Sensory Ataxic Guillain-Barré Syndrome with Dysgeusia after mRNA COVID-19 Vaccination

Guillain-Barré syndrome (GBS) has occasionally occurred in people who have received coronavirus disease 2019 (COVID-19) vaccines. Dysgeusia is rare symptom of GBS. We herein report a rare case of sensory ataxic GBS with dysgeusia just after the second dose of the Pfizer-BioNTech COVID-19 vaccine. Although autoantibodies against glycolipids were not detected, immunotherapy with intravenous immunoglobulin and methylprednisolone pulse therapy effectively ameliorated the symptoms. Our report suggests that the COVID-19 vaccine may induce various clinical subtypes of GBS, including a rare variant with sensory ataxia and dysgeusia.     

山茶花总黄酮对缺血性脑损伤的保护作用

目的研究山茶花总黄酮(TFC)对小鼠急性脑缺血和大鼠局灶性脑缺血的保护作用。方法结扎小鼠双侧颈总动脉建立脑缺血模型,观察TFC对小鼠死亡率及死亡时间的影响。建立局灶性脑缺血(MCAO)模型,观察TFC大鼠对行为学、脑梗死面积的影响,并测定缺血侧脑组织中乳酸脱氢酶(LDH)活性、丙二醛(MDA)及一氧化氮(NO)含量。结果TFC80、40mg·kg-1组可降低缺血小鼠的死亡率,延长死亡时间;60、30、15mg·kg-1组可改善行为障碍,降低行为学评分;60、30mg·kg-1组可减少MCAO大鼠脑梗死范围,降低脑组织中MDA、NO含量,抑制LDH活性的下降。结论TFC对缺血性脑损伤有保护作用,其机制可能与抗自由基和抑制NO生成有关。     

Sukkari dates seed improves type-2 diabetes mellitus-induced memory impairment by reducing blood glucose levels and enhancing brain cholinergic transmission: In vivo and molecular modeling studies

Cognitive decline is one of the serious complications associated with diabetes mellitus (T2DM) of type-2. In this reported work, the effect of aqueous sukkari dates seed extract (ASSE) was evaluated in T2DM-induced rats. T2DM was induced using intraperitoneal injection of nicotinamide and streptozocin (STZ) administration. The diabetic rats were then treated orally with 200 mg/kg and 400 mg/kg of dates seed extract for 30 days and results were compared with metformin-treated groups. The memory functions were assessed using three maze models. Glucose and insulin levels in the blood and acetylcholine, acetylcholinesterase brain homogenates were estimated. The results showed a significant reduction in transfer latency (TL) (p < 0.001) during the elevated plus maze (EPM) test. The novel object recognition (NOR) test revealed a longer exploration time (p > 0.05) with novel objects and a higher discrimination index (p > 0.05). The Y-maze test also showed a significant increase in the number of entries to the novel arm (p > 0.05) and the total number of entries in the trial (p > 0.01) as well as in test (p > 0.05) sessions. Reduction in blood glucose (p > 0.05) and improvement in blood insulin (p > 0.05) levels were also noted. Improvement in ACh levels (p > 0.001) with 400 mg/kg of ASSE and reduction in AChE (p > 0.001) with both doses of ASSE were also observed in the brain homogenates. The results of ASSE were found comparable with the metformin-treated rats. The estimation of phytochemical constituents displayed a significant presence of phenolic content. Further, molecular modeling studies showed ellagic acid, catechin, and epicatechin as the potential molecule interacting with GSK-3β, α-amylase, and AChE and may be responsible for observed bioactivity. In conclusion, ASSE has the ability to alleviate T2DM-related cognitive impairments.     

急性脑卒中患者早期综合康复治疗的临床研究

目的：探讨早期综合康复治疗对脑卒中患者神经功能缺损、运动功能及日常生活活动能力（ADL）的影响。方法：72例急性脑卒中患者随机分为康复组及对照组,康复组在采用常规药物治疗同时,进行早期综合康复治疗;对照组仅采用常规药物治疗。治疗前后的运动功能和日常生活能力（ADL）分别用Fugl-meyer assessment（FMA）和改良的Barthel指数评定。结果：治疗后康复组患者神经功能缺损积分、运动功能和ADL的改善程度明显优于药物治疗组,差别具有显著性（P〈0．05）。结论：急性脑卒中患者早期综合康复治疗与单纯药物治疗相比,在降低其神经功能缺损积分,提高运动功能、ADL的积分上效果更好。     

微创治疗骨质疏松性椎体骨折伴脊髓损伤的疗效观察

目的 观察小切口椎板减压术与椎体成型术结合治疗合并有神经损伤症状的椎体骨质疏松性骨折的疗效,为该类型的骨折提供一微创治疗方法.方法 在椎体成型术之前,先采用小切1:7椎板减压、复位椎体后方突出的骨块,解除脊髓的压迫,然后直视下进行椎体成型操作.结果 手术时间60～89min,操作顺利,无骨水泥向椎管内渗漏.疼痛缓解,神经损经症状1个月内恢复正常.无后凸加重迹象.结论 采用小切口椎板减压术与椎体成型术结合治疗合并有神经损伤症状的椎体骨折,结合了常规椎板减压手术和椎体成型术两种手术的特点,同时在手术中可以有效避免骨水泥向椎管内渗漏的可能.该项技术是治疗伴有神经受损症状的严重的椎体压缩性骨折的有效方法.     

Alterations in structure of the muscle-tendon unit and gait pattern after percutaneous repair of Achilles tendon rupture with the Dresden instrument

BackgroundFunctional deficits after Achilles tendon (AT) ruptures are observed. The relationship between musculotendinous structural alterations and functional outcome is not clear.MethodsKinematic analyses (level walking, stair climbing), patient-reported outcome measures (PROMs), calf atrophy (maximum calf circumference (MCC)), and AT length were evaluated in patients after percutaneous AT repair with the Dresden instrument (n = 20 min. follow-up: 24 months).ResultsPatients achieved good results in PROMs. However, MCC decreased significantly and AT length increased significantly postoperatively. Side-to-side MCC differences over 2 cm resulted in significantly lower PROMs. AT lengthening correlated with increased dorsiflexion and decreased plantarflexion.ConclusionCalf atrophy and AT lengthening after minimally invasive AT repair resulted in inferior ankle kinematics and PROMs.     

Trans-cinnamaldehyde improves neuroinflammation-mediated NMDA receptor dysfunction and memory deficits through blocking NF-κB pathway in presenilin1/2 conditional double knockout mice

A chronic neuroinflammatory response has been considered as a critical pathogenesis promoting neurodegenerative progression in Alzheimer’s disease (AD). During neuroinflammatory process, microglia are excessively activated and simultaneously release numerous pro-inflammatory mediators that cause synaptic dysfunction in the forebrain prior to neuronal degeneration and memory deficits in AD. Thus, prevention of neuroinflammation-mediated synaptic dysfunction may be a potential therapeutic approach against neurodegenerative disorders. Trans-cinnamaldehyde (TCA) is a primary bioactive component derived from the stem bark of Cinnamomum cassia, and it possesses potent anti-inflammatory and neuroprotective activities in in vivo and in vitro experiments. However, the in-depth molecular mechanisms of TCA underlying anti-neuroinflammatory and neuroprotective effects on memory deficits in AD are still unclear. The presenilin 1 and 2 conditional double knockout (PS cDKO) mice exhibit AD-like phenotypes including obvious neuroinflammatory responses and synaptic dysfunction and memory deficits. Here, PS cDKO were used to evaluate the potential neuroprotective effects of TCA against neuroinflammation-mediated dementia by performing behavioral tests, electrophysiological recordings and molecular biology analyses. We observed that TCA treatment reversed abnormal expression of synaptic proteins and tau hyperphosphorylation in the hippocampus and prefrontal cortex of PS cDKO mice. TCA treatment also ameliorated NMDA receptor (NMDAR) dysfunction including impaired NMDAR-mediated responses and long-term potentiation (LTP) induction in the hippocampus of PS cDKO mice. Moreover, TCA possesses an ability to suppress neuroinflammatory responses by diminishing microglial activation and levels of pro-inflammatory mediators in the hippocampus and prefrontal cortex of PS cDKO mice. Importantly, improving NMDAR dysfunction and memory deficits of PS cDKO mice was due to the inhibition of neuroinflammatory responses through TCA’s interruptive effect on the nuclear factor kappa B (NF-κB) signaling pathway. Therefore, TCA may be a potential anti-neuroinflammatory agent for deterring neurodegenerative progression of AD.     

Sensory neuronopathies: A case series and literature review

Sensory neuronopathies are heterogeneous disorders of dorsal root ganglia. The clinical and laboratory features in a single‐centre series, including response to treatment and outcome have been described. They retrospectively included 54 patients meeting Camdessanché et al (2009) criteria for sensory neuronopathy. The patients were classified according to their likely aetiology and analysed their demographic, clinical, neurophysiological, histological and spinal MRI features. The outcome with the modified Rankin Scale (mRS) was evaluated, and the response to treatment was assessed. About 54 patients were included (18 male; median age 54.5 years). The most common initial symptoms were hypoaesthesia, paraesthesia, ataxia and pain. Half of patients had a slow onset, greater than 12 months before seeing a neurologist. The aetiology as possibly inflammatory (meaning nonspecific laboratory evidence of immune abnormality) in 18 patients (33%), paraneoplastic 8 (15%), autoimmune 7 (13%) and idiopathic 6 (11%) was classified. About 31 patients received immune therapy of which 11 (35%) improved or stabilised. Corticosteroids were the most used treatment (24 patients) and cyclophosphamide had the highest response rate (3/6, 50%). At the final follow up (median 24 months) 67% had mRS ≥3 and 46% mRS ≥4, including 15% who died. Worse outcome was associated with generalised areflexia and pseudoathetosis by logistic regression, and with motor involvement and raised CSF protein by univariate analysis. Sensory neuronopathies caused severe disability, especially in patients with generalised areflexia and pseudoathetosis. Of those without an obvious cause, most had some evidence of dysimmunity. Some patients had a positive response to immunotherapy, but rarely enough to improve disability much.     

Recipe standardization of bread using cassava-wheat composite flour

A culturally acceptable standard recipe was developed for two types of breads using cassava-wheat composite flour. Twenty-nine commercial recipes for tea and sugar breads were collected, average weight of basic ingredients determined and used as test recipe. Wheat flour of test recipe was substituted with high-quality cassava flour (HQCF) at 10 and 20% levels with 0% HQCF as control. Comments from stakeholders, including commercial bakers, were factored into the modification of the test recipe to produce the standardized recipes used in this study. Physical characteristics of bread from the standard recipe were determined by standard methods and sensory evaluation by 105 consumers. Increasing HQCF resulted in decrease in specific volume, crumb color intensity and increase in crust color intensity, browning index, hardness, chewiness, and gumminess. Substitution levels up to 20% HQCF for sugar bread and 10% HQCF for tea bread were established to be culturally acceptable; hence can be commercialized.

Practical Application

Cassava is produced in Ghana, therefore its use in the production of bread which is commonly consumed in the country will increase the consumption of cassava; hence larger production and increased income for farmers. Jobs will be created for processors who will produce cassava roots into high-quality cassava flour (HQCF). HQCF is also cheaper, therefore production of bread from this standard recipe will be relatively cheaper than using only wheat flour. Since the standard recipe was developed based on a large number of recipes already used and bread produced from it largely accepted, its market potential will be high.