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To describe the clinical features and prognosis of pediatric anti - N -methyl- d -aspartate receptor (NMDAR) encephalitis from a single center in northern China. The clinical and laboratory characteristics of hospitalized patients with anti -NMDAR encephalitis, stratified by age, were retrospectively studied. Risk factors including relapse and long-term (follow-up ≥1 year) outcomes were analyzed. A total of 273 patients were included between November 2011 and December 2019, and the average age of onset was 7.5 ± 4.0 years (0.5–15.8 years). Of them, 159（58.2%） were female, and the proportion of females increased with age. Seizures were the most common initial symptom. Movement disorders（86.1%） and psychiatric（82.4%） symptoms were most frequent in the acute phase. In the acute stage, the incidence of movement disorders decreased with age (χ2 = 10.676, p = 0.011), while the proportion of psychiatric symptoms increased with age (χ2 = 21.85, p < 0.001) The recurrence rate was 9.6% (24/250). Demyelination was an independent risk factor for relapse (p = 0.006, OR = 5.877, 95% CI: 1.658–20.835). Among the 210 patients who were followed up for more than one year, 28 patients had a poor prognosis (mRS ≥3). Onset age (p = 0.038，OR = 0.844, 95% CI: 0.720–0.991), precursor of viral encephalitis (p = 0.007，OR = 9.876, 95% CI: 1.878–51.940), and ICU admission (p = 0.023，OR = 5.924, 95% CI: 1.280–27.064) significantly affected the prognosis. The mortality rate was 2.9%. The characteristics of anti -NMDAR encephalitis in children are age-dependent. Early-onset, the precursor of viral encephalitis, and ICU admission may indicate poor prognosis. Demyelination may be a risk factor for recurrence. • Pediatric anti -NMDAR encephalitis has age-dependent characteristics. • Early onset, precursor of viral encephalitis, and ICU admission indicate poor prognosis. • Patintes with demyelination prone to relapse. [ABSTRACT FROM AUTHOR]

The neonatal and infantile period is the age group with the highest incidence of epilepsy, in which gene variants in sodium and potassium channels are an important etiology, so the sodium channel blocker class of antiseizure medications may be effective in the treatment of early onset epilepsy. This study aimed to summarize the efficacy and tolerability of oxcarbazepine (OXC) in the treatment of focal epilepsy in neonates and infants under 3 months of age. A retrospective analysis of children with focal epilepsy onset within 3 months of age and treated with OXC in a tertiary pediatric epilepsy center in China was conducted. The efficacy, tolerability and influencing factors of OXC were evaluated. A total of 50 patients were enrolled, with a median age of epilepsy onset of 11.5 (2, 42) days. There were 32 cases of early infantile developmental and epileptic encephalopathy, 10 cases of self-limited neonatal or neonatal-infantile epilepsy, and 8 cases of focal epilepsy that could not be classified as epileptic syndrome. The median age of application of OXC was 47 (31, 66) days. The median follow-up time was 16.5 (10, 25) months, with 7 deaths. Thirty-eight cases (76.0 %) were effective with OXC treatment, including 28 cases (56.0 %) achieved seizure freedom. Of the 34 cases whose pathogenesis involved genetic factors, 19 cases with sodium/ potassium channel gene variants had higher effective and seizure-free rates than those with other gene variants. The most common adverse event was transient hyponatremia. 2 cases had rash and 2 cases had abnormal electrocardiogram, 3 of which discontinued OXC. This single-center retrospective study suggests that OXC is effective and tolerable for the treatment of focal epilepsy in neonates and infants under 3 months of age. The efficacy of OXC is better in patients with sodium/ potassium channel gene variants. • Oxcarbazepine is effective and tolerable in the treatment of focal epilepsy in neonates and very young infants. • Oxcarbazepine is with higher efficiency in patients with GOF variants of sodium channel genes and LOF variants of potassium channel genes. • Adverse reactions leading to withdrawal of oxcarbazepine are skin rashes and premature ventricular rhythm. [ABSTRACT FROM AUTHOR]

Previous studies have demonstrated that language impairments are frequently observed in patients with benign epilepsy with centrotemporal spikes (BECTS). However, how BECTS affects language processing in the Chinese population remains unclear. With the use of functional magnetic resonance imaging (fMRI) in an overt picture-naming task, the present study examined functional connectivity in 27 children with BECTS and 26 healthy controls. The results indicated that children with BECTS showed altered functional connectivity associated with speech production between the left precuneus and the right cerebellum, between the right precuneus and the bilateral thalamus and the left superior temporal gyrus, between the right cuneus and the right postcentral gyrus and the right inferior parietal lobule, and between the right cerebellum and right middle frontal gyrus. Collectively, the findings in this study demonstrate the abnormal functional connectivity basis of speech production in Chinese children with BECTS, providing clues to understanding the brain mechanisms of language-related network in patients with BECTS., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Developmental and epileptic encephalopathy-94 (DEE94) is a severe form of epilepsy characterized by a broad spectrum of neurodevelopmental disorders. It is caused by pathogenic CHD2 variants. While only a few pathogenic CHD2 variants have been reported with detailed clinical phenotypes, most of which lack molecular analysis. In this study, next-generation sequencing (NGS) was performed to identify likely pathogenic CHD2 variants in patients with epilepsy. Three likely pathogenic variants were finally identified in different patients. The seizure onset ages were from two years to six years. Patients 1 and 2 had developmental delays before epilepsy, while patient 3 had intellectual regression after the first seizure onset. The observed seizures were myoclonic, febrile, and generalized tonic-clonic, which had been controlled by different combinations of antiepileptic drugs. Two de novo (c.1809&#95;1809+1delGGinsTT, p.? and c.3455+2&#95;3455+3insTG, p.?) and one maternal (c.3783G>A, p.W1261*) variant were identified, which were all predicted to be pathogenic/likely pathogenic. Molecular analysis was performed in patient 1, and we detected aberrantly spliced products, proving the pathogenicity of this CHD2 variant. New cases with novel variants, along with a detailed clinical and molecular analysis, are important for a better understanding of CHD2-related epileptic encephalopathy.

Reducing the content of Cd in wheat grains is necessary for human health, especially in alkaline farmland in northern China where a large area of soils is heavily polluted with Cd. A field experiment was conducted to investigate the effects of wheat straw biochar (WB) and maize straw biochar (MB) combined solely with ferrous sulfate (FeSO 4 ) or combined with FeSO 4 and pig manure (PFWB and PFMB) on Cd bioavailability in soil and the phytotoxicity of Cd in wheat in an alkaline contaminated soil. The results showed that the application of these treatments decreased the concentrations of CaCl 2 -extractable Cd by 32.8-60.5% and increased the soil organic matter by 36.8-106.7% compared with those of the control treatment. The acid-soluble fraction of Cd was decreased by 3.7-16.8% but the residual fraction was increased by 1.7-13.7%. Furthermore, the addition of WB and MB increased the soil pH by 0.29 and 0.16 units, respectively, while the other treatments decreased the soil pH by 0.16-0.37 units. The concentrations of Cd in different wheat tissues were decreased in amended soils, and these decreases were positively correlated with CaCl 2 -extractable Cd and the acid-soluble fraction of Cd. The ability to accumulate Cd was in the order of root>straw>grain. In addition, there was a downward trend in the bio-concentration and translocation factors under different amendments. The amendments of PFWB and PFMB had better efficiency in the immobilization of Cd in soil and the inhibition of Cd uptake of wheat than WB and MB. In addition, the treatments of PFWB and PFMB increased the wheat yield by 14.3-16.2%, and thus have a great application prospect based on the cost-benefit analysis., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier B.V. All rights reserved.)