Tacrolimus (TAC) is increasingly used for immunosuppression in organ transplantation,dermatomyositis/polymyositis,and myasthenia gravis(MG) patients.^([1]) TAC has a narrow therapeutic window with overexposure leading...Tacrolimus (TAC) is increasingly used for immunosuppression in organ transplantation,dermatomyositis/polymyositis,and myasthenia gravis(MG) patients.^([1]) TAC has a narrow therapeutic window with overexposure leading to acute and chronic forms of adverse reactions (ADRs).After oral administration,TAC is predominantly absorbed in the duodenum and jejunum and has highly variable pharmacokinetics,particularly when diarrhea occurs.^([2,3]) Few data has been published on TAC overexposure following mild diarrhea.Mild diarrhea is relatively common and often unreported,which can easily be overlooked by physicians,especially in the emergency department.Here,we report the occurrence of serious ADRs to TAC after mild diarrhea in a MG patient with community-acquired pneumonia(CAP),including nephrotoxicity,metabolic abnormalities and severe immunosuppression.展开更多
The Qinghai-Tibet Railway, the highest rail in the world, was hailed as a miracle of engineeringwhen it began running a year ago. Today, it isbeing hailed for the economic benefits it hasbrought to the once isolated r...The Qinghai-Tibet Railway, the highest rail in the world, was hailed as a miracle of engineeringwhen it began running a year ago. Today, it isbeing hailed for the economic benefits it hasbrought to the once isolated region of展开更多
Neuroimmune disorders,such as multiple sclerosis,neuromyelitis optica spectrum disorder,myasthenia gravis,and Guillain–Barrésyndrome,are characterized by the dysfunction of both the immune system and the nervous...Neuroimmune disorders,such as multiple sclerosis,neuromyelitis optica spectrum disorder,myasthenia gravis,and Guillain–Barrésyndrome,are characterized by the dysfunction of both the immune system and the nervous system.Increasing evidence suggests that extracellular vesicles and autophagy are closely associated with the pathogenesis of these disorders.In this review,we summarize the current understanding of the interactions between extracellular vesicles and autophagy in neuroimmune disorders and discuss their potential diagnostic and therapeutic applications.Here we highlight the need for further research to fully understand the mechanisms underlying these disorders,and to develop new diagnostic and therapeutic strategies.展开更多
Myasthenia gravis(MG)is an autoimmune disorder that affects the neuromuscular junction.The primary pathology in MG involves the presence of autoantibodies to acetylcholine receptors(AChRs),which results in qualitative...Myasthenia gravis(MG)is an autoimmune disorder that affects the neuromuscular junction.The primary pathology in MG involves the presence of autoantibodies to acetylcholine receptors(AChRs),which results in qualitative and quantitative reductions in the availability of functional AChRs.Cardiac muscles are also affected,resulting in various perioperative cardiac complications.Antistriational antibodies are commonly reported in MG cases with cardiac involvement.In the presence of thymoma,the prevalence of cardiac manifestations in patients with MG increases to approximately 10%-15%.Cardiac involvement in MG may range from asymptomatic electrocardiogram changes to ventricular tachycardia,myocarditis,conduction disorders,heart failure,and sudden death.Increased incidence of atrial fibrillation,ventricular and supraventricular extra systoles,and prolonged QTc have also been reported in patients with MG.Clinicians should consider the evaluation of autonomic dysfunction and risk of cardiovascular disease in patients with MG.展开更多
This editorial aimed to consolidate the current evidence in literature on the association between myasthenia gravis(MG)and cardiac involvement,focusing on the impact of thymoma,antistriational antibodies,and late-onse...This editorial aimed to consolidate the current evidence in literature on the association between myasthenia gravis(MG)and cardiac involvement,focusing on the impact of thymoma,antistriational antibodies,and late-onset MG.Additionally,the study aimed to explore the influence of genetic differences among populations on the association with cardiac disease.We conducted a review of existing literature in PubMed and Google Scholar to find relevant studies on cardiac involvement in MG.We created search criteria using a combination of free text words,including MG,antistriational antibodies,thymectomy,cardiomyopathy,myocarditis,arrhythmias,autonomic dysfunction.Relevant articles published in English language were analyzed and incorporated.The findings indicate a strong association between thymoma,myasthenic crisis,antistriational antibodies,and late-onset MG with cardiac involvement.The study also revealed that genetic differences among populations influence the risk of cardiac disease and electrocardiography(ECG)abnormalities in MG patients.Autonomic dysfunctions altered cardiac autonomic response and increased susceptibility to arrhythmias and sudden cardiac death in MG patients.The study supports the significance of thymoma,antistriational antibodies,and late-onset MG as key factors associated with cardiac involvement in MG patients.It emphasizes the importance of ECG as the initial test in managing MG patients,particularly in the perioperative period,to identify and genetic testing if needed to address their cardiac risk effectively.展开更多
Background: Our study aimed to investigate the clinical value of platelet parameters and the number of Monocytes (MONO) in the peripheral blood of patients with Ocular Myasthenia Gravis (OMG). Methods: Fifty patients ...Background: Our study aimed to investigate the clinical value of platelet parameters and the number of Monocytes (MONO) in the peripheral blood of patients with Ocular Myasthenia Gravis (OMG). Methods: Fifty patients discharged from the Department of Neurology of the First People’s Hospital of Jingzhou City with the diagnosis of OMG from January 1, 2020, to December 31, 2023, were selected as the experimental group, and healthy medical examiners were selected as the control group during the same period. The differences in peripheral blood mononuclear cell count and platelet-related parameters between the two groups were compared. ROC curves were drawn to analyze the clinical value of the studied indexes in patients with OMG. Results: Patients with OMG had significantly higher monocyte counts and narrower platelet distributions compared with normal adults;further logistic regression analysis revealed that higher monocyte counts and narrower Platelet Distribution Width (PDW) may be independent influences on the occurrence of OMG (p Conclusion: Peripheral blood mononuclear cell count and PDW have some diagnostic value in OMG.展开更多
重症肌无力（myasthenia gravis,MG）是一种神经肌肉接头传递障碍的自身免疫性疾病,其病变部位在突触后膜,主要表现为骨骼肌易疲劳。除了我们熟知的症状,MG患者还会出现不安腿综合征（restless legs syndrome,RLS）、睡眠障碍性呼吸（sl...重症肌无力（myasthenia gravis,MG）是一种神经肌肉接头传递障碍的自身免疫性疾病,其病变部位在突触后膜,主要表现为骨骼肌易疲劳。除了我们熟知的症状,MG患者还会出现不安腿综合征（restless legs syndrome,RLS）、睡眠障碍性呼吸（sleep-disordered breathing,SDB）及嗅觉、听觉、认知等非运动症状。MG自身免疫性抗体是目前临床研究的热点,MG的临床分型也倾向于与不同抗体类型有关。展开更多
Objective To explore effective therapeutic method for the treatment of ocular myasthenia gravis. Methods Sixty cases of ocular myasthenia gravis were selected. The acupuncture was applied at Dàzhuī （大椎 GV 14...Objective To explore effective therapeutic method for the treatment of ocular myasthenia gravis. Methods Sixty cases of ocular myasthenia gravis were selected. The acupuncture was applied at Dàzhuī （大椎 GV 14）, Bǎihuì （百会 GV 20）, Shàngxīng （上星 GV 23） of Governor Vessel, and its crossing points with Yinqiao and Yangqiao Meridian, such as Jīngmíng （睛明 BL 1）, shēnmài （申脉 BL 62）, Dìcāng （地仓 ST 4）, Jūliáo （巨髎 ST 3）, Chéngqì （承泣 ST 1 ）, etc. Besides, ginger-partition moxibustion was applied at Yángbái （阳白 GB 14） and Sìbái （四白 ST 2）. The plum-blossom needle was applied at upper limb distribution of lung channel of hand taiyin, heart channel of hand shaoyin and pericardium channel of hand jueyin. The patients’ clinical symptoms, potential degradation percentages of repetitive nerve stimulation （RNS） in low frequency were observed. Results 8 cases were clinically cured, 20 cases were basically cured, 12 cases were remarkably effective, 15 cases were effective and 5 cases were failed. The total effective rate was 91.7%. Compared with before the treatment, the potential degradation percentages of repetitive nerve stimulation in low frequency were lowered [（19.44±6.28）% vs （8.78±3.12）%, （P0.05）]. Conclusion Acupuncture and moxibustion at extra-meridian and collateral for ocular myasthenia gravis could achieve positive efficacy.展开更多
Objective： To investigate the relationship among the latest WHO classification of thymoma, myasthenia gravis （MG） and clinical stages. Methods： To review the pathological sections of 74 patients with thymoma from ...Objective： To investigate the relationship among the latest WHO classification of thymoma, myasthenia gravis （MG） and clinical stages. Methods： To review the pathological sections of 74 patients with thymoma from 1980-2004 using WHO classification （1999）, the statistical software was used to analyze the relationship among the WHO classification, MG and clinical stages. Results： （1） Two cases of type A, 23 cases of type AB, 4 cases of type B1, 27 cases of type B2, 16 cases of type B3 and 2 cases of type C were classified. Type B2 more likely accompanied MG （P〈0.05）, while none with MG occurred for type C. （2） One patient was in stage Ⅰ, 30 were in stage Ⅱ, 38 were in stage Ⅲ, and 5 were in stage Ⅳ. The latest histologic classification was significantly correlated with Masaoka stages （P〈0.01）. Conclusion： The latest WHO classification was correlated with occurrence of MG and finely reflected clinical stage. It can also evaluate the prognosis of patients.展开更多
ERK (Extracellular Signal Regulated Kinase) or MAP kinase is an intracellular signaling molecule. ERK is involved in regulation of various functions i.e. cell proliferation, cell migrations, cell survival and many mor...ERK (Extracellular Signal Regulated Kinase) or MAP kinase is an intracellular signaling molecule. ERK is involved in regulation of various functions i.e. cell proliferation, cell migrations, cell survival and many more. It gets activated in response of various stimuli like growth factors, cytokines, virus, second messengers, transforming agents and carcinogens. While transferring signals from cell surface receptors to cell nucleus, ERK interacts with a numbers of proteins. Physiochemical and functional characterization of these proteins is little known. Thus, we attempted to study physiochemical and functional properties of ERK interacting proteins using bio-computational tools. ExPASy and SOSUI server suggested 22 ERK interacting proteins. Physical and chemical parameters of these ERK interacting partners indicated higher percentage of hydrophobic amino acid and leucine as major constituent. Moreover, the instability index indicated that four proteins are stable in over wide range temperature in vitro, and remaining eighteen proteins were found unstable. In addition, SOSUI server showed that fifteen proteins were soluble and six are trans-membrane in nature.展开更多
基金supported by the Clinical Research Foundation of Zhejiang Provincial Medical Association (2020ZYC-A113)。
文摘Tacrolimus (TAC) is increasingly used for immunosuppression in organ transplantation,dermatomyositis/polymyositis,and myasthenia gravis(MG) patients.^([1]) TAC has a narrow therapeutic window with overexposure leading to acute and chronic forms of adverse reactions (ADRs).After oral administration,TAC is predominantly absorbed in the duodenum and jejunum and has highly variable pharmacokinetics,particularly when diarrhea occurs.^([2,3]) Few data has been published on TAC overexposure following mild diarrhea.Mild diarrhea is relatively common and often unreported,which can easily be overlooked by physicians,especially in the emergency department.Here,we report the occurrence of serious ADRs to TAC after mild diarrhea in a MG patient with community-acquired pneumonia(CAP),including nephrotoxicity,metabolic abnormalities and severe immunosuppression.
文摘The Qinghai-Tibet Railway, the highest rail in the world, was hailed as a miracle of engineeringwhen it began running a year ago. Today, it isbeing hailed for the economic benefits it hasbrought to the once isolated region of
基金supported by the National Key Research and Development Project of Stem Cell and Translational Research by the Ministry of Science and Technology(2020YFA0113100)Innovative Research Team of High-Level Local Universities in Shanghai(SHSMU-ZDCX20211901)+1 种基金the National Natural Science Foundation of China(82071341)the Key Projects of Basic Research of Shanghai Municipal Science and Technology Commission(20JC1412000).
文摘Neuroimmune disorders,such as multiple sclerosis,neuromyelitis optica spectrum disorder,myasthenia gravis,and Guillain–Barrésyndrome,are characterized by the dysfunction of both the immune system and the nervous system.Increasing evidence suggests that extracellular vesicles and autophagy are closely associated with the pathogenesis of these disorders.In this review,we summarize the current understanding of the interactions between extracellular vesicles and autophagy in neuroimmune disorders and discuss their potential diagnostic and therapeutic applications.Here we highlight the need for further research to fully understand the mechanisms underlying these disorders,and to develop new diagnostic and therapeutic strategies.
文摘Myasthenia gravis(MG)is an autoimmune disorder that affects the neuromuscular junction.The primary pathology in MG involves the presence of autoantibodies to acetylcholine receptors(AChRs),which results in qualitative and quantitative reductions in the availability of functional AChRs.Cardiac muscles are also affected,resulting in various perioperative cardiac complications.Antistriational antibodies are commonly reported in MG cases with cardiac involvement.In the presence of thymoma,the prevalence of cardiac manifestations in patients with MG increases to approximately 10%-15%.Cardiac involvement in MG may range from asymptomatic electrocardiogram changes to ventricular tachycardia,myocarditis,conduction disorders,heart failure,and sudden death.Increased incidence of atrial fibrillation,ventricular and supraventricular extra systoles,and prolonged QTc have also been reported in patients with MG.Clinicians should consider the evaluation of autonomic dysfunction and risk of cardiovascular disease in patients with MG.
文摘This editorial aimed to consolidate the current evidence in literature on the association between myasthenia gravis(MG)and cardiac involvement,focusing on the impact of thymoma,antistriational antibodies,and late-onset MG.Additionally,the study aimed to explore the influence of genetic differences among populations on the association with cardiac disease.We conducted a review of existing literature in PubMed and Google Scholar to find relevant studies on cardiac involvement in MG.We created search criteria using a combination of free text words,including MG,antistriational antibodies,thymectomy,cardiomyopathy,myocarditis,arrhythmias,autonomic dysfunction.Relevant articles published in English language were analyzed and incorporated.The findings indicate a strong association between thymoma,myasthenic crisis,antistriational antibodies,and late-onset MG with cardiac involvement.The study also revealed that genetic differences among populations influence the risk of cardiac disease and electrocardiography(ECG)abnormalities in MG patients.Autonomic dysfunctions altered cardiac autonomic response and increased susceptibility to arrhythmias and sudden cardiac death in MG patients.The study supports the significance of thymoma,antistriational antibodies,and late-onset MG as key factors associated with cardiac involvement in MG patients.It emphasizes the importance of ECG as the initial test in managing MG patients,particularly in the perioperative period,to identify and genetic testing if needed to address their cardiac risk effectively.
文摘Background: Our study aimed to investigate the clinical value of platelet parameters and the number of Monocytes (MONO) in the peripheral blood of patients with Ocular Myasthenia Gravis (OMG). Methods: Fifty patients discharged from the Department of Neurology of the First People’s Hospital of Jingzhou City with the diagnosis of OMG from January 1, 2020, to December 31, 2023, were selected as the experimental group, and healthy medical examiners were selected as the control group during the same period. The differences in peripheral blood mononuclear cell count and platelet-related parameters between the two groups were compared. ROC curves were drawn to analyze the clinical value of the studied indexes in patients with OMG. Results: Patients with OMG had significantly higher monocyte counts and narrower platelet distributions compared with normal adults;further logistic regression analysis revealed that higher monocyte counts and narrower Platelet Distribution Width (PDW) may be independent influences on the occurrence of OMG (p Conclusion: Peripheral blood mononuclear cell count and PDW have some diagnostic value in OMG.
文摘重症肌无力（myasthenia gravis,MG）是一种神经肌肉接头传递障碍的自身免疫性疾病,其病变部位在突触后膜,主要表现为骨骼肌易疲劳。除了我们熟知的症状,MG患者还会出现不安腿综合征（restless legs syndrome,RLS）、睡眠障碍性呼吸（sleep-disordered breathing,SDB）及嗅觉、听觉、认知等非运动症状。MG自身免疫性抗体是目前临床研究的热点,MG的临床分型也倾向于与不同抗体类型有关。
文摘Objective To explore effective therapeutic method for the treatment of ocular myasthenia gravis. Methods Sixty cases of ocular myasthenia gravis were selected. The acupuncture was applied at Dàzhuī （大椎 GV 14）, Bǎihuì （百会 GV 20）, Shàngxīng （上星 GV 23） of Governor Vessel, and its crossing points with Yinqiao and Yangqiao Meridian, such as Jīngmíng （睛明 BL 1）, shēnmài （申脉 BL 62）, Dìcāng （地仓 ST 4）, Jūliáo （巨髎 ST 3）, Chéngqì （承泣 ST 1 ）, etc. Besides, ginger-partition moxibustion was applied at Yángbái （阳白 GB 14） and Sìbái （四白 ST 2）. The plum-blossom needle was applied at upper limb distribution of lung channel of hand taiyin, heart channel of hand shaoyin and pericardium channel of hand jueyin. The patients’ clinical symptoms, potential degradation percentages of repetitive nerve stimulation （RNS） in low frequency were observed. Results 8 cases were clinically cured, 20 cases were basically cured, 12 cases were remarkably effective, 15 cases were effective and 5 cases were failed. The total effective rate was 91.7%. Compared with before the treatment, the potential degradation percentages of repetitive nerve stimulation in low frequency were lowered [（19.44±6.28）% vs （8.78±3.12）%, （P0.05）]. Conclusion Acupuncture and moxibustion at extra-meridian and collateral for ocular myasthenia gravis could achieve positive efficacy.
文摘Objective： To investigate the relationship among the latest WHO classification of thymoma, myasthenia gravis （MG） and clinical stages. Methods： To review the pathological sections of 74 patients with thymoma from 1980-2004 using WHO classification （1999）, the statistical software was used to analyze the relationship among the WHO classification, MG and clinical stages. Results： （1） Two cases of type A, 23 cases of type AB, 4 cases of type B1, 27 cases of type B2, 16 cases of type B3 and 2 cases of type C were classified. Type B2 more likely accompanied MG （P〈0.05）, while none with MG occurred for type C. （2） One patient was in stage Ⅰ, 30 were in stage Ⅱ, 38 were in stage Ⅲ, and 5 were in stage Ⅳ. The latest histologic classification was significantly correlated with Masaoka stages （P〈0.01）. Conclusion： The latest WHO classification was correlated with occurrence of MG and finely reflected clinical stage. It can also evaluate the prognosis of patients.
文摘ERK (Extracellular Signal Regulated Kinase) or MAP kinase is an intracellular signaling molecule. ERK is involved in regulation of various functions i.e. cell proliferation, cell migrations, cell survival and many more. It gets activated in response of various stimuli like growth factors, cytokines, virus, second messengers, transforming agents and carcinogens. While transferring signals from cell surface receptors to cell nucleus, ERK interacts with a numbers of proteins. Physiochemical and functional characterization of these proteins is little known. Thus, we attempted to study physiochemical and functional properties of ERK interacting proteins using bio-computational tools. ExPASy and SOSUI server suggested 22 ERK interacting proteins. Physical and chemical parameters of these ERK interacting partners indicated higher percentage of hydrophobic amino acid and leucine as major constituent. Moreover, the instability index indicated that four proteins are stable in over wide range temperature in vitro, and remaining eighteen proteins were found unstable. In addition, SOSUI server showed that fifteen proteins were soluble and six are trans-membrane in nature.
