BACKGROUNDKnowledge about factors influencing the prognosis of resective epilepsy surgery can be used to identify which patients are most suitable for surgical treatment. The aim of this study was to identify preoperative prognostic factors associated with the chance of achieving long-term seizure freedom.

METHODSWe retrospectively reviewed seizure outcomes and clinical, electroencephalography (EEG), magnetic resonance imaging (MRI), histopathology, and surgical variables from 99 epilepsy surgery patients with at least one year of postoperative follow-up. Seizure outcomes were categorized based on the modified classification by the International League Against Epilepsy.

RESULTSWe found that the seizure-free rate was 27.9% after one year, and that it stabilized at about 20.0% between two and six years after surgery. Univariate analysis showed that medial temporal lobe epilepsy with hippocampal sclerosis, MRI with visible focal lesions concordant with EEG, and regional ictal EEG and electrocorticography patterns were associated with a favorable surgical outcome. On the other hand, seizure recurrence within six months, incomplete focus resection, and surgical complications were associated with a poor outcome. Multivariate analysis showed that medial temporal lobe epilepsy with hippocampal sclerosis and MRI with visible focal lesions were independent presurgical predictors of a favorable outcome (P < 0.01). Seizure recurrence within six months was the only significant independent predictor associated with a poor outcome (P < 0.01).

CONCLUSIONHippocampal sclerosis and abnormal MRI findings are strongly associated with a favorable surgical outcome, whereas seizure recurrence within six months is associated with a poor outcome.

Adolescent ; Adult ; Child ; Epilepsy ; surgery ; Female ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome ; Young Adult

OBJECTIVETo ascertain whether the human glucocorticoid receptor (GR) gene polymorphism is associated with cerebral infarction (CI) and essential hypertension (EH) in Chinese.

METHODSThis is a case-control study of Chinese DNA samples abstracted from 163 subjects. The samples were analysed by a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) to determine the intron 4 variant of human GR gene.

RESULTSBy analysis of the samples from both sexes as a whole, no association was observed between the EH+CI group and control group, and between the CI group and control group. However, by analysis of the samples from the females, weak association was observed between the EH+CI group and control group, and between the CI group and control group; the frequency of allele G was 0.64 for the EH+CI group, 0.69 for CI group and 0.46 for control group.

CONCLUSIONThe G allele may be a predisposing gene marker, GR gene intron 4 polymorphism contributes to the development of CI in females.

Asian Continental Ancestry Group ; genetics ; Cerebral Infarction ; ethnology ; genetics ; China ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; genetics ; Humans ; Male ; Polymerase Chain Reaction ; Polymorphism, Restriction Fragment Length ; Polymorphism, Single Nucleotide ; Receptors, Glucocorticoid ; genetics

OBJECTIVETo describe the epidemiology of neural tube defects (NTDs) in high- and low-prevalence areas of China.

METHODSBirth defects surveillance data, collected from 1992 through 1994 was analyzed. These data were collected as part of the Sino-American cooperative project on NTDs prevention. We classified NTDs as anencephaly, encephalocele, high-level and low-level spina bifida (SB) according to location of the lesion (high vs low) and whether the defect was isolated or occurred in association with other birth defects. Rates were compared in the high-prevalence (North) region and the low-prevalence (South) region, after adjusted for classification, urban and rural, season and sex, and calculated the adjusted rate of NTDs.

RESULTSAmong seven hundred and eighty-four NTDs cases in 326 874 recorded births (include in livebirth, stillbirth and fetal death with a gestational age of at least 20 weeks), the overall NTDs prevalence in the North was 5.57/1,000 births, and in the South was 0.88/1 000. There were also significant differences in the prevalence of anencephaly, encephalocele, high-level and low-level SB between North (0.97, 0.49, 2.75 and 1.11/1,000 birth) and South (0.36, 0.15, 0.21 and 0.14/1,000 birth) (P < 0.01), with adjusted prevalences in the North 3 - 7 times higher than those in the South. There were significant difference between urban (2.04) and rural areas (6.57/1,000 birth) in the North (P < 0.01), urban (0.52) and rural areas (0.95/1,000 birth) in the South (P < 0.05). Adjusted prevalence rates in the rural were 3 - 4 times higher than those of urban in the North and 1.6 - 1.9 times higher than in the South; The seasonal rate of high-level SB increased between September and November in the North (3.44/1,000 birth), while the seasonal rate of anencephaly decreased between September and November (0.18/1,000 birth) in the South. However there were no seasonal changes in other classified NTDs both in the South and North.

CONCLUSIONSThe birth prevalence of NTDs in the North of China was the highest in the world. There were significant differences between the North and the South, urban and rural. There was seasonal change in high-level SB in the North, which was in accordance to the phenotype of NTDs. It was suggested that there might exist etiological heterogeneity among anecephalus, low- and high-level SB.

China ; epidemiology ; Female ; Humans ; Incidence ; Male ; Neural Tube Defects ; epidemiology ; Seasons

OBJECTIVETo analyze the impact of hypertensive left ventricular hypertrophy (LVH) on cardiovascular events (CVD) in adult Beijing residents.

METHODSCVD risk factor survey was conducted in 7023 Beijing residents aged 25 - 64 by a stratified-random sample design from 1984 to 1993 in three years interval. CVD events were followed up and the association of the hypertensive LVH and risk of CVD and total death was analyzed by multivariable Cox Regression Model. All subjects were followed up to December 2004.

RESULTSThere were 211 non hypertensive LVH patients in the cohort and were excluded from the study. (1) There were 2240 hypertensive patients among 6812 subjects on baseline. The total prevalence of LVH was 11.8% (16.1% in male and 7.5% in female). (2) Compared to the group with normal blood pressure and without left ventricular hypertrophy, subjects with hypertensive LVH had significantly higher risk for acute coronary, acute stroke, total CVD and total death rate. The relative risks (RR) were 4.92 (95% CI: 2.3, 10.7), 4.2 (95% CI: 2.6, 7.0), 4.1 (95% CI: 2.6, 6.3) and 3.3 (95% CI: 2.0, 5.3), respectively. (3) Compared to the group with hypertension and without LVH, the group with hypertensive LVH had also significantly higher risk for acute stroke, total CVD and total death rate. The RR were 1.8 (95% CI: 1.1, 2.8), 1.7 (95% CI: 1.2, 2.3) and 1.7 (95% CI: 1.1, 2.7), respectively. (4) The population attribute risks (PAR) of hypertensive LVH to the incidents of acute CHD, acute stroke, total CVD and total death were 13.0%, 11.0%, 10.4% and 7.9%, respectively.

CONCLUSIONSHypertensive left ventricular hypertrophy was an independent risk factor for long term risk of cardiovascular events and death.

Adult ; Cardiovascular Diseases ; epidemiology ; etiology ; mortality ; Cause of Death ; China ; epidemiology ; Female ; Follow-Up Studies ; Humans ; Hypertension ; complications ; epidemiology ; Hypertrophy, Left Ventricular ; epidemiology ; etiology ; mortality ; Male ; Middle Aged ; Prospective Studies ; Risk Assessment ; Sampling Studies

OBJECTIVE To explore the the reg ulation of intestinal flora and effects of Qingjie huagong decoction on intestinal mucosal barrier in severe acute pancreatitis （SAP）mode rats . METHODS SAP rat model was induced by intraperitoneal injection of caerulein and lipopolysaccharide.The survival state of rats in each group were observed.The levels of serum amylase ，interleukin 10（IL-10），IL-18 and IL- 1β in serum were all detected. The pathological changes of pancreatic and small intestinal tissue were observed. The expressions of Occludin，ZO-1 and HMGB1 were detected in small intestinal tissue of rats. The structure and relative abundance of intestinal microflora in rats were detected by 16S rRNA high throughput sequencing. RESULTS After the intervention of Qingjie huagong decoction ，abdominal distension symptoms of SAP model rats were significantly relieved ，and their mental state recovered better ；the levels of serum amylase and IL- 18 in serum were decreased significantly （P＜0.05），while the level of IL- 10 was increased significantly （P＜0.05）. The necrotic area of pancreatic tissue and the infiltration of inflammatory cells were reduced ， the degree of intestinal epithelial cell structural disorder was alleviated ，and the shedding of intestinal mucosal epithelium was reduced.The protein expression of HMGB 1 in small intestinal tissue was decreased significantly （P＜0.05），and the protein expression of Occludin and ZO- 1 were increased significantly . Results of 16S rRNA high throughput sequencing showed that Qingjie huagong decoction could increased the relative abundance of probiotics such as Bacteroidea and Lactobacillus in rat intestine ，reduced the colonization of harmful bacteria such as Firmicutes. CONCLUSIONS Qingjie huagong decoction can improve the intestinal barrier by up-regulating the expression of Occludin and ZO- 1 in small intestinal tissue and down-regulating the protein expression of HMGB 1. It can also adjust the relative abundances of different flora to protect the intestinal tract.