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 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 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 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 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.

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 investigate the neuroprotective effect and mechanism of astragalus injection in cerebral ischemia reperfusion injury in rats .Methods A total of 70 healthy adult male Wistar rats were subjected to establish middle cerebral artery occlusion reperfusion models by inserting a monofilament thread from the external -internal carotid artery and treated by injecting 1g/L intraperitoneally astragalus injection (3ml/kg).The neurobehavioral function of rats was evaluated by Longa ’ s test and the cerebral infarction volume was calculated by tetrazolium chloride staining .The shape and ultrastructure of neurons in parietal cortex were observed by HE stain TEM .The early apoptotic ratio of neurons was detected by flow cytometry .The expressions of c-Jun N-terminal kinase 3 ( JNK3) mRNA and protein were determined by RT-PCR and Western blotting , respectively.Results After treatment with astragalus injection , the expressions of JNK3 mRNA and protein reduced significantly , the number of neuronal apoptosis in parietal cortexminus , the cerebral infarction volume shrink, the neuronal shape and ultrastructure and animal neurobehavioral function were improved significantly than those in model group rats .Conclusion The results suggest that astragalus injection may inhibit neuronal apoptosis , reduce the infarction volume and improve the animal neurobehavioral function by down -regulated the expression of JNK 3 gene following cerebral ischemia in rats .

Objective To examine cognitive function of the HIV/AIDS patients in the hospitals measured by the neuropsychological tests battery,make an evaluation of cognitive function of the HIV/AIDS patients,and diagnose the patients with HIV-associated neurocognitive disorders(HAND).Methods Ninety-nine normal individuals and two hundred and thirty HIV/AIDS inpatients,who were sampled by multi-stage random stratified in Guangxi,were tested by the 12 items of the neuropsychological tests.Results HIV / AIDS patients with abnormal neuropsychological test entries proportion ranges located between 21.3％-58.7 ％.The results of 12 items of the neuropsychological tests were associated with the results of clinical diagnosis.Among them,the results of SC time,SCW time,color attachment,and numbers of the contiguous error in WSCT tests were positively associated with the results of clinical diagnosis,and the correlation coefficient were 0.384,0.335,0.237 and 0.129,respectively.There was a negative correlation between the results of the rest assessment and the results of clinical diagnosis ; vocabulary fluency was the highest correlation coefficient,while numbers of the contiguous error in WSCT tests was the lowest.Conclusion A higher proportion of abnormal occurrence of Guangxi HIV / AIDS patients in the 12 neuropsychological test entry,and affect the subjects with or without HIV-related neurological assessment of cognitive impairment.The data suggest that a full neuropsychological tests can be better used for the preliminary study of the HIV ±/AIDS patients neurocognitive function.

Aim To study the transport of geniposide and geniposide in Zhizi Bopi Decoction in MDCK cell membrane model. Methods The safety concentration of geniposide and Zhizi Bopi Decoction in MDCK cells were determined by MTT assay. Then the MDCK cell membrane model was used to investigate the transport of drugs. Firstly, the effects of time, drug concentra-tion, P-gp inhibitor and EDTA on the absorption and transport of geniposide were studied systematically. Secondly, the differences were compared between the transport of the same concentration of geniposide as single compound and that in Zhizi Bopi Decoction in MDCK cell model. The drug concentration was deter-mined by high performance liquid chromatography ( HPLC) to calculate the apparent permeability coeffi-cient (Papp). Results Geniposide transport in MDCK cell monolayer was time and concentration dependent. P-gp inhibitors had no significant effect on its transport and the transport of geniposide was enhanced by ED-TA. The absorption Papp of different concentrations of geniposide in Zhizi Bopi Decoction were ( 8. 96 ± 0. 35 ) × 10 -7 cm · s-1 , ( 8. 95 ± 0. 38 ) × 10 -7 cm · s-1 and (9. 16 ± 0. 30) × 10 -7 cm·s-1, significantly higher than the absorption Papp of geniposide as single compound(5. 85 ± 0. 44) × 10 -7 cm·s-1, (6. 88 ± 0. 38) × 10 -7 cm·s-1 and (6. 31 ± 0. 19) × 10 -7 cm ·s-1 ( P<0. 05 ) . Conclusion The transport of ge-niposide in MDCK cell membrane model is passive transport and is not affected by P-gp. Geniposide may transport via the paracellular route. The Zhizi Bopi De-coction can increase the absorption of geniposide.