Convulsion is a common pediatric emergency and the most frequent clinical feature among the diseases of nervous system in children.Convulsion emergencies are potèntially life-threatening events.Brief convulsions rarely produce lasting effects on the brain.Prolonged convulsions,especially status epilepticus,can lead to permanent neurologic damage.Airway management and timely termination of the convulsion are the initial priorities.Early recognition and accurate diagnosis are crucial for effective emergency treatment of convulsion.

Adrenocortical hormone (ACH) has been used in the treatment of the epilepsies,especially for epileptic encephalopathy,for over 70 years.ACH is clearly established as fast line treatment of infantile spasm and the Landau-Kleffner syndrome.This is typically as monotherapy in infantile spasm,but often in conjunction with anti-epileptic drugs in Landau-Kleffner syndrome,though the mechanism of ACH for epilepsies is not clear.However,in view of these potential adverse side effects,the use of ACH in the treatment of the epilepsies in children must be determined on a risk-benefit basis.

Dermatophagoid.es farinae allergen Ⅰ (Der f Ⅰ ) has been extracted and purified from spent culture medium of Dermatophagoid.es farinae by affinity chromatography coupled with anti-Der f Ⅰ McAb for the first time in China. Furthermore,its physicochemical properties were analysed. By SDS-PAGE,.Der f Ⅰ was estimated to have a molecular weight of 24 kDa and appeared as only one protein band. By isoelectric focusing ,it was revealed to have pIs of 4. 8 - 7. 5 with six protein bands,suggesting that Der f Ⅰ is heterogeneous with complicated composition.

Lennox-Gastaut syndrome ( LGS) is an globally recognized refractory epilepsy,also known as an age-dependent epileptic encephalopathy. It is characterized by multiple seizure types, mental retardation, and slow spike-wave complexes discharges or fast rhythmic bursts during sleep on electroencephalographic re-cordings. Many antiepileptic drugs were reported for the treatment of LGS,but it was difficult to compare their efficacy because of the small sample size and design limitations. Valproate,topiramate and lamotrigine are rec-ommended to be the first-line drugs by most guidelines or expert consensus,and the combination of valproate and lamotrigine or the combination of lamotrigine and topiramate should be preferred as early as possible for initial treatment of LGS in children. Recent progresses of medical treatment of LGS are reviewed and some optical re-gimes are proposed in this paper.

Autism spectrum disorder(ASD)is a kind of neurodevelopmental disorder.Despite the high prevalence of ASD, no definite pathogenesis of ASD has yet been elucidated to date.Accumulating evidence indicated that the pathogenesis of ASD may be related to genetic, environmental and immune factors.Studies has been shown that vitamin D(Vit D)deficiency is negatively correlated with the prevalence of ASD, and that supplementation with Vit D may reduce the risk of ASD.Because of the extensive physiological functions of Vit D, it can act as a steroid hormone in multiple aspects such as genetic, environment and immune profiles.Meanwhile, the genetic, environmental and immune changes could also affect the metabolism and function of Vit D, and vice versa.Therefore, Vit D deficiency probably lead to the development of ASD.This review focuses on the relationship between Vit D and environmental, genetic and immune factors of ASD.

Liver metastasis is the main fact or affecting prognosis.The treatment includes surgery,chemotherapy,gene therapy and local therapy(radiofrequecy,late,PEI and cryotherapy),of which surgery is only curative method.Mortality of surgery is 1%-2%,5-year survival is 35%-38%,but only 10%-25% of liver metastasis of colorectal cancer can receive surgery,so other methods of therapy are considered.We will summarize the mulfi-modal therapy of liver metastasis of colorectal cancer.

Objective To analyze the potential risk factors of infantile spasms (IS) relapse through following up the respondents with IS after different treatment protocols.Methods Sixty-nine cases were collected in the Department of Pediatric Neurology,Jiangxi Children's Hospital from May 2011 to September 2013,who had complete cessation of spasms for at least 28 days or more after the different treatment protocols.The follow-up was performed on these patients until spasms seizure relapse or at least 1 year for those without recurrence.According to the literature review,8 possible risk factors of IS recurrence (gender,age of onset,course of diseases,etiology,high irregular types of electroencephalogram,development quotient,onset time,treatment protocols) were selected,and then Logistic multiple regression was used to analyze the relationship of various potential risk factors with the relapse of spasms.Results (1) The recurrence rate at 6 months and 12 months were 40.6％ (28/69 cases)and 43.5 ％ (30/69 cases),respectively.(2) Among the various potential factors,the age at onset and the time to response were closely related to the IS recurrence.Namely,the non-classic onset(early-onset and late-onset) of IS were more likely to relapse than the classic onset[66.7％ (14/21 cases) vs 33.3％ (16/48 cases),x2 =6.605,P =0.010];the responders beyond 1 week were more likely to relapse than those within 1 week[63.6％ (14/22 cases) vs 34.0％ (16/47 cases),x2 =5.341,P =0.021].There were significant differences between the 2 groups (all P ＜ 0.05).(3) Logistic multiple regression analysis demonstrated that age at onset (Wald =3.603) was most closely related to the relapse of spasms.Conclusions (1) The relapse rate of IS in children was high,and the majority of them relapsed within 6 months.So a long-term,rational and effective clinical management solution should be explored.(2) The age at onset and the time to response are very important risk factors of the IS recurrence,and the former was more significant.So,early diagnosis and early treatment are more likely to improve the efficacy of IS,and reduce the risks of recurrence and improve the prognosis.

Objective To evaluate tension-free repair in the management of recurrent inguinal hernia. Methods From 1/1993 to 12/2002, 163 patients with recurrent inguinal hernia underwent reoperation, clinical data were reviewed. Results The male: female ratio was 138: 25, age from 34 to 76 years. The primary surgery had been traditional hemiorrhaphy without prothesis in 142 cases (87. 1 % , including 65 cases of Bassini ,35 cases of McWay and 42 cases of Shouldice) , a tension-free procedure in 12 cases(7. 4% , including 3 cases of laparoscopic mesh repair) and unknown techniques in 9 cases(5. 5% ). The average interval from the initial surgery to recurrence was 36?14 months (range from 3 months to 10 years). Recurrent hernias were treated with a Shouldice repair in 71 cases(43. 6% ) , a tension-free repair in 92 cases(56. 4% , including a laparoscopic mesh repair in 3 cases). All these 163 cases(100% ) were followed up for 56 ?1 months (range from 30 months to 12 years) after the second surgery. It was found that after reoperation the recurrence rate of Shouldice procedure and tension-free repair was 16. 1% (11/71) and 2. 2% (2/92) respectively (x2 = 8. 327 ,P

OBJECTIVE To investigate the effect of furanodiene(FDE),a diterpene derived from the medicinal plant Zedoary,on apoptosis of human gastric cancer MGC-803 cells induced in vitro. METHODS MGC-803 cells were treated with FDE 46.29~740.74μmol·L-1 for 24,48 and 72 h,and the cell viability was detected with MTT assay. Cell morphology was observed by light microscopy and Hoechst33342 staining. Flow cytometry was used to detect cell apoptotic rate and cell cycle. Rh123 staining and fluorescence probe DCFH-DA were employed to detect the changes in mitochondrial membrane potential (MMP) and reactive oxygen species(ROS). RESULTS MTT Results showed that FDE 46.29-740.74μmol · L-1 exhibited significantly higher cytotoxicity to gastric cancer MGC-803 cells. IC50 for MGC-803 of 24,48 and 72 h treatment was 347.91,257.41 and 101.01μmol·L-1,respectively. Treatment with FDE 92.58-370.32μmol·L-1 for 24 h also caused significant morphological changes in MGC-803 cells. AnnexinⅤ-FITC/PI double staining showed that the apoptotic rate increased after FDE 92.58-370.32μmol·L-1 treatment for 24 h(P<0.05). FDE enabled MGC-803 cell cycle arrest in S phase. DCFH-DA staining showed that FDE resulted in an increase in intracellular ROS levels(P<0.05) when PDE concentration was 370.37μmol·L-1(P<0.05). MMP decreased after FDE treatment when PDE concen?tration was 370.37μmol·L-1(P<0.05). CONCLUSION FDE Possesses potent tumor selected toxicity and can induce apoptosis of MGC-803 cells through cell cycle arresting,which is related to inhibition of DNA biosynthesis.

Objective To observe the effect of dredging acupoints combined with Vojta training on spastic type cerebral palsy (CP).Methods220 children with spastic type CP were randomly divided into the treatment group and control group with 110 cases in each group. The children in the treatment group were treated with traditional Chinese medicine acupuncture and Vojta training, and those in the control group were treated with drug through intravenous dropping. The gross motor function of all children in two groups was assessed with Gross Motor Function Measure (GMFM) before and after treatment.ResultsThe GMFM scores of children in the treatment group were significantly higher than that of the cases in the control group ( P<0.001).ConclusionThe dredging acupoints combined with Vojta training can improve motor function of children with spastic type CP obviously.