Objective To compare the classification rate of three classifications of epilepsy syndromes proposed by International League Against Epilepsy(ILAE),and analyze their stuctural changes.Methods All patients with epilepsy who consecutively visited the epilepsy center of Peking Union Medical College Hospital between Aug.1st,2007 and Mat.31st.2008 were included.Thtee classifications of epilepsy syndromes were used in order.Results In this study,we could categorize 75.5 % of 1356 patients by applying the 1989 international classification of epilepsy syndromes.89.0 % of them by the 2001 proposed diagnostic scheme and 88.1 % of them by the 2006 report.In this aspect,the 2001 and 2006 classifications were better than the 1989 classification(x2=116.3,P<0.01).However,only 11.6 % (157),12.O % (162)and 11.9 % (160)of patients with specific epilepsy syndromes were identified from the 1356 epileptic patients by three classifications.respectively.This data based on the 2001 and 2006 classifications did not change markedly in comparison with the 1989 classification(x2=0.09,P>0.05).Conclusions The 2006 report involve mole scientific mode of classification and systematic evaluation,and can classify more patients with epilepsy.It can be ased in clinical and scientific research.which can not only accumulate data for developing more scientific classification but also stimulate research especially in the fields of genetics and functional morphology.

Objective To establish a new method of quality control for Jie-Er-Yin Lotion.Methods Jie-Er-Yin Lotion and different kinds of agents(without Fructus Cnidii,Cortex Phellodendri Chinensis, Radix Sophorae Flavescentis,excipient agent or all medicinal material agents) were treated with the same approach,then using ~1H-NMR to get all of the chemical component information of the samples and analyze the data from the spectra.Results Analyzing the data with principal component analysis(PCA) by model recognition,the different agents can be distinguished in the scattered plots.Conclusion The ~1H-NMR-PCA is an useful method to identify Jie-Er-Yin Lotion from other preparations and can be used for the quality control of Chinese prepared medicines by simple operation.

Objective To compare the effects of telmisartan and (or) amlodipine on the reversal left ventricular re-modeling in two-kidney one clip hypertensive rats. Methods A total of 50 healthy male SD rats were randomly divided into 5 groups (n=10):two-kidney one clip renal hypertensive (2KIC) model group, sham group, telmisartan (10 mg/kg) group, am-lodipine (2.5 mg/kg) group and telmisartan (10 mg/kg)+amlodipine(2.5 mg/kg) group. The model of two-kidney one clip re-nal hypertensive rats was established. The tail arterial blood pressure was detected once a week. After 20 weeks, rats were sacrificed and specimens were collected. The left ventricular mass index (LVMI) was assessed. The myocardial ultrastructur-al changes were observed by electron microscope. Values of plasma renin activity (PRA), angiotensionⅡ(AngⅡ) and atrial natriuretic peptide (ANP) were measured by enzyme linked immunosorbent assay (ELISA).Results Compared with sham group, the levels of systolic blood pressure (SBP), LVMI, PRA, AngⅡand ANP were significantly higher in 2KIC group (P＜0.01). Compared with 2KIC group, values of SBP, LVMI, PRA and ANP were significantly lower in telmisartan group and am-lodipine group (P＜0.01), but the value of AngⅡwas significantly higher (P＜0.01). The levels of SBP, LVMI, AngⅡand ANP were significantly lower in combined medication group than those of single drug medication group (P＜0.01). There was no significant difference in the plasma PRA level between those groups (P>0.05). Results of myocardial electron microsco-py showed that the left ventricular remodeling was significantly improved in combined treatment group. Conclusion Telmisartan and amlodipine can effectively improve the left ventricular remodeling induced by hypertension. There was more effective therapy using both medications together.

Objective To explore the clinical features and treatment of skin ulcers.Methods A total of 185 skin ulcer patients with clinical data was analyzed retrospectively in our hospital from October 2014-October 2016.Results Of the 185 patients with skin ulcers,84(45.4％) were 51-70 years old,diabetic ulcers were most common,and most occurred in ankle (44.3％) and limbs (35.7％).After further statistical analysis,the healing rate of patients treated by surgery was significantly higher than non-surgical patients.Surgical procedures of local flap transfer after ulcer resection were most commonly used and of the highest healing rate.The number of ulcers,the largest diameter of ulcers,scar ulcers and blood barrier ulcers were four factors that were independent of the outcome of skin ulcers.Conclusions Skin ulcers hospitalized patients are more common in patients over 50 years of age,occur most in the lower limbs.Surgical therapy is the preferred treatment for most ulcers,of which local flap transfer after ulcer resection has the best effect.Ulcer patients should actively treat the primary disease,strengthen the care,early diagnosis,and early treatment.

Objective To investigate the results and complications of hemispherotomy for drug resistant hemispheric epilepsy.Methods The authors reviewed 5 patients who were diagnosed as drug resistant hemispheric epilepsy and operated in the neurosurgery department of Peking Union Medical College Hospital from 2011 to 2013.All the 5 patients were underwent hemispherotomy after carefully multidisciplinary pre-operation evaluation.Results All patients tolerated the procedure well and the postoperative course was smooth.All the 5 patients didn`t have seizure in the period of following up of 46 to 69 months.Conclusions According to literatures and the authors` experience, hemispherotomy is as safe and efficient for hemispheric epilepsy as hemispherectomy.It is most important advance for hemispherectomy.The procedure of hemispherotomy is complex but not very difficult, illustrating a good prospect of application and extension.

Objective To find out whether conversation analysis helps to differentiate psychogenic nonepileptic seizure (PNES) from epileptic seizure in Chinese patients.Methods Twelve unselected patients from Peking Union Medical College Hospital during 2014 to 2016 with diagnostic uncertainty were included.Interactions following standard protocol were carried out.A linguist blinded to all medical data and a neurologist studied videos and transcripts of the interactions.Using a diagnostic scoring aid which includes 17 conversation features summarized from previous researches, they attempted to predict the medical diagnosis of those patients independently.Results Accurate diagnosis was predicted in 10/12 patients by both raters.Average scores of patients with epileptic seizures were 8.00 (linguist) and 6.75 (neurologist), while average scores of paitents with PNES were-5.75 (linguist) and-7.88 (neurologist).Both raters agreed on most individual items (81.86%, 167/204).To demonstrate different features between these two groups, a case comparison was made between one patient with frontal lobe epilepsy and one patient with PNES.Conclusion In Chinese patients, conversation analysis can help differentiate between epileptic seizure and PNES.

Objective:To investigate the chemical constituents in the rattan of Rubia argyi L.. Methods:The air-dried rattan of Rubia argyi L. was powdered and extracted three times by 75% ethanol with refluxing. After removing the solvent under the reduced pressure,the crude extract was dissolved in water,and then filtrated and extracted by petroleum ether and ethyl acetate to obtain crude extract after removing petroleum ether and ethyl acetate. The compounds were isolated and purified by silica gel column chromatogra-phy,reversed-phase silica gel column chromatography and Sephadex LH-20 gel column chromatography,and then identified based on physicochemical properties and spectral analysis(1 H-NMR and 13C-NMR). Results:Totally 13 compounds were isolated from the rat-tan of Rubia argyi L.,and characterized as secoisolariciresinol(1),xanthopurpurin(2),daucosterol(3),dehydroabietic acid(4), 2-hydroxy-1-methoxy-anthraquinone(5),β-sitosterol(6),lirioresinol A(7),2-hydroxy-7-methyl-9,10-anthraquinone(8),strych-novoline (9), ciwujiatone (10), 3,4-divanillyltetrahydrofuran (11), 2-(4-hydroxypheny) -6-(3-methoxy-4-hydroxyphenyl)-3,7-dioxabicyclo[3,3,0]octane (12), and (6S,9R)-vomifoliol (13).Conclusion: The compounds 1-13 are isolated from the rattan of Rubia argyi L. for the first time and the compounds 1,2,4,5 and 7-13 are first isolated from Rubia L..

Objective:To evaluate the role of minimal residual disease (MRD) monitoring during early induction therapy for the treatment of childhood acute lymphoblastic leukemia (ALL).Methods:This was a multicenter retrospective cohort study. Clinical data of 1 164 ALL patients first diagnosed between October 2016 and June 2019 was collected from 16 hospitals in South China Children′s Leukemia Group. According to MRD assay on day 15 of early induction therapy, they were divided into MRD<0.10% group, MRD 0.10%-<10.00% group and MRD≥10.00% group. According to MRD assay on day 33, they were divided into MRD<0.01% group, MRD 0.01%-<1.00% group and MRD≥1.00% group. Age, onset white blood cell count, central nervous system leukemia (CNSL), molecular genetic characteristics and other data were compared between groups. Kaplan-Meier method was used for survival analysis. Cox regression model was used to analyze prognostic factors.Results:Of the 1 164 enrolled patients, there were 692 males and 472 females. The age of diagnosis was 4.7 (0.5, 17.4) years. The white blood cell count at initial diagnosis was 10.7 (0.4, 1 409.0) ×10 9/L. Among all patients, 53 cases (4.6%) had CNSL. The follow-up time was 47.6 (0.5, 68.8) months. The 5-year overall survival (OS) and 5-year relapse-free survival (RFS) rates were (93.1±0.8) % and (90.3±1.1) %. On day 15 of early induction therapy, there were 466 cases in the MRD<0.10% group, 523 cases in the MRD 0.10%-<10.00% group and 175 cases in the MRD≥10.00% group. The 5-year OS rates of the MRD<0.10% group, MRD 0.10%-<10.00% group and MRD≥10.00% group were (95.4±1.0) %, (93.3±1.1) %, (85.4±2.9) %, respectively, while the RFS rates were (93.2±1.6) %, (90.8±1.4) %, (78.9±4.3) %, respectively ( χ2=16.47, 21.06, both P<0.05). On day 33 of early induction therapy, there were 925 cases in the MRD <0.01% group, 164 cases in the MRD 0.01%-<1.00% group and 59 cases in the MRD≥1.00% group. The 5-year RFS rates in the MRD 0.01%-<1.00% group was lowest among three groups ((91.4±1.2) % vs. (84.5±3.2) % vs. (87.9±5.1) %). The difference between three groups is statistically significant ( χ2=9.11, P=0.010). Among ALL patients with MRD≥10.00% on day 15 of induction therapy, there were 80 cases in the MRD <0.01% group on day 33, 45 cases in the MRD 0.01%-<1.00% group on day 33 and 45 cases in the MRD≥1.00% group on day 33. The 5-year RFS rates of three groups were (83.9±6.0)%, (67.1±8.2)%, (83.3±6.9)% respectively ( χ2=6.90, P=0.032). Univariate analysis was performed in the MRD≥10.00% group on day 15 and the MRD 0.01%-<1.00% group on day 33.The 5-year RFS rate of children with CNSL was significantly lower than that without CNSL in the MRD≥10.00% group on day 15 ((50.0±20.4)% vs. (80.3±4.4)%, χ2=4.13, P=0.042). Patients with CNSL or MLL gene rearrangement in the MRD 0.01%-<1.00% group on day 33 had significant lower 5-year RFS rate compared to those without CNSL or MLL gene rearrangement ((50.0±25.0)% vs. (85.5±3.1)%, χ2=4.06, P=0.044;(58.3±18.6)% vs. (85.7±3.2)%, χ2=9.44, P=0.002). Multivariate analysis showed that age ( OR=0.58, 95% CI 0.35-0.97) and white blood cell count at first diagnosis ( OR=0.43, 95% CI 0.27-0.70) were independent risk factors for OS. The MRD level on day 15 ( OR=0.55,95% CI 0.31-0.97), ETV6-RUNX1 fusion gene ( OR=0.13,95% CI 0.03-0.54), MLL gene rearrangement ( OR=2.55,95% CI 1.18-5.53) and white blood cell count at initial diagnosis ( OR=0.52,95% CI 0.33-0.81) were independent prognostic factors for RFS. Conclusions:The higher the level of MRD in early induction therapy, the worse the OS. The MRD levels on day 15 is an independent prognostic factor for RFS.The MRD in early induction therapy guided accurate risk stratification and individualized treatment can improve the survival rate of pediatric ALL.

Adult ; Child ; Child, Preschool ; Electroencephalography ; Epilepsy, Absence ; physiopathology ; Humans