The ketogenic diet (KD) is a special diet with high-fat, low-carbohydrate and moderate amount of protein. The KD therapy is a safe, potentially effective and important treatment of refractory childhood epilepsy in recent years. It has con-ifrmed clinical efifcacy and a generally good prognosis. The adverse reactions of KD treatment are normally less and transient. In this paper, the effective rate, patient compliance, adverse reactions and their causes of KD in treating children with refractory epilepsy were reviewed.

Mycoplasma pneumoniae pneumonia (MPP) accounted for 10%-40% of pediatric community-acquired pneumonia. The clinical manifestations of MPP were complex and varied. In addition to pulmonary inflammation, , the complications with lungs and other organs had been widely reported in MPP. Although the MPP complicated with thrombus in lung, other organs and limbs was rare reported, it was serious and life threatening once thromboembolism happens,. Clinicians should pay great attention to improve the ability of early identiifcation, diagnosis, and treatment. This paper will focus on the mechanism, early identiifcation, early diagnosis and treatment of MPP complicated with thrombosis.

Rotator cuff tears are common shoulder injuries.Because of the advantages of less injury and quick rehabilitation,arthroscopic rotator cuff repair becomes one of the major methods to treat the rotator cuff tears.Postoperative rehabilitation is also as important as the operation of rotator cuff repair.

Objective To establish a new model of the Achilles tendon(AT) contraction by stress-shielding. Methods 8 SD rats were randomly divided into two groups, the normal control group and the experimental group. The ATs of the experimental group were stress-shielded by fixing the upper ankle joint in equines position using a cerclage and transecting the sciatic nerve. The control group received no treatment. All rats were killed three weeks later, and all the ATs of the left hind limbs of the experimental and normal control group were tested morphologically by transmission electron microscope (TEM). Results Compared to the normal control group, the collagen fibrils of the experimental tendons did not arrange very well. The number of tendon cells increased, and some of them were pycnotic. Some mitochondrias were swollen. The proportion of the smaller diameter collagen fibril became lager, and small and large fibrils did not distribute in even. Conclusion Our research is successful compared to the past researches and repeatable.

BACKGROUND:Stress shielding in the Achil es tendons induces over-expression of tumor necrosis factor-α. The degree of tendon contracture remains unclear after the intervention with tumor necrosis factor inhibitor.
OBJECTIVE:To investigate the effects of tumor necrosis factor-αon tendon contracture and the preventive effects of tumor necrosis factor inhibitor (etanercept) on tendon contracture by observing the morphological changes of the stress-shielded Achil es tendons after the intervention with etanercept.
METHODS:A total of 20 healthy male Sprague-Dawley rats were randomly divided into experimental and model groups after stress shielding in Achil es tendons of rat left hind limb. Five rats from either group were randomly selected, and their right hind limbs were considered as normal controls. Immediately after model induction, the rats in the experimental group were subjected with 0.6 mg/kg etanercept, and those in the model group were subcutaneously treated with 1 mL phosphate buffered saline. According to half-life of etanercept, the two groups were separately injected three times. At 2 weeks after intervention, the morphological changes of the Achil es tendons were observed using gross examination and transmission electron microscope.
RESULTS AND CONCLUSION:On gross examination, the Achil es tendons in the experimental group were significantly smoother and smal er than those of the model groups, but thicker than those of the normal control group. Under a transmission electron microscope, the col agen fibrils of the model group were looser and more disordered than those of the experimental group. The col agen fibrils of the experimental group were similar to those of the normal control group in cross section and longitudinal section. These indicated that tumor necrosis factor-αantagonist can obviously prevent stress shielding-induced tendon contracture at 2 weeks.

Aquatic plant duckweed can enrich high concentration of arsenic, it is thus used as the representative of phytofiltration.The mechanism of arsenic tolerance in duckweeds has received much concern.In this study, synchrotron radiation X-ray fluorescence (SRXRF) and X-ray absorption near edge structure (XANES) techniques were used to study the micro-distribution and speciation of arsenic in natural As-rich duckweed from lead-zinc mine.Two monolithic duckweeds, FP1 and FP2, were analyzed by micro SRXRF, setting single point scan time and spot size were 5 s, 70 μm×80 μm and 2 s, 100 μm×100 μm respectively.Six points of FP2 were selected and analyzed by micro XANES in energy range of 11.81-11.96 keV.Pressed-pellet duckweed was analyzed by bulk XANES in energy range of 11.67-12.27 keV.The result showed that As(Ⅲ) was the major speciation of duckweed from bulk XANES and micro-XANES data.SRXRF micro analysis showed that arsenic had significant vein distribution in duckweed, and was not spread into the photosynthetic mesophyll within certain concentration, which may reduce the leaf toxicity triggered by arsenic.This vein distribution may play a role in arsenic tolerance in duckweed.

Objective To observe the change of P300(EP) evoked potentials in pre-and-post acupuncture on post-stroke patientsv following depression.Methods According to Hamiltion Rating Scale for Depression(HRS-D),ninty post-stroke patients were divided into two groups: the depression group(n=63) received acupuncture at Ex-HN1 and Siguan Points and the non-depression group(n=31).After assessed and grouped by HRS-D,and one acupuncture therapeutic course for the depression group,two groups' subjects were tested with P300 potentials.Results Before treatment,the latency of P3 of P300 potentials was longer and the amplitude of P3 was lower in the patients of the depression group compared with the cases in the non-depression group;after the acupuncture treatment,the latency of P3 decreased significantly(P<0.01),and the amplitude of P3 increased significantly(P<0.05) in the patients of the depression group.Conclusion P300 potentials test can help find cognitive dysfunction in post-stroke patients following depression at early stage,and acupuncture treatment in time can lessen or eliminate depression motion of post-stroke patients.

Objective To investigate effects of different concentrations of dexmedetomidine on onset time and clinical time-effect of rocuronium in the processes of the total intravenous anesthesia.Methods Sixty patients with elective anesthesia breast modified radical mastectomy,aged 26 to 55 years,were randomly divided into four groups of 15 patients.Group A (control group):uniform within 10 min before induction of anesthesia saline infusion (NS ; 0.25 ml/kg) ; group B:dexmedetomidine given initial dose 0.3 μg/kg uniform within 10 min before induction of anesthesia infusion finished,anesthesia period 0.3 μg/(g · h) continuous infusion until the end of surgery; group C:dexmedetomidine given initial dose 0.6 μg/kg uniform within 10 min before anesthesia infusion finished,during anesthesia with continuous infusion 0.6 μg/'(kg · h) until the end of surgery ; and group D:dexmedetomidine given initial dose 1 μg/kg uniform within 10 min before anesthesia infusion finished,during anesthesia to 1 μg/(kg · h) continuous infusion to the end of surgery.Patients after the burglary were under multi-monitor vital signs monitoring blood pressure (BP),heart rate (HR),oxygen saturation (SPO2),electrocardiogram (ECG),and after intubation monitoring end-tidal carbon dioxide (EtCO2),recording time T0 and T25.Results No significant difference was found at the T0 time in each group.However,the T25 time (48 ± 6) min in group C and (51 ±6) min in group D was significant longer than that (40 ±6)min in group A (P ＜0.05).The mean artery pressure(MAP) of group C and D [(88.76 ± 7.06)mmHg,(87.89 ± 6.95)mmHg] were significantly lower than group A after dexmedetomidine infusion 5 min later(P ＜ 0.05); The HR of groups B and C [(60.80 ± 7.11)bpm,(63.31 ± 5.78)bpm] were significantly lower than group A before induction (P ＜ 0.05).The HR of group D was significantly lower than group A before induction and after infusion 5 and 30 min later[(66.40 ± 9.49) bpm,(60.52 ± 7.45) bpm,(61.32 ± 7.11) bpm,P ＜ 0.05].Conclusions Under the status of total intravenous anesthesia,different concentrations of dexmedetomidine did not affect the onset time of rocuronium,but dexmedetomidine given up to a certain concentration could enhance the clinical time-effect of rocuronium.

Objective To explore the clinical application of digital chair?side immediate all?ceramic restoration system,design and fabricate inlays and onlays to restore the large?defected molars,and to analyze and evaluate the efficacy of this clinical restoration. Methods Totally 84 inlays and 65 onlays were fabricated with IPS e.max CAD series ceramic blocks by using Cerec AC system to conduct immediate all?ceramic restorations of 149 teeth for 108 patients. The inlays and onlays were applied and cemented to the prepared teeth with dual?cured resin luting agent. The restored molars were re?examined by two dentists after six months. The analysis standard was based on the United States Public Health Service(USPHS criteria) and the results were statistically analyzed(α=0.05). Results There was no statistically significant difference in the case numbers of grade A and grade B for each index comparing the immediate condition to the condition after 6 months. Over 90 percent of ceramic inlays and onlays were quali?fied to be grade A. The restorations were well in the aspects of anatomic morphology,marginal integrity,color match,marginal discoloration,reten?tion,gingival health and secondary caries. Conclusion Computer aided design/computer aided manufacture(CAD/CAM)system combined with machinable glass ceramics can achieve a favorable result in restoration of large?defected teeth. Digital chair?side immediate all?ceramic restoration technique is an ideal solution for large?defected tooth restoration.

In China , some ophthalmic new drug clinical trials used placebo as control .Two principles should be con-sidered in ethical review when placebo was used in these ophthalmic new drug clinical trials .Firstly, using placebo couldn't lead to irreversible or permanent vision loss .Secondly , there should be proper risk management in protocol and risk dis-closure in consent process .There are several important factors , including effects of standard treatment , risks of using pla-cebo, risk management in protocol and risk information in informed consent form , which should be used to assess the ra-tionality of placebo in ethical review .