Objective To evaluate the relation of human immunodeficiency virus (HIV)-1 ribonucleic acid (RNA) loads in cerebrospinal fluid with central neurological diseases. Methods The inpatients with HIV-1 infection diagnosed by Public Health Clinical Center of Chengdu between January 1st, 2015 and March 1st, 2018 were retrospectively included. The included patients were divided into central neurological disease group and non-central neurological disease group, and high viral load group and low viral load group. The demographic data, CD4+ T lymphocyte count, routine detection of cerebrospinal fluid, HIV RNA load in cerebrospinal fluid and plasma of patients with and without central neurological diseases were observed and compared.Multiple logistic regression analysis was used to identify risk factors for central neurological diseases. Results A total of 367 patients were included. In the central neurological disease group, 210 cases (57.22%) were complicated with central neurological diseases, and cryptococcus infection was the most. Compared with the non-central neurological disease group, the increase rate of cerebrospinal fluid cell counts, cerebrospinal fluid cell counts, cerebrospinal fluid HIV RNA positivity and cerebrospinal fluid HIV RNA load were higher in the central neurological disease group (P<0.05). Logistic regression analysis showed that HIV RNA load in cerebrospinal fluid≥100 000 copies/mL and CD4+ T lymphocyte count<200 cells/mm3 were risk factors for central neurological diseases. Conclusion Cerebrospinal fluid HIV RNA load≥100 000 copies/mL is an independent risk factor for HIV/AIDS patients with central neurological diseases and clinical treatment should take this factor into consideration to reasonably optimize the selection of antiretroviral therapy.
Central nervous system vascular disease can be combined with a variety of ocular signs, such as orbital pain, flash, visual field defects, vision loss, eye muscle paralysis. Therefore, some patients were first diagnosed in ophthalmology, including aneurysm rupture, arterial dissection, cerebral apoplexy and other critical nervous system diseases that need rapid treatment. If the doctors didn't know enough, the diagnosis and treatment might be delayed. Most of the vascular diseases of the central nervous system related to ophthalmology have clinical manifestations that cannot be explained by ophthalmology. In the face of chronic conjunctivitis, unexplained visual field defect or cranial nerve paralysis with local ineffective treatment, it is necessary to broaden the thinking of differential diagnosis. To understand the characteristics of vascular diseases of the central nervous system that are prone to ocular manifestations can provide references for the clinical diagnosis and treatment of ophthalmology.
Krüppel-like factor 4 (KLF4) is a member of the sample Kruppel transcription factor protein family, is an evolutionary conservative contain zinc finger transcription factors, involved in regulating many cellular processes, such as cell growth, proliferation, differentiation and invasion, KLF4 expression in a variety of tissues and cells in the body, has widely in many physiological and pathological conditions. Many studies have shown that KLF4 is involved in neurobiological processes such as neuroinflammation, oxidative stress, apoptosis and axon regeneration, and is closely related to a variety of nervous system diseases such as epilepsy, stroke, and Alzheimer’s disease. Now KLF4 in its role in the development of nervous system diseases were reviewed, help to understand the pathogenesis of the disease and clinical treatment for diseases of the nervous system to provide potential targets.
Idiopathic intracranial hypertension (IIH) is a neurological disease, characterized by increased intracranial pressure and papilledema, and often associated with headache, transient loss of vision and pulsatile tinnitus. IIH typically occurs in women of childbearing age. Over 90.0% of patients are with obesity or over weighted. Loss of sensory visual function is the major morbidity associated with IIH and some patients even develop into blindness. Most patients will have varied degrees of visual impairment, or even a few become blind. Frisén grading system, visual field examination and spectral-domain optical coherence tomography can be used to evaluate and monitor the IIH papilledema functionally and morphologically. In recent years, IIH treatment trials in other countries confirmed that, weight loss and low-salt diet combined with acetazolamide treatment has a clear improvement for IIH patients with mild visual impairment. In-depth understanding of the etiology, clinical manifestations, diagnostic criteria and the main treatment has important clinical significance for IIH patients
Objective To investigate the neuropathogenesis of Adieprime;s pupil. Methods The neuroelectrophysiological and neuroimaging data of 42 patients with Adie's pupil (lightnear dissociation and segmental palsy of iris sphincter) were retrospectively analyzed. There were 37 patients with unilateral pupil dilation and 5 patients with bilateral pupil dilation. Cranial magnetic resonance imaging (MRI, 23 patients), Cranial CT scanning (1 patient), nerve conduction velocity (NCV, 14 patients), limb electromyogram (EMG, 5 patients), both lower extremities EMG (9 patients), visual evoked potential (VEP, 18 patients), somatosensory evoked potential (SEP, 11 patients) and electroencephalograms (EEG,5 patients) were performed on some of those patients. Results Central nervous system midline anatomic variations or minor lesions were found in 13/23 cases of MRI/CT imaging. Slowed sensory NCV and multiple sensorymotor peripheral nerve damages were evident in 6/14 cases of the NCV/EMG assay. 5/18 patients showed prolonged latency of VEP P100. 2/11 cases showed peripheral nerve damage in SEP recording, and 1/5 cases showed abnormal EEG. Conclusion Peripheral nerve damage may be an important pathogenesis of Adie's pupil, while the central nervous system damage is also involved in its pathogenesis.
Children’s neurological diseases are complex. Common clinical diseases include autism spectrum disorder, cerebral palsy, attention deficit/hyperactivity disorder, etc. The rehabilitation methods in China mainly start with children’s language and cognition. Animal-assisted intervention is a kind of psychosocial intervention, including animal assisted therapy, animal assisted education or animal assisted activities under specific conditions. With its popularity in the world, this field is rapidly approaching a paradigm shift and can be used as a new supplementary and alternative treatment for children’s neurological diseases. By analyzing the literature on animal-assisted intervention and research on children’s neurological diseases, this paper summarizes the application methods and effects of various types of animals in clinical practice, aiming to provide new intervention methods with scientific theoretical basis for the rehabilitation of children with neurological diseases in China and promote the further development of rehabilitation in China.
This article investigates the role of AMP-activated protein kinase (AMPK) and its downstream signaling targets in mediating cellular processes such as autophagy, apoptosis, and inflammation, offering insights into how acupuncture may treat common central nervous system (CNS) diseases, including ischemic stroke, spinal cord injury, Parkinson disease, and Alzheimer disease. AMPK and its downstream effectors are pivotal in the signaling pathways that underlie the pathophysiology of CNS diseases. These pathways are implicated in a variety of cellular responses that contribute to the progression of neurological disorders. During CNS injury, AMPK can be activated through phosphorylation, triggering the regulation of downstream molecules and exerting protective effects on neuronal function. Acupuncture has been shown to promote neuroprotection and enhance recovery in CNS diseases through multiple mechanisms, one of which involves the activation of AMPK-related signaling pathways. Nevertheless, numerous unresolved challenges remain in this research field.