10.3969/j.issn.1000-3606.2013.06.022

Vaccination in children suffering neurological diseases is a troublesome issue that people es-pecially pediatricians are reluctant to mention. Due to worrying about the emergence of adverse reactions and concerning on the heat induced seizure,doctors and parents tend to cancel or do not recommend these children to be vaccinated. Additionally,the heat sensitive seizures,such as febrile seizure( FS) ,generalized epilepsy with fe-brile seizure plus(GEFS+),Dravet syndrome account for the largest proportion of the seizure related disease and epilepsy syndrome. Their pathogenesis has been proved relating to the mutation of SCN gene of the sodium channel. For children with FS,GEFS+,and Dravet syndrome,vaccination may lead to fever,which even may bring about convulsions,but it will not result in worse prognosis.

Objective To investigate the influence factors of cognitive impairment in epilepsy children with less than 6 years old. Methods Eighty-nine epilepsy children with less than 6 years old were selected. The neuropsychological detection was tested by Gesell developmental diagnostic scale (GDDS), and head imaging examination (CT or MRI) and ambulatory electroencephalogram (EGG) were checked. Results The scores of adaptive behavior, big sports behavior, fine motor behavior, language behavior and personal- social behavior were (82.98 ± 14.02), (85.86 ± 13.79), (83.14 ± 13.44), (84.75 ± 3.29) and (84.99 ± 14.37) scores, the average development quotient of the children with epilepsy were greater than 75 scores, and there were no statistical differences among them (P > 0.05). According to the test results of adaptive behavior, big sports behavior, fine motor behavior, language behavior and personal-social behavior, the rates of developmental delay children were 21.35% (19/89), 19.10% (17/89), 16.85% (15/89), 24.72% (22/89) and 22.47% (20/89), and the rates of moderate to severe developmental delay were 3.37% (3/89), 3.37% (3/89), 4.49% (4/89), 3.37% (3/89) and 3.37%(3/89). Multivariate analysis results showed that first onset age of epilepsy and head imaging performance were correlated with adaptive behavior, big sports behavior, fine motor behavior and personal-social behavior (P < 0.05). Conclusions The first onset age of epilepsy and head imaging performances are the major factors in cognitive performance in epilepsy children with less than 6 years old, so clinical attention should be paid to improve the prognosis of cognitive outcome of epilepsy children, and improve their life quality.

Objective To explore clinical features and misdiagnosis reasons in mitochondrial encephalomyopathy,lactic acidosis,and stroke-like episodes (MELAS) syndrome.Methods The results of clinical data,brain magnetic resonance imaging (MRI),and the course of diagnosis were analyzed in 6 patients with MELAS.Results (1) Clinical features:headache and vomiting were the starting symptoms in 4 of 6 cases,and developmental delay was initial symptoms in 2 of 6 cases.Marasmus occurred in 6 cases,seizure in 5 cases,fever in 3 cases,and hirsutism and visual impairment in 2 cases.(2) Experimental results:blood lactic acid was higher in 6 (4.28 ～ 10.3 mmol/L).(3) Brain MRI:6 patients had abnormal signals in parietal,occipital,temporal lobe,which were not in accordance with vascular distribution.(4) Molecular genetics:All the 6 patients had A3243G gene mutation.(5) Three patients were misdiagnosed for viral encephalitis,and 2 developmental retardation.Conclusions MELAS is characterized with developmental retardation,and repeated encephalitis attack.It is also misdiagnosed because of its variety of clinical features.If patients have high level of lactic acid and multiple MRI signal abnormalities of brain which are not in accordance with vascular distribution,MELAS should be suspected of.Genetic examination and muscle biopsy are especially important in the diagnosis of MELAS.

Increased intracranial pressure is one of the most severe complications with significant mortality in children,so early diagnosis and treatment of this disorder is critical to save the patient's life.This article reviews etiologies,pathophysiology,and general principles of diagnosis and management of increased intracranial pressure.Based on primary diseases and clinical presentations,the goal of therapeutic strategy is to decrease intracranial pressure,avoid neurologic sequelae,and improve the outcome in patients.

Hyperuricemia(HUA),which can induce oxidative stress,endothelial dysfunction,and inflammation,is closely relevant to the metabolic syndrome(MS),such as obesity,impaired fasting blood glucose,hyper-triglyceridemia,and hypertension. Moreover,HUA is of reciprocal causation with insulin resistance(IR). Here,for the prevention and treatment of metabolic diseases such as HUA and MS,the interaction and the regulatory mechanism between MS and HUA are summarized,and the situation that HUA is an important complication of MS is illustrated.

Objective To optimize the extraction process of main active ingredients from Buyang Huanwu Decoction (BHD) by comparing BP neural network combined with genetic algorithm under R language environment with response surface analysis. Methods On the basis of single factor test, the response surface design method was adopted and the main active ingredients of the extract were determined by HPLC. The results were presented in the form of extraction rate. The comprehensive evaluation value of the results was obtained by using the entropy method. Based on this, the best extraction process and the predictive comprehensive evaluation value of extraction rate were firstly obtained by using response surface analysis method. In order to find another best extraction process and comprehensive evaluation predictive value of the main active ingredients in BHD, the optimization of the network model and the discovery of the optimal target were conducted through the BP neural network combined with genetic algorithm under R language environment, respectively. Results The optimum extraction technology in response surface analysis were as follows: Extraction time was 1.8 h; Ethanol concentration was 51%; Extraction temperature was 91 ℃; Liquid material ratio was 14∶1. Under the condition, the comprehensive predicted value was 908.45; The average of the verification test was 897.58; The relative error was 1.20%. The best extraction process by BP neural network combined with genetic algorithm under R language environment was as follows: extraction time was 2 h; Ethanol concentration was 40%; Extraction temperature was 100 ℃; Liquid material ratio was 14∶1. Under the condition, the predicted value was 907.71; The average of the verification test was 905.33; And therelative error was 0.26%. Conclusion Through the comparison of the two analytical methods, it was found that the relative error of neural network combined with genetic algorithm is smaller and the fitting degree with the verification test is higher. That was to say, BP neural network model combined with genetic algorithm in R language environment was more suitable than response surface analysis to optimize the extraction process of the main active ingredients in BHD, which provided a new idea and reference for the discovery of active ingredients and modernization of Traditional Chinese Medicine.

Objective:To identify the distal and proximal influencing factors of father involvement, and explore the mediating role of father's role perception and the moderating role of depression in the effect of his family-of-origin paternal parenting on father involvement.Methods:Totally 572 fathers with children aged under 12 years old completed the father involvement questionnaire, role of the father questionnaire (ROFQ), parental bonding instrument (PBI) and the center for epidemiologic studies depression scale (CES-D). The Pearson correlation analysis and non-parametric percentile Bootstrap method were conducted via SPSS 21.0.Results:(1)Father involvement (2.86±0.58) was found to be negatively correlated with his own family-of-origin paternal indifference (7.30±3.86) ( r=-0.175, P<0.01), positively correlated with his family-of-origin paternal care (10.46±3.98) ( r=0.291, P<0.01), negatively correlated with his depression (7.07±5.09) ( r=-0.266, P<0.01) and positively correlated with his role perception (61.52±5.92) ( r=0.522, P<0.01). (2)Father's role perception partially mediated the relationship between his family-of-origin paternal care and his own paternal involvement (the mediating effect was 0.015, which was 35.71% of the total effects) and fully mediated the relationship between his family-of-origin paternal indifference and his own paternal involvement (the mediating effect was -0.016). (3)Father's depression played a moderating role between his family-of-origin paternal care and his own role perception ( β=-0.069, P<0.05). And it also played a moderating role between his family-of-origin paternal indifference and his own role perception ( β=0.121, P<0.001). The results of J-N methods showed that the values and significance of simple slopes varied according to father's depression levels in both two models. Conclusion:The paternal parenting that fathers had experienced in his family of origin is an important factor affects his own paternal involvement.In the relationship between father's family-of-origin paternal parenting and his own paternal involvement, father's role perception plays a mediating role and his depression level plays a moderating role.

Survivin expresssion in embryo spleen, embryo kidney, embryo liver and in many cancer tissues was determined by RT-PCR, while not in the health liver tissue. Construct the engineered Escherischia coli expressing human survivin and identify the expressed human survivin by Westen-blot. The combination activity of Survivin and RhSmac was determined in vitro. L929 cells transferred with Survivin can survive longer than which transferred with BSA.

In recent years,there has been increasing evidence that microcirculatory disturbance,including vasoconstriction,shunting,inad-equate perfusion,increased blood viscosity,and coagulation,is closely associated with the pathogenesis of acute pancreatitis (AP).These processes may be exacerbated by ischaemia-reperfusion injury and the generation of oxygen radicals.The anatomical features of pancreatic microcirculation,the pathophysiological mechanism of pancreatic microcirculation disturbance and related inflammatory mediators,and pro-gress in the treatment of microcirculatory disturbance in AP are reviewed.It is suggested that the pancreatic and systemic microcirculation may play a key role in the development and progression of AP.