Objective To study the clinical manifestations,etiology,magnetic resonance imaging features,prognosis of patients with bilateral medial medullary infarction.Methods The clinical information of two case reports were summarized with review of the literature.Results The 2 patients with bilateral medial medullary infarction reported here were manifested with progressive quadriplegia,both complicated with respiratory disorders.On etiology,both were due to atherosclerosis,and one was combined with congenital vascular variation.The Y shaped hyperintense signals were seen in diffusion weighted imaging (DWI) cross-section in the medulla oblongata level.And both had poor outcomes that one was dead and the other was discharged with tracheotomy and severe sequela.Conclusions Bilateral medial medullary infarction is presented with complicated symptoms such as quadriplegia,dysarthria,hypoglossoplegia,even respiratory failure,in which quadriplegia is most often seen,and it is associated with a poor clinical prognosis.DWI appears the characteristic Y Shaped sign.

Objective To explore the variations and prognostic factors of hyperhomocysteinaemia in ischemic cerebral apoplexy for the youth who administrated vitamin B6,vitamin B12 and folic acid at pretherapy and post-treatment.Methods One hundred and twenty cases of young patients with ischemic cerebral apoplexy in the Pinggu Hospital of Capital University from January 2003 to December 2013 as case group(intervention group,60 cases and 60 cases of non-intervention group),while 120 youth volunteers with the same period and age without neurological diseases as a control group.Both groups patients were detected for hyperhomocysteinaemia,folic acid and vitamin B12.The non-intervention group was administrated basic treatment,while the intervention group administrated vitamin B6,vitamin B12 and folic acid on this basis.The hyperhomocysteinaemia,folic acid and vitamin B12 were detected repetitively after four weeks.Results Compared with control group,the hyperhomocysteinaemia in ischemic cerebral apoplexy group for the youth had increased significantly ((10.2 ± 3.1) μmmol/L vs.(21.3 ± 4.5) μmmol/L,P ＜ 0.05).The hyperhomocysteinaemia,folic acid and vitamin B12 had no significant differences between intervention group and non-intervention group (P ＞ 0.05).After replenished vitamin B6,vitamin B12 and folic acid,the hyperhomocysteinaemia had decreased significantly ((10.5 ± 3.0) μmnol/L) in intervention group.Folic acid ((6.5±2.8)μg/L) and vitamin B12(450.2±155.6) ng/L) had increased significantly(P＜0.05).Conclusion The hyperhomocysteinaemia increased in ischemic cerebral apoplexy for the youth.It is that hyperhomocysteinaemia decreased by replenished vitamin B6,vitamin B12 and folic acid which make for prognosis in ischemic cerebral apoplexy for the youth.

Objective To analyze the recurrence risk of patients single post-stroke epilepsy. Methods Fifty-eight cases of epilepsy after stroke in Pinggu District Hospital of Beijing were enrolled in this study and their history clinical information were retrospectively collected. All patients were divided into single attack group (A group)and two or more attack group(B group). Results There were 3. 67%(58/1580)stroke patients were developed epilepsy. Among them,0. 38%(6/58)of patients were developed seizures in early stage,and 3. 29%(52/58)in late stage. Thirty-one cases occurred epilepsy once within one years in A group and 27 cases occurred epilepsy more than twice with one year in B group. Initiate epilepsy onset of 2 cases(A1)was at early stage and 29 cases(A2)at late stage in A group. Initiate epilepsy onset of 3 case(B1)was at early stage and 24 cases(B2)at late stage in B group. There was no significant difference in term of types of epilepsy between two groups(χ2 =0. 001,P﹥0. 05). The lesions site of 13 cases was located cortex and 18 cases was located in below cortex in A group,in B group,the lesions site was located in cortex of 17 cases or below cortex of 10 cases,and the difference was not significant(χ2 =2. 555,P﹥0. 05). The hemorrhagic stroke and ischemic stroke were 12 and 19 cases in A group,10 and 17 cases in B group,and there was no significant difference between two groups (χ2 =0. 017,P﹥0. 05). Rhythm of slow wave and the epileptiform discharges were 11 and 2 cases in A group, 11 and 13 cases in B group. About 51. 8% of the patients with recurrence of epilepsy had history of infection in B group. Conclusion For stroke patients,especially hemorrhagic stroke,first seizure is late-onset epilepsy cases. If the electrical activity of the brain is abnormal slow rhythm or epileptiform discharges,close to the cortex is more likely to cause epilepsy recurrence. It is supposed to giving positive antiepileptic drug treatment in the first epilepsy after stroke.

Objective:To investigate the cognition of terminal stage patients'dignity therapy,attitude towards its concept and scheme,willingness of its promotion in college students and to gain some recommendations for improvement.Methods:Combined quantitative and qualitative methods,an anonymous questionnaire survey was conducted in a convenience sample of 220 college students,of which 20 students were selected for in-depth interviews.Results:Only 17.73％ of students had a correct understanding of dignity therapy,94.98％ of them accepted its concept,92.96％ of them held a positive attitude,74.38％ of them were willing to promote dignity therapy,in which female students were dominated (P =0.041).Interview results showed that the contents of dignity therapy were to some extent stiff and not fit for Chinese patients,which might impede its promotion.Conclusion:College students lack the cognition of dignity therapy.But they hold a positive attitude and are willing to promote dignity therapy when they get to know its concept and contents.As seen,dignity therapy has a good future but there are still some obstructions in the promotion,and need to be localized.

Objective: To analyze the current status of latent tuberculosis infection (LTBI) among freshmen in boarding middle schools in Longgang District, Shenzhen, so as to provide reference for formulating tuberculosis prevention and control strategies in the next stage. Methods: Data for tuberculosis health examination conducted among primary and secondary school students in Longgang District of Shenzhen in September 2022 to May 2023 were utilized to analyze the latent tuberculosis infection rate, and to explore the differences in latent tuberculosis infection rate among different grades, school nature, school categories and school levels. Results: The latent tuberculosis infection rate among freshmen in boarding secondary schools in Longgang District, Shenzhen in 2022 was 2.45%. The infection rate among full middle school (6.45%) and high school (3.37%) were higher than that in boarding junior high school (0.28%), nine year education school (0) and twelve year education school (1.00%) ( P <0.01). Moreover, the infection rate of high school freshmen (2.68%) was higher than that of bording junior high school (0.33%), and the rate of public schools (2.87%) and municipal schools (3.24%) were higher than those of private schools (1.78%) and distric-level schools (2.13%) respectively, with statistical significance observed for all differences( χ 2=43.58, 25.15, 22.69, P <0.01). Conclusions The latent tuberculosis infection rate among new boarding secondary students is relatively low in Longgang District of Shenzhen. However, the infection rate is higher in high school, public and municipal school. School should fully guarantee sports participation of students, enhance students awareness of tuberculosis through health knowledge lectures, and reduce the incidence of tuberculosis among students.