Objective To investigate the sleep problems and related affecting factors of primary or possibly symptomatic school-aged children with epilepsy.Methods 54 epilepsy children(7 to 12 years old) and the general 54 healthy children whose gender and age were strictly matched with epilepsy group were investigated by using the chinese version of CSHQ.Results ① The total CSHQ score and 6 subscale scores (bedtime resistance, sleep onset delay,sleep anxiety, night wakings, parasomnias, and daytime sleepiness)were significantly higher in the epilepsy group(P<0.05).② In the epilepsy group, different age groups had statistical difference in the total CSHQ score and 4 subscale scores(sleep resistance, sleep onset delay, sleep duration and sleep anxiety) (P<0.05).The seizure controlled group and the uncontrolled group had statistical difference in the total CSHQ score and all subscale scores, except sleep onset delay(P<0.05).There were statistically significant differences in the total CSHQ score and all subscale scores, except sleep-disordered breathing in different seizure frequency groups(P<0.05).Different seizure type groups had statistical difference in the total CSHQ score and 4 subscale scores(sleep resistance, sleep duration, sleep anxiety and daytime sleepiness)(P<0.05).Different seizure time groups had statistical difference in the total CSHQ score and 5 subscale scores(sleep resistance, sleep onset delay, sleep duration, sleep anxiety and night waking)(P<0.05).Monotherapy group and polytherapy group had statistical difference in the total CSHQ score and 4 subscale scores(sleep onset delay, night waking, parasomnias and daytime sleepiness) (P<0.05).③ Multiple linear regression analysis showed that the main influencing factors of the total CSHQ score and some subscale scores were gender, age, control of seizure, frequency of seizure, type of seizure, time of seizure and the number of drug taking.Conclusion Children with epilepsy compared with healthy children are more likely to have sleep problems, and the occurrence of sleep problems may be related to many factors.

Objective To evaluate the safety and efficacy of Voriconazole on invasive fungal infections in very elderly patients.Methods Clinical data of 24 very elderly patients with invasive fungal infections who had sought treatment at the Department of Geriatrics of our hospital from April 2013 to April 2014 were retrospectively investigated.The classifications and quantities of fungi,accompanying symptoms,adverse reactions,blood tests,and liver and kidney function indicators were recorded and analyzed before and after treatment.Results Each of the 24 cases was found to have been infected with one or more of 17 fungal strains belonging to the genus of Candida.The rate of complete fungal elimination after treatment was 70％ (12/17).Of the 24 cases,5 achieved a full recovery(20.8 ％),10 (41.7 ％) had significant improvement,5 (20.8 ％) had some improvement,and 4 cases(16.7％)showed no therapeutic benefits,with a total effectiveness rate of 62.5 ％.There was no significant difference in liver and kidney function before and after treatment(P＞0.05).A transient increase in serum creatinine occurred in 1 case and defective vision in another patient during Voriconazole treatment.Conclusions The incidence of invasive fungal infections is high in very elderly patients,with Candida as the main pathogen.Voriconazole is effective in treating invasive fungal infections in very elderly patients,and close monitoring of liver and kidney function is required during voriconazole treatment.

Objective To explore the decision-making process of medical students who turned the major from the medicine to other majors,and the related factors that hindered them continuing to study the medicine.Methods According to the design of interpretative phenomenon logical analysis,semi-structured in-depth interviews were used to collect the data.Participants were six undergraduate students who had moved from medical major to another major.Interviews were recorded on audio-tape with the students' permission and then transcribed verbatim.The transcribed interviews were analyzed according to six steps of interpretative phenomenological analysis.Results Even if the participants had left the medical major,they still expressed a strong sense of professional identity for the doctor.However,they also admitted that the professional process of medicine students was very hard and tired,and couldn't get the equal return for their payment.They thus were lack of confidence for the future.Some of the participants talked about the fact that they had been curious about the future of medical students.Internet and seniors were the main avenues for obtaining job-related information,but they were often plagued by the negative information.Education about career adaptation should be carried out as soon as possible,to strengthen the professional identity of medical students,and enhance their ability to defend against negative information,which could help to deal with the status of high turnover rate for medical students.Conclusion Based on the students' perspective,exploring the decision-making process of turning major for medical students will contribute to the educators taking effective strategies to improve the students' career identity,stabilize their professional thought,and reduce the loss of the medical students.

Objective To explore how to improve the capability of emergency rescue to cope with the explosion of hazardous chemicals through analyzing the rescue process of Tianjin port 8 · 12 explosion hazard.Methods The process of explosion emergency rescue on the hazardous chemicals warehouse of Ruihai company in Tianjin Port on the evening of August 12,2015,were analyzed,summarize the experience and lessons.Results There were some shortcomings on field assessment,safety zoning,EMSS,treatment in hospital,personal protection equipment and public knowledge on hazardous chemicals explosion in Tianjin port 8.12 explosion hazard.we should learn from the lessons,to provide reference for the future similar rescue.Conclusions The ability of emergency rescue team to deal with the major hazardous chemicals explosion should further improve,to protect the safety of society and health of common people.

Objective To investigate the correlation between meteorological factors and the incidence of acute cardiovascular disease.Methods The number of calls for ambulance in case of cardiovascular disease between 2006 to 2010 was obtained from Beijing 120 emergency center and the data of meteorological factor during for the same period from Beijing Meteorological professional were collected,and then the impact of the weather factors of different seasons of weather factors on the incidence of cardiovascular disease was ere analyzed by time-stratified case-crossover design.Results The average daily incidence cases of cardiovascular disease in four seasons average daily were 5.61,4.55,5.05 and 6.03 respectively.The association between temperature Temperature and the incidence of acute cardiovascular disease was were non-linear relationship changes in spring and autumn seasons.Atmosphere Air pressure and the incidence were negatively correlated in the winter.The relative humidity of airand the incidence were related in the spring,summer,autumn.Wind and the incidence were related in the spring,summer,but negative correlation in the autumn,winter.Conclusions The incidences of acute cardiovascular disease are higher more in winter and spring than in summer and autumn.The incidences of cardiovascular disease are related with temperature,relative humidity,wind speed and other meteorological factors.,The influence of meteorological factors on the incidence of the disease delays to occur after changes in weather.

A new enhancement method is proposed based on the characteristics of fundus images in this paper. Firstly, top-hat transform is utilized to weaken the background. Secondly, contrast limited adaptive histogram equalization (CLAHE) is performed to improve the uneven illumination. Finally, two-dimensional matched filters are designed to further enhance the contrast between blood vessels and background. The algorithm was tested in DIARETDB0 databases and showed good applicability for both normal and pathological fundus images. A new no-reference image quality assessment method was used to evaluate the enhancement methods objectively. The results demonstrated that the proposed method could effectively weaken the background, increase contrast, enhance details in the fundus images and improve the image quality greatly.
Algorithms ; Contrast Media ; Fundus Oculi ; Humans ; Image Enhancement

ObjectiveTo determine the levels of 8-iso-prostaglandin F2α (PGF2α) in sera and lesions as well as antioxidant capacity in sera of psoriatic patients,and to assess their correlations with disease severity.MethodsSerum and skin tissue samples were collected from 15 healthy controlsand 50 patients with psoriasis vulgaris.Spectrophotometry was performed to determine the levels of total antioxidant capacity (T-AOC) and the activities of antioxidant enzymes such as superoxide dismutase (SOD),catalase (CAT) and glutathione peroxidase (GSH-Px) in serum samples.Enzyme-linked immunosorbent assay (ELISA) and immunohistochemical SP method were carried out to detect the expression level of 8-iso-PGF2α in the serum and tissue specimens respectively.ResultsThe psoriatic patients showed a significant decrease in the serum level of TAOC((12.78 ± 7.75) U/ml vs. (23.17 ± 8.81) U/ml,P＜ 0.01) as well as the activities of SOD((28.91 ±9.35) U/ml vs.(51.36 ± 7.92) U/ml,P＜ 0.01) and GSH-Px ((180.64 ± 47.70) U vs.(244.20 ± 66.68) U,P ＜ 0.01 ) compared with the healthy controls.The serum T-AOC level and SOD activity were lower in patients with severe psoriasis than those with mild or moderate psoriasis ((9.06 ± 5.30) U/ml vs. (15.27 ± 8.18) U/ml,(21.63 ± 5.28) U/ml vs. (33.76 ± 8.28) U/ml,both P＜ 0.01 ),while there was no significant difference in the activity of GSH-Px between patients with severe and mild or moderate psoriasis.The serum CAT activity was significantly higher in patients with mild or moderate psoriasis than in the healthy controls and patients with severe psoriasis ( (36.92 ± 11.31 ) U/ml vs.( 28.55 ± 8.51 ) U/ml and (24.15 ± 9.36 ) U/ml,P ＜ 0.05 and 0.01 ).Increased serum and lesional 8-iso-PGF2α levels were observed in psoriatic patients compared with the healthy controls ( (88.77 ± 25.27) ng/L vs.(38.34 ± 8.94) ng/L,0.0186 ± 0.0082 vs.0.0027 ± 0.0014,both P ＜ 0.01),as well as in patients with severe psoriasis compared with those with mild or moderate psoriasis(( 114.24 ±13.93) ng/L vs.(71.78 ± 14.35) ng/L,0.0279 ± 0.0027 vs.0.0125 ± 0.0030,both P＜ 0.01 ).The psoriasis area and severity index(PASI) score was negatively correlated with T-AOC level,SOD and CAT activities(r =-0.384,-0.573 and -0.444,all P ＜ 0.01 ),positively correlated with serum and lesional 8-iso-PGF2α levels (r =0.710,0.783,both P ＜ 0.01 ),and uncorrelated with GSH-Px activity.None of the parameters was correlated with the course of disease.ConclusionThe serum and lesional levels of 8-iso-PGF2α may be a more sensitive marker for oxidative damage and disease severity.

Emotional and cognitive disorders (EACD),such as depression and anxiety,have become very common in today′s society,seriously affecting human lives and health. Neural plasticity can reflect the anti-stress ability of the nervous system to the internal and external stimulation,and is capable of dynamic changes in structure or function to adapt to environmental changes,as is often manifested in the process of compensation and repair of nerve injuries. EACD is often accompanied by macroscopic and cellular morphological changes in brain tissues and functions. Thus,studies on the mechanisms of neural plasticity will contribute to the treatment of EACD. In this paper ,the role of neural plasticity in the active components of Chinese herbal medicine(ACCHM) is reviewed. The effects of ACCHM on 5-hydroxytryptamine(5-HT)system,and the antioxidant activities and neurotrophic effects of ACCHM are described. ACCHM can affect neural plasticity,playing a neuroprotective role by improving 5-HT levels,reducing oxidative stress in brain cells,and increasing the expression of brain derived neurotrophic factor(BDNF). In summary,one ACCHM could affect neural plasticity through one or more mechanisms. There are interactions between different mechanisms of the same ACCHM. Different ACCHM can play a synergistic effect on the enhancement of neural plasticity because of their different mechanisms.

Heat stroke (HS) is a life-threatening illness characterized by core body temperatures above 40 ℃ coupled with central nervous system (CNS) dysfunction, including delirium, convulsions, and/or coma. Its morbidity has increased dramatically in the past few decades. Multiple organ dysfunction syndrome (MODS) is not only the most serious complication of HS, but also the leading cause of deaths. Understanding the pathogenesis, characteristic and advancement pattern of MODS caused by HS will have a profound effect on the clinical treatment, research and mortality decrease. The pathogenesis, injury characteristic of each system and organ, and treatment methods were summarized in this review so as to deepen the clinical recognition of this disease.

Objective: To optimize and establish the best hydrolysis method of diethyl ester 4-amino-N5-formyl-N8,N10-dideazatetrahydrofolate through the optimization of simple compound of diethyl N-(4-aminobenzoyl)-L-glutamate.Methods: To increase the low yield of hydrolysis reaction of diethyl ester 4-amino-N5-formyl-N8,N10-dideazatetrahydrofolate due to the by-products and difficult purification, we studied the effect of NaOH and KOH, two kinds of alkalis, three concentrations between 0.175-1 mol/L and five types of reaction time involved in 20, 30, 60, 120 and 180 min on the common side chain diethyl N-(4-aminobenzoyl)-L-glutamate.A high performance liquid chromatography was established for measuring the target product and the by-products in reaction liquid in different reaction conditions.Finally, on the basis of the best hydrolysis method of diethyl ester 4-amino-N5-formyl-N8,N10-dideazatetrahydrofolate, we completed the optimization of the hydrolysis reaction conditions of diethyl ester 4-amino-N5-formyl-N8,N10-dideazatetrahydrofolate.Results: We developed the best reaction condition for the hydrolysis of diethyl ester 4-amino-N5-formyl-N8,N10-dideazatetrahydrofolate, which could be carried out easily and efficiently.The results indicated that treated with the optimized condition of 0.3 mol/L KOH in 60 min at the room temperature, diethyl ester 4-amino-N5-formyl-N8,N10-dideazatetrahydrofolate was converted into its diacid derivative in 95.6 % yield, which turned to be a better reaction condition compared with the previous reaction condition.The structures of those compounds were identified to be correct by 1H nuclear magnetic resonance(1H NMR), 13C nuclear magnetic resonance(13C NMR) and electrospray ionization time of flight mass spectrometry (ESI-MS).The purity of the diacid derivative of the compound was determined to be 96% by high performance liquid chromatography(HPLC).The new hydrolysis reaction condition could not only avoid the formation of single ester hydrolysis product and amide bond hydrolysis product, but also improve the yield of the hydrolysis reaction.Conclusion: We have developed an efficient reaction for the hydrolysis of diethyl ester 4-amino-N5-formyl-N8,N10-dideazatetrahydro.Since the final step of the synthesis of classical folic acid antagonists is always the catalyzed hydrolysis of the side chain glutamate, the reaction also has great significance for anti-folic acid anti-tumor inhibitors synthesis.