Objective To document the etiologies of seizures in children admitted to the pediatric observation unit of an inen r city hospital in Chian .Me thods A ot tal of 975 children ( aged 1 month to 18 years old) admitted to the pediatric observation unit of Guangzhou Women adn Children′s Medical Center between October,2013 and October,2014 with seizures were evaluated restrospectively.Results A total of 975 patients were included in this study.The causes of seizures were febrile seizures ( 588 cases,60.3%) , epilepsy( 163 cases, 16.7%) , and benign inaf ntile convulsions associated with mild gasrt oenteritis ( 111 cases,11.4%) .The main causes of seizures for children less than one year old were febrile seizures ( 75 cases,34.1%) and epilepsy(75 cases,34.1%),following by the intracranial infection(22 cases,10.0%). Febrile seizures also predominated the causes of seizures among children between one and six years old(487 cases, 70.3%),whereas benign infantile convulsions associated with mild gastroenteritis accounting for 14.0%(97 cases) of all causes.Meanwhile, the leading causes of seizures for children of six years or older were febrile seizures(26 cases,41.9%) and epilepsy(20 cases,32.3%).Conclusion Febrile seizures is the leading cause of seizures among children.Contrast to previous studies,the proportions of epilepsy and benign infantile convulsions associated with mild gastroenteritis are increasing,while the proportion of intracranial infection is reducing.Rapid assessment and accurately identifying the etiology play an important role in the management of seizures.

Objective:Small cell lung cancer (SCLC) is a highly malignant tumor with a high risk of brain metastasis (BMs). The purpose of this study was to evaluate the clinical factors affecting the occurrence of BMs in patients with stage IIB-IIIB SCLC who achieved complete remission (CR) after thoracic radio-chemotherapy.Methods:Clinical data of 191 patients with stage IIB-IIIB SCLC who achieved CR after thoracic radio-chemotherapy in Zhejiang Cancer Hospital from January 2009 to April 2016 were retrospectively analyzed. Common clinical factors related to the risk of BMs, including gender, age, thoracic radiotherapy dose, combined mode of radiotherapy and chemotherapy, pretreatment serum NSE and LDH, whether PCI was performed, TMN stage and PS score, were analyzed using log-rank method for univariate analysis, COX regression method for multivariate analysis and Kaplan-Meier method to plot the survival curve.Results:Univariate analysis showed that pretreatment LDH level≥240IU, pretreatment NSE ≥17 ng/ml and no PCI were positively correlated with the risk of BMs (all P＜0.05). Multivariate analysis showed that the risk of BMs was only positively correlated with pretreatment LDH≥240IU [HR: 1.90, 95%CI(1.07-3.37), P=0.029], and no PCI [HR:2.08, 95%CI(1.17-3.72), P=0.013]. Conclusion:Pretreatment serum LDH levels provide important value for predicting the risk of BMs in patients with stage IIB-IIIB SCLC who achieve CR after thoracic radio-chemotherapy.

Objective To study and analyze the therapeutic effects of intravenous low dose recombinant tissue plasminogen activator (rt-PA) in the treatment of transient ischemic attack (TIA).Methods A total of 86 TIA patients were selected as the research subjects and divided into observation group (intravenous low dose rt-PA thrombolysis treatment combined with aspirin antiplatelet therapy applied,41 cases) and the control group (single aspirin antiplatelet therapy applied,45 cases) according to the treatment methods.The plasma tissue plasminogen activator (t-PA),the plasminogen activator inhibitor-1 (PAI-1) on admission,at 1,3,7,14 d of the treatment were detected and compared.The control rates of TIA of the patients in the two groups were observed and compared.The patients in the two groups were followed up for 1 year,the ratios of transformation to acute cerebral infarction in the two groups were observed and compared.Results At 1,3 d of the treatment,the plasma t-PA levels of the patients in the observation group were significantly higher than that in the control group,and the differences between the two groups were statistically significant (P ＜ 0.05).At every time points before and after the treatment,the differences of the plasma PAI-1 levels between the two groups were not statistically significant (P ＞ 0.05).There were no statistically significant differences in control rates of TIA in each period of time between the patients in the two groups (P ＞ 0.0 5).During the period of following-up,there were 2 cases and 4 cases of patients with transformation to acute cerebral infarction in the observation group and the control group,respectively,and there was no significant differences in the ratios of transformation to acute cerebral infarction between the two groups (P ＞ 0.05).Conclusion The application of intravenous infusion of low dose of rt-PA for thrombolysis on the basis of the antiplatelet therapy of aspirin can increase the plasma t-PA level in early period of patients with TIA,help to reduce the risk of thrombosis,but has no obvious influences on the plasma PAI-1 levels,the clinical efficacy and the long-term prognosis.

Objective To study and analyze the therapeutic effects of intravenous low dose recombinant tissue plasminogen activator (rt-PA) in the treatment of transient ischemic attack (TIA).Methods A total of 86 TIA patients were selected as the research subjects and divided into observation group (intravenous low dose rt-PA thrombolysis treatment combined with aspirin antiplatelet therapy applied,41 cases) and the control group (single aspirin antiplatelet therapy applied,45 cases) according to the treatment methods.The plasma tissue plasminogen activator (t-PA),the plasminogen activator inhibitor-1 (PAI-1) on admission,at 1,3,7,14 d of the treatment were detected and compared.The control rates of TIA of the patients in the two groups were observed and compared.The patients in the two groups were followed up for 1 year,the ratios of transformation to acute cerebral infarction in the two groups were observed and compared.Results At 1,3 d of the treatment,the plasma t-PA levels of the patients in the observation group were significantly higher than that in the control group,and the differences between the two groups were statistically significant (P ＜ 0.05).At every time points before and after the treatment,the differences of the plasma PAI-1 levels between the two groups were not statistically significant (P ＞ 0.05).There were no statistically significant differences in control rates of TIA in each period of time between the patients in the two groups (P ＞ 0.0 5).During the period of following-up,there were 2 cases and 4 cases of patients with transformation to acute cerebral infarction in the observation group and the control group,respectively,and there was no significant differences in the ratios of transformation to acute cerebral infarction between the two groups (P ＞ 0.05).Conclusion The application of intravenous infusion of low dose of rt-PA for thrombolysis on the basis of the antiplatelet therapy of aspirin can increase the plasma t-PA level in early period of patients with TIA,help to reduce the risk of thrombosis,but has no obvious influences on the plasma PAI-1 levels,the clinical efficacy and the long-term prognosis.

OBJECTIVE: This study was to investigate the expression and significance of Integrins subunits in laryngeal squamous cell carcinoma (LSCC). METHOD: The expression of Integrins subunits was detected by cDNA microarray in 4 cases of primary LSCC tissues and corresponding adjacent normal tissues. Semi-quantitative reverse transcription polymerase chain reaction (RT-PCR) were used to identify the different expression of Integrins subunits in 24 cases of primary LSCC tissues and corresponding adjacent normal tissues. RESULT: A cDNA microarray analysis revealed significant changes in the expression of Integrins subunits, with IntegrinalphaV, Integrinbeta8 being up-regulated and Integrinalpha8 being down-regulated. The result of RT-PCR was consistent with that of cDNA microarray. The mRNA levels of IntegrinalphaV and Integrinbeta8 were significantly higher in LSCC tissues than that in corresponding adjacent normal tissues (1.0131 +/- 0.4780 vs 0.7591 +/- 0.4678 for IntegrinalphaV, P<0.05, 1.7362 +/- 1.3849 vs 1.2267 +/- 0.9363 for Integrinbeta8, P<0.05). The mRNA levels of Integrinalpha8 were significantly lower in LSCC tissues than that in corresponding adjacent normal tissues (0.2646 +/- 0.2622 vs 0.5457 +/- 0.3827, P<0.05). CONCLUSION The expression of IntegrinalphaV, Integrinbeta8, Integrinalpha8 were significantly up-regulated or down-regulated in laryngeal squamous cell carcinoma, which may relate to tumorigenesis and development of laryngeal squamous cell carcinoma.
Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; metabolism ; pathology ; Humans ; Integrin alpha Chains ; genetics ; metabolism ; Integrin alphaV ; genetics ; metabolism ; Integrin beta Chains ; genetics ; metabolism ; Laryngeal Neoplasms ; metabolism ; pathology ; Male ; Middle Aged ; Neoplasm Proteins ; metabolism ; Neoplasm Staging

Objective:To compare the clinical efficacy of neoadjuvant chemoradiotherapy (nCRT) and neoadjuvant chemo-immunotherapy (nCIT) for locally advanced esophageal squamous cell carcinoma (ESCC).Methods:Clinical data of patients who received nCRT or nCIT followed by esophagectomy for locally advanced ESCC between January 2010 and December 2022 were retrospectively collected from Zhejiang Cancer Hospital, with 155 patients in the nCRT group and 470 patients in the nCIT group. Propensity score matching (PSM) was performed in the two groups. After PSM, 120 patients were allocated to the nCRT group and 192 patients to the nCIT group. The pathological response and disease recurrence were compared between the two groups after PSM. Log rank test were used to compare the survival outcomes before and after PSM. Univariate and multivariate Cox regression analyses were performed to identify the prognostic factors for locally advanced ESCC.Results:After PSM, the R0 resection rate in the nCRT group and the nCIT group was 93.3% (112/120) and 93.8% (180/192), respectively, with no statistical significance ( P=0.884). However, the pathological complete response rate in the nCRT group [36.7% (44/120)] was higher than that in the nCIT group [21.4% (41/192), P=0.003]. For patients with R0 resection, the major recurrence pattern was distant metastasis [18.8% (21/112)] in the nCRT group, while the pattern was locoregional recurrence [12.2% (22/180)] in the nCIT group. The 3-year disease-free survival rates were 52.7% and 66.1% ( P=0.022) and the 3-year overall survival rates were 59.2% and 75.5% ( P=0.002) in the nCRT and nCIT groups, respectively. Multivariate Cox regression analysis also revealed that the neoadjuvant therapy mode was an independent prognostic factor for patients with locally advanced ESCC. Compared with nCRT, nCIT could significantly prolong disease-free survival ( HR=0.58, 95% CI: 0.40-0.86) and overall survival ( HR=0.53, 95% CI: 0.35-0.79). Conclusion:These results suggest that nCIT could significantly improve disease-free survival rate and overall survival rate over nCRT in locally advanced ESCC, even with lower pathological complete response rate.

Objective:To compare the clinical efficacy of neoadjuvant chemoradiotherapy (nCRT) and neoadjuvant chemo-immunotherapy (nCIT) for locally advanced esophageal squamous cell carcinoma (ESCC).Methods:Clinical data of patients who received nCRT or nCIT followed by esophagectomy for locally advanced ESCC between January 2010 and December 2022 were retrospectively collected from Zhejiang Cancer Hospital, with 155 patients in the nCRT group and 470 patients in the nCIT group. Propensity score matching (PSM) was performed in the two groups. After PSM, 120 patients were allocated to the nCRT group and 192 patients to the nCIT group. The pathological response and disease recurrence were compared between the two groups after PSM. Log rank test were used to compare the survival outcomes before and after PSM. Univariate and multivariate Cox regression analyses were performed to identify the prognostic factors for locally advanced ESCC.Results:After PSM, the R0 resection rate in the nCRT group and the nCIT group was 93.3% (112/120) and 93.8% (180/192), respectively, with no statistical significance ( P=0.884). However, the pathological complete response rate in the nCRT group [36.7% (44/120)] was higher than that in the nCIT group [21.4% (41/192), P=0.003]. For patients with R0 resection, the major recurrence pattern was distant metastasis [18.8% (21/112)] in the nCRT group, while the pattern was locoregional recurrence [12.2% (22/180)] in the nCIT group. The 3-year disease-free survival rates were 52.7% and 66.1% ( P=0.022) and the 3-year overall survival rates were 59.2% and 75.5% ( P=0.002) in the nCRT and nCIT groups, respectively. Multivariate Cox regression analysis also revealed that the neoadjuvant therapy mode was an independent prognostic factor for patients with locally advanced ESCC. Compared with nCRT, nCIT could significantly prolong disease-free survival ( HR=0.58, 95% CI: 0.40-0.86) and overall survival ( HR=0.53, 95% CI: 0.35-0.79). Conclusion:These results suggest that nCIT could significantly improve disease-free survival rate and overall survival rate over nCRT in locally advanced ESCC, even with lower pathological complete response rate.