Central pontine myelinolysis mimicking glioma in diabetes:A case report

BACKGROUND Central pontine myelinolysis(CPM)usually occurs during rapid correction of serum osmolality,typically with brainstem lesions presenting uniform signals following enhancement on magnetic resonance imaging(MRI).We report a case of CPM caused by diabetes,which was characterized by glioma-like imaging features and the patient responded well to corticosteroids.CASE SUMMARY A 49-year-old man with type 2 diabetes was admitted due to numbness and weakness for 6 mo with progressive aggravation for 2 wk.His complete blood count,serum electrolytes,renal and liver function parameters were within the normal range.MRI showed mass lesions in the brainstem,with unusually inhomogeneous signal intensity after contrast-enhanced scans.His symptoms worsened after hypoglycemic therapy.Due to his clinical history and examination results,CPM was considered the most likely diagnosis.Treatment with corticosteroids was administered with a methylprednisolone pulse in the acute phase followed by dose tapering.During the 8-mo follow-up period,his clinical symptoms and imaging features significantly improved.CONCLUSION Diabetes could rarely be accompanied by CPM,and patients who experience this neurological complication could benefit from corticosteroid treatment.Clinicians should recognize the special relationship between diabetes and CPM,and improve awareness of early identification and appropriate treatment.

Electroacupuncture stimulating Zhongji(CV3),Guanyuan(CV4),and bilateral Dahe(KI12)attenuates inflammation in rats with chronic nonbacterial prostatitis induced by estradiol through inhibiting toll-like receptor 4 pathway

OBJECTIVE:To investigate the anti-inflammatory effect of electroacupuncture(EA)on chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS),also known as chronic nonbacterial prostatitis(CNP),and explore its underlying mechanism.METHODS:A CNP rat was established by surgical castration combined with 17-βestradiol injection in male Sprague-Dawley rats for thirty consecutive days.The CNP rats received EA treatment once a day for eight days.Chronic pelvic pain was evaluated by mechanical withdrawal threshold measurement.The histological change was assessed by hematoxylin-eosin staining.The inflammatory cytokines in prostates were determined by enzyme-linked immunosorbent assays.The expressions of toll-like receptor 4(TLR4),myeloid differentiation factor 88(MyD88),inhibitors of kappa-B alpha(IκBα),and nuclear factor-kappa B(NF-κB)were detected by Western blotting.The nuclear translocation of NF-κB and the location of TLR4 were observed with immunofluorescence staining.RESULTS:The results showed that EA decreased the prostate index,upregulated the mechanical withdrawal threshold,restored the histomorphology of the prostate,reduced the inflammatory factor levels,inhibited NF-κB p65 nuclear translocation,and downregulated the expression levels of critical proteins involved in the TLR4/NF-κB signaling pathway in prostates.CONCLUSIONS:Our findings suggested that EA could relieve pelvic pain and attenuate prostatic inflammation in estradiol-induced CNP rats.The underlying mechanism may be related to the inhibition of the TLR4/NF-κB signaling pathway.