BACKGROUND: Elderly post-stroke secondary epilepsy is the main cause of elderly epilepsy, and has a certain effect on the rehabilitation and prognosis of stroke.OBJECTIVE: To probe into the association of post-stroke epileptic attack with the type, location and size of stroke.DESIGN: A case analysis.SETTING: the Department of Neurology, Qianfoshan Hospital of Shandong Province.PARTICIPANTS: Between January 1999 and December 2004, 68 inpatients (42 males and 26 females) with post-stroke secondary epilepsy, aged 60-83 years with an average of (68±7), were selected from the Department of Neurology, Qianfoshan Hospital of Shandong Province, and all the patients participated in the study voluntarily.METHODS: [1] According to the time of the first attack of post-stroke epilepsy, the patients were divided into early epilepsy (within 2 weeks post stroke) and delayed epilepsy (after 2 weeks post stroke), and the correlation between the time of epilepsy attack and types of stroke was analyzed. [2]Based on the imaging results, the ischemic stroke (including cerebral thrombosis and cerebral embolism) was divided into groups of ＜ 1/4, 1/4-1/2, ＞1/2 of unilateral hemisphere according to the infarcted size, and divided into groups of ＜ 20 mL, 20-40 mL, and ＞ 40 mL according to the amount of cerebral hemorrhage, and the association of epileptic attack with the stroke location and size was analyzed. [3] All the patients received symptomatic treatment, and they were followed up for 6 months to 4 years with an average of 21 months by means of reexamination. [4] The differences of the enumeration data were compared with the χ2 test.RESULTS: All the 68 patients with post-stroke epileptic attack were involved inthe analysis of results. [1] The correlation between the time of epileptic attack and type of stroke: The cases of cerebral hemorrhage and subarachnoid hemorrhage were obviously more in the patients with early epilepsy than in those with delayed epilepsy (10, 2 cases; 4, 0 case, P ＜ 0.05),and the cases of cerebral thrombosis were obviously fewer in the patients with early epilepsy than in those with delayed epilepsy (3, 36 cases, P ＜ 0.05). [2]The association of epileptic attack with the stroke location and size: There were more cases with the infarcted size of 1/4-1/2 and ＞1/2 of unilateral hemisphere than those with the infarcted size of ＜ 1/4 of unilateral hemisphere (26, 17, 9 cases, P＜ 0.05). There were more cases with the 20-40 mL and ＞ 40 mL cerebral hemorrhage than those with ＜ 20 mL cerebral hemorrhage (4, 9, 1 case, P ＜ 0.05). [3] The prognosis of epileptic attack: Of the 21patients with early epilepsy, epilepsy was the first symptom in 6 cases, and no re-attack occurred within 2 weeks in 15 cases. Of the 47 patients with delayed epilepsy, the disease after 1 year was completely controlled in 18 cases,better controlled in 23 cases, and the attack was frequent in 6 cases.CONCLUSION: [1] Early epilepsy is mainly manifested by cerebral hemorrhage, subarachnoid hemorrhage and cerebral embolism, and delayed epilepsy is mainly manifested by cerebral thrombosis. [2] The risk of epilepsy is obviously increased in the patients with the infarcted size over 1/4 of the unilateral hemisphere, and those with ＞ 40 mL cerebral hemorrhage. [3] The prognosis of early epilepsy is better.

Objective To evaluate the therapy effect and prognosis of upper digestive tube hemorrhage resulted from Portal Hypertension,which is dealed with combined devascularization with stitching instrument.Methods Summarized the therapy and prognosis of 41 patients of upper digestive tube hemorrhage resulted from Portal Hypertension,dealed with combined devascularization with stitching instrument.Results All the patients above had no one die for operation and no one had complication of hepatoencephalopathy.after operation 22 patients of this group had complication with medium quantity of ascite.All the patients had no complication with gastric fistulas.Conclusions Combined devascularization with stitching instrument is the best operation for upper digestive tube hemorrhage resulted from Portal Hypertension.

Acute coronary syndrome(ACS) belongs to “thoracic obstruction” and “heartache” in traditional Chinese medicine.Although many ancient physicians has discussed this disease,while due to the impact of “Yang Wei Yin Xian” in Zhang Zhong-jing's theory,the disease caused little attention by far.In the clinical practice,the author found that most ACS patients belong to heat syndrome.Based on TCM constitution theory,the author put forward the ACS was mainly caused by heat accumulation and blood stasis due to the changes of living environment,lifestyle,and diet,etc.According to traditional Chinese medicine theory,emotional disorder,spicy and hot food can burn body fluid,leading to blood stasis.Long term of blood stasis turns to heat,which further consumes heart blood and aggravates blood stasis.Therefore heat accumulation and blood stasis should be paid attention in the treatment of ACS.

Objective To investigate the effects of unilateral and bilateral electrical stimulation of the upper and lower limbs on motor function following cerebral infarction and the expressions of microtubule-associated protein-2 (MAP-2) and survivin in the infarction border zone of rats. Methods Adult male Sprague-Dawley (SD) rats were randomly divided into sham operation, control, impaired limb and bilateral limbs electrical stimulation groups (each group included 32 rats). Acute cerebral infarction was mimicked using a middle cerebral artery occlusion tech-nique. After cerebral infarction for 24 h, the rats were treated daily with or without electrical stimulation. A beam walking test (BWT) was used to measure limbs motor function and immunohistochemistry and HE staining were used to detect the expressions of MAP-2 and survivin in the border zone of infarcted area after electrical stimulation treat-ment for 3, 7, 14 and 21 d. Results Comparet with the control group treatment with electric stimulation led to BWT scores increasing significantly, and bilateral stimulation was more potent in ameliorating motor function thanstimulating the impaired limb only. The expression of MAP-2 was significantly higher in eleetrieal stimulation groups than in control group from the 7th of treatment, and it was higher in bilateral stimulation group than that in unilateral stimulation group from tbe 14th day of treatment. There was no significant difference in MAP-2 expression between bi-lateral stimulation group and sham operation group at the 21st day of treatment. In electrical stimulation groups, at every time point the expressions of survivin were obviously higher than that in sham operation group, and it was higher than that in control group and peaked at the 7tb and 14th day of treatment and in bilateral stimulation group it was no-tably higher than that in unilateral stimulation group. At the 21st d of treatment the level of survivin expression drop-per; however, there was no significant difference between unilateral and bilateral electrical stimulation groups. Con-clusions Treatment with electrical stimulation, particularly in bilateral limbs stimulation, could induce MAP-2 and survivin expressions in the infarction border zone of rats. It also could promote the recovery of motor function in para-lyzed limbs after cerebral infarction of rats. The improvement might involve the up-regulation of MAP-2 and survivin expressions.

Objective To investigate the effects of electric stimulation on motor function and expression of Rho kinase following cerebral infarction in rats. Methods Acute cerebral infarction was modeled in adult male Sprague-Dawley ( SD) rats using the permanent middle cerebral artery occlusion ( PMCAO) technique. The rats were randomly divided into sham operation, control, unilateral electric stimulation and bilateral electric stimulation groups ( each group had 36 rats). Electric stimulation was applied to the paralyzed ( unilateral or bilateral) limbs in the last two groups. Motor function recovery and the expression of Rho kinase were examined using a beam walking test ( BWT) and immunohistochemistry respectively at the 3rd, 7th, 14th and 21st day after stimulation. In addition, the cerebral infarction volume was also determined by 2, 3, 5-triphenyl tetrazolium chloride (TTC) staining at different time points. Results Motor function improved significantly in the electric stimulation groups compared with the control group, and the effect in the bilateral electric stimulation group was better than that in the unilateral electric stimulation group. The expression of Rho kinase decreased remarkably in the electric stimulation groups, and it was significantly lower in the bilateral group than in the unilateral electric stimulation group. No difference in cerebral infarction volume was found at the 3rd day. At the 21st day, the cerebral infarction volume had decreased significantly in both stimulation groups compared with the control group, but no difference was seen between the unilateral and bilateral electric stimulation groups. Conclusions Early electric stimulation, especially bilateral electric stimulation, can improve motor function after cerebral infarction and reduce cerebral infarction volume, which may be associated with down-regulation of the expression of Rho kinase in the border zone of the infarction.

Objective To investigate the effects of electric stimulation on motor function and expression of microtubule-associated protein-2(MAP-2) and survivin of brain tissue in the cerebral infarction rats.Methods Cerebral infarction rat models were made using middle cerebral artery occlusion.After cerebral infarction for 24 h,the rats were respectively treated with electric stimulation on paralyzed(unilateral)or bilateral limbs for 3 d,7 d,14 d,21 d.By using beam walking test(BWT) and immunehistochemistry,the motor function and the expression of MAP-2 and survivin of brain tissue in the border of cerebral infarction area were examined at various time following treatment.Results Compared to control group,the electric stimulation groups showed significant increase in BWT scores after treatment 7 d(all P0.05).In the electric stimulation groups,the expression of survivin of brain tissue were obviously higher than those in the sham operation group at various time points(all P0.05).Conclusions Treatment with electric stimulation,in particular bilateral electric stimulation,can promote the recovery of motor function of paralyzed limbs and induce up-regulation of expression of MAP-2 and survivin in the brain tissue of cerebral infarction rats.

Objective:To evaluate the association between RUNX3 expression and Helicobacter pylori(H.pylori)-associated precancerous gastric lesions.Methods: A population-based study was conducted in Linqu County,Shandong Province,a high-risk area of gastric cancer in China.RUNX3 expression was determined by immunohistochemistry analysis in 1 026 H.pylori infected subjects with different gastric lesions.Results: Among 1 026 subjects,359(35.0%,359/1 026) was positive.The prevalence rates of RUNX3 expression decreased steadily with severity of gastric lesions,65.6%(40/61) among those with superficial gastritis /normal(SG/N),and 22.4%(60/268) among those with dysplasia(DYS)(P

Objectives To access the bacteriology in patients with sepsis due to biliary tract infection to provide a basis for empirical selection of proper antibiotic treatment.Methods This is a single-center retrospective study on 214 patients with biliary tract infection admitted from August 2014 to July 2016 to the surgical intensive care units (ICU) of The First Affiliated Hospital of Sun Yat-sen University.To study the demographic information,sequential organ failure assessment (SOFA),usage of antibiotics before ICU and duration of ICU were analyzed.Bile,peritoneal drainage and blood samples were collected.Results 47 septic shock patients and 25 septic patients due to biliary tract infection were enrolled in the trial.The two groups (the shock group vs.the sepsis group) had a significant difference in the duration of ICU stay [(6.4 ± 4.6) d vs.(2.3 ± 1.8) d,P ＜ 0.05].48 strains of pathogens were isolated from the bile samples.The major pathogens were Escherichia coli (E.coli) (n =23,47.9％),Enterococcus faecalis (n =8,16.7％) and Enterococcus faecium (n =2,4.2％).80 strains of pathogens were isolated from the peritoneal drainage culture samples.E.coli,pseudomonas aeruginosa,and Klebsiella pneumoniae ranked the top 3 species,accounting for 26.3％,11.3％ and 7.5％,respectively.The sensitivity of E.coli isolated from bile to amikacin,imipenem and panipenem were all over 90.0％.Conclusions E.coli was the principal gram-negative bacterium in biliary infection induced sepsis.Early administration of carbapenemes may reduce the occurrence of septic shock in these patients.

N-methyl-D-aspartate receptor (NMDAR) encephalitis in combination with acute peripheral nerve damage is rare. A young female patient with anti-NMDAR encephalitis was admitted to Qianfoshan Hospital in Shandong Province on October 23, 2022. The main manifestations were abnormal mental behavior, consciousness disorders, and flaccid paralysis. Electromyography indicated axonal damage to the upper and lower extremities. Patient was in critical condition and admitted to the ICU with tracheal intubation for central hypoventilation. A combination of critical polyneuropathy was considered. The prognosis was good after hormone shock, immunosuppressive therapy, surgical therapy, anti-infection, respiratory support and symptomatic support. The diagnosis of anti-NMDAR encephalitis with acute peripheral nerve damage is difficult. Immune factors need to be considered and paraneoplastic syndrome should be differentially diagnosed.

Objective: To explore the effect of Wenrun-Xinjin-Peiben paste on the nutrition status, quality of life and pulmonary function in the stable COPD patients. Methods: A total of 94 malnutrition patients with stable COPD were randomly divided into treatment group (47 cases) and control group (47 cases). The patients in the control group took Symbicort 1 suction/time, bid, and the patients were given oxygen therapy, health and diet nutrition education. The patients in the treatment group were given Wenrun-Xinjin-Peiben paste 6 months as well as the control group treatment. The nutritional status (body mass index, triceps skinfold thickness, upper arm circumference, hemoglobin, albumin, prealbumin), quality of life and pulmonary function in the two groups were compared. Results: The curative effect of TCM syndromes was 90.48% in the treatment group, which is significantly higher than 61.90 % in the control group (Z=3.173, P=0.002). The hemoglobin in the treatment group was superior to the control group (135.69 ± 16.42 g/L vs. 122.75 ± 14.99 g/L; t=12.346, P<0.001). The Albumin in the treatment group was superior to the control group (35.89 ± 6.14 g/L vs. 33.01 ± 6.20 g/L; t=2.139, P=0.035). The disease impacts domain of ST George's respiratory questionnaire in the treatment group was superior to the control group (24.9 ± 16.1 vs. 36.6 ± 16.9; t=3.252, P=0.002). Total score of ST George's respiratory questionnaire in the treatment group was superior to the control group (41.4 ± 14.9 vs. 48.0 ± 14.9; t=2.006, P=0.048). The FEV₁ predicted value in the treatment group was superior to the control group (65.22% ± 4.01% vs. 60.17% ± 4.34%; t=5.538, P=0.000). Conclusions The Wenrun-Xinjin-Peiben paste combined with western medicine could help to improve the nutritional status and quality of life of patients in stable COPD.