Syncope is a common pediatric emergency event,which can be caused by various metabolic disorders different from other illness. The major metabolic anomalies include hypoglycemia, hyperventilation,electrolytes imbalance,hypoxemia and others, in which hypoglycemia is caused by hyperinsulinemia,pituitary and adrenal disease, diabetes, ketotic hypoglycemia, inherited metabolic disorders of sugar, organic acids and amino-acids,etc. This article introduced the common metabolic anomalies and their causes,diagnosis and therapy.

The neonatal burst suppression is a severe EEG pattern and always demonstrates serious damage of nerve system. But the outcome of these patients depends on the different etiology. A total of 256 cases of video EEG recordings were analyzed in order to summarize the etiology and outcome of burst suppression. The results showed that some patients in all 17 cases of burst suppression showed EEG improvement. The etiology was the dominant factor in long term outcome. It was suggested that effective video EEG monitoring is helpful for etiologic study and prognosis evaluation.
Electroencephalography/*methods ; Hypoxia-Ischemia, Brain/diagnosis ; Monitoring, Physiologic/methods ; Neonatology/methods ; Video Recording

Objective To compare the myocardial protection effects of cold blood cardioplegia and cold crystalloid cardioplegia in patients undergoing valve replacement surgery.Methods One hundred adult patients with cardiac function Ⅱ～Ⅲ class undergoing primary elective valve replacement surgery due to rheumatic heart disease were retrospectively analyzed.For patients with cardiac arrest,cold blood cardioplegia was applied to 50 cases(Group B),and cold crystalloid cardioplegia to the others(group C).The process of heart resuscitation,the postoperative need of dopamine,the blood pressure and heart rate,the postoperative level of serum myocardial enzyme,the intensive care unit(ICU) stay after operation were collected and statistically analyzed.All the cardioplegic solution was perfused in a similar manner and topical cooling was employed simultaneously.Results There were less cases in group B than in group C who needed isoprenaline for cardiac resuscitation after clamp removal(P0.05).Conclusion The cold blood cardioplegia and cold crystalloid cardioplegia have similar myocardial protection effects on rheumatic heart disease patients with cardiac function Ⅱ～Ⅲ class undergoing valve replacement surgery.

Amphotericin B ; administration & dosage ; therapeutic use ; Antifungal Agents ; administration & dosage ; therapeutic use ; Biomarkers ; blood ; Child ; Cough ; diagnosis ; drug therapy ; etiology ; Cryptococcosis ; Fever ; diagnosis ; drug therapy ; etiology ; Fluconazole ; administration & dosage ; therapeutic use ; Humans ; Lung ; diagnostic imaging ; pathology ; Lung Diseases, Fungal ; complications ; diagnosis ; drug therapy ; Male ; Radiography, Thoracic ; Tomography, X-Ray Computed

The neonatal burst suppression is a severe EEG pattern and always demonstrates serious damage of nerve system. But the outcome of these patients depends on the different etiology. A total of 256 cases of video EEG recordings were analyzed in order to summarize the etiology and outcome of burst suppression. The results showed that some patients in all 17 cases of burst suppression showed EEG improvement. The etiology was the dominant factor in long term outcome. It was sug-gested that effective video EEG monitoring is helpful for etiologic study and prognosis evaluation.

Epilepsy is one of the most common neurological diseases, affecting about 70 million people worldwide, more than half of whom are children.Even though seizure-free is largely achieved by anti-seizure medications, there are still one-third of patients with epilepsy who continue to experience seizure attacks and develop into refractory epilepsy(RE). RE can seriously impair the life-quality of children and their families, and impose a substantial burden on society.Therefore, it is of great significance to explore and discover novel therapeutic methods and strategies for RE in children.This review is aimed to introduce several current and emerging therapeutic approaches for RE, including some new anti-seizure medications, ketogenic diet, neurosurgery, neurostimulation and emerging precision medicine, and provide new treatment strategy to children with RE.

Objective: To study the psychological and behavioral problems of children with tic disorders (TD), and to identify related influencing factors for effective medical intervention strategies. Methods: From June 2020 to June 2021, 69 children with TD were randomly selected as the case group in the pediatric neurologic clinic, while the control group included 69 healthy children who were matched by gender and age. The data were obtained through general questionnaire, Screen for Child Anxiety Related Emotional Disorders-41 (SCARED-41), Strengths and Difficulties Questionnaire-25 (SDQ-25) and the Children s Depression Inventory-Short Form (CDI-10), while psychological and behavioral problems and their related risk factors were analyzed. Results: The total scores of SCARED-41, SDQ-25 and its difficulties scale, and CDI-10 were (22.1±12.5,13.3±12.3) (21.1±6.0,15.9±3.4) ( 15.6± 6.3,9.3±3.6) (3.7±2.9,2.6±2.9) in the TD and control group respectively, with significant differences ( t/Z =3.8, 13.9, 6.9, -2.6, P <0.05). According to multiple linear regression of children in the TD group, statistically significant effects of maternal bachelor degree on SDQ-25 emotional symptoms, associate degree on SDQ-25 prosocial behavior ( B =-2.20, 2.14), lenient parenting attitude on SCARED-41 general anxiety, worry on SDQ-25 hyperactivity ( B =-7.44, 3.00), time spent on electronic devices on SCARED-41 somatic/panic, school phobia and SDQ-25 conduct problems ( B =0.49, 0.30, 0.20) and exercise intensity of small intensity on CDI-10 ( B =-0.15)were observed ( P <0.05). Conclusion Children with TD are prone to emotional disturbances such as anxiety, depression and behavioral problems, all of which are related to their mothers educational background, parents attitude towards discipline, the duration of electronic device use and exercise intensity.

Epilepsy is a prevalent chronic neurological disorder that affects millions of individuals worldwide, with pediatric epilepsy incidence ranging from approximately 0.41‰ to 1.87‰.In recent years, there has been growing interest in high frequency oscillations(HFOs)as a novel biomarker for epileptic seizures due to their non-invasiveness, non-radiation, and promptness.This article provides a concise review of the research findings and advancements in HFOs of scalp electrocorticography, as well as their clinical applications and limitations in pediatric epilepsy.The article emphasizes the significant clinical utility of HFOs in localizing the epileptogenic zone, assessing the severity of epilepsy, evaluating treatment efficacy, detecting susceptibility to epilepsy, and predicting epileptic seizures.

Objective To observe the effect of complement 5a receptor(C5aR)antagonist(PMX53)and palmitic acid(PA)on the inflammatory reaction of microglia,and to investigate the roles and mechanisms of com-plement C5a-C5aR in PA induced microglia inflammation.Methods Microglia from one day old mice was collect-ed,purified and identified by primary culture and immunohistochemical staining,and then was randomly divided into three groups including PA group,PA+PMX53 group and control group.The expressions of tumor necrosis factor-α(TNF-α),Iba-1 and ERK1/2 were determined by ELISA,Western blot and QT-PCR.Results In PA group, the levels of Iba-1 and TNF-α were higher significantly than the control group(P<0.001).Similarly,the levels of ERK1/2 mRNA(P = 0.005 6)and p-ERK1/2 protein(P < 0.001)in the PA group were higher significantly than that in control group in spite of no difference in ERK1/2 protein in all groups. However,the levels of Iba-1,p-ERK1/2 protein,ERK1/2 mRNA and TNF-α in the PA+PMX53 group were significantly lower than that in the PA group(P<0.001),although there was no difference in ERK1/2 protein in all groups.Conclusions C5a receptor antagonist suppresses inflammatory reaction of microglia induced byPA,suggesting that C5a-C5aR-ERK may par-ticipate in the inflammation of microglia induced byPA. Therefore,C5a receptor antagonist may protect the brain tissues from inflammation-induced damage.