Despite the development of successive generations of antiepileptic drugs, phenobarbital has retained a unique position in the therapeutic armamentarium and is still the most widely prescribed treatment for epilepsy worldwide. Although serious systemic side effects of phenobarbital are uncommon, its potential neurotoxicity remains a major concern. This is particularly so in the developed world. These neurotoxic effects include sedation, behavioral problems (in particular, hyperactivity), impaired cognition, depressed mood and affect. We conducted a case control study to evaluate the cognitive effects of phenobarbital treatment in epilepsy patients in rural China. The study patients were treated with phenobarbital monotherapy. Neuropsychological tests including Mini-Mental State Examination, Auditory Verbal Learning Test, Digit Span Test, Verbal Fluency Test, and Digit Cancellation Test were performed at baseline and during follow up. We did not fi nd any signifi cant change in the cognitive function, expect for improvement in verbal fl uency test among patients whose seizures control improved with phenobarbital. We concluded that there was no cognition impairment from treatment with phenobarbital in patients with epilepsy. On the other hand, language function of patients may improve due to the benefi cial effect of seizure control. Phenobarbital remains useful to treat epilepsy particularly in the developing countries.

Langerhans cell histiocytosis (LCH) is a rare proliferative disorder of dendritic cells and the reticular cells. It is divided into single-system langerhans cell histiocytosis (SS-LCH) and multi-system langerhans cell system (MS-LCH). MS-LCH has a very poor prognosis. The key of survival is timely and effective treatment. The treatment protocols include chemotherapy, immunotherapy and stem cells transplantation. In this review, the new advances in the treatment of MS-LCH were systemically reviewed.

ObjectiveTo investigate the cause and characteristics of sports-related spinal cord injury. MethodsAll 38 sports-related spinal cord injury patients admitted in China Rehabilitation Research Center were analyzed retrospectively. Results84.2% （32/38） were male, mean of age was 23.4 (5～58). Diving was the most cause to sports-related spinal cord injury (27/38). Except 2 patients with no fracture and 1 with lumbar fracture, other patients were all with the cervical fractures, in which 57.9% were burst fractures, 18.4% were fracture and dislocations. 47.2% were complete spinal cord injury, 58.2% were incomplete. As for their professions, 10.5% were athletes, 31.6% were students. ConclusionSports-related spinal cord injury can happen in athletes and others, most of them are younger, disability of different degree remains. It is important to prevent sports-related spinal cord injury.

Aged ; Female ; Humans ; Joint Dislocations ; etiology ; surgery ; Joints ; surgery ; Laryngeal Cartilages ; surgery ; Laryngoscopy ; methods ; Male ; Middle Aged ; Treatment Outcome

OBJECTIVETo study the changes of cardiovascular regulating factors in rats during recovery of aerobic exhaustive exercise.

METHODSSixty male Wistar rats were randomly divided into control group, 1 h-exercise group, 3 h-exercise group, exhausted group, 2 h-recovery group and 12 h-recovery group. The rats were killed at corresponding times for each group after an 8-week-long treadmill training, and the levels of NO, ET, ANP and TXB2 in plasma were measured in each group.

RESULTSNO/ET ratio of 1 h-exercise group was significantly higher than that in control group (P < 0.01), while it was significantly decreased in 3 h-exercise group and exhausted group (P < 0.05). ANP contents in rat plasma were significantly higher in 3 h-exercise group, exhausted group and 2 h-recovery group than that in control group (P < 0.05 or P < 0.01). The concentration of TXB2 in plasma was significantly increased in 3 h-exercise group, exhausted group and 2 h-recovery group (P < 0.05).

CONCLUSIONChanges in cardiovascular regulating factors after exhaustive exercise may lead to deficiency of coronary circulation blood/oxygen supply, which may cause exercise-induced fatigue.

Animals ; Atrial Natriuretic Factor ; blood ; Cardiovascular System ; physiopathology ; Endothelins ; blood ; Exercise Test ; Fatigue ; blood ; Male ; Nitric Oxide ; blood ; Physical Conditioning, Animal ; Rats ; Rats, Wistar ; Thromboxane B2 ; blood

Depression is a devastating mental disorder and major depressive disorder (MDD) that afflicts 16％ of the global population at some point in their lives. Currently available classical antide-pressants (SSRIs, SNRIs, TCAs and MOIs), require a minimum of 2–4 weeks of continuous treat-ment to elicit therapeutic relief in depressed patients and are associated with high rates of non-respon-siveness, and limited duration of efficacy. Therefore, faster-acting antidepressant therapies are need-ed,particularly for patients at risk for suicide for current therapies for depression.Although the molecu-lar mechanisms underlying the pathogenesis of depression are still largely unclear, previous studies have suggested that modulators of mammalian target of rapamycin complex 1 (mTORC1) signaling may have beneficial neuroprotective and antidepressant effects. Here, we review recent advances in understanding mTORC1 signaling in depression and potential therapeutic strategies resulting from modulation of the mTORC1 signaling network. We also highlight recent studies considered to support mTORC1 signaling modulation as a rapid-acting antidepressant therapy (e.g. ketamine, scopolamine, GLYX-13, (2R,6R)-HNK, Ro-256891 etc.) and discuss future research directions. Studies on prospec-tive next-generation rapid-acting antidepressant therapies should focus on developing more selective glutamate receptors(e.g.α-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid receptors(AMPARs) agonists or activators)that activate the mTORC1 signaling pathway free of ketamine's adverse effects.

Depression is one of the diseases with the highest disability rate in the world. A large number of studies have shown that the intake of unsaturated fatty acids can deal with depression while chronic overconsumption of saturated fatty acids is a risk factor for depression. It was suggested that the mechanism of saturated fatty acids inducing depression is related to the following four aspects: regulating the function which links to depression in whole brain and specific brain regions, including the hippocampus, the hypothalamic-pituitary-adrenal axis, the striatum, and the prefrontal cortex; stimulating the secretion of inflammatory factors; affecting the balance and function of metabolic regulatory hormones, including leptin, adiponectin, glucocorticoid, and insulin; inducing the disturbance of intestinal flora. This article reviews the relationship between dietary fatty acids and depression, and the possible mechanisms by which saturated fatty acids induce depression from the four aspects mentioned above.

Objective To investigate the accuracy of end-tidal carbon dioxide (PETCO2) in reflecting arterial carbon dioxide (PaCO2) during mechanical ventilation via laryngeal mask airway (LMA) in children. Methods Fifty-two ASA Ⅰ patients, aged 2-9 yr, weighing 10-30 kg, undergoing orthopaedic surgery under general anesthesia, were randomized into 2 groups (n = 26 each) : LMA group and endotracheal tube (ETT) group. After anesthesia was induced with fentanyl, propofol and succinycholine, LMA or ETT was inserted and the children were mechanically ventilated. After the hemodynamics was stable, arterial blood samples were obtained to detect PaCO2, and PETCO2 was recorded simultaneously. Results There was no significant difference in PaCO2 and PCT CO, between groups LMA and ETT ( P ＞ 0.05) . There was no significant difference between PaCO2 and PETCO2 in LMA group (P ＞ 0.05). Conclusion When mechanical ventilation is performed via LMA in children, PETCO2 can reliably reflect PaCO2 and guide the regulation of ventilatory parameters.

Adrenergic beta-2 Receptor Agonists ; administration & dosage ; pharmacokinetics ; therapeutic use ; Asthma ; drug therapy ; Bronchitis ; drug therapy ; Bronchodilator Agents ; administration & dosage ; therapeutic use ; Child ; Child, Preschool ; Delayed-Action Preparations ; Drug Synergism ; Drug Therapy, Combination ; Glucocorticoids ; administration & dosage ; therapeutic use ; Humans ; Infant ; Leukotriene Antagonists ; administration & dosage ; therapeutic use ; Respiratory Sounds ; drug effects ; Terbutaline ; administration & dosage ; analogs & derivatives ; pharmacokinetics ; therapeutic use ; Transdermal Patch

Objective To study the relationship between velocities of ductus venosus(DV),inferior vena cava(IVC) and right hepatic vein(RHV) of fetus,and abnormal perinatal outcome in high-risk pregnancy so as to find out which venous velocity can predict abnormal perinatal outcome and which velocity is the best for predicting abnormal perinatal outcome. Methods Velocities of DV,IVC and RHV in 67 cases of high-risk pregnancy were examined through color Doppler and their relationship with perinatal outcome was analyzed respectively. Results RHV-pulsatility index(PI) ,DV-pre-load index(PLl) ,DV-S/A and IVC-peak velocity index(PVI) could all predict abnormal perinatal outcome in high-risk pregnancy. But RHV-PI had the best prediction, and when its positive cutoff value was taken as 2. 89,the sensitivity for abnormal outcome was 75. 0% ,the specificity was 76. 7% ,and the correct index (Youden index) was 0. 52. Conclusions RHV-PI can best predict abnormal perinatal outcome in high-risk pregnancy,which can help a lot for prompt clinical treatment.