15 Neurological Disorder

15 Neurological Disorder

2015247 Effects of low dose minocycline on the expression of RGMa in a rat model of middle cerebral artery occlusion and reperfusion.TAO Tao（陶涛），et al.Dept Neurol，1st Affil Hosp，Chongqing Med Univ，Chongqing 400016.Chin J Nerv Ment Dis 2015；41（3）：141-144.

Objective To explore the effects of low dose intravenous minocycline on neurological function and the expression of RGMa in rats after focal cerebral ischemia reperfusion.Methods Fifty-five adult male Sprague-Dawley rats were randomly divided into sham-operated group，cerebral ischemia/reperfusion（I/R）group and minocycline-treated group.The cerebral ischemia/reperfusion model was established by 2 h of middle cerebral artery occlusion.2 weeks after ischemia reperfusion，the expression levels of RGMa and growth associated protein 43（GAP-43）were analyzed by using immunohistochemistry and Western blot，respectively.Neurological functional recovery was evaluated using both the modified neurological severity score（mNSS）and staircase test at 2，7，14 and 28 d after ischemia reperfusion.Results Minocycline at a dose of 3 mg/kg via the caudal vein significantly reduced the expression of RGMa protein（0.53± 0.08 vs.1.17±0.15，P＜0.05）and enhanced the expression of GAP-43 protein（0.94±0.10 vs.0.57± 0.09，P＜0.05）in ischemic cortex 2 weeks after ischemia reperfusion.Moreover，minocycline could reduce mNSS and improve forelimb motor function when compared to the I/R group（P＜0.05）.Conclusion Low dose intravenous minocycline（3 mg/kg）can improve neurological functional recovery in a rat model of focal cerebral ischemia reperfusion and the mechanism may be related to the down-regulation of RGMa expression and up-regulation of GAP-43 expression.

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2015248 Effect of intensive blood pressure reduction on peri-hematomal secondary neuronal injury and prognosis in patients with intracerebral hemorrhage.ZHANG Hong（张红），et al.Affil Hosp，Nanjing Med Univ，Nanjing 210006.Chin J Nerv Ment Dis 2015；41（3）：129-134.

Objective To study the influence of early intensive blood pressure（BP）lowering treatment on peri-hematomal secondary neuronal injury and prognosis after acute intracerebral hemorrhage.Methods 36 consecutive patients within 6 h of intracerebral hemorrhage onset were randomly assigned to intensive BP lowering group and guideline BP lowering group.All patients underwent MR spectroscopy at 72 h and were followed up 90 days.N A-cetyl Aspartate/Creatine（NAA/Cr）and lactic acid wave around peri-hematomal at 72 h，neurologic function at early stage，and death and/or disability at 90 d were compared between these two groups.Results Spectrum lines were obtained from thirty-one patients：14 from intensive BP lowing group and 17 from guideline BP lowering group.There was no significant difference in the percentage declines of NAA/Cr at 72 h between the two groups（13.3% ±4.2%vs.11.9% ±2.8%，P= 0.308）.There were no statistical differences either in neurologic function at 7 d or in death and/or di sability at90 d（P＞0.05）.Conclusion Early intensive BP-lowering treatment had no role on peri-hematomal secondary neuronal injury and prognosis after acute intracerebral hemorrhage.Further high-quality and large-scale randomised controlled trial are necessary to verify this result.

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2015249 Correlation between cognitive disorder after acute cerebral infarction with serum uric acid by multivariate analysis.HE Yitao（何奕涛），et al.Dept Neurol，Shenzhen People's Hosp，Shenzhen 518020. Chin J Nerv Ment Dis 2015；41（3）：135-140.

Objective To evaluate the correlation between serum uric acid with cognitive disorder after acute cerebral infarction by prospective study.Methods Four hundred consecutively enrolled patients of acute cerebral infarction were divided into no cognitive impairment group and cognitive impairment group according to the assess of Montreal Cognitive Assessment（MoCA）.Univariate analyses were conducted in the potential risk factors of cognitive impairment including age，sex，smoking，alcohol，hypertension，diabetes，dyslipidemia，level of education，infarction in key parts，atrial fibrillation，serum uric acid，blood homocysteine between two groups.The statistically significant indicators in univariate analyses were used as independent variables and the scores of Mo-CA were used as the dependent variable to conduct multiple linear regression analysis.The assessment on the risk of cognitive impairment after cerebral infarction were conducted according to serum uric acid，sex，age and TOAST classification further.Results Serum uric acid was independent risk factors of cognitive disorder after acute cerebral infarction.The risk of cognitive disorder after acute cerebral infarction was significantly increased in patients with high level of serum uric acid than with normal level and the relative risk was 1.35，95%CI （1.098，1.660）.Especially for the young，male or patients with cerebral infarction in classification of small artery occlusion，the risk increased further，and the relative risk was 1.513，95%CI（1.092，2.096）1.412，95%CI（1.125，1.771）and 1.464，95%CI（1.128，1.900）respectively.Conclusion Exaltation of serum uric acid was independent risk factor of cognitive disorder after acute cerebral infarction.The risk of cognitive disorder after acute cerebral infarction was significantly increased in patients with high level of serum uric acid than with normal level，and especially for the young，male and patients with cerebral infarction in classification of small artery occlusion，the risk increased further.

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2015250 Characteristics of UGT1A4 gene distribution and relationship between its polymorphism and serum concentration of lamotrigine in northern Chinese Han population with epilepsy.YANG Liya（杨丽亚），et al.Dept Neurol，China-Japan Union Hosp，Jilin Univ，Changchun 130033.Chin J Neurol 2015；48（3）：180-184.

ObjectiveToinvestigatethecharacteristicsof UGT1A4 70C＞A（P24T）and UGT1A4 142T＞G （L48V）gene distribution and the relationship between their mutation frequency and the serum concentration of lamotrigine in northern Chinese Han population with epilepsy.Methods A total of 106 epileptic patients who took lamotrigine monotherapy from the First Hospital and the China-Japan Union Hospital of Jilin University between June 2011 and September 2012 were recruited. Liquid chromatography-tandem mass spectrometry was used to measure the serum concentration of lamotrigine. The genotypes of UGT1A4P24T and UGT1A4L48V in all the patients were determined by direct sequencing，and compared with correlative researches of the rest of the population.Results The genotype of UGT1A4 70C＞A of the 106 epilepsy patients was UGT1A4 70CC without mutations.The frequencies of TT，TG and GG genotypes were 77.36%，20.75%and 1.89%，respectively.The distribution characteristics of UGT1A4 142T＞G gene polymorphism showed no statistically significant difference compared with other Asian populations（Japanese，Korean；P＞0.05），but with statistically significant difference compared with the whites（Jordanian，Spaniard，etc；P＜0.05）.According to the genotypes of UGT1A4，the patients were divided into two groups，group A（142TG+142GG）and group B（142TT）.The standardized serum concentration of lamotrigine of group B［（4.503±1.470）μg/ml］was much higher than that of group A［（2.325±0.599）μg/ml；Z=-6.357，P＜0.01］ .The standardized serum concentration oflamotrigine in two patients with UGT1A4 127delA genotype was extremely high，one of whom stopped using lamotrigine（10.15 μg/ml）because of skin rashes. Conclusion UGT1A4 gene has polymorphisms in northern Chinese Han population with epilepsy.UGT1A4 142T＞G and 127delA have certain effect on the serum concentration of lamotrigine.The standardized concentrations of lamotrigine in patients of genotypes 142TT，127delA are much higher，which might contribute to inter-individual variability in lamotrigine disposition.

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2015251 Regulatory mechanisms of interleukin-1β on the cyclooxygenase-2 system expression of human neuroglioma cells.YANG Yunxue（杨允学），et al. Dept Neurosurg，Rizhao Municipal People's Hosp，Jining Med Coll，Rizhao 276826.Natl Med J China 2015；95 （9）：697-702.

Objective To explore the molecular mechanisms by which interleukin-1β（IL-1β）regulates the expression of cytosolic phospholipase A2（cPLA2）and cyclooxygenase-2（COX-2）in human neuroglioma cell.Methods H4 neuroglioma cells were treated with IL-1β（2.5 μg/L）for different timepoints up to 72 h.For MAPK study，cells were incubated for 1 h with MAPK inhibitors，SB203580 and PD98059 and subsequently stimulated with IL-1β（1 μg/L）for 24 h.Northern and Western blot were used to determine the protein expressions of cPLA2and COX-2 respectively.And the content of PGE2in supernatant was determined by enzyme-linked immunosorbent assay（ELISA）.Results A dose of 2.5 μg/L IL-1β induced the protein expressions of cPLA2and COX-2 and a subsequent release of PGE2in a time-dependent manner.And the expressions of cPLA2and COX-2 peaked at 24 h after stimulation（P＜0.05）.The expression of PGE2increased 250 folds after a 72 h culture.Both SB203580 and PD980059 inhibitors reduced IL-1β-induced PGE2production while SB203580 alone reduced the expressions of both cPLA2and COX-2.Conclusion IL-1β induces the expressions of cPLA2and COX-2 and affects COX-2 at the post-translational level by modulating PGE2production through the signal transduction pathways of p38 and p42/44 MAPKs.

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2015252 Electro-clinical features of inferior frontal gyrus and frontal opercular seizures.WANG Haixiang（王海洋），et al.Epilepsy Center，Yuquan Hosp，Tsinghua Univ，Beijing 100040.Chin J Neurol 2015；48 （3）：175-179.

Objective To summarize the clinical features of inferior frontal gyrus and frontal opercular seizures.Methods The clinical presurgical evaluation data of seven patients whose seizures onset zone involved inferior frontal gyrus and frontal opercular were analyzed retrospectively. The data included seizure semiology，scalp and intracerebral video-electroencephalography（EEG），imaging，surgery and follow up results.Results All the patients reported auras，but 5 were non specific auras.Six patients manifested hypermotor seizure and facial changes and facial muscle tonic or asymmetric tonic（rictus）was found in 4 patients.Four patients'MRI showed lesions which indicated focal cortical dysplasia（FCD）.PET images showed hypometabolic changes in the other 3 MRI negative patients.Scalp EEG showed anterior head interictal discharges and lateralization in 5 patients，while ictal EEG showed no lateralization.All the patients underwent a tailored resections.Two patients manifested transcortical motor aphasia and anomic aphasia，which improved 40 or 50 days post-operation.Histology revealed FCD typeⅡin six patients.The preliminary results of seizure follow up were favorable.Conclusion Inferior frontal gyrus and frontal opercular seizures are characterized by non specific auras，facial tonic or asymmetric tonic（rictus）and hypermotor.Autonomic seizures are rare.Scalp EEG shows lateralization，while ictal EEG shows no lateralization.The tailored resections guided by intracerebral EEG has a good outcome.

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