Objective To investigate the clinical characteristics of comorbidity of migraine and epilepsy.Methods The clinical data of 67 patients with migraine were analyzed retrospectively.Results 6 cases appeared epilepsy,focal seizure 2 cases and generalized seizures 4 cases,in the 67 patients with migraine.The epileptiform waves were recorded in 57 cases by EEG,and the fulminated waves were also recorded in 6 patients with epilepsy.Treated by Sodium Valproate,migraine attacks and seizures were all controlled in the 6 cases and also EEG anastated well.Conclusions Comorbidity is existed in migraine and epilepsy.The curative effect is well by Sodium Valproate.

Asian Continental Ancestry Group ; China ; Humans ; Medicine, Chinese Traditional ; Psoriasis ; therapy

Objective To introduce the experience of l ap aroscopic modified Swenson pull-through procedure for the treatment of Hirschspr ung's disease (HD). Methods A modified Swenson procedure was performed in 100 cases of HD, including 21 cases of short-segment phenotype, 72 cases of common phenotype, and 7 cases of long-segment phenotype. The patients w ere aged 8 months ~ 7 years, with a mean age of 1.5 years. A 0? or 30? laparos cope, with an inner diameter of 0.5 cm, was advanced from the umbilicular port, and operating instruments were introduced into the left and right lower quadaran t of the abdomen. The carbon dioxide was insufflated in the abdominal cavity at a pressure of 8~12 mmHg. Biopsies from the colonic seromuscular layer were made for pathological examinations. Laparoscopic dissection of blood vessels of the m esocolon was carried out closely near the colon, until the level 0.5~1 cm above the dentate line. The rectum and sigmoid was mobilized outside through the anus to complete rectal dissection. The proximal colon then was anastomosed to the re ctum by means of full-thickness suture and diagonal heart-shaped closure. Results All the cases were cured, without fatal cases. The operation time was 80~170 min (mean, 110 min), and the intraoperative blood loss was less than 10 ml. There were 5 cases of subcutaneous emphysema and 6 cases of urinary retention. On a follow-up in all the cases for 6~18 months, 5 cases of colitis, 2 cases of soiling, 1 case of anastomotic stricture, and 1 case of delayed anas tomotic leakage were observed. Conclusions Laparoscopic modifi ed Swenson pull-through procedure for Hirschsprung's disease is worthy of being recommended for its minimal invasion and simplicity of performance.

Objective To explore a simple and effective way of establishing a 30 % small-forsize liver transplantation in rats. Methods SD rats were selected as the donors and recipients. Smallfor-size orthotopic live transplantation was performed using Kamada's two-cuff method. Donor's liver was flushed via abdominal aorta and hepatectomy in situ was done. Animals were divided into 3 groups (40 pairs of rats in each): group Ⅰ , median lobe was used as graft; group Ⅱ, right of median lobe and right lobe were used as graft; group Ⅲ, median and right lobes were used as graft. The body weight of the donor was the same as the recipient in groups Ⅰ and Ⅱ , but 100～ 120 g less than in group Ⅲ. The operating time, 7-day survival and technical complications were compared among these 3 groups. Results The operating time of hepatectomy was shorter in group Ⅲ than in groups Ⅰ and Ⅱ (8. 8±0.7 vs 11.5± 1.1 vs 10.1 ±1.0 min, P＜0.01). The cold ischemia time of graft, the anhepatic time, the operating time of recipient and the transplanting successful rate showed no significant difference among the 3 groups. Compared with groups Ⅰ and Ⅱ , the incidence of bleeding,bile leakage and IVC stricture was significantly decreased in group Ⅲ (P＜0. 05). Other complications after operation showed no significant difference among the 3 groups (P＞0. 05). Group Ⅲ had more 7-days survivors and longer median survival time, but there was no significant difference among the 3groups. Conclusion Small for donor body weight with median and right lobes as graft was a more effective and simple way of establishing a 30 % small-for-size liver transplantation in rats with shorter hepatectomy time and less complications after operation.

Objective To evaluate the clinical value of choledochoscopy combined with electrohydraulic lithotripsy (EHL) for the treatment of pancreatolithiasis. Methods From October 2002 to July 2006, choledochoscopy combined with EHL was used in 11 patients with pancreatolithiasis during a dissection of the pancreatic duct combined with pancreato-jejunum Roux-en-Y anastomosis (EHL group). The data of these patients were compared with the data of 12 patients with pancreatolithiasis, who were treated by routine dissection of the pancreatic duct combined with pancreato-jejunum Roux-en-Y anastomosis from January 1995 to September 2002 (Routine group). Results The intraoperative blood loss and the postoperative rate of residual stones in the EHL group were significantly less than those in the routine group [(145.5?82.0) ml vs (406.7?384.9) ml, t=-2.201, P= 0.039; and 0% vs 41.7%, P= 0.037]. The postoperative rate of pain relief in the EHL group was higher than that in the routine group (90.9% vs 58.3%), however the difference was not significant (P=0.155). In the EHL group, 6 patients had diarrhea before the operation, 4 of them achieved relief after the surgery (4/6), which was not significantly more than that in the routine group (5/9, P=1.000). Before the operation, 7 patients in the EHL group and 9 in the routine group had diabetic mellitus; in each group, the disease was relieved in 2 patients after the operation (2/7 vs 2/9, P=0.665). Conclusions Choledochoscopy combined with EHL is effective for the treatment of pancreatolithiasis. The procedure can increase the rate of stone removal, decrease the intraoperative blood loss, and elevate the postoperative rate of pain relief.

Objective To investigate the relationship between carotid intima-media thickness (IMT) and coronary atherosclerosis plaque through coronary CT angiography (CTA) in asymptomatic individuals.Methods Two hundred and fifty cases with CTA screened were selected in asymptomatic individuals,and according to the inspection result they were divided into no plaque group (detection of no coronary atherosclerosis plaque,180 cases) and plaque group (detection of coronary atherosclerosis plaque,70 cases).All cases were checked carotid IMT with B-ultrasonic.Results ANOVAs analysis showed that age and body mass index (BMI) had significant correlation with coronary atherosclerosis plaque (P ＜ 0.05).x2 test was used to show the smoking and family history of coronary heart disease had significant correlation with coronary atherosclerosis plaque (P ＜ 0.05).Univariate Logistic regression analysis showed that carotid IMT,systolic pressure,diastolic pressure,low density lipoprotein cholesterol,fasting serum glucose and creatinine had significant correlation with coronary atherosclerosis plaque (P ＜ 0.05).Multifactor Logistic regression analysis showed that carotid IMT had correlation with coronary atherosclerosis plaque (P ＜ 0.05).Conclusion There is significant relationship between carotid IMT and coronary atherosclerosis plaque in asymptomatic individuals.

Objective: To explore the effect of early enteral nutrition on post-operation recovery of patients undergone liver transplantation.Methods:86 patients undergone liver transplantation were enrolled,among which 37 cases undertook early enteral feeding and 49 cases were mainly giren parenteral nutrition.The infection rate,metabolism condition and immunol function of post-operation were compared.Results:Patients in EN group had a high lever of blood globulin and a lower infection rate,and their liver function recovery,rise of pre-albumin and decrease of CRP were much quick than those of PN group.Conclusion:Early enteral nutrition in post-operation patients can reduce stress reaction,promote synthesis metabolism,improve the recovery of liver cell and decrease the chances of infection.

BACKGROUND: How to determine the proximal section of electricity-injury nerve which is available for nerve grafting, is key point to the functional recovery. The method used before is to observe if there is normal axonal structure under operating microscope. But the clinical result proves unsatisfactory.OBJECTIVE: To evaluate the appliance value of somatosensory evoked potential (SEP) technique in the detection of nerve injury after electrical injury.DESIGN: Retrospective analysis based on the cases.SETTING: Department of Plastic Surgery, Ninth People's Hospital Affiliated to Shanghai Jiaotong University PARTICIPANTS: Totally 12 patients with severe electrical injury who received treatment in the Department of Plastic Surgery, Shanghai Ninth People's Hospital were included in this study. Among them, there were 9male and 3 female, aged from 6 to 54 years.METHODS: SEP of injured nerve was measured progressively and pathological section observation was given correspondingly. The function recovery of patients receiving nerve transplantation by using SEP was evaluated and compared with that before treatment through a follow-up.MAIN OUTCOME MEASURES: Amplitude, latency and corresponding pathological section of SEP of injured nerve as well as the functional recovery of the SEP plane of the cases with patients receiving nerve transplantation by using SEP to choose transplanted plane.plitude and latency of SEP was positively correlative with the quality of were repaired with SEP technique to select the anastomosis site for nerve transplantation and 8 cases were followed up after operation. The average follow-up time was 22.7 months ranging from 17 to 26 months. And 2-point resolution sense reaches grade Ⅱ or Ⅲ in 5 cases. (America hand surgery association criterion: 2-point resolution distance ＜ 6 mm was grade Ⅰ ,6-10 mm was grade Ⅱ ,11-15 mm was grade Ⅲ ,＞ 15 mm was grade Ⅳ).CONCLUSION: Electricity-injured nerve owns complicated pathology.SEP technique is a valuable method for function evaluating or selecting of the anastomsis site for nerve grafting in those cases.

Objective To generally analyze the current situations of clinical research and applications in early enteral nutrition (EEN) after abdominal surgery. Methods The published papers about the current situations of clinical research and applications in EEN after abdominal surgery were reviewed. Results EEN after abdominal surgery seems to be safe and effective, produces a positive nitrogen balance, keeps the integrality of structure and function of the apparatus, protects gut barrier, and reduces or prevents septic complications. Conclusion EEN may be of more benefits and will be one of the best methods of nutrition support after abdominal surgery.