Dose-Response Relationship, Drug ; Enzymes ; adverse effects ; Humans ; Hypersensitivity ; Occupational Diseases ; chemically induced ; Occupational Exposure ; adverse effects

Objective To describe the clinical features of convulsive status epileptieus (CSE) in our hospital and to provide a basis for future CSE prevention and treatment. Methods Patients with CSE hospitalized from January 1996 to October 2007 were prospectively observed. Logistic regression was used to identify predictors of prognosis. Results All 220 eases of CSE were prospeetively analyzed, a hundred and two patients(46.4%) originated from rural areas. The primary cause of CSE was central nervous system(CNS)infectian (72cases, 32.7%), followed by discontinuation or reduction of antiepileptie drugs (AEDs, 35 cases,15.5%). The median duration of CSE was 5 hours and median duration of seizures before treatment was 2 hours; both were longer in rural patients (7.0 and3.5 hours respectively) than in urban patients (3.0 and 2.0 hours, Z=-3.433,-1.558,both P<0.05). The fatality rate by the time of discharge was 15.9%. Logistic regression analysis showed that the duration of CSE (χ2=20.941), a history of epilepsy (χ2=4.910), and respiratory depression (χ2=16.086) were independent predictors of CSE prognosis (allP<0.05) . Comparisons between these data of USA and Europe were made. Conclusions CSE occurs mostly in rural population and epilepsy patients. CNS infection and withdrawal or reduction of AEDs in patients with epilepsy were important triggers of CSE. Antiepileptic therapy for status epilepticus in China falls behind that in the European countries.

The article discusses how to innovate in the departmental rotation examination for the students practicing in hospital in the new time.It is important for the teacher to provide guidance to students and motivate them to take part in comprehensive training of competence actively so as to cultivate the high-level medical students adaptive to the modern society.

Humanistic spirit advocates the concern for human,and the medical value of people foremost.Now status quo of oral medical students' humanities concern is worrying.This paper aims to analyze the reason,and the best way to culture oral medical students' humanities concern is not only to have an aim of training medical professionals who have oral medical knowledge and skills,but also to look upon the education of medical humanistic spirit as important educative content,to improve teachers' humanities diathesis,to enhance the contact between medical students' and society or patients,to foster affection,to train skills,and to establish the good environment of humanities education.

Objective To investigate the effects of maternal deprivation on chronic stress?induced depression behavior and its characteristics in adult rats,and to evaluate the effects of maternal deprivation on the efficacy of escitalopram. Methods Newborn SD male rats were randomly divided into control ( C ) group,maternal deprivation (MD) group,chronic unpredictable stress (CUPS) group,maternal deprivation and chronic unpredictable stress ( MD+CUPS) group. Rats in control group received no experimental han?dling.Rats in MD group and MD+CUPS group received maternal deprivation from the lst day after birth for 14 days.Rats in CUPS group and MD+CUPS group received chronic unpredictable stress from 10 th weeks after birth for 28 days. Screened the rats with depression behaviors and treated them with escitalopram for 4 weeks. Results The incidence of anhedonia was significantly different among 4 groups (χ2=143.24, P<0.05). Pairwise comparison showed significant difference between any two groups (MD+CUPS group (75.76%) >CUPS group (40.98%) > MD group (17.11%) >C group (4.17%), P<0.0083). The incidence of behav?ioral despair was significantly different among 4 groups (χ2=70.34, P<0.05). Pairwise comparison showed the incidence of behavioral despair in MD+CUPS group (43.43%) and CUPS group (39.34%) were signifi?cantly higher than that in MD group (13.51%) and C group (3.33%),but no difference was observed be?tween MD+CUPS and CUPS group (P<0.0083) . The incidence of behavioral despair in MD group was signif?icant higher than that in C group. There was no significant efficacy of escitalopram on anhedonia and behav?ioral despair among 3 stressed models. However the recovery incidence from anhedonia (44/140) was significantly lower than that from behavioral despair (76/140) (χ2=14.93, P<0.05). Conclusion The maternal deprivation in?creases the stress sensitivity and the incidences of anhedonia in adult rats.The efficacy of escitalopram on behavioral despair is higher than that on anhedonia without influence from maternal deprivation.

Objective: To observe the influence of electroacupuncture with different frequencies on rats swimming endurance and sift out the optimal frequency parameter.Methods: Wistar rats were randomly allocated to control group, non-acupoint group and electroacupuncture with low frequency group (EA with 2 Hz group), electroacupuncture with medium frequency group (EA with 15 Hz group), and electroacupuncture with high frequency group (EA with 100 Hz group), acupoints Zusanli (ST 36) and Taichong (LR 3) were punctured and rats load swimming time was used as an index, and the change of swimming endurance time before and after acupuncture was observed. Results: After electro-acupuncture, swimming time was increased in 15 Hz and 100 Hz groups respectively, with the significant differences between before and after acupuncture (P＜0.05). There was also a significant difference in the percentage of increase in swimming time between 15 Hz group and other groups (P＜0.05).Conclusion: It is suggested that electroacupuncture at acupoints Zusanli (ST 36) and Taichong (LR 3) with a frequency of 15 Hz could enhance rats's swimming endurance, and 15 Hz might be an optimal frequency parameter during the electrical stimulation.

Objective To study and evaluate the MRI findings and their diagnostic value for breast carcinoma.Methods Preoperative contrast-enhanced MR imaging and mammography were performed in 12 patients who underwent surgery and were histopathologically proved with breast carcinoma.MR imaging findings were compared with clearly mammography.Results Twenty-one breast lesions in 12 cases were detected with MR imaging.Seventeen of the twenty-one lesions were detected with mammography.Contrast-enhanced MR imaging was superior to mammography to demonstrate lesions in these dense breasts.It could clearly indicate the extension of posterior breast carcinoma into the pectoralis major muscle and the metastases of parasternal lymphatic node,while it was difficult to evaluate with mammography.The "rim enhancement sign" might be valuable to diagnose breast carcinoma.Conclusion The sensitivity and accuracy of MR imaging is superior to that of mammography.Contrast-enhanced imaging of the breast is helpful not only in early diagnosis of breast carcinoma but also in staging breast carcinoma and planning therapy.

Background and purpose:The involvement of estrogen signaling in lung cancer is controversial. But the findings showed that ERβ might play an important role in neoplastic lung biology. Several studies have evaluated expression of ERβin both normal and neoplastic human lung tissues with variable conclusions. We aimed to evaluate the expressive of estrogen receptors (ER)α,βin non-smoking non-small cell lung cancer (NSCLC) and investigate the relationships between the survival and expressions of ERα,β. Methods:Immunohistochemical assay was used to detect the expression ERαand ERβin 144 NSCLC patients, and analyzed the expressions status of ERα,βand survival. Results:The positive rate of ERαwas 7.6%, only in adenocarcinoma cancer. The positive rate of ERβwas 52.1%, and the expressions of stageⅠandⅡwas signiifcantly higher than that of stageⅢandⅣ(P=0.020). The median survival time (MST) of ERβpositive expression was better than that of negative expression (43 months vs 38 months, P=0.028). The MST of ERβpositive expression of female patients was better than that of negative expression (45 months vs 37 months, P=0.033). The MST of ERβpositive expression of adenocarcinoma were 46 months and better than negative 38 months (P=0.021). Conclusion:The expression of ERβwas signiifcantly higher in early-stage non-smoking NSCLC. It indicated that the positive expression of ERβwas related to the better MST, especially in female adenocarcinoma patients.

Background The aspheric intraocular lenses(IOLs)can reduce ocular spherical aberration to some degree.However,the clinical effect depends more on the IOL proper alignment.It becomes more important to study the IOL position in eye,Objective This study was to analyze the position alteration of IOL after phacoemulsification combined with implantation of one-piece soft IOLs.Methods In this prospective control study,80 eyes of 40 patients with age-related cataract were enrolled.The phacoemulsification with IOL implantation was performed in all the eyes.Decentration and tilt of IOL in the nasal superior,superior temporal,inferior temporal and nasal inferior quadrants(the intersection point of the system optical axis and the IOL maximum cross plane were regarded as the ordinate origin)were measured by rotating Scheimpflug camera(Pentacam Oculus)in 3 months postoperatively under the mydriasis condition.Written informed consent was obtained from each subject prior to this trial.Results In the right eye group,the IOL decentered toward temporal in 26 eyes(65％)and infratemporal in 16 eyes(40％).IOLs tilted temporally in the horizontal plane in 37 eyes(92.5％)and tilted inferiorly in the vertical plane in 34 eyes(85.0％).In the left eye group,IOLs decentered temporally 33 eyes(82.5％)and 20 IOLs (50％)infratemporally,IOLs tilted temporally in the horizontal plane in 37 eye(92.5％)and 36 IOLs(90％)tilted inferiorly in the vertical plane.There was no statistical difference for the intercomparsion of horizontal/vertical decentration in various quadrant in the right eye(F =0.221,0.792,P＞0.05).The obvious elevated horizontal decentration was found in the supertemporal and infratemporal quadrants compared with supernasal quadrant in the left eyes but there was no significant difference in the vertical decentration among 3 quadrants(F=0.576,P＞0.05).Decentrations were positively correlated with the tilt in both horizontal and vertical plane(right eye horizontal plane:r=0.374,P=0.002;right eye vertical plane:r=0.402,P=0.001 ;left eye horizontal plane:r=0.377,P=0.002；left eye vertical plane:r=0.347,P=0.002).Conclusions The one-piece soft IOLs(Adapt AO)decenter toward temporal mostly in 3 months after surgery,especially infratemporally in the eye.And the optical axis of the IOL tilt toward infratemperol mostly in both right and left eyes.The decentration and tilt are consisted in the corresponding direction between the right and left eyes.The position of the IOLs showed mirror symmetry between right and left eyes.The IOLs decentration show the positively correlation to tilt whatever in horizontal and vertical plane.

BACKGROUND: It has been recently found that endothelial progenitor cells (EPCs) can promote injured endothelial healing. There is a supposition that in-stent restenosis possibly correlates with the number and/or activity of EPCs.OBJECTIVE: To comparatively observe the number and activity of circulating EPCs in patients with and without coronary in-stent restenosis, and to verify the above-mentioned supposition.DESIGN, TIME AND SETTING: This study, a comparative observation, was performed at the Department of Internal Medicine, Beijing Shijitan Hospital, Department of Internal Medicine, First Hospital, Peking University, and Department of Physiology and Pathophysiology, Peking University Health Science Center between March 2005 and May 2007.PARTICIPANTS: According to the coronary angiography, 15 patients were recruited into the restenosis group and 17patients with patent stents were selected into the control group.METHODS: Total peripheral mononuclear cells were isolated from blood of patients with restenosis or control subjects by Ficoll density-gradient centrifugation. These cells were plated on dishes coated with human fibronection. After 7 days in culture, the nature of adherent cells was confirmed by direct fluorescent staining with the use of 1,1'-dioctadecyl-3,3,3',3'-tetramethylindocarbocyanide percholate-labelled acetylated low-dencity lipoprotein and fluorescein isothiocyanate-labeled ulex europaeus agglutinin-Ⅰ under a laser scanning confocal microscope. Cells demonstrating double-positive fluorescence were identified as differentiating EPCs.MAIN OUTCOME MEASURES: After 7 days of culture, EPCs were counted under an inverted microscope. Proliferation of EPCs was determined using the MTT colorimetric assay. Migration of EPCs was assayed using the scratch assay qualitatively. EPCs adhesion was performed by replating cells on fibronectin-coated dishes and then counting the adherent cells.RESULTS: The number of EPCs was significantly reduced in patients with in-stent restenosis compared with that in the control group (P = 0.001). The proliferative activities were impaired in the in-stent restenosis group than in the control group(P < 0.05). In addition, the migrative activities were also impaired in the in-stent restenosis group, but no significant difference in adherent activities existed between the two groups (P > 0.05).CONCLUSION: The number and functional activities of proliferation and migration of EPCs were decreased in patients with in-stent restenosis, which may be related to the number and/or activities of EPCs.