BackgroundWe assessed clinical predictors of mechanical ventilation in children with Guillain‐Barré syndrome (GBS) to help identify patients who require mechanical ventilation.MethodsWe retrospectively collected the clinical, laboratory, and electrophysiological data of 103 children with GBS. Patients were categorized into two groups based on the requirement for mechanical ventilation. Variables that were significantly different between the two groups in univariate analysis were analyzed by multivariate logistic regression models.ResultsTime from symptom onset to admission (P = .002), facial or bulbar weakness (P = .001), and axonal type (P = .005) were associated with mechanical ventilation in univariate analysis. In multivariate analysis, facial or bulbar weakness (odds ratio [OR], 7.936; P = .013) and axonal type (OR, 4.582; P = .022) were independent predictors for mechanical ventilation.ConclusionsFacial or bulbar weakness and axonal type were associated with increased risk for mechanical ventilation in children with GBS.

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PurposeThis study aimed to investigate whether minocycline could influence alterations of microglial subtypes, the morphology of dendrites and dendritic spines, the microstructures of synapses and synaptic proteins, or even cognition outcomes in immature male mice following status epilepticus (SE) induced by kainic acid.MethodsGolgi staining was performed to visualize the dendrites and dendritic spines of neurons of the hippocampus. The microstructures of synapses and synaptic proteins were observed using transmission electron microscopy and western blotting analysis, respectively. Microglial reactivation and their markers were evaluated using flow cytometry. The Morris water maze (MWM) test was used to analyze spatial learning and memory ability.ResultsSignificant partial spines increase (predominate in thin spines) was observed in the dendrites of neurons after acute SE and partial loss (mainly in thin spines) was presented by days 14 and 28 post‐SE. The postsynaptic ultrastructure was impaired on the 7th and 14th days after SE. The proportion of M1 microglia increased significantly only after acute SE Similarly, the proportion of M2 microglia increased in the acute stage with high expression levels of all surface markers. In contrast, a decrease in M2 microglia and their markers was noted by day 14 post‐SE. Minocycline could reverse the changes in dendrites and synaptic proteins caused by SE, and increase the levels of synaptic proteins. Meanwhile, minocycline could inhibit the reactivation of M1 microglia and the expression of their markers, except for promoting CD200R. In addition, treatment with minocycline could regulate the expression of M2 microglia and their surface markers, as well as ameliorating the impaired spatial learning and memory on the 28th day after SE.ConclusionsDendritic spines and microglia are dynamically changed after SE. Minocycline could ameliorate the impaired cognition in the kainic acid‐induced mouse model by decreasing the damage to dendrites and altering microglial reactivation.

The sustainable development of the Yangtze River will affect the lives of the people who live along it as well as the development of cities beside it. This study investigated the relationship between shipping development and the water environment of the Yangtze River. Canonical correlation analysis is a multivariate statistical method used to study the correlation between two groups of variables; this study employed it to analyze data relevant to shipping and the water environment of the Yangtze River from 2006 to 2016. Furthermore, the Yangtze River Shipping Prosperity Index and Yangtze River mainline freight volume were used to characterize the development of Yangtze River shipping. The water environment of the Yangtze River is characterized by wastewater discharge, ammonia nitrogen concentration, biochemical oxygen demand, the potassium permanganate index, and petroleum pollution. The results showed that a significant correlation exists between Yangtze River shipping and the river’s water environment. Furthermore, mainline freight volume has a significant impact on the quantity of wastewater discharged and petroleum pollution in the water environment.

Objectives: To study the genetic and clinical characteristics of Chinese children with pathogenic proline-rich transmembrane protein 2 (PRRT2) gene-associated disorders.Methods: Targeted next generation sequencing (NGS) was used to identify pathogenic PRRT2 variations in Chinese children with epilepsy and/or kinesigenic dyskinesia. Patients with confirmed PRRT2-associated disorders were monitored and their clinical data were analyzed.Results: Forty-four patients with pathogenic PRRT2 variants were recruited. Thirty-five of them (79.5%) had heterozygous mutations, including 30 frameshifts, three missenses, one nonsense, and one splice site variant. The c.649dupC was the most common variant (56.8%). Eight patients (18.2%) showed whole gene deletions, and one patient (2.3%) had 16p11.2 microdeletion. Thirty-four cases (97.1%) were inherited and one case (2.9%) was de novo. Forty patients were diagnosed with benign familial infantile epilepsy (BFIE), two patients had paroxysmal kinesigenic dyskinesia (PKD) and two had infantile convulsions and choreoathetosis (ICCA). Patients with whole gene deletions had a later remission than patients with heterozygous mutations (13.9 vs. 7.1 months, P = 0.001). Forty-two patients were treated with antiseizure medications (ASMs). At last follow-up, 35 patients, including one who did not receive therapy, were asymptomatic, and one patient without ASMs died of status epilepticus at 12 months of age. One patient developed autism, and one patient showed mild developmental delay/intellectual disability.Conclusion: Our data suggested that patients with whole gene deletions could have more severe manifestations in PRRT2-associated disorders. Conventional ASMs, especially Oxcarbazepine, showed a good treatment response.

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