Objective:To investigate the clinical efficacy of application of Shexiang Tongxin Dropping Pills in patients with coronary heart disease and heart failure due to qi deficiency and blood stasis syndrome. Methods:A prospective study was conducted with 66 patients with coronary heart disease and heart failure, all diagnosed with qi deficiency and blood stasis syndrome, who were admitted to the Department of Internal Medicine at Huzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine from January 2023 to March 2024. The patients were divided into a control group and an observation group, each consisting of 33 patients, based on the odd or even number of their hospital admission numbers. The control group received conventional treatment with Western medicine, while the observation group received Shexiang Tongxin Dropping Pills in addition to the treatment given to the control group. The clinical effects between the two groups were compared, and changes in heart function, traditional Chinese medicine syndrome scores, and serum biomarkers before and after treatment were collected and compared. Results:The overall response rate in the observation group was 96.97% (32/33), which was significantly higher than that of the control group at 75.76% (25/33) ( χ2 = 4.63, P < 0.05). After treatment, the traditional Chinese medicine syndrome scores in the observation group were significantly lower than those in the control group ( t = 9.03, 6.36, 5.55, 12.34, all P < 0.001). The left ventricular end-diastolic diameter, left ventricular end-systolic diameter, and left ventricular end-diastolic volume in the observation group were all lower than those in the control group ( t = 3.66, 7.69, 6.53, all P < 0.05). The 6-minute walk test results and left ventricular ejection fraction in the observation group were significantly higher than those in the control group ( t = -5.06, -18.10, both P < 0.001). The levels of N-terminal pro B-type natriuretic peptide, high-sensitivity C-reactive protein, and serum homocysteine in the observation group were all lower than those in the control group ( t = 18.09, 18.61, 10.87, all P < 0.001). Conclusions:Combining Shexiang Tongxin Dropping Pills with conventional treatment for patients with coronary heart disease and heart failure due to qi deficiency and blood stasis syndrome can effectively enhance clinical outcomes, alleviate symptoms, improve heart function, and reduce inflammatory responses.

Objective:To investigate the clinical efficacy of application of Shexiang Tongxin Dropping Pills in patients with coronary heart disease and heart failure due to qi deficiency and blood stasis syndrome. Methods:A prospective study was conducted with 66 patients with coronary heart disease and heart failure, all diagnosed with qi deficiency and blood stasis syndrome, who were admitted to the Department of Internal Medicine at Huzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang University of Traditional Chinese Medicine from January 2023 to March 2024. The patients were divided into a control group and an observation group, each consisting of 33 patients, based on the odd or even number of their hospital admission numbers. The control group received conventional treatment with Western medicine, while the observation group received Shexiang Tongxin Dropping Pills in addition to the treatment given to the control group. The clinical effects between the two groups were compared, and changes in heart function, traditional Chinese medicine syndrome scores, and serum biomarkers before and after treatment were collected and compared. Results:The overall response rate in the observation group was 96.97% (32/33), which was significantly higher than that of the control group at 75.76% (25/33) ( χ2 = 4.63, P < 0.05). After treatment, the traditional Chinese medicine syndrome scores in the observation group were significantly lower than those in the control group ( t = 9.03, 6.36, 5.55, 12.34, all P < 0.001). The left ventricular end-diastolic diameter, left ventricular end-systolic diameter, and left ventricular end-diastolic volume in the observation group were all lower than those in the control group ( t = 3.66, 7.69, 6.53, all P < 0.05). The 6-minute walk test results and left ventricular ejection fraction in the observation group were significantly higher than those in the control group ( t = -5.06, -18.10, both P < 0.001). The levels of N-terminal pro B-type natriuretic peptide, high-sensitivity C-reactive protein, and serum homocysteine in the observation group were all lower than those in the control group ( t = 18.09, 18.61, 10.87, all P < 0.001). Conclusions:Combining Shexiang Tongxin Dropping Pills with conventional treatment for patients with coronary heart disease and heart failure due to qi deficiency and blood stasis syndrome can effectively enhance clinical outcomes, alleviate symptoms, improve heart function, and reduce inflammatory responses.

Objective:To summarize the clinical characteristics of patients with epilepsy caused by focal cortical dysplasia (FCD), and identify the influencing factors for postoperative seizure controls.Methods:Fifty-seven patients with epilepsy caused by FCD admitted to Department of Neurosurgery, Third Affiliated Hospital of Zhengzhou University from July 2019 to November 2023 were chosen; standard preoperative evaluation, surgery, postoperative management and follow-up were performed. A retrospective study of clinical data, imaging and video electroencephalogram (VEEG) data, surgical approaches, pathological findings, and follow-up data was performed; influencing factors for postoperative seizure controls were analyzed.Results:In these 57 patients with epilepsy caused by FCD, 29 were males (50.88%) and 28 were females (49.12%). Onset age was 30.00 (8.00, 74.50) months, and surgery age was 95.00 (50.00, 138.50) months. Focal to bilateral tonic-clonic seizures (42/57; 73.68%) and epileptic spasms (13/57; 22.81%) were common seizure types. Cranial MRI was positive in 34 patients (59.65%), mainly manifested as abnormal cortical gyri/sulci morphology (17/57; 29.82%). In 43 patients accepted PET-CT, hypometabolic sites were detected in 40 (93.02%), and complete agreement between PET/MRI fusion results and actual lesion sites was noted in 40 (93.02%). FCD type I was noted in 16 patients (28.07%), type II in 39 (68.42%), and type III in 2 (3.51%). By December 2023, 44 (77.19%) had Engel grading I, 4 (7.02%) had grading II, 4 (7.02%) had grading III, and 5 (8.77%) had grading IV. Children with good prognosis (Engel grading I+II) and those with poor prognosis (Engel grading III+IV) showed significant differences in terms of time from first seizure to surgery, positive/negative MRI, and regularity of postoperative ASMs ( P<0.05). Conclusions:Focal to bilateral tonic-clonic seizure is the most common seizure type in patients with epilepsy caused by FCD, and abnormal cortical gyri/sulci morphology is the most common MRI manifestation; PET/MRI fusion imaging is superior to PET-CT or MRI in identifying epileptogenic foci. Poor seizure control can be noted in patients with long onset time to surgery, with negative cranial MRI results, or with irregular postoperative ASMs.

Objective:The aims of the study were to investigate the relationship among atherogenic index of plasma (AIP) and inflammatory adipocytokines with the severity of coronary artery calcification (CAC) score in coronary artery disease (CAD). And then we analyzed the diagnostic value of the new markers on CAC.Methods:A total of 241 patients with CAD diagnosed by coronary CT angiography (CTA) and coronary angiography in Baoding First Central Hospital from June 2019 to June 2020 were retrospectively enrolled. According to the presence of calcification in coronary CTA, they were divided into CAC group ( n=63) and non-CAC group ( n=178). The clinical data of the patients were collected, and the levels of serum inflammatory factors were measured by enzyme-linked immunosorbent assay (ELISA). The correlation between CAC score and AIP and inflammatory cytokines was analyzed. The diagnostic value of AIP and inflammatory factors in the formation of CAC in patients with CAD. Results:The levels of AIP, serum osteoprotegerin (OPG) and oligomeric matrix protein (COMP) in CAC group were higher than those in non-CAC group, while the levels of serum fibroblast growth factor 21 (FGF21) were lower than those in non-CAC group, with statistically significant difference (all P<0.01). Correlation analysis showed that CAC score of CAD patients was positively correlated with AIP, OPG and COMP ( r=0.581, 0.451, 0.326, P<0.05), and negatively correlated with FGF21 ( r=-0.294, P<0.05). Receiver operating characteristic (ROC) curve analysis showed that AIP, OPG, COMP and FGF21 had diagnostic value for CAC in CAD patients (all P<0.05). AIP>0.387, OPG>5.150 ng/ml, FGF21>136.35 pg/ml, COMP>733.16 ng/ml were independent factors affecting the formation of CAC (all P<0.05). Conclusions:The increase of AIP and the change of inflammatory factors can be used as markers for the diagnosis of CAC formation in CAD patients.

Objective Few studies are reported on the clinical characteristics of glioma-related epilepsy (GRE).Postoperative recurrence of epilepsy in some patients seriously affects their recovery.We aimed to explore the duration, frequency and type of the epileptic seizure as well as possible factors for postoperative recurrence of epilepsy.Methods We recorded the frequency and duration of epileptic seizures, analyzed the recurrence-related factors using the Cox regression model, and investigated the risk factors of recurrent epilepsy.Results The postoperative recurrence of epilepsy was found in 24 (26.97%) of the 89 cases, which, compared with the 65 non-recurrence cases, had a significantly longer seizure duration (7[3-10] vs 5[2-9] min, P<0.05) and higher onset frequency (6.5[4-9] vs 5[3-9] times/mo, P<0.05) preoperatively.After surgery, the 24 recurrence cases showed a remarkably reduced seizure duration (1[0.5-2.0] min, P<0.05) and onset frequency (1.5[1-3] times/mo, P<0.05).The main risk factors for epileptic recurrence included the level of the glioma-involved site (HR=6.728, 95% CI: 2.994-15.116), peritumoral edema (>2 cm) (HR=2.867, 95% CI: 1.210-6.795), brain wave type (HR=2.501, 95% CI: 1.058-5.914), and preoperative frequency of epileptic seizure (>6 times/mo) (HR=5.100, 95% CI: 2.437-10.677).Conclusion Postoperative recurrence of epilepsy is associated with the clinical pathological parameters, and the changes of the frequency and duration of epileptic seizures before and after surgery may provide some new theoretical reference for the treatment and prognosis of the disease.

Objective To explore expression of HMGB1 in glioma tissue of glioma-related epilepsy patients. Methods Immunohistochemistry was used to detect the expression of HMGB1 in the tissues from 82 glioma-related epi?lepsy patients (glioma-related epilepsy group), 80 glioma patients (glioma without epilepsy group), 80 intractable epilepsy patients (epilepsy control group) epileptogenic foci tissue and 20 normal controls (negative control group). Results HMGB1 in glioma tissue of glioma-related epilepsy group was significantly higher than that in glioma tissue of glioma without epilepsy grou p (χ2=16.944, P<0.001), especially in low pathological grade glioma tissue. HMGB1 was higher in glioma tissue of glioma-related epilepsy group than in epileptogenic foci tissue of epilepsy control group (χ2=26.094, P<0.001). Expression of HMGB1 in glioma tissue of glioma without epilepsy group (χ2=32.273, P<0.001) and epileptogenic foci tissue of epilepsy control group ( χ2=22.236,P<0.001) was higher than in normal brain tissue of negative control group. In glioma-related epilepsy group, HMGB1 was positively correlated with seizures duration(r=0.365,P=0.001), sei? zures frequency (r=0.531,P=0.000) and pathological grade of glioma tissue (r=0.265,P=0.016). Conclusions HMGB1 is highly expressed in glioma tissues of glioma-related epilepsy; HMGB1 expression is closely related with seizures; and HMGB1 in glioma tissue may contribute to the formation of glioma-related epilepsy.

Objective:To detect the functional role of Fascin1 and its related molecular mechanisms in migration and invasion capacity of glioma cells,we utilized gene specific small interference RNA of Fascin1 in cell line U87 MG. Methods:Fascin1-siRNA or negative siRNA was transfected into U87 MG cells of control group or experiment group. Transwell method was employed to assess the migration and invasion capacity of glioma cells. Western blot analysis was used to detect the protein expression of Fascin1,pAKT and pSTAT3. The impact of PI3K/AKT pathway and STAT3 pathway on migration and invasion of U87 MG cells was verified,via applying LY294002 and LY294002,which was inhibitor of the two pathways respectively. Results:As compared to control groups,the migration and invasion capacity of transfected glioma cells were attenuated about 52% or 43%(P<0. 05),accompanied with the decreased phos-phorylation of AKT and STAT3. As utilizing the inhibitors of AKT and STAT3,attenuated migration and invasion capacity of U87 MG cells were observed. Conclusion:Down-regulated expression of Fascin1 could suppress the migration and invasion capacity of U87 MG cells by inhibiting the phosphorylation of PI3K/AKT pathway and STAT3 pathway.

Objective To investigate the expressions and significance of erythropoietin producing hepatocellular cell line receptor A2 (EphA2) in pediatric brain glioma.Methods Seventy-eight fresh pediatric glioma specimens with a defined histological grade were collected in the Fifth Affiliated Hospital of Zhengzhou University from Jan.2009to Mar.2013,which included 36 of low grade glioma(Ⅰ-Ⅱ grade),42 of high grade glioma(Ⅲ-grade),another 33 cases with brain trauma line pressure to remove children brain tissues were collected as control group.The expressions of EphA2 mRNA and protein were detected by reverse transcription-polymerase chain reaction (RT-PCR),Western blot and immunohistochemistry.Results 1.RT-PCR and Western blot showed that EphA2 did not express in control brain tissue,but the expression levels of EphA2 mRNA were over-expressed in pediatric brain glioma,and the difference was statistically significant(F =36.271,P ＜ 0.05) ;the expression levels of EphA2 protein were significantly higher in high-grade pediatric glioma group than in low-grade pediatric glioma group,and the difference was statistically significant(F =42.839,P ＜ 0.05).2.Immunohistochemistry showed that EphA2 expression was negative in control group,the positive expression in low-grade glioma group was 88.57％,and the positive expression in high-grade glioma group was 100.00％.Moreover,the higher the grade glioma,distribution of EphA2 expression was stronger,and the difference was statistically significant(Z =4.962,P ＜ 0.05).Conclusions The mRNA and protein expression levels of EphA2 were significantly high in pediatric brain glioma which were associated with the grade of glioma.Therefore,EphA2 may participate in the development and progression of pediatric brain glioma.

Objective To investigate the influence of drug refractory temporal lobe epilepsy relapse shortly after surgery in its long-term efficacy.Methods The clinical data of 57 patients with medically intractable temporal lobe epilepsy,underwent surgery from August 2010 to August 2011 in our hospital,were retrospectively analyzed; all the patients were performed surgery,and postoperative treatment of epilepsy (adjustment antiepileptic drugs) in our hospital and rehabilitation center was chosen;the parallel regular follow-up clinic or telephone was also performed.According to the relapse situation one year after surgery,these patients were divided into control group (no epilepsy,n=18) and experimental group (relapse,n=39).Follow-up data,long-term efficacy and overall efficacy between the two groups were analyzed.Results (1) Postoperative medial temporal lobe sclerosis,neoplastic lesions,mixed lesions and normal patients were 27,7,10 and 13,respectively,counting for 47.37％,12.28％,17.54％ and 22.81％ of the patients; (2) on the second year of surgery,patients in the experimental group had 44.44％ satisfactory seizure control,which was significantly lower than those in the control group (74.36％,x2=4.839,P=0.028); (3) Kapan-Meier survival curve indicated that epilepsy remission rate in the control group was significantly higher than that in the experimental group on the second year of surgery (x2=5.928,P=0.017); (4) multivariate Logistic regression analysis showed that risk factors affecting the long-term efficacy included incentives recurrence (OR=4.511,95％CI:3.195-7.569),relapse frequency≥ 3 times (OR=4.281,95％CI:0.040-0.712) and recurrence of epilepsy type to complex partial seizure/generalized tonic-clonic seizures (OR=3.344,95％CI:3.186-8.400).Conclusion Drug refractory temporal lobe epilepsy relapse shortly after surgery will affect its long-term efficacy,and the determinate factors included incentives recurrence,relapse frequency≥ 3 times and recurrence of epilepsy type.

Objective To study the value and effectiveness of surgical management and mapping in supratentorial tumoral complicated with epilepsy and to study the correlations between tumor and the epileptogenic focus.Methods The clinical data of 121 patients with supratentorial cerebral tumor but epilepsy as initial symptom were retrospectively analyzed for the incidence of pre-and postoperative epileptic seizures,including grade Ⅰ glioma in 1 5 cases and grade Ⅱ glioma in 35 cases,grade Ⅲ-Ⅳglioma in 12 cases,menigoma in 32 cases,metastases in 10 cases,cavernous angiomas in 15 cases,and ependymomas in 2 cases.Results Surgery based on CT/MRI,seizure type and EEG changes was conducted.There was no death in operation.The highest incidence was in frontal lobe and the lowest in occipital lobe.Correlations between localization of tumor and the epileptogenic focus:there were 50 cases in the same location,near or beside tumors in 28 cases,far separate apart(＞2 cm)from tumors in 25 cases,no relationship was found in 18 cases.103 patients were followed up for one to nine years.31 patients had a few seizures in the early postoperative period.Epileptic seizures were cured without anti-epilepsy drugs in 83 cases.Conclusion There are some differences between tumors'location and epileptogenic focus in supratentorial tumoral epilepsy.The location and size of epileptogenic zone should be detected before and during operation.The resection of the tumor combined with the resection of the epileptogenic zone"epilepsy surgery"can provide good results.