The epileptic eye and head movements during epileptic seizures may be much more complicated thanpeople originally understood, which can be ipsilateral or contralateral to the electroencephalographyfocus. Here, we describe a male patient with drug resistant focal seizures associated with a directionalseparation between head and eye movement before evolving into generalized tonic-clonic seizure.His contralateral head leading turning showed forced, sustained, and unnatural features companiedby ipsilateral eye staring. Stereoeletroencephalography monitoring was performed, and 4 habitualseizures were recorded over 5 days. Three seizures showed left head leading turning and generalizedtonic-clonic seizure, and only one showed dizziness and ringing in the ears. All the seizures showedthat the ictal onset contacts were located in the posterior inferior temporal sulcus which borders onthe anterolateral part of medial superior temporal area. The patient underwent a resection includingtemporooccipital region, and the histopathology showed focal cortical dysplasia type Ic. He has beenseizure free for two years after operation. The scores of the intelligence and memory quotient improvedhalf year after operation.

Aim To explore the inhibition of Sinica Maxim′s extract( CSME) on resistant infections of burn wounds,such as the methicillin-resistant staphylococcus aureus ( MRSA ) , resistant pseudomonas aeruginosa (RPA) and resistant escherichia coli(RECO). Meth-ods The resistant strains were cultured by MH agar plates. After resistance genes of quality control strains were extracted and appraised, such as mecA, mexB, merA, qacE△1-sull, tnpU/A and mexB, etc, and then,some projects of CSME were detected,such as the antibacterial spectrum, the minimum inhibitory con-centration(MIC), different concentrations of sensitive rate and inhibition curves, etc. Finally, these results were compared with the inhibitory effects of some anti-biotics to determine the sensitivity rates of CSME. Re-sults The MIC of CSME was 62. 5 ,125 ,250 g · L-1 respectively on the MESA, RPA and RECO. The inhi-bition rates of CSME appeared concentration-dependent on these three kinds of resistant bacteria,and the inhi-bition rates of the multi-concentration CSME on RECO were significantly lower than on MRSA and RPA ( P<0. 05). While in MIC,the resistance rates of MRSA on carbenicillin, cefazolin, erythromycin were significant-ly higher than those of CSME(P<0. 05); The inhibi-tion zones of CSME were significantly smaller than those of ceftriaxone, cefepime, imipenem, but greater than those of other antibiotics( P<0. 05 ); The inhibi-tion zones of CSME on RPA were significantly smaller than those of carbenicillin, and greater than those of other antibiotics ( P <0. 05 ) . The inhibition zones of CSME on RECO were significantly smaller than those of ceftriaxone,cefepime,imipenem,ciprofloxacin,nitro-furazone,and greater than those of other antibiotics ( P<0. 05 ) . Conclusions CSME has a significant inhi-bition on burn wound infection with these three kinds of resistant bacteria,such as MRSA,RPA and RECO. It is prompted that CSME could become one of the effective drugs to control burn wound infections with multi-re-sistant strains.

OBJECTIVE:To provide reference for the identification,processing,processing technology and research for ther-mal decomposition products. METHODS:Thermogravimetry- derivative thermogravimetry (TG-DTG) and differential thermal-de-rivative differential thermal (DTA-DDTA) analysis were conducted to scan thermal spectrum of tripterygium from 3 places and T. hypoglaucum,T. regelii,common counterfeits Actinidia arguta and Vitis quinquangularis,determine 7 medicinal materials,its dregs and extractum,and analyze differential spectrum of T. wilfordii and dregs. RESULTS:The TG-DTG and DTA-DDTA thermal spectrum were not only basically similar to each other but also to their dregs. There was a singlet main characteristics peak at about (299±3)℃ only in the DTG curves of extracts of tripterygium from 3 places and T. hypoglaucum extractum with similar intensity, while T. regelii,counterfeits A. arguta and V. quinquangularis showed multiple peaks,and (299 ± 3)℃ was not the main peak. CONCLUSIONS:The thermal spectrum can not distinguish tripterygium and its counterfeits;extractum DTG curves can do it;suit-able processing temperature of tripterygium was 200-380℃. The study can provide reference for the identification,processing,pro-cessing technology and research for thermal decomposition products.

Objective: To explore the risk factors for Type 1 cardio-renal syndrome (CRS1) atfer ST-segment elevation myocardial infarction (STEMI). Methods: A total of 378 patients with STEMI were divided into two groups: a CRS1 group (n=98) and a non-CRS1 group (n=280). Clinical characteristics in the 2 groups were compared, and independent risk factors for CRS1 after STEMI were analyzed, and the effect of emergency Results: In the 378 STEMI patients, CRS1 was found in 98 patients (25.9%). Between the 2 groups, there was significant difference in 12 parameters, including age, history of diabetes, admission mean arterial pressure, admission systolic blood pressure, admission heart rate, Killip classification, left ventricular ejection fraction, baseline serum creatinine, baseline evaluated glomerular ifltration rate (eGFR), emergency PCI, β-blockers and angiotensin converting enzyme inhibitor/angiotensin, receptor antagonist (ACEI/ARB) application (allP<0.05). Multivariate logistic regression showed that age, history of diabetes, admission systolic blood pressure, Killip classification, reduced left ventricular ejection fraction, reduced eGFR, emergency PCI non-undergo and ACEI/ARB non-use were independent risk factors for CRS1 atfer STEMI. In the 256 patients undergoing emergency PCI, 50 patients (19.5%) had CRS1. hTe door-ball time and the amount of contrast agent in the CRS1 group were signiifcantly higher than those in the non- CRS1 group (bothP<0.05), but there was no signiifcant difference in the blood lfow in the “culprit vessel”atfer the PCI (P>0.05). Conclusion: CRS1 is a common complication of STEMI, which is associated with many factors. Immediate revascularization can reduce the incidence of CRS1 in patients with ST-segment elevation myocardial infarction.

Objective To predict the risk of 28-day mortality in septic patients in intensive care unit (ICU) with the combination of Weighted index of comorbidities (WIC) and sepsis-related organ failure assessment (SOFA) score.Methods The clinical data of adult severe sepsis/septic shock patients in Department of Emergency Medicine of Changzheng Hospital and Department of Critical Care Medicine of Jinan Military General Hospital from October 2011 to February 2013 were analyzed retrospectively.The etiological factor,past history,having severe sepsis or not were recorded.Age score,WIC score,acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score and SOFA score were calculated at or 24 hours after admission.The logistic regression was used and the receiver operating characteristic curve (ROC curve) was drawn to calculate the patients' outcome.Results In 310 enrolled patients,223 (71.9％) patients survived and 87 (28.1％) died.Univariate analysis showed that the P values of the age score,WIC score,APACHE Ⅱ score and SOFA score,chronic cardiac insufficiency,type 2 diabetes,cerebrovascular disease,tumor,multiple injury,pulmonary infection and having severe sepsis or not were all less than 0.2.The above 11 variables were put into the multivariate logistic regression equation 1,of which predicted probability was reserved.It revealed that 5 variables were independently associated with 28-day prognosis,of which influence power in descending order were SOFA score [odds ratio (OR) =1.308,95％ confidence interval (95％ CI):1.158-1.478,P=0.000],having severe sepsis or not (OR =0.206,95％ CI:0.100-0.424,P=0.000),APACHE Ⅱ score (OR =1.090,95％CI:1.021-1.164,P=0.010),WICscore (OR=1.441,95％CI:1.067-1.947,P=0.017),agescore (OR=1.228,95％CI:1.027-1.468,P=0).024),the Walswere 18.554,18.369,6.725,5.662,5.067,respectively.The 3 variables,age score,WIC score and SOFA score,were brought into the multivariate logistic regression equation 2,of which predicted probability was reserved too.It revealed that age score (OR=1.330,95％CI:1.145-1.546,P=0.000),WIC score (OR =1.496,95％ CI:1.145-1.546,P=0.000) and SOFA score (OR =1.429,95％ CI:1.303-1.567,P=0.000),were independently associated with the septic patients' 28-day prognosis.There was no significant difference in the area under receiver operating characteristic curve (AUC) between the SOFA score and APACHE Ⅱ score (0.784 vs.0.780,Z=0.014,P=0.989).However,compared with APACHE Ⅱ score,the AUC of equation 1 (0.888) and 2 (0.851) were much more (Z=4.333,P=0.000; Z=2.669,P=0.008).Conclusion The sensitivity of 28-day prognosis by WIC score was improved greatly with the combination of SOFA score and age score.

Objective To estimate the predictive value of neutrophil gelatinase-associated lipocalin in urine (uNGAL) for detection of acute kidney injury (AKI) in the intensive care unit (ICU) critically ill patients.Methods A total of 110 patients from the ICU of three general hospitals were enrolled in the study.The patients were adults more than 18 years of age.After admitted to ICU,the patients were continuously observed for 72 hours.According to the RIFLE criteria for diagnosis of AKI,the patients were classified as AKI group (33 cases) or non-AKI (77 cases).According to the sepsis diagnostic criteria,the patients were classified as sepsis (79 cases) or non-sepsis (31 cases).Exclusion criteria of patients were chronic renal insufficiency,malignant tumor,death after admitted to ICU 24 hours.Serum creatinine and uNGAL of the patients were analyzed daily.The difference of uNGAL between sepsis and non-sepsis patients,AKI and non-AKI patients,sepsis non-AKI and sepsis AKI patients was compared.Moreover,the difference of serum creatinine and uNGAL between AKI and non-AKI patients into ICU 24 h was compared,and the sensitivity and specificity of uNGAL and serum creatinine for diagnosis of AKI in the ICU patients were evaluated using ROC curve.Results The uNGAL levels were all significantly different between sepsis and non-septis patients,AKI and non-AKI patients,sepsis concomitant AKI and sepsis without AKI patients.The uNGAL levels were significantly different between AKI and non-AKI patients in ICU for the first 24 h,while the difference of serum creatinine were not significant.The area under receiver operating characteristic (ROC) curve of uNGAL and serum creatinine of patients in ICU for the first 24 h were 0.828 (95％ CI:O.742-0.914) and 0.583 (95％ CI:0.471-0.695),respectively.The cutoff value of uNGAL was 170 ng/ml,and the sensitivity and specificity were 0.778 and 0.784,respectively.The sensitivity was superior to serum creatinine.Conclusions uNGAL was superior to serum creatinine in the diagnosis of AKI,and could be used as a marker of the early diagnosis of AKI.

Objective: To explore the cognitive level and the mental status of the patients suffering from perimenopausal syndrome in Shanghai, and to identify the traditional Chinese medicine syndrome distribution feature of perimenopausal syndrome. Methods: The cognitive level of the perimenopausal women was evaluated by using general living problem questionnaire. The mental status of the perimenopausal women was evaluated by using self-rating depressive scale. The traditional Chinese medicine syndrome distribution feature of perimenopausal syndrome was identified by using traditional Chinese medical symptoms questionnaire. Results: A total of 634 perimenopausal women finished the investigation. There were 74.76% (474/634) patients who knew little about the perimenopausal syndrome; 77.29% (490/634) patients had a depressive tendency; 8.36% (53/634) patients had depressive disorder. There were 72.40% (459/634) patients who had the symptoms such as susceptibility to anger and restlessness, restless sleep at night, thirst with dry throat and bitter taste, and all these symptoms could be classified into hyperactivity of heart and liver fire syndrome. Conclusion: Patients suffering from perimenopausal syndrome know little about this disease and mostly have depressive tendency, and the major traditional Chinese medicine syndrome pattern is hyperactivity of heart and liver fire based on the chief clinical manifestations of the patients.

OBJECTIVE: To determine the effect of Tongxinluo on the endothelial function and hypersensitive C-reactive protein (hs-CRP) in acute coronary syndrome patients undergoing percutaneous coronary intervention(PCI). METHODS: Thirty-three patients with unstable angina pectoris and 6 patients with acute myocardial infarction who underwent PCI for stenotic lesions of the coronary artery were enrolled. The patients were randomly assigned to a conventional group (n = 19) which took routine treatment or a tongxinluo group (n = 20) which took Tongxinluo(4 capsules once, 3 times per day) at the base of routine treatment after PCI. Nitric oxide synthase (NOS), nitric oxide (NO), endothelium-dependent vasodilation which was evaluated in the brachial artery flow mediated diameter(FMD) and hs-CRP were measured before the PCI and 24 hours and 3 months after the PCI. The correlation between NO and hs-CRP was analyzed. RESULTS: NOS, NO, and FMD in the 2 groups 24 hours after the PCI were significantly lower than those before the PCI(P < 0.05), but hs- CRP obviously increased (P < 0.05). NOS, NO, and FMD 3 months after the PCI in the 2 groups were significantly higher than those before the PCI (P < 0.05 or P < 0.01), but hs-CRP obviously decreased (P < 0.01).All indexes mentioned above in the Tongxinluo group showed greater changes than those of the conventional group(P < 0.05). NO was negatively correlated with hs-CRP (r = -0.3219, P<0.01). CONCLUSION Tongxinluo capsules have obvious beneficial effect on endothelial function and anti-inflammation in acute coronary syndrome patients undergoing PCI, by directly acting on the endothelium and indirectly inhibiting inflammation.
Acute Coronary Syndrome ; blood ; physiopathology ; therapy ; Aged ; Angioplasty, Balloon, Coronary ; methods ; C-Reactive Protein ; metabolism ; Drugs, Chinese Herbal ; therapeutic use ; Endothelium, Vascular ; drug effects ; physiopathology ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy

BACKGROUND: Modified banxia houpu decoction (MBHD) is one of thefamous methods and has been used by Zhang Zhong-jin to treat emotionaldiseases in Han dynasty, and it has been used till now. It can be used totreat depression, anxiety, phychoneurosis and so on.OBJECTIVE: To observe the therapeutic effect of MBHD on treatingheroin abusers with protracted abstinence syndrome and compare the effectwith brown sugar water.DESIGN: Randomized grouping and placebo randomized controlled study.SETTING: School of Medicine, Hubei Institute for Nationalities and theAbstinence Institute of Public Security Bureau of Enshi AutonomousPrepecture.PARTICIPANTS: Totally 187 cases were the abusers of heroin who hadbeen forced to abstinence in the Abstinence Institute of Public SecurityBureau of Enshi Autonomous Prepecture from August 2000 to September2002. There were 101 males and 86 females aged 18-44 years. All pa-tients were known the fact and were randomly divided into control group(n=58), 60-day MBHD group (n=62) and 72-MBHD group (n=67) accordingto double-blind method.METHODS: ① During the abstinence, three groups were treated bylofexidine hydrochloride (LFX) which was produced by the LimitedCompany of Zhengtai Pharmaceuticals Enterprise of Hunan Province (lotnumber: 990619, 10 mg/pill) for 12 days, then they were treated sepa-rated. Give medicine to 60-MBHD group continuously for 60 days (MB-HD: Pinellia Ternate 15 g, Magnolia Bark 30 g, Poria Cocos 20 g, Perilla10 g, Ginger 20 g, Radix Acanthopanacis Senticosi 20 g, Pericarpium CitriReticulate 6 g, Pericarpium Arecae 20 g, Herba Agastachis 10 g. Tradi-tional Chinese medicines were all bought from HuBei Medicine Company;three times a day, one portion for two days), gave the control group red sug-ar water imitate medicine for 60 days (the method was the same as above),72-MBHD group were given the same quantity of MBHD as 60-MBHDgroup when LFX began to detoxifieate, the whole time was 72 days (Thetime before LFX treat 12 days and after 60 days). It took 72 days for thethree groups to be treated by LFX according to single-blind method. ②Heroin protracted abstinence syndrome scale: insomnia, pain syndromes,catarrh syndromes, mental conditions and sexual function. They werescored respectively to 1, 2, 3 according to mild, moderate and severe.③ One year tater collected the urina sanguinis (three times a week con-tinuously) regarded the positive as re-abusers. ④ Measurement andenumeration data were compared with t test and x2 test respectively.MAIN OUTCOME MEASURES: ① Scores of protracted abstinencesyndrome; ② Comparisons of drug re-abusing rate within one year.RESULTS: Totally 187 heroin-dependence patients entered the finalanalysis. ① Scores of protracted abstinence syndrome were lower in 60-day MBHD group and 72-day MBHD group than those in control group(P ＜ 0.01). Scores of pain and catarrh symptoms in 72-day MBHD group were similar to those in 60-day MBHD group (P ＞ 0.05), but scores of insomnia, mental conditions and sexual function were lower than those in 60-day MBHD group (P ＜ 0.01). ② Drug re-abusing rate within one year was lower in 72-day MBHD group than that in control group and 60-day MBHD group [73% (49/67), 95% (55/58), 82% (51/62),P ＜ 0.05],but rate in 60-day MBHD group was similar to that in control group (P ＞ 0.05).CONCLUSION: MBHD can improve the protracted abstinence symptoms of heroin abusers after detoxification. In spite of the complexity of various factors, to effectively control the early stage abstinence symptoms and median stage protracted abstinence symptoms is one of the effective measures to prevent drug re-abusing.

BACKGROUND: It has been verified pharmacologically that honokiol (HL) and magnolol (ML) have distinct effects on central inhibition and muscle relaxation, and some reports prove that they can relieve morphine withdrawal symptoms in animals.OBJECTIVE: To explore the effects of HL and ML on β-endorphin (β-EP) in relieving morphine withdrawal symptoms in rats.DESIGN: Randomized controlled study.SETTING: Pharmacological Department, the Medical School of Hubei national College.PARTICIPANTS: The experiment was conducted from 13 to 29 April,2003. Among 100 adult male SD rats, 30 rats as control group were randomly divided into three subgroups: saline group, HL group and ML group with 10 in each group. The other 70 rats as morphine-dependent group were divided into normal saline group, 5, 40 and 80 mg/kg HL and ML groups with 10 in each group.METHODS: 0.2 mL normal saline, 80 mg/kg HL and 80 mg/kg ML were injected intraperitoneally into rats in control group. The dose of morphine subcutaneously injected was increased in the rats in morphine-dependent group for 6 days to establish the model of acute morphine dependence and model of natural morphine withdrawal symptoms. The last injection was performed at 9:00 on the morning of day 6, and the intraperitoneal injection was performed at 10:30 on the same morning. 0.2 mL normal saline was injected into the rats of saline group. 5, 40 and 80 mg/kg HL and 5,40 and 80 mg/kg ML were given to rats in the other six groups, respectively. Starting from 11:00, half an hour later, all natural morphine withdrawal symptoms were observed in rats within an hour.compared among rats in the 7 morphine-dependent subgroups.control groups than in normal saline group (P ＜ 0.01), and HL group had higher β-EP level than ML group (P ＜ 0.05). β-EP level was obviously lower in morphine-dependent+saline groups than in control+saline groups (P ＜ 0.01).β-EP level in morphine-dependent+5, 40 and 80 mg/kg HL groups and in morphine-dependent+5, 40 and 80 mg/kg ML groups was obviously higher Scores of natural morphine withdrawal symptoms in rats of morphine-dependent group: Scores of wetshakes, penile licking, escape attempts, and weight lost in HL and ML subgroups were obviously lower than those in saline group (P ＜ 0.01).CONCLUSION: HL and ML can markedly restrain morphine withdrawal symptoms and this restraint is related to the increase of β-EP level in the brain. HL and ML have equal inhibitory effects on morphine-dependent rats, but HL is more effective than ML in normal rats.