Objective:To investigate the clinical features, gene mutation and follow-up outcome of children with paroxysmal kinesigenic dyskinesia(PKD).Methods:Clinical data was collected at Beijing Tiantan Hospital Affiliated to Capital Medical University from November 2018 to November 2019.In total, seven children with PKD were recruited, and peripheral blood samples for gene study were collected from six patients and their parents.Mutation analysis of PRRT2 gene was performed by PCR sequencing in children and by Sanger sequencing in patients.Results:Of the seven patients, four were male and three were female, and the median age of onset was 11 years and 6 months, ranging from 5 to 14 years.Among them, two patients were family cases and the other five patients were sporadic cases.The presentation were abnormal involuntary movements provoked by sudden movements, without loss of consciousness.Five patients exhibited dystonia and two patients had dystonia and choreoathetosis.The duration of the attacks lasted for a few seconds to 40 seconds.The frequency ranged from 5 to 15 times per day.PRRT2 mutations, c.649_650insC(P.R217PfsX8), were found in two patients with PKD families and three sporadic PKD cases.Conclusion:The onset age of PKD is pre-school or school age.The attacks manifest as dystonia or mixed with dystonia and choreoathetosis.PRRT2 is the main pathogenic gene of PKD and mutation c. 649_650insC is the hotspot mutation.Low-dose Carbamazepine has good effects.

Objective To investigate mechanism involved in the differentiation of FBL-3 cells(eryth-roleukemia cells)induced by dendritic cells(DC). Methods To cultural the FBL-3 cells together with the DC supematant of different concentration for 72 hours,then we used the Wright's staining methed to record the ma-ture monocyte cell population, the transmission electron microscope to observe the ultramicrostructure, the flow eytoraetry to detect the expression rate of the surface molecular CD14. Results The Wright's staining methed, the transmission electron microscope and the flow cytometry all presented that after being induced by the super-natant of the DC ,the FBL-3 cells can partly differentiate into monocytes,inversion monocyte consistent with the personal characteristics. And the intensity of the DC supernatant was connected with interleukin-12. Conclusion The DC supernatant can induce the FBL-3 cells into monocytoid cell, the differentiated cells correspond to monocyte in macro-appearance,uhramicrostructure and phenotype. The competence of the DC supematant are partly concerned with interleukin-12.

Objective To explore the effect of problem-based learning method in traditional Chinese internal medicine teaching. Methods 58 students enrolled in the major of integrated traditional Chinese and western medicine in class C at the Beijing University of Chinese medicine were arranged to receive PBL(test group)or traditional teaching methods(control group)in 2 courses and complete 116 questionnaires. The teaching outcomes were evaluated by questionnaire and individual interviews. Results Compared with controls,students receiving PBL performed significantly better in terms of active classroom atmosphere, broadening their knowledge, and improving teamwork ability(χ2 were 7.16, 4.07, 4.09, P<0.05). Conclusion The PBL strategy has the advantage than the traditional teaching methods in traditional Chinese internal medicine teaching.

OBJECTIVE To optimize the parameters of passive cutaneous anaphylaxis(PCA)in rats immunized by ovalbumin(OVA). METHODS 1-2 month-old Sprague-Dawley rats were immu?nized by ip injection of OVA(0.2,1.0 and 5.0 mg per rat)mixed with complete Freund′s adjuvant once every other day 3 times. Serum was collected on the 12th-16th days after final immunization. Then the rats were intracutaneously injected with sensitized serum and then stimulated by iv injection of the same dose of OVA mixed with Evans blue after a latent period of 0.5,1.5,3,6,12,24,36,48 and 60 h. Finally,the diameters of blue spots in the skin were measured at stimulation. RESULTS Serum total-IgE(T-IgE)and OVA-specific IgE(sIgE)levels increased significantly and reached the peak on the 3rd-7th days and 12th-16th days after final immunization,respectively. There was no correlation between the serum T-IgE level and OVA-sIgE level when the rats were immunized with OVA at OVA 0.2-5.0 mg per rat. The rats experienced PCA after injection of OVA 1.0 and 5.0 mg per rat. Diameters of blue spots in the skin reached the maximum value after rats were sensitized for 0.5-3 h. Moreover,the shape,color and size of blue spots were better 30-60 min after stimulation. CONCLUSION Optimized PCA is as follows:1-2 month-old rats are immunized on the 1st,3rd and 5th days by ip injection of OVA 1.0-5.0 mg. The immunizing serum is collected at 12-16 d after final immunization. The rats are stimulated by OVA and Evans blue after a latent period of 0.5-3 h. Diameters of blue spots in rats′ skin are then measured 30-60 min after stimulation.

Objective To study the toxic effects of 5-amionlevulinic acid-based photodynamic therapy (ALA-PDT) on human peripheral blood mononuclear cells (PBMCs), cord blood mononuclear cells (CBMCs) and peripheral blood stem cells (PBSCs), and furthermore, to understand the possible causes of this response. Methods We used MTT assay to detect the survival rate of PBMCs, CBMCs and PBSCs after treated by ALA-PDT under the optimum experiment conditions with U937 as control;Annexin V-FITC/PI was used to detect the pattern of cell death induced by ALA-PDT. By using flow cytometry, we detected intracellular PpIX fluorescence intensity. Results After ALA-PDT treatment the survival rate of PBMCs had no significant change;however in PBSCs and CBMCs, the survival rate reduced to 70%, and the survival rate of leukemia cell U937 was the lowest, about 30%. After incubation with ALA,except for PBMCs, intraceUuiar PplX fluorescence intensity of the other two kinds of normal haemocytes and U937 increased obviously. These results combined with the flow cytometry suggested that the main pattern of cell death here was apoptosts. Conclusion Under the optimum experiment conditions, ALA-PDT has a slight effect on normal haemocytes but excellent depletions of leukemia cells. Therefore, it can effectively purify autologons bone marrow or stem cell grafts.

Objective To explore the dosimetric differences between abdominal deep inspiration breath hold(ADIBH)mode and free breath(FB)mode in intensity modulated radiation therapy(IMRT)for left breast cancer.Methods From July 2022 to May 2023,a total of 22 patients who needed adjuvant radiation therapy after left breast cancer surgery in the hospital were selected as the research objects.The simulated computed tomography(CT)positioning images of ADIBH and FB modes were collected,the planned target volume(PTV)and endangered organs were outlined,the IMRT plan was designed,and the dosimetric param-eters of the two modes were compared.Results There was no significant difference in the mean dose(Dmean),homogeneity index(HI)and conformity index(CI)of PTV between the ADIBH and the FB modes(P＞0.05).Compared with the FB mode,the heart Dmean,V5,V10,V20,V30 and V40 in the ADIBH mode decreased by 2.95 Gy,12.21％,8.26％,6.56％,5.41％and 3.48％,respectively,and the left anterior descending(LAD)coronary artery Dmean,maximum dose(Dmax),minimum dose(Dmin)and V40 decreased by 15.99 Gy,16.10 Gy,0.82 Gy and 13.73％,respectively,with statistical significance(P＜0.05).Compared with the FB mode,the dose and volume of heart irradiation in the ADIBH mode at the same level were significantly reduced.Pearson correlation analysis showed that there was a positive correlation between heart Dmean and LAD Dmean in the ADIBH mode(r=0.72),and between heart Dmean and LAD Dmean in the FB mode(r=0.69).Compared with the FB mode,the left lung Dmean of the ADIBH mode decreased by 0.99 Gy,and the difference was statistically significant(P＜0.05).However,there was no significant difference in left lung V5,right lung Dmean and right breast Dmean between the two breathing modes(P＞0.05).Conclusion ADIBH mode can effectively reduce the dose to the heart and LAD,and play a good protective role.

Objective:To investigate the efficacy and safety of the Steward Scale(S Scale)and the Modified Aldrete Scale (A Scale) for resuscitation of children undergoing gastrointestinal endoscopy with general anesthesia.Methods:A total of 199 underage children who underwent non-intubated gastrointestinal endoscopy with general anesthesia in Children′s Hospital, Zhejiang University School of Medicine from July to December 2022 were retrospectively included in this study and divided into preschool group (36 cases), low school-age group (75 cases) and high school-age group (88 cases) according to age. S Scale and A Scale were also performed to evaluate the recovery from anesthesia. The vital signs of the children and the time required for reaching the target were recorded, and the scoring efficiency and safety of the two scales were compared.Results:The time required for S Scale to reach the standard (17.50 ± 9.29) min was significantly lower than that of A Scale (20.80 ± 12.61) min, and the difference between the two groups was statistically significant ( t = 2.97, P<0.01). In the low school-age group, oxygen saturation (0.989 ± 0.010) of A Scale was higher than that of S Scale (0.980 ± 0.015), the difference was significant ( t = 2.17, P<0.05). The time required for S Scale to reach the standard was negatively correlated with age ( r = -0.385, P<0.01). There was no significant correlation between the time required for A scale to reach the standard and the children′s age ( r = -0.089, P>0.05). Conclusions:Although Steward Scale is more efficient than modified Aldrete Scale in evaluating anesthesia resuscitation in underage children undergoing gastrointestinal endoscopy with general anesthesia, modified Aldrete Scale is safer than Steward Scale and is more conducive to ensuring the life safety of children.

Objective : To investigate the effects of luteolin on invasion and migration of endometriosis stromal cells and whether its mechanism is related to the regulation of 15-hydroxyprostaglandin dehydrogenase (HPGD) expres- sion． Methods : The endometrial stromal cells HEM15A were divided into control group (cells were cultured in nor- mal medium) ，luteolin group ( cells were treated with different concentrations of luteolin) ，si-HPGD group ( cells were transfected with si-HPGD) ，si-NC group ( cells were transfected with si-NC ) ，luteolin + si-HPGD Group (cells were transfected with si-HPGD and treated with 20 μmol / L luteolin) ，Luteolin + si-NC Group ( cells were transfected with si-NC and treated with 20 μmol / L luteolin) . Real-time quantitative PCR was used to detect mRNA level of HPGD．Cell proliferation was detected by CCK-8 assay，Transwell and scratch assays were used to detect cell invasion and migration．The protein expression of proliferating cell nuclear antigen (PCNA) ，matrix metallopro- teinase (MMP-2) ，MMP-9 and HPGD were detected by Western blot，and the level of prostaglandin E2 ( PGE2) was detected by ELISA. Results : Compared with 0 μmol / L luteolin，luteolin at 20，50 and 100 μmol / L significantly inhibited the proliferation activity of hEM15A cells，and reduced PCNA expression ( all P＜0. 05) ．Compared with the control group，20 μmol / L of luteolin significantly inhibited cell invasion and migration (P ＜0. 05) ，decreased the expressions of MMP-2 and MMP-9 (P＜0. 05) ，and up-regulated the mRNA and protein levels of HPGD (P < 0. 05) ，while inhibited cellular PGE2 level (P＜0. 05) ．Compared with the luteolin group，the luteolin + si-HPGD group increased cell invasion and migration (P ＜0. 05 ) ，increased the expressions of MMP-2 and MMP-9 (P < 0. 05) ． Conclusion Luteolin regulates HPGD / PGE2 signaling pathway to inhibit the invasion and migration of en- dometrial stromal cells.