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Objective The cerebrospinal fluid (CSF) cytological and imaging features in 4 patients with meningeal carcinomatosis (MC) were investigated to assist with the diagnosis and improve the treatment of the disease. Methods A retrospective analysis was utilized to investigate the clinical manifestations, imaging, and liquid-based CSF cytology of 4 patients with MC by using CSF cytology, all of whom were treated at the Department of Neurology at Wuhan No.1 Hospital from February 2016 to January 2019. Results Four patients (2 males and 2 females) with an average age of (60.00 ± 15.85) years old had a symptom of headache, 2 of whom had a symptom of slow response. Among 4 patients, all had a history of tumor disease; 2 had a history of lung cancer; one had a history of gastric cancer; one had a history of breast cancer. Four patients underwent lumbar puncture. Two patients had increased white blood cell count, and the other 2 demonstrated decreased glucose levels. Three patients had elevated protein levels. There were 3 cases with increased intracranial pressure (ICP) and 4 cases with atypical cells, as indicated by liquid-based CSF cytology. However, no apparent meningeal enhancement was found in 4 patients. One of the patients had a negative PET-CT. All patients had been receiving or received symptomatic treatment during hospitalization. Post hospital discharge, one patient had been in treatment, and the other 3 patients died within one month to one year after diagnosis. Conclusions The imaging findings of patients with MC were atypical. The clinical history of patients with MC can help with diagnosis. The CSF cytology on these patients has considerable significance to diagnosis. [ABSTRACT FROM AUTHOR]

Background: Morvan syndrome is a rare disorder characterized by the combination of peripheral nerve hyperexcitability, encephalopathy and dysautonomia with marked insomnia. It was reported to have association to antibodies to voltage-gated potassium channels including contactin associated protein-like 2 antibodies (CASPR2-Ab) and leucine-rich glioma inactivated protein 1 antibodies (LGI1-Ab). LGI1-Ab was reported to associate with seizures, amnesia, confusion, hyponatraemia and a good prognosis, while CASPR2-Ab with peripheral presentations, probable risk for tumor and a poor prognosis. The vast majority of Morvan syndrome patients were male, with normal magnetic resonance imaging of the brain.Case Presentation: We report a female case presenting with a combination of bilateral leg pain, widespread myokymia, memory disturbance, seizure, hyperhidrosis and insomnia. She had antibodies targeting CASPR2 and LGI1, tested by the indirect immunofluorescence test, which demonstrated the diagnosis of typical Morvan syndrome as well as classical limbic encephalitis. Cranial MRI revealed bilateral hyper-intensity of the medial temporal lobe, insular lobe and basal ganglia on T2/FLAIR and DWI sequence. As the treatment carried on, her serum LGI1-Ab disappeared and her memory loss, seizure and confusion quickly relieved. But her peripheral presentations did not relieve until serum CASPR2-Ab turned negative. Intravenous immunoglobulin treatment showed limited efficacy while she achieved almost complete remission with corticosteroids therapy.Conclusions: This case provides a rare female resource of Morvan syndrome, which is the first patient with both CASPR2-Ab and LGI1-Ab positive Morvan syndrome in China and one of the few female patients with Morvan syndrome reported so far. Through the detailed analysis of her clinical course, the diverse and overlapping clinical phenotype of CASPR2-Ab and LGI1-Ab in patients with Morvan syndrome was obvious and interesting. [ABSTRACT FROM AUTHOR]

Objective: To compare the clinical therapeutic effect on coronavirus disease 2019 (COVID-19) with insomnia between the combined treatment of baduanjin and auricular point sticking therapy and the medication with oral estazolam on the base of the conventional treatment., Methods: A total of 90 patients with COVID-19 accompanied with insomnia were randomly divided into an observation group (45 cases, 3 cases dropped off) and a control group (45 cases). In the observation group, baduanjin , a traditional Chinese fitness activity, was practiced everyday. Besides, auricular point sticking therapy was exerted at ear-shenmen (TF 4), subcortex (AT 4), heart (CO 15), occiput (AT 3), etc. These auricular points were pressed and kneaded three times a day, 30 s at each point each time, consecutively for 12 days. In the control group, estazolam tablets were prescribed for oral administration, 1 mg, once daily, consecutively for 12 days. Before and after treatment, the score of Pittsburgh sleep quality index (PSQI), the score of self-rating anxiety scale (SAS), the score of self-rating depression scale (SDS) and the score of symptoms in traditional Chinese medicine (TCM) were observed in the two groups and the clinical therapeutic effect was evaluated., Results: After treatment, the scores of every item and the total scores in PSQI were all reduced as compared with those before treatment in the two groups ( P <0.01). The scores of sleep time and sleep efficiency in the observation group were lower than those in the control group after treatment ( P <0.05). SAS scores and SDS scores in the observation group and SAS score in the control group after treatment were all reduced as compared with those before treatment ( P <0.01), and SDS score in the observation group was lower than that in the control group ( P <0.01). After treatment, in the observation group, the score of each of the symptoms of TCM, i.e. unsound sleep, irritability and hot temper, profuse sputum and sticky feeling in the mouth, bitter taste in the mouth and foul breath, abdominal distention and poor appetite, as well as lassitude was reduced as compared with that before treatment successively ( P <0.01), and the scores aforementioned (excepted for the unsound sleep) in the observation group were all lower than the control group ( P <0.05). The total effective rates were 83.3% (35/42) in the observation group and 84.4% (38/45) in the control group, without statistical difference in comparison ( P >0.05)., Conclusion: The combined treatment of baduanjin and auricular point sticking therapy improves sleep quality, the conditions of anxiety and depression and the symptoms in TCM for patients of COVID-19 with insomnia. The therapeutic effect of this combined treatment is better than the oral administration of estazolam.

Objective: To observe the effects of acupuncture on neurofunction and neuropsychological factors of chronic alcoholic peripheral neuropathy (CAPN) patients., Methods: Totally 120 CAPN patients were assigned to the common treatment group, acupuncture group A, and acupuncture group B according to random digit table, 40 in each group. All patients recieved conventional drug therapy. Besides, patients in the acupuncture group A were additionally needled at Pishu (BL20), Weishu (BL21), Xuehai (SP10), Yinlingquan (SP9), Zusanli (ST36), Yanglingquan (GB34), Jiexi (ST41), Xuanzhong (GB39), Xiangu (ST43),Taixi (KI3), Quchi (LI11), Waiguan (SJ5), Hegu (LI4), and so on. On these bases patients in the acupuncture group B were needled at Sishencong (EX-HN1), Yintang (EX-HN3), Neiguan (PC6), Taichong (LR3), Sanyinjiao (SP6), and Taiyang (EX-HN5). Acupuncture was performed once a day, 14 times as a course; and then once on every other day, 14 times in total for 4 weeks. All treatment lasted for 8 successive weeks. Neuropathy Impairment Score in the Lower Limbs (NIS-LL), Neurological Severity Score (NSS), Hamilton Depression Scale (HAMD), and Hamilton Anxiety Scale (HAMA) were assessed, motor nerve conduction velocity (MCV) and sensory nerve conduction velocity (SCV) were detected before and after treatment., Results: After 8 weeks of treatment the scores of NIS-LL and NSS significantly decreased in the 3 groups, with statistical difference as compared with before treatment (P < 0.05). Scores of NIS-LL and NSS decreased more in acupuncture groups A and B than in the common treatment group (P < 0.05), and more obvious in acupuncture group B (P < 0.05). Compared with the same group before treatment, MCV and SCV of median nerve, ulnar nerve, common peroneal nerve and tibial nerve increased in acupuncture treatment group A and B after 8-week treatment (P < 0.05). MCV of median nerve, MCV and SCV of common peroneal nerve and tibial nerve significantly increased in the common treatment group (P < 0.05). Compared with the common treatment group, SCV of median nerve, MCV and SCV of ulnar nerve, common peroneal nerve and tibial nerve obviously increased in acupuncture treatment groups A and B after treatment (P < 0.05). MCV of ulnar nerve, MCV and SCV of common peroneal nerve and tibial nerve obviously increased more in acupuncture treatment group A than in acupuncture treatment group B (P < 0.05). At week 8 after treatment scores of HAMD and HAMA were obviously lowered in acupuncture groups A and B, with statistical difference as compared with before treatment (P < 0.05). The scores of HAMD were also decreased in the common treatment group, as compared with before treatment (P < 0.05). At week 8 after treatment scores of HAMD and HAMA were obviously lowered more in acupuncture treatment group B than in acupuncture treatment group A (P < 0.05)., Conclusion: Acupuncture therapy could effectively improve the neurofunction of CAPN patients, and improve complicated anxiety and depression by additionally needling at Sishencong (EX-HN1), Yintang (EX-HN3), Taichong (LR3), Sanyinjiao (SP6), and Taiyang (EX-HN5).

We report a rare case of multicentric reticulohistiocytosis (MRH) associated with liver carcinoma. A 36-year-old man who had been diagnosed as having liver carcinoma for 2 years presented with a 2-month history of multiple papulonodules on the face, ears, neck, and upper chest, accompanied by progressive polyarthralgia of the hands, wrists, elbows and knee joints without fever or chills. Skin histology revealed well defined dermal infiltrate consisting of multinucleated giant cells and macrophages having abundant eosinophilic finely granular cytoplasm with ground glass appearance. Further immunohistochemical studies characterized the lesions as positive for CD68, CD45 and Vimentin. A diagnosis of MRH that was associated with liver cancer was made. Treatment with prednisolone for 2 months resulted in a significant improvement of the skin and joint symptoms, but was discontinued due to his significant enlargement and extensive metastases of the liver carcinoma.

Objective: To study the influence of neuro-psychological factors on the effect of acupuncture in the treatment of Bell's palsy and the overall prognosis in patients., Methods: Fifty patients with Bell's palsy were randomized into the treatment group and the control group, and they were treated with manipulated and non-manipulated acupuncture, respectively. Scorings by subjective perceptive scale of acupuncture, Cartel personality test, and Hamilton Anxiety Scale were performed and the curative effect was assessed according House-Brackmann grading standards., Results: The total effective rate of acupuncture was 78.0% (39/50), and that of manipulated acupuncture was better than that of non-manipulated acupuncture [89.2% (25/28) vs. 63.6% (14/22), P < 0.01]. Visual analogue scoring for perception of "Deqi", evaluated either by patients or by doctors, showed that the scores was higher in the treatment group than in the control group (P < 0.01). Cartel personality test (16PF) found that patients with personality factors of sociability, intellectuality, excitability, braveness, and independence were capable of getting "Deqi" more easily, there existed a significant correlation between personality factors and curative effect. By Hamilton Anxiety Scale scoring, 92.0% (46/50) of the patients were found being in an anxiety state, and the efficacy of treatment was negatively correlated with the degree of anxiety (r = -0.9491, P < 0.05)., Conclusion: Neuro-psychological factors put great influence on the efficacy of treatment for Bell's palsy, multiple measures, such as drug-therapy, acupuncture, psychological intervention, rehabilitation therapy, etc., should be taken in combination for improving patients' prognosis.