Objective To investigate the clinical effect of operation of superficial temporal artery-middle cerebral artery(STA -MCA)bypass combined with temporal muscle sticking in the treatment of adult moyamoya disease.Methods A retrospective analysis was the data of operation,including preoperative evaluation,operation method,postoperative follow -up.Results Postoperative complications occurred in 5 cases,including 3 cases of intracranial hemorrhage,2 cases of cerebral infarction.During the follow -up of 6 -35 months,no recurrent hemor-rhage cases,1 cases of cerebral infarction,TIA remission rate was 93.5%.Postoperative cerebral blood flow of 38 cases significantly improved compared with preoperative by SPET,accounted for 86.3%.Cerebral blood flow of 41 cases was well compensated by vascular bridge,accounted for 91%.Conclusion Operation of STA -MCA bypass combined with temporal muscle sticking can significantly reduce the incidence of stroke,fewer complications,which is an ideal method in the treatment of adult moyamoya disease.

Objective Human bone marrow mesenchymal stem cells were transfected by Smad7 and labeled with green fluores-cent mark.BMMSCs were implanted into rabbit glaucoma operational model and observed surviving condition.Methods Through BP and LR reaction,Smad7 with green fluorescent mark was inserted into human bone marrow mesenchymal stem cells by bacterio-phage,filtered positive colony and picked out cell line.15 New Zealand white rabbits were enforced trabeculectomy with BMMSC, then following up cell survival condition.Results Smad7 expressed stable in human bone marrow mesenchymal stem cells with sat-isfactory green fluorescent mark.BMMSC survived in rabbit trabecula with stable green fluorescent and effective ocular press.Con-clusion Smad7 with green fluorescent mark could be inserted into human bone marrow mesenchymal stem cells stably,and has ef-fective results in rabbit model.

Objective:To analyze the associations between attention deficit hyperactivity disorder (ADHD) and serum vitamin B levels in children.Methods:A total of 103 ADHD children who were diagnosed in the Department of Child and Adolescent Healthcare of Children′s Hospital of Soochow University from September 2018 to April 2019 were selected as the ADHD group, and 89 children of the same age who underwent routine physical examinations served as the healthy control group.The serum levels of vitamin B, including vitamin B 1, vitamin B 2, vitamin B 6, vitamin B 9, and vitamin B 12, were measured by the methods of electrochemistry.Weiss Functional Impairment Rating Scale-Parent Report (WFIRS-P) was applied to analyze the correlation between social function scores and vitamin B levels in ADHD children. Results:The levels of vitamin B 9[(12.55±2.22) nmol/L vs.(13.26±2.54) nmol/L] and vitamin B 12 [(278.54±32.00) ng/L vs.(288.90±31.32) ng/L] in ADHD children were significantly lower than those in healthy children( t=-2.064, -2.261, all P<0.05). No significant difference was observed in serum levels of vitamin B 1, vitamin B 2 and vitamin B 6 between the 2 groups (all P>0.05). Correlation analysis displayed that only vitamin B 12 level was significantly and negatively correlated with social function in the learning/school dimension ( r=-0.208, P=0.035), and no significant correlation was found between other vitamin B levels and social function (all P>0.05). Conclusions:The serum levels of vitamin B 9 and B 12 in ADHD children were obviously lower than those in healthy children of the same age.Serum vitamin B 12 deficiency had an influence on the social function of the learning/school in ADHD children.Attention to the monitoring and timely supplementation of vitamin B in childhood, especially vitamin B 9 and B 12, may be of positive significance in the prevention of the occurrence and development of ADHD to some extent.

Objective To investigate the treatment strategy of operation in torcular herophili meningiomas.Methods Retrospectively analyzed the treatment strategy of operation and follow-up data of 16 cases torcular herophili meningiomas patients.Results Grade Ⅰ resection was 9 cases,grade Ⅱ resection was 5 cases,grade Ⅳ resection was 2 cases.One patient appeared transverse thrombosis in postoperative.Followed up for 26-61 months,all patients had no recurrence.Conclusion By detailed preoperative evaluation,selection of appropriate operative approach,reasonable treatment of venous sinus adhesion tumor,supplemented by the necessary radiotherapy,can reduce the risk of operation and recurrence rate to torcular herophili meningiomas.

Objective To investigate the effect of 17β-estradiol on the proliferation of thyroid stem/ progenitor cells.Methods In thyroid stem/progenitor cells derived from nodular goiters,the effects of 17 β-estradiol on thyrosphere formation,estrogen receptor (ER) expression,cyclin D1 expression,and mitogen activated protein kinase (MPAK) pathway were analysed by BrdU ELISA,conventional and realtime PCR,immunofluorensence staining,and Western blot.Results 17β-estradiol induced thyrosphere formation and proliferation of thyroid stem/ progenitor cells.ER-α and ER-β were expressed in thyroid stem and progenitor cells with higher mRNA expression level of ER-α compared to differentiated thyrocytes (8.85-±0.81 vs 1.10 ±0.35,P＜0.01).Stimulation by 1 mmol/L 17β-estradiol increased cyclin D1 mRNA expression and ERK phosphorylation levels,which was blocked by an ER antagonist,ICI 182780.Conclusion Estrogen stimulated the growth of stem cells derived from thyroid nodules via estrogen receptor,suggesting the relevance of increased thyroid stem cell proliferation with higher prevalence of thyroid nodules in women.

Objective To investigate the effect of B7 Homology 3(B7H3)on brain damage of S .Pneumococcal(SP)meningitis . Methods SP meningitis was established by intracerebral ventricular injection of SP suspension on wild-type BALB/C mice .48 mice were divided into 4 groups and received following injections :NS(CON group) ,recombinant murine B7H3alone(B7H3 group) ,SP group ,SP+B7H3 group .At 18 ,48 ,72 h post infection ,mice were conducted neurobehavior score ,then they were anesthetized and killed by cervical vertebra dislocation ,brains were collected .The mRNA expressions of NSE and S100b were detected by real-time PCR .Results Compared with CON group ,the scores of recombinant murine B7H3 group had no significant change at 18 ,48 ,72 h after infection of SP(P>0 .05);at different time points the scores of SP group were decreased significantly than the CON group (P<0 .05);scores of SP+B7H3 group decreased furtherly than SP group(P<0 .05) .The relative expressions of NSE ,S100b mR-NA in brain tissue homogenate :for the NSE ,S100b mRNA relative expressions ,there was no significant difference between B7H3 and CON group at 18 ,48 ,72 h post SP injection(P>0 .05) .At 18h ,48h ,72h ,post infection mRNA expressions of NSE ,S100b in SP group increased compared with CON group(P<0 .05);the mRNA expressions of NSE ,S100b increased furtherly in SP+B7H3 group compared with SP group(P<0 .05) .Conclusion B7H3 upregulates the mRNA expressions of NSE and S100b ,and promotes the progress of SP meningitis in mice .

Objective To explore the risk factors for childhood death from pneumococcal meningitis.Methods The data of 32 hospitalized children were retrospectively analyzed,who were diagnosed as pneumococcal meningitis and enrolled in the Affiliated Children′s Hospital of Soochow University from November 201 0 to December 201 5.The subjects were divided into the death group and survival group according to their prognosis.The clinical characteristics and laboratory data were compared between 2 groups.Results Between the death group and survival group,there were significant statistically differences in shock within 24 hours after admission(63.6% vs 1 4.3%,P =0.01 3),as well as endotracheal tube intubation(1 00.0% vs 23.8%,P <0.001 ),the levels of cerebrospinal fluid(CSF)IgG[(491 .27 ± 203.53)mg/L vs (267.24 ±1 88.07)mg/L,P =0.006],IgM[(1 1 5.72 ±79.1 9)mg/L vs (32.80 ±28.52)mg/L, P =0.006],IgA[59.52(1 5.51 ,75.69)mg/L vs 1 8.77(9.33,27.54)mg/L,P =0.023],CSF leukocyte[330.00 (1 50.00,380.00)×1 06 /L vs 870.00 (403.00,6 1 60.00)×1 06 /L,P =0.009 ],CSF protein [(4 047.00 ± 1 942.1 6)mg/L vs (2 470.62 ±1 259.94)mg/L,P =0.009],CSF adenosine deaminase (ADA)[35.20(1 8.90, 87.20)U /L vs 8.80(3.05,23.78)U /L,P =0.001 ],serum sodium[(1 30.21 ±2.85)mmol/L vs (1 32.83 ±3.69) mmol/L,P =0.049],serum lactic acid (LA)[4.40 (2.60,5.70)mmol/L vs 2.40 (1 .75,4.50)mmol/L,P =0.01 3],serum C -reactive protein (CRP)[(95.87 ±65.40)mg/L vs (1 65.61 ±83.05)mg/L,P =0.022],serum lactate dehydrogenase (LDH)[81 3.40(465.20,2 31 0.70)U /L vs 359.20(257.85,405.90)U /L,P =0.001 ], platelet[(1 63.82 ±1 64.86)×1 09 /L vs (295.71 ±1 30.29)×1 09 /L,P =0.01 9]and positive rate of blood culture (90.9% vs 47.6%,P =0.023)between the death group and survival group.Conclusions The risk factors associated with mortality in pediatric SPM include shock within 24 hours after admission,endotracheal intubation,hyponatremia, thrombocytopenia,as well as high serum LA level,high serum LDH level,lower serum CRP level or cultures of blood and CSF double positive.

ObjectiveTo investigate the clinical features and prognosis of children with rotavirus gastroenteritis and convulsion.MethodsClinical data of children with rotavirus gastroenteritis hospitalized from January 2010 to December 2013 were retrospectively analyzed. Subjects were divided into the seizure group and no seizure group according to the presence of seizure in the course and compared between the two groups.ResultsThere were no signiifcant differences in sex, age, and the average duration of hospitalization between two groups (allP>0.05). The family history, history of seizures, the levels of serum sodium, calcium, lactate, standard bicarbonate concentration (SB), actual bicarbonate concentration (AB), carbon dioxide content (TCO2) and pH were statistically signiifcant between two groups (allP>0.05). During the follow-up period (outpatient telephone follow-up), the recurrence of seizure in two groups was signiifcant different (P<0.05) and only one (0.54%) child in seizure group developed epilepsy.ConclusionThis study showed that rotavirus gastroenteritis with convulsion is a benign clinical course.

A retrospective analysis was performed on the clinical data of a case of late infantile neuronal ceroid lipofuscinosis admitted in the Department of Neurology, Children′s Hospital Affiliated to Soochow University in 2017.The patient was a 4-year-old girl, who was hospitalized because of " 2 convulsions in 1 day" at 2 years and 10 months old.Since then, she had convulsions and progressive regression of motor, language and intelligence frequently.The clinical feature of the patient included unstable walking, drunkenness, easy falling, shaking hands with objects, hypophrasia, prostation, lack of eye language communication, inability to take care of herself, and intelligence quotient of 1-year-old child.Brain magnetic resonance imaging(MRI) showed cerebellar atrophy; the electroencephalogram suggested spike slow wave and multi-spike slow wave burst with high amplitude.Gene detection: 2 heterozygous variants of TPP1 gene, namely c. 230-1G>C and c. 1027G>A(p.e343k), and they were " possibly pathogenic" . Patients with intractable epilepsy, ataxia, motor language retardation, and cerebellar atrophy on MRI should undergo gene detection should in time, so as to make clear diagnosis and guide prenatal diagnosis and genetic consultation as early as possible.