Stroke canlead to hemiplegia,aphasia,and cognitive impairment,and also complicate with seizure and epilepsy.In recent years,there are more and more studies about post-stroke seizure and post-stroke epilepsy,but the main focus is on risk factors.This article reviews the risk factors,pathogenesis,and treatment of post-stroke seizure and post-stroke epilepsy.

Objective To investigate the effect of dexmedetomidine combined with sufentanil on postoperative analgesia and the vascular crisis in patients undergoing free flap transplantation. Methods Forty patients with ASA physical statusⅠ-Ⅱhaving underwent free flap transplantation were divided into groupⅠand groupⅡaccording to the random digits table method with 20 cases each. The drugs of patient controlled intravenous analgesia (PCIA) in groupⅠwere sufentanil 1.0μg/(kg·d)+tropisetron 5 mg/100 ml, and the drugs of PCIA in group Ⅱ were sufentanil 1.0 μg/(kg · d) +dexmedetomidine 1.0 μg/(kg · d) + tropisetron 5 mg/100 ml. The PCIA pump was set in 2 groups as follows: continuous perfusion rate 2 ml/h, single bolus 2 ml, lockout time 15 min. The visual analogue score (VAS), Ramsay sedation score, press number of PCIA pump within 48 h after operation, satisfaction score after operation, untoward reaction and vascular crisis were recorded. Results The VAS at 6, 12, 24 and 48 h after operation in group Ⅱ were significantly lower than those in group Ⅰ: (2.18 ± 0.41) scores vs. (3.00 ± 0.63) scores, (2.64 ± 0.51) scores vs. (3.82 ± 0.60) scores, (2.55 ± 0.52) scores vs. (3.36 ± 0.51) scores and (2.27 ± 0.47) scores vs. (3.09 ± 0.70) scores, the Ramsay sedation scores were significantly higher than those in group Ⅰ: (2.42 ± 0.51) scores vs. (2.00 ± 0.58) scores, (2.74 ± 0.45) scores vs. (2.11 ± 0.57) scores, (2.58 ± 0.51) scores vs. (2.05 ± 0.52) scores and (2.53 ± 0.51) scores vs. (2.00 ± 0.47) scores, and there were statistical differences (P<0.05). The press number of PCIA pump within 48 h after operation in groupⅡwas significantly lower than that in groupⅠ:(3.75 ± 1.45) times vs. (8.25 ± 2.61) times, the satisfaction score after operation was significantly higher than that in groupⅠ:(2.47 ± 0.51) scores vs. (1.60 ± 0.50) scores, and there were statistical differences (P<0.05). There were no statistical differences in the incidences of untoward reaction and vascular crisis (P>0.05). Conclusions Dexmedetomidine can relieve anxiety and nervousness, reduce postoperative consumption of sufentanil, and decrease the incidence of nausea and vomiting. In addition, dexmedetomidine does not affect the incidence of vascular crisis.

[Summary] A more conservative approach for endometrial cancer ( EC ) is desirable in women who have requirement to preserve fertility, without compromising their survival .In this article, we tried to formulate clinical recommendations of preserving fertility based on suggestions of European Society of Gynaecological Oncology ( ESGO) in 2015 and relevant research progress .

Objective To find the characteristics of stress distribution on condyle during different vertical distances of edentulous jaw.Methods Three dimensional finite element models of the mandible and temporomandibular joint were established with the complete dentures in different heights by helix-CT scanned transverse sections.The stress distribution of the condyle was analyzed under load.Results The compressive stress and tensile stress coexisted on the whole condyle with the different vertical distances.The trend of distribution was consistent practically,but the stress presented a large difference on different locum.With the decrease of the vertical distance(from H-2 to H-6),the stress presented a decreasing trend but an increasing trend at H-8.Conclusion Changes in the vertical distance produce different effects of stress on edentulous jaw under the same load.

Objective To investigate the disinfection effect of the endoscope disinfection machine with acidic oxidizing poten‐tial water on the fiber bronchoscopy .Methods Totlly 460 cases of contamination after diagnosis and treatment in the department , were randomly divided into experimental group (using electrolyzed oxidizing water as disinfectant ;according to the cleaning and dis‐infection of endoscope Koeman brand ECM‐03A type machine bronchoscope disinfection) and control group (with 2% glutaralde‐hyde disinfectant of the traditional five tank cleaning disinfection method ) ,evaluation of endoscopic surface cleanliness ,surface at‐tachment ,pipe blockage and bacterial colony detection .Results The experimental group was better than the control group in the aspects of endoscopic surface cleanliness ,mirror surface attachment ,pipe blockage and so on ;The number of sterile growth in the experimental group was higher than that in the control group ,both in the inner cavity sampling method and the outside sampling method .The number of cases of ≥20 CFU/piece in the experimental group was significantly less than that in the control group , with the cavity sampling method ,the qualified rate of the experimental group was also significantly higher than that of the control group ,the difference was statistically significant (P< 0 .05) .Conclusion The application of acidic oxidizing potential water as a disinfectant in the whole automatic endoscope disinfection machine significantly improve the quality of cleaning and disinfection ,at the same time ,and reduce human labor strength ,improve the application efficiency of fiber bronchoscopy ,worthy of promotion .

Objective To study the relationship between high on-treatment platelet reactivity (HTPR) and early neurological deterioration (END) in acute non-cardiogenic cerebral infarction patients.Methods Two hundred and fifteen acute non-cardiogenic cerebral infarction patients were divided into END group (n=55) and EDD-free group (n=160).The patients were given oral aspirin (300 mg daily) on the day after admission,and fasting blood samples were taken at 6-24 h after the first dose of aspirin.Their platelet aggregative function (PAGT) was assayed with ADP to detect the platelet responsiveness to aspirin.The incidence of HTPR was compared between the two groups.The independent risk factors for END were analyzed by multivariate logistic regression analysis.The value of PAGT in predicting END was assessed according to its ROC curve.Results The incidence of HTRP was higher in END group than in END-free group (63.34％ vs 43.75％,P＜0.05).Multivariate logistic regression analysis showed that HTRP was an independent risk factor for acute non-cardiogenic cerebral infarction.The area under the ROC curve was 0.864 for PAGT in predicting acute non-cardiogenic cerebral infarction (95 ％ CI:0.806-0.922,P=0.000).Conclusion HTPR is closely related with END in acute non-cardiogenic cerebral infarction patients.

As a platform to learn authentic patient experiences, learning health system(LHS)acquires big data from clinical environment and other health-related events, analyzes data to produce new knowledge and applies these knowledge to constantly guide clinical decision and practice, thus contributing effectively to better quality of care and lower medical cost. The authors reviewed LHS in terms of its role model, organizational structure, infrastructure framework, core characteristic elements framework and researcher′s core competence framework. Based on the study, the authors recommended the integration of multi-source heterogeneous medical information platform data, and enhancement of synergy among medical institutions and multi-disciplinary teams in the introduction and localization of LHS into China.

Objective To establish an animal model of cat with chronic pancreatitis (CP),and to investigate the imaging features of MRI and MRCP of normal pancreas and CP.Methods Thirty two cats were randomly divided into control group ( n =8 ) and experimental group ( n =24) ( 3,5,7 weeks after model establishment,eight cats in every group).Partial ligation of the pancreatic duct was used to induce chronic pancreatitis.All cats underwent MRI plain scanning,MRCP scanning 3,5,and 7 weeks after modeling to observe the pancreas morphology.The values of T1 signal intensity of pancreas were obtained using a region of interest (ROI) method,and the diameter of pancreatic duct was measured.The ratios of T1 signal intensity ( rT1 s) between pancreas and liver were calculated and compared.Results Nineteen of 24 cats survived,and 15 cats developed CP,and the pathologic examinations showed mild,middle,severe CP developed in 7,5,3 cats,suggesting a successful model induction rate of 62.5％.The pancreases of cats were displayed clearly on MRI.The signal intensity of pancreas was higher than that of liver on T1WI,whereas it was lower than that of liver on T2WI.Meanwhile,there were four cats' pancreatic ducts were shown on MRCP,the maximum diameter of pancreatic duct was (0.79 ±0.18) mm,and the opening orifice of pancreatic duct was located at descendant duodenum with common bile duct.The rT1 s of ROI of normal pancreas,mild,middle,severe CP was 1.03 ±0.06,0.95 ±0.08,0.90 ±0.10,0.80 ±0.11,and the difference among these groups was statistically significant (t =2.18,P ＜ 0.05 ; t =2.89,P ＜ 0.05; t =4.63,P ＜ 0.01).The maximum diameter of pancreatic duct was (0.79 ±0.18),(0.95 t0.24),( 1.26 ±0.31),(2.67 ±0.71 )mm,and maximum diameter of pancreatic duct of middle,severe CP was significantly different when compared with that of normal pancreas ( P ＜ 0.05 or ＜ 0.01 ).Conclusions The method of partial ligation of pancreatic duct can induce CP in cats.The normal pancreas and CP of cats are similar with human with respect to anatomy,morphology,MR and MRCP imaging features.

Objective To investigated the neuroprotective effect of PTEN inhibitor BPV on cerebral ischemia-reperfusion injury in rats and its mechanism. Methods Male Sprague-Dawley rats were used to induce a reperfusion model of middle cerebral artery occlusion for 1 h. During the reperfusion, the BPV solution (0. 2 mg/kg daily) or the equal volume of saline was injected intraperitonealy immediately. The neurological deficit scores were conducted at day 1, 3,5, and 7 after ischemia-reperfusion. At day 4, triphenyl tetrazolium chloride staining was used to assess cerebral infarction volume. Enzyme-linked immunosorbent assay was used to detect the levels of interleukin 10 (IL-10) and tumor necrosis factor α(TNF-α) in cortical ischemic border zones. Real-time quantitative polymerase chain reaction was used to detect the expression level of PTEN mRNA. Western blotting was used to detect the expression levels of PI3K, Akt, and p-GSK-3β. At day 7, Bielschowsky silver staining was used to detect the axonal distribution in the ischemic border zone of the striatum. Immunohistochemical staining was used to detect the expression of myelin basic protein (MBP). Results At day 4 after ischemia-reperfusion, the infarct volume (32. 27% ± 1. 71% vs. 45. 49% ± 2. 12% ; P < 0. 001), TNF-α concentration in the cortical ischemic border zones (134. 17 ± 10. 38 pg/ml vs. 264. 17 ± 24. 84 pg/ml; P < ), and PTEN mRNA level (1. 19 ± 0. 08 vs. 2. 50 ± 0. 06; P < 0. 001) in the rats of the BPV group were al significantly lower than those of the normal saline group. The IL-10 concentration (186. 83 ± 10. 83 pg/ml vs. 147. 83 ± 11. 62 pg/ml; P < 0. 001), and the expression levels of PI3K (0. 43 ± 0. 08 vs. 0. 26 ± 0. 06; P = 0. 004), Akt (0. 52 ± 0. 05 vs. 0. 40 ± 0. 04;P = 0. 001), and p-GSK-3β (0. 75 ± 0. 08 vs. 0. 38 ± 0. 06; P < 0. 001) were al significantly higher than those of the normal saline group. At day 7 after ischemia-reperfusion, the neurological deficit score (4. 83 ± 0. 41 vs. 6. 33 ± 0. 52; P < 0. 001) in the rats of the BPV group was significantly lower than that of the normal saline group. The axon densities in the ischemic border zones (35. 51% ± 2. 45% vs. 25. 31% ± 2. 79% ; P < 0. 001) and the expression level of MBP (32. 56% ± 3. 46% vs. 27. 81% ± 4. 18% ; P = 0. 037) were significantly higher than those of the normal saline group. Conclusions BPV has neuroprotective effect for cerebral ischemia-reperfusion injury in rats. Its mechanism may be associated with the up-regulation of PTEN downstream proteins PI3K, Akt and p-GSK-3β expression to regulate inflammatory mediators and reduce the inflammatory response.

Objective To estimate the critical value notification of emergency specimens in general laboratory whether a-chieved the desired goals,and to apply quality improvement measures to achieve quality improvement purposes.Methods Critical values of emergency specimens in general laboratory were monitored and collected in 2014.Statistical analysis was done for non-notification rates and sources of the critical values,and quality improvement began in July,2014 by training, continuing education and amonthly bulletin of notification data of critical values.Results Total number of Critical values of emergency specimens in general laboratory in 2014 was 2 648 and 1 950 of them had been reported by telephone.Total notifi-cation rate was 61.4% in the first 6 months,and was 81.4% from July to December.At last,Critical value notification rates increased to 97.72% in December.Conclusion Strengthening the management of critical value notification can help impro-ving the quality of laboratory service,as well as enhancing stuff responsibility and awareness of service for clinic.