The interaction between the immune system and nervous sytem affcts nervous function.There is a close relationship between the episode of epilepsy and immunity,the molecular basis of which is the network of cytokines.In order to quest new methods of contolling epilepsy by regulating the network of cytokines,the roles of several cytokines in the ocurrence and onset of epilepsy were reviewed in this article.

Neuropeptide Y (NPY) is a pancreatic polypeptide-related peptide, consisting of 36 amino acids. NPY is expressed in the nervous system widely and abundantly, mainly in the hippocampus, regulates the excitability of neurons through its receptors (Y_1, Y_2, Y_5). In recent years the research progress indicated the changes induced by seizures in the level and distribution of NPY, its receptors subtypes and their respective mRNAs in brain. The inhibitory action of NPY on glutamate-mediated neurotransmission and in seizure phenomena, suggests that one of its roles in hippocampal physiology is to modulate neuronal excitability by regu-lating glutamate release.

Objective To investigate the relationship between bispectral index (BIS) and cerebrospinal fluid (CSF) concentrations of propofol or effect-site concentrations during target-controlled infusion (TCI) of propofol and evaluate the accuracy of the infusion system targeting at effect-site concentration.Methods Twelve healthy mongrel dogs weighing (17.04? 1.53) kg were anesthetized with intramuscular ketamine 5 mg?kg-1 followed by enflurane inhalation. A catheter was inserted into subarachnoid space and advanced to the base of skull for the collection of CSF. BIS, hemodynamics and PETCO2 were monitored continuously during the experiment. Target effect-site propofol concentration was set at 3 ?g?ml-1 and infusion was continued for 15 min. CSF was collected at 1, 3, 5, 10, 15, 20, 30, 45 and 60 min after infusion was started for determination of propofol concentration by high performance liquid chromatography with fluorescence detection. Results The equilibrium between predicted plasma and effect-site concentration was reached at 10.9 min and the target effect-site concentration was maintained at 3 ?g?ml-1 .The peak CSF concentration of propofol was (0.29? 0.14)?g?ml-1 .CSF concentrations were much lower than the effect-site concentrations at all sampling times (about 18.7% of the effect-site concentration on average) . BIS was consistent with the CSF concentrations of propofol. Both of them reached the lowest or peak values at 5 min after infusion was started, while the peak effect-site concentration was reached relatively later. BIS was found to be better correlated with CSF concentration (? = 0.9195) than with the effect-site concentration (? = 0.554) . The dogs developed hypotension as expected but no other severe adverse effect was observed. Conclusion The inconsistency of BIS with effect-site concentration during TCI of propofol may result from its pharmacokinetic parameters. Good correlation between BIS and CSF concentration indicates that CSF concentration can reflect the pharmacokinetic profileof propofol at effect-site more accurately than the plasma concentration during TCI of propofol targeting at effect-site concentration.

Objective To analyze the changes of the urine sodium and serum sodium in different types and different duration and different temperature in children with febrile seizures,to explore its clinical significance. Methods The children with febrile seizures(n =50)were selected as the group Ⅰ,and the children with fever but without seizure(n =50)were selected as the group Ⅱ,both of them were from pediatric ward.The control group(n =20)without fever or seizure was from Children's Health Section.All the children were checked serum sodium level and urine sodium and urine creatinine level.Results The sodium/creatinine ratio in the groupⅠ[(25.07 ±6.517)] was significantly higher than that in the group Ⅱ[(20.43 ±5.48)]and group Ⅲ[(14.88 ±5.11)](F =33.519, P <0.05),but there was no significant difference of the sodium/creatinine ratio in different ages and different types of the group Ⅰ,and there was negative relevance between the serum sodium and the sodium/creatinine ratio in the groupⅠ(r =-0.517,P <0.05).The mean serum sodium level in the groupⅠ[(133.50 ±3.14)mmol/L]was signifi-cantly lower than that in the group Ⅱ[(137.60 ±2.59)mmol/L]and group Ⅲ[(138.90 ±2.24)mmol/L](F =39.220,P <0.05),but there were no significant differences of the serum sodium in different types and different dura-tion and different temperature of seizure in the group Ⅰ.Conclusion The study shows that serum sodium is lower and the urine sodium is higher in children with febrile seizures,the changes of the urine sodium and serum sodium are not related to the types.The children with febrile seizures should be timely monitoring of serum sodium,urine sodium levels,and according to changes in the level of serum sodium,urine sodium,early appropriate supplement containing sodium liquid and maintaining the blood sodium to normal levels can reduce the recurrence of seizure.

Objective To investigate the relationship between circadian rhythm of perioperative melatonin secretion and neuropsychological status in patients undergoing coronary artery bypass grafting (CABG) .Methods Forty male ASA Ⅱ-Ⅲ patients aged 45-60yr scheduled for elective CABG under hypothermic cardiopulmonary bypass (CPB) or off-pump were enrolled in this study. They were allocated to CPB group ( n = 20) or off-pump group (n - 20). Blood samples were taken before induction of anesthesia (T1 ), 10 min after tracheal intubation (T2), 10 min after heparinization (T3) , 2h after skin incision (T4), immediately before neutralization of heparin with protamine (T5 ), at the end of surgery after skin suture (T6 ) and every 3h after operation for 24h for determination of plasma melatonin concentration using enzyme-linked immunosorbent. Degree of depression was assessed by Self-Rating Depression Scale; anxiety by the State-Trait Anxiety Inventory and cognitive function by neuropsychological tests respectively, the day before operation, 7-10 days after surgery and 3 months postoperatively. Results In the 24 hours after operation the circadian secretion pattern of melatonin was kept in 2 patients in CPB group and 6 patients in off-pump group, but disturbed in the remaining patients in both groups. Postoperative depression scores were significantly higher than the preoperative baseline values in both groups. Anxiety scores at 7-10 days after operation were significantly higher in CPB group than those in off-pump group (P

Objective To determine the changes in perioperative plasma melatonin, cortisol and neuron-specific enolase (NSE) and neuropsychological function in patients who developed CNS complications after coronary artery bypass grafting (CABG) .Methods Three patients developed CNS complications (cerebral infarction, motor aphasia, motor and sensory aphasia) after CABG performed under hypothermic cardiopulmonary bypass (CPB) were studied. Blood samples were taken before induction of anesthesia (T1) , 10 min after tracheal intubation (T2), 10 min after heparinization (T3), at 30 min of CPB (T4) , immediately after discontinuation of CPB (T5), at closure of chest (T6), immediately after returning to ICU (T7) and every 3 h in ICU for 24 h (T8-15) for determination of plasma concentrations of NSE, cortisol and melatonin using enzyme-linked immunosorbent assay and radioimmunoassay. Cognitive function was measured before and 10 to 20 days after operation using a battery of tests, while depression and anxiety were assessed by self-rating depression scale and state-trait anxiety inventory respectively. Results The plasma NSE concentration was increased after operation in all 3 patients. The circadian rhythms of melatonin and cortisol were disturbed in patient 1 and 2 during the 24h after operation but were retained in patient 3. In patient 1 and 3 the performance of the trailing making test, the digit symbol subtest of WAIS-R and the stroop color word interference test were poor, meanwhile they became more depressed and less anxious. Conclusion In patients who develop CNS complication after CABG, there are cognitive decline, sentimental disorders and disrupted circadian rhythm of melatonin and cortisol secretion.

Objective To explore the application of case based learning(CBL)combined with multimedia teaching in the clinical pediatric surgery.Methods 144 five-year program students of Pediatrics in grade 2009 were randomly and evenly divided into the experimental group using CBL with multimedia teaching,and the control group using multimedia teaching mode.After the end of the course the students of the two groups took clinical teaching knowledge test.The evaluation scores were shown by mean ± standard deviation and comparison was made between the two groups with t test.At the same time,teaching satisfaction survey was conducted among the students of the experimental group.Results The usual results,the theoretical scores and total scores of the students in the experimental group were higher than those of the control group students in the operation skills,clinical thinking,and there was statistically significant difference in P＜0.01.(P=0.003,P=0.002,P=0.008,P=0.009,P=0.008).The questionnaire survey shows that compared with traditional multimedia teaching,CBL combined with multimedia teaching can preferably culture students' various abilities and is beneficial to learning.Condusion The use of CBL combined with multimedia teaching can affirmatively improve the clinical teaching effect in the clinical pediatric surgery,and it deserves to be generalized in the future teaching.

Objective To screen the ryanodine receptor type 1(RYR1)gene in a Chinese pedigree with malignant hyperthermia(MH).Methods Total genome was extracted conventionally from peripheral leucocytes of the prohand and the other members of the family.In order to detect mutations in the RYR1 gene,part exons were amplified by polymerase chain reaction(PCR)and then subjected tO automatic DNA sequencing.The detected mumfion in the gene was confirmed in the preband and the other members of the family using Fok Ⅰ restriction analysis.Results DNA sequencing of PCR-amplified fragments of the pwband revealed c.6724C＞T (P.T2206M),a recurrent missense mutation which had been detected in Caucasian MH cages.Restriction analysis of all available family members showed that one daughter and one son of the 4 children of the proband were the missense mutation carriers,indicating that they were MH-susceptible individuals.Conclusion The Chinese susceptible to MH carries the simile RYR1 gene mutation to the Caucasians susceptible to MH.

Objective To make an epidemiological investigation on TORCH infection in children in Pu′er city of Yunnan prov‐ince ,in order to provide references for the prevention and treatment of TORCH infection in children .Methods A total of 1 194 children treated at this hospital from January to December 2014 were selected and divided into five age groups .Serum TORCH spe‐cific IgM and IgG antibodies were detected by using enzyme‐linked immunosorbent assay(ELISA) and the positive rate of TORCH specific antibody and TORCH infection rate were comparatively analysed .Results The positive rate of TORCH specific IgM anti‐body was significantly lower than that of IgG .The range of positive rate of IgM was 0 .00% -3 .10% ,and that of IgG was 10 .13% -82 .24% .The total infection rate of TORCH was 96 .98% .There were no significant differences in the infection rate of single item of TORCH or the total TORCH infection rate among the five different age groups(P>0 .05) .The distribution of infec‐tion rate of single item of TORCH among the five age groups was statistically significantly different(P<0 .05) .There was no sig‐nificant difference in the infection rate of TORCH or the distribution of infection rate of single item of TORCH among different sea‐sons(P>0 .05) .Conclusion Children with TORCH infection in this area mainly are infected by CMV ,followed with RV and HSV infections ,while TOX infection is uncommon .There are no obvious differences in different seasons and children in different age groups .

Objective To analyze the results of children′s respiratory tract infection pathogens IgM antibody nine‐combined de‐tection in Pu′er and grasp the epidemiological characteristics of respiratory tract infection of local children for providing reference for clinical diagnosis and treatment .Methods 1 327 cases of children′s blood sample with respiratory tract infection were randomly sampled from in Pu′er People′s Hospital in 2014 .All the samples were tested with nine respiratory tract infection pathogens IgM antibody detection reagent kit(indirect immunofluorescence) ,and the test results were adopted for statistical analysis .Results There were 446 cases positive for IgM antibody in 1 327 cases of respiratory tract infection children ,the total positive rate was 33 .6% .The Positive rate of mycoplasma pneumonia(MP) was the highest ,for 23 .6% .The second was influenza B virus(INFB) , for 18 .5% .The eosinophilic lung legionella type 1(LP) ,adenovirus(ADV) ,respiratory syncytial virus(RSV) ,influenza A(INFA) and parainfluenza virus(HPIVs) were all much lower :respectively for 0 .4% ,1 .1% ,1 .0% ,1 .1% and 1 .0% .It was showed that no positive results were found in Q fever rickettsia(CB) and chlamydia pneumonia(CP) .There was significant difference of the positive rate among 9 kinds of pathogens(P<0 .05) .There was significant difference of the monthly positive rate among the main six patho‐gens(P<0 .05) .There was significant difference of the positive rate in the different age groups(P<0 .05) .Conclusion The respir‐atory tract infection pathogens of children in Pu′er are mainly mycoplasma pneumoniae and influenza B virus .The epidemiological distribution of the pathogens is related to the age and season ,the clinician should reasonably diagnose and treat according to the test results for children .