Objective:To investigate the clinical features of patients with epilepsy in Neurosurgery Outpatient and influencing factors for their seizure control.Methods:Six hundred and seventy-three epilepsy patients admitted to Neurosurgery Outpatient of 6 hospitals including Fifth Affiliated Hospital of Zhengzhou University from September 2017 to December 2022 were chosen. Clinical data (including general demographic data, education level, onset age, onset cycle and duration, course of onset, family annual income and seizure control) were collected using a questionnaire prepared by He'nan Epilepsy Systematic Diagnosis and Treatment Center to summarize the clinical features. Univariate and multivariate Logistic regressions were used to analyze the influencing factors for their seizure control.Results:(1) In these 673 epilepsy patients, 50 (7.4%), 78 (11.6%), 192 (28.5%), 100 (14.9%), 68 (10.1%), 72 (10.7%) and 113 (16.8%), respectively, were <1 year old (infant stage), 1-2 years old (children stage), 3-5 years old (preschool stage), 6-16 years old (juvenile stage), 17-39 years old (young stage), 40-64 years old (middle-aged stage) and ≥65 years old (elderly stage). In the past medical treatment history, 23.0% (155/673) patients did not receive intervention, 72.4% (487/673) received medication, and 4.6% (31/673) received surgical treatment; 55.9% (376/673) had good seizure control and 44.1% (297/673) had poor seizure control. (2) Secondary education ( OR=2.199, 95% CI: 1.037-15.221, P=0.033), primary education or below ( OR=3.544, 95% CI: 2.101-21.343, P=0.012), daily seizures ( OR=4.788, 95% CI: 1.369-33.103, P=0.011), each seizure lasted ≥3 min ( OR=4.179, 95% CI: 3.338-18.550, P=0.003), course of disease≥3 years ( OR=0.199, 95% CI: 0.077-0.602, P=0.001), course of disease for 1-3 years ( OR=0.379, 95% CI: 0.108-0.882, P=0.031), and currently taken antiepileptic drugs for 3 or more ( OR=6.237, 95% CI: 2.195-17.837, P=0.001) were independent risk factors for poor seizure control in epilepsy patients. Conclusion:In Neurosurgery Outpatient, children with diseases before childhood enjoy the largest proportion; drug therapy remains the main treatment; low education level, short seizure cycle, long duration of attack, long course of disease, and multiple drugs used in these patients imply poor anti-epileptic effecacy.

With the development of our economy and the progress of science and technology,the comfort medicine of children in the perioperative period is gradually promoted.Comfort medicine not only eliminates the physical pain of children,but also avoids the permanent psychological trauma caused by oper-ation and anesthesia.The incidence of preoperative anxiety in children is higher than that in adults,which may have adverse effects on perioperative period and prognosis of children.The characteristics of parents of different children,such as parental anxiety level,parental education level,parental socioeconomic back-ground,family composition,ethnicity,language,and other factors will affect the preoperative anxiety level of children.Intervention measures such as parents'participation in guiding children's preparation for anesthe-sia,management of children's fasting and drinking,and presence at the induction of anesthesia can alleviate children's preoperative anxiety level.For children with disabilities,communication between parents and medical staff in the perioperative period and intervention management of children is important.Compared with the traditional preoperative preparation program,the internet-based family preoperative preparation plat-form provides a comprehensive,effective and personalized information guidance for the families of children,ensuring the comfortable perioperative medical treatment of children.

Objective:To establish the biology reference interval (RI) of peripheral blood procalcitonin (PCT) for children between 3 days and 6 years old in China.Methods:Totally 3 353 reference individuals with apparent health or no specific diseases were recruited in 18 hospitals throughout the country during October 2020 to May 2021. Reference individuals were divided into four groups: 3-28 days, 29 days - 1 year, 1-3 years and 4-6 years. Vein blood or capillary blood were collected by percutaneous puncture from every reference individual. The PCT level in serum and the capillary whole blood were assayed by Roche Cobas e601 and Norman NRM411-S7 immunoanalyzer. Outliers were deleted and 95th percentiles of every group were provided as RIs. Man-Whitney U test or Kruskal-Wallis test were used performed to assess the difference among different gender, age or method groups. Results:The difference of PCT distribution between male and female is not statistically significant, but the difference between serum and capillary whole blood is statistically significant. The differences between age groups are significant too. For Roche e601, serum PCT RI of 3-28 days group is <0.23 μg/L, 29 days - 6 years are <0.11 μg/L. For NRM411, Serum PCT RI of 3-28 days group is <0.21 μg/L, 29 days - 1 year: <0.09 μg/L, 1 - 6 years: <0.10 μg/L. For whole blood PCT, RI of 3-28 days group is <0.26 μg/L, 29 days - 6 years is <0.15 μg/L.Conclusions:Serum and capillary whole blood PCT have different RIs, however, capillary whole blood PCT testing is valuable in pediatric application. Children in 3-28 days show higher PCT levels than other age group. To establish the RIs and understand the differences among different groups are essential for the interpretation and clinical application of peripheral blood PCT testing results.

Objective:To investigate the effect of transforming growth factor (TGF- β) signal in muscle fiber itself during inflammation/immunity response on intramuscular inflammation. Methods:Sixteen wild C57BL/6 mice (wild group) and sixteen mice with skeletal muscle-specific deficiency of T βRⅡ (knock-out group) between 4-8 weeks of age were selected for this study. Acute muscle injury in mice was induced by injection of myotoxin cardiotoxin (CTX) into gastrocnemius. The differences in intramuscular inflammation were compared between the wild and knock-out groups on 0, 4, 7 and 10 d after CTX injection by observing exudation of mononuclear phagocytes, macrophages, M1 type macrophages, CD4 +T cells and helpers T cells (Th1, 2&17). Two newborn C57BL/6 wild mice and 2 SM TGF- βr2-/- knock-out mice were selected to culture primary myoblasts in vitro which were divided into 2 groups: an interferon group subjected to interferon simulation and a control group subjected to addition of an equal amount of solvent. The differences in expression of IL-6, IL-10, MCP-1, MIP-1α, H-2K b, H2-Ea, Toll-like receptor (TLR)3 and TLR7 were compared between the interferon and control groups, as well as between the wild and knock-out groups. Results:On 4&7 d after CTX injection, the ratios of mononuclear/macrophage (75.73%±3.62%, 45.27%± 2.32%), macrophages (38.67%±2.76%, 24.87%±2.19%), M1 macrophages (43.21%±0.11%, 30.43%±2.19%), CD4 +T cells (20.13%±1.62%, 5.67%±0.32%) in the muscle tissue from the knock-out mice were significantly higher than those from the wild mice (58.52%±2.43%, 29.21%±2.45%; 20.63%±2.32%, 16.23%±1.25%; 24.98%±0.35%, 14.23%±1.69%; 10.70%±0.43%, 2.50%±0.45%), with a majority of Th1&Th17 ( P<0.05). In vitro results showed that the levels of IL-6, MCP-1, MIP-1α, H-2K b, H2-Ea and TLR3 were significantly upregulated in the interferon group compared with the control group and that such upregulation in the nock-out mice was more significant than in the wild mice ( P<0.05). Conclusions:Endogenous TGF- β signal activation plays a role in the functional recovery after muscle trauma, because it is involved in the regulation of immune behavior of muscle fibers, thus affecting intramuscular inflammation and muscle regeneration.

Objective:To explore the performance of the commonly used whole blood C-reactive protein (CRP) detection systems and give related recommendation on the performance requirements of detection systems.Methods:A total of 7 540 venous blood samples from 26 maternal, child and children′s hospitals were collected to conduct this multi-center study on the analytical performance of 5 commonly used whole blood CRP detection systems from March to April in 2019. The blank check, carryover, repeatability, intermediate precision, linearity, sample stability, influence of hematocrit/triglyceride/bilirubin, comparison with SIEMENS specific protein analyzer and trueness were evaluated. The 5 systems included BC-5390CRP autohematology analyzer, AstepPLUS specific protein analyzer, Ottoman-1000 Automated Specific Protein POCT Workstation, i-CHROMA Immunofluorometer equipment Reader and Orion QuikRead go detecting instrument. The 5 systems were labeled as a, b, c, d and e randomly.Results:Within the 5 systems, all values of blank check were less than 1.00 mg/L, the carryovers were lower than 1.00%. The repeatability of different ranges of CRP concentrations including 3.00-10.00, 10.00-30.00 and>30.00 mg/L were less than 10.00%, 6.00% and 5.00%, respectively, and the intermediate precision was less than 10.00%. The linearity correlation coefficients of the 5 systems were all above 0.975, while the slope was within 0.950-1.050. Whole blood samples were stable within 72 hours both at room temperature (18-25 ℃) and refrigerated temperature (2-8 ℃). The CRP results were rarely influenced by high triglyceride or bilirubin, except for the immmunoturbidimetric test based on microparticles coated with anti-human CRP F(ab) 2 fragments. When triglyceride was less than 15.46 mmol/L, the deviation of CRP was less than 10.00%. When bilirubin was less than 345.47 μmol/L, the deviation of CRP was less than 10.00%. CRP was more susceptible to Hct on the systems without Hct correction. The deviation of CRP between different Hct dilution concentration and 40% dilution concentration can reach as high as 67.48%. The correlation coefficients ( r) of 5 systems were all more than 0.975 in the range of 0-300.00 mg/L compared with Siemens specific protein analyzer. All systems passed the trueness verification using the samples with specified values of 12.89 and 30.60 mg/L. Conclusion:The performance of 5 systems can basically meet the clinical needs, but it is suggested that the whole blood CRP detection system without automatic Hct correction should be modified manually.

Objective:To analyze the correlation between clinical phenotypes and genotypes in 6 children with primary distal renal tubular acidosis (dRTA).Methods:The clinical data of 6 children confirmed as dRTA in Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science & Technology from November 2017 to August 2019 were collected, and related auxiliary examination was performed to assess their growth and development.The venous whole blood was reserved for Trio whole exome sequencing, and full spectrum genetic disease accurate diagnosis cloud platform was applied to systematic data screening and analysis.The suspected mutations were checked by Sanger sequencing, and then the role of protein was predicted by software.Results:Clinical manifestations, signs and auxiliary examination results of the 6 children accorded with the diagnostic criteria of dRTA, and the prominent characteristics was growth retardation.One case had knee valgus, one had osteoporosis, and the auxiliary examination results showed that both of them had alkaline urine, metabolic acidosis, and hypokalemia.Three children had nephrocalcinosis, and 2 children had nephrolithiasis.The parents of the 6 patients were all normal without phenotypes.Mutations in the SLC4A1 gene were identified in 4 patients, including 1 child with a reported homozygous autosomal recessive missense mutation(c.2102G>A, p.G701D), who had dRTA and hemolytic anemia, and 3 children with the reported de novo heterozygous autosomal dominant missense mutation(c.1766G>A, p.R589H, c.1765C>T, p.R589C), whose age at diagnosis was related to abnormal renal imaging.Compound heterozygous autosomal recessive mutations in the ATPV1B1 gene were identified in 1 patient, and they were novel heterozygous missense mutations (1153C>A, p.P385T and c. 806C>T, p.P269L). A novel homozygous autosomal recessive missense mutation was identified in 1 patient in the ATPV0A4 gene(c.1899C>A, p.Y633X, 208). Conclusions:Mutations in SLC4A1, ATP6V1B1, ATP6V0A4 genes are identified as the main causes of the primary dRTA, and the phenotypes was related to the mutation features and genotypes.Genetic test should be conducted on patients suspected as dRTA for early molecular diagnosis, thereby improving clinical phenotypic screening and individualized treatment.

Objective: To explore the correlation between blood pressure and urinary phthalandione, MMP, MEP, MnBP, MiBP, PAEs. Methods: Three schools were selected from Shenzhen, China for the present study. A total of 765 firstgrade students of Han ethnicity were recruited voluntarily from the selected schools during September 2016 to June 2017. They were divided into normal blood pressure (BP) group (lower than P90 group) and high BP group (BP≥P90). Linear and Logistic regression models were used to analyze the relationships between blood pressure and urine phthalate metabolite levels. Results: Urinary MMP and MnBP in students of high BP group were significantly higher than that of students in normal BP group(t=13.12, 3.97, P<0.05). Linear regression models showed that Z score increased when MMP and MnBP levels increased(P<0.05). Logistic regression model suggested that the risk of high BP increased with the increment of MMP level adjusting creatinine, sex, age and BMI(OR=1.47, P<0.05). There was no statistical significance in the differences after adjusting many factors including family income and education level of parents(P>0.05). Conclusion Urinary phthalate metabolite levels are positively associated with blood pressure in first-grade children.

MicroRNA has speciifc biological and expression properties in transcription level, which has more potential than genomic DNA in the identification for forensic body fluid, species and degraded crime biological materials. Here we introduce the speciifc research of forensic body lfuid identiifcation, research strategies and applied perspectives with forensic miRNA, expecting to provide the application and study of miRNA analysis for reference.

Air Pollutants, Occupational ; chemistry ; Indium ; analysis ; Mass Spectrometry ; methods ; Occupational Exposure ; Spectrum Analysis ; methods ; Workplace

BACKGROUND:The safety and efficacy of simultaneous bilateral total knee replacement or selective unilateral total knee arthroplasty in patients with severe osteoarthritis of the knees are stil controversial. OBJECTIVE:To compare safety and clinical efficacy of patients with osteoarthritis knees after simultaneous bilateral total knee replacement or selective unilateral total knee replacement. METHODS:Total y 60 cases with severe osteoarthritis of the knees (90 knees) undergoing total knee replacement were divided into unilateral total knee replacement group (n=30, 30 knees), and the simultaneous bilateral total knee replacement group (n=30, 60 knees). RESULTS AND CONCLUSION:There was no significant difference in the incidence of other complications such as infection, mortality, pulmonary embolism in patients of both groups (P>0.05). The incidence of cardiovascular complications, postoperative blood loss and blood transfusion were higher in the bilateral knee group than in the unilateral knee group (P<0.05). During fol ow-up at 1 year after replacement, no significant differences in range of motion, muscle strength of quadriceps and hospital for special surgery knee score were detected in patients of both groups (P>0.05). However, Visual Analogue Scale scores were significantly lower in the bilateral knee group than in the unilateral group (P<0.05). These data indicated that the risk of cardiovascular complications was high in patients receiving bilateral total knee replacement. Patients with severe cardiovascular disease should avoid simultaneous bilateral total knee arthroplasty.