Objective To explore the treatment gap and influencing factors of convulsive epilepsy in rural areas of Jiangsu Province.Methods The clinical data of 7836 rural convulsive epilepsy patients screened from 2005 to 2020 were statistically analyzed,and the treatment status,treatment gap and related influencing factors of epilepsy patients were analyzed.Results A total of 7836 patients with convulsive epilepsy were enrolled in this study.The treatment gap for convulsive epilepsy in rural areas of Jiangsu Province was 69.05%.There was no significant difference in the treatment gap between different genders(P＞0.05).There were statistically significant differences in the treatment gap between age(χ2 = 12.196,P =0.007),age of onset(χ2 =58.658,P＜0.001),disease duration(χ2 =65.430,P＜0.001),seizure frequency(χ2 =171.276,P＜0.001),and hospitalization level(χ2 = 122.076,P＜0.001).Multivariate Logistic regression analysis showed that the older the age of onset was,the shorter the course of the disease was,the more frequent the seizures was,and the greater the treatment gap in patients with epilepsy was(all P＜0.05).Patients aged 45-59 years(P =0.012)and treated in municipal and county hospitals(P＜0.001)were more likely to receive regular anti-epileptic treatment.Conclusions There is a significant treatment gap for convulsive epilepsy patients in rural areas of Jiangsu Province.This may be due to insufficient awareness of epilepsy and the underdevelopment of primary healthcare institutions.

Objective:To investigate the effects of blood glucose target management combined with early hemoperfusion on inflammatory reaction and stress in patients with hyperlipidemic acute pancreatitis (HL-AP).Methods:A prospective cohort study was used. One hundred and fifty-nine patients with HL-AP from September 2019 to September 2022 in Zhoukou Central Hospital Affiliated to Xinxiang Medical University were selected. The patients were divided into group A, B and C by random number table method with 53 cases in each group. All patients were given routine treatment. On this basis, the patients in group A were given blood glucose target management, the patients in group B were given early hemoperfusion, and the patients in group C were given blood glucose target management combined with early hemoperfusion. Before treatment and 7 d after treatment, the inflammatory factors (including interleukin-10, IL-10; interleukin-18, IL-18; tumor necrosis factor-α, TNF-α; soluble intercellular adhesion molecule-1, sICAM-1; procalcitonin, PCT; high mobility group protein B1, HMGB1; nuclear factor-κB p65, NF-κB p65), stress indexes (including lipid hydrogen peroxide, LHP; advanced protein oxidation products, AOPPs; catalase, CAT; glutathione peroxidase, GSH-Px; epinephrine, E and cortisol), intestinal mucosal barrier indexes (including D-lactate; diamine oxidase, DAO; endotoxin) and hemorheological indexes (including platelet adhesion rate, plasma specific viscosity, whole blood specific viscosity high shear and thrombus length) were detected. The recovery indexes (urinary amylase recovery time, bowel sound recovery time, exhaust recovery time, abdominal pain relief time and hospitalization time), adverse reactions and curative effect were recorded.Results:There were no statistical differences in the detection indexes before treatment among three groups ( P>0.05). Seven days after treatment, the IL-10, CAT and GSH-Px in group C were significantly higher than those in group A and group B. The IL-18, NF-κB p65, TNF-α, sICAM-1, PCT, HMGB1, LHP, AOPPs, E, cortisol, D-lactic acid, DAO and endotoxin were significantly lower than those in group A and group B with statistical differences ( P<0.05), but no statistical differences in the indexes between group A and group B ( P>0.05). Seven days after treatment, the platelet adhesion rate, plasma specific viscosity, whole blood specific viscosity high shear and thrombus length in group C were significantly lower than those in group A and group B, while the indexes in group B were significantly lower than those in group A, with statistical differences ( P<0.05). The urinary amylase recovery time, bowel sound recovery time, exhaust recovery time, abdominal pain relief time and hospitalization time in group C were significantly shorter than those in group A and group B: (5.73 ± 0.64) d vs. (7.49 ± 0.89) and (7.26 ± 0.85) d, (2.45 ± 0.31) d vs. (5.76 ± 0.73) and (5.83 ± 0.79) d, (2.69 ± 0.42) d vs. (6.04 ± 0.81) and (6.07 ± 0.82) d, (1.87 ± 0.29) d vs. (3.58 ± 0.45) and (3.65 ± 0.46) d, (15.24 ± 1.76) d vs. (18.61 ± 2.29) and (18.78 ± 2.34) d, with statistical differences ( P<0.05), but no statistical differences in the indexes between group A and group B ( P>0.05). The total effective rate in group C was significantly higher than that in group A and group B: 90.57% (48/53) vs. 67.92% (36/53) and 60.38% (32/53), with statistical difference ( P<0.05), but no statistical difference in the total effective rate between group A and group B ( P>0.05). There was no statistical difference in the incidence of adverse reactions among three groups ( P>0.05). Conclusions:The blood glucose target management combined with early hemoperfusion in the treatment of HL-AP can effectively reduce inflammatory reaction and stress state, protect intestinal mucosal barrier function, improve blood rheology, and promote recovery.

Epilepsy is a common neurological disease, and studies have shown that some epilepsy patients are combined with cognitive impairment. In clinical practice, it has been found that, in addition to the seizure itself, anti-seizure medications can also have a corresponding impact on the cognitive function of epilepsy patients. However, the effects of some drugs on the cognitive function of epilepsy patients are still inconclusive, and the mechanism of their influence on cognitive function in epilepsy patients is not elucidated. In recent years, some studies followed up the cognitive function of patients receiving anti-seizure medications therapy, and put forward guidance. This article focused on the research of commonly used drugs on cognitive function, the possible mechanism of drugs affecting cognitive function, the rational use of drugs in different groups of people and the prevention strategies of related cognitive dysfunction, hoping to improve emphasis on cognitive function in epilepsy patients and guide clinical practice.

Objective:To explore the psychometric characteristics of the Chinese version of the health-related social capital scale.Methods:From March to May 2020, after the original scale was translated into Chinese following the Brislin improved translation model, 251 community-dwelling senior citizens aged 65 and above were selected by convenient sampling method. Data analysis was conducted using SPSS 22.0 and AMOS 22.0, including tests of significance, correlation analysis, exploratory factor analysis, and confirmatory factor analysis.Results:Exploratory factor analysis extracted three factors: social participation, social cohesion, and reciprocity, which accounted for a cumulative contribution rate of 61.72%. Confirmatory factor analysis showed that the three-factor model fitted well(χ 2/ df=1.22, RMSEA=0.04, CFI=0.98, GFI=0.93, IFI=0.98, TLI=0.97). Social capital was significantly correlated with perceived social support positively ( r=0.36, P<0.01), and with loneliness negatively ( r=-0.30, P<0.01). The three factors were significantly correlated with the total scale ( r=0.85, 0.50 and 0.52, respectively, all P<0.01). And correlations between the items of each factor were 0.24-0.55, 0.30-0.59, 0.44-0.70, respectively(all P<0.01). The Cronbach's α coefficients of the total scale and three factors were 0.74, 0.72, 0.65 and 0.62, respectively(all P<0.01), and their retest reliability were 0. 92, 0. 87, 0. 82 and 0. 96, respectively(all P<0.01). Conclusion:The Chinese version of health-related social capital scale conforms to the three-factor model with good reliability and validity, which can be used to assess the social capital status of community-dwelling older adults in China.

Objective:To investigate the clinical characteristics and gene sequencing results of NDM, so as to provide evidence for clinical diagnosis and treatment .Methods:Clinical data of 1 child diagnosed with NDM in Hebei People's Hospital in January 2021 were retrospectively analyzed, and DNA gene sequencing was performed in the peripheral blood of the child, and relevant literatures were reviewed.Results:The child was born with a weight of 2.2kg. On the second day after birth, blood glucose significantly increased and insulin and C-peptide levels decreased. After 14 days of insulin treatment, hyperglycemia was still present, which was consistent with the diagnosis of NDM. Genetic testing indicated that there were missense mutations of newborn compound heterozygote in ABCC8 gene: c. 752G > A (p.G251E), c. 772A > G (p.R258G). The mutation of c. 772A > G in ABCC8 gene had not been reported before, and sulfonylureas were effective for the treatment of the child.Conclusion:NDM is a rare monogenic genetic disease with a lack of specificity in clinical manifestations. For children diagnosed or suspected of NDM, genetic testing should be actively carried out, which is of great significance for clinical diagnosis, treatment and prognosis.

Objective:To translate the English version of the health enhancement lifestyle profile-screener into Chinese and assess its reliability and validity based on classical test theory(CTT) and Rasch model among the elderly.Methods:A total of 447 older adults from rural and urban areas in Sichuan Province from December 2020 to March 2021 were selected by convenience sampling, and were surveyed with the revised Chinese version of health enhancement lifestyle profile-screener(HELP-CS). Rasch and CTT-based approaches were used to evaluate the unidimensionality data-model fit, internal consistency, test-retest reliability, criterion validity and discriminant validity of the questionnaire.Results:According to the results of the initial test questionnaire, the ninth question was deleted, and 14 items were retained to form a formal questionnaire. The formal test results showed that HELP-CS met the unidimensionality, and the residual mean square error for item 2 and 14 were within the acceptable range, which were 1.49 and 1.41. Item 10 and 12 had the highest logits, which were 1.87 and 1.91 respectively. There were gender differences in some topics. The Cronbach′s α of the scale was 0.719, and the test-retest reliability was 0.704 after two months. The criterion correlations with HPLP-CE were 0.581.Conclusion:HELP-CS has good adaptability, reliability and validity in the elderly, and can be used as a quick and effective screening tool in the study of the lifestyle of the elderly.

Objective:To investigate the safety and efficacy of early oral feeding in the treatment of mild acute pancreatitis (MAP).Methods:Data of 100 MAP patients from April 2015 to June 2018 admitted in Department of General Surgery in Shanxi Bethune Hospital were collected. According to the time of food intake through the mouth, the patients were divided into early oral feeding group (food intake started when the symptoms of abdominal pain and abdominal distension were alleviated with gastrointestinal functional recovery, but serum amylase and lipase did not decrease to a level below 2 times of normal upper limits) and traditional oral feeding group (food intake started when the symptoms of abdominal pain and abdominal distension were alleviated with gastrointestinal functional recovery, but serum amylase and lipase decreased to a level below 2 times of normal upper limits), with 50 cases in each group. The incidence of abdominal pain or bloating, serum amylase, CRP, organ dysfunction, morbidity and mortality, and median length of hospital stay after eating were compared between the two groups.Results:There were no statistically significant differences on gender, age, etiology, abdominal pain and distension, increased serum amylase, increased blood CRP, and number of organ dysfunction cases between two groups, and there were no deaths in either group. However, the feeding time and length of hospital stay in the early oral feeding group were significantly shorter than those in the traditional oral feeding group, and the differences were statistically significant [(3.00±0.18)d versus (4.84±0.27)d, (8.24±0.33) D versus (9.00±0.26)d, both P<0.05]. Conclusions:Early oral feeding in MAP patients did not aggravate the disease, but helps to correct the nutritional status of the patients, with higher safety and effectiveness.

Objective:To investigate the mediating and moderating effects of resilience on frailty and depression in the community-dwelling old adults.Methods:Totally 871 community-dwelling old adults chosen from different communities were investigated by the geriatric depression scale, Tilburg frailty indicator and 10-item Connor-Davidson resilience scale.SPSS 22.0 and AMOS 24.0 were used for data analysis, including descriptive analysis, correlation analysis, structural equation modeling and hierarchical regression analysis.Results:(1)The score of frailty (3.72±2.89)was positively correlated with the score of depression (2.63±2.57, r=0.16-0.58, P<0.01). The score of resilience(28.24±6.80) was negatively correlated with the score of frailty and depression ( r=-0.10~-0.49, both P<0.01), and frailty predicted 35% of the total variation of depression in the elderly.(2)The mediating effect of resilience was significant and the indirect effect was 0.10, accounting for 12.66% of the total variance.(3) Resilience moderated the relationship between frailty and depression ( β=-0.12, t=-4.11, R2=0.41, P<0.001). The frailty of old adults with lower resilience played a stronger predictive role in depression (simple slope=0.50, t=14.73, R2=0.01, P<0.001). Conclusion:There is a close relationship between frailty and depression in the community-dwelling older adults, and resilience plays both mediating and moderating role in the relationship.

Objective To investigate the resilience characteristics of the elderly disabled,and the effects of individual,family and social factors on resilience.Methods A total of 138 disabled older adults from four districts of Chengdu City were investigated by 10 items Connor-Davidson resilience scale (CDRISC-10),the automatic thoughts questionnaire (ATQ),self esteem scale (SES),revised eysenck personnality questionnaire short scale for chinese(EPQ-RSC) and self-made population sociology questionnaire.Totally 194 community-dwelling older adults without disabilities,as a comparative population,were included in the analysis.Results Compared with the community-dwelling elderly without disability (35.58 ± 5.75,18.13±3.48,18.43±3.08),the scores of resilience(21.38±7.71),strength(10.50±4.08) and hardiness (10.88±4.07) of the elderly disabled were significantly lower(t=-19.56,-17.81,-18.34,P＜0.01).There were no significant differences in the resilience scores of the elderly disabled in terms of gender,urban and rural sources,marital status,education,disability level and family atmosphere.However,there were significant differences in age,disability causes,disability type and family economic conditions (age:thardiess =2.18,P＜0.05.disability causes:tresilience =-2.75,tstrength =-2.22,thardiness =-2.68,P＜0.05.disability type:Fhardiness =2.60,P＜ 0.05.family economic conditions:Fresilience =5.45,Fstrength =4.78,Fhardiness =5.21,P＜0.01).The resilience,automatic thoughts,self-esteem and personality were significant correlation with each other(r=-0.16-0.65,P＜0.05).After controlling age,disability causes,disability type and family economic conditions,self esteem(β=0.291,P＜0.01),extraversion (β=0.287,P＜0.01) and neuroticism (β=-0.254,P＜0.05) were important influential factors of resilience,explained 32.0％ variance in resilience.Conclusion It may be an important way to improve resilience level of the elderly disabled by enhancing their selfesteem,promoting their psychological adjustment and strengthening their emotional management.

Objective To investigate the feasibility and safety of using vasodilators in the treatment of neonates with patent ductus arteriosus (PDA) accompanied by acute heart failure and pulmonary edema. Methods The clinical data of a case of neonatal PDA accompanied by severe cardiac insufficiency and pulmonary edema in Department of Intensive Care Unit (ICU) of Hebei General Hospital, and the neonate's hemodynamic characteristics and the efficacy and adverse reactions of phentolamine, a vasodilator, in the treatment of PDA were retrospectively analyzed. Results In this neonate, on the 8th day after birth and the improvement of pulmonary hyaline membrane disease, the respiratory distress occurred again, which was related to the severe cardiac dysfunction caused by the opening of PDA. Phentolamine was given on the basis of routine treatment to reduce systemic circulatory resistance. Two hours later, the respiratory distress was relieved significantly, that was presumably related to the decline of the left to right shunt volume through the PDA. There were no adverse reactions such as blood pressure reduction and coronary insufficiency. Conclusion Neonatal PDA is easily to be complicated with severe cardiac insufficiency, and vasodilators can reduce systemic circulatory resistance, reduce left to right shunt volume through the ductus arteriosus, and reverse the acute cardiac insufficiency and pulmonary edema, the therapeutic effect of vasodilators is remarkable, safe and reliable in neonatal PDA.