Background and Objectives: Stroke mimics are medical conditions producing stroke-like symptoms but eventually get diagnosed as non-stroke diseases. Epileptic seizure is a common type of stroke mimic. The purpose of this study is to investigate the application of emergency multimodal computed tomography (CT) in the diagnosis of epileptic seizure. Methods: We retrospectively reviewed the case group of patients with suspected stroke in the emergency stroke care service of the First Affiliated Hospital of Suzhou University from September 2017 to October 2019. We included those who underwent multimodal CT, including non-contrasted cranial CT, CT perfusion with CT angiography, and were ultimately diagnosed as epileptic seizures. Ten patients with acute anterior circulation ischemic stroke were assigned as controls. Results: A total of five cases met the inclusion criteria. Multimodal CT was completed within 2.25 to 3.50h from symptom onset. On CT perfusion, hyperperfusion was shown in four cases and slightly increased perfusion in one case with epileptic seizures. Cerebral blood flow and cerebral blood volume were significantly increased, while time to peak and mean transit time decreased in the regions of interest of the epileptic hemisphere when compared to either the non-affected hemisphere or the ischemic area in the control group (P<0.05). The abnormal perfusion areas did not follow vascular territory supply and CT angiography did not show vessel occlusion in the case group. Conclusion: Emergency multimodal CT could be used effectively to differentiate epileptic seizure from stroke.

Seizures (including postictal state) account for about 38% of stroke mimics, which are easily confused with acute ischemic cerebrovascular events. Electroencephalogram, with a low interictal positive rate, has limitations in early diagnosis of epileptic seizures because it is usually unavailable in the emergency room. In acute settings, CT perfusion imaging is economical and has a short examination time. It is widely used for early screening and evaluation of suspected stroke. Seizures are accompanied by perfusion changes and have certain characteristics. CT perfusion patterns in different periods, especially for focal hyperperfusion, can distinguish stroke-like seizures from cerebrovascular events at an early stage. It helps to make a clear diagnosis and appropriate clinical decisions, leading to improve patients′ prognosis.

Objective To evaluate reference range for fasting venous blood cells in the healthy 51 584 elderly people from Shuyang,China.Methods Totally 1000 non-old people and 51 584 elderly people were involved in this study.Fasting venous blood cells were collected from each group of subjects using standard procedures.The collected aliquots were processed according to standard operating procedures to determine participants' complete blood counts.Non-parametric methods were employed to calculate the reference intervals and 95 ％ confidence intervals for complete blood counts by Sysmex XE-2100 blood cell analyzer.Results The reference ranges of fasting venous blood cells in elderly subjects (male,female) were [(3.25-9.45) × 109/L and (3.35-9.39) × 109/L,WBC];[(3.87-5.55) × 1012/L and (3.71-5.19) × 1012/L,RBC] ; [(116.2-169.5)g/L and(107.4-153.6)g/L,Hb] ; [(37.2-52.4) ％ and(35.2-48.6) ％,HCT] ; [(86.3-104.8)fl and (85.2-103.5) fl,MCV] ; [(27.0-33.4) pgand(26.4-32.5)pg,MCH]; [(297.1-335.4)g/L and(293.3-330.5)g/L,MCHC];[[(38.4-54.2) and (38.6-52.9),RDW-SD]; [(11.3-15.4)％ and(11.4-15.3)％,RDW-CV];[(98.8-303.8) × 109/L and (109.9-334.8) × 109/L,PLT] ; [(1.10-3.42) and (1.20-3.78) ml/L,PCT];[(11.2-15.6) fl and(11.3-15.5)fl,MPV]; [[(8.89-16.7)％ and(9.48 17.1)％,PDW];[(20.3-49.1) ％ and (20.5-48.6) ％,PLCR],respectively.13 parameters of fasting venous blood samples in elderly people had statistically significant differences compared with non-old people (all P ＜0.05).Conclusions The reference range of fasting venous blood samples in elderly people are significantly different from non-old people.It is necessary to scientifically and reasonably establish the reference ranges for fasting venous blood cells in local elderly people.

Objective:To elucidate the phenomenon that epileptic seizure occurs in patients with epilepsy without definite diagnosis when driving a motor vehicle and its hazards.Methods:From January 2020 to June 2022, 7 epileptic patients who experienced traffic accidents caused by seizures were selected from the First Affiliated Hospital of Soochow University, and their demographic data, traffic accident related data and epilepsy diagnosis and treatment data were summarized and analyzed.Results:A total of 7 adult patients with epilepsy were collected, including 6 males, 4 of whom had been driving for more than 10 years. Among them, 1 patient drove a bus, and the other 6 patients drove private cars. Totally 5/7 of the accidents resulted in personal injury, and 3/7 of the accidents resulted in personal death. In 5 patients, video electroencephalogram showed interictal epileptiform discharges. In 2 patients, the imaging findings suggested the presence of cerebral cortical lesions that may lead to seizures. In terms of the form of seizure, 3 patients′ seizure type was focal to bilateral tonic-clonic, and the other 4 patients were very probable to be focal impaired awareness seizure.Conclusions:Undiagnosed epileptic seizures lead to traffic accidents, endanger patients and public safety, which need to attract attention from both doctors and patients, as well as the whole society.

With the widespread application of colorectal cancer screening, the surveillance and management of the increasing number of screened population has become a pivotal aspect in preventing and controlling colorectal cancer. In recent years, researches have been conducted on the risk of colorectal cancer incidence and mortality in the population after screening. At the same time, various organizations in Europe and the United States have continuously updated colonoscopy surveillance after screening and polypectomy based on the latest research evidence. In this review, we summarized the current progress of studies on colorectal cancer risk in post-screening colorectal cancer populations and the key points of relevant guideline updates, in order to provide a reference for conducting relevant studies and formulating surveillance guidelines or consensus in China.

With the widespread application of colorectal cancer screening, the surveillance and management of the increasing number of screened population has become a pivotal aspect in preventing and controlling colorectal cancer. In recent years, researches have been conducted on the risk of colorectal cancer incidence and mortality in the population after screening. At the same time, various organizations in Europe and the United States have continuously updated colonoscopy surveillance after screening and polypectomy based on the latest research evidence. In this review, we summarized the current progress of studies on colorectal cancer risk in post-screening colorectal cancer populations and the key points of relevant guideline updates, in order to provide a reference for conducting relevant studies and formulating surveillance guidelines or consensus in China.

The incidence and mortality rates of early-onset colorectal cancer (EOCRC) among people under 50 years old are showing an upward trend. Although traditional epidemiological studies have conducted relatively deep research and screened out environmental factors related to EOCRC, our understanding of the causes, mechanisms, and treatment of this disease is still far from sufficient. In this review, we clarify the current progress of EOCRC, with a particular focus on epidemiology, screening status, clinical symptoms, and prognosis. This provides new evidence for secondary prevention, including precision screening, and offers new ideas for improving the diagnosis and treatment of EOCRC.

The incidence and mortality rates of early-onset colorectal cancer (EOCRC) among people under 50 years old are showing an upward trend. Although traditional epidemiological studies have conducted relatively deep research and screened out environmental factors related to EOCRC, our understanding of the causes, mechanisms, and treatment of this disease is still far from sufficient. In this review, we clarify the current progress of EOCRC, with a particular focus on epidemiology, screening status, clinical symptoms, and prognosis. This provides new evidence for secondary prevention, including precision screening, and offers new ideas for improving the diagnosis and treatment of EOCRC.

Locally advanced rectal cancer(LARC)is associated with a high risk of local recurrence and distant metastasis,making it difficult to be cured by surgery alone.Neoadjuvant chemoradiotherapy followed by surgery is the standard treatment for LARC,with reduced local recurrence rates.However,neoadjuvant chemoradiotherapy is associated with patients' urogenital and sexual dysfunction,which severely affecting their quality of life.Therefore,determining the optimal timing of surgery to balance oncologic and functional outcomes is crucial and challenging.We proposed that choosing the optimal timing of surgery based on preoperative risk assessment of LARC is an effective strategy.The patients with low to moderate risk of recurrence can be considered to perform surgery directly or have preoperative chemotherapy followed by radical surgery.Patients with high risk of recurrence should extend neoadjuvant therapy before surgery to improve oncologic outcomes.In this study we explored the optimal timing of radical surgery for LARC,providing a new idea for individualized and precise treatment of LARC.