Objective To investigate the diagnostic value of serum human β-defensin 2(HBD2)and soluble growth stimulating gene 2(sST2)levels in pediatric refractory Mycoplasma pneumonia.Methods A total of 145 children diagnosed with Mycoplasma pneumonia were recruited,and divided into refractory pneumonia group(n=53)and common pneumonia group(n=92)based on whether they had refractory or common pneumonia.General data were compared between the two groups.Ser-um HBD2 and sST2 levels were measured using enzyme-linked immunosorbent assay(ELISA).Multi-variate logistic regression analysis was used to identify influencing factors for the occurrence of refracto-ry Mycoplasma pneumonia.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the diagnostic value of serum HBD2 and sST2 levels in refractory Mycoplasma pneumonia.Results The proportion of lung consolidation and pleural effusion in refractory pneumonia group was significantly higher,and the fever time was significantly longer than that in common pneumonia group(P＜0.05).Serum HBD2 and sST2 levels in the refractory pneumonia group were signifi-cantly higher than those in the common pneumonia group(P＜0.05).Multivariate Logistic regres-sion analysis indicated that lung consolidation,pleural effusion,high serum HBD2 level and high serum sST2 level were risk factors for pediatric refractory Mycoplasma pneumonia(P＜0.05).The area under the curve and Youden's index for diagnosing pediatric refractory Mycoplasma pneumonia were 0.817 and 0.557 for serum HBD2 level,and 0.841 and 0.607 for serum sST2 level,respec-tively.Combined diagnosis using both markers resulted in an area under the curve of 0.916 and a Youden's index of 0.721.Conclusion The combined detection of serum HBD2 and sST2 levels holds significant diagnostic value for pediatric refractory Mycoplasma pneumonia.

Objective To explore the safety and effectiveness of bridging therapy in elderly patients with acute stroke due to posterior circulation large vessel occlusion.Methods A total of 160 eld-erly patients with acute stroke caused by posterior circulation large vessel occlusion admitted to our department were prospectively recruited and randomly divided into bridging group(n=80)and control group(n=80).The bridging group received thrombolysis treatment and then mechan-ical thrombectomy.The control group received mechanical thrombectomy directly.Prognosis and adverse reactions were compared between the two groups.Results The NIHSS score and BATMAN score after treatment were significantly decreased in both groups(P＜0.01),and the two scores were obviously lower in the bridging group than the control group(6.54±1.23 vs 7.12± 0.98,2.12±0.34 vs 2.87±0.44,P＜0.01).There was no statistical difference in the conversion rate of bleeding after cerebral infarction between the two groups(5.00％vs 3.75％,P＞0.05).The number of intraoperative thrombus removal was significantly lower in the bridging group than the control group(2.43±0.33 vs 2.98±0.41,P＜0.01).Remarkable difference was observed in the mRS score between the two groups after treatment(P＜0.05),with the proportion of mRS score ranging from 0 to 1 larger in the bridging group than the control group(52.50％vs 27.50％,P＜0.05).Conclusion Bridging thrombolysis can significantly improve the neurological function in elderly patients with acute stroke due to posterior circulation occlusion.

Objective To study the clinical value of amplitude integrated EEG(aEEG),EEG reactivity,EEG patterns,and Glasgow Coma Scale(GCS) scores of predicting the prognosis in comatose patients with severe traumatic brain injury.Methods Sixty-four hospitalized comatose patients with severe traumatic brain injury were evaluated by aEEG,EEG reactivity,EEG patterns and GCS and followed up for one year to observe the prognosis of the patients.Results Accuracy of aEEG,EEG reactivity,EEG patterns and GCS in predicting outcomes of comatose patients with severe traumatic brain injury correctly classified as 73.4％,68.8％,73.4％,64.1％ respectively.The accuracy of GCS in evaluating the prognosis of comatose patients with severe traumatic brain injury was lower than that of the other three methods (P＜0.05).There were positive correlations among aEEG,EEG reactivity,EEG patterns,and GCS (r=0.574-0.843,P＜ 0.05).There were positive correlations between aEEG,EEG reactivity,EEG patterns,GCS and the patients' prognosis(r=0.647,0.609,0.621,0.532,P＜ 0.05).Conclusion As a new electroencephalographic technique,aEEG combined with EEG reactivity,EEG patterns,and GCS can be effectively used to evaluate the prognosis of STBI coma patients,which has a certain clinical value.

Objective To determine whether unilateral-only interictal discharges on pre-surgical scalp EEG or multimodal pre-surgical evaluation are associated with surgical outcomes in patients with MR imaging-negative temporal lobe epilepsy (TLE) who underwent standard anterior temporal lobectomy (ATL). Methods One hundred and seventeen patients with TLE who underwent standard ATL from January 2000 to December 2013 were enrolled. According to the seizures at interictal period, these patients were divided into unilateral-only interictal discharge group (n=54) and bilateral interictal discharge group (n=63). According to the preoperative assessment, these patients were divided into multimodal evaluation group (n=72, two and above evaluation strategies besides electroencephalogram) and single modal evaluation group (n=45, electroencephalogram+one evaluation strategy). Follow-up for 12 months was performed; postsurgical outcomes included excellent outcome, defined as Engel class I, and non-excellent outcome, defined as Engel II-IV. Kaplan-Meier survival analysis and Cox proportion hazards were performed to compare the prognoses of patients from different groups. Results Totally, 73 patients (62.4%) achieved excellent outcome following ATL. In 54 with unilateral-only interictal discharges, 41 had excellent outcome; and in 63 with bilateral interictal discharge group, 32 patients had excellent outcome; significant difference in percentage of excellent outcome was noted between the two groups (P<0.05). Fifty of 72 patients receiving multimodal pre-surgical evaluation achieved excellent outcome, and 25 of 45 receiving single modal evaluation achieved excellent outcome; significant difference in percentage of excellent outcome was noted between the two groups (P<0.05). However, the patients with unilateral-only interictal discharges receiving multimodal pre-surgical assessment did not achieve further excellent outcomes as compared with those receiving single modal evaluation, without significant difference (P>0.05). Conclusion Multimodal pre-surgical evaluation is associated with better outcomes following standard ATL in the patients with MR imaging-negative TLE; however, for patients with unilateral-only interictal discharges, multimodal pre-surgical evaluation method may be not essential as compared with single modal pre-surgical evaluation method.