Seizure cluster (SC) is a common clinical phenomenon in patients with epilepsy, which was reported to be associated with post-ictal psychosis, status epilepticus, and increased risk of death, with a negative impact on the quality of life of patients and caregivers, but the diagnostic criteria, management principles and pathogenesis of SC are still unclear."seizure cluster" "acute repitetive seizures" and "cluster seizures" were used to search the relevant literatures in the databases of "Pubmed" "Wanfang Medicine" and "China Knowledge Network" from 1990 to 2019. The definitions, prevalence, risk factors, consequences, possible mechanism, and current management methods of seizure clusters were summaried in this article, to help health care professionals and patients gain a clearer understanding of SC.

Objective To investigate the clinical features, the video electroencephalography ( V-EEG) and synchronous electrocardiography ( ECG) changes in non-epileptic seizures and the significance of ECG monitoring in the diagnosis of epilepsy.Methods We collected 3 patients who came in a chief complaint of“episodes of unconsciousness with limbs twitch”, whose clinical features and EEG, ECG in longterm VEEG monitoring were analyzed.The 3 patients were followed up for at least 6 months.Results The 3 patients were all diagnosed as epilepsy in other hospital,and during the 24-hour VEEG monitoring in our hospital,2 patients showed abnormal cardiac rate and arrest during the attack and corresponding EEG changes after cerebral ischemia and hypoxia.After consultation with the department of cardiology, they were diagnosed as cardiac syncope episode and no attack showed up after the placement of pacemaker.The Q-T interval was prolonged in the other patient during the longterm ECG monitoring, after the coherence check who was diagonsed as severe hypocalcemia combined with myocardial damage due to a lower parathyroid function and had no attack after symptomatic treatment.Conclusions The synchronous ECG monitoring during the attack is of great significance in the differential diagnosis of epileptic and non-epileptic seizures. The ECG changes in patients with longterm VEEG monitoring should be focused on.It is necessary to add the early warning function to prevent the occurrence of accidents.

ObjectiveTo study the level of temperament and self-esteem of children aged 8～12 in Beijing city,as well as their interaction and influenced factor.Methods203 school children aged 8～12 were assessed with Carey's temperament questionnaire(8～12:MCTQ) and The Self-Esteem Scale(SES).ResultsTemperament and self-esteem of school children aged 8～12 were associated with the parental behavior,especially with work style of their fathers.The rhythmicity was found to be negative correlated to the self-esteem scores,and the intensity of reaction was found to be positive correlated to the self-esteem scores.ConclusionParents' behavior and family environment were important to the temperament and self-esteem of school children.

Objective To investigate the causes of pancreatic injury after autologous liver transplantation in rats. Methods Forty-two SD rats were randomly divided into post autologons liver transplantation 1-hour group, 6-hour group, 12-hour group, 24-hour group, 48-hour group, 72-hour group and sham group (6 rats per group). The plasma concentrations of amylase and lipase were measured to assess pancreatic exocrine function. The histomorphological changes of pancreatic tissue were studied under optical and electron microscopes. All data were analyzed via one-way ANOVA. Results The plasma concentrations of amylase and lipnse in post autologous liver transplantation 1-hour group were significantly higher than those in sham group, and they gradually increased as time passed by. The plasma concentrations of amylase and lipase reached peak at hour 48, after which they decreased gradually. There was a significant difference in the plasma concentration of amylase and lipase among the 7 groups (F = 538.622,489.417, P < 0.05). Acute edematous pancreatitis was observed 1 hour after autolognus liver transplantation, and acute hemorrhagic necrotic pancreatitis was observed 6 hours after transplantation. The degree of injury reached a peak 48 hours after transplantation. The number of mitochondria was increased, and endoplasmic reticulum and Golgi apparatus were swollen 1 hour after transplantation, and the area, perimeter, specific surface area and mean gray value of mitochondria were (312±40) mm~2, (80.3±3.8)mm, 0.332±0.039 and 113±11, respectively. As time passed by, the injury of the pancreatic cells was aggravated and autophagosomes were observed. The injury was most severe 48 hours after transplantation, and the area, perimeter, specific surface area and mean gray value of mitochondria were (466±7) mm~2, (108.8±3.7) mm, 0.298±0.009 and 195±12, respectively. There were significant differences in the specific surface area and mean gray value among all the groups (F = 9.322, 76.560, P < 0.05). Conclusion The pancreatic injury after autologous liver transplantation is related to the energy metabolism of the pancreatic cells induced by hypoxia.

Drug Industry ; Humans ; Occupational Diseases ; epidemiology ; prevention & control ; Occupational Exposure ; prevention & control ; Risk Factors ; Ventilation

Objective:To investigate the clinical characteristics and electroencephalogram (EEG) of epilepsy patients with breach rhythm, improve clinical understanding of breach rhythm and avoid over-interpretation.Methods:Twelve epilepsy patients with breach rhythm who visited the Department of Neurology, Xijing Hospital, the Air Force Military Medical University from January 2016 to January 2017 were collected retrospectively. The clinical data, including etiology, clinical manifestations, EEG features and prognosis were summarized, and outpatient and telephone follow-up was performed for at least three years.Results:The clinical data of 12 patients with epilepsy with breach rhythm were collected, including eight males and four females, aged 36-78 years. After analysis, it was found that brain trauma was the most common cause of breach rhythm. Among them, two cases of skull defect were not repaired, eight cases were repaired with skull titanium mesh, one case was repaired with skull polymethylmethacrylate, and one case was repaired with skull polyetheretherketone. The distribution of the breach rhythm in 12 patients was consistent with the abnormal area of the skull. The breach rhythm can be expressed as high amplitude and fast frequency, or low amplitude and slow frequency and appear individually (similar to sharp waves, spikes). On the basis of pleomorphic slow waves, 10 patients were mixed with sharp waves and spike waves, and imaging confirmed that they had brain damage in corresponding parts. All of the 12 patients had a history of seizures, with tonic-clonic seizures and (or) focal seizures being the most common. Three patients with breach rhythm had no clinical seizures for more than five years, and had been taking antiepileptic drugs for epileptic spikes on EEG, and they were given reduction and discontinuation of the drugs and were seizure-free for three years during follow up.Conclusions:Skull repair is a common cause of breach rhythm, and repair materials with different resistances cause different waveforms and frequencies. Breach rhythm, epileptiform discharge and other pathological slow-wave activities can exist at the same time. Breach rhythm is a benign variant phenomenon which needs no special treatment.

Objective:To describe the electroclinical features of the coexistence of epilepsy and narcolepsy.Methods:The electroencephalography database was searched using the terms “epilepsy” and “narcolepsy” over a four-year period from January 2016 to December 2019 in the Xijing Hospital. The clinical and electrophysiological characteristics of patients with coexistence of epilepsy and narcolepsy were studied.Results:Five patients with comorbidity for epilepsy and narcolepsy were found, of which three patients were female, two patients were male. The age at epilepsy onset and narcolepsy onset was 2-12 years and 8-17 years, respectively. There were two patients with juvenile myoclonic epilepsy, one with sleep-related hypermoter epilepsy, one with epilepsy with retardation of brain development, one with symptomatic epilepsy with cognitive decline. All the patients had narcolepsy with cataplexy, which followed the onset of epilepsy by three months to eight years. All the patients accepted 24 h video electroencephalography monitoring and multiple sleep latency test. Interictal epileptic discharges were found, mean sleep latency was<8 min, and two or more sleep onset rapid eye movement periods were recorded. Duloxetine hydrochloride can effectively improve the drowsiness and catalepsy symptoms of narcolepsy, and seizures did not worsen in patients using duloxetine hydrochloride.Conclusions:Both generalized and focal epilepsy can occur in narcolepsy with cataplexy. Duloxetine hydrochloride may be safe and effective in treating narcolepsy in patients with epilepsy.

Objective To investigate the clinical diagnosis,treatment and prevention of fallopian tube prolapse(FTP)after hysterectomy.Methods A total of 7949 patients received hysterectomy from 1983 to Aug 2005 in Peking Union Medical College Hospital,including 6229 cases of trans-abdominal hysterectomy(TAH),780 cases of transvaginal hysterectomy(TVH),and 940 cases of laparoscopic assisted vaginal hysterectomy(LAVH).Nine cases(including 1 case from other hospital)of FTP after hysterectomy were analyzed retrospectively for their symptoms,diagnosis and treatment.All of them were diagnosed according to the results of histology and follow-up.Results The overall incidence of FTP after hysterectomy was 0.11%(9/7949).Incidence of FTP after trans-abdominal hysterectomy was 0.08% (5/6229),after vaginal hysterectomy 0.51%(4/780),and after laparoscopic assisted vaginal hysterectomy 0(0/940).There were no symptoms in 3 cases,but the other 6 cases had symptoms.The pelvic examination revealed the typical prolapsed fimbrial end of a fallopian tube in 3 cases and red granulation tissue in the other 6 cases.All of them were excised vaginally and cauterized.The results were confirmed by histological examination.No recurrent cases were reported in follow up.Conclusions FTP is a rare complication after hysterectomy.The prognosis is well after proper diagnosis and treatment.Salpingectomy or fixation of accessories into the pelvic wall and complete peritonealisation at the time of hysterectomy are important methods to prevent FTP after hysterectomy.

Objective To establish the chick embryo chorioallantioc membrane(CAM)as a model for in vivo research on endometriosis.The model was used to investigate the mechanism of anti-vascular endothelial growth factor(VEGF)antibody for treatment of endometriosis.Methods Human endometrial fragments were explanted onto the CAM.Then anti-VEGF antibody was used for the endometriosis-like lesions after transplantation of human endometrial fragments.The CAM models were treated respectively as control groups and experimental groups.The terminal deoxynucleotidyl transferase-mediated biotin- deoxyuridine triphosphate(dUTP)nick end labeling(TUNEL),proliferating cell nuclear antigen(PCNA) and microvessel density(MVD)were used in vivo for analysis of anti-angiogenesis.Results The apoptosis intensity of anti-VEGF antibody treated groups(6.7?0,9,6.9?0.8)was significantly higher than that of the control groups(5.0?0.9,5.4?1.1;P

OBJECTIVETo summarize our experiences in the diagnosis and treatment of placenta accreta in the second trimester of pregnancy.

METHODSWe retrospectively analyzed the clinical data of 31 patients were admitted to Peking Union Medical College Hospital with placenta accreta in the second trimester of pregnancy from January 2002 to January 2010.

RESULTSAmong 31 cases, one case (3.2%) was suspected to be with placenta accreta by ultrasound examination and 30 cases (96.8%) were normal before delivery. Placenta accreta was identified during follow-up in 12 cases (38.7%) after delivery. Fourteen patients underwent curettage again after delivery,which was effective in 6 patients (42.9%) and failed in 8 patients,in whom uterine artery embolization (UAE) was further applied. Thirteen patients underwent UAE without curettage. In total,21 cases underwent UAE, which was effective in 19 patients (90.5%); one patient with abnormal β-human chorionic gonadotropin (β-HCG) 5 months after embolization underwent lesion resection and one case with slightly increased β-HCG were lost to follow-up. Hysteroscopy was effective in 3 patients,of whom two patients underwent lesion resection by hysteroscopy and one case who was suspected to be with trophoblastic disease by ultrasonography before surgery and confirmed to be placenta accreta during hysteroscopy examination underwent lesion resection. One case experienced hemorrhagic shock during vaginal delivery and underwent emergency laparotomy. Among all these 31 patients,massive hemorrhage occurred in 13 cases during delivery and hemorrhagic shock in 2 cases. Three cases had postpartum hemorrhage and stopped bleeding after UAE. None needed hysterectomy.

CONCLUSIONSPlacenta accreta in the second trimester of pregnancy is usually diagnosed after childbirth,which may be delayed in some cases. Therefore,special attention should be paid to this disease during follow-up. Conservative treatment was the main therapy of placenta accreta in the second trimester of pregnancy. UAE is effective in stopping bleeding.

Adult ; Dilatation and Curettage ; Female ; Follow-Up Studies ; Humans ; Placenta Accreta ; diagnosis ; therapy ; Pregnancy ; Pregnancy Trimester, Second ; Retrospective Studies ; Uterine Artery Embolization ; Young Adult