The pathogenesis of status epilepticus is closely associated with brain injury. Some animals experiments have proved that the activity of calcium / calmodulin-dependent protein kinase 2 ( CaM kinase Ⅱ ) ,oxidative stress, and the imbalance of nervous immune-endocrine factors are not only involved in the mechanisms of status epilepticus, but also act as the initial factor in neuronal injury. The pathophysiological changes after SE,such as acute brain ischemia, hypoxia and the reduced glucose utilization, over-excited neurons, N-methyl-Daspartate (NMDA) and non-NMDA receptor activated, a large amount of cation influx, can give rise to acute necrosis of neurons, also initiate the expression of apoptotic genes, at last leading to apoptosis by cell apoptotic enzymes cascade reaction. Studies have found that the pathway of death receptor activation, mitochondrial damage and endoplasmic reticulum stress mediated the neuronal apoptotic signal transduction after SE.

The increasing identification of genetic causes for epilepsy over the recent years improves the understanding of the underlying epileptog enic process,and allows for the possibility of directed therapeutic approaches.An ideal antiepileptic therapy consists of a drug which is able to influence the functional changes caused by a specific pathogenic variant.In this review,we describe the current precise medicine approaches in genetic epilepsies.Currently established or investigated precise medicine treatments include the ketogenic diet in patients with glucose transporter typel (GLUT1) deficiency,sodium channel blockers in patients with KCNQ2 mutations,and mechanistic target of rapamycin (mTOR)-inhibitors in patients with SCN2A and SCN8A mutations.These predominantly represent already available treatments that were repurposed for use in epilepsy.The development of new therapeutic agents aiming at targets identified in genetic epilepsies will advance epilepsy treatment considerably.

Objective To explore the potential changes of connexin Cx36 in hippocampus and cortical neurons of rats with hyperthermia -induced convulsion.Methods Rats were divided into 2 groups according to the random number table method:normal control group and experimental group.Febrile convulsion model was elicited through im-mersion in warm water.The experimental group was generated following febrile convulsion model:hyperthermia group and febrile convulsion group.Among normal control group,hyperthermia group and febrile convulsion group,western blot analysis and immunofluorescence labeling techniques were used to examine the expression of Cx36 protein in the hippo-campus and cortex area.One -Way ANOVA was used to compare the mean of multiple sample,the LSD test was used to compare the two means.Tamhane′s test was used when variance were uneven.Results The incubation period,seizure duration and temperature were (4.39 ±0.08)min,(5.38 ±0.07)min,(41 .87 ±0.06)℃ after hyperthermia-in-duced convulsion,respectively.Western blot analysis showed that the expression of Cx36 protein in the hippocampus and cortex area decreased gradually after 1 0 times of seizure in normal control group,hyperthermia group and febrile convulsion group,and the febrile convulsion group decreased most obviously.Compared with normal control group and hyperthermia group,respectively,in febrile convulsion group Cx36 expression obviously decreased in the hippocampus and cortex in rats with 1 ,5,1 0 seizure times induced by hyperthermia,and with the increase of number of induced con-vulsion,the expression of Cx36 was significantly decreased in the cortex (0.1 04 ± 0.01 2)and CA1 (0.091 ± 0.01 1 ),CA3 (0.090 ±0.01 1 )and DG (0.092 ±0.01 2)areas of hippocampal neurons compared with the normal control group (0.21 2 ±0.01 7,0.1 67 ±0.01 3,0.1 59 ±0.01 4,0.1 71 ±0.01 3)and the hyperthermia group (0.1 89 ± 0.006,0.1 44 ±0.008,0.1 29 ±0.005,0.1 65 ±0.01 1 )(all P <0.05).Furthermore,the extent of reduction in Cx36 expression seemed to correlate with the number of seizures.Conclusion With the increase of thermal seizure frequen-cy,Cx36 expression of rats was decreased obviously which may lower convulsion threshold and lead to recurrent seizures.

BACKGROUND:Hydrothermal condition of oral environment has an effect on the mechanical properties of dental core materials.
OBJECTIVE:To evaluate effect of water storage on the weight change rates and flexural properties of three dual-cure core buildup composite resins.
METHODS: Rectangular specimens (25 mm×2 mm×2 mm) were prepared from three dual-cure core buildup composite resins (LuxaCore Smartmix Dual, Para core and Clearfil DC Core). Specimens were stored in distiled water at 37℃ for 0, 1 day, 1, 2, 3 weeks and 1 month, respectively, weighted and then subjected to three-point bending test in a universal testing machine.
RESULTS AND CONCLUSION: Weight change rates of the three composite resins increased with immersion time; at the same immersion time, weight change rates of three composite resins ranked as the folowing order: LuxaCore Smartmix Dual > ParaCore > Clearfil DC Core. The flexural strength of LuxaCore Smartmix Dual decreased with immersion time. The flexural strength of ParaCore showed no significant change during 3 weeks immersion (P > 0.05), while it showed a significant decreasing after 1 month immersion (P < 0.05). There was no significant change on the flexural strength of Clearfil DC Core in the whole immersion process(P > 0.05). The flexural modulus of LuxaCore Smartmix Dual showed a decreased trend in the whole immersion process, but it showed that there was no significant change during the first 2 weeks(P > 0.05), while a significant decrease occurred after 3 weeks and 1 month (P < 0.05). Compared with original specimens, the flexural modulus of ParaCore and Clearfil DC Core showed a decreased trend, but this change was not significant (P > 0.05); the flexural properties of three composite resins showed a fluctuant decreased trend along with weight changes increased. To sum up, Clearfil DC Core showed the best water resistance among three composite resins.

Recent studies have shown that brain natriuretic peptide ( BNP ) may be the link between cardiovascular disease and metabolic system. The role for BNP in metabolic pathways has already been the subject of intense interest. This article reviews the evidence of the linkage between BNP and metabolic system.

Purpose Dual-energy coronary artery CT angiography (CTA) is a very promising one-stop examine, but the radiation dose is too high to hinder the development of the technology. The aim of this article is to explore the feasibility of low tube current combined with sonogram-affirmed iterative reconstruction (SAFIRE) technology in dual energy coronary artery CTA scan. Materials and Methods One hundred and twenty patients were randomly divided into four groups according to the tube current of A ball:conventional group (180 mAs) and low-dose groups (150 mAs, 120 mAs, 90 mAs). The SAFIRE 3 reconstruction method was used in the low-dose groups. The differences of mean CT values, image noise, signal-to-noise ratio (SNR), contrast-to-noise ratio (CNR), image quality score and effective dose (ED) of the four groups were compared. Results The coronary artery segment display and the mean CT value of the four groups showed no statistic difference (P>0.05), while the image quality score, noise, SNR, and CNR showed statistic difference (P<0.05). The image quality score, SNR, and CNR was highest in the 150 mAs group, but noise was the lowest. There were no statistic difference of the image quality score, SNR, and CNR between the 180 mAs group and 90 mAs group (P>0.05). The ED was (5.50±1.47) mSv, (4.55±1.16) mSv, (3.41±0.77) mSv and (2.44±0.67) mSv, respectively for the four groups, and there was statistical difference (P<0.05). ED of 90 mAs group decreased 55.62% than that of 180 mAs group. Conclusion Coronary artery CTA using 90 mAs combined with SAFIRE can significantly reduce the radiation dose without losing image quality, thus it has a good prospect of clinical application.

Objective Conventional examination for vision function adopts subjective psychophysics methods.Pattern visual evoked potential (P-VEP) binocular summation response is a new objective way for the test of vision function.But its clinical value in evaluating vision function of amblyopia children is still in controversy.This study was to explore the binocular vision and the feature of P-VEP binocular summation in children with amblyopia and evaluate the significance of P-VEP binocular summation in binocular vision.MethodsThis is a case-controlled study.P-VEP binocular summation response and single ocular P-VEP response was respectively recorded in 151 hyperopia amblyopia children and 80 age- and gender-matched normal children.P-VEP response from children with hyperopia amblyopia was recorded under the corrected vision.The hyperopia amblyopia was diagnosed based on the standard of National Children Amblyopia and Strabismus Prevention and Treatment Working Group.The feature of P-VEP binocular summation was further analyzed and compared with monocular VEP response.Informed consent was obtained from each subject or custodian prior to the trail.ResultsNo significant difference was found in latency between P-VEP binocular summation response and monocular P-VEP response whether amblyopia children or normal children(P＞0.05).Binocular response/monocular response value in amblyopia children was lower than that in normal children(P＜0.05).Binocular response/monocular response value in mild or moderate amblyopia children was higher than that in severe amblyopia children(P＜0.05).Binocular response/monocular response value was significantly reduced in the children with binocular vision than in the children without binocular vision (P＜0.05).ConclusionP-VEP binocular vision,acting as an evaluation factor,could impartially reflect the function of binocular vision of amblyopia children.

Objective To understand the effectiveness of medical cooperation in the Affiliated Hospital of Southwest Medical University with a county hospital for providing a reference basis for medical cooperation.

Objective To evaluate the effectiveness of autologous platelet-rich gel (APG)in the repair of diabetic foot ulcers.Methods This study was a single-center,prospective,randomized controlled trial.A total of 60 patients with diabetic foot ulcers (Wagner grade 2 - 3 )were randomly divided into autologous APG group (treatment group)and recombinant bovine basic fibroblast growth factor gel group (control group).After 8 weeks, we compared wound healing rate and wound healing time at five levels (overall ulcer,superficial ulcer,sinus ulcer, Wagner 2 and Wagner 3)in the two groups.Results In APG treatment group and control group,the healing rate of overall sample ulcer (93.33% vs .63.33%,P =0.005),sinus ulcer (84.62% vs .36.36%,P =0.033),Wagner 3 (81.82% vs .30%,P =0.030)differed significantly,but did not significantly differ in superficial ulcer (100%vs .78.95%,P =0.106)or Wagner 2 (100% vs .80%,P =0.106).Ulcer healing time was 31 d vs .41.5 d,23 d vs .32 d,32 d vs .56 d,25 d vs .32 d,38 d vs .56 d,with significant difference between the two groups (P <0.05). Conclusion Autologous platelet-rich gel can effectively increase the curative rate of diabetic foot and shorten healing time.