10.3969/j.issn.1000-3606.2013.06.022

Objective To investigate the influence factors of cognitive impairment in epilepsy children with less than 6 years old. Methods Eighty-nine epilepsy children with less than 6 years old were selected. The neuropsychological detection was tested by Gesell developmental diagnostic scale (GDDS), and head imaging examination (CT or MRI) and ambulatory electroencephalogram (EGG) were checked. Results The scores of adaptive behavior, big sports behavior, fine motor behavior, language behavior and personal- social behavior were (82.98 ± 14.02), (85.86 ± 13.79), (83.14 ± 13.44), (84.75 ± 3.29) and (84.99 ± 14.37) scores, the average development quotient of the children with epilepsy were greater than 75 scores, and there were no statistical differences among them (P > 0.05). According to the test results of adaptive behavior, big sports behavior, fine motor behavior, language behavior and personal-social behavior, the rates of developmental delay children were 21.35% (19/89), 19.10% (17/89), 16.85% (15/89), 24.72% (22/89) and 22.47% (20/89), and the rates of moderate to severe developmental delay were 3.37% (3/89), 3.37% (3/89), 4.49% (4/89), 3.37% (3/89) and 3.37%(3/89). Multivariate analysis results showed that first onset age of epilepsy and head imaging performance were correlated with adaptive behavior, big sports behavior, fine motor behavior and personal-social behavior (P < 0.05). Conclusions The first onset age of epilepsy and head imaging performances are the major factors in cognitive performance in epilepsy children with less than 6 years old, so clinical attention should be paid to improve the prognosis of cognitive outcome of epilepsy children, and improve their life quality.

Vaccination in children suffering neurological diseases is a troublesome issue that people es-pecially pediatricians are reluctant to mention. Due to worrying about the emergence of adverse reactions and concerning on the heat induced seizure,doctors and parents tend to cancel or do not recommend these children to be vaccinated. Additionally,the heat sensitive seizures,such as febrile seizure( FS) ,generalized epilepsy with fe-brile seizure plus(GEFS+),Dravet syndrome account for the largest proportion of the seizure related disease and epilepsy syndrome. Their pathogenesis has been proved relating to the mutation of SCN gene of the sodium channel. For children with FS,GEFS+,and Dravet syndrome,vaccination may lead to fever,which even may bring about convulsions,but it will not result in worse prognosis.

Objective To explore clinical features and misdiagnosis reasons in mitochondrial encephalomyopathy,lactic acidosis,and stroke-like episodes (MELAS) syndrome.Methods The results of clinical data,brain magnetic resonance imaging (MRI),and the course of diagnosis were analyzed in 6 patients with MELAS.Results (1) Clinical features:headache and vomiting were the starting symptoms in 4 of 6 cases,and developmental delay was initial symptoms in 2 of 6 cases.Marasmus occurred in 6 cases,seizure in 5 cases,fever in 3 cases,and hirsutism and visual impairment in 2 cases.(2) Experimental results:blood lactic acid was higher in 6 (4.28 ～ 10.3 mmol/L).(3) Brain MRI:6 patients had abnormal signals in parietal,occipital,temporal lobe,which were not in accordance with vascular distribution.(4) Molecular genetics:All the 6 patients had A3243G gene mutation.(5) Three patients were misdiagnosed for viral encephalitis,and 2 developmental retardation.Conclusions MELAS is characterized with developmental retardation,and repeated encephalitis attack.It is also misdiagnosed because of its variety of clinical features.If patients have high level of lactic acid and multiple MRI signal abnormalities of brain which are not in accordance with vascular distribution,MELAS should be suspected of.Genetic examination and muscle biopsy are especially important in the diagnosis of MELAS.

Increased intracranial pressure is one of the most severe complications with significant mortality in children,so early diagnosis and treatment of this disorder is critical to save the patient's life.This article reviews etiologies,pathophysiology,and general principles of diagnosis and management of increased intracranial pressure.Based on primary diseases and clinical presentations,the goal of therapeutic strategy is to decrease intracranial pressure,avoid neurologic sequelae,and improve the outcome in patients.

Hyperuricemia(HUA),which can induce oxidative stress,endothelial dysfunction,and inflammation,is closely relevant to the metabolic syndrome(MS),such as obesity,impaired fasting blood glucose,hyper-triglyceridemia,and hypertension. Moreover,HUA is of reciprocal causation with insulin resistance(IR). Here,for the prevention and treatment of metabolic diseases such as HUA and MS,the interaction and the regulatory mechanism between MS and HUA are summarized,and the situation that HUA is an important complication of MS is illustrated.

Chemotherapy, Adjuvant ; Humans ; Stomach Neoplasms ; drug therapy

Adult ; Brenner Tumor ; diagnosis ; pathology ; Female ; Humans ; Ovarian Neoplasms ; diagnosis ; pathology ; Ovary ; pathology ; surgery

In recent years,there has been increasing evidence that microcirculatory disturbance,including vasoconstriction,shunting,inad-equate perfusion,increased blood viscosity,and coagulation,is closely associated with the pathogenesis of acute pancreatitis (AP).These processes may be exacerbated by ischaemia-reperfusion injury and the generation of oxygen radicals.The anatomical features of pancreatic microcirculation,the pathophysiological mechanism of pancreatic microcirculation disturbance and related inflammatory mediators,and pro-gress in the treatment of microcirculatory disturbance in AP are reviewed.It is suggested that the pancreatic and systemic microcirculation may play a key role in the development and progression of AP.

Objective To study the clinic characteristics and the treatment of acute pancreatitis ( AP) with and without hyperlipidemia. Methods The clinical data of 99 patients in our hospital from Jan. 2013 and Dec. 2013 were studied. Patients were divided into the hyper-lipidemic acute pancreatitis ( HAP) group and the control group ( AP without hyperlipidemia) . All the patients received standardized clinical AP treatment. The patient’ s condition, plasma biochemical index, treatment outcome, length of hospital stay, cost, and relapse were ob-served. Results The proportion of severe pancreatitis of HAP group (13. 6%) was obviously higher than that of control group (7. 8%). Blood sugar and uric acid of HAP group were significantly higher than that of control group, and the average blood sugar of HAP group reached to 171% of the control group. And the blood amylase of HAP group was only 44. 5% of that in the control group. One year recur-rence rate of HAP group (13. 6%) was significantly higher than that of control group (2. 6%) with a singnificant difference (P<0. 01). Conclusion It is suggested that hyperlipidemia condition has significant relations with the condition, performance and outcome of acute pan-creatitis.