Objective To explore the features and relevant factors of ecological executive function in adults with id-iopathic or probably symptomatic epilepsy. Methods 120 adults with idiopathic or probably symptomatic epilepsy were compared strictly with 120 healthy controls of the same gender, age , marriage and educational degree. The differences in ecological executive function were compared between the two groups with the Behavior Rating Inven-tory of Executive Function-adult version( BRIEF-A);apply multiple stepwise linear regression analysis was used to explore the correlations between epileptic factors with projects of BRIEF-A. Results Compared with controls,the epileptics yielded higher scores significantly on all projects of BRIEF-A(P<0. 05):global executive composite,be-havioral regulation index,inhibition,shift,emotion control, self-monitoring, metacognition index,initiation, working memory,plan,organization,task monitor. Multiple stepwise linear regression analysis showed that four clinical fea-tures videlicet seizure type, seizure frequency, epilepsy control and antiepileptic drugs were closely related to BRIEF-A while factors such as course of disease,gender,age,marriage,educational degree,initial age were not rele-vant to BRIEF-A. Conclusion The ecological executive function of adults with idiopathic or probably symptomatic epilepsy impairment is affected by seizure type,seizure frequency,epilepsy control and antiepileptic drugs.

Objective To investigate the incidence of adult epilepsy patients with attention-deficit hyperactivity disorder (ADHD) and the characteristics of ADHD subtypes, and to explore the correlations between several epilepsy-related factors with ADHD.Methods According to corresponding inclusion criteria and exclusion criteria, 156 adult epilepsy patients who visited to Neurology Clinic of Zhejiang Hospital and the First Affiliated Hospital of Anhui Medical University from March 2014 to October 2014 were enrolled as a study group to enter this test.Eighty-six nomal adults were enrolled as the control group who matched for the age, gender, inteligence quotient with the study group.Using the chi-square test and Logistic regression analysis and the other statistical methods to analyze the phenomenon of ADHD in adults with epilepsy and the factors that may contribute to the phenomenon.Results The detection rate of ADHD in 156 adult patients with epilepsy was 26.9％ (42/156), significantly higher than that in the heathly control group which was 4.7％ (4/86, x2 =17.862, P ＜ 0.05).Symptomatic epilepsy and the electroencephalogram showed multifocal discharge had higher detection rate of comorbid ADHD and the difference was statistically significant (The detection rate of idiophathic epilepsy was 22.1％ (21/95), symptomatic epilepsy was 46.7％ (14/30), cryptogenic epilepsy was 22.6％ (7/31), x2 =7.362, P =0.025.The detection rate of frontal epileptiform discharges was 30.6％ (11/36), temporal area was 25.9％ (14/54), central area was 18.2％ (4/22), multifocal epileptiform discharges was 46.2％ (12/26), the normal was 1/18, x2 =10.187, P =0.037).The results of binary Logistic regression analysis showed that epilepsy age of onset (B =-0.889, P =0.049) was possibly an important factor for epilepsy with ADHD.Conclusions The risk of ADHD occurred in adults with epilepsy is higher than that in the healthy adults and attention-deficit is the common subtype.The etiology, age of onset and electroencephalogram features of adults with epilepsy may be associated with the occurrence of ADHD.

Objective To explore the correlation of serum ferritin (SF),fibrinogen(FIB) and D-dimer levels in patients with small vessel disease(SVD).Methods 359 patients with SVD were selected,including 186 patients with lacunar infarction ( LI) and 173 patients with leukoaraiosis ( LA) .176 healthy controls were enrolled in this study as control group.The SF,FIB and D-dimer concentrations were measured by radioimmunoassay method and Clauss method respectively .Results The serum levels of SF , FIB and D-dimer in SVD patients were significantly higher than those in the controls [(171.82 ±156.28)μg/L vs (100.37 ±70.11)μg/L,(3.27 ±0.93) g/L vs (2.97 ± 0.88)g/L,(1.10 ±1.06)mg/L vs (0.83 ±0.55)mg/L](all P<0.05).Compared with LI subgroup,the levels of SF,FIB and D-dimer were higher in LA subgroup [(185.22 ±108.55)μg/L vs (159.36 ±89.69)μg/L,(3.32 ± 0.86)g/L vs (3.23 ±0.99)g/L,(1.29 ±1.17)mg/L vs (1.03 ±0.80)mg/L],but the differences were not signifi-cant(all P<0.05).Multivariate regression analysis revealed that by comparison to the reference quartile ,the odds ra-tio (95%CI) for SVD patients in the higher quartile (SF>151.16μg/L,D-Dimer>1.02 mg/L) were 3.444(95%CI=2.097-5.158,P<0.001) and 1.767(95%CI=1.114-2.803,P=0.016),respectively after multivariable ad-justment.Conclusion The increased levels of SF ,FIB and D-dimer are closely related with SVD .FIB and D-dimer might come to be attractive approaches to prevent the progress of SVD .

Objective To explore features and relevant factors about the ecological executive function of children with idiopathic or cryptogenic epilepsy.Methods 50 children with idiopathic or cryptogenic epilepsy against were compared with 50 normal ones of the same gender,age group and educational level.All the subjects'parents completed the Behavior Rating Inventory of Executive Function(BRIEF).Results The scores of children with idiopathic or cryptogenic epilepsy in global executive composite (GEC),behavioral regulation index (BRI) and metacognition index (M I) of BRIEF (respectively,55.12± 10.49,53.74 ± 10.35,56.60 ± 10.99) were significantly higher than those of the control group (respectively,48.10 ± 6.35,47.18± 5.84,48.16 ± 6.23) (P＜ 0.01).Multiple stepwise linear regression analysis showed that 4 clinical features namely seizure type,gender,age and epilepsy control were closely related to BRIEF while factors such as educational level,outbreak age,course of disease,family history and antiepileptic drugs were not relevant to BRIEF.Conclusion The ecological executive function of children with idiopathic or cryptogenic epilepsy faulty and is affected by seizure type,gender,age,epilepsy control.

Objective To investigate the sleep problems and related affecting factors of primary or possibly symptomatic school-aged children with epilepsy.Methods 54 epilepsy children(7 to 12 years old) and the general 54 healthy children whose gender and age were strictly matched with epilepsy group were investigated by using the chinese version of CSHQ.Results ① The total CSHQ score and 6 subscale scores (bedtime resistance, sleep onset delay,sleep anxiety, night wakings, parasomnias, and daytime sleepiness)were significantly higher in the epilepsy group(P<0.05).② In the epilepsy group, different age groups had statistical difference in the total CSHQ score and 4 subscale scores(sleep resistance, sleep onset delay, sleep duration and sleep anxiety) (P<0.05).The seizure controlled group and the uncontrolled group had statistical difference in the total CSHQ score and all subscale scores, except sleep onset delay(P<0.05).There were statistically significant differences in the total CSHQ score and all subscale scores, except sleep-disordered breathing in different seizure frequency groups(P<0.05).Different seizure type groups had statistical difference in the total CSHQ score and 4 subscale scores(sleep resistance, sleep duration, sleep anxiety and daytime sleepiness)(P<0.05).Different seizure time groups had statistical difference in the total CSHQ score and 5 subscale scores(sleep resistance, sleep onset delay, sleep duration, sleep anxiety and night waking)(P<0.05).Monotherapy group and polytherapy group had statistical difference in the total CSHQ score and 4 subscale scores(sleep onset delay, night waking, parasomnias and daytime sleepiness) (P<0.05).③ Multiple linear regression analysis showed that the main influencing factors of the total CSHQ score and some subscale scores were gender, age, control of seizure, frequency of seizure, type of seizure, time of seizure and the number of drug taking.Conclusion Children with epilepsy compared with healthy children are more likely to have sleep problems, and the occurrence of sleep problems may be related to many factors.

Objective To investigate the effects of GM1 and Edaravone on expressions of PDK1,GSK3βprotein in ischemic penumbra after local cerebral ischemia/reperfusion in intraluminal thread occlusion of the middle cerebral artery rats and its related mechanism. Methods The local cerebral ischemia/reperfusion model was established by intraluminal thread occlusion of the middle cerebral artery. The animals were randomly divided into pseudo surgery group,model group,GM1 group, Edaravone group and GM1 and Edaravone group. Using the techniques of immu-no-histochemical sraining,the expressions of PDK1,GSK3β protein were observed at 3,7 and 14 days in ischemic penumbra. Results In ischemic penumbra,3,7,14 days each time point,a value and positive unit of the PDK1 protein expression in GM1 and Edaravone groups were higher than those in GM1 or Edaravone groups(P<0. 05), model groups(P<0. 01);a value and positive unit of the GSK3βprotein expression in GM1 and Edaravone groups were lower than those in GM1 or Edaravone groups(P<0. 01),model groups (P<0. 01). Conclusion GM1 and Edaravone resist neural cell apoptosis,regulate PI3K /Akt signal transduction pathway by enhancing PDK1 protein and restraining GSK3β expression after local cerebral ischemia /reperfusion in artery rats.

Objective To study the clinical effect of expert tibial nail (ETN) in the treatment of distal tibial fractures. Methods From October 2007 to June 2008,ETN was performed in 13 patients with distal tibial fractures. There were eight males and five females, at age range of 25-47 years (33.8 on average). According to AO/ASIF classification, there were three patients with 43-A1 fractures, four with 43-B1 fractures, four with 43-B2 fractures and two with 43-C1 fractures. All the patients were with close fractures except for three patients with Gustilo-Anderson type Ⅰ fractures. Their clinical data were analyzed for assessing the clinical effect of ETN. Results All patients were followed up for a mean time of 8.4 months (range 3-13 months), which showed that all the fractures obtained stable fixation and sound healing, with no complications like breakage of ETN, wound infection, fracture nonunion or limb shortening. According to Johner-Wruhs standard, the functional results were excellent in 10 patients and good in three. Conclusion ETN has advantages of minimal invasion, shorter operation time, stronger fixation,better soft tissue protection and better functional recovery for distal tibial fractures in comparison with traditional open reduction and buttress plate fixation.

56 school-aged children with epilepsy and 37 normal ones of the same gender,age and educational level were selected. All the subjects' parents completed the child adaptive behavior scale, the mutiple stepwise linear re-gression was used to explore the impact of epilepsy related factors on social adaptive function. The social adaptive function of school-aged children with epilepsy faulty is affected by seizure frequence,gender,age,epilepsy control, clinical course,and the number of antiepileptic drugs.

Objective To explore the social support and characteristics of ecological executive function in adult patients with epilepsy,and their correlation.Methods Evaluate the social support and ecological executive function in 65 cases of adult epilepsy patients and 60 normal ones of the same gender,age group and educational level using the Social Support Rating Scale (SSRS) and the Behavior Rating Inventory of Executive Function-adult version (BRIEF-A).The date were statistically analyzed with independent sample t test,Pearson correlation analysis and multiple stepwise regression analysis.Results The scores of adult epilepsy patients in global executive composite,subjective support,objective support and support utilization of SSRS(respectively,37.01±6.74,19.51 ± ±4.77,7.18±2.73,7.45± 1.75) were lower than those of the control group(respectively,40.89±8.54,23.52±2.85,11.02±2.43,9.55±2.88).The scores of adult epilepsy patients in global executive composite (GEC),behavioral regulation index(BRI) and metacognition index(MI) of BRIEF(respectively,55.12± 10.49,53.74± 10.35,56.60± 10.99) were significantly higher than those of the control group (respectively,48.10± 6.3,47.18± 5.84,48.16± 6.23) (P＜0.01).SSRS scores,subjective support,objective support and support utilization were obviously negative to BRIEF scores,behavioral regulation index (BRI) and metacognition index (MI) (P＜ 0.01).Seizure type and SSRS scores were closely related to BRIEF (P＜0.01).Conclusion The epilepsy patients show a lack of social support and ecological executive function dysfunction.The lack of social support is significantly related with ecological executive dysfunction.

Objective To investigate the serum level of C-reactive protein (CRP) in patients with cerebral infarction and its effect on the prognosis of brain infarction.Methods 113 patients (86 with thrombosis and 27 with lacunar infarction) and 48 healthy persons as control were enrolled in this study. The serum level and abnormal rate of CRP were determined. All the patients were scored by clinic neurological function deficit scale (NDS).Results The serum level of CRP in the patients with thrombosis was higher than that in the patients with lacunar infarction. It was also higher in the patients with lacunar infarction than in normal controls (all P