Chinese medicine dispensing granule is made by qualified decoction pieces with modern pharmaceutical technology, which has the characteristics of flexible prescription, flexible dose, fast onset and easy absorption. However, there is great controversy in whether it has curative effects, also there are problems with non-conformant standard of prescription, high price, and incomplete varieties. In this case, advantages and disadvantages of present Chinese medicine dispensing granule are analyzed and discussed thoroughly in this article so that we can provide references for the benign development of Chinese medicine dispensing granule industry.

The clinical data of a case of paroxysmal extreme pain disorder(PEPD) in Guangdong 999 Brain Hospital were retrospectively analyzed.The male patient, age of first examination was 7 months, began to have recurrent tonic accompanied by facial redness or cyanosis at 5 months after birth.The patient was diagnosed with epilepsy.The oral solution of sodium valproate and Levetiracetam were not effective.The video electroencephalogram examination displayed that, when the patient had tonic and bradycardia, the synchro electroencephalogram did not show epileptic discharge, so the patient was considered to have non-epileptic tonic.Genetic examination suggested that SCN9A gene mutation of c. 5240T >C resulted in amino acid changes: Val1747Ala.Combined with the skin changes, the patient was diagnosed as PEPD caused by SCN9A gene mutation.After the treatment with Carbamazepine, the patient′s abnormal skin changed and his-epileptic tonic disappeared, and his condition improved significantly.The early stage of PEPD can be mainly manifested as non-epileptic tonic.It is easy to be misdiagnosed as epilepsy, so the patient′s characteristic skin changes should be noticed, and genetic examination is also helpful in the diagnosis of the disease.

Triclosan, a broad-spectrum antimicrobial agent, was reported to have been widely detected in various human biological samples such as urine, blood and human milk among foreign populations. In China, limited reports have been found on human exposure to triclosan, and the reported urinary triclosan concentrations were significantly lower than that of American populations. Besides, the potential influencing factors still remain unclear regarding human exposure to triclosan, but evidences suggest that those in middle age and with higher household income and higher social class tend to have higher urinary triclosan concentrations. Furthermore, triclosan exposure tend to differ by sex, geography, heredity, metabolism and life style.
China ; Environmental Exposure ; analysis ; Humans ; Middle Aged ; Triclosan ; analysis

Objective:To investigate the clinical features of encephalocraniocutaneous lipomatosis (ECCL).Methods:The clinical characteristics, imaging manifestations and electroencephalogram changes of five patients with ECCL from Guangdong 999 Brain Hospital between December 2016 and February 2019 were collected and analyzed.Results:All five cases showed ocular, skin and central nervous system anomalies. Corneal anomalies were found in five cases, eyelid coloboma in three cases, calcification of the globe in two cases, and choristoma in one case. All five cases presented with naevus psiloliparis, three cases with small nodular skin tags on eyelids, and three cases with café-au-lait spots on the trunk. Dysplasia of the right cerebral hemisphere was observed in all five cases, four cases with enlargement of the right ventricle, three cases with arachnoid cysts, and one case with dysplasia of the corpus callosum. The onset of the seizures of five cases was found within one year old. Spasms were observed in five cases, partial seizure in three cases, and tonic seizure in one case. Five cases were drug-resistant epilepsy. Seizures decreased significantly after adrenocorticotropic hormone treatment in one case and seizures free after surgery in one case. One case had seizure free by corpus callosotomy, but had a relapse after four months. Three cases used ketogenic diet, including one case with epileptic seizure reduction, one case with development progress. All five cases had developmental delays. The exon gene sequencing of four cases was found normal. KRAS gene mutation was found in brain tissue of one patient.Conclusions:ECCL is a rare clinical disease that often involves the nervous system, skin and eyes. The seizures of the patients are often difficult to control and have development delays. Surgery may be necessary to control the seizures. ECCL is thought to be somatic mutations, which are hard to detect in the blood and can be found in affected tissues.

Objective　To explore the relationship between gene mutation types and clinical phenotypes in patients with tuberous sclerosis complex accompanied by epilepsy. Methods　TSC gene was detected in patients with tuberous sclerosis accompanied by epilepsy diagnosed in Guangdong Sanjiu brain hospital from October 2013 to October 2019.The patients with gene positive were genotyped and the clinical data of the patients with gene positive were collected to explore the relationship between different gene mutation types and clinical phenotypes. Results　85 patients were TSC gene positive，of which 34 （40.0%） were TSC1 gene mutation in which 4 （11.8%） were splice mutation，10 （29.4%） were frameshift mutation，4 （11.8%） were nonsense mutation and 16 （47.0%） were missense mutation. 51 （60.0%） were TSC2 gene mutation，in which 3 were splice mutation （5.9%），19 were frameshift mutation （37.3%），1 was nonsense mutation （1.9%），25 were missense mutation （49.0%） as well as 3 were large fragment deletion （5.9%）. The mutation rate of frameshift mutation and missense mutation was higher. The age of onset was divided into ≤ 1 year old，～3 years old，～6 years old，～18 years old and >18 years old. It was found that there were significant differences in TSC1 and TSC2 genes among different age of onset （P<0.05）. At the same time，the incidence of renal disease and mental retardation was statistically significant in TSC1 and TSC2 genes （P<0.05 respectively）. In addition，according to the type of gene mutation，the patients were divided into three groups：frameshift mutation group，missense mutation group and other mutations （including splice mutation，nonsense mutation and large fragment deletion） group. It was found that the incidence of heart disease was significantly different in different gene mutation types （P<0.05 respectively）. Conclusion　There were many different types of TSC1 and TSC2 gene mutation types and clinical phenotypes. The onset age of TSC2 mutation is younger and more prone to have kidney disease and mental retardation. Missense mutations are more likely to develop heart disease. The study of genotype-phenotype relationship can make a preliminary assessment of disease development and prognosis in TSC patients.