ObjectiveTo observe the dynamic changes of neuroglobin (NGB) expression in hippocampus after status epilepticus(SE) in rats, and to explore the role of NGB in epileptic seizures.Methods40 healthy male Sprague Dawley rats were randomly divided into two group according to random number table method:control group (n=5) and epilepsy model group(n=35).Epilepsy model group according to observation time was divided into:0h, 1h, 3h, 12h, 24h, 10d and 30d.Intraperitoneal injection Lithium-pilocarpine (20 mg/kg~127 mg/kg, Li-PC) to establish the rat model of SE.Observe the behavioral changes in rats with epilepsy.Nissl staining was used to detect the neuronal damage in hippocampus. Streptavidin-biotin-peroxidase complex immunohistochemical method was used to detect the expression level of NGB in hippocampus;ResultsAfter SE, the neurons in hippocampus were severely damaged with the progress of epileptic seizures, the number of surviving neurons in CA1, CA3 regions showed a near linear decline.Among them, the number of surviving neurons in (12h, 24h, 10d, 30d)CA1, (0h, 12h, 24h, 10d, 30d)CA3 and(12h, 24h, 10d, 30d) DG area were significantly lower than that of the control group (P < 0.05).The expression level of NGB in CA1, CA3 and DG region of hippocampus were increased after SE, and both of CA1 and DG were reached peak in 24h after SE, but was still higher than the control group.And the CA3 area showed a continue rising trend.Among them, CA1(24h, 10d, 30d), CA3(24h, 10d, 30d) and DG(12h, 24h, 10d, 30d) were higher than that of control group significantly (P < 0.05).In addition, it was found that there was a positive correlation between the number of surviving neurons in CA3 area and the expression level of NGB (R=0.306, P=0.011).ConclusionUp-regulation of NGB expression in hippocampus after status epilepticus, and was positively correlated with the number of neurons in the CA3 area, suggesting that up regulation of NGB expression may be a compensatory protective mechanism of ischemic injury induced by seizures, and participate in the protection of epilepsy related neuronal damage.
Purpose To analyze the clinical characteristicsand prognostic factors of Status epilepticus (SE) in children. Methods The clinical data of 33 children with SE treated in Jinan Central Hospital Affiliated of Shandong University from January 2014 to June 2021 were collected, and their clinical characteristics were analyzed. Then, according to Glasgow prognosis scale, the children were divided into good prognosis group (n=20) and poor prognosis group (n=13). The age of first attack, duration of attack, type of attack and SE classification, EEG, cranial imaging and etiology were used to analyze the influencing factors of SE prognosis. Results 75.7% were 0 ~ 6 years old in the age of first attack, and 29 cases of convulsive status epilepticus accounted for 87.9% in the classification of seizure types. There were significant differences in age of first attack, duration of attack, EEG, history of mental retardation and etiology between the two groups (P<0.05); Logistic regression analysis showed that the age of first attack, duration of attack, history of mental retardation and EEG were independent factors affecting the prognosis. Conclusion Low age, especially ≤ 6 years old, is the high incidence of SE in children at first attack. Most children are symptomatic and have obvious incentives. Convulsive SE is the main type of SE in children. The age of first onset, duration of epilepsy, history of mental retardation, and EEG can affect the prognosis of SE.
Objective Through investigating and analyzing the training status quo of rural doctors in Liangshan Yi Autonomous Prefecture of Sichuan province, to find out problems existing in the training. Methods In October 2010, the on-site questionnaires were distributed to 300 rural doctors from 13 counties who were studying at medical schools of Liangshan Prefecture. The data of their training status were recorded with Epidata 3.0 software and then analyzed with SPSS 16.0 software. Results Among the total 300 questionnaires distributed, 279 were valid with the response rate of 93%. The results showed that: rural doctors in Liangshan Prefecture were generally low in education background and short of knowledge and skills, and took over the burden of the training tuition; and the training content was not fully correlated with theirs actual demands. Conclusion This paper suggests, the in-service training should be conducted on the following bases: the actual situation of Liangshan Prefecture, the adequate consideration of characters of minority region, the improvement of training quality, and the formulation of supporting policies and implementing methods.
Clinical pharmacy practice guidelines have developed rapidly in recent years. They provide a series of recommendations for optimizing drug treatment management and improving pharmaceutical care appropriateness and are widely employed in clinical practice. Based on literature review and the experience of guideline development, this paper summarized the meaning, formulation methods, formulation status, and registration of clinical pharmacy practice guidelines, and provided suggestions for the development of guidelines.
Objective To study the factors that affect the prognosis of status epilepticus (SE) and to improve the understanding of clinicians. Methods A retrospective analysis of 57 patients with SE witch from the General Hospital of Ningxia Medical University and Cardio-cerebrovascular Disease Hospital were carried out to collect their clinical data. The data were analyzed by SPSS 17.0 software. The prognosis of the patients was assessed by the Status epilepticus severity score (STESS) scale. Results A total of 57 patients were included, 53 cases improved, 4 cases were automatically discharged. Telephone follow-up showed that 4 cases of automatic discharge were dead. The mortality rate of SE was 7.02%. The most common cause of SE was acute cerebrovascular disease (17.54%), followed by intracranial infection (10.53%); The most common incidence were the occasional medication, self-medication, withdrawal (15.79%). Age, state of consciousness and concurrent infection were associated with prognosis (improvement/death) (P<0.05). STESS score of 0 to 2 points were 45 patients, all improved; score of 3 to 5 points were 12 patients, 8 patients improved, 4 patients died. There were significant differences in the prognosis between the two groups (P<0.05). Conclusions Age, state of consciousness, concurrent infection were related to prognosis, more than 65 years, the state of consciousness for the sleeping or coma had the poor prognosis. STESS scale can predict the prognosis of patients effectively.
Objective To investigate the disease constitution and hospitalization cost in Yong’an Central Township Health Center (YaC) in Shuangliu County of Sichuan Province from 2008 to 2010, so as to provide baseline data for further research. Methods Questionnaire and focus interview were carried out; case records and cost information of YaC inpatients in 2008, 2009 and 2010 were collected. The diseases were classified according to ICD-10 based on the first diagnose and the cost was analyzed. Data including general information of the inpatients, discharge diagnosis, hospitalization expenses, and drug cost etc. were rearranged and analyzed by Excel software. Results a) The total number of inpatients were 4 236, 4 335 and 4 844 in 2008, 2009 and 2010, respectively. Females were more than males (56.99% vs. 42.96%, 55.59% vs. 44.1%, 54.36% vs. 45.62%), and their disease spectrum included 20 categories, which accounted for 95% of disease classes of ICD-10; b) The inpatients suffering from top three systematic diseases accounted for 62.74% to 72.31%, which included the respiratory, digestive, urinary tract and urogenital systematic disease; c) The top 15 single diseases were upper respiratory infection, acute bronchitis, pulmonary infection, acute gastroenteritis, fracture, acute appendicitis, chronic bronchitis, calculi in urinary system, cerebral vascular insufficiency, lumbar vertebra disease, acute gastritis, superficial injury, chronic gastritis, hypertension, and cholecytolithiasis or cholecystitis; d) The number of inpatients in the group of over 15-24 ages with chronic diseases increased with age and females were more than males. The acute disease burden of inpatients in 0-4 age group was the heaviest, who only suffered from acute diseases and males were more than females. The inpatients in 25-54 age group suffered from more acute diseases than chronic diseases and females were more than males; and e) The inpatients’ average costs of chronic diseases were higher than those of acute diseases in 2010 (1 564.45 yuan vs. 1 104.11 yuan) and those of either Xintian Central Township Health Center (1 311.81 yuan) or Gaozha Central Township Health Center (1 002.99 yuan). Conclusion a) In recent three years, the main systematic diseases that inpatients suffer are digestive, respiratory, and urinary tract and urogenital system diseases; the acute diseases are more than the chronic; the acute diseases mainly include infection and injury; b) During the past three years, the top 15 diseases have been stable and the same diseases include upper respiratory infection, pulmonary infection, acute bronchitis, acute appendicitis, acute gastritis, acute gastroenteritis, fracture, chronic gastritis, chronic bronchitis, and calculi in urinary system; c) It should be paid attention to the inpatients with chronic diseases in over 15-24 age group and the inpatients with acute diseases in 0-4 age group; and d) The inpatients’ average costs of top 15 diseases in 2010 were higher than those of either XtC or GzC, and consideration on rationality of the hospitalization cost should be paid attention to.
Status epilepticus (SE) is one of the most common neurological emergencies. Prolonged seizures can cause permanent neuronal death in the central nervous system, necessitating early recognition and timely intervention. Although there is some consensus on the diagnosis and treatment of SE, the high heterogeneity of SE patients presents a significant challenge for standardized management and prognosis prediction. This review summarizes the current research progress on the diagnosis, treatment, and prognosis of SE, aiming to provide references for early diagnosis, early treatment, and early prediction of prognosis.
ObjectiveTo study the status-quo of doctors' workload in China, analyze its influential factors, and to provide references for relevant policy-making. MethodsA multi-centre cross-sectional study was conducted. Clinical doctors who had worked for more than 6 months from 46 hospitals in 10 provinces were enrolled. The included doctors' workload was measured with working time per week and number of daily service patients. SPSS 20.0 software was used to analyze the data. ResultsA total of 1 537 doctors were included. The number of daily service outpatients and that of daily service inpatients per doctor were 22.17±20.95 person and 13.24±11.13 h, respectively. Working time per week were 54.06±10.76 h. The significant influential factors of the number of daily service outpatients were gender, employment relationship, hospital grade, age, professional title, and location; while those of the number of daily service inpatients were hospital grade, professional title, and location. Besides, type of department, hospital grade, doctor's age, education background and location were closely related to working time per week. ConclusionChinese doctors' workload is very heavy especially for long-time work. Hospitals and health departments should develop some target measures to reduce doctor's workload, so as to ensure medical safety.
Objective To investigate the medical technical services of the primary health care institutions in Chengdu and provide suggestions to improve their capability. Methods From October to November 2016, a questionnaire survey was conducted towards all the 390 primary health care institutions (including urban community health service centers and rural township health centers) in the 22 districts/cities/counties of Chengdu. Descriptive statistical methods was used for analysis. Results A total of 390 questionnaires were issued, and 379 valid questionnaires were recovered. In the primary health care institutions, the proportion of laboratory technicians, ultrasound technicians, electrocardiogram technicians and radiological technicians accounting for overall medical staffs was 3.32%, 2.04%, 1.75%, and 2.43%, respectively. The setup rate of laboratory, B-ultrasonic room, electrocardiogram room in the urban community health service centers was 94.02%, 93.16%, and 94.02%, respectively, which was similar with the rural township health centers (93.51%, 95.42%, and 90.08%, respectively). The top three medical technical services provided by the primary health care institutions were blood glucose test (96.04%), blood routine test (95.25%) and urinary routine test (95.25%), and the latter three were lung function test (18.21%), blood gas analysis (8.18%) and CT (5.28%). Conclusion Primary health care institutions in Chengdu need to improve the standardization of medical technical projcects and improve their service capability.
Objective To investigate the inpatient disease constitution of Jili Community Health Service Center (JCHSC) in Liuyang City of Hunan Province from 2008 to 2010, so as to learn about the local burden of diseases and to provide baseline data for further study. Methods Both questionnaire and focus interviews were applied to collect inpatients’ records in JCHSC between 2008 and 2010. Based on the primary diagnosis on hospital discharge record, the diseases were standardized and classified according to the International Classification of Disease, 10th Edition (ICD-10). Data including general information of the inpatients and discharge diagnosis were rearranged and analyzed by using Microsoft Excel 2003 and SPSS 13.0 software. Results a) The total numbers of inpatients were 4 804, 6 011 and 6 552 in 2008, 2009 and 2010, respectively, and males were less than famales (37.89% vs. 62.11%, 37.68% vs. 62.32%, 41.09% vs. 58.91%); b)The disease spectrum included 19 to 21 categories, accounting for 90.5% to 100% of ICD-10; c) The top 5 systematic diseases accounted for 78.91%-83.61%, including circulate, digestive, pregnancy, parturition and puerperium, genitourinary, and respiratory system diseases; d) The top 15 single diseases were coronary heart disease, urinary calculi, cholecyslithiasis or accompanied with cholecystitis, chronic gastritis, hypertension, diabetes, chronic bronchitis, pulmonary infection and inguinal hernia; and e) In these 3 years, most of the inpatients suffered from chronic diseases rather than acute diseases, mostly over 35 years old; while the acute diseases were commonly seen in patients younger than 15 years old. Conclusion a) In recent 3 years, the major inpatient systematic diseases are circulate, digestive, pregnancy, parturition and puerperium, genitourinary, and respiratory system diseases. The chronic diseases are more than the acute, and mainly focus on coronary heart disease, urinary calculi and chronic bronchitis; b) Nine common inpatient disease spectrum of the top 15 single diseases keep same in recent 3 years; and c) Further attention should be paid to the chronic patients over 35 years old and the acute patients less than 15 years old.