Lactylation-driven METTL3-mediated RNA m6A modification promotes immunosuppression of tumor-infiltrating myeloid cells.

Tumor-infiltrating myeloid cells (TIMs) are crucial cell populations involved in tumor immune escape, and their functions are regulated by multiple epigenetic mechanisms. The precise regulation mode of RNA N6-methyladenosine (m6A) modification in controlling TIM function is still poorly understood. Our study revealed that the increased expression of methyltransferase-like 3 (METTL3) in TIMs was correlated with the poor prognosis of colon cancer patients, and myeloid deficiency of METTL3 attenuated tumor growth in mice. METTL3 mediated m6A modification on Jak1 mRNA in TIMs, the m6A-YTHDF1 axis enhanced JAK1 protein translation efficiency and subsequent phosphorylation of STAT3. Lactate accumulated in tumor microenvironment potently induced METTL3 upregulation in TIMs via H3K18 lactylation. Interestingly, we identified two lactylation modification sites in the zinc-finger domain of METTL3, which was essential for METTL3 to capture target RNA. Our results emphasize the importance of lactylation-driven METTL3-mediated RNA m6A modification for promoting the immunosuppressive capacity of TIMs.

Free-space coupled, large-active-area superconducting microstrip single-photon detector for photon-counting time-of-flight imaging.

Numerous applications at the photon-starved regime require a free-space coupling single-photon detector with a large active area, low dark count rate (DCR), and superior time resolutions. Here, we developed a superconducting microstrip single-photon detector (SMSPD), with a large active area of 260 µm in diameter, a DCR of ∼5k c p s, and a low time jitter of ∼171p s, operated at a near-infrared of 1550 nm and a temperature of ∼2.0K. As a demonstration, we applied the detector to a single-pixel galvanometer scanning system and successfully reconstructed the object information in depth and intensity using a time-correlated photon counting technology.

An Arabidopsis pre-RNA processing8a (prp8a) missense allele restores splicing of a subset of mis-spliced mRNAs.

Eukaryotic precursor mRNAs often harbor noncoding introns that must be removed prior to translation. Accurate splicing of precursor messenger RNA depends on placement and assembly of small nuclear ribonucleoprotein (snRNP) sub-complexes of the spliceosome. Yeast (Saccharomyces cerevisiae) studies established a role in splice-site selection for PRE-RNA PROCESSING8 (PRP8), a conserved spliceosome scaffolding protein of the U5 snRNP. However, analogous splice-site selection studies in multicellular eukaryotes are lacking. Such studies are crucial for a comprehensive understanding of alternative splicing, which is extensive in plants and animals but limited in yeast. In this work, we describe an Arabidopsis (Arabidopsis thaliana) prp8a mutant that modulates splice-site selection. We isolated prp8a-14 from a screen for suppressors of pex14-6, which carries a splice-site mutation in the PEROXIN14 (PEX14) peroxisome biogenesis gene. To elucidate Arabidopsis PRP8A function in spliceosome fidelity, we combined prp8a-14 with various pex14 splice-site mutations and monitored the double mutants for physiological and molecular consequences of dysfunctional and functional peroxisomes that correspond to impaired and recovered splicing, respectively. prp8a-14 restored splicing and PEX14 function to alleles with mutations in the exonic guanine of the 5'-splice site but did not restore splicing or function to alleles with mutations in the intronic guanine of 5'- or 3'-splice sites. We used RNA-seq to reveal the systemic impact of prp8a-14 and found hundreds of differentially spliced transcripts and thousands of transcripts with significantly altered levels. Among differentially spliced transcripts, prp8a-14 significantly altered 5'- and 3'-splice-site utilization to favor sites resulting in shorter introns. This study provides a genetic platform for probing splicing in plants and hints at a role for plant PRP8 in splice-site selection.

Millimeter-scale active area superconducting microstrip single-photon detector fabricated by ultraviolet photolithography.

The effective and convenient detection of single photons via advanced detectors with a large active area is becoming significant for quantum and classical applications. This work demonstrates the fabrication of a superconducting microstrip single-photon detector (SMSPD) with a millimeter-scale active area via the use of ultraviolet (UV) photolithography. The performances of NbN SMSPDs with different active areas and strip widths are characterized. SMSPDs fabricated by UV photolithography and electron beam lithography with small active areas are also compared from the aspects of the switching current density and line edge roughness. Furthermore, an SMSPD with an active area of 1 mm × 1 mm is obtained via UV photolithography, and during operation at 0.85 K, it exhibits near-saturated internal detection efficiency at wavelengths up to 800 nm. At a wavelength of 1550 nm, the detector exhibits a system detection efficiency of ∼5% (7%) and a timing jitter of 102 (144) ps, when illuminated with a light spot of ∼18 (600) µm in diameter, respectively.

Experimental Twin-Field Quantum Key Distribution over 1000 km Fiber Distance.

Quantum key distribution (QKD) aims to generate secure private keys shared by two remote parties. With its security being protected by principles of quantum mechanics, some technology challenges remain towards practical application of QKD. The major one is the distance limit, which is caused by the fact that a quantum signal cannot be amplified while the channel loss is exponential with the distance for photon transmission in optical fiber. Here using the 3-intensity sending-or-not-sending protocol with the actively-odd-parity-pairing method, we demonstrate a fiber-based twin-field QKD over 1002 km. In our experiment, we developed a dual-band phase estimation and ultra-low noise superconducting nanowire single-photon detectors to suppress the system noise to around 0.02 Hz. The secure key rate is 9.53×10^{-12} per pulse through 1002 km fiber in the asymptotic regime, and 8.75×10^{-12} per pulse at 952 km considering the finite size effect. Our work constitutes a critical step towards the future large-scale quantum network.

Association between the MCP-1 -2518 A > G (rs1024611) polymorphism and susceptibility to type 2 diabetes mellitus and diabetic nephropathy: a meta-analysis.

BACKGROUND: Studies evaluating the association between monocyte chemoattractant protein-1 (MCP-1) -2518 A > G (rs1024611) polymorphism and type 2 diabetes mellitus (T2DM) and diabetic nephropathy (DN) are contradictory. The present study aims to provide a comprehensive assessment and more reliable estimation of the relationship between the MCP-1 rs1024611 polymorphism and T2DM and DN risk. METHODS: Eligible articles were retrieved from the PubMed, Web of Science, EMBASE, Cochrane, and China National Knowledge Infrastructure databases. The effect summary odds ratios (ORs) and 95% confidence intervals (CIs) were obtained to calculate the summary effect size. Heterogeneity was analyzed by subgroup analysis and meta-regression. Publication bias was tested using funnel plots and Egger's test. RESULTS: In total, sixteen studies were included. Thirteen studies involving 2,363 patients with T2DM and 4,650 healthy controls found no significant association between the MCP-1 rs1024611 polymorphism and T2DM in the overall population. Ethnicity stratification found an association between the GG + GA genotype and decreased T2DM risk in Caucasians (OR = 0.79, 95% CI: 0.66-0.93, P = 0.006; PQ = 0.372). No significant risks were found in the Asian population for any genetic models. Seven studies found an association between the GG + GA genotype and DN risk in the Asian population (OR = 1.37, 95% CI: 1.11-1.71, P = 0.004, PQ = 0.222). No significant risks were found in the Caucasian population with any genetic models. There were no statistically significant differences in genotype distribution between patients with T2DM and DN in Asians or Caucasians. Meta-regression revealed that genotyping method was a major driver of heterogeneity in five genetic models (GG + GA vs. AA: P = 0.032; GG vs. GA + AA: P = 0.028; GG vs. AA: P = 0.035; GG vs. GA: P = 0.041; G vs. A: P = 0.041). CONCLUSION: The MCP-1 rs1024611 polymorphism is associated with susceptibility to T2DM in Caucasians and DN in Asians. Larger, well-designed cohort studies are needed in the future to verify this association.

The XylR/NtrC-type regulator CbsR positively regulates upstream pathway of chlorobenzene degradation in Pandoraea pnomenusa.

AIMS: Pandoraea pnomenusa MCB032 completely degrades chlorobenzene, whose metabolic pathway is encoded by cbs and clc gene clusters. The putative regulatory factors ClcR and CbsR are predicted to regulate the cbs and clc gene clusters. This research aims to understand the function of ClcR and CbsR. METHODS AND RESULTS: RT-PCR analyses demonstrated that the cbsFAaAbAcAdB operon that encodes catabolic pathways for the degradation of chlorobenzene to chlorocatechol is located on an operon. Moreover, the clcABCDE operon is involved in the 3-chlorocatechol pathway. Gene knockout and transcriptional analysis showed that the transcription of the cbsFAaAbAcAdB operon is positively regulated by CbsR, whereas the clcABCDE operon is activated by ClcR. Primer extension analysis was used to locate the transcription start sites of the cbsFAaAbAcAdB and cbsR operons. Electrophoretic mobility shift assay analyses showed that CbsR is bound to the sites in the promoter regions of cbsFAaAbAcAdB and cbsR operons. CONCLUSION: The XylR/NtrC-type regulator CbsR positively regulates the transcription of the cbsFAaAbAcAdB operon encoding the upstream pathway of chlorobenzene catabolism, while the LysR-type regulator ClcR activates the clcABCDE operon encoding the downstream pathway.

Microbial detoxification of 3,5-xylenol via a novel process with sequential methyl oxidation by Rhodococcus sp. CHJ602.

The compound 3,5-xylenol is an essential precursor used in pesticides and industrial intermediate in the disinfectants and preservatives industry. Its widespread application makes it an important source of pollution. Microbial bioremediation is more environmentally friendly than the physicochemical treatment process for removing alkylphenols from a polluted environment. However, the 3,5-xylenol-degrading bacteria is unavailable, and its degradation mechanism remains unclear. Here, a 3,5-xylenol-metabolizing bacterial strain, designated Rhodococcus sp. CHJ602, was isolated using 3,5-xylenol as the sole source of carbon and energy from a wastewater treatment factory. Results showed that strain CHJ602 maintained a high 3,5-xylenol-degrading performance under the conditions of 30.15 °C and pH 7.37. The pathway involved in 3,5-xylenol degradation by strain CHJ602 must be induced by 3,5-xylenol. Based on the identification of intermediate metabolites and enzyme activities, this bacterium could oxidize 3,5-xylenol by a novel metabolic pathway. One methyl oxidation converted 3,5-xylenol to 3-hydroxymethyl-5-methylphenol, 3-hydroxy-5-methyl benzaldehyde, and 3-hydroxy-5-methylbenzoate. After that, another methyl oxidation is converted to 5-hydroxyisophthalicate, which is metabolized by the protocatechuate pathway. It is catalyzed by a series of enzymes in strain CHJ602. In addition, toxicity bioassay result indicates that 3,5-xylenol is toxic to zebrafish and Rhodococcus sp. CHJ602 could eliminate 3,5-xylenol in water to protect zebrafish from its toxicity. The results provide insights into the bioremediation of wastewater contaminated 3,5-xylenol.

High-efficiency broadband fiber-to-chip coupler using a 3D nanoprinting microfiber.

We propose a method for coupling a tapered optical fiber to an inverted tapered SiN waveguide by fabricating a microfiber using 3D nanoprinting lithography. The microfiber consists of three parts: a tapered cladding cap, an S-bend, and a straight part, all composed of high-refractive-index material. Light is adiabatically coupled from the tapered fiber to the printed microfiber through the cladding cap. The light is then transmitted through the S-bend and the straight part with low loss and is finally coupled to the waveguide through the evanescent field. In the simulation, our design can achieve a high coupling efficiency (TE mode) of ∼97% at a wavelength of 1542 nm with a wide bandwidth of ∼768n m at the 1-dB cutoff criterion.

Experiences and perceptions of acute myocardial infarction patients with a prolonged decision-making phase of treatment seeking: A meta-synthesis.

AIMS: To describe the experiences and perceptions of acute myocardial infarction (AMI) patients with a prolonged decision-making phase of treatment-seeking. BACKGROUND: Previous attempts to reduce the treatment-seeking time of AMI have been less than optimal. Due to the coronavirus disease 2019 (COVID-19) pandemic, the situation of prehospital delay is possibly worse. Decisions to seek treatment are influenced by multiple factors and need individualised interventions. Understanding patients' external and internal experiences and psychological perceptions is essential. DESIGN: Meta-synthesis. DATA SOURCES: We searched PubMed, Embase, Cochrane Library, Web of Science, Scopus and four Chinese databases from inception to April 2022. METHODS: We screened the retrieved articles with predetermined inclusion and exclusion criteria, and reviewed articles using Thomas and Harden's (BMC Medical Research Methodology, 2008 8, 45) qualitative thematic synthesis approach. The Joanna Briggs Institute critical appraisal tool for qualitative research was used to assess the quality of studies. RESULTS: Twenty-one studies were included, identifying four themes and nine sub-themes. The four primary themes were difficulty recognising and attributing symptoms, attempt to act, unwillingness to change and self-sacrifice. CONCLUSION: Deciding to seek treatment is a complex social and psychological process, which needs comprehensive interventions considering personal and sociocultural factors and factors related to the COVID-19 pandemic. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Details of interventions for decisions to seek treatment in AMI patients need to be further designed and evaluated. IMPACT: Results would help healthcare professionals to implement individualised management of decision-making of treatment-seeking among AMI patients, and improve medical records of patients' prehospital experiences. REPORTING METHOD: The Preferred Reporting Items for Systematic Reviews 2020 checklist was used to report the findings. PATIENT OR PUBLIC CONTRIBUTION: Two AMI patients contributed to the data synthesis by giving simple feedback about the final themes.

Multi-F-Structured MOF Materials Enhance Nanogenerator Output Performance for Corrosion Protection of Metallic Materials.

MOF (metal organic framework) materials have been used as functional materials in a number of fields due to their diverse spatial tunability, which produces rich porous structures with stable and continuous pores and a high specific surface area. A triboelectric nanogenerator can convert trace mechanical energy into electrical energy, and the application of MOF materials to triboelectric nanogenerators has been intensively studied. In this work, we report on two MOFs with similar spatial structures, and the modulation of the end microstructures was achieved using the difference in F content. The output performance of friction power generation increases with the increase in F content, and the obtained polyacidic ligand materials can be used to construct self-powered corrosion protection systems, which can effectively protect metallic materials from corrosion.

Global research trends of immunotherapy and biotherapy for inflammatory bowel disease: a bibliometric analysis from 2002 to 2021.

BACKGROUND: It is known that inflammatory bowel disease is the result of a defective immune system, and immunotherapy and biological therapy have gradually become important means to treat it. This paper focused on the bibliometric statistical analysis of the current research progress to summarize the research status of this field and analyze the research trends in recent years. METHODS: Two visualization tools, CiteSpace and VOSviewer, were used to explore the data of journals, institutions, countries/regions, authors, references, and keywords for the literature included in the Web of Science Core Collection from January 1, 2002, to December 31, 2021. RESULTS: A total of 312 papers were published in 120 journals by 603 institutions from 40 countries/regions, with 9463 co-cited references. The United States has the most publications with the highest total citations in the world. Inflammatory Bowel Diseases published the maximum number of papers, and Gastroenterology devoted the most co-citations to immunotherapy and biological therapy for IBD. In addition, we found that the studies before 2009 mostly focused on clinical trials while researchers have paid more attention to clinical management in therapy for IBD since 2009. Combination therapy and management of the treatment for the disease have become research hotspots. CONCLUSION: The focus of immunotherapy and biotherapy for IBD has shifted from clinical trials to the management of the risks and benefits of immunotherapy.

Benzophenone-3 breaches mouse Sertoli cell barrier and alters F-actin organization without evoking apoptosis.

Benzophenone-3 (BP-3), one of the most commonly utilized ultraviolet filters in personal care products, has aroused public concern in recent years for its high chances of human exposure. Previous studies have found that BP-3 can impair testes development and spermatogenesis, but the targets of BP-3 are still unknown. In this study, primary Sertoli cells from 20-day-old mice were treated in vitro with 0-100 µM BP-3 for 24 h to identify its toxicity on Sertoli cells and Sertoli cell barrier. Results demonstrated that BP-3 could induce a notable change in cell morphology and impair Sertoli cell viability. The analysis of transepithelial electrical resistance showed that the integrity of the Sertoli cell barrier was destroyed by BP-3 (100 µM). Some structural proteins of the barrier including ZO-1, Occludin, and Connexin43 were lower expressed and the localization of basal ectoplasmic specializations protein ß-catenin was altered because of BP-3 treatment. Further exploration suggested that BP-3 led to Sertoli cell F-actin disorganization by affecting the expression of Rictor, a key component of the mTORC2 complex. Moreover, although increased DNA damage marker γH2A.X was observed in the treatment group, the cell apoptosis rate was changeless which was further confirmed by increased BAX and stable Bcl-2 (two primary apoptosis regulating proteins). In conclusion, this study revealed that BP-3 had the potential to perturb the Sertoli cell barrier through altered junction proteins and disorganized F-actin, but it could hardly evoke Sertoli cell apoptosis.

Mechanisms and strategies to overcome immunotherapy resistance in hepatobiliary malignancies.

Unprecedented advances have been achieved in hepatobiliary cancer treatment with immune checkpoint blockade (ICB). However, the efficacy of ICB in patients with hepatobiliary malignancies is still limited. Resistance to immunotherapies is often orchestrated by complicated tumor-host-microenvironment interactions but could also occur after initial efficacy, mostly when only partial responses are obtained. Clarification of cancer-resistance mechanisms will be beneficial to provide the rationale for the administration of personalized drugs. Here, we review the factors related to resistance to immune-targeted therapies in hepatobiliary malignancies and discuss the potential strategies for overcoming resistance and future directions of immunotherapy development.

Sixteen-channel fiber array-coupled superconducting single-photon detector array with average system detection efficiency over 60% at telecom wavelength.

We report a compact, scalable, and high-performance superconducting nanowire single-photon detector (SNSPD) array by using a multichannel optical fiber array-coupled configuration. For single pixels with an active area of 18 µm in diameter and illuminated at the telecom wavelength of 1550 nm, we achieved a pixel yield of 13/16 on one chip, an average system detection efficiency of 69% at a dark count rate of 160 cps, a minimum timing jitter of 74 ps, and a maximum count rate of ∼40Mcps. The optical crosstalk coefficient between adjacent channels is better than -60dB. The performance of the fiber array-coupled detectors is comparable with a standalone detector coupled to a single fiber. Our method is promising for the development of scalable, high-performance, and high-yield SNSPDs.

pH-Controlled Assembly of Two Polynuclear Dy(III)-Containing Polytungstoarsenates with Magnetic and Luminescence Properties.

Two novel polynuclear dysprosium (Dy)-containing polytungstoarsenates, CsK7Na16[(AsW9O33)6Dy6W10O24(H2O)23]·40H2O (1) and Cs2K18Na18[(AsW9O33)7Dy7W8O21(H2O)17(µ3-OH)(OH)]·78H2O (2), have been synthesized via the reaction of the preformed polyoxometalate (POM) precursor [As2W19O67(H2O)]14- and Dy3+ ions through controlling pH. The polyanion of 1 can be described as a dimer of two similar trimers {(AsW9O33)3Dy2W5O12(H2O)6} that are linked by Dy cation and two µ2-oxo groups, and the Dy(III) ions in 1 are arranged in a linear fashion. Compound 2 presenting an interesting W-shaped structure, assembly composed of a dimeric {(AsW9O33)2W3Dy2O8(H2O)7}, a trimer {(AsW9O33)3W4Dy2O11(OH)(H2O)3}, and a particular sandwiched {(AsW9O33)2WDy3O4(µ3-OH)(H2O)7} segment concatenated by µ2-oxo groups. The solid-state luminescence performances and lifetime decay behaviors of 1 and 2 were systematically researched at ambient temperature, and time-resolved fluorescence spectra of 1 and 2 indicate energy transfer (ET) from the photoexcitation O → M ligand to the metal charge-transfer (LMCT) bands of the POM ligands to Dy3+ ions. Moreover, the dynamic magnetic measurement indicates that 1 and 2 exhibit slow relaxation of the magnetization.

Ribonucleic Acid Export 1 Is a Kinetochore-Associated Protein That Participates in Chromosome Alignment in Mouse Oocytes.

Ribonucleic acid export 1 (Rae1) is an important nucleoporin that participates in mRNA export during the interphase of higher eukaryotes and regulates the mitotic cell cycle. In this study, small RNA interference technology was used to knockdown Rae1, and immunofluorescence, immunoblotting, and chromosome spreading were used to study the role of Rae1 in mouse oocyte meiotic maturation. We found that Rae1 is a crucial regulator of meiotic maturation of mouse oocytes. After the resumption of meiosis (GVBD), Rae1 was concentrated on the kinetochore structure. The knockdown of Rae1 by a specific siRNA inhibited GVBD progression at 2 h, finally leading to a decreased 14 h polar body extrusion (PBE) rate. However, a comparable 14 h PBE rate was found in the control, and the Rae1 knockdown groups that had already undergone GVBD. Furthermore, we found elevated PBE after 9.5 h in the Rae1 knockdown oocytes. Further analysis revealed that Rae1 depletion significantly decreased the protein level of securin. In addition, we detected weakened kinetochore-microtubule (K-MT) attachments, misaligned chromosomes, and an increased incidence of aneuploidy in the Rae1 knockdown oocytes. Collectively, we propose that Rae1 modulates securin protein levels, which contribute to chromosome alignment, K-MT attachments, and aneuploidy in meiosis.

Spatial Distribution and Environmental Risk of Arsenic and Antimony in Soil Around an Antimony Smelter of Qinglong County.

The purpose of this study was to investigate the distribution of arsenic (As) and antimony (Sb) in soils around an antimony smelter at Qinglong together with the soil pollution levels and potential ecological risk. The results show that (1) total concentrations of As (23 ~ 539 mg/kg) and Sb (19.7 ~ 5681 mg kg-1) were higher than the Guizhou province-level background values (As, 20; Sb, 2.24), especially Sb. Their dominant geochemical speciation was the residual fraction which accounted for > 90% of the total concentrations. (2) The distribution of As and Sb in soils influenced mainly by land-use type, altitude, predominant wind direction, and distance from the pollution source. (3) The geo-accumulation index shows that the soil was highly contaminated with Sb and moderately with As. The potential ecological risk index shows that As posed a moderate risk and Sb a high risk. The general ecological risk was classified as high risk. However, the risk index coding method shows low environmental risk from As and Sb.

Promoting bidirectional extracellular electron transfer of Shewanella oneidensis MR-1 for hexavalent chromium reduction via elevating intracellular cAMP level.

The bioreduction capacity of Cr(VI) by Shewanella is mainly governed by its bidirectional extracellular electron transfer (EET). However, the low bidirectional EET efficiency restricts its wider applications in remediation of the environments contaminated by Cr(VI). Cyclic adenosine 3',5'-monophosphate (cAMP) commonly exists in Shewanella strains and cAMP-cyclic adenosine 3',5'-monophosphate receptor protein (CRP) system regulates multiple bidirectional EET-related pathways. This inspires us to strengthen the bidirectional EET through elevating the intracellular cAMP level in Shewanella strains. In this study, an exogenous gene encoding adenylate cyclase from the soil bacterium Beggiatoa sp. PS is functionally expressed in Shewanella oneidensis MR-1 (the strain MR-1/pbPAC) and a MR-1 mutant lacking all endogenous adenylate cyclase encoding genes (the strain Δca/pbPAC). The engineered strains exhibit the enhanced bidirectional EET capacities in microbial electrochemical systems compared with their counterparts. Meanwhile, a three times more rapid reduction rate of Cr(VI) is achieved by the strain MR-1/pbPAC than the control in batch experiments. Furthermore, a higher Cr(VI) reduction efficiency is also achieved by the strain MR-1/pbPAC in the Cr(VI)-reducing biocathode experiments. Such a bidirectional enhancement is attributed to the improved production of cAMP-CRP complex, which upregulates the expression levels of the genes encoding the c-type cytochromes and flavins synthetic pathways. Specially, this strategy could be used as a broad-spectrum approach for the other Shewanella strains. Our results demonstrate that elevating the intracellular cAMP levels could be an efficient strategy to enhance the bidirectional EET of Shewanella strains and improve their pollutant transformation capacity.

[Vasovagal syncope or postural orthostatic tachycardia syndrome in children with neurological symptoms at disease onset: a clinical analysis of 88 cases].

OBJECTIVE: To study the clinical features of vasovagal syncope (VVS) and postural orthostatic tachycardia syndrome (POTS) in children with neurological symptoms at disease onset. METHODS: A retrospective analysis was performed on the medical data of 88 children with the initial symptoms of the nervous system, such as transient loss of consciousness, dizziness, headache, and convulsion, who were finally diagnosed with VVS or POTS. RESULTS: Of the 88 children, there were 35 boys (40%) and 53 girls (60%), with an age of 4-15 years. The peak age of onset was between 10 and 13 years. All the children had the initial symptoms of transient loss of consciousness, dizziness, headache, and convulsion. Nervous system diseases were excluded by electroencephalography, cerebrospinal fluid examination, and cranial MRI. Of the 88 children, 53 (60%) were confirmed with VVS, and 35 (40%) with POTS, according to the results of head-up tilt test (HUTT). Five children with the initial symptom of transient loss of consciousness were misdiagnosed with epilepsy. Predisposing factors were determined for 59 children (67%), and prolonged standing was the most common factor, followed by change in body position and strenuous exercise. Premonitory symptoms were observed in 66 children (75%), among which chest discomfort was the most common symptom, followed by gastrointestinal symptoms (nausea, vomiting, and abdominal pain) and pale complexion. All 88 children received health education and exercise for autonomic nerve function, among whom 53 children with VVS were given oral rehydration salts and 35 children with POTS were given oral rehydration salts and metoprolol. All 88 children were followed up for 18 months, and the response rates to the above treatment at 3, 6, 12, and 18 months of follow-up were 87%, 93%, 93%, and 90% respectively. CONCLUSIONS: In addition to nervous system diseases, functional cardiovascular diseases including VVS and POTS should be considered for children with the initial symptoms of transient loss of consciousness, dizziness, headache, and convulsion. HUTT can be used to make a confirmed diagnosis, and the early treatment can achieve a good outcome.