ObjectiveTo identify the early predictors of refractory epilepsy (RE). MethodsAll 173 epileptic patients with correct diagnosis and reasonable treatment were enrolled. The 106 patients were classified as drug non-responsive epilepsy (DNR-EP). The remaining 63 patients were classified as drugresponsive epilepsy (DR-EP). With multiple logistic regression, the clinical characteristics between the two groups were compared to identify the early predictors of RE. ResultsMultiple logistic regression analysis demonstrated that more than 10 seizures before treatment (OR =4. 46, 95％ CI 1.60-12. 40, P =0. 004),mental retardation at early time ( OR =19. 87, 95％ CI 3. 60-109. 78, P =0. 001 ) and abnormal electroencephalogram(EEG) with epileptiform wave after treatment ( OR =7.57, 95％ CI 2. 54-22. 56,P ＜0. 01 ) were independent predictors of RE.Response to initial therapy was a protective factor of RE (OR=0.05, 95％ CI 0.018-0. 139, P＜0.01). ConclusionPatients who have many seizures before treatment, mental retardation at the early time, epileptiform abnormality in EEG after treatment and who are resistant to initial therapy are likely to develop into refractory epilepsy.

No abstract available.
Humans ; Mucinoses

Objective To compare the efficacy of ultrasound-guided fine-needle aspiration(US-FNA)biopsy in diagnosing solid and complex thyroid nodules with different size. Methods One hundred and seventy-five thyroid FNA biopsies were prospectively performed on 168 patients ranging from 4 to 75 years of age. Sixty-three nodules were surgically excised and the others were clinically followed-up. The cytology diagnoses were categorized into four groups: benign, malignant, suspicious and unsatisfactory. Results There was no significant complication in the all 115 solid and 60 complex thyroid lesions and there were 36and 3 malignant nodules respectively in solid and complex thyroid nodules. The nondiagnostic rates of solid and complex nodules were 7％ and 8％. The accuracy of US-FNA in diagnosing complex thyroid nodules was comparatively equal to that of in solid thyroid nodules. In solid thyroid nodules, the sensitivity and accuracy in ≤1 cm group were similar to that of in ＞1 cm group. Conclusions US-FNA was an accurate and reliable method to diagnose thyroid solid and complex lesions.

To date, multiple genetic susceptible genes/loci associated with rheumatoid arthritis (RA) have been identified and confirmed through large-scale genetic association studies and genome-wide association study (GWAS). However, the heritability of RA could be not fully explained by these genetic factors, and gene-gene interaction might account for part of the missing heritability. Indeed, genetic interaction study is a critical research direction in the field of genetic epidemiology of RA, and these studies have provided novel insights into the genetic basis and pathogenesis of RA. Additionally, these studies have also provided scientific reference for risk prediction and prevention of RA. This review is aimed to present a summary of recent progress in genetic interaction study of RA, thus implicate further research in this field.

Objective To compare the operative precision between pioneer drilling guiding and full navigation guiding plates in the flapless immediate implantation. Methods Data of 50 immediate implants, which were implanted from 47 outpatients (50 implants) of Tianjin Stomatological Hospital from 2014 to 2016 were retrospectively analyzed. The patients were conducted on the pioneer drilling guiding system (22 implants) and full navigation guiding sytem (28 implants). The cone beam CT (CBCT) was preliminarily taken and modeled for each patient. All of the patients underwent implant surgery after making guiding plates by three-dimensional reconstruction, simulation planting design and the application of digital rapid prototyping technology. Cavity preparations were made by pioneer drilling and full navigation assisted with planting drills respectively to finish implantation. The post-operative CBCT was taken and performed the three-dimensional reconstruction. The implantation precision guiding by two systems were compared. Results All of the 50 immediate implants were successfully completed with the guiding plates. Implant mucositis appeared in one case after 3 months of temporary repair, and after the targeted therapy, the final repair was finished. The rest cases were finally completed. No implant was loose or fell off. The deviation was less in neck apex and root apex angle in full navigation group than that of pioneer drilling guiding group (P<0.01). But there was no significant difference in axial angle between the two groups after navigation and implantation (P>0.05). Conclusion The digital surgical guiding plates provide nice technical support for the application of the flapless immediate implantation. And the full navigation system has higher precision than that of the pioneer drilling navigation system.

OBJECTIVETo study the role of proximal nerve stimulation at Erb point in the early diagnosis of Guillain-Barré syndrome (GBS) in children.

METHODSThirty-two children who were diagnosed with GBS between October 2013 and December 2014 received neurophysiological examination. Thirty healthy children were used as controls. Compound muscle action potentials and distal motor latency of the median and ulnar nerves were determined and analyzed after nerve stimulation at the wrist, elbow, and Erb point in the two groups. Moreover, F-wave latency of the median nerve and H-reflex latency of the tibial nerve were measured and analyzed in the two groups.

RESULTSThe F-wave and H-reflex latencies were significantly longer in the patient group than in the control group (P<0.05). In thirty-two patients, the numbers of patients with abnormal amplitude, abnormal latency, and conduction block at Erb's point were 24 (75%), 22 (69%), and 20 (62%), respectively. The patient group had significantly lower amplitudes but significantly longer latencies of the ulnar and median nerves at Erb point than the control group (P<0.05). There were no significant differences in the amplitudes and latencies at the wrist and elbow between the two groups (P>0.05).

CONCLUSIONSThe nerve stimulation at Erb point holds promise as a routine examination for the early diagnosis of GBS.

Adolescent ; Child ; Early Diagnosis ; Electrodiagnosis ; methods ; Female ; Guillain-Barre Syndrome ; diagnosis ; physiopathology ; H-Reflex ; Humans ; Male ; Neural Conduction ; physiology ; Reaction Time

OBJECTIVETo construct a recombinant lentiviral vector for manganese superoxide dismutase (MnSOD) gene expression, and observe its effect on the proliferation of esophageal cancer cells in vitro.

METHODSChemical methods were employed for synthesis of the MnSOD cDNA sequence sections, along with the attB sites. Target gene fragment was constructed on the pMD-18T vector, and the recombinant plasmid pDONR221 was obtained after BP recombination reaction. Sequencing was followed by LR recombination reaction between the plasmid and DEST to obtain the lentiviral vector, which worked with helper plasmid for co-transfection of human embryonic kidney epithelial cells (293T cells). Amplification was done to determine its titer, and both transfection and selection procedures were made to get two stable transfected esophageal cancer TE-1 cell lines with medium MnSOD expression (TE-1Mm cells) and high MnSOD expression (TE-1Mh cell), and empty vector cell (TE-1Mn cells). Reverse transcription polymerase chine reaction (RT-PCR), immunofluorescence, immunocytochemistry and Western blot were used to detect the target gene with respect to its expression in the TE-1 cells. Additionally, colorimetric 3-[4,5-dimethy thiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) assay, agar colony formation assay, annexin V-FITC/PI staining and flow cytometry experiments were also conducted as to observe the influence of the medium and high MnSOD overexpressions on the proliferation of esophageal cancer cells.

RESULTSRT-PCR indicated that the transfected TE-1 cells showed positive MnSOD expression at different levels. Immunofluorescence, immunocytochemistry and Western blot suggested that TE-1Mm cells and TE-1Mh cells had MnSOD protein expression at different levels. MTT assay indicated that TE-1Mm cells had a significantly decreased survival rate compared with that of the two control cells (TE-1 cells and TE-1Mn cells), and TE-1 Mh cells had an significantly increased survival rate (P<0.05). The colony formation ability of TE-1Mm cells was (23.0 +/- 2.7)%, and that of TE-1Mh cells was (45.3 +/- 4.5)%, significantly different form the (34.7 +/- 4.2)% in TE-1 cells and (33.7 +/- 4.7)% in TE-1Mn cells (P<0.05). Annexin V-FITC/PI double staining experiment of the stably transfected cells cultured for 48 h showed that the early apoptosis rate in TE-1Mm cells was (10.6 +/- 1.0)%, significantly higher than (2.6 +/- 0.2)% in the TE-1 cells, (2.5 +/- 0.6)% in the empty vector cells and (1.0 +/- 0.1)% in the TE-1Mh cels (P<0.05). The fluorescence index (FI) of mitochondrial apoptosis of TE-1Mm cells was 0.948 +/- 0.019, significantly lower than that of TE-1 cell (1.000 +/- 0.022) and empty vector The fluorescence index of TE-1Mn cells (0.997 +/- 0.023) and TE-1 cells (1.000 +/- 0.022) were significant different from that of 0.948 +/- 0.019 in TE-1Mm cells and 1.076 +/- 0.022 in TE-1Mh cells, indicating a significant difference of mitochondrial apoptosis between the cell groups. FCM results indicated that the ROS fluorescence index of TE-1Mm cells was 0.859 +/- 0.040, that of TE-1Mh cells was 0.763 +/- 0.039, significantly lower than that of TE-1 cells (1.000 +/- 0. 042) and empty vector cells (1.002 +/- 0.047) (P<0.05).

CONCLUSIONSStably transfected cell lines with MnSOD expression have been successfully established. MnSOD overexpression shows bidirectional effect on the proliferation of esophageal cancer cells.

Apoptosis ; Cell Line, Tumor ; Cell Proliferation ; Esophageal Neoplasms ; metabolism ; pathology ; Gene Expression Regulation, Neoplastic ; Genetic Vectors ; HEK293 Cells ; Humans ; Lentivirus ; genetics ; Mitochondria ; pathology ; Plasmids ; RNA, Messenger ; metabolism ; Reactive Oxygen Species ; metabolism ; Recombinant Proteins ; genetics ; metabolism ; Superoxide Dismutase ; genetics ; metabolism ; Transfection

AIMTo synthesize four water-soluble metal porphyrins [5, 10, 15, 20-tetra[4-(4'-pyridine-1) butyloxy phenyl] metalloporphyrins bromide, metal = Zn (I), Cu (II), Mn (III) and Co (IV)] as analogous enzyme having two anti-active oxygen functions.

METHODSThe first function, scavenging O2-, has been proved by using riboflavine-methionine photoreduction methods. The second function, scavenging H2O2, has been demonstrated by using the oxidating Vit C. The third function, scavenging HO*, has been demonstrated by using Fenton reaction. The complexes were measured by the mice liver homogenate technique of mice.

RESULTSFour model compounds could scavenge O2- in the concentration range of 1.0 x 10(-5) - 1.0 x 10(-6) mol x L(-1), decompose H2O2 in the concentration of 1.5 x 10(-6) - 1.0 x 10(-6) mol x L(-1), scavenge HO* in the concentration of 2.0 x 10(-8) - 1.0 x 10(-8) mol x L(-1). All showed that they had obvious action of decreasing the lipid peroxidation in the concentration of 1.0 x 10(-7) mol x L(-1).

CONCLUSIONAll above-mentioned complexes were considered to be qualified analogous enzymes of anti-active oxygen.

Animals ; Cobalt ; Copper ; Free Radical Scavengers ; chemical synthesis ; pharmacology ; Hydrogen Peroxide ; metabolism ; Hydroxyl Radical ; metabolism ; In Vitro Techniques ; Lipid Peroxidation ; drug effects ; Liver ; metabolism ; Malondialdehyde ; metabolism ; Manganese ; Metalloporphyrins ; chemical synthesis ; pharmacology ; Mice ; Reactive Oxygen Species ; metabolism ; Zinc

Objective To investigate the level of homocysteine among healthy examination people and the possible related factors.Methods Retrospective analysis was performed to collect 1 259 results of healthy examination people from July to September in 2015,and 564 patients were confirmed to be hyperhomocysteinemia.The serum level of lipoids,glucose,uric acid and blood routine results were also collected.Results The incidence of hyperhomocysteinemia was 45.52％,and man has a higher rate than woman.The results of logistic regression showed positive results of UA (OR =1.006,95％ CI =1.005-1.008),HBG(OR =1.035,95％CI=1.026-1.045),and PLT (OR =0.996,95％ CI =0.993-0.998) in high hyperhomocysteinemia patients.Condusion High UA、HBG and low PLT levels are risk factors in hyperhomocysteinemia,and could be the important way for the early diagnoses of hyperhomocysteinemia.

Objective To investigate the current status,evolving hotspots,and emerging trends in the field of human re-source allocation research in public hospitals,both domestically and internationally,to provide a reference for future research di-rections in China.Methods CiteSpace was used to conduct a visual analysis of the research literature on human resource alloca-tion in public hospitals based on China National Knowledge Infrastructure(CNKI)and the Web of Science(WOS).The analysis encompassed co-authorship,institutional collaboration,keyword co-occurrence and clustering,and burst detection.Results A total of 1 417 Chinese articles and 981 international articles were included.Domestic research in this field focused more on healthcare reform and management,resource allocation,hierarchical diagnosis,and treatment,and informatization and efficiency improvement.On the contrary,international research primarily centered on the employee satisfaction,healthcare system quality,work environment and medical staff.Future trends in domestic research included cost reduction,efficiency enhancement,and a greater emphasis on public welfare in public hospitals,while international research was beginning to explore the influence of polit-ical concepts in this field.Conclusion Compared to international research,domestic research needs to further improve its theo-retical and localized understanding,broaden its research scope,explore the interdisciplinary collaboration opportunities,and delve into research directions such as the application of artificial intelligence and automation technology in healthcare services,management of a diverse workforce,and innovative management techniques and applications.