Ictal semiology is essential for the pre-operative evaluation of candidates for epilepsy surgery. We propose an ictal sign of temporal lobe epilepsy (TLE) termed tonic-automotor (TA), defi ned as contralateral tonic spasm of upper limb associated with ipsilateral hand automotor seizure and often accompanied ipsilateral head turning. We assessed the occurrence and lateralizing/localizing value of TA in TLE, we analyzed 129 seizures in 41 patients with TLE: 90 seizures in 30 patients with TLE of hippocampal sclerosis (TLE/HS) and 39 seizures in 11 patients with TLE of other lesions (TLE/ non-HS). When compared with unilateral automotor seizure and unilateral tonic spasm, TA occurred more frequently in TLE/HS patients (40% vs 10% and 16.7%). In addition, 24 seizures in 12 patients with TA were observed only in TLE/HS patients and contralateral to the seizure focus based on the side of tonic spasm. However, there was no signifi cant difference in the TLE/HS between dominant side and nondominant side. In addition, TA sign occurred relatively early in the ictal phase. Thus, TA may be a more reliable lateralizing sign of epileptogenic zone and a semiologic marker of TLE/ HS patients.

The composition of intestinal microflora is closely related to the occurrence and development of colorectal cancer (CRC). Among them, Fusobacterium nucleatum (Fn) has been proved directly related to the recurrence, metastasis and chemotherapy resistance of CRC. Therefore, it is of great significance for the prevention and treatment of colorectal cancer by the exploration potential anti-Fn drug targets and discovery small molecule drugs. However, no selective anti-Fn small molecule inhibitors have been reported so far as well as their anti-Fn thereby "anti-Fn further anticancer" mechanisms are unclear. Herein, this article reviews the potential therapeutic targets and small molecule ligands of Fn in order to provide a reference for the development of anti-Fn and anti-CRC small molecule drugs.

Objective To understand of work status and professional ability of ICU specialist nurse,test their specialist ability level,improve and enhance the specialist nurse management to maximize their roles in promoting the development of clinical nursing.Methods 38 ICU nurse specialists who have got the nursing credentials more than one year were surveyed through self-questionnaire about working conditions,including general conditions,work status,income,self-assessment of specialist ability in future.Results 100％ ICU trained the younger nurses,and discuss the nursing management and problems.36.8％ nurses participated clinical nursing and night shift,5.3％ nurses have never joined ward inspection.Rates of reaching the standard were higher and above the 90％ in those three aspects: practice in clinical work,guided teaching and providing information for family member.Grasp of academic knowledge (86.8％),theory teaching (86.8％) and providing academic knowledge for nursing (86.8％) needed to be improved.Paper searching and reading (65.8％),paper writing (57.9％) and research design (47.4％) were relatively lower.Conclusions Culturing and using the specialist nurses in ICU lack the program and rationality; Specialist nurses have vague role; talent team was lacked; pay status needs increased; research ability needed enhanced; admittance,training and using criteria were lacked.

Immune thrombocytopenia purpura (ITP) is a disorder mediated by antiplatelet antibodies and characterized by accelerated destruction of platelets and impaired platelet production. The mainstay therapies for ITP have included corticosteroids, the immune globulin intravenous immunoglobulin and IV anti-D (monoclonal antibodies against the D antigen of the Rh system), vinblastine or a monoclonal anti-CD20 antibody that transiently depletes CD20(+) B cells, danazol, cyclophosphamide and even splenectomy to refractory one. Most of ITP patients responded to those treatment, while more than 30% of whom may relapse sooner or later. The recombinant forms of human TPO were discontinued from human use in clinic because recipients of these agents developed significant thrombocytopenia secondary to production of neutralizing antibodies that cross-reacted with endogenous TPO. All above mentioned treatments have side effects and severe infection may arise post splenectomy. The more powerful treatment with less side effects are needed. There are two TPO receptor agonist, AMG531 and Eltrompobag, have approved in Europe for the treatment of ITP. Both of them can improve the differentiation of megakaryocyte and platelets production. Combination treatment including pancytoprotector shows good effect in the treatment of refractory and relapsed ITP in China. Altogether, individual treatment of ITP is the contemporary trend in both clinical and preclinical practice. In this review the pathogenesis of ITP and its clinical therapies were reviewed, the individual regiments for treating ITP patients were discussed.
Humans ; Purpura, Thrombocytopenic, Idiopathic ; classification ; immunology ; therapy

Objective:To determine whether ox-LDL (oxdized low-density lipoprotein) is highly deposited on the uremic vessel wall and its influence on the vascular remodeling. Methods: Segments of radial arteries were obtained from 21 uremic subjects during the operation of A-V fistula prior to hemodialysis. Segments of internal thoracic arteries of similar diameter were obtained from patients with benign chest tumors as control.The vascular lesions and ox-LDL, CD68,MCP-1, eNOS,ET-1, PCNA,FN on the vessel wall were determined by means of H-E stain and immunohistochemistry. Results： With H-E stain,atherosclerotic plaques were found in the radial arteries of 4 uremic patients. The middle layer of the arteries in uremic patients were obviously thickened, and the T/D　(thickness of the wall/external diameter) ratio was significantly higher than those in control group(P<0.01). ox-LDL,CD68,MCP-1, ET-1, PCNA,FN on the vessel wall in uremic patients were much higher than those in control group (P<0.01). Moreover, ox-LDL on the vessel wall was positively related to the expression of other above mentioned substances on the vessel wall (P<0.01). Whereas the expression of eNOS on the vessel wall was lower than control group (P<0.01),and was negatively related to ox-LDL on the vessel wall(P<0.01). Conclusion: ox-LDL is an important factor contributing to uremic vascular remodeling by increasing the migration,adhesion and infiltration of monocyte,the proliferation of vascular smooth muscle cell and dysfunction of endothelia.

Objective:To determine whether ox-LDL (oxdized low-density lipoprotein) is highly deposited on the uremic vessel wall and its influence on the vascular remodeling. Methods: Segments of radial arteries were obtained from 21 uremic subjects during the operation of A-V fistula prior to hemodialysis. Segments of internal thoracic arteries of similar diameter were obtained from patients with benign chest tumors as control.The vascular lesions and ox-LDL, CD68,MCP-1, eNOS,ET-1, PCNA,FN on the vessel wall were determined by means of H-E stain and immunohistochemistry. Results： With H-E stain,atherosclerotic plaques were found in the radial arteries of 4 uremic patients. The middle layer of the arteries in uremic patients were obviously thickened, and the T/D　(thickness of the wall/external diameter) ratio was significantly higher than those in control group(P<0.01). ox-LDL,CD68,MCP-1, ET-1, PCNA,FN on the vessel wall in uremic patients were much higher than those in control group (P<0.01). Moreover, ox-LDL on the vessel wall was positively related to the expression of other above mentioned substances on the vessel wall (P<0.01). Whereas the expression of eNOS on the vessel wall was lower than control group (P<0.01),and was negatively related to ox-LDL on the vessel wall(P<0.01). Conclusion: ox-LDL is an important factor contributing to uremic vascular remodeling by increasing the migration,adhesion and infiltration of monocyte,the proliferation of vascular smooth muscle cell and dysfunction of endothelia.

Objective To explore the effect of ox-LDL,MCP-1,CD68 on the survival of arteriovenous fistula in radial arteries of uremic patients.Methods Segments of radial arteries were obtained from 23 uremic subjects (29～68 years old) in the initial operation of arteriovenous fistula prior to hemodialysis.The deposit of ox-LDL and the expression of MCP-1,CD68 on the vascular wall were measured by immunohistochemistry.The survival time of arteriovenous fistula was followed by survival analysis.Results COX regression revealed that each of these risk factors,ox-LDL,MCP-1, CD68,played an important role in the survival time of arteriovenous fistula when they entered the model independently.The hazard ratios were 1.008 (P=0.008,95% CI:1.002064～1.014104), 1.007(P=0.O00,95%CI:1.003853～1.010966),and 1.098496 (P=0.000,95%CI:1.047909～1.151526)respectively.When all the three factors entered the COX regression model,the whole model was still founded.MCP-1 and CD68 still played important roles in the survival of arteriovenous fistula.The hazard ratios were 1.006(P=0.025) and 1.113(P=0.001) respectively.With the hazard ratio of 0.997,ox-LDL did not reach the statistic significance (P=0.414).Conclusions The more deposit of ox-LDL and the more expression of MCP-1,CD68 on the vascular wall,the more shortened survival time of arteriovenous fistula.Particularly,the inflammation is the independent risk factor for the prognosis of arteriovenous fistula in uremic patients.

Objective To evaluate left ventricular function in patients with hypertensive hypertrophic cardiomyopathy(HHC)using real-time 3-dimensional echocardiography(RT-3DE).Methods Thirty patients with HHC and 32 control subjects were studied.Full-volume RT-3DE data from apical window were acquired,and regional volumetric time curves of 17 segments were obtained by fast 3-dimensional border detection software.Several left ventricular function parameters were calculated semiautomatically,including global left ventricular end-diastolic volume(EDV),end-systolic volume(ESV),left ventricular ejection fraction(LVEF),the ratio of ESV/EDV of 17 segments,the standard deviation(SD)and difference(Dif)(adjusted by the R-R interval) of time to minimum systolic volume(Tmsv)in 16 segments(Tmsv16-SD and Tmsv16-Dif).Results EDV and ESV were significantly larger in patients with HHC than that in control subjects[(88±29)ml vs (72±15) ml,t=-2.680,P=0.008;(28±10)ml vs (22±6 )ml,t=-2.613,P=0.01].HHC had a higher ratio of ESV/EDV at interventricular septum(IVS)compared with control group[mid-segments of anterior IVS:(40.51±20.28)% vs (26.43±10.10)%,t=-3.378,P=0.002;mid-segments of posterior IVS:(41.44±23.55)% vs (24.46±8.12)%,t=-3.688,P=0.001;apical segments of IVS:(30.96±21.31)% vs (19.53±7.33)%,t=-2.745,P=0.01].In patients with HHC,Tmsv16-SD and Tmsv16-Dif were significantly longer[(2.48±1.38)% vs (1.16±0.26)%,t=-5.117,P＜0.001;(7.67±5.07)% vs (3.95±1.48)%,t=-3.865,P＜0.001].And the prevalence of left ventricular dyssynchrony was higher than that in control subjects(43% vs 3%).Conclusions HHC patients may have regional left ventricular systolic dysfunction before global changes,and have a higher prevalence of left ventricular dyssynchrony.RT-3DE is a useful imaging modality for assessing left ventricular systolic function.

The aim of this study was to investigate the curative effect of amifostine (AMF) combined with recombinant human erythropoietin (rhEPO) on the aged patients with myelodysplastic syndrome. Two aged MDS patients (one aged 91; another 86) were treated with amifostine and rhEPO over a period of 4 weeks. The results showed that a short-term curative effect was observed and transfusion interval was prolonged in both patients after 4 week treatment with 5 x 0.4 g AMF plus 3 x 6,000 U rhEPO per week. The reticulocyte count in MDS-RA patient returned to normal at first week of treatment and still remained in normal level for 4 weeks; leukocyte, hemoglobin and platelet values in peripheral blood of MDS-RCMD patient obviousby increased, the abnormally increased reticulocyte value displayed a decrease trend after amifostine plus rh-EPO treatment. In conclusion, amifostine plus rhEPO may have a good therapeutic effect for aged MDS patients, and its clinical long-term curative effect still needs further evaluation.
Aged ; Aged, 80 and over ; Amifostine ; therapeutic use ; Drug Therapy, Combination ; Erythropoietin ; therapeutic use ; Humans ; Male ; Myelodysplastic Syndromes ; drug therapy ; Recombinant Proteins ; Time Factors ; Treatment Outcome

The present study was aimed to investigate the damage effect of hepatocyte growrh promoting substance (HGS) on the HL-60 cell DNA in vitro and to explore the possible mechanism underlying the effect. Experiment was divided into 3 groups: one was control group, in which 0.9% NaCl solution was added, and other two were experimental group 1 and group 2, where 22.5 microg/ml and 40 microg/ml HGS were added, respectively. HL-60 cell growths were compared between groups with and without HGS. Single cell gel electrophoresis (SCGE) was used to detect DNA damage of HL-60 cell. DNA electrophoresis was used to detect the apoptosis of HL-60 cells caused by HGS. The results showed that the inhibitory effects of HGS on growth of HL-60 cells were observed in group with 22.5 microg/ml and group with 40 microg/ml after culture for 2 days, the DNA ladder and the apoptosis of HL-60 cells occurred in these 2 groups on day 2 after addition of HGS, the counts of HL-60 cells with comet tail in these experimental groups were found to be more increased in comparison with control group. In conclusion, the HGS can inhibit the growth of HL-60 cell and the apoptosis of HL-60 cells should be induced through pathway of DNA damage caused by HGS.
Animals ; Animals, Newborn ; Apoptosis ; drug effects ; genetics ; Cattle ; Cell Proliferation ; drug effects ; Comet Assay ; DNA Damage ; DNA, Neoplasm ; analysis ; genetics ; HL-60 Cells ; Humans ; Peptides ; pharmacology