Objective To investigate effects of three kinds of neutral,happy,sad emotional faces stimulus on sustained attention task using N170 in depression patients to analysis the correlation of depression in patients with depression,anxiety severity and the amplitude and latency of N170.Methods Twenty-eight patients with depression aged from 22 to 69 years (case group),and 31 healthy controls (control group) aged from 20 to 61 years were recruited for the study.Subjects were asked to perform tasks in the selection of attention following randomly presented three kinds of happy,neutral and sad emotional faces stimuli.Brain auditory evoked potential including N170 amplitude and latency were recorded during the tasks.HAMD and HAMA were used to assess the severity of depression and anxiety.Results There was significant difference between case group and control group in N170 latency by three kinds of happy,neutral and sad emotional faces stimulation in the local skull (T5,T6,O1,O2) (P＜0.05).But the difference was not significant in N170 amplitude (P＞0.05).The total score of HAMD in case group had a positive correlation with N170 amplitude by neutral facial emotion stimulation in part of T5 (r=0.443,P=0.018).Conclusion There is significant change in the initial cognitive processing of different emotional faces in the patients with depression.And the severity of depression is related to the N170 amplitude induced by the neutral emotional faces stimulation in some parts of brain.

Objective To investigate the relationship between eosinophil and in-stent restenosis in acute coronary syndrome patients. Methods One hundred and fifity-one ACS cases werenenrolled in this study. According to the results of coronary angiography (the stented segment lumen loss over 50% was judged to be ISR), patients were divided into the restenosis group and the non-restenosis group. Results Based on the logistic analysis, no significant association was found between eosinophil and ISR, and even after adjustment of related risk factors (P > 0.05). The stratification analysis showed that the high level of eosinophil might increase the risk of ISR in ACS patients with history of hypertension (P = 0.038) and myocardial infarction (P = 0.032). Conclusion Eosinophil may be associated with the risk of ISR in ACS patients with history of hypertension and myocardial infarction. The underlying mechanisms need to be elucidated in further study.

Objective　To define the range of the normal values of MRI signals of hippocampal formation(HPF) for the diagnosis of early stage Alzheimer's disease and hippocampal sclerosis.Methods　MRI signals of 254 normal adults were measured on the transverse section.Results　HPF signal intensities were:T1 relaxation times,629±73 ms;T2 relaxation times,83±5.5 ms;and proton density value,5978±651.The T2 value range(χ±2S)was 72～94 ms,and mean 83 ms.T2 value greater than 104 ms will be associated with evidence of hippocampal pathologic changes.The mixed signal intensity of T2WI(30,60,120)were:3907±407,2657±347,1288±174.The signal intensity ratios of T2WI were:1.02,1.07,1.13.Conclusion　As for the histological features of temporal lobe cortex and HPF,T1relaxation times and proton density values are matched but T2 relaxation times of HPF are relatively longer.

Objective To investigate the etiology,clinical characteristics and prognostic indicators of neonatal refractory seizures.Methods Forty-six newborns admitted to the neonatology ward of Peking University First Hospital from January 1,2000 till July 31,2011 with refractory seizures were chosen as the subject,and another 42 newborns with nonrefractory seizures who were admitted at the same period were chosen as the nonrefractory seizures group.The etiologies,clinical characteristics and prognosis of newborns in the two groups were compared.The newborns with refractory seizures were further divided into two subgroups:one was composed of 11 newborns with normal prognosis,and the other was composed of 35 newborns with unfavorable prognosis.The etiologies and clinical characteristics of seizure in thses two subgroups were also compared.Chi-square or Fisher's exact test was applied to compare the difference between groups; Logistic regression analysis was applied to determine the risk factors of refractory seizures and its prognosis.Results (1) The first three common causes of neonatal refractory seizures were severe perinatal brain damage (8/46,17.4％),encephalodysplasia (7/46,15.2％) and congenital metabolic diseases (3/46,6.5％).Seizure attack every day,severe abnormal electroencephalogram,statural convulsivus and unfavorable prognosis were significantly higher in the refractory seizure group than that in the nonrefractory seizures group [91.3％ (42/46) vs 57.1％ (24/42) ; 55.6％ (25/45) vs 5.4％ (2/37) ;17.4％(8/46) vs 0.0％(0/42) ; 76.1％(35/46) vs 21.4％(9/42),x2 =13.665,23.123,Fisher's exact test and 26.236,respectively,all P＜0.01].Seizure attack everyday (OR=3.811,95％CI:1.019-14.258,P =0.047) and severe abnormal electroencephalogram (OR =16.384,95％ CI:3.421-78.472,P=0.000) were independent risk factors of refractory seizures.(2) Among those newborns with refractory seizures and unfavorable prognosis,the failure rate of phenobarbital administration was 80.0％(28/35),higher than those with normal prognosis (4/11) (Fisher's exact test,P=0.010).Therefore,poor phenobarbital therapeutic efficacy indicated an unfavorable prognosis (OR=12.444,95％CI:2.530-61.217,P=0.002).Conclusions The common causes of neonatal refractory seizures are perinatal brain damage,encephalodysplasia and congenital metabolic diseases.The clinical characteristics of refractory seizure are frequent seizure attacks (more than once a day),severe abnormal electroencephalogram and statural convulsivus,and unfavorable prognosis is common.Poor therapeutic effect of phenobarbital prompts adverse outcome.

Objective To analyze and summarize clinical manifestations of inflammatory bowel disease (IBD) in neonates.Methods From 2007 to 2013,three neonates were diagnosed with IBD in Peking University First Hospital.Data on these three cases with neonatal IBD were analyzed.The coding region of the interleukin 10 receptor A (IL10RA) gene was detected using direct Sanger sequencing in one of the patients.The literature was reviewed.Results The three newborns were 4-12 days old,all had symptoms of diarrhca,mucosanguineous feces and oral ulcers,accompanied by hypoalbuminemia and a family history.Two of these infants had perianal lesions,and one had liver damage and scizures.All three patients had elevated white blood cells and were anti-proteinase 3 positive.Two had elevated C-reactive protein and erythrocyte sedimentation rate,and one had positive antinuclcar antibodies and double stranded DNA antibodies.Colonoscopy showed multiple ulcers affecting the ileocecum and colon.The infants received treatment including antibiotics,switching formula feeding and 5-aminosalicylic acid.After treatment,one infant was cured,one died although glucocorticoids and azathioprine were used,and the other with a IL10RA gene mutation recovered,this infant had a compound heterozygous mutation with c.301C ＞ T (p.Arg101Trp),c.421G ＞ A (p.Gly141Arg) and whose parents were carriers.The literature review showed that fever and abnorrnal defecation were the main clinical features,and examination of serum antibodies showed a lower positive rate.The patients had a poor response to medications and most required surgery.IL10RA gene mutations were detected in some patients.Conclusions Neonates with diarrhea and a family history may have IBD and should undergo colonoscopy as early as possible.

ObjectiveTo analyze the characteristics of neonatal hyperammonemia and citrullinemia caused by argininosuccinate lyase (ASL) gene mutations, and to have a better understanding of this disease. MethodsA neonatal patient with the onset of hyperammonemia and citrullinemia admitted to the Department of Pediatrics of Peking University First Hospital on April 2, 2014, was retrospectively studied. Peripheral blood leukocyte DNA of the patient and his parents was collected to detectASS1,ASL andSLC25A13 gene mutations. The literature related to neonatal hyperammonemia, citrullinemia and argininosuccinic aciduria was reviewed. ResultsThe baby in this case appeared lethargic, had weaker crying and food refusal since three days after birth, and analysis of blood amino acid found a marked increase in blood ammonia (1 332μmol/L) and a significant rise in citrulline (759.12μmol/L). Sanger sequencing detection revealed compound heterozygous mutations in theASL gene (c.434 A>G, c.857A>C) and this c.857A>C mutation was the first reported case in China. This case of hyperammonemia and citrullinemia was confirmed as argininosuccinic aciduria caused by ASL gene mutations. A protein-limited diet and the treatment of arginine and L-carnitine were given. His blood ammonia decreased to normal level and there was a significant improvement in physical and intellectual progress at five months old. Unfortunately, he had an intestinal infection when he was over five months old and the blood ammonia level tested in the local hospital was 480μmol/L. Gradually there was a disturbance of consciousness, then coma, and he finally died after active rescue in the local hospital.ConclusionsHyperammonemia and citrullinemia in neonates are likely to be argininosuccinic aciduria and a gene mutation test may be helpful for diagnosis.

Objective To study the clinical features,diagnosis and treatment of neonatal very early onset inflammatory bowel disease(VEO-IBD) to improve the diagnosis and treatment of the disease.Method From Jan 2013 to Dec 2015,five infants with VEO-IBD admitted to Peking University First Hospital were reviewed and analyzed.Their clinical data included general condition,clinical symptoms,laboratory tests,autoimmune antibodies (ANCA,dsDNA,ANA and ENA),colonoscopy,pathological results and therapeutic response.Interleukin-10 receptor A (IL-10RA) gene was examined in all patients.All the patients were followed up for more than 1 year.Result Three of the five patients had a family history.Persistent diarrhea was the most common presenting symptom.One of them received surgery because of intestinal necrosis and developed typical symptoms of IBD half a year later.Bloody stool or positive fecal occult blood test were found in all infants.Fever,anemia,oral ulcer,perianal lesions and malnutrition were common concomitant symptoms.Most of the patients had elevated WBC,CRP and ESR,and 4 of them had positive autoimmune antibodies.Colonoscopy showed multiple ulcers affecting the colon.Intestinal biopsies revealed acute and chronic inflammation.4 of patients were found to have cryptitis and crypt abscesses.Gene sequencing revealed IL-10RAgene mutation in all five patients,including 1 case with homozygous mutation and 4 heterozygous mutations.4 patients received steroid and mesalazine therapy and only 1 patient's symptoms were controlled.However,the colonoscopy result was still abnormal in this patient.4 patients had poor response to further infliximab and (or) thalidomide therapy.1 of them received surgery because of intestinal obstruction at 2-year-old.Conclusion Neonatal VEO-IBD was associated with IL-10RA gene mutation.The patients had severe symptoms and poor response to conventional medications.The effects of biological agents and thalidomide were still not sure.

Objective To study the neurological prognosis of neonates with ventriculomegaly and its influencing factors.Method A retrospective study was conducted among neonates with ventriculomegaly in Peking University First Hospital from January 2013 to December 2015.A series of cranial ultrasonography were performed after birth and the Gesell development scale was conpleted after six months.x2 test and two-independent-sample t test were used for statistical analysis.Result Among 103 cases of ventriculomegaly,95 cases (92.2％) had mildly enlarged lateral ventricles and 8 cases (7.8％) significantly enlarged.83 cases received serial cranial ultrasound examinations after birth.The lateral ventricles of 9 patients (10.8％) bacame wider and 74 (89.2％) not.The Gesell development scales were completed in 65 cases 6 months after birth.Among them,8 patients with widening lateral ventricles got poor prognosis (100％).Among 57 patients without progressively widening lateral ventricles,6 (10.5％) had poor prognosis.The difference was statistically significant (P ＜ 0.001).No correlation was found between the severity of the lateral ventricle widening and the neurological outcome (P =1.000).There were 2 cases with other abnormalities,and 1 case got poor prognosis on follow-up.Conclusion Most neonatal ventriculomegaly patients have mild and isolated lateral ventricle enlargement.Most of them remain stable or gradually return to normal.The patients with progressively widening lateral ventricles are likely to have adverse neurological prognosis.

Objective To study the characteristics and its risk fastors of brain development of the preterm infant early after birth in amplitude-integrated electroencephalography(aEEG). Methods The 153 preterm infants who had seen a doctor in Peking University First Hospital from April 2009 to August 2013 accepted the aEEG check at term of corrected gestational age ( ≥ 38 weeks but < 42 weeks of corrected gestational age). The risk factors of brain development, such as gestational age ( < 30, 30 ≤ - ≤ 33+6 and 34≤-≤36+6 weeks), clinical informations [relatively stable group including 104 cases without any serious complications or brain injury, the group only suffering from a serious brain injury (19 cases), and the group only suffering from severe systemic disease (30 cases)] and nutrition (good or malnutrition), were analyzed. Also the relationship between the aEEG and the cranial ultrasound detected at the same time and the Gesell Developmental Scale at six months of corrected gestational age. Theχ2 test, two independent samples t-test and Logistic regression analysis were used for statistical analysis. Results The aEEG of 52%(79/153) cases reached the level of normal full-term newborn at term of corrected gestational age, only 48% (74/153) were abnormal. The abnormal rate of aEEG results in relatively stable preterm infants decreased from 3/6 (<30 weeks) to 35%(13/37) at 34 ≤ - ≤ 36+6 weeks, but the difference was not statistically significant (χ2=1.998, P=0.353). The abnormal rate of aEEG results in the group suffering from a serious brain injury was higher than the relatively stable preterm infants [14/19 vs 44%(46/104) ,χ2=5.578, P=0.024]. In relatively stable preterm infants, there was no difference of the abnormal rate of the aEEG results between intrauterine malnutrition group and good nutrition group [46%(19/41) vs 43%(27/63),χ2=0.122, P=0.727]. Neither was between extrauterine malnutrition group and good nutrition group [52%(13/25) vs 42%(33/79),χ2=0.805, P=0.369]. Serious brain injury was independent risk factor of abnormal aEEG (OR=3.453, 95%CI: 1.177-10.132, P=0.024). The coincidence rate of aEEG and the cranial ultrasound examination or the scores of Gesell Developmental Scale was 57%(56/98) and 50%(10/20), respectively. Conclusions The brain catch-up development may appears early after birth in preterm infants, which are impaired by lower gestational age and the severe brain injury. It is more effective of aEEG for evaluating the brain development of preterm infants when combines with other methods.

To improve the therapeutic effect of mild hypothermia, avoid the adverse impact of mild hypothermia on cerebral blood flow, and improve the prognosis of hypoxic-ischemic encephalopathy, it is necessary to further explore the mechanism of cerebral hemodynamic disorder in hypoxic-ischemic encephalopathy under mild hypothermia treatment, the influence of systemic hemodynamic changes on cerebral blood flow, and the use of near-infrared spectroscopy to monitor cerebral blood flow and adjust the dosage of vasoactive drugs for avoiding large fluctuation of cerebral blood flow during mild hypothermia treatment and rewarming.