0.05).Conclusions Neither the new nor old SIRS diagnostic criteria had a high conforning rate with neonatal critical illnesses;There was no significant difference between them in each clinical item.It shows that the new SIRS diagnostic criteria is not superior to the old one,therefore we should improve the neonatal SIRS diagnostic criteria in the future.

Objective To evaluate the effectiveness of three neurological assessments in experimental autoim?mune encephalomyelitis. Methods Thirty-two female C57BL/6 mice (18-20g) were randomly divided into normal group (n=15) and immune group (n=17). Immune group were induced subcutaneously in the flank by emulsion consisted of MOG33-35 and complete Freund’s adjuvant. Mice were assessed by two investigators for 35 days after immunization in a blinded manner using Kono’s 5-point criterion, Weaver’s 15-point criterion and improved 15-point criterion. Based on H&E staining, we analyzed the accuracy, sensibility and dependency of three assessments. Results 35-day clini?cal-score plots revealed that the fluctuation of symptoms was more obvious in improved 15-point criterion compared with the other two criteria. 15-point criterion and improved 15-point criterion are more accurate than 5-point criterion in atypical-onset EAE. 15-point criterion and improved 15-point criterion could detect the neurological deficits much earli?er than 5-point criterion (P<0.001). Neurological scores assessed by improved 15-point were well correlated with the pathological findings during the peak and remission stage. Conclusion Improved 15-point criterion is better neurological score system than Kono’s 5-point criterion and Weaver’s 15-point criterion because of its accurate assessment of the neurological deficits in experimental autoimmune encephalomyelitis.

Objective:To investigate the efficacy and safety of ketogenic diet (KD) therapy in the epilepsy of infancy with migrating focal seizures (EIMFS) associated with TBC1D24 gene mutation.Methods:Clinical data of two children with TBC1D24 gene-related EIMFS were collected retrospectively, who were admitted to Department of Pediatrics, Fujian Medical University Union Hospital from 2019 to 2020. Their clinical characteristics and the efficacy and safety of KD therapy were analyzed, and literature review was conducted.Results:Seizures were onset before six months old in the two children with TBC1D24 gene-related EIMFS. Multifocal myoclonic seizures were manifested and happened frequently, lasting for more than 30 minutes sometimes. Developmental retardation was obvious in the two children. A small amount of focal sharp, spike, sharp-slow complex, and spike-slow complex waves were showed in the interictal electroencephalography (EEG). TBC1D24 gene mutations were found in the two children, one with a compound heterozygous mutation (c.1025C>T, p.S342L; c.229_c.240delATCGTGGGCAAG,p.I77_K80del), and the other with a homozygous mutation [c.119G>A,p.R40H(Arg40His)]. Both of those were potentially pathogenic. A variety of anti-epileptic drugs showed poor outcome for the two children. The epilepsy was drug-refractory one. After four to 17 months of KD therapy, the epilepsy in the two children was controlled effectively. There was not obvious adverse reactions. Among six children with TBC1D24 gene-related EIMFS in the literature review, four cases were effective or partially effective for KD therapy, one was discontinued due to insufficient ketogenic ratio, and one was discontinued without effect. There were no obvious adverse reactions in the six children.Conclusions:TBC1D24 gene-related EIMFS is mostly drug-refractory epilepsy. Early KD therapy may help to control seizures.

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Objective To evaluate the effect of neoadjuvant chemotherapy on lymph node micrometastasis and DC cell number in stage Ⅲ gastric cancer patients.Methods Lymph node micrometastases in pathologically negative lymph nodes from 76 stage Ⅲ gastric cancer patients [56 cases with neoadjavant chemotherapy (NCT) and 20 cases without],were assessed by cytokeratin-20 antibody.Dendritic cells (DC) in HE positive lymph nodes,HE negatives near tumor foci and HE negatives far foci were assessed by CD83 antibody respectively.Patients were divided into four groups:group 0 (20 cases without NCT),group 2 (two courses of NCT in 29 patients),group 3 (three courses of NCT in 16 patients),group 4 (four courses of NCT in 11 patients).Results In NCT group there were two patients with micrometastases (2/56).All the patients were with micrometastases in control group (20/20).Difference was statistically significant (P =0.000).In HE-positive lymph node group:the number of CD83-positive DC in 2 times group,3 times group,and 4 times group when compared with no chemotherapy group were statistically significant (P20 =0.001,P30 =0.000,P40 =0.000).In HE-negative lymph node near foci group:the number of CD83-positive DC in 3 times group,and 4 times group compared with 0 group were statistically significant increased (P30 =0.001,P40 =0.001).In HE-negative lymph node far foci group:the number of 4 times group was significantly higher than 0,2 and 3 group (P40 =0.000,P42 =0.000,P43 =0.001).Conclusions Neoadjuvant chemotherapy is effective in the prevention of lymph node micrometastases in stage Ⅲ gastric carcinoma and it increases the number of mature dendritic cells in lymph nodes.

Objective To compare the cervical intervertebral movements produced by posteroanterior cervical mobilization and posteroanterior cervical mobilization combined with cervical traction by using the radiographic measurement.Methods The study recruited 12 normal volunteers (6 men,6 women),aged 18 to 25 years (22.9±4.7 years),heighted (164± 7)cm and weighed (54.7 ± 7.6)kg.All the subjects were administered with posteroanterior cervical mobilization followed by posteroanterior cervical mobilization while having cervical traction,or vice versa,with an interval of 2 days in between.The X-ray films were collected before and after the treatment,using 4 static cervical lateral views.The axial displacement of posterior and anterior intervertebral separation (IVS),and the shear displacement of vertebral body as well as the rotation and displacement rate of the motion segments in the sagittal plane before and after the treatment were measured on the radiographic images and compared.Results It was shown that the posteroanterior cervical mobilization produced greater C2-C7 rotation range of motion in the sagittal plane,as compared to that by the posteroanterior mobilization while having cervical traction (P ＜ 0.05).The posteroanterior mobilization produced a significantly greater increase of anterior IVS of the C5 segment and the summation of C2-C7 posterior IVS than those by posteroanterior mobilization while having cervical traction (P ＜ 0.05).However,the posterior IVS and the posterior zygapophysial joints separation of C2-C7 produced by the posteroanterior mobilization during traction were more prominent (P ＜ 0.05).There was no statistical difference between anteroposterior displacements of the vertebral body produced by the two interventions.Comparing with the baseline,the posteroanterior mobilization caused posterior movement of the vertebral bodies of C5 to C2,while the posteroanterior cervical mobilization during traction produced posterior movement of C5 to C2 vertebral bodies and anterior movement of C6 body.Conclusion The cervical posteroanterior mobilization significantly increased the lordosis from C3 to C7,and reduced posterior IVS and zygapophysial joints separation.However,the posteroanterior mobilization during traction changed the intervertebral movements.

Objective To explore the reasons and the best treatment options of facial mass complicated after exogenous growth factor injections.Methods 17 cases of postoperative complications caused by exogenous growth factor injections were retrospectively analyzed.15 patients with chin masses received mass resection and repairment with submental fat and fascial flap.Facial masses of the other 2 patients were located in cheek.Simple cheek mass resection was usually useful.All the patients had scar treatment.The postoperative satisfactory survey was investigated after 6 months.Results The incisions of 17 patients were healed well.An analysis through color Doppler ultrasound examination showed no residual or recurrent mass within half a year follow-up.One of the 17 patients had facial asymmetry and needed further treatment.Others were satisfied with the facial appearance of treatment.Conclusions The masses resulted from injection of exogenous growth factor should be cut off timely and reasonable reconstruction through fat and fascial flap and scar treatment are helpful to restore the original appearance of patients.

OBJECTIVE To explore the relationship between intubation of general anesthesia and lower respiratory tract infection.METHODS Totally 947 cases were divided into bronchial intubation group(groupⅠ,541 cases) and(tracheal) intubation group(groupⅡ,406 cases) for a retrospective analysis about lower respiratory tract(infection).The(sputum) samples of(infected) patients were took germiculture and antibiotic susceptibility.RESULTS There were 26 cases arisen lower respiratory tract infection in group Ⅰ and there were 18 in group Ⅱ.The(incidence) was 4.81% and 4.43%,respectively.86.36% pathogens of sputum samples were non-zymophytes,it was a direct proportion between high(antimicrobial) resistance rate and lower respiratory tract infection rate.The infection rate of 60-70 years old and under 49 years patients was 9.56% and 2.04%,respectively.The infection rate of(patients) undergoing anesthesia less 3h and over 3h was 3.26% and 6.14%,respectively,with significant(differences)(P

Objective: To study the influence of high cell incubating temperature on AMP-activated protein kinase(AMPK) activity and lipid metabolites of piglets hepatocytes in vitro.Method: Primary hepatocytes of piglets about age 55d were separated and cultured under 37 ℃(control) or 42 ℃(heat stress).The anabolic and catabolic products of [14C]-oleic acid were detected for hepatocytes and culture media at 60min,120min and 180min.There were 9 replicates per time point.Result: Heat stress activated AMPK activity and enhanced fatty acid oxidation.The production of [14C]-CO2 and [14C]-acid soluble metabolites(ASM) was higher in heat stress group than in the control.At the same time,heat stress depressed the incorporation of [14C]-oleate into phospholipids,monoglycerides,triglycerides,cholesterol and cholesteryl ester.Conclusion: Heat stress activated AMPK activity and enhanced the formation of anabolic products and depressed catabolic products in piglets hepatocytes in vitro.

ObjectiveTo introduce clinical experience of the modified lateral crural reverse island skin flap with two sets of blood supply system for aged ankle & foot soft tissue defect.MethodsOn the anatomy base that cutaneous artery branches of lateral crural reverse island skin flap and perforating branches of sural neurocutaneous vascular flap were originated from peroneal artery, we designed the modified lateral crural reverse island skin flap located in posterolateral cruris treated for aged ankle & foot soft tissue defect. The modified flap had two sets of blood supply system which were from lateral crural flap and sural neurocutaneous flap.ResultsAll 11 flaps survived. The skin grafting of donor sites healed well. Followed up 3-9 months, six cases were satisfactory. Five cases with extensor defect were regained by tendon transplantation after 3 months of the operations.Conclusion The modified lateral crural reverse island skin flap with two sets of blood supply system is a good method for aged ankle & foot soft tissue defect.