Objective To explore the effect of microsurgery for refractory temporal lobe epilepsy . Methods A retrospective analysis was made in 102 patients with refractory temporal lobe epilepsy from January 2005 to December 2011.The patients received comprehensive preoperative localization , intraoperative frontotemporal pterional incision , and microsurgical resection of epileptogenic focus .The efficacy was evaluated according to the Engel standards .Indications such as self-care ability, learning ability, and working ability were used to evaluate the quality of life , which were recorded and compared before and after operation . Results Follow-up was accomplished in all the 102 cases for a duration of 1 year and 9 months to 7 years.There were no mortality and serious complications .The effects evaluations at 1 year after operation showed complete disappearance of symptoms ( levelⅠ) in 61 cases (59.8%), almost disappearance (level Ⅱ) in 17 cases (16.7%), symptoms improvement more than 75% (level Ⅲ) in 13 cases (12.7%),and ineffective (level Ⅳ) in 11 cases (10.8%), bearing an effective rate of 89.2% (91/102) and a good-and-excellent rate of 76.5%(78/102).At one year and nine months postoperatively , 6 patients could not take care of themselves , 32 patients obtained partial self-care, and 64 patients had complete self-care,as compared with which there were 21 patients, 67 patients, and 14 patients preoperatively, respectively, having significant differences before and after surgery (Z =-7.001, P =0.000). Statistical significances were obtained before and after operation in 67 cases of children and adolescents with learning ability ( Z=-3.747, P =0.000) and in 35 adult cases with working ability ( Z =-2.564, P =0.010). Conclusions Microsurgical treatment is an effective method for refractory temporal lobe epilepsy .Patients ’ quality of life can get significant improvement after surgery.

Female rats were fed with lead acetate 100mg/kg/day(group Ⅰ) or 200 mg/kg/day (group Ⅱ) for 5 days, at the day 7 to 11 of gestation prior to killing. The results shown that the mean level of blood lead in rats of group I was 27.90?8.47?g/dl, and corpus luteum or placenta were injured lightly. In the group Ⅱ, the level of blood lead reached 48.77?16.15?g/dl which correspond to human subacute intoxication, the structure of corpus luteum and placenta were injured prominently, and the activity of 3-hydroxysteroid dehydrogenase is lower than that of control group, about 1/20 of latter. The number of embryos in group Ⅱ were absorbed about 31.69%. However, the gonadotropic cells of pituitary did not affected prominently after treatment with lead. The human chorionic villi of placenta were cultured in medium with lead acetate 0.51?g/ml, 2.5?g/ml, 5?g/ml respectively, for 3 to 4 days. The struture of chorionic villi were damaged obviously after culture with lead more than 2.51?g/ml, and the concentration of hCG in culture medium was decreased. The results indicated that lead affected the corpus luteum, placenta and embryo, and exerted direct action on human trophoblast.

Objective To investigate the drug resistance and prevalence of integrons in clinical isolates of Pseudomonas aerugino‐sa(PA) and to analyze the correlation between presence of integrons and drug resistance .Methods A total of 260 non‐repetitive clinical isolates of PA were obtained from this Hospital;antimicrobial susceptibility testing was performed by using the K‐B disk diffusion methods;statistical analysis was performed by using the WHONET5 .0 software .Integrons were detected by using poly‐merase chain reaction(PCR) .Results Among the 260 clinical isolates of PA ,the resistance rates against 14 antibacterial agents from low to high were imipenem(18 .5% ) ,amikacin(18 .8% ) ,cefepime(20 .3% ) ,piperacillin/tazobactam(21 .5% ) ,ceftazidime pen‐tahydrate(22 .6% ) ,aztreonam(31 .9% ) ,tobramycin(31 .9% ) ,cefoperazone(38 .1% ) ,gentamicin(38 .8% ) ,piperacillin(41 .9% ) , ciprofloxacin(49 .2% ) ,cefotaxime(61 .9% ) and sulfamethoxazole/trimethoprim(70 .4% ) ,respectively .A total of 109 isolates pres‐ented Class Ⅰ integrons and 4 isolates presented class Ⅱintegrons ,while no class Ⅲ integrons were found in any isolates .Except for polymyxin ,the resistance rates of class Ⅰ integrons positive isolates against antibacterial agents examined in this study were significantly higher than those of class Ⅰ integrons negative isolates (P<0 .05) .Conclusion The classⅠand class Ⅱ integrons are the prevalent types in the local region ,which might be closely related to the drug resistance in clinical isolates of PA .

Animals ; Male ; Muscle, Skeletal ; metabolism ; Myogenic Regulatory Factors ; metabolism ; Physical Conditioning, Animal ; Rats ; Rats, Sprague-Dawley ; Running

Objective: To evaluate the efficacy and safety of intra-arterial thrombolysis and intravenous thrombolysis in the treatment of acute ischemic cerebral infarction through a meta-analysis. Methods: The literatures of the randomized controlled trials of using urokinase or recombinant tissue plasminogen activator for intra-arterial thrombolysis and intravenous thrombolysis in the treatment of acute ischemic cerebral infarction from January 1 ,2000 to August 5,2010 were reviewed. The primary outcome measures were the proportions of neurological improvement (basic cure + excellent results) in the intra-arterial thrombolysis and intravenous thrombolysis groups. The secondary outcome measures were the European Stroke Scale (ESS) scores after the treatment and the proportion of symptomatic intracranial hemorrhage. The meta-analysis software, RevMan 4. 2 was applied for pooling the data of all the findings. Two reviewers extracted the data independently. Results: A total of 11 articles either from foreign or domestic sources and 723 patients with acute cerebral infarction were included, in which 305 patients underwent intra-arterial thrombolysis and 418 underwent intravenous thrombolysis. Circled digit oneThe total improvement rate of the intra-arterial thrombolysis was 70. 92% and that of intravenous thrombolysis was 61. 29%. There was significant difference between them (χ2 =4. 895,P < 0. 05). Amelioration of neurological function deficits in the intra-arterial thrombolysis group was significantly higher than that in the intravenous thrombolysis group ( OR = 1. 79, 95% CI 1. 19 -2.70, P=0. 005). ESS score within 24 hours after the thrombolysis was significantly higher in the intra-arterial thrombolysis group than that in the intravenous thrombolysis group ( WMD =7. 69, 95%CI;4. 80 - 10. 59,P <0.000 01 ). Circled digit twoThe rate of symptomatic intracranial hemorrhage in the intra-arterial thrombolysis group was 7.54% and in the intravenous thrombolysis group was 6.94%. There was no significant difference between the two groups (χ2 = 0. 096, P > 0. 7 ). There was no significant difference in thrombolytic modes in the risk of complicating intracranial hemorrhage between the two groups (OR = 1. 12, 95% CI:0. 63 - 2.01,P = 0.69). Conclusion: The efficacy of intra-arterial thrombolysis for acute cerebral infarction is superior to that of intravenous thrombolysis, and both the incidences of symptomatic intracranial hemorrhage is comparable. A large, high-quality randomized controlled trial is need for further verification.

Objective To study the influence of Salvia miltiorrhiza bge. f. alba(SMA) on apoptosis and Bcl-2 expression in human umbilical vein endothelial cell (HUVEC) in vitro. Methods HUVECs were isolated using perfusion and enzyme digestion methods, and the obtained cells were identified by morphological observation and VIII = Ag immunoreactivity examination. The cells in the exponential phase of growth were treated with H2O2 and different concentrations of SM A (high dose, 0.10 g/ml, low dose, 0.01 g/ml). The cell apoptosis was determined by flow cytometric analysis and Bcl-2 expression was examined by immunofluorescence mehtod. Results SMA significantly decreased the H2O2-induced apoptosis of HUVECs (P<0.01 in high dose group and P<0.05 in low dose group), and significantly increased the expression of Bcl-2 in high dose group(P<0.01). Conclusion SMA can inhibit H2O2-induced apoptosis of HUVEC, which might be associated with the increase of Bcl-2 expression. Salvia miltiorrhiza bge. f. alba; umbilical veins; endothelial cell; apoptosis; bcl-2 genes.

Objective To investigate the characteristics and influencing factors leading to sudden cardiac death (SCD) of incarcerated prisoners. Methods Seventy-five SCD cases of prisoners between 2000 and 2013 in Henan province were collected, and environment, psychological and physical factors were retro-spectively analyzed. Combined with histopathological results, specific factors of SCD were also studied. Results In the 75 cases, 21 cases (28%) had definite chronic past medical histories, and 75 cases (100%) had cardiovascular disease confirmed by autopsy. Conclusion Due to presence of the potential cardiac diseases, special incarcerated environment, psychological stress, and body-restraint might be the precipitat-ing factors in SCD of those prisoners.

BACKGROUND: Distractor has decided the development of distraction osteogenesis since it was applied in oral and maxillofacial surgery. How to breach the limit of traditional distraction osteogenesis lies on designing three-dimensional (3-D) distractor.OBJECTIVE: To explore the design and manufacture of 3-D external distractor for zygomatic bone.SETTING: Department of Oral and Maxillofacial Surgery, First Affiliated Hospital of Anhui Medical University.DESIGN: An experiment of the external distraction system for 3-D distraction osteogenesis.MATERIALS: The distractor was made of biological material titanium with well histocompatibility, and consisted of three parts (support, expansion and direction-change) as well as some fittings such as titanium backup plate, spanner and rubber mat, etc.METHODS: Caprine of 10 months old were selected to separate the heads and prepare for isolated zygomatic models. Zygomatic bones were generally curve and made up of four-process-in-one, with the identical formation as human being. According to principle of mechanical movement,two support plates were designed to move relatively, which transferred randomly along with two perpendicular directions. It was done to change the direction and model 3-D distraction osteogenesis on zygomatic bone of the isolated caprine cranium.MAIN OUTCOME MEASURES: 3-D transference of expansion board and whole stabilization of distractor were observed in the process of distraction osteogenesis.RESULTS: The self-prepared 3-D external distractor was 30 g. The lengthener was built to provide 3-D suture expansion osteogenesis by changing the direction. The expansion bar could be moved about 2 cm in anteroposterior axes, 3.5 cm in perpendicular axes, 3 cm in coronal axes.CONCLUSION: The 3-D distractor is simple, accurate and practicable in experimental study, and lays a foundation for clinical study in the future.

BACKGROUND: With the improvement of artificial joint materials, continuous consummation of prothesis design and the maturity of total knee replacement (TKR), excellent effects has been achieved in treatment of serious rheumatoid arthritis (RA) and osteoarthritis with TKR. At present, it is generally thought in China and abroad that staged rehabilitative treatment of step by step should be conducted as early as possible after TKR, which can promote the recovery of patient's knee joint function, and enable patients to freely care themselves so as to enhance their qualities of life.OBJECTIVE: To explain the rehabilitative treatment after TKR and relevant researches.DATA SOURCES: A computer based search of Medline database for relevant articles from January 1998 to August 2005 were conducted with the key words of "total knee replacement, rehabilitation, therapy" and the language was limited to English. Meanwhile, Chinese journal full-text database and Wanfang database were retrieved for relevant Chinese papers from January 1990 to December 2004 with the key words of "total knee replacement, rehabilitation, therapy".STUDY SELECTION: Data were checked in the first trial, accepting criteria:①Items, procedures, process and announcements in the rehabilitative treatment after TKR. ② Retrospective investigations about specific cases. Exclusive criteria: repetitive researches.DATA EXTRACTION: A total of 37 literatures in accordance with above requirements were retrieved and 22 repetitive researches were excluded.Fifteen articles were in accordance with the inclusive criteria: 3 were reviews about TKR and relevant rehabilitative treatment, 8 were clinical researches related to rehabilitative treatment after TKR, 4 were analyzing researches on relevant factors of rehabilitative treatment after TKR. Besides,there were 3 other relevant monographs.DATA SYNTHESIS: Rehabilitative treatment was extremely important to the clinical effects of TKR, which was the key reason why anticipated effects could be achieved after TKR. Exercise for power, training of motion of joint, proprioceptive sensation training and gait training were the most important contents of postoperative rehabilitation treatment. Comprehensive rehabilitative training was essential to maximum recovery of knee joint function including various agonistic muscle training plus extending and flexing power of knee joint; continuous passive training of motion of knee joint in early period plus motion of joint; proprioceptive sensation training in amelioration of motor controllability, postural rectification and balance-keep capability and gait training in correction of abnormal gait.CONCLUSION: Staged rehabilitative treatment of step by step after TKR should be conducted as early as possible, which is absolutely important to exercise for power, training of motion of joint, proprioceptive sensation training, gait training and promotion of functional recovery of knee joints in patients.

Objective To examine the effect of donepezil on cognitive function of Alzheimer's disease from a naturalistic observation in memory clinic.Methods From the subject pool in memory clinic,thirteen patients with mild to moderate Alzheimer's disease(meeting NINCDS-ADRDA criteria of probable AD)were enrolled in the naturalistic observation.Donepezil with dosage of 5 mg daily Was administered.Cognitive Ability Screening Instrument (CASI)Was used to assess the cognitive function,and was administered at baseline,3 and 6 months after treatment with donepezil.Resuits After 6-month treatment with donepezil,the change of score of verbal fluency from baseline Was significant[(4.3±3.1)vs(6.2±2.7),P＜0.05].There was a trend that constructional praxis was also improved after 6-month treatment(P=0.06).The change of scores of other cognitive domains remained the sanle(P＞0.05).Conclusion In the naturalistic observation at memory chnic,donepezil may improve verbal fluency of AD patients,and keep most cognitive function stable.