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Objective: To investigate the clinical characterization, treatment and prognosis of anti-GQ1b antibody syndrome. Methods: The clinical data of 8 patients with positive serum anti-GQ1b antibody from the Department of Neurology of Nanjing Brain Hospital between June 2016 and July 2018 were analyzed retrospectively. Their serums were tested by immunoblotting. Relevant literatures were reviewed to investigate possible pathogenesis. Results: Of the 8 cases, 4 cases were male, 4 cases were female; their age ranged from 16 to 76 (47±21) years old. Seven of them were with acute onset, the time course of the disease ranged from 2 to 15 (7±4) days. Six cases had a history of influenza prior to the onset of the presenting symptoms. In terms of the clinical manifestations of the eight patients, two were affected with Guillain-Barre syndrome (GBS), two with Cavernous sinus syndrome, one with Miller Fisher syndrome, one with both GBS and spinal cord demyelination, one with Bulbar paralysis, and one with chronic inflammatory demyelinating polyneuropathy (CIDP). The anti-GQ1b antibody IgG in serum was positive in 6 patients, two of whom were combined with positive IgG of anti-GD1b antibody in serum. The anti-GQ1b antibody IgM in serum was positive in 1 patient, and the anti-GQ1b antibody IgM and anti-GT1b antibody IgM in cerebrospinal fluid (CSF) were both positive in the other patient. In terms of the treatment, 3 patients (3/8) received vitamin B treatment only, 2 patients (2/8) received steroid plus vitamin B treatment, 2 patients (2/8) received intravenous immunoglobulin (IVIG) plus vitamin B treatment, and 1 patient (1/8) received steroid plus IVIG treatment. During the 8-33 months' follow-up after discharge, 6 patients were significantly improved in their symptoms, one with mild diplopia, one with limbs weakness, numbness and difficulty in walking. The symptoms of one patient (case 3) fluctuated twice and recovered again after treatment. Conclusions: The disease spectrum of anti-GQ1b antibodies syndrome is broad, and main symptom is ophtalmoplegia. Immunotherapy with IVIG and steroid would be beneficial to prognosis.

Objective: To determine the therapeutic efficacy and the influencing factors for the long/middle-term outcomes of percutaneous vertebroplasty (PVP) in the treatment of painful osteoporotic vertebral compression fractures (OVCFs)., Methods: This prospective study recruited a total of 131 consecutive OVCF patients treated with PVP at a single institution from March 2005 to December 2009. There were 106 females and 25 males. Pre- and postoperative evaluations included a visual analog scale (VAS) for pain, the Roland-Morris disability questionnaire (RDQ) scores and patient activity levels. Various factors probably correlated with long-mid term efficacy were also analyzed., Results: Both VAS and RDQ scores decreased significantly (P < 0.05). And the activity levels showed significant post-therapeutic improvement (P < 0.01); Univariate and multivariate analysis showed that the influencing factors for the long/middle-term efficacy were age, number of OVCF(s) per time, activity level after discharge and newly occurring OVCF (Z = -2.03, -2.68, 5.38 and -1.73; P = 0.043, 0.007, 0.001 and 0.034 respectively)., Conclusion: PVP is an efficient pain-relieving procedure. The long/middle-term efficacy after PVP is mostly correlated with both the patient age and the natural course of underlying conditions.

Objective: To evaluate the myocardial systolic function and ventricular remodeling in heart failure rat induced by myocardial infarction (MI) with S/SRI and MMP-9., Methods: A total of 70 male SD rats were randomly assigned to 4 groups: 4 weeks and 8 weeks MI (anterior descending branch of left coronary artery were ligated), sham operation (thoracotomy without ligation of coronary artery) and non-operated control group. The regional myocardial systolic function of rats was quantified with S/SRI. The myocardial MMP-9 expression was detected by Western blot., Results: In the 4 weeks MI group, all segment's Ssys, SRsys, the strain of end-systole were reduced while PSI was increased compared to sham and non-operated group with the exception of the inferior wall. These changes were more significant in 8 weeks MI group compared to the 4 weeks MI group. In the 4 weeks MI group, the expression of MMP-9 was significantly upregulated than the sham operation group and this upregulation was more significant at 8 weeks post MI., Conclusions: S/SRI can quantitative evaluate the regional systolic function of heart failure rat induced by myocardial infarction. Progressive upregulation of myocardial MMP-9 expression paralleled the deterioration of regional systolic function in this heart failure rat model.

Objective: To evaluate the long-term effects of percutaneous lumbar discectomy (PLD) and microendoscopic discectomy (MED) in treatment of lumbar disc herniation., Methods: A questionnaire survey by letter and telephone was conducted among 104 patients undergoing PLD and 82 patients undergoing MED during January 2000 to March 2002, to investigate the Oswestry disability index (ODI), Short Form-36 (SF-36) score, and Japanese Orthopedic Association (JOA) score., Results: The excellent/good rate (ODI score=0-20%) of the MED group was 79.27%, significantly higher than that of the PLD group (71.15%, P=0.0397). However, longer The hospitalization duration of the MED group was 11, 6 d, significantly longer than that of the PLD group (7.9 d, P<0.01), and the mean cost of the MED group was, significantly higher than that of the PLD group (P<0.01). Long-term complications were observed in 3 patients of the MED group (3.49%) while none in the PLD group., Conclusion: Both PLD and MED are minimally-invasive-technique with a long-term efficacy and safety on lumbar disc herniation. Although the long-term outcome of the MED group is better than PLD, the complication rate, hospitalization duration, and cost of the MED group are higher.

Objective: To analyze the clinical features of patients with acute myocardial infarction underwent successful thrombolytic therapy post cardiopulmonary resuscitation., Methods: This retrospective analysis included 65 patients with acute myocardial infarction underwent successful intravenous thrombolysis post cardiopulmonary resuscitation. The cases were collected from Chinese Journal Full-text Database from 1996 to 2006, only patients met the recanalization criteria of coronary artery were included., Results: Most of the patients were male (93.8%, 61/65) and aged less than 65 years (81.5%, 53/65). Cardiopulmonary resuscitation was performed within 5 min after cardiac arrest in 63 patients (96.9%). Defibrillation was performed 3.2 times per patient, chest compression in 52 patients (80.0%) and tracheal intubation in 21 patients (32.3%). The restoration time of spontaneous circulation were achieved within 10 min in 36 cases (55.4%), between 11 - 30 min in 19 cases (29.2%)and between 31 - 107 min in 10 cases (15.4%). Thrombolysis agents (urokinase, recombinant streptokinase or recombinant tissue-type plasminogen activator) were given intravenously at 172 +/- 92 min after acute myocardial infarction. Mild hemorrhage was seen in 12 cases (18.5%) and there was no report on severe hemorrhage event. The hemorrhage incidence tended to be higher than that of reported large Chinese thrombolysis trials (11.1% - 15.1%, P > 0.05)., Conclusion: Thrombolytic therapy was relatively safe and effective for those middle-aged male AMI patients received rapid cardiopulmonary resuscitation (< 5 min after cardiac arrest) and with shorter spontaneous circulation restoration time (<30 min).

Objective: To explore the effect of low molecular weight heparin (LMWH) on the changes of pulmonary surfactant associated protein A (SPA) of rats in acute pulmonary embolism., Methods: Male SD rats were injected with medical gelfoam microspheres via jugular vein to induce PE model. Rats were randomized into three groups: control group (n = 8), embolism for 2 weeks group (n = 8) and LMWH therapy group (n = 8); The LMWH therapy group were injected Nadroparin subcutaneously immediately after operation, 0.1 ml/10 kg, once every 12 h. Saline were injected into the control group instead of gelfoam granule solution without further procedure. All the rats were sacrificed at the time of 2 weeks. Pulmonary artery pressure were detected by right heart catheterization and artery blood gas were analyzed at the time of sacrifice. Lung tissue were sliced and dyed with HE to observe the embolism of pulmonary artery. Methods of RT-PCR and western blot were used to study the changes of SPA mRNA and SPA protein in lung tissue., Results: In control group, embolism group and LMWH group, the pulmonary pressure were (14.2 +/- 4.1) mm Hg, (29.0 +/- 8.2) mm Hg, (25.50 +/- 2.74) mm Hg respectively (F3.01, P < 0.05); the artery oxygen blood pressure (PaO2) were (94.1 +/- 8.8) mm Hg, (73.4 +/- 14.3) mm Hg, (82.86 +/- 3.73) mm Hg respectively (F 1.31, P < 0.05); SPA mRNA in three groups were 1.43 +/- 0.51, 0.87 +/- 0.35, 1.07 +/- 0.20 respectively (F 2.87, P < 0.05); and SPA protein were 1.00 +/- 0.00, 0.52 +/- 0.32, 0.90 +/- 0.22 respectively (F 2.96, P < 0.05); Under microscope, lung tissue were seen congestion, edema, infiltration of inflammatory cells in embolism group, which were lessened in LMWH group., Conclusions: The lung SPA decrease significantly in acute pulmonary embolism, and LMWH can increase the SPA, which may be one of mechanisms of LMWH in treatment of pulmonary embolism.

Objective: To identify the risk factors associated with symptomatic vasospasm after aneurysmal subarachnoid hemorrhage (SAH)., Methods: The clinical data of 186 cases with SAH verified by radiology and lumbar puncture were reviewed retrospectively., Results: Fifty-five of the 186 patients (29.6%) developed symptomatic vasospasm. The incidence of symptomatic vasospasm was significantly higher in the patients of Fisher grade III than in those of Fisher grade I and Fisher grade II, in the patients in poor clinical status at admission the in those in better clinical status, and in the patients with repeated reoccurrence of SAH then in those without reoccurrence (all P < 0.01). Sex, age, treatment modality, and use of antifibrinolytic drugs (AFD) did not influence the development of symptomatic vasospasm (all P > 0.05). Multivariate analysis showed that Fisher grade III [odds ratio (OR) 2.549, 95% confidence interval (CI) 1.406 - 4.517], poor clinical status at admission (OR 2.342, 95% CI 1.320 - 4.159) and repeated reoccurrence of SAH (OR 2.492, 95% CI 1.394 approximately 4.448) were associated with the increased risk of symptomatic vasospasm., Conclusion: Fisher grade III, poor clinical status at admission and repeated reoccurrence of SAH are significant independent risk factors of symptomatic vasospasm. The presence of symptomatic vasospasm can be independently predicted by the amount of subarachnoid hemorrhage, clinical status at admission, and times of SAH.