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Background: Chlamydia suis is an important, globally distributed, highly prevalent and diverse obligate intracellular pathogen infecting pigs. To investigate the prevalence and genetic diversity of C. suis in China, 2,137 nasal, conjunctival, and rectal swabs as well as whole blood and lung samples of pigs were collected in 19 regions from ten provinces of China in this study. Results: We report an overall positivity of 62.4% (1,334/2,137) of C. suis following screening by Chlamydia spp. 23S rRNA-based FRET-PCR and high-resolution melting curve analysis and confirmatory sequencing. For C. suis-positive samples, 33.3 % of whole blood and 62.5% of rectal swabs were found to be positive for the C. suis tetR(C) gene, while 13.3% of whole blood and 87.0% of rectal swabs were positive for the C. suis tet(C) gene. Phylogenetic comparison of partial C. suis ompA gene sequences revealed significant genetic diversity in the C. suis strains. This genetic diversity was confirmed by C. suis-specific multilocus sequence typing (MLST), which identified 26 novel sequence types among 27 examined strains. Tanglegrams based on MLST and ompA sequences provided evidence of C. suis recombination amongst the strains analyzed. Conclusions: Genetically highly diverse C. suis strains are exceedingly prevalent in pigs. As it stands, the potential pathogenic effect of C. suis on pig health and production of C. suis remains unclear and will be the subject of further investigations. Further study is also required to address the transmission of C. suis between pigs and the risk of 'spillover' and 'spill-back' of infections to wild animals and humans. [ABSTRACT FROM AUTHOR]

Background: Highly hypnotizable individuals have impaired executive function, elevated motor impulsivity and increased emotional sensitivity, which are sometimes found in bipolar disorder patients. It is then reasonable to assume that certain aspects of hypnotic susceptibility differ with the types of bipolar disorder. Methods: The Stanford Hypnotic Susceptibility Scale: Form C (SHSS:C) test, the Mood Disorder Questionnaire (MDQ), the Hypomanic Checklist-32 (HCL-32) and the Plutchick-van Praag Depression Inventory (PVP) were applied to 62 patients with bipolar I disorder, 33 bipolar II disorder, and 120 healthy volunteers. Results: The passing rate of the SHSS:C 'Moving hands apart' item was higher in bipolar I patients than in controls, whereas for 'Mosquito hallucination' the rate was lower. Bipolar I and II patients scored significantly higher on MDQ, HCL-32 and PVP scales than controls. The passing rates of 'Mosquito hallucination' in controls, 'Arm rigidity' in bipolar I, and 'Age regression' in bipolar II predicted the respective MDQ scores. Conclusion: In contrast to cognitive suggestions, bipolar I patients followed motor suggestions more often under hypnosis. Furthermore, both bipolar disorder patients and healthy volunteers demonstrated associations between mania levels and certain hypnotic susceptibility features. Our study aids in better understanding the altered conscious states in bipolar disorders, and encourages the use of related psychotherapy for these patients. [ABSTRACT FROM AUTHOR]

Background: A unified clinical approach to diagnose autoimmune encephalitis was published in Lancet Neurology in 2016. Purpose of our study is to examine the feasibility and reasonability of the 2016 "A clinical approach to diagnosis of autoimmune encephalitis" in China with a retrospective study.Methods: We retrospectively collected 95 cases of autoimmune encephalitis and non autoimmune encephalitis cases with detailed clinical data from Beijing Tongren Hospital and the China National Knowledge Infrastructure (CNKI). All cases were analysed stepwise according to the approach in Lancet Neurology to compare the new diagnosis with the final clinical diagnosis.Results: The disease course of these 95 cases ranged from 2 to 540 days. Initial symptoms include fever, headache, seizure, mental and behavioral disorders, memory deterioration and illusion. Based on symptoms and signs when the patient came to the hospital, the sensitivity and specificity of criteria were as follows: possible autoimmune encephalitis (pAE) 84% and 94%, definite autoimmune limbic encephalitis (dALE) 38% and 96%, probable anti-N-methyl-D-aspartate receptor encephalitis (prNMDARE) 49% and 98%. The sensitivities of the above three criteria and the specificity of pAE were low during early disease stage, while the specificities of dALE and prNMDAER remained relatively high in different time periods.Conclusions: This new autoimmune encephalitis diagnostic approach can recognize possible autoimmune encephalitis. The chances of a case being autoimmune-mediated following classification as autoimmune encephalitis with the new criteria are high. The flowchart is recommended to use as a whole. At the early disease stage, criteria with low sensitivity and high specificity, such as dALE and prNMDARE, lead most cases to enter subsequent diagnosis steps, namely autoantibody detection in the flowchart. Final diagnoses can only be made by autoantibody tests. These factors may make it challenging for clinicians to make diagnosis promptly and to begin immune-modulating therapy immediately. Moreover, the criteria for patients with paraneoplastic syndromes (PNSs) should be considered to avoid diagnosis omission. For Chinese patients, a multi-centre, prospective study on the clinical manifestations, laboratory diagnostic technology, therapy, and prognosis is greatly needed. [ABSTRACT FROM AUTHOR]

Background: Headache symptoms self-reported by migraine patients are largely congruent with the clinician-used diagnostic criteria, but not always so. Patients' self-reports of headache symptoms might offer additional clues to characterize migraine with (MA) and without (MO) aura more precisely.Methods: Firstly, we invited 324 participants with a life-long headache attack to answer an item-matrix measuring symptoms of primary headaches, then we performed both exploratory and confirmatory factor analyses to their answers and refined a headache symptom questionnaire. Secondly, we applied this questionnaire to 28 MA and 52 MO patients.Results: In participants with a life-long headache, we refined a 27-item, structure-validated headache symptom questionnaire, with four factors (scales) namely the Somatic /Aura Symptoms, Gastrointestinal and Autonomic Symptoms, Tightness and Location Features, and Prodromal/Aggravating Symptoms. Further, we found that MA patients reported higher than did MO patients on the Somatic/Aura Symptoms and Tightness and Location Features scales.Conclusions: Compared to MO, MA was conferred with more prominent tightness and location features besides its higher somatic or aura symptoms. Patients' self-reports of headache symptoms might offer more clues to distinguish two types of migraine besides their clinician-defined criteria. [ABSTRACT FROM AUTHOR]

Background: Bipolar disorder types I (BD I) and II (BD II) might present different dysfunctions of the cortex and brainstem, as reflected by the second exteroceptive suppression period of temporalis muscle activity (ES2) under different stimuli of external emotions. Methods: This study included 30 BD I and 20 BD II patients, and 40 healthy volunteers. All participants were invited to answer the Mood Disorder Questionnaire, the Hypomania Checklist-32, and the Plutchik-van Praag Depression inventory, as well as to undergo the ES2 test under external emotional-stimuli (emotional pictures plus sounds) of Disgust, Erotica, Fear, Happiness, and Sadness. Results: The scale scores were elevated in both patient groups, but were not correlated with ES2 parameters. Compared to healthy controls, BD I showed prolonged ES2 latency under Erotica, and their perceived happiness and sadness intensities were negatively correlated with the respective ES2 durations, while BD II showed prolonged ES2 latencies under Disgust and Happiness, and shortened ES2 durations under Disgust, Happiness and Sadness. Moreover, ES2 duration under Sadness was significantly shorter in BD II than that in BD I. Conclusions: The cortico-brainstem inhibitory dysfunctions in BD I and BD II was different, and this difference was independent of the patient's ongoing emotions. Our study thus provides some hints to distinguish the two types of bipolar disorders. [ABSTRACT FROM AUTHOR]

Background: The existing literature contains no information regarding inflammatory cytokine expression in unilateral acute primary angle-closure (APAC) affected eyes and fellow eyes with primary angle closure suspect (PACS). To measure levels of various inflammatory cytokines in the aqueous humor (AH) of APAC affected eyes and fellow eyes with a diagnosis of PACS (18 unilateral APAC eyes and 18 fellow eyes with PACS), and determine the underlying correlation between them.Methods: The total levels of 12 cytokines including granulocyte colony-stimulating factor (G-CSF), interleukin (IL)-6, IL-8, monocyte chemotactic protein (MCP)-1, MCP-3, macrophage-derived chemokine (MDC), macrophage inflammatory protein (MIP)-1β, and vascular endothelial growth factor (VEGF) etc. were assessed using the multiplex bead immunoassay technique. The level of cytokines in different groups was analyzed by a 2-related-samples nonparametric test. Data on patient demographics, preoperative intraocular pressure (IOP), number of glaucoma medications, as well as several ocular biological parameters were also collected for correlation analysis.Results: The APAC patients had significantly higher levels of G-CSF, IL-6, IL-8, MCP-1, MCP-3, MDC, MIP-1β, and VEGF in the AH samples from unilateral APAC affected eyes than in fellow eyes with PACS (all P < 0.05). The cytokines showed positive correlations between each other (P < 0.0071).Conclusions: Cytokine networks in the AH may have critical roles in the progression of APAC. Thus, different cytokine expression in both eyes of the same patient may help us to understand the different pathology in APAC and PACS. [ABSTRACT FROM AUTHOR]

Background: To report the thickness of the retina, retinal ganglion cell (RGC)-related layers, and choroid in healthy subjects using swept source optical coherence tomography (SS-OCT).Methods: One hundred and forty-six healthy volunteers were consecutively recruited for this prospective observational study. Thickness of retina, RGC-related layers, and choroid in the standard early treatment of diabetic retinopathy study (ETDRS) grid were automatically measured using one SS-OCT (DRI OCT-1, Topcon, Japan). The IOL Master (Carl Zeiss Meditec, Germany) was used to measure axial length (AL).Results: Thicknesses of the average macular ganglion cell complex (GCC) and ganglion cell-inner plexiform layer (GCIPL) were 105.3±9.7 and 78.5±6.2 um respectively. Neither of them was significantly related with sex, age, or AL. Both showed strong correlations with retinal thickness (r=0.793, p=0.000; r=0.813, p=0.000, respectively) and with similar topographic distributions within the retina. The thicknesses of retina and GCC/GCIPL in the inner sectors were significantly higher than in the outer sectors of the EDTRS area, while in the same region of the macula, the choroid exhibited completely different patterns of topographic variation. Men had 7.8 um thicker retina and 34.9 um thicker choroid than women after adjustment for age and AL (all p<0.05). Age and AL could significantly influence the choroidal thickness but not the retina (all p<0.05).Conclusion: Thickness of GCC/GCIPL in healthy Chinese individuals is not dramatically different across gender, age, and AL groups in terms of ETDRS grid, but sex is critical for retinal and choroidal thickness. Choroidal structure (but not retinal) can be significantly influenced by age and AL. [ABSTRACT FROM AUTHOR]