Objective: To investigate the correlation of emotional and behavioral problems with sleep problems in children with cerebral palsy, so as to provide reference for intervention of emotional and behavioral problems in children. Methods: A cross sectional survey was conducted, and 402 children aged 6-18 with cerebral palsy who were adopted by social welfare institutions in Guangzhou City from January 2023 to January 2024 were selected to investigate their full time nurses. The Parents Strengths and Difficulties Questionnaire (SDQ) was used to assess the emotional and behavioral problems of children with cerebral palsy, and the Children s Sleep Habits Questionnaire (CSHQ) was used to assess sleep problems. Multiple linear regression analysis was used to analyze the correlation between the sleep problem of children with cerebral palsy and the emotional and behavioral problems. Results: The prevalence of emotional and behavioral difficulties among children with cerebral palsy was 15.7%. The median sleep problem score of children with emotional and behavioral problems [37.0(36.0, 41.0)] was significantly higher than that of children without emotional and behavioral [35.0(34.0, 36.0)] ( Z =-5.74, P <0.01). The results of multiple linear regression analysis showed that after adjusting covariables such as age, gender, cerebral palsy classification, language retardation, visual impairment and epilepsy, the total sleep problem score of children with cerebral palsy was positively correlated with the total difficulty score ( β= 0.28, 95%CI =0.17-0.34, P <0.05). Conclusions Sleep problems in children with cerebral palsy are associated with emotional and behavioral difficulties. Understanding of the management of sleep problems in children with cerebral palsy should be enhanced to reduce the incidence of emotional and behavioral problems in children with cerebral palsy.

Peripherally-induced movement disorders (PIMD) are a group of involuntary movements that emerge after an injury to a body part outside the central nervous system. The phenomenology of PIMD encompasses both hyperkinesia and hypokinesia involving multiple parts of the body. The diagnosis of this disease mainly relies on the temporal and spatial relationship between peripheral injuries and movement disorders. The etiology, pathogenesis and treatment of PIMD have been a matter of debate. This article will review the clinical features, classification, diagnosis, treatment and possible pathogenesis of PIMD, and discuss the limitations and controversies of PIMD-related researches, aiming to advance the understanding of PIMD and avoid clinical misdiagnosis.

Objective: To investigate the association between cysteine level and lumbar spine (LS) bone mineral density (BMD) among children with cerebral palsy, so as to provide a basis for bone health enhancement among children with cerebral palsy. Methods: A total of 149 children aged 10-18 with cerebral palsy who were admitted to the G city Social Welfare Institute (Luogang District) from January 2023 to January 2024. Basic demographic characteristics of children with cerebral palsy were extracted from medical records system. Cysteine levels were measured using the enzyme cycling method. LS BMD of the children was determined by specialized rehabilitation physicians using dual energy X ray absorptiometry, and the corrected BMD Z -scores for LS were calculated. Non restrictive cubic splines and segmented multiple linear regression were employed to analyze the correlation between cysteine levels and age specific height Z -scores (HAZ scores) for LS BMD in children with cerebral palsy. Results: The median cysteine concentration in children with cerebral palsy was 9.13(8.42, 10.30)μmol/L, with significantly higher levels in spastic type children [9.28(8.53，10.49)μmol/L] compared to non spastic types [8.64(7.89，9.66)μmol/L]( Z=-2.46，P <0.05). The median LS BMD HAZ score was -1.07( -2.10 , -0.16), and the detection rate of decreased bone mass was 29.5%. There was an "L" shaped association between serum homocysteine concentration and LS BMD HAZ score in children with cerebral palsy. When serum homocysteine concentration was below 8.7 μmol/L, a significant negative correlation was observed between LS BMD HAZ score and serum homocysteine concentration ( B=-0.32, 95%CI =-1.06 to -0.15, P <0.05). Conclusions The significant negative correlation between cysteine levels and LS BMD in children with cerebral palsy at lower cysteine concentrations, which suggests a potentially higher sensitivity to the influence of homocysteine than healthy children and adolescents, warranting attention even if not reaching the standard of hyperhomocysteinemia.

OBJECTIVE: To analyze the phenotype and genetic mutations in a pedigree affected with factor Ⅺ (FⅪ) deficiency. METHODS: Activated partial thromboplastin time (APTT), FⅪ activity (FⅪ:C) and FⅪ antigen (FⅪ:Ag) were determined for the proband and his family members. All exons and exon-intron boundaries of the FⅪ gene of the proband were analyzed by direct sequencing. Suspected mutation was verified in his family members. RESULTS: The proband had APTT of 82.4 s, FⅪ:C of 0.8%, and FⅪ:Ag of <1%. DNA sequencing showed that he has carried c.1033A>T (Lys327X) mutation in exon 10 and c.1325delT (Leu424CysfsX8) mutation in exon 12 of the FⅪ gene. His elder sister, son, daughter, two granddaughters and one grandson were heterozygous carriers of the c.1033A>T mutation, while his older sister and younger brother were heteozygous carriers of the c.1325delT mutation. Analysis using Mutation Taster software showed that both p.Lys327X and p.Leu424CysfsX8 may affect the function of protein and lead to the corresponding disease. CONCLUSION The novel mutations of Lys327X and Leu424CysfsX8 of the the FⅪ gene probably underlie the pathogenesis of congenital coagulation factor Ⅺ deficiency in this pedigree.
Exons ; Factor XI ; genetics ; Factor XI Deficiency ; genetics ; Female ; Heterozygote ; Humans ; Male ; Mutation ; Pedigree

Objective To study the clinical characteristics of syndrome types of laryngeal cough ,in order to provide an epidemiology basis for classification diagnosis. Methods Medical history,clinical signs and symp-toms of patients with laryngeal cough were collected. And questionnaire survey was carried out. Results (1)Of the 4 syndrome types,compared with wind evil invading lung type laryngeal cough incidence,the insecure defen-sive exterior and intrinsic special type showed no statistical difference(P>0.05). And the comparative differences between the rest 2 groups are of statistical differences(P < 0.05).(2)The onset time was analyzed. The results show laryngeal cough incidence from yin deficiency type and fire hyperactivity type showed no statistical difference (P > 0.05). The rest are all of statistical difference(P < 0.05).(3)The clinical course was analyzed. No differ-ence was found between spleen deficient phlegm type ,yin deficiency and fire hyperactivity type laryngeal cough (P>0.05). Differences of the rest 2 groups showed statistical difference(P<0.05).(4)The state of illness was analyzed. The results showed statistical difference between spleen phlegm type and yin deficiency and fire hyperac-tivity type(P<0.05). No statistical difference can be found between the rest 2 groups(P>0.05).(5)The cross-tab chi-square test was carried out on the 4 groups of syndromes on the nasal allergy eye and allergy concomitant incidence. The results showed that there was no significant difference between the 4 groups(P>0.05).(6)On the phlegm part,the results showed difference between wind evil invading lung type and yin deficiency and fire hyper- activity type laryngeal cough(P>0.05). Differences between the rest 2 groups are of statistical significance(P<0.05).(7)Foreign body sensation was analyzed. The results showed no difference between insecure defensive exte-rior and intrinsic special type and wind evil invading lung type ,deficient spleen phlegm type and yin deficiency and fire hyperactivity type(P>0.05). Differences between the rest 2 groups are all of statistical significance(P<0.05). Conclusions The 4 groups of syndrome types,insecure defensive exterior and intrinsic special type and wind evil invading lung type are the most common. Deficient spleen phlegm type is middle ,yin deficiency and fire hyperactivity type come next. Cough caused by wind invading lung mainly occurs in the evening. Its duration is usually within 1 month. It may be accompanied by phlegm with or without occasional pharyngeal paraesthesia. The daily life is usually unaffected or slightly affected. Cough caused by deficiency of vital energy and specific intrinsic quality mainly occurs in the morning. Its duration is usually 3 months to 1 year. It may be accompanied by less phlegm or no phlegm without or with occasional pharyngeal paraesthesia. The daily life is unaffected or slightly affected. Cough caused by Yin deficiency and fire hyperactivity occurs from time to time. It duration is more than 1 year. It may be accompanied by phlegm with pharyngeal paraesthesia. The daily life is unaffected or seriously affected. Cough caused by spleen deficiency and phlegm turbidity mainly occurs in the morning. Its duration is more than 1 year. It may be accompanied by more phlegm with pharyngeal paraesthesia. The daily life is seriously affected.

To study the regulating effect of Astragalus Polysaccharides ( APS) to the mice infected by Brucella suis S2.Methods:120 BALB/c mice were randomly divided into 4 groups:experimental mice were injected APS 1 ml ( 0.4,1.2,3 mg/ml) via peritoneal cavity respectively once a day and the control group was injected with the same volume of saline for 3 days,then infected with Brucella suis S2 1 ml (1×107 L-1 ) by ip.Five mice of each group were killed through eye bloodletting at 1,6,12,24,48, 72 h respectively post-infection with Brucella suis S 2 and the peritoneal macrophage were obtained respectively to make smear.Phagocytic rate and phagocytic index were calculated by the Wright Giemsa staining after infected 1 h.TNF-α,IL-12 and IFN-γlevels of serum at different time points were measured by ELISA.The bacterial load of MΦand spleen were measured by coating method.Results:The phagocytic rate and phagocytic index of MΦin APS 3 dose groups were higher than those of the control group ( P<0.05 ).The microbial load of MΦin APS 3 dose groups at 1 h infected by Brucella suis S 2 were significantly higher than those of control,but significantly lower than those of control at 6,12,24,48,72 h after infected by Brucella suis S2.The microbial load of spleen in APS 3 dose groups at 6 h infected by Brucella suis S 2 were significantly higher than those of control ,but significantly lower than those of control at 12,24,48,72h after infected by Brucella suis S2.The concentrations of TNF-α,IL-12 and IFN-γin the serum of APS groups had significantly been improved ( P<0.05 ).Conclusion: APS can promote the activation of MΦin vivo and strengthen the activity of phagocytosis and killing to Brucella suis S 2.APS can promote the secretion of TNF-α,IL-12 and IFN-γof mice,strengthen the cellular immune response of mice to Brucella suis S 2.

Objective To explore the ways to decrease the postoperative complications of pancreaticoduodenectomy. Methods Thirty-four patients who underwent pancreaticoduodenectomy between January 1998 and December 2004 were reviewed retrospectively. A duct-to-mucosa pancreaticojejunostomy was performed mostly for patients, and an end-to-end pancreaticojejunal invagination for 5-patients with a soft pancreas and a small pancreatic duct. The end-to-side hepaticojejunostomy and the Roux-en-Y reconstruction of gastrointestinal continuity were performed for all patients. Results The hospital mortality was zero. The postoperative complications occurred in the form of wound infection was 4(12%), delayed gastric emptying was 1(3%), pneumonia was 1(3%), intra-abdominal collections was 1(3%) and pancreaticojejunostomy leak was 1(3%). In 1 patient with pancreaticojejunostomy leak, the closure was achieved with the conservative treatment. Intra-abdominal bleeding, intra-abdominal abscess and other anastomotic leakage were not seen in any of patients. The median follow-up was 21 months (ranging from 6 months to 5 years), none of patients had clinical evidence of steatorrhea, bile reflux gastric disease, anastomotic ulcer, retrograde cholangitis and dumping syndrome, there was no new case of diabetes. Conclusions Proper method of reconstruction produces encouraging results in decreasing the complications after pancreaticoduodenectomy.

Objective To explore the surgical treatment of advanced rectal carcinoma in aged people. Methods The clinical data of 65 aged patients with advanced rectal carcinoma from 2000 to 2004 were analyzed retrospectively. Results All cases were Dukes D stage or accompanied with hepatic metastasis. Hartmann's operation was performed in 26 cases, single lumen sigmoidostomy in 11 cases, double lumen sigmoidostomy in 11 cases and resection of hepatic metastatic cancer in 12 cases. Rectal upper arterial catheter chemotherapy was performed in 19 cases and hepatic arterial catheter chemotherapy in 15 cases. The 3-year survival rate of Hartmann's operation was 34%(9/26), and the average survival time was 20?3.17 months in the patients underwent rectal upper and hepatic arterial catheter chemotherapy, and 10?1.77 months in the patients who could not be treated surgically(P

Objective To study the relationship between the CT value and injury of ultrastructure in posttraumatic acute diffuse brain swelling(PADBS). Methods The change of CT value of brain tissue was analyzed at posttrauma and preoperation in 9 patients, in combination with the ultrastructure in brain parenchyma in 36 specimen taken from operations. The relationship between the descend of CT value and ultrastructure injury was analysed.Results The CT value of brain in preoperation was lower than it in posttrauma first scanning(2.5～4.3 HU).The capillary distention and stenosis and the diffuse edema in pericapillary and intercellular were observed under transmission electron microscopy(TEM). The nucleolus of neuronal cells displaced to membrane or disappeard. Chromation agglutionation, nuclear membrane circuity, perinuclear diffuse lipid drops and blankspace were detected. The mitochondrion swelling, mitochondrial crest blurring or effacement, rough endoplasmic reticulum distension and its’ granules detachmen were also seen under TEM. Axolemma edema, microfilaments and microtubules derangement in axis-cylinder were found too. The similar phenomena existed in astrocyte.Conclusion The descent of CT value in PADBS was relevant to the aggravation of vasogenic cerebral edema, cytotoxic cerebral edema and ultrastructure injury in brain parenchyma.

The cytochemical method of Ca-ATPase activity was studied in this article. The native made reagent was utilized and worked in our department, The appearance of Ca-ATPase activity was researched for the cells of hepar, kidney, brain and oviduet, especially for the membrane system of myocardium cell.