Objective To evaluate long-term efficacy and safety of Topiramate in patients with various types of epilepsy.Methods 115 patients with epilepsy were underwent open-label experience with Topiramate as monotherapy or add-on therapy. The efficacy was assessed after 6 months. The rates of seizure-free and Topiramate retention were estimated after 1 and 2 years, and side effect were also evaluated during open-label treatment period.Results (1) After 6 months, total effective rate was 83.9% in monotherapy group and 66.1% in add-on therapy group. Topiramate was proved to be effective on various types of epilepsy, but there were not significant differences in seizure-free rate and total effective rate between the different types. (2) The optimal dosage was ( 105.72?48.28) mg/d in children and ( 176.26?62.81) mg/d in adults. (3) The seizure-free rate was 40.0% at 1 year and 28.7% at 2 years, and retention rate was 67.8% at 1 year and 46.1% at 2 years. (4) Side effects were observed in 34 patients (29.6%), including mild to moderate events related to central nervous system, anorexia and weight decrease.Conclusion Topiramate is a widespread antiepileptic drug with high efficacy and safety for long-term administration.

Objective To explore the influence of percutaneous gastrostomy-jejunostomy ( PEG-J) on the nutritional status and prognosis of critically ill patients in ICU .Methods Totally 58 patients who received me-chanical ventilation in the ICU of Changshu No .1 People's Hospital from January 2013 to December 2015 were di-vided into two groups according to random number table:treatment group ( n=28, enteral nutrition by establis-hing PEG-J tube in 120 hours after excluding contraindications );and control group ( n=30, nasogastric tube as the way of giving enteral nutrition and if delayed gastric emptying happened , nasogastric tube would be replaced by nasointestinal tube).The incidence of ventilation-associated pneumonia (VAP) within 28 days, duration of ICU stay, and duration of mechanical ventilation were compared between these two groups .Results The inci-dence of 28-day VAP (7.14%vs.26.67%, P=0.049), duration of ICU stay [ (13.6 ±5.9) d vs.(16.8 ± 4.4) d, P=0.024], duration of mechanical ventilation [ (8.1 ±5.0) d vs.(10.7 ±4.5) d, P=0.041] were significantly lower or shorter in treatment group than in control group .Conclusions The use of PEG-J tube for enteral nutrition in critically ill patients is reliable and safe .It also helps to reduce VAP .

Objective To investigate the effects of body-weight support treadmill training(BWSTT) on function of lower limbs.Methods 46 hemiplegic patients after stroke were randomly divided into the therapy group(n=23) and control group(n=23).The subjects of both groups were administered with standardized rehabilitation program.The therapy group was also given BWSTT in addition.Both groups were evaluated before and after treatment using Functional Ambulation Category(FAC),Fugl-Meyer Assessment(FMA),Berg Balance Scale(BBS).Results Before treatment,there was no significant difference between these 2 groups in terms of scores with FAC,FMA and BBS.After treatment,both groups were significantly improved regard to their scores with FAC,FMA and BBS(P<0.01),with the therapy group scored significantly better than the control group(P<0.01).Conclusion BWSTT can significantly improve walk ability and balance function of the hemiplegic patients after stroke.

Objective To observe whether or not long-term inhalation of nitrous oxide can affect the cardiac function in rats. Methods Sprague-Dawley rats of either sex were randomly divided into four groups. Group A: inhaled common air for 50 days as control; Group B: inhaled 500mL/L N_2O for 15 days, two hours every day; Group C: inhaled 500mL/L N_2O for 30 days, two hours every day; Group D: inhaled 500mL/L N_2O for 50 days, two hours every day. Float glass intracellular microelectrode recording technique was used for observation of the duration (MAPD_(90), MAPD_(50) and MAPD_(20)) and amplitude of action potentials (APs) of left ventricular muscle cells in vitro. Angiotensin-2 (Ang-2) and eNOS were detected by immunohistochemical technique. Results ① Compared with that in Group A, the Aps duration of left ventricular muscle cells (MAPD) in Group B had no significant change while the MAPDs in Group C and Group D were extended significantly. There were no significant differences among the four groups in Aps amplitude. ② The expression of Ang-2 did not differ significantly between Group B and Group A. The expression level was higher in Group C and D than in Group A. ③ The expression level of eNOS was significantly lower in Group C and D than in Group A (P<0.05). Conclusion Long-term inhalation of N2O can significantly affect the cardiac function in rats, which may be related to higher expression of AngⅡin the heart induced by the long-time excitation of sympathetic nerves.

Objective To study the modulation of central amygdale (CeA)on cardiac nociception with electrical stimulation in rats.Methods The heart pain model of adult male Sprague-Dawley rats was established with intrapericardial injection of capsaicin; then the evoked electromyography (EMG ) responses in the spinotrapezius (SPT)were observed as an index.Immunohistochemical method was used to observe the expression of c-fos in CeA;The rats were divided into normal control group,intrapericardial saline injection control group,and intrapericardial capsaicin injection group. The changes of EMG responses after electrical stimulation on CeA (intensity of 30μA and 70μA)were observed separately by electrophysiology in different groups.Results① Compared with normal control group, intrapericardial capsaicin injection group had significantly increased expression of c-fos in CeA.However,c-fos expression did not differ significantly between intrapericardial saline injection group and normal control group;② After 30μA electrical stimulation on CeA,EMG response in SPT significantly decreased in intrapericardial capsaicin injection group compared with that in control group;the total discharge rate was (78.58±4.62)% of that of control group (P<0.05).After 70μA electrical stimulation on CeA, the total discharge rate was (54.89±3.98)% of that of control group (P<0.05).Conclusion CeA may be involved in cardiac nociceptive transmission in rats and has inhibitory effects on the modulation of rat cardiac nociception.

Objective To observe the cardiosomatic motor reflex (CMR)of rats, and to clarify the descending modulation of nucleus raphes magnus (NRM)in cardiac nociception and its pathway.Methods 34 male healthy SD rats were randomly divided into NRM electrical stimulation group (n=8 ), NRM stimulation combined with dorsolateral funiculus (DLF ) transection group (n= 8 ), NRM stimulation combined with antagonist of 5-hydroxytryptamine (5-HT)methysergide intrathecal administration group (n=18).The rat model of CMR was established through inj ecting capsaicin into the pericardial sac of the rats in various groups. The electromyogram (EMG) response of dorsal spinotrapezius muscle was used as detection index, and by placing the stimulation electrode in NRM and (or)intrathecal catheterization, the descending inhibitory modulation of NRM in CMR and the influence of DLF tansection or methysergide intrathecal administration in descending inhibitory modulation of NRM were observed.Results Compared with before stimulation,the EMG response was decreased after NRM electrical stimulation (75 μA) (P<0.05 );after bilateral DLF transection, the EMG response after NRM stimulation was significantly increased compared with before DLF transection (P<0.05 ), and there was no significant difference compared with its control (P> 0.05 ). In addition, after intrathecal administration of methysergide,the EMG response after NRM stimulation was significantly increased compared with before intrathecal treatment of methysergide (P<0.05),but it was still significantly smaller than that of its control (P<0.05). Conclusion Cardiac nociception evoked by capsaicin stimulation is subject to descending inhibitory modulation from NRM,and the descending inhibition from NRM is conveyed via the DLF and partially mediated by endogenous 5-HT system.

The characteristics of ductal adenocarcinoma of colon under eieciror: microscopy were stout and dense microvill, with small roots buried in the top of cytoplasm. The ullrarnorphological changes of carcinomatous infiltration was similar to the picture observed in vitro cultivation of cancer cells.In 104 cases out of 159, there was an over expression of ras oncogenes P21, indicating that carcinoma of colon was related to activation of ras oncogenes. Examination with monoclonal antibodies yielded a positive rate of 83.4%- 95.7%, indicating that most of the carcinomas had colon related antigens. This phenomenon should play an important role in raising the diagnostic accuracy, and it also should serve as an indicator of effective treatment. In 62 cases of mucoid adenocarcinoma and 30 cases of signet ring cell carcinoma, there was a marked reduction of mueoitin sulfate with an increase in sialic acid mucus. The letter was a glycoprotein containing hydroxyl mucus, and it facilitated the separation of cancer cells to infiltrate and metastasize.in 134 cases, AgNOR was quantified, and there were 13.05? 1.48 granules in each mucleas. There was more abundant AgNOR in undifferentiated cancer, while the number of AgNOR fluctuated between 10.56 to 11.83 in papillary adenocarcinoma, ductal adenocarcinoma, and mucoid adenocarcinoma. indicating the qunantity of AgNOR was related to degree of malignancy in colonic carcinoma.

Objective:To investigate the value of artificial intelligence (AI)-assisted quantitative measurement in evaluation of the dynamic changes of CT for COVID-19 pneumonia.Methods:The clinical and chest CT dynamic imaging data of 99 patients with confirmed COVID-19 pneumonia who were hospitalized in Wuhan Central Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 15, 2020 to March 10, 2020 were retrospectively analyzed. According to the definitive diagnosis, the 99 patients were classified into common ( n=36), severe ( n=33) and critical ( n=30) type, the CT imaging findings of each type were analyzed, including CT basic signs, total volume of pneumonia lesions and percentage of pneumonia lesions of the total lung volume (volume ratio). AI software was used to quantitatively evaluate the dynamic changes of chest CT images. The quantitative indicators included CT peak time of lesions, total volume of lesions peak, volume ratio of lesions peak, maximum growth rate of total volume and maximum growth rate of volume ratio. Kruskal-Wallis rank sum test was used to compare the difference of quantitative indexes between the 3 types, and χ 2 test or Fisher exact probability test was used to compare the difference of qualitative indexes between the 3 types. Sequence measurement and scatter plots were used to show the evolution trend of the volume ratio of the three types of COVID-19 pneumonia lesions. The ROC curve was used to analyze the value of the volume ratio of pneumonia lesions and its maximum growth rate in predicting the conversion of common pneumonia to severe or critical pneumonia. Results:There were statistically significant differences in age and gender distribution among patients with common, severe and critical COVID-19 ( P<0.05), the age of severe and critical types were significantly higher than that of common type ( P<0.01). Compared with common [2.5 (1.0, 5.0) d] and critical type[2.5 (1.0, 4.0) d], the time from onset to the first chest CT scan of severe type was prolonged [5.0 (2.5, 8.0) d, P<0.01]. There were statistically significant differences in involvement of multiple lung lobes (20 cases, 29 cases, 25 cases, χ2=10.403, P=0.006) in patients with common, severe and critical COVID-19 at the first scan, the incidence of the involvement of multiple lung lobes in severe and critical types was significantly higher than that of common type ( P=0.002). The volume ratios of patients with common, severe and critical COVID-19 at the first scan were statistically significant [1.0% (0.2%, 4.7%), 9.30% (1.63%, 26.83%), 2.10% (0.64%, 8.61%), Z=14.236, P=0.001], and the volume ratio of severe type was significantly higher than that of common type ( P<0.001), there was no statistically significant difference between common type and critical type ( P=0.062). Follow-up CT showed that the pneumonia lesions showed a dynamic transformation of progress and recovery, and it was seen that the coexistence of multiphase lesions. The trend line in the scatter plot of the three types of COVID-19 pneumonia lesions showed that the lesions in the advanced stage developed from less to more. The lesion peak volume ratios of the common, severe and critical types were 9.75% (4.83%, 13.18%), 29.80% (23.99%, 42.36%) and 61.81% (43.73%, 72.82%), respectively, the difference was statistically significant ( Z=74.147, P<0.001). The maximum growth rates of lesion volume ratio were 1.27% (0.50%, 1.81%)/d, 4.39% (3.16%, 5.54%)/d and 6.02% (4.77%, 9.96%)/d, respectively, the difference was statistically significant ( Z=52.453, P<0.001). The peak times of lesions were 12.0 (9.0, 15.0) d, 13.0 (10.0, 16.0) d and 16.5 (12.0, 25.0)d, respectively, the difference was statistically significant ( Z=9.524, P=0.009). Taking the volume ratio of pneumonia lesion 22.60% and the maximum growth rate of the volume ratio 1.875%/d as the boundary value, the sensitivity of diagnosing common type to severe or critical type was 92.10% and 96.83%, and the specificity was 100% and 80.56%, respectively. The area under the curve was 0.987 and 0.925, respectively. Conclusions:The lesions of COVID-19 pneumonia show a similar parabolic change on CT imaging. The use of AI technology to dynamitcally and accurately measure the CT pneumonia lesion volume ratio is helpful to evaluate the severity of the disease and predict the development trend of the disease. Patients with a rapid growth of volume ratio are more likely to become severe or critical type.

OBJECTIVETo investigate the role of ventrolateral periaqueductal gray (VL-PAG) metabotropic glutamate receptors subtype 7 and 8 (mGluR 7/8) in descending modulation of cardiosomatic motor reflex (CMR) in rats.

METHODSAMN082 (agonist of mGluR 7) and DCPG (agonist of mGluR 8) were injected into the VL-PAG of a rat model of CMR to observe their effects in modulating CMR. The raphe magnus nucleus (NRM) or the gigantocellular reticular nucleus (Gi) was then damaged, and the changes in VL-PAG descending modulation were observed.

RESULTSSelective activation of mGluR 7 of the VL-PAG by AMN082 obviously facilitated capsaicin (CAP)-induced CMR (P<0.05), which was suppressed by DCPG-induced mGluR 8 activation (P<0.05). These facilitatory or inhibitory effects were completely reversed by group III mGluR antagonist MSOP. Damaging the NRM of VL-PAG main relay nucleus did not significantly affect the facilitatory effect produced by AMN082 microinjection (P>0.05), but partially attenuated the inhibitory effect of DCPG microinjection (P<0.05). Both the facilitatory effect of AMN082 and the inhibitory effect of DCPG were reduced obviously after bilateral Gi damage (P<0.05).

CONCLUSIONVL-PAG mGluR 7 and mGluR 8 mediate biphasic regulation of CMR in rats probably through activation of different sub-nuclei and different neurons in the rostroventral medulla.

Animals ; Benzhydryl Compounds ; pharmacology ; Benzoates ; pharmacology ; Glycine ; analogs & derivatives ; pharmacology ; Male ; Medulla Oblongata ; metabolism ; Periaqueductal Gray ; metabolism ; Physical Conditioning, Animal ; Rats ; Rats, Sprague-Dawley ; Receptors, Metabotropic Glutamate ; agonists ; metabolism ; Reflex ; physiology

OBJECTIVETo observe the descending modulation of cardiac nociception by the rostral ventromedial medulla (RVM) in rats.

METHODSA rat model of cardiosomatic motor reflex (CMR) was established by injecting capsaicin into the pericardial sac to induce cardiac nociception, and the electromyogram (EMG) response of the dorsal spinotrapezius muscle was studied. The RVM was electrically stimulated (25, 75 and 100 µA) or destroyed to examine whether RVM exerted descending modulation on cardiac nociception.

RESULTSElectrical stimulation of the RVM at 8 sites produced intensity-dependent inhibition of EMG responses to noxious cardiac stimulus (F[2,21]=43.188, P=0.001). Electrical stimulation at 3 sites caused facilitated EMG responses, but the increased magnitude of the EMG was not dependent on stimulation intensity (F[2,6]=0.884, P=0.461). Stimulation at 11 sites produced biphasic effects: at a low intensity (25 µA), the elicited EMG magnitude was significantly larger than baseline (P<0.05), and at greater intensities (75/100 µA), the stimulation caused suppression of the EMG magnitude to a level significantly lower than the baseline (P<0.05). Electrolytic lesion of the RVM resulted in significantly increased EMG responses compared with the baseline and sham lesion group.

CONCLUSIONCardiac nociception evoked by capsaicin stimulation is subjected to descending biphasic modulation by the RVM, which produces predominantly descending inhibition on heart pain.

Animals ; Capsaicin ; pharmacology ; Electric Stimulation ; Electromyography ; drug effects ; Male ; Medulla Oblongata ; physiology ; Nociception ; Nociceptors ; drug effects ; physiology ; Pain ; physiopathology ; Pericardium ; drug effects ; physiology ; Rats ; Rats, Sprague-Dawley ; Sensory System Agents ; pharmacology