Analysis of the Effectiveness of Targeted Nursing in Children with Severe Viral Encephalitis Complicated with Respiratory Failure

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.

Development of a High-throughput Sequencing Platform for Detection of Viral Encephalitis Pathogens Based on Amplicon Sequencing

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.

The Diagnostic Value of Oligoclonal Band Detection in Viral Encephalitis

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.

Advances in viral encephalitis:Viral transmission,host immunity,and experimental animal models

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.

Shuanghuanglian injection downregulates nuclear factor-kappa B expression in mice with viral encephalitis

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.

Alterative application of five anticonvulsants according to the half life for the treatment of status epilepticus in children with severe viral encephalitis

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.

Inhibitory effects of Shuanghuanglian injection on nuclear factor-kappa B expression in mice with viral encephalitis in a time-and dose-dependent manner

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.

Expression of Cytokines IL-2, IL-10 and TNF-α in Mice with Herpes Simplex Viral Encephalitis

The expression of the cytokines IL-2, IL-10, TNF-α and their roles in mice with herpes simplex viral encephalitis （HSE） were studied. By using semiquantitative reverse transcription polymerase chain reaction （RT-PCR）, the expressions of IL-2, IL-10 and TNF-α mRNA in control group, HSE group and acyclovir （ACV）-treated group were detected and the pathological changes of brain were observed. It was found that after HSV1 infection, the cerebral lesions of haemorrhage and necrosis in mice were observed under the microscopy, and the levels of IL-2, IL-10 and TNF-α were increased remarkably. After treatment with ACV after HSV1 infection, the cerebral lesions in mice were improved, the level of IL-2 maintained stable, IL-10 was increased consistently, and TNF-α was decreased significantly as compared with those in HSE group. In acute HSE, many cytokines are upregulated, including IL-2, IL-10 and TNF-α to eliminate virus and TH1 type response is dominant. In convalescence, there is a shift in the cytokine expression profile from TH1 profile to TH2 profile and the shift can inhibit the overexpression of immune response in animals. ACV has remarkable effects in the treatment of HSE.

Clinical Efficacy and Application Progress of Reduning Injection in Children with Viral Encephalitis

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.

Serum VCAM-1 content in children with viral encephalitis and its correlation with nerve injury and inflammatory response

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.

Detection and significance of EEG, neurological function, immune function and related factor levels in children with viral encephalitis

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.

Correlation between SP-D content in cerebrospinal fluid and severity of viral encephalitis

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.

Case report of the treatment and experience of mental disorders due to chronic viral encephalitis

Viral encephalitis is a common clinical condition.Its clinical manifestations are variable and include neurological symptoms and psychiatric abnormalities,which makes clinical diagnosis and treatment difficult.To date,there are only a few reported cases on mental symptoms of chronic viral encephalitis.We present a case of a 16-year old male patient who was previously hospitalised and diagnosed with schizophrenia and treated with aripiprazole 15 mg/day but failed to respond.The patient was then given antiviral therapy and recovered after 2 weeks.Clinicians should be aware of the possbility that chronic mental disorders could be caused by viral encephalitis.In the future,diagnosis of chronic functional mental disorders should include viral encephalitis in the differential diagnosis.

Anti-N-methyl-D-aspartate receptor-associated encephalitis: A review of clinicopathologic hallmarks and multimodal imaging manifestations

Anti-N-methyl-D-aspartate receptor-associated encephalitis(NMDARE)is a rare immune-mediated neuroinflammatory condition characterized by the rapid onset of neuropsychiatric symptoms and autonomic dysfunction.The mechanism of pathogenesis remains incompletely understood,but is thought to be related to antibodies targeting the GluN1 subunit of the NMDA receptor with resultant downstream dysregulation of dopaminergic pathways.Young adults are most frequently affected;the median age at diagnosis is 21 years.There is a strong female predilection with a female sex predominance of 4:1.NMDARE often develops as a paraneoplastic process and is most commonly associated with ovarian teratoma.However,NMDARE has also been described in patients with small cell lung cancer,clear cell renal carcinoma,and other benign and malignant neoplasms.Diagnosis is based on correlation of the clinical presentation,electro-encephalography,laboratory studies,and imaging.Computed tomography,positron emission tomography,and magnetic resonance imaging are essential to identify an underlying tumor,exclude clinicopathologic mimics,and predict the likelihood of long-term functional impairment.Nuclear imaging may be of value for prognostication and to assess the response to therapy.Treatment may involve high-dose corticosteroids,intravenous immunoglobulin,and plasma exchange.Herein,we review the hallmark clinicopathologic features and imaging findings of this rare but potentially devastating condition and summarize diagnostic criteria,treatment regimens,and proposed pathogenetic mechanisms.

Meningoencephalitis due to Listeria monocytogenes in a Young Immunocompetent Patient: Case Report with Literature Review

Meningoencephalitis secondary to Listeria monocytogenes (L. monocytogenes) mainly affects newborns, the elderly and immunocompromised people;there are extremely rare cases in which said infection occurs in immunocompetent individuals. We present the case of a young adult patient without immunocompromise, who developed meningoencephalitis due to L. monocytogenes;This case is exceptional, since it occurred in an individual outside the classic age group, in addition to not having risk factors, which is why it should be considered an atypical causal agent.

APPLIED STUDY ON BA IN SPORADIC VIRAL ENCEPHALITIS

目的:探讨脑电地形图在散发性病毒性脑炎中的应用价值。方法:40例散发性病毒性脑炎患者的脑电地形图被检查了。结果:这40例病人的脑电地形图的改变是明显的。结论:脑电地形图在散发性病毒性脑炎的诊断、治疗和预后中有重要应用价值。

THE STUDY APPLIED ON BA IN PATIENTS WITH SPORADIC VIRAL ENCEPHALITIS

目的:探讨脑电地形图在散发性病毒性脑炎患者中的应用价值。方法:94例散发性病毒性脑炎患者的脑电地形图被检查。结果:94例散发性病毒性脑炎患者的脑电地形图改变是明显的。结论:脑电地形图在散发性病毒性脑炎患者的诊断、治疗和预后中有重要应用价值。

A case of Rickettsia felis infection-induced encephalitis in a pregnant woman

Rickettsia felis is an exclusively cytozoic Gram-negative prokaryote with cat fleas as the major vectors.[1]As early as 1918,Rickettsia felis was detected in cat fleas in Europe and named Rickettsia ctenocephali.[2]Symptoms of fever,malaise,headache,maculopapular rash and eschar are observed in patients with Rickettsia felis infection.

Anti-N-methyl-D-aspartate receptor type autoimmune encephalitis with severe pneumonia:a case report

Autoimmune encephalitis(AE)is a type of encephalitis caused by autoimmune disease.AE was included on a list of the first batch of 121 rare diseases published by the Chinese National Health Commission on 11^(th)May 2018.Currently,patients with AE account for 10%-20% of encephalitis cases,with 54%-80% of those cases classified as the anti-N-methyl-D-aspartate receptor(NMDAR)type,which is the most common type.[1]In 2010,China reported the first case of a patient withanti-NMDARtype AE.

Isolated Hyperacute T-Waves in West Nile Encephalitis Indicating Atypical Variant of Stress-Induced Cardiomyopathy

Several cardiac outcomes have been reported with West Nile-encephalitis;however, the underlying pathophysiology remains complex. We present a 42-year-old female, with multiple sclerosis, whose neurological symptoms and respiratory decline were finally explained by the diagnosis of West Nile-encephalitis. During her admission, the isolated peaked T-waves indicated the underlying stress-induced cardiomyopathy. The absence of all other causes of hyperacute T-waves, their subsequent resolution with the resolution of infection and improvement in wall motion abnormalities, further supported the association. This case highlights the importance of considering hyperacute T-waves in an approach towards the diagnosis of WNV-encephalitis related atypical variant of stress-induced cardiomyopathy.