Objective:To summarize the clinical characteristics, diagnosis, treatment, and prognosis of neonatal meningitis caused by Mycoplasma hominis. Methods:We present the clinical data, diagnosis and treatment of a premature infant with Mycoplasma hominis meningitis who was admitted to the Department of Neonatology, the Second Affiliated Hospital of Wenzhou Medical University in June 2020. Relevant literature up to May 2021 was retrieved with the strategy of "( Mycoplasma hominis) AND (meningitis OR central nervous system OR cerebrospinal fluid) AND (newborn)" from CNKI, Wanfang, and PubMed database. The clinical manifestations, examinations, diagnosis, treatments and prognosis of cases with complete clinical data were summarized using two-sample rank sum test. Results:A premature female infant at gestational age of 27 +4 weeks presented with repeated low-grade fever and apnea since the 7 days of life. Cerebrospinal fluid testing in a local hospital showed neutrophil-based leukocytosis, which indicated purulent meningitis. However, empiric antibiotic treatment did not improve the infant's condition. The patient was transferred to our hospital due to dyspnea for 32 days and repeated fever for 25 days. Mycoplasma hominis was detected from the cerebrospinal fluid samples using metagenomic next generation sequencing (NGS). Treatment with erythromycin was ineffective, but the patient improved and discharged after changing to chloramphenicol for 18 d without any side effects. A total of 21 English articles were retrieved, and no Chinese literature was retrieved, involving 22 infants. Of the 23 cases including the present case, 14 were preterm, eight were term and one with no available data; 19 were born by vaginal delivery; the median age of onset was 11.0 d ( P25- P75: 7.0-18.0 d). The initial symptoms included fever, convulsions, irritability, and apnea. Blood routine examination showed elevated white blood cell count in ten cases and elevated C-reactive protein in seven cases. In the cerebrospinal fluid testing, white blood cell count increased in 19 cases, protein increased in 20 cases, and glucose decreased in 13 cases. Eight cases were confirmed by 16S RNA polymerase chain reaction amplification technology, seven by serum antibodies test, two cases by culture and microscopic findings, two cases by culture alone, one case by Mycoplasma kit, and one by NGS. The main treatment was the administration of tetracyclines, quinolones, chloramphenicol, lincosamides, etc. (alone or in combination). Two cases improved without using special anti- Mycoplasma drugs. Of the 23 patients, 15 had hydrocephalus, eight had intracranial hemorrhage, four had cerebral ischemic infarction, and two had cerebral abscess. Four cases had good prognosis,16 cases had adverse prognosis, and other three without available data. The median time to start sensitive antibiotic therapy in children with good prognosis was 4.5 d(3.6-5.0 d) after diagnosis, which was earlier than that in children with adverse prognosis [16.8 d (7.0-25.0 d)]( Z=－2.27, P=0.023). Conclusions:Mycoplasma hominis infection has non-specific clinical manifestations and should be considered for infants with intracranial infection that is not responding to empirical antibiotic treatment. NGS is helpful in detecting Mycoplasma hominis and chloramphenicol can be an option for the treatment.

Objective To analyze the medication rules and mechanism of Professor YANG Lixin in the treatment of tic disorder(TD)and to provide reference for the treatment of tic disorder.Methods Medical records of Professor YANG Lixin's treatment of tic disorder from the pediatric outpatient department of Guangdong Hospital of Chinese Medicine in 2016 was collected.Frequency analysis and cluster analysis were carried out by using TCM inheritance assistance platform(V2.5)to obtain the core prescriptions.Then network pharmacological analysis was conducted according to the above results.TCMSP,ETCM,TCMID,Batman and other databases were used to screen the active constituent of core prescription,then Genecard,Drugbank and other databases were used to obtain TD-related disease targets and generate Venn diagram.The drug-disease intersection targets were obtained and uploaded to STRING.The core network was built by using Cytoscape 3.7.2.GO functional enrichment analysis and KEGG pathway enrichment analysis of common targets were performed using Metascape database.Finally,molecular docking was performed using AutoDock vina and Pyrx to further screen the core target of the core prescription for TD treatment.Results A total of 3 443 medical records were collected,involving 77 kinds of Chinese medicinals,10 kinds of high-frequency drugs.The medicinal herb in cold nature was the most used.The main meridians were lung meridian and spleen meridian.The mainly medicinal flavor was pungent,sweet and bitter.A total of 32 data and 4 core combinations were obtained from the association rules and the cluster analysis,respectively.There were 145 core active ingredients,220 target genes,1 290 disease targets,and 58 drug-disease common targets for 7 core drugs(Citri Reticulatae Pericarpium,Glycyrrhizae Radix et Rhizoma,Pinelliae Rhizoma Preparatum,Bambusae Caulis in Taenias,Poria,Ostreae Concha,Uncariae Ramulus Cum Uncis).There were 422 GO enrichment items,304 biological processes,44 cellular processes,74 molecular functions,186 biological functions,and 68 KEGG enrichment pathways.The main active ingredients are kaempferol,7-methoxy-2-methyl isoflavone,formononetin and β-sitosterol,which mainly act on SLC6A4,SLC6A3,HTR2A and HTR2C,etc..Signal transduction is regulated through key signaling pathways such as neuroactive ligand-receptor interaction,serotonin synapses,cGMP-PKG.Molecular docking results showed that core targets had strong binding activity with their corresponding compounds.Conclusion Data mining,network pharmacological analysis and molecular docking were used to obtain the medication rules and the mechanism of Professor YANG Lixin for treating TD,which provide ideas for the new prescription combination in treating TD.