1.Aggravation of electroencephalographic features in an epileptic child treated by oxcarbazepine monotherapy: A case report and review of the literature
Fang YANG ; Ling LIU ; Qian LI ; Jiafei DAI ; Maowei CHENG ; Li KONG ; Shenning ZHANG ; Guanghui CHEN
Journal of Medical Postgraduates 2011;24(5):495-498
Objective Benign childhood epilepsy with centrotemporal spikes (BECT) is the most common partial epilepsy syndrome in children, and responds well to carbamazepine (CBZ), oxcarbazepine (OXC), and valproic acid (VPA). The aim of this study is to investigate the therapeutic effect of OXC on BECT. Methods We retrospectively discussed a case of partial epilepsy in a 6-year-old boy with no abnormality on neuroradiologic examination. Results The patient′s seizures were easily controlled by administration of OXC, but electroencephalography (EEG) identified deterioration of the EEG features following the introduction of OXC monotherapy. Then OXC was gradually decreased in dose and substituted with VPA. When VPA was increased to the dose of 0.5g/d, the boy had no more seizures and exhibited normal EEG in the conscious state. Conclusion OXC may induce new types of seizure and aggravate EEG features although it is considered to be the first-line anti-epileptic drug (AED) and much better tolerated than either phenytoin or CBZ.
2.Craniofacial morphological changes induced by a mandibular repositioning oral appliance and their significance
Maorong TONG ; Xirong XIA ; Xilong ZHANG ; Ehong CAO ; Yinyin ZHAO ; Yi SHI
Journal of Medical Postgraduates 2000;13(1):4-7
Objectives: To identify any craniofacial morphological changes induced by a mandibular-repositioning oral appliance (MRA) and to explore the possibility of predicting the treatment response to MRA by cephalometric analysis in patients with obstructive sleep apnea (OSA). Methods: Seventy OSA patients [male/female: 63/7; age: (50.5±11.6) years; BMI: (27.6±4.6) kg/m2; AI: (34.9±21.3) episodes/hour; and oxygen saturation nadir: (66.3±16.5) %] were enrolled. MRA was fabricated individually for each patient after the consultation by a dentist. Polysomnographic (PSG) examination was repeated with MRA in place 3 months after the initiation of the MRA therapy. For cephalometric analysis, a pair of cephalograms of each patient was obtained, one with and another without MRA. Results and Conclusions: After 3 months' treatment, AI was (156±19.2) episodes/hour, significantly reduced compared with the pre-treatment average AI (34.9±21.3 episodes/hour,P<0.000 1). Oxygen saturation nadir improved from (66.3±16.5)% (pre-treatment) to (74.1±15.5)% (with MRA) (P<0.001). A reduction of AI≥50% was achieved in 42 patients. Insertion of MRA led to anterior shift of the mandible, increase in upper airway width and area and decrease in upper airway length. Those with evident retrognathia and longer anterior upper facial height were more likely to benefit from the MRA management.
3.The immunohistochemical study of the macrophages and natural killer cells in hepatocellular carcinoma tissues
Gang CHEN ; Dianzhong LUO ; Zhenbo FENG ; Fang GUO ; Ping LI
Journal of Medical Postgraduates 2005;18(10):905-910
Objective:To investigate the number and distribution of macrophages (Mφ) and natural killer(NK) cells in hepatocellular carcinoma (HCC), paraneoplastic,cirrhosis and normal liver tissues and their relationship with the prognosis of HCC patients. Methods:Surgical specimens from 60 cases of HCC, 62 cases of cirrhosis and 23 cases of normal liver tissues were investigated by immunohistochemical staining of CD68 and CD57 with a streptavidin-horseradish peroxidase detective system.The correlation of the number of Mφ and NK cells in different tissues with the clinical tumor parameters was also studied. Results:①The order of the number of Mφ from the highest to the lowest was:paraneoplastic,cirrhosis, normal, HCC(P<0.05);and the number of NK cells from the highest to the lowest was:HCC, paraneoplastic, normal, cirrhosis(P<0.05).②The number of Mφ decreased successively with the decrease of the HCC differentiation(P<0.05);There was no relationship between the number of NK cells in HCC and histological grade. ③There was no relationship between the number of Mφ in HCC and clinical TNM stage ;The number of NK cells in HCC had degressive tendency with the clinical TNM stage(P<0.05). ④The number of Mφ and NK cells in HCC in the cases with metastasis in 15 months was significantly lower than that without metastasis(P<0.05, 0.01).⑤There was a linear positive correlation between the number of Mφ and NK cells in HCC (r=0.344, P<0.05). Conclusion:The number of Mφ and NK cells in HCC in the cases with metastasis is significantly lower than that without metastasis;The number of Mφ has a close correlation with the HCC differentiation, and positive correlation with the number of NK cells;The number of Mφ and NK cells might be important markers to estimate the immune status and useful factors to predict the prognosis of HCC patients.
4.Observations of the therapeutic effects and side effects of 6-mercaptopurine on refractory childhood nephrotic syndrome
Zhengkun XIA ; Guangling LIU ; Yuanfu GAO ; Yuanfeng FU ; Lianfeng ZHANG ; Zhongmin FAN ; Jie FU
Journal of Medical Postgraduates 2002;15(6):510-513
Objectives: The aim of the study was to evaluate the therapeutic effects of 6-mercaptopurine in the treatment of refractory childhood nephrotic syndrome (NS). Methods: According to the varieties of NS, 6-mercaptopurine (2 mg/kg body weight daily) combined with corticosteroid or 6-mercaptopurine (2 mg/kg body weight daily) alone after tapering of steroids were given to 28 consecutive children with primary NS in our hospital. Results: One month after the use of 6-mercaptopurine, proteinuria was decreased. The duration of improvement was 9~28 days, with mean duration of 17 days. Over-all effective rate was 85.7%. Among different varieties of NS, the best therapeutic effect was noted in steroid-dependent children; the better therapeutic effect in steroid-resistant children; and good therapeutic effect in frequently relapsing children. The effective rates were 100%, 84.6%, 81.8% respectively. All the pathological varieties of 28 children were confirmed by renal biopsy. The better therapeutic effects were noted in slight mesangial proliferative glomerulonephritis (MsPGN) and minimal change nephrotic syndrome (MCNS). The less therapeutic effect was noted in membranoproliferative glomerulonephritis (MPGN). Their therapeutic effective rates were 92.9%, 80%, 66.7% respectively. Unfortunately, drug-induced aplastic anemia was seen in 2 cases. Slight gastrointestinal reactions were present in 6 cases. There were no side reaction on the gonad. Conclusions: The great difference in the therapeutic effects is related to the different pathologic varieties of NS. With regard to the treatment of refractory NS in children, the pathological varieties should be confirmed by renal biopsy as soon as possible. Based on the renal biopsy, 6-mercaptopurine can be considered in the treatment of MsPGN and MCNS. As a result, relapses could be reduced; the duration of remission could be prolonged, and the side reactions from steroid treatment could be avoided. The use of 6-mercaptopurine for the treatment of refractory NS is one of the effective therapy.
5.Teh immediate-early gene c-fos and opilepsy
Journal of Medical Postgraduates 2001;14(2):169-172
C-fos,one of the immediate-early genes,encodes Fos,which appears to modulate the express of more “downstream” genes and attribute to long-term changes in cellular function.Recently,c-fos has been researched on extensively and progress has been acquired greatly.This article summarizes c-fos on structure,function and the relationship to epilepsy.
6.Lung inflammatory injury after cardiopulmonary bypass
Journal of Medical Postgraduates 2001;14(2):164-168
Cardiopulmonary bypass(CPB) can induce systemic inflammatory response syndrome(SIRS).This review elaborated the influences of SIRS in acute lung injury after CPB.
7.Interventional therapy of cavernous hemangioma of the liver(CHL)
Xiao LI ; Weixin REN ; Yulan GU
Journal of Medical Postgraduates 2001;14(2):162-164
This assay reviewed the feeding arteries of CHL and summarized the mechanism,technologic method and common embolization agent of interventional therapy,as well as its effect,indications,contraindications and complications.
8.Application of high dose chemotherapy in therapy for non-Hodgkin's lymphoma
Cheng WANG ; Peng WU ; Xuewen WANG
Journal of Medical Postgraduates 2001;14(2):157-161
High dose chemotherapy(HDC) with stem cell transplantion(SCT) has been used widely to treat non-Hodgkin's lymphoma(HHL).Its curative effect has been confirmed by many trials.But controversy still exists,such as application of HDC for various NHL subtypes,the optimum opportunity and method for transplantation.HDC has become standard therapy for recuring cases which are sensitive to chemotherapy and was a suitable consolidation therapy after remission for high-risk cases.Allogenic bone marrow marrow transplantation,only used for some special cases,need further study.
9.Application of radionuclide imaging in Orthopaedics
Qiang WANG ; Jianning ZHAO ; Xin SHI
Journal of Medical Postgraduates 2001;14(2):154-157
Radionuclide imaging was widely used in the diagnosis and treatment of skeletal diseases.It is of early diagnostic value in metastatic osteosarcoma,osteomyelitis and Paget's disease,and early affirmative value in vitality of transplanted bone.It also demonstrates a significant analgesic effect on theosteosarcoma and metastatic osteosarcoma.
10.Research progresses of atlas fracture
Jun ZOU ; Yurong WANG ; Jianning ZHAO ; Sujia WU
Journal of Medical Postgraduates 2001;14(2):150-153
Atlas fracture is a rare lesion occurred in cervical vertebrae.This review summarize the new approach about the classification,etiological factors,clinical manifestations,diagnosis methods and treatments of the disease.