Febrile seizures ( FS ) is a common convulsive disorder in infants and young children. It is clinically classified into simple febrile seizures(SFS)and complex febrile seizures(CFS). Although intensively investigated,it remains controversial on the etiology,pathogenesis,treatment,long-term prognosis of FS,even the definition itself is still under debate. This paper briefly reviews recent advances on the underlying mechanisms of FS,including involvement of genetic factors,role of ion channels,and immunologic and neurotransmitter dysreg-ulation. We also gathered some new insights on the treatment and prevention of FS,aiming to improve our under-standing of FS.

ObjectiveTo investigate the effectiveness and safety of insulin glargine in the treatment of patients with type 2 diabetes mellitus (T2DM),and verify the new remedy called one central and three steps for T2DM.MethodsUsed multicenter,random,open and self-control study.Two hundred and three cases with T2DM treated with insulin glargine were divided into four groups according to different therapy:30 cases with one needle method,106 cases with one needle and one pill method,48 cases with one long-acting and several short-acting method,and 19 cases with one long-acting,one pill and several short-acting method.The changes of blood glucose,glycosylated hemoglobin (HbA1c),weight and so on before and after treatment were observed.ResultsThe levels of fasting plasma glucose(FPG),2 h postprandial plasma glucose (2hPPG) and HbA1c decreased significantly after treatment than those before treatment[(5.78 ±0.76)mmol/L,(8.37 ±:1.37) mmol/L,(6.81 ±0.38)％ vs. (11.73 ±4.49) mmol/L,(16.73 ±4.96) mmol/L,(9.43 ± 2.31 )％,P ＜ 0.01 ].The weight and body mass index had no obvious changes before and after treatment( P ＞ 0.05 ).There was significant difference in the level of FPG,2hPPG and HbA1c before and after treatment in four groups respectively(P＜0.01 ).There was only 1 case who occurred hypoglycemia during the treatment.ConclusionThe therapy,one central and three steps,is not only effective and safe,but also convenient and cheap for T2DM.

ObjectiveTo investigate the correlation between the expression of VEGF and the lymph node metastasis of colorectal carcinoma.MethodsVEGF was detected by immunohistochemistry in 24 cases of colorectal carcinoma with lymph node metastasis and 16 case of colorectal carcinoma without lymph node metastasis.CD34 was used as a marker to evaluate the MVD.All the data were analyzed using 10.1 statistical package.The comparison was performed by x2 test and Spearman rank correlation analysis.The level of significance is α =0.05.Resultsin the 40 cases of colorectal carcinoma,24 cases encountered lymph node metastasis with an MVD (40.65 ± 11.80) and 21 cases were VEGF positive (87.5％).In the 16 cases without metastasis,the MVD was (25.02 ± 11.52) and 4 cases were VEGF positive (25.0％).MVD and VEGF were significantly different between thecases with lymph node metastasis and those without (t =-4.138,x2 =16.00,P ＜0.01 ).In the 40 cases,there were 25 cases with positive VEGF with an MVD (41.33 ± 11.61 ) and 15 cases with negative VEGF with and MVD (22.84 ±8.88).The difference between the cases with positive VEGF and those with negative VEGF (t =5.301,P ＜0.05 ).VEGF level was positive correlated with MVD in the colon cancer ( rs =0.539,P ＜ 0.05 ).Conclusion VEGF may play a role in promoting the lymph node metastasis of colorectal carcinoma

Objective To explore the inclusion criteria of community-based palliative care service.Methods From July 2017 to September 2017,three rounds of Delphi consultation for development of inclusion criteria of community-based palliative care was conducted.With judgment sampling method,23 senior executives and managers from 6 pilot units of palliative care service in Shanghai were selected and invited to participate in the consultation,which included the importance,coercion and completeness of the inclusion criteria.According to the consulting results,the inclusion criteria of community palliative care services was developed.Results The median age of experts was 35 years (29-55 years,with a quartile spacing of 7 years).The average working experience of experts was (13.7 ± 7.5) years,in which that for palliative care was (4.1 ± 1.6) years.The authority coefficient was 0.82,and the Kendall coordination coefficient was 0.337 (P＜0.01) for the importance of inclusion criteria.In the developed criteria,the four mandatory inclusion criteria were patient needs,the provision ability of community health service centers,compliance with legal requirements and compliance with the concept of palliative care service;and the five non-mandatory inclusion criteria were heavy needs and demands,high cooperation from patients and their families,high satisfaction of patients and their families,within the scope of community health service centers and clinical guidelines for the operations.Conclusion The experts of this research have high enthusiasm and authority,and the developed inclusion criteria of community palliative care service contents are reasonable and feasible.This studymay provide reference for setting up the contents adjustment mechanism of community-based palliative service.

Objective To analyze the dynamic changes in serum adiponectin(APN)levels after acute myocardial infarction(AMI)and its relationship with heart failure(HF)and major adverse cardiovascular events(MACE).Methods A total of 124 AMI patients who underwent percutaneous coronary intervention(PCI)in our hospital from January 2021 to December 2023 were enrolled as AMI group.Additionally,30 patients with non-AMI coronary artery disease and 30 healthy individu-als were included in non-AMI coronary artery disease group and healthy group,respectively.General information such as age,gender,smoking,alcohol consumption,hypertension,diabetes,and blood lipids were recorded for all subjects.Serum APN levels were measured using the enzyme-linked im-munosorbent assay(ELISA)method;plasma brain natriuretic peptide(BNP)levels were determined by immunofluorescence;and left ventricular ejection fraction(LVEF)was assessed using echocardio-graphy.Changes in serum APN levels and its relationship with BNP,LVEF,and MACE were recor-ded during a one-year follow-up period.Results AMI patients had lower serum APN levels than those in the non-AMI coronary artery disease group and the healthy group,while levels of total choles-terol(TC),low-density lipoprotein cholesterol(LDL-C);Lipoprotein-associated phospholipase A2(Lp-PLA2),and the proportions of smokers and diabetics were higher(P＜0.05).A one-year follow-up of AMI patients revealed an upward trend in serum APN and BNP levels and a downward trend in LVEF levels at one week,one month,three months,six months,and one year postoperatively(P＜0.05).APN and BNP levels peaked one month after PCI,while LVEF reached its lowest level at the same time point.However,there were no statistically significant changes in these indicators in the subsequent 11 months(P＞0.05).The incidence of MACE in AMI patients at one,three,six,and twelve months postoperatively was 2.8％,3.2％,4.6％,and 8.8％,respectively.Both preoper-ative and one-month postoperative serum APN levels had high predictive value for the occurrence of HF and MACE within one year in AMI patients,and the area under the curve for predicting HF and MACE one month postoperatively was larger than that preoperatively(P＜0.05).Conclusion Ser-um APN levels in AMI patients show an upward trend after PCI,peaking one month postoperatively.At this time point,serum APN levels have the highest predictive value for the occurrence of HF and MACE.

Objective To analyze the dynamic changes in serum adiponectin(APN)levels after acute myocardial infarction(AMI)and its relationship with heart failure(HF)and major adverse cardiovascular events(MACE).Methods A total of 124 AMI patients who underwent percutaneous coronary intervention(PCI)in our hospital from January 2021 to December 2023 were enrolled as AMI group.Additionally,30 patients with non-AMI coronary artery disease and 30 healthy individu-als were included in non-AMI coronary artery disease group and healthy group,respectively.General information such as age,gender,smoking,alcohol consumption,hypertension,diabetes,and blood lipids were recorded for all subjects.Serum APN levels were measured using the enzyme-linked im-munosorbent assay(ELISA)method;plasma brain natriuretic peptide(BNP)levels were determined by immunofluorescence;and left ventricular ejection fraction(LVEF)was assessed using echocardio-graphy.Changes in serum APN levels and its relationship with BNP,LVEF,and MACE were recor-ded during a one-year follow-up period.Results AMI patients had lower serum APN levels than those in the non-AMI coronary artery disease group and the healthy group,while levels of total choles-terol(TC),low-density lipoprotein cholesterol(LDL-C);Lipoprotein-associated phospholipase A2(Lp-PLA2),and the proportions of smokers and diabetics were higher(P＜0.05).A one-year follow-up of AMI patients revealed an upward trend in serum APN and BNP levels and a downward trend in LVEF levels at one week,one month,three months,six months,and one year postoperatively(P＜0.05).APN and BNP levels peaked one month after PCI,while LVEF reached its lowest level at the same time point.However,there were no statistically significant changes in these indicators in the subsequent 11 months(P＞0.05).The incidence of MACE in AMI patients at one,three,six,and twelve months postoperatively was 2.8％,3.2％,4.6％,and 8.8％,respectively.Both preoper-ative and one-month postoperative serum APN levels had high predictive value for the occurrence of HF and MACE within one year in AMI patients,and the area under the curve for predicting HF and MACE one month postoperatively was larger than that preoperatively(P＜0.05).Conclusion Ser-um APN levels in AMI patients show an upward trend after PCI,peaking one month postoperatively.At this time point,serum APN levels have the highest predictive value for the occurrence of HF and MACE.

Objective    To investigate the learning curve of non-tube and early oral feeding procedure following McKeown minimally invasive esophagectomy (MIE). Methods    We analyzed the clinical data of 38 patients (26 males, 12 females, aged 42–79 years) with esophageal cancer who received non-tube and early oral feeding procedure after surgery at the Affiliated Tumor Hospital, Zhengzhou University from November 2017 to August 2018. They suffered upper thoracic esophageal cancer (n=4), middle thoracic esophageal cancer (n=22) or lower thoracic esophageal cancer (n=12). Results    McKeown MIE was successfully performed on 38 patients. Oral feeding began 1.7 (1-4) days after surgery in the 38 patients with non-tube. Pneumonia/atelectasis occurred in 5 patients (13.1%), respiratory failure in 1 patient (2.6%), arrhythmia in 3 patients (7.9%), hoarseness in 5 patients (13.1%), anastomotic fistula in 1 patient (2.6%), cervical incision infection in 1 patient (2.6%), pneumomediastinum and infection in 1 patient (2.6%) and gastric emptying disorder in 2 patients (5.2%). No death was observed. After 26 patients with McKeown MIE were treated with enhanced recovery after surgery procedure, the operation time and complications could reach a relatively stable state and entered a plateau phase of learning curve. Conclusion    Non-tube and early oral feeding procedure following MIE is technically safe and feasible. It can shorten hospital stay, relieve the discomfort of placement of nasogastric and nutrition tube and may reduce the incidence of complications. The learning curve of non-tube and early oral feeding procedure following MIE is  about 26 cases.