[Clinical and genetic analysis of tyrosine hydroxylase deficiency of six cases]

The clinical and molecular genetic data of 6 patients with genetically confirmed tyrosine hydroxylase deficiency(THD) diagnosed in Department of Neurology, Qilu Hospital of Shandong University from March 2017 to February 2022 were retrospectively collected and analyzed. The 6 patients were from 5 families. Among them, 5 patients had persistent or paroxysmal abnormal walking posture, 4 patients had dystonia of head and face, including spasm of perioral and oculopharyngeal muscles, hyperactivity, and binocular upvision, 4 patients showed obvious morning light and evening heavy phenomenon, 2 patients had postural tremor of limbs, 2 patients had psychomotor retardation from childhood, 1 patient only had limb and cervical muscle weakness, 1 patient had epileptic seizures. Of the 6 patients, only 1 was adult-onset, and the rest were child-onset. Four patients had good response to low-dose dopa preparation, 2 patients from the same family had poor response to dopamine treatment, requiring extremely low dose initiation and multi-frequency titration treatment. However, the long-term treatment effect was poor with obvious abnormalities. Gene testing of 5 families revealed 8 mutations in the TH gene, with c.698G>A (p.R233H) being the hot spot mutation site. The clinical manifestations of THD are complex. Besides paroxysmal or persistent dystonia, it can also be accompanied by eye movement crisis, muscle weakness, epilepsy, and delayed mental and motor development. Most patients respond well to low-dose dopamine preparations, but a small number of patients require titration treatment with extremely low-dose dopamine preparations, and the long-term effect is not satisfactory.

[Responses of canopy stomatal conductance of Platycladus orientalis to soil water under water control.]

A water-controlled experiment with four treatments (no rain, half raining, natural raining and double raining) was carried out in a Platycladus orientalis forest. The factors including soil water content (SWC), precipitation, sap flow density (J_s), leaf area index (LAI), vapor pressure deficit (VPD) were monitored during August 2016 to August 2017. We further analyzed the response of canopy stomatal conductance (g_s) to changes of SWC. The results showed that the SWC of plots (half, natural and double raining) showed a positive correlation with precipitation, and the range of SWC was 4.9%-16.0%, 7.2%-22.9%, 7.4%-29.6%, respectively. The SWC in the plot with no rain decreased by 50% from August to October. The daily g_s reached a peak of 166.64 mmol·m^-2·s^-1 at 14:00 in July, which was significantly higher than other months. A bimodal phenomenon occurred. The daily g_s reached a peak of 54.1 mmol·m^-2·s^-1 at 12:00 in January. Under the three rain plots, diurnal variation of g_s and SWC showed a negative quadratic correlation. The SWC corresponding to the peak of g_s was 8.5%, 12.5% and 18.5%, respectively, close to the annual average SWC. Sensitivity (δ) of g_s to VPD /reference canopy stomatal conductance (g_sref) was more than or equal to 0.6 in different water-controlled plots, indicating that soil water condition was more suitable for water demand of P. orientalis. When SWC was between 3.7% and 7.5%, the δ and g_sref increased rapidly, indicating that stomata had better regulation ability, and that plant stomata was more sensitive to VPD. When SWC increased to 11%, SWC alteration did not affect the response sensitivity of g_srefand g_s to VPD. There might be a SWC threshold value for the adaptation of P. orientalis. By closing or reducing stomatal aperture, leaf water potential decreased, P. orientalis could adapt to excessive VPD and avoid excessive transpiration, which was more effective in regulating transpiration.

Blood pressure control in ultra-early basal ganglia intracerebral hemorrhage

OBJECTIVE

We performed this study to investigate the effect of blood pressure control in ultra-early basal ganglia intracerebral hemorrhage.

PATIENTS AND METHODS

120 patients with ultra-early basal ganglia intracerebral hemorrhage were randomly divided into experimental group (strengthened antihypertensive) and control (normal antihypertensive). Each group consists of 60 patients, whose contractive pressure were controlled by intravenous antihypertensive drugs among 130-140 mmHg and 160-180 mmHg respectively for 24 h, after 1 h of beginning treatment. They were all evaluated by NIH Stroke Scale (NIHSS) before and after the treatment. Cranial CT, hematoma volume, hematoma enlargement, edema volume, serum matrix metalloproteinase-9 level were performed and compared between groups.

RESULTS

After 24 h, hematoma volume and hematoma enlargement in the experimental group was significantly lower than control (p < 0.05). After 14 days, NIHSS score in the experimental group was significantly lower than control (p < 0.05). Cerebral edema amount and serum MMP-9 level in the experimental group were significantly lower than control after 5 days and 14 days.

CONCLUSIONS

Ultra-early basal ganglia intracerebral hemorrhage can remarkably reduce hematoma enlargement, cerebral edema, serum MMP-9 level, and improve the neurological function.