BACKGROUND:Multiple sclerosis (MS) is an autoimmune disease in which inflammation plays a pivotal role in its pathogenesis. The inflammatory response is regulated by a complex network of cells and mediators, including circulating proteins such as cytokines and inflammatory mediators. Metabolomics is a powerful analytical approach that may provide diagnostic and therapeutic targets for MS. However, the causal effects of circulating inflammatory proteins and cerebrospinal fluid metabolites (CSFMs) on MS, as well as whether CSFMs act as mediators, remain unclear. OBJECTIVE:In this study, we obtained data on circulating inflammatory proteins, CSFMs, and MS from the largest genome-wide association study (GWAS) dataset of the International Multiple Sclerosis Genetics Consortium (IMSGC). METHODS:We utilized the Mendelian randomization (MR) mediation analysis method to investigate the causal relationships among circulating inflammatory proteins, CSFMs and MS. Inverse variance weighting (IVW) served as the primary statistical method. Additionally, we explored whether CSFMs act as mediators in the pathway from circulating inflammatory proteins to MS. RESULTS:Our findings reveal that there are five inflammatory proteins associated with MS. MR analysis reveals a positive correlation between the genetic prediction of three inflammatory proteins and the occurrence of MS. Our study reveals a link between 10 CSFMs and MS. Further MR analysis reveals a positive correlation between the genetic prediction of 6 CSFMs and the development of MS. Notably, CSFMs do not exhibit a reverse effect on MS. Our study establishes a significant causal effect of circulating inflammatory proteins and CSFMs on the progression of MS. Furthermore, CSFMs do not serve as an intermediary factor in the pathway connecting inflammatory proteins with MS. Circulating inflammatory proteins and CSFMs are causally associated with MS, and CSFMs do not appear to be intermediate factors in the pathway from inflammatory proteins to MS.

急性胰腺炎是内镜逆行胰胆管造影术(ERCP)治疗最常见的并发症，但进展为重症急性胰腺炎(SAP)者少见。SAP病程复杂，后期可能会合并感染性胰腺坏死、腹腔出血、多器官功能障碍等，十分凶险。现报道1例ERCP后SAP合并腹腔出血，又因出血量大引起失血性休克和多器官功能障碍患者的多学科诊治过程。该患者胰腺坏死伴感染，又先后3次发生腹腔出血，伴失血性休克、急性肝损伤、急性肾损伤，经过多学科诊治最终抢救成功。

Depressive disorder is a prevalent psychiatric disorder with complicated pathological mechanism.It has been proved that aseptic inflammation of the central nervous system (CNS) plays an important role in the pathogenesis of depressive disorder. High mobility group box 1 (HMGB1) is a non-histone DNA-binding protein widely presented in eukaryotic nuclei that can induce the central inflammatory response when released into the extracellular space, which in turn participates in the onset of depressive disorder. Therefore, this paper reviewed the researches of HMGB1 in depressive disorder, in order to provide reference for further research.

BACKGROUND: Spinal dural arteriovenous fistula (SDAVF) is a rare spinal vascular malformation which can cause permanent neurologic dysfunction. The purpose of this study was to investigate the relationship between the clinical and imaging characteristics of SDAF and its prognosis. METHODS: All patients diagnosed with SDAVF and hospitalized in our hospital from February 2004 to September 2018 were retrospectively recruited. The clinical and imaging data of these patients were collected, and then a subgroup analysis was performed to find the association between clinical and imaging characteristics of SDAF and its prognosis. RESULTS: A total of 79 patients were included in the analysis. The median age of the patients was 59 years, with men having a predominant morbidity (84.4%). The mean duration of symptoms was 7 months, and most patients had more than 2 symptoms before hospitalization (n = 43, 44.4%). The fistula mainly occurred in the lower thoracic spine (n = 40, 50.6%), followed by the lumbar spine (n = 18, 22.8%) and upper thoracic spine (n = 16, 20.3%). Of 58 patients with magnetic resonance images available, 45 (77.6%) were identified with high T2-weighted image (T2WI) signal in the spinal cord, and 51 (87.9%) with T2WI flow voids on the spinal surface. Multivariate logistic regression analysis found that preoperative Aminoff-Logue Scale (ALS) scores were associated with postoperative function improvement after adjustment for sex, age, and duration of symptoms (P = 0.013; odds ratio, 1.375; 95% confidence interval, 1.07-1.77). CONCLUSIONS: Preoperative ALS scores are associated with improved prognosis in patients with SDAVF. Both surgical ligation and endovascular embolization can improve functional outcomes and delay disease progression.

In recent years, the prevalence of depression has been increasing, causing a serious global burden of disease. Previous studies have proved that low-grade inflammation is involved in the process of depression. To explore the role of inflammation in the pathogenesis of senile depression, neutrophil to lymphocyte ratio (NLR) was used in this study, as a biological marker for non-specific inflammation. The present study was conducted among elderly adults from a randomly selected Community in Yangpu District, Shanghai from November 1 to December 30, 2017. 665 participants were included in the present study, including 276 males (median age was 68 years old) and 389 females (median age was 67 years old). NLR was calculated based on results of hematology examination. Depressive symptoms were assessed using the simplified version of Geriatric Depression Scale (GDS), the participant with total score greater than five points was considered to be depressed. The association between NLR and depression was evaluated separately for men and women. The prevalence of depression was 35.1% for men and 34.4% for women. No associations were found between NLR and depression among males. Nevertheless, compared with normal women, NLR was significantly increased in women with depressive symptoms (P = 0.020). Logistic regression analysis showed that NLR was independently associated with geriatric depression in women. The odds ratios (ORs) of depression was 2.152 (1.095, 4.227; P = 0.026) for the fourth compared with the first quartile of NLR. In conclusion, this study showed increased NLR was significantly associated with geriatric depression in women, but not men.

Long noncoding RNA (lncRNA) represents a class of transcripts longer than 200 nucleotides and is a vital molecular component for competing endogenous RNA (ceRNA), which has significant biological function. Recent studies indicated that lncRNA and ceRNA mediated by lncRNA are closely related to the risk of stroke, inflammation and angiogenesis in stroke, which provides a new direction for the diagnosis and treatment of stroke. This article reviewed that the research progress of lncRNA and ceRNA mediated by lncRNA in stroke.

[摘要] 目的 探讨老年人罹患抑郁症及共病 2 型糖尿病后的血糖、血脂水平改变及其与认知功能的关系。 方法 以 2017 年 11 月 1 日至 12 月 30 日接受健康体检的 60~79 岁老年人作为研究对象,根据入组、排除标准最 终纳入抑郁共病糖尿病组(共病组) 59 例、单纯抑郁组 106 例、单纯糖尿病组 84 例、无糖尿病或抑郁症(对照 组)248 例。统计各组老年人下述资料:基本生理指标(身高、体质量、腰围、臀围与血压)、体质量指数(BMI) 及腰臀比(WHR);血糖、血脂水平;蒙特利尔认知评估(MoCA)量表评估结果。分析各组间 BMI、WHR、血 压、血糖、血脂水平的差异,以及与 MoCA 量表评估的校正总分、各认知域之间的关系。结果 (1)各组老年人 在身高、体质量、BMI、WHR 及舒张压方面差异无统计学意义(P 均>0.05);收缩压和脉压差异均有统计学意义 (P 均<0.01),且单纯糖尿病组二者升高最显著。(2)与对照组相比,共病组与单纯糖尿病组空腹血糖 (FBG)、口服葡萄糖耐量试验(OGTT)2 h 血糖、糖化血红蛋白(HbA1c)均升高(P 均<0.01),单纯抑郁组差 异无统计学意义(P>0.05)。共病组的三酰甘油(TG)水平较对照组升高(P<0.05),共病组与糖尿病组较对照 组的高密度脂蛋白(HDL)均降低(P<0.05,P<0.01)。(3)各组老年人 MoCA 量表的校正总分差异无统计学意 义(P>0.05);与对照组相比,其他 3 组的注意力得分均降低(P 均<0.01);共病组的流畅性、定向得分较对照 组降低(P<0.05,P<0.01),同时定向得分较糖尿病组也降低(P<0.05)。(4)简单线性回归分析显示,FBG、 HbA1c对 MoCA 量表的校正总分呈负向影响(b=-0.339,P=0.006;b=-0.482,P=0.023),FBG、OGTT 2 h 血 糖、HbA1c 对注意力得分呈负向影响(b=-0.119,P<0.001;b=-0.040,P=0.002;b=-0.161,P=0.006)。 (5)多元线性回归模型分析显示,FBG 对 MoCA 量表校正总分呈负向影响(B=-0.349,P=0.004)。结论 高 血糖状态可能是抑郁共病糖尿病老年人认知功能障碍的危险因素。 [关键词] 老年人;抑郁; 2 型糖尿病; 血糖;脂类;认知功能障碍 [中图分类号] R 749.42;R 587.2 [文献标志码] A [文章编号] 0258-879X(2018)11-1224-06