| Chapter One A retrospective analysis of 67 cases of HIV-negative neurosyphilis patients with abnormal mental behavior as the first symptomObjective To summarize the clinical characteristics of HIV-negative neurosyphilis patients with abnormal mental behavior as the first symptom,and provide reference for the diagnosis of the course of neurosyphilis and the monitoring of its curative effect.Materials and Methods Clinical data of confirmed cases were retrospectively analyzed,and part of them were statistically analyzed by SPSS 22.0 statistical software.P<0.05 was considered statistically significant.Results Among the 67 patients,52 were males(77.6%),15 were females(224%),63 were middle-aged and elderly(94.0%),and 4 were adolescents(6.0%).There were 38 cases of paralytic dementia(56.7%),21 cases of meningeal vascular type(31.3%),3 cases of tuberculosis(4.5%),1 case of meningeal type(1.5%),and 4 cases of mixed type(6.0%).There was no significant difference in age,CSF protein,CSF IgG in different clinical types of neurosyphilis(P>0.05),and there was a significant difference in CSF white blood cell count(F=23.7,P<0.05).In MRI examination,21 cases(31.3%)had multiple ischemic foci,17 cases(25.4%)had multiple leukodystrophy,and the rest had cerebral atrophy(22.4%),infarction(11.9%),and encephalitis like changes(3.0%).All 67 patients were treated with antiinfective drugs.At 6 months follow-up,53 patients(79.1%)were effectively treated.Conclusion The majority of hiv-negative neurosyphilis patients with initial symptoms of abnormal mental behavior are middle-aged and elderly males.The laboratory examination of CSF is of significance in determining the clinical type of neurosyphilis,and the MRI examination is helpful in determining the clinical type and outcome of neurosyphilis.The early antibiotic treatment promotes the outcome of the disease.Chapter Two Analysis of Th1,Th2 and Th17 related cytokines in peripheral blood of patients with neurosyphilis and syphilis serofast at different clinical stagesObjective The expression levels of Th1,Th2 and Th17 related cytokines in peripheral blood of patients with neurosyphilis and syphilis sero-fixation at different clinical stages were detected to understand the status of cell-immune-related cytokines in patients.Materials and Methods A total of 79 patients(including 6 asymptomatic patients,23 patients in the early stage and 50 patients in the late stage)diagnosed with neurosyphilis from September 2017 to October 2019 in our hospital were collected,including 65 patients with serum fixation and 30 patients in the control group(healthy subjects).The expression levels of Th1 cytokines(Il-2,IFN-?),Th2 cytokines(IL-4,IL-6,IL-10)and Th17 cytokines(TNF,IL-17A)in peripheral blood of each group were detected by enzyme-linked immunosorbent assay,and the results were statistically analyzed.Results The levels of IL-2?IFN-??IL-4?IL-17A in patients with neurosyphilis,serum fixation and the control group were statistically different(P<0.05).Peripheral blood IL-2,IFN-? and IL-4 in patients with neurosyphilis and serum fixation were higher than those in the control group and IL-17A was lower than those in the control group,showing statistical differences(P<0.05).There was no significant difference between neurosyphilis and Th1,Th2 and Th17 cytokines in peripheral blood of patients with serum fixation(p>0.05).The levels of IL-2?IFN-??IL-4?IL-17A in patients with neurosyphilis at different clinical stages were statistically different from those in the control group(P<0.05).There was no significant difference in IL-17A between early neurosyphilis and the control group(P>0.05),and IL-17A in patients with advanced neurosyphilis was lower than that in the control group(P<0.05).Conclusion Patients with neurosyphilis and serum fixation have abnormal immune function.The immune status of patients at different stages is different.Th1,Th2 and Th17 cytokines are involved in the immune response of patients with neurosyphilis and serological fixation and there is an abnormal balance. |
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