In order to assess the diagnostic value of CT,EEG and conventional radiography and to probe the etiology of epilepsy,the CT films and relative materials of 119 cases of epilepsy were analyzed retrospectively.It was found that the combined examination of CT and EEG could significantly increase the accuracy of diagnosis and minimize the chances of misdiagnosis.CT was especially useful to examine those cases clinically suspected to have lesions in the frontal,parietal or temporal lobe.CT was also important to distinguish the cases of early epilepsy from those of delayed one.Early epilepsy usually resulted from benign lesions with good prognosis but lacked localization signs clinically.Delayed epilepsy mostly is caused by neoplastic or vascular lesinos with poor prognosis,and localization signs were usually present.Prompt CT examination would be helpful in its management.It was also found that early epilepsy was mostly secondary in nature.

Objective To investigate the role of estrogen in spontaneous repair of osteochondral defect,so as to provide guidance for the application of estrogen in tissue engineering.Methods Seventytwo healthy adult female SD rats (4-month-old) were assigned to negative control group (group A,n =24),ovariectomized group (group B,n =24) and ovariectomized + estrogen treatment group (group C,n =24) according to the random number table.Rats in group C were intraperitoneally injected 0.1 mg/kg estradiol benzoate once per week after operation.An osteochondral defect model (diameter:2 mm,height:1.5 mm) was established in femoral trochlea of rats 4 weeks after operation.At 2,10 and 20 weeks after the modeling,8 rats from each group were sacrificed.Femoral condyles were collected to measure bone volume fraction (BVF),number of bone trabeculae (Tb.N),trabecular thickness (Tb.Th) and trabecular spacing (Tb.Sp) in the osteochondral defect area by micro-CT scanning.Morphological changes were observed by HE staining,histomorphological changes and cartilage regeneration by safranine O-fast green staining,osteoclast count by tartrate-resistant acid phosphatase (TRAP) staining,distribution of matrix metalloproteinase-9 (MMP-9) by immunohistochemistry and expressions of osteoprotegerin (OPG),receptor activator of nuclear factor-κB ligand (RANKL) and MMP-9 by real-time-PCR.Results Compared to group B,increased BVF and Tb.N and decreased Tb.Sp were observed in groups A and C at each time point.More bone matrix formations were observed in groups A and C than in group B at 2 weeks,cysts (also known as cystic cavities) in regenerated subchondral bone and cracks in subchondral bone plate were observed in group B at 10 and 20 weeks,and proliferation of osteoclasts was active within lesions in group B at 10 and 20 weeks.Compared to group B,lowered levels of RANKL and MMP-9 (P ＜ 0.05) and significantly increased level of OPG (P ＜ 0.01) were observed in groups A and C at each time point,and osteoclast count in groups A and C was lowered at 10 and 20 weeks (P＜0.05).No regeneration of cartilage layer was observed in all groups.Conclusions Excessive proliferation of osteoclasts results in formation of cystic cavities and cracks.Estrogen improves the speed and quality of bone repair by regulating activities of osteoblasts and osteoclasts,so it can be used to treat osteochondral defect in tissue engineering.

ObjectiveTo investigate the expression levels of vascular endothelial growth factor (VEGF)in knee synovial membranes and synovial fluids whether it could be a marker for progressive osteoarthritis.MethodsKnee synovial membranes and synovial fluids of patients with osteoarthritis who were underwent total knee arthroplaaty or arthroscopy were collected. They were classified into four groups according to the radiographic grading[Kellegren-Lawrence(K-L) grade]. Appoint K-L-0-grade patients who suffered from menisci injuries only served as controls. The levels of VEGF in the synovial fluid were measured by enzymelinked immunosorbent assay(ELISA) and VEGF-secreting cells were identified by immunohistochemistry.ANOVA was used for statistical analysis. ResultsVarious degrees of inflammation could be found in all the samplesevaluated histologically on HE-stained sections. Synovial tissue inflammation presented as synovial lining thickening, and inflammatory cells infiltration. VEGF expressed in the synovium linings and surrounding blood vessels. The VEGF levels in the synovial fluids were increased accordingly with K-L grades, which reached the peak level in the late stage of osteoarthritis. The levels of VEGF in the synovial fluids were significantly higher in patients with osteoarthritis[from (1181±116), (1632±140) to (2252±216) pg/ml]than in those with menisci injury (P＜0.01); The percent ages positive cell in each groups were (5±4)％ , (9±4)％,(16±6)％ and (21±6)％ respectively, there were significantly differences too (P＜0.01). ConclusionVEGF originated from synovial tissue may play a role in the pathogenesis of osteoarthritis. High levels of VEGF in the synovial fluids can be regarded as the marker of active osteoarthritis.

Objective To better understand students' professional perception,humanistic education status quo and their preference to different humanistic education methods.Methods Questionnaire was conducted for 990 undergraduate students (2006 grade- 2010 grade) at medical school of Shanghai Jiao Tong university.SPSS 17.0 statistical software was used to analyze results of the questionnaire.Results Nearly 45％ students chose to major in clinical medicine out of personal interest.The identification of students for humanistic quality was lower than that for clinical knowledge and skills.More than 50％ students believed doctors were with high humanistic quality and there was a gap between students′ action and their understanding of the medical career identity and medical humanistic cultivation.More than 50％ students preferred activities that train medical and auxiliary skills.Nearly 67％ students also showed a shallow reading habit from regular internet surfing.Conclusion The professional perception of medical students are influenced by both social and historical factors influence.The gap between understanding and action is a consequence of current humanistic educational system.The humanistic educational methodology should conform to the psychological and s~ial characteristics of contemporary students.

The method of preparation of a Milk Substitute, formula 5410, and its nutritive value on rats have been reported in previous communications. Further tests of its nutritive effect were made by feeding a group of 100 infants including 4 premature and 10 undernourished. Another group of 43 infants fed with human breast milk or cow's milk were observed during the same period as controls. Among the infants of the two groups there were 6 pairs of twins; one of each pair was fed with the Milk Substitute and the other with human or cow's milk. Great majority of the infants were cared by their own mothers whose cooperation had been secured, while the rest of the infants (10%) were kept in our nursery.The Milk Substitute feeding was started with infants between half and six months of age, with an average age of three months. Observations were continued until they all reached one year old. Fish liver oil and ascorbic acid were supplied to infants of both the experimental and the control groups. Vegetable soup and fruit juice were given to the infants before five months of age. Then various kinds of other foods, including rice porridge, wheat flour nudols, bread, crackers, mashed meat and vegetable and egg yolk were individually supplemented furnishing not more than 1/3 of the total caloric intake, (at the age of one year), as the family income permitted.The appetite of the experimental infants was normal. There was no digestive disturbances and abnormal frequency and appearance of the stool. The average daily caloric intake was similar to those recorded in the literature.The body weight and height of the babies in the experimental group fell well within the normal range. The average initial body weight and height of the infants in the experimental group were somewhat lower than those of the control; however, the height reached .that of the control at the age of 7 months, and the weight at about 11 months. The red blood cell counts and the hemoglobin value of the blood were normal.Values of blood alkaline phosphatase activity higher than 15 Bodansky units were shown in 20 babies of the experimental group (27%) and 8 babies of the control group (23%) at the beginning of the observation; only 4 babies in the experimental group were found abnormal high blood alkaline phosphatase value at the end. At the beginning, 3 cases of rickets and 3 cases of suspected rickets were indicated by the radiograph of the wrist bones of the babies in the experimental group, and only one suspected ricket in the control group were observed; and they all became normal at the end of the experiment. Besides, there were no other signs of any nutritional deficiency among all the infants.

Objective To investigate the effect of carotid artery stenting (CAS) on cognitive function in patients with asymptomatic severe carotid artery stenosis.Methods The patients with asymptomatic severe carotid stenosis (stenosis ≥ 70％) were enrolled in the study.The cognitive function evaluation was performed before CAS,1 and 3 months after procedure respectively with mini-mental status scale (MMSE),digital span (DS),Chinese auditory learning test (CALT),judgment of line orientation test (JLOT),and verbal fluency test (VFT),including attention,memory,visual spatial function,and frontal fluency function.Results A total of 26 patients with asymptomatic severe carotid artery stenosis who performed CAS were enrolled,18 were males and 8 were females (aged 52 to 79 years,mean 64.19 ±6.76 years),and the years of education was 9.84 ± 3.29 years.Eighteen patients had left carotid artery stenosis and 8 had contralateral carotid artery stenosis.CAS was performed successfully in all patients,and no complications occurred.Compared with the CAS before procedure,all the cognitive functions were improved significantly at 1 and 3 months after procedure (all P ＜0.01),however,there was no significant difference between 1 and 3 months after procedure (all P＞ 0.05).Conclusions CAS may improve cognitive function in patients with asymptomatic severe carotid artery stenosis,and it was more obvious in the early postoperative period.

Objective To study and summarize the successful experience and the safety, easibility, practicality and operation skills of totally laparoscopic extraperitoneal herniorrhaphy (TEP). Methods From October 2006 to May 2008,225 patients in our two hospitals were performed TEP (265 totally laparoscopic extraperitoneal hernia repairs for inguinal hernia), including 55 direct inguinal hernia, 197 indirect inguinal hernia and 13 complex inguinal hernia operations. Among the 225 patients, 185 patients had unilateral hernia and 40 patients had bilateral hernias, including 29 recurrent hernia. Results The operations were lasted for 30 to 182 minutes(the average operating duration was 48 minutes for unilateral hernia and 106 minutes for bilateral hernia). The patients stayed in hospital for 2 to 8 days(the average inpatient hospital stay was 3.0 ± 1.2 days). The most common complication was scrotum bematomas,which appeared in 18 cases. Urinary re-tention appeared in 21 cases. Inguinal pain appeared in 5 cases. Bladder injury appeared 1 case. All the pa-tients were followed up for 3 months- 3 years. There was only 1 case of recurrence. Conclusions The proce-dure of TEP is safe,with faster postoperative recover,less pain,lower incidence of pain,better comfort quality and lower recurrence rate. TEP should be the main laparoscopic procedure for inguinal hernia repair.

Objective:To explore the status of depression symptoms and related factors of depressive symptoms in middle-aged and elderly disabled people in China and provide references on the preventive cares of depression.Methods:Research data were obtained from the 2018 follow-up data of China Health and Retirement Longitudinal Study(CHARLS).Disabled people were selected as the research object. The scores of center for epidemiological studies depression scale(CES-D) were used to evaluate depressive symptoms. Fourteen variables derived from the 3 dimensions of demographic characteristics, health status, and health related behaviors were utilized in this study.SAS 9.4 were used for descriptive analysis, univariate analysis and Logistic regression analysis.Results:A total of 1 708 middle-aged and elderly disabled people were included, among whom 932(54.5%)were diagnosed with depressive symptoms, and the score of CES-D was (11.45±7.19).Self-rated poor health, self-rated poor memory, life dissatisfaction, physical pain were the risk factors of depressive symptoms ( OR=1.87, 4.22, 1.83, 5.30, 1.75). Male, educational level (middle-high school, high school or above), sleeping duration (6-9 h) were the protective factors of depressive symptoms( OR=0.74, 0.72, 0.10, 0.56). Conclusion:Middle-aged and elderly disabled people in China have a high detection rate of depressive symptoms. Female, lower education background, inadequate amount of sleep, self-rated unsatisfactory healthy, self-rated poor memory, dissatisfaction towards life and suffering from physical pain may be more likely to have depressive symptoms in middle-aged and elderly people with disabilities.

OBJECTIVE To observe the regulation effect of chidamide on energy metabolism in HCT-8 and HT-29 cells. METHODS HCT-8 and HT-29 cells were treated with chidamide 5,10 and 20 μmol · L-1. Morphological changes of these cells were observed under an ordinary optical microscope. Cell proliferation was detected by MTT. ATP production was determined by CellTiter-Glo? assay kit. Metabolic changes were tested by glycolytic stress kit. The mRNA level of lactate dehydrogenase A (LDH-A)was analyzed by real-time quantitative PCR,whereas the protein level of LDH-A was analyzed by Western blotting. RESULTS Compared with control group,cell morphology of HCT-8 and HT-29 cells in chidamide treated group was irregular,accompanied by deformation,shrinkage and cell debris, and the inhibitory rate of proliferation increased(P<0.05). There was no significant difference in ATP total content between chidamide 5 and 10 μmol · L-1 16 h treatment groups,but in chidamide 20 μmol · L-1 treatment group it was decreased(P<0.05). Chidamide 20μmol · L-1 had no effect on oxygen consumption rate, but glycolysis ATP generation rate was reduced by 30.7% and 37.9%(P<0.05),respectively. Chidamide 20μmol · L-1 had no effect on LDH-A mRNA level,but it decreased the protein level of LDH-A(P<0.01). CONCLUSION Chidamide can abate the respiratory metabolic ability of HCT-8 and HT-29 cells. The mechanism may be related to the down-regulation of LDH-A.

Peritoneal metastasis is the second leading cause of death of colorectal cancer patients. Cytoreductive surgery (CRS) combined with hyperthermia intraperitoneal chemotherapy (HIPEC) is the primary method to treat peritoneal metastasis of colorectal cancer, though there remain some controversies. We reviewed current studies of colorectal peritoneal carcinomatosis (PC) and CRS+ HIPEC, and discussed some issues with regard to the scoring system for peritoneal metastasis, selection criteria for CRS+ HIPEC treatment, and the new drug application for colorectal PC. Peritoneal carcinomatosis index (PCI) is the most useful scoring system for peritoneal metastasis and CRS+ HIPEC is the primary treatment for colorectal PC. Patients with PCI<20 should receive thorough assessment on the feasibility of R0 or R1 resection and CRS+ HIPEC treatment. For patients with unresectable PC at the initial stage, active drug therapy should be adopted to achieve tumor regression, so that some of them would have the opportunity to receive CRS+ HIPEC treatment.