Objective To analyze the clinical features,treatment and prognosis of children with post-stroke epilepsy.Methods Sixty-nine children with epilepsy after cerebral stroke who were admitted to Guangdong General Hospital from Jan.2009 to Mar.2013 were retrospectively reviewed,including etiology,clinical features,laboratory examinations,treatment and prognosis.Results Among 260 stroke patients,69 of them (26.5 ％) developed epilepsy,but there was no significant difference between boys and girls(x2 =0.725,P =0.394).The incidence of post-stroke epilepsy differed significantly among different types (x2 =12.000,P =0.02),highest in the children with subarachnoid hemorrhage(47.8％,11/23 cases),followed by those with cerebral hemorrhage (34.6％,27/78 cases),and lastly,those with cerebral ischemia (19.5％,31/159 cases).Among them,53 patients developed seizures in the early stage (76.8％,53/69 cases),others in the late stage(23.2％,16/69 cases),early-onset epilepsy was more common in hemorrhagic stroke and late-onset epilepsy was more common in ischemic stroke,which differed significantly(x2 ＝ 4.778,P =0.029).The electroencephalogram background generally showed slow-wave in the early-onset epilepsy.The composition of seizure types differed significantly among different types of stroke (x2 =8.461,P =0.015).Forty-five of 58 patients (77.6％) suffered from cortical lesions and 13 of 58 patients (22.4％) suffered from subcortical lesions.Those children with post-stroke epilepsy who regularly use of antiepileptic drugs were followed up for 6 months to 4 years,81.2％ (56/69 cases)of clinical seizures were controlled.Conclusions The incidence of epilepsy after stroke is higher in children than in adults,cerebral stroke seizure occurs more commonly in cases with hemorrhagic stroke,especially with subarachnoid hemorrhage.Conventional antiepileptic treatment is effective.

Objective To explore the effect of vitamin K2 on β-glycerophosphate(β-GP)-induced rat vascular smooth muscle cells (VSMCs) calcification and and the mechanism.Methods VSMCs were obtained from rat aortic,and identified by immunocytochemistry,then randomly divided into control group,high phosphorus group,vitamin K2 group (the group was settled three subgroups according to the concentration of vitamin K2 based on the high phosphorus medium,namely 10 μmol/L,25 μmol/L,50 μmol/L) and noggin (bone morphogenetic protein pathway inhibitor) group.Calcification was visualized by Alizarin red staining,calcium load in cells was quantified by o-cresolphthalein complexone method and alkaline phosphatase (ALP) activity was measured after stimulating 14 days,gene expressions of bone morphogenetic protein-2 (BMP-2),SMAD1,SMAD7 and Runx2 mRNA were detected by RT-PCR,Runx2 protein levels was detected by Western blotting after stimulating 3 days.Results Compared with the cells in control group,high phosphorus induced cell calcification,increased ALP activity,up-regulated the expression of BMP-2,SMAD1,Runx2 mRNA (P ＜ 0.05) and down-regulated the expression of SMAD7 (P ＜ 0.01),while compared with high phosphorus group,the calcium deposition,ALP activity and the expression of BMP-2,SMAD1,Runx2 mRNA were remarkably reduced in a dose-dependent manner by treatment with vitamin K2 (P ＜ 0.05) and the expression of SMAD7 was increased (P ＜ 0.01).Compared with high phosphorus group,SMAD1 and Runx2 expression in noggin group were remarkably reduced(P ＜ 0.01).Conclusion Vitamin K2 inhibits β-glycerophosphate-induced VSMCs calcification which correlates with the suppression of the expression of osteoblast markers through the down-regulation of bone morphogenetic protein pathway.

Objective To investigate the different exposure and treatment methods for the chorda tympanic nerve in middle ear surgery, and discuss the surgery techniques and the feasibility of the chorda tympanic nerve protection.Methods From September 2013 to March 2016, 155 cases of middle ear surgeries at Zhujiang hospital were included in this study, including 24 cases of type I tympanoplasty, 6 cases of atticotomy and type I tympanoplasty, 22 cases of atticotomy and type II tympanoplasty, 23 cases of canal-wall-up mastoidectomy and tympanoplasty,74 cases of canal-wall-down mastoidectomy and tympanoplasty, 6 cases of stapedotomy.The conditions of exposure and protection of the chorda tympanic nerve in the operation were compared, and their taste function at 3 days to 1 months postoperatively through questionnaires were evaluated.Results The preservation rate of the chorda tympanic nerve was up to 89.03%(138/155).There were 17 cases of chorda tympanic nerve injuries, of which 15 cases suffered hypogeusia with the rate being 88.2%(15/17).In 126 cases of the complete protection of the chorda tympanic nerve, 13 of them appeared hypogeusia at 10.3% (13/126), but they recovered within 1 months postoperatively.One case of delayed facial paralysis occurred in 16 days postoperatively, and recovered completely after 2 weeks of treatment with glucocorticoids.There was a significant difference in the incidence of postoperative abnormal taste between the complete protection of the chorda tympanic nerve and fracture during operation.Conclusion According to the different position and exposure of chorda tympanic nerve, the individual measures should be taken in middle ear surgery to protect the chorda tympanic nerve.

OBJECTIVE: To observe the effects of Modified Rhizoma Alismatis decoction on the expression of aquaporin 8 (AQP8) in liver tissue of hyperlipemia model rats, and to investigate the mechanism of preventing and treating hyperlipemia.METHODS: Total of 60 rats were randomly divided into blank control group (distilled water), model group, positive control group (simvastatin 1. 89 mg/kg) and modified Rhizoma Alismatis decoction high-dose, medium-dose and low-dose groups (29. 56, 14. 78, 7. 39 g/kg, calculated by crude drug), with 10 rats in each group. Those groups were given high-fat diet to induce hyperlipemia model and given relevant medicine intragastrically once a day for consecutive 5 weeks except that blank control group was given normal diet. After administration, the serum contents of TG, TC, HDL-C and LDL-C in rats were detected, and the pathomorphology changes of liver tissue were observed; the mRNA and protein expression of AQP8 in liver tissue were detected. RESULTS: Compared blank control group, the serum contents of TG, TC and LDL-C in model group were increased significantly (P<0. 05 or P<0. 01),while the serum content of HDL-C was decreased significantly (P<0. 01); pathological changes were found in liver tissue, such as irregular cell arrangement and hepatic sinusoidal hyperemia and edema; mRNA and protein expression of AQP8 in liver tissue were increased significantly (P<0. 01). Compared with model group, above indexes of treatment groups were improved significantly (P<0. 05 or P<0. 01); the structure of liver tissue tended to be normal and the fatty degeneration was obviously alleviated. CONCLUSIONS: Modified Rhizoma Alismatis decoction can regulate the mRNA and protein expression of AQP8 in liver tissue so as to play the effects on the prevention and treatment of hyperlipidemia.

OBJECTIVETo study the changes in 24-hour video electroencephalogram (EEG) and epileptic attacks after levetiracetam add-on therapy in children with frontal lobe epilepsy and epileptiform discharges.

METHODSA prospective study was carried out in 105 children with the frontal lobe epilepsy who received long-term treatment with 1 or 2 types of antiepileptic drug but still with epileptiform discharges in ECG. Levetiracetam add-on therapy was administered at the initial daily dose of 20 mg/kg (given in 2 doses) for 2 weeks followed by an increase of the dose to 30 mg/kg with a maintenance dose of 30-40 mg/kg. The changes in seizure attacks and 24-hour video-EEG monitoring after a 6-month therapy were observed.

RESULTSLevetiracetam add-on therapy reduced epileptiform discharges in 55 children (52.3%) and resulted in significant changes in EEG (P<0.05). Of the 77 children with clinical seizures, complete seizure control was achieved in 12 cases after the therapy, and the seizure attacks were reduced in 28 cases, showing a total response rate of 51.9%; the reduction in seizure attacks was positively correlated with EEG improvement (P<0.001).

CONCLUSIONLevetiracetam add-on therapy can decrease epileptiform discharges in EEG and reduce clinical seizure attacks in children with frontal lobe epilepsy with only mild adverse reactions.

Adolescent ; Anticonvulsants ; administration & dosage ; therapeutic use ; Child ; Child, Preschool ; Electroencephalography ; Epilepsy, Frontal Lobe ; drug therapy ; physiopathology ; Female ; Humans ; Infant ; Male ; Piracetam ; administration & dosage ; analogs & derivatives ; therapeutic use ; Prospective Studies ; Treatment Outcome

Objective:To explore the progress and prospect of evaluation methods for infertility patients.Methods:From September 2017 to December 2020,199 cases of infertility patients who have accepted mini-hysteroscopy examination in the Department of Gynecological Endocrinology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University.The patients who had primary ovary insufficiency,tubal infertility were excluded;patients with hysteroscopy contradiction,such as acute or sub-acute vaginal tract inflammation,en-dometrium lesion or endometrium carcinoma,severe cardiovascular,liver or kidney insufficiency were excluded.40 patients were excluded and 15 patients lost follow up,144 patients were eventually included in the analysis.The patient's age,body mass index,infertility etiology,preoperative and postoperative stimulate ovulation cycle,pregnancy state and pregnancy time were recorded.The effect of mini-hysteroscopy on ovulation induction cycle was analyzed in pregnant patients.Results:The average age of 144 patients was 32.10±4.67 years old.96 (66.67％) patients were found to have intrauterine abnormalities,while 48 (33.33％) patients were found to have normal intrauterine cavity.48 cases of pregnancy,accounting for 33.33％;the median and interquartile ranges[M (Q1,Q3)]of ovulation induction cycles before and after surgery were respectively[3 (0,5)],[2 (1,3)],the difference was statistically significant(P ＜ 0.05).Among the 48 pregnant patients,32 of them had no structural lesions in hysteroscopy,the ovula-tion induction cycle of these patients before and after hysteroscopy were respectively[5 (0,9)],[1 (0,3)],the difference was statistically significant (P ＜ 0.05).Conclusion:Uterine cavity evaluation is important for the assessments of fertility.As an advanced diagnosis instrument,mini-hysteroscopy can not only timely detect the intrauterine abnormalities of patients,but also with great application value in shorten the ovulation cycle in infertility patients and increase the pregnancy rate.

ObjectiveTo explore the efficacy and mechanism of Danshen Zexie decoction in treating the rats with metabolic-associated fatty liver disease （MAFLD）. MethodSixty male SD rats were randomized into control group， model group， essentiale （polyene phosphatidylcholine capsules， 0.144 g·kg^-1） group， and low-， medium-， and high-dose Danshen Zexie decoction （1.16， 2.32， and 4.64 g·kg^-1， respectively） groups. The rat model of MAFLD was established with high fat diet， and 8-week therapy started at the induction of MAFLD. The serum levels of total cholesterol （TC）， triglyceride （TG）， alanine aminotransferase （ALT）， and aspartate aminotransferase （AST）， as well as the liver levels of TC， TG， free fatty acid （FFA）， superoxide dismutase （SOD）， glutathione （GSH）， and malondialdehyde （MDA）， were measured. The pathological changes of liver were observed by hematoxylin-eosin （HE） staining and oil red O staining， and the steatosis score and oil red O staining area were calculated. The level of reactive oxygen species （ROS） in the liver was detected by immunofluorescence. The protein levels of adenosine monophosphate-activated protein kinase （AMPK）， p-AMPK， nuclear factor E₂-related factor 2 （Nrf2）， glutamate-cysteine ligase catalytic subunit （GCLC）， glutamate-cysteine ligase modifier subunit （GCLM）， and nicotinamide adenine dinucleotide phosphate： quinine oxidoreductase （NQO1） in the liver were determined by Western blot. ResultCompared with control group， the modeling of MAFLD elevated the levels of TC， TG， ALT， and AST in the serum and TC， TG， FFA， MDA， and ROS in the liver （P<0.01）， lowered the levels of SOD and GSH and down-regulated the protein levels of phosphorylation（p）-AMPK， Nrf2， GCLC， GCLM， and NQO1 in the liver （P<0.05， P<0.01）. Further， a large number of lipid droplet vacuoles and balloon-like lesions appeared in the hepatocytes， and the steatosis score and oil red O staining area increased in the model group （P<0.01）. Compared with model group， Danshen Zexie decoction lowered the levels of TC， TG， ALT， and AST in the serum and TC， TG， FFA， MDA， and ROS in the liver （P<0.01）， increased the levels of SOD and GSH and up-regulated the protein levels of p-AMPK， Nrf2， GCLC， GCLM， and NQO1 in the liver （P<0.05， P<0.01）. Moreover， the decoction alleviated the degree of liver steatosis （P<0.05， P<0.01）. ConclusionDanshen Zexie decoction protects against MAFLD by activating AMPK/Nrf2 signaling pathway and suppressing oxidative stress.

ObjectiveTo explore the mechanism of Broussonetiae Fructus （BF） in preventing and treating drug-induced liver injury （DILI） induced by acetaminophen （APAP） through the endoplasmic reticulum stress pathway. MethodSixty C57BL/6N mice were randomly divided into normal group， model group， silybin group （3.4 g·kg^-1）， and high-， medium- and low-dose BF groups （3.0， 1.5， 0.75 g·kg^-1）， with 10 mice in each group. The DILI model was induced by intragastric administration of APAP at 800 mg·kg^-1， and drugs were administered simultaneously for 10 consecutive days. The serum contents or activities of alanine aminotransferase （ALT）， aspartate aminotransferase （AST）， total bilirubin （TBIL）， and direct bilirubin （DBIL） were measured. Hematoxylin-eosin（HE） staining was performed to observe the pathological changes in liver tissues. The morphological changes in liver mitochondria were observed by transmission electron microscopy. The activities or content of superoxide dismutase （SOD）， malondialdehyde （MDA）， total antioxidant capacity （T-AOC）， glutathione （GSH）， glutathione disulfide （GSSG）， glutathione peroxidase （GSH-Px）， and adenosine triphosphate （ATP） in the serum and liver tissues were detected by the colorimetric method. The expression of reactive oxygen species （ROS） in liver tissues was detected by immunofluorescence. The gene expression of glucose-regulated protein 78 （GRP78）， CCAAT/enhancer-binding protein homologous protein （CHOP）， and c-Jun N-terminal kinase （JNK） in liver tissues was detected by Real-time quantitative polymerase chain reaction （PCR）. ResultCompared with the normal group， the model group showed increased serum activities or content of ALT， AST， TBIL， and DBIL （P<0.01）， increased MDA and GSSG contents （P<0.01）， decreased contents or activities of SOD， T-AOC， GSH， GSH-Px， and ATP （P<0.01）， swollen hepatocytes with inflammatory infiltration and lamellar necrosis， swollen and broken mitochondria of hepatocytes， and increased mRNA expression of GRP78， CHOP， and JNK （P<0.01）. Compared with the model group， the groups with drug intervention showed decreased serum content or activities of ALT， AST， TBIL， and DBIL （P<0.05， P<0.01）， reduced MDA and GSSG contents（P<0.05， P<0.01）， and increased contents or activities of SOD， T-AOC， GSH， GSH-Px， and ATP （P<0.05， P<0.01）， improved swollen hepatocytes， inflammatory infiltration， and lamellar necrosis， recovered bilayer membrane structure in mitochondria of hepatocytes， and decreased mRNA expression of GRP78， CHOP， and JNK （P<0.05， P<0.01）. ConclusionBF has preventive and therapeutic effects on APAP-induced DILI mice， and the mechanism may be related to the reduction of endoplasmic reticulum stress and oxidative stress level in vivo.