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Background and purpose of the central nervous system (central nervous system, CNS) infection is a common disease of the nervous system, increasing trend in recent years, is to save lives and reduce sequelae key to early diagnosis and treatment of patients with central nervous system infection. Due to the extensive use of antibiotics in the clinical diagnosis and treatment, and clinical manifestations of meningitis complicated and changeable, so many cases are often presented with atypical symptoms and laboratory findings, the clinical diagnosis is not clear delay treatment; infection of the central nervous system, cerebrospinal fluid ( Cerebrospinal fluid, CSF) cytology found that the majority of non-specific and pathogen detection difficulties caused by the diagnosis difficult, the rate of misdiagnosis and missed diagnosis rate is high. Which the infectious pathogen Mycobacterium tuberculosis has been found to be the most important one of the correct diagnosis, early treatment is decided an important prognostic factor of tuberculous meningitis. Genome analysis, the M. tuberculosis genome containing over 4000 genes, of which there are 250 genes encoding fatty acid metabolism enzymes. Mycobacterium tuberculosis cell wall peptidoglycan architecture, The covalent binding Arabinogalactan branch bacteria acid. Branch bacteria acid is the nature of fatty acids, and the virulence of Mycobacterium tuberculosis, Mycobacterium tuberculosis escape is closely related to the ability of the immune system to attack the evidence illustrates the the Mycobacterium tuberculosis importance of fat metabolism. Notch ligands DLL1 (Delta-Like 1) is the human homologue of the Drosophila Notch ligand Delta body, is composed of 723 amino acids L-type transmembrane protein, a Notch ligand Delta/Serrate/LAG-2 (DSL ) region followed by eight tandem epidermal growth factor-like repeat sequences and a short cytoplasmic C-terminal region; using a pair of primers, cloned by PCR amplification from the Delta gene sequence of a primer. Notch is a transmembrane receptor, play a role in a variety of organs and cell development, mainly determined by the direction of the cell differentiation. Therefore, the inhibition of the Notch signaling pathway, gene mutation or abnormal activation may be associated with many neurological diseases such as Alzheimer's disease, Parkinson's disease, stroke, brain tumor, brain reperfusion injury. , Notch1 signal can be through the regulation of fatty acid activation of the transcription factor to affect the formation of the fat cells, and play an important role in fat metabolism. Based on the above theoretical speculation, Tuberculosis (TB) is a chronic wasting disease, caused by fat metabolism, the presence of the excessive differentiation of fat cells; accelerate as the Notch ligands DLL1 shedding helps Notch signaling promotes adipocyte differentiation. Therefore, this study using enzyme-linked immunosorbent assay (enzyme-linked Immunosorbent Assays, ELISA) for quantitative determination of the cerebrospinal fluid and serum of patients with diseases of the central nervous system infection in the Notch ligand DLL1 content to explore the central nervous system of infectious diseases diagnostic value, in order to find a new method of diagnosis of tuberculous meningitis. Materials and Methods definite diagnosis of infectious diseases of the central nervous system of 90 patients were divided into tuberculous meningitis (tuberculous meningitis group) 40 cases of viral brain (film) inflammation (disease brain group), 30 cases of purulent meningitis (meningitis group) 20 cases; and the normal control group (28 cases), brain metastases (tumor group) 12 cases of multiple sclerosis (MS group) nine cases of Guillain - Barre syndrome (GBS group) 7 cases. Patients CSF by enzyme-linked immunosorbent assay for the quantitative determination in serum Notch ligands DLL1 content. 1 groups in CSF Notch ligand the DLL1 content, tuberculous meningitis group was significantly higher than the other groups, tuberculous meningitis group compared with the other groups showed a significant difference (P lt; 0.01), and other groups between there was no significant difference (P gt; 0.05). 2. Serum Notch ligands DLL1 content of tuberculous meningitis group and tumor group was significantly higher than other groups, compared to the group of tuberculous meningitis group with disease brain, meningitis group, the control group, MS group, GBS group have extremely significant with difference (P lt; 0.01), disease brain group, group of brain MS group, GBS group and the control group compared to the non-significant difference (P gt; 0.05), knot brain group and tumor group compared to the non-significant differences (P gt; 0.05). 3 groups CSF Notch ligand DLL1 content CSF protein, cell count, glucose, chloride and intracranial pressure were not correlated. Conclusion 1 in CSF and serum of patients with central nervous system infection, tuberculous meningitis Notch ligand the DLL1 content significantly higher disease brain, meningitis and normal controls, MS, the GBS group CSF and serum and intracranial metastasis tumor CSF Notch ligand DLL1 the content is very low. 2 by CSF and serum Notch ligands DLL1 the content of the joint detection, diagnosis and differential diagnosis has important reference significance for a variety of central nervous system infections, a new and simple method, as a central nervous system infection The value of the diagnostic material. 3.Notch the ligand DLL1 detected as a new indicator, may have important clinical value in the diagnosis of tuberculous meningitis.
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