Objective To investigate effect of edaravone on serum inflammatory factors, 6-keto-prostaglandin F1α(6-keto-PGF1α), thromboxane B2, endothelial function and serum copeptin and N-terminal brain natriuretic peptide (NT-proBNP) in patients with acute cerebral infarction.Methods From March 2013 to September 2014, 213 cases of acute cerebral infarction were selected in the hospital and randomly divided into control group (n=101) and observation group (n =112).Control group were given conventional symptomatic treatment, and observation group were given edaravone injection on the basis of control group.The serum inflammatory cytokines, 6-keto-PGF1α, thromboxane B2, endothelial function, serum copeptin, NT-proBNP and nerve function score and activities of daily living ( ADL) score were compared between two groups.Results Serum CRP, IL-8, IL-10 in observation group after treatment were significantly lower than control group (P<0.05).Plasma thromboxane B2 in observation group after treatment was significantly lower than control group (P<0.05).The levels of 6-keto-PGF1αwas significantly higher than control group (P<0.05).Serum copeptin and NT-proBNP levels in observation group after treatment were significantly lower than control group (P<0.05).Plasma ET-1 in observation group after treatment was significantly lower than control group ( P<0.05 ) , and plasma NO was significantly higher than the control ( P<0.05 ).Neurological function in observation group after treatment was significantly lower than control group (P<0.05), and ADL score was significantly higher (P<0.05). Conclusion The preliminary study shows that edaravone in treatment of acute cerebral infarction may be associated with decreasing serum inflammatory cytokines, increasing 6-keto-PGF1αand reducing thromboxane B2, improving endothelial function and reducing serum copeptin and N-terminal natriuretic peptide.

Objective To investigate impact of rosuvastatin on cardiac function, lipid levels, blood rheology level and endothelial function in patients with coronary heart disease.Methods 149 cases were randomly divided into two groups, the treatment group (n=76) and control group(n=73).Control group with conventional symptomatic treatment, treatment group on the basis of control group combined rosuvastatin treatment.Cardiac function, blood lipid levels, blood rheology changes and endothelial function levels before and after treatment were comparative analysis.Results LVEF significantly increased after treatment than before treatment between two groups (P<0.05), while LVESV, LVEDV after treatment than before treatment were significantly lower ( P<0.05 ) , LVEF in treatment group was significantly higher than control group ( P<0.05 ) , LVESV, LVEDV was significantly lower than that of control group (P<0.05).The two groups of LDL-C, TC, TG after treatment was significantly lower than before treatment (P<0.05), but HDL-C was higher than before treatment(P<0.05).LDL-C, TC, TG in treatment group after treatment was significantly lower than control group (P<0.05), whereas HDL-C after treatment was significantly higher than control group (P<0.05).Fibrinogen, plasma viscosity, whole blood low shear viscosity, whole blood viscosity was lower than that before treatment (P<0.05), which in treatment group was significantly lower than control group (P<0.05).NO, FMD was significantly higher than before treatment (P<0.05), and ET was significantly lower than before treatment (P<0.05).NO, FMD in treatment group was significantly higher than control group (P<0.05), and ET was significantly lower than control group (P<0.05).Conclusion Rosuvastatin can significantly improve cardiac function, improve blood lipid levels, lower levels of blood rheology, improve endothelial function.

Objective To discuss the effect of operations for comminuted patella fractures with cable cerclage and revised tension band. Method Retrospective study of clinical effects of 120 patella fractures cases which used cable(cable group,55 cases) or NT-PC (NT-PC group,65 cases) to internal fix.Results At 10 to 38 ( 19.50 ± 1.15 ) months follow-up, all cured well in 12 weeks. Compared with the operative time, the amount of blood loss, length of hospitalization, time for cure, the incidence of complications,there were no significant differences between two groups (P ＞ 0.05 ). The B (o)stman score of cable group [(27.0 ±0.2) scores] was better than that of NT-PC group [(25.1 ±0.6) scores](P＜0.05). Conclusion Using cable cerclage and revised tension band to internal fix for comminuted patella fractures,the operations are facile and the results are satisfactory.

Objective To assess the efficacy and safety of ketogenic diet(KD) on refractory epilepsy in children.Methods KD treatment was designed to observe the effects for 12 weeks.Totally 22 children with 16 boys and 6 girls were enrolled in the study.The epileptic syndromes included infantile spasms(13 cases),Lennox-Gastaut syndrome(4 cases),Dravet syndrome(2 cases),and the unclassified(3 cases).The KD was prepared according to the modified Johns Hopkins regimen.Urinary ketones were measured every day to ensure that ketosis state and parents′ diaries were kept to find out when it started to work and the change of seizure frequency.Effects of KD was evaluated by Engel standard.Blood chemistry was done at baseline,4 weeks and 12 weeks to analyze the effects of KD on metabolism.Side effects were monitored and treated.Results All cases completed the KD regimen for at least 2 weeks,19 cases for at least 4 weeks,and 10 cases for at least 12 weeks.Sixteen out of 22 children experienced the seizure reduction within 3 weeks(1-15 d),especially in the first week,and seizure free appeared within 5 weeks(1-32 d) in 8 cases.Overall,the diet achieved the seizure-free in 36.4%(8/22 cases) and an over 90% of seizure frequency reduction in 22.7%(5/22 cases).The efficacy of KD seemed not correlated with the sex,age,etiopathogenisis,and syndromes and so on.Blood chemistry suggested a normal range of glucose level at 4 weeks,though higher than that at the baseline.The blood triglyceride and total cholesterol level at 12 weeks increased strikingly,even beyond the normal range compared with the baseline.The side effects mainly including transient gastrointestinal symptoms and metabolic disturbances were mostly tolerable.Conclusions KD is probably a feasible therapy on refractory epilepsy in children,with quick and high efficacy and few side effects.

Objective To explore the initial clinical and imaging characteristics of basal ganglia germinoma in children.Methods Four patients with basal ganglia germinoma were reported.Their clinical features,laboratory findings,radiological manifestations,treatment and outcome were analyzed.They recieved radiation therapy and chemotherapy after diagnosis.All patients were clinically diagnosed,according to the results of low-dose cranial irradiation.The outcomes were followed up for 2 years.Results All patients were male and school-aged(9-13 years) children.The course of the disease ranged from 5 to 13 months.All patients were presented with slowly progressive hemiparesis,and 2 cases of them were presented with cognitive decline and psychosis.Seizure occurred in 2 patients.The serum ?-human chorionic gonadotropin(?-hcG) level was significantly increased in 2 patients(30.16 IU/L and 77.85 IU/L,respectively),and mildly elevated in 1 patient(4.29 IU/L),while serum ?-hcG level in another case was within normal control range.MRI demonstrated mildly high intensity in the left or right basal ganglia on T1-weighted and T2-weighted images without remarkable occupying lesion.Ipsilateral hemiatrophy of the hemisphere and midbrain was also noted.Inhomogeneous Gd-DTPA enhancement was observed.All patients had been treated with radiation therapy and chemotherapy.During 2 years follow up,significant improvement was observed in all patients after therapy,imaging lesions disappeared and the elevated ?-hcG level of those elevated before therapy returned to normal.Conclusions Early diagnosis and treatment for basal ganglia germinoma are critically important to improve the prognosis.In young male patients with progressive hamiparesis,basal ganglia germinoma should be considered for differentiation,if abnormal high intensity signals in basal ganglia on T1-weighted and T2-weighted image with ipsilateral hemiatrophy of the hemisphere are demonstrated on MRI,even without occupying effect.

A review of the drug supply for international rescue teams in their earthquake rescue in recent years. Based on the characteristics of drug supply assurance and requirements, experiences and setbacks were summarized in an effort to build practical rescue drug management ways. Such drug management ways, when built, will maximize rescue drug use efficiency.

Objective To investigate the clinical and electroencephalogram (EEG) characteristics of children with electrical status cpilepticus during sleep (ESES), and the response to medication therapy. Methods AEEG and VEEG including an entire sleeping c-ycle were performed on 26 patients with ESES. The clinical and EEG changes, neuropsychological impairment and the response to medication therapy were followed up. Results Twenty five patients had seizures,21 cases had normal psychomotor development before ESES. After the onset of the disease,Fifteen cases developed language disorder, 16 cases developed psychological and behavior abnormalities, 13 cases had both of the problems Seventeen patients belonged to epileptic syndrome. Patients in this cohort had good response to clonazepam and valproate treatment. Cortical steroid could dispel the electrical discharge. Eighteen patients had been followed up. Seizures stopped in 15 cases after treatment ESES disappeared in 16 cases, 4 of them still had neuropsychological impairment ESES sustained in 2 cases Conclusions ESES is a specific EEG phenomenon. Continue epileptic form discharge during non - rapid cye movement sleep is the major cause of neuropsychological impairment in patients with ESES. To control the seizures and electrical state are very important for the prevention and treatment of neuropsychological impairment.

Objective To explore the clinical characteristics ,diagnosis, treatment and prognosis of phaeohyphomycosis. Methods Clinical data were collected, including history, physical examination, cranial and spinal imaging. Brain biopsy was performed. Data of the pathology and incubation of brain tissue were analyzed. Responsiveness to treatment was followed up. Results A previously healthy three and half years old boy was presented to our unit, with a three- month history of recurrent headache, vomiting, progressive paraplegia accompanied by urinary continence and constipation. A computed tomogram scan and magnetic resonance imaging of the brain revealed multiple lesions located in the region of the parietal - occipital lobes, periventricular area and frontal lobe, with prominent surrounding edema and irregular peripheral enhancement of the mass after the administration of contrast materials. A cerebral biopsy was performed and the pathological report was cerebral phaeohyphomycosis. The culture of the tissue and cerebrospinal fluid grew a same fungus identified as exo-phiala dermatitidis. The patient's response to therapy was poor, the parents of the boy gave up therapy, and the boy died 1 month later. Conclusions Cerebral Phaeohyphomycosis caused by Exophiala dermatitidis is rare, but the most serious form of fungus infection. Pathology and incubation of the tissue are essential for diagnosis. There is no curative therapy and the prognosis is poor.

OBJECTIVEWilson's disease (WD) is an autosomal recessive disorder characterized by excessive accumulation of copper in the liver and later in the brain and other organs. Penicillamine acts as a reductive chelator. Zinc salts induce the synthesis of metallothionein in cells. Thus these two drugs are theoretically synergistic for the treatment of the disease. However, the two drugs may also have some unfavorable interactions. In this study, the effect of the therapy with combined penicillamine and zinc salts was evaluated based on the follow-up observations of 21 patients with Wilson's disease.

METHODSUsing the combined therapy of penicillamine [10-30 mg/(kg.d)] and zinc (22.5 mg, 3 times per day), follow-up study by hospitalization or communication with telephone or mail.

RESULTSBefore treatment, all the 21 patients were suffered from chronic liver disorder. Among them, 13 patients (62%) showed to be reactive to the treatment for their liver disorder, 5 patients (24%) died, and 3 patients (14%) dropped off our follow-up study. Among the 5 patients who died, 3 died within 40 days after treatment, one had taken penicillamine only 8 mg/(kg.d), and one died after discontinuation of the treatment by the parents. Of the 12 patients having neurological involvement, neurological symptoms disappeared or markedly improved in 11 patients after treatment. One patient dropped off the follow-up study. The patient with renal tubular acidosis responded well to the treatment. Urine routine analysis was followed up in 6 of the 7 patients with hematuria. Hematuria disappeared in one, became less severe in 1, and remained unchanged in 4 patients. Hypersensitivity to penicillamine was found in one patient. WBC and platelet were found decreased further in 3 patients after the medications.

CONCLUSIONSThe combined therapy with penicillamine and zinc salts was effective in treatment of patients with Wilson's disease.

Adolescent ; Antidotes ; administration & dosage ; adverse effects ; therapeutic use ; Child ; Drug Therapy, Combination ; Female ; Follow-Up Studies ; Hepatolenticular Degeneration ; drug therapy ; Humans ; Male ; Penicillamine ; administration & dosage ; adverse effects ; therapeutic use ; Treatment Outcome ; Zinc ; administration & dosage ; adverse effects ; therapeutic use

Objective To evaluate multi-slice spiral computed tomography(MSCT)in the diagnosis and preoperative staging of gastrointestinal cancer.Methods (1)Three hundred and thirty-two gastric cancer patients underwent preoperative MSCT examination.The staging of gastric cancer by MSCT was compared with histological examination.(2)Seventy-three small intestinal cancer patients underwent preoperative MSCT,and 70 healthy adults were selected as normal contr01.The MSCT images of small intestinal lymphoma and small intestinal cancer were compared with those of normal small intestine.(3)Two hundred and twenty-eight colorectal cancer patients underwent preoperative MSCT,and the features of the MSCT images of colorectal cancer were analyzed by chi-square test.Results (1)The overall accuracy of MSCT in the assessment of gastric wall invasion,lymph node metastasis and distal metastasis were 78.2%(244/312),67.3%(210/312)and 93.8%(30/32),respectively.More information such as the location of lesions and the vessels around the stomach couldbe provided by MSCT image.(2)Abdominal masses,diffuse thickening of intestinal wall and intestinal obstruction were the main features of small intestinal cancer,while mesenterie and retroperitoneal lymph nodes metastases were rarely detected.The presentation of small intestinal lymphoma detected by MSCT were completely the opposite.(3)Signs such as"coarse surface"and"heterogeneous enhancement"were important to the diagnosis of colorectal cancer.The measurement of the MSCT value is helpful in the differential diagnosis of colorectal cancer and colonic inflammation.Conclusions MSCT can provide correct imaging information on the diagnosis and preoperative staging of gastrointestinal cancer.The combination of MSCT and endoscopy can improve the accuracy of diagnosis.