Obstructive sleep apnoea in patients with epilepsy: a meta-analysis.

PURPOSE: The aim of this study was to accurately determine the prevalence of obstructive sleep apnoea (OSA) in patients with epilepsy (PWE) and to evaluate the efficacy of seizure control after treating OSA. METHODS: Articles were identified through a search of both MEDLINE and Embase. The articles were collected and data were extracted independently by two authors. OSA was described using the following terms: Apnoea/hypopnoea index (AHI) and respiratory disturbance index (RDI). The variables were calculated using DerSimonian and Laird's random-effects model and odds ratio (OR). RESULTS: The prevalence of mild-to-severe OSA in PWE was determined to be 33.4 % (95 % CI 20.8-46.1 %), and PWE are more susceptible to OSA as compared to healthy controls (OR 2.36; 95 % CI 1.33-4.18). Males were shown to be more susceptible to OSA than females (OR 3.00; 95 % CI 2.25-3.99). The results also indicated that the prevalence of OSA in patients with refractory epilepsy is not higher than the prevalence of OSA in PWE overall (17.5 vs 33.4 %). The prevalence of OSA was not found to be significantly different for different seizure types or in the number of antiepileptic drugs (AEDs). Patients that had been treated with continuous positive airway pressure (CPAP) were shown to have better seizure control than those untreated (OR 5.26; 95 % CI 2.04-13.5). CONCLUSIONS: The prevalence of OSA in PWE is higher than in the general population. Additionally, the results of our study suggest that CPAP treatment results in a reduction of seizures.

Association between epilepsy and systemic autoimmune diseases: A meta-analysis.

PURPOSE: To investigate the association between systemic autoimmune diseases (SAD) and epilepsy and to determine whether the strength of this association is increased in the young. METHODS: A meta-analysis was done, analyzing the association between epilepsy and SAD using the available data in Medline and Embase through February 2016. We followed the recommendations of the PRISMA (preferred reporting items for systematic reviews and meta-analyses) statement and the MOOSE (meta-analysis of observational studies in epidemiology) guidelines. RESULTS: A total of twenty-five studies met the inclusion criteria for this meta-analysis, which included 10,972 patients with epilepsy (PWE) and 2,618,637 patients with SAD. The PWE cohort was shown to have more than a 2.5-fold increased risk of SAD. The patients with SAD were also shown to have a more than 2.5-fold increased risk of epilepsy. The results indicated that patients <20 years of age had a 3-fold increased risk of SAD and epilepsy (OR=3.04 [95% CI 1.27-7.27], P=0.01; OR=3.15 [95% CI 1.92-5.15], P<0.01; respectively), and these risks were shown to be higher than patients >20 years of age. The PWE cohort had a 2.6-fold increased risk of celiac disease (OR=2.65 [95% CI 1.41-4.97], P<0.01). The patients with systemic lupus erythematosus had a 4.5-fold increased risk of epilepsy (OR=4.57 [95% CI 2.40-8.67], P<0.01). CONCLUSIONS: There is an association between epilepsy and SAD, which was shown to be stronger at a young age.

Tranexamic acid-associated seizures: A meta-analysis.

PURPOSE: To investigate the incidence rate of tranexamic acid (TXA)-associated seizures. METHODS: Two electronic databases (Medline and Embase) were searched. We looked for additional studies in the references of all identified publications. The cutoff day was 2015 Dec 06. Two authors independently reviewed the titles and abstracts of the publications identified firstly. Odds ratio (OR) and 95% confidence interval (CI) were used to compare discontinuous variables. RESULTS: Ten studies enrolling 26,079 patients with TXA exposure and 7395 patients with non-TXA exposure were included. The cumulative incidence rate of TXA-associated seizures is 2.7%. The odds ratio of seizure is 5.39 (95%CI: 3.29-8.85; I(2)=0%; P<0.001) in patients with TXA exposure vs patients with non-TXA exposure. The incidence rate of TXA-associated seizures increased when the dose levels increased. CONCLUSION: The risk of seizure increased in patients with TXA exposure and the incidence rate of TXA-associated seizures increased when the dose levels increased.

Prognosis Analysis of Coronary Heart Disease Complicated with Heart Failure Patients Abandoning PCI and Receiving Drug Comprehensive Therapy / 中国药房

OBJECTIVE:To investigate the prognosis of coronary heart disease complicated with heart failure patients abandon-ing percutaneous coronary intervention (PCI) and receiving drug comprehensive therapy. METHODS:From Dec. 2010 to Jul. 2012,217 patients with coronary heart disease complicated with heart failure in our hospital were divided into operation group (105 cases) and non-operation group (112 cases). Based on routine treatment,operation group was given aspirin combined with clopidogrel before and after PCI,and non-operation group was given aspirin combined with clopidogrel all the time. The patients were followed up regularly during discharging from hospital to May 2015 by outpatient,telephone and coronary angiography re-checking,lasting for 24-38 months. Death cases,readmission and revascularization again caused by main adverse cardio-cerebrovas-cular events were recorded during follow-up period. RESULTS:7 cases and 8 cases in operation group and non-operation group did not accept follow-up;median follow-up time was 33 months and 32 months,respectively. Case number of myocardial infarction, heart failure and death in non-operation group was more than operation group,with statistical significance (P<0.05). 94 patients survived in operation group in 3 years,with survival rate of 95.9%;66 in non-operation group,with survival rate of 63.5%;with statistical significance(P<0.05). The survival time of non-operation group was shorter than that of operation group,with statistical significance(P<0.05). CONCLUSIONS:Although we still cannot get the conclusion that PCI is a better treatment or drug therapy is better. But the survival rate of patients are not optimistic 3 years after abandoning PCI coronary heart disease patients with severe myocardial ischemia should choose PCI firstly.

Influence of Coriaria Lactone on Ca2+-activated K+ channels in rat hippocampal pyramidal neurons / 中国组织工程研究

BACKGROUND: Electrical activity of nerve cells is based on the ion channel activity on cell membrane. Epilepsy is basically characterized by abnormal neuronal discharge. The foundation is ion channel activation on cell membrane and ion transmembrane movement, however, whether Ca2+-activated K+ channel involves in epilepsy induced by Coriaria Lactone is still unclear.OBJECTIVE: Considering rat hippocampal pyramidal neurons as target,we investigate the effect of Coriaria Lactone on neuronal Ca2+-activated K+ channels in epilepsy induced by Coriaria Lactone.DESIGN: Randomized controlled experimental trials.SETTING: Department of Neurology, West China Hospital, Sichuan University and Institute. of Myocardium Electrophysiology of Luzhou Medical College.MATERIALS: This experiment was carried out in Luzhou Medical College, Sichuan Province, from May to December 2000. Totally 100 Wistar infant rats within 24-hour ages were selected.METHODS: Wistar infant rats were anaesthetized and its hippocampus was obtained under disinfected state, pyramidal neurons were cultured for 7-10 days, neurons growing well with typical shape model were colleted normal control group, 19 dishes were added with DMEM culture medium,given different membrabe voltage and then followed by adding in te3 subgroups with 8 dishes each one. Added seperately DMEM culture medium containing f0-8, 10-7, 10~ mol/L concentration of calcium ion, and 2.0 mL/L Coriaria Lactone induced epilepsy group: added with DMEM culture medium with different dosages of Coriaria Lactone and finally tetraethylamine in each concentration of 26 dishes for totally 130 dishes.Cell-attache method and inside-out method of patch-clamp technique were used to record the neuronal single channel electricity. The open probability, average opening hour and closing hour, electric current amplitude of channel were analyzed.activated K+ channels of pyramidal neurons at normal, various membrane To observe and record the influence of Coriaria Lactone on the activation of pyramidal neuronal cell membrane, as well as the role of tetraethylamine.were only small amount of pyramidal neurons randomly opening its Ca2+-activated K+ channels and it displayed obvious voltage-dependent property.The channel electric conductance was (122.79±21.68) pS. The channels the inside-out condition, Ca2+-activated K+ channel displayed calcium iondependent property. The average opening rate was 0.022±0.006, 0.040±0.007, 0.142±0.049 when the calcium concentration was 10-8, 10-7,aria Lactone could increase the opening rate of Ca2+-activated K+ channels when the free calcium ion in bath solution was 10-8 mol/L and memLactone, 1.0 mL/L Coriaria Lactone could increase the average opening time of Ca2+-activated K+ channels (1.867±0.210, 6.900±0.120, P ＜ 0.01), and reducing the average closing time (78.505±7.192,6.233±0.854, P ＜ 0.01).CONCLUSION: In epilepsy induced by Coriaria Lactone, the activation of Ca2+-activated K+ channels might play an important role of negative modulation.

Effect of coriaria lactone on adenosine triphosphate-sensitive potassium channels in pyramidal neurons / 中国组织工程研究

BACKGROUND: Abnormal neuronal discharge arose from the activation of cell membrane ion channels and transmembrane ion transport. The electric activity of the cells is associated with cell metabolism fundamentally through adenosine triphosphate (ATP)-sensitive potassium(KATP) channels.Currently the involvement of KATP channels in the pathogenesis of epilepsy and the regulation of KATP channels by coriaria lacton (EL) remain unknown.OBJETCIVE: To investigate the changes of cell membrane KATP channels in rat hippocampal neurons in response to CL as an epilepsy-inducing agent, and explore the role of KATP channels in the pathogenesis of epilepsy.DESIGN: Randomized controlled experiment.SETTING: Department of Neurology, West China Hospital Affiliated to Sichuan University, and Teaching and Research Section of Physiology,West China College of Preclinical Medicine and Forensic Medicine of Sichuan University.MATERIALS: This experiment was carried out at Luzhou Medical College between May and December 2000. Hippocampus pyramidal neurons were obtained from neonatal Wistar rats and randomized into normal control group, tetraethylammonium chloride (TEA) group, DNP group, CL group, and electric conductance and dynamics group.METHODS: The hippocampus of newborn Wistar rats was separated under aseptic condition and cultured for 24 hours prior to treatment with 10 μmol/L cytarabine for selective cell culture for 7-10 days. The cells in good growth exhibiting typical morphology of pyramidal neurons were then selected for patch-clamp experiment. The cells in the normal control group were treated with normal saline, which was replaced by 5 mmol/L TEA in TEA group, by 30 μmol/L DNP then 0.5 mol/L ATP in DNP group, and by 1.0 mL/L CL then 1 μmol/L glibenclamide in CL group. In electric conductance and dynamics group, the clamp voltage was firstly adjusted to investigate the channel opening before CL was added to the cells.MAIN OUTCOME MEASURES: ① Activity and curve of neuronal KATP channels; ② Effects of various clamp voltages on the channels activity and the effects of interventions with DNP, ATP and TEA; ③ Activation of neuronal membrane KATP channels induced by CL and the influence of glibenclamide.RESULTS: The reversal potential of the channels approximated 0 mV in homologous high-potassium solution. The opening of KATP channels increased along with the absolute value of the clamp voltage in a voltage-dependent manner, which was blocked by TEA. The electric current-voltage (Ⅰ-Ⅴ)curve could be fitted to a straight line with the electric conductance of (78.23±12.04) pS. Administration of 30 μmol/L DNP enhances the opening of the channels, which could be suppressed by 0.5 mol/L ATP.Addition of 1.0 mL/L CL to the cells caused obviously increased channel opening, which was suppressed by 1 μmol/L glibenclamide. The channel opening time was (1.754±0.060) ms for epileptic neuron τ01and (1.733±0.046) ms for normal neurons, showing no significant difference between them (n=25, t=0.147, P ＞ 0.05), but compared with the channel opening time of (2.441±0.265) ms for τ02 normal neurons, and duration was significantly prolonged in the epileptic neurons to reach (10.446±0.579)ms (n=25, t=0.000, P ＜ 0.01).CONCLUSION: The opening of KATP channels is responsible for reducing the action potential frequency for neuronal protection, which might be a negative feedback mechanism.

Exploring and discussing the construction of experimental course of parasitology / 中华医学教育探索杂志

To catch hold of opportunity,reforming and innovation of experimental teaching were explorered and discussed according to the characteristic of parasitological course.We cultured synthetic diathesis of students by arranging reasonably supply of teachers and exhibiting PBL teaching modes,and regulating modes of experimental teaching content and improving experimental conditions.

Improving Professional Qualities of Teathers Leads to Better Teaching Effectiveness / 中华医学教育探索杂志

It's proposed for university teathers to improve their professional qualities by means of solidly mastering one's own professional theories,strengthening knowledge of relative subjects,and as well as training scientific research ability etc to evoke active study and obtain better teaching effect.

Pathological Change in Hydatid Cysts of Echinococcus granulosus Treated with High Intensity Focused Ultrasound / 中国寄生虫学与寄生虫病杂志

Objective To investigate the pathological change in Echinococcus granulosus hydatid cysts treated with high intensity focus ultrasound (HIFU). Methods Thirty cysts with thinner wall and proper elasticity, taken from livers of infected sheep, were randomly divided into three groups. By cyclical multilayer radiation around the cyst wall,two experiment groups were treated with HIFU under 150 W and 250 W sound power respectively. The control group was treated by ordinary ultrasound for 2 min. Results The inner cyst wall of hydatid treated with HIFU became curved,thicker, stiffer, white and less transparent. The germinal layer was detached mostly from the laminated layers of hydatid in the experiment groups. Images from the transmission electron microscopy showed that in the experiment groups fabric texture of hydatid changed significantly and germinal cells were broken. Conclusion HIFU in a model of cyclical multilayer radiation causes pathological damage of the E. granulosus hydatid.