Objective Viral encephalitis is an infectious disease severely affecting human health.It is caused by a wide variety of viral pathogens,including herpes viruses,flaviviruses,enteroviruses,and other viruses.The laborat...Objective Viral encephalitis is an infectious disease severely affecting human health.It is caused by a wide variety of viral pathogens,including herpes viruses,flaviviruses,enteroviruses,and other viruses.The laboratory diagnosis of viral encephalitis is a worldwide challenge.Recently,high-throughput sequencing technology has provided new tools for diagnosing central nervous system infections.Thus,In this study,we established a multipathogen detection platform for viral encephalitis based on amplicon sequencing.Methods We designed nine pairs of specific polymerase chain reaction(PCR)primers for the 12 viruses by reviewing the relevant literature.The detection ability of the primers was verified by software simulation and the detection of known positive samples.Amplicon sequencing was used to validate the samples,and consistency was compared with Sanger sequencing.Results The results showed that the target sequences of various pathogens were obtained at a coverage depth level greater than 20×,and the sequence lengths were consistent with the sizes of the predicted amplicons.The sequences were verified using the National Center for Biotechnology Information BLAST,and all results were consistent with the results of Sanger sequencing.Conclusion Amplicon-based high-throughput sequencing technology is feasible as a supplementary method for the pathogenic detection of viral encephalitis.It is also a useful tool for the high-volume screening of clinical samples.展开更多
Objective: This study aims to explore the differences in cerebrospinal fluid oligoclonal band (CSF-OCB) expression among different age groups in viral encephalitis and its reference value for diagnosis. Methods: Forty...Objective: This study aims to explore the differences in cerebrospinal fluid oligoclonal band (CSF-OCB) expression among different age groups in viral encephalitis and its reference value for diagnosis. Methods: Forty-two patients with viral encephalitis were divided into two groups: 25 adults and 17 children. The presence of oligoclonal bands in the cerebrospinal fluid (CSF) was detected using polyacrylamide gel electrophoresis, and CSF routine analysis was conducted for comparative analysis. Results: The CSF-OCB positivity rate was higher in the adult group (48%) compared with the pediatric group (11.76%), with a statistically significant difference (P Conclusion: 1) The expression of CSF-OCB positivity in patients with viral encephalitis is age-related, with higher positivity rates observed in adults compared to children. 2) Although CSF oligoclonal band detection is not a specific diagnostic marker for viral encephalitis in adults, it still holds certain reference value.展开更多
Objective:To explore and analyze the effectiveness of targeted nursing in children with severe viral encephalitis complicated with respiratory failure.Methods:From April 2021 to April 2023,74 children with severe vira...Objective:To explore and analyze the effectiveness of targeted nursing in children with severe viral encephalitis complicated with respiratory failure.Methods:From April 2021 to April 2023,74 children with severe viral encephalitis complicated with respiratory failure admitted to the Department of Pediatrics of our hospital were selected as the research objects and divided into the target group(n=37)and the reference group(n=37).Targeted nursing was given to the target group,while general nursing was given to the reference group.Physical rehabilitation,motor scores,and lung function were compared between the groups.Results:The recovery time of limb abnormalities,convulsions,abnormal consciousness,and cranial nerve disorders in the target group was significantly better than that in the reference group(P<0.05).The motor function,joint activity and pain,sensory function,and total score of the target group were significantly lower than those of the reference group(P<0.05).After the intervention,lung function indicators including VC(vital capacity),FVC(forced vital capacity),and MVV(maximum voluntary ventilation)of the target group were better than those of the reference group(P<0.05).Conclusion:Targeted nursing can shorten the recovery period of severe viral encephalitis complicated with respiratory failure in children,speed up the recovery of motor function,and improve lung function.This nursing model has a significant application effect in children with severe viral encephalitis complicated with respiratory failure.展开更多
Viral infections have led to many public health crises and pandemics in the last few centuries.Neurotropic virus infection-induced viral encephalitis(VE),especially the symptomatic inflammation of the meninges and bra...Viral infections have led to many public health crises and pandemics in the last few centuries.Neurotropic virus infection-induced viral encephalitis(VE),especially the symptomatic inflammation of the meninges and brain parenchyma,has attracted growing attention due to its high mortality and disability rates.Understanding the infectious routes of neurotropic viruses and the mechanism underlying the host immune response is critical to reduce viral spread and improve antiviral therapy outcomes.In this review,we summarize the common categories of neurotropic viruses,viral transmission routes in the body,host immune responses,and experimental animal models used for VE study to gain a deeper understanding of recent progress in the pathogenic and immunological mechanisms under neurotropic viral infection.This review should provide valuable resources and perspectives on how to cope with pandemic infections.展开更多
Previous studies have confirmed that the anti-virus effects of Shuanghuanglian injection may be associated with nuclear factor-kappa B activity. This study observed nuclear factor-kappa B expression in mice with viral...Previous studies have confirmed that the anti-virus effects of Shuanghuanglian injection may be associated with nuclear factor-kappa B activity. This study observed nuclear factor-kappa B expression in mice with viral encephalitis, and showed significant decreases in nuclear factor-kappa B protein and mRNA levels following Shuanghuanglian injection. The inhibitory effect was more significant with prolonged intervention duration and increased treatment dose. These findings verify that Shuanghuanglian injection plays a therapeutic role in viral encephalitis by reducing expression of nuclear factor-kappa B in a time- and dose-dependent manner.展开更多
A mouse model of viral encephalitis was induced by intracranial injection of a Coxsackie virus B3 suspension. Quantitative real-time reverse transcription-PCR and western blot assay were applied to detect mRNA and pro...A mouse model of viral encephalitis was induced by intracranial injection of a Coxsackie virus B3 suspension. Quantitative real-time reverse transcription-PCR and western blot assay were applied to detect mRNA and protein expression of intelectin-2 and nuclear factor-kappa B in the viral encephalitis and control groups. Nuclear factor-kappa B and intelectin-2 mRNA and protein expression were significantly increased in mice with viral encephalitis. After intraperitoneal injection of Shuanghuanglian at a dose of 1.5 mg/kg for 5 successive days, intelectin-2 and nuclear factor-kappa B protein and mRNA expression were significantly decreased. To elucidate the relationship between intelectin-2 and nuclear factor-kappa B, mice with viral encephalitis were administered an intracerebral injection of 107 pfu recombinant lentivirus expressing intelectin shRNA. Both protein and mRNA levels of intelectin and nuclear factor-kappa B in brain tissue of mice were significantly decreased. Experimental findings suggest that Shuanghuanglian injection may downregulate nuclear factor-kappa B production via suppression of intelectin production, thus inhibiting inflammation associated with viral encephalitis.展开更多
BACKGROUND： Traditional subhibernation therapy may easily cause complications, such as respiratory depression and hyportension because of application of chlorpromazine hydrochloride and promethazine in a large dosage...BACKGROUND： Traditional subhibernation therapy may easily cause complications, such as respiratory depression and hyportension because of application of chlorpromazine hydrochloride and promethazine in a large dosage. OBJECTIVE： To observe therapeutic effect of modified subhibernation therapy （alterative application of five anticonvulsants according to the half life） on status epilepticus in children with severe viral encephalitis （VE）. DESIGN： Contrast observation. SETTING： Department of Pediatrics, the First Hospital of Jilin University. PARTICIPANTS： The participants in present study were 96 patients with severe viral encephalitis including 52 boys and 44 girls who received treatment in the Department of Pediatrics, the First Hospital of Jilin University from February 2000 to March 2006. All children met the diagnostic criteria of Zhufutong Practice Pediatrics （the seventh edition）. Two weeks ago, they ever got upper respiratory infection or enteronitis and so on before the onset, spirit abnormal, behavior disorder, limbs act disorder, vomit, headache, convulsion, nervous system masculine signs such as limbs act disord, autonomic nerve damage manifestation, brain nerve palsy, dysreflexia, meningeal irritation sign, cerebrospinal fluid and electroencephalography （EEG） abnormity. All parents provided the confirmed consent. The patients were randomly divided into control group （n =40） and experimental group （n =56）. METHODS： Patients in the control group received anticonvulsion, ice compress and routine treatment. The convulsion was treated with five drugs： 0.5 mg/kg wintermin and phenergan, respectively, 100 g/L chlorpromazine hydrochloride （0.5 mL/kg）, 5 mg/kg luminal, 0.3 mg/kg ansiolin. When convulsion attacked, those five drugs were given alternatively; however, those were not given if the convulsion did not attack. Children in the experimental group were treated with improved subhibernation therapy based on routine treatment. The dosages of anticonvulsants were as the same as those in the control group. Based on the half life, every drug was alternated every 4-6 hours. In addition, anticonvulsants administrated for 2 successive days whether tic attacked or not. Then the hypnotic was removed gradually. MAIN OUTCOME MEASURES： Therapeutic efficacy, time of disappeared clinical symptoms and physical sign, and security of administration. RESULTS： All the 96 patients were involved in the final analysis. ① Total effective rate and reliability： Total effective rate was higher in the treatment groups than the control group （χ2=5.871 7, P 〈 0.05）. All patients did not have respiratory depression and side effects. ② Time of disappeared clinical symptoms and physical sign： Recovery time of convulsion, fever, headache and vomit was shorter in the treatment group than that in the control group, and there was significant difference （t =17.612 1-34.330 7, P 〈 0.05）; in addition, symptoms of status epilepticus were relieved obviously. Meanwhile, recovery time of paralysis, coma and anepia was shorter in the treatment group than that in the control group, and there was significant difference （t =10.660 8-24.700 8, P 〈 0.05）. CONCLUSION： Therapeutic effect of improved subhibernation therapy on status epilepticus induced by severe viral encephalitis is positively and safer.展开更多
Viral encephalitis in children caused by multiple viral infections,as a common central nervous system disease in pediatrics,has a high incidence in China.Its clinical symptoms usually include infection,poisoning,intra...Viral encephalitis in children caused by multiple viral infections,as a common central nervous system disease in pediatrics,has a high incidence in China.Its clinical symptoms usually include infection,poisoning,intracranial hypertension,and disturbance of consciousness.In severe cases,it can even endanger the lives of patient children.At present,the clinical treatment of the viral encephalitis mainly uses traditional Chinese medicine preparations such as Reduning Injection.The efficacy is significant.It can not only relieve the uncomfortable symptoms in a short time,but also has low incidence of adverse reactions.In this study,the factors that cause viral encephalitis in children were analyzed,and the efficacy,pharmacological action and clinical application of Reduning Injection were comprehensively elaborated,to provide a reference for clinical doctors to rationally treat viral encephalitis in children.展开更多
Objective: To investigate the serum VCAM-1 content in children with viral encephalitis and its correlation with nerve injury and inflammatory response. Methods: A total of 60 children with viral encephalitis who were ...Objective: To investigate the serum VCAM-1 content in children with viral encephalitis and its correlation with nerve injury and inflammatory response. Methods: A total of 60 children with viral encephalitis who were treated in Xianyang First People's Hospital between December 2015 and January 2017 were selected as viral encephalitis group, and 50 healthy children who accepted vaccination in the hospital during the same period were selected as normal control group. The differences in serum levels of VCAM-1, nerve injury-related indexes and inflammatory factors were compared between two groups of children, and Pearson test was used to further evaluate the correlation of serum VCAM-1 content with nerve injury and inflammatory response in children with viral encephalitis. Results: Immediately after admission, serum VCAM-1 content of children with viral encephalitis was significantly higher than that of normal control group;serum nerve injury-related indexes CK-BB, MBP, β-EP and NSE contents were higher than those of normal control group;serum inflammatory factors IL-6, IL-18 and γ-IFN contents were higher than those of control group. Pearson test showed that serum VCAM-1 content in children with viral encephalitis was positively correlated with nerve injury and inflammatory response. Conclusion: Serum VCAM-1 content is high in children with viral encephalitis, and the specific content is directly correlated with the severity of nerve injury and inflammatory response.展开更多
Objective:To detect the content of SP-D in cerebrospinal fluid(CSF) of children with viral encephalitis, evaluate the correlation between SP-D and indexes of brain injury, inflammatory reaction and cellular immune dis...Objective:To detect the content of SP-D in cerebrospinal fluid(CSF) of children with viral encephalitis, evaluate the correlation between SP-D and indexes of brain injury, inflammatory reaction and cellular immune disorder.Methods: 78 cases of viral encephalitis children diagnosed in our hospital during December 2016 to May 2018 were selected as Viral encephalitis group, 51 cases of fever without intracranial infection children were selected as Control group. The cerebrospinal fluid samples of two groups were taken and SP-D, brain injury-related indicators, inflammatory indicators and T lymphocyte subsets were detected. Pearson test was used to analyze the relationship between SP-D content in CSF and above indicators.Results: Content of SP-D in CSF of Viral encephalitis group was lower than that of control group (P<0.05). Contents of MBP, CK-BB, NSE and S100B in CSF of Viral encephalitis group were higher than those of Control group;contents of IL-1β, TNF-αand ICAM-1 in CSF of Viral encephalitis group were higher than those of Control group;distribution proportion of CD3+, CD4+ T lymphocytes and CD4+/CD8+ ratio in CSF were lower than those of Control group, and levels of CD8+ were higher than that of Control group (P<0.05). Correlation analysis showed that, SP-D content in CSF of viral encephalitis children was directly related to brain injury indexes, inflammatory indexes and T lymphocyte subsets distribution levels(P<0.05).Conclusion: Content of SP-D in CSF of viral encephalitis children decreases abnormally, the specific content is directly related to the degree of brain injury, intracranial inflammation and cellular immune dysfunction. It is important to evaluate the severity of the disease.展开更多
Objective:To analyze the changes of EEG,neurological function,immune function and inflammatory factors in children with viral encephalitis and their clinical significance.Methods:60 children with viral encephalitis in...Objective:To analyze the changes of EEG,neurological function,immune function and inflammatory factors in children with viral encephalitis and their clinical significance.Methods:60 children with viral encephalitis in our hospital were collected as observation group and 60 healthy children were collected as control group during the same period.The electroencephalogram(EEG)of the children in the observation group was observed,and the serum levels of S100B protein(S100B),neuron specific enolase(NSE),myelin basic protein(MBP),immunoglobulin G(IgG),immunoglobulin M(IgM),hypersensitive C-reactive protein(hs-CRP)and cystatin C(Cyst C)were detected and compared between the two groups.Results:The electroencephalogram results of the observation group showed that 55 cases were abnormal,the positive rate was 91.67%.Among them,30 cases were mild abnormal,19 cases were moderate abnormal and 6 cases were severe abnormal.The serum levels of S100B,NSE and MBP of patients in the observation group were(231.26±25.74)ng/L,(18.92±2.03)ug/L,(1.44±16.23)ug/L,which were significantly higher than the control group(P<0.05);The serum levels of IgG and IgM were(7.45±0.76)g/L,(0.83±0.09)g/L respectively,which were significantly lower than those in the control group(P<0.05).The serum levels of hs-CRP and Cyst C of patients in the observation group were(4.59±0.51)mg/L,(14.38±0.09)mg/L,respectively,which were higher than those of the control group(P<0.05).Conclusion:The positive rate of EEG diagnosis was high.The changes of neurological function,immune function factors,hs-CRP and Cyst C levels may become important reference indicators for auxiliary diagnosis and early treatment of children with viral encephalitis.Neurological function,immune function factors,hs-CRP and Cyst C are all related to the progression of viral encephalitis.The above indicators can be used as important indicators for assistant diagnosis and early treatment of viral encephalitis in children.展开更多
Human herpesvirus 6(HHV-6)is a significant pathogen following solid organ transplantation.Here,we report a 64-year-old female with cirrhosis related to nonalcoholic fatty liver disease who underwent orthotopic allogen...Human herpesvirus 6(HHV-6)is a significant pathogen following solid organ transplantation.Here,we report a 64-year-old female with cirrhosis related to nonalcoholic fatty liver disease who underwent orthotopic allogeneic liver transplantation and was ultimately diagnosed with HHV-6 encephalitis through cerebrospinal fluid analysis and MRI.Empirical treatment with daily ganciclovir was initiated according to characteristics indicative of viral encephalitis 3 days before confirmed diagnosis.Subsequent improvement in symptoms was observed,with clearance of HHV-6 from the blood.The complex diagnosis and management of this case accentuate the possibility of serious consequences of HHV-6 infection in postoperative liver transplant patients.Clinicians must maintain a high index of suspicion for HHV-6 reactivation,especially given its association with immunosuppressive drug regimens.Prompt recognition and initiation of antiviral therapy are paramount,particularly when patients present with fever or psychiatric symptoms,as these may indicate HHV-6 encephalitis.展开更多
Viral encephalitis is a devastating disease with high mortality,and survivors often suffer from severe neurological complications.Microglia are innate immune cells of the central nervous system(CNS)parenchyma whose tu...Viral encephalitis is a devastating disease with high mortality,and survivors often suffer from severe neurological complications.Microglia are innate immune cells of the central nervous system(CNS)parenchyma whose turnover is reliant on local proliferation.Microglia express a diverse range of proteins,which allows them to continuously sense the environment and quickly react to changes.Under inflammatory conditions such as CNS viral infection,microglia promote innate and adaptive immune responses to protect the host.However,during viral infection,a dysregulated microglia-T-cell interplay may result in altered phagocytosis of neuronal synapses by microglia that causes neurocognitive impairment.In this review,we summarize the current knowledge on the role of microglia in viral encephalitis,propose questions to be answered in the future and suggest possible therapeutic targets.展开更多
Aim: To compare the difference between viral encephalitis patients complicated with epilepsy group and those without epilepsy. Methods: The authors retrospectively study 116 cases of viral encephalitis patients admitt...Aim: To compare the difference between viral encephalitis patients complicated with epilepsy group and those without epilepsy. Methods: The authors retrospectively study 116 cases of viral encephalitis patients admitted to the General Hospital of Ningxia Medical University and the Cardia-Cerebrovascular Disease Hospital of Ningxia Medical University from January 2011 to December 2016. There were 39 cases with epilepsy and 77 cases without epilepsy. By surveying the Hospital Information System, the authors collected their clinical data including general situations, medical history, physical examination, clinical presentation, laboratory examination, cerebrospinal fluid examination, imaging examination, electroencephalogram examination (EEG), treatment, and discharge conditions. The authors used SPSS for further analysis and statistics. Results: Medical history: there were significant differences between the two groups in disturbance of consciousness, cognitive dysfunction, and admission conditions (P < 0.05). No significant differences were found in other clinical manifestations. Auxiliary examination: in cerebrospinal fluid (CSF) examination, the patients with epilepsy had higher glucose (P < 0.05). Brain imaging examination shows that cortical involvements in patients with epilepsy were higher (P < 0.05), and EEG examination showed that patients with epilepsy were more severe (P < 0.05). No significant differences were found in other auxiliary examination. Treatment and prognosis: all the patients were given antiviral treatment. Twenty-eight cases of the patients with epilepsy (71.79%) are used of antiepileptic drugs. The prognosis of patients with epilepsy was poor (P < 0.05). Conclusion: Viral encephalitis frequently manifests with seizures in its acute phase, and the incidence of seizures in our study was 33.62%. The main form was generalized seizures (64.10%), which could occur at any age;patients with epilepsy had a higher cortical involvement on imaging and a higher degree of EEG abnormalities than patients without;patients with epilepsy had a higher level of glucose in the CSF;an episode of viral encephalitis complicated with seizures could aggravate disturbances of consciousness and cognitive impairment. The prognosis of patients with epilepsy was poor.展开更多
Importance:Viral encephalitis and meningitis are severe infectious diseases responsible for substantial morbidity and mortality in children.Enteroviruses are typically the most common causative agents of viral encepha...Importance:Viral encephalitis and meningitis are severe infectious diseases responsible for substantial morbidity and mortality in children.Enteroviruses are typically the most common causative agents of viral encephalitis and meningitis.Objective:This study aimed to investigate the etiology of viral encephalitis and meningitis among children in Hebei province,China.Methods:Cerebrospinal fluid samples from children with viral encephalitis (n=309) and meningitis (n=133) were collected between Nov 2013 and Dec 2015 and viral pathogens were identified by real-time and multiplex PCR.Amplification and sequencing of partial VP1 genes was used to type enteroviruses.Results:The causative pathogen was successfully detected in 176 (57％) patients with viral encephalitis and 82 (61.7％) patients with viral meningitis.The most common causative agents of both viral encephalitis and meningitis were enteroviruses (55.7％ and 64.6％ of cases,respectively).The most common enterovirus serotypes identified were echovirus 18,echovirus 6 and echovirus 30.Echovirus 18 accounted for 74.4％ of all typed enteroviruses and caused a viral encephalitis and meningitis outbreak in Hebei province in 2015.By contrast,the major enterovirus serotypes circulating in 2014 were echovims 6 and echovirus 30.Interpretation:Enteroviruses were the main causative agents of viral encephalitis and meningitis in children in Hebei province from Nov 2013 to Dec 2015.Echovirus 18 became the leading cause of viral encephalitis and meningitis for the first time in Hebei province in 2015.展开更多
Introduction Viral encephalitis caused by varicella zoster virus (VZV)mainly occurs in immunocompromised individuals and patients with VZV infection in the brain or nerves of the cervical or upper thoracic spinal cord...Introduction Viral encephalitis caused by varicella zoster virus (VZV)mainly occurs in immunocompromised individuals and patients with VZV infection in the brain or nerves of the cervical or upper thoracic spinal cord.However,viral encephalitis caused by VZV affecting distant body parts,such as herpes zoster of the waist and abdomen,is rare.How herpes zoster virus reaches the central nervous system (CNS) is unclear.We herein present an atypical case of waist and abdomen herpes zoster infection that progressed to the CNS in a 48-year-old healthy,immunocompetent patient without brain magnetic resonance imaging (MRI) abnormalities,and may enrich the knowledge of viral encephalitis caused by herpes zoster.展开更多
OBJECTIVE: To study the character of mutants originating from Japanese encephalitis viruses and the relationship between the characterization of mutant strains and E protein expression. METHODS: Persistent infection w...OBJECTIVE: To study the character of mutants originating from Japanese encephalitis viruses and the relationship between the characterization of mutant strains and E protein expression. METHODS: Persistent infection was established with standard strains of Japanese encephalitis viruse, known as parental viruse, in a human hepatoma cell line, KN73. Cells were subcultured weekly using trypsinization techniques. Cell-associated viruses of persistently infected cells were collected by a freeze and thaw method. Virus titers were examined by plaque method using baby hamster kidney (BHK) cells. Indirect immunofluorescence assays were used to examine E and NS3 protein antigens. Western blot analysis was used to test expression of E and NS3 proteins. RESULTS: In the early phase (24 - 36 h) post-infection, virus titer in culture fluid from KN73 cells infected with parental viruses were 10(6) PFU/ml. They were 10(3 - 4) PFU/ml in the late phase (3 years) post-infection. The titer of cell-associated viruse was 10(2 - 3) PFU/ml. A virus super-infection assay found that virus titers in culture fluid from persistently infected KN73 cells acutely super- infected with parental viruses were much lower than that of culture fluids in acutely infected normal KN73 at the same phase. Indirect immunoflurescence assay revealed that the quantity of viral antigens in persistently infected KN73 cells was lower than that in acutely infected KN73 cells with parental viruses. Western blot analyses indicated that the molecular weights of E and NS3 proteins were 53 kD and 73 kD, respectively. Expression of NS3 protein in persistently infected KN73 cells was stable but expression of E protein was markedly suppressed. CONCLUSIONS: The virulence and reproduction of viruses obtained from persistently infected KN73 cells, which have some features of DI viruses and were involved in persistent infection, was lower than that of parental viruses. These mutants may have be related to the decrease in E protein expression.展开更多
基金supported by the National Key Research and Development Program(grant number:2022YFC2305304).
文摘Objective Viral encephalitis is an infectious disease severely affecting human health.It is caused by a wide variety of viral pathogens,including herpes viruses,flaviviruses,enteroviruses,and other viruses.The laboratory diagnosis of viral encephalitis is a worldwide challenge.Recently,high-throughput sequencing technology has provided new tools for diagnosing central nervous system infections.Thus,In this study,we established a multipathogen detection platform for viral encephalitis based on amplicon sequencing.Methods We designed nine pairs of specific polymerase chain reaction(PCR)primers for the 12 viruses by reviewing the relevant literature.The detection ability of the primers was verified by software simulation and the detection of known positive samples.Amplicon sequencing was used to validate the samples,and consistency was compared with Sanger sequencing.Results The results showed that the target sequences of various pathogens were obtained at a coverage depth level greater than 20×,and the sequence lengths were consistent with the sizes of the predicted amplicons.The sequences were verified using the National Center for Biotechnology Information BLAST,and all results were consistent with the results of Sanger sequencing.Conclusion Amplicon-based high-throughput sequencing technology is feasible as a supplementary method for the pathogenic detection of viral encephalitis.It is also a useful tool for the high-volume screening of clinical samples.
文摘Objective: This study aims to explore the differences in cerebrospinal fluid oligoclonal band (CSF-OCB) expression among different age groups in viral encephalitis and its reference value for diagnosis. Methods: Forty-two patients with viral encephalitis were divided into two groups: 25 adults and 17 children. The presence of oligoclonal bands in the cerebrospinal fluid (CSF) was detected using polyacrylamide gel electrophoresis, and CSF routine analysis was conducted for comparative analysis. Results: The CSF-OCB positivity rate was higher in the adult group (48%) compared with the pediatric group (11.76%), with a statistically significant difference (P Conclusion: 1) The expression of CSF-OCB positivity in patients with viral encephalitis is age-related, with higher positivity rates observed in adults compared to children. 2) Although CSF oligoclonal band detection is not a specific diagnostic marker for viral encephalitis in adults, it still holds certain reference value.
文摘Objective:To explore and analyze the effectiveness of targeted nursing in children with severe viral encephalitis complicated with respiratory failure.Methods:From April 2021 to April 2023,74 children with severe viral encephalitis complicated with respiratory failure admitted to the Department of Pediatrics of our hospital were selected as the research objects and divided into the target group(n=37)and the reference group(n=37).Targeted nursing was given to the target group,while general nursing was given to the reference group.Physical rehabilitation,motor scores,and lung function were compared between the groups.Results:The recovery time of limb abnormalities,convulsions,abnormal consciousness,and cranial nerve disorders in the target group was significantly better than that in the reference group(P<0.05).The motor function,joint activity and pain,sensory function,and total score of the target group were significantly lower than those of the reference group(P<0.05).After the intervention,lung function indicators including VC(vital capacity),FVC(forced vital capacity),and MVV(maximum voluntary ventilation)of the target group were better than those of the reference group(P<0.05).Conclusion:Targeted nursing can shorten the recovery period of severe viral encephalitis complicated with respiratory failure in children,speed up the recovery of motor function,and improve lung function.This nursing model has a significant application effect in children with severe viral encephalitis complicated with respiratory failure.
基金supported by the National Natural Science Foundation of China(81825011,81930038,81961160738)Program of Shanghai Academic/Technology Research Leader(22XD1400800)Strategic Priority Research Program of the Chinese Academy of Sciences(XDB19030200)。
文摘Viral infections have led to many public health crises and pandemics in the last few centuries.Neurotropic virus infection-induced viral encephalitis(VE),especially the symptomatic inflammation of the meninges and brain parenchyma,has attracted growing attention due to its high mortality and disability rates.Understanding the infectious routes of neurotropic viruses and the mechanism underlying the host immune response is critical to reduce viral spread and improve antiviral therapy outcomes.In this review,we summarize the common categories of neurotropic viruses,viral transmission routes in the body,host immune responses,and experimental animal models used for VE study to gain a deeper understanding of recent progress in the pathogenic and immunological mechanisms under neurotropic viral infection.This review should provide valuable resources and perspectives on how to cope with pandemic infections.
基金the Health Research Fund from Health Department of Shaanxi Province,China,No. 04015
文摘Previous studies have confirmed that the anti-virus effects of Shuanghuanglian injection may be associated with nuclear factor-kappa B activity. This study observed nuclear factor-kappa B expression in mice with viral encephalitis, and showed significant decreases in nuclear factor-kappa B protein and mRNA levels following Shuanghuanglian injection. The inhibitory effect was more significant with prolonged intervention duration and increased treatment dose. These findings verify that Shuanghuanglian injection plays a therapeutic role in viral encephalitis by reducing expression of nuclear factor-kappa B in a time- and dose-dependent manner.
基金funded by the Health Research Fund from the Health Department of Shanxi Province, China, No.04015
文摘A mouse model of viral encephalitis was induced by intracranial injection of a Coxsackie virus B3 suspension. Quantitative real-time reverse transcription-PCR and western blot assay were applied to detect mRNA and protein expression of intelectin-2 and nuclear factor-kappa B in the viral encephalitis and control groups. Nuclear factor-kappa B and intelectin-2 mRNA and protein expression were significantly increased in mice with viral encephalitis. After intraperitoneal injection of Shuanghuanglian at a dose of 1.5 mg/kg for 5 successive days, intelectin-2 and nuclear factor-kappa B protein and mRNA expression were significantly decreased. To elucidate the relationship between intelectin-2 and nuclear factor-kappa B, mice with viral encephalitis were administered an intracerebral injection of 107 pfu recombinant lentivirus expressing intelectin shRNA. Both protein and mRNA levels of intelectin and nuclear factor-kappa B in brain tissue of mice were significantly decreased. Experimental findings suggest that Shuanghuanglian injection may downregulate nuclear factor-kappa B production via suppression of intelectin production, thus inhibiting inflammation associated with viral encephalitis.
文摘BACKGROUND： Traditional subhibernation therapy may easily cause complications, such as respiratory depression and hyportension because of application of chlorpromazine hydrochloride and promethazine in a large dosage. OBJECTIVE： To observe therapeutic effect of modified subhibernation therapy （alterative application of five anticonvulsants according to the half life） on status epilepticus in children with severe viral encephalitis （VE）. DESIGN： Contrast observation. SETTING： Department of Pediatrics, the First Hospital of Jilin University. PARTICIPANTS： The participants in present study were 96 patients with severe viral encephalitis including 52 boys and 44 girls who received treatment in the Department of Pediatrics, the First Hospital of Jilin University from February 2000 to March 2006. All children met the diagnostic criteria of Zhufutong Practice Pediatrics （the seventh edition）. Two weeks ago, they ever got upper respiratory infection or enteronitis and so on before the onset, spirit abnormal, behavior disorder, limbs act disorder, vomit, headache, convulsion, nervous system masculine signs such as limbs act disord, autonomic nerve damage manifestation, brain nerve palsy, dysreflexia, meningeal irritation sign, cerebrospinal fluid and electroencephalography （EEG） abnormity. All parents provided the confirmed consent. The patients were randomly divided into control group （n =40） and experimental group （n =56）. METHODS： Patients in the control group received anticonvulsion, ice compress and routine treatment. The convulsion was treated with five drugs： 0.5 mg/kg wintermin and phenergan, respectively, 100 g/L chlorpromazine hydrochloride （0.5 mL/kg）, 5 mg/kg luminal, 0.3 mg/kg ansiolin. When convulsion attacked, those five drugs were given alternatively; however, those were not given if the convulsion did not attack. Children in the experimental group were treated with improved subhibernation therapy based on routine treatment. The dosages of anticonvulsants were as the same as those in the control group. Based on the half life, every drug was alternated every 4-6 hours. In addition, anticonvulsants administrated for 2 successive days whether tic attacked or not. Then the hypnotic was removed gradually. MAIN OUTCOME MEASURES： Therapeutic efficacy, time of disappeared clinical symptoms and physical sign, and security of administration. RESULTS： All the 96 patients were involved in the final analysis. ① Total effective rate and reliability： Total effective rate was higher in the treatment groups than the control group （χ2=5.871 7, P 〈 0.05）. All patients did not have respiratory depression and side effects. ② Time of disappeared clinical symptoms and physical sign： Recovery time of convulsion, fever, headache and vomit was shorter in the treatment group than that in the control group, and there was significant difference （t =17.612 1-34.330 7, P 〈 0.05）; in addition, symptoms of status epilepticus were relieved obviously. Meanwhile, recovery time of paralysis, coma and anepia was shorter in the treatment group than that in the control group, and there was significant difference （t =10.660 8-24.700 8, P 〈 0.05）. CONCLUSION： Therapeutic effect of improved subhibernation therapy on status epilepticus induced by severe viral encephalitis is positively and safer.
基金National Natural Science Foundation of China(81873218)。
文摘Viral encephalitis in children caused by multiple viral infections,as a common central nervous system disease in pediatrics,has a high incidence in China.Its clinical symptoms usually include infection,poisoning,intracranial hypertension,and disturbance of consciousness.In severe cases,it can even endanger the lives of patient children.At present,the clinical treatment of the viral encephalitis mainly uses traditional Chinese medicine preparations such as Reduning Injection.The efficacy is significant.It can not only relieve the uncomfortable symptoms in a short time,but also has low incidence of adverse reactions.In this study,the factors that cause viral encephalitis in children were analyzed,and the efficacy,pharmacological action and clinical application of Reduning Injection were comprehensively elaborated,to provide a reference for clinical doctors to rationally treat viral encephalitis in children.
文摘Objective: To investigate the serum VCAM-1 content in children with viral encephalitis and its correlation with nerve injury and inflammatory response. Methods: A total of 60 children with viral encephalitis who were treated in Xianyang First People's Hospital between December 2015 and January 2017 were selected as viral encephalitis group, and 50 healthy children who accepted vaccination in the hospital during the same period were selected as normal control group. The differences in serum levels of VCAM-1, nerve injury-related indexes and inflammatory factors were compared between two groups of children, and Pearson test was used to further evaluate the correlation of serum VCAM-1 content with nerve injury and inflammatory response in children with viral encephalitis. Results: Immediately after admission, serum VCAM-1 content of children with viral encephalitis was significantly higher than that of normal control group;serum nerve injury-related indexes CK-BB, MBP, β-EP and NSE contents were higher than those of normal control group;serum inflammatory factors IL-6, IL-18 and γ-IFN contents were higher than those of control group. Pearson test showed that serum VCAM-1 content in children with viral encephalitis was positively correlated with nerve injury and inflammatory response. Conclusion: Serum VCAM-1 content is high in children with viral encephalitis, and the specific content is directly correlated with the severity of nerve injury and inflammatory response.
文摘Objective:To detect the content of SP-D in cerebrospinal fluid(CSF) of children with viral encephalitis, evaluate the correlation between SP-D and indexes of brain injury, inflammatory reaction and cellular immune disorder.Methods: 78 cases of viral encephalitis children diagnosed in our hospital during December 2016 to May 2018 were selected as Viral encephalitis group, 51 cases of fever without intracranial infection children were selected as Control group. The cerebrospinal fluid samples of two groups were taken and SP-D, brain injury-related indicators, inflammatory indicators and T lymphocyte subsets were detected. Pearson test was used to analyze the relationship between SP-D content in CSF and above indicators.Results: Content of SP-D in CSF of Viral encephalitis group was lower than that of control group (P<0.05). Contents of MBP, CK-BB, NSE and S100B in CSF of Viral encephalitis group were higher than those of Control group;contents of IL-1β, TNF-αand ICAM-1 in CSF of Viral encephalitis group were higher than those of Control group;distribution proportion of CD3+, CD4+ T lymphocytes and CD4+/CD8+ ratio in CSF were lower than those of Control group, and levels of CD8+ were higher than that of Control group (P<0.05). Correlation analysis showed that, SP-D content in CSF of viral encephalitis children was directly related to brain injury indexes, inflammatory indexes and T lymphocyte subsets distribution levels(P<0.05).Conclusion: Content of SP-D in CSF of viral encephalitis children decreases abnormally, the specific content is directly related to the degree of brain injury, intracranial inflammation and cellular immune dysfunction. It is important to evaluate the severity of the disease.
基金Youth Science Foundation of National Natural Science Foundation of China.Project No:81701548.
文摘Objective:To analyze the changes of EEG,neurological function,immune function and inflammatory factors in children with viral encephalitis and their clinical significance.Methods:60 children with viral encephalitis in our hospital were collected as observation group and 60 healthy children were collected as control group during the same period.The electroencephalogram(EEG)of the children in the observation group was observed,and the serum levels of S100B protein(S100B),neuron specific enolase(NSE),myelin basic protein(MBP),immunoglobulin G(IgG),immunoglobulin M(IgM),hypersensitive C-reactive protein(hs-CRP)and cystatin C(Cyst C)were detected and compared between the two groups.Results:The electroencephalogram results of the observation group showed that 55 cases were abnormal,the positive rate was 91.67%.Among them,30 cases were mild abnormal,19 cases were moderate abnormal and 6 cases were severe abnormal.The serum levels of S100B,NSE and MBP of patients in the observation group were(231.26±25.74)ng/L,(18.92±2.03)ug/L,(1.44±16.23)ug/L,which were significantly higher than the control group(P<0.05);The serum levels of IgG and IgM were(7.45±0.76)g/L,(0.83±0.09)g/L respectively,which were significantly lower than those in the control group(P<0.05).The serum levels of hs-CRP and Cyst C of patients in the observation group were(4.59±0.51)mg/L,(14.38±0.09)mg/L,respectively,which were higher than those of the control group(P<0.05).Conclusion:The positive rate of EEG diagnosis was high.The changes of neurological function,immune function factors,hs-CRP and Cyst C levels may become important reference indicators for auxiliary diagnosis and early treatment of children with viral encephalitis.Neurological function,immune function factors,hs-CRP and Cyst C are all related to the progression of viral encephalitis.The above indicators can be used as important indicators for assistant diagnosis and early treatment of viral encephalitis in children.
基金supported by the Foundation of Jilin Province Department of Finance(20210204097YY)the Health Department of Jilin Province(JLSWSRCZX2020-045)Beijing Liver-GallbladderMutual charity Fund(GDXZ-08-18).
文摘Human herpesvirus 6(HHV-6)is a significant pathogen following solid organ transplantation.Here,we report a 64-year-old female with cirrhosis related to nonalcoholic fatty liver disease who underwent orthotopic allogeneic liver transplantation and was ultimately diagnosed with HHV-6 encephalitis through cerebrospinal fluid analysis and MRI.Empirical treatment with daily ganciclovir was initiated according to characteristics indicative of viral encephalitis 3 days before confirmed diagnosis.Subsequent improvement in symptoms was observed,with clearance of HHV-6 from the blood.The complex diagnosis and management of this case accentuate the possibility of serious consequences of HHV-6 infection in postoperative liver transplant patients.Clinicians must maintain a high index of suspicion for HHV-6 reactivation,especially given its association with immunosuppressive drug regimens.Prompt recognition and initiation of antiviral therapy are paramount,particularly when patients present with fever or psychiatric symptoms,as these may indicate HHV-6 encephalitis.
基金Open Access funding enabled and organized by Projekt DEAL.M.P.was supported by the Sobek Foundation,the Ernst-Jung Foundation,the DFG(SFB 992,SFB1160,SFB/TRR167,Reinhart-Koselleck-Grant,and Gottfried Wilhelm Leibniz-Prize)and the Ministry of Science,Research and Arts,Baden-Wuerttemberg(Sonderlinie“Neuroinflammation”).This study was supported by the DFG under Germany’s Excellence Strategy(CIBSS-EXC-2189-Project ID390939984).The figures were created with BioRender.com。
文摘Viral encephalitis is a devastating disease with high mortality,and survivors often suffer from severe neurological complications.Microglia are innate immune cells of the central nervous system(CNS)parenchyma whose turnover is reliant on local proliferation.Microglia express a diverse range of proteins,which allows them to continuously sense the environment and quickly react to changes.Under inflammatory conditions such as CNS viral infection,microglia promote innate and adaptive immune responses to protect the host.However,during viral infection,a dysregulated microglia-T-cell interplay may result in altered phagocytosis of neuronal synapses by microglia that causes neurocognitive impairment.In this review,we summarize the current knowledge on the role of microglia in viral encephalitis,propose questions to be answered in the future and suggest possible therapeutic targets.
文摘Aim: To compare the difference between viral encephalitis patients complicated with epilepsy group and those without epilepsy. Methods: The authors retrospectively study 116 cases of viral encephalitis patients admitted to the General Hospital of Ningxia Medical University and the Cardia-Cerebrovascular Disease Hospital of Ningxia Medical University from January 2011 to December 2016. There were 39 cases with epilepsy and 77 cases without epilepsy. By surveying the Hospital Information System, the authors collected their clinical data including general situations, medical history, physical examination, clinical presentation, laboratory examination, cerebrospinal fluid examination, imaging examination, electroencephalogram examination (EEG), treatment, and discharge conditions. The authors used SPSS for further analysis and statistics. Results: Medical history: there were significant differences between the two groups in disturbance of consciousness, cognitive dysfunction, and admission conditions (P < 0.05). No significant differences were found in other clinical manifestations. Auxiliary examination: in cerebrospinal fluid (CSF) examination, the patients with epilepsy had higher glucose (P < 0.05). Brain imaging examination shows that cortical involvements in patients with epilepsy were higher (P < 0.05), and EEG examination showed that patients with epilepsy were more severe (P < 0.05). No significant differences were found in other auxiliary examination. Treatment and prognosis: all the patients were given antiviral treatment. Twenty-eight cases of the patients with epilepsy (71.79%) are used of antiepileptic drugs. The prognosis of patients with epilepsy was poor (P < 0.05). Conclusion: Viral encephalitis frequently manifests with seizures in its acute phase, and the incidence of seizures in our study was 33.62%. The main form was generalized seizures (64.10%), which could occur at any age;patients with epilepsy had a higher cortical involvement on imaging and a higher degree of EEG abnormalities than patients without;patients with epilepsy had a higher level of glucose in the CSF;an episode of viral encephalitis complicated with seizures could aggravate disturbances of consciousness and cognitive impairment. The prognosis of patients with epilepsy was poor.
基金National Science and Technology Major Projects for the Control and Prevention of Major Infectious Diseases in China(grant numbers 2017ZX10104001-005-010,2013ZX10004-202)%Beijing Natural Science Foundation(grant number 7184208)%Beijing Outstanding Young Talent Training Projects(grant number 2014000021469G237)%Capital Clinical Feature Project of Beijing Technology Program(grant number Z151100004015046)%Basic and Clinical Research Cooperation Project of Capital Medical University(grant number 17JL11)%Research Training Fund of Capital Medical University (PYZ2017012)This study was supported by the Beijing Children's Hospital Affiliated to Capital Medical University,Children's Hospital of Hebei Province.We would like to acknowledge all the physicians and participants for collecting clinical specime
文摘Importance:Viral encephalitis and meningitis are severe infectious diseases responsible for substantial morbidity and mortality in children.Enteroviruses are typically the most common causative agents of viral encephalitis and meningitis.Objective:This study aimed to investigate the etiology of viral encephalitis and meningitis among children in Hebei province,China.Methods:Cerebrospinal fluid samples from children with viral encephalitis (n=309) and meningitis (n=133) were collected between Nov 2013 and Dec 2015 and viral pathogens were identified by real-time and multiplex PCR.Amplification and sequencing of partial VP1 genes was used to type enteroviruses.Results:The causative pathogen was successfully detected in 176 (57％) patients with viral encephalitis and 82 (61.7％) patients with viral meningitis.The most common causative agents of both viral encephalitis and meningitis were enteroviruses (55.7％ and 64.6％ of cases,respectively).The most common enterovirus serotypes identified were echovirus 18,echovirus 6 and echovirus 30.Echovirus 18 accounted for 74.4％ of all typed enteroviruses and caused a viral encephalitis and meningitis outbreak in Hebei province in 2015.By contrast,the major enterovirus serotypes circulating in 2014 were echovims 6 and echovirus 30.Interpretation:Enteroviruses were the main causative agents of viral encephalitis and meningitis in children in Hebei province from Nov 2013 to Dec 2015.Echovirus 18 became the leading cause of viral encephalitis and meningitis for the first time in Hebei province in 2015.
基金supported by the National Natural Science Foundation of China (No. 81660514)the Xinjiang Uygur Autonomous Region Natural Science Foundation (No. 2016D01C102)
文摘Introduction Viral encephalitis caused by varicella zoster virus (VZV)mainly occurs in immunocompromised individuals and patients with VZV infection in the brain or nerves of the cervical or upper thoracic spinal cord.However,viral encephalitis caused by VZV affecting distant body parts,such as herpes zoster of the waist and abdomen,is rare.How herpes zoster virus reaches the central nervous system (CNS) is unclear.We herein present an atypical case of waist and abdomen herpes zoster infection that progressed to the CNS in a 48-year-old healthy,immunocompetent patient without brain magnetic resonance imaging (MRI) abnormalities,and may enrich the knowledge of viral encephalitis caused by herpes zoster.
文摘OBJECTIVE: To study the character of mutants originating from Japanese encephalitis viruses and the relationship between the characterization of mutant strains and E protein expression. METHODS: Persistent infection was established with standard strains of Japanese encephalitis viruse, known as parental viruse, in a human hepatoma cell line, KN73. Cells were subcultured weekly using trypsinization techniques. Cell-associated viruses of persistently infected cells were collected by a freeze and thaw method. Virus titers were examined by plaque method using baby hamster kidney (BHK) cells. Indirect immunofluorescence assays were used to examine E and NS3 protein antigens. Western blot analysis was used to test expression of E and NS3 proteins. RESULTS: In the early phase (24 - 36 h) post-infection, virus titer in culture fluid from KN73 cells infected with parental viruses were 10(6) PFU/ml. They were 10(3 - 4) PFU/ml in the late phase (3 years) post-infection. The titer of cell-associated viruse was 10(2 - 3) PFU/ml. A virus super-infection assay found that virus titers in culture fluid from persistently infected KN73 cells acutely super- infected with parental viruses were much lower than that of culture fluids in acutely infected normal KN73 at the same phase. Indirect immunoflurescence assay revealed that the quantity of viral antigens in persistently infected KN73 cells was lower than that in acutely infected KN73 cells with parental viruses. Western blot analyses indicated that the molecular weights of E and NS3 proteins were 53 kD and 73 kD, respectively. Expression of NS3 protein in persistently infected KN73 cells was stable but expression of E protein was markedly suppressed. CONCLUSIONS: The virulence and reproduction of viruses obtained from persistently infected KN73 cells, which have some features of DI viruses and were involved in persistent infection, was lower than that of parental viruses. These mutants may have be related to the decrease in E protein expression.
