[Clinical features and prognosis analysis of myelin oligodendrocyte glycoprotein antibody-positive optic neuritis]

Objective: To investigate the clinical characteristics and prognosis of myelin oligodendrocyte glycoprotein (MOG) antibody-positive optic neuritis (ON). Methods: The data of 39 patients with MOG antibody-positive ON in the Department of Neurology of Beijing Tongren Hospital, Capital Medical University from January 1, 2017 to October 31, 2019 were retrospectively collected. There were 25 males and 14 females, aged from 15 to 80 (40±16) years. According to the recurrence, the patients were divided into two groups: the recurrence group (n=12) and the non-recurrence group (n=27). The clinical manifestations, relapse-related factors, magnetic resonance imaging (MRI) manifestations, treatment and prognosis of the two groups were analyzed. Results: A total of 63 eyes were involved, including 30 cases of optic perineuritis (OPN), accounting for 47.6% (30/63). The number of attacks ranged from 1 to 9, among which 12 patients had more than 2 attacks. There were 37 eyes [58.7% (37/63)] with severe visual loss (SVL) at the time of onset, and 7 eyes [11.1% (7/63)] with SVL at the final follow-up. Forty-eight eyes [76.2% (48/63)] had optic disc edema. Forty seven eyes [74.6% (47/63)] showed long-segment disease on optic nerve MRI. One case was complicated with aseptic meningitis and encephalitis. The recurrence group was younger than the non-recurrence group [(28.5±9.8) years vs (43.3±16.4) years, P=0.001]. There were no statistically significant differences between the two groups in gender, bilateral onset, initial visual acuity, final visual acuity, optic disc edema, head and spinal cord lesions, and immunosuppressant (all P>0.05). All patients were treated with methylprednisolone (MP) pulse therapy during the acute attack, and 16 of them were additively treated with immunosuppressive agents; the pain was alleviated or relieved significantly after the application of glucocorticoids. Conclusions: MOG antibody-positive ON often occurred in both eyes at the same time, often manifesting as OPN, often accompanied by optic disc edema, and SVL at the beginning of the disease, but most of the visual recovery was good, might be associated with meningitis and encephalitis. MRI of the optic nerve showed that the lesions often manifested as long-segment lesions. Glucocorticoids could alleviate pain and promote the recovery of visual function.

[The effect of long-term low dose prednisone on bone mineral density in patients with systemic lupus erythematosus]

Objective: To investigate the effect of long-term low dose prednisone administration on bone mineral density (BMD) in patients with inactive systemic lupus erythematosus (SLE). Methods: A total of 118 inactive female SLE patients with long-term administration of low dose prednisone were recruited from the Department of Rheumatology and Immunology at An hui Provincial Hospital.All patients were given low dose prednisone for long-term (≤10 mg/d, more than half a year). According to prednisone doses, subjects were divided into two groups, namely group A (≤7.5 mg/d) and group B (7.5-10 mg/d). In addition, patients were also divided into four groups based on the duration of administration, including groupⅠ≤3 years, Ⅱfrom 4-5 years, Ⅲ 6-10 years and Ⅳ>10 years.Twenty-nine healthy people were recruitedas normal controls.The BMD was measured by dual energy X-ray absorptiometry.The association of BMD with prednisone dose and duration was compared between different groups. Results: The incidence of osteopenia in all patients with SLE was 42.4%(50/118), and the incidence of osteoporosis was 14.4%(17/118). BMD of all bone sites in both group A and B were significantly lower than that in normal control group (P<0.05). Similarly, the BMD of all bone sites in groupⅠ, Ⅱ, Ⅲ and Ⅳ were significantly decreased (P<0.05). What needed to be stressed was the BMD in group Ⅳ was lower than those in other three groups (P<0.05). Multiple logistic regression analysis showed that the cumulative prednisone dose was the risk factor for osteopenia, while taking calcium and alfacalcidol were protective factors. Conclusion: Long-term use of low dose prednisone result in the decrease of BMD in patients with inactive SLE.The lumbar spine and femoral neck had more severe osteopenia. Long-term administration of prednisone, even less than 7.5 mg/d, can also cause osteopenia.Calcium and alfacalcidol were protective factors of BMD.

[Epidemiological features of heatstroke in Shaoxing, China in 2008-2014]

OBJECTIVE

To investigate the epidemiological features of heatstroke in Shaoxing, China in 2008-2014, and to provide a reference for developing prevention and control measures for heatstroke.

METHODS

The reports on heatstroke in Shaoxing in 2008-2014 were collected from the China Information System for Disease Control and Prevention, and the data were summarized and analyzed.

RESULTS

A total of 1 676 heatstroke cases were reported in Shaoxing in 2008-2014, among which 1 485 cases(88.6%) were mild heatstroke and 191 cases(11.4%) were severe heatstroke. Nine persons died of severe heatstroke, and the fatality rate was 0.5%(9/1 676). Among these persons, 4(44.4%, 4/9) were the elderly living at home, 4 (44.4%, 4/9) were farmers (working outdoors), and 1(11.2%, 1/9) was unemployed. The male patients with heatstroke accounted for 66.3%(1 111/1 676), and those with severe heatstroke accounted for 13.1%(146/1 111); the female patients with heatstroke accounted for 33.7%(565/1 676), and those with severe heatstroke accounted for 8.0%(45/565); there were significant differences between male and female patients(χ(2)=9.94, P=0.002). The mean age of patients with heatstroke was 48.7±18.8 years; the mean age of male patients was 49.8±17.9 years, and that of female patients was 46.6±20.3 years, with a significant difference between the male and female patients(t=3.19, P<0.001). Most of the patients experiencing heatstroke were in their forties or fifties, each accounting for 19.2%(321/1 676); in male patients who experienced heatstroke, those in their fifties accounted for the highest percentage(21.5%, 239/1 111), and in female patients who experienced heatstroke, those in their twenties accounted for the highest percentage (18.9%, 107/565). Based on stratification by age, the severity of heatstroke differed significantly between male and female patients in their forties, fifties, sixties, seventies, and eighties(P<0.05). Most of the cases of heatstroke occurred in June to September, accounting for 98.9%(1 657/1 676), particularly in July and August, accounting for 87.1%(1 460/1 676).

CONCLUSION

In Shaoxing, heatstroke usually occurs in summer, and most cases are mild. Middle-aged and elderly men and farmers(working outdoors) are susceptible to heatstroke, and warnings on heatstroke and emergency treatment of severe heatstroke should be enhanced.