Topiramate has been used increasingly in the management of psychiatric conditions. Clinical trials demonstrated that topiramate augmentation was effective in controlling negative symptoms in schizophrenia. This case report presents a case of a 38-year-old man with schizophrenia who achieved full negative symptom remission upon the adjunctive use of topiramate. However, the remarkable finding of this case is the concomitant decrease in the level of prolactin when topiramate (50 mg/day) was started and the rebound after discontinuation of topiramate. Previous studies stated that topiramate could prevent antipsychotic-induced weight gain and adverse metabolic effects. To the authors’ knowledge, no study has reported that topiramate augmentation could be a treatment strategy for antipsychotic-induced hyperprolactinemia. This finding could be verified by well-designed clinical trials.
IntroductionImmune checkpoint inhibitors (ICIs) prevent the immune escape of tumor cells, which is beneficial to immune cells such as T lymphocytes to continuously monitor and kill tumor cells, and ultimately play an effective role in anti-tumor. ICI-associated myocarditis (irMyositis) was rarely reported, but its onset appeared latent, rapidly developed, and lethal, which has gradually attracted the attention of clinicians. Case ReportWe reported cases of fulminant myocarditis in 3 patients with thymoma who were treated with pembrolizumab, one of the programmed cell death protein 1 inhibitors (PD-1 inhibitors).Management & OutcomeThe 3 patients were treated with methylprednisolone, immunoglobulin. Temporary pacemaker implantation was performed when case 1 suffered atrioventricular dissociation and ventricular escape. Cardioversion was performed in case 2 for the onset of ventricular tachycardia. In case 3, Extra-Corporeal Membrane Oxygenation was implemented. Unfortunately, the heart function did not improve and was succeeded by multiple organ failure in all 3 cases. The family withdrew treatment and led to lethal outcomes.DiscussionAlthough ICIs have achieved encouraging results in anti-tumor, their adverse reactions cannot be ignored. Patients with thymoma are more prone to autoimmune reactions which are needed more attention1. We reported cases of immunotherapy-associated myocarditis in patients with previous PM, showing the clinical and pathological features in the specific populations.
Backgroundhe circadian clock extensively regulates physiology and behavior. In space, the astronauts encounter many environmental factors that are dramatically different from those on earth, however, the effects of these factors on circadian rhythms and the mechanisms remain largely unknown. The present study aimed to investigate the changes in the mouse circadian rhythm and gut microbiome under simulated space capsule conditions, including microgravity, noise and low atmospheric pressure.ResultsNoise and low atmospheric pressure were loaded in the capsule while the conditions in the animal room remained constant. The mice in the capsule showed disturbed locomotor rhythms and faster adaptation to a 6-h phase advance. RNA sequencing of hypothalamus samples revealed that microgravity simulated by hind limb unloading (HU) and exposure to noise and low atmospheric pressure led to decreases in the quantities of differentially expressed genes (DEGs), including circadian clock genes. Changes in the rhythmicity of genes implicated in pathways of cardiovascular deconditioning and more concentrated circadian phases were found under HU or noise and low atmospheric pressure. Furthermore, 16S rRNA sequencing revealed dysbiosis in the gut microbiome, and noise and low atmospheric pressure may repress the temporal discrepancy in the microbiome community structure induced by microgravity. Changes in diel oscillation were observed in a number of gut bacteria with critical physiological consequences in metabolism and immunodefense.ConclusionsOur data demonstrate that in addition to microgravity, exposure to noise and low atmospheric pressure affect the robustness of circadian rhythms and the community structure of the gut microbiome, and these factors may interfere with each other in their adaptation to respective conditions. These findings are important to further our understanding of the alteration of circadian rhythms in the space complex environment.
Background: Circadian clock plays a critical role in synchronizing the inner molecular, metabolic and physiological processes to the environmental cues with a period of 24 h. Misalignment in the circadian rhythms leads to decreased adaptation and performance and increased risk of associated disorders. The non-24-h schedules and shift schedules are commonly used in maritime operations, both of which could result in disturbance of circadian rhythms.Methods: In this study, we recruited volunteers and conducted two experiments: in one experiment 15 subjects followed an 8-h on and 4-h off schedule (non-24-h schedule), and in the second experiment 12 subjects followed a 3-d rotary schedule with consecutive shift in sleep time (phase-changing schedule). The serum/blood biochemical variables were measured and the serum miRNAs of the volunteers in the second experiment were subjected to transcriptomic miRNA sequencing.Results: The results show both of the schedules caused comprehensive changes in the blood/serum biochemical variables. Notably, significant elevation in serum phosphate was observed in both experiments: 1.210 ± 0.141 in control and 1.330 ± 0.117 in recovery (P = 0.014) in the first experiment and 1.193 ± 0.152 in control and 1.343 ± 0.099 in recovery (P = 0.007) in the second experiment. In addition, a subset of serum miRNAs targeting genes involved in circadian rhythms, sleep homeostasis, phosphate metabolism and multiple critical physiological processes or pathways were identified in the second experiments.Conclusions: This study reveals that non-24-h and shift schedules lead to changes in a large spectrum of blood/serum biochemical variables due to circadian misalignment. Schedules with frequent shift may cause remarkable changes in serum miRNAs which are involved in multiple physiological pathways. These findings would help understand the deleterious effects of shift schedules and develop optimized strategy to enhance welfare and performance of the shift workers.
This study use noise and vibration analytical system to test and analyze the noise and vibration of subway station hall, draw the conclusion: analysis the noise test results when the vehicles through the subway station hall. The noise rises as the frequency increases, gets the peak value nearby 5000 Hz, the high of test point gives lesser influence to noise contribution. The vibration occurred in low frequency range, get the peak value in the frequency band from 70 to 80 Hz. Learn from the test position, the noise and vibration nearby escalator are higher than the other positions, that's because of the vibration and shock come into the escalator moving. The test results above offer the basis to for the subway station hall's vibration damping and noise reduction design.
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