Objective To explore the risk factors in children with epilepsy and their effects on attack rate of epilepsy.Methods One hundred and sixty epilepsy patients(patient group,88 boys and 72 girls)and 150 healthy children(control group,72 boys and 78 girls)were selected.All children conformed epilepsy at the west China second hospital were consecutively included in the study for 6 months period.The range of age was from 1 month to 16 years[(7.0?4.7)years old] of patient group children.All children with epilepsy had no-causation seizure for more than twice time and were diagnosed by electroencephalogram.Neurologically normal children in same period,matched for age and sex,visiting the health care clinic were selected as controls.The range of age was from 2 month to 16 years [(6.3?4.5)years old] of control group children.The risk factors examined were febrile convulsions,head trauma,central nervous system infections,abnormal perinatal history,family history of epilepsy and parental consanguinity.The data of patients and controls were obtained from a questionnaire through personal interviews.Details on the patient,family history,and parental age at the time of childbirth were included.Medical records were then reviewed.According to the data type,the statistics were performed with ?2 test and the significance level was the P

Objective To investigate the feasibility and efficacy of the intensity modulated radiotherapy (IMRT) with oral S-1 for locally advanced pancreatic cancer.Methods Forty-two patients with locally advanced pancreatic cancer were selected,and the patients were divided into 2 groups by random digits table method with 21 cases each.The patients in treatment group were treated by IMRT combined with oral S-1 40 mg/m2 twice daily from day 1 to day 14 of a 21-d cycle;the patients in control group were treated by IMRT combined with 30 min intravenous infusions of gemcitabine 1 000 mg/m2 on day 1,8,21 and 29.Radiation was concurrently delivered at a dose of 50.4 Gy (1.8 Gy/d,5 times per week,28 fractions).The dose of intensity modulated radiotherapy was 1.8 Gy/time (5 times/week,50.4 Gy/28 times).The recent curative effect and untoward reaction were assessed at the end of radiotherapy after 4 weeks.Results There were no statistical differences in efficient rate and disease control rate between treatment group and control group:57.1％ (12/21) vs.47.6％ (10/21) and 85.7％ (18/21) vs.76.2％ (16/21),P ＞ 0.05.The neutropenia rate and thrombocytopenia rate in treatment were significantly lower than those in control group:23.8％ (5/21) vs.57.1％ (12/21) and 28.6％ (6/21) vs.66.7％ (14/21),and there were statistical differences (P ＜ 0.05).There were no statistical differences in the incidences of anemia,nausea,vomiting,elevated aminotransferase and fatigue (P＞ 0.05).Conclusions The IMRT with oral S-1 for locally advanced pancreatic cancer is safe and effective.It is worthy of clinical promotion.

Objective To retrospectively investigate the clinical features of localized primary small bowel stromal tumors (SBSTs) and the impacting factors for prognosis.Methods The clinical and pathological data of 89 consecutive SBSTs patients,with pathologically confirmed,who underwent complete resection in Ruijin hospital between January 2003 and September 2007 were collected and analyzed.All patients were followed up for assessment of tumor recurrence and metastasis.The impacts of clinical and pathologic factors on rate of disease free survival (DFS) of the patients was evaluated.Results In total of 89 follow-up patients,15 patients were diagnosed with tumor recurrence and 9 of them died.The tumor size,mitotic index and pathological risk stratification were statistically related with DFS (P=0.000,P=0.006,P=0.000,respectively) by using Kaplan-Meier univaritate analysis.Tumor size and mitotic index were proved to be independent prognostic factors for tumor recurrence by multivariate analysis COX regression model.Conclusions Tumor size and mitotic index are related with tumor recurrence,and can be regarded as independent predictive factors of tumor recurrence.

ObjectiveToexplore the appearance ofmusclecrushinjuryatquantitative ultrasonographic elastography by supersonic shear imaging (SSI).MethodsThe animal experiment was done using a special balloon cuff device to create left hind leg crush injury with a force of 18.6 kPa.Twentythree New Zealand rabbits had crush injury of extremity and survived for 72 hours.SSI quantitative elastography was performed in crushed and no-crushed regions of each rabbit hind leg.Quantitative lesion elasticity was measured in terms of the Young modulus (in kilopascals) at 30 min,2 h,6 h,24 h and 72 h after the release of the crushing pressure.A receiver operating characteristic (ROC) curve analysis was used to assess diagnostic performance.ResultsThe area of crushed region in left hind leg accounted for 2.6％ -3.0％ of body surface area in 23 rabbits.The crushed regions exhibited maximum elasticity values of (19.51 ± 6.74)kPa,(21.47 ± 5.54) Pa,(11.36 ± 5.35)kPa,(15.09 ± 3.31)kPa and (13.72 ± 3.74) kPa,and mean elasticity values of (12.44 ± 3.77)kPa,(13.20 ± 3.60)kPa,(6.80±2.86)kPa,(10.04 ± 2.95)kPa and (6.94 ± 0.97)kPa at 30 min,2 h,6 h,24 h and 72 h after the release of the crushing pressure.Comparing with those of no-crushed regions,they were higher obviously (P＜0.001).ROC curves showed that extremity crush injury was diagnosed by using elasticity value,and the greater the elasticity value,the greater the diagnostic value.Conclusions SSI provides quantitative elasticity measurements,thus adding complementary information that potentially could help in crush injury characterization with conventional ultrasonography.

Objective Through exploring the concordance of objective multi-parameters analysis and perceptual evaluation,to establish an objective multi-parameters evaluation protocol of voice disorder and to make the evaluation of voice objectification and quantification. Methods Voice samples from 271 patients ( 124 female and 147 male)with dysphonia and 69 control subjects with normal voice (37 female and 32 male)were recorded and assessed by a jury composed of 5 experts in phoniatrics from different hospitals.The jury was instructed to classify voice samples according to the G (grade) component of the GRBAS scale on a visual analogue scale secondarily transformed in a 4-point scale ranging from 0 for normal to 3 for severe dysphonia. The voice samples were unified sentences and ordered randomly 3 times,the mean of 3 evaluation scores were the final results.The objective parameters,including fundamental frequency ( F0),jitter,shimmer,fundamental frequency standard deviation (FOSD),normalized noise energy (NNE),harmonic-to-noise ratio (HNR) and maximal phonatory time ( MPT),were measured on a 2-second sustained vowel/a/ including its initial segment,using the software Dr.Speech for Windows.The data were analyzed using SPSS11.0.Results All objective parameters except for F0 had high correlation with G and the variance tendency of these parameters values was coherent with the extent of voice disorder.And there were statistical differences between adjacent voice disorder groups. Male and female objective multi-parameters protocols were established respectively consisting of jitter,shimmer,FOSD, NNE,HNR and MPT using discriminant analysis ( P ＜ 0.05 ). The concordance between perceptual evaluation and objective multiparameters evaluation was 81.6％ in male and 83.2％ in female.The concordance of evaluation of normal voice and severe voice disorder groups were better than that of mild and moderate voice disorder groups.All mis-grading voices were judged in the adjacent voice group.Conclusions The objective parameters of voice are able to reflect the characteristic of its perceptual evaluation and the concordance between perceptual evaluation and objective multi-parameters evaluation is good. The objective multi-parameters evaluation protocol we established could provide an objective and quantitative evaluation method for voice disorders.

Aged ; Bronchoscopy ; Esophageal Neoplasms ; complications ; Female ; Humans ; Male ; Middle Aged ; Stents ; Thyroid Neoplasms ; complications ; Tracheal Stenosis ; etiology ; therapy

Objective To investigate the feasibility of reducing bolus?tracking monitor frequency in coronary CT angiography (CTA). Methods This prospective study including 120 patients with suspected coronary artery disease (CAD). According to the examination registration order, the patients were divided into groups A, B and C (n=40 for each group). All patients underwent coronary CTA with bolus?tracking technology, and were monitored at 10 s after the injection of contrast. The monitoring frequency of bolus?tracking for Group A was every 1.14 s, that for Group B was every 1.47 s , and for Group C was every 2.00 s, while the trigger threshold was set as 100 HU. To evaluate the image quality, the objective evaluation included signal noise ratio (SNR) and contrast noise ratio (CNR) of aorta (AO), CNR of left main coronary artery (LM) and right coronary artery (RCA), and the subjective score was recorded for each coronary artery segment. The monitoring times when CT density of the region of interest (ROI) reached the threshold, the CT value and the effective dose (ED) in the 3 groups were recorded. Objective image quality, monitoring parameters and radiation dose were compared using analysis of variance method, subjective image quality was compared withχ2 tests. Results There was no significant difference in AO (SNR and CNR), LM (CNR) and RCA (CNR) among the 3 groups, respectively (P>0.05). Subjective image quality scores of groups A, B, C were (1.879±0.042), (1.876±0.042), (1.881±0.042 ), with no significant difference (χ2=0.003,P>0.05). The monitoring times of to reach the threshold in groups A, B, C were (4.78±2.37), (3.76±1.39), (2.77±0.99), and ED were (0.058±0.031),(0.031±0.011), (0.021±0.007) mSv, with the significant difference (F=9.009, 31.998, respectively, P<0.01). Peak CT values during monitoring among three groups were (133 ± 24), (142 ± 39), (137±26) HU, respectively, with no significant difference (F=0.575,P=0.565). Conclusions It is feasible to reduce monitoring times when performing coronary CTA in dual?source CT scanner. The bolus?tracking monitor frequency in every 2 seconds can not only obtain satisfactory image quality, but also significantly reduce radiation dose.

Objective To study the expression of BRMS1mRNA in human breast cancer tissues and their significance.Methods The expression of BRMS1mRNA was detected by reverse transcription-polymerase chain reaction(RT-PCR) in 71 breast cancer tissues and adjacent breast tissues,12 patients with benign breast tumors and 12 patients with normal breast tissue,and semi-quantitative analysis of band densities was also performed.Results The expression of BRMS1mRNA in 71 patients with breast cancer and adjacent breast tissue was 0.378?0.046 and 0.918?0.044,respectively;the expression of BRMS1mRNA in 12 patients with benign breast tumors and 12 patients with normal breast tissue was 0.908?0.047 and 0.934?0.028 respectively.BRMS1mRNA expression was significantly lower in breast cancer tissue compared to adjacent breast tissue,benign breast tumors and normal breast tissue(P0.05),but was related to axillary lymph node metastasis and clinical stage(P

Background With the widely application of phacoemulsication for cataract,dry eye-associated symptoms,such as foreign body sensation and burning frequently occur after cataract surgery in some patients.Objective This study was to evaluate the repair effects of recombinant human epithelial growth factor (rhEGF) on ocular surface injuriy after phacomulsification. Methods This was a prospective study,and informed consent was obtained from each subject before the experiment.One hundreds and twenty eyes of 89 consecutive patients after phacomulsification for age-related cataract were collected and randomized into rhEGF group,hyaluronic acid group and control group and 40 eyes for each.RhEGF drops and hyaluronic acid drops were topically administered 4 times per day for consecutive 4 weeks after surgery in corresponding group,and no drops mentioned above was used in the control group.The 0.3％ ofloxacin eye ointment and tobramycin+dexamethasone drops were used as the element drops in all patients of each group.Corneal fluorescein staining score,tear film break-up time ( BUT),Schrimer Ⅰ test without topical anesthesia were performed 1 day before surgery and 1 day,1 week,2 weeks and 1 month after surgery.Results The demography and the relevant surface examinational outcomes were no significantly different among the rhEGF group,hyaluronic acid group and control group in preoperation (age:F =3.74; gender:x2 =0.615; corneal fluorescein staining:F =0.247 ; BUT:F =0.579 ; Schrimer Ⅰ test:F =0.475 ; all P＞ 0.05 ).With the prolong of the time,the corneal fluorescein staining scores and Schrimer Ⅰ test values appeared a early ascent and latterly decline,and the BUT value showed a early shorten and latterly restore,with a statistically significant differences among various time points( F时间 =6.754,6.079,6.233,P＜0.01 ).Meanwhile,statistically significant differences were found in the corneal fluorescein staining scores,Schrimer Ⅰ test values and BUT among these 3 groups (F分组 =4.953,4.511,4.071,P＜0.05 ).The corneal fluorescein staining scores in the rhEGF group were significantly lower than those in the hyaluronic acid group at 2 weeks and 1 month after operation(P=0.039,0.014),and the BUT values in the rhEGF group were significantly longer than ones in the hyaluronic acid group at 1 week and 2 weeks after operation (P =0.019,0.007).The Schrimer I test values were significantly reduced in the rhEGF group compared with hyaluronic acid group at 1 week,2 weeks and 1 month after operation (P=0.022,0.003,0.019). Conclusions RhEGF promotes the repair of the ocular surface injury in the patients with age-related cataract after phacomulsification.

Objective To evaluate the efifcacy and safety of hemostatics of injected gelatin matrix (HIGM) under the guidance of contrast-enhanced ultrasound (CEUS) for treating splenic trauma in canine model. Methods A total of 24 commercial hybrid dogs underwent celiotomy with creation of uniformly blunt splenic trauma lesion of 4.0 cm×4.0 cm×2.5 cm (length, width and depth, respectively) by hemostatic clamp. Subjects were prospectively randomized into two groups. The treatment group was treated with HIGM under the guidance of CEUS and the positive control group received thrombin solution. Conventional ultrasound and CEUS were performed to record the ascites and the splenic lesion areas at 1st, 3rd, 7th, 14th and 21st day. The ifne needle biopsy and splenectomy were performed for histopathologic examination. The weight, free intraperitoneal lfuid and injury site were compared with t test between HIGM and postive group. Results All animals in two groups survived. All dogs stopped hemorrhage after injection of HIGM under CEUS guidance. The area of injury site was (12.91±0.89) cm2, (4.45±0.75) cm2 and (1.38±0.23) cm2 at 1st, 3rd and 7th day and splenic lesions were not found at 14th and 21st day in all dogs (n=12) of HIGM group. The splenic lesion was (16.74±0.91) cm2, (11.26±0.99) cm2, (8.02±0.82) cm2 and (1.58±0.36) cm2 in the postive group at 1st, 3rd, 7th and 14th day and splenic lesions were not found at 21st day in all dogs (n=12). At 7th and 14th day post-injection, lesion areas were statistically significant between two groups (t=27.162, P=0.008;t=15.129, P=0.001). Free intraperitoneal lfuid was (0.91±0.05) cm at 1st day detected by conventional ultrasound and free intraperitoneal fluid was not found at 3rd, 7th, 14th and 21st day in all dogs (n=12) of HIGM group. The free intraperitoneal fluid in thepositive group was (1.96±0.17) cm, (1.30±0.11) cm and (0.81±0.12) cm at 1st, 3rd and 7th day and free intraperitoneal lfuid was not found at 14th and 21st day in all dogs (n=12). At 1st, 3rd and 7th day post-injection, free intraperatitoneal lfuid was statistically significant between two groups (t=20.934, P=0.003; t=41.310, P=0.000; t=22.520, P=0.000). Histopathological examination showed that there was no foreign body and foreign body granuloma and the structure of red pulp was recovered at 7th, 14th and 21st day. Gross anatomy showed that the splenic injury site was recovered completely without complications. Conclusion This study explored the value of HIGM for splenic trauma and provided a preliminary experimental evidence for clinical treatment.