Objective To investigate the abilities of emotion recognition and social cognition in patients with idiopathic epilepsy and further explore the factors related to the impairments.Methods After 24-hour EEG monitoring,70 people with idiopathic epilepsy were administered with a neuropsychological battery for basic cognitive assessment and then were tested with the Eye Basic Emotion Discrimination Task (EBEDT) and the Eye Complex Emotion Discrimination Task (ECEDT).Results Compared with health controls,people with epilepsy got significantly lower score in recognizing happy (19.3±2.0 vs 19.9±0.2),angry (17.9±2.0 vs 18.9±1.0),sadness (18.1±2.3 vs 19.2±1.0),fear (16.4±1.9 vs 17.6±1.3),disgust (17.6±2.1 vs 18.6±1.2) and surprise (18.3±1.5 vs 19.1±1.1) (P＜0.05,respectively),as well as complex emotions ((23.3±4.2) vs (27.1±2.8),P＜0.05).There was no significant difference between the two groups in gender recognition (P＞0.05).Significant positive correlation was found between the total score of basic emotions and the mind reading (r=0.444,P=0.000) in the patient group.Correlation analysis revealed significant relation between the total correct number of emotion recognition and the level of anxiety,depression and the executive function in epilepsy group (P＜0.05,respectively).Significant associations were found between the ECEDT and the Digital Span test,the Stroop test,Beck Depression Index and Hamilton Anxiety Scale (P＜0.05,respectively).Conclusion People with epilepsy have general impairments of emotion recognition and theory of mind,the impairments may be associated with the state of mood disorder and the weakened executive function.

Objective: To explore the clinical features and prognosis in patients with Takayasu arteritis (TA) combining neurological symptoms. Methods: We retrospectively studied 274 TA patients combining neurological symptoms who admitted to our hospital from 2002-01 to 2013-10 for their clinical and imaging features with prognosis. Results: The ratio of male to female was 1:4.3 and the mean age of disease onset was at (28.2±11.2) years. The most common neurological symptom was dizziness (214/274 cases, 78.1%), most frequent type was type III TA (112 cases, 40.9%), most common affected artery was left subclavian artery (147 cases, 53.6%), and there were 77 cases (28.1%) with (3-4) branches of the aortic arch involvement. For stroke conditions, ischemic stroke was more frequently observed in patients with steno-occlusive lesions in subclavian artery and common carotid artery, while hemorrhagic stroke was more frequently found in patients with steno-occlusive lesions in descending aorta, abdominal aorta and/or renal artery. Heart failure was the most common cause of death, it was also the most common cardiovascular event in surviving cohorts. Conclusion: TA patients could have many neurological symptoms, which were related to the number and site of artery involvement.

Objective:To observe any effect of alternate side whole body vibration on the muscle strength, balance and walking ability of persons with sarcopenia.Methods:Forty elderly persons with sarcopenia were randomly divided into an experimental group and a control group, each of 20. Both groups received conventional balance and lower-limb muscle strength training, but the experimental group also received 9-14Hz whole body vibration treatment with an amplitude of 2-3mm, 5 one-minute groups a day, 5 times a week. Before and after 8 weeks of treatment, both groups′ lower limb strength, 6m step speed, exercise ellipse area, exercise track length, and Up and Go test (TUGT) time were measured.Results:In the experimental group the average bilateral iliopsoas muscle strength and all the other measurements had improved significantly. In the control group, the exercise ellipse area with the eyes closed and the exercise track length with the eyes open and all the other measurements had improved significantly compared with before the training. But all of the experimental group′s outcomes were, on average, significantly better than those of the control group.Conclusion:Low frequency vibration training can better improve the muscle strength, balance and walking ability of elderly persons with sarcopenia. It can be used for prevention as well as treatment.

Objective: To analyze the spatial temporal distribution characteristics of tuberculosis among high school students at county levels in Gansu Province from 2018 to 2022,so as to provide a scientific basis for tuberculosis prevention and control in schools. Methods: Tuberculosis data from high school students in counties (districts) reported in Gansu Province from 2018 to 2022 was collected from the Tuberculosis Information Management System and Infectious Disease Information Reporting System of the Chinese Disease Prevention and Control Information Management System. Demographic data of high school students in counties (districts) came from the General Management System of the Chinese Disease Prevention and Control Information Management System, and the spatial clustering of the reported incidence rate of pulmonary tuberculosis among high school students in Gansu Province in the past five years was analyzed using the methods of global spatial autocorrelation (Moran s I) and local indicators of spatial audocorrelation(LISA). Results: A total of 41 885 pulmonary tuberculosis cases were reported in various counties of Gansu Province From 2018 to 2022, with an average reported incidence rate of 32.81/100 000. During the same period, 1 170 high school students cases were reported, with an average reported incidence rate of 13.72/100 000. With the exception of 2020, the reported incidence rate of pulmonary tuberculosis among high school students was non random distribution in other 4 years, showed a moderate intensity of spatial clustering. From 2018 to 2022, most counties in Gansu Province reported that the incidence rate of pulmonary tuberculosis among high school students was 10.00/100 000 or below, the counties with reported incidence rate >40.00/100 000 were mainly distributed in Luqu County, Maqu County, Diebu County, Hezuo City, Xiahe County of Gannan Prefecture, Gangu County and Wushan County of Tianshui Prefecture, Wenxian County and Kangxian County of Longnan Prefecture, Huachi County of Pingliang Prefecture, Huanxian County of Qingyang Prefecture. The number of counties where the reported incidence rate of tuberculosis among high school students more than 30.00/100 000 gradually decreased from 2018 to 2022. In the past five years, the reported incidence rate of tuberculosis among high school students in all counties of Gannan Prefecture remained above 40.00/ 100 000 . The LISA analysis results showed that the high incidence areas were mainly concentrated in Gannan Prefecture. Conclusions The epidemic situation of pulmonary tuberculosis among high school students in Gansu province from 2018 to 2022 is still a serious condition, showing the characteristics of unbalanced regional distribution. The reported incidence rate shows a strong spatial clustering, and the hot spots are concentrated in the counties (districts) of Gannan prefecture in Gansu Province.

Objective:To investigate mucosal injury after high-dose methotrexate (HD-MTX) chemotherapy in treatment of children with acute lymphoblastic leukemia (ALL), and to analyze the association with methotrexate blood concentration, risk stratification and clinical efficacy.Methods:The data of 95 children with ALL who received 539 times of HD-MTX chemotherapy in the First Hospital of Harbin from November 2015 to October 2018 were retrospectively analyzed, and the association of mucosal injury with methotrexate blood concentration, disease risk degree and clinical efficacy was also analyzed.Results:Among 95 children who received 539 times of HD-MTX chemotherapy, the total incidence of mucosal injury was 8.4% (45/539); the incidence of mucosal injury was 4.6% (11/239), 7.6% (8/105), 13.3% (26/195), respectively in the low-risk group, middle-risk group and high-risk group. With the elevation of disease risk, the incidence of mucosal injury was increased ( χ2 = 10.787, P < 0.05). There was no correlation of the degree of mucosal injury with methotrexate blood concentration and disease risk degree (all P > 0.05), and the mucosal injury was not related with the clinical efficacy ( P > 0.05). Conclusion:After the application of HD-MTX in children with ALL, adjustment of the dose of rescue drug by monitoring of methotrexate blood concentration can improve the safety of therapeutic drugs.

Objective:To explore the therapeutic effect of low-dose arsenous acid/tretinoin with or without low-dose cytarabine induction regimen on myelodysplastic syndromes (MDS) with TET2 gene mutation in children.Methods:Nine children with MDS who were hospitalized at the First Hospital of Harbin from March 2009 to April 2018 were collected, including 3 cases of refractory cytopenia of childhood (RCC), 4 cases of MDS with excess of blasts type Ⅰ (MDS-EBⅠ) and 2 cases of MDS with excess of blasts type Ⅱ (MDS-EBⅡ). The next-generation gene sequencing method (NGS) was applied to detect the TET2 gene mutation in bone marrow cells of children with MDS. The low-dose arsenous acid/tretinoin with or without low-dose cytarabine induction regimen was adopted to conduct tiered therapy on children with MDS. The clinical efficacy was assessed in line with the MDS response evaluation criteria adopted by the MDS International Working Group (IWG) in 2006.Results:Among the 9 patients, the short-term clinical efficacy was observed in 8 cases. Two patients with TET2 gene mutation achieved the short-term clinical efficacy of bone marrow complete remission (mCR) and hematological improvement (HI). Among 7 patients without TET2 gene mutation, 4 patients obtained CR, 1 patients obtained mCR and HI, and 1 patients obtained stable disease (SD) in terms of the short-term clinical efficacy.Conclusion:The low-dose arsenous acid/tretinoin with or without low-dose cytarabine regimen may be beneficial to MDS children with TET2 gene mutation.

Objective:To explore the diagnostic application and characteristics of contrast-enhanced ultrasound in exertional rhabdomyolysis (ERM).Methods:Three cases of ERM patients admitted to Department of Neurology, the First Medical Center of Chinese People′s Liberation Army General Hospital in August 2019 were selected and clinical data of the patients were collected including medical history, serum muscle enzyme, electromyography, magnetic resonance imaging (MRI) and dynamic contrast-enhanced ultrasound of the thigh muscles within one week after onset.Results:All three patients had muscle soreness and dark urine after exercise and their serum muscle enzyme level exceeded five times of normal value which could be definitely diagnosed as ERM. Skeletal muscle MRI showed equal or slightly longer T 1, longer fat-suppressed T 2 weighted fluid attenuated inversion recovery images, and high diffusion weighted imaging signal. In this group, one case of femur muscle MRI showed adductor longus and semitendinosus myopathy, other two cases showed quadriceps. All cases′ MRI score was grade one. Echogenic enhancement can be seen in normal ultrasound of diseased skeletal muscle. Contrast-enhanced ultrasound showed a dynamic strengthening process in which the central area was firstly strengthened, then strengthened in peripheral area. Dynamic contrast-enhanced ultrasound showed characteristic changes in ERM with early and obvious enhancement in the central area and uneven enhancement in the central area. Conclusions:Dynamic contrast-enhanced ultrasonography of ERM lesions has its characteristic changes. The enhancement of the central area of the lesion appeared early and obvious while the surrounding area appeared late and weak, showing the characteristic of "water ripple" concentric circle reinforcement. This enhancement characteristic suggested that ERM skeletal muscle was unevenly damaged and the central area was more obvious.

Objective:To explore the imaging manifestations of central nervous system aspergillosis (CNSAG).Methods:The cranial imaging changes of five CNSAG patients admitted to the First Medical Center of People′s Liberation Army General Hospital from 2013 to 2019 were analyzed and their imaging characteristics were summarized.Results:There were four males and one female with the minimum age of 20 years old and maximum age of 59 years old. Among the five cases, two cases mainly occurred in the cavernous sinus and three cases in the cerebral parenchyma. Long T 1-weighted and long T 2-weighted signals were observed in all the lesions of the cerebral parenchyma, while equal or short T 1-weighted, equal or long T 2-weighted signals were observed in the lesions of the cavernous sinus. Magnetic resonance imaging (MRI) of the brain of all cases showed multiple ring enhancement, which could form serrate or lace-like arrangement along the periphery of the lesion and gather together to form "honeycomb" enhancement characteristics. The degree of peripheral enhancement was more obvious, and the scope of enhancement increased after the disease was aggravated. High diffusion weighted imaging (DWI) signal can be seen in the ring enhanced focus, which is the MRI feature of abscess, and high DWI signal can be seen at the edge of the enhanced ring. Susceptibility weighted imaging showed low bleeding signal, no characteristic changes in the spectrum, and decreased perfusion in the central area. Computer tomography scan showed normal or equal density mass lesions, obvious edema or complicated infarction showed irregular low-density shadow, and bleeding showed high-density shadow. Conclusion:MRI showed mixed signal and circular enhancement, computer tomography showed normal or isodense mass lesions, or irregular low-density shadow, and bleeding signs could be found in CNSAG.

Objective:To summarize the clinical characteristics and therapeutic efficacy of central nervous system (CNS) aspergillosis.Methods:The clinical manifestations, laboratory examination, neuroimaging features, treatment and prognosis of 37 cases of CNS aspergillosis diagnosed and treated in the First Medical Center of People′s Liberation Army General Hospital from January 2000 to January 2021 were retrospectively analyzed. According to the correlation between intracranial lesions and paranasal sinus lesions, they were divided into two groups: rhino-cerebral aspergillosis (RA, n=21) group and cerebral aspergillosis (CA, n=16) group. Results:Only 16.2% (6/37) of CNS aspergillosis patients had a clear background of immunosuppression, but 35.1% (13/37) were complicated with diabetes. The most common clinical manifestations were headache (73.0%, 27/37), cranial nerve involvement (59.5%, 22/37) and fever (37.8%, 14/37). Cerebrospinal fluid characteristics included increased pressure (53.8%, 14/26), increased white blood cell count (46.7%, 14/30), decreased glucose (30.0%, 9/30), increased protein (70.0%, 21/30), and high positive results of the metagenomic next-generation sequencing (mNGS) of pathogenic microorganism (7/10). Cranial magnetic resonance imaging showed that commonly involved sites were sinus, orbital apex, posterior orbit, cavernous sinus (43.2%, 16/37) and cerebral lobes (27.0%, 10/37). Treatment options included antifungal drugs alone (64.9%, 24/37), combination of drugs and surgery (27.0%, 10/37) and surgery alone (8.1%, 3/37). Compared with the CA group, RA group had fewer males [47.6% (10/21) vs 14/16, χ2=6.34, P=0.012] and older age [(54.2±19.4) years vs (38.4±18.4) years, t=2.50, P=0.017], and was more prone to headache [85.7% (18/21) vs 9/16, χ2=4.00, P=0.046) and cranial nerve involvement [81.0% (17/21) vs 5/16, χ 2=9.31, P=0.006]. The misdiagnosis rate of these patients in the early stage was 73.0% (27/37). A total of 29 patients (85.3%, 29/34) were treated with voriconazole successively, and the course of treatment was 3.0 (0.5, 10.4) months. Compared with salvage therapy, the mortality of primary therapy was lower (4/17 vs 9/12, χ2=7.54, P=0.006). All patients were followed up to December 2021, and 17 patients died, with a mortality rate of 45.9% (17/37). Conclusions:CNS aspergillosis may have no definite immunosuppressive background. Some of CNS aspergillosis patients are complicated with diabetes, and the clinical manifestations of the disease lack specificity, with high misdiagnosis rate in the early stage, no inflammatory changes in cerebrospinal fluid, and high positive rate of mNGS for pathogenic microorganism. Early and long-term application of voriconazole can significantly reduce the mortality rate.

Objective To investigate the effect of daily soft brace wearing on plantar dynamics during walking in patients with chronic ankle instability(CAI). Methods A total of 52 patients with unilateral chronic ankle instability(CAI)in Beijing Rehabilitation Hospital from February,2021 to January,2023 were randomly divided into control group(n=26)and experimental group(n=26).Both groups underwent an eight-week exercise training program.The control group wore placebo brace dur-ing daily activities,while the experimental group wore soft ankle brace.Plantar dynamic parameters were mea-sured using a pressure plate system during walking,including peak plantar pressure and plantar impulse before and after intervention. Results Six participants dropped out in the control group and five in the experimental group,resulting in a final inclu-sion of 41 participants.After intervention,there was no significant difference in peak plantar pressure and im-pulse on the affected side in the control group among different areas(P＞0.05).In the experimental group,the peak pressure and impulse in the heel medial,heel lateral and forefoot medial areas increased(|t|＞4.192,P＜0.001),while the peak pressure and impulse in the midfoot and lateral forefoot areas decreased(t＞2.984,P＜0.05);the peak pressure and impulse in the heel medial,heel lateral and forefoot medial areas were higher in the experimental group than in the control group(|t|＞2.126,P＜0.05),and the peak pressure and impulse were low-er in the midfoot and forefoot lateral areas(t＞2.133,P＜0.05). Conclusion Wearing a soft brace during daily activities may optimize the distribution of peak plantar pressure and plan-tar impulse on the affected side in patients with CAI,which may prevent recurrence of sprains.