China ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Hepatitis B ; drug therapy ; Humans ; Liver Cirrhosis ; drug therapy ; Liver Diseases, Alcoholic ; drug therapy ; Phytotherapy

Adolescent ; Alkanes ; poisoning ; Alkenes ; poisoning ; Daphne ; chemistry ; Humans ; Male

Administration, Oral ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Peracetic Acid ; administration & dosage ; poisoning ; Poisoning ; diagnosis ; therapy

The refractory epilepsy refers to the epilepsy whose seizures couldn't be cured after using two kinds of correctly selected antiepileptic drugs which can be tolerated and enough dosage and duration of monotherapy or combination therapy.The pathogenesis of intractable epilepsy is complex,and there is no established theory at home and abroad.Recently,more and more attention has been paid to the correlation between mitochondrial dysfunction caused by oxidative stress and intractable epilepsy.Based on the summary of common treatment of refractory epilepsy and by searching the related literature at home and abroad,further investigation would be made to explore the diagnosis and treatment of intractable epilepsy theory in order to provide new strategies for diagnosis and treatment of intractable epilepsy.

Objective To Summarize the application of digital artery dorsal distal interphalangeal joint perforator flap to repair finger tip skin defect,and at the same time,the method and effect of anastomosis of finger dorsal branch of digital nerve sensory reconstruction.Methods From September 2012 to March 2015,78 patients 92 fingers were treated in Orthopedics Department of Jinshan Branch Hospital of the Sixth People′s Hospital of Shanghai,all patients with finger artery distal interphalangeal joint dorsal cutaneous branches of the dorsal flap pedicled with retrograde,transferred to repair the skin defect of finger end,and anastomosis of dorsal branch of the proper digital nerve reconstruction.Results Postoperative vascular crisis occurred in 8 cases,2 cases of partial flap necrosis and healed after symptomatic treatment.All flaps survived,the wounds healed in I stage,and the donor site healed in I stage.All the 73 cases were followed up,the follow-up period ranged from 3.0 to 12.0 months,an average of (7.8±2.5) months.The postoperative appearance and feel good,soft texture,abrasion resistance,no tenderness,cold resistance,dynamic two-point recovered to 4.0-8.0 mm,average (5.3±0.9) mm.Static two-point discrimination was 4.0-9.0 mm,average (5.8±1.2) mm.The method of TAM was used to determine the function of the 67 fingers,good for the 7 finger,but also for the 5 finger and the difference of the 0 finger.The excellent and good rate was up to 93.7%.Conclusion The operation without sacrifice of major arteries and nerves by finger,the middle finger dorsal skin for non functional surface area,and at the same time by anastomosis of dorsal branch of the proper digital nerve reconstruction,without surgery two times,is one of the ideal surgical repair of skin defect of the finger end.

Objective To explore the dysfunction of dendritic cells (DC) related to TGFβ reversed after blocking the TGFβ signal pathway by recombinant adenovirus vector encoding for Smad7.Methods Smad7 by recombinant adenovirus vector was transfected into dendritic cells.Expression of immunologic phenotypes was detected by FCM,and CTL activity induced by DC was compared.Results The DC modified with Smad7 still expressed high adhesiveness factor related to maturation even if existing exogenous TGFβ1,which was significant statistically compared with DC transfected with control adenoviral vector (P ＜0.01).Even if existing exogenous TGFβ1,the DC modified with Smad7 pulsed with soluble antigen associated with Lewis pulmonary carcinoma could still induce potent CTL activity against Lewis pulmonary carcinoma,which showed significant difference with DC-Ad-c (P ＜0.01).Conclusion The inhibitory effects on function of DC of TGFβ may be reversed by blocking the Smad signal of TGFβ pathway.

Objective To investigate the score changes of graduates majoring in clinical medicine after using the method of “role of identification”. Methods Sixty students who were undertaking internship in Endocrinology Department of Shanghai Traditional Chinese Medicine Hospital received three-week clinical teaching and examination. Then they got into one-week “role of identification”, and were appointed as clinical teachers to teach what they have learned during the last 3 weeks to the next batch of interns and make another examination. Scores of the two examinations were compared. Results Scores of the examination after received the method in“role of identification”improved significantly (P<0.01). Conclusion The method of“role of identification”can enhance clinical medicine graduates’ mastery of professional knowledge.

Objective Systematic evaluation of cerebrolysin in the treatment of neonatal hypoxic -ischemic encephalopathy.Methods Computer search Cochrane Library, EMBase, PubMed, Chinese Journal Full-text Database (CNKI), Chinese Biomedical Literature Database (CBM), Wanfang Database ( each database retrieval time from its creation to May 2016 ) About cerebrolysin Randomized controlled clinical trial of neonatal hypoxic -ischemic encephalopathy.According to the inclusion and exclusion criteria of the literature, the methodological quality of the included research was evaluated and the data were extracted.Metadata was analyzed by RevMan 5.3 software.Results A total of 41 RCT patients were enrolled, with a total of 3695 patients, the experimental group was 1932 cases, the control group was 1763 cases.Meta analysis showed, the efficacy of cerebrolysin in the treatment of neonatal hypoxic-ischemic encephalopathy was significantly higher than that in the control group [OR=3.85, 95% CI (3.15,4.70), P<0.000001], for the impact of clinical symptoms, the number of primitive reflexes of neonatal hypoxic-ischemic encephalopathy in the treatment group was significantly higher than that in the control group [MD=-1.22, 95% CI ( -2.06,-0.38), P=0.004], muscle tension recovery days[MD=-1.69, 95% CI ( -1.80,-1.58), P<0.00001], conscious state recovery days[MD=-1.32, 95% CI ( -2.25,-0.40), P=0.005], seizure recovery days [MD=-2.36, 95% CI ( -3.70, -1.03), P =0.0005], and other indicators were shorter than the control group, the difference between the experimental group and the control group was statistically significant.Conclusion Cerebrolysin havean effective in treating HIE.

Objective To evaluate blood flow structure and quantify the variation of the flow within left ventricle,assess the impact of chronic heart failure(CHF) by vector flow mapping(VFM).Methods Twenty-seven patients with chronic heart failure and thirty controls were involved.The flow vector images on the section plane of the flow within the left ventricle were acquired by VFM.Time-flow(T-F) curve and all other peak systolic and diastolic flow curve include normal velocity profile,parallel velocity profile,vector profile,flow profile were analyzed by DSA-RS1 program.Results Ventricular ejection peak S,rapid ventricular filling peak E and atrial systole peak A were relatively lower at basal and middle segments in CHF group than normal control group.Normal velocity profile,velocity profile,flow profile at peak S and E were lower at basal and middle segments in CHF group than normal control group.Conclusions VFM technology could provide quantitative and intuitive information to demonstrate the flow structure of the ventricle and evaluate the cardiac function in patients with CHF.

Objective To explore the mechanism of immunologic injury in patients with Tourette's syndrome(TS). Methods The serum level of anti-brain antibody ( ABAb) , antinuclear antibody ( ANAb) , soluble IL-6 receptor (sIL-6R) and soluble gpl30(sgp130) in patients with TS were analyzed by commercially available ELISA kits,and the titer of anti-streptolysin O ( ASO) in TS and in control was examined with latex enhanced immunoturbidimetry. Results The level of sIL-6R and sgpl30 was significantly elevated in TS compared with control group [(44. 1 ± 15.8)ng/mL vs (30. 3 ± 9. 0) ng/mL and (69. 0 ±24. 6)ng/mL vs (47. 3 ±14. l)ng/mL,P <0. 01 respectively]. ASO titer(250 U/mL) was found higher in TS than that in control(P <0. 01). The positive rates of anti-brain an-tibody and antinuclear antibody in TS were higher than that in control group (66% vs 4% and 53% vs 25% , P <0. 01 respectively). The level of ABAb negatively correlated with sgpl30 concentration( r = 0. 375, P <0. 05 ). Conclusion IL-6 signal transduction might be involved in Tourette's syndrome to lead the function enhancementand start cascade of feedback inhibition, because of elevated levels of slL-6R, sgp130, ANAb and ABAb in serum.Autoimmune-related injuries may potentially explain the pathogenesis of the disease.