Objective To explore the clinical manifestations and recovery from neuroimaging abnormalities of acute disseminated encephalomyelitis (ADEM),in order to improve the understanding of ADEM.Methods A total of 47 children with ADEM in Department of Neurology,Children′s Hospital of Soochow University were followed up for 1 year.The clinical manifestations,auxiliary examination (especially neuroimaging),treatment and prognosis were analyzed.The recovery conditions from clinical and neuroimaging abnormalities were summarized.Results Among 47 cases,37 cases (78.72%) had prodromic infection history,and 5 cases (10.64%) had the history of vaccination.The clinical manifestations were varied,including 36 cases (76.60%) with somatic discomfort,30 cases (63.83%) with fever,30 cases (63.83%) with disturbance of consciousness,28 cases (59.57%) with epileptic seizure,24 cases (51.06%) with headache and dizziness,22 cases (46.81%) with nausea and vomiting,15 cases (31.91%) with dyskinesia,15 cases (31.91%) with cranial nerve injury,9 cases (19.14%) with incoordination,and 8 cases (17.02%) with mental and behavior disorders.Abnormal lesions presented multiple,asymmetric patchy and large patchy signal image showed by brain magnetic resonance imaging (MRI),and 7 cases (14.89%) involved the spinal cord.All patients received the treatment of Methylprednisolone [15-20 mg/(kg·d)] combined with intravenous gamma globulin (total 2 g/kg,3 to 5 days).The dose of Methylprednisolone gradually decreased after it had been used for 3 days.In the end,it was replaced by an oral administration of Prednisone [1.0-2.0 mg/(kg·d)],and the total treatment period was for 2-3 months.The follow-ups of 47 children with ADEM showed that the MRI lesions of all the children were reduced and the MRI lesions in 4 (8.51%) of them disappeared completely after 0.5 month of follow-up;the lesions disappeared completely in 13 cases (27.66%) after 1 month of follow-up;the lesions disappeared completely in 23 cases (48.94%) after 3 months of follow-up;the lesions disappeared completely in 32 cases (68.09%) after 6 months of follow-up;the lesions disappeared completely in 43 cases (91.49%) after 1 year of follow-up;and finally there were 4 cases (8.51%) with residual lesions.Conclusion The clinical manifestations of children with ADEM are varied.Most children with ADEM have a favorable prognosis.Imaging lesions of 68.09% of the cases completely disappeared after the onset of 6 months.Imaging lesions in 91.49% of the cases completely disa-ppeared at the onset of 1 year.Only a small fraction of patients present permanent lesions.

Objective: To explore the relationships among social support, depression, anxiety and suicide ideation among middle school students in rural areas of south Sichuan Province so as to provide a scientific basis for promoting middle school students’ mental health and reducing suicide ideation. Methods: A sum of 2 217 students of grade 7 and 10 from 2 township middle schools in mountainous areas of Zizhong County, Sichuan Province, were investigated by means of typical sampling and cluster random sampling. Social Support Rating Scale (SSRS), Self-rating Scale for Depression (SDS), Self-rating Anxiety Scale (SAS) and Self-compiled adolescent health questionnaire were used to measure suicidal ideation, and structural equation model was used for statistical analysis. Results: The depression score of middle school students was (13.51±12.57), and the self-rating scale for Depression score of girls was (14.61±12.67), higher than that of boys (12.24±12.34). The SSRS score of Social Support Rating Scale of junior high school students was (35.49±5.88), which was higher than that of senior high school students (34.70±5.43), and the differences were of statistical significance(t=4.46, 2.67, P<0.05). The results of structural equation model showed that depression and anxiety directly affected suicidal ideation, and the standardized effects were respectively 0.11 (95%CI=0.06-0.16) and 0.09(95%CI=0.05-0.14). Depression and anxiety were the intermediate variables in the relationship between social support and suicidal ideation, and the mediating effects were respectively -0.46(95%CI=-0.51--0.41) and -0.21(95%CI=-0.27--0.16). Studying period could play a mediating role in the indirect effect made by social support on suicide ideation through anxiety. Conclusion Anxiety and depression have significant mediating effect on the relationship between social support and suicidal ideation among middle school students in rural areas of south Sichuan province. Anxiety and depression intervention are important measures to reduce suicide ideation among low social supporters.