of DMD. [ABSTRACT FROM AUTHOR]

Malnutrition is common after stroke, usually caused by cognitive disorder, dysphagia, paralysis, sensorimotor disability and visual field defect. Many researches indicate that the initiation of early enteral nutrition in stroke patients would own enormous clinical benefits, including a decrease in the risk of death and infectious diseases, shorter hospital stay and lower health expenditure. However, irregular nutrition management could increase the incidence of hypostatic pneumonia and urinary tract infection. Therefore, both European Society for Parenteral and Enteral Nutrition (ESPEN) and American Society for Parenteral and Enteral Nutrition (ASPEN) recommended that nutrition screening and assessment and nutrition support be initiated as soon as possible, preferably within 24 h of hospital admission, to improve clinical outcomes. Chinese neurologists and patients have accepted this concept and have done many worthful studies in the past few years. This paper summarized the common methods of nutrition assessment and measurement of interstinal barrier function, in order to monitor the nutritional status of stroke patients, and push the establishment and improvement of nutrition support system for stroke patients in China. [ABSTRACT FROM AUTHOR]

Post-stroke depression (PSD) is one of the common complications after stroke. However, it is often overlooked in clinical practice. As a result, many patients have been misdiagnosed or never been diagnosed. Post-stroke depression directly affect cognitive function, late rehabilitation, functional recovery and the quality of life in stroke patients, and is closely related to the high recurrence rate, disability rate and mortality of stroke. In order to deepen the understanding of early and late PSD, this paper summarized recent progress of PSD at home and abroad, and made a brief introduction on the epidemiology, pathogenesis, influencing factors, screening and diagnosis, treatment and prevention of PSD. [ABSTRACT FROM AUTHOR]

Surgery is currently the most appropriate treatment for early-stage non-small cell lung cancer (NSCLC). Increasing unilateral or bilateral multiple primary lung cancer being found, segmentectomy has attracted wide attention for its unique advantages in the treatment for such tumors. Ground glass opacity dominant early-stage NSCLC is associated with a good prognosis and can be cured by segmentectomy, however, the treatment of solid-dominant NSCLC remains controversial owing to the invasive nature. With the in-depth study on the lymph node metastasis pathway, radiological characteristics and molecular biology of NSCLC, a large part of solid nodules with certain characteristics can also be cured by segmentectomy. This paper reviews the research status and progress about the indication of segmentectomy. [ABSTRACT FROM AUTHOR]

hronic obstructive pulmonary disease (COPD) and lung cancer are global high incidence and high mortality diseases, which seriously increase the socio-economic burden. Smoke exposure, genetic susceptibility and chronic inflammation are common susceptible factors. At present, abnormal inflammatory immune response plays an important role in the occurrence and development of the two diseases. In the process of immune response, tumor microenvironment (TME) is gradually produced, which is beneficial to angiogenesis and immunosuppression, and finally leads to immune escape of tumor cells, leading to tumor formation. In this paper, the present situation of COPD complicated with lung cancer and the relationship between abnormal immune response, especially Treg/Th17, and its occurrence and development are briefly reviewed. [ABSTRACT FROM AUTHOR]

Uncontrolled hemorrhagic shock is the main cause of death in patients with traumatic injuries. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a rapidly performed and less- invasive treatment to stop bleeding. The REBOA balloon may be placed at the location of bleeding to achieve hemostasis. Prior to balloon placement, the indications for placement must be evaluated, including non-thoracic aortic trauma and non-traumatic patients with postpartum hemorrhage, and the appropriate sheath size (from 5 to 8 French) must be selected based on the bleeding site. As vascular injury of aortic dissection, rupture, or perforation may occur during the procedure, changes in hemodynamic parameters should be monitored. After balloon placement, ischemic complications due to blood flow occlusion such as lower extremity ischemia and acute renal failure should be tracked. After balloon removal, reperfusion injuries may occur, which can result in multiple organ failure, and should be observed closely. When caring for patients receiving REBOA, physicians should explain the procedure to their families to obtain informed consent. Also, nurses should prepare supplies and closely monitor changes in critical life signs to minimize the risks of hypotension, arrhythmia, and changes in consciousness during the procedure. After placement, the neurovascular and peripheral limbs "5P" (pain, pallor, paresthesia, pulselessness and paralysis) condition should be evaluated and recorded in detail. This treatment approach requires further study and research to assess the long-term impacts of placement and improve quality of care in these patients. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD) is one of most common neurodegenerative diseases, which gradually begins and develops after 65 years old, presenting as progressive and irreversible memory loss and other cognitive decline, and finally causes dementia and disability. Therefore, early diagnosis, timely treatment and effective prevention of AD have been become important clinical and scientific problems. During the period of Twelfth Five-Year Plan for National Economic and Social Development, our team have engaged in AD diagnosis and treatment for a long time and carried out studies in the field of pathogenesis, epidemiology, screening of risk factors, neuropsychological tests, imaging, biomarkers and early intervention of AD. This paper has summarized these research achievements. [ABSTRACT FROM AUTHOR]

Etiology of epilepsy is complex. Immune has been defined as one of the etiological groups of epilepsy. Autoimmune epilepsy attracts experts worldwide to investigate and new conceptual definitions has been proposed. Based on the pathophysiology, autoimmune epilepsy includes two entities, which are acute symptomatic seizures secondary to autoimmune encephalitis (AE) and autoimmune - associated epilepsy (AAE). We interpret the new concepts, the characteristics of extracellular and intracellular neuronal antibodies which contribute to the pathogenesis of epilepsy, and AE manifested by seizures in this review. We hope that the article helps researchers and clinicians have a better understanding of AAE and use standard terms in practical situations, thus improving diagnosis and treatment of epilepsy. [ABSTRACT FROM AUTHOR]

Objective To evaluate brain plasticity by resting-state fMRI (rs-fMRI), and to explore the potential neuroendocrine mechanism of repetitive transcranial magnetic stimulation (rTMS) in improving post-stroke cognitive impairment (PSCI) in patients with low thyroid hormone (TH) level. Methods A total of 28 patients with PSCI with low TH level who received rehabilitation treatment in Shijiazhuang People's Hospital from August 2020 to December 2021 were randomly divided into rTMS group (n = 15) and control group (n = 13). Cognitive function was assessed by Montreal Cognitive Scale (MoCA) before and 4 weeks after rTMS, and serum levels of tri-iodothyronine (T3), thyroxine (T4) and thyroid stimulating hormone (TSH) were measured by double antibody sandwich method. rs - fMRI was used to calculate the fractional amplitude of low - frequency fluctuation (fALFF) and observe the activated brain regions after stimulation. Pearson correlation analysis was used to obtain the distribution of synchronous changes of activated brain areas based on whole-brain functional connection strength of hypothalamus and serum TH level in 2 groups. Results After 4 weeks of intervention, compared with control group, MoCA score (F = 1163.054, P = 0.000), and serum T3 (F = 1111.685, P = 0.000), T4 (F = 847.333, P = 0.000), TSH (F = 251.316, P = 0.000) in rTMS group was increased. In rTMS group, fALFF value increased mainly in posterior cerebellar lobe (t = 4.699, P < 0.05), middle frontal gyrus (t = 4.356, P < 0.05) and superior frontal gyrus (t = 5.675, P < 0.05), while fALFF value decreased in superior temporal gyrus (t = -7.874, P <0.05) and middle temporal gyrus (t = - 5.776, P < 0.05). The enhanced functional connectivity of the whole brain with bilateral hypothalamus as the region of interest (ROI) and the simultaneous increase of serum T3 and TSH levels were mainly concentrated in the cerebellum, frontal lobe and parahippocampal gyrus. Conclusions rTMS can indirectly affect hypothalamic function through cerebral cortex, increase serum TH level and improve cognitive function in PSCI patients. [ABSTRACT FROM AUTHOR]

Objective To summarize the clinical features of optic neuritis (ON) complicated with chronic hepatitis B virus (HBV) infection, and evaluate the effectiveness of different treatment regimens, recurrence of ON, visual prognosis, HBV reactivation, liver function and liver structure changes. Methods and Results Total 19 patients (23 eyes) with acute ON complicated with chronic HBV infection admitted to Beijing Tongren Hospital, Capital Medical University from January 2015 to June 2021 were included. There were 13 females and 6 males, 15 cases with monocular onset, 17 cases with unidirectional course of disease, and 6 cases with optic disc edema. The time to the worst visual acuity (peak time) was 3 (2, 7) d after onset, and 16/23 eyes had severe visual impairment. Enhanced MRI showed abnormal intensity in orbital, intraductal or intracranial segments of optic nerve, even involving optic nerve sheath and optic chiasm. Anti-nuclear antibody (ANA) was positive in 5 cases and A type Sjögren's syndrome antibody (SSA) was weakly positive in one case. Cerebrospinal fluid (CBF) pressure decreased in 1/7 cases and white blood cell count increased in 2/7 cases. HBV DNA positive group (HBV DNA ≥ 100 IU/ml, 10 cases and 11 eyes) had more severe visual impairment than negative group (HBV DNA < 100 IU/ml, 9 cases and 12 eyes), the difference was statistically significant (Fisher's exact probability: P = 0.005, 0.003). HBV DNA positive group was treated with entecavir, and the recurrence of ON was ignored during follow-up. HBV DNA negative group didn't receive antiviral therapy, one case progressed to cirrhosis, 3 cases had abnormal liver function, and 2 cases had HBV reactivation. Conclusions The visual function of patients with ON complicated with chronic HBV infection was seriously impaired, and the response to glucocorticoid therapy was not good. The visual impairment of patients with positive HBV DNA was more serious than patients with negative HBV DNA. Patients with ON complicated with chronic HBV infection should be treated with antiviral drugs in combination with glucocorticoid therapy. [ABSTRACT FROM AUTHOR]

Objective To investigate the risk factors of anti - N - methyl - D - aspartate receptor (NMDAR) encephalitis with acute symptomatic seizure (ASS), and establish a Nomogram model based on clinical indicators. Methods A retrospective analysis was performed on 84 patients with anti-NMDAR encephalitis who were diagnosed in Beijing Tiantan Hospital, Capital Medical University from May 2012 to October 2020. Univariate and multivariate Logistic regression analyses were used to determine the risk factors of anti - NMDAR encephalitis with ASS, and a Nomogram model was constructed. The receiver operating characteristic (ROC) curve and calibration curve of the model were plotted, and Hosmer - Lemeshow goodness of fit test was performed. Results In all 84 patients, 63 cases (75%) presented with ASS, and 35 cases (41.67%) had ASS as the initial symptom. Logistic regression analysis showed male (OR = 7.680, 95%CI: 1.811-32.562; P = 0.006), psychosis and abnormal behavior (OR = 6.486, 95%CI: 1.818-23.141; P = 0.004), anti-NMDAR antibody titer in cerebrospinal fluid (CSF) ≥ 1:32 (OR = 9.322, 95%CI: 2.132-40.766; P = 0.003) were the risk factors of anti-NMDAR encephalitis with ASS, older age was the protective factor (OR = 0.942, 95%CI: 0.903-0.983; P = 0.006). A Nomogram model was established based on the 4 risk factors, and the area under curve (AUC) of ROC was 0.862 (95%CI: 0.776-0.949, P = 0.000). Calibration curve showed a good agreement between the predicted probability and the actual probability of ASS occurrence, and Hosmer-Lemeshow test showed there was no statistical difference (χ² = 4.318, P = 0.827). Conclusions Male, young age, psychosis and abnormal behavior, and anti-NMDAR antibody titer in CSF ≥ 1:32 are more likely to have ASS in patients with anti-NMDAR encephalitis. This Nomogram model constructed based on the above 4 indicators may accurately and conveniently predict ASS and provide a reference for clinical diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Persons with dysphagia have difficulties chewing and swallowing food because of functional, structural, or psychological reasons. Dysphagia may cause choking or the inhalation of food into the trachea and lungs. Patients with dysphagia often induce the coughing reflex when drinking water and brushing teeth and tend to suffer from gum bleeding. As a result, their caregivers tend to reduce the frequency of or discontinue teeth brushing, which promotes the spread of periodontal disease, dental caries, and oropharyngeal secretions colonizing in the oral cavity or throat. When a patient suffers a choking attack or aspiration, bacteria is inhaled into the trachea and lungs, causing aspiration pneumonia. Furthermore, patients with choking issues are often be fitted with nasogastric tubes to facilitate the delivery of nutrients and water. Long-term use of nasogastric tubes also significantly increases the risk of aspiration pneumonia. Adjusting eating posture, improving food texture, conducting swallowing rehabilitation, providing training, and practicing proper oral care are an effective approach to preventing the onset of chewing and swallowing disorders and aspiration pneumonia. [ABSTRACT FROM AUTHOR]

Autoimmune encephalitis (AE) associated with epilepsy is a significant clinical syndrome, which is characterized by refractory seizures, cognitive deficits, neuropsychiatric disturbances. Many studies have been clearly notified that early diagnosis combined with immunotherapy can apparently improve prognosis, thus early diagnosis and treatment are highly essential. In recent years, the neuroimaging, especially functional imaging, plays a critical role in the early diagnosis and prognostic assessment of AE associated with epilepsy. This review summarized the methods and results of functional imaging in the diagnosis of epilepsy associate associated with AE, to provide an imaging basis for clinical and differential diagnosis and prognostic assessment. [ABSTRACT FROM AUTHOR]