Objective To investigate the clinical features of the spectrum of upper gastrointestinal diseases in children and to provide assistance in the prevention,diagnosis and treatment of upper gastrointestinal diseases in children.Methods Clinical data of 424 children aged 2 months to 14 years who were hospitalised for gastroscopy in the paediatrics department of the First People's Hospital of Yunnan Province from January 2018 to June 2023 were collected,and retrospective analyses were performed for the children's clinical presentation,gastroscopy results,and HP infections.Results The symptoms of vomiting and diarrhea in infants were significantly different from those in preschool and school age groups(P＜0.05).The positive rate of lesions under gastroscopy was 96.46％.The main diseases found were non-atrophic gastritis(222 cases),bile reflux gastritis(42 cases),non-atrophic gastritis with erosion(30 cases),duodenitis(25 cases),reflux esophagitis(15 cases)and others(75 cases).Helicobacter pylori(HP)was detected in 300 of the 424 cases,and 105 cases were HP positive,with a detection rate of 35.00％.Conclusion Abdominal pain was the main symptom of upper gastrointestinal diseases in school-age and pre-school children.Vomiting and diarrhea were the main symptoms of upper gastrointestinal diseases in infants.There was no gender difference in HP infection,but there was a difference in age.

Objective:To investigate the correlation between triglyceride-glucose (TyG) index and high on-treatment platelet reactivity (HTPR) during clopidogrel treatment in patients with ischemic stroke.Methods:Patients with ischemic stroke who received maintenance dose of clopidogrel (75 mg/d) in the Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine from January 2017 to March 2021 were retrospectively included. The highest quartile (Q4) of the TyG index was defined as insulin resistance. Platelet reactivity was assessed by thromboelastogram and clopidogrel HTPR was defined as the clot strength induced by adenosine diphosphate (MA ADP) >47 mm. Multivariate regression model was used to analyze the independent correlation between TyG index and platelet reactivity. Results:A total of 83 patients were included. The TyG index showed a linear correlation with MA ADP. The patients were divided into 4 groups according to the quartile of TyG index. The incidence of clopidogrel HTPR increased significantly with the increase of the quartile of the TyG index ( Ptrend=0.017). Multivariate analysis showed that there was a significant independent correlation between insulin resistance and clopidogrel HTPR (odds ratio 4.597, 95% confidence interval 1.285-16.446; P=0.019). Conclusions:In patients with ischemic stroke treated with clopidogrel, the incidence of clopidogrel HTPR gradually increases with the increase of the quartile of the TyG index. The insulin resistance assessed by the TyG index is independently associated with clopidogrel HTPR.

Essential palatal tremor is relatively rare in clinical practice, which manifests involuntary and rhythmic contraction of soft-palate along with auditory click. The cause is unknown and there is no specific treatment at present. This article reports a female patient with essential palatine tremor, who presented with involuntarily beating of soft palate, disappeared during sleep, had sensory tricks, and gradually developed mental and psychological problems such as anxiety disorders. After treatment with integrated traditional Chinese and Western medicine, the symptoms improved. The clinical features of the case were analyzed, relevant literature was reviewed, and the possible etiology and characteristics of the disease were explored, so as to provide reference for clinical diagnosis and treatment.

Objective:To compare the changes of cerebral blood flow (CBF) in bipolar disorder type Ⅱ patients with and without suicidal ideation.Methods:Pseudo-continuous arterial spin labelling (pCASL) was examined with resting-state functional magnetic resonance imaging(rs-fMRI) on all subjects, CBF images of bipolar disorder type Ⅱ depression with suicidal ideation ( n=48), Bipolar Disorder type Ⅱ without suicidal ideation ( n=41), healthy controls ( n=62) at rest were collected. One-way ANOVA and Gaussian random field (GRF) were used to compare the CBF values between the groups to locate the regions with significant change. Results:Compared with the control group, CBF of left superior temporal gyrus (extending to the temporal pole) ( t=3.87, P<0.01; t=4.44, P<0.01) and left putamen ( t=4.04, P<0.01; t=3.19, P<0.01) increased in bipolar disorder type Ⅱ patients with and without suicidal ideation, and CBF of the right posterior cingulate gyrus (extending to the calcarine gyrus) decreased in bipolar disorder type Ⅱ patients with suicidal ideation( t=-4.66, P<0.01). Conclusions:There were abnormal CBF in left superior temporal gyrus and left putamen in bipolar disorder type Ⅱ patients with suicidal ideation and bipolar disorder type Ⅱ patients without suicidal ideation, while the decreased CBF in right posterior cingulate gyrus may be the specific brain change in bipolar disorder type Ⅱ patients with suicidal ideation.

Objective:To compare the changes of cerebral blood flow (CBF) in bipolar disorder type Ⅱ patients with and without suicidal ideation.Methods:Pseudo-continuous arterial spin labelling (pCASL) was examined with resting-state functional magnetic resonance imaging(rs-fMRI) on all subjects, CBF images of bipolar disorder type Ⅱ depression with suicidal ideation ( n=48), Bipolar Disorder type Ⅱ without suicidal ideation ( n=41), healthy controls ( n=62) at rest were collected. One-way ANOVA and Gaussian random field (GRF) were used to compare the CBF values between the groups to locate the regions with significant change. Results:Compared with the control group, CBF of left superior temporal gyrus (extending to the temporal pole) ( t=3.87, P<0.01; t=4.44, P<0.01) and left putamen ( t=4.04, P<0.01; t=3.19, P<0.01) increased in bipolar disorder type Ⅱ patients with and without suicidal ideation, and CBF of the right posterior cingulate gyrus (extending to the calcarine gyrus) decreased in bipolar disorder type Ⅱ patients with suicidal ideation( t=-4.66, P<0.01). Conclusions:There were abnormal CBF in left superior temporal gyrus and left putamen in bipolar disorder type Ⅱ patients with suicidal ideation and bipolar disorder type Ⅱ patients without suicidal ideation, while the decreased CBF in right posterior cingulate gyrus may be the specific brain change in bipolar disorder type Ⅱ patients with suicidal ideation.

Memory function is the core component of human brain cognition.Memory impairment significantly affects people's daily life and social ability,but existing cognitive training or drug therapy can not effectively improve memory function.In recent years,new techniques and methods have been emerging in brain science research,especially neural regulation techniques,such as transcranial electrical / magnetic stimulation,which can significantly regulate cognitive ability and effectively promote memory function.Transcranial direct current stimulation is a kind of noninvasive and safe technique.It can regulate cerebral cortex activity by changing the cerebral cortex excitability,and play a role in regulating brain function.At present,there have been reports at home and abroad that transcranial direct current stimulation can promote memory function and improve memory effectively.This technique is applied to the diagnosis and treatment of clinical diseases,but its mechanism is not clear.This article reviews the mechanism and application of transcranial direct current stimulation (TDCS) in promoting different types of memory function in order to provide evidence for early intervention and treatment of memory impairment.

Objective To investigate the effect of high-definition transcranial direct current stimula-tion on visual spatial working memory in patients with schizophrenia. Methods Sixty-six patients with schizophrenia were enrolled in a randomized,double-blind,placebo-controlled study. The subjects were ran-domized into a true stimulation group of 33 patients and a placebo control group of 33 patients,each patient only received one stimulation. After receiving a stimulus,the left dorsolateral prefrontal lobe was stimulated by high-precision transcranial direct current. The true stimulation group was stimulated with a current of 1. 5 mA for 20 min. The control group used pseudo-stimulation,and only the current was passed within 30 s of the beginning and the end of the stimulation. Both groups completed the neuropsychological background test and the n-back task before stimulation,and the stimulation was performed after five days. After the stimula-tion,the two groups completed the n-back task again,and compared the Changes in grades to reflect changes in working memory before and after the pseudo-stimulation. Results Before the stimulation,the response rate of the 3-back task was compared with that of the control group ((0. 32±0. 21),(0. 32±0. 22)),the true stimulation group ((0. 28 ± 0. 19), ( 0. 35 ± 0. 21)), and the difference was statistically significant ( F=5. 298,P=0. 025). Conclusion Using high-definition transcranial direct current stimulation to stimulate the left dorsolateral prefrontal cortex using can improve the visual memory function of patients. In the future,this technique can be applied to the cognitive promotion of memory impairment in patients with schizophrenia.

Objective:To express the glycoprotein D of herpes simplex virus type 2 (gD2) in the insect cells,and to determine its immunogenicity.Methods:HSV-2 genome was used as the template for amplification of gD2 extracellular domain fragment gene by PCR.The PCR product was inserted into the vector Bacmind,and the constructed recombinant plasmid gD2-Bacmind was transfected into the sf9 cells to package the recombinant baculovirus.The Sf9 cells were infected by recombinant baculovirus seed derived from the forth passage(P4),the titer of P4 recombinant baculovirus was detected by a plaque assay and the expression of recombinant protein gD2 was determined by Western blotting method.The supernatant of infected cells was collected and purified by Ni-NTA affinity chromatography to obtain the target protein gD2,the purified gD2 protein was used to immunize the BALB/c mice in 0, 2, 4 weeks (gD2 group),and PBS was used as negative control(PBS group);the titers of gD2 specific IgG in serum were detected by ELISA assay.Results: The PCR analysis and sequencing results proved that gD2-Bacmind was constructed correctly.The titer of recombinant baculovirus was 2.0×109 pfu·mL-1,the purified gD2 was about 37 000 with expectation,the percentage of gD2 in total protein was 90%.The average value of Log10 of titer of gD2 specific IgG in serum detected by ELISA assay in gD2 group at the sixth week was 4.34,and there was significant difference compared with PBS group(P<0.01).Conclusion: The gD2 expressed by insect-baculovirus expression vector system has the immunogenicity and can be selected as candidate protein for HSV-2 vaccine.

Objective To explore whether the ability of intertemporal choice is impaired in schizophrenic patients and in their unaffected siblings.Methods Twenty-five schizophrenia patients,twenty-five unaffected siblings of patients and thirty healthy controls were recruited in the study."Delay-discounting" task and a battery of cognitive neuropsychological assessment were used to examine the intertemporal decision-making.Results (1) the value of k was ((0.005±0.009 in schizophrenia,0.011±0.014 in unaffected siblings and 0.024±0.029 in healthy controls,respectively.There was significant difference in k value among these three groups (F=9.487,P＜0.001).There were significant differences in k value between patients group and healthy controls,and between unaffected siblings and healthy controls (P＜0.05).There was no significant difference between schizophrenia and their unaffected siblings (P＜0.05).(2) Pearson correlation analysis not showed any relationship between neuropsychological test and the value of k.Conclusion The ability of intertemporal choices is impaired in schizophrenia and their unaffected siblings to a great degree.