Objective To analyse the differences between idiopathic and symptomatic childhood epilepsy with occipital patoxysms. Methods The medical records of 38 patients with interictal spikes and/or sharp waves over occipital areas,posterior temporal-parietal areas,or both were retrospectively analysed.Epidemiological data,ictal symptoms,electroencephalogram,neuroimaging studies,treatment response and prognosis were compared using chi-square test or Mann-Whitney U test. Results Four patients of idiopathic group had positive family history related to nervous system.Seizures were more frequent in symptomatic group than in idiopathic group.Both groups showed autonomic symptoms,while ictal vomiting and deviation of eyes were more common in the presence of Panayiotopoulos type.The prognosis of idiopathic group was much better than that of symptomatic group. Conclusion Panayiotopoulos syndrome is more common.Neurologic deficits and electroencephalographic characteristics are major factors to predict seizure remission in children with occipital lobe epilepsy.Idiopathic childhood epilepsy with occipital paroxysms may result in better prognosis.

Acute Disease ; Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Male ; Pancreatitis ; diagnosis ; etiology ; therapy ; Prognosis

Glomerulonephritis, IGA ; classification ; pathology ; Humans ; Kidney ; pathology

Objective To explore the effect of the prenatal dexamethasone treatment on the preventionof wet lung syndrome in the newborn of elective caesarean section at term. Methods Two hundred cases of elective caesarean section at term (the gestation age was less than 39 weeks) were divided into observation group and control group,with 100 cases in each by random digits table. Observation group was treated with four intramuscular injections of 6 mg dexamethasone in the 24 hours to 7 days before delivery, and control group was treated with 0.9% sodium chloride injection with the same method. The clinical data and the incidence of the wet lung syndrome of the newborn were collected. Results The incidence of the wet lung syndrome of the newborn was 1%(1/100) in observation group and 9%(9/100) in control group,and the incidence of the severity of the wet lung syndrome of the newborn was 1% ( 1/100) in observation group and 2%(2/100) in control group. There were no complication in observation group and 1 case in control group.The incidence and the severity of the wet lung syndrome of the newborn in observation group were less than that in control group significantly (P = 0.009,0.049). Conclusion Prenatal dexamethasone treatment can reduce the incidence of the wet lung syndrome of the newborn and decrease the incidence of the severity and complication of elective caesarean section at term.

Objective To distinguish primary CMV infection from reactivation or reinfection. Methods A urea denaturation test was included in the washstep of the standard IgG ELISA in 12 patients of age＜12 whose serum CMV-IgG were positive, avidity indexes of CMV-IgG were measured. Results Among children aged 1～12 years, the varieties of avidity indexes of CMV-IgG in A group(IgM negative and IgG positive) and B group(IgM positive and IgG positive) had the same trend. There was only one case in B group whose avidity index was under 30%, the other were all above 30%, and most were above 50%. But among 40 children aged 1～12 months,the avidity indexes were under 30% in 21 cases,8 cases were 30～50% ,and 11 cases were above 50%. The antibody avidity in 1～6 months children was influenced by their mothers lgG,80% (12/15) of 7 ～12 months children had low-avidity antibodies. Conclusion CMV infection mostly occurred among 1～12 months children. Urea denaturation test was an efficient method to distinguish primary CMV infection from reactivation or reinfection.

Objective To compare the differences in histological morphology and hemodynamics between benign and malignant tumor, as well as differences between the different perfusional regions in tumors of the same type. Methods Thirty cases with malignant breast carcinoma and 30 cases with fibroadenoma were inspected by contrast enhanced ultrasound with time-intensity quantitive analysis. Perfusion index like peak intensity(PI), area under the curve(AUC), time to peak(TTP) and wash-out time (WOT) were collected both inside and at the margin of focus. The ultrastructures of new microvessesl were observed routinely with microscopy and transmission electron microscopy. Results The curve of malignant tumor group was characterized as ascend rapidly and drop slowly while the benign group presented as ascend slowly and drop rapidly. The AUC and WOT of malignant tumor group were significantly higher than that of benign group,while the PI and TTP had no statistical difference. In malignant tumor group,PI, AUC and WOT of the margin of focus were significantly higher than that of inside region of focus,while TTP was the opposite. However,there was no statistical differences between the perfusion parameter inside and outside of focus in benign group. The ultrastructures of newly built blood vessels in malignant group had strong ability to split,which was different from normal endothelium cells but was similar to other tumor foci. The margin of foci were characterized with dilatating and distorting vessels,and the center of the foci were occupied by narrow,occlusive new vessels and contracted anamorphic endothelium cells and pericytes. Rich microvessel areas located in the margin of foci. Conclusions The perfusion pattern,modality of time-intensity curve, mean perfusion parameter and variance of regional perfusion parameters are valuable diagnostic basis in discriminating benign and malignant breast tumor. The density,modality,distribution,structure and function of new microvessels in tumor focus are also keystone factors when tumors are assessed by means of imaging.

The research reviews the purpose, significance and indwelling method of indwelling nasal jejunum in critically ill patients with neurosurgery in recent years and It also studies the effects of indwelling on organ function. For example, improving pulmonary ventilation function can reduce the mechanical ventilation time of patients with mechanical ventilation; can effectively promote intestinal tissue and function, reducing electrolyte disturbance;and long-term catheter can affect the liver function, the occurrence of gastric retention, diarrhea, obstruction of the pipeline and the related complications. The authors hope to provide a reference for the clinical care. At present, the use of nasal jejunum is the trend of enteral nutrition in critically ill patients with neurosurgery, but the replacement time of nasal jejunum tube, oral care and other related complications are lack of corresponding research.

Bacterial extracellular metalloproteases ( BEMPs) are a large group of metal ion-contai-ning proteases. All BEMPs identified so far are endopeptidase or endoprotease. BEMPs can be classified into nine metalloprotease families based on the sequences and structures of enzymatic molecules. Double-valence zinc ion ( Zn2+) is necessarily required by catalytic centers of most BEMPs. The main function of BEMPs in non-pathogenic heterotrophic bacteria is to hydrolyze environmental proteins and polypeptides to provide vari-ous amino acids as nutrients. However, BEMPs of pathogenic bacteria, serving as important virulence fac-tors, help the pathogens invade into hosts and spread in hosts. In recent years, the roles and mechanism of BEMPs in bacterial pathogenesis have attracted great attention. Here, we make a brief review about the structures and types as well as the functions and pathogenic roles of BEMPs.

Speeding up the training of quality personnel in clinical medicine is an important historic mission of clinicians. Practice has proven that the training, growth and maturity of quality clinical personnel are inseparable from clinical practice. Thus, firstly, clinical workers must, in accordance with the goals of training, rigorously enforce process management, including implementation of the training regulations, strict assessments, and cultivation of abilities in doing scientific research and writing up research papers. Secondly, the overall quality of postgraduates must be enhanced. Thirdly, files of postgraduates must be set up. Fourthly, experience in training academic degree postgraduates in clinical medicine should be constantly summed up, including ways of strengthening organization and control and clarifying goals and requirements