Vagus nerve stimulation is an effective treatment for drug-resistant epilepsy, and its efficacy and safety have been confirmed after over two decades of clinical practices.However, reassuring predictors to evaluate whether patients with drug-resistant epilepsy could gain benefit from vagus nerve stimulation has not been established, because the underlying mechanism remain poorly understood.Previous studies revealed that presumable patient-related predictors included age, epileptic seizure type, epilepsy etiology, epilepsy syndrome, cognitive and behavioral responsiveness, scalp electroencephalographic related signals and heart rate variability related signals.However, most of the predictors still remain controversial due to the factors such as the heterogeneity of different research design.This article aims at analyzing and concluding the information from relevant literatures, and summing up the predictors of efficacy before vagus nerve stimulation in refractory epilepsy to highlight the future work.

Objective To explore the influence and curative effect of leflunomide combined with ginkgo leaf extract and dipyridamole on hypercoagulable state in patients with nephrotic syndrome.Methods Ninety-five patients who were the first diagnosed nephrotic syndrome were divided into experiment group (50 cases) and control group (45 cases) by random digits table method.The patients in experiment group were treated with leflunomide combined with ginkgo leaf extract and dipyridamole,while the patients in control group were treated with leflunomide.The coagulation function and renal function indexes were respectively detected before and after treatment.Results After treatment,the expression level of platelet activation complexes (PAC)-1 in experiment group decreased from (7.33 ± 1.69)％ to (2.58 ±0.97)％,and the expression level of CD62p decreased from (6.15 ± 1.59)％ to (3.18 ± 1.03)％,which were significantly lower than those after treatment in control group [(7.23 ± 1.41)％ and (5.99 ± 1.51)％],and there were statistical differences (P ＜ 0.05).The prothrombin time in experiment group extended from (10.62 ±0.45) s to (12.88 ± 0.69) s,and the activated partial thromboplastin time extended from (23.33 ± 2.79) s to (30.57 ±3.88) s,which were significantly longer than those after treatment in control group [(11.21 ±0.48) s and (23.46 ± 2.79) s],and there were statistical differences (P ＜ 0.05).The plasma D-dimer in experiment group decreased from (2.58 ± 1.23) mg/L to (0.89 ± 1.12) mg/L,the plasma fibrinogen decreased from (3.68 ± 1.21) g/L to (1.89 ± 0.74) g/L,which were significantly lower than those after treatment in control group [(2.33 ± 1.22) mg/L and (3.25 ± 1.33) g/L],and there were statistical differences (P＜0.05).The serum creatinine,blood urea nitrogen and 24 h urine protein levels after treatment in the 2 groups were significantly lower than those before treatment,but the serum creatinine and 24 h urine protein levels after treatment in experiment group were significantly lower than those in control group [(85.38 ± 18.56) μ mol/L vs.(115.23 ± 20.88) μ mol/L,(1.07 ± 0.38) g vs.(2.57 ± 0.99) g],and there were statistical differences (P ＜0.05).Conclusions The application of the leflunomide combined with ginkgo leaf extract and dipyridamole has great effects on releasing the hypercoagulable state and improving the renal function of patients with nephrotic syndrome.

Objective To discuss the treatment effect of well-differentiated thyroid carcinoma.Methods From 1992 to 2002,42 cases of well-differentiated thyroid carcinoma invading the laryngotrachea were treated in shanxi tumor hospital.Radical tumor resection were 6 cases,local shaving-off tumor resection were 32 cases and incomplete tumor resection were 4 cases.Some patients received postoperative radiotheraPy.Results In the 42patients,the overall 5-year survival rates were 76.2%(32/42).Conclusion Although well-differentiated thyroid carcinoma invaded the laryngotrachea,the operation can increase the curative effect and the patient's living standand.

Objective To investigate the roles of renin-angiotens in system(RAS)and aldosterone(ALD),endothelin(ET),nitricoxide(NO)in patients with renal hypertension(40 cases)and adrenocorticoadenomas(35 cases),35 normal subjects were included in the study as controls.Methods Radioimmunoassay(RIA)was used to de termine the plasma concentrations of the renin,angiorensin Ⅱ(AⅡ),aldosterone,ET in the abovecases.Enzymicas say was adopted to examine the plasma concentration of the nitricoxidesynthase(NOS).Results TIhe plasma concentrations of renin,angiotennsin Ⅱ,aldosterone,endothefin in the patients with renal hypertension were significantly higher than those in the control group(P＜0.01)except with the concentration of NOS,which were lower than that in controls(P＜0.05);the plasma concentrations of the ALD,ET,in the patients with adrenocorti-caladenoma were higher that those in controls(P＜0.01)but renin and A Ⅱ were lower(P＜0.05).Conclusion Determination of the plasma renin,angiotensionⅡ,aldosterone and NO might be able diagnose renal hypertension and adrenocorti coadenoma earlier.

60 cases with a history of recurrent respiratory infections were studied The serum levels of immunoglobulin G and A were measured by means of radial diffusion and the results were compared with 41 normal subjectsof the same age. In 23 cases (38. 3%), serum IgA level was below meanvalue-SD. It was remarkably decreased in 8 patients with prolonged pneu-monia(P≤0.05). The serum IgG concentration was elevated above mean va-lue + SD in 14 patients, 8 of whom suffered from bronchitis. There was,furthermore, another group of 7 patients with bronchitis whose IgA levelwas elevated above mean value + SD. The results suggested that deficiencyof serum IgA might be a cause of recurrent respiratory infections andmight give rise to a prolonged course of pneumonia in some patients.

Objective To observe the effect of silencing the expression of ADM using RNA interfering technique on the expression ofβ-catenin and terminal differentiation of osteosarcoma cells.Methods After the intervention of 0 h,48 h and 72 h by ADM siRNA,we observed the change of distribution ofβ-catenin in F5M2 using immunocytochemistry staining.The expression levels of total and phosphorylatedβ-catenin and GSK3βwere detected by Western blot after the intervention by ADM siRNA.The F5 M2 cells treated with ADM siRNA were subjected to HE staining,alkaline phosphatase (ALP)assay and immunocytochemistry staining to investigate the biological effects of ADM siRNA on the morphology and terminal differentiation of F5M2 cells.Results After the intervention of 0 h,48 h and 72 h by ADM siRNA,the distribution ofβ-catenin was transferred from the cytoplasm to the nucleus.ADM siRNA downregulated the expression level of P-β-catenin and upregulated P-GSK3βdetected by Western blot.HE staining revealed that the configuration of F5M2 had undergone restorational changes similar to those of normal cells after ADM siRNA treatment.ALP assay and immunocytochemistry staining showed that the expression of the earlier and later molecular biomarkers of terminal differentiation,including ALP and osteocalcin were strongly positive.Conclusion Silencing the expression of ADM can activateβ-catenin to transfer to the nucleus from the cytoplasm,and induce osteosarcoma cells to make terminal differentiation through activatingβ-catenin signaling pathway.

OBJECTIVE:To analyze the general patterns and characteristics of drug-induced lupus (DIL) induced by inflix-imab,and to provide reference for the safety of drug use. METHODS:Usinginfiximab,lupusas searching words,inflix-imab-induced DIL literatures included in CJFD,VIP and PubMed from Jan. 2002 to Jun. 2016 were retrieved and analyzed. RE-SULTS:Totally 30 effective literatures were retrieved,involving 31 DIL patients,there were 8 male cases (25.81%) and 23 fe-male cases(74.19%);17 patients aged more than 50(54.84%). 20 cases occurred within 5-24 weeks(64.51%). 16 patients re-ceived infliximab alone (51.61%). Main clinical manifestations were skin rash or photosensitivie enteritig (15 cases),joint pain (16 cases,multiple arthritis and synovitis)and fever(12 cases). 5 patients suffered from 3 above symptoms simultaneously. Labo-ratory examination mainly manifested as antinuclear antibody,double stranded DNA antibody and anti-histone antibody positive. Thirty patients with DIL received drug withdrawal or steroid hormones treatment,among which the symptoms of 26 patients disap-peared after drug withdrawal or treatment within 6 months,and 1 patient deteriorated. CONCLUSIONS:DIL-induced by inflix-imab invovle patients'age and gender,disease types,family history and other factors. Clinicians should be aware of rules and char-acteristics of DIL induced by infliximab,and tighten drug use monitoring to reduce ADR.

This paper introduces the principle and parameters of the ophthalmic excimer laser curer. Such aspects are also involved in as the detection method and device for the parameters of the excimer laser as well as the selection of the detection devices.

Objective:To study the insulin resistance and leptin resistance in women with polycystic ovary syndrome(PCOS).Methods:Body mass index(BMI),serum leptin,fasting blood glucose(FBG),fasting insulin(FINS),serum triglyceride,total cholesterol,high-density lipoprotein,low-density lipoprotein and insulin resistance index(HOMA-IR) were assessed in 30 normal women,30 simple obesity women and 41 PCOS women.Results:①The PCOS patients showed higher levels of BMI,serum leptin,FINS,HOMA-IR and low-density lipoprotein,and lower levels of high-density lipoprotein than that in normal control.Compared to simple obesity women,there only showed higher FINS level and lower BMI in PCOS women.②Serum leptin levels in PCOS patients were concerned with BMI、FINS、HOMA-IR and serum triglyceride levels.③There were no significant difference of the FINS and HOMA-IR between normal women and non obese PCOS women,but the obese PCOS women showed higher levels of FINS and HOMA-IR than that in simple obesity women;the serum leptin levels showed no significant difference between normal women and non-obese PCOS women,simple obesity women and obese PCOS women. Conclusion:PCOS patients may have insulin resistance and leptin resistance;There may have regulative effect between leptin resistance and insulin resistance in PCOS patients;There are direct relationship between insulin resistance and PCOS;The rise of serum leptin level in PCOS women may be the assident manifestation of obesity.

Objective:To evaluate the effect of Ginseng-Sini in early goal directed treatment septic shock under PICCO.Methods: Forty four patents with septic shock were randomly divided into control group, which treated with Ginseng-Sini on the basis of routine treatment under PICCO, observation groups, which treated with only the basis of routine treatment under PICCO. Before and after the drugs were given for 6 hours, HR, IMAP, CVP, SpO2, Lac, CI, ITBVI, SVRI were monitored.Results: Before treatment, HR, IMAP, CVP, SpO2, Lac, CI, ITBVI, SVRI of the observation group were not different from the control group(P>0.05); after 6 hours of treatment, CI of the observation group were higher than that of the control group(P<0.05).Conclusion: Ginseng-Sini in the early goal directed of septic shock is effective, especially in improving tissue perfusion.