Epilepsy is one of the common chronic diseases in neurology, and antiepileptic medication is the main treatment method. Studies have shown that epileptic seizures may disrupt the permeability of the blood brain barrier (BBB), and BBB disruption may also lead to epilepsy. This article reviews the mechanism of BBB in the pathogenesis of epilepsy based on relevant research progress, elucidates the relationship between BBB and epilepsy, and proposes possible directions for future research and development of antiepileptic drugs.
Objective To understand pathogenesis, clinical manifestations, diagnosis, treatment, and prognosis of metaplastic breast cancer (MBC), and to provide some new ideas for clinical diagnosis and treatment, and exploration of scientific research for it. Method The relevant literatures of the latest research on MBC were reviewed and analyzed. Results At present, the pathogenesis of the MBC was still uncertain. The incidence of the MBC was lower, and it’s clinical manifestations were not specific. Compared with the invasive breast cancer, the tumor diameter was larger, the growth was faster, the differentiation degree was lower, the risks of the local and distant metastases were higher, while the lymph node metastasis was rare. Because of the clinical manifestation, auxiliary examination, and imaging examinations were lack of specificity, the diagnosis was difficult. Although the preoperative puncture could provide a reliable diagnosis evidence, it was difficult for distinguishing and accurate diagnosis due to it’s more subtypings. Some of the specific molecular targets could provide a help for it. At present, the modified radical mastectomy was often performed, the axillary lymph node metastasis was relatively rare in the MBC, so the sentinel lymph node biopsy was more important in the treatment of the MBC. The therapeutic effect was limited by the endocrine therapy, targeted therapy, or neoadjuvant chemotherapy and was poor by the systemic chemotherapy. Although the radiotherapy and chemotherapy could improve the overall survival and prolong the disease-free survival and control the local recurrence, the difference of it’s therapeutic effect was great due to the complex MBC typing. Conclusions MBC is a highly malignant and strongly invasive tumor, and it has more subtypings. Clinical manifestation and preoperative examination are lack of specificity, hence it is easy for misdiagnosis or missed diagnosis. Unified treatment guideline is lack of, prognosis is poor. So, it needs to explore some new treatment methods and formulate standardized treatment guidelines in order to achieve a better therapeutic effect.
Progressive ischemic stroke is one of the major diseases damaging the health of Chinese people. Its pathogenesis is complex and there are many influencing factors, but the treatment methods are limited. In recent years, the rapid development of neuroimaging and the results of various clinical trials have been reported in succession, which have made new progress in the clinical diagnosis and treatment of progressive ischemic stroke. This paper summarizes the progress of progressive ischemic stroke, introduces its pathogenesis (including increased intracranial pressure and reduced perfusion pressure, thrombosis progression, hemorrhagic transformation, cerebral edema, and inflammatory response), influencing factors, predictive indicators (including image indicators, biochemical indicators, and molecular biology indicators) and treatment (including admission to “stroke unit”, intravascular treatment, platelet aggregation inhibition treatment, anticoagulation treatment, and general treatment), to provide references for preventing the occurrence and development of progressive ischemic stroke, assessing the condition, guiding treatment and improving the prognosis.
Chronic obstructive pulmonary disease is often accompanied by anxiety or depression. The exacerbation of anxiety and depression can lead to the deterioration of chronic obstructive pulmonary disease, reduce patients’ quality of life, worsen poor prognosis, and increase the risk of death. Anxiety and depression are one of the important causes of death in patients with chronic obstructive pulmonary disease, but the complexity of their risk factors and pathogenesis often lead to clinicians being unable to make accurate diagnosis and treatment in a timely manner. Based on existing research, this article elaborates on the risk factors and pathogenesis of chronic obstructive pulmonary disease complicated with anxiety or depression, aiming to improve the diagnosis and treatment ability of clinical physicians for chronic obstructive pulmonary disease complicated with anxiety or depression, achieve timely diagnosis and treatment, improve patients’ prognosis, and improve quality of life.
ObjectiveTo review the research progress on etiology and pathogenesis of spina bifida. MethodsBy consulting relevant domestic and foreign research literature on spina bifida, the classification, epidemic trend, pathogenesis, etiology, prevention and treatment of it were analyzed and summarized. ResultsSpina bifida, a common phenotype of neural tube defects, is classified based on the degree and pattern of malformation associated with neuroectodermal involvement and is due to the disturbance of neural tube closure 28 days before embryonic development. The prevalence of spina bifida varies greatly among different ethnic groups and regions, and its etiology is complex. Currently, some spina bifida patients can be prevented by folic acid supplements, and with the improvement of treatment technology, the short-term and long-term survival rate of children with spina bifida has improved. ConclusionThe research on the pathogenesis of spina bifida will be based on the refined individual information on exposure, genetics, and complex phenotype, and will provide a theoretical basis for improving prevention and treatment strategies through multidisciplinary cooperation.
With the tremendous progress in fundus imaging and histopathology over the past decade, the understanding of age-related macular degeneration (AMD) has taken a qualitative leap. AMD is defined as a progressive neurodegenerative disease of photoreceptors and retinal pigment epithelium (RPE) characterized by extracellular deposits under RPE and the retina, including drusen, basal laminar and linear deposits, and subretinal drusenoid deposits, that can evolve to atrophy of the retina, RPE and choroid and neovascularization in the choroid and/or retina. It is the leading cause of blindness and visual impairment in older populations, despite recent advances in treatments. AMD is a multifactorial disease with genetic and environmental factors including advanced age, smoking, high-fat diet, and cardiovascular disorder to enhance the disease susceptibility. The physiopathologic mechanism includes inflammatory processes (complement pathway dysregulation, inflammasome activation), intrinsic (e.g., photo-oxidation) and extrinsic oxidative insult to the retina, age-related metabolic impairment (mitochondrial, autophagic and endoplasmic reticulum stress). Autophagy dysfunction and local inflammation in aged RPE specially result in the extracellular deposits, cell death and AMD. Further investigation of the pathogenesis of AMD will provide with new therapeutic targets and strategy for prevention and treatment of the disease in the early stages.
Vaccine-associated uveitis (VAU) usually refers to a rare adverse reaction that occurs after vaccination. The clinical manifestations of VAU are most often anterior with mild symptoms and responded promptly to topical corticosteroids. However, more severe forms of posterior and panuveitis may also occur, such as multiple evanescent white dot syndrome, Vogt-Koyanagi-Harada syndrome, and acute posterior multifocal placoid pigment epitheliopathy. The pathogenesis of VAU is still unclear. Currently, it mainly includes vaccine Shoenfeld syndrome, type Ⅲ hypersensitivity reaction caused by immune complex deposition, direct infection with live attenuated vaccine, and molecular mimicry theory. VAU is self-limiting, and most patients heal without treatment. In the future, it is recommended to ask all patients with uveitis about their recent vaccination history in the clinic. For patients with inactivated vaccine or recombinant/subunit vaccination history, the possibility of developing Shoenfeld syndrome should be considered, and the history, signs and symptoms related to autoimmune diseases should be carefully looked for.