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.

Adult ; Arsenic Poisoning ; therapy ; Female ; Hemodiafiltration ; methods ; Humans ; Male ; Middle Aged ; Occupational Diseases ; therapy ; Treatment Outcome

Aim To investigate the Yiqi Yangyin Qingre Oral Liquid(YYQ) on insulin resistance in hyperglycemic fatty rats.Methods The model of hyperglycemic fatty rats was induced by intravenous injection with a low dose of streptozotocin(STZ) and a fed high fat and high caloric diet.The YYQ was given via gavage for a period of 4 weeks.The fasting blood glucose(FBG),oral glucose tolerance(OGT),serum insulin(INS),triglyceride(TG),total cholesterol(TC),free fatty acid(FFA)levels,glucose infusion rate(GIR) by euglycemic hyperinsulinemic clamp technique as well as erythrocyte insulin receptors(INSR)of rats were tested when the experiment was finished.The weight of the epididymal fat pads and the perirenal fat pads were measured.The IR,IRS-1mRNA expressions in liver tissue were measured by RT-PCR technology.Results YYQ treatment decreased the levels of FBG,TC,TG,LDL-C,FFA and increased the level of HDL-C in hyperglycemic fatty rats.As compared with the model rats,glucose tolerance was improved and body weight was reduced in hyperglycemic fatty rats treated with YYQ.Moreover,YYQ treatment upregulated IR,IRS-1mRNA expressions in liver tissue and increased insulin receptor amounts on the erythrocytes surface as well as GIR in the hyperinsulinemic euglycemic clamp experiment.Conclusions YYQ ameliorated insulin resistance in hyperglycemic fatty rats,and its mechanism might be related to increment of INSR and stimulation of insulin pathway.

Objective To study the diagnostic value of multi-direction adjusted multiplanar reconstruction (MPR)by 64-slice CT myelography (CTM)in diagnosing cervical nerve injury,and the possibility of the MPR to replace conventional myelography and CT direct-scanning axial images.Methods Twenty-six patients with cervical nerve root injury were examined by conventional myelograpby and 64-slice CT using isotropic parameters.Then multi-direction MPR were performed to display nerve roots on coronal and sagittal planes besides axial images.Twenty-six patients were performed surgical operations and diagnosis were obtained.The coincident diagnosing rate with surgical operations results were compared statistically among multi-direction MPR,direct-scanning axial CT images,conventional myelography.The numbers of images were also compared between axial MPR and direct scanning axial CT images.Results Direct sign of nerve root avulsion was the loss of normal nerve root defect seen in the Isovist filled thecal sac in 6d-slice CT,which was found in 31 nerve roots.Indirect signs included:(1)Traumatic pseudomeningocele: 29 nerve roots showed the leak of Isovist into nerve root sheath,and extended into foramina;(2)Arachnoid cyst: 26 nerve roots clearly displays cystic distension in nerve root,which has low- density fine clew form septation from subarachnoid cavity and no nerve root in the cyst ;(3)Deformity of the subarachnoid space : deformity of thecal sac,partially lack of Isovist into arachnoid space,which was found in 17 nerve roots.The coincident diagnosing rate of cervical nerve root injury by multi-direction adjusted coronal MPR imaging was 92.6% (50/54),which was higher than by axial CT (77.8%,42/54)and conventional myelography (68.5%,37/54),There was significant difference between the conventional myelography, direct-scanning axial CT,multi-direction MPR images (Kappa = 0.686,0.772,0.920, respectively,P

Objective To observe the curative effect of captopril and metoprolol in the treatment of chronic Keshan disease (CKD). Methods One hundred and ninty-five patients with CKD chosen from Juxian, Wulian, Yishui, Pingyi, Sishui and Zoucheng in Shandong Province were randomly assigned to control group, captopril group and metoprolol group according to NYHA cardiac functional grading. All cases were given diuretics, digitalis and vasodilating agents as routine treatment. On this basis, captopril and metoprolol was administered in captopril group and metoprolol group respectively. After 12 months of follow-up visit, the causes of cardiac death, hospitalization status and the changes of heart size, electrocardiogram, blood pressure and heart rate were all observed. Results It was found that the mortality of captopril group and metoprolo] group was 4.76% (3/63), 5.00% (3/60) respectively, both lower than the control group 10.61%(7/66). But this difference had no statistically significance(P=0.39). Besides, the hospitalization days of each year in captopril group and metoprolol group was respectively (19.12± 20.35) and(18.86±21.52)days, much more reduced than in the control group[(21.45±21.74)days, q=3.17, 3.38, P<0.05]. The detection rate of cardiothoracic ratio decreased in captopril group and metoprolol group [45% (27/60) and 40.4% (23/57)] After treatment showed more pronounced amelioration than the control group [18.6% (11/59), χ2=9.51,6.59, all P<0.0125], still the detection rate of cardiomegaly and invariability had no significant difference among three groups (χ2=2.50,4.75, all P>0.05). The elimination coefficient of ectopic rhythm in metoprolol group [56.5% (13/23)] was pronounced higher than the control group and captopril group [23.8% (5/21), 22.7% (5/22)], but differences had no statistically significance(P=0.0358,0.0331, all P>0.0125). Significant differences were found in systolic blood pressure(SBP), diastolic blood pressure(DBP) and heart rate(HR) in three groups prior and post-treatment(F=47.51,44.23,80.66, all P<0.01). The interaction of therapy and treatment time had influence on SBP and HR (F=3.19,37.44, all P<0.05), but had no influence on DBP(F=2.21, P> 0.05). There was no difference in SBP, DBP or HR among three groups before treatment(F=0.28,0.57,1.80, all P>0.05). After treatment, SBP and DBP in captopril group, metoprolol group and the control group[(109.0±10.9), (112.2±12.8), (114.7±13.2)mm Hg, (69.3±7.2), (72.1±9.5), (73.3±9.3)mm Hg] were all lowered compared with pre-treatment[ (117.1±13.4), (119.0±14.4), (117.6±14.1)mm Hg and (74.2±10.2), (76.3±10.8), (75.4±11.1)mm Hg, t=4.79,4.47,2.08,5.12, 4.32,2.15, all P<0.05]. HR was reduced in metoprolol group, being [(66.2±7.7), (75.9±11.5)times/min] before and after treatment(t=10.81, P<0.01), while it remained unchanged in captopril group and control group[(70.6±8.0), (72.6±10.5) times/min and (71.9±10.4), (73.8± 12.2)times/min, t=1.77,1.74, all P>0.05]. After treatment, both SBP and DBP of captopril group were significantly lower than that in the control group (q=3.52,3.56, all P<0.05); HR was reduced in metoprolol group, lower than that in captopril group and control group(q=5.44,3.73, all P<0.01). Conclusions Having a tendency of depressing mortality, captopril and metoprolol can reverse or delay myocardial remodeling and reduce admission rate in a safe,reliable and economic way, and are worth to be widely used in the treatment of chronic Keshan disease.

Objective To investigate the incidence of Keshan disease(KSD) in Shandong province and to supply evidence for scientific control of the disease.Methods According to the scheme of KSD monitoring in Shandong province,the KSD cases were searched in 7 counties,and representative 3 counties and 6 villages were selected as key monitoring sites.In each site,about 420 residents were checked by asking detailed disease history,physical examination,and electrocardiography (ECG) tracings.Suspected cardiac abnormalities were taken chest posteroanterior X-ray film.At the same time,residents hair and food samples were collected to detect selenium levels in internal and external environments,and residents' income and per capita share of grain and other basic information were collected.Results ①Two hundred and fifty-nine medical units were searched,1132 cases of myocardial disease were found out and 638 suspected cases were identified and 142 chronic KSD cases were diagnosed.②In the 6 monitoring sites,2538 residents were surveyed and 91 cases of KSD were detected(of which 77 cases of potential,14 cases of chronic),the detection rate was 3.58％.A total of 2127 residents were traced ECG and the incidence of abnormal ECG was 24.5％ (521/2127),of which ST-T changes,T-wave changes,sinus bradycardia,sinus arrhymia,sinus tachycardia,and atrial premature beats et al were more common.Of the 75 X-ray films,39 cases had enlarged heart(in which 21 of mild,13 of moderate,5 of severe).③A total of 406 hair and grain samples were collected,respectively,and the selenium content of hair was approaching the level of appropriate,and the selenium content of food was still low.The annual per capita incomes of each site were between 3000 - 5900 Yuan,and residents main staple food was flour.Conclusions KSD in Shandong province is in a relatively stable situation.But latent and chronic KSD cases can still be detected.The internal environment selenium levels are elevated since the local living standards and dietary nutrition are improved.

Background and purpose:Vascular endothelial growth factor(VEGF) is a potent angiogenic mediator and angiogenesis has important effects on tumor growth and metastasis.The present study was to investigate the relationship between genetic polymorphism of VEGF and heredity risk factor of lung cancer.Methods:VEGF genotypes were determined by PCR-RFLP method in 171 patients with lung cancer and 172 healthy controls.Software PHASE 1.0 was used to construct the haplotypes of every individual.Unconditional logistic regression model was used to analyze the statistical association of genotypes or haplotypes in the two groups adjusted by gender and age. Results:Individuals with at least one-2578A allele had a significantly decreased risk of lung cancer compared with those carrying-2578CC genotype.When the analyses were stratified by gender,the combined-2578 CA and AA genotype,were associated with a considerably reduced risk of lung cancer(P=0.001,OR=0.303,95%CI=0.15 3-0.601).The distribution of the two haplotypes(936C/-2578C and 936C/-2578A) among overall lung cancer cases was significantly different from that among the controls(P=0.016,0R=0.317,95%CI=0.124-0.809 and P=0.018,OR=0.547, 95%CI=0.331-0.903).When the cases were categorized by tumor histology,the distribution of C-C haplotype in the adenocarcinoma(AC) group was associated with a substantially lowered risk of AC(P=0.004,0R=0.237,95%CI=0.090- 0.627),compared with the reference haplotypes.Conclusion:VEGF polymorphism may be a critical risk for the genetic risk factor to lung cancer.

Animals ; Aorta ; pathology ; Atherosclerosis ; blood ; etiology ; metabolism ; Chemokine CCL2 ; metabolism ; Cholesterol ; blood ; Cholesterol, Dietary ; administration & dosage ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Dehydroepiandrosterone ; pharmacology ; Diet, Atherogenic ; Immunohistochemistry ; Rabbits ; Random Allocation ; Triglycerides ; blood ; Vascular Cell Adhesion Molecule-1 ; metabolism

Objective To analyze the situation of smoking control calls at 12345 citizens′ hotline in Shanghai and investigate the smoking control hotspots concerned by citizens, the handling efficiency and quality of the hotline management, especially after the tobacco control ordinance was amended. Methods Statistical analysis was made on 48 945 smoking control calls, and data model established by natural language processing. Results After amendment of the tobacco control ordinance, there was a great increase in the number of smoking control calls, which reached a peak in 2017, and became 6.7 times that of 2016.Complaint report was the most important part of tobacco control calls, accounting for 76.24% of the total.Work and dining places were the main venue for complaints, while restaurants and offices were with the largest number of calls.The proportion of health departments in all responsible departments was the largest, accounting for 29.71%.Criticism and education were still the main way to deal with the problem, which was far from meeting the demands of citizens in this regard. Conclusion Publicity can mobilize the enthusiasm of the citizens to participate in tobacco control.The working efficiency and quality of responsible departments still needs to be improved.Citizen′s appeal can serve as a reference for future amendments to the law.

OBJECTIVETo investigate the relationship between RASSF1A gene expression and DNA methylation or histone modification in laryngeal carcinoma tissues.

METHODSChromatin immunoprecipitation (ChIP), methylation specific polymerase chain reaction (MSP) and realtime quantitative reverse transcription polymerase chain reaction (realtime RT-PCR) were used to analyze RASSF1A gene promoter region histone H3 lysine 9 methylation, H3 lysine 4 methylation, H3 lysine 9 acetylation, DNA methylation, and RASSF1A gene expression in laryngeal carcinoma tissue of 50 cases.

RESULTSDNA methylation rate of gene RASSF1A was 62% in 50 cases of laryngeal carcinoma, but no DNA methylation was found in normal control group, with a significant difference (χ(2) = 15.381, P < 0.05). DNA methylation had no correlation with age, gender, differentiation degree, T stage, pathological type and lymph node metastasis (P > 0.05). The affection of DNA methylation group was more than unmethylation group to expression of gene RASSF1A (t = -3.108, P < 0.01). There was positive correlation between RASSF1A deletion and gene hypermethylation or between H3 lysine 9 methylation of RASSF1A gene promoter and DNA methylation in laryngeal carcinoma tissue(r = 0.816, P < 0.05), but there was negative correlation between H3 lysine 4 methylation of RASSF1A gene promoter and DNA methylation (r = -0.837, P < 0.05) and no correlation between H3 lysine 9 acetylation and DNA methylation (r = -0.383, P > 0.05).

CONCLUSIONSLaryngeal tumor suppressor gene RASSF1A promoter methylation is a key factor down-regulating the gene expression, and histone modifications also plays an important role in tumor development.

Adult ; Aged ; CpG Islands ; DNA Methylation ; Female ; Gene Deletion ; Gene Expression Regulation, Neoplastic ; Gene Silencing ; Histones ; genetics ; metabolism ; Humans ; Laryngeal Neoplasms ; genetics ; metabolism ; Male ; Middle Aged ; Neoplasm Staging ; Promoter Regions, Genetic ; Tumor Suppressor Proteins ; genetics