Objective To summarize the clinical and EEG characteristics of benign epilepsy of childhood with centro-temporal spikes(BECCT). Methods The clinical and EEG data of 78 children with BECCT were retrospectively analyzed. Results The onset age of this disease was 3 to 14 years, and 62 patients aged 5 to 10 years(62/78,80%). The seizures of 72 cases(72/78,92.3%)were associated with sleep. 63 cases(73/78,80.8%)were partial seizures, and 15 cases(15/78,19.2%) were generalized seizures. EEG demonstrated that there were sharp or spike waves of interior discharge in the centro-temporal area of one or two sides, 55.4% cases were positive in awake EEG, and 92% cases were positive in sleep EEG. 93.2% cases were responsive to antiepileptic drugs. Conclusion The characteristics of BECCT were as follows: partial epilepsy related to sleep, partial seizure types and sharp or spike waves of EEG in centro-temporal area. EEG sleep induction test could increase positive diagnostic rate of this disease, and the prognosis of this disease was fine. The early diagnosis is helpful for the patients' prognosis, and can alleviate psychological suffering of the patients and their families.

It was reported that three cases of neuropsychiatric complications after liver transplantation were enrolled from Department of Hepatobiliary Surgery, Weifang People's Hospital from March 2001 to August 2004. Two cases of delirium kind of mental disorder, and one patient had epilepsy and limb movement disorder. All subjects were mainly given immunosuppressant drug therapy, a timely correction of fluid and electrolyte imbalance and symptomatic treatment. Postoperative prognosis of patients as well as the diagnosis and treatment of patients were retrospectively observed. Case one, male aged 54 years of hepatitis B liver cirrhosis and large, with a history of hypertension for 15 years and diabetes for 10 years. On September 25th, 2001 the patient received piggyback liver transplantation. During and after transplantation the patient received a strong impact on the treatment with the Dragon 1 000 mg. After 28 days,the patient died of hyperbilirubinemia, hyperkalemia, liver and kidney failure clinically. Case two, male aged 47 years of hepatitis B, cirrhosis and huge hepatocellular carcinoma, chronic calculous cholecystitis, with a history of hypertension for 5 years and diabetes for 2 years. On December 26th, 2001 the patient was treated with piggyback liver transplantation. At day 44 the patient had obvious cough with yellow-green phlegm, sputum culture was Aspergillus spp (50%) and diflucan for the treatment. Till day 53, drowsiness and depressed spirit appeared; at day 54, the patient was disoriented, and at day 55 hemiparesis occurred at right side, gradually coma, by brain CT scan it confirmed to be intracerebral hemorrhage, and died. Case three, male aged 59 years of hepatitis B, cirrhosis of liver atrophy with right hepatic small hepatocellular carcinoma. On August 20th, 2004 the patient was given classic modified line-situ liver transplant surgery without venovenous bypass. Four days after sudden aphasia, gradually motor dysfunction, swallowing dysfunction,restlessness and epilepsy appeared. After Phenytoin Sodium, chloral hydrate enema and luminal sodium treatment, focal epilepsy and irritable symptoms were effectively controlled, but aphasia and left hemiparesis still occurred. After five months, the patient died of cerebral hemorrhage. Incidence rate of neuropsychiatric complications are high after liver transplantation. Besides, brain hemorrhage is a serious complication and has a high mortality rate. It is important and positive of reducing bleeding, maintaining hemodynamics and environmental stability to avoid the large blood transfusion and infusion for the prevention of serious complications.

It was reported that three cases of neuropsychiatric complications after liver transplantation were enrolled from Department of Hepatobiliary Surgery,Weifang People's Hospital from March 2001 to August 2004. Two cases of delirium kind of mental disorder,and one patient had epilepsy and limb movement disorder. All subjects were mainly given immunosuppressant drug therapy,a timely correction of fluid and electrolyte imbalance and symptomatic treatment. Postoperative prognosis of patients as well as the diagnosis and treatment of patients were retrospectively observed. Case one,male aged 54 years of hepatitis B liver cirrhosis and large,with a history of hypertension for 15 years and diabetes for 10 years. On September 25th,2001 the patient received piggyback liver transplantation. During and after transplantation the patient received a strong impact on the treatment with the Dragon 1 000 mg. After 28 days,the patient died of hyperbilirubinemia,hyperkalemia,liver and kidney failure clinically. Case two,male aged 47 years of hepatitis B,cirrhosis and huge hepatocellular carcinoma,chronic calculous cholecystitis,with a history of hypertension for 5 years and diabetes for 2 years. On December 26th,2001 the patient was treated with piggyback liver transplantation. At day 44 the patient had obvious cough with yellow-green phlegm,sputum culture was Aspergillus spp (50%) and diflucan for the treatment. Till day 53,drowsiness and depressed spirit appeared; at day 54,the patient was disoriented,and at day 55 hemiparesis occurred at right side,gradually coma,by brain CT scan it confirmed to be intracerebral hemorrhage,and died. Case three,male aged 59 years of hepatitis B,cirrhosis of liver atrophy with right hepatic small hepatocellular carcinoma. On August 20th,2004 the patient was given classic modified line-situ liver transplant surgery without venovenous bypass. Four days after sudden aphasia,gradually motor dysfunction,swallowing dysfunction,restlessness and epilepsy appeared. After Phenytoin Sodium,chloral hydrate enema and luminal sodium treatment,focal epilepsy and irritable symptoms were effectively controlled,but aphasia and left hemiparesis still occurred. After five months,the patient died of cerebral hemorrhage. Incidence rate of neuropsychiatric complications are high after liver transplantation. Besides,brain hemorrhage is a serious complication and has a high mortality rate. It is important and positive of reducing bleeding,maintaining hemodynamics and environmental stability to avoid the large blood transfusion and infusion for the prevention of serious complications.

[Objective]To investigate the effect of chondroitinase ABC(ChABC) after spinal cord injury(SCI) in adult rats,and to evaluate the significance of treatment. [Methods]Forty adult Wistar rats were divided into two groups: the control group(group A),the chondroitinase ABC group(group B).The thoracic T10 spinal cord injury model was made by impactor model II manual.After SCI,group B animals received ChABC treatment,while group A animals only received blank saline.The locomotor functions(BBB score) and the neuroelectrophysiological changes(SEP&MEP) of the rats were evaluated.Twelve weeks after SCI,biotinylated dextran amine(BDA) was injected into the cerebral cortex to trace the corticospinal tracts(CST).Then two weeks after the tracing,the animals were killed and the spinal cord frozen sections were made.The tissue sections were processed with Cy3 fluorescence stain,HE stain and anti NF-200 immuohistological stain.The section images were analyzed by Image Pro Plus image analyzing software.All the statistics were performed by SPSS 13.0 software.[Results]At 4 weeks after SCI,group B had obvious higher BBB scores than control group(P

Objective To assess the surgical skills and clinical outcomes of selective splenic pedicle occlusion (SSPO) in laparoscoic partial splenectomy.Methods Between May 2011 and Nov 2016,40 patients undergoing laparoscopic partial splenectomy were devided into selective splenic pedicle occlusion group (14 cases) and conventional laparoscopic partial splenectomy group (26 cases).Results There were no significant differences in preoperative patient characteristics between the two groups.Significantly less intraoperative blood loss (82 ± 36) ml vs (178 ± 81) ml (t =-4.2,P =0.001) were observed in group of SSPD,There were no significant differences between the groups in operative time (111 ± 17) min vs (127 ±40) min(t =-1.4,P =0.19),transfusion rate (0/14,0/26) (P =1),conversion rate (0/14,0/26) (P =1),postoperative complications (1/14,2/26) (Fisher =0.063,P =0.80) and length of postoperative hospital stay (7.1 ± 2.3) d vs (6.0 ± 1.3) d (t =1.28,P =0.22).Conclusions SSPO is feasible and safe for patients receiving laparoscopic partial splenectomy.

Objective To evaluate the effect of the transcranial magnetic stimulation on upper-extremity function rehabilitation and changes in the excitability of cerebral cortex,and to evaluate from the viewpoint of electro-physiology the prognosis so as to guide the rehabilitation treatment of patients after stroke.Methods Forty-six patients in the early stage after a stroke were given TMS examinations of the ipsilateral brain region.Those with the motor evoked potentials (MEPs) amplitudes lower than 50 μV were classified into a motion-induced experimental negative group (the negative group),whiie those whose MEP amplitude reached 50 μV or more were classified as movement-induced positive (the positive group).Both groups were given the same treatment.Before and after 2,4 and 8 weeks of treatment the Fugl-Meyer movement function rating scale was used to assess their bilateral upper limb movement function.TMS technology was used to detect any change in the resting motor threshold (RMT) and the amplitude (Amp) of MEPs in the motor cortex.The incubation period of the cortex (CL) and the central motor conduction time (CMCT) in the contralateral motor cerebral cortex were also observed.Results After 4 weeks of treatment,the average score of the positive group on Fugl-Meyer upper movement function rating scale reached (54.99±2.76),significantly higher than before treatment and significantly higher than the negative group's average (P＜0.05).After 8 weeks of treatment,the average score in the positive group had increased further to 73.11±2.98,still significantly higher than that of the negative group (P＜0.01).After treatment,RMT decreased progressively in both groups,but that of the negative group dropped from (98.35±10.12) to (30.35±7.31) (9＜0.01),with significantly greater decline in amplitude and rate than that of the positive group (P＜0.05).After treatment,the Amp of both groups showed a gradual increasing trend.Amp increased earlier in the positive group,but there was no significant difference in the extent of the increase between the two groups (P＞0.05).After the treatment the CL and CMCT had shortened significantly in the negative group compared to before the treatment (P＜0.05),while there was no significant change in CL and CMCT after the treatment (P＞0.05).Conclusions The excitability of the contralateral motor cortex changes after a stroke.TMS can be used to characterize the MEP to monitor and predict recovery.This should help clinicians prepare more scientific rehabilitation plans.

BACKGROUND:Peripheral nerve defect due to limb dysfunction has always been the difficulty faced by the medical profession. Ideal materials and processing technology for constructing a tissue engineering scaffold targeting peripheral nerve repair are stil in research stage. OBJECTIVE:To review the research progress in peripheral nerve repair using col agen/silk fibroin nerve conduits. METHODS:In this paper, the first author retrieved the PubMed and CNKI from 2003 to 2016 to search articles regarding methods of constructing artificial nerve scaffolds and selection of raw materials. Data from these articles were col ected, summarized and analyzed. RESULTS AND CONCLUSION:Forty-six articles were included for final analysis. Col agen and its degradation products trigger no inflammatory response in the host because of high biocompatibility and biodegradability. However, its use is largely limited by its rapid degradation and poor physical performance. Silk fibroin has a high flexibility and biocompatibility, and exhibits a slow degradation in vivo. As a rapid prototyping technique, three-dimensional printing can print various forms of scaffolds within a short time, characterized as high-quality pore structure and large-scale production. Given these, the col agen/silk fibroin nerve conduit prepared using the three-dimensional printing technology can maintain the biocompatibility and even improve the mechanical properties of the raw materials. Until now, more investigations on nerve repair using col agen or silk fibroin have been done, and we have never stopped improving the production process of these scaffolds. Therefore, the col agen/silk fibroin scaffold prepared using the three-dimensional printing technology is expected to become the main candidate for the repair of peripheral nerve defects.

Objective To evaluate the effect of injecting botulinum toxin A (BTX-A) to the external urethral sphincter on detrusor wall thickness (DWT) and the bladder function of spinal cord injury patients with detrusor-sphincter dyssynergia (DSD).Methods Twenty-one adult patients with DSD due to spinal cord injury were recruited.A single 100 IU dose of botulinum toxin A was injected into their external urethral sphincters via an uhrasound-guided transperineal route.DWT,detrusor leak-point pressure (DLPP),post-void residual volume (PRV) and maximum bladder capacity(MBC) were assessed by urodynamic examination and ultrasound evaluation before and 4 and 8 weeks after the injection.Results Four weeks later a significant decrease in PRV was observed,but no significant difference in DWT,DLPP or MBC.After eight weeks the mean DWT value had decreased by 17％,a significant reduction.There were also significant improvements in DLPP,PRV and MBC at eight weeks compared with the of baseline values.Conclusions BTX-A injection to the external urethral sphincter can reduce DWT and improve bladder function in spinal cord injury patients with DSD.

Objective To investigate the application value of enhanced recovery after surgery(ERAS) in laparoscopic pancreaticoduodenectomy (LPD).Methods The retrospective cohort study was adopted.The clinical data of 64 patients who underwent LPD from January 2014 to January 2016 in the Shangjin Hospital of West China Hospital of Sichuan University were collected.Of the 64 patients,41 patients managed with ERAS program between March 2015 and January 2016 were allocated into the ERAS group,23 patients managed with traditional perioperative treatment between January 2014 and Febuary 2015 were allocated into the traditional group.The following indexes were observed:(l) intraoperative status:operation time,volume of intraoperative blood loss,conversion to open surgery,pylorus preservation.(2) Postoperative status:the time to out-of-bed activity,time to postoperative flatus,time of drainage tube removal,postoperative complications (pancreatic leakage,bile leakage,hemorrhage,delayed gastric emptying,abdominal infection,cardiovascular complications),duration of postoperative hospital stay,death within the postoperative 30 days.(3) Follow-up status:incidence of complications after discharge and survival of patients.The follow-up including incidence of complications after discharge and survival of patients was conducted by outpatient examination and telephone interview up to March 2016.Measurement data with normal distribution were presented as (x) ± s and analyzed by t test.Count data were analyzed using the chi-square test or Fisher exact probability.Results (1) Intraoperative status:the operation time,volume of intraoperative blood loss,number of patients with conversion to open surgery and pylorus preservation were (377 ± 38) minutes,(164 ± 48) mL,1,40 in the ERAS group and (392 ± 53) minutes,(152 ±31)mL,2,21 in the traditional group,showing no statistically significant difference between the 2 groups (t =5.02,8.43,x2=1.29,1.29,P ＞ 0.05).(2) Postoperative status:the time to out-of-bed activity,time to postoperative flatus,time of drainage tube removal and duration of postoperative hospital stay were (1.7 ± 0.6)days,(2.5 ± 0.6) days,(5.3 ± 1.7) days,(9.1 ± 1.3) days in the ERAS group and (2.1 ± 0.9) days,(3.8 ±1.2) days,(8.2 ± 2.6) days,(11.9 ± 1.8) days in the traditional group,showing statistically significant differences between the 2 groups(t =-5.28,-7.01,-16.20,-10.67,P ＜ 0.05).The numbers of patients with pancreatic leakage in stage A,B and C,bile leakage,hemorrhage,delayed gastric emptying,abdominal inflection,cardiovascular complications and death in the postoperative 30 days were 8,0,0,0,1,3,0,1,1 in the ERAS group and 5,1,0,1,1,3,2,1,0 in the traditional group,respectively,showing no significant difference between the 2 groups (x2=0.37,1.81,0.18,0.57,3.68,0.18,P ＞0.05).(3) Follow-up status:the 64 patients were followed up for a median time of 11 months (range,1-25 months).During the follow-up,number of patients complicated with diabetes,local tumor recurrence,liver metastasis and death were 5,4,1,0in the ERAS group and 2,5,2,3 (2 died of tumor recurrence and 1 died of myocardial infarction) in the traditonal group.Conclusion Application of ERAS in the perioperative management of LPD is safe and effective,meanwhile,it can accelerate the recovery of patients who underwent LPD and shorten the duration of hospital stay.