ObjectivesTo study surgical outcomes and safety of unilateral anterior temporal lobectomy (ATL) in patients with intractable bilateral temporal lobe epilepsy (TLE) and dominant seizure-onset in unilateral temporal lobe. MethodsTwenty three carefully selected patients with bilaterial TLE and dominant seizure-onset in unilateral temporal lobe were enrolled and divided into surgery and medicine groups according to the treatment.Seizure control were recorded for 2 to 5 years.Changes of full scale of intelligence quotient(IQ),and overall quality of life (QOL),percentage of therapeutic satisfaction,and surgical complications were analyzed 2 years after enrolling. ResultsFavor seizure control (Engel Class I and Class Ⅱ) reached 66.7% (10/15),60% (9/15),and 50% (5/10) at 1,2 and 5 years follow-up after unilateral ATL respectively,the percentages in medicine group is 12.5%,0% and 0% accordingly,and there were significant differences in seizures controls between patients with unilateral ATL and cases with medicine.Significantly differences were also found in changes of patients'QOL and full scale IQ at 2 years follow-up between surgery and medicine groups,and average score of overall QOL improved 5.27±6.45 in surgery group,and declined 1.40±3.58 in medicine group.In ATL group,patients with short preoperative history of seizure presented more favor seizure control than those with long preoperative history,and patients with favor seizure control and short preoperative history of seizure had more chance to improve QOL and IQ after ATL. ConclusionIntracranial EEG is vital in diagnosis of bilateral TLE.Unilateral ATL presents favor seizure control and did not render serious memory and IQ injury in carefully selected patients with true bilateral TLE and dominant seizure-onset in unilateral temporal lobe.
ObjectiveTo investigate the drug use,symptoms and lung function of asthma patients in communities. MethodsA cooperation project of "Cohort Study in Putuo District Health Survey" was conducted by Shanghai Putuo People's Hospital and the Harvard School of Public Health from August 2007 to January 2010 .Home questionnaires were collected in the communities in 13 residential quarters in Changzheng town,Ganquan town in Putuo District,Shanghai. ResultsA total of 27 042 respondents was inquired,in which there were a total of 488 asthma patients with the total prevalence rate of 1.80 percent. 189 cases (47.49%) frequently used anti-asthma drugs in nearly a year,and 209 cases (52.51%) less frequently used anti-asthma drugs. In the patients frequently using anti-asthma drugs,FEV1%pred was (65.30±25.78)% with FEV1%pred ≥80% in 50 cases (32.68%).St. George score was 36.80±28.02 in this subgroup.More symptoms presented in 129 cases(69.73%)in the past year. In the patients less frequently using anti-asthma drugs,FEV1%pred was (81.55±19.01)% with FEV1%pred ≥80% in 99 cases (56.57%). St. George score was 7.61±15.56.There were symptoms presented in 42 cases (20.59%) in the past year. ConclusionMore than half asthmatic patients do not receive regular medicine treatment in communities in Shanghai. Some patients still suffer from asthma symptoms long with poor St. George score and lung function although frequently using anti-asthma medication,suggesting asthma treatment is not standard.