To explore whether oral rehydration salts (ORS) is effective in the treatment of children with vasovagal syncope (VVS). One hundred and sixty-six consecutive patients with recurrent syncope and positive head-up tilt testing (HUTT) were recruited, randomly divided to conventional therapy (health education and tilt training) plus ORS (with 500 ml of water) group (Group I, 87 patients) and conventional therapy group (Group II, 79 patients). Therapeutic effect was evaluated by changes of syncopal episode and reperformed HUTT response. At the end of 6-month follow-up, syncopal episode did not reoccur in 49 (56.3 %) patients, decreased in 34 (39.1 %) patients, and had no obvious change or increased in four (4.6 %) patients in Group I, and the results were 31 (39.2 %), 37 (46.8 %), and 11 (14 %) in Group II, respectively. The difference was significant (χ (2) = 7.074, P < 0.05). When HUTT was reperformed, 57 (65.5 %) and 28 (35.4 %) patients had negative response and 30 (34.5 %) and 51 (64.6 %) patients had positive response, respectively, in Group I and Group II. The difference was also significant (χ (2) = 13.808, P < 0.01). In Group I, the two aspects had no difference between vasodepressor type and mixed type; however, syncopal episode had a significant difference between children aged ≤12 and >12 years (χ (2) = 6.371, P < 0.05); there was no difference in reperformed HUTT response. ORS with 500 ml of water is an effective therapy for VVS. It can be recommended as one of non- pharmacological treatment measures in children with VVS.

Introduction: Berberine has been reported to inhibit cancer cell growth by apoptosis induction and exhibits a protective role against cancer progression. The current study aims to investigate the effects of berberine on acute lymphoblastic leukemia (ALL) and the mechanism beyond apoptosis. Methods: Cell viability was determined in ALL cell lines EU-6 and SKW-3 using trypan blue staining. Cell autophagy was determined by immunofluorescence and Western blot. ALL xenograft mice were established to investigate the anti-tumor effects of BBR. The molecular mechanism was explored in ALL cell lines using siRNA and signaling inhibitors. Results: Herein, we show that berberine treatment significantly inhibits ALL cell viability and promotes cell death by inducing autophagy in a dose-dependent manner. Moreover, berberine significantly alleviates the aggressive pathological condition in ALL xenograft mice. Mechanistic studies exhibit that berberine induces autophagic death in ALL cells by inactivating AKT/mTORC1 signaling. Chemically targeting AKT/mTORC1 signaling controls berberine-induced cell autophagy in vitro, and blockade of autophagic process blunts berberine-alleviated pathological condition in vivo. Discussion: In conclusion, our study reveals that berberine could induce ALL cell autophagic death by inactivating AKT/mTORC1 signaling that could be used to develop small molecule drug for ALL treatment.

Head-up tilt test (HUT) is widely used as a diagnostic tool. It reproduces vasovagal attacks in many susceptible patients. Although it is known to be safe and well tolerated, it is a procedure with potential neurologic complications. We observed that it could cause transient aphasia in some patients. To explore clinical characteristics and possible pathogenesis of aphasia induced by HUT, we reviewed the data of patients undergoing HUT in our hospital. 13 patients experienced transient aphasia in 3,488 cases. According to the hemodynamic changes, the incidence in vasodepressor, mixed, cardioinhibition and the negative response were 6.67, 5.52, 0 and 1.14 ‰ orderly, and not significantly different among the groups. It had significant difference between the positive response and the negative response and between vasodepressor and the negative response (both p < 0.05). The incidence in adults was significantly higher than that in children (<18 years) (p < 0.01), but not different between female and male. The average onset time was 11.33 ± 6.66 min (range 4-17 min) during baseline HUT or 4.90 ± 2.69 min (range 2-10 min) during sublingual nitroglycerin-provocated HUT. The duration was 3-60 min, except for one who was completely relieved of the disorder 4 h later. In conclusions, there is a risk of provoking transient aphasia during HUT. It reminds that performer should alert the possibility of transient aphasia during the test, especially when the patient is an adult and has a positive response.

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