作者：
Min Zhang;Ling Zhang;Shitao Fang;Yun Wang;Jinkun Guo;...
期刊：
Journal of Orthopaedics,2025年67:132-139 ISSN：0972-978X
通讯作者：
Lei Mi
作者机构：
[Lei Mi; Mi, Lei; Jinkun Guo; Min Zhang] Hunan Univ Chinese Med, Clin Med Coll, Peoples Hosp Hunan Prov 2, Dept Orthopaed Med Ctr,Brain Hosp Hunan Prov, Changsha 410007, Peoples R China.;[Ling Zhang] Cent South Univ, Xiangya Hosp 3, Dept Nursing, Changsha 410013, Peoples R China.;[Shitao Fang] Hanshou Cty Peoples Hosp, Dept Orthopaed, Changde 415999, Peoples R China.;[Yun Wang] Shandong First Med Univ, Affiliated Hosp 1, Dept Surg, Jinan 250013, Peoples R China.
通讯机构：
[Mi, L ] H;Hunan Univ Chinese Med, Clin Med Coll, Peoples Hosp Hunan Prov 2, Dept Orthopaed Med Ctr,Brain Hosp Hunan Prov, Changsha 410007, Peoples R China.
关键词：
Hallux valgus;Scarf osteotomy;Precision treatment;Finite element analysis
摘要：
Background The treatment of hallux valgus is currently in face of many challenges in clinical practice. Although conventional surgical procedures can correct deformities to a certain extent, some key parameters such as osteotomy displacement and angle are often difficult to determine, leading to increased uncertainty in surgical outcomes and a relatively high incidence of postoperative complications.
The treatment of hallux valgus is currently in face of many challenges in clinical practice. Although conventional surgical procedures can correct deformities to a certain extent, some key parameters such as osteotomy displacement and angle are often difficult to determine, leading to increased uncertainty in surgical outcomes and a relatively high incidence of postoperative complications.
Objective Hallux valgus is a common foot deformity that often leads to pain, difficulty in walking, and other health problems, seriously affecting the quality of life of patients. In order to provide patients with more precise treatment, we aimed to simulate the Scarf osteotomy for the treatment of hallux valgus using the finite element method, and comparatively analyze the mechanical performance indicators under different distal osteotomy displacements. We hoped to provide scientific and reasonable treatment plans for clinical practice and better treatment outcomes for patients.
Hallux valgus is a common foot deformity that often leads to pain, difficulty in walking, and other health problems, seriously affecting the quality of life of patients. In order to provide patients with more precise treatment, we aimed to simulate the Scarf osteotomy for the treatment of hallux valgus using the finite element method, and comparatively analyze the mechanical performance indicators under different distal osteotomy displacements. We hoped to provide scientific and reasonable treatment plans for clinical practice and better treatment outcomes for patients.
Methods A volunteer with moderate hallux valgus was selected as the research subject in this study. Preoperative plantar pressure test was conducted, and the CT data of the patient's affected foot was collected to create the finite element model using finite element software. After verifying the validity of the model, it was used to simulate the translational Scarf osteotomy under different settings. Specifically, the distal end of the bone fragment was pushed outwards by varying distances (2 mm, 4 mm, 6 mm, and 8 mm) and was fixed with screws. The maximum Von Mises stresses on the first to fifth metatarsal bones, the sole and the heel under four different surgical settings were compared with the preoperative values, and the changes in the maximum Von Mises stress on the screws were examined.
A volunteer with moderate hallux valgus was selected as the research subject in this study. Preoperative plantar pressure test was conducted, and the CT data of the patient's affected foot was collected to create the finite element model using finite element software. After verifying the validity of the model, it was used to simulate the translational Scarf osteotomy under different settings. Specifically, the distal end of the bone fragment was pushed outwards by varying distances (2 mm, 4 mm, 6 mm, and 8 mm) and was fixed with screws. The maximum Von Mises stresses on the first to fifth metatarsal bones, the sole and the heel under four different surgical settings were compared with the preoperative values, and the changes in the maximum Von Mises stress on the screws were examined.
Results When the distal end of the bone fragment was pushed outwards by 6 mm, the maximum Von mises stress on the first metatarsal bone (9.4711 MPa) reached its highest value, while the maximum Von mises stresses on the second and third metatarsal bones (0.34062 MPa and 1.6246 MPa, respectively) and on the screws (40.99 MPa) were at the lowest values. The maximum plantar pressure detected during static test was 0.292 MPa, while the maximum plantar stress observed in the finite element model was 0.25733 MPa, indicating comparable values between the two.
When the distal end of the bone fragment was pushed outwards by 6 mm, the maximum Von mises stress on the first metatarsal bone (9.4711 MPa) reached its highest value, while the maximum Von mises stresses on the second and third metatarsal bones (0.34062 MPa and 1.6246 MPa, respectively) and on the screws (40.99 MPa) were at the lowest values. The maximum plantar pressure detected during static test was 0.292 MPa, while the maximum plantar stress observed in the finite element model was 0.25733 MPa, indicating comparable values between the two.
Conclusions Based on precise and customized preoperative design and finite element analysis, it was found that the Scarf osteotomy with the distal end of the bone fragment pushed outwards for 6 mm could yield the best treatment effect for hallux valgus. Under this setting, the stress on the first metatarsal bone was the highest, while the stresses on the second and third metatarsal bones were the lowest, suggesting that it can relieve the stress on lateral metatarsal bones and improve the stress distribution of the forefoot. Overall, Scarf osteotomy under 6 mm setting can effectively correct hallux valgus deformity, reduce the incidence of metastatic plantar pain and prevent the recurrence of metastatic plantar pain after surgery. By improving the patient's plantar stress distribution, this surgical setting is expected to provide better clinical outcomes.
Based on precise and customized preoperative design and finite element analysis, it was found that the Scarf osteotomy with the distal end of the bone fragment pushed outwards for 6 mm could yield the best treatment effect for hallux valgus. Under this setting, the stress on the first metatarsal bone was the highest, while the stresses on the second and third metatarsal bones were the lowest, suggesting that it can relieve the stress on lateral metatarsal bones and improve the stress distribution of the forefoot. Overall, Scarf osteotomy under 6 mm setting can effectively correct hallux valgus deformity, reduce the incidence of metastatic plantar pain and prevent the recurrence of metastatic plantar pain after surgery. By improving the patient's plantar stress distribution, this surgical setting is expected to provide better clinical outcomes.
作者机构：
[Qin, Yue; Yang, Jun; Yang, Chong; Dong, Zaiwen; Yang, Jin] Second Peoples Hosp Dali Bai Autonomous Prefecture, Dept Orthoped, Dali, Yunnan, Peoples R China.;[Su, Yuhan; Qin, Yue; Zhang, Tengteng; Chen, Haiyu; Xu, Baoyan; Huang, J; Zou, Tianxiang; Wu, Renrong; Huang, Jing] Cent South Univ, Natl Clin Res Ctr Mental Disorders, Natl Ctr Mental Disorders, Dept Psychiat,Xiangya Hosp 2, Changsha, Hunan, Peoples R China.;[Su, Yuhan; Qin, Yue; Zhang, Tengteng; Chen, Haiyu; Xu, Baoyan; Zou, Tianxiang; Wu, Renrong; Huang, Jing] Cent South Univ, Xiangya Hosp 2, China Natl Technol Inst Mental Disorders, Changsha, Hunan, Peoples R China.;[Teng, Ziwei] Hunan Univ Chinese Med, Sch Clin Med, Dept Psychiat, Brain Hosp Hunan Prov,Peoples Hosp Hunan Prov 2, Changsha, Hunan, Peoples R China.;[Liu, Jieyu] Cent South Univ, Xiangya Hosp 2, Dept Ultrasound Diag, Changsha, Hunan, Peoples R China.
通讯机构：
[Yang, C ; Dong, ZW] S;[Huang, J ] C;Second Peoples Hosp Dali Bai Autonomous Prefecture, Dept Orthoped, Dali, Yunnan, Peoples R China.;Cent South Univ, Natl Clin Res Ctr Mental Disorders, Natl Ctr Mental Disorders, Dept Psychiat,Xiangya Hosp 2, Changsha, Hunan, Peoples R China.
关键词：
Magnetic resonance imaging;Obesity;Schizophrenia & psychotic disorders;Transcranial Magnetic Stimulation
摘要：
INTRODUCTION: Antipsychotics are likely to cause weight gain owing to increased appetite and other metabolic disturbances in patients with schizophrenia on prolonged medication. Conventional high-frequency repetitive transcranial magnetic stimulation has been employed to treat people with obesity and has shown certain effectiveness. The goal of this clinical trial is to evaluate the efficacy of intermittent theta burst stimulation (iTBS) in ameliorating appetite increase and weight gain induced by antipsychotics in patients with schizophrenia. METHODS AND ANALYSIS: In this randomised, double-blind, sham-controlled trial, 60 participants will be enrolled and allocated (1:1) to receive active or sham iTBS on the dorsolateral prefrontal cortex for 5 consecutive days. Appetite, body mass index, clinical symptoms, cognitive function and laboratory indicators will be assessed at baseline, after 5 days of treatments, and at 2 weeks and 4 weeks after all treatments. MRI examination will be conducted to detect brain structure, perfusion and functional connectivity. Data analysis will be conducted in a modified intention-to-treat population. The results of the study will provide evidence on the effectiveness and feasibility of iTBS in improving increased appetite induced by antipsychotics and explore the underlying neuroendocrine pathway affected by the intervention. The primary objective is to evaluate the efficacy of iTBS in weight gain in patients with schizophrenia taking antipsychotics. The secondary objective is to identify the neuroendocrine changes related to appetite in response to iTBS by assessing the variables of cognitive control, glucolipid metabolism and brain activity. ETHICS AND DISSEMINATION: The study protocol has been approved by the National Clinical Medical Research Center Ethics Committee of The Second People's Hospital of Dali Bai Autonomous Prefecture (no: 2023YN3) and The Second Xiangya Hospital (no: 2024K008). Written informed consent will be obtained voluntarily before enrolment. The results will be disseminated through publication in peer-reviewed journals and presentation at international conferences. TRIAL REGISTRATION NUMBER: NCT05783063.
摘要：
PURPOSE: Schizophrenia (SCZ) is a severe mental disorder with complex etiology. Research shows propionate metabolism is crucial for neurological function and health. This suggests abnormalities in propionate metabolism may link to SCZ. Therefore, identifying biomarkers associated with propionate metabolism might be beneficial for the diagnosis and treatment of SCZ patients. METHODS: SCZ datasets and propionate metabolism-related genes (PMRGs) from public databases were obtained. DE-PMRGs were identified through differential and correlation analysis of PMRGs. Machine learning was used to screen for key genes and validate expression levels, aiming to identify potential biomarkers. Gene Set Enrichment Analysis (GSEA) and immune infiltration analysis were performed on the biomarkers. An upstream regulatory network was constructed, and potential drugs targeting these biomarkers were explored. Finally, real-time fluorescence quantitative PCR (qPCR) was used to verify biomarker expression levels. RESULT: A total of 11 DE-PMRGs were identified, and machine learning technology was employed to further screen for 5 key genes. Among these, LY96 and TMEM123 emerged as potential biomarkers through expression verification. A diagnostic model was developed, achieving an area under the curve (AUC) greater than 0.7, which indicates strong diagnostic performance. Additionally, nomograms based on these biomarkers demonstrated promising predictive capabilities in assessing the risk of SCZ. To explore gene functions and regulatory mechanisms at a deeper level, a competitive endogenous RNA (ceRNA) regulatory network was constructed, including 2 biomarkers, 72 microRNAs, and 202 long non-coding RNAs. In addition, a regulatory network containing 2 biomarkers and 104 transcription factors (TFs) was also established to investigate the transcription factors interacting with the biomarkers. Potential biomarker-targeted drugs were identified by exploring the DrugBank database; notably, LY96 exhibited higher binding affinities for four drugs, with docking scores consistently below-5 kcal/mol. The qPCR results indicated that the expression levels of LY96 and TMEM123 in the whole blood of SCZ patients were significantly higher than those in the healthy control group, which was consistent with the results in the GSE38484 and GSE27383 datasets. CONCLUSION: This study identified disease diagnostic biomarkers associated with propionate metabolism in SCZ, specifically LY96 and TMEM123. These findings offer novel perspectives for the diagnosis and management of SCZ.
关键词：
case report;drug dependence;drug misuse;pregabalin;withdrawal symptoms
摘要：
Pregabalin misuse and dependence have become emerging concerns in recent years, particularly in regions where traditional drug-related crimes have been curbed, prompting users to seek alternative substances. Although pregabalin is primarily used for treating conditions such as epilepsy, neuropathic pain, and generalized anxiety disorder, its sedative and euphoric effects make it prone to misuse. This case report presents a 20-year-old male who developed pregabalin dependence after using the drug intermittently at escalating doses over a year. He experienced withdrawal symptoms including palpitations, tremors, irritability, insomnia, and auditory hallucinations upon cessation of the drug, which were alleviated by resuming pregabalin use. Upon admission, he was diagnosed with pregabalin dependence, hyperuricemia, and thyroid nodules. The patient underwent a comprehensive treatment plan involving benzodiazepines, antidepressants, and antipsychotics, leading to substantial improvement in mood, anxiety, psychotic symptoms, and withdrawal symptoms. This case highlights the growing issue of pregabalin misuse, the associated withdrawal symptoms, and the importance of early intervention and systematic treatment strategies. It emphasizes the need for stricter prescription controls, patient education on the risks of misuse, and multidisciplinary approaches to the treatment of pregabalin dependence. Further research is necessary to better understand the mechanisms behind pregabalin misuse and to develop improved prevention and treatment protocols.
期刊：
JCPSP-JOURNAL OF THE COLLEGE OF PHYSICIANS AND SURGEONS PAKISTAN,2025年35(5):636-641 ISSN：1022-386X
通讯作者：
Chen, X
作者机构：
[Li, Keyu; Zhu, Liangdong] First Hosp Changsha, Dept Resp & Crit Care Med, Changsha, Hunan, Peoples R China.;[Guo, Minfang] Hunan Normal Univ, Dept Hepatobiliary Surg, Affiliated Hosp 1, Changsha, Hunan, Peoples R China.;[Gan, Siyu] Hunan Univ Chinese Med, Sch Clin Med, Changsha, Hunan, Peoples R China.;[Chen, Xia; Chen, X; Fu, Yong] Hunan Univ Med, Dept Nephrol & Rheumatol Immunol, Affiliated Hosp 1, Hunan, Peoples R China.
通讯机构：
[Chen, X ] H;Hunan Univ Med, Dept Nephrol & Rheumatol Immunol, Affiliated Hosp 1, Hunan, Peoples R China.
关键词：
Immunosuppressant;Rituximab;Meta-analysis
摘要：
Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a potentially life-threatening systemic autoimmune disease. This study aims to compare the effectiveness and safety of biologics and immunosuppressive agents in the maintenance treatment of AAV. A comprehensive search was conducted in Medline, PubMed, Embase, and the Cochrane Library databases to identify the relevant randomised controlled trials (RCTs). Nine RCTs involving 1,157 patients were included. For primary efficacy, rituximab had a lower relapse rate than azathioprine (AZA) and mycophenolate mofetil (MMF) (odds ratio (OR): 0.47, 95% confidence interval (CI): 0.26-0.84 and OR: 0.23, 95% CI: 0.08-0.68, respectively). Based on the result of the surface under the cumulative ranking curve (SUCRA), rituximab had the highest probability of reducing relapse (SUCRA = 86.6%), followed by cyclophosphamide (CYC), belimumab + AZA, methotrexate (MTX), AZA, and MMF. Regarding major relapse, rituximab also showed the highest probability (SUCRA = 93.6%). Concerning safety, there were no significant differences in the incidence of SAEs and serious infection among the different medicines. According to the SUCRA, MMF had the lowest probability of SAEs and serious infection. In conclusion, rituximab may be a treatment method for effectively reducing relapses in AAV patients during maintenance therapy among the medicines investigated. MMF has shown the lowest incidence of SAEs and serious infection. Key Words: Immunosuppressant, Rituximab, Meta-analysis.
期刊：
Journal of Orthopaedics,2025年70:1-8 ISSN：0972-978X
通讯作者：
Lei Mi
作者机构：
[Mi, Lei; Guo, Jinkun] Department of Orthopaedic, Clinical Medical College of Hunan University of Traditional Chinese Medicine, Changsha, 410007, Hunan, China;[Mi, Lei; Guo, Jinkun; Zhang, Ming] Department of Orthopaedic Medicine Center, The Second People's Hospital of Hunan Province(Brain Hospital of Hunan Province), Changsha, 410007, Hunan, China;[Zhang, Ling] Department of Nursing, The Third Xiangya Hospital of Central South University, Changsha, 410013, Hunan, China;[Fang, Shitao] Department of Orthopaedic, Hanshou County People 's Hospital, Changde, 415999, Hunan, China;[Wang, Yun] Department of Surgery, Shandong First Medical University First Affiliated Hospital, Jinan, 250013, Shandong, China
通讯机构：
[Mi, L ] H;Department of Orthopaedic Medicine Center, The Second People's Hospital of Hunan Province(Brain Hospital of Hunan Province), Changsha, 410007, Hunan, China<&wdkj&>Department of Orthopaedic, Clinical Medical College of Hunan University of Traditional Chinese Medicine, Changsha, 410007, Hunan, China
摘要：
Objective To compare the biomechanical stability between two different external fixation methods (locked steel plates versus external fixation frame) for the treatment of A1b tibial fractures based on finite element analysis, and to provide theoretical reference for clinical application.
To compare the biomechanical stability between two different external fixation methods (locked steel plates versus external fixation frame) for the treatment of A1b tibial fractures based on finite element analysis, and to provide theoretical reference for clinical application.
Methods Based on CT data of the left tibia from a healthy male volunteer, a normal three-dimensional (3D) tibial model was constructed using modeling software, which was further derived into a A1b tibial fracture model. Then, On the basis of the fracture model constructed above, the finite element models of locking compression plate and unilateral external fixator were fixed respectively. Further, 4 different test conditions (i.e., 4-point bending, axial compression, clockwise torsion, and counterclockwise torsion) were simulated under the same loading and constraint conditions for both models, in order to comparatively evaluate the equivalent peak stress and peak overall displacement of the fracture site between the two methods.
Based on CT data of the left tibia from a healthy male volunteer, a normal three-dimensional (3D) tibial model was constructed using modeling software, which was further derived into a A1b tibial fracture model. Then, On the basis of the fracture model constructed above, the finite element models of locking compression plate and unilateral external fixator were fixed respectively. Further, 4 different test conditions (i.e., 4-point bending, axial compression, clockwise torsion, and counterclockwise torsion) were simulated under the same loading and constraint conditions for both models, in order to comparatively evaluate the equivalent peak stress and peak overall displacement of the fracture site between the two methods.
Results From the experimental data corresponding to the maximum load under 4 different test conditions, it was found that the peak stress of tibia and the equivalent peak stress of fractured tibia with external fixation was roughly ranged 49.16–269.59 MPa and 34.99–559.58 MPa in the two fixation methods under various test conditions. Overall, external fracture fixation with locked steel plates showed a greater equivalent peak stress and a smaller peak overall tibial displacement than that with external fixation frame did.
From the experimental data corresponding to the maximum load under 4 different test conditions, it was found that the peak stress of tibia and the equivalent peak stress of fractured tibia with external fixation was roughly ranged 49.16–269.59 MPa and 34.99–559.58 MPa in the two fixation methods under various test conditions. Overall, external fracture fixation with locked steel plates showed a greater equivalent peak stress and a smaller peak overall tibial displacement than that with external fixation frame did.
Conclusions Locked steel plates may be superior external fixation frame in terms of biomechanical properties in the treatment of A1b tibial fractures, and can be used as an alternative option for patients who cannot tolerate external fixation frame.
Locked steel plates may be superior external fixation frame in terms of biomechanical properties in the treatment of A1b tibial fractures, and can be used as an alternative option for patients who cannot tolerate external fixation frame.
作者：
Jinkun Guo;Meng Que;Jinyan Guo;ZhongFan Liu;Yan-Jun Che
期刊：
Journal of Orthopaedics,2025年67:177-182 ISSN：0972-978X
通讯作者：
Que, M;Che, YJ
作者机构：
[Meng Que; Jinkun Guo] Department of Orthopaedic Medicine Center, Clinical Medical College of Hunan University of Traditional Chinese Medicine, Brain Hospital of Hunan Provincial, Changsha, Hunan, 410007, PR China;[Jinyan Guo] ShanXi University of Traditional Chinese Medicine, Third Clinical College, Taiyuan, Shanxi, 030000, PR China;[ZhongFan Liu] Department of Orthopaedics II, CiLi County People's Hospital, ZhangJiaJie, Hunan, 427000, PR China;[Yan-Jun Che] Orthopedics and Sports Medicine Center, The Affiliated Suzhou Hospital of Nanjing Medical University, 242 Guangji Road, Suzhou, Jiangsu, 215008, PR China
通讯机构：
[Che, YJ ] N;[Que, M ] H;Hunan Univ Tradit Chinese Med, Brain Hosp Hunan Prov, Dept Orthopaed Med Ctr, Clin Med Coll, Changsha 410007, Hunan, Peoples R China.;Nanjing Med Univ, Affiliated Suzhou Hosp, Orthoped & Sports Med Ctr, 242 Guangji Rd, Suzhou 215008, Jiangsu, Peoples R China.
摘要：
Purpose To perform therapeutic assessment of tranexamic acid on functional recovery after rotator cuff repair surgery in terms of early and mid-term follow up.
To perform therapeutic assessment of tranexamic acid on functional recovery after rotator cuff repair surgery in terms of early and mid-term follow up.
Methods From December 2021 to April 2023, a total of 40 patients with rotator cuff injury were enrolled and randomly assigned to two groups with equal number of patients, and all patients received shoulder arthroscopic surgery before receiving either tranexamic acid or normal saline managements. Patients in the experimental group, group A, treated with 2g tranexamic acid (diluted with normal saline to 20ml) via intra-articular injection, while patients in the control group (group B) received 20ml normal saline management. The whole process was conducted in accordance with randomized double-blind controlled trials. Clinical outcomes were assessed preoperatively and postoperatively via American Shoulder and Elbow Surgeons (ASES) score, a UCLA shoulder rating, a CONSTANT score, and visual analog scale (VAS). Early and mid-term follow-up were performed at 1 week, 1 month, 3 months, and 6 months after surgery.
From December 2021 to April 2023, a total of 40 patients with rotator cuff injury were enrolled and randomly assigned to two groups with equal number of patients, and all patients received shoulder arthroscopic surgery before receiving either tranexamic acid or normal saline managements. Patients in the experimental group, group A, treated with 2g tranexamic acid (diluted with normal saline to 20ml) via intra-articular injection, while patients in the control group (group B) received 20ml normal saline management. The whole process was conducted in accordance with randomized double-blind controlled trials. Clinical outcomes were assessed preoperatively and postoperatively via American Shoulder and Elbow Surgeons (ASES) score, a UCLA shoulder rating, a CONSTANT score, and visual analog scale (VAS). Early and mid-term follow-up were performed at 1 week, 1 month, 3 months, and 6 months after surgery.
Results The ASES score and CONSTANT score at 1 month, 3 months and 6 months after operation in the tranexamic acid group were higher than those in the normal saline group (p < 0.05). Meanwhile, the UCLA score at 3 months and 6 months after operation in the tranexamic acid group was higher than that in the normal saline group (p < 0.05). In addition, the muscle strength score and external rotation value at 6 months after operation in the tranexamic acid group and normal saline group were higher than those in the normal saline group (p < 0.05). There was no significant difference in the VAS score between the two groups at each observation cut-off point (p > 0.05).
The ASES score and CONSTANT score at 1 month, 3 months and 6 months after operation in the tranexamic acid group were higher than those in the normal saline group (p < 0.05). Meanwhile, the UCLA score at 3 months and 6 months after operation in the tranexamic acid group was higher than that in the normal saline group (p < 0.05). In addition, the muscle strength score and external rotation value at 6 months after operation in the tranexamic acid group and normal saline group were higher than those in the normal saline group (p < 0.05). There was no significant difference in the VAS score between the two groups at each observation cut-off point (p > 0.05).
Conclusions Injection of tranexamic acid after rotator cuff repair surgery plays an positive role on the recovery of patients muscle strength and tone as well as shoulder flexibility. Therapeutic assessment demonstrates the favorable clinic efficacy either early or mid-term follow-up.
Injection of tranexamic acid after rotator cuff repair surgery plays an positive role on the recovery of patients muscle strength and tone as well as shoulder flexibility. Therapeutic assessment demonstrates the favorable clinic efficacy either early or mid-term follow-up.
作者机构：
[Tang, Jiayu; Peng, Gang; Luo, Yiyi; Liang, Jiahua; Song, Xuwei] The School of Clinical Medicine, Hunan University of Chinese Medicine, No. 300, Bachelor Road, Hanpu Science and Education Park, Yuelu District, Changsha, Hunan Province, 410208, China;[Tang, Jiayu] Department of Neurology, Brain Hospital of Hunan Province, 427 Furong Middle Road, Changsha, 410007, Hunan, China
通讯机构：
[Tang, JY ] B;The School of Clinical Medicine, Hunan University of Chinese Medicine, No. 300, Bachelor Road, Hanpu Science and Education Park, Yuelu District, Changsha, Hunan Province, 410208, China<&wdkj&>Department of Neurology, Brain Hospital of Hunan Province, 427 Furong Middle Road, Changsha, 410007, Hunan, China
关键词：
Case report;Myelin-oligodendrocyte glycoprotein antibody-associated disease;Paraneoplastic syndrome;Rectal cancer
摘要：
Background Myelin-oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a rare autoimmune disease characterized primarily by central nervous system demyelination. We report a rare case of MOGAD coexisting with rectal adenocarcinoma.
Myelin-oligodendrocyte glycoprotein antibody-associated disease (MOGAD) is a rare autoimmune disease characterized primarily by central nervous system demyelination. We report a rare case of MOGAD coexisting with rectal adenocarcinoma.
Case report A 59-year-old female presented with fever and bilateral lower limb weakness. MRI of the brain revealed abnormal signals in multiple regions of the cerebrum, brainstem, and spinal cord. Both serum and cerebrospinal fluid tested positive for MOG antibodies. The symptoms improved after steroid therapy. During hospitalization, colonoscopy and pathological examination revealed rectal cancer, which was subsequently treated surgically. After six months of follow-up, neither the tumor nor MOGAD recurred.
A 59-year-old female presented with fever and bilateral lower limb weakness. MRI of the brain revealed abnormal signals in multiple regions of the cerebrum, brainstem, and spinal cord. Both serum and cerebrospinal fluid tested positive for MOG antibodies. The symptoms improved after steroid therapy. During hospitalization, colonoscopy and pathological examination revealed rectal cancer, which was subsequently treated surgically. After six months of follow-up, neither the tumor nor MOGAD recurred.
Conclusion Paraneoplastic etiologies may also contribute to the development of MOGAD. To date, no cases of MOGAD associated with rectal cancer have been reported. It remains uncertain whether paraneoplastic neurologic syndrome (PNS) is involved in this patient.
Paraneoplastic etiologies may also contribute to the development of MOGAD. To date, no cases of MOGAD associated with rectal cancer have been reported. It remains uncertain whether paraneoplastic neurologic syndrome (PNS) is involved in this patient.
关键词：
alcohol;case report;e-cigarettes;phencyclidine use disorder;polydrug use;primidone;tiletamine;withdrawal
摘要：
BACKGROUND AND OBJECTIVES: Polydrug use has caused serious harm to public health, especially involving novel psychoactive substances. Tiletamine, an N-methyl-D-aspartate receptor (NMDAR) antagonist commonly used as a veterinary anesthetic, has recently emerged in China as an additive in e-cigarettes. However, the long-term impacts of tiletamine and its combined use with other substances remain poorly understood. This case report aims to provide further insight into the clinical manifestations and treatment of tiletamine abuse, particularly focusing on the tremors induced by polydrug use. CASE PRESENTATION: The patient had five years of intermittent alcohol use and five months of etomidate abuse. After combining tiletamine for two months, he was repeatedly hospitalized due to coarse tremors, poor sleep and appetite. Based on his substance use pattern and related outcomes, he was diagnosed with phencyclidine use disorder. Initially, intravenous diazepam (20 mg/day) effectively alleviated the tremors. During the second hospitalization, the same dose took longer to take effect, and by the third hospitalization, the dose was increased to 30 mg/day without reducing the tremors. Therefore, primidone was added and gradually titrated to 50 mg/day. The patient's tremors began to improve by the eighth day and significantly diminished by the tenth day. As we gradually replaced diazepam with lorazepam, the patient insisted on discharge. CONCLUSIONS: Polydrug users, particularly those using NMDAR antagonists and gamma-aminobutyric acid type A receptor (GABA-AR) agonists, may be at increased risk of developing tiletamine dependence, with more severe consequences due to cross-addiction. The combination of alcohol and tiletamine could exacerbate neuroexcitotoxicity during withdrawal, potentially contributing to severe tremors. The successful management of tremors with a combination of neuroinhibitory therapies suggested an effective strategy for complex cases. Further studies are needed to better understand the long-term impacts and risks of tiletamine dependence.
通讯机构：
[Zhang, W ] B;Brain Hosp Hunan Prov, Peoples Hosp Hunan Prov 2, Dept Radiol, Changsha 410021, Peoples R China.
关键词：
Glymphatic system;MRI;High-grade glioma;DTI-ALPS;Perivascular spaces;Central nervous system
摘要：
OBJECTIVES: This study seeks to determine if patients with high-grade glioma (HGG) demonstrate glymphatic system (GS) impairments using Diffusion Tensor Imaging Along Perivascular Spaces (DTI-ALPS). Additionally, it aims to examine the factors affecting GS performance and their implications for HGG prognosis. METHODS: The study enrolled fifty HGG patients alongside fifty age- and sex-matched healthy individuals. Each participant underwent diffusion tensor imaging with a Philips 3.0T MRI scanner to assess and compute the ALPS index within perivascular spaces. Variables such as gender, grade, location, volume, peritumoral edema volume, mass-edema index (peritumoral edema volume/tumor volume) and ALPS index were recorded. The Student's t-test and rank sum test compared the ALPS indices between HGG patients and healthy controls to evaluate hemispheric differences. Linear and multivariate Cox regression analyses were utilized to discern factors influencing the ALPS index and to establish independent prognostic markers for HGG, respectively. RESULTS: The ALPS indices in both hemispheres were significantly lower in HGG patients, with the ipsilateral hemisphere exhibiting further reduced levels than the contralateral (P < 0.001). In comparisons involving tumor and edema volumes, no significant variations were observed between the hemispheres within HGG patients harboring larger tumors (P = 0.079) or lesser edema volumes (P = 0.24). A decrease in postoperative ALPS indices compared to preoperative figures was noted (P < 0.001). Univariate linear regression indicated a negative relationship between the ipsilateral ALPS index and peritumoral edema volume (P = 0.0392). Kaplan-Meier analysis demonstrated shorter survival times in patients with lower ALPS indices. Moreover, multivariate Cox regression highlighted tumor grade (HR = 1.548, P = 0.023) and ipsilateral ALPS index (HR = 0.040, P = 0.003) as crucial prognostic indicators. CONCLUSION: In patients with HGG, there is impaired GS function in both hemispheres of the brain. Additionally, the impaired GS function in the tumor-side hemisphere is associated with tumor-associated edema. Following surgery, further damage to GS function is observed in both hemispheres of the brain in HGG patients. Poor GS function in the tumor-side hemisphere is correlated with a worse prognosis in HGG patients.
摘要：
目的:利用网络药理学方法和实验验证分析脊痛消胶囊治疗腰椎间盘突出症(lumbar disc herniation,LDH)的作用机制.方法:从中药系统药理学(Traditional Chinese Medicine Systems Pharmacology,TCMSP)、中药分子机理的生物信息学分析工具(Bioinformatics Analysis Tool for Molecular Mechanism of Traditional Chinese Medicine,BATMAN-TCM)、中医药资料@Taiwan和Swiss数据库中检索并筛选脊痛消胶囊的有效成分及其作用靶点,并使用GeneCards、人类孟德尔遗传(Online Mendelian Inher-itance in Man,OMIM)和DisGeNET数据库预测LDH的疾病靶点,再将活性成分作用靶点与疾病靶点进行映射,得到脊痛消胶囊治疗LDH潜在靶点,继续在STRING数据库中进行蛋白互作分析(protein-protein interaction,PPI),将结果导入Cytoscape软件获取PPI网络图和"药物-活性成分-潜在靶点"网络图.利用clusterProfiler包对潜在靶点进行基因本体(Gene Ontology,GO)功能、京都基因与基因组百科全书(Kyoto Encyclopedia of Genes and Genomes,KEGG)通路富集分析,用Autodock Vina和Discovery Studio软件对活性成分和关键靶点进行分子对接验证.最后以脊痛消胶囊为干预因素,在LDH模型大鼠进行实验验证.结果:网络药理学结果显示,共收集到脊痛消胶囊活性成分139 种、靶点479 个,获得LDH靶点590 个,映射得到84 个交集靶点,通过PPI网络筛选得到脊痛消胶囊治疗LDH的关键治疗靶点 10 个:信号转导和转录激活因子 3(signal transducer and activator of transcription 3,STAT3)、转录因子 JUN(transcription factor Jun-1,JUN)、白细胞介素(interleukin,IL)-6、IL-10、丝裂原活化蛋白激酶 1(mitogen-activated protein kinase 1,MAPK1)、FOS蛋白(protein c-fos,FOS)、连环素(catenin beta-1,CTNNB1)、丝裂原活化蛋白激酶14(MAPK14)、蛋白激酶B(protein kinase B,PKB/AKT1)和肿瘤坏死因子(tumor nec-rosis factor,TNF),GO功能富集分析显示交集靶点涉及2 163 种生物学过程、36 种细胞组分和102 种分子功能,KEGG通路富集分析显示,共涉及155 条信号通路,分子对接结果显示核心靶点与成分对接结合良好.实验验证结果显示,脊痛消胶囊可显著降低LDH模型大鼠血清IL-6 和TNF-α水平,提高血清IL-10 水平,降低髓核组织p-JUN/JUN、p-FOS/FOS、p-JNK/JNK和p-p38MAPK/p38MAPK水平.结论:脊痛消胶囊可以通过抑制炎症反应和JNK/MAPK信号通路的激活从而起到保护LDH模型大鼠的作用.
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The precise risk factors and molecular mechanisms underlying CNS tumors remain unverified. Growing evidence suggests that Circular RNAs (circRNAs) have numerous significant biological functions in disease progression. In this review, we provide an overview of the relationship between circRNAs and CNS tumors and discuss the diagnostic and therapeutic potential of circRNAs in CNS tumors. Abstract Background Central nervous system (CNS) tumors originate from the spinal cord or brain. The study showed that even with aggressive treatment, malignant CNS tumors have high mortality rates. However, CNS tumor risk factors and molecular mechanisms have not been verified. Due to the reasons mentioned above, diagnosis and treatment of CNS tumors in clinical practice are currently fraught with difficulties. Circular RNAs (circRNAs), single‐stranded ncRNAs with covalently closed continuous structures, are essential to CNS tumor development. Growing evidence has proved the numeral critical biological functions of circRNAs for disease progression: sponging to miRNAs, regulating gene transcription and splicing, interacting with proteins, encoding proteins/peptides, and expressing in exosomes. Aims This review aims to summarize current progress regarding the molecular mechanism of circRNA in CNS tumors and to explore the possibilities of clinical application based on circRNA in CNS tumors. Methods We have summarized studies of circRNA in CNS tumors in Pubmed. Results This review summarized their connection with CNS tumors and their functions, biogenesis, and biological properties. Furthermore, we introduced current advances in clinical RNA‐related technologies. Then we discussed the diagnostic and therapeutic potential (especially for immunotherapy, chemotherapy, and radiotherapy) of circRNA in CNS tumors in the context of the recent advanced research and application of RNA in clinics. Conclusions CircRNA are increasingly proven to participate in decveloping CNS tumors. An in‐depth study of the causal mechanisms of circRNAs in CNS tomor progression will ultimately advance their implementation in the clinic and developing new strategies for preventing and treating CNS tumors.
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<jats:title>Abstract</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>The comorbidity between diabetes mellitus and depression was revealed, and diabetes mellitus increased the prevalence of depressive disorder, which ranked 13th in the leading causes of disability‐adjusted life‐years. Insulin resistance, which is common in diabetes mellitus, has increased the risk of depressive symptoms in both humans and animals. However, the mechanisms behind the comorbidity are multi‐factorial and complicated. There is still no causal chain to explain the comorbidity exactly. Moreover, Selective serotonin reuptake inhibitors, insulin and metformin, which are recommended for treating diabetes mellitus‐induced depression, were found to be a risk factor in some complications of diabetes.</jats:p></jats:sec><jats:sec><jats:title>Aims</jats:title><jats:p>Given these problems, many researchers made remarkable efforts to analyze diabetes complicating depression from different aspects, including insulin resistance, stress and Hypothalamic–Pituitary–Adrenal axis, neurological system, oxidative stress, and inflammation. Drug therapy, such as Hydrogen Sulfide, Cannabidiol, Ascorbic Acid and Hesperidin, are conducive to alleviating diabetes mellitus and depression. Here, we reviewed the exact pathophysiology underlying the comorbidity between depressive disorder and diabetes mellitus and drug therapy.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>The review refers to the available literature in PubMed and Web of Science, searching critical terms related to diabetes mellitus, depression and drug therapy.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>In this review, we found that brain structure and function, neurogenesis, brain‐derived neurotrophic factor and glucose and lipid metabolism were involved in the pathophysiology of the comorbidity. Obesity might lead to diabetes mellitus and depression through reduced adiponectin and increased leptin and resistin. In addition, drug therapy displayed in this review could expand the region of potential therapy.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>The review summarizes the mechanisms underlying the comorbidity. It also overviews drug therapy with anti‐diabetic and anti‐depressant effects.</jats:p></jats:sec>
