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Objective:To observe the clinical effect of Perampanel on the add-on therapy in children with drug-resistant epilepsy.Methods:Clinical data of children with drug-resistant epilepsy treated with add-on therapy of Perampanel in the Department of Pediatrics, Fujian Medical University Union Hospital from January to June 2020 were retrospectively analyzed, aiming to assess the therapeutic efficacy of Perampanel on the add-on therapy of drug-resistant epilepsy.The self-control effective rate of Perampanel before and after treatment were counted.Results:A total of 20 cases of 2-12 year-old children with drug-resistant epilepsy were collected, including 14 males and 6 females.Their mean age, age of onset and course of disease were (5.82±2.39) years, (3.41±1.96) years and (2.40±1.48) years, respectively.Among them, 1 case had simple partial seizures, 7 cases had complex partial seizures, 1 case had generalized seizures and 5 cases had epilepsy syndromes, there were 6 cases with undetermined seizure attack.After 3-month add-on therapy of Perampanel, 4 cases of children with drug-resistant epilepsy were seizure-free, 8 cases had the reduced frequency of seizure for 50% or more, 2 cases had the reduced duration of seizure, 1 case had the reduced severity of seizure, while 4 cases did not respond to perampanel and 1 case was aggravated.Based on the criteria of reduced frequency of seizure for more than 50%, the therapeutic efficacy of add-on therapy of Perampanel achieved 60% in children with drug-resistant epilepsy.Conclusions:The third generation of anti-seizure medication Perampanel can effectively reduce the frequency of seizure, especially in the elder children and those with certain epilepsy syndromes.
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Objective:To investigate the correlation between intraplaque hemorrhage (IPH) and new-onset embolic cerebral infarction after basilar artery angioplasty or stenting.Methods:Consecutive patients with severe basilar atherosclerotic stenosis underwent basilar artery angioplasty or stenting in the Department of Neurology, Guangdong Provincial Hospital of Chinese Medicine from January 2015 to February 2022 were retrospectively enrolled. High resolution magnetic resonance vessel wall imaging (HRMR-VWI) and diffusion-weighted imaging (DWI) were performed within one week before procedure, and brain DWI or CT examination was performed within 72 h after procedure to determine the patients with new-onset embolic cerebral infarction.Results:A total of 32 patients were enrolled in the analyze. IPH existed in 10 patients with basilar artery culprit plaque, and 5 had new-onset embolic cerebral infarction after procedure. The incidence of embolic cerebral infarction in the IPH group was significantly higher than that in the non-IPH group (50% vs. 0%; P=0.001). The proportion of patients with IPH in the embolic cerebral infarction group was significantly higher than that in the non-embolic cerebral infarction group (100% vs. 18.5%; P=0.001). Conclusion:IPH may be associated with new-onset embolic cerebral infarction after basilar artery angioplasty or stenting.
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Objective To evaluate the implementation and effectiveness of syphilis prevention and control in Hubei Province from 2011 to 2020, to summarize the experience and practice, to analyze the existing problems and causes, and to study and put forward policy and strategy suggestions, so as to provide reference for formulating the national “14th five-year plan” and carrying out the next step of prevention and control work. Methods The National STD Prevention and Control Management Information System, STD Prevention and Control New Media Health Service Platform, National AIDS Comprehensive Prevention Information System, and National Management Information System for the Prevention of AIDS, Syphilis, and Mother-to-Child Transmission of Hepatitis B were used to analyze and evaluate the completion of main prevention and control indicators in Hubei Province. Results Among the 16 evaluation indexes, 10 indexes including the effectiveness of syphilis promotion and training for various groups of people, the proportion of pregnant women undergoing syphilis testing in the monitoring and testing work, and the effectiveness of syphilis prevention and treatment, all met the requirements of the plan. In addition, some of the 5 indexes failed to meet the requirements of the plan. Conclusion Hubei Province has fairly fulfilled the work requirements of the Plan. It is still necessary to strengthen the syphilis prevention and control to ensure the urban pregnant women infected with syphilis and their infants to receive standardized STD diagnosis and treatment services, and the drug users in the drug maintenance treatment clinic to receive free syphilis testing, and to provide referral services for the syphilis antibody positive patients at AIDS voluntary counseling and testing points.
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Objective To investigate the prevalence and epidemiological characteristics of enuresis in children aged 5-13 years old in Jinshan District, Shanghai, and analyze the relevant pathogenic factors, so as to provide a reference for clinical prevention and treatment of enuresis in children and related psychological diseases. Methods Using the medical history collection table (CMT checklist) of ICCS (International Association for Urinary Control of Children) as a guidance, a random cluster sampling was performed on 1 000 preschool and school-age children from 9 representative schools with a relatively concentrated population in Jinshan District. Results Excluding the missing and invalid questionnaires, a total of 785 cases were included in the study, and the total prevalence of enulists in 5-13 children was 7.77% (61 cases), among which 42 cases were 5-7 years old (68.85%), 12 cases were 8-10 years old (19.67%), and 7 cases were 11-13 years old (11.48%). There were statistically significant differences among the age groups (χ2=52.87，P=0.001)). Among the affected children, 3.31% (26 cases) were in urban areas and 4.46% (35 cases) in rural areas (P<0.05). The prevalence of boys (38 cases) and the prevalence of girls (23 cases) were statistically significant (P<0.05). The characteristics of enuresis, organic diseases, and attention were analyzed in 61 children diagnosed with enuresis. Children with enuresis ≥7 times/week were the highest (33 cases), accounting for 54.10%; children with 3-6times/week (19 cases) accounted for 31.15%; 2 times/week (9 cases) accounted for 14.75%. Physical examination abnormalities (including urinary routine abnormalities: urinary tract infection, hematuria, high urinary calcium or phimosis) were found in 18 cases, accounting for 29.51%. Four patients (6.56%) had a family history of enuresis. Fifty-two (85.25%) of the affected children had psychologically related problems: introverted personality, impulsiveness, inferiority, lack of concentration, medium or inferior academic performance. Conclusion The prevalence of enuresis in 5-13 children was 7.77%. There were significant differences between urban and rural areas, different age groups and genders as well. Most sick children developed organic diseases and some degree of psychological problems. A timely diagnosis and treatment of enuresis in children in combination with psychological guidance and behavioral intervention is necessary for the prevention of the occurrence of enuresis related psychological problems.
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Objective To study the value of radiofrequency ablation of gallbladder beds in radical surgery for stage T1b gallbladder cancer.Methods A retrospective study was conducted on 21 patients with stage T1 b gallbladder cancer treated in the Department of Hepatobiliary Pancreas and Spleen Surgery,West Campus,Beijing Chaoyang Hospital,Capital Medical University,from April 1,2011 to March 31,2019.Patients who were diagnosed with frozen section during operation were included into the surgery group.Patients who were diagnosed postoperatively and underwent radical surgery for the gallbladder carcinoma were included in the secondary surgery group.The differences in surgical time,bleeding volume,survival rate,and survival time between the two groups after regular follow-up were compared,and the 5-year cumulative survival rates and overall survival time of the two groups were calculated.Results All patients underwent radical gallbladder cancer surgery.There were 14 males and 7 females,aged from 26 to 70 (49.0 ± 13.5)years.There were no perioperative deaths.There were 15 patients in the operation group,and 6 patients in the secondary surgery group.The bleeding volume of the surgery group was significantly less than the secondary surgery group [(101.3 ± 35.5) ml vs.(177.0 ± 44.6) ml,P ＜ 0.05].There were no significant differences in surgical time,survival rate,and survival time between the two groups (all P ＞ 0.05).The 5-year cumulative survival rate for the two groups of patients was 56.5％,and the overall survival time was (79.0 ± 9.3) months.Conclusions Radiofrequency ablation of the gallbladder bed was safe and effective in radical surgery of T1 b gallbladder cancer.For T1 b stage gallbladder cancer,which is difficult to diagnose during surgery,secondary radical surgery achieved the same results as primary radical surgery.
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Objective:To investigate and evaluate the anti-tumor activity of hydroxychloroquine ( HCQ) in vitro. Methods:CCK-8 assay was applied to detect the inhibitory effect of HCQ at different concentrations(4. 78, 9. 55, 19. 10, 38. 20,76. 40 μg?ml-1 ) on A549 cells, HepG2 cells, HT-29 cells, K562 cells, Hela cells and B16 cells. Absorbance was detected by a microplate reader, and then the inhibitory rate of the tumor cells and the IC50 was calculated. Results:Compared with those of the negative control group, the inhibitory rates of HCQ at different concentrations against the six tumor cells were all increased significantly in a dose-dependent manner (P<0. 01). The inhibitory rates of the tumor cells were all above 60% when the concentration reached 38. 20μg?ml-1. The IC50 was 26. 70(A549), 27. 47(HepG2), 5. 72(HT-29), 14. 03(K562), 20. 21(Hela) and 13. 62(B16) μg?ml-1, respectively. Conclusion:HCQ shows anti-tumor activity on several cancer cells in vitro. There may be a good application prospect for HCQ in the treatment of colorectal cancer, liver cancer, cervical cancer, melanoma and leukemia.
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Objective To test the pathogeny of Vibrio cholerae strains of the epidemic in Jinzhou of Hubei Province.Methods Traditional methods of biochemistry,immobihzation test,string test and typing of blood serum were used to test the 6 strains isolated.The virulence gene which was cholera enterotoxin (ct) was detected by PCR.The whole genome DNA finger print of confirmed strains was analyzed by pulsed field gel electrophoresis (PFGE) after digestion respectively with two enzymes Not Ⅰ and Sfi Ⅰ.The DNA fingerprints were analyzed for clusters.Results The 6 strains of Vibrio cholerae were all O139 by traditional laboratory tests;virulence gene was detected in all 6 strains.The banding pattern was the same in the two maps of PFGE.The results of cluster analysis showed that the similarity coefficient of the six strains was 100％.Conclusion The epidemic of Vibrio cholerae is caused by the same pathogenic bacterium which is O139.
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Objective To investigate the clinical value of serum procalcitonin (PCT) in the diagnosis and treatment of the patients with high fever of acute illness.Methods A total of 285 febrile patients suffered from acute illness were divided into the conventional group (n =122) and the PCT group (n =163).The routine blood examination and serum level of C-reactive protein (CRP) detection were carried out for the dignosis of these febrile patiens of two groups,and in addition,serum PCT determination was carried out in the patients of PCT group.The diagnosis was comnfirmed by etiology or immunologic assays.Routine guidelines of administrating antibiotics were used for treatment in the conventional group.Whereas the antibiotic therapy given to patients of PCT group was guided by the serum PCT levels.Two groups were compared in respect of the antibiotics costs,duration of treatment with antibiotics,percentage of patients treated with antibiotics,efficiency of antibiotics treatment and the mortality rate.The patients of PCT group were further divided as per inflammatory markers of bacterial infection into three subgroups,namely bacterial infection group,viral infection group and non-infection group.At last,the relationship between serum PCT level and the prognosis of patients was analyzed.Results The cost of antibiotics,percentage of patients treated with antibiotics,and course of antibiotics treatment were (Y) (3586.5 ± 703.3),95.08％ and (15.01 ± 11.21) days,respectively in conventional group,whereas (Y) (1871.2 ± 433.5),54.60％,(11.22 ±7.10) days in PCT group with statistically significant difference between two groups (P ＜ 0.01),but there were no significant differences in clinical efficiency and mortality between groups (P ＞ 0.05).Serum PCT (1.12 ± 0.88) ng/ml in bacterial infection group was higher than that in both virus infected group (0.21 ± 0.1 1) ng/ml and non-infected group (0.18 ± 0.13) ng/ml.There was no statistics difference in serum PCT level between virus infected group and non-infected group (P ＞ 0.05).The diagnosis of bacterial infection with serum PCT was better than other inflammatory markers because serum PCT had high sensitivity,specificity,positive predictive value (PPV) and negative predictive value (NPV).Conclusions Serum PCT level was reliable to differentiate the nature of acute infection with high fever and to evaluate the prognosis by emergency physicians.There was an important significance for rational use of antibiotics by the guidance of PCT levels.
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Objective To investigate the pathogenic characteristics of Vibrio cholera strains isola-ted from Hubei province in 2012 , and to identify the source of infection by analyzing their genetic correla-tions.Methods The biochemical identification , toxin gene detection and drug susceptibility test were car-ried out to analyze a total of 35 Vibrio cholera strains isolated from three epidemic areas .Comparison of ge-nomic DNA fingerprints and cluster analysis among isolates of Vibrio cholera was conducted by using pulsed-field gel electrophoresis ( PFGE ) .Results All of the 35 strains were Vibrio cholera O139 , of which 71.42%were toxic strains.The drug resistance rates of Vibrio cholera strains to tetracycline, cotrimoxazole and rifampincin were 57.14%, 88.57%and 80.00%, respectively.Analysis of genomic DNA fingerprints of the isolates showed highly similar with similarity values ranging from 80%-100%.Most of the strains iso-lated from the same epidemic area fell into the same one cluster with 100% homology in genome Only a strain isolated from turtle in Jingzhou area was belong to a different cluster .Conclusion The Vibrio cholera O139 strains were the dominant strains causing the outbreaks of cholera in Hubei province in 2012 .Most of them were toxigenic strains .A large majority of the strains had developed resistance to tetracycline , cotri-moxazole and rifampincin , but all strains showed high susceptibility to ceftriaxone and imipenem .Vibrio cholera strains isolated from the same epidemic area were mainly belonged to the same one cluster , sugges-ting the same source of infection .However, the strains varied among different epidemic area .Follow-up in-vestigations of three outbreaks of cholera in this study were all associated with food infection .Therefore , more attention should be paid to food sanitation and safety measurement .Although a non-toxigenic strain iso-lated from turtle was not associated with the epidemic of cholera , surveillance for seafood and aquatic prod-ucts would still be necessary .
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Objective To study the relationship between the cardiac markers in ST-segment elevation myocardial infarction (STEMI) and quality of life (QOL) six months later.Methods N-terminal pro-B-type natriuretic peptide (NT-proBNP),cardiac troponin I (cTnI),creatine kinase isoenzyme-MB (CK-MB)and myoglobin(Myo) was tested in 76 patients with STEMI on admission(0 h) and 24 h after admission.QOL six months later was evaluated by using the SF-36 health survey questionnaire.The relationship between the cardiac markers and QOL was analyzed by multivariate linear regression analysis.Results The total SF-36 scores and the scores of physical function,body pain and general health showed negative linear correlation with NT-proBNP on admission (0 h) and 24 h after admission (P ＜ 0.05).The total SF-36 scores and the scores of physical function and body pain showed negative linear correlation with cTnI on admission (0 h)and 24 h after admission (P ＜ 0.05).The total SF-36 scores and the scores of body pain showed negative linear correlation with CK-MB on 24 h after admission (P ＜ 0.05).The scores of vitality showed negative linear correlation with Myo on admission (0 h) (P ＜ 0.05).Conclusion The higher levels of NT-proBNP,cTnl and CK-MB indicate the lower QOL six months later.
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Objective To analyze and compare the emergency therapeutic methods for renal colic,and to explore the preferable way of emergency therapies for renal colic.Methods A total of 340 cases of renal colic in emergency department were randomly divided into groups A (pethidine),B (diclofenac sodium),C (phloroglucinol),and D (diclofenac sodium + phloroglucino).The average time of therapeutic effect after given 30 min in different groups was observed.Results The average time of effect in group A [(9.53 ±3.34) min],group D[(10.49 ±2.54) min],and group B[(10.51 ±2.27)min] and they were much shorter than group C [(18.51 ±4.86) min] (P ＜0.01).There was no significant difference in the effective rate among the 4 groups(P ＞ 0.05).The relapse rate of group C (11.43％) and group D (9.00％) were much lower than group A (24.59％) and group B(23.75％).There was no adverse reaction in group C.The rates of adverse reactions in group B (2.27％) and group D (2.78％) were much lower than group A (27.27％).Conclusions Diclofenac sodium combined with phloroglucinol was preferable emergency treatment for renal colic.
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In order to adapt to the modern medical development,the selective course on bacterial drug-resistance was opened for master postgraduates.This paper analyzed the curricular contents,the teaching methods and the questionnaire-done by the master postgraduates.The students could know well the mechanism of bacterial drug-resistance and the basic principle on apphcation of antimicrobial agents.
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Objective To develop a PCR-mverse dot blot hybridization(RDB)assay to rapidly detect pathogenic mycoplasmas in genitourinary tract.Methods Universal primers were designed and applied to amplify the 16S rRNA gone of ureaplasma parvum(Up),ureaplasma urealyticum(Uu),Mycoplasma genitalium(Mg),Mycoplasma hominis(Mh)by using nestcd PCR.Specific nucleotide probes of Up,Uu,Mg and Mh Were constructed and immobilized onto nylon membranes.PCR products were denatured and hybridized、with specific oligonucleofide probes on nylon membrane.The sensitivity and specificity of the PCR-RDB assay were evaluated based.on the hybddizafion results.Also,PCR-RDB Was utilized to detect pathogenic mycoplasmas from 60 clinical samples.Results The four probes selectively hybridized with the PCR product of corresponding mycoplasmas,and no cross hybridization was observed.The detection limit of PCR-RDB Was one colony forming unit(CFU)of mycoplasma.Out of the 60 clinical samples、19were positive for mycoplasm,Mixed infections were found in three samples,including two coinfected with Up and Uu and one with Uu and Mg.Conclusion PCR-RDB is a rapid,specific and sensitive approach to the identification of pathogenic mycoplasmas in urogenital tract.
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Objective To investigate the role of PPAR-γ in the gene expression of T-bet/GATA-3 in Jurkat T cells,and to explore the mechanisms underling this sensitizing effect of the change of TH cell subpopulation group.Methods Jurkat T cells were stimulated with PPAR-γ agonist pioglitazone.TH cell related cytokine IFN-γ and IL-10 was detected by ELISA,and the expression of transcription factors(T-bet and GATA-3)mRNA was detected by RT-PCR.To prove the PPAR-γ-dependent effect.the PPAR-γ-specific antagonist GW9662 was used.Results Stimulated with agonist PPAR-γpioglitazone.the concentration of IFN-γ and IL-10 and the expression of transcription factor T-bet and GATA-3 mRNA were both significantlY decreased in Jurkat T cells obviously,and these actions were dependent on the time and the concentrations of pioglitazone.Added with antagonist GW9662 at the same time,such inhibitory actions of IFN-γ and T-bet expression were recovered.but not IL-10 and GATA-3.Conclusion Pioglitazone can inhibite T cells proliferation and their secretion of cytokines.Pioglitazone can inhibit TH1 cells from secreting cytokines,and it is a PPAR-γ-dependent effect related to T-bet.The inhibition on TH2 is not a PPAR-γ-dependent effect and it is GATA-3 related.
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Objective: To investigate the protective effect and its mechanisms of Jiusuyu on gastric mucosa of acute alcoholism mice.Methods: Acute alcoholism mouse models were set up by intragastric administration of 56? Hongxing Erguotou wine,compared with Gehuajiecheng liquid,the effect of Jiusuyu on gastric mucosa pathological histology,SOD、MDA、NO and ET-1 of acute alcoholism mice were observed.Results: The gastric mucosa of mice in model group appeared obvious bleeding,fester and ulcer;a lot of phlegmonosis cells infiltrating could be seen below mucosa.At the same time the activity of SOD and level of NO in gastric mucosa were decreased(P
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Objective To investigate the resistant status and to type the phenotype and plasmid profiles of prevalent gonococcal strains. Methods A total of 98 gonococcal strains isolated from 1998 to 1999 in Zhanjiang was identified systemically. The susceptibilities of 98 strains of gonococci to penicillin,tetracycline and ciprofloxacin were detected by agar dilution method. The β － lactamase production was tested by iodometric method. The plasmids were extracted by alkaline lysis technique. Results The prevalence of gonococcal strains resistant to penicillin, tetracycline and ciprofloxacin were 22.44％ ,45.94％ and 55.12％ ,respectively. There were 6 positive strains for β － lactamase, accounting for 6.12％ (6/98). The most common phenotypes were susceptiblePT、 CMRNGT、 CMRNGPT and TRNG, accounting for 43.86％ ,23.46％ ,10.20％ and 10.20％ ,respectively. The detection rate of plasmids were 91.84％ .Among them, the percentages of 42.5 kb,39.5 kb,7.4 kb and 4.2 kb plasmids accounted for 11.22％ ,41.82％ ,59.16％ and 67.32％ ,respectively.There were 12 types of plasmid profiles(PP), the predominant types were 7.4kb＋ 4.2kb and 39.5kb＋ 7.4kb＋ 4.2kb, accounting for 21.42％ and 17.34％ ,respectively. Conclusion The gonococcal strains resistant to ciprofloxacin are very high in Zhanjiang. The phenotype and plasmid profiles of the strains have characteristic distribution.
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AIM: To observe pathomorphological changes in cerebral cortex and hippocampus in the mouse with synthetic vascular dementia. METHODS: The synthetic vascular dementia model was produced in the mouse. Animals were killed 7 d, 15 d, and 30 d after the operation, brain tissues were removed and embedded in paraffin. Section of 8?m thickness were stained with hematoxylin-eosin(HE) and Nissl methods, and observed with light microscope. RESULTS: The cerebral cortex in the mouse became thinner on the seventh day, karyopyknosis in partial nervous cells was formed, the number of local neurons was reduced, sieve structure was observed, and glial cells proliferated, with the similar results 15 d and 30 d after operation. Model mouses hippocampal cells in CA 1 area were reduced and almost disappeared 30 d after operation. At the same time, glial cells were abundantly proliferated, tubercles were formed. Cells in CA 2, CA 3 area were also reduced and hippocampal sclerosis occurred. CONCLUSION: Delayed necrosis of hippocampal pyramidal cells may be the pathological basis of ischemia cerebral vascular dementia.
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Besides performing medical moral rules, aneasthetist should be of special morals and deal with the relation to patients and surgeon.
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Objective To explore the role of plasmids in inducing drug-resistance in Neisseria gonor-rhoeae.Methods The change of drug-susceptibility in Neisseria gonorrhoeae was compared before and after experiments of resistant plasmids conjugation,transformation and deleting.Results The drug-resistance was transferred from resistant strains to sensitive strains through the conjugation and transformation of resistant plasmids,while the drug susceptibility could be recovered through deleting such plasmids from resistant strains.Conclusion The plasmids play an important role in the development of drug-resistance in Neisseria gonorrhoeae.