Anti-N-methyl-d-aspartate receptor encephalitis in children: Incidence and experience in Hong Kong

Aim

The study aims to analyze the incidence, clinical features, investigation findings and treatment outcomes of anti-N-methyl-d-aspartate receptor encephalitis in children from Hong Kong.

Co‐occurrence of astrocytoma and astroblastoma: Case report and literature review

A 41‐year‐old man presented to us with left arm and leg weakness and mild word finding difficulties. His preoperative magnetic resonance imaging (MRI) demonstrated abnormal T1 and T2 signal changes in the right temporal lobe and basal ganglia, indicative of possible glioma. An awake craniotomy for right temporal lobectomy was performed and the tumor was resected. Full pathologic workup later revealed the patient had two distinct tumors occurring simultaneously, anaplastic astrocytoma and astroblastoma. We review the literature regarding the treatment of anaplastic astrocytoma and astroblastoma and discuss their co‐occurrence.     

What is the role of the cerebellum in the pathophysiology of dystonia?

Journal of Neurology -     

Structurally defined signaling in neuro-glia units in the enteric nervous system

Coordination of gastrointestinal function relies on joint efforts of enteric neurons and glia, whose crosstalk is vital for the integration of their activity. To investigate the signaling mechanisms and to delineate the spatial aspects of enteric neuron-to-glia communication within enteric ganglia we developed a method to stimulate single enteric neurons while monitoring the activity of neighboring enteric glial cells. We combined cytosolic calcium uncaging of individual enteric neurons with calcium imaging of enteric glial cells expressing a genetically encoded calcium indicator and demonstrate that enteric neurons signal to enteric glial cells through pannexins using paracrine purinergic pathways. Sparse labeling of enteric neurons and high-resolution analysis of the structural relation between neuronal cell bodies, varicose release sites and enteric glia uncovered that this form of neuron-to-glia communication is contained between the cell body of an enteric neuron and its surrounding enteric glial cells. Our results reveal the spatial and functional foundation of neuro-glia units as an operational cellular assembly in the enteric nervous system.     

早产儿三元整合式教育方案的构建与实施

目的 建立早产儿三元整合式教育方案,并探讨其培训效果。方法 组建三元整合教育团队,按照早产儿的发育发展特点构建教育课程,搭建教育平台,包括开办家长学校、开展家长微课堂、视频引导、家长床旁照护操作培训等。采用NICU家长满意度调查表调查并比较培训前后家长满意度。结果 培训后早产儿家长的满意度总分为（191.90±0.20）分,培训前满意度总分为（176.00±4.40）分,差异有统计学意义（t=-41.68,P<0.001）;培训前后家长的知识和信息维度、家长参与照护维度、医护人员专业态度维度得分的比较,差异有统计学意义（t₁=-20.83,P₁<0.001;t₂=-27.30,P₂<0.001;t₃=-27.10,P₃<0.001）。结论 早产儿三元整合式教育方案能提升家长的照护知识和参与照护能力,提高家长对医护人员专业态度的满意度。     

Impact of small-for-size liver grafts on medium-term and long-term graft survival in living donor liver transplantation: A meta-analysis

BACKGROUND Small-for-size grafts(SFSGs) in living donor liver transplantation(LDLT) could optimize donor postoperative outcomes and also expand the potential donor pool. Evidence on whether SFSGs would affect medium-term and long-term recipient graft survival is lacking.AIM To evaluate the impact of small-for-size liver grafts on medium-term and longterm graft survival in adult to adult LDLT.METHODS A systematic review and meta-analysis were performed by searching eligible studies published before January 24, 2019 on Pub Med, EMBASE, and Web of Science databases. The primary outcomes were 3-year and 5-year graft survival.Incidence of small-for-size syndrome and short term mortality were also extracted.RESULTS This meta-analysis is reported according to the guidelines of the PRISMA 2009 Statement. Seven retrospective observational studies with a total of 1821 LDLT recipients were included in the meta-analysis. SFSG is associated with significantly poorer medium-term graft survival. The pooled odds ratio for 3-year graft survival was 1.58 [95% confidence interval 1.10-2.29, P = 0.014]. On the other hand, pooled results of the studies showed that SFSG had no significant discriminatory effect on 5-year graft survival with an odds ratio of 1.31(95%confidence interval 0.87-1.97, P = 0.199). Furthermore, incidence of small-for-size syndrome detected in recipients of SFSG ranged from 0-11.4% in the included studies.CONCLUSION SFSG is associated with inferior medium-term but not long-term graft survival.Comparable long-term graft survival based on liver graft size shows that smaller grafts could be accepted for LDLT with appropriate flow modulatory measures.Close follow-up for graft function is warranted within 3 years after liver transplantation.     

Efficacy of Split Schedule Versus Conventional Schedule Neoadjuvant Cisplatin-Based Chemotherapy for Muscle-Invasive Bladder Cancer

Neoadjuvant cisplatin-based chemotherapy (NAC; 70 mg/m²) is standard of care for muscle-invasive bladder carcinoma (MIBC). Many patients (pts) cannot receive cisplatin because of renal impairment, and administration of cisplatin 35 mg/m² on day 1 + 8 or 1 + 2 (i.e., split schedule) is a commonly used alternative. In this retrospective analysis, we compared complete (pT0) and partial (<pT2) pathologic response rates between split schedule (SS) and conventional schedule (CS) pts, after 1:1 matching on chemotherapy regimen, number of cycles, tumor histology, and clinical stage. Eighty matched pts were identified. pT0 rates were 17.5% (95% confidence interval [CI], 7%–33%) and 32.5% (95% CI, 19%–49%) in SS and CS cisplatin pts, respectively (p = .21), corresponding to an odds ratio for pT0 of 0.45 (95% CI, 0.16–1.31) with SS cisplatin. Split schedule cisplatin was associated with numerically but not statistically significant lower pathologic response rates relative to full dose.