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Several anti‑Aβ monoclonal antibody drugs have been approved for clinical use at home and abroad recently. In order to facilitate its safe and effective treatment of anti‑Aβ monoclonal antibody drugs for Alzheimer's disease (AD) in China, we present recommendations for the clinical use of anti‑Aβ monoclonal antibody drugs based on existing clinical trials and the clinical practice of AD treatment with Aducanumab at Ruijin Hospital Hainan Branch, Shanghai Jiaotong University School of Medicine. The recommendations include clinical indications, pre ‑ medication assessment and preparation, medication instructions and precautions, as well as post ‑ medication clinical monitoring, which is aimed to furnish clinicians with comprehensive medication guidance.

Alzheimer's disease (AD) is a chronic progressive degenerative disease with gradually decreasing cognition. Because of the high prevalence, heavy social burden and wide interaction with others, the ethical issues are increasingly prominent. This article focuses on the details, such as disclosing diagnosis, breaking bad news, advance directives, hospice care and palliative care, and driving. From these issues, as a medical staff, we should know and respect our patients and their families sufficiently. We should make a reasonable treatment with patients and their families for a better outcome. At the same time, more propaganda about advance directives and hospice care should be taken for a healthier perception. doi:10.3969/j.issn.1672⁃6731.2021.04.005

As one of the indispensable means of medical examination, neuroimaging methods play a vital role in the diagnosis of Parkinson's disease (PD) and Parkinson - plus syndromes. The review summarized neuroimaging characteristics of PD and Parkinson - plus syndromes, and the application of structural MRI (sMRI), fMRI, PET and SPECT on diagnosis and differential diagnosis of related diseases and syndromes. [ABSTRACT FROM AUTHOR]

Background: Huntington's disease (HD) is an autosomal dominant disorder, typically characterized by chorea due to a trinucleotide repeat expansion in the HTT gene, although the clinical manifestations of patients with juvenile HD (JHD) are atypical.Case Presentation: A 17-year-old boy with initial presentation of tics attended our clinic and his DNA analysis demonstrated mutation in the HTT gene (49 CAG repeats). After treatment, his symptoms improved. Furthermore, we performed literature review through searching the databases and summarized clinical features in 33 JHD patients.Conclusion: The most prevalent symptoms are ataxia, and two cases reported that tics as initial and prominent manifestation in JHD. Among them, 88% patients carried CAG repeats beyond 60 and most of them have family history. This case here illustrates the variable range of clinical symptoms of JHD and the necessity of testing for the HD mutation in young patients with tics with symptoms unable to be explained by Tourette's syndrome (TS). [ABSTRACT FROM AUTHOR]

Micro RNA regulation of transcript expression has been reported in patients with Alzheimer's disease ( AD). Here, we investigate the role of micro RNA-146a (mi RNA-146a), a brain-enriched mi RNA, which is upregulated in AD patients. Through analysis of predicted targets of mi RNA-146a, low-density lipoprotein receptor-related protein-2 (Lrp2), a member of the LDLR family that is known to play a protective role in AD, was identified. Overexpression of mi RNA-146a in SH- SY5Y cells significantly decreased Lrp2 expression, resulting in a reduction of Akt activation and induction of proapoptotic caspase-3, thereby increasing cell apoptosis. Thus, specific mi RNA-146a regulation may contribute to AD by downregulating the Lrp2/Akt pathway. [ABSTRACT FROM AUTHOR]

Compared with early-onset familial AD (FAD), the heritability of most familial late-onset Alzheimer's disease (FLOAD) cases still remains unclear. However, there are few reported genetic profiles of FLOAD to date. In the present study, targeted sequencing of selected candidate genes was conducted for each of 90 probands with FLOAD and 101 unrelated matched normal controls among Chinese Han population. Results show a significantly lower rate of mutation in APP and PSENs, and APOE ε4 genetic risk is higher for FLOAD. Among the Chinese FLOAD population, the most frequent variant was CR1 rs116806486 [5.6%, 95% CI (1.8%, 12.5%)], followed by coding variants of TREM2 (4.4%, 95%CI (1.2%, 10.9%)) and novel mutations of ACE [3.3%, 95%CI (0.7%, 9.4%)]. Next, we found that novel pathogenic mutations in ACE including frame-shift and nonsense mutations were in association with FLOAD regardless of APOE ε4 status. Evidence from the Alzheimer's disease Neuroimaging Initiative (ADNI) database also supported this finding in different ethnicities. Results of in vitro analysis suggest that frame-shift and nonsense mutations in ACE may be involved in LOAD through decreased ACE protein levels without affecting direct processing of APP., (© 2021 Chongqing Medical University. Production and hosting by Elsevier B.V.)