Meningeal carcinomatosis (MC) is a disease that malignant tumor cells cultivate in the cerebrospinal fluid or meninges. With the development of therapy methods and new techniques, survival time of patients with tumor is prolonged, and the incidence of MC is increasing. Diagnosis is based on the evaluation of clinical manifestations, cerebrospinal fluid and neuroimaging findings. Furthermore, in recent years, the diagnostic value of the tumor-derived cell-free DNA in the cerebrospinal fluid (CSF) is promising and may improve the diagnostic yield of CSF analysis. Traditional treatments of MC include surgery, radiation therapy, systemic therapy, and intrathecal therapy. Recently, molecular targeted therapy and immunotherapy have received more and more attention. The authors review the epidemiology, pathogenesis, clinical manifestation, diagnosis and treatment of MC in solid cancer, and discuss the diagnosis and treatment options currently available as well as those under investigation.

Creutzfeldt-Jakob disease (CJD), which is caused by prion scrapie protein, is a rare, chronic, transmissible and fatal disease. Clinical manifestations of CJD include rapidly progressive dementia, cerebellar ataxia, visual disturbance, as well as pyramidal and extrapyramidal tract signs. Four subtypes of CJD have been reported, including sporadic, familial or genetic, iatrogenic and variant. Given the infectiousness and high mortality of the disease, it is imperative that earlier and more accurate diagnostic methods are developed. In the past years, 14-3-3 protein testing and periodic sharp wave complexes in electroencephalogram have been widely used in CJD clinical diagnosis; and the abnormal hyper-intensity in diffusion weighted imaging has also been used. Recently, there has been a focus on the diagnostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography. New findings of potential biomarkers in cerebrospinal fluid and decreases in diffusion tensor imaging measures have emerged as having an association with CJD. Magnetic resonance spectroscopy has also drawn attention as an emerging method for diagnosis. In this review, the progress in auxiliary examinations of CJD is discussed and the potential, future diagnostic methods are introduced.

Aim: Myasthenia gravis (MG) is a rare and heterogeneous disease for which there is no generally accepted standard of care. Thus, it is critical that MG experts develop consensus guidelines based on their practice and disease management to assist clinicians and provide advice for insurance companies, health organizations and institutional review boards.

Methods: An international treatment guidance was developed based on national guidelines established in the US, Denmark, Norway, Germany, Japan, Netherlands, United Kingdom and Europe. The RAND/UCLA appropriateness method (RAM) was applied to reach consensus among 15 worldly renowned experts and experienced clinicians.

Results: This paper introduced the RAM procedure with its principles and applications and conducted a brief review of the resulting 2016 international consensus guidance for MG in comparison to clinical experience and management of Chinese MG patients.

Conclusion: The 2016 international consensus guidance is a major contribution to the treatment and management of MG, providing an up-to-date expert consensus to assist clinicians around the world, especially those with limited experience and/or practice in countries/regions that have limited resources to develop local treatment guidelines. It is also an important contribution showing how RAM can help to develop consensus guidance for treatment of rare diseases based on scientific findings and expert experience.

Herpes simplex encephalitis (HSE) can cause permanent injury to the brain parenchyma. As such, it is usually treated as a medical emergency for which correct immediate diagnosis and introduction of specific therapies are critical for survival and prognosis. Here, the authors review the current status of diagnosis and treatments and discuss unsolved issues surrounding therapeutic interventions. The authors also highlight the current expectations for future management of HSE.

Aim: The herpes simplex virus (HSV), one of the most common viruses infecting humans, is featured by a high infection rate and usually causes complex disorders difficult to diagnose and treat. Disease progression is always combined with the specific interaction between organism and environment, but genetic factors play a decisive role in most pathogenic processes. Like most human disorders, individual difference has also been involved in the pathogenesis of HSV infection. The present study aimed to screen the potential gene loci that regulates human predisposition to HSV infection.

Methods: With reference to previous studies, inbred mouse lines with significantly distinct predisposition to HSV infection were chosen for gene loci screening. Gene sites on mouse chromosome 17 associated with susceptibility to HSV infection were then identified by correlation analysis and genome-wide scanning technique.

Results: Genes affecting the vulnerability of mice to HSV infection were mapped to three regions on the 17th mouse chromosome, D17MIT51.1, D17MIT39.1 and the region between D17MIT180.1 and D17MIT184.

Conclusion: The results suggest that the mouse genetic background plays an important role in its susceptibility to HSV-1 infection, which might be regulated by multiple predisposing quantitative trait loci.

Aim: The pathogenesis of central nervous system infections (CNSI) has not been fully understood; some studies indicated that reactive oxygen species may induce brain damage. The aim of our study was to investigate serum antioxidant status in patients with CNSI.

Methods: The serum levels of uric acid (UA), bilirubin and albumin of 548 individuals were enrolled in our study, comprising of 114 healthy controls (HC) and 434 patients with five different kinds of CNSI, which including viral meningitis and/or meningoencephalitis, cysticercosis of brain, tuberculous meningitis and/or meningoencephalitis, cryptococcus meningitis and/or meningoencephalitis, and bacterial meningitis and/or meningoencephalitis.

Results: The data suggested that there were reducing levels of oxidation state (serum UA, bilirubin and albumin) in CNSI patients when compared with HC. Likewise, similar results were observed when cohorts were divided into male and female subgroups.

Conclusion: The authors demonstrated that serum antioxidant status in patients with CNSI was lower; the reason may be due to exhaustion of antioxidant capacity. Therefore, enhancing antioxidant power and keeping oxidative stress and antioxidants in balance may be beneficial to the patients with CNSI.