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Background: Developmental and epileptic encephalopathy (DEE) is a group of neurodevelopmental disorders characterized by early-onset seizures predominantly attributed to genetic causes. Nevertheless, numerous patients remain without identification of a genetic cause. Methods: We present four unrelated Chinese patients with SPOUT1 compound heterozygous variants, all of whom were diagnosed with DEE. We also investigated functions of SPOUT1 using the spout1 knockout zebrafish model. Results: The four unrelated DEE patients with SPOUT1 compound heterozygous variants were all males. Their onset age of seizure ranged from 3 months to 6 months (median age 5 months). All patients had epileptic spasms, and were diagnosed with infantile epileptic spasms syndrome (IESS). Three patients had microcephaly during infancy. Brain MRI in three patients showed white matter hypomyelination and bilaterally widened frontotemporal subarachnoid space. At the last follow-up, two patients exhibited drug-resistant epilepsy, one achieved seizure freedom following vigabatrin treatment, and one died at the age of 4 years and 5 months from probable sudden unexpected death in epilepsy. Seven different SPOUT1 variants were identified in the four patients, including six missense variants and one deletion variant. AlphaFold2 prediction indicated that all variants alternated the number or the length of bonds between animo acids in protein SPOUT1. Neurophysiological results from spout1 knockout zebrafish revealed the presence of epileptiform signals in 9 out of 63 spout1 knockout zebrafishes (P = 0.009). Transcriptome sequencing revealed 21 differentially expressed genes between spout1 knockout and control groups, including 13 up-regulated and 8 down-regulated genes. Two axonal transport-related genes, kif3a and ap3d1, were most prominently involved in enriched Gene Ontology (GO) terms. Conclusions: This study identified SPOUT1 as a novel candidate gene of DEE, which follows the autosomal-recessive inheritance pattern. IESS is the most common epilepsy syndrome. Downregulation of axonal transport-related genes, KIF3A and AP3D1, may play a crucial role in the pathogenesis of DEE. [ABSTRACT FROM AUTHOR]

Background: Patients with migraine often experience not only headache pain but also cognitive dysfunction, particularly in attention, which is frequently overlooked in both diagnosis and treatment. The influence of these attentional deficits on the pain-related clinical characteristics of migraine remains poorly understood, and clarifying this relationship could improve care strategies. Methods: This study included 52 patients with migraine and 34 healthy controls. We employed the Attentional Network Test for Interactions and Vigilance–Executive and Arousal Components paradigm, combined with electroencephalography, to assess attentional deficits in patients with migraine, with an emphasis on phasic alerting, orienting, executive control, executive vigilance, and arousal vigilance. An extreme gradient boosting binary classifier was trained on features showing group differences to distinguish patients with migraine from healthy controls. Moreover, an extreme gradient boosting regression model was developed to predict clinical characteristics of patients with migraine using their attentional deficit features. Results: For general performance, patients with migraine presented a larger inverse efficiency score, a higher prestimulus beta-band power spectral density and a lower gamma-band event-related synchronization at Cz electrode, and stronger high alpha-band activity at the primary visual cortex, compared to healthy controls. Although no behavior differences in three basic attentional networks were found, patients showed magnified N1 amplitude and prolonged latency of P2 for phasic alerting-trials as well as an increased orienting evoked-P1 amplitude. For vigilance function, improvements in the hit rate of executive vigilance-trials were exhibited in controls but not in patients. Besides, patients with migraine exhibited longer reaction time as well as larger variability in arousal vigilance-trials than controls. The binary classifier developed by such attentional deficit features achieved an F1 score of 0.762 and an accuracy of 0.779 in distinguishing patients with migraine from healthy controls. Crucially, the predicted value available from the regression model involving attentional deficit features significantly correlated with the real value for the frequency of headache. Conclusions: Patients with migraine demonstrated significant attentional deficits, which can be used to differentiate migraine patients from healthy populations and to predict clinical characteristics. These findings highlight the need to address cognitive dysfunction, particularly attentional deficits, in the clinical management of migraine. [ABSTRACT FROM AUTHOR]

Objective To summarize the electrophysiological and muscle pathological characteristics of Lambert - Eaton myasthenic syndrome (LEMS). Methods and Results Twelve LEMS patients referred to China - Japan Friendship Hospital between January 2010 and December 2021 were included. Clinically, they all showed proximal muscle weakness and reduced or disappeared tendon reflexes. Electrophysiologically, all 12 patients showed decreased compound muscle action potential (CMAP) amplitudes, normal distal motor latency (DML), and normal motor and sensory conduction velocities. Ten patients underwent repetitive nerve stimulation (RNS) test: all had amplitude increments of more than 100% at high - frequency RNS, and 8 had amplitude decrements of more than 15% at low - frequency RNS. Three patients completed the post-exercise facilitation (PEF) test: the ulnar nerve CMAP amplitude reached a peak immediately after maximum voluntary contraction of the abductor digiti minimi for 5-10 s and then gradually decreased to near baseline level after contraction for 60 s; the ulnar nerve CMAP amplitude reached a peak immediately after maximum voluntary contraction for 10 s, and then rapidly decreased to near baseline level after 15 s. On needle EMG, 8 patients showed normal motor unit action potential (MUAP), 3 showed short - duration MUAP mimicking myopathy, and one showed long - duration MUAP mimicking neuropathy. Two patients with normal MUAP underwent biceps biopsy, which showed selective type - fiber atrophy. Conclusions Electrophysiologically, CMAP amplitudes of LEMS patients are usually diffusely low or borderline. LEMS patients have amplitude increments of more than 100% at high-frequency RNS, and some have amplitude decrements of more than 15% at low-frequency RNS. PEF Needle EMG is usually normal, but some show myogenic lesions, and some show neurogenic lesions. Muscle biopsy shows selective type - fiber atrophy. Needle EMG myogenic lesion may not be associated with pathologically selective type - fiber atrophy. [ABSTRACT FROM AUTHOR]

Introduction: The accuracy of surface ECG algorithms for predicting the origin of outflow tract ventricular arrhythmias (OT‐VAs) might be questioned. Intracardiac electrograms recorded at anatomic landmarks could provide new predictive insights. We aim to evaluate the efficacy of a novel criterion utilizing the activation pattern of the coronary sinus (CS) in localizing OT‐VAs, including VAs originating from the right ventricular outflow tract (RVOT), endocardial left ventricular outflow tract (Endo‐LVOT), and epicardial left ventricular outflow tract (Epi‐LVOT). Methods: We measured the ventricular activation time of the mitral annulus (MA) from the onset of the earliest QRS complex of VAs to the initial deflection over the isoelectric line at local signals, namely the QRS‐MA interval. The activation at 3 and 12 o'clock of the MA was recorded as the QRS‐MA3 and QRS‐MA12 intervals, respectively. Their predictive values were compared to previous ECG algorithms. Results: A total of 68 patients with OT‐VAs were enrolled (51 for development and 17 for validation). From early to late, the ventricular activation sequences at MA12 were as follows: Epi‐LVOT, Endo‐LVOT, and RVOT. In LBBB morphology OT‐VAs, the QRS‐MA12 interval was significantly earlier for LVOT origins than RVOT origins. In the combined cohort of development and validation cohort, a cut‐off value of ≤10 ms predicted the LVOT origin with a sensitivity of 100% and specificity of 78%. The QRS‐MA12 interval ≤ −24 ms additionally predicted epicardial LVOT sites of origin. Conclusions: The QRS‐MA interval could accurately differentiate the OT‐VAs localization. [ABSTRACT FROM AUTHOR]

Introduction: Left bundle branch pacing (LBBP) is a physiological pacing modality. However, the long procedure and fluoroscopy time of LBBP is still a problem. This study aims to compare the clinical outcomes between transthoracic echocardiography (TTE)‐ and X‐ray‐guided LBBP. Methods: This is a single‐center, prospective, randomized controlled study. Consecutive patients who underwent LBBP in our team from June 2022 to November 2022 were enrolled. Procedure and fluoroscopy time, pacing parameters, electrophysiological and echocardiographic characteristics, as well as complications were recorded at implantation and during follow‐up. Results: In this study, 60 patients were enrolled and divided into two groups: 30 patients were allocated to the X‐ray group and the remaining 30 to the TTE group. There was no significant difference in the success rate between the two groups (86.7% vs. 76.7%, p = .317). The procedure time of TTE group was comparable to that of the X‐ray group (9.0 vs. 12.0 min, p = .063). However, the fluoroscopy time in the TTE group was significantly lower than that of the X‐ray group (2.5 vs. 5.0 min, p = .002). There were no statistically significant differences in pacing parameters, electrophysiological and echocardiographic characteristics, or complications between the two groups at implantation and during follow‐up. Conclusion: TTE‐guided LBBP is a feasible and safe method. Compared with X‐ray, TTE showed a comparable success rate and procedure time, but it could significantly reduce the fluoroscopy time of LBBP. [ABSTRACT FROM AUTHOR]

Introduction: Takotsubo cardiomyopathy (TTC), also known as stress‐induced cardiomyopathy, resembles acute heart failure syndrome but lacks disease‐specific diagnosis and treatment strategies. TTC accounts for approximately 5–6% of all suspected cases of acute coronary syndrome in women. At present, animal models of TTC are often created by large amounts of exogenous catecholamines such as isoproterenol. However, isoproterenol injection cannot fully simulate the onset of stress‐induced cardiomyopathy in humans since stress is not an instantaneous event. Methods: Rats were immobilized for 6 h per day for 1–14 days. To examine whether the TTC model was successful, echocardiography was employed; Elisa detected serum sympathetic activation markers; and the Open‐Field test (OFT) was used to analyze behavioral changes in rats after stress. Western blot and histology were used to assess sympathetic remodeling, inflammation levels, and fibrosis; qRT‐PCR was used to explore the levels of fibrosis and myocardial hypertrophy. The electrical stability of ventricular was determined by electrophysiological testing. Results: The rats showed severe stress behavior and local sympathetic remodeling of the heart after only 1 day of stress. After 3 days of stress, the induction of ventricular tachyarrhythmia increased prominently. The highest incidence of TTC in rats was at 5 days of immobilization stress. The pathological left ventricular remodeling caused by immobilization (IMO) stress includes inflammatory infiltration, fibrosis, and myocardial hypertrophy. Conclusions: Our study confirms the hypothesis that IMO stress can mimic Takotsubo cardiomyopathy, and the various effects on the heart depending on the duration of IMO stress. We observed the highest incidence of TTC occurred after 5 days of stress. Furthermore, there is a gradual occurrence of electrical and structural remodeling as the stress duration prolongs. [ABSTRACT FROM AUTHOR]

The occurrence of sequelae is common after heatstroke. There is a lack of risk prediction data regarding the prevalence of sequelae. This study aims to develop a predictive model for the sequelae after heatstroke, including cerebellar dysfunction. Heatstroke patients admitted to our hospital in the past 8 years were retrospectively enrolled. Regression analyses were conducted to identify risk factors associated with sequelae and cerebellar dysfunction. A prediction model for post-heatstroke sequelae was developed and internally and externally validated. Twenty-three percent of the patients experienced sequelae, with cerebellar dysfunction accounting for 51.7%. Patients with sequelae had longer duration of hyperthermia and coma, lower Glasgow Coma Scales scores, elevated core temperature, increased incidence of multiple organ dysfunction upon admission, and a worse prognosis compared to non-sequelae patients. Patients with cerebellar injury exhibited impaired balance, and a Sepsis-related Organ Failure Assessment (SOFA) score > 5 is an independent risk factor. The prediction system included advanced age, coma, and an APACHE-II score > 10 upon admission, predicting sensitivity = 0.8966, specificity = 0.8925, and AUC of ROC curve = 0.941 (95% CI: 0.884 ~ 0.976). The C-index in the internal verification was 0.942 (95% CI: 0.847 ~ 0.981) and the AUC in the external verification was 0.816 (95% CI: 0.699 ~ 0.902). The prediction system included advanced age, coma, and higher APACHE-II scores as variables, indicating a significant prevalence of sequelae. Higher SOFA scores were associated with the increased occurrence of cerebellar dysfunction and balance impairment. The prediction system could better predict sequelae after heatstroke. [ABSTRACT FROM AUTHOR]

Background: The growing demand for electrophysiology (EP) treatment in China presents a challenge for current EP care delivery systems. This study constructed a discrete event simulation (DES) model of an inpatient EP care delivery process, simulating a generalized inpatient journey of EP patients from admission to discharge in the cardiology department of a tertiary hospital in China. The model shows how many more patients the system can serve under different resource constraints by optimizing various phases of the care delivery process. Methods: Model inputs were based on and validated using real-world data, simulating the scheduling of limited resources among competing demands from different patient types. The patient stay consists of three stages, namely: the pre-operative stay, the EP procedure, and the post-operative stay. The model outcome was the total number of discharges during the simulation period. The scenario analysis presented in this paper covers two capacity-limiting scenarios (CLS): (1) fully occupied ward beds and (2) fully occupied electrophysiology laboratories (EP labs). Within each CLS, we investigated potential throughput when the length of stay or operative time was reduced by 10%, 20%, and 30%. The reductions were applied to patients with atrial fibrillation, the most common indication accounting for almost 30% of patients. Results: Model validation showed simulation results approximated actual data (137.2 discharges calculated vs. 137 observed). With fully occupied wards, reducing pre- and/or post-operative stay time resulted in a 1–7% increased throughput. With fully occupied EP labs, reduced operative time increased throughput by 3–12%. Conclusions: Model validation and scenario analyses demonstrated that the DES model reliably reflects the EP care delivery process. Simulations identified which phases of the process should be optimized under different resource constraints, and the expected increases in patients served. [ABSTRACT FROM AUTHOR]

Simple Summary: Batocera horsfieldi Hope (Coleoptera: Cerambycidae) has a wide host range, attacking nearly 100 tree species, and has become a devastating native forestry pest in China. Studies of various phytophagous insect attractants have shown that plant volatiles can be used as effective bait while minimizing the cost and labor of manual control. In this study, we searched for key plant-derived volatile attractants for B. horsfieldi by extracting and evaluating volatile components of host plants using beetle electrophysiological responses and Y-tube behavioral experiments. We provide a theoretical framework for the green control of the beetle. Following infestation by phytophagous insects, changes in the composition and relative proportion of volatile components emitted by plants may be observed. Some phytophagous insects can accurately identify these compounds to locate suitable host plants. We investigated whether herbivore-induced plant volatiles (HIPVs) generated by herbivory on Pistacia chinensis Bunge (Sapindales: Aceraceae) might be semiochemicals for the host location of Batocera horsfieldi Hope (Coleoptera: Cerambycidae). We performed two-choice bioassays (indoor darkroom, inside cages) on plants damaged by adult feeding and intact control plants. Volatiles from these plants were then collected and identified, and the response of adult antennae to these compounds was tested via electroantennography (EAG). The behavioral responses of B. horsfieldi to these compounds were finally assessed using a Y-tube olfactometer. Host plant choice tests show that B. horsfieldi prefers feeding-damaged P. chinensis over healthy trees. In total, 15 compounds were collected from healthy and feeding-damaged P. chinensis, 10 of which were shared in both healthy and feeding-damaged P. chinensis, among which there were significant differences in the quantities of five terpenes, including α-pinene, β-pinene, α-phellandrene, D-limonene, and β-ocimene. In EAG assays, the antennae of B. horsfieldi adults responded strongly to (Z)-3-hexen-1-ol, β-ocimene, 3-carene, γ-terpinene, D-limonene, myrcene, and α-phellandrene. The antennae of B. horsfieldi adults responded in a dose–response manner to these compounds. Y-tube behavioral experiments showed that four compounds attracted mated females ((Z)-3-hexen-1-ol, β-ocimene, 3-carene, and α-phellandrene), two compounds ((Z)-3-hexen-1-ol and α-phellandrene) attracted males, and adults of both sexes avoided D-limonene. Feeding bioassays showed that (Z)-3-hexen-1-ol and β-ocimene could promote the feeding of B. horsfieldi and that D-limonene inhibited this response. These results could provide a theoretical basis for developing attractants or repellents for B. horsfieldi. [ABSTRACT FROM AUTHOR]

Background: Cancer has become significant comorbidity in patients with atrial fibrillation (AF). However, little is known about the efficacy and safety of AF ablation, the first‐line rhythm control strategy, in patients with cancer. This study aims to evaluate the incidence and risk of AF recurrence and safety endpoints in patients with cancer compared to the non‐cancer group after ablation. Methods: From August 2011 to December 2020, we consecutively enrolled cancer patients in the China‐AF cohort. We used propensity score matching (1:3) to select the control group and assessed the risk of AF recurrence and adverse events after ablation in cancer patients using a multivariable Fine and Gray competing risk model. Results: A total of 203 patients with cancer were enrolled and 21 of them were active cancer, with a median follow‐up of 12.3 months. The cumulative incidence of AF recurrence was comparable between patients with and without cancer (43.8% vs. 51.1%; p =.88). No difference in the risk of AF recurrence, thromboembolism, major bleeding, and mortality was observed after adjusting confounders. Active cancer was not associated with an increased risk of AF recurrence compared to the stable disease (SHR = 1.32; 95% CI 0.72–2.43; p =.46). Cancer was associated with a low risk of cardiovascular hospitalization (SHR, 0.54; 95% CI, 0.36–0.81; p =.01). Subgroup analysis found that hematological malignancy was associated with a high risk of AF recurrence (SHR, 5.68; 95% CI, 3.00–10.8; p <.001). Conclusions: This study suggests that catheter ablation could be feasible for rhythm control of AF patients with concomitant cancer. [ABSTRACT FROM AUTHOR]

Transcatheter radiofrequency ablation has been widely introduced for the treatment of tachyarrhythmias. The demand for catheter ablation continues to grow rapidly as the level of recommendation for catheter ablation. Traditional catheter ablation is performed under the guidance of X‐rays. X‐rays can help display the heart contour and catheter position, but the radiobiological effects caused by ionizing radiation and the occupational injuries worn caused by medical staff wearing heavy protective equipment cannot be ignored. Three‐dimensional mapping system and intracardiac echocardiography can provide detailed anatomical and electrical information during cardiac electrophysiological study and ablation procedure, and can also greatly reduce or avoid the use of X‐rays. In recent years, fluoroless catheter ablation technique has been well demonstrated for most arrhythmic diseases. Several centers have reported performing procedures in a purposefully designed fluoroless electrophysiology catheterization laboratory (EP Lab) without fixed digital subtraction angiography equipment. In view of the lack of relevant standardized configurations and operating procedures, this expert task force has written this consensus statement in combination with relevant research and experience from China and abroad, with the aim of providing guidance for hospitals (institutions) and physicians intending to build a fluoroless cardiac EP Lab, implement relevant technologies, promote the standardized construction of the fluoroless cardiac EP Lab. [ABSTRACT FROM AUTHOR]

Objective: This study aims to evaluate three types of manual toothbrushes [Cross action (CA), Flat trim (FT), and orthodontic type (OT)] in terms of efficacy in plaque removal in patients undergoing fixed orthodontic treatment. Background: Manual toothbrushes are an essential part of oral hygiene for primary prevention. Plaque control, however, can be influenced by a number of individual and material-related factors. Individual factors include the presence of fixed orthodontic appliances on tooth surfaces, such as brackets and bands, which create difficulties with oral hygiene and lead to plaque formation. The evidence for the effectiveness of advanced bristle designs (multilevel, criss-cross) of the manual toothbrush alone in removing plaque in patients undergoing orthodontic therapy is limited. Methods: The experiment followed the Consolidated Standards of Reporting Trials (CONSORT) guidelines. This was a three treatment, three-period crossover clinical trial with a single brushing exercise. Thirty subjects were randomized to one of the three treatment sequences of different bristle designs: (CA, FT, and OT). The primary outcome measure was the difference in the plaque scores (baseline minus post-brushing) at each study period, as determined by the Turesky-Modified Quigley–Hein Plaque Index. Results: Of the thirty-four subjects enrolled in the study, thirty of the subjects met the inclusion criteria and completed all three periods of the study. The mean age was 19.5 ± 1.52 years, with a range of 18–23 years. The differences between treatments in plaque score reduction after brushing were statistically significant (p-value <.001). The treatment differences were statistically significant (p-value <.001) favoring the FT toothbrush over the OT and CA types of toothbrush designs. On the contrary, the difference between the OT and CA types was not statistically significant. Conclusions: Plaque was significantly removed by the conventional FT toothbrush after a single brushing compared to the OT and CA types. [ABSTRACT FROM AUTHOR]

If evolution was/is a fact, a simplified/unifying approach to explain cellular physiology is warranted. Such a perspective should agree with the thermodynamic, kinetic, structural, and operational‐probabilistic considerations; without invoking overt intelligence or determinism, and must enable a synthesis from chaos. In this regard, we first list salient theories in cellular physiology for (i) powering (generation of chemical/heat energy), (ii) coherence (interconnectivity and workability as a unit), (iii) homeostasis (metabolizing and expelling of unfamiliar/unwanted materials, maintaining concentration/volume), and (iv) cellular electrical‐mechanical activities. While doing so, we discuss the scopes and limitations of (a) the classical active‐site affinity and recognition‐based modality of lock‐key and induced‐fit enzyme‐catalytic mechanisms established by Fischer/Koshland, (b) membrane‐pump hypothesis acclaimed by biologists‐physicians and historically championed by the British Nobel‐laureates like Hodgkin–Huxley–Katz–Mitchell, and (c) association‐induction hypothesis advocated by physicists–physiologists from various parts of the world, for example, Gilbert Ling (China–USA), Gerald Pollack (USA), Ludwig Edelmann (Germany), Vladimir Matveev (Russia), and so on. We apply murburn concept (from "mured burning," capturing the thesis that one‐electron redox equilibriums involving diffusible reactive species play vital roles in maintaining life order) to amalgamate several core cellular functions and further discuss the prospects for establishing the continuum of the principles of physics in biology. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the current status of cognitive development and central auditory processing development of preschool children with minimal and mild hearing loss (MMHL) in Nanjing, China. Method: We recruited 34 children with MMHL and 45 children with normal hearing (NH). They completed a series of tests, including cognitive tests (i.e., Wechsler Preschool and Primary Scale of Intelligence and Continuous Performance Test), behavioral auditory tests (speech-in-noise [SIN] test and frequency pattern test), and objective electrophysiological audiometry (speech-evoked auditory brainstem response and cortical auditory evoked potential). In addition, teacher evaluations and demographic information and questionnaires completed by parents were collected. Results: Regarding cognitive ability, statistical differences in the verbal comprehensive index, full-scale intelligence quotient, and abnormal rate of attention test score were found between the MMHL group and the NH group. The children with MMHL performed poorer on the SIN test than the children with NH. As for the auditory electrophysiology of the two groups, the latency and amplitude of some waves of the speech-evoked auditory brainstem response and cortical auditory evoked potential were statistically different between the two groups. We attempted to explore the relationship between some key indicators of auditory processing and some key indicators of cognitive development. Conclusions: Children with MMHL are already at increased developmental risk as early as preschool. They are more likely to have problems with attention and verbal comprehension than children with NH. This condition is not compensated with increasing age during the preschool years. The results suggest a possible relationship between the risk of cognitive deficit and divergence of auditory processing. [ABSTRACT FROM AUTHOR]

OBJECTIVE To access the efficacy and safety of the double-ProGlide technique for the femoral vein access-site closure in cryoballoon ablation with uninterrupted oral anticoagulants (OAC), and its impact on the electrophysiology laboratory time as well as hospital stay after the procedure in this observational study. METHODS Patients with atrial fibrillation undergoing cryoballoon ablation with uninterrupted OAC at Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China from May 2019 to May 2021 were enrolled in this study. From October 2020, double-ProGlide technique was consistently used for hemostasis (ProGlide group), and before that conventional manual compression was utilized (manual compression group). The occurrence of vascular and groin complications was accessed during the hospital stay and until the three-month follow-up. RESULTS A total of 140 participants (69.30% of male, mean age: 59.21 ± 10.29 years) were evaluated, 70 participants being in each group. Immediate hemostasis was achieved in all the patients with ProGlide closure. No major vascular complications were found in the ProGlide group while two major vascular complications were occurred in the manual compression group. The incidence of any groin complication was obviously higher in subjects with manual compression than patients with ProGlide devices (15.71% vs. 2.86%, P = 0.009). In addition, compared with the manual compression group, the ProGlide group was associated with significantly shorter total time in the electrophysiology laboratory [112.0 (93.3-128.8) min vs. 123.5 (107.3-158.3) min, P = 0.006], time from sheath removal until venous site hemostasis [3.8 (3.4-4.2) min vs. 8.0 (7.6-8.5) min, P < 0.001], bed rest time [8.0 (7.6-8.0) h vs. 14.1 (12.0-17.6) h, P < 0.001] and hospital stay after the procedure [13.8 (12.5-17.8) h vs. 38.0 (21.5-41.0) h, P < 0.001]. CONCLUSIONS Utilization of the double-ProGlide technique for hemostasis after cryoballoon ablation with uninterrupted OAC is feasible and safe, which has the clinical benefit in reducing the total electrophysiology laboratory time and the hospital stay length after the procedure. [ABSTRACT FROM AUTHOR]

Objective: We aimed to investigate the effects of different doses of dexmedetomidine (Dex) on evoked potentials in adult patients undergoing spinal surgery under intravenous anesthesia with low-concentration desflurane. Methods: Ninety patients were divided into three groups at random. To maintain anesthesia in the control group (group C), desflurane 0.3 MAC (minimal alveolar concentration), propofol, and remifentanil were administered. Dex (0.5 μg·kg−1) was injected for 10 min as a loading dose in the low-dose Dex group (group DL), then adjusted to 0.2 μg·kg−1·h−1 until the operation was completed. Dex (1 μg·kg−1) was injected for 10 min as a loading dose in the high-dose Dex group (group DH), then adjusted to 0.7 μg·kg−1·h−1 until the operation was completed. The additional medications were similar to those given to group C. The perioperative hemodynamics, body temperature, intraoperative drug dosages, fluid volume, urine volume, blood loss, the latency and amplitude of somatosensory evoked potentials (SEPs) at four different time points, the incidence of positive cases of SEPs and transcranial motor evoked potentials (tcMEPs), and perioperative adverse reactions were all recorded. Results: Data from 79 patients were analyzed. The MAP measured at points T2-T4 in group DH was higher than at corresponding points in group C (P < 0.05). The MAP at point T4 in group DL was higher than at corresponding points in group C (P < 0.05). The remifentanil dosage in group DH was significantly lower than in group C (P = 0.015). The fluid volume in group DL was significantly lower than in group C (P = 0.009). There were no significant differences among the three groups in the amplitude and latency of SEP at different time points, nor in the incidence of warning SEP signals. The incidence of positive tcMEP signals did not differ significantly between groups C and DL (P > 0.05), but was significantly higher in group DH than in groups DL (P < 0.05) or C (P < 0.05). The incidence of intraoperative hypertension was significantly higher in group DH than in group C (P = 0.017). Conclusions: Low-dose Dex has no effect on the SEPs and tcMEPs monitoring during spinal surgery. High-dose Dex has no effect on SEPs monitoring, but it may increase the rate of false positive tcMEPs signals and the incidence of intraoperative hypertension. Trial registration: This study has completed the registration of the Chinese Clinical Trial Center at 11/09/2020 with the registration number ChiCTR2000038154. [ABSTRACT FROM AUTHOR]

Objective To summarize the characteristics of delayed facial paralysis (DFP) after retrosigmoid approach surgery for vestibular schwannoma and screen its related influencing factors. Methods A total of 171 patients with vestibular schwannoma treated in The First Affiliated Hospital of Zhengzhou University from January 2019 to May 2021 were included in the study. All patients underwent retrosigmoid approach surgery under neuroelectrophysiological monitoring. Before and after the surgery, facial paralysis was classified according to House - Brackmann (H - B) grade of facial nerve function. Univariate and multivariate forward Logistic regression analysis was used to screen related risk factors of DFP after vestibular schwannoma surgery. Results Patients were divided into DFP group (n = 19) and non- DFP (NDFP) group (n = 152) according to whether there was DFP after surgery. The tumor diameter in DFP group was smaller than that in NDFP group (t = 6.623, P = 0.001), the proportion of small tumors (χ² = 18.585, P = 0.000) and the proportion of slight adhesion between tumor and facial nerve (χ² = 21.442, P = 0.000) were higher than those in NDFP group. Logistic regression analysis showed small tumor (OR = 15.797, 95%CI: 3.324-75.081; P = 0.001) and slight adhesion between tumor and facial nerve (OR = 11.690, 95%CI: 3.413-40.042; P = 0.000) were risk factors for DFP after vestibular schwannoma surgery. Following up to one year after surgery, the recovery rate of facial nerve function (H-B grade I-II) in DFP group was 17/19. Conclusions The patients with small tumor volume and slight adhesion between tumor and facial nerve are prone to DFP, and the prognosis of facial nerve function in such patients is good. [ABSTRACT FROM AUTHOR]

Objective To explore the application of membranous concept in vestibular schwannoma surgery. Methods A total of 39 patients with vestibular schwannoma who received membranous surgical treatment in The First Affiliated Hospital of Anhui Medical University from May 2020 to June 2021 were enrolled. Through the retrosigmoid approach, the intraoperative electrophysiological monitoring was performed, and the membranous concept was used to separate the brain stem of the tumor and the interface between the tumor and the facial nerve and the cochlear nerve. Facial nerve function was evaluated by the House-Brackmann (H -B) grade and hearing was evaluated by the American Academy of Otolaryngology- Head and Neck Surgery (AAO-HNS) scale at one day, one week and one year after surgery. Results Total resection was performed in 31 cases (79.49%) and nearly total resection in 8 cases (20.51%). Facial nerve anatomical preservation was achieved in all patients, and facial nerve function returned to normal or nearly normal (H - B grade I - II) 84.62% (33/39), moderate facial paralysis (H - B grade III) 10.27% (4/39), moderate and severe facial paralysis (H-B grade IV) 5.13% (2/39) on the first day after surgery. One week after surgery, 71.79% (28/39) of patients with normal or nearly normal facial nerve function, 15.38% (6/39) of moderate facial paralysis, 10.27% (4/39) of moderate and severe facial paralysis, and 2.56% (1/39) of severe facial paralysis (H-B grade V). One year after surgery, 92.31% (36/39) of patients with facial nerve function returned to normal or nearly normal, 5.13% (2/39) of patients with moderate facial paralysis, and 2.56% (1/39) of patients with moderate and severe facial paralysis. Among the 10 patients (25.64%) who retained effective hearing before surgery (AAO-HNS grade ≥ C), there were 4, 3 and 6 cases at one day, one week and one year after surgery, respectively. Those who did not retain effective hearing before surgery did not recover effective hearing after surgery. According to the comparison of tumor volume and nature, the proportion of patients with normal facial nerve function (H-B grade I) in the tumor volume ≤ 3 cm group was higher than that in > 3 cm group [12/18 vs. 19.05% (4/21); Fisher's exact probability: P = 0.006], the proportion of patients with normal facial nerve function in the solid tumor group was higher than that in cystic group [71.43% (15/21) vs. 1/10; Fisher's exact probability: P = 0.010] at one year after surgery. Conclusions The membranous concept in vestibular schwannoma surgery can protect facial nerve function well, and has a positive effect on the protection of cochlear nerve and brain stem. [ABSTRACT FROM AUTHOR]

In September 2020, China has made a commitment to achieving "peak carbon dioxide emissions" before 2030 and "carbon neutrality" before 2060 at the General Assembly of the United Nations. Then, at the Climate Ambition Summit, China pointed out the important responsibility and mission of the power industry to serve "peak carbon dioxide emissions and carbon neutrality". The key issues such as what kind of electric market to build and what kind of main energy will be chosen to build the power system were proposed. For the new power system, there will be new changes in the links of "source, network, load, storage". However, the reform of the electricity market cannot be ignored, either. How to determine the type of electricity sales company and how to develop a suitable electricity sales strategy is one of the important studies that need to be explored at present. Therefore, the main body of electricity sales companies under new power system reform in China are analyzed in our studies, Then, we reviewed the current situation of electricity market reform at home and abroad. Finally, the thought on electricity market reform is presented. [ABSTRACT FROM AUTHOR]

Objective To summarize the clinical, laboratory, imaging, electrophysiological and histopathological features and therapeutic responses of patients with paranodopathy with positive anti - neurofascin 155 (NF155) antibody. Methods and Results Five patients who visited Xuanwu Hospital, Capital Medical University in January 2017 to August 2020 with positive anti -NF155 antibody, were men with onset ages 10 to 61 years old. The clinical manifestations were subacute onset, gradual progress, distal limb weakness, numbness, tremor and ataxia. The distal limbs were more severe than the proximal and lower limbs were more severe than the upper. Five patients were positive NF155-IgG4. Cerebrospinal fluid protein was significant increased. There were cervical and lumbosacral nerve roots enlargement. The distal latency of compound muscle action potential (CMAP) prolonged, the conduction velocity decreased, and the F -wave latency extended. Sural nerve biopsy showed axonal degeneration, the Ranvier node widened, the transverse band disappeared, and the space between the myelin loop and axon increased without inflammatory cell infiltration and "onion bulb" structure. Glucocorticoid therapy and intravenous immunoglobulin (IVIg) were not effective or initially effective, then failed, while rituximab was effective. Conclusions Patients with positive anti -NF155 antibody paranodopathy showed heterogeneity in clinical characteristics and treatment. Early stage should do antibody examination and diagnosis. Early treatment could prevent myelin and axonal injury and preserve nerve function. [ABSTRACT FROM AUTHOR]

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Purpose: Although acquisition of Chinese lexical tones by second language (L2) learners has been intensively investigated, very few studies focused on categorical perception (CP) of lexical tones by highly proficient L2 learners. This study was designed to address this issue with behavioral and electrophysiological measures. Method: Behavioral identification and auditory event-related potential (ERP) components for speech discrimination, including mismatch negativity (MMN), N2b, and P3b, were measured in 23 native Korean speakers who were highly proficient late L2 learners of Chinese. For the ERP measures, both passive and active listening tasks were administered to examine the automatic and attentioncontrolled discriminative responses to within- and across-category differences for carefully chosen stimuli from a lexical tone continuum. Results: The behavioral task revealed native-like identification function of the tonal continuum. Correspondingly, the active oddball task demonstrated larger P3b amplitudes for the across-category than within-category deviants in the left recording site, indicating clear CP of lexical tones in the attentive condition. By contrast, similar MMN responses in the right recording site were elicited by both the across- and within-category deviants, indicating the absence of CP effect with automatic phonological processing of lexical tones at the pre-attentive stage even in L2 learners with high Chinese proficiency. Conclusion: Although behavioral data showed clear evidence of categorical perception of lexical tones in proficient L2 learners, ERP measures from passive and active listening tasks demonstrated fine-grained sensitivity in terms of response polarity, latency, and laterality in revealing different aspects of auditory versus linguistic processing associated with speech decoding by means of largely implicit native language acquisition versus effortful explicit L2 learning. [ABSTRACT FROM AUTHOR]

Tea black tussock moth, Dasychira baibarana (Matsumura) (Lepidoptera: Lymantriidae), is a devastating pest species of the tea plant in China. Here, we evaluated the responses of D. baibarana to tea plant volatiles using gas chromatography coupled electroantennographic detection (GC–EAD), eleclectroantennography (EAG), and a Y-tube olfactometer. In total, 11 of 18 analyzed compounds elicited GC–EAD responses from test insects. GC–EAD bio-active compounds were further investigated using EAG and behavioral responses. In the EAG analysis, male moths had significantly greater responses to four compounds [(Z)-3-hexenyl butyrate, (Z)-3-hexen-1-ol, ocimene and benzyl alcohol] than female moths. For females, maximum EAG amplitudes, were recorded in response to linalool, (Z)-3-hexenyl hexanoate and (Z)-jasmone. In EAG and behavioral bio-assays, the responses of both sexes were dose independent. In behavioral bio-assays male moths responding significantly to (Z)-3-hexen-1-ol, ocimene, (Z)-3-hexenyl butyrate, linalool, benzyl alcohol, and (Z)-jasmone at various concentrations. For females, significant behavioral responses were observed to (Z)-3-hexenyl hexanoate, followed by (Z)-jasmone, linalool, ocimene, and benzyl alcohol. However, neither sex was sensitive to 4 of the 11 tested compounds, phenyethyl alcohol, phenylacetonitrile, (E)-nerolidol, and indole. The present results showed that tea plant volatiles influenced the behavior of D. baibarana moths, which will greatly contribute in developing eco-friendly control strategies for D. baibarana , through the application of a blend of compounds that showed significant EAG and behavioral responses or a blend combined with female-produced sex pheromones. [ABSTRACT FROM AUTHOR]

Aims: Pulsed field ablation (PFA) is an emerging non-thermal ablative modality demonstrating considerable promise for catheter ablation of atrial fibrillation (AF). However, these PFA trials have almost universally included only Caucasian populations, with little data on its effect on other races/ethnicities. The PLEASE-AF trial sought to study the 12-month efficacy and the safety of a multi-electrode hexaspline PFA catheter in treating a predominantly Asian/Chinese population of patients with drug-refractory paroxysmal AF., Methods and Results: Patients underwent pulmonary vein (PV) isolation (PVI) by delivering different pulse intensities at the PV ostium (1800 V) and atrium (2000 V). Acute success was defined as no PV potentials and entrance/exit conduction block of all PVs after a 20-min waiting period. Follow-up at 3, 6, and 12 months included 12-lead electrocardiogram and 24-h Holter examinations. The primary efficacy endpoint was 12-month freedom from any atrial arrhythmias lasting at least 30 s. The cohort included 143 patients from 12 hospitals treated by 28 operators: age 60.2 ± 10.0 years, 65.7% male, Asian/Chinese 100%, and left atrial diameter 36.6 ± 4.9 mm. All PVs (565/565, 100%) were successfully isolated. The total procedure, catheter dwell, total PFA application, and total fluoroscopy times were 123.5 ± 38.8 min, 63.0 ± 30.7 min, 169.7 ± 34.6 s, and 27.3 ± 10.1 min, respectively. The primary endpoint was observed in 124 of 143 patients (86.7%). One patient (0.7%) developed a small pericardial effusion 1-month post-procedure, not requiring intervention., Conclusion: The novel hexaspline PFA catheter demonstrated universal acute PVI with an excellent safety profile and promising 12-month freedom from recurrent atrial arrhythmias in an Asian/Chinese population with paroxysmal AF., Clinical Trial Registration: ClinicalTrials.gov Identifier: NCT05114954., Competing Interests: Conflict of interest: V.Y.R. has served as consultant to and has received equity compensation from Hangzhou Dinova EP Technology Co., Ltd; and unrelated to this manuscript, he serves as a consultant for and has equity in Ablacon, Acutus Medical, Affera-Medtronic, Apama Medical-Boston Scientific, Anumana, APN Health, Aquaheart, Atacor, Autonomix, Axon Therapies, Backbeat, BioSig, CardiaCare, CardioNXT/AFTx, Circa Scientific, CoRISMA, Corvia Medical, East End Medical, EPD-Philips, EP Frontiers, Epix Therapeutics-Medtronic, EpiEP, Eximo, Farapulse-Boston Scientific, Field Medical, Focused Therapeutics, HRT, Intershunt, Javelin, Kardium, Keystone Heart, LuxMed, Medlumics, Middlepeak, Neutrace, Nuvera-Biosense Webster, Oracle Health, Restore Medical, Sirona Medical, SoundCath, Valcare; unrelated to this work, has served as a consultant for Abbott, AtriAN, Biosense-Webster, BioTel Heart, Biotronik, Boston Scientific, Cairdac, Cardiofocus, Cardionomic, CoreMap, Fire1, Gore & Associates, Impulse Dynamics, Medtronic, Novartis, Philips, and Pulse Biosciences; and has equity in DRS Vascular, Manual Surgical Sciences, Newpace, Nyra Medical, Surecor, and Vizaramed. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose., (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Objectives. To observe and analyze the parameters of the sacral reflex and pudendal nerve somatosensory evoked potential (SSEP) in patients with multiple system atrophy (MSA) with respect to factors such as age, disease course, and subtype and provide evidence for the clinical diagnosis of MSA. Materials and Methods. A total of 51 MSA patients and 30 healthy controls were selected from the First Affiliated Hospital of Wenzhou Medical University from May 2013 to November 2015. Electrophysiological sacral reflex detection and SSEP detection were performed using the Keypoint EMG/EP system. The extraction rate, latency, and amplitude of the sacral reflex and SSEP in the MSA group and control group were compared. Results. The sacral reflex latency and amplitude in patients with MSA were statistically different from those of the healthy controls. The latency of sacral reflex increases with the prolongation of the disease course, and the amplitude and initiation rate decrease with the prolongation of the disease course. There was no significant difference in sacral reflex latency and amplitude between MSA patients of different ages and subtypes. There was no significant difference in the latency or amplitude of SSEP between the MSA group and healthy control group. Conclusions. The latency of sacral reflex increases with the prolongation of the disease course, and the amplitude and extraction rate decrease with the prolongation of the disease course. There was no significant difference in the parameters of sacral reflex between young MSA patients and elderly patients. And there was no statistically significant difference between MSA-P subtypes and MSA-C subtypes. This trial is registered with ISRCTNCR2009041. [ABSTRACT FROM AUTHOR]

Host-plant volatiles play vital roles for insects to locate foraging, mating, and oviposition sites in the environment. As one of the devastating invasive forestry pests, Hyphantria cunea causes a great annual loss in China, and understanding its chemical ecology is an important task. The current research was done in terms of chemical analysis, electrophysiology, and behavioral assays on H. cunea to assess its olfactory reception toward host-plant volatiles. A screen of possible common host volatiles was done, targeting on five favored hosts of H. cunea , harvesting six potential bioactive compounds from a total of 78 odorant components. Six types of antennal sensilla were investigated on their distributions on the antennae, and sexual dimorphism was described. H. cunea showed responses to all selected host-related volatiles in electroantennogram tests, and linalyl butyrate elicited the strongest responses. Furthermore, mating rates in adult pairs that are exposed to dibutyl phthalate and phytol have been significantly increased, while oviposition rates and female fecundity were not influenced. The results of the current study provide initial evidence showing that universal host-derived volatile cues are essential for H. cunea moth in terms of mating, which can also provide insights into the development of botanical attractants. [ABSTRACT FROM AUTHOR]

Sensoryneuronal hearing loss (SNHL) is one type of hearing impairment. The incidence of hearing loss (HL) is 1–3 per 1000 births. Complementary therapies may be effective in addressing the maladies of infants with HL. The aim of this study was to assess the efficacy of foot reflexotherapy in an infant with SNHL. The patient was a 3-month-old infant with SNHL. Pretest and post-test for HL were conducted using an audiologic method (auditory brainstem responses) combined with behavioral audiometry. The subject was treated with foot reflexotherapy for 30 min per session four times per week for a period of 24 weeks. Foot reflexotherapy was effective in auditory recuperation of an infant with SNHL. The results of this novel study suggest that foot reflexotherapy can be an effective complementary treatment for infants with SNHL, especially for those 3 to 9 months of age. [ABSTRACT FROM AUTHOR]

Fall webworm, Hyphantria cunea Drury (Lepidoptera: Erebidae) is extremely adaptable and highly invasive in China as a defoliator of ornamental and forest trees. To better understand the chemical orientation of this insect towards its host products, we determined the structure and distribution of antennal sensilla of H. cunea by scanning electron microscopy (SEM). The results showed that the male antenna was bipectinate and the female antenna was serrate, and they made of three parts, a scape, a pedicel, and a flagellum of more than 58 flagellomeres. Based on their morphology, sensilla squamiformia, sensilla basiconica, sensilla trichodea (ST1, ST2, ST3), sensilla chaetica, sensilla coeloconica, sensilla styloconica and Böhm bristles were distinguished on the antennae in both sexes. The putative functions of these sensilla also were discussed with reference to their morphology, distribution, and ultrastructure. We expect these results to help develop further electrophysiological investigations aiming to a better understanding of H. cunea olfaction. [ABSTRACT FROM AUTHOR]

Xin Su Ning (XSN) is a China patented and certified traditional Chinese herbal medicine used to treat premature ventricular contractions (PVCs) since 2005. XSN is formulated with 11 herbs, designed to treat arrhythmia with phlegm-heat heart-disturbed syndrome (PHHD) according to Chinese medicine theory. The rational compatibility of the 11 herbs decides the therapeutic outcome of XSN. Due to the multicomponent nature of traditional Chinese medicine, it is difficult to use conventional pharmacology to interpret the therapeutic mechanism of XSN in terms of clear-cut drug molecule and target interactions. Network pharmacology/systematic pharmacology usually consider all the components in a formula with the same weight; therefore, the proportion of the weight of the components has been ignored. In the present study, we introduced a novel coefficient to mimic the relative amount of all the components in relation with the weight of the corresponding herb in the formula. The coefficient is also used to weigh the pharmacological effect of XSN on all relative biological pathways. We also used the cellular electrophysiological data generated in our lab, such as the effect of liensinine and isoliquiritigenin on NaV1.5 channels; we therefore set sodium channel as one of the targets of these two components, which would support the clinical efficacy of XSN in treating tachyarrhythmia. Combining the collected data and our discovery, a panoramagram of the pharmacological mechanism of XSN was established. Pathway enrichment and analysis showed that XSN treated PHHD arrhythmia through multiple ion channels regulation, protecting the heart from I/R injury, inhibiting the apoptosis of cardiomyocyte, and improving glucose and lipid metabolism. [ABSTRACT FROM AUTHOR]

Chinese consumers’ craze about imported products, especially foods and drugs, peaked after various safety incidents, such as the contamination of Chinese dairy products. Recently, this boom has gradually receded because of the constant quality problems of imported products and the stricter safety supervision of domestic products. Researchers have measured consumer’s perception toward domestic and imported products in various ways. In the current research, we investigated whether the country-of-origin stereotype has weakened in Chinese young consumers at the neurological level. By using a word-pair paradigm, 21 young participants were required to classify positive or negative words while event-related potentials were recorded. The results showed that reaction time to identify negative words following presentation of imported products (imported-negative condition) was longer than domestic products (domestic-negative condition). The amplitudes of N270 and LPP evoked in the imported-negative condition were significantly larger than those in the domestic-negative condition, possibly reflecting the higher expectation conflict when participate identified the adjectives as negative primed by imported healthy-related products. These findings revealed that young Chinese consumers still evaluated imported products better than domestic products. [ABSTRACT FROM AUTHOR]

Objectives: At present, there is no effective method of evaluating the electrophysiological changes in cardiac myocytes during off-pump coronary artery bypass grafting (OPCAB). Therefore, we preliminarily explored the relationship between electrophysiological characteristics and the changes in cardiac function of 24 patients undergoing OPCAB. Methods: We used the CARTO3 system for epicardial electrophysiological mapping before surgery, during left anterior descending branch anastomosis, diagonal branch anastomosis and after surgery for 24 patients undergoing OPCAB. Data, including local activation time (LAT), bipolar voltage value (BV) and conduction velocity, were processed and analyzed by the system. Intraoperative invasive blood pressure, heart rate and arterial blood gas analysis data were recorded. Continuous electrocardiography (ECG) monitoring was performed three days after surgery. Routine resting myocardial perfusion imaging (MPI) and adenosine stress-gated MPI were performed before surgery. Patients were re-examined before discharge. Results: By analyzing the change in the LAT value, we found that the order of excitation of local myocardial cells changed after surgery. In addition, the LAT change in myocardial cells closer to the anastomosis was more significant. The earliest pacing point on the left anterior descending (LAD) coronary artery territory map was the third point (from the proximal to distal LAD) before OPCAB, but the earliest pacing point moved down to the fourth point (closer to the anastomosis) after the diagonal (DIA) anastomosis was complete. On the DIA territory map, the earliest pacing point was the fourth point before OPCAB; this moved up to the third point (closer to the anastomosis) after DIA bypass grafting. The voltages of all points were increased after myocardial revascularization. Compared with the preoperative period, the third, fourth and fifth points on the LAD territory map increased significantly after LAD anastomosis was complete (p=0.007, p=0.001, p=0.009, respectively). On the DIA territory map, the voltages of the first, second and third points were remarkably increased after completing the DIA anastomosis compared to before OPCAB and after LAD anastomosis completion (p=0.001, p=0.008, p<0.001 and p=0.006, p=0.032, p=0.002, respectively). The average conduction velocity (ACV) of all mapped points increased after OPCAB compared with before OPCAB (p<0.05). Postoperative resting MPI and adenosine stress-gated MPI showed that left ventricular global systolic function improved, the left ventricular ejection fraction (LVEF) increased significantly (p<0.05) and the left ventricular end systolic volume (LVESV) decreased significantly (p<0.05) compared to the preoperative MPI. Conclusions: Adequate surgical coronary revascularization could lead to more stable electrical activity of local cardiomyocytes, thus, illustrating the specific mechanism of coronary revascularization for improving the cardiac function from an electrophysiological perspective. [ABSTRACT FROM AUTHOR]

Hereditary sensory neuropathy (HSN) comprises a group of progressive peripheral neuropathies predominantly affecting the sensory nerves. To date, two different ATL3 gene mutations have been reported to be responsible for HSN type 1F (HSN1F). Here, we report a family in which the members presented numbness of the lower limbs and recurrent foot ulceration. Symptoms of foot ulcers disappeared in the years after onset, which suggests that the family members showed benign and mild symptoms compared with the affected patients reported previously. Laboratory examinations and electrophysiological data suggested axonal degeneration of the peripheral sensory nerves, while motor neurons were not involved. Exome sequencing revealed the previously reported c.C1013G (p.Pro338Arg) mutation of the ATL3 gene. This is the first report of ATL3 mutation in Chinese patients with HSN. Cells expressing mutant ATL3 exhibited disruption of the endoplasmic reticulum network, suggesting a dominant‐negative effect. There was no significant difference in the expression of the endoplasmic reticulum stress marker binding immunoglobulin protein (BiP) between cells expressing wild‐type or mutant ATL3. Further studies are required to ascertain the relevance of the changes in endoplasmic reticulum morphology to axonal degeneration of sensory nerves. [ABSTRACT FROM AUTHOR]

Objective: Full-field electroretinogram (ffERG) is an objective test to determine the electroretinal activities in response to light stimulation for investigating retinal physiology and diagnosing retinal diseases. This study aimed to establish a reference data set of photopic electroretinogram (ERG) of Chinese preschool children in Hong Kong to facilitate clinical and research studies., Methods and Analysis: Preschool children aged 3-7 years with normal vision were recruited from local kindergartens. Eye examinations, including cycloplegic spherical equivalent refraction (SER), axial length (AL) and keratometry (K) measurements, were performed. ffERGs of the International Society for Clinical Electrophysiology of Vision (ISCEV) standard photopic flash and 30-Hz flicker protocols were measured using RETeval with Sensor Strip skin electrodes. ERG waveform characteristics were extracted, and relationships between ERG, age, SER, AL and K were evaluated., Results: A total of 479 children completed the measurements (mean age: 5.0±0.9 years, 45.5% female). Mean, 95% CIs, 5th-95th percentile range of the ERG parameters were reported. Age was positively associated with amplitudes of b-wave and 30-Hz flicker (p<0.01), but negatively associated with implicit times of b-wave and 30-Hz flicker (p<0.01). AL was significantly associated with all amplitudes of a-wave, b-wave and 30-Hz flicker (p≤0.01) and implicit time of both a-wave and 30-Hz flicker (p<0.05). K was positively associated only with 30-Hz flicker amplitude (p=0.01), and no association between all responses and SER., Conclusion: Reference data set of photopic ERG of Chinese preschool children was established. Cross-sectional investigations revealed associations between ERG, age, SER and AL, which were speculated to further implicate the role of retina in refractive error development., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Functional role of filum terminale (FT) was not well studied though it contains structure basis for nerve impulse conduction. We aimed to explore the possible functions of the FT from the perspective of triggered electromyography (EMG) during surgery., Methods: We retrospectively reviewed intraoperative neurophysiological monitoring data from pediatric patients who underwent intradural surgeries at the lumbar level in Shanghai Children's. Hospital from January 2018 to March 2023. Altogether 168 cases with complete intraoperative neurophysiological recordings of the FT were selected for further analysis. Triggered EMG recordings of the filum originated from two main types of surgeries: selective dorsal rhizotomy (SDR) and fatty filum transection., Results: 96 cases underwent SDR and 72 cases underwent fatty filum transection. Electrical stimulation of the FT with fatty infiltration did not elicit electromyographic activity in the monitored muscles with the maximum stimulus intensity of 4.0 mA, while the average threshold for FT with normal appearance was 0.68 mA, and 89 out of 91 FT could elicit electromyographic responses in monitored channels. The threshold ratio of filum to motor nerve roots at the same surgical segment was significantly higher in patients with fatty filum, and a cut-off point of 21.03 yielded an area under curve of 0.943, with 100% sensitivity and 85.71% specificity., Conclusion: Filum with normal appearance can elicit electromyographic activity in the lower limbs/anal sphincter similar to the performance of the cauda equina nerve roots. The threshold of fatty filum is different from that of normal appearing FT. Triggered EMG plays an important role in untethering surgeries., (© 2024. The Author(s).)

Objective To explore the clinical features of post - traumatic Guillain -Barré syndrome (GBS). Methods A retrospective analysis on clinical data of 6 cases was performed from August 2013 to June 2017 in our hospital, including clinical symptoms and signs, electrophysiological examinations, serum anti - ganglioside antibodies (AGA), cerebrospinal fluid (CSF), clinical diagnosis, treatment and prognosis. Results All cases had different histories of trauma or surgery, and the average duration from trauma to onset of GBS was 8 d. Clinical symptoms included progressive symmetrical weakness of limbs in 6 cases, respiratory muscle paralysis in 4 cases and cranial nerve damage in 4 cases. Serum anti - GM1 IgG antibodies were detected in one case, and anti -GM1 and GD1b IgG antibodies were detected in one case. CSF examination showed increased white blood cell (WBC) count in 2 cases, increased protein quantification in 6 cases, protein-cell separation in 4 cases, and the main electrophysiological findings were axonal injuries of motor fibers. Three cases were diagnosed as acute motor axonal neuropathy (AMAN), one case was acute motor - sensory axonal neuropathy (AMSAN), and 2 cases were acute inflammatory demyelinating polyradiculoneuropathy (AIDP). The average duration from onset to respiratory muscle paralysis was 3.25 d. One case abandoned treatment 27 d after mechanical ventilation and died. One case refused mechanical ventilation and died. Five cases were injected intravenous immunoglobulin (IVIg) for 0.40 g/(kg•d), and one case were only given glucocorticoid by intervenous drip for 500 mg/d. The average follow-up was 9.50 months. Four survival cases suffered from different degrees of muscle atrophy, 3 cases had good recovery and one had muscle grade 3-4. Conclusions Post - traumatic GBS can occur after different traumatic stress, with severe clinical manifestations, high mortality and poor prognosis. Timely electrophysiological examination helps to make an early diagnosis. [ABSTRACT FROM AUTHOR]

Aim and Objective To evaluate the effect of rehabilitation exercises combined with Direct Vagina Low Voltage Low Frequency Electric Stimulation ( DES) on pelvic nerve electrophysiology and tissue function after delivery. Background Whether and how DES effects pelvic floor dysfunction ( PFD) are not known clearly. Design This was a randomised, controlled clinical trial. Methods The 189 primiparous women 20-35 years old and with an episiotomy or second degree episiotomy tear were divided into three groups: the control group ( n = 60) received routine postpartum guidance 2 hr postpartum, the training group ( n = 63) performed rehabilitation exercises (Kegel exercises and pelvic movements) from 2 days postpartum until 3 months postpartum, and the combination group ( n = 66) received DES 15 times (3 times a week for 30 min at a time) beginning at the sixth week postpartum in addition to performing rehabilitation exercises. Adopt international standard scale and score method to inspect maternal life treatment, such as pelvic organ prolapse situation ( POP-Q division), the degree of incontinence score and pelvic floor muscle intensity of muscular contraction. Data were collected during the third month after delivery. Results Three months postpartum, there were differences among the three groups in the POP-Q grade, the degree of incontinence score, the Oxford grade for pelvic floor muscle strength and the pelvic floor muscle electrophysiology condition. Additionally, there were significant differences regarding the pubic symphysis clearance. Rehabilitation exercises can promote healing of the maternal pubic symphysis and recovery of the pelvis. The total electrical value, type I muscle fibre strength and type II muscle fibre strength were significantly increased in the combination group after treatment than before treatment. Conclusion Rehabilitation exercises combined with DES were beneficial to the recovery of postpartum pelvic nerve tissue function, and a synergistic effect was observed when the two methods were combined. Relevance to clinical practice These conclusions justify that rehabilitation exercise combined with DES can better relieve uncomfortable symptoms postpartum and improve the women's quality of life. [ABSTRACT FROM AUTHOR]

Background: Brugada syndrome (BrS) is an inherited disease that can lead to sudden cardiac death. Medications, such as antidysrhythmics, and fevers can unmask or induce the Brugada pattern on an electrocardiogram (ECG). This case report highlights a patient who developed drug-induced Brugada type I pattern after a procainamide infusion for the treatment of new-onset atrial fibrillation (AF) or flutter and discusses the implications for this incidental but potentially lethal finding., Case Report: We report a case of a young man who presented to the emergency department (ED) with new-onset AF with rapid ventricular response that began within 12 h of presentation. ED treatments included a crystalloid IV fluid bolus, diltiazem pushes, synchronized electrical cardioversion, and a procainamide infusion. After the procainamide infusion, the patient developed ECG findings consistent with Brugada pattern. Both the AF and Brugada pattern resolved spontaneously within 24 h. The patient was discharged without implantable cardioverter defibrillator placement due to presumed isolated procainamide-induced Brugada pattern and lack of concerning features, such as inducible dysrhythmia during electrophysiology study, family history of sudden death, and history of syncope. The patient was counseled to follow-up with genetics and avoid BrS-inducing medications. WHY SHOULD AN EMERGENCY PHYSICIANS BE AWARE OF THIS?: Procainamide, an option for the treatment of AF in the ED, can provoke Brugada pattern. If encountered, it is important to recall that some patients may not be diagnosed with BrS if determined to be low risk according to the Shanghai criteria. All patients should be referred to cardiology for further evaluation., 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 © 2023 Elsevier Inc. All rights reserved.)

Background: The prognostic implication of conversion from initially non-shockable to shockable rhythms in patients with out-of-hospital cardiac arrest (OHCA) remains unclear. Our objective is to determine whether the conversion to shockable rhythms is a reliable predictor of short- and long-term outcomes both in patients who initially presented with pulseless electrical activity (PEA) and in those with asystole.Methods: A secondary analysis was performed on non-traumatic OHCA cases ≥18 years old with PEA or asystole as initial rhythms, who were treated in the field and enrolled in the Resuscitation Outcomes Consortium (ROC) PRIMED study (clinicaltrials.gov/ct2/show/NCT00394706). We reported the characteristics and outcomes for those patients with or without shocks delivered in the field. Logistic regression analysis assessed the association of shock delivery with pre-hospital return of spontaneous circulation (ROSC), survival to hospital discharge and favorable neurological outcome as well.Results: Of the 9902 included cases, 3415 (34.5%) were initially in PEA and 6487 (65.5%) were in asystole. 744 (21.8%) PEA and 1134 (17.5%) asystolic patients underwent rhythm conversions and received subsequent shocks. For asystolic patients, the adjusted odds ratios (ORs) of shock delivery for pre-hospital ROSC, survival to discharge and favorable neurological outcome were 1.862 (95%CI 1.590-2.180), 3.778 (95%CI 2.374-6.014) and 4.154 (95%CI 2.192-7.871) respectively, while for PEA patients they were 0.951 (95%CI 0.796-1.137), 1.115 (95%CI 0.720-1.726) and 1.373 (95%CI 0.790-2.385) respectively.Conclusions: Conversion to shockable rhythms was associated with better outcomes in initially asystolic OHCA patients, whereas such associations were not observed in patients initially in PEA. [ABSTRACT FROM AUTHOR]

Borneol is a compound widely used in ophthalmic preparations in China. Little is known about its exact role in treating eye diseases. Here we report that transient receptor potential melastatin 8 (TRPM8) channel is a pharmacological target of borneol and mediates its therapeutic effect in the eyes. Ca2+ measurement and electrophysiological recordings revealed that borneol activated TRPM8 channel in a temperature- and dose-dependent manner, which was similar to but less effective than the action of menthol, an established TRPM8 agonist. Borneol significantly increased tear production in guinea pigs without evoking nociceptive responses at 25°C, but failed to induce tear secretion at 35°C. In contrast, menthol evoked tearing response at both 25 and 35°C. TRPM8 channel blockers N-(3-Aminopropyl)-2-[(3-methylphenyl)methoxy]-N-(2-thienylmethyl)benzamide hydrochloride (AMTB) and N-(4-tert-butylphenyl)-4-(3-chloropyridin-2-yl)piperazine-1-carboxamide (BCTC) abolished borneol- and menthol-induced tear secretion. Borneol at micromolar concentrations did not affect the viability of human corneal epithelial cells. We conclude that borneol can activate the cold-sensing TRPM8 channel and modestly increase ocular surface wetness, which suggests it is an active compound in ophthalmic preparations and particularly useful in treating dry eye syndrome. [ABSTRACT FROM AUTHOR]

Aims: This study sought to investigate electrocardiographic characteristics, electrophysiological features, and radiofrequency ablation in patients with focal atrial tachycardia (AT) originating from the septal mitral annulus.Methods and Results: In 13 patients with AT originating from the septal mitral annulus, activation mapping was performed to identify the earliest activation site. Successful ablation was performed through either a transseptal (n = 12) or a retrograde aortic approach (n = 1). As confirmed by electrogram recordings, fluoroscopy, and three-dimensional (3D) mapping, successful ablation sites were located in the anterior paraseptal, mid- to anteroseptal, and posterior septal mitral annulus in eight, three, and two patients, respectively. Foci for all locations demonstrated a negative/positive appearance in lead V1. Mapping in the right atrium demonstrated that the earliest right atrial activation was near the septum (His-bundle region or proximal coronary sinus). The electrograms at the successful ablation sites were fractionated in 9 patients, and presented with an atrial:ventricular ratio of <1 in all 13 patients. There were no complications in any patients and long-term success was achieved in 12 of 13 patients during the 23 ± 6 months following ablation.Conclusion: The area surrounding the septal mitral annulus, most commonly the anterior paraseptal, is an unusual, but important site of origin for focal AT, which is associated with a distinctive P-wave morphology and atrial endocardial activation sequence. Radiofrequency ablation of AT originating from the septal mitral annulus, through either a transseptal or a retrograde aortic approach appears to be safe and effective. [ABSTRACT FROM AUTHOR]

According to the three-tier hierarchy of motivational potency in the self system, the self can be divided into individual self, relational self, and collective self, and individual self is at the top of the motivational hierarchy in Western culture. However, the motivational primacy of the individual self is challenged in Chinese culture, which raises the question about whether the three-tier hierarchy of motivational potency in the self system can be differentiated in the collectivist brain. The present study recorded the event-related potentials (ERPs) to evaluate brain responses when participants gambled for individual self, for a close friend (relational self), or for the class (collective self). The ERP results showed that when outcome feedback was positive, gambling for individual self evoked a larger reward positivity compared with gambling for a friend or for the class, while there is no difference between the latter two conditions. In contrast, when outcome feedback was negative, no significant effect was found between conditions. The present findings provide direct electrophysiological evidence that individual self is at the top of the threetier hierarchy of the motivational system in the collectivist brain, which supports the classical pancultural view that individual self has motivational primacy. [ABSTRACT FROM AUTHOR]

Background: Idiopathic ventricular arrhythmias (VAs) originating from the pulmonary sinus cusp (PSC) have not been sufficiently clarified.Objectives: The goal of this study was to investigate the prevalence, electrocardiographic characteristics, mapping, and ablation of idiopathic VAs arising from the PSC.Methods: Data were analyzed from 218 patients undergoing successful endocardial ablation of idiopathic VAs with a left bundle branch block morphology and inferior axis deviation.Results: Twenty-four patients had VAs originating from the PSC. In the first 7 patients, initial ablation performed in the right ventricular outflow tract failed to abolish the clinical VAs but produced a small change in the QRS morphology in 3 patients. In all 24 patients, the earliest activation was eventually identified in the PSC, at which a sharp potential was observed preceding the QRS complex onset by 28.2 ± 2.9 ms. The successful ablation site was in the right cusp (RC) in 10 patients (42%), the left cusp (LC) in 8 (33%), and the anterior cusp (AC) in 6 (25%). Electrocardiographic analysis showed that RC-VAs had significantly larger R-wave amplitude in lead I and a smaller aVL/aVR ratio of Q-wave amplitude compared with AC-VAs and LC-VAs, respectively. The R-wave amplitude in inferior leads was smaller in VAs localized in the RC than in the LC but did not differ between VAs from the AC and LC.Conclusions: VAs arising from the PSC are not uncommon, and RC-VAs have unique electrocardiographic characteristics. These VAs can be successfully ablated within the PSC. [ABSTRACT FROM AUTHOR]

Background Cryoballoon ablation is an alternative for the treatment of atrial fibrillation (AF). We assess the relationship among pulmonary vein (PV) electrophysiology, balloon temperature, and persistent PV isolation (PVI), and report procedural properties, safety, and efficacy of this technique in a Chinese center for the first time. Methods A total of 70 patients with paroxysmal (n = 57) and persistent (n = 13) AF were consecutively enrolled. PVI was performed with cryoballoon catheter. Real-time recording of dissociation of PV potentials was attempted using a circumferential mapping catheter. Results Successful PVI was achieved in 274 of 282 (97.2%) PVs. Procedural duration was 115.2 ± 24.8 minutes and fluoroscopy time was 29.6 ± 8.9 minutes. Real-time PV potential recording was achieved in 232 (84.3%) PVs. Regarding time to isolation, a cut-off value of less than 60 seconds was predictive of persistent PVI with a sensitivity of 0.76 and specificity of 0.82 (area under curve = 0.835; P < 0.0001). The nadir balloon temperature was significantly lower in PVs without early reconduction (-46.3 ± 0.5°C vs -40.2 ± 1.3°C, P < 0.0001). However, there was an insignificant trend that the balloon temperature at isolation was higher in PVs without reconduction (-33.9 ± 0.7°C vs -36.4 ± 2.0°C, P = 0.14). The overall complication rate was 5.7%. After a median follow-up of 6.5 (range 3.2-14.9) months, 76% of patients were free of AF recurrence with a blanking period of 3 months. Conclusions Real-time PV potentials can be recorded in most PVs. The time to isolation is predictive of the persistency of PVI. The nadir balloon temperature, not the balloon temperature at isolation, is significantly lower in PVs without reconduction. [ABSTRACT FROM AUTHOR]

Pouched Mitral Isthmus and Ablation Block Background Previous studies have described the impact of mitral isthmus (MI) anatomy on the likelihood of achieving MI linear block in patients with native mitral valves (NMV) who underwent atrial fibrillation (AF) ablation. However, none have investigated that issue in AF patients with mechanical mitral valve replacements (MMVR). Methods and Results Twenty-nine consecutive patients who developed symptomatic persistent AF post-MMVR and referred for ablation were enrolled. Twenty-nine patients with NMV who underwent ablation of persistent AF during the same period were matched. With preprocedural cardiac computed tomographic imaging, MI anatomical features of all the participants were analyzed. Pouched MI was observed in 19 (65.5%) MMVR patients versus to 6 (20.7%) controls (P = 0.001). Bidirectional linear block across MI was achieved in 21 (72.4%) MMVR patients and 22 (75.9%) in the controls (P = 0.764). In the multivariable analysis, pouched MI was an independent predictor of incomplete MI block. Conclusions Pouched MI accounts for the majority of AF patients with MMVR and may be associated with incomplete bidirectional linear block of MI. [ABSTRACT FROM AUTHOR]

Existing literature on the mini-ultimatum game indicates that counterfactual comparison between chosen and unchosen alternatives is of great importance for individual's fairness consideration. However, it is still unclear how counterfactual comparison influences the electrophysiological responses to unfair chosen offers. In conjunction with event-related potentials' ( ERPs) technique, the current study aimed to explore the issue by employing a modified version of the mini-ultimatum game where a fixed set of two alternatives (unfair offer vs. fair alternative, unfair vs. hyperfair alternative, unfair offer vs. hyperunfair alternative) was presented before the chosen offer. The behavioral results showed that participants were more likely to accept unfair chosen offers when the unchosen alternative was hyperunfair than when the unchosen alternative was fair or hyperfair. The ERPs results showed that the feedback-related negativity ( FRN) elicited by unfair chosen offers was insensitive to the type of unchosen alternative when correcting for possible overlap with other components. In contrast, unfair chosen offers elicited larger P300 amplitudes when the unchosen alternative was hyperunfair than when the unchosen alternative was fair or hyperfair. These findings suggest that counterfactual comparison may take effect at later stages of fairness consideration as reflected by the P300. [ABSTRACT FROM AUTHOR]

Probucol Prevents Atrial Remodeling Introduction Diabetes mellitus (DM) is an independent risk factor for atrial fibrillation (AF). However, the underlying mechanisms for the increased propensity for AF in the setting of DM and the potential effects of probucol on atrial remodeling remain unclear. Methods and Results Eighty Japanese rabbits were randomly assigned to normal/control group (Control, n = 20), alloxan-induced diabetic group (DM, n = 20), probucol-treated group (Control-P, n = 20), and probucol-treated diabetic group (DM-P, n = 20). Rabbits in the DPR and CPR groups were orally administered probucol (1,000 mg/day) for 8 weeks. Serum and left atrial tissue malonaldehyde (MDA), superoxide dismutase (SOD), myeloperoxidase (MPO), and catalase (CAT) levels were assessed. Isolated Langendorff perfused rabbit hearts were prepared to evaluate atrial refractory effective period (AERP) and its dispersion (AERPD), interatrial conduction time (IACT), and vulnerability to AF. Atrial interstitial fibrosis was also evaluated. The mRNA expression levels of TNF-α and TLR4 were analyzed. The protein expressions of NF-κB, HSP70, TGF-β, and ERK in left atrial tissue were analyzed by Western blot. Probucol administration decreased the inducibility of AF in diabetic rabbits and attenuated atrial interstitial fibrosis. The DM-P rabbits exhibited significant alleviation of oxidative stress, evidenced by reduced serum and tissue MDA, compared with diabetic rabbits. Moreover, NF-κB, TGF-β, and HSP70 protein expression and TNF-α mRNA expression were significantly downregulated by probucol treatment in alloxan-induced diabetic rabbits. Conclusions Probucol prevents atrial remodeling and suppresses AF development in alloxan-induced diabetic rabbits. Its inhibitory effects on oxidative stress, NF-κB, TGF-β, and TNF-α overexpression may contribute to its antiremodeling effects. [ABSTRACT FROM AUTHOR]

Objective We have reported 'heat-sensitization' responses during suspended moxibustion, whose occurrence is associated with significantly better therapeutic effects. The present study aimed to characterize the electrophysiological features of this interesting phenomenon with high-density electroencephalography ( EEG). Methods We performed EEG recording in a group of patients with chronic low back pain before, during, and after moxibustion treatment at DU3. Results 12 out of 25 subjects experienced strong heat-sensitization during moxibustion, which was accompanied by increased power spectral densities ( PSDs) at the theta, alpha, and beta frequency bands. The scalp topographies of averaged power indicated that the theta and beta PSD changes were most obvious in fronto-central regions, whereas those of the alpha band were more global. In addition, nonsensitized and sensitized groups showed distinct activity patterns, with heat-sensitization inducing increased phase coherence at the theta and beta ranges. Conclusions These data were the first objective evidence of heat-sensitization responses during suspended moxibustion, which were characterized by widespread oscillatory changes in scalp EEG. [ABSTRACT FROM AUTHOR]

Abstract: Dolomedes mizhoanus and Dolomedes sulfurous are two venomous spiders found in the same area in southern China and are characterized by living in water plants and feeding on fish. In this study, the chemical compositions and activities of these venoms were compared. Both venoms contain hundreds of peptides as shown by off-line RP-HPLC/MALDI-TOF-MS analysis, but have a different peptide distribution, with D. mizhoanus venom containing fewer high molecular mass (7000–9000 Da) peptides (3%) than D. sulfurous venom (25.6%). Patch-clamp analyses showed that both venoms inhibited voltage-activated Na+, K+ and Ca2+ channels in rat DRG neurons, however, differences in their inhibitory effects were observed. In general, D. mizhoanus venom had lower inhibitory activity than D. sulfurous venom and both venoms had a different inhibitory spectrum against these ion channels, showing that both venoms are useful for identifying antagonists to them. In addition, intrathoracic injection of both venoms caused severe neurotoxic effects in zebrafish and death at higher concentrations, respectively. Considering that both spiders belong to the same genus, live in the same area and have similar habits, elucidation of the differences between the peptide toxins from both venoms would provide new molecular insights into the evolution of spider peptides. [Copyright &y& Elsevier]