The ketogenic diet (KD) is a special diet with high-fat, low-carbohydrate and moderate amount of protein. The KD therapy is a safe, potentially effective and important treatment of refractory childhood epilepsy in recent years. It has con-ifrmed clinical efifcacy and a generally good prognosis. The adverse reactions of KD treatment are normally less and transient. In this paper, the effective rate, patient compliance, adverse reactions and their causes of KD in treating children with refractory epilepsy were reviewed.

Mycoplasma pneumoniae pneumonia (MPP) accounted for 10%-40% of pediatric community-acquired pneumonia. The clinical manifestations of MPP were complex and varied. In addition to pulmonary inflammation, , the complications with lungs and other organs had been widely reported in MPP. Although the MPP complicated with thrombus in lung, other organs and limbs was rare reported, it was serious and life threatening once thromboembolism happens,. Clinicians should pay great attention to improve the ability of early identiifcation, diagnosis, and treatment. This paper will focus on the mechanism, early identiifcation, early diagnosis and treatment of MPP complicated with thrombosis.

Rotator cuff tears are common shoulder injuries.Because of the advantages of less injury and quick rehabilitation,arthroscopic rotator cuff repair becomes one of the major methods to treat the rotator cuff tears.Postoperative rehabilitation is also as important as the operation of rotator cuff repair.

Objective To establish a new model of the Achilles tendon(AT) contraction by stress-shielding. Methods 8 SD rats were randomly divided into two groups, the normal control group and the experimental group. The ATs of the experimental group were stress-shielded by fixing the upper ankle joint in equines position using a cerclage and transecting the sciatic nerve. The control group received no treatment. All rats were killed three weeks later, and all the ATs of the left hind limbs of the experimental and normal control group were tested morphologically by transmission electron microscope (TEM). Results Compared to the normal control group, the collagen fibrils of the experimental tendons did not arrange very well. The number of tendon cells increased, and some of them were pycnotic. Some mitochondrias were swollen. The proportion of the smaller diameter collagen fibril became lager, and small and large fibrils did not distribute in even. Conclusion Our research is successful compared to the past researches and repeatable.

BACKGROUND:Stress shielding in the Achil es tendons induces over-expression of tumor necrosis factor-α. The degree of tendon contracture remains unclear after the intervention with tumor necrosis factor inhibitor.
OBJECTIVE:To investigate the effects of tumor necrosis factor-αon tendon contracture and the preventive effects of tumor necrosis factor inhibitor (etanercept) on tendon contracture by observing the morphological changes of the stress-shielded Achil es tendons after the intervention with etanercept.
METHODS:A total of 20 healthy male Sprague-Dawley rats were randomly divided into experimental and model groups after stress shielding in Achil es tendons of rat left hind limb. Five rats from either group were randomly selected, and their right hind limbs were considered as normal controls. Immediately after model induction, the rats in the experimental group were subjected with 0.6 mg/kg etanercept, and those in the model group were subcutaneously treated with 1 mL phosphate buffered saline. According to half-life of etanercept, the two groups were separately injected three times. At 2 weeks after intervention, the morphological changes of the Achil es tendons were observed using gross examination and transmission electron microscope.
RESULTS AND CONCLUSION:On gross examination, the Achil es tendons in the experimental group were significantly smoother and smal er than those of the model groups, but thicker than those of the normal control group. Under a transmission electron microscope, the col agen fibrils of the model group were looser and more disordered than those of the experimental group. The col agen fibrils of the experimental group were similar to those of the normal control group in cross section and longitudinal section. These indicated that tumor necrosis factor-αantagonist can obviously prevent stress shielding-induced tendon contracture at 2 weeks.

Aquatic plant duckweed can enrich high concentration of arsenic, it is thus used as the representative of phytofiltration.The mechanism of arsenic tolerance in duckweeds has received much concern.In this study, synchrotron radiation X-ray fluorescence (SRXRF) and X-ray absorption near edge structure (XANES) techniques were used to study the micro-distribution and speciation of arsenic in natural As-rich duckweed from lead-zinc mine.Two monolithic duckweeds, FP1 and FP2, were analyzed by micro SRXRF, setting single point scan time and spot size were 5 s, 70 μm×80 μm and 2 s, 100 μm×100 μm respectively.Six points of FP2 were selected and analyzed by micro XANES in energy range of 11.81-11.96 keV.Pressed-pellet duckweed was analyzed by bulk XANES in energy range of 11.67-12.27 keV.The result showed that As(Ⅲ) was the major speciation of duckweed from bulk XANES and micro-XANES data.SRXRF micro analysis showed that arsenic had significant vein distribution in duckweed, and was not spread into the photosynthetic mesophyll within certain concentration, which may reduce the leaf toxicity triggered by arsenic.This vein distribution may play a role in arsenic tolerance in duckweed.

Objective To observe the change of P300(EP) evoked potentials in pre-and-post acupuncture on post-stroke patientsv following depression.Methods According to Hamiltion Rating Scale for Depression(HRS-D),ninty post-stroke patients were divided into two groups: the depression group(n=63) received acupuncture at Ex-HN1 and Siguan Points and the non-depression group(n=31).After assessed and grouped by HRS-D,and one acupuncture therapeutic course for the depression group,two groups' subjects were tested with P300 potentials.Results Before treatment,the latency of P3 of P300 potentials was longer and the amplitude of P3 was lower in the patients of the depression group compared with the cases in the non-depression group;after the acupuncture treatment,the latency of P3 decreased significantly(P<0.01),and the amplitude of P3 increased significantly(P<0.05) in the patients of the depression group.Conclusion P300 potentials test can help find cognitive dysfunction in post-stroke patients following depression at early stage,and acupuncture treatment in time can lessen or eliminate depression motion of post-stroke patients.

In China , some ophthalmic new drug clinical trials used placebo as control .Two principles should be con-sidered in ethical review when placebo was used in these ophthalmic new drug clinical trials .Firstly, using placebo couldn't lead to irreversible or permanent vision loss .Secondly , there should be proper risk management in protocol and risk dis-closure in consent process .There are several important factors , including effects of standard treatment , risks of using pla-cebo, risk management in protocol and risk information in informed consent form , which should be used to assess the ra-tionality of placebo in ethical review .

[Objective] To observe the effect of stanozolol on proliferation and differentiation of cultured growth plate chondrocytes in vitro.[Methods] At 3 week of age,Sprague–Dawley rats received 2.5 mg/kg in slow-released GnRHa (triptorelin) which was repeated every 2 weeks for 2 times,at 7-week old.The tibial growth plate cartilage were aseptically dissected and tripsin and EDTA digested for 0.5 h,then collagenase digested for 3 h at 37 ℃.Chondrocytes were cultured in DMEM:F12 medium for 48 h,the cells were starved for 24 h in serum-free DMEM:F12 medium before stanozolol treatment.In dose-effect groups,chondrocytes were incubated in serum-free media in various concentrations of stanozolol for 48 h.In time-course groups,chondrocytes were incubated in serum-free media in various times of stanozolol (10-8 mol/L).immunohistochemical staining of collagen Ⅱ,Ⅹ,PCNA,and MTT were conducted.[Results] The results of MTT,PCNA,and typeⅡcollagen synthesization demonstrated stanozolol enhanced the proliferation of the chondrocytes,time-course studies had shown that the proliferation were maximally stimulated by stanozolol after 2 or 3 days of incubation and decreased again after longer periods of incubation.Stanozolol stimulated the proliferation of the chondrocytes dose-dependently at 10-11 mol/L and 10-8 mol/L,maximally stimulatory concentrations of Stanozolol was 10-9 ～ 10-8 mol/L,and decreased again after higher concentration of stanozolol.Stanozolol did not stimulated type X collagen synthesization from 10-11 mol/L ～ 10-8 mol/L,but experiments showed that type X collagen was already stimulated after incubation in Stanozolol (10-7 ～ 10-5 mol/L).Time-course studies had shown those typeⅩcollagen synthesizations were stimulated by stanozolol after 4 ～ 5 days of incubation.[Conclusion] Stanozolol enhances the proliferation of chondrocytes of pubertal female rat treated with GnRHa in vitro (time-course- dependent and concentration -dependent).

Objective To evaluate the value of single leaflet replacement of bovine pericardium in the treatment of aortic valve insufficiency using transthoracic echocardiography(TTE) and transesophageal echocardiography(TEE).Methods TTE and TEE examination were performed for 25 cases pre-operation,postpump intraoperative and 3-6 months after the operation,to judge the structure and the regurgitation of the aortic valve.And the inside diameter of left atrium(LA)and left ventricle(LV)in the same plane and the same phase were also been measured.Results The degree of aortic regurgitation(AR)before operation were significantly different with that postpump intraoperative(P＜0.001)evaluated by TEE.There was no difference in the degree of AR by postpump intraoperative TEE and those of AR by TTE 3-6 months after surgery(P＞0.1).The inside diameter of LA[(3.80±1.37)em]and LV[(5.75±1.32)cm]before repair were larger than those 3～6 months after surgery[LA(3.19±0.90)cm,LV(4.72±1.19)cm,P＜0.001].Conclusions The replacement of single aortic valve with bovine pericardium to treat aortic valve insufficiency is a good alternative for patients with satisfactory short-term results,but long-term results are not clear.