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 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.

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 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 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 .

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.

In order to provide a reference and theoretical guidance of the evaluation of electronic medical record (EMR) and establishment of evaluation system in China, we applied a bibliometric analysis to assess the application of methodologies used at home and abroad, as well as to summarize the advantages and disadvantages of them. We systematically searched international medical databases of Ovid-MEDLINE, EBSCOhost, EI, EMBASE, PubMed, IEEE, and China's medical databases of CBM and CNKI between Jan. 1997 and Dec. 2012. We also reviewed the reference lists of articles for relevant articles. We selected some qualified papers according to the pre-established inclusion and exclusion criteria, and did information extraction and analysis to the papers. Eventually, 1 736 papers were obtained from online database and other 16 articles from manual retrieval. Thirty-five articles met the inclusion and exclusion criteria and were retrieved and assessed. In the evaluation of EMR, US counted for 54.28% in the leading place, and Canada and Japan stood side by side and ranked second with 8.58%, respectively. For the application of evaluation methodology, Information System Success Model, Technology Acceptance Model (TAM), Innovation Diffusion Model and Cost-Benefit Access Model were widely applied with 25%, 20%, 12.5% and 10%, respectively. In this paper, we summarize our study on the application of methodologies of EMR evaluation, which can provide a reference to EMR evaluation in China.
Bibliometrics ; China ; Databases, Factual ; Electronic Health Records ; Information Storage and Retrieval

Objective:To analyze the causes, influencing factors and trends of dead on arrival cases in children′s Hospital in the past 5 years, aiming to provide direction and basis for reducing the dead on arrival cases of children.Methods:We collected the dead on arrival cases in the department of emergency at Shanghai Children′s Hospital from January 2015 to December 2019, classifed and analysed the gender, age, native place, death season, time of death, and possible causes of death, and then studied the correlation between above factors and the cases.Results:A total of 151 dead on arrival cases were collected.The annual number decreased year by year, and boys were more than girls in gender.Most of them were infants under 1 year old, and nonlocal children were more than Shanghai native.The above differences were statistically significant, but there was no significant difference in the distribution of death season and death time.In terms of the cause of death, perinatal diseases accounting for 33.8%(51/151), those accompanied with severe underlying diseases accounting for 39.1%(59/151), accidental death accounting for 14.6%(22/151), unexplained deaths accounting for 12.6%(19/151). Those distribution differences were statistically significant( χ2=32.497, P<0.001). Meanwhile, there were statistic differences in gender and age of the cases with severe underlying diseases( χ2=4.898, P=0.027; χ2=32.169, P<0.001), and the year and age distributions of the accidental death cases also had significant differences( χ2=16.636, P=0.002; χ2=14.727, P=0.002). Conclusion:To reduce dead on arrival cases of children, we should do a good job in perinatal health care and screening, reduce premature birth and birth defects, actively conduct propaganda to prevent children′s accidental injuries, popularize medical first aid knowledge, and strengthen children′s transport system.

Objective To compare the duration of neuromuscular blockade in laparoscopic and open surgical approaches following a single bolus dose of rocuronium or cisatracurium.Methods One hundred female patients underwent either laparoscopic or open gynaecological surgery were randomly and equally divided into OR group (rocuronium administered in open surgery),OC group (cisatracurium administered in open surgery),LR group (rocuronium administered in laparoscopic surgery) and LC group (cisatracurium administered in laparoscopic surgery).Anaesthesia was induced with sufentanil of 0.5 μg/kg and propofol of 2 mg/kg,and neuromuscular blockade was induced with rocuronium of 0.9 mg/kg or cisatracurium of 0.15 mg/kg,intravenously.Then adductor pollicis trainof-four responses following ulnar nerve stimulation were monitored with mechanomyography.We recorded the duration of the first twitch (T1) occurrence after the injection of rocuronium or cisatracurium,and the duration from T1 recovered to 5 ％ and 25 ％ of baseline.Results The mean time from the end of injection of rocuronium until spontaneous recovery to T1,and to recovery to 5％and 25％ of baseline,was significantly prolonged in LR group [(44.8 ± 10.7) min,(52.8 ± 11.2) min and (62.6 ± 13.5) min] compared with OR group [(36.2 ± 4.0) min,(41.8 ± 6.8) min and (49.5 ±7.5) min] (P all＜0.05) On the other hand,there was no significant difference on the duration of neuromuscular blockade between LC group and OC group.Conclusions Neuromuscular blockade may be prolonged following a single bolus dose of rocuronium given during laparoscopic procedures,which should be on the alert,and assess neuromuscular function to ensure safe recovery.