[Development of parenting behavior scale for caregivers of children aged 2 to 6 years and analysis for its reliability and validity].

To develop a caregiver parenting behavior scale for children aged 2 to 6 years, and to verify its reliability and validity. This study recruited 1 350 caregivers of children aged 2 to 6 years. The item discrimination analysis and exploratory factor analysis were used to analyze the structure, dimensions and items of the scale. Homogeneity reliability, split-half reliability and test-retest reliability were used to analyze the reliability of the scale. Content validity and construct validity were used to analyze the validity of the scale. The results showed that the final scale contained 7 dimensions and 45 items. Cronbach's α coefficient of the total scale was 0.945; the coefficient of split half was 0.899; the test-retest reliability analysis showed that the correlation coefficients between the two tests were 0.893 (total score), 0.854 (social), 0.832 (language), 0.871 (gross motor), 0.893 (fine motor), 0.862 (cognitive), 0.832 (self-care), and 0.872 (sensory). The content validity analysis was carried out by two rounds of expert argumentation using Delphi expert consultation method. The Kendall coefficient of the items score in two rounds of Delphi expert consultation was 0.813 (P<0.01). The structure validity analysis showed that there were significant correlations between each dimension and the total scale, also between each dimension of the scale, and the extracted average variance values of each dimension was greater than the correlation coefficients between this dimension and other dimensions. In conclusion, the reliability and validity of the scale are qualified. It can be used as a tool to evaluate and guide the parenting behavior of caregivers of children aged 2 to 6 years.

[Personalized therapy for Helicobacter pylori on initial treatment: the initial treatment is the decisive battle].

As widespread eradication treatment continues, the rate of (Helicobacter pylori, H. pylori) antibiotic resistance is increasing. Together with host CYP2C19 gene polymorphisms, H. pylori coccoid transformation, patient compliance, irregular treatment regimens or empirical repeated eradication therapy by physician, H. pylori eradication rates have gradually decreased. Personalized treatment is an effective measure to achieve successful eradication of H. pylori in the initial treatment. With the first approval of molecular diagnostic kit for H. pylori clarithromycin resistance in China and the updated definition of refractory H. pylori infection by the American Gastroenterological Association (AGA), the personalized treatment of H. pylori guided by antibiotic resistance genotype detection in initial treatment, that follows the latest international consensus and guidelines, conforms to the national situation and surpasses the international standards, has come to the forefront.

Moiré graphene nanoribbons: nearly perfect absorptions and highly efficient reflections with wide angles.

The strong absorption and reflection from atomically thin graphene nanoribbons has been demonstrated over the past decade. However, due to the significant band dispersion of graphene nanoribbons, the angle of incident wave has remained limited to a very narrow range. Obtaining strong absorption and reflection with a wide range of incident angles from atomically thin graphene layers has remained an unsolvable problem. Here, we construct a tunable moiré superlattice composed of a pair of graphene nanoribbon arrays to achieve this goal. By designing the interlayer coupling between two graphene nanoribbon arrays with mismatched periods, the moiré flat bands and the localization of their eigen-fields was realized. Based on the moiré flat bands of graphene nanoribbons, highly efficient reflection and nearly perfect absorption was achieved with a wide range of incident angles. Even more interesting, is how these novel phenomena can be tuned through the adjustment of the graphene's Fermi energy, either electrostatically or chemically. Our designed moiré graphene nanoribbons suggest a promising platform to engineer moiré physics with tunable behaviors, and may have potential applications in the field of wide-angle absorbers and reflectors in the mid-infrared region.

P Doping Promotes the Spontaneous Visible-Light-Driven Photocatalytic Water Splitting in Isomorphic Type II GaSe/InS Heterostructure.

The development and design of clean and efficient water splitting photocatalysts is important for the current situation of energy shortage and environmental pollution. A new type of isomorphic GaSe/InS heterostructure is constructed, and the optoelectronic properties were studied through first-principles calculations. The results show that GaSe/InS vdW heterostructure is a type II semiconductor with a band gap of 2.09 eV. However, through the analysis of the energy band edge position and Gibbs free energy change of water splitting, it is found that the GaSe/InS heterostructure is difficult to undergo overall water splitting. Therefore, nonmetallic element P doping is considered, the established P-doped GaSe/InS (P-GaSe/InS) heterostructure could maintain the type II band arrangement, and under acidic conditions, P-GaSe/InS heterostructure could spontaneously undergo overall water splitting thermodynamically. Furthermore, the low exciton binding energy of P-GaSe/InS heterostructure highlights better light absorption performance. Therefore, these findings indicate that P-GaSe/InS heterostructure is a promising photocatalyst in overall water splitting.

Separating and trapping of chiral nanoparticles with dielectric photonic crystal slabs.

Chiral separation is a crucial step in many chemical synthesis processes, particularly for pharmaceuticals. Here we present a novel method for the realization of both separating and trapping of enantiomers using the dielectric photonic crystal (PhC) slabs, which possess quasi-fourfold degenerate Bloch modes (overlapping double degenerate transverse-electric-like and transverse-magnetic-like modes). Based on the designed structure, a large gradient of optical chirality appears near the PhC slab, leading to the extreme enhancement of chiral optical forces about 3 orders of magnitude larger than those obtained with circularly polarized lights. In this case, our method provides a reference for realizing all-optical enantiopure syntheses.

Spontaneous Enhanced Visible-Light-Driven Photocatalytic Water Splitting on Novel Type-II GaSe/CN and Ga2SSe/CN vdW Heterostructures.

With the aggravation of environmental pollution and the energy crisis, it is particularly important to develop and design environment-friendly and efficient spontaneous enhanced visible-light-driven photocatalysts for water splitting. Herein novel type-II van der Waals (vdW) GaSe/CN and Ga2SSe/CN heterostructures are proposed through first-principles calculations. Their electronic properties and photocatalytic performance are theoretically analyzed. In particular, their appropriate band gap and band-edge position meet the requirements of the oxygen evolution reaction, and the reaction is thermodynamically feasible in most pH ranges. The unique band alignment of these heterostructured photocatalysts leads to high solar-to-hydrogen energy conversion efficiencies up to 15.11%, which has a good commercial application prospect. More excitingly, with the application of 2% biaxial strain, the smooth progress of the water-splitting reaction of the GaSe/CN and Ga2SSe/CN heterostructures can still be maintained, and the carrier mobility and optical absorption characteristics can be effectively improved. Consequently, these findings suggest that the GaSe/CN and Ga2SSe/CN vdW heterostructures have promising potentials as photocatalysts for water splitting. This work may provide a promising clue for the design of efficient and stable photocatalytic water-splitting catalysts under visible spectroscopy.

Bacillus amyloliquefaciens TL106 protects mice against enterohaemorrhagic Escherichia coli O157:H7-induced intestinal disease through improving immune response, intestinal barrier function and gut microbiota.

AIMS: This study evaluated the effects of Bacillus amyloliquefaciens TL106, isolated from Tibetan pigs' faeces, on the growth performance, immune response, intestinal barrier function, morphology of jejunum, caecum and colon, and gut microbiota in the mice with enterohaemorrhagic Escherichia coli (EHEC)-induced intestinal diseases. METHODS AND RESULTS: In all, 40 female C57BL/6J mice were randomly divided into four groups: mice fed a normal diet (Control), mice oral administration of TL106 daily (Ba), mice challenged with EHEC O157:H7 on day 15 (O157) and mice oral administration of TL106 daily and challenged with EHEC O157:H7 on day 15 (Ba+O157). The TL106 was administrated to mice for 14 days, and mice were infected with O157:H7 at day 15. We found that TL106 could prevent the weight loss caused by O157:H7 infection and alleviated the associated increase in pro-inflammatory factors (TNF-α, IL-1ß, IL-6 and IL-8) and decrease in anti-inflammatory factor (IL-10) in serum and intestinal tissues of mice caused by O157:H7 infection (P < 0·05). Additionally, TL106 could prevent disruption of gut morphology caused by O157:H7 infection, and alleviate the associated decrease in expression of tight junction proteins (ZO-1, occludin and claudin-1) in jejunum and colon (P < 0·05). In caecum and colon, the alpha diversity for bacterial community analysis of Chao and ACE index in Ba+O157 group were higher than O157 group. The TL106 stabilized gut microbiota disturbed by O157:H7, including increasing Lachnospiraceae, Prevotellaceae, Muribaculaceae and Akkermansiaceae, and reducing Lactobacillaceae. CONCLUSIONS: We indicated the B. amyloliquefaciens TL106 can effectively protect mice against EHEC O157:H7 infection by relieving inflammation, improving intestinal barrier function, mitigating permeability disruption and stabilizing the gut microbiota. SIGNIFICANCE AND IMPACT OF THE STUDY: Bacillus amyloliquefaciens TL106 can prevent and treat intestinal disease induced by EHEC O157:H7 in mice, which may be a promising probiotic for disease prevention in animals.

Lowering the Schottky barrier height of G/WSSe van der Waals heterostructures by changing the interlayer coupling and applying external biaxial strain.

Graphene-based van der Waals (vdW) heterostructures composed of two-dimensional transition metal dichalcogenides (TMDs) and graphene show great potential in the design and manufacture of field effect transistors. However, the Schottky barrier generated by the contact between metal and semiconductor hinders the conduction of electrons, so it is necessary to effectively adjust the Schottky barrier and form a low-resistance Ohmic contact. Based on first-principles calculations, graphene/WSSe (G/WSSe) heterostructures have been established and the corresponding electronic properties have been studied. Firstly, these heterostructures form an n-type Schottky contact with a SBH of 0.35 eV and a p-type Schottky contact with a SBH of 0.66 eV at their respective interfaces. In addition, the Schottky contact can be significantly adjusted by changing the interlayer coupling or applying an external biaxial strain, and an Ohmic contact could also be formed under the biaxial strain. This study not only offers a basic understanding of G/WSSe heterostructures, but also provides a reference for the application of G/WSSe heterostructures in optoelectronic and nanoelectronic devices.

[Oncologic outcomes of early stage cervical cancer performed operation by different laparoscopic surgical procedures: analysis of clinical data from mutiple centers].

Objective: To evaluate the oncologic outcomes of different laparoscopic radical hysterectomy. Methods: From January 2011 to December 2014, the laparoscopic operation cases of cervical cancer at stage Ⅰb1, Ⅰb2, Ⅱa1 and Ⅱa2, including the histologic subtypes of squamous-cell carcinoma, adenocarcinoma and adenosquamous carcinoma, were collected in five clinical centers. The data were divided into two groups according to the surgical procedures, that is, modified laparoscopic-vaginal radical hysterectomy (mLVRH) and total laparoscopic radical hysterectomy (TLRH). The overall survival rate (OS), disease-free survival rate (DFS) at 5 years were retrospectively analyzed in this study. Results: There were 674 cases in total, including 377 cases of mLVRH, 297 cases of TLRH. (1) The OS at 5 years: the mLVRH was 96.1% and the TLRH was 92.0%, and the mLVRH was higher than that of TLRH （P=0.010）. Stratify analysis， including stage of disease （Ⅰb1 and Ⅱa1）， histologic subtypes （squamous-cell carcinoma, adenocarcinoma）， lymph node metastasis， revealed that, ① Stage of disease: in stage Ⅰb1, the OS at five years of mLVRH was higher than that in TLRH group （98.6% vs 93.6%, P=0.012）. In stage Ⅱa1, there was significant difference between the two groups, the OS at five years of mLVRH and TLRH were 93.6% and 77.6% （P=0.007）. ② Histologic subtypes: for the OS at five years of squamous-cell carcinoma, mLVRH and TLRH were 96.1% and 92.3%, and there was significant difference （P=0.046）； for adenocarcinoma, the OS at five years were 91.0% and 88.6%， and there was no difference between two groups （P=0.230）. ③ Lymph node metastasis： the mLVRH and TLRH with lymph node metastasis, the OS at five years were 98.6% and 96.4%; the mLVRH and TLRH without lymph node metastasis, the OS at five years were 89.3% and 80.8%. There were no significant differences between the two groups,respectively (P=0.156， P=0.093）. (2) The DFS at 5 years: there was no significant difference between mLVRH and TLRH (94.1% vs 90.9%, P=0.220). Stratify analysis for stage of disease, the mLVRH group was higher than that in the TLRH group in stage Ⅰb1 (97.0% vs 92.8%, P=0.039). However, for stage Ⅱa1, there was no significant difference between mLVRH and TLRH group （88.2% vs 75.8%, P=0.074）. Conclusions: The results of this retrospective study indicated that different laparoscopy surgical procedures had diverse oncologic outcomes. The OS at 5 years of the mLVRH is superior to the TLRH. The DFS at 5 years in Ⅰb1 stage, the mLVRH is higher than the TLRH. Therefore, the modified laparoscopy is still an alternative surgery for early cervical cancer patients when following the principle of no-tumor-exposure.

[Efficacy of minimally invasive pulmonary surfactant administration in preterm infants with neonatal respiratory distress syndrome: a multicenter clinical trial].

Objective: To explore the feasibility and safety of minimally invasive surfactant administration (MISA) in preterm neonates with respiratory distress syndrome (NRDS). Methods: In this multicenter prospective randomized controlled trial, 92 preterm infants with gestation age ≤30 weeks and diagnosed with NRDS were enrolled in 8 level Ⅲ neonatal intensive care units (NICU) in Beijing-Tianjin-Hebei Region from 1(st) July 2017 to 31(st) December 2018. They were randomly assigned to minimally invasive surfactant administration (MISA) group or endotracheal intubation surfactant administration (EISA) group according to random number generated by computer. Infants in both groups received calf pulmonary surfactant preparation at a dose of 70-100 mg/kg. The data of demography, perinatal situation, medication administration, complications, clinical outcomes in the two groups were compared with Chi-square test, Student's t-test, Mann-Whitney U test or Fisher's exact test. Results: Among the 92 preterm infants, 53 were males, 39 were females; 47 were in the MISA group (25 males), and 45 were in the EISA group (28 males). The gestational age and birth weight were (29.5±1.2) weeks and (1 271±242) g in all patients, (29.5±1.4) weeks and (1 285±256) g in the MISA group, and (29.6±0.9) weeks and (1 255±227) g in the EISA group. The duration of surfactant infusion and the length of whole procedure in the MISA group were significantly longer than that in the EISA group (60 (18, 270) s vs. 50 (30, 60) s, Z=3.009, P=0.003; 90 (60, 300) s vs. 60 (44, 270) s, Z=3.365, P=0.001). For the outcomes, the incidence of hemodynamically significant patent ductus arteriosus (hsPDA) and bronchopulmonary dysplasia (BPD) were lower in the MISA group than in the EISA group (36% (17/47) vs. 67% (30/45), χ(2)=8.556, P=0.003; 26% (12/47) vs. 47% (21/45), χ(2)=4.464, P=0.035). Conclusions: Minimally invasive surfactant administration is applicable in preterm infants ≤30 weeks gestational age with NRDS. Although the length of whole procedure is longer than route endotracheal administration, the benefit of decreasing the incidences of hsPDA and BPD outweighs this demerit.

Comparison of mRNA expression from Y-chromosome X-degenerate region genes in taurine cattle, yaks and interspecific hybrid bulls.

The yattle (dzo) is an interspecific hybrid of the taurine cattle (Bos taurus) and the domestic yak (Bos grunniens). F1 hybrid yattle bulls are sterile due to spermatogenic arrest and have misregulation of spermatogenesis genes in the testes. However, the expression pattern of Y chromosome-linked genes in cattle, yaks and yattle testes is still unknown. In this study, we analyzed the mRNA expression pattern of 10 genes known to be present as single copies in the X-degenerate region of the bovine male-specific region of the Y chromosome. Using male-specific primers and reverse transcription quantitative PCR, the ubiquitously transcribed tetratricopeptide repeat gene, Y-linked (UTY), oral-facial-digital syndrome 1, Y-linked (OFD1Y) and ubiquitin specific peptidase 9, Y-linked (USP9Y) genes were ubiquitously expressed and significantly more highly expressed in yattle than in cattle and yaks testes (P < 0.001). RNA binding motif protein, Y-linked (RBMY) had testes-specific expression, and eukaryotic translation initiation factor 1A, Y-linked (EIF1AY) was expressed mainly in testis, whereas yattle and cattle did not show significant differences with respect to the expression of RBMY and EIF1AY. Thus, based on the model of yattle bull sterility, the high expression of UTY, OFD1Y and USP9Y may be associated with yattle infertility.

Topological all-optical logic gates based on two-dimensional photonic crystals.

In this work, we report the design of topological filter and all-optical logic gates based on two-dimensional photonic crystals with robust edge states. All major logic gates, including OR, AND, NOT, NOR, XOR, XNOR, and NAND, are suitably designed by using the linear interference approach. Moreover, numerical simulations show that our designed all-optical logic devices can always work well even if significant disorders exist. It is expected that such robust and compact logic devices have potential applications in future photonic integrated circuits.

Strong terahertz magneto-optical phenomena based on quasi-bound states in the continuum and Fano resonances.

We propose new ways to produce strong terahertz (THz) magneto-optical phenomena from monolayer graphene based on bound states in the continuum (BICs) and Fano resonances. The BICs and Fano resonances of radiation modes in the monolayer graphene are realized by designing the photonic crystal slab-graphene-slab structure. Based on them, the magnetic circular dichroism near 100% has been achieved. Importantly, such magneto-optical phenomena can be modulated in intensity and frequency using only electrostatic doping at a fixed magnetic field. Comparing two ways to produce magneto-optical phenomena, it is found that the way based on BICs exhibits some advantages such as good electrical tenability due to narrower resonance width, higher conversion efficiency and more stability with the change of incident angle. These phenomena can appear in a broad THz range by designing the nanostructures, which are very beneficial to polarization conversion and optoelectronic devices.

Type-II InSe/ g-C3N4 Heterostructure as a High-Efficiency Oxygen Evolution Reaction Catalyst for Photoelectrochemical Water Splitting.

We propose a conceptual design of InSe/ g-C3N4 van der Waals heterostructure to achieve highly efficient and spontaneous water splitting. InSe/ g-C3N4 possesses a direct band gap of 2.04 eV with type-II band alignment, which is beneficial to the separation of electrons and holes and exhibits proper valence and conduction-band positions for the redox reactions of H2O. In addition, the adsorption of multiple water molecules and the changes of free energy on InSe/ g-C3N4 have been calculated to understand the oxygen evolution reaction (OER) process of water splitting. The free energies of reaction on three sides are all downhill, and the values of Δ G reduce to about -0.406 eV, indicating that the OER of water splitting is a thermodynamically permissible reaction without the aid of any other substance. Therefore, the water-splitting reaction could be thermodynamically continued using InSe/ g-C3N4 as a photocatalyst, which indicates that InSe/ g-C3N4 is an excellent candidate for photocatalyst or photoelectronic applications.

Effect of hydroxyselenomethionine on lactation performance, blood profiles, and transfer efficiency in early-lactating dairy cows.

The current study investigated the effects of hydroxyselenomethionine (HMBSe), a novel organic selenium (Se) additive, on lactation performance, blood profiles, antioxidative status, and transfer efficiency of Se in early-lactation dairy cows. Sixty multiparous early-lactating dairy cows with similar days in milk (57 d; standard deviation = 9.9) and milk yield (36.5 kg/d; standard deviation = 1.42) were fed a basal diet containing 0.04 mg of Se/kg (dry matter basis). These cows were assigned to 1 of 4 groups following a randomized complete block design as follows: control (basal diet) or HMBSe addition (0.1, 0.3, or 0.5 mg of Se/kg of dry matter). The experiment lasted for 13 wk, with the first week as adaptation. The results showed that milk yields (raw, protein, and lactose) and feed efficiency were improved in a quadratic manner following increased dietary HMBSe addition, whereas energy-corrected milk, 4% fat-corrected milk, and total solid yields tended to be enhanced quadratically. In terms of whole-blood variables, red blood cell and white blood cell levels were increased quadratically, whereas hemoglobin concentration increased linearly with increased HMBSe addition. Plasma nonesterified fatty acid concentrations tended to increase linearly along with HMBSe addition. Plasma superoxide dismutase activity increased quadratically with increased HMBSe addition. The total antioxidant capacity in plasma tended to improve quadratically when cows were fed more HMBSe. Moreover, plasma malondialdehyde concentrations of dairy cows tended to decrease in a quadratic manner when dietary HMBSe increased. The Se concentrations in milk, plasma, and milk/plasma ratio increased linearly following increased HMBSe addition. In conclusion, HMBSe improved lactation performance, health status, and milk Se concentrations in early-lactating dairy cows.

[Effects of intrathecal transient receptor potential vanilloid 1 blocker on cervical distension induced visceral pain response].

Objective: With the aid of an acute visceral pain model of uterine cervical distension (UCD), the present study aimed to observe the effects of intrathecal administration of transient receptor potential vanilloid 1 (TRPV1) antagonist SB-366791 on UCD induced-visceral nociception as well as its involved molecular mechanisms. Methods: A total of 30 Sprague-Dawley-derived adult virgin female rats were used. UCD model was established under isoflurane inhalation anesthesia. Briefly, a lower abdominal incision at midline was made to expose the uteral cervix, two metal rods were inserted through both sides of the cervix separately, one rod was fixed and the other one was connected to a pulley system with application of manual weighted traction (0, 25, 50, 75 or 100 g) for simulating 1 h of cervical distension. In addition, 12 Sprague-Dawley-derived adult virgin female rats were subjected to intrathecal catheter implantation, and UCD was established 7 days later. The rats were divided randomly into two groups; one group was administrated with intrathecal SB-366791 while the other was administrated with the same volume of saline as control. The 75 g distension force was then applied for an hour and the electromyographic (EMG) of musculus rectus abdominis, heart rate as well as respiratory frequency were measured continuously during the surgery. The spinal cord (T(12)-L(2)) was collected 30 minutes after UCD for the detection of changes of c-FOS and TRPV1 expression. Results: UCD increased EMG activity (P<0.05) and c-FOS expression (P<0.05) in the deep dorsal horn region and central canal of the spinal cord (T(12)-L(2)) in a stimuli-dependent manner, the expression of TRPV1 in the T(12)-L(2) spinal cord also increased in response to UCD stimulation (P<0.05). Compared with the saline group, intrathecal SB-366791 significantly decreased EMG activity (P<0.05) as well as spinal c-FOS (P<0.05) expression induced by UCD. Conclusions: UCD in rats increases EMG activity of musculus rectus abdominis as well as spinal c-FOS and TRPV1 expression. Intrathecal administration of TRPV1 antagonist SB-366791 significantly decreases the visceral nociception induced by UCD.

[Clinical analysis of 71 cases of anti-N-methyl-D-aspartate receptor encephalitis in children].

Objective: To investigate the clinical features, treatment strategies and long term outcomes of children with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. Methods: The data of clinical features, auxiliary examinations, treatments and prognosis in children with anti-NMDAR encephalitis in Xiangya Hospital of Central South University from March 2014 to October 2017 were collected and retrospectively analyzed. A total of 71 patients were enrolled, including 33 males and 38 females. The youngest age of onset was 4 months old, and the age of onset was (9±4) years. The first-line immunotherapy treatment for anti-NMDAR encephalitis was short course corticosteroid (high-dose impulse therapy and oral maintenance therapy for 1 month in acute period) and (or) immunoglobulin. The clinical evaluation was performed 2 weeks after first-line immunotherapy treatment. The second-line immunotherapy treatment, including rituximab and (or) cyclophosphamide, would be started if the symptoms did not improve significantly and the modified Rankin scale (mRS) score ≥3. All patients were followed up and evaluated for prognosis. T-test, Mann-Whitney U, Chi square test and Fisher's exact probability method were used for comparison between good outcome group and poor outcome group, first-line immunotherapy group and first-line immunotherapy combined with second-line immunotherapy group. Results: The more common clinical manifestations were psychiatric symptoms (n=61, 86%), dyskinesia (n=55, 77%) and convulsions (n=51, 72%). Two cases (3%) had tumors. Electroencephalogram (EEG), cerebro-spinal fluid (CSF) and brain magnetic resonance imaging (MRI) studies were abnormal in 83% (59/71), 39% (27/69) and 38% (27/71) patients, respectively. For the treatment regimens, all the 71 patients underwent first-line immunotherapy, resulting in improvement within 14 days in 40 cases (56%), and 1 case (1%) died. The rest 30 cases (42%) received second-line immunotherapy. The patients were followed up for 5.0-41.8 months, with a median of 19.3 months. At the last follow-up, 49 cases (69%) recovered completely, 15 cases (21%) had mild disability, 6 cases (8%) had severe disability, 1 case (1%) died and 3 cases (4%) had relapse. There were significant differences between the groups with good prognosis and poor prognosis on admission to pediatric intensive care unit (PICU) and consciousness disorder (10/64 vs. 5/7, 39/64 vs. 7/7, P=0.047, 0.004). There were significant differences between first-line immunotherapy group and the first-line combined second-line immunotherapy group on admission to PICU, consciousness disorder, sleep disorder and first mRS score (12% (5/41) vs. 33% (10/30), 44% (18/41) vs. 93% (28/30), 56% (23/41) vs. 90% (27/30), 3 (1-5) vs. 4 (3-5), respectively; χ(2)=4.645, 18.555, 9.560, Z=5.184, P=0.031, <0.01, 0.002, <0.01, respectively). Conclusions: Anti-NMDAR encephalitis can occur in all ages of children. The most common clinical manifestations are psychotic symptoms, dyskinesia and convulsions. Paraneoplastic cases are less common in children. Immunotherapy is effective. The second-line immunotherapy should be given after the failure of first-line therapy (mRS score≥3).

Sodium tanshinone IIA sulfate protects myocardium against paraquat-induced toxicity through activating the Nrf2 signaling pathway in rats.

OBJECTIVE:: To investigate the therapeutic effect and mechanism of sodium tanshinone IIA sulfate (STS) on paraquat (PQ)-induced myocardial injuries in a rat model. METHODS:: Healthy adult Sprague Dawley rats were randomly divided into normal control, PQ, and PQ + STS groups. PQ group was given a single intragastric administration of PQ (80 mg/kg). PQ + STS group was intraperitoneally injected with STS (1 ml/kg) at 30 min following PQ exposure. Rats in control and PQ groups were injected with equal amount of saline. After 12, 24, 48, and 72 h, rats were killed, and the apoptosis of myocardial cells was detected. Myocardial expression of Bax and Bcl-2 was measured. The activity of the nuclear erythroid 2-related factor 2 (Nrf2) pathway was assessed by Western blot. RESULTS:: The apoptotic cells in PQ group were significantly increased in a time-dependent manner compared with the control group ( p < 0.01). The rats in PQ group exhibited significantly lower Bcl-2 expression, but notably higher Bax expression at 12, 24, 48, and 72 h after PQ exposure ( p < 0.05 or 0.01). STS intervention markedly reduced the proportion of apoptotic myocardial cells, increased Bcl-2 expression, and decreased Bax expression at 24, 48, and 72 h after treatment ( p < 0.05 or 0.01). The expression of phosphorylated Nrf2 and heme oxygenase 1 in PQ + STS group was significantly increased compared with PQ and control groups ( p < 0.05 or 0.01). CONCLUSION:: STS effectively inhibits PQ-induced myocardial cell apoptosis in rats via modulating the Nrf2 pathway, suggesting its potential as a promising therapeutic agent for PQ-induced myocardium damage.

[Endemic situation of schistosomiasis in surveillance sites of Tianmen City from 2015 to 2018].

OBJECTIVE: To monitor the change patterns of the endemic situation of schistosomiasis in Tianmen City from 2015 to 2018, so as to provide the evidence for formulating the schistosomiasis control strategy in the city. METHODS: A total of 8 schistosomiasis surveillance sites were assigned in Tianmen City from 2015 to 2018, and the endemic situation of schistosomiasis and the related epidemiological factors were monitored. RESULTS: During the period from 2015 to 2018, a total of 15 983 local person-times and 3 629 mobile populations were detected for schistosomiasis using an indirect hemagglutination test (IHA) in Tianmen City, and the sero-prevalence was 0.88% to 1.44% and 0.96% to 2.39%, respectively; however, no egg-positives were identified. A total of 1 245 herd-times were detected, and no egg-positives were found in bovines. In addition, the areas of snail habitats were 116.69 to 117.23 hm2 and the mean densities of living snails were 0.07 to 0.17 snails/0.1 m2 during the study period; however, no infections were identified in snails. CONCLUSIONS: The endemic situation of schistosomiasis appears low in Tianmen City; however, the factors related to schistosomiasis transmission remain in the city. The integrated strategy with emphasis on the control of infectious sources should be still intensified to consolidate the schistosomiasis control achievements.