15 Neurological Disorder

15 Neurological Disorder

2015117 Clinical，electrophysiological and skin biopsy studies of peripheral neuropathy w ith sm all fibers involvem ent：a report of 34 cases.SUN Bo（孫博），et al.Dept Neurol，Chinese PLA General Hosp，Beijing 100853.Natl Med JChina 2014；94（43）：3397-3401.

Ob jectiveTo explore the relationship between clinical features，electrophysiology and intraepidermal nerve fiber density（IENFD）in peripheral neuropathy with small fibers involvement and determine the diagnostic value of 13-item small-fiber neuropathy and symptoms inventory questionnaire（SFN-SIQ）and neuropathy symptom score［lower limb］（NSS［LL］）in small fiber neuropathy（SFN）.M ethodsA total of 34 consecutive patients with peripheral neuropathy with symptoms of small fiberswere enrolled and divided into two groups of small fiber injury and small and large fiber injury.SFN-SIQ，NSS［LL］and neuropathy disability score［lower limb］（NDS［LL］）were administered.Nerve conduction studies and skin biopsy were conducted in unilateral lower limb.The relationship between IENFD and these scales was assessed by partial correlation.Receiver operating characteristic analysis was applied for evaluating the diagnostic value of SFN-SIQ and NSS［LL］in small fiber injury.Independent sample t test was used to compare various parameters of two groups.And similar statistical method was used for IENFD abnormal and normal groups to detect the clinicoelectrophysiological differences.ResultsAccording to the international normative reference of IENFD，13 patients could be diagnosed with peripheral neuropathy with small fibers involvement.IENFD wasmoderately correlated with SFN-SIQ（r=0.437，P=0.012）and marginally correlated with NSS［LL］（r=0.334，P=0.062）.The diagnostic value of SFNSIQ and NSS［LL］was moderate for small fiber injury（Az=0.753，P=0.012 for SFN-SIQ，Az=0.712，P=0.040 for NSS［LL］）andthe best diagnostic indicator of each scale was 6.The value of NDS［LL］was apparently elevated in small and large fiber injury group versus small fiber injury group（t=-5.605，P＜0.001）.The IENFD abnormal group had a higher NSS［LL］value than that of the IENFD normal group（t=-2.047，P= 0.049）.No differences of electrophysiological parameters existed between IENFD abnormal and normal groups.ConclusionChinese normative reference of IENFD should be formulated for the diagnosis of small fiber neuropathy.SFN-SIQ and NSS［LL］may screen for small fiber neuropathy and both are convenient during patient follow-ups.Large sample studies are warranted to further evaluate the clinical values of SFN-SIQ and NSS［LL］.

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2015118 Relation between SOX2 and m iR-200b and their in fluences in clinical pathology and p rognosis in gliomas.CHAIChang（柴昌），et al.Dept Neurosurg，1st Affil Hosp，Zhengzhou Univ，Zhengzhou 450052. Chin JNeuromed 2014；13（10）：984-989.

Ob jectiveTo analyze the relation between SOX2 and miR-200b and their influences on clinical pathology and prognosis of gliomaspatients.MethodsOne hundred and twenty-three human glioma specimens，collected in our hospital from January 2001 to December 2005 and conformed by pathology，were chosen in our study；other 23 healthy brain tissues collected during intracranial decompression were used as controls.Real-time quantitative PCR（qRT-PCR）was employed to detect the miR200b expression；immunohistochemistry was used to detect the SOX2 expression.Relations between SOX2 and miR-200b in different grades of gliomas were analyzed；the correlations of clinical parameters with SOX2 and miR-200b expressions were analyzed；Cox proportional hazards regression model was used to analyze the influences of SOX2 and miR-200b expressions in survival times of the patients，and the survival curves of patients with different SOX2 and miR-200b expressions were compared.ResultsThe higher the pathology grade，the lower the miR-200b expression；gliomas of gradeⅢandⅣhaving SOX2 positive expression enjoyed significantly lowermiR-200b expression than those having SOX2 negative expression（P＜0.05）.The SOX2 and miR-200b expressions in gliomas of different pathology grades were significantly different（P＜0.05）.Cox proportional hazards regressionmodel indicated thatmiR-200b and SOX2 were the independent risk factors for prognosis of gliomas.In patients of gradeⅢand gradeⅣgliomas，significantly higher 5 years survival rate in patients with high miR200b expression was noted as compared with low miR200b expression（P＜0.05），and significantly higher 5 years survival rate in patients with negative SOX2 expression was noted as compared with those with positive SOX2 expression（P＜0.05）.ConclusionThe miR-200b and SOX2 expressions show difference only in poor differentiated tissues of gradeⅢandⅣgliomas；the two have influence in the survival time.

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2015119 Effect of Kv channel-interacting p rotein 1 over-exp ression on excitability of p rim ary cu ltured hippocampal neurons.LIMeng（李萌），et al.Instit Neurosci，2nd Affil Hosp，Guangzhou Med Univ，Guangzhou 510260.Chin J Neuromed 2014；13（10）：990-993.

ObjectiveTo investigate the effect of Kv channelinteracting protein 1（KCNIP1）over-expression on K+currents and neuronal excitability in priamary cultured hippocampal neurons.M ethodsEnhanced green fluorescent protein plasmids carried KCNIP1（pEGFP-KCNIP1）were established；empty pEGFP vectors were used as controls；primary cultured hippocampal neurons were transfected with pEGFP-KCNIP1 and control vectors. Whole-cell patch clamp technique was used for electrophysiological recording.ResultsThe cultured neurons transfected with pEGFP-KCNIP1 led to KCNIP1 over-expression.The amplitudes of A-type K+currents in the KCNIP1-overexpress neurons were significantly higher than that in the control group［（0.96±0.17）nA vs.（0.72±0.09）nA，P＜0.05］，while no significant difference was found between the component of steadystate outwards K+currents and controls.Current clamp analysis revealed significantly decreased frequency of evoked discharges and subthreshold membrane potential oscillations，and statistically increased membrane resistance of the hippocampal neurons in the group ofKCNIP1over-expression as compared with those in the controls（P＜0.05）.ConclusionOver-expression of KCNIP1 could inhibit neuronal discharges possibly via its potentiation on A-type K+currents.

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2015120 Values of stereotactic guidance of intraoperative high-field magnetic resonance imaging for multip le intracranial lesions.SUN Xiang（孫祥），et al.Dept Neurosurg，Tianjin Med Univ General Hosp，Tianjin 300052.Natl Med JChina 2014；94（43）：3421-3424.

ObjectiveTo explore the diagnostic and therapeutic values of stereotactic guidance of intraoperative high-field magnetic resonance imaging（iMRI）formultiple intracranial lesions.MethodsWe retrospectively assessed 18 patientswithmultiple intracranial lesions undergoing stereotactic guidance of high-field iMRI between June 2011 and May 2013.The procedures included biopsy of stereotactic guidance（n=6），stereotactic aspiration and drainage for brain abscess（n=4），stereotactic aspiration and intracavitary irradiation with32P for mixed solid and cystic craniopharyngiomas（n=3）and stereotactic hematoma evacuation（n=5）.ResultsFor 6 cases with highfield iMRI stereotactic guidance，the target lesions were precisely predetermined and pathological specimens confirmed by clinical follow-up results.For 12 cases with multiple cystic lesions and multiple intracranial hematoma，aspiration of hematoma and liquidswas satisfactory. And the course of clinical treatment was significantly shortened.And therewas a lower incidence of postoperative complications.ConclusioniMRImay guide precisely stereotactic surgery.And it has important clinical significance for confirming the diagnosis of multiple intracranial lesions and shortening their treatment courses.

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2015121 Association between cerebrovascu lar disease and chronic kidney disease in Chinese cerebral infarction patients.LUO Jingjing（羅晶晶），et al. Dept Neurol，1st Hosp，Peking Univ，Beijing 100034. Chin JNeurol 2014；47（11）：752-757.

Ob jectiveTo investigate the association between kidney function and cerebrovascular disease，and find out the prevalence of chronic kidney disease（CKD）in Chinese cerebral infarction patients.M ethodsClinical data of 419 patientswho underwent intra-and extracranial vessel examination in our department from January 2008 to February 2013 were retrospectively reviewed and analyzed.We evaluated the degree and extentof cerebrovascular stenosis by carotid duplex ultrasound，transcranial Doppler ultrasound，magnetic resonance angiography，computed tomography angiography and digital subtraction angiography，evaluated white matter lesions（WML）by MRI，and measured the kidney function by the adaption ofMDRD（Modification of Diet in Renal Disease）equation.Then we analyzed the association between them in these patients.Resu lts（1）In 419 patients，the prevalence of CKD was 12.4%（52）.The patients included 222 patientswithout cerebrovascular stenosis，63 patients with mild stenosis，63 patients with moderate stenosis，44 patients with severe stenosis and 27 patients with occlusion.CKD（Z=-3.070，P=0.002）and renal function（r=0.194，P＜0.01）were associated with cerebrovascular stenosis.（2）In 419 patients，103 patients had intracranial vascular stenosis，45 patients had extracranial vascular stenosis，and 49 patients had intraand extracranial vascular stenosis.Compared with the patients without stenosis，CKD was associated with intracranial stenosis（χ2=4.784，P=0.032），extracranial stenosis（χ2=8.732，P=0.003），and intra-and extracranial stenosis（χ2=5.308，P=0.021）.（3）In 175 patients，including 82 patients with mild WML，63 patients with moderate WML，and 30 patients with severe WML，the CKD stage was significantly associated with the degree ofWML.（4）In the Logistic regression analysis，CKD was an independent risk factorof cerebrovascular stenosis（OR=0.485，95%CI 0.254-0.927，P= 0.029），and CKD（OR=0.395，95%CI 0.159-0.978）was an independent risk factor of extracranial vascular stenosis，but not an independent risk factor of WML.ConclusionCKD patients suffer more severe cerebrovascular stenosis，and have higher prevalence of extracranial vascular stenosis.The prevalence of CKD in cerebral infraction patients is higher than that in the national epidemiological investigation.

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2015122 Multi-factor analysis of the central nervous system infection after invasive intracranial p ressure m onitoring.LIHaiyan（李海燕），et al.Dept Emerg Med，Guiyang Med Coll Affil Hosp，Guiyang 550004. Chin JNeurol 2014；47（11）：763-766.

Ob jectiveTo investigate the related factors of central nervous system infection in patients who received invasive intracranial pressure monitoring.MethodsThe clinical data of 63 patients who received invasive intracranial pressure monitoring were retrospectively analyzed.Possible related factors including gender，age，disease，Glasgow coma scale score，emergency operation or selective operation，duration of the operation，drainage tube placement site，drainage tube lifetime，sensor insertion site，sensor indwelling duration，electrolytes，glucose and other complications were studied and compared retrospectively between patients with and without central nervous system infection.All data were analyzed with univariate analysis and multivariate Logistic regression analysis to identify the related factors and independent risk factors associated with central nervous system infection.ResultsIn univariate analysis，drainage tube placement site（χ2=12.345，P=0.002），drainage tube lifetime［（2.5±0.9）d and（6.3±5.7）d in patients without and with central nervous system infection，respectively，t=-4.434，P=0.000］，sensor insertion site（χ2=4.701，P=0.030），sensor indwelling duration［（6.5±3.0）d and（8.9±4.6）d in patientswithout and with central nervous system infection，respectively，t=-2.420，P=0.019］and other complications（χ2= 13.086，P=0.000）were the relevant factors of central nervous system infection（P＜0.05）.Inmultivariate Logistic regression analysis，the sensor insertion site（OR= 0.047，P=0.000）and other complications（OR= 10.953，P=0.019）were the independent risk factors for the central nervous system infection.ConclusionThere are a variety of factors related to central nervous system infection in patientswith placementof intracranial pressure monitoring.The sensor insertion site and other complications were the independent risk factors for the central nervous system infection.

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2015123 Analysis of the causes of m icturition anddefecation dysfunction in motor neuron disease patients.ZHAO Lei（趙蕾），et al.Dept Neurol，PUMC& CAMS，Beijing 100730.Chin J Neurol 2014；47（11）：767-771.

ObjectiveTo investigate the clinical features and causes ofmicturition and defecation dysfunction in motor neuron disease（MND）patients.M ethodsThe micturition and defecation function was evaluated by a questionnaire covering storage and voiding of urine and feces respectively in 50 MND patients.The clinical features and external anal sphincter electromyography（EAS-EMG）were analyzed to explore the cause ofmicturition and defecation dysfunction in MND patients.ResultsMicturition and defecation dysfunction was detected in 9 of 50（18.0%）MND patients.The main types ofmicturition and defecation dysfunction were constipation（4/9），urinary frequency，urgency with or without incontinence，fecal urgency（4/9），powerlessness for micturition and defecation（2/9），hesitancy formicturition（1/9）.EASEMG was normal in 9 MND patients accompanied with micturition and defecation dysfunction.ConclusionMND patients accompanied with micturition and defecation dysfunction were not very rare.Constipation，urgency and powerlessnesswere themain types ofmicturition and defecation dysfunction and they were not related to the function of external anal sphincter.Gastrointestinal dysfunction from abnormal autonomic nerve involvement，muscle weakness and the resulted reduced activity，severe upper motor neuron damage and respiratory muscle weaknessmay be themain causes ofmicturition and defecation dysfunction in MND patients.

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2015124 Relationship between reduction of regional cerebral b lood flow in norm al appearing white m atter and the extent of age-related white matter lesions.TANG Jie（唐杰），et al.Dept Neurol，Huashan Hosp，Fudan Univ，Shanghai 200040.Chin J Neurol 2014；47（11）：758-762.

ObjectiveTo explore the relationship between reduction of regional cerebral blood flow in the normal appearing white matter（NAWM）and the extent of age-related white matter lesions（WML）.M ethodsWe used Fazekas scale to divide all participants intofour groups（normal，mild，moderate，severe）according to the extent of the lesions showed on MRI.Regional cerebral blood flow（rCBF）in the area of WML and NAWM was measured by xenon contrast CT examination.ResultsA total of56 caseswere selected.The average rCBF（ml· 100 g-1·min-1）in the lesions（WML）around ventricle，in right centrum ovale and in left centrum ovale was 20.33±2.52，21.27±1.02，21.03±1.83 formild，respectively；16.33±2.03，15.55±1.71，15.91± 0.98 for moderate；14.05±2.63，14.46±2.17，14.23±1.95 for severe.The average rCBF（m l· 100 g-1·min-1）in the NAWM around ventricle，in right centrum ovale and in left centrum ovale respectively was20.79±2.78，22.26±1.9，22.15±2.4 for normal；21.12±2.95，22.17±1.50，22.25±2.13 for mild，18.02±2.41，19.45±1.94，19.62±1.54 for moderate；16.38±3.22，18.18±2.84，16.74±2.97 for severe.The decrease of rCBF in the severe and moderate lesion areas wasmore serious than that in the mild lesion areas and reached statistic significance（P＜0.05）；The decrease of rCBF in the severe andmoderate lesion areas was more serious than that in the area of NAWM in the same grade and reached statistic significance（P＜0.05）.The decrease of rCBF in the area of NAWM around severe and moderate lesion areas was more serious compared with that around mild lesion areas or normal areas（P＜0.05）；But the difference of rCBF in the area of NAWM around mild lesion areas and normal areas did not show any statistic significance.ConclusionChronic ischemiawas found to be existed not only in the lesions（WML）but also in the area of NAWM around the lesions，and was related to the extentof the lesions.Chronic ischemiamay play a key role in themechanism of aged-related WML.

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2015125 Direct econom ic burden of cerebrovascular disease，during 1993-2008 in China.LU Jing（路靜），et al.Public Health Sch，PUMC，Beijing 100730. Chin JEpidemiol2014；35（11）：1263-1266.

ObjectiveTo evaluate the status and trend of direct economic burden on cerebrovascular disease，from 1993 to 2008 in China.M ethodsUsing two-step model to calculate the economic costwith related trend of cerebrovascular disease within the population among those over 30-year-olds，from 1993 to 2008.Data was gathered from the National Health Service Surveys Analysis Reports of 1993，1998，2003 and 2008，including outpatient and inpatient cost.ResultsThere appeared a significant increase on the burden of cerebrovascular diseases in the period of 15 years，with direct economic cost increasing from 8.473 billion to 103.125 billion RMB.In fact，the actual increase was 5.3 times，without the influence of the price.The average annual growth rate was 13.1%，exceeding the rate of total expenditure on health and GDP during the same time span.In addition，the growth rate in 2003-2008 was the fastest，which appeared to be 19.8%.ConclusionBurden that caused by cerebrovascular disease on individuals and the whole society was heavy which warrented further theoratical and practical studies on it.

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2015126 Effect of Salvinorin A on expression of vascular endothelial grow th factor in hippocampus after cerebral ischem ia-reperfusion.WANG Zhenhong（王震虹），et al.Dept Anesthesiol，Renji Hosp，shanghai Jiaotong Univ Med Sch，shanghai200127.Shanghai Med J 2014；37（8）：678-681.

Ob jectiveTo observe the effect and mechanism of Salvinorin A（SA）on the expression of vascular endothelial growth factor（VEGF）in hippocampus after cerebral ischemia-reperfusion（I/R）.MethodsMale Sprague-Dawley（SD）ratsweighing 300-350 gwere divided into 4 group randomly：sham operation group，I/R group，SA group，and Norbin（kappa opioid receptor antagonist）+ SA group.The expression of VEGF protein in hippocampus CA1 and CA3 region wasmeasured by immunohistochemistry 6 h after I/R.The apoptosis was investigated by TdT-mediated dUTP nick end labeling（TUNEL）. Cell necrosiswas identified by pathological test.ResultsThe positive percentages of cell apoptosis and necrosis were significantly higher in I/R group at6 h following ischemia-reperfusion than those in sham operation group， SA group and Norbin+SA group（all P＜0.05）.But the positive percentages of cell apoptosis and necrosis were significantly lower in SA group than those in Norbin+SA group（all P＜0.05）.Upregulation of VEGFwas showedin I/R group as compared with sham operation group，further upregulation in SA group and Norbin+SA group in CA1 and CA3（all P＜0.05）.And the expression of VEGF in SA group were significantly higher than those in Norbin+SA group in CA1 and CA3（both P＜0.05）.ConclusionReperfusion after 10-min total cerebral ischemia may result in apoptosis and necrosis of neurocytes.SA can depress brain tissue damage caused by cerebral ischemia by inducing VEGF expression in CA1 and CA3 of hippocampus.Kappa opioid receptor takes part in protection of SA.

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2015127 A prelim inary study of the effect of m itochond rial autophagy on cognitive function in rats of early interm ittent hypoxia.WANG Ling（王玲），et al.Dept Resp Hebei United Univ Hosp，Tangshan 063000.Chin J Tuberc Respir Dis 2014；37（11）：840-844.

ObjectiveTo explore the effectofmitochondrial autophagy on cognitive function in rats of early intermittent hypoxia by observing hippocampal CA1 pyramidal cell mitochondrial autophagy and the expression of related proteins in a intermittent hypoxia（IH）animal model.MethodsSeventy-two adult male Wistar rats were randomly divided into a control group（UC）and a 5%intermittent hypoxia（IH）group.The compressed air was given to the UC group while rats in 5%IH group suffered from 7-hour IH every day.On 1 d，3 d，5 d，7 d，10 d and 14 d after the completion of themodel，transmission electron microscopy was used to observe rat hippocampal CA1 pyramidal cell mitochondrial ultrastructural changes，and immunohistochemistry assay was used to detect the expression of Beclin-1 and LC3.The Morris water test was performed to detect the learning and memory function in the rats.ResultsCompared with the UC group，the 5%IH group began to show mitochondrial size and shape changes，swelling，reduced matrix density，cristae，mitochondrial vacuolization，and typicalmitochondria autophagosome formation from the 3 d.In the 5%IH group，Beclin-1 and LC3 protein expressions were significantly increased compared with the UC group（P＜0.05）.The expressions of Beclin-1 and LC3 were different among different time points（P＜0.05）；with the extension of time，their expressions firstly increased，peaked at 10 d（P＜0.05），and then decreased at 14 d（P＜0.05）.The level of learning and memory of the rats in the 5%IH group had no obvious changes compared with the UC group on 1 d，3 d，5 d，7 d，and 10 d，but the level started to drop at14 d with a significant difference（P＜0.05）.The level of learning and memory of the rats in the UC group was not different among different time points（P＞0.05）.ConclusionEarly intermittent hypoxia induced hippocampus mitochondrial autophagy and autophagy-related protein expression in rats.Mitochondrial autophagymay reduce the damage to cognitive function of the rats exposed to early intermittent hypoxia.

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2015128 Altered anatom ical asymmetry in children w ith attention deficit/hyperactivity disorder：a pilot op tim ized voxel-based m orphom etric study.CAO Qingjiu（曹慶久），et al.Peking Univ 6th Hosp，Instit Mental Health，Beijing 100191.Natl Med J China 2014；94（43）：3387-3391.

Ob jectiveMounting evidence suggests that attention deficit/hyperactivity disorder（ADHD）is related with abnormal anatomical asymmetry in some brain regions，such as basal ganglia.However，few cross-sectional studies have examined the abnormalities of anatomical asymmetry in whole brain of ADHD.Thus this cross-sectional study was to explore the anatomical asymmetry in whole brain of ADHD with optimized voxel-based morphometry（OVBM）.M ethodsTwenty-five boys with ADHD and 27 age and gender-matched controlswere recruited.All participants were right-handed.The grey matter concentration of each voxel was calculated with OVBM.A statistical evaluation of greymatter asymmetry was then conducted on normalized grey matter images and their flipped counterparts.ResultsOne-sample t-test revealed that the whole-brain anatomical asymmetry pattern was similar in two groups.Through group comparisons，ADHD showed reversed greater asymmetry in left than in right in superior and middle frontal gyri versus controls.ConclusionAnatomical asymmetry of prefrontal cortex is abnormal in children with ADHD.And abnormal anatomical asymmetrymay play an important role inthe pathophysiology of ADHD.

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2015129 Association of chronic kidney disease and cerebral m icrobleeds in patients with ischem ic stroke.PENG Qing（彭清），et al.Dept Neurol，Peking Univ 1st Hosp，Beijing 100034.Chin JNeurol 2014；47（11）：747-751.

ObjectiveTo investigate the association between the presence of cerebralmicrobleeds and chronic kidney disease in patients with ischemic stroke.M ethodsPatients with ischemic stroke within 1-6 months were consecutively recruited.CranialMRIwas taken within twoweeks after recruitment.Cerebralmicrobleeds were assessed using Microbleed Anatomical Rating Scale on gradient echo MRI.Demographics including sex，age and risk factors were obtained.Chronic kidney disease was defined and classified according to National Kidney Fundation-Kidney Disease Outcome Quality Initiative Guideline.Glomerular filtration rate（GFR）was estimated by using the abbreviated Modification of Diet in Renal Disease equation.Resu ltsOf the 636 patients included，mean age was（59.8±10.1）years，435（68.4%）weremale.Sixty-six had decreased estimated GFR（eGFR；＜60 ml·min-1·1.73 m-2）.Two hundred and one（31.6%）patients had cerebralmicrobleeds，which were most commonly located in deep or infratentorial location（133/201，66.2%）.The presence of cerebral microbleedswasmuch higher in patients with decreased eGFR than the others［48.5%（32/66）vs29.6%（169/ 570），χ2=9.709，P=0.002］.Age，history of hypertension and decreased eGFR were associated with the presence of cerebral microbleeds in univariate analysis. In multivariate analysis，decreased eGFR was independently associated with the presence of cerebralmicrobleeds in deep or infratentorial location（OR=1.457，95%CI 1.044-2.034，P=0.027），butnotassociated with the presence of cerebralmicrobleeds in pure lobe.ConclusionImpaired kidney function is associated with the presence of cerebralmicrobleeds in deep or infratentorial regions in patientswith ischemic stroke.

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