Objective To investigate the prognosis and its influencing factors of post-encephalitic epilepsy ( PEE) .Methods Fifty viral encephalitis patients with PEE were followed up, which prognosis was observed by whether their no seizures for at least 1 year or not.The clinical data of patients was collected, and the relate risk factors on the poor prognosis of PEE were analyzed.Results The disturbance of consciousness and the seizure presence during acute encephalitis, more than ten seizures in poor prognosis group were much higner than the good one (all P<0.01).The age, sex, seizure type, dysphrenia and neurological defect in acute encephalitis, status epileptisus in acute encephalitis, abnormal EEG and abnormal head CT/MRI had no correlation with poor prognosis ( all P>0.05 ) .Multiple logistic regression analysis demonstrated that disturbance of consciousness during acute encephalitis、seizures presence in acute encephalitis were independent risk factors of poor outcome in PEE ( OR=7.269,95%CI:1.22 -43.35,P=0.029;OR =22.893,95%CI:4.02 -130.43,P=0.000).Conclusion Disturbance of consciousness during acute encephalitis, seizure presence in acute encephalitis both are the single risk factors of poor prognosis in PEE.

Face ; surgery ; Hand Transplantation ; Humans ; Organ Transplantation ; Transplantation, Homologous

Objective To explore the influence and its efficacy of Tong-Xinluo capsule on plasma endothelin levels in the patients with acute cerebral infarction(ACI).Methods 60 patients with ACI enrolled within 72 h of onset were allocated to Tong-Xinluo group(n=30) or control group(n=30) randomly.The control group was treated with Piracetam and aspirin,while Tong-Xinluo was provided 4 tablets tid for 30 d together with Piracetam and aspirin in the other group.Before and at 30th day after treatment,the patients were evaluated by European stroke scale(ESS) and activities of daily living(ADL),and the changes of ESS and ADL were served as the index of efficacy.The plasma level of endothelin-1(ET-1) was tested in the meanwhile.Results 30th day after treatment,there was a significant derease of ET-1 both in Tong-Xinluo group [(40.3?20.5)pg/ml] and control group [(31.5?14.7)pg/ml](P

Objective To observe the protective effect of Chinese traditional medicine Ginkgo Biloba extract on rat brain with cerebral ischemia/reperfusion.Methods Compared with ischemia/reperfusion group, Ginkgo Biloba extract-treated group was observed the change of ischemia and edema volume and NAA and lactate in by DWI and ~1H-MRS examination after cerebral ischemia /reperfusion 1 h,3 h,6 h. Results A significant reductions in infarct volume were found in the Ginkgo Biloba extract-treated group compared with the control group after cerebral ischemia 60 min/reperfusion 1 h,3 h,6 h. Ginkgo Biloba extract could decrease the concentration of Lac/(PCr+Cr) and prevent the decline of the concentration of NAA /(PCr+Cr) after cerebral ischemia/reperfusion, it had significantly difference compared with the control group(all P

Using information on the Emergency Department of the Sino-Japanese Friendship Hospital-reconstructed in January of 2002-as primary data, the authors provide a general view of the model for the building, management and development of emergency departments in China in the 21" century. There are two aspects to the issue. One concerns the composition of the hardware architecture of the emergency department, including emergency medical service system(EMSS), modified layout and facilities, medico-technical departments with a complete range of functions, rational emergency medical service procedures as well as pie-hospital first aid and facilities for long-distance network medical treatment. The other concerns the composition of the software architecture of the emergency department, including the transformation of the employment system of emergency medical personnel, the change of emergency service concepts, the personnel performance and financial control of the emergency department, and the development of an emergency department culture.

Objective To verify the efficacy and safety of Edaravone,a novel hydroxy-free radical scavenger,on acute cerebral infarction(ACI).Methods We performed a randomized,placebo-controlled,parallel-group,double-blind study on ACI patients. 63 patients,enrolled within 48h of onset,were allocated to Edaravone group( n = 31) or the placebo group( n = 32) randomly. Edaravone was infused at a dose of 30 mg,twice a day,for 14 days. Meanwhile,Hydroxyethylrutin and Aspirin were taken as basic treatment. The therapies of the placebo group were similar to those of Edaravone group except for Edaravone.Before treatment and at 7th,14th and 21th day after treatment,the neurological deficits and activities of daily living (ADL) were evaluated using European Stroke Scale (ESS) and Barthel Index respectively. 3 months later,all the patients were followed up for survival and ADL.Results At 21th day the increase rate of ESS was evaluted.There were significan difference between Edaravone group[(60.3?28.2)%] and the placebo group[( 35.1? 23.6)%]( P

Objective To investigate the influence of Levetiracetam(LEV) and Topiramate(TPM) on P-glycoprotein(P-gp) expression at brain in the epileptic rats.Methods The epileptic rat models were made with 1.5 ?g(3 ?l) Kainic acid stereotaxic injected into male SD rats' hippocampi(epilepsy group) and the control group rats were injected with 3 ?l normal saline(NS).The rats in epilepsy group(18 rats) and control group(15 rats) were randomized into TPM,LEV and NS subgroups(6 or 5 rats for each subgroup) to receive once-daily orally feeding of TPM(50 mg/kg),LEV(40 mg/kg) and NS(same amount NS) for 30 d.Immunohistochemistry(EnVision) was used to measure the level of P-gp exprssion in the rats brain.The level of P-gp expression was semi-quantitatively analyzed by mean integrated blue(MIB) value in Leica Qwin imaging analysis & measuring system.Results The expression levels(MIB value) of P-gp in hippocampus and temporal lobe in epilepsy subgroups were significantly higher than those in the corresponding control subgroups(P

Objective To explore the clinical characteristics of neuromyelitis optica(NMO).Methods The clinical data of 18 patients with NMO were analyzed retrospectively.Results Of the enrolled patients,15 cases(83.3%) were relapsing form of NMO,16 cases(88.9%) were female and the mean onset age was 36 years old.Simultaneous bilateral optic neuritis(ON) or ON occured sequentially and horizontal impairent of spinal cord were the main clinic features in these 18 patients.Of the patients who received spinal cord MRI examinations,4 cases showed the lesions located in cervical cord,6 cases in thoracic cord and 5 cases in both cervical and thoracic cord.13 cases revealed lesions in spinal cord extended across 3 or more vertebral segments.Furthermore,brain lesions were detected by MRI in 6 patients.The mean onset number of per patient was five.Seven patients presented with mild disability,7 patients with median disability,2 patients with severe disability and death of 2 patients.Conclusions Most patients with NMO are female and relapsing form accounts for the majority type.The cardinal manifestations are bilateral ON and longitudinally extensive transverse myelitis(LETM).Some patients show brain lesions that may be detected by MRI examination.Relatively high relapsing frequency of clinical event and severe impairing are common in NMO.

Objective To explore the clinical,imaging and pathologic features of hypertrophic cranial pachymeningitis (HCP).Methods The clinical data of one HCP patient who treated in our hospital and other 77 HCP patients from literatures were analyzed retrospectively.Results The clinical manifestation of all the 78 HCP patients had chronic headache,multiple cranial nerves impairment.The secondary was psychiatric disorder(10.3%),ataxia(9.0%) and seizure disorder(6.4%).Hemiplegia,menorrhea and galactosis were found few.Headache was the first onset symptom in the 74 cases (94.9%).HCP was often misdiagnosed subarachnoid hemorrhage,hypotensive cranial pressure headache and cerebral venous sinus thrombosis in early stage.MRI demonstrated local or diffused thickened dura,especially in cerebral falx and/or tentorium of cerebellum,which could be enhanced through reinforced scanning.Pathological evidence indicated an obvious proliferation of dura fiber tissue accompanied with inflammatory cells infiltration.Corticosteroid was effective to all the cases.Conclusions The clinical manifestation of HCP was multiplicity,but it mainly was chronic headache and multiple cranial nerves impairment.MRI demonstrates local or diffused thickened dura especially in cerebral falx and/or tentorium of cerebellum.MRI has an important significance for diagnosis.

Objective To investigate the expression of endothelin converting enzyme (ECE) mRNA in patients with acute cerebral infarction (ACI) and its clinical significance.Methods Blood samples from 40 patients with ACI (patient group) within 72 hours after the onset of ACI and 28 gender and age-matched healthy subjects (control group) were collected on admission. Plasma concentrations of endothelin-1 (ET-1) as well as the serum levels of cholesterol, triglyceride, low density lipoprotein,high density lipoprotein, apoA1, apoB, lipoprotein a and fasting plasma glucose in each sample were measured and analyzed. Additionally, semi-quantitative RT-PCR was performed to check the ECE mRNA level in the blood cells. European stroke scale (ESS) was used to evaluate ACI patients' neurological deficit on admission.Results (1) ECE mRNA could be detected in every blood sample from either patient group or control group. However, the ECE mRNA level increased significantly in the patient group compared with that in the control group (0.31?0.092 versus 0.25?0.10, t=2.46, P=0.016). (2) The plasma ET-1 concentration in patient group was also significantly higher than that of control subjects (183.27?56.63pg/ml versus 156.47?34.24 pg/ml, t=2.23, P=0.029). (3) Plasma ET-1 concentration was negatively correlated with ECE mRNA level in the control group (r=-0.452, P=0.021). However, the result in the patient group was not the same as the control group. (4) The ET-1 concentration and ECE mRNA level in the patients had histories of hypertension, diabetes mellitus and stroke were not significantly different from those in the patients without these histories. (5) No significant correlation existed between plasma ET-1 concentration and ECE mRNA level and age of the patient, ESS score, fasting plasma glucose and serum lipid. Conclusions ECE mRNA level is significantly increased in the early stage of ACI, which may be associated with the acute-phase reaction of cerebral infarction and may have deleterious effects on the development of neuronal injury. Our results suggest the protective reflection in the endothelin system of normal human body may be disturbed by the onset of ACI. The relationship between ECE mRNA level and neurological deficit degree, stroke risk factors is worthy for further study.