Epilepsia partialis continua in a patient with Behçet's disease

Behçet's disease (BD) is a multisystemic, recurrent, inflammatory disorder of unknown aetiology. Neurological involvement is characterised either by primary parenchymal lesions or secondary to major vascular involvement. Seizures are rarely seen in BD and their occurrence can be related to seizure provoking factors or exacerbation of the disease. We experienced a case of neuro-BD presenting with subacutely developing mental and behavioral changes, followed by left dominant tetraparesis with bilateral pyramidal signs, fever and left hand focal motor seizures with elementery clonic motor signs which later evolved into right hand epilepsia partialis continua (EPC) of Kojevnikov. The seizures were very resistant to antiepileptic drugs and 8 months after neurological involvement the patient died. The EPC evolving after neurological involvement is associated with high mortality rate.     

Comparison of Short Form-36 Health Survey and Nottingham Health Profile in moderate to severe patients with COPD

Objective  To compare the health-related quality of life (HRQoL) assessed by Short Form-36 Health Survey (SF-36) and Nottingham Health Profile (NHP) on the basis of lung function and exercise capacity parameters in patients with moderate to severe chronic obstructive pulmonary disease (COPD).
Methods and materials  The investigation was a prospective, quality-of-life survey and cross-sectional study of 130 consecutive COPD patients. The NHP and SF-36 as generic HRQoL instruments, the Chronic Respiratory Disease questionnaire (CRQ) as a disease-specific HRQoL instrument and 6-minute walking test, severity of dyspnea, leg fatigue and lung function, were the measurements and instruments used in the study.
Results  It was determined that the subscales of both questionnaires were generally related with the FEV₁, walking distance, CRQ, severity of dyspnea and leg fatigue values ( P  < 0.05). The much higher correlation coefficient was determined between these parameters and NHP compared with the SF-36. Only NHP was found to be correlated with the age, body mass index and smoking consumption ( P  < 0.05).
Conclusions  The stronger relation of NHP with the clinical and physical parameters of the patients compared with that of SF-36 may be associated with the increased sensitivity of NHP to the clinical state owing to the increasing respiratory symptoms of our old patients with moderate to severe obstruction and/or the more intelligible and easy-to-respond nature of NHP compared with SF-36.     

慢性HBV感染患者血清CP，HNF1α与肝组织病理分级及分期的相关性研究

目的　分析慢性乙型肝炎病毒（ hepatitis B virus,HBV）感染者血清铜蓝蛋白（ ceruloplasmin,CP）、肝细胞核因子 1α（hepatocyte nuclear factor 1α,HNF 1α）与肝组织病理分级及分期的相关性。方法　选取 2018年 2月～ 2020年 12月于甘孜藏族自治州人民医院就诊并接受肝脏活组织检查的慢性 HBV感染者 158例,并选取同期医院内体检正常者 50例为对照组,检测血清 CP,HNF 1α,丙氨酸氨基转移酶（ alanine transferase,ALT）和天门冬氨酸氨基转移酶（aspartate amino transferase ,AST）,并对慢性 HBV感染患者进行肝穿刺病理检查,评估组织炎症分级（ G0～ G3）和纤维化分期（ F0～ F4）,分析患者血清 CP,HNF 1α水平与肝组织病理分级及分期的相关性。结果　感染组 CP（205.63±18.74 mg/L）和 HNF 1α（3.25±0.91 ng/ml）水平低于对照组（ 283.59±22.35 mg/L,6.38±0.83 ng/ml）, ALT（149.67±23.91 U/L）和 AST（109.84±19.23 U/L.）水平高于对照组（ 25.13±5.62 U/L,19.93±4.37 U/L）,差异具有统计学意义（ t=21.634～ 36.457,均 P＜ 0.05）。＜ G2级患者 CP（211.37±20.54 mg/L）和 HNF 1α（3.42±1.05 ng/ml）水平高于 ≥ G2级者（ 186.86±15.32 mg/L,2.69±0.83 ng/ml）; ALT（134.56±17.68 U/L）和 AST（92.53±17.93 U/L）水平低于≥ G2级者（ 199.08±22.34 U/L,166.45±20.58 U/L）,差异具有统计学意义（ t=3.872～ 21.183,均 P＜ 0.05）。＜ F2期患者 CP（215.69±21.37 mg/L）和 HNF 1α（3.58±1.12 ng/ml）水平高于 ≥ F2期者（ 171.54±16.64 mg/L,2.13±0.55 ng/ml）;ALT（130.25±16.52 U/L）和 AST（84.53±18.23 U/L）水平低于≥ F2期者（215.48±21.69 U/L,195.61±21.37 U/L）,差异均具有统计学意义（ t=7.431～ 30.857,均 P＜ 0.05）。血清 CP和 HNF 1α升高分别是肝组织炎症（ OR=0.776,0.832）或纤维化显著（ OR=0.753,0.848）的独立保护因素（均 P＜ 0.05）;CP,HNF 1α分别与 ALT和 AST呈负相关性（r=-0.452,-0.429;-0.521,-0.483,均 P＜ 0.05）。结论　血清 CP和 HNF 1α水平与慢性 HBV感染患者病情严重程度密切相关,可反映肝组织炎症及纤维化进程。     

Serum measurement of interleukin‐31 (IL‐31) in paediatric atopic dermatitis: elevated levels correlate with severity scoring

Background Interleukin‐31 (IL‐31) is a novel T‐helper‐lymphocyte‐derived cytokine that plays an important role in human T‐cell‐mediated skin diseases. When overexpressed in transgenic mice, IL‐31 induces severe pruritus resembling eczema in humans. Serum IL‐31 was previously found overexpressed in adults with atopic dermatitis (AD). The novelty of this study is the use of a pediatric patient group as well as comparison of IL‐31 levels during flare and quiescence. Objective This case‐controlled longitudinal study was designed to determine the levels of IL‐31 in serum of AD children and its associations in relation to disease activity and severity. Methods Sera were obtained from 50 AD children and 40 healthy volunteers. IL‐31 levels were measured using a sandwich ELISA. All AD patients were followed up and re‐sampled for serum IL‐31 after clinical remission. Serum IL‐31 levels were correlated with AD disease activity and severity variables. Results Serum IL‐31 levels were significantly higher whether during AD flare [median, 1600; mean (SD) = 1457.8 ± 770.4 pg/mL] or quiescence (1040; 958.7 ± 419.5 pg/mL), than those in controls (220; 197.3 ± 91.9 pg/mL). Serum IL‐31 levels were significantly higher in the high disease severity group compared with the moderate or low severity group. Moreover, serum IL‐31 levels correlated positively with the calculated severity scores (LSS, SSS and SCORAD index). Conclusion The results of this study confirm the importance of IL‐31 in AD pathophysiology. Serum IL‐31 level is an objective reliable marker of AD severity in children. It may represent a novel target for antipruritic drug development.     

Fascioliasis: US, CT, and MRI findings with new observations

Background: The purpose of this study is to describe the ultrasonographic (US), computed tomographic (CT), and magnetic resonance imaging (MRI) findings in fascioliasis and to emphasize the impact of radiology in diagnosis. Methods: Radiologic findings in 23 consecutive patients with fascioliasis were prospectively recorded. All patients had at least one US and CT examination, and 10 of them were studied by MRI. All diagnoses were confirmed by serologic methods. In the first three cases, initial diagnosis was reached by microscopic demonstration of the parasites' eggs in bile obtained by US-guided gallbladder aspiration. Results: In the hepatic phase of fascioliasis, multiple, confluent, linear, tractlike, hypodense, nonenhancing hepatic lesions were detected by CT. On US, the parasites could be clearly identified in the gallbladder or common bile duct as floating and nonshadowing echogenic particles. MRI showed the lesions as hypo- or isointense on T1-weighted images and as hyperintense on T2-weighted images. Conclusions: CT findings in the hepatic phase and US findings in the biliary phase are characteristic of fascioliasis. Because clinical and laboratory findings of fascioliasis may easily be confused with several diseases, radiologists should be familiar with the specific radiologic findings of the disease to shorten the usual long-lasting diagnostic process. Received: 15 December 1999/Accepted: 26 January 2000     

舒芬太尼对0.75%罗哌卡因蛛网膜下腔阻滞效应的影响

目的:观察舒芬太尼对0.75%罗哌卡因蛛网膜下腔阻滞效应的影响。方法:40例择期行下腹部以下手术患者(ASAⅠ～Ⅱ级)随机分成两组:Ⅰ组(n=20)的蛛网膜下腔用药为罗哌卡因22.5mg,Ⅱ组(n=20)为罗哌卡因22.5mg+舒芬太尼5μg。分别观察两组的蛛网膜下腔阻滞效应及相关的副反应。结果:两组之间的血流动力学指标及相关副反应均无统计学差异(P>0.05)。运动阻滞起效时间、达最大运动阻滞时间、最大Bromage分级、运动阻滞持续时间、感觉阻滞起效时间、镇痛向尾延伸时间、痛觉减退平面和痛觉消失平面均无明显差异(P>0.05)。而镇痛向头延伸时间、镇痛减退至T12时间、镇痛持续时间Ⅱ组均长于Ⅰ组(P<0.01)。结论:小剂量舒芬太尼可明显延长0.75%罗哌卡因蛛网膜下腔阻滞的感觉阻滞时间,且无明显副反应,适合于时间较长的下腹部及下肢手术的麻醉。