Objective To study the clinical features of the variants of benign childhood epilepsy with central temporal spikes (BECT).Methods The clinical data of 12 hospitalized pediatric patients with BECT from Jan 2007 to Jan 2014 were retrospectively reviewed. Results There were 7 boys and 5 girls in 12 patients. The age of onset was from 3 to 9 years old. Two cases were dizygotic twins. The atypical symptoms included atypical absence of 10 cases, negative myoclonic seizure of 8 cases, speech expression disorders and oral-pharynx apraxia of 4 cases. The electroencephalography (EEG) of all 12 patients showed abundance of spike and waves (SW) in rolandic areas during wake-up and sleep. The SW index was 50%-85% during slow sleep in all patients.Conclusions The variants of BECT are often associated with EEG deterioration. Understanding the clinical featuress and EEG characteristics can help the diagnosis of BECT variants.

Objective To analyze the potential etiologies and risk factors of childhood stroke. Methods This study retrospectively reviewed the clinical data of 159 children who were admitted from Jan.2006 to Jan.2014. Results The 159 children were composed of 100 boys and 59 girls , with median onset age of 1.8 years (ranged from 1 day to 12 years old) and median peak age of 0.9 years (ranged from 3 months to 2.8 years old). Their initial symptoms included limb hemiplegia,language dififculties and convulsion. The common causes included infections found in 46 cases (central nervous system infection in 32 cases, respiratory and gastrointestinal tract infection in 14 case), head injury in 42 cases, vitamin K deifciency in 29 cases, Moyamoya disease in 8 cases, heart diseases in 11 cases, spontaneous hemorrhage in 11 cases and 12 cases of unknown reason. Infectious diseases were the most common cause of children acute ischemic stroke in toddler period;and vitamin K1 deifciency were the most common cause of children hemorrhage stroke in infancy. The most common region of infarction is basal ganglia and middle cerebral artery in neuronal imaging. The median age at the time of diagnosis was 1.4 days. The median time of inhospital was 28 days. The median apex time was 4.3 days. Conclusions Among 159 cases, acute ischemic stroke is much more common than hemorrhagic stroke in children stroke, and the major risk factors are infections and head injury;Vitamin K1 deifciency is a major risk factor in infants with hemorrhagic stroke.

Objective To explore the effect of pulse irrigation combined with autologous blood transfusion on inflammatory markers and thrombosis index, such as C-reactive protein (CPR), erythrocyte sedimentation rate (ESR), tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in patients undergoing total knee arthroplasty. Methods 96 patients due to knee osteoarthritis underwent unilateral total knee arthroplasty were randomly divided into experimental group (pulse irrigation combined with autologous blood transfusion after surgery ) and control group (alone autologous blood transfusion after surgery), PT, APTT, TNF-α, IL-6, D-Dimer of two groups at different time points were detected and compared. All patients underwent lower extremity vascular ultrasound examination after operation. Results PT, APTT values were no significant different between two groups (P > 0.05), TNF-α, IL-6 values of day1 and day7 after surgery in the experimental group were lower than the control group(P < 0.05), D-Dimer values of day4 after surgery were lower than the control group (P <0.05), the incidence of deep vein thrombosis (DVT) in the experimental group was lower than the control group (P < 0.05). Conclusion Pulse irrigation combined with postoperative autologous blood transfusion in total knee arthroplasty had no influence in blood coagulation , and can reduce inflammation and the incidence of DVT than alone autologous blood transfusion,thus is beneficial to the patient recover.

Objective The study was conducted to investigate the acute phase of convulsion related problem on the clinical manifestations,imaging and electroencephalograph (EEG) examination of purulent meningitis.Methods Cluster sampling method was employed to select children in our hospital,a total of 301 cases with purulent meningitis was analyzed retrospectively.Among them,62 cases had convulsion.The incidence of convulsion in the acute phase of the purulent meningitis,risk factors,and prognosis were analyzed.Results The convulsion incidence rate of acute purulent meningitis was 20.60％.The partial seizure was eight cases (12.90％).The secondarily generalized seizure following partial seizure was 15 cases (24.19％).The generalized seizure was 32 cases (51.61％).The convulsive status was 7 cases (11.29％).The EEG abnormality was significantly different between the convulsion group and the no convulsion group (P ＜ 0.05).The incidence of brain organic damage was significantly different between two groups (P ＜0.05).The multivariate unconditional logistic regression analysis showed,cause of disease,first symptom,disturbance of consciousness,obvious signs,and cerebrospinal fluid culture with convulsion were the relevant factors (P ＜ 0.01).Conclusions The most common seizure of purulent meningitis was the generalized seizure.Brain organic damage easily resulted in convulsion of purulent meningitis.The days of hospitalization,cause of disease,first symptom,disturbance of consciousness,obvious signs,and cerebrospinal fluid culture with convulsion were the positively relevant factors.Those positively relevant factors in combination of the clinical manifestations,imaging,and EEG examination in children would play an important role in diagnosis,treatment,and prognosis evaluation of convulsion derived from purulent meningitis.Moreover,convulsion affects the disease recovery in children with purulent meningitis.

BACKGROUND:Rheumatoid arthritis is a common chronic systemic autoimmune disease which is characterized by synovial lesions and bone erosion. The clinical treatment is stil a difficulty.
OBJECTIVE:To explore the effect of exogenous hydrogen sulfide on the articular lesions in rheumatoid arthritis rats.
METHODS:Sprague-Dawley rats were divided into four groups:control group, model group, high concentrations of hydrogen sulfide intervention group, low concentrations of hydrogen sulfide intervention group. At 2 and 4 weeks after intervention, the arthritis index, levels of serum inflammatory cytokines (tumor necrotic factor-αand interleukin-1β), pathological change of synovial tissue, average absorbance of knee joint specimens using col agen-II immunohistochemical staining were measured.
RESULTS AND CONCLUSION:The arthritis index, levels of serum inflammatory cytokines and inflammatory infiltration of synovial staining in the model group and two intervention groups were higher than that in control group, the high concentrations of hydrogen sulfide intervention group was significantly higher than the model group (P<0.05) while the low concentrations of hydrogen sulfide intervention group was lower than the model group (P<0.05). The average absorbance of knee cartilage specimens using col agen-II immunohistochemical staining was lower in the model group and two hydrogen sulfide intervention groups compared with the control group, the high concentrations of hydrogen sulfide intervention group was significantly lower than the model group (P<0.05) while low concentrations of hydrogen sulfide intervention group was higher than the model group (P<0.05). Hydrogen sulfide has a regulatory effect on rheumatoid arthritis, high concentrations of hydrogen sulfide aggravate arthritis and cartilage degradation, low concentrations of hydrogen sulfide reduce arthritis and protect cartilage.

Objectives To investigate the failure cause of valproate monotherapy for newly diagnosed generalized epilepsy in children and to investigate the factors related to the failure. Methods The newly diagnosed cases of general?ized epilepsy were recruited and given valproate monotherpy. After 2 years of treatment and regular follow-up, they were divided into control group and poor effect group.according to their response to the treatment. The clinic data and electro?encephalogram were collected. The reasons of treatment failure were studied using Logistic regression analysis. Results There were 231 patients who had completed this study in all. After 2 years, 62 cases had switched to other drugs because of poor efficacy. Efficacy of was satisfactory in 169 cases of children. There were 3 cases of poor compliance, and one case switched to other drug due to side effect. There were statistically significant (P<0.05) in the abnormal electroenceph?alogram (EEG) rate (poor effects group 90.32%vs. control group 61.54%), abnormal cranial magnetic resonance imaging (MRI) rate (poor effects group 45.16%vs. control grou p23.08%) and the first age of onset [poor effects group 0.50(0.42, 2.50)year vs. control group 0.75(1.50, 5.16)year] between the good effects group and poor effects group. Univariate anal?ysis showed that mental retardation,birth asphyxia,abnormal bain MRI,the first episode of age were statistically signifi? cant different between these two groups (P<0.05). Further multivariate regression analysis showed that the low first onset age (OR=2.124 P=0.004)、mentalretardation (OR=10.535,P=0.000, abnormal brain MRI(OR=1.603,P=0.020), asphyxia at birth(OR=1.913 P=0.027)were independent risk factors for the poor efficacy of valproate. Conclusions The main rea?sons for the failure of valproate monotherpy in children with generalizedepilepsy are poor efficacy,bad compliance, ad?verse reactions. The risk factors of poor efficacy are the low first onset age, mental retardation, abnormal brain MRI and asphyxia at birth etc.

Aim To observe the effects of panaxdiol saponins component ( PDS-C) extracted and isolated
from Chinese ginseng herb as new Chinese patent med-icine on the promotion of hematopoiesis and the regula-tion of the immune system in treating mice models with aplastic anemia ( AA ) . Methods For preparation of immune mediated AA models, BALB/c mice were ex-posed to sublethal doses of 5. 0 Gy γ radiation, fol-lowed by transplanted lymphocytes from DBA/2 donor mice. The mice models were divided into six groups in-cluding normal control, AA model, PDS-C treated groups with lower, medium and higher dosages, cy-closporine ( CsA) as positive drug control. Both PDS-C and CsA were administered by gastrogavage for 15 days. The peripheral blood cells counts and bone mar-row pathological examination were tested, the percenta-ges of Th1/Th2/Treg cells from spleen were measured, the protein expression levels of T-bet, GATA-3 and FOXP3 transcription factors in spleen cells were detec-ted. Results Curative effect of PDS-C on treating AA
mice was satisfactory. The peripheral hemoglobin, white blood cells and platelet counts in PDS-C groups with medium and higher doses were significantly higher than those in model control. Meanwhile, PDS-C ele-vated the percentages of Th2 cells and Treg cells, but decreased the percentage of Th1 cells, as well as up-regulated the GATA-3 , FOXP3 and down-regulated the T-bet protein levels. Conclusion PDS-C possesses the activities of promoting hematopoiesis obviously. It can improve marrow myelosuppression, enhance the re-covery of hematopoiestic function, and elevate the pe-ripheral blood cells counts. PDS-C also pays its immu-noregulatory efficacy though recovering from unbal-anced Th1/Th2/Treg cells in treating immune media-ted AA mice.

Objective To solve the problem of network in the Medical Information Management System of mobile medical team in the condition of field.Methods Carrier class AP/network bridge with the function of dual-band tri-mode and directional and omnidirectional wireless receiving and transmitting network were used to realize the WLAN wireless local net.Results Applied in the Binghai Docking Manoeuvre in recent 2 years,the system satisfied the field medical station.Conclusion The wireless network is of high security,the devices of the network are easy and convenient to be spread and folded,and with less cost because they can be used repeatedly.

Objective To evaluate the influence of situation-background-assessment-recommendation (SBAR) communication model on critical thinking ability in intensive care unit (ICU) nurses. Methods In May 2015, a total of 350 ICU nurses compliance with the study inclusion criteria, from a Class Ⅲ Grade A general hospital in He'nan Province, were selected by cluster sampling. The baseline survey of ICU nurses' critical thinking ability was carried out by critical thinking disposition inventory-Chinese version (CTDI-CV). The critical thinking ability of ICU nurse was investigated again after a-year-long implementation of morning shift meeting featured by SBAR communication model, and then, compared with that one year ago. Results After one-year practice of SBAR communication model oriented morning shift meeting, the total score of critical thinking ability increased from (242.39±37.07) to (262.60±35.96), and the difference was statistically significant (t=-7.105, P<0.001). The positive ability of critical thinking increased from 7.5% to 17.2%, and the difference was statistically significant (χ2=8.274, P< 0.05). Conclusions The application of morning shift meeting characterized by SBAR communication model can contribute to the elevation of ICU nursing staff's critical thinking ability.

Objective Complement plays an important role in the pathogenesis of myasthenia gravis.The formation of membrane attck complex and the damage of neuromuscular junction are inseparable from the activation of complement.Then to investigate the influencing factors of serum complement C3,C4 in children with myasthenia gravis and investigate the degree of influence of related factors.Methods One hundred sixty seven cases of hospitalized or outpatient myasthenia gravis children from the Department of Neurology in Hunan Children's Hospital were collected,including 33 cases of general MG,134 cases of ocular MG,and 36 cases of normal children as control group.The concentrations of serum C3,C4,IgG,IgM,IgA,IgE were detected by immune compare turbid.The influencing factors of complement C3,C4 were investigated and compared.Results The serum C3 levels were 1.07 ± 0.22 g/L,and the serum C4 levels were(0.17 ± 0.05)g/L in the general MG.The serum C3 levels were (1.01 ± 0.20)g/L,the serum C4 levels were(0.20 ± 0.08)g/L in the ocular MG.There were(1.36 ± 0.28) g/L for C3 levels,(0.25 ± 0.11) g/L for C4 levels in the control group.Compared with the control group,there were significant difference in C3 and C4 between the general MG and ocular MG(P ＜0.01 or 0.05).The partial correlations coefficients of C3 and course of disease,IgG and C3,C3 and C4 were-0.162,0.135,0.446(P ＜0.01 or 0.05).The multiple linear regression equations were as followed:C4 =0.420 × C3,C3 =0.655 + 1.148 × C4 + 0.008 × body weight-.005 × course of disease.Using univaruate analysis,the effect factors of C4(F =18.151,P =0.000),body weight(F =6.420,P =0.003),course of disease (F =3.015,P =0.039),age × course of disease × body weight (F =2.997,P =0.042) to C3 were significant (P ＜ 0.05,or P ＜ 0.01).Conclusion The C3 levels are mainly affected by C4,body weight,duration and some interaction effects among several impact factors in children with MG.C4 is mainly affected by C3.