The neuropsychological outcome of pediatric patients with refractory epilepsy treated with VNS — A 24-month follow-up in Taiwan

ObjectivesMultiple studies have reported the benefits of vagus nerve stimulation (VNS) on neuropsychological outcomes. The aim of this study was to investigate how VNS affects cognition and psychosocial adjustment in children with refractory epilepsy (RE), and to determine the efficacy of VNS in a Taiwanese population.MethodsWe conducted a one-group pretest–posttest study on pediatric patients with RE. The study comprised 19 males and 18 females, all aged < 18 years. We recorded seizure frequency at 3, 12, and 24 months after VNS device implantation. Intelligence quotients (IQ) were assessed using the Wechsler Intelligence Scale for Children — IV. The Parental Stress Index (PSI) scores were evaluated by a pediatric psychologist.ResultsVagus nerve stimulation device implantation significantly reduced seizure frequency at 3, 12 and 24 months, especially in young children (< 12 years). No significant improvement in IQ test performance was observed, though there were significant improvements in the PSI, especially in young children.ConclusionsVagus nerve stimulation device implantation does not significantly improve cognition function, but it does significantly reduce seizure frequency and stress in parent–child relationships, especially in young children (< 12 years). These findings suggest that VNS should be considered as an alternative therapy for patients proven to have seizures that are medically refractory, especially those younger than 12 years of age.     

超声刀和电刀对胃癌患者手术前后免疫功能及应激的影响

目的 探讨超声刀和电刀对胃癌根治术后免疫功能和术后应激的影响.方法 前瞻性分析63例胃癌改良根治术患者资料,其中35例使用超声刀,28例用电刀,比较两组淋巴结清扫时间、术中出血量、术后72 h引流量情况,应用流式细胞仪测定两组术后外周血中T淋巴细胞亚群CD3+、CD4+、CD8+、CD4+/CD8+比率,术后第2天检测血白细胞计数、粒细胞百分比、C反应蛋白、血糖.结果 超声刀组与电刀组相比,CD3+、CD4+、CD8+、CD4+/CD8+比率,血糖无明显差异(P>0.05);对比术中出血量、淋巴结清扫时间、术后72 h引流量、白细胞计数、粒细胞百分比、C反应蛋白,超声刀组均有明显减少(P<0.05或P<0.01).结论 两种工具在胃癌根治术中切除效果及对术后免疫功能影响无明显差异,但应用超声刀术后恢复快且对术后应激反应小.     

Expression of core?binding factor alpha 1 and collagen Ⅱ in patients with chronic kidney disease stage 5

Objective To study the relationship between the medial artery calcification and expression of core?binding factor alpha 1 (Cbfα?1) and collagen Ⅱ (ColⅡ) in chronic kidney disease(CKD) stage 5 patients. Methods Pieces of radial arteries were taken from 40 patients with CKD stage 5 during internal arteriovenous fistula operation. Ten patients with subtotal gastrectomy and normal renal function were chosen as control. The vessels were examined for calcification by von Kossa stain and for the presence of Cbfα?1 and ColⅡ by immunohistochemistry. According to von Kossa stain, CKD stage 5 patients were divided into no calcification group, mild?moderate calcification group and severe calcification group. Other related factors including serum calcium，phosphate, intact parathyroid hormone (iPTH), C?reactive protein (CRP), triglyceride(TG), cholesterol(TC) and low?density lipoproteins(LDL) were also detected. Results Seventeen (42.5%) of CKD Stage 5 patients showed vascular calcification, while calcification was not found in controls. Most calcification occurred in medial layer．Positive immunohistochemical staining of core?binding factor and ColⅡ was found in the smooth muscular cell plasma of medial layer in the vessels with calcification. However, above positive staining was also observed in 78.3% of no calcification group. But there was little staining in control group. Positive staining score of Cbfα?1 and ColⅡ in severe calcification group was significantly higher than that in no calcification group. Same findings were obtained in mild?moderate calcification group, but the difference between them was not statistically significant. CRP and Ca×P were positively correlated with staining score of Cbfα?1 and ColⅡ. Serum phosphate was positively correlated with Cbfα?1 (r=0.786, P<0.01) and ColⅡ (r=0.785, P<0.01) respectively． Conclusions 42.5% of CKD stage 5 patients in our group shows vascular calcification, which occurrs mainly in medial layer. High expression of Cbfα?1 and ColⅡ can be observed in vascular calcification of radial arteries, which is earlier than vascular histological changes. Cbfα?1 and ColⅡ may be involved in the development of vascular calcification.     

激光共聚焦显微镜观察钛板和死骨表面细菌生物膜的形成能力（英文）

背景：细菌在金属植入物和死骨表面附着并形成的生物膜是造成骨骼肌肉系统的慢性感染的根本原因。目的：观察并比较细菌在钛板和死骨表面形成细菌生物膜的能力。方法：用改良的基质培养法制备细菌生物膜模型,将10块钛板圆柱和10片死骨随机配对,每一对放置在同一个培养瓶中用其菌液浸泡淹没,在同一个培养环境中培养。用荧光染料对各组细菌生物膜进行染色,激光共聚焦显微镜下观察并采集图像。结果与结论：与死骨相比,钛板表面的细菌生物膜厚度较小（P〈0.05）,其细菌生物膜中层和深层的活菌率较高（P〈0.05）。说明细菌在死骨形表面成细菌生物膜的能力强于钛板。     

硒酵母联合308nm准分子激光治疗白癜风的临床疗效观察

目的探讨硒酵母联合308nm准分子激光治疗白癜风的临床疗效。方法 200例白癜风患者按治疗方式分为两组：100例硒酵母联合308nm准分子激光治疗患者为观察组,同期100例单纯308nm准分子激光治疗患者为对照组。比较两组患者过氧化氢酶（CAT）、谷胱甘肽-过氧化物酶（GSH-PX）、丙二醛（MDA）、脂质过氧化物（LPO）、免疫球蛋白G（IgG）及其亚类、临床疗效。结果连续治疗16周后,观察组患者血清GSH-PX、CAT明显高于对照组（P〈0.05）;观察组患者MDA、LPO明显低于对照组（P〈0.05）。观察组患者IgG、IgG1、IgG2a、IgG2b和IgG3的抗体水平显著升高,与对照组比较差异具有统计学意义（P〈0.05）。对照组治疗总有效率为64.0%,观察组总有效率为84.0%,观察组疗效明显优于对照组（P〈0.05）。结论硒酵母联合308nm准分子激光治疗白癜风疗效确切,值得临床推广使用。     

肌源干细胞治疗女性压力性尿失禁研究进展

压力性尿失禁(SUI)的治疗方法包括手术与非手术治疗,其中注射疗法以其简便、安全、微创而广受欢迎,但由于注射材料的局限,该疗法近期效果好,远期效果较差。肌源干细胞作为多能干细胞,不仅具有多向分化潜能,且具低免疫原性、无变应原性,能诱导分化成肌而具收缩性,是理想的注射材料,对它们的研究和发现为注射治疗SUI提供了广阔的应用前景。     

胰激肽原酶对自发性高血压大鼠肾损害的保护作用

背景 胰激肽原酶是一种糖蛋白,作用于激肽原,使之裂解生成激肽,激肽促进内皮细胞释放一氧化氮(NO)与前列腺素I2(PGl2),引起血管扩张、血管渗透性增加,从而发挥降压、保护肾脏、心脏等生理学作用.目的 观察胰激肽原酶干预对自发性高血压大鼠(SHR)肾功能的影响,探讨激肽释放酶激肽系统在高血压及肾脏保护方面的可能机制.方法 36周龄SPF级雄性SHR 12只随机分成高血压对照组(B组)与高血压治疗组[C组,给予胰激肽原酶800 U/(kg·d)灌胃治疗12周],每组各6只.另有年龄匹配的雄性WKY大鼠6只作为正常血压对照组(A组).治疗前、后,观察3组大鼠血压、血肌酐(Scr)、尿素氮(BUN)、NO、6-酮-前列腺素F1a(6-K-PGF1a)及尿微量白蛋白(MAU)、尿β2微球蛋白(β2-MG)、N-乙酰-β-D-氨基葡萄糖苷酶(NAG)浓度及肾脏组织病理改变,并用逆转录聚合酶链反应(RT-PCR)方法测定肾皮质组织型激肽释放酶mRNA的表达.结果 胰激肽原酶治疗后C组血压较B组明显下降(P＜0.01);MAU、β2-MG、NAG定量明显降低(P＜0.01),血清NO、6-K-PGF1a水平升高(P＜0.05);肾皮质组织型激肽释放酶mRNA表达水平增加(P＜0.05).对照组大鼠肾小球小动脉管壁增厚,管腔狭窄,个别小球硬化;胰激肽原酶治疗后肾小动脉结构正常,未见小球硬化.结论 胰激肽原酶能显著减少尿微量蛋白、逆转肾小动脉硬化改变,保护肾功能,其机制可能与血压下降,血清NO、6-K-PGF1a水平及肾脏组织激肽释放酶水平升高有关.     

薄荷水质量控制方法的研究

目的 完善薄荷水的质量控制方法。方法 采用薄层色谱法鉴别薄荷水中的薄荷素油,用气相色谱法测定薄荷水中薄荷脑的含量。结果 薄层色谱法鉴别专属性强;气相色谱法中,薄荷脑线性范围为5.0~80.0μg/ml(r=0.999 9),平均回收率为103.16%,RSD为1.81%。结论 该法操作简便,结果准确,灵敏度高,重复性好,可有效地控制薄荷水的质量。     

腰椎板开窗术后微小骨粒回植模型的建立及意义

目的 建立兔腰椎板开窗术后微小骨粒回植模型,为临床提供实验依据。方法 将18只雄性新西兰兔,分为两组。对照组在全麻后以L5棘突为中心,充分显露左侧L5椎板,用微型小枪钳慢慢咬去椎板、黄韧带,进行开窗术,暴露约0.8 x 0.3 cm大小骨窗后直接缝合处理。实验组在L5左侧开窗后将开窗咬下的碎骨粒剪碎,然后将碎骨粒镶嵌于医用胶原蛋白海绵,塑成拱桥形,放置于硬膜外开窗处,缝合切口,术后观察椎板开窗位置CT及组织学变化。结果 CT检查示术后8周实验组开窗处微小骨粒形成菲薄的骨板,12周后形成的骨板较厚,骨梁连续,椎管形态及容积无明显变化,未见脊髓受压。对照组开窗处在8、12周局部有少量骨质增生,周围黏连组织侵入椎管,椎管未重建。结论 兔椎板开窗处再植自体微小骨粒的骨重建,形成的骨板可遮挡疤痕侵入椎管,减少椎管内黏连。