Propofol is one of the most commonly used intravenous anesthetic agents during cancer resection surgery. A previous study has found that propofol can inhibit invasion and induce apoptosis of ovarian cancer cells. However, the underlying mechanisms are not known. miR-9 has been reported to be little expressed in ovarian cancer cells, which has been related to a poor prognosis in patients with ovarian cancer. Studies have also demonstrated that propofol could induce microRNAs expression and suppress NF-κB activation in some situations. In the present study, we assessed whether propofol inhibits invasion and induces apoptosis of ovarian cancer cells by miR-9/NF-κB signaling. Ovarian cancer ES-2 cells were transfected with anti-miR-9 or p65 cDNA or p65 siRNA for 24 h, after which the cells were treated with different concentrations of propofol (1, 5, and 10 μg/mL) for 24 h. Cell growth and apoptosis were detected using MTT assay and flow cytometry analysis. Cell migration and invasion were detected using Transwell and Wound-healing assay. Western blot and electrophoretic mobility shift assay were used to detect different protein expression and NF-κB activity. Propofol inhibited cell growth and invasion, and induced cell apoptosis in a dose-dependent manner, which was accompanied by miR-9 activation and NF-κB inactivation. Knockdown of miR-9 abrogated propofol-induced NF-κB activation and MMP-9 expression, reversed propofol-induced cell death and invasion of ES-2 cells. Knockdown of p65 inhibited NF-κB activation rescued the miR-9-induced down-regulation of MMP-9. In addition, overexpression of p65 by p65 cDNA transfection increased propofol-induced NF-κB activation and reversed propofol-induced down-regulation of MMP-9. Propofol upregulates miR-9 expression and inhibits NF-κB activation and its downstream MMP-9 expression, leading to the inhibition of cell growth and invasion of ES-2 cells.

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All the recurrent afebrile seizures initially diagnosed as CwG, irrespective of the kinds and frequency of relapses, showed favorable prognoses. CwG maybe falls within the category of situation-related seizures, rather than epilepsy.

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SUMMARYObjective: To explore if afebrile seizures associated with minor infections are a single category of seizure, or a set of different kinds of seizures. Methods: We conducted this prospective cohort study on three kinds of first afebrile seizure: first afebrile seizure associated with gastrointestinal infection (AS-GI), first afebrile seizure associated with nongastrointestinal infection (AS-nGI), and first unprovoked seizure (US). The Kaplan-Meier estimate risks of recurrent seizures were analyzed and compared pairwise. The characteristics of recurrent seizures were also compared pairwise. Results: The Kaplan-Meier estimate risks of recurrent seizure at 2 years of the AS-GI, AS-nGI, and US groups were 6.9%, 23.7%, and 37.8%, respectively. The pairwise differences were significant between the AS-GI and US groups (p < 0.001) and between the AS-GI and AS-nGI groups (p = 0.001), but not significant between the US and AS-nGI groups (p = 0.066). Among unprovoked subsequent seizures in patients with recurrence, the pairwise differences were significant between the AS-GI and US groups (p < 0.001) and between the AS-GI and AS-nGI groups (p = 0.005), but not significant between the US and AS-nGI groups (p = 0.417). Significance: Afebrile seizures associated with minor infections are indeed of two distinguishable kinds: AS-GI, if free of risk factors such as a family history of epilepsy, had a better prognosis and should be categorized as an acute symptomatic seizure, whereas patients with first AS-nGI, like patients with first US, may have recurrent unprovoked seizures, which suggests this category's essential difference from AS-GI. The minor infections include gastrointestinal infection, respiratory infection (usually of the upper respiratory tract), and others of uncertain origin. For gastrointestinal infection, there is a concept of "benign convulsion with mild gastroenteritis (CwG)." The word "benign" indicates a good prognosis: a very low chance of having unprovoked seizures later in life. [4][5][6] In addition, CwG seems to be a new entity, which was more likely to be categorized as situation-related seizures than epilepsy, although it is not described in the classification of the International League Against Epilepsy (ILAE). 4,5,7 However, for afebrile seizure induced by nongastrointestinal infection, the risk of recurrence of unprovoked seizure is much higher than that for afebrile seizure induced by gastrointestinal infection, 1 whereas another study 3 shows that only this kind of first seizure and first unprovoked seizure would have subsequent unprovoked seizures. This evidence suggests that seizures caused by gastrointestinal infection and nongastrointestinal infection are essentially different: the former is probably in the category of situation-related seizures, whereas the latter may have a likeness to unprovoked seizure.Therefore, we designed this prospective cohort study on three kinds of first afebrile seizures: first afebrile seizure associated with gastrointestinal infection (AS-GI), first afebril...

Japanese encephalitis (JE) is usually a monophasic disease; however, in rare cases, patients with JE may have an early relapse after a partial recovery, giving rise to a biphasic pattern for the disease. In this study, we report three pediatric cases in which post-JE relapse was characterized by movement disorder and/or behavioral problems, and was related to anti-N-methyl-D-aspartate receptor (NMDAR) immunoglobulin G (IgG). Serum and cerebrospinal fluid were examined for anti-NMDAR IgG in three patients who had confirmed JE and then developed relapsing symptoms which were similar to those of anti-NMDAR encephalitis. The main symptoms of the two young children were choreoathetosis, irritability, and sleep disorder; while for the teenager, agitation, mutism, rigidity, and sleep disorder were the main symptoms. Samples of cerebrospinal fluid from all patients were positive for anti-NMDAR IgG, and all patients gradually improved with immunotherapy. Testing for NMDAR antibodies is highly recommend in patients with JE, especially those with a relapsing syndrome involving movement disorder and/or behavioral problems, as these patients may benefit from immunotherapy.