In the use of antiepileptic drugs in patients with epilepsy,1/3 of the patients with epilepsy can not get effective control,showing resistance to antiepileptic drugs.Now the mechanism of drug resistance is considered to be caused by multiple factors work together.The concept and connotation between drug-resistant epilepsy and refractory epilepsy are different.Since 2010,the international union of antiepileptic proposeddrug-resistant epilepsy expert consensus,different medical centers use the new defition to study different populations and confirm that the new definition is effective and reliable.However,there are some controversier about the drug dosage,drug kinds,judge for determining evaluation index and the treatment judgement in that definition.

Objective To investigate the protective effect of early enteral nutrition (EN) on the function of intestinal barrier in acute pancreatitis (AP) patients.Methods From April 2014 to April 2016,a total of 81 AP patients admitted to our hospital were randomly divided into EN group (41 cases) and total parenteral nutrition (TPN) group (40 cases) by the method of opening envelop.The levels of serum albumin,inflammation cytokines and index of intestinal barrier function were compared between the two groups.Results No significant differences were found in the demographic characteristics between EN and TPN group at the 1st,3rd,7th day (all P＞0.05).Compared with TPN group,EN group showed significantly higher level of serum albumin since the 7th day (t=4.623,4.517,all P＜0.05) and significantly lower level of serum CRP since the 7th day (t=2.211,3.010,all P＜0.05) and significantly lower level of serum TNF-α since the 3rd day(t=2.095,3.364,3.249,all P＜0.05).In the aspect of intestinal barrier,compared with TPN group,the patients in EN group showed significantly lower level of serum D-lactic since the 7th day(t=3.940,2.626,all P＜0.05) and significantly lower level of serum DAO also since the 7th day(t=3.090,2.880,all P＜0.05).Conclusion EN can effectively maintain the level of serum albumin,decrease the level of serum inflammation cytokines and protect the function of intestinal mucosa barrier.

Objective To study the nutrition status of premature infants in the early postnatal stage.Methods According to the physical development standard,the premature neonates for treatment in our NICU from Jun.2007 to Jun.2009 were enrolled and divided into normal growth group and extrauterine growth restriction(EUGR) group.The nutrition status of these premature neonates were evaluated respectively.SPSS 13.0 software was used to analyze the data.Results Compared with EUGR group,the durations of regaining birth weight were shorter in normal growth group(t=-13.83,P0.05).Conclusions Premature neonates are prone to encounter extrauterine growth retardation.Extrauterine growth retardation had great impact on premature neonates.Premature neonates should be strengthened with nutrition supplement in order to reduce the incidence of extrauterine growth retardation.

Endophthalmitis ; etiology ; Humans ; Metals ; Occupational Exposure ; adverse effects

Objective To research operative procedure, results and complications of treatment of the intra-articular distal humeral fractures.Methods 16 cases of these fracture were fixed operatively through a posterior approach with plates on both the medial and the lateral column in adults, and Kirschner wires in children. Results 15 patients were followed up for 5～36 months, the fractures healed in 1 2～6 5 months.Complications as follows: each electric burn of skin, superficial infection, palsy of ulnar nerve, loss of screws and non-union in one case, stimulation of Kirschner wires in 2 cases. Conclusions Triceps-splitting,elbow posterolateral approach or olecranon osteotomy are well suited to the exact visualisation and accurate reduction of this difficult fracture with minimal damage.The election of interfixation model should base on the age and the fracture type.

Objective To study on the relation between Helicobacter pylori (Hp) infection and gastric metaplasia in the duodenum(DGM) in the duodenal ulcer(DU) patients to elucidate the pathogenesis of DU.Methods One hundred and twenty-one patients were examined by endoscopy, pathology and Hp infection test.Results The detection rates of Hp in stomach and in duodenal bulb were much higher in patients with DU(90 4%, 40 4%) than those in patients without DU(60 9%, 2 9%, both P

Objective To investigate the effect of left lateral segmentectomy combined with fiber choledochoscope for hepatobiliary calculus.Methods Eighty-seven patients with hepatobiliary calculus who underwent hepatectomy from December,1998 to December,2008 were reviewed retrospectively.Forty-six patients underwent the section of common bile duct to remove calculus combined with left lateral segmentectomy and fiber choledochoscope( Group A),41 patients underwent left hepatectomy and section of common bile duct to remove calculus( Group B).The postoperative stone residual rate,complications and long-term outcome were compared between the two groups.Results The postoperative stone residual rate of either group was zero.Intraoperative bleeding ( 401.1 ± 180.4ml) ,operative times ( 202.5 ±36.6 rmin) of group A were significantly lower than those of the group B (515.9 ± 200.6ml and 257.3 ± 42.9min) ( P ＜ 0.001 and 0.01,respectively) .Hospital stays of group A was lower than that of group B,but this is no statistical significance ( P ＞ 0.05 ) .The incidence of postoperative complications were similar in the two groups( 15.2% v.s.24.4% ,P ＞ 0.05 ).The effective rates of the two groups were similar (91.3 % VS 92.7 %,P ＞ 0.05 ).Conclusions The long-term and short-term outcome of left lateral segmentectomy combined with fiber choledochoscope for hepatobiliary calculus is similar to that of left hepatectomy ,and can successfully shorten the hospital stay and reduce the hospital fee.

Female ; Humans ; Liver Transplantation ; adverse effects ; Male ; Mycoses ; diagnosis

There has been much difference between effectiveness and harm in evidence evaluation. Many evidence ranking or grading systems have been developed'by researchers in the world. However, no evidence ranking or grading systems are based on safety research reality. Those existing evidence ranking or grading systems are prone to evaluating effectiveness evidence not proper for harm evidence. It is necessary to develop a new system for harm evidence. We put forward to establishing the body of evidence for harm for postmarketing traditional Chinese medicine as required by our daily research work. We do hope such an ideal could be helpful and indicative for evidence evaluation for harm.
Medicine, Chinese Traditional ; adverse effects ; Product Surveillance, Postmarketing

Objective To investigate the curative effect and safety of microinvasive percutaneous nephrolithotomy (MPCNL) and ureteroscope lithotripsy (URSL) in treatment of children′s (≤6 years old) middle and upper segment ureteral calculi. Methods Eighty children (≤6 years old) with middle and upper segment ureteral calculi were selected, and they were divided into observation group and control group according to random number table method with 40 cases each. The children of observation group were treated with MPCNL, and the children of control group were treated with URSL. The operation time, hospitalization time, calculi clearance rate of the first phase, decline situation of the postoperative hemoglobin and hematocrit and complication were compared between 2 groups. Results The operation time and hospitalization time in observation group were significantly shorter than those in control group:(45.43 ± 9.76) min vs. (68.32 ± 11.28) min and (8.12 ± 1.03) d vs. (13.45 ± 2.34) d, the calculi clearance rate of the first phase was significantly higher than that in control group: 100.0% (40/40) vs. 62.5%(25/40), the incidence of complication was significantly lower than that in control group:20.0%(8/40) vs. 60.0% (24/40), and there were statistical differences (P<0.05). There were no statistical differences in the decline situation of the postoperative hemoglobin and hematocrit between 2 groups (P>0.05). Conclusions The MPCNL in treatment of children′s middle and upper segment ureteral calculi has short operation time, high calculi clearance rate of the first phase, and low incidence of perioperative complication. Compared with URSL, the URSL is safe and efficient, and it is worthy of clinical application.