Objective To analyze the clinical features and efficacy of different treatments on 5 cases with Landau-Kleffner syndrome (LKS) with poor prognosis.Methods Five patients with LKS who had poor prognosis were enrolled in the Children's Hospital of Fudan University from September of 2008 to December of 2012.The clinical features and findings of video electroencephalograph (VEEG) of these patients were analyzed.In addition,the outcomes of treatments (antiepileptic drug,corticosteroids and ketogenic diet) on LKS who had poor prognosis were studied.The outcome of epilepsy was classified by using the Engel classification scheme and the outcome of electrical status epilepticus during sleep (ESES) was classified by the decrease in spike wave index (SWI).Results All of 5 patients (2 male and 3 female) had auditory agnosia and epileptic seizure.All patients had normal background activity and epileptiform discharges,and the location of epileptiform discharge was mainly from bilateral temporal;3 patients had ESES.Four out of the 5 patients had refractory epilepsy and the other one got seizure free with antiepileptic drug.Four patients received corticosteroids for 6 months.The aphasia disappeared in 1 patient,improved in 1 patient and sustained in the other 2 patients.Three patients who had ESES did not response to corticosteroids.Among 3 patients receiving ketogenic diet,1 patient was seizure free and the ESES disappeared;in another SWI was reduced;the rest one had a significant reduction in seizure.All the patients had improvement in their aphasia and cognition,however they still had cognitive disorder of various degrees.Conclusions The patients who had multiple seizure type or special seizure type may have poor outcome.Most of these patients have refractory epilepsy or persistent ESES.Corticosteroids can improve aphasia and cognition,but the persistence of ESES can make aphasia and cognition worse.Ketogenic diet can be used as an alternative treatment for refractory epilepsy or persistent ESES in LKS.

Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Mining ; Noninvasive Ventilation ; Pneumoconiosis ; rehabilitation ; Treatment Outcome

Objective To determine the perioperative hidden blood loss (HBL) associated with different fixation methods for intertrochanteric fracture.Methods We retrospectively studied 128 patients with 31-A1 and 31-A2 intertrochanteric fractures which underwent internal fixation with dynamic hip screw (DHS,n=35),short reconstruction intramedullary hip screw (IMHS,n=55) or percutaneous compression plate (PCCP,n=38) from January 2008 to January 2012.The HBL were calculated and compared.Results The mean total hidden blood loss (THBL) was more than 7 times than the mean apparent blood loss (ABL) in all the three groups.For the THBL,there were significant statistical differences among three groups; no difference was found between IMHS and DHS group.For the phasic hidden blood loss (PHBL),there was no difference among the three phase of treatment in DHS group.But in IMHS and PCCP group,there were significant differences between the 4th-5th day and the 1st day,the 2nd-3rd day after operation; no difference was found between the Ist and the 2nd-3rd day.For the ratio of PHBL/THBL there were significant differences between the 4th-5th day and the 1st day,the 2nd-3rd day after operation; but no statistical differences were found between the 1st day and the 2nd-3rd day after operation.Conclusion It can be concluded that HBL after surgery for intertrochanic fractures is much greater than that observed intra-operatively.The IMHS and DHS cause more HBL than PCCP.Frequent post-operative measurements of haemoglobin are necessary,especially the first three days after surgery.

Objective:To evaluate the reliability of localization of the impacted teeth by assessing various conventional radiographies. Methods:32 patients with impacted teeth were included. The impacted teeth were localized by conventional roentgenographic techniques including panoramic radiography (PR) and linear tomography (LT).Results:Dentomaxillary orthopantomographic solution (PR,LT and PR combined with LT) clearly presented the position of the impacted teeth. Serial cross-section linear tomography also ensured the shape and axis of the impacted teeth captured on the radiograph. The accuracy of the localization was further verified by the surgical exposure in 5 cases. Conclusion:Orthopantomographic assessing can directly and precisely localize the buccal and lingual position of the impacted teeth.

Biodegradable PLGA [poly(lactide-co-glycolide acid)] have shown significant potential for sustained and targeted delivery of several pharmaceutical agents, including DNA. We reviewed the formulating approaches of PLGA nanoparticles/microspheres as DNA carriers and utilization for gene therapy and vaccine adjuvant.

Colorectal cancer is currently the world's fourth incidence of malignant tumors,the early clinical manifestations are not obvious,so the early diagnosis is difficult to find,most of them are in progress.Treatment of advanced stage with chemotherapy,interventional therapy,radiotherapy and other methods,in which chemotherapy in the killing of tumor cells at the same time,the normal cells of the body also has a killing effect.In recent years,all kinds of new nano targeting delivery system has been developed,which can be targeted to the tumor tissue,so it is more and more important in the treatment of intestinal tumor,especially with metastasis.The author has made an overview of the types of nano drug carrier materials,the research status and its application in the research of colorectal cancer.

Objective To explore the surgical treatment effect reconstructing calcaneus partial defect with deep iliac circumflex artery illium lamella and sural nerve slap. Methods Sevens of calcaneus fracture with posterior part defect from July 2005 to July 2010 were rehabilitated with deep iliac circumflex artery ilium lamella whose artery were anastomosed to posterior tibial artery and whose skin were repaired with sural nerve slap. Results All patients were obtained follow-up,which ranged from 9 to 30 months with a mean of 19.5 months. Its Bohler angle maintain a range from 35 to 45 degree and foot bridge maintain its figure,as well as perfect skin.According to Maryland grades system,the result were excellent in 3 cases with score 90,good in 2 with score 85 and fair in 2 with score 75. Conclusion It is a perfect method for calcaneus trauma which lose its foot bridge to rehab its figure and function with deep iliac circumflex artery ilium lamella and sural nerve slap.

Objective To estimate the adverse effects of total suspended particles exposure on cardiovascular disease mortality.Methods Cardiovascular disease mortality and TSP monitoring data from1996to2000in Shenyang were collected.The association between TSP concentration and the mortality of cardiovascular diseases was analyzed using Poisson regression model adjusted for season,temperature and humidity variation using a parametric method.Results It was found that each50?g /m 3 increment of TSP was associated with an OR of1.0122(95%CI =1.0036-1.0209)of cardiovascular disease mortality in the general population,an OR of1.0278(95%CI =1.0160-1.0398)in the male group,1.0406(95%CI =1.0294-1.0519)in the female group,1.0430(95%CI =1.0343-1.0519)in the general aged group,1.0577(95%CI =1.0452-1.0703)in the aged male group and1.0427(95%CI =1.0284-1.0572)in the aged female group.Conclusion The results showed that there was an association between TSP concentration and the cardiovascular disease mortality in Shenyang.It was considered that TSP might be one of the risk factors related to the increase of cardiovascular disease mortality.

Objective:The study aims to investigate the expression of integrin ?V?3 and its relationship in gastric cancers.Methods:The tumoral and normal tissues were collected from 65 cases of gastric cancer patients and 40 controls.The clinical phasing and pathological staging of the patients were recorded,and immunohistochemical analysis was used to detect the expression of integrin ?V?3 and microvessel density(MVD)in gastric cancers.Results:The positive rate of integrin ?V?3 expression was significantly higher in gastric cancer tissues than normal mucosal tissues(72.38% vs 22.86%,?2=8.35,P=0.032).There was a significant difference in integrin ?V?3 expression or MVD between tumors of infiltrating and expanding growth patterns(?2=14.97,P=0.002;t=10.150,P=0.001,respectively),cancers in T3～T4 and T1～T2 stages(?2=15.21,P=0.015;t=5.961,P=0.001,respectively).The positive rate of integrin ?V?3 expression and MVD also showed corelationship with lymph node invasion and metastases.Conclusion:Tumoral expression of integrin?V?3 was closely related with biological behavior of gastric cancers,suggesting that detection of integrin ?V?3 expression may present a potential tool to evaluate the clinical and pathological staging,lymph node status and metastases.