Nonconvulsive status epilepticus (NCSE)is a peculiar kind of status epilepticus,which is not un-common in children,but it always be misdiagnosed due to its unnoticeable clinical signs.So far,there is no international unifying diagnose standard of NCSE.Therefore,electroencephalography(EEG)monitoring is recommended.Now,the progress in this field of clinical manifestation and EEG features of NCSE was reviewed.

0.05).DBP and DEHP obviously induced a decrease in organ body weight ratios of testis and epididymis and an increase in organ body weights ratios of liver.Obvious decrease in the sperm counts,spermatozoon survival rate and significant increase in the rate of the sperm deformation were observed.There was synergism between DBP and DEHP on the testis,epididymis and liver organ body weight ratio,as well as sperm counts,sperm survival and deformation rates.Pathological examination showed the seminiferous tubules were irregular shape,degenerative atrophy and interstitial substance broadening,and the seminiferous epithelium were degeneration.Epididymis epithelium was damaged and few of mature sperm was seen.Conclusion DBP combined with DEHP can cause obvious toxic effects on reproductive function in male rats.DBP and DEHP mixture can strongly affect the sperm quantity and quality.Also,some toxic effects to epididymis are observed.

Objective To study the combined toxic effects of di-n-butyl phthalate(DBP)and di-2-ethylhexyl phthalate(DEHP)on sex hormone and lipid peroxidation in male rats.Methods According to 2?2 factorial analysis,thirty-two healthy and clean adult male SD rats were randomly divided into 4 groups,including a control group(given coin oil) and three experimental groups:DBP(1/20 LD50,1.0 g/kg,dissolved in coin oil),DEHP(1/20 LD50,1.7 g/kg,dissolved in coin oil) and DBP+DEHP(1.0 g/kg + 1.7 g/kg,dissolved in coin oil),8 rats in each group,through gavage,once a day,for 8 consecutive weeks.The spectrophotometric method was used to measure the activity of lipid peroxidation SOD,GSH and GSH-Px level in testis homogenate.The activities of ACP,AKP and ?-GT were assessed in testis homogenate.Radioimmunoassay was used to determine the testosterone,LH and FSH levels in the serum.Results There was synergism between DBP and DEHP on the SOD activity in testicle and testosterone level in serum,and there was antagonism between DBP and DEHP on the ?-GT and ACP activity in testicle,as well as the FSH level in serum.Conclusion DBP combined with DEHP can cause obvious toxic effects on reproductive function in male rats.The change of testosterone biosynthetic enzymes and the levels of T in serum and disordered physiologic balances of hypothalamic-pituitarytestis axis may be key factors contributing to the decrease of testosterone,then the decrease of reproductive function in male rats.

Objective To investigate the difference and treatment strategy of malignancy-associated dermatomyositis and other para-neoplastic neurological syndromes (PNS).Methods The clinical characteristics of a patient with malignancy-associated dermatomyositis and poly radiculoneuropathy was reported and the relevant literature was reviewed.Results Patients with dermatomyositis had increased risk of malignancies,and should routinely screened.Dermatomyositis and polyradiculoneuropathy was clinically similar,but could rarely be seen in the same malignant patient.Malignancy -associated dermatomyositis and PNS had similar pathogenesis.The treatment strategy of both was similar.Malignancy specific treatment should be initiated and immune suppressive agents should be prescribed concurrently.Conclusion Rheumatolgists should aware the association between dermatomyositis and potential underlying malignancies.Multiple para-neoplastic syndromes could be seen in the same patient,but the diagnosis should be considered as one.

Objective To improve the understanding of drug-induced lupus (DIL) and the differences from systemic lupus erythematosus (SLE).Methods Clinical manifestation and treatment of patients with definite DIL were retrospectively analyzed.Results Six patients with DIL were enrolled in this study,including 4 females and 2 males.Two patients were diagnosed after receiving interferon,one after soluble tumor necrosis factor receptor fusion protein,one after propylthiouracil,one after penicillamine,and one after levofloxacin.High titer of antinuclear antibody was identified in all six patients,including 3 with positive anti-dsDNA antibody.One patient had positive anti-Sm antibody.One patient had positive anti-RNP antibody.One patient had anti-nucleosome antibody.One patient had anti-histone antibody.One patient had antimitochondrial antibodies-M2,and one patient had anticardiolipin antibodies.Conclusion Patients with DIL are not as severe as those with SLE.After cessation of suspected drugs and administration of standard treatment,the clinical outcome of DIL is satisfying.

Objective To investigate the change of plasma marinobufagenin (MBG) level and the expression of its receptor Na+-K+-ATPase (NKA) in renal biopsy specimens of chronic glomerulonephritis (CGN) patients. Methods Twenty-eight CGN patients and 14 healthy people were enrolled in the study. The plasma MBG concentration was measured by competitive inhibition ELISA system. Immunofluorescence and immunohistochemistry staining were applied to detect the expression of NKA in renal biopsy specimens of 28 CGN patients and analyzed by semi quantitively. Results Compared with healthy controls, CGN patients had significant lower plasma MBG concentration [(0.579±0.214) nmol/L vs (0.715±0.154) nmol/L, P＜0.05], without further significant difference between CGN patients with hypertension and with normal blood pressure [(0.595±0.231) nmol/L vs (0.557±0.197) nmol/L, P＞0.05]. Meanwhile, proximal tubular staining of NKA was decreased compared with normal controls. The NKA positive staining area of the CGN group was lower than that of normal controls [2.1% (0.5%-6.2%) vs 5.6% (3.5%-10.8%), P＜0.01] and correlated with 24-hour urinary sodium excretion (r=0.551, P＜0.01).Conclusion Decreased plasma MBG level and its receptor expression on proximal tubules may play a role in the regulation of sodium in CGN.

Aim To investigate the effects of CYP2C19 polymorphism on the pharmacokinetics and comparative bioavailability of omeprazole in Chinese population.Methods Eighteen healthy male volunteers were selected,of whom 6 were CYP2C19 wild type(w/w),6 were CYP2C19 heterozygous variant(w/m) and the rest were CYP2C19 homozygous variant(m/m).A randomized two-period crossover study was performed.Subjects were assigned to receive test or reference omeprazole as a single oral dose of 40 mg randomly.After a washout period of one week,subjects received the alternative omeprazole formulation.Multiple blood samples of 3 ml were obtained over 12 h after dosing and plasma concentrations of omeprazole were measured by LC/MS method.The modeling of individual pharmacokinetics and the pharmacokinetic parameters of omeprazole were estimated by 3P97.Results The AUC and Cmax of reference omeprazole formulation in w/w,w/m,m/m groups were 1178.44±340.24,2328.10±1011.83,5062.02±1097.29 μg·h·L~(-1) and 602.87±118.25,926.43±134.48,1406.29±233.58 μg·L~(-1),respectively,with significant differences among the three groups(P<0.05).Significant differences were also observed in other pharmacokinetic parameters such as k_e、CL/F、t_(1/2) and Vd/F among the three groups(P<0.05).With regard to test omeprazole formulation,the AUC and C_(max) in w/w,w/m,m/m groups were 1224.82±531.67,2723.34±519.29,5692.49±1575.35 μg·h·L~(-1) and 618.74±231.43,910.67±125.99,1303.31±152.01 μg·L~(-1),respectively,which,as well as k_e,CL/F,t_(1/2) and Vd/F were significant different among the three groups(P<0.05).No significant differences were observed in comparative bioavailability among groups with the values of 94.29%±14.06%,93.08%±11.22%,91.84%±13.03% in w/w,w/m,m/m groups respectively(P>0.05).Conclusions Different CYP2C19 genotypes,leading to functional heterogeneity of CYP2C19,may affect pharmacokinetic profile of omeprazole.Therefore,genotyping CYP2C19 gene before omeprazole therapy will be of great benefit for optimizing individual therapy regimen.There is no significant difference of omeprazole comparative bioavailability with regard to CYP2C19 genetic polymorphism.

Objective To study the relationship between hepatocellular apoptosis and glycogen contents during hepatic cold preservation reperfusion and its mechanism.Methods Based on the model of four groups of rabbit livers with different hepatocellular glycogen contents, hepatocellular apoptosis and bax gene expression were observed during hepatic cold preservation reperfusion.Results Apoptotic hepatocytes were obviously found in 60 minute reperfusing livers subsequent to 9 hour cold storage, and there was significant difference in the numbers of apoptotic hepatocytes among all the groups. In the same time, there was the close relationship between the levels of bax gene expression and the glycogen contents of hepatocytes.Conclusion Intracellular abundant glycogen may significantly depress the hepatocellular apoptosis during hepatic cold preservation reperfusion by decreasing hepatocellular bax gene expression.

Objective To assess the application of MRI in diagnosis of oblique vaginal septum syndrome (OVSS).Methods Clinical and imaging data of 41 patients with OVSS confirmed by surgery from March 2011 to November 2016 were retrospectively analyzed.Results The average age of patients was 20.5 year (10-46 years).The primary clinical symptoms were menorrhalgia (16 cases) and menorrhagia (13 cases).There were 12 cases of type Ⅰ,23 cases of type Ⅱ,5 cases of type Ⅲ and 1 case of type Ⅳamong 41 cases of OVSS.The resections for OVSS were performed in 35 cases.Forty two cases were diagnosed as OVSS by MRI scan,and 41 were confirmed by surgery,the accuracy of MRI diagnosis was 97.6％ (41/42).MRI showed uterus didelphys,hydrocolpos or hematocolpos with varying degrees,and revealed ipsilateral renal agenesis in all 41 cases.Conclusion MRI scan can accurately diagnose oblique vaginal septum syndrome and provide comprehensive information for clinical treatment.

Objective To explore the clinical features and gene mutations of blepharophimosis-ptosis-intellectual-disability syndrome (BPID). Methods The clinical data, diagnosis and treatment of a child with BPID in neonatal intensive care unit (NICU) were reviewed. Based on the literature retrieved from PubMed database, the common classification, clinical features, diagnosis and genetic counseling of BPID and its affiliated blepharophimosis-mental retardation syndromes (BMR) were reviewed. Results This male infant was 39 weeks of gestational age with birth weight of 1920 g, and was admitted to NICU 15 min after birth due to dyspnea. The main clinical manifestations were facial deformity such as biepharophimosis, ptosis and micromandible, inspiratory dyspnea with laryngeal cartilage softening, malformations of the thorax and feeding difficulties. A heterozygous mutation in UBE3B gene was identified by complete exon sequencing and he was diagnosed of BPID, a rare genetic disorder. Reviewing the literature, there was no relevant report in domestic. While one foreign literature was found to report 5 patients from 4 families having a subtype of BMR, a kind of autosomal recessive diseases caused by mutations in the UBE3B gene. Conclusion BPID is a rare clinical entity of BMR. Complete exon sequencing can be used to diagnose the disease.