目的 总结以双下肢乏力为主要表现的、合并低叶酸血症的患者的临床特征。方法 选择自2017年1月—2020年12月在我院神经内科住院的患者,分为3组：双下肢乏力伴叶酸缺乏组,共23例;叶酸缺乏合并脑血管病组,共129例;叶酸缺乏的健康体检者,为来我院行健康体检、无意中发现叶酸水平降低者,共42例,比较3组患者特征。结果 双下肢乏力伴叶酸缺乏组患者的发病年龄在19~88岁之间,平均（63.82±20.24）岁,男女比为2.3∶1。起病时间（13.34±17.88）d。与叶酸缺乏合并脑血管病组以及与叶酸缺乏的健康体检者相比,双下肢乏力伴叶酸缺乏组患者脑叶缺血灶数量较少,差异有统计学意义,P分别=0.001和0.008;与叶酸缺乏的健康体检者相比,双下肢乏力伴叶酸缺乏组患者放射冠和侧脑室缺血灶数量无变化,差异无统计学意义,P>0.05;与叶酸缺乏合并脑血管病组以及与叶酸缺乏的健康体检者相比,双下肢乏力伴叶酸缺乏组患者整体脑组织缺血灶总数较少,差异有统计学意义,P分别<0.01和0.05。结论 临床上遇到双下肢乏力患者,尤其是发病年龄在63岁左右,男性,起病时间在13 d左右,颅内整体缺血灶、尤其脑叶缺血灶较少的患者,需要警惕低叶酸血症所致双下肢乏力的可能。

Objective To summarize the clinical characteristics of patients with lower extremity weakness as the main manifestation and hypofolicemia．Methods Patients admitted in our neurology inpatient center from January 2017 to December 2020 were selected and divided into 3 groups．Group A consisted of 23 cases of bilateral lower extremity weakness combined with folic acid deficiency．Group B consisted of 129 cases of folic acid deficiency combined with cerebrovascular disease．Group C consisted of 42 healthy people with folic acid deficiency who came to our hospital for health check-up and found that the level of folic acid was decreased accidentally．The clinical characteristics of the three groups of patients were compared．Results The age of onset in group A was between 19 and 88 years old,with an average of（63.82±20.24）years old,and the male to female ratio was 2.3∶1．The onset time was（13.34±17.88）days．Compared with the group B and group C,the number of cerebral lobe ischemic area in group A was lesser,and the difference was statistically significant,P=0.001 and 0.008,respectively．Compared with group C,the number of corona radiata and lateral ventricle ischemic lesions in group A did not change,and the difference was not statistically significant,P>0.05．Compared with group B and group C,the total number of ischemic lesions in the overall brain tissue of group A was lesser,and the difference was statistically significant,P<0.01 and P=0.05 respectively．Conclusions When we encounter patients with bilateral lower extremity weakness in clinical practice,especially the average age of onset is around 63 years old,male,the onset time is about 13 days,and the overall intracranial ischemic lesions,especially the lobar ischemic lesions are less,we need to think of the possibility of bilateral lower extremity weakness caused by hypofolate．

目的 探究叶酸对子宫内膜癌作用的靶基因。方法 通过转录组测序筛选叶酸作用下子宫内膜癌细胞中的差异基因,生存分析寻找对子宫内膜癌具有生存意义的差异基因,qPCR及western blot检测其在叶酸作用下的表达。结果 转录组测序发现36个差异基因,生存分析发现FMN1,TRIB3,INHBE及NRBP2的表达对子宫内膜癌具有生存意义,qPCR及western blot验证叶酸作用下NRBP2在子宫内膜癌细胞中的表达下调。结论 叶酸下调子宫内膜癌中NRBP2基因的表达,NRBP2可能是叶酸对子宫内膜癌作用的靶标。

Objective To explore the target genes of folic acid on endometrial carcinoma. Methods The differential genes in endometrial cancer cells treated with folic acid were screened by transcriptome sequencing. Survival analysis was used to find the differential genes with survival significance. QPCR and western blot were used to detect their expression under the action of folic acid. Results 36 differential genes were found by transcriptional sequencing. Survival analysis showed that the expression of FMN1,TRIB3,INHBE and NRBP2 had survival significance in endometrial carcinoma. QPCR and western blot confirmed that the expression of NRBP2 in endometrial cancer cells was down-regulated by folic acid. Conclusion Folic acid down-regulates the expression of NRBP2 gene in endometrial carcinoma, and NRBP2 may be the target of the effect of folic acid on endometrial carcinoma.