Epilepsy is a common chronic disease of the nervous system in children.Antiepileptic drugs are the first choice for the treatment of epilepsy.However,about 20％-40％ of children with epilepsy will develop intractable epilepsy,which can affect children's mental development and bring heavy burden to families and the society.In addition to antiepileptic drugs,epilepsy surgery,neuromodulation and ketogenic diet can also be used as alternative treatments of intractable epilepsy.In order to give a reasonable advice,neurologists must be familiar with the indications and the advantages and disadvantages of the antiepileptic drugs and the various alternative treatments mentioned above.Only in this way can we reduce seizure frequency,even achieve the goal of curing epilepsy.

OBJECTIVE: A series of studies has been reported concerning deep venous thrombosis following artificial hip replacement. This paper is aimed to summarize the occurrence factor and preventive measures for deep venous thrombosis following artificial hip replacement.METHODS: A computer-based online search of VIP database was undertaken by the first author to identify the articles about the deep venous thrombosis following artificial hip replacement published in between January 1994 and October 2009 with the key words of"artificial hip replacement and deep venous thrombosis". Inclusive criteria: ①Occurrence factor of deep venous thrombosis following artificial hip replacement. ②Diagnostic criteria and diagnostic methods of deep venous thrombosis following artificial hip replacement. ③Preventive strategy for deep venous thrombosis following artificial hip replacement. Inclusive criteria: repetitive research or obsolete documents. Totally 25 literatures were included in this paper.RESULTS: The agreement has been basically achieved for pathogenesis and risk factor of deep venous thrombosis following artificial hip replacement. The pathogenesis included blood hypercoagulable state, slow blood flow (or stasis), and vessel wall damage. Meanwhile, elderly, cerebrovascular disease, varicose vein or intravenous surgery, were the risk factors of deep venous thrombosis. Mechanical therapy or medication could be selected for preventing patients against deep venous thrombosis following artificial hip replacement with different features. It was an acceptable method for most patients using mechanical therapy, which could not induce drug adverse reaction, but the clinical efficacy remained uncertain for high-risk patient population, thus, medication should be combined. Low molecular heparin was considered first-choice drugs for preventing deep venous thrombosis following artificial hip replacement, which was characterized by common uses and reliable effects. CONCLUSION: Studies on influencing factor and preventive treatment of deep venous thrombosis following artificial hip replacement has arisen more attention in medical circles. The understanding of pathogenesis, correlation factors and preventive measures plays an important role in decreasing incidence deep venous thrombosis.

Objective To explore the value of CT venography (CTV) in diagnosis of cerebral venous sinus thrombosis (CVST) . Methods 16 patients with CVST were examined by CTV. 2D and 3D vascular images were reconstructed through workstation. Results Filling-defect was seen as "empty triangle sign" on the axial image.Multiple CVST were displayed in 11 patients,among them,8 cases involved superior sagittal sinus,3 cases involved lateral sinus. Single CVST was displayed in 5 patients,2 cases involved superior sagittal simes,2 cases involved straight sinus,1 case involved inferior sagittal sinus. The irregular narrowing or occlusion of the sinus and dilation of the branch of vein were observed in all 16 patients on 2D or 3D images. Hydrocephalus, cerebral infarction and cerebral hemorrhage were seen in 11 cases, 6 cases and 4 cases respectively. Conclusion CTV is a sensitive and distinctive technique in diagnosing CVST.

The challenge of the emergence of drug-resistant influenza strains, which is caused by wide spread utilization of direct-acting antivirals (DAAs), accelerates the research and exploration towards host targeted agents. In contrast to DAAs targeting viral replication components, host targeted agents, which regulate host factors and pathways linked to viral replication, can interfere the replication of influenza. Additionally, the innate immune system is activated by influenza during the early stage of infection, so manipulating the innate immune response may prevent the viral infection. However, the excessive inflammatory response induced at the late phase of influenza infection would lead to severe tissue injures. Thus, it is very important to explore drugs with anti-inflammatory actions to suppress these immune imbalances and tissue injures. Here we overview the current progresses about host targets related to anti-influenza drugs.

Animals ; Female ; Hippocampus ; physiology ; Learning ; Long-Term Potentiation ; Male ; Memory ; Mice ; Mice, Inbred Strains ; Pregnancy ; Prenatal Exposure Delayed Effects ; psychology ; Tobacco Smoke Pollution

Objective To study the clinical efficacy of Wenweinjiangni granule combined with allantoin aluminum on patients with peptic ulcer and the changes of serum gastrin,transforming growth factor-α(TGF-α)and interleukin-8(IL-8)to explore the best treatment for patients with peptic ulcer.Methods 86 patients with peptic ulcer admitted in our hospital from July 2014 to July 2015 were selected as subjects of this study.The control group was treated with allantoin aluminum,and the observation group was treated with Wenweijiangni granule combined with allantoin.The serum levels of Gas,TGF-α,IL-8,adverse reaction and therapeutic effect were observed in the two groups.Results After treatment,the levels of Gas and IL-8 in the observation group were significantly lower than those in the control group [(68.96±21.26)pg/mL vs.(82.75±24.08)pg/mL(6.93±2.31)μg/L vs.(5.06±2.07)μg/L,(11.86±2.10)μg/L vs.(14.97±2.76)μg/L](P<0.05).The total incidence of side effects in the observation group was less than that in the control group(6.97％vs.23.25％)(P<0.05).The total effective rate of the observation group was better than that of the control group(95.34％vs.76.74％)(P<0.05).Conclusion The combination of Wenweijiangni granule and allantoin aluminum can improve the ulcer surface of patients with peptic ulcer,improve Gas,TGF-α and IL-8,which is more effective and more effective than aluminum allantoin alone.

Objective In order to deeper understand DCIS,improve the rate of diagnosis and therapeutic efficacy.Methods The clinical data of 123 DCIS treated at the First Affiliated Hospital of China Medical University were retrospectively analyzed in regards to age at onset of disease,clinical features,breast ultrasound examination,mammography examination,pathology,immunohistochemistry examination,and surgical methods.Results(1) The average age at onset was(47.7?9.3) years.(2)The major features on physical examination were breast lump in 79cases,nipple discharge in 19cases,and breast pain with glandular thickening in 30 cases.(3)Among 45 cases that underwent both ultrasound and mammography examination,in 17cases(60%) and 30 cases(66.7%) respectively,might be positive for malignancy,but the difference between the 2 melhods was not significant.With the use of both methods togather,diagmosis of possible malignant lesion was made in 37 cases(82.2%).(4) Sixty-five cases underwent breast ultrasound examination,substantive mass was found in 43 cases(66%),blood flow signals in 41 cases(63%),ductal dilatation in 52 cases(80%) and intraductal spotty strong light beam in 33 cases(50.7%).(5) Fifty-two cases underwent breast mammography examination,which showed sand-like calcification,mass with calcification clusters,localized gland density and breast tumor.(6)The immunohistochemistry examination included estrogen receptor(ER),progesterone receptor(PR),p53 and c-erbB-2,but the rate of positive expressios of those indices showed no significance difference between DCIS and DIS with microvasion(DCIS-MI).(7)Six cases underwent radical mastectomy(of which there were 3 cases of DCIS-MI).Modified radical mastectomy was done in 86 cases,including 59 cases of DCIS,27 cases of DCIS-MI.Lymph node metastasis was found in 2 cases of DCIS,and 5 cases of DCIS-MI.ConclusionsCombined breast ultrasound and mammography can increase the rate of DCIS diagnosis.

Objective To observe the effect of selective intra-arterial thrombolytic therapy for central retinal artery thrombosis. Methods 100 000-250 000U of urokinase were injected into the ophthalmic artery via a catheter in the ophthalmic artery or the internal carotid artery to carry out the thrombolytic therapy. Results The visual acuity was significantly improved from light perception or finger counting to 0.1 in 8 of a total of 26 cases, partially improved in 10 cases, and no change in vision in 8 cases. The time interval from the onset of the disease to thrombolysis was within 8 days in the 18 patients who showed improvement, 3 of them showed significant improvement, of whom 2 received the treatment within 3 days. Conclusion Selective intra-arterial thrombolytic therapy is effective for the treatment of central retinal artery thrombosis. The effect was closely related to the time interval from the onset of the disease to thrombolysis. The thrombolytic therapy should be carried out as soon as possible.

Objective: To observe the inlfuence of simvastatin combining ezetimibe on blood levels of glucose and lipids in patients of acute coronary syndrome (ACS) with impaired glucose tolerance (IGT).
Methods: A total of 316 patients with ACS and IGT were randomly divided into 2 groups: Treatment group, the patients received simvastatin 20 mg/day with ezetimibe 10 mg/day,n=160 and Control group, the patients received simvastatin 20 mg/day,n=156. All patients were treated for 24 months. Blood levels of total cholesterol (TC) and low density lipoprotein cholesterol (LDL-C) were observed at 6, 12 and 24 months of medication; fasting blood glucose (FBG), 2 hour postprandial blood glucose (2hPG), glycosylated hemoglobin (HbA1c) and the number of patients with new onset diabetes were examined at 6 days and 12, 24 months of medication.
Results:①In Treatment group, at 6 months of medication, blood levels of TC (mmol/L) and LDL-C (mmol/L) were (3.5 ± 0.5) and (2.1 ± 0.4) which were both lower than baseline levels (5.2±1.2) and (3.5±0.5),P<0.05; at 12 and 24 months, TC and LDL-C were (3.1 ± 1.0), (1.8 ± 0.6) and (3.0 ± 0.6), (1.8 ± 0.5), TC and LDL-C were consistently decreased, all P<0.05. In Control group, at 6 months of medication, TC and LDL-C were (4.0 ± 0.5) and (2.4 ± 0.5) which were both lower than baseline levels (5.3 ± 0.8) and (3.1 ± 0.4),P<0.05; at 12 and 24 months, TC and LDL-C were (3.8 ± 0.6), (2.3 ± 0.6) and (3.7 ± 0.5), (2.1 ± 0.7), allP<0.05. TC and LDL-C levels in Treatment group were lower than Control group at 6, 12 and 24 months of medication, allP<0.05.②In Treatment group, FBG (mmol/L) levels at 12 and 24 months were similar to 6 days,P>0.05; HbA1c at 12 and 24 months were similar to baseline,P>0.05; 2hPG (mmol/L) level at 24 months was higher than 6 days (9.5 ± 1.1) vs (8.7 ± 1.0),P<0.05; there were 26 patients with new onset diabetes at 24 months after medication. In Control group, 2hPG level at 24 months was higher than 6 days (9.6 ± 0.8) vs (8.7±0.7); there were 25 patients with new onset diabetes at 24 months after medication. The levels of FBG, 2hPG, HbA1c and the number of patients with new onset diabetes were similar between 2 groups, allP>0.05.
Conclusion: Ezetimibe combining simvastatin may better reduce blood lipids, while it had no real effect on blood glucose metabolism in patients with ACS and IGT.

Objective To investigate the protective mechanism of Interleukin 33 (IL-33) in preventing myocardial ischemia and reperfusion injury in rats. Methods A rat model with myocardial I/R with 32the adult male SD rats , which were randomly divided into 4 groups: SO group , I/R group , IL-33 + I/R group , SB230580 + IL-33 + I/R group. The levels of LDH, CK, TNF-α, IL-6, HMGB1, Bcl-2, total caspase-3, cleaved caspase-3 and P-P38 were detected. Results After reperfusion, IL-33 significantly decreased the levels of serum LDH and CK and the expression of TNF-α, IL-6 , cleaved caspase-3 , but significantly increased the expressions of Bcl-2, p-P38 (P < 0.05). SB230580 attenuated the protective role of IL-33 on myocardial I/R in a certain degree. Conclusions IL-33 may prevent myocardial I/R injury via inhibiting inflammation and cardiocyteapoptosis by way of P38 MAPK signaling pathway.