Advances in research on neuromyelitis optica spectrum disorders and its clinical heterogeneity

Neuromyelitis optica spectrum disorders(NMOSD)is a demyelinating disease mainly involving the optic nerve and spinal cord.It has recurrent and aggravating attacks and high disability rate.Most patients have a stepwise progression,resulting in complete blindness or paraplegia.NMOSD lesions contain not only the optic nerve and spinal cord,but also other neurological and non-neurological symptoms,which has clinical heterogeneity.The discovery of aquaporin-4-immunoglobulin G(AQP4-IgG)attributed it to autoimmune ion-channel disease,and rituximab(RTX)has achieved good clinical efficacy in the treatment of NMOSD.Myelin oligodendrocyte glycoprotein(MOG)antibodies have been found in some AQP4-IgG-negative NMOSD patients,which have different clinical and immunological features,posing new challenges to the diagnosis and treatment of NMOSD,which may require re-design and testing of new immune-targeted drugs.

Real world epidemiological characteristics of acute ischemic stroke in young people in northwest Hubei Province

Objective:acute ischemic stroke is oc-curing in younger and younger individuals.This paper aims to explore the real-world epidemiological characteristics of young stroke patients in northwest Hubei.Methods:the information of acute stroke patients under 50 years old in northwest Hubei Province was collected,including age,gender,region,education level,smoking and drinking,onset season,etc,and epidemiological analysis was carried out.Results:a total of 344 patients with acute ischemic stroke were surveyed.The males accounted for 69.19%,and the average age was 44.94±5.61 years old;the females accounted for 30.18%,and the average age was 45.22±5.02 years old.The distribution of patients varied,with most living in urban areas.There were more male patients than female patients.The proportion of patients with an education level below junior high school was higher than that of patients with an education level above junior high.Twenty-nine point thirty-six percent of all young people with stroke smoked and drank.Stroke occurred in all seasons,but the incidence of stroke was relatively high in summer and autumn.There was a significant difference in the ratio of males to females(P<0.001).Conclusion:the incidence rate of acute stroke in young people in northwest Hubei Province is unique.With the increase of age,men in all ages are more prone to strokes than women.The incidence of stroke among young people in urban areas is higher than in surrounding counties.The incidence rate decreases with the increase of education level.More strokes occur in summer and autumn than in winter and spring.Smoking and drinking do not show obvious effects on the incidence rate.

Tracing enterococci persistence along a pork production chain from feed to food in China

The prevalence and transmission of vancomycin-resistant Enterococcus(VRE)in enterococci being as probiotics has been neglected in the scientific literature.The application of enterococci in feed,food and health products may cause VRE transmission through the food chain.This study evaluated phenotypic resistance of Enterococcus species to 20 antibiotics along a pork production chain from feed to food.It also assessed the genetic diversity of Enterococcus faecium isolates.A total of 510 samples(feed,n=70;swine manure,n=400;swine carcasses,n=20,and retail pork,n=20)were collected in Beijing,China.A total of 328 enterococci isolates with 275 E.faecium and 53 Enterococcus faecalis were identified using 16 S rRNA.Antimicrobial susceptibility to all enterococci isolates was conducted using the KeB method for 20 antibiotics from 9 categories.Multilocus sequence typing(MLST)was conducted on the E.faecium isolates to survey the dissemination of enterococci in the pig industry.The results showed that only 26 enterococci isolates were sensitive to the 20 antibiotics,while half of the isolates(164/328)had acquired multi-drug resistance.The resistant rate to furazolidone was 68.60%,followed by 42.99%to tetracycline.One vancomycin-resistant E.faecium isolates were isolated from feed origin and 2 from manure origin,with minimum inhibitory concentrations to vancomycin of 1,024,64,and 64 mg/mL,respectively.The MLST outcomes showed that the 275 E.faecium isolates belonged to 11 sequence types(ST)including ST40,ST60,ST94,ST160,ST178,ST296,ST361,ST695,ST726,ST812 and ST1014.The ST of the feedsourced VRE was ST1014,while the 2 manure-sourced VRE was ST69.ST1014 evolved from ST78,which was the dominant clonal complex in most cities of China,leading to the spreading of VRE.These findings revealed the potential safety hazards of commercial probiotic enterococci in China and showed that there is a risk of the VRE horizontally transferring from feed to food.