Automatic detection of epilepsy from EEGs using a temporal convolutional network with a self-attention layer.

BACKGROUND: Over 60% of epilepsy patients globally are children, whose early diagnosis and treatment are critical for their development and can substantially reduce the disease's burden on both families and society. Numerous algorithms for automated epilepsy detection from EEGs have been proposed. Yet, the occurrence of epileptic seizures during an EEG exam cannot always be guaranteed in clinical practice. Models that exclusively use seizure EEGs for detection risk artificially enhanced performance metrics. Therefore, there is a pressing need for a universally applicable model that can perform automatic epilepsy detection in a variety of complex real-world scenarios. METHOD: To address this problem, we have devised a novel technique employing a temporal convolutional neural network with self-attention (TCN-SA). Our model comprises two primary components: a TCN for extracting time-variant features from EEG signals, followed by a self-attention (SA) layer that assigns importance to these features. By focusing on key features, our model achieves heightened classification accuracy for epilepsy detection. RESULTS: The efficacy of our model was validated on a pediatric epilepsy dataset we collected and on the Bonn dataset, attaining accuracies of 95.50% on our dataset, and 97.37% (A v. E), and 93.50% (B vs E), respectively. When compared with other deep learning architectures (temporal convolutional neural network, self-attention network, and standardized convolutional neural network) using the same datasets, our TCN-SA model demonstrated superior performance in the automated detection of epilepsy. CONCLUSION: The proven effectiveness of the TCN-SA approach substantiates its potential as a valuable tool for the automated detection of epilepsy, offering significant benefits in diverse and complex real-world clinical settings.

Comparative Analysis of Complete Chloroplast Genomes of Rubus in China: Hypervariable Regions and Phylogenetic Relationships.

With more than 200 species of native Rubus, China is considered a center of diversity for this genus. Due to a paucity of molecular markers, the phylogenetic relationships for this genus are poorly understood. In this study, we sequenced and assembled the plastomes of 22 out of 204 Chinese Rubus species (including varieties) from three of the eight sections reported in China, i.e., the sections Chamaebatus, Idaeobatus, and Malachobatus. Plastomes were annotated and comparatively analyzed with the inclusion of two published plastomes. The plastomes of all 24 Rubus species were composed of a large single-copy region (LSC), a small single-copy region (SSC), and a pair of inverted repeat regions (IRs), and ranged in length from 155,464 to 156,506 bp. We identified 112 unique genes, including 79 protein-coding genes, 29 transfer RNAs, and four ribosomal RNAs. With highly consistent gene order, these Rubus plastomes showed strong collinearity, and no significant changes in IR boundaries were noted. Nine divergent hotspots were identified based on nucleotide polymorphism analysis: trnH-psbA, trnK-rps16, rps16-trnQ-psbK, petN-psbM, trnT-trnL, petA-psbJ, rpl16 intron, ndhF-trnL, and ycf1. Based on whole plastome sequences, we obtained a clearer phylogenetic understanding of these Rubus species. All sampled Rubus species formed a monophyletic group; however, sections Idaeobatus and Malachobatus were polyphyletic. These data and analyses demonstrate the phylogenetic utility of plastomes for systematic research within Rubus.

Enhanced Antibacterial and Wound Healing Using a Metal-Organic Cluster Inspired by Artificial Photosynthesis.

Bacterial infection poses a constant threat to human health. It is crucial to develop cost-effective and multifunctional solutions to combat bacteria. In this study, inspiration has been taken from artificial photosynthesis and a hydrogel containing a photocatalytic metal-organic cluster (MOC) has been creatively formulated for wound healing and antibacterial purposes. Complete photocatalytic cycles have been achieved by combining the oxidative Ti-center and the reductive Cu-center, in which reactive oxygen species (1 O2 and ·OH) have been generated. The MOC has the capability to eliminate Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) at a concentration of 40 µg mL-1 . In addition, the hydrogel formulation (H-MOC) has been applied to wounds infected with S. aureus, resulting in improved healing efficiency. This work presents an innovative approach to utilizing photocatalytic biomaterials as non-antibiotic medications.

LncRNA HAGLR silencing inhibits IL-1ß-induced chondrocytes inflammatory injury via miR-130a-3p/JAK1 axis.

BACKGROUND: Osteoarthritis (OA), the most common form of arthritis, is accompanied by destruction of articular cartilage, development of osteophyte and sclerosis of subchondral bone. This study aims to explore whether lncRNA HAGLR can play a role in OA, and further clarify the potential mechanism. MATERIAL AND METHODS: StarBase and luciferase reporter assay were applied for predicting and confirming the interaction between lncRNA HAGLR, miR-130a-3p and JAK1. The levels of lncRNA HAGLR and miR-130a-3p were analyzed using quantitative reverse transcription PCR (qRT-PCR). The proliferation, cytotoxicity and apoptosis of CHON-001 cells were evaluated by MTT, lactate dehydrogenase assay (LDH) and Flow cytometry (FCM) analysis, respectively. Moreover, expression of cleaved Caspase3 protein were determined by Western blot assay. The release of inflammatory factors (TNF-α, IL-8, and IL-6) was detected by ELISA. RESULTS: lncRNA HAGLR directly targets miR-130a-3p. Level of lncRNA HAGLR was substantially higher and miR-130a-3p level was memorably lower in IL-1ß stimulated CHON-001 cells than that in Control group. Furthermore, lncRNA HAGLR silencing alleviated IL-1ß induce chondrocyte inflammatory injury, as evidenced by increased cell viability, reduced LDH release, decreased apoptotic cells, inhibited cleaved-Caspase3 expression, and reduced secretion of secretion of inflammatory factors. However, miR-130a-3p-inhibitor reversed these findings. We also found miR-130a-3p directly targeted JAK1 and negatively regulated JAK1 expression in CHON-001 cells. In addition, JAK1-plasmid reversed the effects of miR-130a-3p mimic on IL-1ß-induced chondrocytes inflammatory injury. CONCLUSION: Silencing of lncRNA HAGLR alleviated IL-1ß-stimulated CHON-001 cells injury through miR-130a-3p/JAK1 axis, revealing lncRNA HAGLR may be a valuable therapeutic target for OA therapy.

Neural Modeling of Portrait Bas-Relief From a Single Photograph.

In this paper, we present an end-to-end neural solution to model portrait bas-relief from a single photograph, which is cast as a problem of image-to-depth translation. The main challenge is the lack of bas-relief data for network training. To solve this problem, we propose a semi-automatic pipeline to synthesize bas-relief samples. The main idea is to first construct normal maps from photos, and then generate bas-relief samples by reconstructing pixel-wise depths. In total, our synthetic dataset contains 23 k pixel-wise photo/bas-relief pairs. Since the process of bas-relief synthesis requires a certain amount of user interactions, we propose end-to-end solutions with various network architectures, and train them on the synthetic data. We select the one that gave the best results through qualitative and quantitative comparisons. Experiments on numerous portrait photos, comparisons with state-of-the-art methods and evaluations by artists have proven the effectiveness and efficiency of the selected network.

Circ_0067835 Knockdown Enhances the Radiosensitivity of Colorectal Cancer by miR-296-5p/IGF1R Axis.

BACKGROUND: Colorectal cancer (CRC) is one of the most common malignant cancers globally. Circular RNAs (circRNAs) have been implicated in the development of CRC. In this paper, we set to explore the precise action of circ_0067835 in CRC progression and radioresistance. METHODS: Quantitative real-time polymerase chain reaction (qRT-PCR) was used to evaluate the expression of circ_0067835, microRNA-296-5p (miR-296-5p) and insulin-like growth factor 1 receptor (IGF1R). Western blot was used to measure the level of IGF1R protein. Cell proliferation, cell cycle distribution and apoptosis were determined by Cell Counting Kit-8 (CCK-8), colony formation, flow cytometry and caspase-3 activity assays, respectively. The direct relationship between miR-296-5p and circ_0067835 or IGF1R was verified by dual-luciferase reporter assays. Additionally, in vivo assays were applied to confirm the role of circ_0067835 in vivo. RESULTS: Exosomal circ_0067835 was upregulated in the serum of CRC patients after radiotherapy. Exosome-mediated circ_0067835 knockdown repressed cell proliferation, cell cycle progression, and enhanced cell apoptosis and radiosensitivity in vitro. Circ_0067835 sponged miR-296-5p to regulate IGF1R expression in CRC cells. Moreover, the knockdown of circ_0067835 regulated CRC cell behaviors by up-regulating miR-296-5p and down-regulating IGF1R in vitro. Furthermore, circ_0067835 knockdown diminished tumor growth and promoted cell radiosensitivity in vivo. CONCLUSION: Circ_0067835 knockdown suppressed CRC progression and enhanced CRC cell radiosensitivity partially by the miR-296-5p/IGF1R axis. The findings established a rationale that targeting circ_0067835 might be a promising point for improving CRC treatment.

Dual-target Inhibitors Based on BRD4: Novel Therapeutic Approaches for Cancer.

BACKGROUND: Currently, cancer continues being a dramatically increasing and serious threat to public health. Although many anti-tumor agents have been developed in recent years, the survival rate of patients is not satisfactory. The poor prognosis of cancer patients is closely related to the occurrence of drug resistance. Therefore, it is urgent to develop new strategies for cancer treatment. Multi-target therapies aim to have additive or synergistic effects and reduce the potential for the development of resistance by integrating different pharmacophores into a single drug molecule. Given the fact that majority of diseases are multifactorial in nature, multi-target therapies are being exploited with increasing intensity, which has brought improved outcomes in disease models and obtained several compounds that have entered clinical trials. Thus, it is potential to utilize this strategy for the treatment of BRD4 related cancers. This review focuses on the recent research advances of dual-target inhibitors based on BRD4 in the aspect of anti-tumor. METHODS: We have searched the recent literatures about BRD4 inhibitors from the online resources and databases, such as pubmed, elsevier and google scholar. RESULTS: In the recent years, many efforts have been taken to develop dual-target inhibitors based on BRD4 as anti-cancer agents, such as HDAC/BRD4 dual inhibitors, PLK1/BRD4 dual inhibitors and PI3K/BRD4 dual inhibitors and so on. Most compounds display good anti-tumor activities. CONCLUSION: Developing new anti-cancer agents with new scaffolds and high efficiency is a big challenge for researchers. Dual-target inhibitors based on BRD4 are a class of important bioactive compounds. Making structural modifications on the active dual-target inhibitors according to the corresponding structure-activity relationships is of benefit to obtain more potent anti-cancer leads or clinical drugs. This review will be useful for further development of new dual-target inhibitors based on BRD4 as anti-cancer agents.

A novel anatomically pre-contoured side-specific titanium plate versus the reconstruction plate for quadrilateral plate fractures of the acetabulum: a propensity-matched cohort study.

BACKGROUND: Surgical treatment of acetabular fractures involving a quadrilateral plate is a challenge to orthopedic surgeons. We have developed a novel fixation technique using a specially shaped reconstruction plate combined with several buttress screws of a quadrilateral plate which was also called a dynamic anterior plate-screw system for quadrilateral plate (DAPSQ) to treat acetabular fractures involving quadrilateral plate since 2005 (RP group). And the long-term follow-up results have confirmed the effectiveness and safety of this technique. After 2016, standardized titanium plate (STP group) of DAPSQ have been designed and applied. The aim of the study was to compare the clinical efficacy of anatomical plate and the reconstruction plate of DAPSQ in the treatment of quadrilateral plate fractures. METHODS: We led a propensity-matched cohort study of quadrilateral plate fractures. Twenty-two patients were included in the STP group during the inclusion period (2016-2018) and were matched to 22 cases in our database of the RP group (2008-2016). The primary outcome measures were the quality of reduction and functional outcomes. Intraoperative conditions were also compared. RESULTS: Of these 22 consecutive patients in the STP group, the mean age was 46.7 years and the most common fracture pattern was a both-column fracture (12 cases, 54.5%) according to Letournel-Judet classification. The mean follow-up period was 23.1 months (range 12-37). There were no significant differences between the two groups with regard to the quality of reduction using the Matta radiological criteria and functional outcomes evaluated by the modified Merle d'Aubigné score (P > 0.05). Compared with the RP group, the STP group had a shorter operation time (245.1 min vs. 286.8 min, P = 0.020), less intraoperative blood loss (1136.4 mL vs. 1777.3 mL, P = 0.014), and transfusion (780.9 vs. 1256.8 mL, P = 0.035). The complication rate was 18.2% in the STP group, and there was no significant difference compared with the RP group (36.4%) (P > 0.05). None of the cases in the two groups had quadrilateral screws entering the hip or implant failure. CONCLUSIONS: The fixation of standardized titanium plate in quadrilateral plate fractures showed a similar result to the reconstruction plate, in terms of quality of reduction and functional outcome. The standardized titanium plate of DAPSQ has the advantages of a short operation time, less intraoperative bleeding, and blood transfusion, and it is worth further promotion and research.

Single Ilioinguinal Approach to Treat Complex Acetabular Fractures with Quadrilateral Plate Involvement: Outcomes Using a Novel Dynamic Anterior Plate-Screw System.

OBJECTIVES: To evaluate the efficacy and safety of a novel fixation technique referred to as the dynamic anterior plate-screw system for quadrilateral plate (DAPSQ) for complex acetabular fractures with quadrilateral plate involvement through the single ilioinguinal approach. METHODS: A total of 32 patients with acetabular fractures, selected between January 2009 and March 2016, were managed by DAPSQ with "quadrilateral screws" through single ilioinguinal approach. The primary outcomes measure was the reduction quality evaluated according to the Matta radiological criteria, and the functional outcomes were evaluated by the modified Merle d'Aubigné score at the last follow-up. Secondary outcomes were postoperative complications and intraoperative conditions included, for instance, operation time and blood loss. RESULTS: Of these 32 consecutive patients, 19, 9, and 4 were classified as both columns, anterior column posterior hemi-transverse, and T-shaped fractures, respectively, and with an average of 47 months' follow-up. Anatomic reduction was obtained in 19 cases (59%), imperfect reduction in 9 cases (28%), and poor reduction in 4 cases (13%). The modified Merle d'Aubigné scores were excellent in 15 cases (47%), good in 13 cases (41%), fair in 2 cases (6%), and poor in 2 cases (6%). Three cases sustained temporary lateral femoral cutaneous nerve injuries. One patient had a superficial wound infection that resolved after debridement. Five patients had posttraumatic arthritis; one of them underwent total hip arthroplasty at 46 months. No cases had quadrilateral screws entering the hip joint. CONCLUSION: The use of DAPSQ with quadrilateral screws is an effective and safe choice for complex acetabular fractures with quadrilateral plate involvement through the single ilioinguinal approach.

Portrait Relief Modeling from a Single Image.

We present a novel solution to enable portrait relief modeling from a single image. The main challenges are geometry reconstruction, facial details recovery and depth structure preservation. Previous image-based methods are developed for portrait bas-relief modeling in 2.5D form, but not adequate for 3D-like high relief modeling with undercut features. In this paper, we propose a template-based framework to generate portrait reliefs of various forms. Our method benefits from Shape-from-Shading (SFS). Specifically, we use bi-Laplacian mesh deformation to guide the relief modeling. Given a portrait image, we first use a template face to fit the portrait. We then apply bi-Laplacian mesh deformation to align the facial features. Afterwards, SFS-based reconstruction with a few user interactions is used to optimize the face depth, and create a relief with similar appearance to the input. Both depth structures and geometric details can be well constructed in the final relief. Experiments and comparisons to other methods demonstrate the effectiveness of the proposed method.

Self-Stabilized Precipitation Polymerization and Its Application.

An effective, value-added use of the large amounts of olefinic compounds produced in the processing of petroleum, aside from ethylene and propylene, has been a long outstanding challenge. Here, we developed a novel heterogeneous polymerization method, beyond emulsion/dispersion/suspension, termed self-stabilized precipitation (2SP) polymerization, which involves the nucleation and growth of nanoparticles (NPs) of a well-defined size without the use of any stabilizers and multifunctional monomers (crosslinker). This technique leads to two revolutionary advances: (1) the generation of functional copolymer particles from single olefinic monomer or complex olefinic mixtures (including C4/C5/C9 fractions) in large quantities, which open a new way to transform huge amount of unused olefinic compounds in C4/C5/C9 fractions into valuable copolymers, and (2) the resultant polymeric NPs possess a self-limiting size and narrow size distribution, therefore being one of the most simple, efficient, and green strategies to produce uniform, size-tunable, and functional polymeric nanoparticles. More importantly, the separation of the NPs from the reaction medium is simple and the supernatant liquid can be reused; hence this new synthetic strategy has great potential for industrial production.

Insulin receptor substrate-4 interacts with ubiquitin-specific protease 18 to activate the Jak/STAT signaling pathway.

Ubiquitin-specific protease 18 (USP18) as a negative regulator of the Jak/STAT signaling pathway plays an important role in the host innate immune response. USP18 has been shown to bind to the type I interferon receptor subunit 2 (IFNAR2) to down-regulate the Jak/STAT signaling. In this study, we showed that insulin receptor substrate (IRS)-4 functioned as a novel USP18-binding protein. Co-precipitation assays revealed that two regions (amino acids 335-400 and 1094-1257) of IRS4 were related to bind to the C- terminal region of USP18. IRS4 binding to USP18 diminished the inhibitory effect of USP18 on Jak/STAT signaling. IRS4 over-expression enhanced while IRS4 knock-down suppressed the Jak/STAT signaling in the presence of IFN-a stimulation. As such, IRS4 increased IFN-a-mediated anti-HCV activity. Mechanistically, IRS4 promoted the IFN-a-induced Jak/STAT signaling by interact with USP18. These results suggested that IRS4 binds to USP18 to diminish the blunting effect of USP18 on IFN-a-induced Jak/STAT signaling. Our findings indicated that IRS4 is a novel USP18-binding protein that can be used to boost the host innate immunity to control HCV, and potentially other viruses that are sensitive to IFN-a.

[Value of serum miR-17-92 cluster in diagnosis of retinoblastoma].

OBJECTIVE: To investigate the value of serum miR-17-92 cluster in the diagnosis of retinoblastoma (RB). METHODS: Serum samples were collected from 20 children with RB and 20 healthy controls. Quantitative real-time PCR was used to measure the expression of miR-17-92 cluster. The expression of miR-17-92 cluster was compared between children with different stages of RB and the changes in the expression of miR-17-92 cluster after multimodality therapy were analyzed. The receiver operating characteristic (ROC) curve was used to investigate the value of serum miR-17-92 cluster in the diagnosis of RB. RESULTS: Compared with the healthy controls, the children with RB had significantly higher relative expression of miR-17-3P, miR-17-5P, miR-18a, and miR-20a in serum (P<0.05), and miR-18a showed the greatest increase. There were no significant differences in the relative expression of miR-19a, miR-19b-1, and miR-92a-1 between children with RB and healthy controls (P>0.05). There were no significant differences in the expression of miR-17-5P, miR-17-3P, miR-18a, and miR-20a between the children with early-to-moderate stage of RB and those with advanced stage of RB (P>0.05), but there were significant reductions after multimodality therapy (P<0.05). In the diagnosis of RB, the areas under the ROC curve (AUCs) for serum miR-17-3P, miR-17-5P, miR-18a, and miR-20a were 0.770, 0.755, 0.828, and 0.665 respectively, and miR-18a had the largest AUC, with a sensitivity of 90% and a specificity of 65%. CONCLUSIONS: miR-17-3P, miR-17-5P, miR-18a, and miR-20a are highly expressed in the serum of children with RB, and miR-18a may be used as a new marker for the diagnosis of RB.

MxA is a positive regulator of type I IFN signaling in HCV infection.

Type I interferons (IFNs) are a family of primordial cytokines that respond to various pathogen infections including Hepatitis C virus (HCV). Type I IFNs signal through Jak/STAT pathway leading to the production of a few hundred interferon stimulated genes (ISGs). The aim of this study was to explore the role of one of these ISGs, MxA in HCV infection and type I IFN production. Plasmid encoding MxA was cloned into PcDNA3.1-3×tag vector and MxA expression was confirmed both at mRNA (RT-PCR) and protein (Western blot, WB) levels. IFNα and IFNß productions were quantified by RT-PCR from cell lysate and by ELISA kit from culture medium following MxA over-expression in Huh7.5.1 cells. The activation status of Jak/STAT signaling pathway was examined at three levels: p-STAT1 (WB), interferon sensitive response element (ISRE) activity (dual luciferase reporter gene assay), and levels of ISG expression (RT-qPCR). J6/JFH1 HCV culture system was used to study the role of MxA in HCV replication. Our findings indicated that MxA over-expression inhibited HCV replication and potentiated the IFNα-mediated anti-HCV activity; MxA stimulated the production of IFNα, IFNß, and enhanced IFNα-induced activation of Jak-STAT signaling pathway. We concluded that MxA is a positive regulator of type I IFN signaling in HCV infection.

[A preliminary study of retinoblastoma-related serum tumor markers].

OBJECTIVE: To screen out retinoblastoma (RB)-related serum tumor markers by measuring the levels of serum alpha fetoprotein (AFP), carcino-embryonic antigen (CEA), neuron-specific enolase (NSE), carbohydrate antigen 125 (CA125), carbohydrate antigen 153 (CA153), carbohydrate antigen 199 (CA199), and carbohydrate antigen 724 (CA724) in children with RB. METHODS: The levels of seven serum tumor markers (AFP, CEA, NSE, CA125, CA153, CA199, and CA724) were determined in 20 children with RB and 20 healthy children (control) using a chemiluminescent immunoassay. RESULTS: The serum levels and positive rates of NSE, CA153, and CA199 in the RB group were significantly higher than those in the control group (P<0.05). However, there were no significant differences in the levels of AFP, CEA, CA125, and CA724 between the two groups (P>0.05). NSE had the highest sensitivity, but a relatively low specificity for the diagnosis of RB. CA153 and CA199 had a relatively high specificity, but a relatively low sensitivity for the diagnosis of RB. CONCLUSIONS: The serum levels and positive rates of NSE, CA153, and CA199 are high in children with RB. Combined measurement of these three serum tumor markers may have an important diagnostic value for RB.

ISG12a inhibits HCV replication and potentiates the anti-HCV activity of IFN-α through activation of the Jak/STAT signaling pathway independent of autophagy and apoptosis.

Interferon stimulated (sensitive) genes (ISGs) are the effector molecules downstream of type I/III interferon (IFN) signaling pathways in host innate immunity. ISG12a can be induced by IFN-α. Although ISG12a has been reported to inhibit the replication of HCV, the exact mechanism remains to be determined. In this study, we investigated the possible mechanisms of ISG12a anti- HCV property by exploring the production of type I IFN and the activation of Janus kinase/signal transducer and activator of transcription (Jak/STAT) signaling pathway, apoptosis and autophagy in Huh7.5.1 cells transiently transfected with ISG12a over-expression plasmid. Interestingly, we found that ISG12a inhibited HCV replication in both Con1b replicon and the HCV JFH1-based cell culture system and potentiated the anti-HCV activity of IFN-α. ISG12a promoted the production of IFN α/ß and activated the type I IFN signaling pathway as shown by increased p-STAT1 level, higher Interferon sensitive response element (ISRE) activity and up-regulated ISG levels. However, ISG12a over-expression did not affect cell autophagy and apoptosis. Data from our current study collectively indicated that ISG12a inhibited HCV replication and potentiated the anti-HCV activity of IFN-α possibly through induced production of type I IFNs and activation of Jak/STAT signaling pathway independent of autophagy and cell apoptosis.

Interferon-Stimulated Gene 15 Conjugation Stimulates Hepatitis B Virus Production Independent of Type I Interferon Signaling Pathway In Vitro.

Hepatitis B virus (HBV) is an important account of infectious hepatitis and interferon (IFN) remains one of the best treatment options. Activation of type I IFN signaling pathway leads to expressions of IFN-stimulated genes (ISGs) which play important roles in antiviral and immunomodulatory responses to HBV or hepatitis C virus (HCV) infection. Our previous studies indicated that ISG15 and its conjugation (ISGylation) were exploited by HCV to benefit its replication and persistent infection. This study was designed to assess the role of ISG15 and ISGylation in HBV infection in vitro. The levels of ISG15 and ISGylation were upregulated by ISG15 plasmid transfection into HepG2.2.15 cells. Decreased ISGylation was achieved by siRNA targeting UBE1L, the only E1 activating enzyme for ISGylation. Overexpression of ISG15 and subsequent ISGylation significantly increased the levels of HBV DNA in the culture supernatants although the intracellular viral replication remained unaffected. Silencing UBE1L, with decreased ISGylation achieved, abrogated this ISGylation-mediated promoting effect. Our data indicated that overexpression of ISG15 stimulated HBV production in an ISGylation-dependent manner. Identification of ISG15-conjugated proteins (either HBV viral or host proteins) may reveal promising candidates for further antiviral drug development.

[Changing trends and clinical characteristics of febrile seizures in children].

OBJECTIVE: To investigate the clinical characteristics and changing trends of febrile seizures (FS) in children. METHODS: The clinical data of 1 922 children with FS admitted from 2004 to 2013 were analyzed retrospectively. The clinical characteristics and changing trends of FS in the two five-year periods were analyzed. RESULTS: In 1 922 children with FS, the male/female ratio was 2.27:1. The mean age at onset was 3.0±1.8 years, while the peak age at onset was 1-3 years. There were 1 556 children (80.96%) with simple FS and 366 (19.04%) with complex FS. The number of children with FS in the second five-year period (1 202 cases) increased by 66.9% compared with that in the first five-year period (720 cases). The proportion of children with complex FS was significantly higher in the second five-year period than in the first five-year period (21.13% vs 15.56%; P<0.05). In children with simple FS, there were no significant differences in the age and body temperature at onset, convulsion duration, and the incidence of complications between the two five-year periods (P>0.05). However, children with complex FS had a significantly lower age at onset, a significantly lower body temperature at onset, a significantly longer convulsion duration, and a significantly higher incidence of complications including myocardial injury and hyponatremia in the second five-year period than in the first five-year period (P<0.05). CONCLUSIONS: In the last decade, the number of children with FS and incidence of complex FS increased, and the outcome became worse according to clinical characteristics, suggesting that more attention should be paid to timely diagnosis and treatment of complex FS.

[Preventive effect of behavioral therapy plus flunarizine in children with migraine].

OBJECTIVE: To investigate the preventive effect of behavioral therapy plus flunarizine in children with migraine. METHODS: Ninety pediatric patients with migraine between January 2011and January 2014 were randomly divided into treatment group (45 cases) and control group (45 cases). The treatment group received behavioral therapy in addition to oral flunarizine, while the control group received oral flunarizine alone. All patients were followed up for 3 months to evaluate the therapeutic effect by the Pediatric Migraine Disability Assessment Score (PedMIDAS) and improved Bussone headache index. RESULTS: There were no significant differences in PedMIDAS (P>0.05) and improved Bussone headache index (P>0.05) between the control and treatment groups before treatment. Significant differences were observed in PedMIDAS (16±8 vs 20±10; P<0.05) and improved Bussone headache index (25±18 vs 37±21; P<0.05) between the two groups after 3 months of treatment. CONCLUSIONS: Preventive treatment of behavioral therapy plus oral flunarizine shows a better clinical efficacy than oral flunarizine alone in children with migraine and holds promise for clinical application.

[Clinical features and risk factors of co-morbid tic disorder in children with attention deficit hyperactivity disorder].

OBJECTIVE: To study the clinical features and risk factors of co-morbid tic disorder (TD) in children with attention deficit hyperactivity disorder (ADHD). METHODS: A total of 312 children with ADHD were involved in this study. Subtypes of co-morbid TD, incidences of TD in different subtypes of ADHD (ADHD-I, ADHD-HI and ADHD-C) were observed. Thirteen potential factors influencing the comorbidity rate of TD in ADHD were evaluated by univariate analysis and multiple logistic regression analysis. RESULTS: Forty-two of 312 children with ADHD suffered from co-morbid TD (13.5%). Comorbidity rate of TD in children with ADHD-C (24.1%) was significantly higher than in those with ADHD-HI (10.9%) and ADHD-I (8.8%) (P<0.05). There were 21 cases (50.0%) of transient TD, 12 cases (28.6%) of chronic TD, and 9 cases (21.4%) of Tourette syndrome. The univariate analysis revealed 6 factors associated with comorbidity: addiction to mobile phone or computer games, poor eating habits, infection, improper family education, poor relationship between parents and poor relationship with schoolmates. Multiple logistic analysis revealed two independent risk factors for comorbidity: improper family education (OR=7.000, P<0.05) and infection (OR=2.564, P<0.05). CONCLUSIONS: The incidence of co-morbid TD in children with ADHD is influenced by many factors, and early interventions should be performed based on the main risk factors.