Vagus nerve stimulation is an effective treatment for drug-resistant epilepsy, and its efficacy and safety have been confirmed after over two decades of clinical practices.However, reassuring predictors to evaluate whether patients with drug-resistant epilepsy could gain benefit from vagus nerve stimulation has not been established, because the underlying mechanism remain poorly understood.Previous studies revealed that presumable patient-related predictors included age, epileptic seizure type, epilepsy etiology, epilepsy syndrome, cognitive and behavioral responsiveness, scalp electroencephalographic related signals and heart rate variability related signals.However, most of the predictors still remain controversial due to the factors such as the heterogeneity of different research design.This article aims at analyzing and concluding the information from relevant literatures, and summing up the predictors of efficacy before vagus nerve stimulation in refractory epilepsy to highlight the future work.

Objective:To study the phenotypes of T cell in patients with Hashimoto thyrioditis (HT) and to analyze its relationship with the impairment of follicles, so as to provide evidence for clinical diagnosis and treatment. Methods: Totally 136 HT specimens were obtained by fine needle aspiration biopsy (FNAB) and were divided morphologically(L, P, O type). The serum parameters (TPOAb, TGAb, TSH) were tested, and 20 cases with nontoxic goiter were taken as control. Immuno-histochemical assay was performed with 60 specimens and FCM (Flow cytometry ) was used to study 23 specimens. The T cell infiltration and the distribution of CD3+ . CD4+ . and CD8+ T cells were compared between all types of HT tissues. The correlationship between the atrophic degree of follicle with T lymphocytes infiltration and phenotype was analyzed. Results: It was found that L type (n = 58) and P type (n = 28) had more serious follicle atrophy than that of O type (n = 20) (P

Objective: To evaluate the self-developed intelligent assist order system for parenteral nutrition on the control of concentration exceeding standard of positive ions.Methods: The special comments, pharmacist audit and information control were used to intervene the concentration exceeding standard of positive ions in parenteral nutrition orders and the effect of the three intervention methods were evaluated.Results: For the intervention of concentration exceeding standard of positive ions in parenteral nutrition orders, the information control was better than the special comments and pharmacists audit.Conclusion: The intelligent assist order system for parenteral nutrition can solve the problem of concentration exceeding standard and promote the rational application of parenteral nutrition in hospitals.

Objective: To construct the management model for intravenous drug use based on index system in a hospital.Methods: A three-level organizational framework was established, the KPI assessment method was used to set control index and observational index respectively for outpatients and inpatients.The completion of the clinical department indicators were monitored and analyzed with the help of the hospital information systems, and regulated by pharmacy and management tools.Results: After the application of the hospital intravenous drug use management model, the qualification rate of intravenous medication orders was improved in December 2015 (89%) when compared with that in December 2014 (68%), and the difference was statistically significant(P＜0.05).The indices of intravenous drug use of inpatients and outpatients in 2015 were significantly improved when compared with those in 2014.Conclusion: The hospital intravenous drug use management model based on index system construction can effectively reduce unnecessary intravenous medication and promote the rationality of intravenous medication.

ObjectiveTo explore the relative factors of the compliance in schizophrenic out-patients.Methods118 schizophrenic out-patients chosen randomly were investigate with the compliance and assessed with Clinical Global Impression-Severity of Illness (CGI-SI), Social Disability Screening Schedule (SDSS), Brief Psychiatric Rating Scale (BPRS) and Treatment Emergent Symptom Scale (TESS) by telephone. Logistic regression analysis was used to confirm the relative factors of the compliance.Results56.8% of all patients were of full compliance. The risk factors of compliance in schizophrenic out-patients were the frequency of medicine taken, the scores of CGI-SI and the insight of the illness. ConclusionIt is important to choose effective and convenient antipsychotic drugs and improve the insight of the illness to enhance the compliance of the schizophrenic out-patients.

A microfluidic chip with micropillar arrays for three-dimensional (3D) cell culture was designed and validated.The chip consisted of a polydimethylsiloxane (PDMS) channel plate and a glass cover plate.One cell culture chamber composed of two rows of micropillar arrays and two lateral channels for transporting the culture medium were integrated on the PDMS channel plate.The spacing between micropillars directly affects the chip performance, which is critical for the design of the chip.In this work, the spacing between micropillars was optimized by numerical simulation and experimental validation.With the optimized microfluidic chip, the mixture of cells and extracellular matrix mimics could be steadily injected into the cell culture chamber, the nutrients in the culture medium from the lateral channels could quickly diffuse into the chamber, and the cell metabolites could also timely diffuse out of the chamber.To test the stability of the microenvironment in the microfluidic chip, neural stem cells were three-dimensionally cultured.

Objective To investigate the association with death for serum parameters at the time of diagnosis and its value in predicting the death in infants with hemophagocytic syndrome (HPS).Methods A retrospective case-control study was conducted on 108 children with HPS who were admitted to our center between July 2005 and July 2012.For each patient,demographic,laboratory data and outcome information were collected.The patients were divided into death and surviving groups based on the follow-up results.The relation between serum markers and death was examined using the COX proportional hazards model and decision tree.Results Of 108 infants with HPS,33 died corresponding to a fatality rate of 30.6％ and 90.3％ of deaths occurred within 8 weeks after diagnosis.Following features were significantly associated with death:white blood cells (WBC) ＜5 x 109/L (HR =9.08,95％ CI 3.07 ～ 26.87),hemoglobin ＜80 g/L (HR =6.15,95％ CI 1.68 ～ 22.49),albumin ＜ 28 g/L (HR =4.63,95％ CI 1.12 ～ 7.39),serum ferritin ＞ 1 100 μg/L (HR =3.05,95％ CI 1.28 ～ 16.75),trigeminal ganglion ≥4 mmol/L (HR =2.88,95％ CI 1.51 ～ 8.60),and prothromin time ≥ 16 s (HR =3.60,95 ％ CI 1.28 ～ 7.24),and fever for more than 2 weeks (HR =5.39,95％ CI 1.97 ～ 14.66).Decision tree demonstrated that the probability of death was as high as 100％ for infants with WBC ＜5 x 109/L and hemoglobin ＜ 80 g/L.The odds of dying was still 66.7％ for infants who had WBC≥5 × 109/L but reported trigeminal ganglion ≥4 mmol/L after having fever for more than 2 weeks.Conclusion The first 8 weeks after the onset of HPS is the critical period of treatment.There are several easily available serum predictors of early mortality in HPS infants,particularly the WBC and hemoglobin level,which may help guide treatment decisions.

Cochlear Implantation ; HIV Infections ; Humans

Objective To investigate the microRNAs expression profile in human colorectal cancer with or without liver metastasis and try to screen miRNA associated with liver metastasis in colorectal cancer. Methods Twenty five surgical resected colorectal cancer specimens were collected and frozen in liquid nitrogen. Three without liver metastasis and three with liver metastasis were selected, from which total RNAs were isolated. The expressions of miRNAs in these two types of specimens were detected by illumine microRNA microarray, and the difference of miRNA expression was screened. The biochip results were verified with real-time RT-PCR in all colorectal caner specimens. Results The miRNA expression was significantly different in colorectal cancer with liver metastasis and without liver metastasis. Compared with colorectal cancer without liver metastasis, 28 miRNA expressions was different in colorectal cancer with liver metastasis, 4 up regulated and 24 down regulated. The quantity of miR-139-3p expression in colorectal cancer with liver metastasis was 1.75±0.40, up regulated compared with that incolorectal cancer without liver metastasis(0. 69 ±0.58,P＜0.05). The quantity of miR-19a expression in liver metastasis was 0. 39±0. 20, downregulated compare with no liver metastasis( 1.38 ± 0.98, P＜0. 05). The result of miRNA biochip was consistent with that of RT-PCR. Conclusion The difference of miRNA expression might relate to liver metastasis of colorectal cancer. The specific miRNAs expression profile might provide new target for diagnosis and treatment of colorectal cancer with liver metastasis.

ObjectiveTo investigate the mechanism of bis（2-ethylhexyl） phthalate （DEHP） in inducing cholestasis and liver injury in mice. MethodsIn the in vivo experiment， adult female ICR mice were randomly divided into control group （corn oil） and DEHP group （200 mg/kg/d）， and a model of cholestasis was established by intragastric administration for 4 weeks. After blood and liver tissue samples were collected from all mice， a biochemical analyzer was used to measure the level of total bile acid （TBA） in serum and the liver， and a microplate reader was used to measure alkaline phosphatase （ALP） and gamma-glutamyl transpeptidase （GGT）； HE staining was used to observe the pathological changes of the liver； RT-PCR was used to measure the mRNA expression levels of the inflammatory factors interleukin-1β （IL-1β）， interleukin-6 （IL-6）， and tumor necrosis factor-α （TNF-α） in the liver； liquid chromatography/triple quadrupole mass spectrometry was used to measure the bile acid profile in the liver of mice. In the in vitro experiment， AML-12 mouse hepatocytes were cultured and treated with DEHP （250 µmol/L）， DCA （125 µmol/L）， and CDCA （125 µmol/L） for 24 hours， and RT-PCR was used to measure the mRNA expression levels of the inflammatory cytokines IL-1β， IL-6， and TNF-α. The independent-samples t test was used for comparison of continuous data between two groups； a one-way analysis of variance was used for comparison between multiple groups， and the LSD-t test was used for further comparison between two groups. ResultsThe in vivo experiment showed that compared with the control group， the DEHP group had significant increases in the serum levels of TBA， ALP， and GGT and the level of TBA in the liver （the t values are respectively -4.396， -5.109， -8.504， -3.792 and -7.974， all P<0.05，）. Compared with the control group， the DEHP group had significant increases in cholic acid， chenodeoxycholic acid， taurocholic acid， deoxycholic acid， and ursodeoxycholic acid （the t values are respectively -2.802， -3.177， -2.633， -2.874 and -2.311， all P<0.05）. HE staining of the liver showed that the mice in the DEHP group had enlargement of the portal area， bile duct deformation， inflammatory cell infiltration around the bile duct， and significant increases in the mRNA expression levels of the inflammatory factors IL-1β， IL-6， and TNF-α in the liver （the t values are respectively -2.539， -2.823 and -4.636， all P<0.05）. The in vitro experiment showed that the actual difference in hepatocyte viability after 0-1 000 µmol/L DEHP treatment does not exceed 15%， but there were significant increases in the mRNA expression levels of the inflammatory cytokines IL-1β， IL-6， and TNF-α after treatment with DEHP at different concentrations of 125 µmol/L， 250 µmol/L， and 500 µmol/L （all P<0.05）. Compared with DEHP stimulation alone， the combined stimulation of CDCA and DEHP upregulates the cytokine in hepatocyte IL-1β mRNA levels （P<0.01）； the combined stimulation of DCA and DEHP can significantly increase the cytokine in hepatocyte IL-1β and IL-6 mRNA levels （all P<0.01）. ConclusionDEHP exposure can cause cholestasis and induce liver inflammation in mice， possibly by promoting the production of toxic bile acids and the secretion of inflammatory factors.