Objective To analyze the clinical features,treatment and prognosis of children with post-stroke epilepsy.Methods Sixty-nine children with epilepsy after cerebral stroke who were admitted to Guangdong General Hospital from Jan.2009 to Mar.2013 were retrospectively reviewed,including etiology,clinical features,laboratory examinations,treatment and prognosis.Results Among 260 stroke patients,69 of them (26.5 ％) developed epilepsy,but there was no significant difference between boys and girls(x2 =0.725,P =0.394).The incidence of post-stroke epilepsy differed significantly among different types (x2 =12.000,P =0.02),highest in the children with subarachnoid hemorrhage(47.8％,11/23 cases),followed by those with cerebral hemorrhage (34.6％,27/78 cases),and lastly,those with cerebral ischemia (19.5％,31/159 cases).Among them,53 patients developed seizures in the early stage (76.8％,53/69 cases),others in the late stage(23.2％,16/69 cases),early-onset epilepsy was more common in hemorrhagic stroke and late-onset epilepsy was more common in ischemic stroke,which differed significantly(x2 ＝ 4.778,P =0.029).The electroencephalogram background generally showed slow-wave in the early-onset epilepsy.The composition of seizure types differed significantly among different types of stroke (x2 =8.461,P =0.015).Forty-five of 58 patients (77.6％) suffered from cortical lesions and 13 of 58 patients (22.4％) suffered from subcortical lesions.Those children with post-stroke epilepsy who regularly use of antiepileptic drugs were followed up for 6 months to 4 years,81.2％ (56/69 cases)of clinical seizures were controlled.Conclusions The incidence of epilepsy after stroke is higher in children than in adults,cerebral stroke seizure occurs more commonly in cases with hemorrhagic stroke,especially with subarachnoid hemorrhage.Conventional antiepileptic treatment is effective.

CT data regarding PUMCⅡ d2 adolescent idiopathic scoliosis obtained from one female patient were input into modeling software minics 11.11 to obtain medical simulation model.Then finite element analysis models of AIS patients (T1-S) were created by introducing simulation models into software abaqus 6.7.Finite element models of T6 11 segments were corrected by 5 different correction methods:simple concave bracing,simple convex pressurization,concave distraction and convex compression simultaneously,concave distraction prior to convex compression and concave distraction after convex pressurization.Abaqus software was used to simulate correction of scoliosis with vertebral arch pedicle screw by loading 50 N,100 N,and 200 N distraction forces on the concave side pedicles of the end vertebrae T6 and T11.The displacement of vertebrae T6 in Y-axis (sagittal plane) and Z-axis (coronal plane),which respectively represented the correction effects of kyphosis and scoliosis,was compared between prior to and after correction.Simple concave distraction provided better outcomes in terms of displacement of T6 in Z-axis than the remaining four methods (P ＜ 0.01).Concave distraction and convex compression simultaneously,concave distraction prior to convex pressurization and concave distraction after convex compression produced identical displacements of T6 in Y-axis,which were all better than simple concave distraction (P＜ 0.01).The present findings imply that for curative effects of five methods on correction of scoliosis in the coronal plane:simple concave distraction＞ concave distraction and convex compression simultaneously = concave distraction prior to convex compressio= concave distraction after convex compression ＞ simple convex pressurization;for curative effects of five methods on correction of kyphosis in the sagittal plane:simple convex compression ＞ concave distraction and convex compression simultaneously = concave distraction prior to convex compression= concave distraction after convex compression＞ simple concave bracing.Simple concave distraction could not produce obvious corrective effects on kyphosis rather than lead to worsened kyphosis to some extent.Simple convex compression could not produce obvious corrective effects on scoliosis rather than result in aggravated scoliosis to some extent.

ObjectiveTo explore the relationship between serum sCD40L level and coronary stenosis degree in acute coronary syndromes(ACS) patients with different glucose tolerance conditions.Methods154 patients with ACS were divided into normal glucose tolerance group ( NGT),impaired glucose tolerance group (IGT) and type 2 diabetes group (T2DM) according to the OGTT.The levels of serum sCD40L were detected by ELISA,and all patients underwent coronary angiography in order to calculate their Gensini score.Then the relationship between serum sCD40L level and coronary stenosis was analyzed by statistics.ResultsThe Gensini scores of IGT[(41.8 ± 19.8)score] and T2DM groups [(40.1 ± 18.7)score] were higher than NGT group [(21.9 ± 15.3)score] ( P ＜0.01 ),but there was no statistical difference between IGT and T2DM ( P ＞ 0.05 ) group.The serum sCD40L levels of IGT[(2.46 ± 0.79 )ng/ml]were higher than NGT group [(2.12 ± 0.81 )ng/ml] ( P ＜ 0.05 ),and the serum sCD40L levels in T2DM group [( 2.57 ± 0.68) ng/ml] were obviously higher than NGT group [( 2.12 ± 0.81 ) ng/ml] ( P ＜ 0.01 ).The serum sCD40L levels in T2DM group were higher IGT group,but there was no statistical difference between T2DM and IGT groups( P ＞0.05).Statistical analysis revealed that serum sCD40L levels had no statistical difference among the three groups and it had no relationship with coronary stenosis ( r =-0.147,P ＞0.05).ConclusionsCD40/CD40L activation would occur in the patients of ACS with wildly abnormal blood sugar,not only in those who had diabetes with much higher blood sugar.The serum sCD40L level in the ACS patients with abnormal glucose tolerance had no relationship with the severity of coronary stenosis.

Objective To discover T cell reactive peptides of mycobacterium tuberculosis antigen Rv2608 for treatment or adjuvant treatment for tuberculosis.Methods The T cell epitopes of Rv2608 were predicted by bioinformatics.The long-chain peptides were screened with strong affinity with HLA-A0201,HLA-A1101,and HLA-A2402.The physical and chemical characters of the peptides were predicted.The stable and hydrophilic peptides for chemical synthesis were selected.The T cell reactivity of the peptides in patients with active tuberculosis was detected by ELISPOT.The results were compared with the clinical diagnosis kits TSPOT.TB.Results Four peptides of Rv2608 were predicted and screened,and they could be active T cells of patients with active TB.Rv2608p3 was the most efficient to prime the T cell response.Conclusions Software prediction was consistent with the result of ELISPOT.Rv2608p3 might be the candidate for therapeutic vaccine for tuberculosis.

Adolescent ; Adult ; China ; epidemiology ; Humans ; Middle Aged ; Motor Activity ; Rural Population ; Suburban Population ; Urban Population

Objective:To explore the relationship between CD244 and the phenotype and function of CD56bright NK cells of patients with active pulmonary tuberculosis.Methods: PBMCs were isolated from peripheral blood by density gradient centrifugation.The expression of CD244,CD94,NKG2D on the CD56bright NK cells from the active pulmonary tuberculosis patients and healthy controls was detected by flow cytometry.And then analyzed the relationship of the expression of CD244 with Tim3,CD27,CD62L,CCR7,IFN-γ and CD107a in CD56bright NK cells by flow cytometry.Results: The expression of CD244 on the CD56bright NK cells showed no significant difference between the patients with active pulmonary tuberculosis and healthy controls without MTB antigen.The expression of CD244 was significantly increased on CD56bright NK cells of patients with tuberculosis stimulated with MTB antigen.The expression of CD94 and NKG2D on CD56bright NK cells showed no difference between patients and healthy controls.The proportion of Tim3+ cells in CD244+CD56bright NK cells was significantly higher than CD244-CD56bright NK cells.While the expression of CD62L and IFN-γ decreased significantly in CD244+CD56bright NK cells.The expression of CD107a on CD56bright NK cells was not significantly different between CD244+ cells and CD244-cells.Conclusion: The expression of CD244 on CD56bright NK cells in patients with active pulmonary tuberculosis increased significantly,maybe inhibit IFN-γ co-work with Tim3.CD244 has nothing to do with degranulation of CD56bright NK cells.

Objective: To describe the status and trend of dietary energy, protein and fat pattern of Chinese residents. Method : 23 470 households including 68 962 subjects were randomly sampled from 132 counties in 31 provinces, autonomous regions and the municipalities. The 24 h dietary recall method for 3 consecutive days was used in dietary survey and weighing method was used for condiment intake. Results: The average energy intake per reference man per day was 9.42 MJ (2 250.5 kcal), 11.8% and 29.6% from protein and fat respectively. The percentages of energy from fat of big city residents arrived 38.4%. The percentages of energy from cereals, animal food and pure energy food were 57.9%, 12.6% and 17.3% respectively. The average protein intake per reference man per day was 65.9 g, 52%, 7.5% ,25.1% and 15.3% from cereals, bean and bean product, animal food and other foods respectively. The average fat intake per reference man per day was 76.3 g, 39.2% from animal food. Conclusion: The dietary change of Chinese residents represents the characteristics of the transition period, including the decrease of energy and protein intake per capita, decrease of the percentage of dietary energy supplied by cereals and increase of fat intake per capita,especially from animal foods, and the proportion of energy contributed by fat.

Objective To study the correlation between the level of CaMKIV and essential hypertension (EH) in Shihezi community. Methods One hundred and forty-six patients with EH and 142 with normal blood pressure are enrolled from 15 communities in shihezi. We collected the clinical data, including blood pressure, body mass index, waist circumference, blood lipids. The serum level of CaMKIV was detected using an enzyme linked immunosorbent assay. Results The serum level of CaMKIV in the EH group was significantly lower than that in the normal blood pressure group (P < 0.05). The serum CaMKIV was negatively correlated with systolic BP and diastolic BP (r = -0.304, -0.452, all P < 0.05), with more obvious correlation with patients whose diastolic blood pressure was over 100 mmHg (r = -0.571, P < 0.05). Conclusions The serum level of CaMKIV is negatively correlated with EH, which is an independent factor of EH.

OBJECTIVETo study the changes in 24-hour video electroencephalogram (EEG) and epileptic attacks after levetiracetam add-on therapy in children with frontal lobe epilepsy and epileptiform discharges.

METHODSA prospective study was carried out in 105 children with the frontal lobe epilepsy who received long-term treatment with 1 or 2 types of antiepileptic drug but still with epileptiform discharges in ECG. Levetiracetam add-on therapy was administered at the initial daily dose of 20 mg/kg (given in 2 doses) for 2 weeks followed by an increase of the dose to 30 mg/kg with a maintenance dose of 30-40 mg/kg. The changes in seizure attacks and 24-hour video-EEG monitoring after a 6-month therapy were observed.

RESULTSLevetiracetam add-on therapy reduced epileptiform discharges in 55 children (52.3%) and resulted in significant changes in EEG (P<0.05). Of the 77 children with clinical seizures, complete seizure control was achieved in 12 cases after the therapy, and the seizure attacks were reduced in 28 cases, showing a total response rate of 51.9%; the reduction in seizure attacks was positively correlated with EEG improvement (P<0.001).

CONCLUSIONLevetiracetam add-on therapy can decrease epileptiform discharges in EEG and reduce clinical seizure attacks in children with frontal lobe epilepsy with only mild adverse reactions.

Adolescent ; Anticonvulsants ; administration & dosage ; therapeutic use ; Child ; Child, Preschool ; Electroencephalography ; Epilepsy, Frontal Lobe ; drug therapy ; physiopathology ; Female ; Humans ; Infant ; Male ; Piracetam ; administration & dosage ; analogs & derivatives ; therapeutic use ; Prospective Studies ; Treatment Outcome

Objective:To compare the clinical, pathological features and prognosis of patients who underwent pancreaticoduodenectomy with standard or extended lymph node dissection for pancreatic ductal adenocarcinoma.Methods:A retrospective study was performed on 158 pancreatic head cancer patients who underwent radical resection at the First Affiliated Hospital of Nanjing Medical University from Jul 2017 to Feb 2019. The clinicopathological characteristics and prognosis between the standard dissection group and the extended dissection group were compared. The relationship between the number of examined lymph nodes, positive lymph nodes, and the lymph node ratio, together with their relationship with survival were analyzed.Results:Survival analysis showed no statistical difference in survival between the standard resection group and the extended resection group ( P=0.99). There were statistical differences in gender and age composition between the two group, but no significant differences in operation time, blood loss, or postoperative complications were found. Patients with less examined lymph nodes tended to be of stage N0. examined lymph nodes is positively correlated with positive lymph nodes but is not significantly correlated with lymph node ratio. Positive lymph nodes is strongly correlated with lymph node ratio. The location of lymph node metastasis was not survival-related. Conclusions:There is no prognostic difference between standard lymph node dissection and extended lymph node dissection in pancreatic cancinoma patients after Whipple procedure.