With the rapid development of neuroelectrophysiology, neuroimaging and other technologies, a large amount of evidence has shown that the occurrence and development of idiopathic generalized epilepsy (IGE) are closely related to the cortical-subcortical neural network. This article intends to review the relevant research on how the cerebral cortex and subcortical structures such as the thalamus, basal ganglia, and cerebellum are involved in the cognitive impairment of IGE, as well as the important subcortical neural nuclei targets currently targeted in the treatment of drug-resistant epilepsy by neuromodulation, to evaluate the feasibility of neuromodulation therapy in clinical practice.

Epilepsy is a chronic neurological disorder characterized by abnormal brain network function. The localization of the epileptogenic zone and feature analysis of the epileptic networks are key issues in clinical diagnosis and treatment as well as in research of disease mechanisms. In recent years, electroencephalography-functional magnetic resonance imaging (EEG-fMRI), by integrating the high temporal resolution of EEG and high spatial resolution of fMRI, has provided an important tool for localizing epileptogenic zones and researching epileptic networks. This article reviews the recent advance in EEG-fMRI in epilepsy, with a focus on its role in localizing the origin of epileptic seizures, exploring the epileptic networks of different modalities, analyzing the characteristics of epileptic networks, and studying the pathogenesis of epilepsy combined with cognitive impairment, in order to analyze pathophysiological mechanisms of epilepsy and provide new perspectives for clinical diagnosis and treatment.

This report described a pregnancy and delivery in a 28-year-old patient with methylmalonic aciduria (MMA) cblC type. The diagnosis was established during the perioperative period of thrombectomy for cerebral venous sinus thrombosis, when hyperhomocystei-nemia was detected. Further investigation confirmed MMA with MMACHC gene variants c.80A>G (paternal) and c.609G>A (maternal), consistent with the cblC subtype. During pregnancy, the patient continued supplementation with hydroxocobalamin, levocarnitine, and betaine while maintaining a normal diet without protein restriction. Both the metabolic disease and fetal growth remained well-controlled. Unexplained vomiting occurred at 32?1 weeks of gestation, leading to cesarean delivery at 33?1 weeks. Postoperative recovery was uneventful with resolution of vomiting. The newborn was discharged after four weeks of neonatal care and demonstrated normal growth during follow-up. As adult MMA patients may pursue pregnancy, and evidence-based guidelines for management during gestation are limited, further case reports are needed to accumulate experience.

With the rapid development of neuroelectrophysiology, neuroimaging and other technologies, a large amount of evidence has shown that the occurrence and development of idiopathic generalized epilepsy (IGE) are closely related to the cortical-subcortical neural network. This article intends to review the relevant research on how the cerebral cortex and subcortical structures such as the thalamus, basal ganglia, and cerebellum are involved in the cognitive impairment of IGE, as well as the important subcortical neural nuclei targets currently targeted in the treatment of drug-resistant epilepsy by neuromodulation, to evaluate the feasibility of neuromodulation therapy in clinical practice.

Epilepsy is a chronic neurological disorder characterized by abnormal brain network function. The localization of the epileptogenic zone and feature analysis of the epileptic networks are key issues in clinical diagnosis and treatment as well as in research of disease mechanisms. In recent years, electroencephalography-functional magnetic resonance imaging (EEG-fMRI), by integrating the high temporal resolution of EEG and high spatial resolution of fMRI, has provided an important tool for localizing epileptogenic zones and researching epileptic networks. This article reviews the recent advance in EEG-fMRI in epilepsy, with a focus on its role in localizing the origin of epileptic seizures, exploring the epileptic networks of different modalities, analyzing the characteristics of epileptic networks, and studying the pathogenesis of epilepsy combined with cognitive impairment, in order to analyze pathophysiological mechanisms of epilepsy and provide new perspectives for clinical diagnosis and treatment.

This report described a pregnancy and delivery in a 28-year-old patient with methylmalonic aciduria (MMA) cblC type. The diagnosis was established during the perioperative period of thrombectomy for cerebral venous sinus thrombosis, when hyperhomocystei-nemia was detected. Further investigation confirmed MMA with MMACHC gene variants c.80A>G (paternal) and c.609G>A (maternal), consistent with the cblC subtype. During pregnancy, the patient continued supplementation with hydroxocobalamin, levocarnitine, and betaine while maintaining a normal diet without protein restriction. Both the metabolic disease and fetal growth remained well-controlled. Unexplained vomiting occurred at 32?1 weeks of gestation, leading to cesarean delivery at 33?1 weeks. Postoperative recovery was uneventful with resolution of vomiting. The newborn was discharged after four weeks of neonatal care and demonstrated normal growth during follow-up. As adult MMA patients may pursue pregnancy, and evidence-based guidelines for management during gestation are limited, further case reports are needed to accumulate experience.

Objective Reliability and validity of the Chinese version of disability attitude scales(DAS-CN)toward disabled persons were created and tested to provide an assessment instrument for measuring the attitude of medical staff toward disabled persons in China.Methods Authorised by the author of DAS in August 2020,based on BRISLIN translation model,the English version of DAS was translated into Chinese followed by back translation,cultural debugging and then put it into pre-experiment in September 2020.The reliability and validity of the finalised DAS-CN were further tested in a survey with 400 randomly selected medical staff in rehabilitation from 8 general hospitals in Jinzhou,Panjin,Yingkou and Fushun in Liaoning Province,China by using the convenience sampling method in March 2021.Results A total of 357 surveyees completed the survey.The localised DSA-CN was composed of 4 dimensions with a total of 20 items,including 4 items in clinical knowledge and skills,4 in clinical responsibility,8 in clinical behaviour and 4 in emotional response.The Cronbach α coefficient of the scales was 0.943,with the split-half reliability and test-retest reliability at 0.824 and 0.899,respectively.The Cronbach α coefficient of each dimension was 0.843～0.944,and the split half reliability was 0.854～0.904.The test-retest reliability ranged from 0.701 to 0.913.The KMO value of exploratory factor analysis was 0.921.The Bartrett spherical test value was 5534.981(P<0.01).The total explanatory rate of variation was 73.050%.Conclusion The Chinese version of Disability Attitude Scales(DSA-CN)has good reliability and validity.Therefore,DSA-CN can be used as an instrument in investigation of the current status about the attitudes towards the disabled persons among the medical staff in China.

Humans ; Vaccines, Inactivated ; COVID-19/prevention & control* ; Vaccination ; Viral Vaccines ; Immunity ; Antibodies, Viral

BACKGROUND: Gestational diabetes mellitus (GDM) brings health issues for both mothers and offspring, and GDM prevention is as important as GDM management. It was shown that a history of GDM was significantly associated with a higher maternal risk for GDM recurrence. The incidence of GDM recurrence was unclear because of the incidence of second-child was low before 2016 in China. We aim to investigate the prevalence of GDM recurrence and its associated high-risk factors which may be useful for the prediction of GDM recurrence in China. METHODS: A retrospective study was conducted which enrolled participants who underwent regular prenatal examination and delivered twice in the same hospital of 18 research centers. All participants were enrolled from January 2018 to October 2018, where they delivered the second baby during this period. A total of 6204 women were enrolled in this study, and 1002 women with a history of GDM were analyzed further. All participants enrolled in the study had an oral glucose tolerance test (OGTT) result at 24 to 28 weeks and were diagnosed as GDM in the first pregnancy according to the OGTT value (when any one of the following values is met or exceeded to the 75-g OGTT: 0 h [fasting], ≥5.10 mmol/L; 1 h, ≥10.00 mmol/L; and 2 h, ≥8.50 mmol/L). The prevalence of GDM recurrence and development of type 2 diabetes mellitus were calculated, and its related risk factors were analyzed. RESULTS: In 6204 participants, there are 1002 women (1002/6204,16.15%) with a history of GDM and 5202 women (5202/6204, 83.85%) without a history of GDM. There are significant differences in age (32.43 ± 4.03 years vs. 33.00 ± 3.34 years vs. 32.19 ± 3.37 years, P  < 0.001), pregnancy interval (4.06 ± 1.44 years vs. 3.52 ± 1.43 years vs. 3.38 ± 1.35 years, P  = 0.004), prepregnancy body mass index (BMI) (27.40 ± 4.62 kg/m2vs. 23.50 ± 3.52 kg/m2vs. 22.55 ± 3.47 kg/m2, P < 0.001), history of delivered macrosomia (22.7% vs. 11.0% vs. 6.2%, P < 0.001) among the development of diabetes mellitus (DM), recurrence of GDM, and normal women. Moreover, it seems so important in the degree of abnormal glucose metabolism in the first pregnancy to the recurrence of GDM and the development of DM. There are significant differences in OGTT levels of the first pregnancy such as area under the curve of OGTT value (18.31 ± 1.90 mmol/L vs. 16.27 ± 1.93 mmol/L vs. 15.55 ± 1.92 mmol/L, P < 0.001), OGTT fasting value (5.43 ± 0.48 mmol/L vs. 5.16 ± 0.49 mmol/L vs. 5.02 ± 0.47 mmol/L, P < 0.001), OGTT 1-hour value (10.93 ± 1.34 mmol/L vs. 9.69 ± 1.53 mmol/L vs. 9.15 ± 1.58 mmol/L, P < 0.001), OGTT 2-hour value (9.30 ± 1.66 mmol/L vs. 8.01 ± 1.32 mmol/L vs. 7.79 ± 1.38 mmol/L, P < 0.001), incidence of impaired fasting glucose (IFG) (fasting plasma glucose ≥5.6 mmol/L) (31.3% vs. 14.6% vs. 8.8%, P < 0.001), and incidence of two or more abnormal OGTT values (68.8% vs. 39.7% vs. 23.9%, P < 0.001) among the three groups. Using multivariate analysis, the factors, such as age (1.07 [1.02-1.12], P = 0.006), prepregnancy BMI (1.07 [1.02, 1.12], P  = 0.003), and area under the curve of OGTT in the first pregnancy (1.14 [1.02, 1.26], P  = 0.02), have an effect on maternal GDM recurrence; the factors, such as age (1.28 [1.01-1.61], P  = 0.04), pre-pregnancy BMI (1.26 [1.04, 1.53], P = 0.02), and area under the curve of OGTT in the first pregnancy (1.65 [1.04, 2.62], P = 0.03), have an effect on maternal DM developed further. CONCLUSIONS The history of GDM was significantly associated with a higher maternal risk for GDM recurrence during follow-up after the first pregnancy. The associated risk factors for GDM recurrence or development of DM include age, high pre-pregnancy BMI, history of delivered macrosomia, the OGTT level in the first pregnancy, such as the high area under the curve of OGTT, IFG, and two or more abnormal OGTT values. To prevent GDM recurrence, women with a history of GDM should do the preconception counseling before preparing next pregnancy.
Adult ; Blood Glucose/metabolism* ; China/epidemiology* ; Diabetes Mellitus, Type 2/epidemiology* ; Diabetes, Gestational ; Female ; Fetal Macrosomia ; Glucose Intolerance ; Humans ; Male ; Pregnancy ; Retrospective Studies

ObjectiveTo investigate the level of humanized nursing abilities of nursing staff in rehabilitation department, and to explore the relationship with attitudes toward the persons with disabilities and work achievement. MethodsFrom December, 2020 to March, 2021, 196 nursing staff in rehabilitation department in eight tertiary hospitals in Jinzhou, Panjin, Yingkou and Fushun in Liaoning, China were investigated with attitude of healthcare professionals toward persons with disability scale, work achievement scale and Healthcare Professional Humanization Scale for Nursing (HUMAS). ResultsThe score of HUMAS was (73.39±10.75), and the average score of total items was (3.86±0.57). The scores of attitudes toward the persons with disabilities and work achievement positively correlated with the score of HUMAS (r = 0.208~0.774, P < 0.01). Work achievement partially mediated the attitudes toward the persons with disabilities and the humanized nursing abilities, with mediating effect of 0.420, accounting for 52.83% of the total effect. ConclusionThe humanized nursing ability of nursing staff in rehabilitation department needs to be improved. The better the attitudes toward the persons with disabilities are, the higher the work achievements are, the higher the humanized nursing abilities are. Attitudes toward the persons with disabilities among nursing staff in rehabilitation department may not only directly affect humanized nursing abilities, but also indirectly affect the humanized nursing abilities through the sense of work achievement.