Association of elevated plasma CCL5 levels with high risk for tic disorders in children.

Abnormal levels of some peripheral cytokines have been reported in children patients with tic disorders (TDs), but none of these cytokines can be a biomarker for this disease. Our aim was to systemically profile differentially expressed cytokines (DECs) in the blood of TD patients, examine their associations with TD development, and identify from them potential biomarkers for the prediction and management of the risk for TDs. In this study, a cytokine array capable of measuring 105 cytokines was used to screen for DECs in the plasma from 53 comorbidity-free and drug-naïve TD patients and 37 age-matched healthy controls. DECs were verified by ELISA and their associations with TD development were evaluated by binary logistic regression analysis. Elevation of a set of cytokines was observed in TD patients compared with controls, including previously uncharacterized cytokines in tic disorders, CCL5, Serpin E1, Thrombospondin-1, MIF, PDGF-AA, and PDGF-AB/BB. Further analysis of DECs revealed a significant association of elevated CCL5 with TD development (p = 0.005) and a significant ROC curve for CCL5 as a risk factor [AUC, 0.801 (95% CI: 0.707-0.895), p < 0.0001]. Conclusion: This study identifies associations of a set of circulating cytokines, particularly CCL5 with TD development, and provides evidence that high blood CCL5 has potential to be a risk factor for TD development. Clinical Trial Registration: identifier ChiCTR-2000029616.

Sleep disturbances and sleep patterns in children with tic disorder: A case-control study.

Study objectives: To characterize sleep disturbances and sleep patterns in children with Tic disorder (TD), and explore their association with TD severity and types. Methods: A case-control study was conducted in 271 children with TD recruited from a clinical setting and 271 non-TD children recruited from a primary school, matched by age (mean = 8.47 years, SD = 1.53 years) and gender (15.1% female). The Children's Sleep Habits Questionnaire (CSHQ) was used to assess sleep patterns and sleep disturbances. The TD types and severity were assessed with the Yale Global Tic Severity Scale (YGTSS). Results: The TD children scored higher on CSHQ total score than non-TD group (t = 29.50, p < 0.001) and demonstrated severer global sleep disturbance. Compared to non-TD children, TD children presented with increased risks for global sleep disturbance (aOR: 1.95; 95% CI = 1.20-3.06), and most specific sleep disturbances, including bedtime resistance (aOR: 3.15; 95% CI = 1.96-5.06), sleep onset delay (aOR: 3.43; 95% CI = 1.58-7.46), sleep anxiety (aOR: 2.83; 95%CI = 1.83-4.38), parasomnias (aOR: 3.68; 95% CI = 2.02-6.62), night waking (aOR: 9.29; 95% CI = 2.64-32.65), sleep disordered breathing (aOR: 1.72; 95% CI = 1.03-2.90) and daytime sleepiness (aOR: 1.72; 95% CI = 1.09-2.74). Children with mild and moderate tics, Provisional Tic Disorder (PTD), Chronic Tic Disorder (CTD) and Tourette Syndrome (TS) presented with more global and more specific sleep disturbances. In addition, combined ADHD, etc. Conclusion: Children with TD are major risks for increased sleep disturbances, especially for those with severe and chronic symptoms. Furthermore, comorbid ADHD increases risk in certain areas of sleep. These findings highlight the importance to consider sleep outcomes in the assessment and treatment for children with TD.

The Efficacy of Acupuncture on Tic Disorders in Children: A Retrospective and Propensity Score-Matched Study.

Background : Acupuncture has been considered as a complementary or alternative therapy for children with tic disorders (TD), but its efficacy remains largely unknown. This study retrospectively examined the efficacy of acupuncture treatment for TD in children over the course of 12 weeks. Methods: Data were collected from Traditional Chinese Medicine clinics in a public pediatric hospital in Shanghai between June 2020 and March 2021. A total of 250 patients with TD were included in the study, with 122 patients exposed to acupuncture therapy combined with conventional treatment (observation group), and 128 patients exposed to conventional treatment alone (control group). Propensity score matching analyses were used to balance baseline characteristics, resulting in 78 matched patients for each group. Reductions in the Yale Global Tic Severity Scale (YGTSS) total score were analyzed in the two groups after 12 weeks of treatment. Results: The two groups reached equilibrium in terms of baseline demographic characteristics and YGTSS total score after the propensity score matching (P > 0.05). Compared to the control group, the reduction in the YGTSS total score after 12 weeks of treatment was greater for the observation group (OR = 2.94, 95% CI: 1.03, 8.39, P = 0.04), and this association was stronger for patients who had significant vocal tics (ß = 0.29, 95% CI: 0.88, 2.68, P = 0.001). The clinical efficacy for the observation group was significantly better than the control group. Conclusions: We provided preliminary evidence supporting the therapeutic effect of acupuncture for TD in children. Hence, our findings indicate that acupuncture could be an adjuvant treatment efficacious for TD in children, especially for vocal tics.

[A clinical investigation of plaque control efficacy and safety of Sonicare toothbrush in children].

PURPOSE: To provide theoretical basis for children's oral health instruction and children's dental prophylaxis by comparing the plaque control efficacy and safety of Sonicare and manual toothbrush in 3-9 years old children. METHODS: One hundred and eighty healthy children were included in this study and were divided into 2 groups with 90 children in each group: aged 3-6 years and 6-9 years respectively. In each group, the subjects were randomly instructed to use either Sonicare for kids (SFK) or manual tooth brush (MTB). During a 28-day clinical trial period, oral hygiene was examined and plaque index（Rustogi modified Navy plaque index，RMNPI） was recorded at baseline, and at visits on the 7th and the 28th day (D0, D7, D28). The data were analyzed by R software. RESULTS: Both MTB and SFK could remove a certain amount of dental plaque. In the group of 3-6 years old children, the plaque reduction rates of children using SFK were 17.09%±14.4%(D0), 27.14%±11.4%(D7), 33.52%±18.3%(D28), respectively, which were significantly higher than that of children using MTB [11.86%±9.7%(D0), 11.83%±9.1%(D7), 13.73%±11.0%（D28）] (P<0.05). Similarly, in the group of 6-9 years old children, the plaque reduction rates of children using SFK were 20.05%±10.52%(D0), 22.76%±13.46%(D7), 22.31%±9.74% (D28), which were significantly higher than that of children using MTB [9.15%±7.07%(D0), 7.26%±6.81%(D7), 11.54%±8.27%（D28）] (P<0.05). Further analysis revealed that the plaque index was decreased gradually in 3-6 years old children using SFK after 3 months of follow-up (P<0.05). In addition, there was better compliance and safety in children using SFK. CONCLUSIONS: Sonicare can remove plaque efficiently, and can control plaque and improve oral hygiene quality effectively in children in a long period, which implies that the application of Sonicare is worthy of promoting to control dental plaque in children.

[Ecological stability on biological removal of iron and manganese filter under poor nutritional conditions].

To supply necessary bacteria and available nutrients, a method of returning backwashing wastewater to the bio-filter for removal of iron and manganese was used. The ecological stability of bio-filter was investigated from 3 aspects: iron and manganese removal efficiency, micro-ecological characteristics and the quantity distribution of dominant bacteria. The results indicated that, the bio-filter held strong antishock loading capability, when the system was operated at high filtration rate (10-13.9 m/h) and high manganese concentration (3.5-4.5 mg/L), a removal rate more than 98.9% of iron and manganese was achieved. Iron and manganese oxidizing bacteria are the dominant microflora in biological filtering layer, they not only adhere on filter sand materials (4.3 x 10(6) MPN/mL) to form compact biofilm, but also exist among filter materials void (6.5 x 10(6) MPN/mL) to form suspended flocs, which is very important to complete removal of iron and manganese. In the past 5 years, the bio-filter realized a continuous and stable operation and kept a high removal efficiency of iron and manganese without adding any nutrients.