Epileptogenesis is a dynamic process of gradual progression from normal developing brain to pathological epileptic brain， which is the latent and budding stage of epilepsy. Combining the understanding of epileptogenesis in children from Western medicine and traditional Chinese medicine （TCM）， we proposed that the viewpoints of constitutional transformation， phlegm pathogen inducing epilepsy， and brain collateral damage， which correspond to key pathological mechanisms， namely gene polymorphism， immunoinflammation， and microvascular dysfunction of the blood-brain barrier， respectively. Based on these insights， strategies for prevention and treatment of epileptogenesis in children， as well as potential research directions are explored.

Epilepsy is a chronic neurological disorder that often begins in childhood and can extend over the entire life course; therefore, it is necessary to establish a long-term, systematic life-course management model. Whole life-cycle disease management emphasizes interventions at key points in time and focuses on diagnosis and treatment points at all stages of life and disease processes. Guided by the concept of holism and preventive treatment, this article discussed the application strategies of TCM in the prevention, control, treatment, health and management of epilepsy in children at different stages. In the prevention period, the disease should be prevented first, and early screening should be carried out; in the control period, the disease should be prevented from changing, and the early intervention of Chinese materia medica should be carried out; during the treatment period, the combination of disease and syndrome and dynamic syndrome differentiation by stages were adopted; during the rehabilitation period, the treatment of different diseases with the same treatment should be emphasized to manage the comorbidity and improve the prognosis; in the long-term management period, the prevention and recovery after stroke should be focused on, and the comprehensive management scheme of TCM in the transition period from children to adults should be put forward. This article systematically expounded the role of TCM in improving seizure control rate and prognosis in the whole life-cycle management of childhood epilepsy, and actively explored the construction of the whole process health management system of chronic diseases.

The chemical properties of characteristic components are significant to the manufacturing quality control of big brand traditional Chinese medicine. In this study, the Huangjing Zanyu Capsules were used as the research carrier to determine the content of five characteristic components including icraiin, emodin, schisandrin A, 2,3,5,4'-tetrahydroxystilbene-2-O-β-D-glucoside, and osthole simultaneously by high-performance liquid chromatography(HPLC). The results showed that the chemical properties of five cha-racteristic components had a good linear relationship(r>0.999 9) within the quantitative range; the relative standard deviations(RSD) was 0.11%-2.0% and 0.25%-2.8% respectively for intra-day and inter-day precision; the RSD of repeatability was 1.8%-2.6%; the RSD of stability within 48 hours was 0.19%-2.8%, and the average recovery rate was 95.52%-100.1%, all meeting the requirements of pharmaceutical quantitative analysis. Additionally, the interval estimation method was used to directly reflect the distribution of samples with abnormal chemical properties of characteristic components, and the results showed ten samples were detected beyound the 95% control line of confidence level. Multivariate statistical process control(MSPC) method was used to monitor the abnormal samples of Huangjing Zanyu Capsules collectively, and the results showed that two samples were beyond the 95% control line of Hotelling's T~2 and three samples beyond the 95% control line of squared prediction error(SPE), indicating consistent quality control of Huangjing Zanyu Capsules. In conclusion, the proposed method is not only accurate and efficient but also a compensation for the traditional single-component quality control method, providing a scientific basis for the quality control in manufacturing process of Huangjing Zanyu Capsules. Furthermore, it could also serve as a reference method for the quality control in manufacturing big brand traditional Chinese medicine.
Capsules ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; Medicine, Chinese Traditional ; Quality Control

Objective To evaluate the effect and cost-effectiveness of three commonly used molluscicides, 4% "Luo-wei" (tea-seed distilled saponins, TDS), 50% niclosamide ethanolamine salt wettable powder (NESWP), and 26% metaldehyde and niclosamide suspension concentrate (MNSC) in large-scale field application, so as to provide the references for formulating the strategy of snail control. Methods The field test and parallel comparison were implemented. A marshland with Oncomelania hupensis snails of the Yangtze River was divided into 4 parts (10 hm²) for the research, and three of them were experimental areas while the last one was a blank control area. The experimental areas were sprayed with 4% "Luo-wei", 50% NESWP and 26% MNSC respectively for 3 times and the interval was 1 week. Seven days after each spraying the effect of snail control was investigated, and the costs of molluscicides, labor, transportation, fuel consumption and mechanical loss were recorded. The cost of each molluscicide, snail mortality, snail density, and the cost of increasing 1% of snail mortality per 100 m² were analyzed and compared. Results After the first, second and third spraying, the corrected snail mortality rates were 67.34%, 76.55% and 84.60% respectively in the 4% "Luo-wei" group; the corrected snail mortality rates were 64.71%, 75.17% and 83.89% respectively in the 50% NESWP group; the corrected snail mortality rates were 66.55%, 76.27% and 86.67% respectively in the 26% MNSC group. There was no significant difference among the 3 groups in the snail mortality at the same spraying time (χ² = 1.590, 0.571, 3.238, all P > 0.05) . In addition, along with the increase of the spraying times, the snail mortality of each group was increased significantly compared to that of the control group (χ² = 79.333, 94.718, 117.020, all P < 0.01) . After the first, second and third spraying, the reduction rates of snail density were 69.82%–86.60% in the 4% "Luo-wei" group, 68.66%–86.55% in the 50% NESWP group, and 71.89%–88.87% in the 26% MNSC group respectively. The decreasing amplitude of the snail density was more than 85% in all the experimental areas after 3 rounds of spraying molluscicide. The snail control costs per 100 hm² were 19.57, 11.97 Yuan and 10.47 Yuan in the 4% "Luo-wei" group, 50% NESWP group, and 26% MNSC group respectively. After the first, second and third spraying, the costs of increasing 1% of snail mortality per 100 m² were 0.30, 2.08 Yuan and 2.38 Yuan in the 4% "Luo-wei" group, 0.20, 1.10 Yuan and 1.32 Yuan in the 50% NESWP group, and 0.17, 1.04 Yuan and 0.97 Yuan in the 26% MNSC group respectively, and the cost-effectiveness was the highest at the first spraying in all the three groups. Conclusions The effects of the three molluscicides for snail control are similar, but the efficacy of snail control is reduced as the spraying time increases.

OBJECTIVETo examine the benefits of anterolateral thigh myocutaneous flaps in reconstruction of oral and maxillofacial defects.

METHODSPatients were recruited from February 2002 to June 2013 in the Department of Oral and Maxillofacial Surgery of Central South University. All patients (1,185 patients, 1,212 transferred flaps) underwent reconstructive surgery employing anterolateral thigh myocutaneous flaps. Basic information for all patients including defect side, flap size and type, recipient vessel processing method, donor complications, and postoperative quality of life were recorded and statistically analyzed.

RESULTSAmong the 1 212 transferred flaps, 1 176 survived and 36 showed necrosis, for a survival rate of about 97.0%. No cases presented with local serious complications, and 90% of patients achieved good functional recovery and aesthetically acceptable results after reconstruction of oral and maxillofacial defects at various locations using anterolateral thigh myocutaneous flaps. The time for anastomosis of one vein was significantly less than that for two veins (P=-0.000 3), which indicated one vein anastomosis could significantly reduce the operating time. The incidence of venous crisis, the survival rate after treatment, and the rate of venous crisis resulting in flap necrosis were comparable between the groups (P>0.05).

CONCLUSIONAnterolateral thigh myocutaneous flaps can be easily obtained and provide a good amount of muscle for filling dead space and fascia lata. These flaps can meet the various requirements of oral and maxillofacial defects. Therefore, the anterolateral thigh myocutaneous free flaps are more suitable for oral and maxillofacial defects than other flaps.

Free Tissue Flaps ; Humans ; Maxillofacial Abnormalities ; surgery ; Myocutaneous Flap ; Necrosis ; Quality of Life ; Reconstructive Surgical Procedures ; methods ; statistics & numerical data ; Surgery, Oral ; Thigh ; Wound Healing

BACKGROUND:Vascular grafts made of expanded polytetrafluoroethylene have been shown to have highly hydrophobic surface characterized by resistance to water penetration and biological durability. OBJECTIVE:To investigate the effects of vascular grafts made of expanded polytetrafluoroethylene for repair of peripheral arterial injuries. METHODS:Thirty-eight patients with peripheral arterial injuries, consisting of 30 males and 8 females, aged 17-61 years, were included in this study. After conventional fluid infusion, anti-shock treatment, anti-inflammation, and debridement, they received implantation of vascular grafts made of expanded polytetrafluoroethylene. A 12-month folow-up observation was performed to investigate the recovery of affected limbs and vascular patency in patients. RESULTS AND CONCLUSION:After implantation of vascular grafts made of expanded polytetrafluoroethylene, al vessels were unblocked and no cases died or had limbs amputated. Blood supply of al affected limbs recovered to normal and there was no vascular anastomotic infection. Imaging results showed that vascular patency rate was 100%. Ultrasound examination results showed that at the end of the folow-up period, the inner wal of the vascular grafts was smooth, obvious mural thrombus or anastomotic stenosis did not occur in any case, vascular patency rate was 92% (35/38), and no adverse reactions related to artificial vessels were observed. These findings suggest that vascular grafts made of expanded polytetrafluoroethylene for repair of peripheral arterial injuries exhibit striking surface anticoagulant property and long-term patency.

Objective??To?examine?the?benefits?of?anterolateral?thigh?myocutaneous?flaps?in?reconstruction?of?oral?and?maxillofacial?defects. Methods??Patients?were?recruited?from?February?2002?to?June?2013?in?the?Department?of?Oral?and?Maxillofacial?Surgery?of?Central?South?University.?All?patients?(1?185?patients,?1?212?transferred?flaps)?underwent?reconstruc-tive?surgery?employing?anterolateral?thigh?myocutaneous?flaps.?Basic?information?for?all?patients?including?defect?side,?flap?size?and?type,?recipient?vessel?processing?method,?donor?complications,?and?postoperative?quality?of?life?were?recorded?and?statistically?analyzed.?Results??Among?the?1?212?transferred?flaps,?1?176?survived?and?36?showed?necrosis,?for?a?survival?rate?of?about?97.0%.?No?cases?presented?with?local?serious?complications,?and?90%?of?patients?achieved?good?functional?recovery?and?aesthetically?acceptable?results?after?reconstruction?of?oral?and?maxillofacial?defects?at?various?locations?using?anterolateral?thigh?myocutaneous?flaps.?The?time?for?anastomosis?of?one?vein?was?significantly?less?than?that?for?two?veins?(P=0.000 3), which?indicated?one?vein?anastomosis?could?significantly?reduce?the?operating?time.?The?incidence?of?venous?crisis,?the?sur-vival?rate?after?treatment,?and?the?rate?of?venous?crisis?resulting?in?flap?necrosis?were?comparable?between?the?groups?(P>0.05).?Conclusion??Anterolateral?thigh?myocutaneous?flaps?can?be?easily?obtained?and?provide?a?good?amount?of?muscle?for?filling?dead?space?and?fascia?lata.?These?flaps?can?meet?the?various?requirements?of?oral?and?maxillofacial?defects.?Therefore,?the?anterolateral?thigh?myocutaneous?free?flaps?are?more?suitable?for?oral?and?maxillofacial?defects?than?other?flaps.

Objective To identify the factors that were predictive of outcome and to determine the effect of age on perioperative complications.Methods Reviewed the records of 1 100 consecutive patients who underwent anterolateral thigh flap free flap transfers for oral and maxillofacial cancer surgery defects between February 2002 and March 2013.All patients were divided into two groups:A group (＜60 years old) and B group (≥60 years old).Postoperative complications were analyzed from all patients.Results There were 781 cases in A group and 319 in B group.The overall success rate was 97.2％(1 100/l 132)[97.3％ (781/803) in A group,97.0％ (319/329) in B group,P＞0.05].The overall complication rate was 27.5％ (302/1 100)[25.9％ (202/781) in A group,31.3％ (100/319) in B group,P=0.064].Multivariate Cox regression analyses revealed that American Society of Anesthesiologists (ASA) status (P＜0.001),operation time (P=0.021) and comorbidity (P=0.002) were the independent factor for the complication of patients.However,age (P＞0.05) was not an independent factor for the complication of patients.Conclusions Oral and maxillofacial reconstruction using anterolateral thigh flap free flaps in elderly patients can achieve similar outcomes as in younger patients.Controlling operative time is very important in reducing postoperative complications and improving the results of surgery.

DiGeorge Syndrome ; genetics ; Humans ; Phenotype ; Twins, Monozygotic

Objective To summarize the anatomic characteristic of sigle pedicled double island free anterolateral thigh flaps and to evaluate its application and classification.Methods Between January 2010 and March 2013,76 patients underwent free femoral anterolateral double island flap reconstruction of the defects in oral and maxillofacial region.Summarized the anatomic features of perforators,such as the number and origin of the perforators.Results According to the anatomic features and regularity of perforators,76 cases of femoral anterolateral double island flaps were divided into 3 types:trunk type (type Ⅰ),15 cases (20％),in which the perforators of two flaps originated in descending branch and transverse branch of lateral femoral circumflex artery respectively; branch type (type Ⅱ),55 cases (72％),in which both the perforators originated in lateral femoral circumflex artery descending branch or lateral femoral circumflex artery transverse branch; bifurcation type (type Ⅲ),6 cases (8％),in which two perforators originated in the two bifurcation of one perforator.Among the 76 cases,75 survived and 1 showed partial necrosis.Conclusions According to the anatomic features and regularity of perforators,femoral anterolateral double island flaps can be divided into 3 types:trunk type (Ⅰ type),branch type (Ⅱ type),bifurcation type (Ⅲ type).