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Narcolepsy is a rare sleep disorder characterized by excessive daytime sleepiness (EDS), cataplexy, sleep hallucination and sleep paralysis, and the vast majority of patients are accompanied by anxiety. There are neuronal interconnections and projections between the neural circuits of narcolepsy and anxiety, which may share common pathophysiology mechanisms, and some medications used clinically to treat cataplexy in narcolepsy may also improve anxiety. In this study, we propose to review the epidemiologic research, pathogenesis and therapeutic advances in narcolepsy with anxiety, with the aim of increasing the diagnosis and treatment of narcolepsy with anxiety and improving the prognosis of narcolepsy with anxiety patients.

Objective To summarize and analyze the clinical features and comorbidity of attention deficit and hyperactive disorder (ADHD) with self⁃limited epilepsy with centrotemporal spikes (SeLECTS) in children. Methods A total of 89 SeLECTS patients diagnosed in Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology from July 2020 to December 2022 were selected. The social demographic data, clinical manifestation, video electroencephalography (VEEG) results, treatment and prognosis of the children were collected. Swanson, Nolan and Pelham⁃Ⅳ Rating Scale (SNAP⁃Ⅳ) was used to assess the comorbidity of ADHD. Results 1) Clinical features: there were 49 males and 40 females in 89 cases of SeLECTS. The age of onset was 3-12 years old, with an average of (7.22 ± 2.04) years old. The main seizure forms were motor seizures of focal origin (36 cases, 40.45%) and focal progression to bilateral tonic ⁃ clonic seizures (46 cases, 51.69%), and 7 cases (7.87%) had both. Main manifestations were unilateral clonic or tonic⁃clonic seizures, drooling, strabismus or upward movement of eyes, abnormal oral movement, and throat vocalization. 2) EEG characteristics: background activity of VEEG of 56 patients was normal, and epileptiform discharge waveforms were mainly sharp (spike) waves, sharp (spike) slow waves complex, spike clusters, and electrical status epilepticus during sleep (ESES). Spike wave index (SWI) during slow wave sleep was 33.00 (19.25, 53.25). 3) Treatment and prognosis: 37 cases (41.57%) were seizure⁃free at least 6 months, and 23 cases (25.84%) were seizure⁃free at least 12 months. 4) Comorbidity: 44 patients (49.44%) had comorbid ADHD. Compared with the non⁃ADHD group, the ADHD group had a younger age of onset (t = 1.621, P = 0.002), a higher SWI (Z = ⁃ 2.134, P = 0.038) and a higher incidence of ESES (χ2 = 4.308, P = 0.038). Conclusions SeLECTS is a self⁃limited epilepsy syndrome in children with characteristic clinical and electroencephalographic features. For children with younger age, higher SWI and ESES, comorbid ADHD should be considered.

Objective To analyze the seizure characteristics of epilepsy in the course of different types of autoimmune encephalitis (AE), and to screen the markers of early diagnosis value. Methods A total of 91 patients with AE with epileptic seizure admitted to Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from August 2014 to January 2021 were collected. The clinical data included social demographic data, pathogenic characteristics, EEG and imaging characteristics, treatment and prognosis. Results 1) Anti⁃N⁃methyl⁃D⁃aspartate receptor (NMDAR) encephalitis (n=58), anti⁃γ⁃aminobutyric acid receptor type B (GABABR) antibody⁃associated encephalitis (n=12) and anti⁃leucine rich glioma inactivated protein 1 (LGI1) antibody⁃associated encephalitis (n=12) were common types of AE. 2) Rapid progressive dementia [79.12% (72/91)], sleep disorders [79.12% (72/91)] and mental disorders [75.82% (69/91)] were the main non⁃epileptic symptoms, but mood disorders or speech disorders were rare. 3) In the course of encephalitis, 76.92% (70/91) of patients had generalized tonic⁃clonic seizure (GTCS), which were the characteristic seizure type of anti⁃GABABR antibody⁃associated encephalitis (12/12). While faciobrachial dystonic seizure (FBDS) was the specific seizure type of anti⁃LGI1 antibody⁃associated encephalitis [4.40% (4/91)]. 4) The main manifestations of VEEG were background slow waves [37.88% (25/66)], slow waves combined with epileptic discharges [27.27% (18/66)] or epileptic discharges [18.18% (12/66)], but the increase of fast wave activity [1.52% (1/66)] was rare. There was also no abnormal brain wave [15.15% (10/66)]; δ brush was observed in only 2 patients with anti⁃NMDAR encephalitis. 5) MRI abnormalities [58.89% (53/90)] were mainly found in hippocampus amd temporal lobe, characterized by T2WI and FLAIR hyperintersity, mainly in patients with anti⁃LGI1 antibody⁃associated encephalitis (9/12). 6) Immunotherapy [97.80% (89/91)] and antiepileptic seizure medicine [94.51% (86/91)] were the preferred treatment options. The mean follow⁃up was 48.50 months, and the fatality rate was 14.29% (10/70), with the highest rate of anti⁃GABABR antibody⁃associated encephalitis (4/9). The recurrence rate of epilepsy was 10.17% (6/59), and the long⁃term recurrence rate of anti⁃DPPX antibody⁃associated encephalitis was relatively high (2/3). Conclusions Different types of AE with epileptic seizure have specific clinical characteristics, which is of great significance for early diagnosis and prognosis.

AbstractBackground and ObjectiveMethodsResultsConclusionCyclin-dependent protein kinases (CDKs) have been suggested as prospective therapeutic targets because they control processes vital to the survival and growth of cancer cells. However, research on the varied CDK expression profiles and prognostic factors in osteosarcoma is still lacking.The osteosarcoma microRNA (GSE65071) and gene expression profiles were retrieved from the Gene Expression Omnibus (GEO) database (GSE42352). A substantial variation in prognosis was discovered in CDKs using the TARGET database. Cytoscape was used to construct the miRNAs-CDKs network, and functional and pathway enrichment analyses were completed. It was looked at how immune checkpoint genes, m6A-related genes, and CDKs interact.In patients with osteosarcoma compared to normal samples, CDK1-5, CDK18, CDK16, and CDK17 gene expression levels were considerably greater, whereas CDK7-9, CDK11B, CDK16, and CDK20 gene expression levels were significantly lower. Patients with osteosarcoma who had low CDK3 and 18 gene levels or high CDK6, 9 gene levels were predicted to have a favorable prognosis and a long-life expectancy. Immune checkpoint genes, m6A-related gene expression, and CDKs expression all showed some connection. Finally, a network of crucial CDKs and miRNAs was constructed.According to our research, CDK3, 6, 9, and 18 have been identified as possible therapeutic targets for osteosarcoma, and CDKs may have a role in controlling m6A mutations in tumor cells as well as immune checkpoint regulation. [ABSTRACT FROM AUTHOR]

To investigate the risk factors for the development of portal hypertension in patients with decompensated cirrhosis and analyze their prognosis. Methods: Patients with decompensated cirrhosis who were admitted to our hospital and Qu fu People's Hospital from June 2022 to June 2023 were included in this study. Among them, there were 45 male and 15 female patients, with a median age of 56 (range: 35– 77) years. A comparative analysis was performed between Group A (hepatic venous pressure gradient, HVPG < 16 mmHg) and Group B (HVPG ≥ 16 mmHg) patients, along with various clinical outcomes. Multivariate analysis was conducted to explore the risk factors influencing the occurrence of portal hypertension and adverse prognosis in patients with cirrhosis. Results: In Group A patients with portal hypertension, we observed lower levels of aspartate aminotransferase, laminin, serum hyaluronic acid, type III procollagen N-terminal peptide, total bile acids, and cholylglycine acid compared to Group B. On the other hand, levels of alanine aminotransferase, white blood cells, and serum albumin were higher in Group A than in Group B. These differences between the groups were statistically significant (P < 0.05). Multivariate analysis of the aforementioned risk factors indicated that low white blood cell count, high cholylglycine acid levels, and high serum hyaluronic acid levels were identified as independent risk factors for the occurrence of difficult-to-control complications in decompensated portal hypertension among patients with liver cirrhosis (P < 0.05). Conclusion: Liver cirrhosis patients with portal hypertension and multiple risk factors like low white blood cell count and high liver transaminase levels should be cautious regarding the progression of portal hypertension when combined with splenomegaly, liver fibrosis, and bile stasis, as it often indicates a poor prognosis. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodsResultsConclusionIntervertebral disk degeneration (IVDD) is one of the most common causes of low back pain. However, in the etiology of IVDD, the specific method by which nucleus pulposus (NP) cell senescence and the immune response induce disease is uncertain.Gene Expression Omnibus database was used to find differentially expressed genes (DEGs), differentially expressed miRNAs (DE miRNAs), differentially expressed lncRNAs (DE lncRNAs), and differentially expressed circRNAs (DE circRNAs). Functional enrichment analysis was performed through Enrichr database. Potential regulatory miRNAs, lncRNAs and circRNAs of mRNAs were predicted by ENCORI and circBank, respectively.We identified 198 upregulated and 131 downregulated genes, 39 upregulated and 22 downregulated miRNAs, 2152 upregulated and 564 downregulated lncRNAs, and 352 upregulated and 279 downregulated circRNAs as DEGs, DE miRNAs, DE lncRNAs, DE circRNAs, respectively. Functional enrichment analysis revealed that they were significantly enriched in Toll-like receptor signaling route and the NF-kappa B signaling pathway. An mRNA–miRNA–lncRNA/circRNA network linked to the pathogenesis of NP cells in IVDD was constructed based on node degree and differential expression level. Eight immune-related DEGs (6 upregulated and 2 downregulated genes) and five aging-related DEGs (3 upregulated and 2 downregulated genes) were identified in the critical network.We established a novel immune-related and aging-related triple regulatory network of mRNA–miRNA–lncRNA/circRNA ceRNA, among which all RNAs may be utilized as the pathogenesis biomarker of NP cells in IVDD. [ABSTRACT FROM AUTHOR]

AbstractFerroptosis has recently been shown to play a significant role in the progression of intervertebral disk degeneration (IDD), although the underlying mechanism is still unknown. The objective of this work was to use stringent bioinformatic techniques to clarify the crucial roles played by genes associated with ferroptosis in the emergence of IDD. For additional study, the microarray data pertinent to the IDD were acquired from the Gene Expression Omnibus database. The ferroptosis-related and IDD-related genes (FIDDRGs) were identified using a variety of bioinformatic techniques, which were also used to carry out function enrichment analysis, protein–protein correlation analysis, build the correlation regulatory network, and examine the potential connections between ferroptosis and immune abnormalities and inflammatory responses in IDD. A total of 16 FIDDRGs were eliminated for the further function enrichment analysis, and 10 hub FIDDRGs were chosen to build the correlation regulatory network. Hub FIDDRGs were shown to be highly associated with M2 macrophages and hub inflammatory response-related genes in IDD. When seen as a whole, our findings can give fresh perspectives on the mechanistic studies of ferroptosis in the emergence of IDD and new prospective targets for the therapeutic approaches. [ABSTRACT FROM AUTHOR]