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.

BACKGROUND: Spinal cord injury is a damage to the spinal cord with a high morbidity that can be divided into primary and secondary injury. Secondary injury does more harm to the body than primary injury, which can be regulated and improved through proper interventions. In addition to the drugs, surgical decompression and other traditional treatments, hypothermia is an important physical intervention that has been shown to regulate secondary injury following spinal cord injury, and hold neuroprotective effect.OBJECTIVE: To introduce different hypothermia treatments for spinal cord injury and the effect on the disordered environment after spinal cord injury, as well as summarize the latest progression. METHODS: A computer-based search of CNKI and PubMed databases was conducted for the articles addressing the application of hypothermia in spinal cord injury published from January 2001 to June 2016, using the keywords of therapeutic hypothermia or low temperature, spinal cord injury in Chinese and English, respectively. RESULTS AND CONCLUSION: Hypothermia is divided into systematic and local hypothermia, and the former is simple and convenient, but it may lead to complications. Local hypothermia can quickly reach the target temperature, to make deep hypothermia at injury site and stablize the core temperature in the body, but it is invasive, and the necessary time of locating and maintaining effective temperature is a challenge. In general, hypothermia can improve the disordered microenvironment after spinal cord injury, reduce inflammatory infiltration, regulate the expression of relative genes and proteins, and promote the proliferation and differentiation of endogenous nerve cells. There are basic and clinical studies on hypothermia neuroprotection against spinal cord injury from various aspects; thereafter, hypothermia is a promising treatment strategy for spinal cord injury.

Objective To compare biliary tract intraductal papillary mucinous neoplasm (BT-IPMN) with intraductal papillary mucinous neoplasm of the pancreas (P-IPMN).Methods From January 2008 to December 2013,eleven (6.0％) cases of BT-IPMNs were retrospectively identified from a total of 182 biliary tract tumors resected in our institution,while 50 cases underwent surgery for P-IPMN.The mean age of the 11 BT-IPMN cases was 57.3 years (range 40 to 74 years).There were 8 men (73.0％).The mean age of the 50 P-IPMN cases was 57.4 years (range 33 to 85 years).There were 34 men (68.0％).The clinical features,radiologic findings,pathology,surgical strategies,and long-term follow up outcomes between the 2 groups of patients were analyzed.Results There was no significant difference between BT-IPMN and P-IPMN in the following aspects:mean age,sex ratios and clinical presentation [including the most common presenting symptom abdominal pain (73.0％ vs.68.0％),and elevated tumor markers (CEA and CA19-9)].The mean tumor size of BT-IPMN was significantly smaller than P-IPMN (1.7 vs.4.1 cm,P ＜ 0.05).Macroscopically visible mucin was detected in all the 11 patients basing on the original surgical reports.The most common abnormal preoperative imaging findings for BT-IPMN were bile duct dilatation (100％) and intraluminal masses (55.0％).Most cases (82.0％) involved the intrahepatic bile duct and hilum.For tumor clearance,we conducted left hepatectomy in most cases (64.0％).Only one patient underwent biopsy and choledochojejunostomy for multiple tumors involving the extrahepatic,right and left bile ducts.BT-IPMN was likely to have a higher risk of malignancy (55.0％ vs.44.0％) and poorer prognosis (median survival,57 vs.63 months),although there was no significant difference (P ＞ 0.05).The patient without tumor resection died of liver failure 22 months after palliative surgery.Conclusions BT-IPMNs are very rare and they had some similarity with P-IPMN.Complete resection of BT-IPMN is associated with good survival.

Objective To evaluate the use of three-dimensional reconstruction (3D) to improve the success rate in the first attempt of radiofrequency ablation (RFA) for small hepatocellular carcinoma (HCC).Methods A retrospective study was conducted on 109 patients with small HCC (with single nodule from 3 to 5 cm in diameter) treated with radiofrequency ablation between June 2010 and June 2013.A safe ablation margin was evaluated before and after radiofrequency ablation.The patients were divided into two groups: the 3D-RFA group (49 patients were evaluated by three-dimensional reconstruction before RFA treatment) and the 2D-RFA group (60 patients were not evaluated by three-dimensional reconstruction before RFA treatment).The success rate of the first attempt of radiofrequency ablation, recurrence free survival, overall survival and complications were compared between the two groups.Results The success rate of first ablation reached 95.9％ (47/49) in the 3D-RFA group which was significantly higher than the 48.3％ (29/60) in the 2D-RFA group (P ＜ 0.05).The local tumor progression rate was 8.1％ in the 3D-RFA group versus 23.3％ in the 2D-RFA group (P ＜0.05).The 1-, 2-, 3-year recurrence free survival rates were 85.4％, 63.9％, and 49.8％ respectively in the 3D-RFA group and 72.4％, 43％, and 34.4％ respectively in the 2D-RFA group (P ＜ 0.05).The 1-, 2-, 3-year overall survival rates were 91.4％,78.4％, and 60.9％ respectively in the 3D-RFA group and 83.3％, 58.7％, and 40.9％ respectively in the 2D-RFA group (P ＜0.05).Complications occurred significantly less in the 3D-RFA group (4％, 2/49) than the 2D-RFA group (13.3％, 8/60;P ＜ 0.05).Conclusion Three-dimensional reconstruction improved the success rate of the first attempt of radiofrequency ablation and the prognosis of patients, and with less complications for small hepatocellular carcinoma.

Objective To evaluate surgical therapies for chronic pancreatitis.Method The clinical data of 229 patients admitted for chronic pancreatitis during March 2009 to November 2013 in our hospital was retrospectively analyzed,different operation method and their clinical outcome were compared.Results Drainage operations or resection operations were made to all these 229 patients according to different types.57 patients underwent longitudinal pancreaticojejunostomy (LPJ procedure).118 patients received local resection of the head of pancreas combined with longitudinal pancreaticojejunostomy (Frey procedure in 105 cases,Berne procedure in 6 cases,Beger procedure in 7 cases).7 patients received pancreaticoduodenectomy,21 patients received distal pancreas resection,26 patients received other procedures.Post-operative pain relief rate was 89.3％,overall morbidity was 19.6％.Conclusions In cases of chronic pancreatitis,different surgical types are adopted according to their individual indications.Operation in accordance with pathological types guarantees clinical outcome.

cholesterol 7α-hydroxylase gene ( CYP7A 1 ) plays a key role in the catabolism of cholesterol into bile acids. To investigate whether the A-204C polymorphism in CYP7A1 gene affects the gene expression,using luciferase as the reporter gene, four recombinants were constructed by inserting forward or reverse sequence with A or C allele at the polymorphism site into the promoter-less vector pGL3-basic. The constructs were then transfected into four cell lines and the luciferase activity of each expression vector was examined by dual luciferase reporter gene assay system. The results showed that activities of the forward sequence of both genotypes were higher than that of reverse sequence. Promoter activity of the recombinants with A allele was about one third lower than that with C allele. According to the analysis with TRANSFAC database, there may exist a Zic3 binding site when there is the C allele at -204. Our study indicates that the A-204 C polymorphism in CYP7A1 promoter region decreases its promoter activity and thus represses the gene expression, possibly due to the lack of a potential Zic3 binding site.

BACKGROUND:Studies on basic research of magnetic treatment of limb ischemic disease are not much, because poor compliance of animals and the stability of the magnetic field strength are difficult to control, resulting in big experimental error and decreased credibility of the results. For this kind of problem, experimental study on low-frequency electromagnetic magnetic cages for treatment of ischemic limbs was conducted, thus overcoming the two major issues of poor compliance of animals and difficult control of the stability of magnetic field strength.
OBJECTIVE:To investigate the effects of self-made low-frequency magnetic fields of rabbit cages on neovascular growth-promoting factor of rabbits with limb ischemia.
METHODS:A total of 96 rabbit models of atherosclerosis were constructed, numbered and randomly divided into ischemia group and non-ischemia group (12 treatment combination in each group). Experiments in each group were performed four times according to the requirement of factorial design. Electromagnetic field intensity factor A (0, 3, 6, 12 mT) and the time factor B (3, 5, 7 days) were set.
RESULTS AND CONCLUSION:Low-frequency magnetic field could apparently promote hypoxia inducible factor-1α, vascular endothelial growth factor and CD34 expression in ischemic limb of rabbits. Electromagnetic field intensity factor A was a key factor for contributing to the expression of hypoxia inducible factor-1α, vascular endothelial growth factor and CD34, and the time factor B was secondary factor. Low-frequency magnetic field also promoted hypoxia inducible factor-1αexpression in non-ischemia limb, but did not promote vascular endothelial growth factor and CD34 expression. Thus, the expression of vascular endothelial growth factor and CD34 was regulated by hypoxia inducible factor-1α, as wel as other factors, in the ischemic state.

BACKGROUND: Diffusion tensor imaging is a common technique applied for clinical studies of the brain, but it is rarely used for the diagnosis or prognosis of spinal cord injury. OBJECTIVE: To establish a rat model of spinal cord injury using micrological techniques, and to evaluate spinal cord transection with diffusion tensor imaging technology, thus providing a good animal model for further intervention. METHODS: Twelve healthy Sprague-Dawley rats were applied to establish spinal cord injury models using precise microscopic techniques, and another six rats in the sham operated group served as controls. Spinal cord transection of experimental rats after modeling was observed using diffusion tensor imaging. Motor evoked potentials and somatosensory evoked potentials were used to detect electrical physiological changes of rats.Neurological function changes of rats were evaluated using slope experiments and Basso, Beattie and Bresnahan scores. RESULTS AND CONCLUSION: After experimental rats regained consciousness, their lower extremities exhibited complete paralysis, the tails cannot swing, accompanying urinary retention. Diffusion tensor imaging displayed the T10 segment of spinal cord was completely transected. Motor and sensory evoked potential waveform were not drawn compared than control group. At 1 day, 1 week, 2 weeks, 4 weeks after operation, the test angle of slope experiments was less than 30° and Basso, Beattie and Bresnahan score was less than 10 points; as the time prolonged, lower limb irritating reflections of some rats were visible, but no initiative functional activity was found, local spinal cord structure were severely damaged. Precise microscopic techniques can successfully establish spinal cord injury model in rats, and diffusion tension imaging clearly visualizes the complete transection of the T10 spinal cord.

Objective To investigate the role of network platform for treatment and rescue of acute and severe cerebrovascular diseases in improving treatment level of patients with acute ischemic stroke.Methods The differences of number of patients accepted venous thrombolysis, number of patients accepted emergency intravascular interventional treatment, and time from admission to intravenous thrombolysis (door to needle time [DNT]) were analyzed in patients with acute ischemic stroke admitted to our hospital in the first year (2016) and the second and third years (2017 and 2018) of construction of network platform for treatment and rescue of acute and severe cerebrovascular diseases in Yunfu city. The National Institutes of Health Stroke Scale (NIHSS) scores were compared in 120 patients selected randomly from online referral (study group,n=60) and non-online referral (control group,n=60) within the same time periods in 2018.Results In 2017 and 2018, the number of patients accepted intravenous thrombolysis was 85 and 103, respectively, and the rate of intravenous thrombolysis was 9.92％ and 9.83％; they were all significantly larger/higher than those in 2016 (n=50, 6.97％,P<0.05). In 2017 and 2018, the number of patients accepted emergency endovascular treatment was 56 and 129, respectively, and the emergency endovascular treatment rate was 6.53％ and 12.31％; they were all higher than those in 2016 (n=44 and 6.14％), and the differences between those in 2018 and 2016 were statistically significant (P<0.05). The DNT ([82.00±18.75] min in 2017 and [77.00±32.17] min in 2018) was significantly shorter than that in 2016 ([109.00±30.58] min,P<0.05). The NIHSS scores of the study group and control group were 4.70±3.64 and 8.90±5.62, respectively, after one week of treatment, both of which were lower than those before treatment (14.30±6.29 and 13.60±6.37); and after treatment, the NIHSS scores of the treatment group were statistically lower than those of the control group (P<0.05). Conclusion Construction and effective operation of network platform for treatment and rescue of acute and severe cerebrovascular diseases is an effective guarantee to improve the success rate of treatment for patients with acute ischemic stroke.