Epilepsy is one of the common diseases in the nervous system with its complicated pathogenesis still remains unknown.The drug resistance mechanism of intractable epilepsy has always been a key point in the research of neuroscience.A possible cause for the drug resistance is the over expression of efflux drug transporters,e.g.ATP-binding cassette transporters,which may decrease extracellular antiepileptic drugs levels in brains of intractable epilepsy patients.ATP-binding cassette transporters are super family of transporter proteins that require ATP hydrolysis for the transport of substrates across membranes,including P-glycoprotein,multidrug resistance-associated protein,major vault protein and breast cancer resistance associated protein.They are major impediment for the AED successful treatment of many forms of refractory epilepsy in human.This paper reviews the research progress on over-expression of ATP-binding cassette transporters and mechanism of drug resistance in intractable epilepsy.

Objective To evaluate the value of serum granulocyte colony-stimulating factor(G-CSF),interlukin-8(IL-8)and white blood cell count(WBC)in detecting acute surgical bacterial infections.Methods A total of 36 patients with infections and 32 with traumatic diseases admitted in Beijing Tongren Hospital without use of antibiotics before admission were recruited,as well as 30 normal healthy controls.Three milliliters of peripheral blood were collected from each of them.Serum G-CSF and IL-8 were measured by enzyme-linked immunosorbent assay(ELISA).Results Of all the 68 patients,serum G-CSF Was(82±71)ng/L in average in those with infections,significantly higher than that in those with trauma(15±7)ng/L(P＜0.01)and controls(7±4)ng/L(P＜0.01).Conclusions Serum G-CSF may be used as a sensitive indicator for acute surgical bacterial infections.

In recent years,morbidity of thyroid carcinoma is rising,but its mortality decreased because of the standardized diagnosis and treatment.Pecially to the development and improvement of the surgical treatment.In this field,there has not reached the common understanding at present.In this article we review the extent of surgery,re-operation of the thyroid carcinoma,neck lymph dissection,131I ablation and thyroid hormone suppression therapy.

Objective To explore the optimal treatment options of Stanford type B aortic dissection. Methods A to?tal of 51 patients with Stanford type B aortic dissection who visited the General Hospital of Tianjin Medical University from May 2008 to March 2013 were analyzed retrospectively. Survival and recovery of patients were evaluated by follow ups. Pa?tients were divided to TEVAR group(40 cases)and conservative group(11 cases)according to the treatment they recieved. Results Operations were successful in all 40 patients. There were two cases of perioperative death(5%). And none of pa?tients died in TEVAR group during follow-up. One case among 11 patients who received conservative treatment dead in hos?pital(9.1%)while other 7 cases died during follow-up(63.6%). Kaplan-Meier survival curve showed that two-year survival rate of TEVAR group was significantly higher than that of conservative group. In TEVAR group, the maximum diameter of the aorta presented a decreasing trend and thrombosis was seen in artificial lumen with time going after operation. Conclu?sion For patients with Stanford type B aortic dissection, TEVAR presented a high success rate and promoted remodeling of the aortic genuine and aritificial lumen. What’s more, it can significantly improve patient’s survival rate and recovery in short or mid-term period compared with effect of traditional conservative treatment.

To assure the clinical quality and requirement of CT shelter used in field environment, the factors related with the practical application were studied. The evaluation indicators of CT equipment were investigated. Based on the technical modification of vehicle shelter CT, the scanning conditions of shelter CT were analyzed. Moreover, the comparative study was done between shelter CT and common CT in hospitals. In result, in order to meet maneuverability application in the field, vehicle shelter CT was restrictive by the field conditions, traffic impacts and running requirement. The application of vehicle shelter CT was affected by the factors, such as mechanical stabilization, moving precision, power fluctuations and variations of temperature and humidity, etc. The results were helpful to improve the clinical quality of vehicle shelter CT and made a base for the quality control study in the future.
Humidity ; Temperature ; Tomography, X-Ray Computed ; instrumentation

Actins ; metabolism ; Angiotensins ; pharmacology ; Animals ; Breast Neoplasms ; blood supply ; drug therapy ; metabolism ; pathology ; Cell Proliferation ; Female ; Fibroblasts ; metabolism ; pathology ; physiology ; Humans ; Interferon-gamma ; therapeutic use ; Neoplasm Invasiveness ; Neoplasm Metastasis ; Neovascularization, Pathologic ; Prognosis ; Transforming Growth Factor beta1 ; metabolism

The reverse problem of Electrical impedance tomography(EIT) is a highly ill-posed problem.It is concluded that spatial prior information could improve the final image quality.This paper proposes a new method for obtaining prior information.By this method,the inspected cross-section contour and internal structure for EIT can be achieved.

Objective To evaluate the correlation between the elastic modulus of prostate and the degree of bladder outlet obstruction (BOO) in benign prostatic hyperplasia (BPH) patients in order to build a new non-invasive diagnostic indicator for BOO.Methods From november 2011 to November 2012,a total of 34 BPH patients were enrolled in this prospective study.Clinical information of the patients including age,international prostate symptom score (IPSS) and quality of life (QOL) were collected.The morphological features of prostate including total prostate volume,transitaion zone volume and transition zone index were detected by transrectal ultrasound (US),and prostate elastic modulus was detected using shear wave sonoelastograhy.After US examination,urodynamic study was performed by the urologist and pressure-flow curves were used to determine the diagnosis and the degree of bladder outlet obstruction.The correlation of prostate elastic modulus and other features including clinical information,morphological features and urodynamic features with the degree of bladder outlet obstruction were evaluated.ROC curves were evaluated.The feature with the best diagnostic performance was obtained,the diagnostic values of which were calculated.Results 9 patients had no BOO,with the average prostate elastic modulus of (27.3±5.0) kPa; 12 patients had mild to moderate BOO,with the average prostate elastic modulus of (30.7±2.8) kPa; 13 patients had severe BOO,with the average prostate elastic modulus of (34.7±2.4) kPa.The prostate elastic modulus had higher correlation coefficient with the degree of bladder outlet obstruction than the other features (r =0.754,P=0.000).It also had the highest AUC of 0.853 (95％CI 0.720-0.986).At a cutoffof 31.65 kPa,the sensitivity,specificity and accuracy of the prostate elastic modulus for the diagnosis of BOO were 72％,90％and 81％ respectively.Conclusion The prostate elastic modulus is highly correlated with the degree of bladder outlet obstruction,which might serve as a novel,promising indicator to evaluate BOO in BPH patients.

It is significant to enhance the doctor-patient communication ability for medical graduates during clinical practice stage and establish appropriate doctor-patient communication sense,which is also important to promote medical education quality and cultivate qualified medical talents.This paper analyzed the common problems in doctor-patient communication for medical graduates.For example,patients did not trust the intern students;the students were nervous when faced with patients;some did not pay attention to their images;some called patients improperly.Then,it put forward some measures:to set up the communication and training courses,to carry out the communication skill training in clinical practice,and to attach importance to the doctor-patient communication skill practice.

Objective To explore the short and long term curative effects of percutaneous transhepatic cholangioscopic lithotomy (PTCSL) in the treatment of intrahepatic stone (IHS).Methods 38 IHS patients were enrolled,who were treated with PTCSL between January 2008 and July 2013.Results PTCSL was successfully completed in all the 38 IHS cases.Stone clearance rate was 84.2％ and the average episode of stone removal was (2.6 ± 0.9) times.Average diameter of percutaneous transhepatic fistula was (18.4 ± 0.6) F and the average time from percutaneous transhepatic puncture and fistulization to cholangioscopic lithotomy was (7.2 ± 0.7)d.The average operation time was (68 ± 20) min,intraoperative blood loss was (20 ± 13) ml,and hospitalization was (4 ± 2) days.The hepatolith recurrence rate in patients with stones completely removed was 37.5％ (12/32),and 1 case developed into biliary cirrhosis.Patients with calculi residual suffered from higher hepatolith recurrence rate of 83.8％ (5/6),with biliary cirrhosis found in 1 case.Conclusions PTCSL is safe and effective in treating primary IHS,which is indicated in multiple recurrent IHS especially in after biliary surgery patients.It has the advantages of minimally invasion,less bleeding,less postoperative pain,less complications,and fast postoperative recovery.