Objective To evaluate clinical efficacy and electroencephalogram(EEG)changes quantitatively after the ketogenic diet (KD) by single sample entropy (SampEn) in the treatment of infantile spasms (IS),and to learn the quantitative relationship between the clinical efficacy and EEG.Methods Patients diagnosed as IS were enrolled and started KD in Shenzhen Children's Hospital from April 2010 to December 2013.The SampEn of EEG data in these patients before and after treatment with KD were analyzed.Patients were classified as seizure-free group and non-seizure-free group according to the therapeutic responsiveness to KD.The SampEn findings from two groups were compared to explore the effect of KD on EEG and its related factors.Results Among 35 patients,more than 2 months of treatment,10 cases were seizure free,25 cases still had seizures.SampEn was 0.377 ± 0.246 before treatment,and 0.725 ± 0.405 after treatment in all patients,there was significant difference (Z =-4.351,P =0.000).SampEn was 0.342 ± 0.277 before treatment,and 0.929 ± 0.379 after treatment in seizure free group,there was significant difference between 2 groups(Z =-3.371,P =0.001).While SampEn was 0.391 ± 0.237 before treatment,and 0.643 ± 0.393 after treatment in non-seizure free group,there was a significant difference between 2 groups(Z =-3.371,P =0.001).The mental and motor development was improved after KD with improvement rate were 56％ (14/25 cases) and 70％ (7/10 cases),respectively,but there was no statistical difference(P =0.704).Conclusions No matter seizures are controlled or not,KD can increase the complexity of electrical activity in the brain,which was more obvious in the seizure-free group.Intellectual and movement development can be improved in patients with KD.

Although the ketogenic diet(KD) has originally been used to treat epilepsies,plenty of evidence about the efficacy to intractable epilepsy has not accumulated until recently.These epilepsy or epilepsy syndrome include:Dravet syndrome,Doose syndrome,infantile spasms,Angelman syndrome with epilepsy,tuberous sclerosis complex and focal cerebral dysplasia or other structural epilepsy.It is worth paying more attention to the efficacy of KD on cognition,language development and behavior problems.

Maternally expressed gene 3 (MEG3) is a tumor-suppressing gene,and MEG3 RNAs,its products,are a series of long noncoding RNAs.The MEG3 gene is lost in kinds of human tumors,further more,the methylation of related DNA region is directly associated with the deficiency of MEG3 expression.Studies show that MEG3 gene and MEG3 RNAs can inhibit cell proliferation and induce apoptosis,which is associated with the fuction of tumor suppressor gene p53.

Objective To construct a maternally expressed gene 3(MEG3)expression plasmid vec-tor,and to obtain MEG3 over-expressed human pancreatic carcinoma SW1990 cells by transfection,and to ana-lyze the effect of MEG3 overexpression on the proliferation of human pancreatic carcinoma SW1990 cells. Methods A complete gene sequence based on the sequence of MEG3 in the GenBank was designed and inser-ted into the eukaryotic expression vector pcDNA3. 0 to construct recombinant plasmid pcDNA3. 0-MEG3. It was identified by sequencing and transfected into human pancreatic carcinoma SW1990 cells. The expression of MEG3 in SW1990 cells was confirmed by RT-PCR. The effect of MEG3 on proliferation was evaluated by MTT assay. In this study,the SW1990 cells transfected by plasmid pcDNA3. 0 were named negative control group, and the usual SW1990 cells were named blank control group. Results A MEG3 expression plasmid vector-pcDNA3. 0-MEG3 was constructed successfully. And pcDNA3. 0-MEG3 vector was transfected into SW1990 cells successfully. The expression of MEG3 at mRNA in MEG3-SW1990 cells increased significantly,about 895 times(F = 73. 592,P ﹤ 0. 01). The results of MTT assay indicated that over-expressed MEG3 could obviously inhibit SW1990 cells proliferation in vitro. After SW1990 cells transfected with pcDNA3. 0-MEG3 for 72 hours, the absorbance value was 0. 81 ± 0. 06,with a statistically significance(F = 33. 489,P ﹤ 0. 01)compared with negative control group(1. 17 ± 0. 07)and blank control group(1. 08 ± 0. 03). Conclusion A MEG3 expre-ssion plasmid vector-pcDNA3. 0-MEG3 is constructed successfully. It is confirmed that MEG3 and its product have obvious inhibitory effects for the proliferation of human pancreatic carcinoma SW1990 cells.

Objective To investigate the correlation between serum C-reactive protein (CRP) level and carotid atherosclerotic plaque calcification in patients with ischemic stroke or transient ischemic attack (TIA).Methods The patients with non-cardiogenic ischemic stroke or TIA in anterior circulation performed head and neck vascular CTA at 1-6 months from the time of onset were enrolled prospectively.The demographic and clinical data were collected and serum CRP levels were detected.Univariate and multivariate logistic regression analyses were used to determine the correlation between the serum CRP level and the carotid atherosclerotic plaque calcification.Results A total of 165 patients were enrolled.Their age was 62.4± 10.6years,male patients accotnted for 66.7％;113 patients (68.5％)had carotid atherosclerotic plaque calcification (calcification group),52 (31.5％) did not have carotid atherosclerotic plaque calcification (non-calcification group).The age of the calcification group (median,interquartlle;66 [58-73] years vs.58 [51-66] years;Z=-3.738,P＜0.001) and CRP levels (1.9 [0.5-3.8] mg/L vs.0.0 [0.0-2.2] mg/L;Z =-4.126,P ＜ 0.001) were significantly higher than those of the non-calcification group.There were no significant differences in other baseline clinical data between the two groups.Multivariate logistic regression analysis showed that age (odds ratio 1.063,95％ confidence interval 1.024-1.104;P =0.001) and CRP levels (odds ratio 1.209,95％ confidence interval 1.030-1.419;P=0.020) were still significantly correlated with the plaque calcification after adjusting for other confounding factors.Conclucions Carotid plaque calcification was correlated with older age and increased serum CRP level in patients with ischemic stroke or TIA.

Objective To explore the effectiveness and safety of temporary immunosuppressant withdrawal for the management of severe infection after liver transplantation.Methods Fifty-one patients with severe infection after liver transplantation were divided into control group (24 cases) and withdrawal group (27 cases ) according to the immunosuppression protocol.In the withdrawal group, the immunosuppressive drugs were temporarily suspended according to ATP values of CD4 + T cell and CD4 + T lymphocyte subsets counting until infection was controlled.The liver function,the incidence of acute rejection and the graft survival rate were monitored during the process.The side effects were observed.Result Severe infection was cured in 39 patients.There were 9 deaths in the control group in which the immunosuppressant was continued during the course of infection and 3 in the withdrawal group,respectively.The median suspension of immunosuppressant in trial group was ( 15.5 ± 4.8 ) d ( 6 ～ 22 d) ; CD4 + T lymphocyte subsets counting rose from (65.60 ± 32.58)/μl to (103.04 ± 12.39)/μl,ATP values of CD4 + T cell rose from (79 ±23) μg/L to ( 112 ± 11 ) μg/L; meanwhile,the temperature dropped from (38.3 ± 1.2) ℃ to (36.4 ± 1.1) ℃,WBC dropped from (15.7 ± 4.4) × 109/L to (6.3 ± 3.8) × 109/L,CRP dropped from ( 153.4 ± 37.1 ) mg/L to ( 16.5 ± 4.8) mg/L.During the course of treatment and follow-up,liver function of patients in the trial group remained normal and no acute rejection occurred.Compared with the control group,the temperature recovery time in the trial group was shorter ( respectively F =5.32,8.37,9.12,all P ＜ 0.05) and the therapeutic outcome was better.Conclusions The cellular immune function test could be evaluated according to the ATP values of CD4 + T cell and CD4 + T lymphocyte subsets counting.For severe infection after liver transplantation, anti-infection treatment and simultaneously withdrawing immunosuppressants help to control the infection.

Objective The expression and neuroprotective effect of meteorin in neurons and astrocytes after cerebral infarc-tion have yet to be clarified.This study was to investigate the expression and location of meteorin in the rat model of middle cerebral ar -tery occlusion (MCAO) and its neuroprotective effect against oxygen -glucose deprivation (OGD)-induced injury in cultured neurons or astrocytes. Methods Forty-two healthy adult male SD rats were randomly divided into 6 groups of equal number:sham operation and 6 h, 12 h, 24 h, 3 d, and 7 d MCAO.The cortical tissue was harvested for determination of the expression and location of meteorin by Western blot and immunohistochemistry as well as the meteorin expression in the neurons and astrocytes subjected to OGD. The neuroprotective effect of meteorin on the neurons and astrocytes was e-valuated by CCK8 and PI/Hoechst33342 staining. Results Com-pared with the sham operation group, the expression of meteorin was decreased after MCAO and reached the lowest level at 3 days ( P<0.01) , mainly in the neurons and astrocytes.Exogenous meteorin helped the survival of the astrocytes subjected to OGD, with the A value decreased in the groups of OGD ( 0.63 ) , OGD +meteorin
(0.78), and OGD+PBS (0.60) as compared with the sham control ( 1.51) (P<0.01), with no statistically significant differences among the former three groups (P>0.05).Concerning the effect of meteorin intervention on the OGD-induced injury of the astrocytes, the A value was significantly reduced in OGD (1.24 ±0.17), OGD+meteorin (1.51 ±0.30), and OGD+PBS (1.23 ±0.16) in comparison with the sham control (2.43 ±0.12) (P<0.01), lower in the OGD and OGD+PBS groups than in the OGD+meteorin group ( P<0.05) . Conclusion Meteorin is mainly expressed in the neurons and astrocytes after MCAO and it promotes the survival of the astrocytes with OGD-induced injury.

Objective To evaluate the prevalence of low bone mineral density in patients with inflammatory bowel disease(IBD) and to identify its risk factors. Methods A cross-sectional survey was carried out in IBD patients. Anthropemetric measures, biochemical markers of nutrition and bone mineral density measurement were completed for these patients as well as healthy control subjects. Results Seventy-seven Crohn's disease (CD) and 43 ulcerative colitis(UC) patients were enrolled, and 37 healthy volunteers were recruited as healthy controls(HC). The T value of CD patients, UC patients and HC was -1.72±1.20,-1.26±1.12 and-0.62±0.87 respectively and the T value of CD patients was significantly lower than that of HC (P=0.000). The prevelance of osteoporosis in CD, UC and HC was 23.3%, 14.0% and 0 respectively. The prevelance of osteoporosis in CD was higher than that in HC (P=0.003). Logistic regression analysis indicated that low BMI(BMI≤18.4 kg/m~2) was an independent risk factor for osteoporosis both in CD (OR=11.25,95% CI 3.198-39.580, P=0.000) and in UC (OR= 14. 50,95% CI 1.058-88.200, P=0.045) patients. Age, disease duration, clinical activity active index (CDAI), oral steroid therapy, immunosuppressant treatment and serum vitamin D concentration were not found to be correlated with osteoperosis in IBD patients. Conclusions Low bone mineral density is common in both CD and UC patients and low BMI is an independent risk factor for osteoporosis in IBD patients.

Objective To investigate the clinical and neuroimaging features of hypoglycemia encephalopathy in the elderly. Methods The history and clinical features of 36 patients who had undergone brain CT and MRI were analyzed retrospectively. Results Twenty-seven patients had infections and fevers as a trigger, presenting all kinds of symptoms. Eleven cases were found to have abnormal signals in bilateral caudate nucleus and lenticular nucleus in MRL But CT examination showed no new lesions in corresponding position. Hypoglycemia encephalopathy were commanly found in the elderly who had diabetes mellitus and treated with drugs. After being followed up for 6 months, their neuroimaging did not change. Conclusions Because the patients often present unconsciousness and weakness with a sudden onset, hypoglycemia is easily mistaken for other disorders, especially in the elderly. For those with consciousness, we should pay more attations to hypoglycemia. Brain CT has no value of diagnosing hypoglycemia encephalopathy, while MRI plays an impotant role in diagnosing the disease. The characteristic MRI features predicts a bad prognosis.

Objective To summarize surgical treatment of Takayasu arteritis,and analysis the drug treatment effect during the perioperative period.Methods Retrospective analysis 46 patients with Takayasu's arteritis disease and received cardiovascular surgery between January 2010 to December 2015,in Anzhen Hospital.By collecting their clinical characteristics,preoperative drug therapy,surgical treatment,pathological examination results to analyze operation conditions,effect of drugs and preoperative conditions.Results The perioperative mortality rate was 2.2％ and the complication rate was 23.9％ in 46 patients.There were 34 patients with symptomatic relief in the perioperative period,11 patients didn't take hormone drugs before operation.There were 11 cases of complications during the perioperative period,of which 7 patients were in active stage and 10 patients had not been used before operation.Conclusion The surgical treatment of patients with Takayasu's arteritis disease can effectively improve symptoms.The patients in Takayasu's arteritis active stage will affect the outcome of the surgery.Rational use of hormone drugs before surgery,can effectively control the patient's condition,improve the rate of remission of symptoms,and effectively reduce the incidence of perioperative complications.