This article aims to improve the understanding of Lance-Adams syndrome （LAS） in clinical practice. By analyzing the clinical data of a patient diagnosed with LAS in 2021 and conducting a literature review， this article elaborates on the clinical symptoms， pathogenesis， diagnostic methods， and treatment regimens of LAS. LAS is a rare central nervous system disorder characterized by action myoclonus after cerebral hypoxia. The etiology of LAS is mainly associated with cerebral hypoxia， and cardiopulmonary resuscitation and asphyxia are the most common predisposing factors for LAS. Characteristic manifestations on electroencephalography have an important value in diagnosis. Clinicians should enhance their ability to identify LAS through typical clinical symptoms and electroencephalography in the early stage. This article also points out that there are still many challenges in the treatment of LAS， which requires further research and exploration. This article has an important reference value in improving the understanding， diagnosis， and treatment of LAS.
Electroencephalography

Objective To analyze the value of heparin-binding protein(HBP)and interleukin-17A(IL-17A)levels in bronchoalveolar lavage fluid in predicting prognosis of elderly patients with se-vere pneumonia.Methods A total of 105 elderly patients with severe pneumonia in the hospital from May 2022 to May 2024 were selected and divided into death group(n=32)and survival group(n=73)based on their survival outcomes within 28 days after admission.The levels of HBP and IL-17A in bronchoalveolar lavage fluid were compared between the two groups;the Logistic regression analysis was conducted to explore the influencing factors for prognosis in elderly patients with severe pneumoni-a;the receiver operating characteristic(ROC)curve was plotted to analyze the predictive efficiencies of HBP and IL-17A in bronchoalveolar lavage fluid for the prognosis of elderly patients with severe pneumonia.Results The levels of HBP and IL-17A in bronchoalveolar lavage fluid in the death group were significantly higher than those in the survival group(P＜0.01).There were significant differ-ences in the Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ)score and blood lac-tate(Lac)level between the two groups(P＜0.01).Logistic regression analysis showed that HBP(OR=3.084,95％CI,1.326 to 4.694),IL-17A(OR=4.521,95％CI,2.164 to 7.841),APACHE Ⅱscore(OR=2.039,95％CI,1.069 to 2.859),and Lac(OR=2.627,95％CI,1.168 to 3.058)were influencing factors for the prognosis of elderly patients with severe pneumonia(P＜0.05).When the optimal cut-off values were set at 15.92 ng/mL for HBP and 109.34 pg/mL for IL-17A,the area under the curve(AUC)for the combined prediction of prognosis by HBP and IL-17A in bronchoalveolar lavage fluid was 0.852,with a 95％CI of 0.801 to 0.948.The AUC for the com-bined prediction of prognosis by HBP and IL-17A in bronchoalveolar lavage fluid was significantly higher than that for single tests(Z=2.906,2.416,P=0.007,0.014).Conclusion Increased levels of HBP and IL-17A in bronchoalveolar lavage fluid,decreased APACHE Ⅱ score,and in-creased Lac are influencing factors for the prognosis of elderly patients with severe pneumonia.Com-bined detection of HBP and IL-17A in bronchoalveolar lavage fluid has high sensitivity in predicting the prognosis of elderly patients with severe pneumonia.

Objective To analyze the pathogenic bacteria and drug resistance of peritoneal dialysis-associated peritonitis(PDAP),and provide a clinical reference for the rational use of antibiotics.Methods The demographic data of PDAP patients admitted to the peritoneal dialysis(PD)Center of the First Affiliated Hospital of Soochow University from July 1,2015 to December 30,2021 were collected,and the pathogens,drug resistance and prognosis were retrospectively analyzed.Results A total of 150 episodes of PDAP occurred in 92 patients.The positive rate of PD fluid culture was 61.33％,including 65 cases(70.65％)of Gram-positive(G+)bacteria,mainly Staphylococcus and Streptococcus.Gram-negative(G-)bacteria were in 16 cases(17.39％),mainly Escherichia coli and Enterobacter cloacae.There were 11 cases(11.96％)of multiple infections,including 5 cases of combined fungal infection.From 2016 to 2021,the incidence of G+bacteria-related PDAP decreased from 14 to 8 cases.G+strains were resistant to methicillin(35.00％),and were sensitive to linezolid(100.00％),teicoplanin(100.00％)and rifampicin(100.00％).The sensitivity rate to vancomycin was 98.59％.G-strains were sensitive to ceftazidime(86.36％),ceftizoxime(88.89％)and amikacin(100.00％).The MIC of vancomycin against Staphylococcus showed an upward trend in 2019-2021.The overall cure rate of PDAP was 81.33％in patients who responded to antibiotic treatment,and the cure rate of G+bacteria was higher than that of multiple infections(89.23％vs.36.36％,P＜0.01).The outcome of patients with multiple infections,especially those with concurrent fungal infection was poor.Conclusion The incidence of PDAP in the PD center has shown a decreasing trend in recent years.G+bacteria are still the main pathogenic bacteria causing PDAP,and they are highly resistant to methicillin,so vancomycin should be used as empirical therapy.For G-bacteria,cefotaxime and amikacin can be chosen as empirical therapy.There is a drift in the MIC values of vancomycin against Staphylococcus in the study period,so it is necessary to monitor the MIC of vancomycin against Staphylococcus and its changing trend.

Objective:To compare the awakening effects of enriched environmental quantitative stimulation and conventional rehabilitation on patients with consciousness disorder after traumatic brain injury (TBI).Methods:A retrospective cohort study was conducted to analyze the clinical data of 60 patients with consciousness disorder after TBI admitted to Hospital of Zhejiang Provincial Armed Police Corps from October 2021 to October 2022, including 38 males and 22 females, aged 26-72 years [(41.6±13.2)years]. The injury was located at the frontal and temporal lobe in 37 patients, at the brain stem in 9, and at the thalamus in 14. The types of injury included cerebral contusion and laceration in 36 patients and intracerebral hematomas in 24 patients. The Glasgow Coma Scale (GCS) score on admission was 5-8 points in 11 patients, 9-12 in 34, and 13-15 in 15. Disease course was (19.2±5.4)days. A total of 30 patients received conventional rehabilitation treatment (conventional rehabilitation group) and 30 patients received enriched environmental quantitative stimulation on the basis of conventional rehabilitation treatment, which lasted 4 cycles in 28 days (quantitative stimulation group). The Coma Recovery Scale-Revised (CRS-R) score, Activities of Daily Living (ADL) score, and brainwave α/δ ratio (ADR) before treatment and at the second and fourth treatment cycles were compared between the two groups. The incidence of complications at the end of the fourth treatment cycle and the rate of favorable outcome of Glasgow Outcome Scale (GOS) at the last follow-up were compared between the two groups.Results:All the patients were followed up for 6-12 months [(8.3±2.5)months]. There were no significant differences in CRS-R score, ADL score, or brainwave ADR between the two groups before treatment ( P>0.05). At the second treatment cycle, they were (13.03±0.73)points, (14.83±0.95)points and 0.35±0.11 respectively in the quantitative stimulation group, which were all higher than those in the conventional rehabilitation group [(11.18±0.14)points, (8.74±0.43)points and 0.29±0.09 respectively] ( P<0.05). At the fourth treatment cycle, they were (17.83±0.23)points, (52.93±10.75)points and 0.44±0.11 respectively in the quantitative stimulation group, which were all higher than those in the conventional rehabilitation group [(13.67±0.35)points, (40.56±7.15)points and 0.37±0.07 respectively] ( P<0.05). The CRS-R score, ADL score, and brainwave ADR at the second treatment cycle were significantly higher than those before treatment, and they were even higher at the fourth treatment cycle than those at the second treatment cycle ( P<0.05). At the end of the fourth treatment cycle, the incidence of complications in the quantitative stimulation group was 13.3% (4/30), which was lower than that of the conventional rehabilitation group [36.7% (11/30)] ( P<0.05). At the last follow-up, the favorable outcome rate of GOS was 80.0% (24/30) in the quantitative stimulation group, which was superior to 66.7% (20/30) in the conventional rehabilitation group ( P<0.05). Conclusion:Compared with the conventional rehabilitation treatment, enriched environmental quantitative stimulation for patients with consciousness disorder after TBI achieves enhanced consciousness level, activity of daily life and electroencephal reactivity, together with decreased incidence of complications and improved prognosis.

Objective To develop and verify a specific serum bactericidal assay(SBA) in vitro for dysentery serum antibody,in order to evaluate the immune efficacy of dysentery bivalent conjugate vaccine.Methods A standardized SBA was developed by identification of strains, preparation of working bacteria stocks, determination of the percentage recovery rates of working bacteria stocks and complement screening according to the reference method published by WHO reference laboratory in US University of Alabama at Birmingham(UAB), and verified for the specificity, linearity, precision as well as robustness. The titers of 20 pairs of serum samples were determined using the developed SBA method.Results The strains were confirmed to be Shigella flexneri 2a(S.flexneri 2a) and Shigella sonnei(S.sonnei), and their working bacteria stocks were constructed respectively. The percentage recovery rates of working bacteria stocks of the two types were 92% and 94% after cryopreservation for more than 2 h, and 91% and 96% after cryopreservation for 6 months, respectively. The both working dilutions were determined to be 20 000, and the numbers of surviving bacteria were 115 and 109 CFU/spot respectively at this working dilution. Two batches(07634EL and 011834EL) of complements could be used as working complements. The CV of reproducibility of the method was less than 30%, and the inter-assay CV was less than 50%, indicating that the reproducibility and intermediate precision of the method were good. The bactericidal titers of the two serotypes were completely inhibited when the concentrations of homologous dysentery polysaccharide were 50 and 40 μg/mL, respectively, while the inhibition was still lower than 20% even when the concentration of heterologous dysentery polysaccharide increased to 200 μg/mL, which indicated that the method had a good specificity. The logarithmic value of bactericidal titer and the logarithmic value of initial dilution multiple of both two serotypes were significantly negatively correlated, with R~2 of 0.997 4 and 0.996 2, respectively.The antibacterial titers of S.flexneri 2a and S.sonnei antibodies increased significantly compared with those before immunization.Conclusion A standardized SBA in vitro for dysentery specific antibody was successfully developed, which can be used to assess the immune efficacy of dysentery bivalent vaccine.

Objective To explore the regulatory role of Abelson interactor 2(ABI2)in progression and prognosis of gastric cancer.Methods TIMER2.0,GEPIA,Kaplan-Meier Plotter and DAVID databases were used to analyze ABI2 expression in pan-cancer and its association with the prognosis of gastric cancer.Gastric cancer and adjacent tissues from 120 patients undergoing radical gastrectomy in our hospital between January,2016 and October,2018 were examined for ABI2 expression and its correlation with disease progression and prognosis.MGC-803 cell models of ABI2 knockdown and overexpression were established for observing the changes in cell proliferation,migration,and invasion,and the impact of ABI2 expression modulation on xenograft growth was evaluated in nude mice.Results Database analysis and examination of the clinical samples showed that ABI2 was highly expressed in gastric cancer tissues.Survival analysis suggested that gastric cancer patients with a high expression of ABI2 had a reduced postoperative 5-year survival rate(P<0.0001),and further Cox univariate and multivariate survival analyses indicated that a high ABI2 expression was an independent risk factor affecting the patients survival outcomes(P=0.022,HR=1.887,95%CI:1.096-3.249).Enrichment analysis suggested the involvement of ABI2 in Wnt signaling.In MGC-803 cells,ABI2 overexpression promoted cell proliferation and xenograft growth in nude mice,increased the expressions of vimentin and N-cadherin,and lowered E-cadherin expression,while ABI2 knockdown produced the opposite effects.Mechanistic analysis revealed that ABI2 overexpression promoted the expressions of Wnt2 and β-catenin in both MGC-803 cells and the xenografts,and their expressions were significantly lowered by ABI2 knockdown.Conclusion ABI2 is highly expressed in gastric cancer,which affects long-term prognosis of the patients,possible due to its regulatory effect on Wnt signaling to promote proliferation,migration and invasion of gastric cancer cells.

Objective To explore the regulatory role of Abelson interactor 2(ABI2)in progression and prognosis of gastric cancer.Methods TIMER2.0,GEPIA,Kaplan-Meier Plotter and DAVID databases were used to analyze ABI2 expression in pan-cancer and its association with the prognosis of gastric cancer.Gastric cancer and adjacent tissues from 120 patients undergoing radical gastrectomy in our hospital between January,2016 and October,2018 were examined for ABI2 expression and its correlation with disease progression and prognosis.MGC-803 cell models of ABI2 knockdown and overexpression were established for observing the changes in cell proliferation,migration,and invasion,and the impact of ABI2 expression modulation on xenograft growth was evaluated in nude mice.Results Database analysis and examination of the clinical samples showed that ABI2 was highly expressed in gastric cancer tissues.Survival analysis suggested that gastric cancer patients with a high expression of ABI2 had a reduced postoperative 5-year survival rate(P<0.0001),and further Cox univariate and multivariate survival analyses indicated that a high ABI2 expression was an independent risk factor affecting the patients survival outcomes(P=0.022,HR=1.887,95%CI:1.096-3.249).Enrichment analysis suggested the involvement of ABI2 in Wnt signaling.In MGC-803 cells,ABI2 overexpression promoted cell proliferation and xenograft growth in nude mice,increased the expressions of vimentin and N-cadherin,and lowered E-cadherin expression,while ABI2 knockdown produced the opposite effects.Mechanistic analysis revealed that ABI2 overexpression promoted the expressions of Wnt2 and β-catenin in both MGC-803 cells and the xenografts,and their expressions were significantly lowered by ABI2 knockdown.Conclusion ABI2 is highly expressed in gastric cancer,which affects long-term prognosis of the patients,possible due to its regulatory effect on Wnt signaling to promote proliferation,migration and invasion of gastric cancer cells.

Objective To screen mitochondria-related genes in Crohn's disease (CD) based on the Gene Expression Omnibus (GEO) database, construct an artificial neural network diagnostic model and evaluate its performance. Methods The CD-related datasets GSE186582 and GSE102133 were downloaded from the GEO database for differential expression genes (DEGs) screening. The intersection of DEGs and mitochondrial genes from the MitoCarta 3.0 database was obtained. Least absolute shrinkage and selection operator regression and random forest algorithms were used to identify CD-specific genes and construct an artificial neural network diagnostic model. The model was further validated by the validation set GSE95095, and the diagnostic performance was evaluated by the area under the curve (AUC) of the receiver operating characteristic curve. The immune cell infiltration in CD was assessed by the CIBERSORT algorithm, and the relationship between biomarkers and infiltrated immune cells was investigated. Results A total of 551 DEGs were obtained, including 275 upregulated and 276 downregulated genes. There were 20 mitochondria-related genes associated with CD. A total of 9 mitochondria-related feature genes (SOD2, MTHFD2, BPHL, PXMP2, RMND1, AGXT2, MAOA, HMGCS2, MAOB) were screened by two machine learning algorithms. An artificial neural network diagnostic model was constructed by the selected feature genes. The values of AUC of the model in the training and validation groups were 0.956 and 0.736 respectively. Immune cell infiltration analysis showed that the feature genes were associated with resting memory CD4⁺ T cells, activated memory CD4⁺ T cells, activated dendritic cells, neutrophils, and CD8⁺ T cells. Conclusion The artificial neural network diagnostic model for CD based on 9 mitochondrial genes has good predictive performance.

Objective To construct a prognostic prediction model for hepatocellular carcinoma (HCC) based on immune and metabolism related genes, analyze the prognostic immune response of HCC patients, and screen potential drugs for HCC treatment through drug sensitivity analysis. Methods HCC expression profiling and clinical data were obtained from The Cancer Genome Atlas (TCGA) database, and a list of immune-related genes was obtained from the Immport database; the Perl language was used to extract metabolism-related pathway gene sets from the Molecular Signatures Database(MSig DB), and co-expression related genes were found through differential analysis and co-expression analysis; the univariate Cox regression analysis, the least absolute shrinkage and selection operator (LASSO) regression analysis, and multivariate Cox regression analysis were used to screen prognosis-related genes and construct a risk prognosis model for HCC, and risk scores for all HCC samples were calculated. Using the median risk score as the critical value, the reliability of the prognostic model was evaluated through risk curves, Kaplan-Meier survival analysis, receiver operating characteristic (ROC) curves, independent prognostic analysis, and Nomograms. The correlations between risk scores and pathway enrichment analysis as well as immune cell infiltration were analyzed. Drug sensitivity analysis was used to identify potential therapeutic drugs for HCC. Results Five immune and metabolic genes with independent prognostic value were obtained, and a prognostic model based on immune and metabolic genes was constructed. Survival analysis showed that in the total dataset, training group and validation group, the survival rate of the low-risk group was significantly higher than that ofthe high-risk group (P < 0.05). The areas under the ROC curves of the prognostic model for the training group at 1, 3 and 5 years were 0.780, 0.699 and 0.706 respectively. Cox regression analysis showed that grading and risk score could be used as independent prognostic factors for HCC (P < 0.05), with a concordance index of 0.734 (95%CI, 0.669 to 0.798), indicating good model performance. Immune cell infiltration results showed significant differences in resting NK cells, monocytes, M0 macrophages, and M1 macrophages between the high-risk and low-risk groups (P < 0.05). Drug sensitivity analysis screened 12 drugs that may have potential therapeutic effects in HCC patients (P < 0.01). Conclusion The prognostic model of HCC based on five immune and metabolic genes has good predictive performance, and can be used as a new indicator for prognosis evaluation; the 12 drugs screened out have potential efficacy for HCC.

Objective To analyze of the therapeutic effect of Weifuchun capsules combined with quadruple therapy on elderly patients with chronic atrophic gastritis(CAG)infected with Helicobacter pylori(Hp).Methods Elderly Hp-infected CAG patients admitted to Affiliated Hospital of Shaoxing University from April 2019 to April 2023 were divided into a control group(treated with classic quadruple therapy)and an experimental group(treated with Weifuchun capsules combined with classic quadruple therapy)according to different regimens.The clinical treatment effects of two groups of patients were compared,the clinical symptom scores,changes in serum gastrointestinal hormones,inflammatory factors levels before and after treatment,and the adverse reactions and Hp recurrence were compared.Results A totol of 300 patients were included in the study,with 150 cases in each group.After treatment,the clinical symptom score,pepsinogen(PG)Ⅱ,high-sensitivity C-reactive protein(hs-CRP),serum tumor necrosis factor-α(TNF-α),interleukin(IL)-6,and IL-8 levels in the experimental group were lower than those in the control group(P＜0.05),and the levels of PG Ⅰ,gastrin-17(GAS-17)in the serum,and total effective rate were higher than those in the control group(P＜0.05).The difference in the incidence of adverse reactions between the two groups was not statistically significant(P＞0.05),and no Hp recurrence was seen in either group.Conclusion The combination of Weifuchun capsules and classic quadruple therapy has shown good efficacy in treating elderly Hp-infected CAG patients,which can effectively improve the clinical symptoms,regulate gastrointestinal hormone secretion,and has good safety.