Status epilepticus (SE) is one of the common medical emergencies of the pediatric age group.It may lead to serious and even irreversible neurological abnormalities,even death,if not diagnosis and treatment properly.To recognise etiology,rise factors,seizure type,treatment,outcome and the correlation between each other of children with status epilepticus are significant for management.This paper aimed to review recent epidemiological studies on children with status epilepticus,in order to provide evidences for the current clinical practice and further research.

Objective:To investigate the relationship between emotion variability and assessment of psychiat-ric symptoms in middle school students,and validate that by structure equation modeling.Method:A total of 129 junior middle school students aged 13 -15 years were selected and assessed with the SCL-90 scale for psychiatric symptoms,the Adolescent Daily Emotion Regulation Questionnaire (ADERQ)for emotion regulation strategies, daily reconstruction method (DRM)for emotion variability during two weeks.Results:The students had higher positive emotion score than negative emotion score [(2.7 ±0.7)vs.(1.4 ±0.3),P <0.001],and higher negative emotion variability than positive emotion variability [(0.4 ±0.1 )vs.(0.3 ±0.1 ),P =0.012].Positive emotion variability and negative emotion variability were positively correlated with total scores of SCL-90 (r =0.34,0.24;Ps <0.001).Structural equation modeling revealed positive emotion variability,negative emotion variability and e-motion regulation strategy of cognitive appraisal had a direct effect on psychiatric symptoms (the path coefficient were 0.21,0.28,-0.24;Ps <0.001),cognitive immersed strategy had a direct effect on psychiatric symptoms and negative emotion variability(the path coefficient was 0.14,0.13,P =0.037,P =0.041).Conclusions:It suggests that both negative emotion variability and positive emotion variability play an important role in psychiatric symp-toms.

BACKGROUND: Femoral head necrosis is a common progressive disabling disease in orthopedics, and it is difficult to reverse disease progression. Eventually, the loss of hip function seriously impact patient’s quality of life. OBJECTIVE: To review the research progress of bone marrow mesenchymal stem cells in the treatment of femoral head necrosis. METHODS: The PubMed, CNKI and WanFang databases were searched for relevant articles with the keywords of “bone marrow mesenchymal stem cells, femoral head necrosis” in English and Chinese, respectively. The search time was from January 2001 to April 2019. Articles that were not related to the purpose of the research and repetitive articles were excluded, and 42 articles that met the criteria were finally included for review. RESULTS AND CONCLUSION: Bone marrow mesenchymal stem cells potentially repair the femoral head,not only providing precursor cells, but also secreting cytokines and growth factors and initiating cell healing in thefemoral head. A large number of experimental and clinical studies have proved that bone marrow mesenchymal stem cells are available for the treatment of early femoral head necrosis.

Objective To assess the value of imaging examination technologies such as 2-D ultrasound(2-DUS),helical computed tomography (CT),contrast-enhanced ultrasonography (CEUS) and contrast-enhanced CT (CECT) in the positioning and qualitative diagnosis of pancreatic diseases.Methods 2-DUS,helical CT findings were comparatively reviewed to analyze in 44 cases(45 lesions) with pancreatic space-occupying lesions verified by operation and pathology,and investigated the enhanced mode and the perfusion features of CEUS and CECT in different phases.Results In 45 lesions,there were 29 malignant lesions and 16 benign lesions.CEUS and CECT had greater diagnostic value compared to 2-DUS and helical CT.The sensitivity,specificity and accuracy of 2-DUS for the malignant lesions were 72.41 ％,62.50％ and 66.67 ％,while the helical CT were 68.97％,75.00 ％ and 68.89 ％.The sensitivity,specificity and accuracy of CEUS for the malignant lesions were 93.10％,87.50％ and 91.11％,while the CECT were 86.21％,93.75％ and 86.67％.There was no statistical difference between CEUS and CECT in detecting pancreatic space-occupying lesions.Conclusions CEUS and CECT can provide more accurate diagnosis on for pancreatic space-occupying lesions than 2-DUS and helical CT.Following CECT,CEUS is a new technology for diagnosis on pancreatic space-occupying lesions.

Aim To observe the effects of total flavones of hippophae rhamnoides L on myocardial ischemia-reperfusion injury and the MMP-9 and TIMP-1 expression in cardiac tissues of rats,and to explore the protective mechanism of total flavones of hippophae rhamnoides L on myocardial ischemia-reperfusion injury.Methods Fifty rats were classified into 4 groups by using the random grouping principle:model group,losartan group,sindacon group of different doses and sham operation group.The myocardial ischemia-reperfusion injury model was established by ligating left anterior descending coronary artery for 30 minutes and releasing then.The cardiac muscle tissue was stained by HE to observe its necrosis area and pathological changes as well as the expression of MMP-9 and TIMP-1by immunohistochemistry method.Results HE sections showed that necrosis of cardiac muscle in rats was significantly relieved in sindacon group by using different doses compared with model group,and immunohistochemistry sections showed that the sindacon group using different doses decreased the expression of MMP-9 compared with the model group and increased the expression of TIMP-1.Conclusion Sindacon has protective effect on cardiac muscle after the myocardial ischemia-reperfusion injury,and its mechanism may be related to its inhibition of the MMP-9 and increasing TMPM-1 expression in cardiac muscle.

Objective To quantify the right ventricular (RV) function in patients with left heart disease (LHD) related pulmonary hypertension (PH) by two-dimensional speckle tracking imaging (2D-STI),and explore its potential value in diagnosis of reactive PH.Methods Forty healthy volunteers and 65 patients with LHD related PH were enrolled.PH patients were further divided into two subgroups according to pulmonary vascular resistance(PVR):passive PH group and reactive PH group.A complete 2D-STI derived longitudinal strain of RV free wall was performed,and the basal,middle,apical longitudinal peak systolic strain (LS) and RV free wall global LS (RVLSbas,RVLSmid,RVLSapi and RVLSfw) were measured.Results Compared to control group,RVLSbas and RVLSfw in reactive PH group decreased significantly (all P ＜0.05).Compared to passive PH group,RVLSbas and RVLSfw in patients with reactive PH decreased significantly (all P ＜0.05).The differences of RVLSbas and RVLSfw between control group and passive PH group had no statistical significance (all P ＞0.05).No significant differences in etiology and left ventricular ejection fraction (LVEF) were observed between PH subgroups (all P ＞0.05).The area under the ROC curve of RVLSbas in predicting reactive PH was 0.93,the cut-off value was-21.86,and the sensitivity and specificity were 83 ％ and 89 ％,respectively.The area under the ROC curve of RVLSfw was 0.79,the cut-off value was-13.84,and the sensitivity and specificity were 59％ and 89％,respectively.Conclusions 2D-STI can realize quantitative assessment of RV function in patients with LHD related PH.RVLSbas and RVLSfw may have important clinical value in diagnosing patients with reactive PH,and differential diagnosis value between patients with passive PH and patients with reactive PH.

Objective To investigate the possibility and accuracy of predicting malignant middle cerebral artery infarction (mMCAI) with bedside electroencephalography (EEG). Methods Thirty-five patients with massive hemispheric infarction (MHI) underwent bedside EEG monitoring within 48 h of onset. The EEG indicators were interpreted blindly, and the clinical, laboratory and imaging parameters were analyzed. The patients were divided into mMCAI group and non-mMCAI group according to whether they had occurred mMCAI or not within 7 days of onset. The differences of EEG indicators, clinical, laboratory and imaging parameters between the 2 groups were compared. When the parameters of significant difference and statistical significance appeared the odds ratio (OR) of occurring mMCAI were analyzed, and their accuracy of predicting mMCAI was calculated. Results Of the 35 patients with MHI, 20 were in the mMCAI group and 15 were in the non-mMCAI group. There were significant differences in the EEG indicators (infarction on the contralateral side, including disintegration of occipital α rhythm, generalized slow-wave, dominant frequency wave low amplitude, regional attenuation without delta [RAWOD]pattern, and absence of EEG reactivity), clinical parameters (nausea accompanied with vomiting), and imaging parameters (the infracted area more than the entire MCA territory, and midline shifting 3 to 5 mm at the level of septum pellucidum) between the 2 groups (P < 0. 05). Of those, the risk of mMCAI was the highest in patients with disintegration of occipital a rhythm on the contralateral side of infarction (P = 22. 67, 95% CI 3. 89-132. 10). The sensitivity of predicting mMCAI was 85. 0%, the specificity was 80.0%, the positive predictive value was 85.0%, and the negative predictive value was 80. 0%, which were superior to other EEG indicators and clinical or imaging parameters. Conclusions Bedside EEG indicators can early predict mMCAI, moreover, the predictive accuracy is superior to the clinical and imaging parameters.

Objective To investigate the methods and strategies of therapeutic ERCP in patients with duodenum stricture.Methods Endoscopic procedure,success rate and complications in patients with duodenum stricture who underwent ERCP were retrospectively analyzed.Results In 7276 patients who underwent therapeutic ERCP,duodenum stricture was found in 158 (2.17％),patients with malignant tumor infiltration in 120 and benign stricture in 38.The total success rate of ERCP and biliary drainage was 84.2％,with posture change or guidewire leading method in 96 patients,stylolitic water sac dilation in 33and duodenum metal stent placement before biliary drainage in 4.The procedure was failed in 25 patients.Minor bleeding occurred in 5 patients and no major complication including massive bleeding or perforation was observed.Conclusion ERCP is safe,effective and feasible for patients with duodenum stricture,which can be performed by posture change or guidewire leading method in mild stricture,and stylolitic water sac dilation or duodenum metal stent placement in severe stricture.

Objective To investigate the accuracy of serum neuron-specific enolase (NSE)predicting malignant middle cerebral artery infarction(mMCAI).Methods A total of 40 patients with acute massive cerebral infarction within 24 hours after symptom onset were recruited.Blood samples were collected at 24,36 and 48 hours after symptom onset.Serum NSE concentration was determined by automatic electrochemiluminescence analyzer.mMCAI was defined as hernia signs in clinical practice,and CT/ MRI showed mass effect.The receiver operating characteristic curve was used to analyze the accuracy of serum NSE concentration in predicting mMCAI at 3 time points.Results Sixteen patients(40%)developed mMCAI.The serum NSE concentration for predicting the accuracy of mMCAI was poor at 24 hours after symptom onset;the serum NSE concentration for predicting the specificity of mMCAI was high (96%)at 36 hours after symptom onset,but the sensitivity was lower(69%);the serum NSE concentration for predicting the specificity(92%)and sensitivity(88%)of mMCAI were high at 48 hours.Conclusions The serum NSE conoentration and its dynamic changes may predict the occurrence of mMCAI,and the predicting time points are appropriate from 36-48 hours after symptom onset.

This paper analyzed the status of the medical students'volunteer services in China and abroad , dis-cussed the feasibility and necessity of medical students'volunteer service .The influence factors , elvaluation and ef-fectiveness of the medical students'volunteer services were sumed up , and its development tendency was also dis-cussed .The following suggestions were put forward , namely improving the volunteer service participation , making the voluntary service a routine work , aiming to giving references for medical schools and volunteer organizations car-rying out the medical students'volunteer services .