Most of the present antiepileptic drug trials focus on efficacy and short-term safety with limited information relevant for daily clinical practice, such as spectrum of efficacy, effective dose, titration method, drug interactions, and long-term outcome. Antiepileptic drug trials more akin to daily clinical practice should also be emphasized in future trials. There are, limited randomized control trials for certain seizure types or epilepsy syndromes, such as Lennox-Gastaut syndrome and severe myoclonic epilepsy in infancy. The author proposed self-controlled “class S” study in patients who has well-defined epilepsy syndrome with homogeneity in evolution of illness and high frequency of seizures.

China ; Humans ; Occupational Exposure ; statistics & numerical data ; Solvents

Objective To assess value of contrast enhanced ultrasonography(CEUS)in diagnosis of extracranial carotid stenosis.Methods Baseline ultrasonography and CEUS were performed in 108 patients with extracranial carotid stenosis.The location and degree of stenosis were judged and compared with the results of digital subtraction angiography(DSA).Results Of 108 patients,DSA diagnosed 81 vessels in 62 cases of mildintermediate stenosis which consisted of 33 common carotid arteries(CCAs),43 internal carotid arteries(ICAs)and 5 external carotid arteries(ECAS),51 vessels in 39 cases Of severe stenosis(46 ICAs and 5 CCAs)and 7vessels in 7 cases of complete occlusion(7 ICAs).The surface of intima and the interface of media-adventitia were depicted clearly by CEUS.The consistent rates in diagnosis on mild-intermediate stenosis,severe stenosis and complete obstruction by baseline ultrasonography and CEUS were 76.5%and 9 1.4%(P＜0.05).60.8%and94.1%(P＜0.001),28.6%and 100%(P＜0.05)respectively when judged by DSA as the golden standard.CEUS and DSA were correlated significantly on calculating the stenosis rate(r=0.975,P＜0.001).Conclusions CEUS can assess the degree of extracranial carotid stenosis accurately and non-invasively which is superior to baseline ultrasonography and correlated significantly with DSA.

Objective To investigate the role of transcriptional-coactivator with PDZ-binding motif( TAZ) in genistein-induced osteoblastogenic differentiation of mouse bone marrow-derived mesenchymal stem cells ( BMSCs) .Methods Mouse BMSCs were cultured in phenol red-freeα-MEM containing osteogenic supplements for inducing osteogenic differentiation.BMSCs were transfected with siRNA-TAZ and treated with genistein.The temporal sequence of osteoblastic differentiation in BMSCs cultures was assayed by measuring alkaline phosphatase activity (ALP) and calcium deposition.The mRNA expression of bone sialoprotein ( BSP) and osteocalcin ( OC) were detected by reverse transcription-polymerase chain reaction(RT-PCR).The binding interaction between TAZ and cbfa1 was identified by co-immunoprecipitation.Results TAZ expression was detected during the induction of osteogenic differentiation, the ALP activity and calcium deposition were significantly decreased in BMSCs which were transfected with siRNA-TAZ.Genistein(0.01-1 μmol/L) exhibited a dose-dependent effect on TAZ expression in mouse BMSCs cultures.Treatment with genistein ( 1 μmol/L ) resulted in increased ALP avtivity and calcium deposition of BMSC cultures as function of time.Genistein(1μmol/L) also promoted the nuclear localization of TAZ and augmented the interaction between TAZ and cbfa1, and by which upregulated cbfa1-mediated gene expression such as BSP and OC.However, the ALP avtivity and calcium deposition, as well as the expression of BSP and OC were not promoted by genistein in BMSCs transfected with siRNA-TAZ.Conclusion These data suggest that the TAZ plays an important role in genistein-induced osteoblastic differentiation of mouse BMSCs cultures.

Objective To investigate the clinical significance of WDHD1 protein expression in esophageal squamous cell carcinoma.Methods The expression of WDHD1 protein in esophageal squamous cell carcinoma,adenocarcinoma of esophagus and normal esophagus tissues by immunohistochemical MaxVision was detected.Results The expression of WDHD1 protein in the tissues of esophageal squamous cell carcinoma was significantly higher than that in the normal esophagus tissues and adenocarcinoma of esophagus (15.68 ± 3.01 vs.3.89 ± 2.98 and 4.66 ± 2.46)(P ＜ 0.05),there was no significant between normal esophagus tissues and adenocarcinoma of esophagus (P ＞ 0.05).The expression of WDHD 1 protein in the tissues of esophageal squamous cell carcinoma,high-middle differentiation tissues was higher than poorly differentiation,TNM stage Ⅲ + Ⅳ stage was higher than Ⅰ + Ⅱ stage,depth of invasion T3 + T4 was higher than T1 + T2,with lymph node metastasis tissue was higher than without,differences was statistically significant (P ＜0.05).Conclusions The higher expression of WDHD1 protein is the marker of high invasive and low histological grade of esophageal squamous cell carcinoma,and WDHD1 in esophageal squamous cell carcinomas may play an important role in development.

Objective To analyze the clinical manifestation,auxiliary examination,treatment,prognosis of 16 cases who experienced inadvertent injection of intrathecal microcontent vincristine,and and they were followed up for 5 years.Methods To collect detailed medical record material for 5 years of 16 pediatric blood oncology patients who appeared with nervous system damage symptoms caused by inadvertent administration of microcontent vincristine intrathecally,combined with subsequent visits at the clinic,or through telephone and letters followed-up.Results Clinical manifestations of lumbosacral radicular dysfunction were found in all 16 cases,among them 2 cases also had cervicothoracic radicular damage symptoms.The first sign was weakness in lower limbs,subsequently,walking difficulty.Cerebrospinal fluid protein was higher than normal in 3 cases.Magnetic resonance imagine of the brain and spinal cord revealed demyelination in the white matter of 2 cases.Electromyographic revealed neurogenic damage and showed complete or partial denervation changes in 11 cases that received this examination.After the treatment consisted of medication use to improve nerve nutrition metabolism and promote nervous function recovery,combined with positive rehabilitation therapy,13 cases had improvement from level Ⅰ to Ⅲ in myodynamia.Of 9 cases with neurogenic bladder,4 cases were back to normal,3 cases were improved to different extent.Till Oct.2012,6 cases lived in remission,9 cases including 6 cases of recurrence died of the primary disease or complication in the treatment process,and 1 case died of penicillin anaphylactic shock almost 1 year after chemotherapy.Conclusions Inadvertent intrathecal injection of microcontent vincristine can cause lumbosacral radicular dysfunction.Trace amounts of vincristine intrathecally cumulative can also cause serious damage to the nervous system.The early application of horrmone and nerve nutrition drugs combined with positive rehabilitation therapy have surely curative effect to alleviate the neuropathy for inadvertent administration of microcontent vincristine intrathecally.

Agricultural Microbiology is a professional foundation curriculum for biology,botany and envi-ronmental majors in agricultural universities.After 1999,with the increase enrollment of the national under-graduate education and rapid construction of the university,the number of majors and students increased rapidly and quality of students and talent demand of society changed dramatically.Under such condition,in order to meet the society demand of microbiology,according to the distinguishing feature of different major groups,based on strengthening the basis teaching and stretching application teaching,new curriculum teaching model and method were explored positively,and then new curriculum system was constructed.Be-ing aroused sufficiently of the students’ subjective initiative,both the teaching quality and comprehensive quality were improved.

BACKGROUND: This study aimed to investigate the prevalence rate of critical illness-related corticosteroid insufficiency (CIRCI) and the effect of low-dose glucocorticoid on prognosis of CIRCI in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). METHODS: Since January 2010 to December 2012, 385 patients, who met the criteria of AECOPD, were enrolled in the Intensive Care Unit (ICU) of the First People's Hospital and Municipal Central Hospital of Xiangtan City. The AECOPD patients complicated with CIRCI screened by an adrenalcorticotrophic hormone test within 12 hours after admission to ICU were divided into a treatment group (n=32) and a control group (n=31) for a prospective, randomized and controlled clinical trial. Hydrocortisone (150 mg/d) or normal saline was injected intravenously for 7 days. The patients were followed up for 28 days after injection. The endpoint included 28-day survival time, non-shock time, ICU stay and the period of non-mechanical ventilation. The markers of inflammation C-reactive protein, tumor necrosis factor-α, interleukin 6 and procalcitonin were measured at baseline and 7 days after treatment. The variables were analyzed by Student's t test, the non-parametric statistical test, the Chi-square test or the Kaplan-Meier method with SPSS18.0 statistic software. A P value <0.05 was considered statistically significant. RESULTS: Totally 63 patients were diagnosed with CIRCI by an adrenalcorticotrophic hormone test and the prevalence rate was 16.4％. The shock rate of the AECOPD patients complicated with CIRCI was higher than that of the AECOPD patients without CIRCI (23.8％ vs. 8.7％, P<0.01). Kaplan-Meier analysis revealed that the 28-day survival time of the treatment group was obviously longer than that of the control group (P<0.05). Compared with the control group, shock-free days within 28 days was longer in the treatment group (18.2±9.5 vs. 25.8±4.1, P<0.05). Treatment with low-dose glucocorticoid obviously decreased the markers of infection and inflammation (P<0.01), such as C-reactive protein (13.2±5.5 mg/L vs. 8.3±3.1 mg/L for the control group; 13.5±5.9 mg/L vs. 5.1±2.3 mg/L for the treatment group), tumor necrosis factor-α (26.1±16.2 g/L vs. 17.5±11.7 g/L for the control group; 25.0±14.8 g/L vs. 10.4±7.8 g/L for the treatment group) and procalcitonin (3.88 g/L vs. 2.03 g/L for the control group; 3.77 g/L vs. 1.26 g/L for the treatment group). Furthermore, the markers in the treatment group decreased more obviously than those in the control group (P<0.01). CONCLUSION: The prevalence rate of CIRCI was higher in the patients with AECOPD in the department of critical medicine, and low-dose glucocorticoid treatment for one week reduced the 28-day mortality, shock time and markers of infection and inflammation.

ObjectiveTo investigate and compare the behavioral changes, neuron loss of hippocampus and mossy fiber sprouting between pilocarpine-induced status epilepticus (SE) model and pentylenetetrazole (PTZ) kindling model in rats.MethodsAfter two different epilepsy models were made, Vedio was adopted to observe the behavioral changes. Nissl staining and Neo-timms' staining were separately used to observe and compare the neuron loss of hippocampus and mossy fiber sprouting in the dentate gyrus (DG) at different time points during epileptogenisis.ResultsNo recurrent spontaneous seizure, no neuron loss and no mossy fiber sprouting were found in PTZ kindling model; whereas obvious neuron loss was found in CA1, CA3 of hippocampus and hilus of DG, and mossy fiber sprouting were found in pilocarpine model in parallel with recurrent spontaneous seizures. ConclusionPTZ kindling model resembles absence epilepsy in human, while pilocarpine-induced status epilepticus model resembles chronic temporal epilepsy in human. Neuron loss and mossy fiber sprouting may play an important role in epileptogenisis. Pilocarpine-induced epilepsy model can be regarded as an ideal chronic temporal epilepsy model.

Objective To investigate the imaging characteristics and differentiating value of hepatic perfusion disorders(HPD)in small focal liver lesions(≤3 cm),the transient hepatic hyperechoic enhancement(THHE),with contrast-enhanced ultrasonography(CEUS)during arterial phase and explore the potential mechanism.Methods Two hundred and sixty-eight small foeal liver lesions found in 215 patients who had undergone CEUS were retrospectively evaluated in this study.Hepatic parenchymal THHEs around those lesions were diagnosed and the CEUS characteristics as well as the detecting rate related to different lesions were analyzed.Results Forty-five among 268 lesions(16.8%)showed surrounding THHEs during CEUS and they exhibited fast wash-in to form hyperechoic area of different shape and range and then those area became fast washout to be isoechoic in contrast with peripheral liver parenchyma.According to the imaging morphology,THHEs could be divided into four types:type Ⅰ,wedge-or fan-shaped(51.1%);type Ⅱ,encircling-shaped(20.0%);type Ⅲ,nodule-like-shaped(11.1%);type Ⅳ,irregular-shaped(17.8%).According to the pathology,the liver focal lesions could be divided into three groups:benign group,which consisted of 88 lesions and 8(9.1%)lesions showed surrounding THHEs of which 87.5% presented type Ⅲ and Ⅳ;malignant group,which consisted of 141 lesions and 31(22.0%)lesions showed surrounding THHEs of which 67.7% presented type Ⅰ;tumor-like lesions group,which consisted of 39 lesions and 6(15.4%)lesions showed surrounding THHEs of which 66.7% presented type Ⅱ.There was significant difference in the composition of THHEs type among three groups(P＜0.001).The detecting rate of THHEs in benign group was lower than that in other groups(P＜0.05).Conclusions THHEs showed with CEUS in small liver focal lesions are representation of HPD and have different detecting rate and imaging morphology type in different lesions.It is very important to recognize and distinguish THHEs surrounding focal lesions,which could help to make differential diagnosis,avoid incorrect diagnosis and judge the size of lesions correctly.