Objective To study the value of video EEG combined with MRI in the diagnosis of intractable epilepsy.Methods40 patients with intractable epilepsy treated in our hospital from 2013 to 2015 were selected as the subjects.In 40 patients, 26 patients with hippocampal sclerosis, 2 cases of patients with temporal lobe atrophy with cerebral dysplasia, 4 cases of patients with cerebral gray matter and macrogyria, 3 cases of vascular malformation, 1 cases of patients with intracerebral cyst, 2 cases of patients with glioma, 2 cases of patients with traumatic epilepsy.Retrospective of The clinical data of the selected patients were analyzed and the manifestations of epileptic foci were reflected by MRI, The use of video EEG was used to detect the status and source of EEG during epileptic seizure and epilepsy Analysis, combined with MRI scan and video EEG results, control surgery pathological changes, analysis of the results, draw conclusions.ResultsThere were 21 cases of the accurate location of interictal EEG.The accuracy was 52.5%, and the accuracy of the location of epileptogenic foci was about 40, and the accuracy was about 100%.The accuracy of MRI in the diagnosis of epileptic foci and related lesions was 35 cases, the accuracy rate was 87.5%, and the number of lesions was qualitative and accurate in the case of 30 cases, with an accuracy rate of 75%.ConclusionVideo EEG combined with MRI examination for drug refractory epilepsy diagnosis has important clinical value, can make a more accurate diagnosis of patients with epileptogenic foci, provide information for surgical treatment of intractable epilepsy patients, with further clinical promotion and application significance.

Objective To study the effects of oligohydramnios in full-term pregnancy women deliveried on the perinatal outcomes.Methods 320 suspected oligohydramnios cases from January 2008 to June 2009 were taken as observation group,and compared with 320 cases full-term pregnant women with normal amniotic fluid and without any high-risk factors as control group.B-type ultras onography was used to determine the volume and index of amniotic fluid and fetal umbilical blood flow index (S/D).Blood estriol was determined combining with non-stress test(NST)and oxytocin challenge test(OCT) or contraction stress test(CST) examination to evaluate maternal and fetal situation.The perinatal outcomes of the two groups was analyzed and compared.Result The neonatal asphyxiation and mortality rate between the two groups had no significant difference( P ＞ 0.05).The rate of cesarean section in the observation group was increased( P＜ 0.05).Conclusion The term pregnancy women with oligohydramnion during labour diagnosed by B-type ultrasonography should select vaginal delivery based on comprehensive examination.

BACKGROUND:The Notch signaling pathway is evolutionarily highly conserved and mediated by cel-cel interactions, which is widely involved in cel differentiation, proliferation and apoptosis. This critical transduction system participates in coordinating various functions of vascular endothelial cels, thus playing a vital role in the formation and remodeling of vascular network. OBJECTIVE: To elucidate the components of Notch signaling pathway and its impact on angiogenesis. METHODS: A computer-based online search of PubMed and CBM databases was performed. High-quality articles related to mechanism of angiogenesis regulated by Notch signaling were included, and repetitive studies were excluded. RESULTS AND CONCLUSION:Totaly 31 literatures were selectively included in this review. Angiogenesis is a complicated and muti-stage biological event and has been delicately regulated. Notch signaling participates in the regulation of every stage of angiogenesis directly or indirectly via the crosstalk with vascular endothelial growth factor, BMP-SMAD signaling and extracelular matrix molecules. Furthermore, consistent output of Notch signaling is essential for maintaining the stability and integrity of adult vascular system. This review wil thoroughly clarify the latest progress on angiogenesis regulated by Notch signaling and provide theoretical basis and a potential target for designing therapeutic methods against vascular disease.

A 34-year-old male patient with suspected pheochromocytoma was referred to our department for paroxysmal hypertension. Pheochromocytoma was confirmed by very high plasma nor-metanephrine ( NMN ) and metanephrine ( MN ). Contrast CT of the adrenal disclosed a 3.0 cm x 3.0 cm mass in the left adrenal. 18 F-FDG-PET-CT showed high uptake only in the left adrenal. When the patient's blood pressure was well controlled with 4 mg/d doxazosin for 2 weeks, surgery was then performed under laparoscopy. A round solid left adrenal pheochromocytoma was resected. After surgery, plasma MN and NMN levels returned to normal, and the patient was free of clinical symptoms with normal blood pressure. This patient has been followed 3 years with normal blood pressure, MN, and NMN levels, without tumor recurrence shown hy adrenal CT.

Objective To approach the changes of advanced glycosylated end products (AGEs),surfactant proteins A (SP-A) in the lung of experimental diabetic rats and their relationship. Methods 48 male SD rats were divided into diabetes mellitus (DM) group and control group, each group with 24 rats.The DM rat model was made by injecting streptozocin (60mg/kg) into caudal vein. The rats were killed and the lung was individually taken out at the end of 4, 12 and 20 weeks after the models were established. The changes of AGEs, SP-A in rats lung were observed with immunohistochemical assay and the images were analyzed( black is minimum of gray, white is maximum of gray ). Results We observed a great quantity of AGEs positive cells in the alveolar epithelial cells, bronchial mucosal epithelium, angio-endothelial cell and smooth muscle cells of the DM rats. The average gray (AG) was inferior to that of the controls(4weeks 93.92 ± 7.92 vs 104. 75 ± 8. 20; 12 weeks 76. 25 ± 6. 76 vs 93.50 ± 7.56; 20 weeks 47.63 ± 7.96 vs 142. 38 ± 19. 76; P ＜0. 05) and decreased with the DM course. In the 4 weeks DM rats, there were a few SP-A positive cells in the type Ⅱ alveolar epithelial cells, Clara cells and alveolar macrophage cells. In the 12 and 20 weeks DM rats, there were a great many CTGF and TGF-β1 positive cells. The AG was inferior to that of the controls( 12 weeks 75.63 ± 6. 70 vs 110. 50 ± 13.20;20 weeks 47.38 ± 4. 84 vs 97. 25 ± 9. 87; P ＜ 0. 01 ). Conclusion With the progress of diabetes, DM rats' pulmonary alveolar type Ⅱ cells injury appeared, that might be related with the deposition of AGEs.

A 57-year-old female patient was admitted to our hospital because of sustained hyponatremia within stress dose of hydrocortisone replacement after transsphenoidal partial pituitary tumor surgery. Multiple clinical parameters investigation for 2 weeks was shown increasing serum Na+and uric acid level and decreasing blood pressure level under water restriction about 500 ml/d, and even without hydrocortisone replacement, the serum Na+ still maintain normal level. After surgeries and radiotherapy, the tumor was undetectable and serum Na+ level was within the normal range without any water restriction.

Objective To evaluate the efficacy and safety of treating liver cancer using 131I-anti-CD147-monoclonal-antibody (131I-anti- CD147-McAb) by transcatheter hepatic arterial infusion (TAI) in a rabbit liver cancer model. Methods Forty-five rabbit models were randomly divided into three groups evenly. Transcatheter hepatic artery infusion under general anesthesia were performed in all three groups. Group A:control group, saline. Group B:pure 131I solution. Group C: 131I-anti-CD147-McAb solution. About 2 ml blood sample was obtained from all rabbits for liver, kidney,and thyroid function at pre-TAI and post-TAI 1 day, 3 days ,7 days, 14 days, 21 days. The rabbits were scanned by single photon emission computed tomographic (SPECT) to monitor radionuclide bio-distribution and tumor size on 1 day, 7 days, 14 days, 21days after procedures in group B and C. On 14 days after procedure, five rabbits were randomly selected to be sacrificed in each group for pathological and immunological investigations. The remaining rabbits continued to be fed, and survival rates were measured. Results The TAI and SPECT-CT/CT procedures were successfully performed in all rabbits. Test results showed that AST and ALT levels tended to increase transiently 1 day after TAI (P<0.05). The liver function returned to pre-operative levels (P> 0.05) 7 days after TAI. FT3 and FT4 mean values of rabbits in group B and C continued to decline 7 days after TAI, while thyroid stimulating hormone (TSH) showed corresponding increase (P<0.05). WBC mean value of rabbits in group B and C declined slightly after procedures (P>0.05). SPEC-CT imaging of rabbits shows that most of the radionuclide was gathered in the gastrointestinal tract and thyroid in Group B, however, radionuclide was mainly concentrated in the tumor lesions in Group C. Fourteen days after procedures, radionuclide imaging of all rabbits disappeared in group B and C. The VX2 liver tumors increased rapidly after treatment in group A and B;but the tumors gradually reduced their size in group C. At 14 days after TAI: The proportion of tumor necrosis in group C was significantly greater than that in groups A and B (P<0.05). The microvessel density (MVD) number of residual tumor in group C was less than groups A or B (P<0.05).TUNEL analysis suggested that more apoptosis bodies was displayed in the residual tumor tissue in group C than that in groups A and B, but the expression of MMP-2 and vessel endothelial grouth factor (VEGF) was significantly reduced in group C than group A and group B. Median survival time of the rabbits in groups A, B, C was 22 days, 26 days and 54 days respectively. Survival time of the rabbits in group C was significantly prolonged than other two groups (P<0.01). Conclusions Radioimmunotherapy with 131I-anti-CD147-McAb by TAI can inhibit the growth and metastasis of liver cancer, and prolong the survival of experimental animals. The method is effective and safe in this animal study.

[Summary] A 61-year-old female patient was diagnosed as ACTH independent Cushing′ syndrome, right adrenal adenoma, right facial infection. The situation was well controlled with antibacterial agents, abscess incision drainage and ketoconazole therapy. The patient received partial adrenolectomy of her right adrenal gland 16 months later. This case indicated that anti-adrenal agents could be a reasonable choice when the Cushing′syndrome patients were acompanied with severe infection.

Objective To investigate the effects of morroniside on fibrinogen (Fib), prothrombin time (PT), activated partial thromboplastin time (APTT) and thrombin time (TT) in focal cerebral ischemia/reperfusion in rats. Methods The animal model was induced with occlusion of middle cerebral artery (MCAO) with suture embolus, and morroniside was then administered intragastrically at the dose of 30, 90 and 270 mg/kg for 7 d. Acetyl salicylic acid was taken as positive control drug. The content of Fib, and PT, APTT and TT were measured withrelated kits. Results Compared with the sham-operated group, the concentration of Fib significantly increased (P<0.001) and PT, APTT and TT significantly shortened in the model group (P<0.001); however, compared with the model group, morroniside significantly decreased Fib content (P<0.01) and prolonged PT, APTT and TT (P<0.05). Conclusion Morroniside can antagonize the coagulation function in focal cerebral ischemia/reperfusion in rats.

ObjectiveTo retrospectively analyse the data of patients with suspected primary aldosteronism (PA) during the last five years.The receiver operating characteristic (ROC) curve was used to evaluate the value of aldosterone to renin ratio (ARR) in screening primary aldosteronism.MethodsThe clinical data of ARR in supine and upright positions were collected in 590 patients with suspected during January 2006 to August 2010.There were 357 patients diagnosed as primary aldosteronism and 233 patients as essential hypertension among these patients.100 patients with suspected primary aldosteronism took the upright and random ARR during September 2010 to April 2011 ; Among these patients,29 patients were diagnosed as primary aldosteronism and 71 as cases of essential hypertension.ROC curve was made to retrospectively define the method and the cut-off value of the supine,upright or random ARR.ResultsThe area under the curve(AUC) of the supine ARR in the 590 patients who took the supine and upright ARR during January 2006 to August 2010 was 0.838 (0.805-0.867 ) and the AUC of the upright ARR was 0.873 (0.843-0.899 ).There was significant difference between these two AUC readings (P＜0.01 ).The AUC in the upright ARR of the 100 patients who took the upright and random ARR during Septeuder 2010 to April 2011 was 0.962 (0.928 -0.995 ) and the AUC of the random ARR was 0.944 (0.893-0.994 ).There was no significant difference between these two AUC readings (P＞0.05).The upright ARR cutoff value with 400 ( pg · ml-1 )/( ng· ml-1 · h 1 ) yielded a sensitivity of 91.9％ and a specificity of 64.2％ to diagnosis of PA.ConclusionUpright ARR value was more suitable in the screening test than supine ARR value.Random ARR showed similar effect as the upright ARR.In our research,under strict control of the drug,position and detection time,ARR value with 400 ( pg · ml-1 )/( ng· ml-1 · h-1 ) can be the cutoff point in screening the suspcctcd PA patients.