Objective To investigate the therapeutic efficacy of granulocyte colony-stimulating factor in combination with tadalafil in patients with thin endometrium undergoing artificial cycle frozen-thawed embryo transfer(FET).Methods A prospective randomized clinical trial was conducted involving sixty patients with thin endo-metrium who underwent artificial cycle FET at the Reproductive Center of Qinhuangdao First Hospital between January 2021 and October 2023.The patients were randomly assigned to two groups:the control group(n=30)received tadalafil,while the study group(n=30)received granulocyte colony-stimulating factor in addition to tadalafil.Endometrial ultrasound characteristics,uterine artery blood flow parameters,and pregnancy outcomes were compared between the two groups before and after treatment.Results Before treatment,no significant differ-ences were observed between the research group and the control group in terms of endometrial thickness or endome-trial volume(P>0.05).Ultrasound assessments were repeated after 8 and 14 days of treatment.Compared with baseline measurements,both endometrial thickness and volume exhibited significant increases in both groups(all P<0.05).By day 14 post-treatment,the research group demonstrated significantly greater endometrial thickness and volume compared to the control group(P<0.05).With regard to endometrial patterns,no significant differences were noted between the two groups prior to treatment(P>0.05).After 14 days of treatment,the proportion of patients exhibiting a Type A endometrial pattern in the research group was significantly higher than that in the control group(P<0.05).Prior to treatment,no statistically significant differences were observed between the two groups in terms of pulsatility index(PI),resistance index(RI),systolic/diastolic ratio(S/D),vascularization index(VI),flow index(FI),or Vascularization Flow Index(VFI)(all P>0.05).Following 14 days of treatment,both groups showed significant increases in VI,FI,and VFI compared to baseline values(all P<0.05),along with significant reductions in PI,RI,and S/D(all P<0.05).At 14 days post-treatment,the S/D ratio in the research group was significantly lower compared to the control group,while the VFI was significantly higher(P<0.05).However,statistical analysis showed no significant differences between the two groups in terms of embryo implanta-tion rate,clinical pregnancy rate,early miscarriage rate,and live birth rate(P>0.05).Conclusion For patients with thin endometrium undergoing FET,the combination of granulocyte colony-stimulating factor and tadalafil is more effective than tadalafil alone in improving endometrial receptivity and uterine blood perfusion.

Objective To investigate the therapeutic efficacy of granulocyte colony-stimulating factor in combination with tadalafil in patients with thin endometrium undergoing artificial cycle frozen-thawed embryo transfer(FET).Methods A prospective randomized clinical trial was conducted involving sixty patients with thin endo-metrium who underwent artificial cycle FET at the Reproductive Center of Qinhuangdao First Hospital between January 2021 and October 2023.The patients were randomly assigned to two groups:the control group(n=30)received tadalafil,while the study group(n=30)received granulocyte colony-stimulating factor in addition to tadalafil.Endometrial ultrasound characteristics,uterine artery blood flow parameters,and pregnancy outcomes were compared between the two groups before and after treatment.Results Before treatment,no significant differ-ences were observed between the research group and the control group in terms of endometrial thickness or endome-trial volume(P>0.05).Ultrasound assessments were repeated after 8 and 14 days of treatment.Compared with baseline measurements,both endometrial thickness and volume exhibited significant increases in both groups(all P<0.05).By day 14 post-treatment,the research group demonstrated significantly greater endometrial thickness and volume compared to the control group(P<0.05).With regard to endometrial patterns,no significant differences were noted between the two groups prior to treatment(P>0.05).After 14 days of treatment,the proportion of patients exhibiting a Type A endometrial pattern in the research group was significantly higher than that in the control group(P<0.05).Prior to treatment,no statistically significant differences were observed between the two groups in terms of pulsatility index(PI),resistance index(RI),systolic/diastolic ratio(S/D),vascularization index(VI),flow index(FI),or Vascularization Flow Index(VFI)(all P>0.05).Following 14 days of treatment,both groups showed significant increases in VI,FI,and VFI compared to baseline values(all P<0.05),along with significant reductions in PI,RI,and S/D(all P<0.05).At 14 days post-treatment,the S/D ratio in the research group was significantly lower compared to the control group,while the VFI was significantly higher(P<0.05).However,statistical analysis showed no significant differences between the two groups in terms of embryo implanta-tion rate,clinical pregnancy rate,early miscarriage rate,and live birth rate(P>0.05).Conclusion For patients with thin endometrium undergoing FET,the combination of granulocyte colony-stimulating factor and tadalafil is more effective than tadalafil alone in improving endometrial receptivity and uterine blood perfusion.

In the past few decades, the global obesity population has been increasing, and still has an upward trend. With obesity, the risk of cardiovascular and cerebrovascular diseases has increased. It’s found that an increase in body mass index is associated with the occurrence of some cardiovascular and cerebrovascular diseases Hypertension and hyperlipidemia, as common chronic cardiovascular diseases, are particularly affected by obesity, which has attracted extensive attention in recent years. Moreover, the occurrence of hypertension and hyperlipidemia under the influence of obesity is significantly related, and their synergy can also cause a variety of cardiovascular and cerebrovascular diseases. However, there is still less work to study these three factors at the same time. Therefore, on the basis of summarizing the molecular mechanisms of obesity affecting hypertension and hyperlipidemia, this paper summarizes the relevant molecular mechanisms of hypertension and hyperlipidemia under the influence of obesity, and points out the co-acting molecules, providing a reference for future research on cardiovascular and cerebrovascular diseases.

Objective:To summarize the clinical characteristics of SYNGAP1-related epilepsy in children.Methods:Data of 13 patients with SYNGAP1 gene variants diagnosed with epilepsy at Department of Neurology, Beijing Children's Hospital were collected retrospectively from March 2017 to October 2020 and the patients were followed up. The clinical features, electroencephalogram(EEG), brain imaging, gene results and treatment were summarized.Results:Twelve patients were followed up successfully among the 13 patients with SYNGAP1 variants. The last follow-up age was 5 years and 7 months (3 years and 1 month to 9 years).The onset age of seizures was 2 years (4 months to 3 years). Seizure types included eyelid myoclonia with or without absence (9 cases), myoclonic seizure (5 cases), atypical absence (4 cases), suspicious atonic seizures(4 cases),unclassified fall attack (6 cases), and the frequency of seizures varied from several times to more than 100 times per day. Four cases had the mimic phenotype of myoclonic astatic epilepsy. The seizures of 10 cases could be triggered by eating (5 cases), emotion (5 cases), fever (3 cases), voice (2 cases), fatigue (2 cases), etc. Electroencephalography (10 cases) showed interictal generalized or focal epileptiform discharges (9 cases), and atypical aphasia (4 cases), myoclonic seizure (2 cases) and eyelid myoclonic seizure (1 case) were monitored. Of the 12 cases, 9 were added with valproate, all of which were effective (the frequency of seizures reduced>50%). Five cases received combined levetiracetam, in 3 the treatments were effective. To last follow-up, 3 cases were seizure free from 6 months to 1 year and 1 month, but the remaining 7 cases still had seizures, one or several times per day. All 13 cases had developmental retardation (speech ability impaired mostly), 2 cases were severe, 10 cases were moderate, 1 case was mild. The SYNGAP1 gene variants of 13 patients were all de novo, including 12 variants. Among them, 4 were frameshift variants, 4 were nonsense variants, 2 were missense variants and 2 were splice site variants.Conclusions:Patients with SYNGAP1-related epilepsy have an early onset age and many seizure types. The main seizure type is eyelid myoclonia with or without absence, and other seizure types include myoclonic seizure, atypical absence, unclassified fall attack, etc. Valproate is effective in most patients, but seizures in some patients might be intractable. Most patients have developmental delay (mainly moderate and severe), speech ability impaired mostly.

Objective:To investigate the clinical and laboratory characteristics of subacute sclerosing panencephalitis (SSPE).Methods:The clinical, laboratory and electroencephalogram (EEG) data of eight patients with SSPE who admitted to the Department of Neurology, Beijing Children's Hospital, Capital Medical University, from May 2014 to February 2019 were retrospectively analyzed and followed up.Results:Four of the patients were male and four were female, who aged from two years and seven months to 13 years and five months with a median onset age of five years and six months. All of the eight cases had disease onset with progressive mental and physical regression, then developed periodic myoclonic seizures at the course of 11 days to 11 months. Video EEG examinations showed persistent generalized periodic complex waves with long interval (3-20 s). The IgG titers of measles virus in blood and cerebrospinal fluid of all cases were significantly increased. There was no significant abnormality in blood/urine metabolism screening nor head magnetic resonance imaging for the first time. Five cases performed head magnetic resonance imaging again, in which two cases with deepening hemispheric sulcus, two cases with cerebral white matter signal abnormalities. Antiepileptic drugs, gamma globulin, adrenocortical hormone and antiviral drugs were used after diagnosis though all were ineffective. All patients presented progressive deterioration. During the follow-up period of three months to two years and seven months, four patients died, of which three patients died at the time of five months, one year and two months, two years and six months after onset respectively, and the other one was unknown.Conclusions:The diagnostic clues of SSPE are progressive mental and physical regression, recurrent myoclonic seizures during period Ⅱ, as well as the extensive periodic complex waves of EEG. It is necessary to detect measles virus IgG antibody in blood and cerebrospinal fluid to make a definite diagnosis. There is no specific treatment for SSPE and its prognosis is very poor.

Objective: To explore the clinical characteristics and genotyping results of childhood-onset myoclonus dystonia syndrome caused by SGCE variants. Methods: The clinical data of 9 children with SGCE-related myoclonus dystonia syndrome admitted at either the Department of Neurology, Beijing Children′s Hospital, Capital Medical University or the Department of Pediatrics, Peking University First Hospital from May 2018 to October 2019 were collected and the patients were followed up. The definite diagnosis was made on the basis of whole exome sequencing and multiple ligation-dependent probe amplification. The clinical features and gene test results were analyzed retrospectively. Results: Data of 9 patients (4 boys and 5 girls) diagnosed as myoclonus dystonia syndrome caused by SGCE variants were collected. The onset age ranged from 1 year to 3 years and 2 months. The first symptom was myoclonus in 4 cases, while dystonia in the remaining 5 cases. In the course of the disease, 9 cases had myoclonus and 8 had dystonia. Myoclonic jerks were characterized by involuntary jerks in both upper limbs in 8 patients. Six patients had involuntary jerks of lower limbs, resulting in gait instability or even falling. The myoclonus was exacerbated during the fine motor activities, emotional stress or fatigue. Dystonia was characterized by abnormal gait, including 5 cases with right leg dystonia, and 3 cases with the left leg dystonia. Three probands had a positive family history. Intellectual development was normal in all cases. There was no obvious abnormality in video-electroencephalogram (EEG) during both ictal and interictal periods. Electromyography (EMG) and brain magnetic resonance imaging (MRI) of 9 patients were normal. Nine patients carried SGCE gene variants, including 3 frame shift variants, 2 nonsense variants, 2 missense variants, 1 fragment deletion variant and 1 splice site variant. Seven variants were inherited paternally, and 2 variants were de novo. Madopar was used in 8 patients, and nitrazepam in 4 patients, leading to the decrease in the myoclonus jerks and improvement of gait in 6 and 2 patients, respectively. Conclusions SGCE gene variants can cause myoclonus dystonia syndrome. The onset of the disease may occur at infancy or preschool age, with either myoclonic jerks or dystonia as the initial symptom. Non-epileptic myoclonus is the prominent symptom, with upper limb mainly involved. Most of the patients have the accompanying symptoms of dystonia, and some of them may have spontaneous symptom relief. SGCE gene is imprinted maternally, and the inherited variants of SGCE are paternal in origin.

Objective : To understand the epidemiological characteristics of injury deaths among residents in Taizhou,and to provide evidence for prevention and control of injury death. Methods : The monitoring data of injury deaths in Taizhou residents from 2010 to 2016 were derived from the Chronic Disease Surveillance Information Management System of Zhejiang Province. Descriptive epidemiological methods were used to analyze injury mortality,cause of death,population characteristics and life lost due to injury. Results : From 2010 to 2016,a total of 26 313 injury death cases were reported in Taizhou,with an average annual injury mortality rate of 63.61/100 000 and a standardized rate of 56.64/100 000; the mortality rate of injury from 2010 to 2016 showed a downward trend year by year（P<0.05）,and the annual change percentage（APC）was -7.1%. The mortality rates of 0-14 years old,15-44 years old,45-64 years old,65 years old and above group were 15.37/100 000,22.45/100 000, 69.64/100 000 and 315.69/100 000. There were statistically significant differences in the mortality rates of residents between different age groups （P<0.05）. Except for there were no statistically significance differences between the mortality rates of 15-44 years old and 0-14 years old in 2013 and 2014（both P>0.008 3）. The mortality rate in each year from 2010 to 2016 were decreased by 0-14 years old,15-44 years old,45-64 years old,65 years old and above group （all P<0.008 3）. The mortality rate of all age groups showed a downward trend year by year（P<0.05）. The top five injury death causes were accidental falls（17.97/100 000）,motor vehicle traffic accidents（13.97/100 000）,drowning（5.59/100 000）,suicide （5.25/100 000）,other accidents and harmful effects（4.50/100 000）,accounting for 84.35% of the total number of deaths. The injury death causes of the 0-14 years old group were mainly drowning,which was 407 cases,accounting for 1.55% of the total number of deaths; for 15-44 years old group and the 45-64 years old group,the main causes were motor vehicle traffic accidents,which were 1 373 and 2 354 cases,accounting for 5.22% and 8.95%,respectively; for 65 years old and above group,the main cause was mainly accidental falls,which was 6 777 cases,accounting for 25.76%. The years of potential life lost （PYLL） due to injury was 328 678 person-years and the years of potential life lost rate （PYLLR） was 7.95‰. Conclusion The injury mortality rates of Taizhou residents were declined from 2010 to 2016. The mortality rate of elderly residents due to injury were high and accidental falls was the main cause of injury deaths.

Objective To explore the assessment system of humanistic communication in the grad-uation examination of pediatric residents. Methods A humanistic communication assessment program and an evaluation form were designed and put into practice in the graduation examination of pediatric residents in 2016 and 2017 in Beijing Children's Hospital affiliated to Capital Medical University and the scores were collected and analyzed to compare the differences in pediatric residents who have undergone system-atic physician-patient communication scene training and who didn't. With this analysis, the assessment system was further improved. Results Of all the 5 dimensions, communication content, nonverbal skills, and communication effects and the comparison of their respective scores were statistically significant. The scores of the residents who have undergone systematic physician-patient communication scene training are much better than those who didn't. Conclusion This assessment system focuses on the investigation of ability. From the design of examination questions and assessment scenes, to the evaluation of students per- formances, only when candidates have mastered the skills of communication can they do well in examina-tions and achieve good results.

Objective To discuss the clinical manifestations,imaging features and prognosis of children with mild encephalitis/encephalopathy with a reversible splenial lesion(MERS).Methods Twenty-five patients with MERS admitted to Beijing Children′s Hospital,Capital Medical University,between November 2013 and March 2016 were enrolled and their clinical and imaging data were retrospectively analyzed.Ages of onset of these 25 cases were from 6 months to 13 years old.Because of different clinical manifestations in different onset ages,these 25 cases were divided into 2 groups:≤6 years old group (20 cases),with the onset age of 6 months to 3 years and 9 months old(average 2 years and 2 months);>6 years old group(5 cases),with the onset age of 9 years 3 months to 13 years old (average 10 years and 10 months).Results Nineteen cases among the 25 patients had infection history before onset,including 10 cases of digestive tract infection(all were ≤6 years old children),9 cases of respiratory tract infection(6 children ≤6 years old and 3 children >6 years old).The main clinical manifestations included convulsion (18/25 cases,72.0%),fever (17/25 cases,68.0%),vomiting (11/25 cases,44.0%),and disturbance of consciousness (11/25 cases,44.0%).The main clinical manifestation of ≤6 years old group was convulsion (18/20 cases,90.0%),while the main clinical manifestations of the>6 years old group were fever(3/5 cases,60.0%),headache and dizziness(2/5 cases,40.0%),and none of the patients in >6 years old group had convulsion.Eight cases had liver function injury,myocardial enzymes increased in 10 cases,and hyponatremia occurred in 9 cases.Magnetic resonance imaging (MRI) showed 21 cases were type Ⅰ MERS(only involving corpus callosum),and 4 cases of type Ⅱ MERS which involved corpus callosum as well as deep brain white matter,subcortical white matter (centrum semiovale).MRI lesions disappeared after 8-56 days (average 16.5 days) of anti-infection and reducing intracranial pressure treatment.Conclusion MERS is more common in ≤6 years old children,and digestive tract infection is common in ≤6 years old children,while respiratory tract infection is common in >6 years old children.The symptoms in children are mainly manifested as fever,convulsion,vomiting,conscious disturbance,and so on.Infection and hyponatremia are the main causes of MERS in children.MRI is the first choice of imaging examination methods.

OBJECTIVE To investigate the characteristics and laws of changes in electrically evoked auditory brainstem responses(EABR),electrically evoked stapedius reflex(ESRT) after cochlear implantation in children with inner ear malformation.METHODS 88 cases of Australian 24 multi-channel cochlear implants were divided into normal group and inner ear malformation group,The EABR and ESRT thresholds were measured at different periods within one year after operation.Behavior auditory responses,T-level and C-level were measured 1 year postoperatively to analyze their characteristics and changes.RESULTS The EABR and ESRT thresholds in the patients with inner ear malformation were significantly higher than those in the normal cochlear group(P＜0.05).The changing trend of EABR and ESRT were the same in the 2 groups,the overall trend is that low frequency value is low,high frequency value is higher.EABR,ESRT threshold increased gradually after 1 year,EABR was significantly correlated with T-level,and ESRT was significantly correlated with C-level.CONCLUSION The changes of EABR and ESRT thresholds in the cochlear implantation of the inner ear malformation group were similar to those of the normal cochlear group,the thresholds can be used to guide mapping for the inner ear malformation of the cochlear implant.