2017年 · 第50卷第07期

Biological rhythm is the result of long-term adaptation between the body and the external environment, mainly manifested as periodic life activities, which have an important influence on life maintenance and normal physiological activities. Normal biological rhythms are regulated by biological rhythm systems. In mammals, biological rhythm is mainly generated in the suprachiasmatic nuclein (SCN) of the hypothalamus, and is maintained by the molecular mechanism of biological rhythm gene-clock gene generating transcription-translation positive and negative feedback loop, so that the sleep-wake cycle, resting-movement cycle, hormone secretion and metabolic activity exhibit circadian rhythm output. Parkinson's disease is a neurodegenerative disease, and there are also biological rhythm disorders. These phenomena not only directly affect the therapeutic effect of patients, but also lead to a decrease in the quality of life of patients and even accelerate the progression of the disease. Therefore, in-depth research on the biological rhythm of Parkinson's disease may be a new perspective to explore the mechanism and treatment of the disease.

Parkinson's disease is a neurodegenerative disease mostly occurring in middle-aged and elderly people. It is mainly manifested by the degeneration and necrosis of dopaminergic neurons in the substantia nigra of the midbrain, which leads to the reduction of dopamine projected to the striatum and the formation of Lewy bodies in residual neurons, thus causing motor symptoms such as resting tremor, muscle stiffness, bradykinesia and postural instability. Parkinson's disease is the second most common neurodegenerative disease after Alzheimer's disease. It can be divided into sporadic Parkinson's disease (sPD) and familial Parkinson's disease (fPD), of which sPD accounts for about 90%. Parkinson's disease progresses slowly, and it is speculated that patients may develop non-motor symptoms as early as ten years before the onset of motor symptoms. Therefore, it is very important to find the methods and markers for early diagnosis of Parkinson's disease^[1,2]。 We investigated the pathology and pathogenesis of Parkinson's disease by immunohistochemistry and HE staining on different parts of the brain, nodular ganglia (containing vagus nerve) and intestinal nervous system in a necropsy sPD patient.

Vertebral artery dissection rarely involves the spinal cord, and involvement of the posterior spinal artery is even less common. Hsu et al.^[1]By searching the PubMed platform, 17 case reports were systematically reviewed, of which only 29% of patients developed posterior spinal artery syndrome. We report a rare case of posterior spinal artery syndrome with vertebral artery dissection and fibromuscular dysplasia (FMD) for clinical reference.

The incidence rate of cerebral venous sinus thrombosisi (CVST) accounts for 1% of all strokes, and the annual incidence rate is (3~4) /1 million. It is more common in young adults, and 85% of patients have clear factors of thrombosis^[1]。 Patients with aplastic anemia complicated with CVST are even rarer. One case of aplastic anemia complicated with CVST admitted by us is reported below.

Cerebral hemorrhage is a common disease with critical disease and high disability rate in neurology department. The incidence rate is (60~80) /100,000 per year, accounting for 20% ~30% of all strokes in China, and thalamic hemorrhage accounts for 6% ~25% of cerebral hemorrhage, second only to putamen hemorrhage^[1]In addition to the general clinical manifestations of cerebral hemorrhage, due to its special anatomical structure, its own characteristics can also appear, and the clinical manifestations are complex and diverse^[2,3]Such as: characteristic eye signs, partial dance-throwing, aphasia, mental disorders, cognitive and personality changes, etc. However, hearing loss due to thalamic hemorrhage has not been reported in China at present. One case admitted to our department is reported as follows.

Alzheimer's disease (AD) is a neurodegenerative disease of the brain with progressive cognitive impairment and memory impairment. The clinical manifestations are continuous deterioration of cognitive and memory functions, progressive decline of daily living ability, accompanied by various neuropsychiatric symptoms and behavioral disorders. Today, there are about 20 million AD patients worldwide, and with the aging of the population, the prevalence of AD is increasing year by year. AD has become one of the causes of death after heart disease, cancer and stroke, which seriously affects the quality of life of the elderly and brings a huge economic burden to society and families^[1,2]。 However, so far, there is no treatment that can prevent or reverse the progression of the disease. The existing AD treatment drugs only focus on symptomatic treatment and can only delay the progression of the disease^[3]。 Therefore, it is of great significance to master the pathogenesis of AD, find and develop effective therapeutic drugs and diagnosis and treatment methods for AD. The emergence of optogenetic technology enables people to manipulate the activity of specific brain regions and specific neurons to study their physiological functions, which provides the possibility of accurately determining the pathogenesis of AD and provides new ideas for AD treatment.

Although there are advanced examination techniques for the etiological diagnosis of stroke at present, about 1/3 of patients with ischemic stroke can't determine the cause, which is clinically called cryptogenic stroke. Among them, occult atrial fibrillation is considered to be one of the most important potential causes, so many studies have been devoted to improving the diagnosis rate of atrial fibrillation. Indeed, multiple ECG screening and prolonged ECG screening time can greatly improve the detection rate of atrial fibrillation, but related research results suggest that there are still many cryptogenic stroke patients who have never shown atrial fibrillation. In the CRYSTAL atrial fibrillation study, even if the ECG monitoring time is extended to 3 years, the detection rate of atrial fibrillation is still only close to about 1/3^[1]。 In recent years, more and more studies have shown that some markers reflecting left atrial abnormalities, such as left atrial abnormalities defined by electrocardiogram^[2,3]Left atrial enlargement^[4,5,6,7]And elevated levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) are closely related to ischemic stroke^[8]。 Here, we review the research progress between left atrial abnormalities and ischemic stroke.

Zika virus, a member of the genus Flavivirus in the family Flaviviridae, was discovered and named in the 1940s. The virus has gradually become a hotspot of international medical research. Recently, more and more case reports and case-control studies have confirmed that Zika virus can cause the occurrence of Guillain-Barré syndrome (GBS) and produce Zika virus-related GBS. There is no review report with a comprehensive summary of Zika virus-related GBS. Therefore, we reviewed the latest research progress of Zika virus-related GBS from the aspects of epidemiology, clinical manifestations, possible pathogenesis, etc., as well as the prospect of future research, so as to provide some reference for clinicians to understand Zika virus-related GBS.

Migraine is a common neurological disease, with a prevalence of 9.3% in China, 5.9% in men and 12.8% in women^[1]。 The disease is mainly characterized by recurrent pulsatile headache on one or both sides, often accompanied by nausea, vomiting, phonophobia and photophobia. Its recurrence rate and disability rate seriously affect the physical and mental health of patients, and bring a heavy burden to families and society. The pathogenesis of migraine mainly includes the theory of cortical diffusion inhibition, trigeminal neurovascular theory, vascular origin theory, serotonin theory, etc. There is growing evidence that dopamine plays an important role in the pathogenesis of migraine and its treatment.