BACKGROUND: Elderly post-stroke secondary epilepsy is the main cause of elderly epilepsy, and has a certain effect on the rehabilitation and prognosis of stroke.OBJECTIVE: To probe into the association of post-stroke epileptic attack with the type, location and size of stroke.DESIGN: A case analysis.SETTING: the Department of Neurology, Qianfoshan Hospital of Shandong Province.PARTICIPANTS: Between January 1999 and December 2004, 68 inpatients (42 males and 26 females) with post-stroke secondary epilepsy, aged 60-83 years with an average of (68±7), were selected from the Department of Neurology, Qianfoshan Hospital of Shandong Province, and all the patients participated in the study voluntarily.METHODS: [1] According to the time of the first attack of post-stroke epilepsy, the patients were divided into early epilepsy (within 2 weeks post stroke) and delayed epilepsy (after 2 weeks post stroke), and the correlation between the time of epilepsy attack and types of stroke was analyzed. [2]Based on the imaging results, the ischemic stroke (including cerebral thrombosis and cerebral embolism) was divided into groups of ＜ 1/4, 1/4-1/2, ＞1/2 of unilateral hemisphere according to the infarcted size, and divided into groups of ＜ 20 mL, 20-40 mL, and ＞ 40 mL according to the amount of cerebral hemorrhage, and the association of epileptic attack with the stroke location and size was analyzed. [3] All the patients received symptomatic treatment, and they were followed up for 6 months to 4 years with an average of 21 months by means of reexamination. [4] The differences of the enumeration data were compared with the χ2 test.RESULTS: All the 68 patients with post-stroke epileptic attack were involved inthe analysis of results. [1] The correlation between the time of epileptic attack and type of stroke: The cases of cerebral hemorrhage and subarachnoid hemorrhage were obviously more in the patients with early epilepsy than in those with delayed epilepsy (10, 2 cases; 4, 0 case, P ＜ 0.05),and the cases of cerebral thrombosis were obviously fewer in the patients with early epilepsy than in those with delayed epilepsy (3, 36 cases, P ＜ 0.05). [2]The association of epileptic attack with the stroke location and size: There were more cases with the infarcted size of 1/4-1/2 and ＞1/2 of unilateral hemisphere than those with the infarcted size of ＜ 1/4 of unilateral hemisphere (26, 17, 9 cases, P＜ 0.05). There were more cases with the 20-40 mL and ＞ 40 mL cerebral hemorrhage than those with ＜ 20 mL cerebral hemorrhage (4, 9, 1 case, P ＜ 0.05). [3] The prognosis of epileptic attack: Of the 21patients with early epilepsy, epilepsy was the first symptom in 6 cases, and no re-attack occurred within 2 weeks in 15 cases. Of the 47 patients with delayed epilepsy, the disease after 1 year was completely controlled in 18 cases,better controlled in 23 cases, and the attack was frequent in 6 cases.CONCLUSION: [1] Early epilepsy is mainly manifested by cerebral hemorrhage, subarachnoid hemorrhage and cerebral embolism, and delayed epilepsy is mainly manifested by cerebral thrombosis. [2] The risk of epilepsy is obviously increased in the patients with the infarcted size over 1/4 of the unilateral hemisphere, and those with ＞ 40 mL cerebral hemorrhage. [3] The prognosis of early epilepsy is better.

The cascade release of cytokine the critical aggravation factor for acute pancreatitis,induces the multi-ple organ dysfunction syndrome (MODS) and death at last. Nuclear factor-kappa B as a number of regulation of the nuclear factor can specific bind with a variety of gene promoter sites κB site, which cause inflammatory reaction, apoptosis, pathophysiologic reaction. The specific inhibitor of nuclear factor-kappa B can inhibit the activity of nu-clear factor-kappaB, inhibit the body's inflammatory response, and improve the prognosis of acute pancreatitis; it may be a potential target site for acute pancreatitis therapy. However, the other researches also found that inhibition of nuclear facter-κB could significantly increase the aggravation of acute pancreatitis. Accordingly, nuclear factor-kappa B research possess the important rank about the body's inflammatory respanse.

Objective To study the residual gallbladder stones and the relationship between the onset of acute pancreatitis and its surgical treatment.Methods Retrospective analysis was made in 13 patients with residual gallbladder admitted tO the hospital from June 1998 to December 2007,of which 8 cases of residual gallbladder stones and acute pancreatitis were invostigated.Thirteen cases of patients had underovent cholecystectomy 2 to 9 years before,the first symptoms occurred before 1 month to 8 years.Other remnants of the gallbladder were diagnosed by B-ultrasound and CT,magnetic resonance cholangiopancreatography (MRCP).Results Two cases were confirmedas pigment stones;6 cases as cholesterol stones(size0.2 cm ～0.5 cm,an average of 3.2 cm);1 cases as anonlalous pancre-aticobiliary junction(anomalous pancreaticobiliary ductal union,APBDU);5 cases as anomal;8 cases(61.5%)as episode of acute pancreatitis.Au patients underwent resection of residual gallbladder,with line choledochal cyst excision and biliary-enteric Roux-en-Y internal drainage in 1 case.choledocholithotomy T-tube drainage in 3 cases.Postoperative follow-up of residual gallstone was done in 8 cases,no pancreatitis attack in 6 cases,pancreatitis attack in 2 cases.Significant difference was found in onset of acute pancreatitis (P=0.019,P<0.05).Five patients without stones in patients with postoperative all none pancreatitis attack.Conclusion Patients with residual gallbladder stones are prone to acute pancreatitis,and cholecystectomy for patients with residual treatment Can reduce the pancreatitis attack.

Autoimmune pancreatitis is a chronic autoimmune-related pancreatitis.It is characterized by a high globulin, IgG~4 increased, anti-carbonic anhydrase antibody and anti-lactoferrin antibodies exist, diffuse swelling of the pancreas, a significant lymphocyte infiltration accompanied by fibrosis, multiple clinical manifestations , and sensitive to the hormone treatment.

Objective: To explore serum levels of lipoprotein associated phospholipase A2 ( LP-PLA2) in patients with acute coronary syndrome (ACS) who is smoking, to further clarify the impact of smoking on LP-PLA2 and the relationship with coronary artery disease (CAD). Methods: A total of 170 patients who received coronary angiography (CAG) because of chest pain in our hospital from 2015-01 to 2015-12 were enrolled. According to CAG results and smoking history, the patients were divided into 2 groups:Control group, n=70 healthy subjects including 2 subgroups as Smoking control subgroup, n=31 and Non-smoking control subgroup, n=39; ACS group, n=100 patients including 2 subgroups as Smoking ACS and Non-smoking ACS subgroups, n=50 in each subgroup. Blood levels of LP-PLA2 and C-reactive protein (CRP) were detected and compared among different groups. Results: Serum levels of LP-PLA2 in Smoking control subgroup was higher than Non-smoking control subgroup, P=0.018; LP-PLA2 level in Smoking ACS subgroup was higher than Non-smoking ACS subgroup,P=0.027; LP-PLA2 level in ACS group was higher than Control group,P=0.000. Serum levels of LP-PLA2 was positively related to CRP (r=0.724,P<0.01). Conclusion: Blood levels of LP-PLA2 and CRP were increased in ACS patients suggesting both of them might be involved in CAD occurrence; LP-PLA2 level was even higher in smokers implying this is could be one of the reasons for smokers were more likely to suffer from CAD and aggravate CAD progress.

Objective To assess the relationship between anterior-inferior glenohumeral instability and glenoid version.Methods Both shoulders in 24 patients with unilateral anterior-inferior glenohumeral instability were scanned with multiplanar spiral CT scanner(MSCT).The scapula and the humerus were reconstructed by the volume rendering technique and multiplanar reformation in 4 slices on axial plane from glenoid top to its bottom.The scapular glenoid version angles of 24 patients were measured bilaterally in 4 levels,and compared bilaterally by statistic analysis.Results From the top to the bottom,the scapular glenoid version angle in the side with anterior-inferior glenohumeral instability was respectively(-15.24?10.18)?,(-8.22?8.47)?,(-2.88?4.56)? and(-2.49?6.43)?,while the angle in the healthy side was respectively(-15.07?12.11)?,(-10.63?7.25)?,(-6.04?3.61)? and(-5.26?3.02)?.Only the difference at the 4th plane was significant between the healthy side and the affected side(P

Objective To introduce the method,characteristics and indication of unreamed in-tramedullery nailing in treatment of open tibia fractures.Methods 28 cases were classified according to the Gustilo method:18 belonged to type I,8 type II and 2 type III a.26 nails with 8mm in diameter and 2 nails with 7mm in diameter were used.Results All cases were fixed successfully with unreamed nailing without any X-ray aids.All of fractures had no infection,and healed in an average time of 5.6 months.There were no broken nails and screws in this series.Conclusion The unreamed intramedullary nailing is an advantageous therapeutic method with simple management,little trauma and wide indication in management of open tibia fractures.

Objective To analyze the effect of different procedures of alimentary reconstruction for the digestive and absorptive functions of patients after total gastrectomy. Methods From January 2012 to January 2013,there were 114 patients with gastric cancer,of which 58 patients received Roux-en-Y anastomosis were the control group,56 patients received P-type jejunal loop esophageal jejunal Roux-en-Y anas-tomosis were the observation group,the nutritional status and postoperative complications of two groups were compared. Results The level of RBC,HGB,TP and ALB of the observation group were significantly higher than that of the control group(P<0. 05),the incidence rate of in-traoperative complications,diarrhea and reflux esophagitis of the two groups had no significant differences (P>0. 05),but the incidence rate of postoperative dumping syndrome and abdominal distension of the observation group were significantly lower than that of the control group (P<0. 05). Conclusion The efficacy of P-type jejunal loop esophageal jejunal Roux-en-Y anastomosis for gastric surgery was superior to Roux-en-Y anastomosis.

Child ; Humans ; Neoplasms ; Quality of Life

Objective To evaluate the effects of recombinant human growth hormone(r- hGH)replacement therapy on glucose metabolism in children with growth hormone deficiency(GHD) Methods Replacement therapy with domestic r - hGH was done in 15 children with GHD for 3 months. Oral glucose tolerance test (OGTT) and insulin .releasing test (IRT) were performed before and after 3 months of r-hGH replacement therapy. Venous blood was sampled before and 30,60,120 min after glucose load for measurements of plasma glucose (PG) and insulin (INS).Results OGTT were normal in 15 patients before treatment. After 3 months of r-hGH therapy, fasting plasma glucose remained unchanged, but PG 30 min(P