Objective To understand the status quo of medical staffs engaged in epilepsy and EEG in Shanxi Province, analyze the existing problems, and summarize the improvement and development direction of epilepsy and EEG in Shanxi Province. Methods A questionnaire survey was conducted among medical staff of epilepsy and electroencephalogram specialty in public hospitals at or above county level in whole province and municipalities. Results ① Generally speaking, there are 17 males and 473 females in this study, with an average age of 38.7 years, the youngest was 23 years-old and the oldest was 70 years-old; ② The regional distribution has a tendency of decrease from Taiyuan in Shanxi Province to the remote areas of southeast, northwest and northwest China, and the epilepsy treatment in some poverty-stricken areas have not even been carried out; ③ The shortest time of working is 3 months and the longest is more than 40 years. The proportion of junior collage students, undergraduates, masters and doctors is 24%, 50%, 25% and 1% respectivel. The professional titles of primary, medium-level, vice-senior and senior are 24%, 39%, 26% and 11% respectively. Conclusion The number of medical workers engaged in EEG specialty in Shanxi Province is insufficient, the regional development is not balanced, and the number of junior and medium-level professional titles is large. We can formulate a mobile policy to encourage experienced medical personnel to communicate with weak areas, so as to improve the overall level of epilepsy and EEG professional development in Shanxi Province.
Objective The purpose of this study was to explore the expressions of EPO-R, JAK2 and STAT-5 in the human brain with refractory epilepsy and the role in neural apotosis. Methods Collecting the brain tissue of 24 patients with intractable epilepsy (as experimental group) who were hospitalized and underwent surgery in the Epilepsy Center of the First Hospital Jilin University between March 2010 to July 2011 and 6 cases of accidental or unnatural death immediately following autopsy (as control group) as required by law during the same term. Immunohistochemical was performed to observe the expression of EPO-R, JAK2 and STAT-5 in brain tissue and statistical analysis was performed. Results ① EPO-R, JAK2 and STAT-5 were expressed in both experimental and control groups. In experimental group, the positive-cell number were 41.05±2.40, 50.21±2.50 and 60.18±2.84 under light microscope (400×). While in control group, the positive-cell number were 23.00±0.49, 27.00±0.88 and 25.93±0.33. There were significant differences between the 2 groups (P<0.001). ② There were the pathologic and ultrastructural changes in the human brain with refractory epilepsy. Under the optical microscope, we can observe that the distribution of neurons was uneven and immature neurons were visible. We can see that the nuclei were vacuolar, less cytoplasm, dark staining, hyalomitome acidophilic body, and the neurons became triangular due to degeneration. The proliferation and hyperemia appeared in small vascular and glial cells. Under the transmission electron microscope we observed degeneration and necrosis of the nerve cells, nuclear karyopyknosis, nucleolis dyssymmetry and karyolemma breakage and even dissolution. The mitochondria and astrocytes were swelling. We also saw that part of the mitochondrial cristae was abnormal. Conclusion ① We found neuronal apotosis in the human brain with refractory epilepsy. ② The expression of EPO-R, JAK2 and STAT-5 in intractable epilepsy was significantly increased in neurons and glial cells compared with the control group. The high expression of EPO-R, JAK2 and STAT-5 is unrelated with course and frequency of epileptic seizures. ③ The pathway of EPO-R/JAK2/STAT-5 may be involved in the pathophysiological processes of neural protective effect of endogenous EPO against brain injury induced by epileptic seizures.
ObjectiveTo study the differentially expressed proteins of recombinant human erythropoietin (r-HuEPO) in hippocampus of Pentetrazol (PTZ) -induced epileptic rats, and to provide a basis for exploring the pathogenesis of epilepsy and seeking new therapeutic targets. Methods Twelve 6~8-week-old Sprague Dawley rats that weighted 230~250 g were randomly divided into two groups: PTZ group, PTZ+ EPO group. The differential proteins of recombinant human EPO in hippocampus of pentylenetetrazole-induced epileptic rats were analyzed and identified by TMT technique based on mass spectrometry.Results 139 differentially expressed protein sites were detected in hippocampal tissues of epileptic rats, of which 55 were up-regulated and 84 down-regulated. Conclusion Recombinant human erythropoietin can inhibit many differentially expressed proteins in the hippocampus of pentaerythraze-induced eclampsia rats by upregulation of Isocitrate dehydrogenase (NADP), Reduced nicotinamide purine dinucleotide phosphate (NADPH), Thioredoxin reductase 2 mitochondrial (TrxR), reduce nerve cell damage.
Objective To investigate the efficacy and safety of ultrasound-guided TAP block for the anesthesia in peritoneal dialysis (PD) catheter implantation. Methods Patients with end-stage renal disease who intended to receive PD catheter implantation in the West China Hospital of Sichuan University were enrolled from April 2015 to February 2016. Those who met the inclusion criteria were randomly divided into two groups: the local filtration anesthesia (LF) group and the TAP group. The two groups got the ultrasound guided TAP block (The LF group got a shame TAP block by making the skin wheal and just inserting the needle into the TAP with the guidance of ultrasound), then the LF group received local filtration anesthesia twenty minutes later, with the TAP group had sham LF anesthesia by injection of saline at the incision subcutaneously. The anesthetist generated the random allocation sequence and performed all TAP/sham blocks according to the allocation of each patient. The patients, investigators were all blind to the allocation. The follow-up time was 3 months. The primary outcomes were the rate of alteration to general anesthesia and the VAS score during and after the surgery. The dosages of sufentanil for analgesia during and after were recorded. The satisfaction to the effect anesthesia by the operation doctors, PD catheter related complications and adverse events related to TAP block or anesthetic agent were also recorded. Statistic analysis was conducted using SPSS 19.0 software. Results A total of 36 patients were included, 12 cases in the LF group and 24 cases in the TAP group. The rate of alteration to general anesthesia in the TAP group was 4.12% and was significantly lower than that in the LF group (33.3%) (P=0.034). The VAS scores at the time points of incision of skin, division of subcutaneous tissue and anterior rectus sheath, opening the peritoneum, insertion of PDC, suture of skin, 2 hours and 24 hours after operation were significantly lower in the TAP group compared to the LF group (P values=0.001, 0.037, 0.000, 0.001, 0.029, 0.035, and 0.000, respectively). The TAP group consumed less sufentanil during the operation and showed a higher satisfaction of the operation doctors. There were no significant differences in the PD catheter related complications and adverse events between the two groups. Conclusion The ultrasound-guided TAP block can be an effective and safe anesthesia method for PD catheter implantation. Because of the limitation of small sample size of this study, a multiple center study with larger sample size is suggested.
This is the sixth paper in the evidence-based medicine glossary series. In this paper, We mainly introduced the concept of research synthesis, systematic review and meta-analysis and review developing process of these glossary.