Objective To evaluate the clinical efficiency of intermittent photic stimulation (IPS) with pattern and red color plastic plates in video-electroencephalography(EEG).Methods Three hundred and fifty-eight patients hospitalized in Wuhan Children's Hospital from March 2013 to March 2014 were selected,and they were examined by using stroboscope with a red plastic plate,a dots printed plastic plate,and ordinary white flicker for photic driving response (PDR),photoparoxysmal responses (PPR),photoconvulsive response (PCR).The results of patients with PDR,PPR,PCR were analyzed.Results The PDR synchronously evoked by the three flickering patterns were in 29 cases,and the amplitude of photic drivings evoked by ordinary white flicker and red flicker were higher than that of flickering dot pattern [(30.294 ± 7.767) μV,(31.103 ± 8.920) μV vs (24.436 ± 8.075) μV],and there were significant differences(t =2.983,2.815,P =0.003,0.008).However,there was no significant difference between ordinary white flicker and red flicker (t =0.368,P =0.710).The PPR evoked were in 17 cases,and 16 cases (94.12％) of them were evoked by red color,while 10 cases (58.82％) wcre evoked by white light,and 1 case only evoked by flickering dot pattern.However,stronger intensity and longer duration time of PPR were evoked by red color than by white light.In 3 patients with positive PCR,the epileptic seizure was more likely to be evoked by red color or pattern plastic plate.Conclusions IPS with red and pattem plastic plate is more potent in eliciting photosensitive epilepsy in video-EEG than the ordinary white light.Moreover,it could reduce the discomfort of eyes without influencing PDR in comparison to the ordinary white light.

BACKGROUND:Carboxymethyl chitosan (CMCS),a chitin derivative,has a good application performance that makes it become a safe and effective hemostatic material.OBJECTIVE:To determine the hemostatic effect of CMCS and its biosecurity properties.METHODS:(1) CMCS powder was scattered on the caudal vein and liver wounds of Sprague-Dawley rats,and the hemostatic time was recorded as experimental group,while the time for natural haemostasis of the wound was recorded as control group.(2) CMCS powder was scattered on the tail,femoral artery and liver wounds of ICR mice,and the hemostatic time was recorded as experimental group,while the time for natural haemostasis of the wound was recorded as control group.(3) CMCS,Sodium dodecyl sulfate solution and distilled water were respectively applied on the skin of albino rabbits in a skin irritation test.(4) A delayed-type hypersensitivity test of CMCS was carried out by intradermal injection of CMCS in guinea pigs.(5) An intradermal irritation test was carried out by subcutaneous injection of normal saline containing CMCS and normal saline,respectively.Another intradermal irritation test was carried out by subcutaneous injection of the supernatant of CMCS olive oil extract and olive oil,respectively.RESULTS AND CONCLUSION:(1) Compared with the control group,the hemostatic time for caudal vein and liver wounds were significantly shortened in the Sprague-Dawley rats in the experimental group (P ＜ 0.01).(2) Compared with the control group,the time of hemostasis on the tail,femoral artery and liver wounds was significantly shortened in the ICR mice in the experimental group (P ＜ 0.05 or P ＜ 0.01).(3) The CMCS had no irritation to the skin of albino rabbits and no allergic reaction to the skin of guinea pigs.To conclude,the CMCS has good hemostatic effect on the wound in Sprague-Dawley rats and ICR mice,and has no skin irritation,allergic reactions and intradermal irritation reactions in albino rabbits and guinea pigs,which is a relatively safe hemostatic material.

Objective To explore the survival,migration and differentiation of embryonic stem cells after transplantation into striatum and provide advantageous data for feasibility and safety of therapeutic transplantation. Methods We transplanted embryonic stem cells(undifferentiated ESCs and ESCs that had already developed into the stage of neural progenitor cells respectively) into striatum of the rat.Then differentiated cells were determined by morphological observation,Nissl's staining,TH and BrdU immunocytochemistry. Results We found that after transplanted 4 weeks,partially differentiated ESCs could survive and migrate into the surrounding host tissue.Some of them differentiated into TH-positive cells which had Nissl's bodies in cytoplasm.Whereas undifferentiated ESCs couldn't differentiate into TH-positive cells effectively and have the tendency to form tumor.Conclusion When conducting transplantation experiments of ESCs,it's better for ESCs to be induced into the stage of neural progenitor cells first and then transplanted.;

Objective To evaluate the efficacy of automated medication management system in increasing clinical anesthesia management specification.Methods Sixty registered anesthesiologists of both sexes in our hospital,residents or attending physicians,with 1-10 yr of work experience,were divided into 2 groups (n =30 each) using a random number table:traditional medication management mode group (group T) and automated medication management system group (group A).In the clinical anesthesia work,traditional artificial management mode was used in group T,the mode of automated medication management system was used in group A,and 2 licensed pharmacists worked in the center pharmacy of our hospital were introduced for each group.Time of taking medicine was recorded by licensed pharmacists,and the error rates of taking medicine and recording were determined by licensed pharmacists.Results Compared with group T,the error rates of taking medicine and recording were significantly decreased (P＜0.01),and no significant change was found in the time of taking medicine in group A (P＞0.05).Medication errors including taking wrong anesthesia drug,wrong prescription recording,wrong names of the common drugs and drug omission were not detected in group A.Conclusion Application of automated medication management system can reduce the occurrence of errors made in taking medicine and recording,specify medication management and increase the quality of clinical anesthesia management.

OBJECTIVETo investigate the expression of acetyl coenzyme A synthetase short-chain family member 2 (ACSS2) in patients with colorectal cancer (CRC) and its biological role.

METHODSA total of 74 CRC tissue samples and 40 normal colorectal tissues were tested by immunohistochemical staining to detect the expression of ACSS2 (cell staining intensity score: 0 points: without staining, 1 points: weak staining, 2 points: intensity staining, 3 point: strong staining; the percentage of positive cells in tumor or negative score: 0 points: negative, 1 point: <25% positive cells, 2 points: 25%-50% positive cells, 3 points: 50%-75% positive cells, 4 points: >75% positive cells. The product of above two scores was the final score.). Association of ACSS2 expression with clinicopathological characteristics was analyzed. Small interfering RNA (siRNA, including A and B group) was used to knock down the expression of ACSS2 in colorectal cell lines (Lovo, HCT116) and their proliferation, migration and epithelial-mesenchymal transition (E-cadherin and Snail as markers) after knocking down were observed.

RESULTSThe expression of ACSS2 was significant higher in CRC tissue than that in normal colorectal tissue (tumor average score 6.284, normal tissue average score 3.625, P<0.01) and the percentage of positive cell was higher than that in normal tissue (tumor 69.9%, normal tissue 45.1%, P=0.000). The use of ACSS2 siRNA successfully knocked down the expression of ACSS2 in Lovo and HCT116 cells. A mild suppression of cell proliferation was observed 5 days after planked (A450 value: Lovo-NC 1.758±0.041, Lovo-ACSS2-siA 1.485±10.026, Lovo-ACSS2-siB 1.371±0.049; HCT116-NC 2.609±0.038, HCT116-ACSS2-siA 2.260±0.042, HCT116-ACSS2-siB 2.295±0.029). While a remarkable ability decline of cell migration was found (Lovo-NC 225±5/field, Lovo-ACSS2-siA 40±5/field, Lovo-ACSS2-siB 79±3/field; HCT116-NC 198±7/field, HCT116-ACSS2-siA 96±7/field, HCT116-ACSS2-siB 77±9/field, P<0.05). Real-time quantitative PCR detection showed that in Lovo cells, expression of E-cadherin up-regulated and expression of Snail down-regulated, while in HCT116 cells, E-cadherin up-regulated slightly [E-cadherin: Lovo NC 1.000±0.211, Lovo-siA 3.403±0.207, Lovo-siB 2.658±0.420 (P<0.05); HCT116 NC 1.000±0.121, HCT116-siA 1.349±0.197, HCT116-siB 1.528±0.147(P>0.05); Snail: Lovo NC 1.000±0.085, Lovo-siA 0.468±0.030, Lovo-siB 0.499±0.088 (P<0.05); HCT116 NC 1.000±0.118, HCT116-siA 0.265±0.020, HCT116-siB 0.194±0.017 (P<0.05)].

CONCLUSIONCRC tissues have high expression of ACSS2, which may be associated with cell migration and epithelial-mesenchymal transition.

OBJECTIVESTo increase the diagnosis and treatment of ectopic ACTH syndrome.

METHODSThe data of 12 ectopic ACTH syndrome patients treated from 1985 to 1999 were retrospectively analyzed.

RESULTSTwelve patients were diagnosed as having ACTH syndrome by endocrinary test and primary tumors were ascertained by imaging examination. Follow-up from 7 months to 8 years showed 3 out of 5 patients with radical resection of primary tumor died. One patient with bilateral adrenorectomy was still alive. All patients received only chemotherapy except one died.

CONCLUSIONSPatients with Cushing's syndrome should be evaluated by endocrine test and followed up by imaging screen examination. The key points to increase treatment effect include early detection, localization and resection of primary tumors.

ACTH Syndrome, Ectopic ; Adrenocorticotropic Hormone ; Cushing Syndrome ; Humans

ObjectiveTo investigate the influence of Mycobacterium tuberculosis (MTB) co-infection and other factors on the HIV replication level in antiretroviral treatment na(i)ve patients.MethodsSix hundred TB patients and 465 HIV infectors were recruited between April 2010 and September 2010.TB coinfections were diagnosed in HIV infected cases with chest X-ray,checking TB in sputum with anti-acid staining and culture of the sputum,histopatholo diagnosis and clinical diagnosis.HIV infections were screened in TB patients with the 3rd generation ELISA antibody test.Sixty-one antiretroviral treatment na(i)ve HIV/TB co-infectors and 34 HIV infectors with CD4 T cell count below 350 cells/μl were included in this study.Information about the demography,epidemiology and results of clinical diagnostic tests of HIV and TB was collected through pathography and questionnaires from all participants.HIV viral load were detected with COBAS AmpliPrep/COBAS TaqMan(R) System of Roche Company.ResultsThe viral load of HIV/TB co-infectors was (5.05±0.93) lg copies/ml,while the viral load of HIV infectors was (5.06±0.76) lg copies/ml,after control of age,race,marital status,education,route of HIV infection,HIV clade and CD4 T cell count,there was no significant difference between the two groups (P=0.94).CRF01_AE HIV-1 infection was associated with higher HIV viral load compared with non CRF01_AE (OR=8.07,95％ CI 1.07-61.20,P=0.04).ConclusionNo obvious effect of MTB co-infection on HIV replication level of HIV infected cases with relatively low CD4 T cell count in Guangxi region,while the CRF01_AE HIV infected individuals showed higher viral load,we should raise concern on the monitoring and treatment on this population.

Objective To study the relationship and clinicopathological significance of Numb and epithelial?mesenchymal transition related proteins in human pancreatic cancer( PC)? Methods Sixty?three cases of pancreatic cancer tissues were obtained from department of gastrointestinal surgery in the First Hospital of China Medical University from January 2005 to December 2012, all samples were histopathologically proved to be adenocarcinoma? The expressions of Numb, E?cadherin and Vimentin proteins in 63 cases of pancreatic cancer specimens were detected by immunohistochemistry? Western blot and real?time PCR were used to examine the protein and mRNA levels in two pancreatic cancer cell lines?Pearson and chi?squared tests were used to analyze the relationship and clinicopathological characters with PC patients? Kaplan?Meier curve and log rank test were used to estimate the difference of PC patients′survival? Results The positive rates of Numb,E?cadherin and Vimentin expressions were 46?0%,41?3%and 28?6%, respectively? Numb expression was negatively associated with tumor size, differentiation and UICC stage( r=-0?310, P= 0?010;r=-0?359, P= 0?004;r=-0?228, P=0?020) , while E?cadherin expression was negatively related with tumor differentiation( r=-0?316,P=0?012)? In contrast,Vimentin expression was positively related with pancreatic cancer differentiation and lymph metastasis( r=0?264,P=0?036;r=0?274, P=0?030 )?Correlation analysis showed Numb had a positive association with E?cad expression( r= 0?325, P= 0?010 ) , but had no association with Vimentin? Moreover, patients with co?expression of Numb and E?cadherin had a significantly better overall survival in Kaplan?Meier univariate analysis(P=0?046)?Immunoblotting and real?time PCR showed that high Numb protein and mRNA levels in BxPC?3 cells were followed with high E?cadherin and low Vimentin expressions,whereas low Numb protein and mRNA levels in PANC?1 cells were followed with low E?cadherin and high Vimentin expressions, respectively? Conclusions Numb has a positive relationship with E?cadherin in both pancreatic cancer tissues and cells?The interaction between them might participate in the initiation and development of epithelial?mesenchymal transition in pancreatic cancer.

Objective To study the relationship and clinicopathological significance of Numb and epithelial?mesenchymal transition related proteins in human pancreatic cancer( PC)? Methods Sixty?three cases of pancreatic cancer tissues were obtained from department of gastrointestinal surgery in the First Hospital of China Medical University from January 2005 to December 2012, all samples were histopathologically proved to be adenocarcinoma? The expressions of Numb, E?cadherin and Vimentin proteins in 63 cases of pancreatic cancer specimens were detected by immunohistochemistry? Western blot and real?time PCR were used to examine the protein and mRNA levels in two pancreatic cancer cell lines?Pearson and chi?squared tests were used to analyze the relationship and clinicopathological characters with PC patients? Kaplan?Meier curve and log rank test were used to estimate the difference of PC patients′survival? Results The positive rates of Numb,E?cadherin and Vimentin expressions were 46?0%,41?3%and 28?6%, respectively? Numb expression was negatively associated with tumor size, differentiation and UICC stage( r=-0?310, P= 0?010;r=-0?359, P= 0?004;r=-0?228, P=0?020) , while E?cadherin expression was negatively related with tumor differentiation( r=-0?316,P=0?012)? In contrast,Vimentin expression was positively related with pancreatic cancer differentiation and lymph metastasis( r=0?264,P=0?036;r=0?274, P=0?030 )?Correlation analysis showed Numb had a positive association with E?cad expression( r= 0?325, P= 0?010 ) , but had no association with Vimentin? Moreover, patients with co?expression of Numb and E?cadherin had a significantly better overall survival in Kaplan?Meier univariate analysis(P=0?046)?Immunoblotting and real?time PCR showed that high Numb protein and mRNA levels in BxPC?3 cells were followed with high E?cadherin and low Vimentin expressions,whereas low Numb protein and mRNA levels in PANC?1 cells were followed with low E?cadherin and high Vimentin expressions, respectively? Conclusions Numb has a positive relationship with E?cadherin in both pancreatic cancer tissues and cells?The interaction between them might participate in the initiation and development of epithelial?mesenchymal transition in pancreatic cancer.

OBJECTIVETo summarize the experience of minimally invasive treatment in 520 patients with intracranial aneurysms on a retrospective study.

METHODSThe measures used in the treatment of 520 patients were reviewed in terms of timing of surgery, induced-hypotensive anesthesia, brain protection combined with temporal occlusion of the feeding artery, external drainage of CSF, dynamic monitoring of intracranial pressure, blood flow velocity, serum osmolality and CT scanning, anti-vasospasm therapy as well as selected interventional endovascular embolization of aneurysms.

RESULTSOf the 520 patients, 485 were treated with either direct clipping or endovascular embolization and 35 patients were treated non-surgically. In 449 patients undergoing direct clipping and 36 undergoing endovascular embolization, intraoperative rupture of aneurysm occurred in 27 (6.0%) and 0%, respectively. Death occurred in 13 (2.6%), hemiplegia in 8 (1.6%), and vegetative state in 2 (0.4%). The operative mortality of direct clipping was 3.8% in 210 patients before 1990 and 1.8% in 275 patients after 1990 (36 patients undergoing endovascular embolization, the operative mortality was 0%).

CONCLUSIONThe outcome of patients with intacranial aneurysms can be markedly improved and the operative mortality can be lowered by minimally invasive treatment.

Adult ; Aneurysm, Ruptured ; mortality ; therapy ; Embolization, Therapeutic ; Female ; Follow-Up Studies ; Humans ; Intracranial Aneurysm ; mortality ; surgery ; Intraoperative Complications ; mortality ; Male ; Microsurgery ; Middle Aged ; Minimally Invasive Surgical Procedures ; Retrospective Studies ; Survival Rate ; Treatment Outcome