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Abstract Background There are very limited reports on anti-metabolic glutamate receptor5 (mGluR5) encephalitis, especially lacking of pediatric research. The disease was mostly accompanied by tumors, mainly Hodgkin's lymphoma. No reports of other tumors, such as gangliocytoma have been reported to associate with anti-mGluR5 encephalitis so far. Case presentation and literature reviews We reported a case of a 12-year-old boy with anti-mGluR5 encephalitis complicated with gangliocytoma. The patient suffered from mental disorders including auditory hallucination, and sleep disorders. His cranial magnetic resonance imaging (MRI) showed an abnormality in the right insular lobe. Autoimmune encephalitis antibodies testing was positive for mGluR5 IgG antibody both in cerebrospinal fluid and serum (1:3.2, 1:100 respectively). Abdominal CT indicated a mass in left retroperitoneal confirmed with gangliocytoma via pathology. The patient underwent resection of gangliocytoma. After first-line immunotherapy (glucocorticoid, gamma globulin), his condition was improved. Furthermore, we provide a summary of 6 pediatric cases of Anti-mGluR5 encephalitis. Most of them complicated with Hodgkin's lymphoma, except the case currently reported comorbid with gangliocytoma. The curative effect is satisfactory. Conclusions We report the first patient with anti-mGlur5 encephalitis complicated with gangliocytoma. It suggests that in addition to paying attention to the common lymphoma associated with anti-mGlur5 encephalitis, we should also screen the possibility of other tumors for early detection of the cause, active treatment and prevention of recurrence.

Comprehensive and systematic research linking land-hydrological correlations is lacking in the study of factors driving watershed runoff variations. It quantitatively analyzes the overall watershed hydrological conditions using the range of variability approach (RVA) and applies the Budyko hypothesis to identify driving factors of annual runoff variations. The study also explores the impact of individual land use types on runoff across various timescales using the SWAT model in conjunction with historical and extreme scenarios in the Han River Basin. Results reveal that following abrupt changes, the Han River Basin experiences negative alterations in its hydrological indices and overall conditions. Among the driving factors, the lower cushion surface has the most significant impact on runoff. At an annual scale, runoff increases by 12.57 and 20.4% for cropland and construction land scenarios, while forest and grassland scenarios lead to decreases of 8.45 and 2.32%, respectively. Runoff sensitivity to land use changes is notably higher in the wet season than in the dry season at the quarterly and monthly scales. This study offers valuable insights into the integrated management of land use and water resources in the Han River Basin. HIGHLIGHTS Using IHA – RVA analysis of watershed hydrological situation changes.; Attribution analysis of runoff before and after 1991 is conducted using the Budyko hypothesis.; Integrating five distinct land use scenarios, we constructed a SWAT model to quantify the impact of different land use types on runoff.;

Quantitatively separating the influence of climate change and human activities on runoff is crucial to achieving sustainable water resource management in watersheds. This study presents a framework for quantitative assessment by integrating the indicators of hydrologic alteration, the whale optimization algorithm and random forest (WOA-RF), and the water erosion prediction (WEP-L) models. This framework quantifies the differences in hydrological conditions and their driving forces at multi-timescales (annual, seasonal, and monthly). The results indicate that the runoff of the Wu River has decreased since 2005. Climate factors were found to influence the interannual variation of runoff mainly. Meanwhile, human activities had a more significant impact in autumn, with a relative contribution rate of 59.0% (WOA-RF model) and 70.8% (WEP-L model). Monthly, the picture is more complex, with the results of the WOA-RF model indicating that climate change has a significant impact in July, August, and September (88.8%, 92.7%, and 79.3%, respectively). However, the WEP-L model results showed that the relative contribution of land use is significant in April, May, June, October, and November (51.24%, 64.23%, 63.63%, 53.16%, and 50.63%, respectively). The results of the study can be helpful for regional water allocation. HIGHLIGHTS Based on indicators of the hydrologic alteration range of variation approach, the changes of hydrological regime in the Wujiang River basin in the past 30 years were analyzed.; Natural runoff was reconstructed by the whale optimization algorithm and random forest and the water erosion prediction models.; The effects of climate change and human activities on runoff change on annual, monthly, and seasonal scales were quantified.;

Abstract Objective Explore the clinical characteristics and prognosis of children with norovirus (NoV)‐associated benign convulsions with mild gastroenteritis (CwG). Methods We retrospectively analyzed the Clinical and laboratory data of children with NoV‐associated CwG admitted to the emergency department of Guangzhou Children's Hospital between January 2019 and January 2020. And patients were followed up for 23–36 months. Results There are 49 cases met the CwG criteria. Vomiting was the first symptom in 31 (63.3%) patients, and vomiting could be the main or the only gastrointestinal symptom. The mean frequency of seizures was 3.8 ± 2.4 episodes. Most patients (95.9%) experienced seizures that lasted for less than 5 min. Of the 43 (87.8%) cases followed up from 23 to 36 months, only one experienced recurrent convulsions (after rotavirus infection). Significance NoV‐associated CwG patients were prone to experiencing more convulsions. However, because most NoV‐associated CwG patients had good prognosis, long‐term use of anticonvulsants are unnecessary.

Objective: Neurodevelopmental impairment has been realized as the most common complication in children with congenital heart disease undergoing cardiac surgery during the past 30 years. But little attention has been paid to this problem in China. The potential risk factors for adverse outcomes include demographic, perioperative, and socioeconomic factors, which are vastly different in China compared with the developed countries in previous reports. Methods: Four hundred twenty-six patients (aged 35.9 ± 18.6 months) at about 1- to 3-year follow-up after cardiac surgery were prospectively enrolled from March 2019 to February 2022. Griffiths Mental Development Scales-Chinese was used to evaluate the quotients of overall development and 5 subscales of the child's locomotor, language, personal-social, eye-hand coordination, and performance skills. Demographic, perioperative, socioeconomic, and feeding type during the first year of life (breastfeeding, mixed, or never breastfeeding) were examined to identify the risk factors for adverse neurodevelopmental outcomes. Results: Mean scores were 90.0 ± 15.5 for development quotient, 92.3 ± 19.4 for locomotor, 89.6 ± 19.2 for personal-social, 85.5 ± 21.7 for language, 90.3 ± 17.2 for eye-hand coordination, and 92 ± 17.1 for performance subscales. For the entire cohort, the impairment in at least 1 subscale was found in 76.1% of the cohort (>1 SD below population mean) with 50.1% being severe (>2 SDs below the mean). The significant risk factors included prolonged hospital stay, peak level of postoperative C-reactive protein, socioeconomic status, and never breastfeeding or mixed feeding. Conclusions: Neurodevelopmental impairment is substantial in terms of incidence and severity in children with congenital heart disease undergoing cardiac surgery in China. Risk factors contributing to the adverse outcomes included prolonged hospital stay, early postoperative inflammatory response, socioeconomic status, and never breastfeeding or mixed feeding. There is an urgent need for standardized follow-up and neurodevelopmental assessment in this special group of children in China.

Study region: The Min River basin, China. Study focus: In order to investigate the ecohydrological response under historical and future land use changes, we simulated daily runoff sequences under different land use scenarios by coupling the PLUS model with the Physical Hydrological Model and quantitatively assessed the ecohydrological impacts of different land use changes in the watershed by combining the IHA method. New hydrological insights for the region: The Min River Basin is dominated by grassland, woodland and, cultivated land which account for 94 % of the total. During the period 2000–2020, the area of cultivated land decreased by 4.47 % overall, and construction land increased by 78.68 % overall. Compared to the base year of 2010, the multi-year average monthly runoff increased under different land use scenarios. The high flow indicators (1 daymax, 7 daymax, and 30 daymax) had the largest increasing trend under the natural development scenario in 2030, 54 m3/s, 33 m3/s, and 24 m3/s, respectively, whereas their increase decreased under the ecological protection scenario in 2030; the low flow indicators (1 daymin, 7 daymin, and 30 daymin) decreased less in the 2030 eco-protection scenario than in the natural development scenario, where they decreased by − 5 m3/s, − 9 m3/s, and − 11 m3/s, respectively. The results of the study contribute to a deeper understanding of the response of watershed hydrological processes to land-use change.

River heat flux (HF) regime has been significantly affected by anthropogenic activities and climate variation, and it is of great significance to deeply explore intrinsic driving mechanisms and ecological effects. This study uses the middle reaches of the Yangtze River as its research area and, by constructing the wavelet model and the IHA-RVA model, quantifies the evolution mechanism and internal law of ‘flow- water temperature (WT) – HF’ over the past four decades and investigates the effects of Three Gorges Dam on the ecological reproduction of ‘four major Chinese carp’. The results show that, (1) flow and WT have three change cycle scales; the overall hydrologic variations of flow and WT were 64% and 62%, respectively, close to high variation. (2) The overall HF shows a decreasing trend from 1983 to 2019, with significant changes in HF in spring and winter regulated by the Three Gorges Reservoir; the basin flow-WT-HF relationships exhibit a hysteretic pattern, with the maximum WT occurring one month after the peak HF and flow. (3) The ‘four major Chinese carp’ natural breeding season is closely related to the time when the WT reaches 18 °C; HF is a vital habitat factor that influences fish spawning and reproduction. HIGHLIGHTS Analysis of flow and water temperature changes in the upper reaches of Yangtze River based on wavelet analysis and IHA-RVA model.; Variation of heat fluxes in the upper reaches of the Yangtze River around 2003.; Heat flux is one of the important influencing factors on the spawning output of four major Chinese carp, and the suitable heat flux range for spawning of four major Chinese carp is identified.;

ObjectiveNusinersen, an extremely expensive biologic drug (around 100,000 US$ per dose) that needs to be administered intrathecally, is approved for the treatment of 5q-spinal muscular atrophy (SMA). Because of the low muscle tone of the back muscles of pediatric SMA patients, especially type 1 SMA patients, the safe, effective, and fast execution of sheath injection is needed. Therefore, a modified intrathecal injection method was developed accordingly. This paper aims to describe the applicability and safety of this modified method.MethodsThe modified intrathecal injection method (MIIM) mainly includes a septal needle-free closed infusion connector between the lumbar puncture needle and the syringe, besides the procedures of routine lumbar puncture. Its applicability and safety were evaluated through clinical observation.ResultsA total of 92 children with SMA have successfully received nusinersen treatment at our hospital using the modified method since 2019 without obvious adverse events related to the modified injection method. Based on the clinical feedback of operators, the advantages of the modified method include successfully injecting the total dose of nusinersen with constant injection rate and a more stable fixation of the puncture needle, as well as making the operator more relaxed. However, compared with the routine method, the procedure of the modified method has additional steps.ConclusionThe modified intrathecal injection method is an effective and safe method to inject nusinersen when weighing the pros and cons, and it may also be used for administering intrathecal injections of other expensive medicines or for patients with other strict requirements for intrathecal injection.

Background The ratio of cerebrospinal fluid (CSF) to peripheral blood glucose at the same period is an important index for diagnosing and monitoring the efficacy of central nervous system infection, especially bacterial meningitis. Some guidelines refer that blood glucose measurement should be carried out before lumbar puncture. The main reason is to avoid possible effect of stress response induced by lumbar puncture on the level of blood glucose. However, there is no consensus on whether it should be followed in actual clinical work, since up to now no research work having been published on whether lumbar puncture will induce the changes on blood glucose. Our study aimed to investigate the changes of peripheral blood glucose before and after lumbar puncture. Methods In order to clarify the influence of timing of peripheral blood glucose measurement at the same period of lumbar puncture, a prospective study was conducted including children with an age range from 2 months to 12 years old in the neurology department of a medical center. For those children who need lumbar puncture due to their illness, their blood glucose was measured within 5 min before and after lumbar puncture, respectively. The blood glucose level and the ratio of CSF to blood glucose before and after lumbar puncture were compared. Meanwhile, the patients were divided into different groups according to the factors of sex, age and sedation or not for further comparison. All statistical analyses of the data were performed using SPSS version 26.0 for Windows. Results In total, 101 children who needed lumbar puncture during hospitalization from January 1, 2021, to October 1, 2021, were recruited with 65 male and 36 female respectively. There was no significant difference on the level of blood glucose, CSF to blood glucose ratio before and after lumbar puncture among the children (p > 0.05). No differences were observed within different groups (sex, age, sedation or not) either. Conclusion It is unnecessary to emphasize blood glucose measurement should be carried out before lumbar puncture, especially for pediatric patients. From the perspective of facilitating smoother cerebrospinal fluid puncture in children, blood glucose measurement after lumbar puncture might be a better choice.

Abnormal gray matter (GM) asymmetry has been verified in autism spectrum disorder (ASD), which is characterized by high heterogeneity. ASD is distinguished by three core symptom domains. Previous neuroimaging studies have offered support for divergent neural substrates of different core symptom domains in ASD. However, no previous study has explored GM asymmetry alterations underlying different core symptom domains. This study sought to clarify atypical GM asymmetry patterns underlying three core symptom domains in ASD with a large sample of 230 minors with ASD (ages 7–18 years) and 274 matched TD controls from the Autism Brain Imaging Data Exchange I (ABIDE I) repository. To this end, the scores of the revised autism diagnostic interview (ADI-R) subscales were normalized for grouping ASD into three core-symptom-defined subgroups: social interaction (SI), verbal communication (VA), and restricted repetitive behaviors (RRB). We investigated core-symptom-related GM asymmetry alterations in ASD resulting from advanced voxel-based morphometry (VBM) by general linear models. We also examined the relationship between GM asymmetry and age and between GM asymmetry and symptom severity assessed by the Autism Diagnostic Observation Schedule (ADOS). We found unique GM asymmetry alterations underlying three core-symptom-defined subgroups in ASD: more rightward asymmetry in the thalamus for SI, less rightward asymmetry in the superior temporal gyrus, anterior cingulate and caudate for VA, and less rightward asymmetry in the middle and inferior frontal gyrus for RRB. Furthermore, the asymmetry indexes in the thalamus were negatively associated with ADOS_SOCIAL scores in the general ASD group. We also showed significant correlations between GM asymmetry and age in ASD and TD individuals. Our results support the theory that each core symptom domain of ASD may have independent etiological and neurobiological underpinnings, which is essential for the interpretation of heterogeneity and the future diagnosis and treatment of ASD.

IntroductionBacterial meningitis (BM) is an infectious disease with high morbidity and mortality rates in children. Although vaccination has improved prevention of BM, this severe disease continues to cause considerable harm to children across the globe. Several risk factors have been identified for BM, including immune status, age, and sex. However, additional patient and disease information is required in order to better understand the local characteristics, epidemiology and risk factors of BM.MethodsHere, we collected information from 252 children with BM in the Guangzhou Women and Children Medical Centre medical record database infected with Streptococcus agalactiae, Streptococcus pneumoniae, or Escherichia coli between May 2015 and May 2022.ResultsThe three pathogen infected BM cased showed distinct trends during the period, and distribution of three BM pathogens across age groups varied significantly. We reviewed the antimicrobial resistance patterns for each of the pathogens which may direct drug use in BM. Finally, we found blood WBC was a protective factor, while glucose levels in the CFS was risk factor, for the length of hospitalization.DiscussionCollectively, this study provides multi-parameter characteristics of BM, and potentially guide the drug use.

Despite the Yangtze River Basin (YRB)’s abundant land and forestry resources, there is still a dearth of research on forecasting habitat quality changes resulting from various geographic and environmental factors that drive landscape transformations. Hence, this study concentrates on the YRB as the focal area, with the aim of utilizing the Patch Landscape Upscaling Simulation model (PLUS) and the habitat quality model to scrutinize the spatial distribution of landscape patterns and the evolution of HQ under four scenarios: the natural development scenario (NDS), farmland protection scenario (CPS), urban development scenario (UDS), and ecological protection scenario (EPS), spanning from the past to 2030. Our results show that (1) from 2000 to 2020, the construction land in the YRB expanded at a high dynamic rate of 47.86% per year, leading to a decrease of 32,776 km2 in the cultivated land area; (2) the UDS had the most significant expansion of construction land, followed by the NDS, CPS, and EPS, which had higher proportions of ecologically used land such as forests and grasslands; (3) from 2000 to 2020, the HQ index ranged from 0.211 to 0.215 (low level), showing a slight upward trend, with the most drastic changes occurring in the low-level areas (−0.49%); (4) the EPS had the highest HQ (0.231), followed by the CPS (0.215), with the CPS increasing the HQ proportion of the lower-level areas by 2.64%; (5) and in addition to government policies, NDVI, DEM, GDP, and population were also significant factors affecting landscape pattern and changes in habitat quality.

Abstract Background Autism is a lifelong disability associated with several comorbidities that confound diagnosis and treatment. A better understanding of these comorbidities would facilitate diagnosis and improve treatments. Our aim was to improve the detection of comorbid diseases associated with autism. Methods We used an FP-growth algorithm to retrospectively infer disease associations using 1488 patients with autism treated at the Guangzhou Women and Children’s Medical Center. The disease network was established using Cytoscape 3.7. The rules were internally validated by 10-fold cross-validation. All rules were further verified using the Columbia Open Health Data (COHD) and by literature search. Results We found 148 comorbid diseases including intellectual disability, developmental speech disorder, and epilepsy. The network comprised of 76 nodes and 178 directed links. 158 links were confirmed by literature search and 105 links were validated by COHD. Furthermore, we identified 14 links not previously reported. Conclusion We demonstrate that the FP-growth algorithm can detect comorbid disease patterns, including novel ones, in patients with autism.

In this study, the effects of the annealing temperature and holding time on the δ ferrite content in M50NiL bearing steel are evaluated. The results indicate that when the temperature increases from 900°C to 1200°C, the δ ferrite content increases as a result of the increase in the Cr equivalent in the matrix, which decreases the stability of austenite and promotes the transformation of γ ⟶ δ. At 1300°C, the δ ferrite content sharply increases because the austenite transforms into δ ferrite in large quantities when heated to the γ + δ phase region. When the steel is annealed at 1200°C, the content of δ ferrite first decreases and then increases with increasing holding time (0.5–50 h). Meanwhile, the δ ferrite content reaches the lowest value of 3.5% after 30 h of annealing. The decrease in the δ ferrite content is attributed to the increase in the Ni equivalent in δ ferrite, which promotes the transformation from δ ferrite to austenite. The increase in the δ ferrite content is attributed to the diffusion of Mo and V ferrite-forming elements into grains, resulting in the nucleation of a large amount of δ ferrite.

Background. We aimed to delineate the genotype and phenotype of patients with KCNQ2 mutations from South China. Methods. Clinical manifestations and characteristics of KCNQ2 mutations of patients from South China were analyzed. Previous patients with mutations detected in this study were reviewed. Results. Eighteen epilepsy patients with KCNQ2 mutations, including seven self-limited neonatal epilepsy (SeLNE), two self-limited infantile epilepsy (SeLIE) and nine developmental and epileptic encephalopathy (DEE) were enrolled. The age of onset (p=0.006), mutation types (p=0.029), hypertonia (p=0.000), and seizure offset (p=0.029) were different in self-limited epilepsy (SeLE) and DEE. De novo mutations were mainly detected in DEE patients (p=0.026). The mutation position, EEG or the age of onset were not predictive for the seizure or ID/DD outcome in DEE, while the development of patients free of seizures was better than that of patients with seizures (p=0.008). Sodium channel blockers were the most effective anti-seizure medication, while the age of starting sodium channel blockers did not affect the seizure or development offset. We first discovered the seizure recurrence ratio in SeLNE/SeLIE was 23.1% in South China. Four novel mutations (c.790T>C, c.355_363delGAGAAGAG, c.296+2T>G, 20q13.33del) were discovered. Each of eight mutations (c.1918delC, c.1678C>T, c.683A>G, c.833T>C, c.868G>A, c.638G>A, c.997C>T, c.830C>T) only resulted in SeLE or DEE, while heterogeneity was also found. Six patients in this study have enriched the known phenotype caused by the mutations (c.365C>T, c.1A>G, c.683A>G, c.833T>C, c.830C>T, c.1678C>T). Conclusion. This research has expanded known phenotype and genotype of KCNQ2-related epilepsy, and the different clinical features of SeLE and DEE from South China. [ABSTRACT FROM AUTHOR]