The brain is an important organ in the human body with high metabolic requirements, and epilepsy, as a common neurological disease, also exhibits high metabolic characteristics in its lesion area. At present, controlling seizures caused by drug-resistant epilepsy or specific metabolic defects through metabolic regulation has shown good anti epileptic effects. In recent years, people have become increasingly interested in the relationship between brain metabolism and epileptic seizures. So far, several new anti epileptic therapies targeting metabolic pathways have been proposed, including inhibition of glycolysis, targeted lactate dehydrogenase, and dietary therapy. It is highly promising to intervene in epilepsy by regulating brain metabolism, but currently we still lack a thorough understanding of the role of brain metabolism in controlling epilepsy. This review aims to gain a deeper understanding of energy metabolism in the brain and its correlation with epilepsy, emphasizing the regulation of neuronal excitability through glycolysis, in order to search for effective anti epileptic therapies, in order to better understand the role of glycolysis in epileptic seizures and reveal potential therapeutic targets for epilepsy.

ObjectiveTo establish a green passage for elderly patients with hip fracture, and explore the feasibility and nursing mode of establishing an independent orthopedics unit for elderly patients with hip fracture. Methods? From January 2017 to June 2018, a total of 391 cases of elderly patients with hip fracture in the Second Affiliated Hospital of Wenzhou Medical University were selected. The patients were divided into two groups according to their admission to the ward. The 213 patients in the elderly hip fracture independent orthopedics unit group were admitted to the emergency green channel; 178 patients in the general orthopedics ward were given routine treatment and nursing. The time interval from admission to operation and the prognosis were compared between the two groups. Results? 77.46% of the elderly patients in the independent orthopedics unit group received operation within 36 hours after admission, while only 29.21% in the general orthopedics ward group, with statistical significance (P＜ 0.01). Rehabilitation and discharge rate of independent orthopaedic unit group was 89.20% and 77.53% in control group within one week after operation. The difference was statistically significant (P=0.009). Conclusions? The establishment of independent orthopedics unit with green channel in geriatric orthopedics reduces the waiting time, bed rest and hospitalization time of patients, and saves medical and nursing resources.

Objective: To evaluate the effect of total parathyroidectomy and autotransplantation (TPTX+AT) and total parathyroidectomy (TPTX) on secondary hyperparathyroidism (SHPT). Methods: PubMed, EMBASE and Cochrane library were searched from inception to June 2017 for relative studies, which were screened according to inclusion criteria. Meta-analysis of included study were conducted to compare the improvement of symptoms, persistent SHPT, recurrent SHPT, reoperation, hypoparathyroidism, duration of operation and hospitalization between TPTX+AT group and TPTX group. Results: A total of 11 studies with 1212 patients were included. Results of meta-analyses showed no difference between TPTX+AT and TPTX regarding improvement of symptoms and persistent SHPT (RR=1.03, P=0.70; RR=0.81, P=0.67, respectively), but TPTX was associated with lower risks of recurrent SHPT and reoperation (RR=0.25, P<0.01; RR=0.19, P<0.01). Patients with TPTX had higher rate of hypoparathyroidism (RR=2.68, P<0.01) but shorter time of operation (MD=-17.3, P=0.01). Durations of hospitalization were similar between the two groups (MD=-0.06, P=0.98). Conclusion Compared with TPTX+AT, TPTX reduces the risks of recurrent SHPT, reoperation and operation time, but has higher risk of hypoparathyroidism.