Epilepsy is one of the most common diseases in children.The diagnosis,classification and treatment of epilepsy are improving gradually and meet with the international standards.However,the understanding of the clinical significance of epilepsy combined with the mental and behavioral problems is not sufficient,which leads to the backlogging of the diagnosis and intervention of the co-morbidity,and further affects the long-term prognosis.The prevalence of epilepsy co-morbid with attention deficit hyperactivity disorder (ADHD) is high,which seriously affects the quality of the lives in children and their families.Timely diagnosis and standardized treatment is very important for the clinical workers to improve the long-term prognosis of these children.In this paper,the possible mechanism,the disease characteristics,the standardized diagnosis and treatment of epilepsy combined with ADHD,are briefly introduced.

Objective:To improve previous method of primary rat cortical neuron culture to get purer and more long-lasting cells for study.Methods:Timed-pregnant Wistar rats at a gestational age of 16 or 17 days(16-17 d) were used.Fetal brains were removed and the cerebral cortices were dissected out.Papain digestion and mechanical dissociation were combined to conduct mono-cell suspending media.Four to six hours(4-6 h) post-plating,all plating media were removed from cultures and replaced with Neurobasal medium supplemented with B27.On the third day,10 ?mol/L cytosine arabinoside(Ara-C) was added to the culture for 24 h to inhibit the outgrowth of glial cells.Half of the culture medium was changed every week.The morphological changes of neuron cells were observed by light microscope.Double immuno-staining of microtubule-associated protein 2(MAP2) and karyon were applied to assess the culture purity.Evaluation of synapse formation was processed by immunocytochemical analysis using antibodies against both pre-and postsynaptic protein markers.Results:The improved method could remarkably increase the cell number and reduce neuronal damnification.The primary culture was characte-rized by high uniformity,purity,normal synapse formation and longtime livability.Conclusion:This is a simple and reliable technique for the in vitro primary culture of rat cortical neurons.

A questionnaire survey on chronic heart failure management was conducted in 110 physicians from Xindu,Supo,Jiajiang and Xinhua community hospital in Chengdu from January 2007 to June 2010.Results showed that 77.3％ (85/110) of community physicians lacked knowledge about prevention,diagnosis and treatment of chronic heart failure,and the diagnostic accuracy rate was only 51.3％ (40/78) in these community hospitals.There was lack of awareness of the guideline of chronic heart failure:the rate of β blockers use was 15.0％ (6/40) and only 5.0％ (2/40) used the target dose; the rate of angiotensin converting enzyme inhibitor use was 17.5％ (7/40) and only 7.50％ (3/40) used the target dose.In addition,90％ (99/110) of community doctors lacked the education and management for patients with heart failure.The survey suggests that the current situation of chronic heart failure management in community physicians in Chengdu is unsatisfactory.It is necessary to strengthen the training of community physicians.

Objective To study the clinical application of the complete audiologic evaluation battery consisting of ABR,ASSR and behavioral audiometry in sound field for the identification of sensorineural losses in children.Methods In the study 48 children were divided as group PTA of the children assessed by pure tone audiometry and ABR and ASSR test,and group BA of the children unable to perform on behavioral evaluations.Results The analysis of the audiometric results of group PTA showed significant correlation between the ASSR thresholds and pure tone thresholds(P＜0.01) at various frequencies.The correlation coefficients were 0.75,0.76,0.76,and 0.83 at different frequencies.The ASSR-PTA linear regression was utilized.The comparison of the ABR and ASSR results of group BA indicated that 23 ears responded in ASSR but without responses in ABR.Those without ASSR responses also had no ABR There were 116 tests in total four frequencies for the 29 ears.83 responses were obtained from ASSR,89 responses from behavior audiometry and 96 from the use of the both tests.Conclusion The comprehensive audiologic evaluation battery could be used to test younger children with severe heating loss children as compared to the pure tone audiometry alone.More detailed data can be obtained thus from children to assist in rehabilitation in a more effective mariner.

AIM and METHOD: In terms of difference value between bleeding blood volume that caused hemorrhagic shouk (HS) and residual blood volume at 2 h after HS, showed that HS at 5.3 kPa level was compen- satory and at 4.0 kPa level was decompensatory. Comparing some blood changes between HS two levels and their changes while pretreated with captopril (Capt. ) to reduce the release of angiotensin Ⅱ (Ang-Ⅱ), so as to inveshgate the significance of Ang - Ⅱ during HS. RESULTS: The residual blood volume in 4.0 kPa HS + Capt. group are again from near "zero" value in simple 4.0 kPa HS group. In both two HS level groups found blood dilution and was not influenced by pretreating with Capt.; contents of K+ and aldosterone increased, but Na+ had no changes, in Capt. + HS group, the former two contents reduced and Na+ had no changes comparing with each HS group. In two HS groups, the bind lactate, lactic dehydrogenase (LDH), blood urea nitrogen (BUN) increased and had more increment in 4.0 kPa HS group. All these changes could be prevented by pretreating with Capt. The blood glucose in 5.3 kPa HS group increased markedly and Capt. had no influence on it, but decreased extremely in 4.0 kPa HS group and Capt. could make it re - increased. CONCLUSIONS: Artery blood pressure (ABP) at 5 .3 kPa level was compensatory HS and ABP at 4 .0 kPa level was decompensatory HS, some changes on decompensatory HS were more serious and severe than compensatory HS, Capt. has protective effects on some changes during HS and could prolong the survival time of decompensatory HS, all that indicated the increment of Aug - Ⅱ is an important pathogenetic factor during HS.

Objective To analyze the results of survival and local regional control of early-stage breast cancer patients treated with breast-conserving surgery and whole breast radiation therapy, and to explore the factors influencing local control. Methods From October 1995 to September 2005,335 patients with early-stage breast cancer were treated with breast conservative therapy, including 25 with post-operative radiotherapy alone( group A), 194 with sequential chemo-radiotherapy( group B) ,80 with concurrent chemoradiotherapy( group C), and 36 with chemo-radio-chemotherapy (group D). Axillary dissection was performed in 312 patients and sentinel node biopsy in 2. Adjuvant chemotherapy was given to 310 patients. Radiation of 50 Gy in 25 fractions was delivered to the whole breast in 256 patients,and to the breast and regional nodes in 79. Another 10 Gy in 5 fractions was boosted to the tumor bed. The proportion of patients with surgery-radiation interval of less than 4 weeks,4-8 weeks,8-20 weeks and over 20 weeks was 16.4%, 23.6% ,37.3% and 22.7% ,respectively. Concurrent chemo-radiation and" sandwich" modality were delivered in 80 and 36 patients,respectively. Results The median follow-up was 48(25.3-146.7) months. The 5-year local-regional control and ipsilateral breast control rates were 94.5% and 95.6%, respectively. The 5-year disease-free survival,metastasis-free survival and overall survival rates were 88.6% ,93.2% and 98.8% ,respectively. Lymph-vascular invasion and neural invasion were significant factors influencing local control in univariate analysis. No significant differences were found in local control rates among different surgery-radiation intervals or different sequencing of radiotherapy and chemotherapy. Multivariate analysis showed that lymph-vascular invasion and reexcision for positive or unknown margin were independent prognostic factors influencing local control. In group A + B, C and D, the frequency of grade Ⅲ skin toxicity was4.5%.80.0%.and 77.0%,respectively(χ2=226.00,P=0.000).Conclusiom Breast conservative therapy for early-stage breast eancer results in good local-regional control and overall survival.Lymph-vascular invasion and reexcision are independent prognostic factors for local control.Surgery-radiation interval and sequencing of radiotherapy and chemotherapy have no impact on local contr01.Grade Ⅲ skin toxicity of the concurTent radio.chemotherapy and the chemo.radio.chemotherapy group is significantly higher than that of the sequential chemotherapy-radiotherapy plus radiotherapy alone group.

Objective:To observe the clinical effects of tuina plus Western medication for functional dyspepsia (FD) due to liver qi stagnation and spleen deficiency.Methods:A total of 72 patients in conformity with the inclusion criteria of FD were randomly divided into an observation group and a control group based upon the random number table,36 cases in each group.The control group was treated with mosapride citrate dispersible tablets,and the observation group was treated with the same tablets plus tuina.Before the treatment and 4 weeks after the treatment,the clinical symptoms,quality of life (QOL) and depression severity were observed by the scale,and were followed up two months later after the treatment for assessment of the clinical effects.Results:After the treatment and at the follow-up,the symptom scores of FD and the sores of Hamilton depression rating scale (HAMD) in both groups decreased,and the scores in Chinese version of quality of life questionnaire for functional digestive disorders (Chin-FDDQL) increased,with statistically significant differences in comparison with the same group before the treatment (all P＜0.05).In comparison between the two groups at the same time point after the treatment,the scores of FD symptoms,HAMD and Chin-FDDQL were improved better in the observation group than those in the control group,with statistically significant differences (all P＜0.05).The total effective rates at the follow-up were 91.7％ in the observation group and 75.0％ in the control group,without statistical difference between the two groups (P＞0.05).The rate of clinical cure and remarkable effect was 66.7％ in the observation group,higher than 41.7％ in the control group,it is higher in the observation group than that in the control group,with a statistically significant difference between the two groups (P＜0.05).Conclusion:Tuina plus Western medication is precise in the therapeutic effects for FD due to liver qi stagnation and spleen deficiency and can effectively relieve clinical symptoms,elevate the QOL and alleviate depression severity of the patients.Moreover,it's better than the treatment by Western medication alone in the long-term therapeutic effects.

Objective To assess the outcome of liver transplantation in patients over sixty years of age,in order to attempt to expand the indications of liver transplantation. Methods From August,2000 to January,2002, the clinical data of 36 patients who underwent liver transplantation in our department were analysed retrospectively. Of the 36 cases, the data (operating time, the length of hospitalization, rejection rate and ICU stay days after operation) of 5 patients whose age were ≥60 years (elderly group) and the data of 31 patients whose age were under 60 years (

Objective To investigate the feasibility of quantitative measurement of fat concentration by CT spectral imaging in a mice model of fatty liver.Methods Twenty-four mice with different degrees of fatty liver underwent CT spectral imaging.CT values of liver parenchyma under mixed X-ray energy and 65 keV,fat concentration based on various basic material pairs (fat/water,fat/io-dine,fat/calcium)and spectral curves were obtained.Liver specimens were obtained to measure the concentration of triglyceride , and HE staining was performed.Correlations between various CT indexes and triglyceride concentration were analyzed.Results Correlation between fat concentration (fat/water pair)and triglyceride (r =0.91 5 )was better than that between CT values on 65 keV and triglyceride (r=-0.858),as well as polychromatic CT values (r=-0.81 6).All the P values were<0.001.Correlations between fat concentrations based on fat/iodine or fat/calcium pairs and triglyceride were relatively low (r=-0.726,-0.660).CT indexes on 1.25 mm slice thickness performed better than those on 2.5 mm.With fatty liver degree increased,the shape of spectral curve changed gradually.Conclusion Liver fat concentration can be measured by CT spectral imaging noninvasively,accurately and quantitatively in a mice model of fatty liver.

BACKGROUND: Because the continuity and integrity of the trachea are likely damaged to some extent after tracheostomy, the implementation of sequential ventilation has certain difficulties, and sequential invasive-noninvasive ventilation on patients after tracheostomy is less common in practice. The present study aimed to investigate the feasibility of invasive-noninvasive sequential weaning strategy in patients after tracheostomy. METHODS: Fifty patients including 24 patients with withdrawal of mechanical ventilation (conventional group) and 26 patients with sequential invasive-noninvasive weaning by directly plugging of tracheostomy (sequential group) were analyzed retrospectively after appearance of pulmonary infection control (PIC) window. The analysis of arterial blood gases, ventilator-associated pneumonia (VAP) incidence, the total duration of mechanical ventilation, the success rate of weaning and total cost of hospitalization were compared between the two groups. RESULTS: Arterial blood gas analysis showed that the sequential weaning group was better than the conventional weaning group 1 and 24 hours after invasive ventilation. The VAP incidence was lowered, the duration of mechanical ventilation shortened, the success rate of weaning increased, and the total cost of hospitalization decreased. CONCLUSION: Sequential invasive-noninvasive ventilator weaning is feasible in patients after tracheostomy.