Infantile spasms constitutes an unique,age-specific epilepsy syndrome of early infancy characterized by epileptic spasms often accompanied by neurodevelopmental regression and an electroencephalograph finding of hypsarrhythmia.For the complex and various etiologies,the pathogenesis remains unclear.Although the relevant guidelines and consensuses are being updated all the time,but proven therapies are still limited because of efficacy,tolerability,at times even availability.In this paper,the current findings regarding up-to-date advances in the treatment of infant spasms were reviewed,especially in use of the corticosteroid and vigabatrin as well as the quality-of-care indicators for infantile spasms.

BACKGROUND: Mental disorders of college students, especially medical college students, deteriorate year by year.Mental disorders can not only restrict healthy development of body and mind, but also cause social crisis.OBJECTIVE: To survey the prevalence of mental status and the correlation between mental status and family dynamics among medical college students.DESIGN: Randomized cluster sampling.SETTING: Center of Mental Health, the First Affiliated Hospital, Chongqing University of Medical Science.PARTICIPANTS: A total of 801 sophomores were selected from a medical university of Chongqing from November 2004 to June 2005.METHODS: ① Symptom Checklist-90 (SCL-90) was used to evaluate mental status among college students. If those students whose total scores were ≥ 200 and/or the score of any factor in SCL-90 was ≥ 3, they were regarded as having mental problem. The higher the scores were, the severer the mental problemwas. ② Family dynamics questionnaires, including family atmosphere, individuation, systemic logic and disease opinion, were used to evaluate characteristics of family dynamics. There were 4 items: family atmosphere, individuation, systemic logic and disease opinion. The more comfortable and cheerful the family atmosphere was, the lower the scores were; the greater the differentiated degrees were, the lower the scores of individuation were; the more objective the disposal of problems was,the lower the scores of systemic logic were; the more subjective the duty of recovery was, the lower the scores of disease opinion were.MAIN OUTCOME MEASURES: ① Prevalence of mental disorder; ② comparing scores of family dynamics between disorder group and normal group; ③ results of correlation analysis and step regression analysis between mental disorder and family dynamics.RESULTS: Among 801 questionnaires, 747 were involved in the final analysis. ① Prevalence of mental problem was 19.4%. ② The scores of family atmosphere, Individuation, systemic logic and disease opinion were all higher in disorder group than those in normal group, with significant differences (3.10±0.49, 2.66±0.64; 2.92±0.54, 2.77±0.58; 2.79±0.55,2.69±0.54; 2.58±0.67, 2.36±0.62, P ＜ 0.05). ③ The total score of SCL-90 was positive correlation with points of family atmosphere and disease opinion (r=0,184, 0,156, P ＜ 0.05). Family atmosphere, individuation and disease opinion were analyzed by regression equation.C0NCLUSION: Mental status of college students is closely related to family dynamics. Family atmosphere and disease opinion play a great role in mental disorder.

Objective To investigate the clinical features of acute mesenteric ischemia (AMI) in the elderly and provide evidence for early prevention,diagnosis and treatment of AMI for elderly patients.Methods A retrospective analysis was performed in 104 patients with AMI in our hospital,who were divided into two groups:the elderly group (aged≥60 years) and the non-elderly group (aged ＜ 60 years).Clinical manifestations,misdiagnosis rate,laboratory data,underlying diseases,treatment and prognosis were compared between the two groups.Results Acute superior mesenteric artery thromboembolus (ASMATE) was the main cause of AMI in the elderly group and acute mesenteric venous thrombosis (ASMVT) was the main cause of AMI in the non-elderly group.Elderly patients were more prone to misdiagnosis as compared with the non-elderly group (P =0.007).Abdominal pain (100.0％) was the most common clinical manifestation of AMI patients,followed by vomiting (58.7％).Nausea and vomiting were strongly associated with AMI in the elderly (P＜0.05).In laboratory data,serum creatinine,lactate dehydrogenase and uric acid were higher and the D-Dimer level was lower in elderly patients than in non-elderly patients (P＜0.05).Hypertension,atrial fibrillation,arteriosclerosis,ischemic heart disease,cerebral infarction and chronic renal insufficiency were more common in the elderly with AMI (all P＜0.05),while history of alcohol intake was higher in the non-elderly group (P=0.042).Hypertension,arteriosclerosis and cerebral infarction were independent relevant factors for elderly-onset AMI (P =0.000,OR =4.057;P =0.001,OR=4.585;P=0.007,OR=4.269).The number of patients with colon necrosis was higher in the elderly group than in the non-elderly group (P=0.038),and the prognosis was worse in the elderly group than in the non-elderly group (P=0.001).Conclusions ASMATE is the main cause of AMI in elderly patients.Nausea and vomiting are the main clinical manifestations,together with impaired renal function.Hypertension,arteriosclerosis and cerebral infarction are the independent relevant factors for elderly-onset AMI.Elderly patients are more prone to misdiagnosis,show more severity and have worse prognosis.

Objective To explore the relation between serum TGF?1 and diabetic nephropathy(DN). Methods Forty-five cases of type 2 diabetes mellitus patients were divided into three groups according to urine albumium excretion rate (UAER): normoalbuminuria (NA)group; microalbuminuria (MA) group; macroalbuminuria group (overt DN). Serum TGF?1, fasting blood glucose (FBG), HbAlc.BUN. Cr. Ccr were detected in all cases. Microalbundnuria group and macroalbuminuria group were respectively divided into group.treated with captopril and regular treatment group. Results Serum TGF?1, had significantly differences in four groups(23. 95?8. 01ng/ml vs 35.02?6. 70ng/ml, 39.3i? 5. 35ng/ml vs 58. 58?9. 56ng/ml,P

0.05).Conclusion The elevation of GH involved in the pathogenesis of diabetic microangiopathy possibly by exacerbation of disorders of glucose and lipid metabolism.

Objective To study the effect of valsartan on expression of MCP-1 in the myocardium of diabetic rats,to investigate the protective effect of valsartan on the myocardium of diabetic rats.Methods 30 rats were divided into at random:normal control group(NC group),diabetic model group(DM group),diabetic model plus valsartan therapy group(DV group).Diabetic rats were induced by STZ,at 8th week,expression of MCP-1 in the myocardium of diabetic rats,and diabetic rats treated with valsartan was detected respectively by using immunohistochemistry.Results At 8th week,the expression of MCP-1 of DM group was much higher than in both DV group and NC group(P

Objective:T explore the longitudinal mediation of emotional labor and emotion regulation between occupational stress and job burnout in cinema employees.Methods:This study was a two-point longitudinal study (Interval of 2 months) with the 1067 employees from 44 city cinemas across the country as the sample,using the Emotional Labor Questionnaire (ELQ) to measure the degree of emotional labor,Emotion Regulation Questionnaire (ERQ) to measure the degree of emotion regulation,Occupational Stress Indicator-2(OSI-2) to measure the degree of occupational stress,Maslach Burnout Inventory(MBI) to measure the degree of job burnout and Job Satisfaction Scale to measure the degree of job satisfaction.A series of structural equation model analyses was conducted for data analyses.Results:The scores of expression suppression were negatively correlated with scores of occupational stress (r =-0.16,P ＜0.01),and positively correlated with the scores of job satisfaction (r =0.17,P ＜0.01).The structural equation model which include the scores of occupational stress as the predictive variable,the scores of emotional labor and emotion regulation as the mediator,the scores of job burnout and job satisfaction as the outcome variable fit well.Emotional labor (surface acting and deep acting) acted as a mediator between occupational stress and job burnout(95 ％ CI:0.03-0.05;0.02-0.05).Emotion regulation (cognitive reappraisal) acted as a mediator between occupational stress and job bumout(95％ CI:0.01-0.03).Conclusion:Emotional labor and emotion regulation acted as a mediator between occupational stress and occupational outcomes.Expression suppression has positive effect in Chinese culture.People who well in using cognitive reappraisal can lead to positive work effect througgh more deep acting and less surface acting.

To study the clinical features, diagnosis, and treatment of SCN8 A-related infantile spasm, one 21-month-boy identified a de novo mutation of SCN8 A-related infantile spasm was admitted to West China Second University Hospital, Sichuan University in September 2019 and was enrolled as a research subject.The clinical manifestation and diagnosis process were analyzed by carrying out the retrospective analysis method.This case is the first report on SCN8 A-related infantile spasm in China.This child had hiatal hernia, which has never been reported in SCN8 A gene mutation people.The boy shows marked developmental regression after the onset of seizures at 8-month-old, and a variety of antiepileptic drugs are ineffective.Recently, seizure types have changed into infantile spasm.Levetiracetam was stopped, and provided adrenocorticotropic hormone (ACTH). After treatment, the spasm was relieved.Hiatal hernia may be a phenotype of SCN8 A gene mutation.Sodium channel blockers display high efficacy in SCN8 A-related epilepsy.ACTH therapy for SCN8 A-related infantile spasm is effective.

BACKGROUND:The levels of interleukin-1 (IL-1) and tumor necrosis factor-α (TNF-α) are increased during infectious brain edema, and are positively relevant to the degree of brain damage. However, whether TNF-α can enhance blood brain barrier (BBB) permeability remains unclear, especially in vitro.OBJECTIVE: To understand the changes and possible mechanism of the BBB permeability induced by TNF-α in vitro.DESIGN: Randomized controlled cell model study in vitro.SETTING:Department of Pediatrics, Xiangya Hospital, Central South University; Department of Biochemistry, Xiangya Medical College, Central South University.MATERIALS: Twenty 7-day-old healthy Sprague-Dawley rats, of clean grade and either gender, were provided by the Animal Center, Xiangya Hospital, Central South University. TNF-α was purchased from sigma Company; DMEM fluid medium and fetal bovine serum were purchased from Hyclone Company; Y-27632 was purchased from Alexis Company,and rabbit anti-human factor Ⅷ -related antigen was purchased from Zymed Company; Mouse anti-rat glial fibrillary acidic protein (GFAP) was purchased from Neomarkers. Other biochemical reagents were imported (Sigma Company).METHODS: This experiment was carried out in the Xiangya Hospital, Central South University between March 2004 and April 2005. Brain microvascular endothelial cells and astrocytes were co-cultured 10 days to set up rat models of BBB in vitro. Then, the cells were divided into 4 groups: model group(BBB models were prepared), TNF-α group ( BBB model incubated with 0.01 g/L TNF-α for 5 hours), Y-27632 pretreated group ( BBB model incubated with 30 μmol/L Y-27632 for 1 hour before 0.01g/L TNF-α challenge ) and Y-27632 control group (BBB models only incubated with Y-27632 as those in the Y-27632 pretreated group). The effect of TNF-α on BBB permeability was observed by detecting the 125 I -BSA, which passed through the inserts at each time point (30,60,120 and 240 minutes) using .γradioimmunoassay counter.MAIN OUTCOME MEASURES: The 125 I -BSA, which passed through the inserts in rat models of BBB at different time points after intervention.RESULTS: The 125 I -BSA, which passed through the inserts in rat models of BBB, was all significantly higher in the TNF-α group than in the other groups at 30, 60, 120 and 240 minutes after intervention, respectively (P ＜ 0.01), and reached the peak at 240 minutes; The 125 I -BSA, which passed through the inserts, was lower in the Y-27632 pre-treated group than in the TNF-α group at 30 and 60 minutes after intervention (P＜ 0.01). There was also significant difference in 125 I -BSA permeation between Y-27632 pretreated group and Y-27632 control group after 120 minutes (P ＜ 0.05).CONCLUSION: TNF-α can increase BBB permeability, and Y-27632 pretreatment can early reverse the effect of TNF-α on BBB permeability.

Objective To provide the anatomic basis of flap which was anatomized to the ankle by Anatomy study of vascular net around ankle joint.Methods 32 lower limbs were infiltrated into red emulsion;4 perfusions of lower limbs,artery;2 cases of radiography;1 lower limb was infiltrated into black ink.Application anatomy was observed the origin,track-way,branches and configuration in ankle and foot.Results The blood provision in ankle includes three parts;All the patients recovered well after treatment by careful flap-design.Conclusion The vascular net around anatomy of the ankle can provide help for the design,the choice and the operation of ankle's,tissue flap,and the function's,recovery after surgery.