Objective:To analyze the application of antitoxin therapy in severe infant botulism.Methods:A retrospective analysis was conducted on 14 cases of severe infant botulism treated at 3 pediatric medical centers from July 2020 to August 2024. This study investigated antitoxin dosage, treatment duration, discontinuation criteria and adverse reactions.Results:A total of 14 cases (12 males and 2 females) were included, with an age of 5.0 (3.8, 7.0) months. Botulinum toxin typing revealed 10 cases of Type B, 2 cases of Type A and 2 untyped cases. The interval from symptom onset to antitoxin administration was 9.0 (6.0, 11.5) d. The initial dosage of type A antitoxin was 12 500 (10 000, 22 500) U, while type B was 5 000 (5 000, 5 000) U. The dosage was tapered in some cases after symptom improvement, the duration of treatment was 16.5 (9.8, 25.3) d. In total, 11 infants discontinued medications after improvement in muscle strength, while 3 infants discontinued treatment after obtaining negative results from fecal mouse bioassays. Adverse events were reported in 2 cases, both of which resulted in rash, and 1 case was complicated with anaphylactic shock. All the patients survived upon discharge with a follow-up period of 11 d to 3 years and 8 months. Totally 12 infants had fully recovered, while 2 infants were still recovering after discharge.Conclusion:Antitoxin therapy is a feasible and safe approach which showed favorable prognosis in severe infant botulism.

The aim of this study is to investigate the protective effect of idebenone (IDE) combined with borneol (BO) against Parkinson's disease (PD). In this study, wild-type AB zebrafish and transgenic Tg ( vmat2: GFP) zebrafish with green fluorescence labeled dopamine neurons were used to establish the PD model with 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine hydrochloride (MPTP). Following drug treatment, the behavioral performance and dopamine neuron morphology of zebrafish were evaluated, and regulation of dopamine signaling pathway-related genes was determined using RT-qPCR. The results showed that IDE combined with BO improved the behavioral disorders of zebrafish such as bradykinesia and shortening movement distance, also effectively reversed the damage of MPTP-induced dopaminergic neurons. At the same time, the expression of dopamine synthesis and transportation-related genes was up-regulated, and the normal function of the signal transduction pathway was restored. The combination showed a better therapeutic effect compared to the IDE monotherapy group. This study reveals the protective mechanism of IDE combined with BO on the central nervous system for the first time, which provides an important experimental basis and theoretical reference for clinical combination strategy in PD treatment.
Animals ; Zebrafish ; Signal Transduction/drug effects* ; Animals, Genetically Modified ; Dopamine/metabolism* ; Neuroprotective Agents/pharmacology* ; Disease Models, Animal ; Camphanes/pharmacology* ; Ubiquinone/pharmacology* ; Parkinson Disease/drug therapy* ; Dopaminergic Neurons/metabolism*

Inflammatory bowel disease(IBD)is a non-specific chronic inflammatory bowel condition.Crohn's disease(CD)and ulcerative colitis(UC)are the 2 main types of IBD.IBD is prone to recurrent attacks,which is associated with many factors,such as immune dysfunction,intestinal microenvironment homeostasis imbalance,and environmental and genetic factors;however,its specific pathogenesis is still unclear.Zebrafish has recently emerged as an emerging animal model and have been used extensively for mechanistic research into IBD,model construction,activity evaluation,and screening of anti-IBD agents,due to their unique biological advantages.Based on the latest research progress using zebrafish in the field of IBD,this review systematically introduces the intestinal development characteristics,tissue structure,intestinal immunity,IBD model,and the application of drug screening in zebrafish,to demonstrate the value of zebrafish in the study of IBD.

Inflammatory bowel disease(IBD)is a non-specific chronic inflammatory bowel condition.Crohn's disease(CD)and ulcerative colitis(UC)are the 2 main types of IBD.IBD is prone to recurrent attacks,which is associated with many factors,such as immune dysfunction,intestinal microenvironment homeostasis imbalance,and environmental and genetic factors;however,its specific pathogenesis is still unclear.Zebrafish has recently emerged as an emerging animal model and have been used extensively for mechanistic research into IBD,model construction,activity evaluation,and screening of anti-IBD agents,due to their unique biological advantages.Based on the latest research progress using zebrafish in the field of IBD,this review systematically introduces the intestinal development characteristics,tissue structure,intestinal immunity,IBD model,and the application of drug screening in zebrafish,to demonstrate the value of zebrafish in the study of IBD.

Objective:To analyze the application of antitoxin therapy in severe infant botulism.Methods:A retrospective analysis was conducted on 14 cases of severe infant botulism treated at 3 pediatric medical centers from July 2020 to August 2024. This study investigated antitoxin dosage, treatment duration, discontinuation criteria and adverse reactions.Results:A total of 14 cases (12 males and 2 females) were included, with an age of 5.0 (3.8, 7.0) months. Botulinum toxin typing revealed 10 cases of Type B, 2 cases of Type A and 2 untyped cases. The interval from symptom onset to antitoxin administration was 9.0 (6.0, 11.5) d. The initial dosage of type A antitoxin was 12 500 (10 000, 22 500) U, while type B was 5 000 (5 000, 5 000) U. The dosage was tapered in some cases after symptom improvement, the duration of treatment was 16.5 (9.8, 25.3) d. In total, 11 infants discontinued medications after improvement in muscle strength, while 3 infants discontinued treatment after obtaining negative results from fecal mouse bioassays. Adverse events were reported in 2 cases, both of which resulted in rash, and 1 case was complicated with anaphylactic shock. All the patients survived upon discharge with a follow-up period of 11 d to 3 years and 8 months. Totally 12 infants had fully recovered, while 2 infants were still recovering after discharge.Conclusion:Antitoxin therapy is a feasible and safe approach which showed favorable prognosis in severe infant botulism.

【Objective】 To explore the effect of nifedipine controlled-release tablets on left wrist pulse wave transit time (PWTT) in hypertensive patients. 【Methods】 We selected 262 essential hypertensive patients hospitalized at Chinese PLA General Hospital Hainan Branch from August 2021 to December 2022. The patients were divided into observation group (n=140) and control group (n=122) according to whether or not taking nifedipine controlled release tables. The left wrist PWTT at 0.5 h, 2.5 h, 4.5 h, 6.5 h and 8.5 h after administration of the medicine was collected with a smart watch for statistical analysis. 【Results】 ①The PWTT in the observation group (93±15, 93±13, 87±15, 85±15, 84±10) and the control group (98±18, 92±16, 90±10, 89±8, 89±9) decreased gradually with the extension of time (F=11.448, P<0.001). ②The PWTT decreased by the same amplitude (F=2.206, P>0.05). ③There was no significant difference in PWTT between the observation group and the control group at five time points (F=1.164, P>0.05). 【Conclusion】 Administration of nifedipine controlled-release tablets does not affect PWTT of primary hypertensive patients’ left wrist.

Objective:To investigate the predictive value of stress hyperglycemic ratio (SHR) and hypoperfusion volume for early neurological deterioration (END) in patients with minor stroke due to large vessel occlusion in anterior circulation.Methods:Consecutive patients with minor stroke due to large vessel occlusion in anterior circulation admitted to the Department of Neurology, Zhangjiagang Hospital Affiliated to Soochow University from October 2021 to January 2024 were included retrospectively. Minor stroke was defined as a baseline National Institutes of Health Stroke Scale (NIHSS) score of ≤ 5. SHR was calculated as the fasting blood glucose to glycated hemoglobin ratio, and CT perfusion imaging Tmax >6 s volume represented severe hypoperfusion volume. END was defined as an increase of ≥4 in NIHSS score compared to the baseline within 24 hours of onset. Multivariate logistic regression analysis was used to determine the independent risk factors for END. Receiver operating characteristic (ROC) curves was used to determine the predictive value of each independent predictor for END. Results:A total of 190 patients were enrolled, including 52 females (27.4%), aged 65.89±14.30 years. The baseline NIHSS score was 3 (interquartile range, 2-5). Forty-six patients (24.2%) experienced END, and 22 received salvage endovascular treatment. Univariate analysis showed that there were significant differences in severe hypoperfusion volume, SHR, and the proportion of patients with fasting blood glucose >7 mmol/L between the END group and the non-END group (all P<0.05). Multivariate logistic regression analysis showed that SHR (odds ratio [ OR] 7.736, 95% confidence interval [ CI] 1.082-55.286; P=0.041) and Tmax >6 s volume ( OR 1.006, 95% CI 1.001-1.010; P=0.009) were the independent predictive factors for END. ROC curve analysis showed that area under the curve of SHR and Tmax >6 s volume for predicting END were 0.720 (95% CI 0.632-0.807) and 0.649 (95% CI 0.561-0.737), respectively. The optimal cutoff value for SHR was 1.03, and the sensitivity and specificity were 60.9% and 79.9%, respectively; the optimal cutoff value for Tmax >6 s volume was 38.7 ml, and the sensitivity and specificity were 89.1% and 39.6%, respectively. The area under the curve of combining the two indicators to predict END was 0.736 (95% CI 0.654-0.848). Conclusion:In patients with minor stroke due to large vessel occlusion in anterior circulation, higher SHR and larger severe hypoperfusion volume have certain predictive value for END.

Objective:To summarize the clinical characteristics and prognosis of severe infant botulism and evaluate the therapeutic effect of botulinum antitoxin in the pediatric intensive care unit (PICU).Methods:The clinical data of 8 cases diagnosed with infantile botulism were retrospectively analyzed in the PICU of Beijing Children′s Hospital from October 2019 to August 2023. Data of basic demographic information, clinical manifestations, laboratory tests, treatment and prognosis of each child were collected and analyzed using descriptive statistical methods.Results:Eight laboratory-confirmed cases of infant botulism were included in this study, all of which were male infants with an age of 6.0 (3.3,6.8) months. Three of the children were from Inner Mongolia Autonomous Region, 2 of them were from Hebei, and the other 3 were from Beijing, Shandong and Xinjiang Uyghur Autonomous Region, respectively. All the patients were previously healthy. In 4 of these cases, the possible cause was the ingestion of either honey and its products or sealed pickled food by the mother or child before the onset of the disease. The first symptom was poor milk intake (4 cases), followed by shallow shortness of breath (7 cases), limb weakness (7 cases) and so on. The typical signs were bilateral dilated pupils (8 cases) and decreased limb muscle strength (8 cases). The main subtype was type B (7 cases), and only 1 case was classified as type A. Six of the children were treated with antitoxin therapy for a duration of 24 (19, 49) d. Seven of them had invasive mechanical ventilation. All the patients survived upon discharge with a follow-up period of 29 d to 3 years and 8 months. Six patients had fully recovered, and 2 recently discharged patients were gradually recovering.Conclusions:For infants with suspected contact or ingestion of botulinum and presented with bilateral pupillary paralysis, muscle weakness and clear consciousness, the stool should be collected for diagnostic testing using a mouse bioassay as soon as possible. Type B was the most common type. The antitoxin treatment was effectiveness and the prognosis was well.

Objective:To search, evaluate and summarize the best research evidence of perioperative intestinal management in patients with cervical spinal cord injury, so as to provide evidence-based basis for clinical nursing practice.Methods:Literature on perioperative intestinal management of cervical spinal cord injury were systematically searched in databases, domestic and foreign relevant guidlines network and professional associations, such as UpToDate, Cochrane Library, PubMed, China National Knowledge Infrastructure, Wanfang Database, etc. The search period was from the establishment of the databases to October 1, 2023. The quality of the included literature was evaluated and the evidence was extracted and summarized.Results:Finally, 9 articles were included, including 2 guidelines, 2 expert consensuses, 1 randomized controlled trials, and 4 observational studies. Twenty-five pieces of evidence were summarized across six aspects: assessment, diet management, physical activity, physical therapy, drug therapy, prevention and management of intestinal complications.Conclusions:The best evidence of perioperative intestinal management in patients with cervical spinal cord injury summarized in this study can provide reference for clinical nursing practice.

Objective:To investigate the risk factors and predictive value of early neurological deterioration (END) in patients with minor stroke caused by middle cerebral artery occlusion.Methods:Consecutive patients with minor stroke caused by middle cerebral artery occlusion admitted to Zhangjiagang Hospital Affiliated to Soochow University from October 2021 to May 2023 were retrospectively included. Minor stroke was defined as the National Institutes of Health Stroke Scale (NIHSS) score ≤5 at admission, and END was defined as an increase of ≥4 from baseline in the NIHSS score within 24 h of admission (excluding intracranial hemorrhage). Multivariate logistic regression analysis was used to determine independent risk factors for END. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of various risk factors on END. Results:A total of 130 patients with minor stroke caused by middle cerebral artery occlusion were included, of which 33 (25.4%) had END and 97 (74.6%) did not. Univariate analysis showed that there were statistically significant differences in NIHSS scores, volume with cerebral blood flow <30%, CT perfusion mismatch volume, baseline blood glucose, and baseline white blood cell count between the END and non-END groups (all P<0.05). Multivariate logistic regression analysis showed that CT perfusion mismatch volume (odds ratio [ OR] 1.010, 95% confidence interval [ CI] 1.003-1.017; P=0.007) and baseline white blood cell count ( OR 1.582, 95% CI 1.200-2.085; P=0.001) were the independent risk factors for END. ROC curve analysis showed that the area under the curves of CT perfusion mismatch volume and baseline white blood cell count for predicting END were 0.748 (95% CI 0.660-0.835; P<0.001) and 0.757 (95% CI 0.659-0.854; P<0.001), respectively. The area under the curve of combined predicting END was 0.821 (95% CI 0.738-0.905; P<0.001). Conclusions:CT perfusion mismatch volume and baseline white blood cell count are independent risk factors for the occurrence of END patients with minor stroke caused by middle cerebral artery occlusion, and the combination of the two has good predictive value for END.