Objective To analyze the outcome of reoperation in drug resistant epilepsy after failed surgery or recurrence in children,and to identify the predictors of the outcome of reoperation and inspiration of epilepsy resection surgery.Methods Analysis was done on data of 4 patients with drug resistant epilepsy diagnosed in Department of Neurosurgery Epileptic Center,Fuzhou General Hospital of Nanjing Military Command from Sep.2011 to Sep.2012.Clinical manifestation,preoperative evaluation,postoperative follow-up of the children were analyzed.Results After first epilepsy resection surgery,3 patients had little decrease in seizure rate(Engel class Ⅳ),the other one had seizure freedom (Engel class Ⅰ),but got recurrence after 2 years.Four cases were all underwent extended resection reoperation du-ring the study period.Types resection included temporoparietooccipital (3/4 cases) and frontal (1/4 cases),mean follow-up 11.25 months.One of the 4 patients had seizure freedom (Engel class Ⅰ),and 3 cases of the 4 patients had seizure reduction (Engel class Ⅱ) at last follow-up,in addition,none of them had significant or unacceptable complication.Conclusions Patients with recurrent drug resistant epilepsy after an initial resection surgery can regain seizure freedom outcome when they underwent repeat resection surgery after comprehensive reevaluation.Predictors with likelihood of seizure freedom after reoperation are:(1) retained medial temporal structures or relevant magnetic resonance imaging structural lesion;(2) original surgery suboptimal; (3) preceding evaluation suggests solitary identified focus;(4) semiology relate to preoperative seizures.

OBJECTIVE:To explore the importance of self-supervision spirit in the PIVAS.METHODS:According to the characteristics of PIVAS in our hospital,the importance of self-supervision spirit in PIVAS was introduced and the methods to cultivate the spirit were evaluated.RESULTS & CONCLUSIONS:Self-supervision spirit of staff can reduce mistakes and improve the working of PIVAS to promote the safety of clinical drug use.

Objective To study the expression of GRHL-3 in diffuse large B-cell lymphoma (DLBCL) tissues and its clinical significance.Methods One hundred and sixty-eight pathology paraffin-embedded diffuse large B-cell lymphomas tissues were collected from January 2006 to September 2011.Immunohistochemistry was used to detect the expression of GRHL-3 protein in the above tissues.Results The positive expression rate of GRHL-3 protein in the GCB type tissues was higher than that in the non-GCB type tissues [84.87 ％(101/119) vs 14.29 ％ (7/49), P ＜ 0.01].Further analysis indicated that in the non-GCB type tissues,the positive expression rate of GRHL-3 in the latter stage group was significantly higher than that in the early stage group [90.00 ％ (63/70) vs 77.56 ％ (38/49), P ＜ 0.01].The positive expression rate of GRHL-3 in the lactatede hydrogenase increased group was significantly higher than that in the normal lactated hydrogenase [91.67 ％ (77/84) vs 68.57 ％ (24/35), P ＜ 0.01].The positive expression rate of GRHL-3 in the extranodal involvement status ≥ 2 group was significantly higher than that in the extranodal involvement status 0-1 group [96.29 ％ (26/27) vs 81.52 ％ (75/92), P ＜ 0.05].The positive expression rate of GRHL-3 in the IPI score 4-5 group was significantly higher than that in the IPI score 0-1 group [91.30 ％ (65/69) vs 66.67 ％ (18/27), P ＜ 0.01] and IPI score 2-3 group [91.30 ％ (65/69) vs 79.96 ％ (18/23), P ＜ 0.05].However, the expression of GRHL-3 had no correlation with the gender, age, and performance status of DLBCL.Conclusion The positive expression rate of GRHL-3 protein in the GCB type tissues is higher than that in the non-GCB type tissues.The positive expression rate of GRHL-3 in the DLBCL is correlated with the Ann Arbor stage, lactate dehydrogenase, extranodal involvement status and IPI score.

lusionsThe CEUS findings are different between benign and malignant gallbladder adenomas. The enhancement pattern and speed are useful for differentiating benign from malignant adenomas.

Objective: To study on the effect of clinical nursing in preventing adverse drug reaction of injection preparation of traditional Chinese medicine, explore nursing strategy of adverse drug reaction,promote the rational use of traditional Chinese medicine injection preparations in clinical practice by analyzing the adverse drug reactions of traditional Chinese medicine injection in our hospital. Methods: A retrospective analysis of 362 cases of adverse drug reactions reported by the National ADR Surveillance Center from January 2017 to November 2018 was carried out in our hospital. In accordance with the guidelines of the Ministry of Health Manual on reporting and monitoring adverse drug reactions. By using Microsoft office Excel 2007, the ADR reports were summarized and analyzed according to age, sex, type and frequency, time of adverse reactions, and involvement system of adverse reactions. Results: In 362 cases of ADR, the ratio of male to female patients was about 1.1∶1.There were 65 cases of children under 12 years old, accounting for 18%, and 117 cases of people over 61 years old, accounting for 32.3%,the proportion of other age groups was lower than those of the elderly and children. Most of the drugs with ADR appeared in blood circulation (208 cases), followed by heat-clearing and detoxifying drugs (102 cases) and anti-tumor drugs (52 cases). The common ADR involvement system of traditional Chinese medicine injection is nervous system reaction, skin allergic reaction, cardiovascular system reaction, local injury of injection, gastrointestinal tract system. Conclusions Attention should be paid to the role of nurses in monitoring adverse reactions of traditional Chinese medicine injections, strengthening the propaganda and education of nurses' ADR monitoring work, strengthening nurses' cognition of ADR, enhancing nurses' service and consciousness to patients with static injection of traditional Chinese medicine, and standardizing the process of drug use, thus reducing possible injury to patients due to adverse reactions caused by the use of traditional Chinese medicine injection.

10.3969/j.issn.2095-4344.2013.23.010

Human maltase-glucoamylase (MGAM) hydrolyzes linear alpha-1,4-linked oligosaccharide substrates, playing a crucial role in the production of glucose in the human lumen and acting as an efficient drug target for type 2 diabetes and obesity. The amino- and carboxyl-terminal portions of MGAM (MGAM-N and MGAM-C) carry out the same catalytic reaction but have different substrate specificities. In this study, we report crystal structures of MGAM-C alone at a resolution of 3.1 Å, and in complex with its inhibitor acarbose at a resolution of 2.9 Å. Structural studies, combined with biochemical analysis, revealed that a segment of 21 amino acids in the active site of MGAM-C forms additional sugar subsites (+ 2 and + 3 subsites), accounting for the preference for longer substrates of MAGM-C compared with that of MGAM-N. Moreover, we discovered that a single mutation of Trp1251 to tyrosine in MGAM-C imparts a novel catalytic ability to digest branched alpha-1,6-linked oligosaccharides. These results provide important information for understanding the substrate specificity of alpha-glucosidases during the process of terminal starch digestion, and for designing more efficient drugs to control type 2 diabetes or obesity.
Acarbose ; chemistry ; Amino Acid Sequence ; Catalytic Domain ; Crystallography, X-Ray ; Glycoside Hydrolase Inhibitors ; Humans ; Hydrogen Bonding ; Intestines ; enzymology ; Kinetics ; Maltose ; chemistry ; Molecular Sequence Data ; Mutagenesis, Site-Directed ; Mutation, Missense ; Oligosaccharides ; chemistry ; Pichia ; Protein Binding ; Recombinant Proteins ; antagonists & inhibitors ; chemistry ; genetics ; Substrate Specificity ; Surface Properties ; alpha-Glucosidases ; chemistry ; genetics

Objective:To compare the use of continuous constant negative pressure drainage and intermittent suction mode drainage in abdominal wall angioplasty to minimize the impact of complications.Methods:From May 2017 to August 2019, the Department of Medical Cosmetology and Plastic Surgery, Wuhan Third Hospital treated 76 female patients after expanded flap repair, aged 27-35 years, with an average age of 30.5±14.2 years, and 58 female patients after abdominal wall plasty, aged 38-55 years, with an average age of 47.8±7.8 years. They were divided into intermittent negative pressure drainage group and continuous negative pressure drainage group. The negative pressure values in different intervals were set according to the type of operation. The drainage volume, drainage time, incidence of hematoma, subcutaneous effusion, flap necrosis rate, primary wound healing rate and drainage related bleeding were recorded and compared between the two groups.Results:After expanded flap repair in 38 cases, flap necrosis occurred in 1 case and hematoma in 3 cases; After abdominal wall plasty in 29 cases, flap necrosis occurred in 0 cases and hematoma in 1 case. The primary healing of incision was higher ( P<0.05), the drainage volume was larger, but the drainage time was shorter ( P<0.05), and no bleeding related to drainage was observed. The effect of monitoring drainage was positively correlated with the effect of operation. Conclusions:Continuous and constant negative pressure drainage is related to the prognosis of patients undergoing expansion flap repair and abdominal wall plasty. It is helpful to improve the effect of plastic surgery and the quality of nursing work. It is an effective method for nursing management after plastic surgery.

Objective:To study the current status of research in the field of iodine nutrition for pregnant women and to detect the hot spots and future trends in the field of iodine nutrition for pregnant women.Methods:Using "pregnant women" and "iodine" as search terms, we searched the literature related to iodine nutrition in pregnant women from January 2000 to December 2021 in China Knowledge Network (CNKI) database, Wanfang database and Chinese Medical Journal Full Text Database. CiteSpace 6.2.2.0 software was used to sort out the publication status, core authors and research hotspots of the papers.Results:A total of 879 valid papers were included, with an overall number of publications increasing trend from 2000 - 2021 and a decline after 2017. Among the 879 papers, 29 first authors were core authors (M≈3), and 109 papers were published, accounting for 12.40% of the total literature; several research groups with relatively stable collaborative relationships had been formed, with the larger collaborative team of Chen Zupei and Zhang Wanqi at Tianjin Medical University. Keyword co-occurrence analysis showed that pregnant women, urinary iodine, and iodine nutrition were high-frequency keywords; keywords with mediated centrality > 0.07 were pregnant women (0.48), pregnancy (0.40), urinary iodine (0.37), iodine deficiency disorders (0.25), iodine nutrition (0.20), thyroid (0.12), thyroxine (0.10), infants and children (0.09). The analysis of the emergent words showed that the evolution of iodine nutrition research themes in pregnant women was broadly based on studies of iodine nutrition monitoring results in key populations such as newborns and infants from 2000 - 2011, studies such as the range of thyroxine reference values during pregnancy from 2012 - 2016, and changes in iodine nutrition status of pregnant women and children after adjustment of iodized salt concentration from 2017 - 2021. The clustering results showed that a total of 355 keywords were aggregated to yield 10 clusters, and the average profile value of clusters (Silhouette) > 0.8, which was a reasonable clustering result; the study topics can be divided into three major categories, iodine nutrition and goiter monitoring results in key populations, thyroid hormones and pregnancy outcomes during pregnancy, and studies on thyroid-related diseases.Conclusions:Iodine plays an important role in the health of pregnant women and their offspring, and changes in the iodine nutrition status of pregnant women should be closely monitored. In response to the new trends of change that are currently present, multidisciplinary cooperation should be developed to respond to social concerns and jointly promote the maintenance of iodine nutrition in pregnant women at appropriate levels.

Objective To investigate the relationship between atrial fibrillation and left heart structure change in patients with hemodialysis combined with hemoperfusion.Methods A total of 60 patients with end-stage renal disease who underwent hemodialysis combined with hemoperfusion treatment in Ganzhou Hospital of Traditional Chinese Medicine from December 2020 to December 2021 were selected.Thirty patients with atrial fibrillation were included in observation group,and thirty patients without atrial fibrillation were included in control group.The left heart structure indexes of two groups were compared,and the relationship between atrial fibrillation and left heart structure change in patients with hemodialysis combined with hemoperfusion was analyzed.Results Left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),left atrium diameter(LAD),interventricular septal thickness(IVST),and left ventricular posterior wall thickness(LVPWT)in observation group were higher than those in control group,and left ventricular ejection fraction(LVEF)was lower than that in control group(P<0.05).Logistic regression analysis showed that the decrease of LVEF and the increase of LVEDD,LVESD,LAD,IVST and LVPWT were associated with atrial fibrillation in patients with hemodialysis combined with hemoperfusion(P<0.05).The results of receiver operating characteristic curve showed that area under the curve of LVEDD,LVESD,LAD,LVEF,IVST and LVPWT in diagnosing atrial fibrillation in patients with hemodialysis combined with hemoperfusion were 0.724,0.708,0.760,0.761,0.762 and 0.758,respectively,which had certain diagnostic value.Conclusion Atrial fibrillation in patients with hemodialysis combined with hemoperfusion is related to the change of left heart structure,and the left heart structure indexes are helpful to assist the diagnosis of atrial fibrillation.