Neurocognitive impairment frequently occurs in epilepsy patients,especially in children,which has been considered to interfere the development of mind and body and cause mental retardation.Now it has attracted wide attention from doctors home and abroad.The mechanisms are complicated,and may be influenced by several factors.Different locations of epileptiform focuses cause different cognitive impairment.This review aims to illustrate the major cognitive impairment in relation to the epileptogenic zone in brain,with a more detailed interest for temporal lobe epilepsy,frontal lobe epilepsy,occipital lobe epilepsy and parietal lobe epilepsy.

Bupleurum chinense used in the study were cultivated in the experimental fields of Gansu agricultural University for three years. The seeds of B. chinense were collected every 3 days 10 d after the blossom. The result showed that the 1 000-grain fresh weight reached the maximum 43 d after the blossom and then decreased rapidly, at the mature period the fresh weight of seeds were falling to the same level of the dry weight. The dynamic change of the grain dry matter accumulation showed as an S-shape curve, the rapid increase stage was 25-34 d following the flower, and the grain filling was ended 46 d after blossom. Grain filling rate was under the law "fast-slow-fast-slow". And there were two peaks of grain filling rate appeared, after reached the second peak 28 d after the flower the filling rate decreased rapidly and stayed steadily 43 d after flowering. The dehydration rate was also measured at its maximum 43 d following flower. The indexes of seeds all reached the top 52 days following the blossom, when the germination rate reached the peak (34.33%) and water content of seeds was near 10%. The rate of germination and the 1 000-graid weight of seed showed significant positive correlation, while the water content of seeds was found significant negatively correlation with germination percentage. So the best time for harvest should be 52 d after flowering (9 month), the seeds collected at that time showed both high quality and germination rate.
Bupleurum ; chemistry ; growth & development ; Flowers ; growth & development ; Germination ; Seeds ; chemistry ; growth & development ; Water ; analysis

Adult ; Endocarditis ; complications ; Endocarditis, Bacterial ; complications ; Heart Defects, Congenital ; complications ; Humans ; Male ; Pulmonary Valve ; microbiology

Aged ; Carcinosarcoma ; Female ; Humans ; Male ; Middle Aged ; Nose Neoplasms ; Paranasal Sinus Neoplasms ; Teratoma

Objective To investigate hospital staffs' appraisals on public hospitals reform.Methods 890 medical staffs were randomly investigated by questionnaire,to learn their comments on the implementation of reform measures,public-benefit nature and reform outcomes of the reform,as well as problems found with the government and improvement suggestions,and difficulties encountered in such a reform.Results The hospital staffs' appraisals on the reform tend to be low,as 36.4％ of them hold that the reform is less effective in its outcomes or a mere formality (19.8％).The staff blamed the lack of system breakthrough (67.9％),lack of financial support (61.1％),and insufficient support from the doctors as stakeholders (49.1 ％),for most of the problems of the reform.Conclusion It is suggested to win over support of the medical staff for the reform; to improve the laws and policies related to the reform; and to establish an effective supervision system for public hospitals.

Objective To investigate changes of serum cystatin C(Cys C),uric acid,HsCRP, IL-6,TNF-?,and lipids in patients with primary and secondary type Ⅱ b hyperhpidemia.Methods Seventy- five patients with primary and secondary type Ⅱb hyperlipidemia and 75 healthy controls were included in this study.Serum levels of TC,TG,HDL-C,LDL-C,apoAI,apoB,Lp(a),Cys C,UA,HsCRP were measured by immunoturbidimetric assay on AU-640,and IL-6,TNF-? were detected.Results Patients showed higher serum TC,TG,LDL-C,apoB,UA,Cys C and HsCRP than the controls.The levels in patients were(3.70? 0.66)mmol/L,(9.50?0.92)mmol/L,(4.50?0.31)mmol/L,(1.70?0.21)g/L,(1.21?0.17) mg/L,(441.4?114.7)?mol/L,(11.5?3.2)mg/L respectively,while levels in controls were(1.88? 0.66)mmol/L,(4.00?0.66)mmol/L,(2.80?0.33)mmol/L,(0.74?0.23)g/L,(0.71?0.18) mg/L,(343.0?113.9)?mol/L,(1.8?0.7)g/L respectively.Serum Cys C was positively correlated with HsCRP and UA(P

Objective To investigate technique and clinical effect of total en bloc spondylectomy for thoracic and lumbar chondrosarcoma.Methods From January 2010 to March 2012,6 patients with thoracic or lumbar chondrosarcoma underwent total en bloc spondylectomy.There were 4 males and 2 females,aged from 25 to 54 years (average,38 years).The tumor ranged from T3 to L3; 1 located in T3 and T4,1 in T7,1in T11,1 in L1,1 in L2 and 1 in L3.According to Tomita surgical classification system,there was 1 case of type 2,1 case of type 4,3 cases of type 5 and 1 case of type 6.One patient underwent tumor resection through single posterior approach,while the other 5 patients underwent anterior dissection and posterior resection of tumor.All spines were reconstructed by posterior fixation with pedicle screws and anterior interbody fusion with titanium mesh cages or artificial vertebrae.Results The average amount of blood loss was 3200 ml (range,2100 to 6300 ml).The duration of operation ranged from 3.5 to 12 hours (average,5.5hours).Two patients obtained wide resection,3 obtained marginal resection,and 1 had intralesional margin.The complications included 2 cases of cerebrospinal leak,1 case of pleural effusion and 1 case of pulmonary infection.There was no wound infection and death during peroperative period.All patients were followed up for 6 to 32 months (average,19 months).The neurological function improved from preoperative Frankel C to postoperative Frankel E in 2 cases.All patients obtained bone union 6 to 12 months (average,8 months) after operation.At final follow-up,all patients could walk without aid,and there was no recurrence.Conclusion The total en bloc spondylectomy is an effective method for thoracolumbar chondrosarcoma,which could provide a satisfied tumor control and neurological function improvement.

Objective To explore the short?term functional outcomes of the reconstruction of the proximal humerus by re?verse shoulder arthroplasty after tumor rescetion. Methods 8 patients who underwent reverse shoulder arthroplasty after tumor resection between January 2013 and December 2014. 5 were female and 3 were male, mean aged was 38 years old (25-61). 2 chon?drosarcomas and 6 giant cell tumors. Enneking stageing of 2 cases with chondrosarcoma were stageⅠB and stageⅡB. 6 giant cell tumors were Campanacci stage 3, meanwhile 3 cases had pathological fractures. The deltoid and axillary nerve were intact in all patients by image analysis before the operation. The proximal humerus was resected according to Malawer typeⅠresection. Then reverse shoulder arthroplasty reconstruction and bone graft was performed. The follow?up was scheduled, and the patient received X?ray examination of the shoulder. The range of motion of the shoulder was measured, the Constant?Murley score and musculoskel?etal tumor society(MSTS) score was recorded. Results The mean duration of the operation was 2.7 h (2-3.5 h). The bleeding in the operation was 510 ml (300-850 ml). The mean length of humerus resection was 8 cm (6-10 cm). The allografts were used in 7 cases and reimplantation after tumor bone deactivation was used in one. The latissimus dorsi transfer were performed in 2 cases. The rotator cuff were resected 1-1.5 cm from the great and lesser tubercles. The follow?up was 13 months (3-26 months). No infec?tion, dislocation, or loosening of prosthesis was found by the last follow?up. The X?ray showed the case who received reimplanta?tion after tumor bone deactivation had achieved bone union 1 year postoperation,7 cases received allograft had still nonunion at the host?graft junction. Bone resorption were found in all cases in different extent but the prosthesis were stable. No local recur?rence of the tumor was found. At last follow?up, active abduction was 155° (100°-175° ) and active forward elevation was 150° (115°-170°) and Constant?Murley score was 76%(68%-87%). The MSTS score was 92%(87%-97%). Conclusion The func?tional outcomes of the reconstruction of the proximal humerus by reverse shoulder arthroplasty after tumor rescetion was satisfied in early period. The reverse shoulder arthroplasty can be used in younger patient, but long?term results need further study.

Objective To evaluate the diagnostic efficiency of deep fungal infection by detecting the serum galactomannan ( GM) and bronchoalveolar lavage fluid ( BALF) GM, serum G test and fungal culture of BALF in patients with suspected invasive fungal infection ( IFI) in lungs.Methods A retrospective analysis was performed of the results of serum /BALF GM test ,serum G test and BALF culture from 148 patients with suspected pulmonary IFI .The indexes involved sensitivity , specificity , positive predictive value , negative predictive value , as well as diagnostic capacity for deep fungal infection with separated or combined tests .Results Among the 148 cases, 48 cases were clinically diagnosed with IFI and the rest were excluded.Among the 48 IFI cases, 3 cases were positive in serum GM test , 25 cases were positive in BALF GM test , 31 cases were positive in G test and 30 cases were positive in fungal culture .The combined detection showed a sensitivity of 91.6%,specificity of 70.0%, positive predictive value of 59.5% and negative predictive value of 94.6%.Conclusion The combination of GM/G tests and fungal culture can significantly improve the clinical diagnostic efficiency of pulmonary IFI .

Objective:To compare the biomechanical effects between oblique Ban-pulling manipulation and lumbar erection-rotation manipulation in sitting position in treating lumbar intervertebral disc herniation (LIDH). Methods:A three-dimensional finite element model of L3-S1 was developed to carry out a comparative study between oblique Ban-pulling manipulation and lumbar erection and rotation manipulation in sitting position. The disc protrusion was assumed to be on the rear left of L4 disc, and the manipulations were performed on the right side. The loading process was simulated by two steps. In the first step, only the compression loading was imposed, and in the second step, both the compression loading and axial rotation moment were imposed. The displacement and stress distribution in L4 disc were investigated. Results:The values of stress and displacement in the second step were lower than those in the first step in each manipulation. The stress and displacement differences between the two steps were respectively 1.79 times and 3.03 times larger in oblique Ban-pulling manipulation than those in lumbar erection-rotation manipulation in sitting position. Conclusion: Oblique Ban-pulling manipulation may result in a better biomechanical effect than lumbar erection-rotation manipulation in sitting position for LIDH.