Electroclinical aspects and therapy of Han patients with juvenile myoclonic epilepsy in northern China.

OBJECTIVE: The objective of this study was to assess the electroclinical aspects and treatment of Han patients with juvenile myoclonic epilepsy (JME) in northern China. METHODS: One hundred fifty-six outpatients with JME from six epilepsy centers, between January 2011 and June 2012, were followed up for at least two years. They underwent twenty-four-hour video-EEG recording. Brain imaging was performed using magnetic resonance imaging (MRI). Clinical aspects, electroencephalographic (EEG) features, and antiepileptic drugs (AEDs) received were reviewed. RESULTS: Generalized tonic-clonic seizures (GTCS) were found in 150/156 patients. Delay of diagnosis was 4.60±9.92years. Photosensitivity was more common in eye closure condition during IPS in patients with JME; in addition, patients with JME with myoclonic seizures (MS) and GTCS as seizure types were likely to present photoparoxysmal responses (PPRs). The 82 nontreated patients showed a median latency to first interictal or ictal generalized spike-wave discharge (GSWD) of 50min (IQR: 22-102min). The first GSWDs were recorded in 63%, 76%, 90%, and 98% patients within one, two, three, and 4h, respectively; only 2% of patients had first GSWDs after 4h. One hundred eleven patients (111/156) chose extended-release valproate (VPA) at daily doses ≤1000mg. The percentages of seizure-free patients among MS, GTCS, and absence seizure (AS) groups were 88.3%, 99.0%, and 94.9%, respectively. CONCLUSION: Photoparoxysmal responses were more common in patients with JME with MS and GTCS and rare in patients with JME with MS and AS in northern Chinese Han patients. Most patients with JME in northern China chose VPA as first therapeutic choice, and low dose (500 to 1000mg daily) of extended-release VPA may be an optimal choice for them. Video-EEG monitoring for at least 4h may be helpful in detecting the first interictal or ictal GSWD in patients with potential JME. Moreover, video-EEG monitoring performed at about 9 o'clock in the morning with patients in the awake state might be useful to find the first GSWD. For JME diagnosis, Class II criteria are more helpful than Class I counterparts, the latter yielding more missed diagnoses.

Differential analysis of clinical efficacy on patients with serious infection in ICU by different meropenem regimens.

To investigate the difference in clinical efficacy and safety of different meropenem regimens on patients with serious infection in ICU. Then, 228 patients with serious infection in ICU were divided by random into control group (intermittent administration in 1000mg/30min single dose) and research group (continuous administration in 200mg/10min +800mg/180min), respectively. The blood concentration of meropenem were recorded in two groups at different time points, and difference in treatment effectiveness, iconographic effectiveness, bacterial eradication rate, 28-day survival rate and many other clinical scoring indices (SOFA, APACHEII, CPIS, and SIRS) were compared between two groups. There were 212 patients completing the whole research, including 104 patients in research group and 108 patients in control group. The difference in treatment effectiveness (77.8% vs 53.7%), iconographic effectiveness (51.0% vs 18.5%), and 28-day survival rate (86.5% vs 64.8%) between two groups performed statistical significance (P<0.05). However, the difference in bacterial eradication rate (48.0% vs 46.3%) performed no statistical significance. Eight hours later, the difference in average blood concentration between two groups (9.61±3.63µg/ml vs 1.5±0.51µg/ml) showed statistical significance. Moreover, the difference in clinical scoring indices except APACHE II score between two groups performed statistical significance. It was helpful to maintain the blood concentration of meropenem by extending the transfusion time. Therefore, it could increase the clinical cure rate and 28-day survival of patients with serious infection in ICU, improve clinical indices, and reduce the usage amount of antibiotics.

Four new alkylamides from the roots of Zanthoxylum nitidum.

Phytochemical investigation on the roots of Zanthoxylum nitidum led to the isolation of four new unsaturated alkylamides, zanthoxylumamides A-D. Their structures were established via the detailed spectroscopic analyses.

[Primary investigation of formation and genetic mechanism of land subsidence based on PS-InSAR technology in Beijing].

The present paper adopts permanent scatterer interferometric synthetic aperture radar(PS-InSAR) technique to obtain land subsidence information in Beijing plain area. Then, combined with the time series of meteorological data, groundwater dynamic monitoring data, interferometric data and geological structure data, the formation and evolution mechanism of land subsidence were revealed. The results show that (1) Beijing regional land subsidence characteristics are obvious, more land subsidence funnel areas are interconnected, the settlement is influenced by rainfall recharge and exhibits seasonal fluctuation characteristics; (2) The land subsidence center and groundwater drawdown funnel centre are not fully consistent, unconfined aquifer and shallow confined aquifer are the major contribution factors and have greater impact on the land subsidence; (3) Land subsidence mainly occurred in the clay layer with a thickness of 50-70 m; (4) Land subsidence caused by tectonic controls is significant and the deformation gradient is great on both sides of the fault.

[Spatial-temporal evolution characterization of land subsidence by multi-temporal InSAR method and GIS technology].

Long-term over-exploitation of underground resources, and static and dynamic load increase year by year influence the occurrence and development of regional land subsidence to a certain extent. Choosing 29 scenes Envisat ASAR images covering plain area of Beijing, China, the present paper used the multi-temporal InSAR method incorporating both persistent scatterer and small baseline approaches, and obtained monitoring information of regional land subsidence. Under different situation of space development and utilization, the authors chose five typical settlement areas; With classified information of land-use, multi-spectral remote sensing image, and geological data, and adopting GIS spatial analysis methods, the authors analyzed the time series evolution characteristics of uneven settlement. The comprehensive analysis results suggests that the complex situations of space development and utilization affect the trend of uneven settlement; the easier the situation of space development and utilization, the smaller the settlement gradient, and the less the uneven settlement trend.

Methylglyoxal accumulation contributes to accelerated brain aging in spontaneously hypertensive rats.

While it is well-acknowledged that neurovascular dysfunction in hypertension is tightly associated with accelerated brain aging, we contend that the deleterious effects of hypertension may extend beyond affecting only the arteries. Methylglyoxal (MG) derived from glycolysis, is involved in the accumulation of advanced glycated end products (AGEs), which are the hallmarks of neurodegenerative disorders. Therefore, the present study aims to firstly investigate the role of MG metabolism in the hypertension-accelerated brain aging process. The results of our study indicate that the levels of MG increase with age in both the plasma and hippocampus of SHRs at 12, 16, and 30 weeks old. AGE methylglyoxal-hydro imidazoline-1 (MG-H1) is primarily localized in astrocytes, while its presence was not observed in neurons and microglia within the hypertensive hippocampus. Our observations also suggest that angiotensin II (Ang II) enhances glucose uptake and glycolysis while reducing the expression of Glo1 in cultured astrocytes. N-acetylcysteine (NAC) was found to counteract the increase in escape latency and inhibit the activation of the AGEs-RAGE axis in 30-week-old SHRs. NAC decreased Iba-1 immunofluorescence intensity, inhibited the levels of pro-inflammatory markers, and enhanced the abundance of anti-inflammatory markers in the hippocampus of SHRs. Moreover, NAC reduced the immunofluorescence signal of 4HNE and increased the content of GSH and SOD in SHRs. Finally, NAC was observed to inhibit apoptosis in the hippocampus of SHRs. Collectively, we firstly showed the enhanced accumulation of MG in the hypertensive brain, whereas the clearance of MG by NAC treatment mitigated the aging process and attenuated AGEs generation, neuroinflammation, and oxidative damage.

Roles and inhibitors of FAK in cancer: current advances and future directions.

Focal adhesion kinase (FAK) is a non-receptor tyrosine kinase that exhibits high expression in various tumors and is associated with a poor prognosis. FAK activation promotes tumor growth, invasion, metastasis, and angiogenesis via both kinase-dependent and kinase-independent pathways. Moreover, FAK is crucial for sustaining the tumor microenvironment. The inhibition of FAK impedes tumorigenesis, metastasis, and drug resistance in cancer. Therefore, developing targeted inhibitors against FAK presents a promising therapeutic strategy. To date, numerous FAK inhibitors, including IN10018, defactinib, GSK2256098, conteltinib, and APG-2449, have been developed, which have demonstrated positive anti-tumor effects in preclinical studies and are undergoing clinical trials for several types of tumors. Moreover, many novel FAK inhibitors are currently in preclinical studies to advance targeted therapy for tumors with aberrantly activated FAK. The benefits of FAK degraders, especially in terms of their scaffold function, are increasingly evident, holding promising potential for future clinical exploration and breakthroughs. This review aims to clarify FAK's role in cancer, offering a comprehensive overview of the current status and future prospects of FAK-targeted therapy and combination approaches. The goal is to provide valuable insights for advancing anti-cancer treatment strategies.

ATG5 attenuates inflammatory signaling in mouse embryonic stem cells to control differentiation.

Attenuated inflammatory response is a property of embryonic stem cells (ESCs). However, the underlying mechanisms are unclear. Moreover, whether the attenuated inflammatory status is involved in ESC differentiation is also unknown. Here, we found that autophagy-related protein ATG5 is essential for both attenuated inflammatory response and differentiation of mouse ESCs and that attenuation of inflammatory signaling is required for mouse ESC differentiation. Mechanistically, ATG5 recruits FBXW7 to promote ubiquitination and proteasome-mediated degradation of ß-TrCP1, resulting in the inhibition of nuclear factor κB (NF-κB) signaling and inflammatory response. Moreover, differentiation defects observed in ATG5-depleted mouse ESCs are due to ß-TrCP1 accumulation and hyperactivation of NF-κB signaling, as loss of ß-TrCP1 and inhibition of NF-κB signaling rescued the differentiation defects. Therefore, this study reveals a previously uncharacterized mechanism maintaining the attenuated inflammatory response in mouse ESCs and further expands the understanding of the biological roles of ATG5.

[Effects of 5-Aza-dC on 5-Fu chemosensitivity by modulating TIP30 gene expression in human colorectal cancer cells].

OBJECTIVE: To investigate the effect of 5-Aza-2'-deoxycytidine (5-Aza-dC) on TIP30 gene expression and the relationship between TIP30 expression and the sensitivity to 5-fluouracil (5-Fu) in colorectal cancer cells. METHODS: The methylation profile of TIP30 gene in HCT116 colorectal cancer cells was determined by methylation-specific PCR. The levels of TIP30 mRNA and protein were determined by RT-PCR and Western blot after the 5-Aza-dC treatment. MTT assay was used to detect the chemosensitivity of HCT116 cells to 5-Fu. RESULTS: TIP30 gene displayed complete DNA methylation in the HCT116 cells without 5-Aza-dC pretreatment. After the 5-Aza-dC treatment for 3 days, only demethylating PCR amplification product was detected and TIP30 gene showed DNA demethylation. With the prolongation of the time of removal of 5-Aza-dC treatment, methylated and demethylated PCR amplification products were observed and TIP30 gene displayed both DNA methylation and DNA demethylation in the colorectal cancer cells. At the day 10 after removal of 5-Aza-dC, methylating PCR amplification product appeared and TIP30 gene showed DNA methylation. No expressions of TIP30 mRNA and protein were detected in the HCT116 cells untreated with 5-Aza-dC. After the treatment of 5-Aza-dC for 3 d and then removed the 5-Aza-dC, the expressions of TIP30 mRNA and protein were increased obviously. With the prolonged time after 5-Aza-dC removal, the expressions of TIP30 mRNA and protein decreased and reached the lowest level on day 10. The IC50 values of 5-Fu were 41.62, 33.17 and 4.96 µg/ml in the HCT116 cells pretreated with 5-Aza-dC, d0 and d10 with the drug removal after drug treatment for 3 d, respectively. CONCLUSIONS: The results of this study show that the expression of TIP30 gene may be associated with its DNA methylation status and may affect the sensitivity of colorectal cancer cells to 5-Fu.

[The impact of load density differences on land subsidence based on build-up index and PS-InSAR technology].

The excessive mining for underground water is the main reason inducing the land subsidence in Beijing, while, increasing of load brought by the urban construction aggravate the local land subsidence in a certain degree. As an international metropolis, the problems of land subsidence that caused by urban construction are becoming increasingly highlights, so revealing the relationship between regional load increase and the response of land subsidence also becomes one of the key problems in the land subsidence research field. In order to analyze the relationship between the load changes in construction and the land subsidence quantitatively, the present study selected the TM remote sensing image covering Beijing plain and used Erdas Modeler tool to invert the index based on building site (IBI), acquired the spatial and temporal change information in research area further; Based on results monitored by PS-InSAR (permanent scatterer interferometry) and IBI index method, and combined with the GIS spatial analysis method in the view of pixels in different scales, this paper analyzes the correlation between typical area load change and land subsidence, The conclusions show that there is a positive correlation between the density of load and the homogeneity of subsidence, especially in area which has a high sedimentation rate. Owing to such characteristics as the complexity and hysteretic nature of soil and geological structure, it is not obvious that the land subsidence caused by the increase of load in a short period. But with the increasing of local land load made by high density buildings and additional settlement of each monomer building superposed with each other, regional land subsidence is still a question that cannot be ignored and needs long-term systematic research and discussion.

Detecting residual brain networks in disorders of consciousness: A resting-state fNIRS study.

Functional near infrared spectroscopy (fNIRS) is an emerging non-invasive technique that allows bedside measurement of blood oxygenation level-dependent hemodynamic signals. We aimed to examine the efficacy of resting-state fNIRS in detecting the residual functional networks in patients with disorders of consciousness (DOC). We performed resting-state fNIRS in 23 DOC patients of whom 12 were in minimally conscious state (MCS) and 11 were in unresponsive wakefulness state (UWS). Ten regions of interest (ROIs) in the prefrontal cortex (PFC) were selected: both sides of Brodmann area (BA) 9, BA10, BA44, BA45, and BA46. Graph-theoretical analysis and seed-based correlation analyses were used to investigate the network topology and the strength of pairwise connections between ROIs and channels. MCS and UWS exhibited varying degrees of the loss of topological architecture, and the regional nodal properties of BA10 were significantly different between them (Nodal degree, PLeft BA10 = 0.01, PRight BA10 < 0.01; nodal efficiency, PLeft BA10 = 0.03, PRight BA10 < 0.01). Compared to healthy controls, UWS had impaired functions in both short- and long-distance connectivity, however, MCS had significantly impaired functions only in long-distance connectivity. The functional connectivity of right BA10 (AUC = 0.88) and the connections between left BA46 and right BA10 (AUC = 0.86) had excellent performance in differentiating MCS and UWS. MCS and UWS have different patterns of topological architecture and short- and long-distance connectivity in PFC. Intraconnections within BA10 and interhemispheric connections between BA10 and 46 are excellent resting-state fNIRS classifiers for distinguishing between MCS and UWS.

Calcium isotopic geochemistry of geothermal systems in the tectonically active southeastern Tibetan Plateau.

The global Calcium (Ca) cycle is closely coupled to the carbon cycle, and Ca isotopes have potential in tracing it. Even though groundwater is one of the main reservoirs of Ca at the Earth's surface, few data are available for groundwater, and the behavior of Ca and its isotopes in geothermal systems remains unknown. Here we analysed the stable Ca and radiogenic Sr isotope compositions of thermal waters distributed along the Jinsha and Yalong river valleys in the southeastern Tibetan Plateau. The Ca isotopic composition of the thermal water ranges from 0.45 to 2.16 ‰ (δ44/40Ca values relative to SRM 915a). The thermal waters collected from carbonate aquifers have higher δ44/40Ca values than bedrocks, which was attributed to secondary carbonate precipitation accompanied by CO2 degassing. In contrast, δ44/40Ca values in thermal waters collected from clastic and igneous rocks are similar to bedrock. Despite some thermal waters undergoing secondary silicates formation and CaNa ion exchange, such processes maybe not play a significant role in governing the Ca isotopic composition of these thermal waters. This suggests that Ca isotopes can be used to trace secondary carbonate precipitation driven by CO2 degassing (e.g. travertine) in geothermal systems located in tectonically active areas.

[Pollution Properties and Ecological Risk Assessment of Heavy Metals in Farmland Soils and Crops Around a Typical Manganese Mining Area].

In order to assess the ecological risks of heavy metals and explore the pattern of heavy metal migration between farmland and corresponding crops in a typical and closed manganese mining area in Hunan province, farmland soils and crops surrounding the mining area (pollution area) and away from the mining area (control area) were collected, and then the contents of Cr, Mn, Ni, Cu, Zn, As, Cd, and Pb were analyzed. The sources and distribution of heavy metals in farmland soils were analyzed using Kriging spatial interpolation and principal component analysis, and the ecological risk was evaluated using the single factor index, comprehensive pollution index, and potential ecological risk index. The results showed that the surrounding farmland soils in the closed Manganese mining area presented serious pollution of Cd, Zn, As, and Mn, in which the average contents of the above heavy metals in the dry land soil in the polluted area were 6.22, 612.28, 37.72, and 1506.2 mg·kg-1, respectively. Compared with the soil risk screening value of agricultural land, the over-standard rates of Cd, Zn, and As were 88.41%, 94.20%, and 84.06%, respectively, and the average content of Mn in the farmland soil was three times that of the background value in the Hunan soil; however, the heavy metal pollution in the paddy field was relatively light. The principal component analysis showed that the sources of Cd, Mn, and Zn in the farmland soil were related to the manganese ore mining, whereas the source of As in the farmland soil might originate from agricultural activities. The pollution area was at a heavy pollution level, and the main pollution factors were Cd, Mn, and Zn. The Cd in the farmland soil could pose a strong potential ecological risk, but the rest of the heavy metals presented only a slight potential ecological risk. The content of Cr, Pb, and Cd in the crops in the study area exceeded the standard, and the exceeding standard rate was between 1.1% and 37.3%, where the average content of over-standard heavy metals in corn was higher than that in rice, and the average content of heavy metals in leafy vegetables was higher than that in root vegetables. The soil pollution degree of heavy metals could affect the accumulation ability of crops, and different crops had different accumulation abilities. For instance, leafy vegetables and root vegetables easily accumulated Cd and Zn; however, rice and corn separately enriched Cd and Cr, as well as Zn and Cu. The contents of heavy metals in dryland soils had a positive correlation with the content of heavy metals in corresponding crops. The contents of Cd and As in the paddy field and rice presented a positive correlation, but the remaining six heavy metal contents in rice (i.e., Cr, Mn, Ni, Cu, Zn, and Pb) did not correlate with the content of the paddy fields.

Calcium isotopes tracing secondary mineral formation in the high-relief Yalong River Basin, Southeast Tibetan Plateau.

Calcium is a critical element in the global carbon cycle due to its role in carbon sequestration via silicate weathering and carbonate formation. Here we apply calcium (δ44/40Ca) and strontium (87Sr/86Sr) isotopes to explore such chemical weathering processes in a river system draining a diverse range of geologic and climatic environments: the Yalong River, China, and its tributaries. This river originates on the Tibetan Plateau and represents one of the upper reaches of the Changjiang River, China. The Ca isotopic composition of the dissolved load of the Yalong River ranges from 0.60‰ to 1.02‰ (relative to the NIST standard SRM 915a). Higher δ44/40Ca values were found in the plateau and lowland rivers, with lower values in the mountainous rivers. Correlations between riverine dissolved δ44/40Ca values, Sr/Ca ratios, and calcite saturation index indicate that the precipitation of secondary carbonates governs the Ca isotopic composition and carbon transformation in most of this river system. However, such correlations are not seen in the lowland tributaries, where the relationship between δ44/40Ca and lithium (Li) isotopes instead suggests a control by topography and climate, via secondary clay mineral formation. Specifically, heavy rainfall in the lowland regions lowers the pH of the soil solution, which inhibits the precipitation of secondary carbonates. In addition, the flat terrain and thick soils increase the time for water-rock interaction, which favours the formation of secondary clay minerals that preferentially incorporate the lighter Ca isotopes. Overall, this study highlights the potential of stable Ca isotopes, when used in combination with other isotope systems (e.g. Sr and Li isotopes), to quantify secondary mineral formation processes in large river basins.

Preclinical studies of the triazolo[1,5-a]pyrimidine derivative WS-716 as a highly potent, specific and orally active P-glycoprotein (P-gp) inhibitor.

Multidrug resistance (MDR) is the main cause of clinical treatment failure and poor prognosis in cancer. Targeting P-glycoprotein (P-gp) has been regarded as an effective strategy to overcome MDR. In this work, we reported our preclinical studies of the triazolo[1,5-a]pyrimidine-based compound WS-716 as a highly potent, specific, and orally active P-gp inhibitor. Through direct binding to P-gp, WS-716 inhibited efflux function of P-gp and specifically reversed P-gp-mediated MDR to paclitaxel (PTX) in multiple resistant cell lines, without changing its expression or subcellular localization. WS-716 and PTX synergistically inhibited formation of colony and 3D spheroid, induced apoptosis and cell cycle arrest at G2/M phase in resistant SW620/Ad300 cells. In addition, WS-716 displayed minimal effect on the drug-metabolizing enzyme cytochrome P4503A4 (CYP3A4). Importantly, WS-716 increased sensitivity of both pre-clinically and clinically derived MDR tumors to PTX in vivo with the T/C value of 29.7% in patient-derived xenograft (PDX) models. Relative to PTX treatment alone, combination of WS-716 and PTX caused no obvious adverse reactions. Taken together, our preclinical studies revealed therapeutic promise of WS-716 against MDR cancer, the promising data warrant its further development for cancer therapy.

Latest therapeutic target for gastric cancer: Anthrax toxin receptor 1.

Anthrax toxin receptor 1 (ANTXR1), also known as tumor endothelial marker 8, is a highly conserved cell surface protein overexpressed in tumor-infiltrating vessels. It was first found in vascular endothelial cells of human colorectal cancer. Although our understanding of its physiological function is limited, it has been found that ANTXR1 binds collagen and promotes migration of endothelial cells in vitro. ANTXR1 is upregulated in vessels of different tumor types in mice and humans, and is also expressed by tumor cells themselves in some tumors, such as gastric, lung, intestinal and breast cancer. Developmental angiogenesis and wound healing were not disturbed in ANTXR1 knockout mice, but compared with wild-type mice, growth of melanoma was impaired after ANTXR1 knockout, indicating that host-derived ANTXR1 can promote tumor growth on the basis of immune activity. Previous studies have shown that ANTXR1 vaccines or sublethal doses of anthrax toxin can inhibit angiogenesis, slow tumor growth and prolong survival. These studies suggest that ANTXR1 is necessary for tumor rather than physiological angiogenesis. It has been found that ANTXR1 plays an important role in tumor angiogenesisas well as in the growth and metastasis of many kinds of tumors. This article reviews the physiological function of ANTXR1 and its role in different kinds of cancer.

Sinistral portal hypertension associated with pancreatic pseudocysts - ultrasonography findings: A case report.

BACKGROUND: Sinistral portal hypertension associated with pancreatic pseudocysts is rare, often caused by extrinsic compression of splenic vein, the follow-up examinations by ultrasonography for early diagnosis are quietly necessary since haematemesis, a life-threatening condition. Few studies have reported the ultrasonography findings of sinistral portal hypertension. CASE SUMMARY: A 52-year-old man presented with acute abdominal pain after drinking, steatorrhea, weight loss and accidentally melena in the past 2 mo. He underwent ultrasound-guided fine needle aspiration in other hospital and diagnosed with pancreatic pseudocysts. Ultrasonography imaging, in our department, appeared as cystic heterogeneous hypoechoic area with the size of 4.7 cm × 3.8 cm that located posterior to the body and tail of pancreas, adjacent to splenic vein associated with thrombosis resulted from compression. Spleen incrassated to approximately 7.3 cm, but no dilation of main portal vein was presented. Color Doppler Flow Imaging demonstrated the formation of splenic venous collateral, nevertheless no significantly flow signals was observed in splenic vein. Pulsed Doppler revealed that the peak velocity of splenic venous collateral was 18.4 cm/s with continuous waveform. Laparotomy confirmed sinistral portal hypertension associated with pancreatic pseudocysts, subsequently distal pancreatectomy combined with splenectomy and partial gastrectomy was performed. CONCLUSION: It's important clinically to know the ultrasound appearance of sinistral portal hypertension associated with pancreatic pseudocysts for sonographer and physician.

Surgical outcomes and survival for T4 gastric cancer extending to the transverse colon.

BACKGROUND: For the treatment of locally advanced (T4) gastric cancer, extended multi-organ resection remains controversial. This study aimed to evaluate the surgical outcomes and survival of patients with T4 gastric cancer extending to the transverse colon. METHODS: A total of 2,652 gastric cancer patients underwent surgery between December 2011 and December 2015. Data from 40 of these patients who underwent curative resection for T4 gastric cancer extending to the transverse colon were obtained. Patient characteristics, related complications, long-term survival, and prognostic factors for T4 gastric cancer were analyzed. RESULTS: Postoperative morbidity occurred in 5 (12.5%) patients. All of the patients were cured with conservative treatment. No procedure-related mortality occurred. The 1-, 3-, and 5-year overall survival (OS) rates were 75.0%, 49.2%, and 36.9%, respectively, with a median survival time of 24 months. Univariate analysis revealed tumor size (P=0.049), advanced T stage (P=0.013), and lymph node metastasis (P=0.006) to be poor prognostic factors of OS. Advanced T stage and lymph node metastasis were identified by multivariate analysis as being independent prognostic factors. Further, it was observed that lymph node metastasis grade was associated with poorer OS. CONCLUSIONS: Patients with T4 gastric cancer extending to the transverse colon might benefit from curative resection with acceptable morbidity and mortality.

Antidepressants for the treatment of narcolepsy: A prospective study of 148 patients in northern China.

Narcolepsy is a life-long neurological disorder characterized by excessive daytime sleepiness (EDS) and cataplexy. At present, Sodium oxybate, modafinil, methylphenidate and other stimulants are recommended first-line therapies for narcolepsy but are difficult to obtain in China. One hundred forty-eight patients with narcolepsy were treated with antidepressants and administered the Epworth Sleepiness Scale (ESS) and the Maintenance of Wakefulness Test (MWT) before and after treatment from August 2012 to August 2017. The subjects were followed for 1-6 years after treatment. Improvement in sleepiness, cataplexy, cataplexy-like episodes, and antidepressant side effects were assessed. There were significant differences in the mean sleep latency (MSL) and sleep onset rapid eye movement periods (SOREMPs) in MWT and ESS scores, cataplexy and cataplexy-like episodes before and after treatment (p < 0.01). Venlafaxine demonstrated significantly greater improvements in MSL in the MWT (p < 0.01). Early awakenings and dry mouth were the most common adverse effects.

Photosensitive epilepsy and photosensitivity of patients with possible epilepsy in Chinese Han race: A prospective multicenter study.

Photosensitive is probably caused by multiple factors including gender, familiar, etc. We aim to study the clinical and EEG features of Chinese Han patients with photosensitivity. A total of 5482 consecutive patients with possible epilepsy from 3 center in China. Of the 73 patients with PPR to IPS, 48 were female. 69.9% patients were evoked by frequency ranged 8 Hz-25 Hz, with accompanying seizures in 13 patients. 6 of 9 patients with eyes closure sensitivity experienced epileptic seizures during IPS. We found some new features: 1) The patients with eyes closure sensitivity apt to experience electro-clinical seizures provoked by IPS; 2) Female epilepsy patients with PPR and ECS maybe difficult to be seizure free. Preventive measures for related seizures should be performed to the patients with generalized PPR, upper threshold evoking frequency, and eyes closure sensitivity when they received the IPS.