Objective: To assess the surgical techniques and surgical outcomes of temporoparietooccipital and parietooccipital disconnection. Methods: The authors conducted a retrospective review of clinical, neuropsychological, EEG, imaging data in 16 patients with intractable epilepsy who underwent temporoparietooccipital and parietooccipital disconnection between April 2008 and October 2011. Of the 16 cases, 12 were males and 4 were females. The age of seizure onset was from 0.1 to 27 years (average 6.6) and disease duration of 0.1 to 18 years (average 7.5). The surgery was performed between the age of 3 and 37 years (average 14.1). Nine patients underwent temporoparietooccipital disconnection, 5 patients parietooccipital disconnection and 2 patient parietooccipital disconnection and temporal lobotomy. Results: After a mean follow-up of 1.6 years (range 0.5–3.9 years), 13 patients (81%) were seizure free, 1 patient had Engel Class II seizure outcome and 2 patient had Engel class III outcome. Two patients exhibited severe brain swelling and one patients had second resective operation with good recovery. None of the patients developed new motor defi cits postoperatively and there was no mortality. Conclusion: Temporoparietooccipital and parietooccipital is a safety and effective epilepsy surgery procedure for patients with epileptic zone localization to the posterior quadrant on one side. The results of surgical disconnection for posterior quadrantic epilepsy have yielded excellent seizure outcomes in 81% of the patients, with no mortality or major morbidity.

OBJECTIVE: To determine the content of the related substances in azithromycin tablet by HPLC-electrochemical detector.METHODS: The column was Gamma ARP-1/P.The mobile phase consisted of 0.014 mol?L-1 dipotassium hydrogen phosphate/0.020 mol?L-1 sodium hydroxide(pH was adjusted to 11 by phosphoric acid and sodium hydroxide)-acetonitrile(71∶29) at a flow rate of 0.7 mL?min-1.The column temperature was 40 ℃.The injection volume was 50 ?L.Glass carbon working electrode was set at +900 mV.RESULTS: The linear ranges of erythromycin peroxide,deoxyazithromycin,azithromycin impurity A,and N-demethlation azithromycin were 0.15～1.80 ?g(r=0.999),0.09～1.08 ?g(r=0.999),0.23～2.76 ?g(r=0.998) and 0.30～3.60 ?g(r=0.998),respectively.The average recoveries were 98.9%(RSD=1.1%),94.6%(RSD=5.4%),103.4%(RSD=3.4%) and 96.2%(RSD=4.3%),respectively.The contents of the related substances were all below 0.7%.CONCLUSION: The established method is reproducible,sensitive and reliable,and applicable for the detection of the related substances in azithromycin tablets.

The levels of plasma immunoreactive atrial natriuretic polypeptide (ir-ANP) were determined by radioimmunoassay in 59 children with congenital heart disease (CHD). It was showed that the ir-ANP levels of the patients with left to right shunt were higher than those of control (P0.05). The iir-ANP levels of patients with HYHA II degree were increased significantly (P

Objective To explore the clinical significance and changes of tumor necrosis factor-?(TNF-?)and interleukin-6(IL-6)level in children with acute viral myocarditis(AVM).Methods TNF-? and IL-6 level in serum from 53 AVM children and 20 healthy children were measured by radio-immunoassay and enzyme-linked immunosorbent assay(ELISA).The relation between the levels of TNF-? and IL-6 in serum with the occurrence and development in acute viral myocarditis was analyzed.Results Thirty-two were males and 21 females in the 53 AVM children.The ages ranged from 3-11 years old.There were 12 males and 8 females in control group.The serum level of TNF-? and IL-6 were(526.7?32.9),(3.23?0.53)mg/L in AVM group and(383.1?27.5),(1.63?0.22)mg/L in control group.There were significant difference between the 2 groups(Pa

Objective To evaluate the clinical effects and adverse reaction of raltitrexed combined with radiation for esophageal carcinoma in elderly patients.Methods Sixty patients were randomly divided into two groups by the envelope method, 30 patients in experimental group received raltitrexed combined with radiotherapy and 30 patients in control group received radiotherapy only.Patients in both groups received conventional radiotherapy with a total dose of 56-60 Gy/28-30 F.In experimental group, raltitrexed 2.6 mg/m2 was administered concurrently with the radiotherapy on d1 and d22.Two cycles of concurrent chemotherapy were administered during radiotherapy.The short-term effects, survival times and adverse reactions of the two groups were compared.Results The total effective rates of experimental group and control group were 93.3% and 73.3%, respectively, and there was statistically significant difference between the two groups (χ2=4.320, P=0.038).The median survival times of experimental group and control group was 24.0 months and 12.0 months, respectively, and there was statistically significant difference by Log-rank test (χ2=6.048, P=0.014).The major adverse reactions of grade 3-4 in experimental group and control group were radiation-induced esophagitis (10.0% vs.3.3%;χ2=0.268, P=0.605), leukopenia (13.3% vs.10.0%;χ2=0.000, P=1.000), thrombocytopenia (3.3% vs.0;P=1.000), nausea and vomiting (6.7% vs.0;χ2=0.517, P=0.472), and the differences were not statistically significant.Conclusion Raltitrexed combined with radiotherapy can enhance the short-term effect and prolong the survival time for the elderly esophageal carcinoma patients, and the adverse reactions are mild.It is worthy of further clinical study.

Objective To investigate the clinical effect and pathogenesis of tiopronin in treating acute pancreatitis complicated with liver damages. Methods Eighty-one patients with acute pancreatitis complicated with liver damages were randomly divided into two groups. The control group (40 cases) received routine treatment, and the treatment group (41 cases ) received routine treatment and tiopronin. The liver function, pancreatic enzyme indexes and C-reactive protein (CRP), the length of hospital stay was recorded. Results After 8 days' treatment, the liver function improved, and the levels of pancreatic enzyme indexes and CRP were decreased significanfly in both groups, and these changes were more obvious in treatment group (P <0.05). The length of hospital stay of mild acute pancreatitis in treatment group was significantly shorter than that in control group [ (8.6 ± 2.7 ) d vs. ( 13.8 ± 3.5 ) d ] (P < 0.05 ). Conclusions Tiopronin has beneficial effects in treating acute pancreatitis complicated with liver damages,and it has a therapeutic effect in acute pancreatitis at the same time. The mechanism may be related with the inhibition of inflammatory mediators, oxygen free radicals scavenging and other effects.

A variety of views and approaches were found in the appraisal and judgments of the people's courts in various provinces and cities,on medical disputes involving absence of a hand or foot of newborns,which result in different or event contradictory court decisions.This study made an analysis of the characteristics,nature,and classification of such cases as well as countermeasures of medical institutions,with recommendations on rational and appropriate handling of such cases,for the purposes of legitimate rights maintenance of both doctors and patients,and promotion of mutual understanding between the two parities,and establishment of a harmonious doctor-patient relationship.

Objective To observe the effect of irbesartan on the expression of angiopoietinlike protein 2 (ANGPTL2) in the diabetic rats kidney and explore the underlying mechanism.Methods A total of sixty male SD rats were divided into normal control group (NC group,n=15) and experimental group (n=45) randomly.The experimental group was fed with high sugar-fat diet and given a low dose streptozocin (STZ 30 mg/kg)to establish type 2 diabetic model.Rats successfully induced diabetes were randomly divided into 2 groups:diabetes group (DM) and irbesartan group (DI).Weight,blood pressure,blood glucose,serum creatinine (Scr),blood urea nitrogen(BUN),24 hour urinary albumin(UAL) and renal histomorphology were observed after drug intervention at the 4th,8th and 12thweeks.The expression of ANGPTL2 in renal tissue were detected by immunohistochemistry,real-time PCR and Western blotting.Results The levels of Scr,BUN,TG,TC and UAL in group DM were higher than in group NC at the 4th,8th and 12th week (all P ＜ 0.05).Compared with that in group DM,above indexes were lower in group DI at the 4th,8th and 12th week (all P ＜ 0.05).The pathological changes of the kidney in group DM were more serious than that in group DI.The expression of ANGPTL2 in group DM was much higher than that in group NC at the 4th,8th and 12th week (all P ＜0.05),and irbesartan treatment inhibited the up-regulation of ANGPTL2 in group DI(all P ＜ 0.05).Conclusion The expression of ANGPTL2 increases in T2DM rats kidney tissue with time and irbesartan can inhibit the up-regulation of ANGPTL2 in T2DM rats.

Objective To explore the improving effect of L-leucine on memory impairment in plateau and the mecha-nism. Methods After successfully trained in the 8-arm radial maze,50 male Kunming mice were selected and randomly divid-ed into normoxic control group (NC group),model group,and L-leucine (low,medium and high dose) groups.Animals in L-leu-cine groups were intragastrically given 0.473 g?kg-1 ,0.945 g?kg-1 and 1.89 g?kg-1 L-leucine for 7 days and those in NC and model control groups were administered the same volume of purified water for the same period of time.At the 4th day of the treat-ment,the mice in the model control group and L-leucine groups were placed in a large low-pressure and low-oxygen chamber to simulate low-pressure hypoxic environment of the plateau (7 500 m,3 d).The 8-arm radial maze was used to measure the spatial learning and memory ability of mice and dry-wet method to measure the water content of brain tissue.HE staining was employed to observe the cell morphological changes in CA1 region of the hippocampus.The expression levels of mTOR,P70S6K and 4E-BP1 mRNA in the hippocampus were detected by SYBR Green real-time PCR. Results The reference memory error ( RME) ,total error ( TE) ,testing time ( TT) ,and water content of brain tissue were significantly increased,the neuron injury was exacerbated in CA1 region of the hippocampus,and the expression levels of mTOR and P70S6K mRNA were markedly decreased in model control group when compared with those in NC group (P<0.05 or P<0.01).These indexes,however,were significantly improved in L-leu-cine groups,especially in high-dose group. Conclusion L-leucine can improve memory impairment in plateau,and the mecha-nism may involve the activation of mTOR and its downstream substrates (4E-BP1 and P70S6K).

Objective To know the point prevalence rate of social anxiety disorder(SAD) in Daqing University,and explore the influence factors about growth environment.Methods Data came from a large representative sample of 1878 university students,who were selected by stratified random cluster sampling methods according to the constituent ratio of students.They finished general situation questionnaire,interaction anxiety scale (IAS),adolescent self-rating life events check list(ASLEC),Egma Minnen av Bardndosnauppforstran(EMBU) respectively.According to the score of IAS,they were divided into 3 groups of high,mid and low.And then all of the high group,the 50％ and 10％ randomly of the mid and the low group respectively accepted the face-to-face interviews with 6 trained psychiatrists referred to SCID-I/P.Results Among 1878 Daqing university students,191 of them were diagnosed as SAD,with a point prevalence rate of 8.89％.The rate of rural students was higher than that in urban students(12.3％ vs.8.5％,x2 =7.966,P=0.017),and the rate of non-only child was higher than only child (12.0％ vs.9.1％,x2 =4.055,P=0.044).There were significant differences between SAD and No-SAD on many factors of ASLEC and EMBU.Logistic regression analysis showed that study stress in ASLEC(B=0.206),father's warm (B =-0.070),father's overprotection (B =0.286),mother's punishment (B =0.159),only child or not (B =-0.685) entered into regression equation.Conclusion The point prevalence rate of SAD in Daqing university students is 8.89％ and influenced by several growth environmental factors.Only child or not,father's warm,father's overprotection,mother's punishment,study stress in ASLEC can forecast SAD occurrence.