A clinical analysis of electrical status epilepticus during sleep in children and a follow-up study of methylprednisolone pulse therapy / 中国当代儿科杂志

OBJECTIVE@#To study the clinical features of electrical status epilepticus during sleep (ESES) in children, as well as the clinical effect of methylprednisolone pulse therapy in children with ESES.@*METHODS@#A retrospective analysis was performed using the clinical data of 78 children with ESES. Among these children, 56 children who had had the failure of antiepileptic drugs were treated with methylprednisolone pulse therapy at a dose of 15-20 mg/(kg·d) for three courses. Each course of treatment was 3 days, followed by oral prednisone [1-2 mg/(kg·d)] for 3 days. The role of methylprednisolone pulse therapy in eliminating ESES, controlling clinical seizures, and improving intelligence and behaviors was analyzed.@*RESULTS@#The mean age of onset of epilepsy in 78 children was 6.8±2.4 years, and the mean age for the first occurrence of ESES was 7.6±2.5 years. Compared with normal children, children with ESES had delayed intelligence development and higher scores of some behavior problems. Methylprednisolone pulse therapy had an overall response rate of 73% (41/56) on clinical seizures, and the overall response rate on electroencephalography (EEG)/spike-wave index was 70% (39/56) after treatment. There were significant improvements in verbal intelligence quotient, performance intelligence quotient and full intelligence quotient, and significant reductions in the scores of learning problems, impulse-hyperactivity and hyperactivity index after treatment (P<0.05). The overall recurrence rate after 1-year follow-up was 29% (11/38).@*CONCLUSIONS@#ESES often presents around school age and impairs children's intelligence and behaviors. Methylprednisolone pulse therapy has a marked efficiency in reducing clinical seizures and EEG discharges in children with ESES and can improve intelligence and behavior development, but the recurrence rate remains high.

Application of 3D digital orthopedic techniques in treatment of acetabular fracture / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the therapeutic effect of three-dimensional digital orthopedic techniques in treatment of acetabular fractures.</p><p><b>METHODS</b>We retrospectively analyzed 50 cases of acetabular fracture treated between March, 2007 and December, 2013. The lamellar CT scanning data were imported into Mimics software, and 3D anatomical models of the pelvic and proximal femur were reconstructed. Computer-assisted analysis was carried out to understand the condition of fractures and simulate fracture reduction. The pelvic models were manufactured by rapid prototyping technique for definite diagnosis and typing of acetabular fractures and subsequent surgical treatment.</p><p><b>RESULTS</b>Three-dimensional reconstruction images and rapid prototyping pelvic models faithfully represented the findings in operations. Preoperative simulation of the operation shortened the time of operation and reduced the volume of bleeding in the operation. All the patients were followed up for 6 to 24 months. According to Matta imaging score, anatomical reduction was achieved in 41 cases and satisfactory reduction in 9 cases. According to the Harris functional criteria, 32 patients had excellent, 12 had good and 6 had acceptable outcomes with a rate of excellent and good outcomes of 88%.</p><p><b>CONCLUSION</b>Three-dimensional digital orthopedic techniques allow accurate display of the acetabulum and the spatial relation of the anatomic structures to assist in fracture diagnosis, typing and treatment.</p>

Glycemic Variation in Tumor Patients with Total Parenteral Nutrition / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Hyperglycemia is associated with poor clinical outcomes and mortality in several patients. However, studies evaluating hyperglycemia variation in tumor patients receiving total parenteral nutrition (TPN) are scarce. The aim of this study was to assess the relationship between glycemia and tumor kinds with TPN by monitoring glycemic variation in tumor patients.</p><p><b>METHODS</b>This retrospective clinical trial selected 312 patients with various cancer types, whose unique nutrition treatment was TPN during the monitoring period. All patients had blood glucose (BG) values assessed at least six times daily during the TPN infusion. The glycemic variation before and after TPN was set as the indicator to evaluate the factors influencing BG.</p><p><b>RESULTS</b>The clinical trial lasted 7.5 ± 3.0 days adjusted for age, gender, family cancer history and blood types. There were six cancer types: Hepatic carcinoma (HC, 21.8%), rectal carcinoma (17.3%), colon carcinoma (CC, 14.7%), gastric carcinoma (29.8%), pancreatic carcinoma (11.5%), and duodenal carcinoma (DC, 4.8%). The patients were divided into diabetes and nondiabetes groups. No statistical differences in TPN glucose content between diabetes and nondiabetes groups were found; however, the tumor types affected by BG values were obvious. With increasing BG values, DC, HC and CC were more represented than other tumor types in this sequence in diabetic individuals, as well as in the nondiabetic group. BG was inclined to be more easily influenced in the nondiabetes group. Other factors did not impact BG values, including gender, body mass index, and TPN infusion duration time.</p><p><b>CONCLUSIONS</b>When tumor patients are treated with TPN, BG levels should be monitored according to different types of tumors, besides differentiating diabetes or nondiabetes patients. Special BG control is needed for DC, HC and CC in both diabetic and nondiabetic patients. If BG overtly increases, positive measurements are needed to control BG values. The ClinicalTrials.gov ID is NCT02024321.</p>

Effect of Oxcarbazepine on multidrug resistance associated protein 1 expression in hippocampus of kainic acid-induced seizure in rats during development period rats / 中华实用儿科临床杂志

Objective To observe the expressions of multidrug resistance-associated protein (MRP) 1 in the hippocampus of the rat models with chronic epilepsy,and to explore whether antiepileptic drug oxcarbazepine(OXC) affects the expression of MRP1.Methods One hundred rats of 14 days old were randomly divided into model group(n =52) and the control group(n =48).The model group received intraperitoneal injection of kainic acid(KA) 1 mg/kg (0.5 g/L) to induce seizures,and the control group rats were injected the same dose of 9 g/L chloride.According to Lado standard classification of seizures,the young rats whose seizure degree was beyond 5 and became status epilepticus after intraperitoneal injection used as successful seizure models if they caught the spontaneous seizures after 2 weeks.When spontaneous seizures were developed,48 surviving KA rats were divided into KA group and KA + OXC group.Rats in the control group were divided into NS group and NS + OXC group.After spontaneous recurrent seizures,the treatment groups began to take drugs.Each group started to be sacrificed from the beginning of drug perfusion at different times and they were divided into the 4th week group,the 6th week group and the 8th week group.The expression of MRP1 in hippocampus(CA3 area) was detected by immunohistochemistry methods.Results 1.Epileptic performance:all rats injected with NS had no epileptic performance.In the chronic epilepsy,Ⅰ-Ⅴ Racine grade of spontaneous recurrent seizures were found in all rats with KA.The rats in KA group had higher epilepsy seizure frequency than those in KA + OXC group (P ＜ 0.05).2.The rats in NS group and NS + OXC group had fewer MRP1 positive cells,and there was no significant difference at all time points between NS group and NS + OXC group (P ＞ 0.05).The trend of expression in KA group and KA + OXC group gradually increased.The MRP1 positive cells in KA + OXC group compared with those in the KA group was significantly different in the 8th week(P ＜0.05),while there was no significant difference in the 4th week and the 6th week(all P ＞0.05).And there was a significant difference in the positive cells in KA group compared with those of KA group(P ＜0.05).The expression of MRP1 positive cells in KA + OXC group increased significantly compared with those in NA + OXC group(all P ＜ 0.05).Conclusions MRP1 plays an important role in resistance mechanisms of refractory epilepsy,while the expression of MRP1 can be induced by using OXC in a long term.

Exploration and practice of bilingual teaching in pediatrics of the undergraduates / 中华医学教育探索杂志

To further explore the result of bilingual teaching in pediatrics,we randomly chose 200 undergraduates of 4 class and released students'questionnaires about bilingual teaching with teaching content before and after class to assess students'understanding of bilingual teaching and analysed appraisal result.We found no significant difference of student score between students accepting bilingual teaching and not accepting the bilingual teaching,but there was difference for English tests and expression level.So we think that students can fully accept the bilingual teaching of pediatrics under the premise with selecting appropriate teaching methods and means.

Study on Hippocampus Neurogenesis in Rats with Different Ages / 实用儿科临床杂志

Objective To explore the effect of age on neurogenesis of dentate gyrus granule cell and the impact on differentiation of newborn cells in rats.Methods SD rats were selected and divided into 5 groups according age of 7,14,28,60,180 d(n=8),and the neurogenesis of dentate gyrus granule cell in hippocampus with normal development was detected,using 5-bromo-BrdU(BrdU) labled newborn neuron and ?-tubulin protein(TuJ1) and glial fibrillary acidic protein(GFAP) labeled glial cells,and understood the newborn cells to neurons and glial cell differentiation ratio.Results Neurogenesis was found in dentate gyrus granule cell layer with hippocampus of all different age rats.Various forms of cells with a larger nucleus that were round,oval,diamond were distributed over the entire granule cell layer.BrdU-positive cells within each group were 158.07?5.37,141.28?7.27,116.93?9.24,76.56?6.88,41.42?4.45,the number of BrdU-positive cells were reduced with the growth of rats(P0.05);4%-5% newborn cells expressed GFAP.In addition,some of the BrdU-positive cells at the same time did not express TuJ1 or GFAP.Conclusions There are neurogenesis in dentate gyrus granule cell in rats of different age.The new born cells mostly differentzate into granule neuron cell.The capability of cell proliferation are decreased with the growth of age.