Gelastic seizure (GS) is a type of epilepsy characterized primarily by inappropriate bursts of laughter, with or without other epileptic events. Based on the timing of symptoms, the presence of emotional changes, and disturbances of consciousness, GS is classified into simple and complex types. The generation of laughter involves two major neural pathways: the emotional pathway and the volitional pathway. The neural network involved in GS includes structures such as the frontal lobe, insula, cingulate gyrus, temporal lobe, and brainstem.The most common cause of GS is a hypothalamic hamartoma, and stereotactic electroencephalography can record discharges from the lesion itself. Surgical removal of the hypothalamic hamartoma can result in immediate cessation of GS in the majority of patients, while some may experience partial improvement with persistent epileptic-like discharges detectable on scalp electroencephalography (EEG). Early surgical intervention may improve prognosis.In cases of non-hypothalamic origin of GS with no apparent imaging abnormalities, focal discharges are often observed on EEG and these cases respond well to antiepileptic drugs. Conversely, patients with structural abnormalities suggested by imaging studies tend to have multifocal discharges and a poorer response to medication. In a small subset of medically refractory non-hypothalamic GS, surgical intervention can effectively control symptoms.This article provides a comprehensive review of the etiology, neural networks involved, EEG characteristics, and treatment options for GS, with the goal of improving understanding of this relatively rare type of epileptic seizure.
Objective To explore the value of laparoscopic hepatectomy for small hepatocellular carcinoma (HCC) of non-peripheral type. Methods The clinical data of 34 patients with small HCC of non-peripheral type underwent laparoscopic liver resection from March 2008 to April 2011 in our hospital were analyzed retrospectively. Results Thirty-two patients received successful total laparoscopic hepatectomy without blockage of liver blood flow，and 2 were converted to open surgery. The operative time was （162±65） min （100-220 min） and the blood loss was （295±166） ml （100-750 ml）. There were postoperative complications in 4 patients， included cross-section bleeding in 2 cases and ascites in 2 cases. There were no complications such as biliary fistula， infection， carbon dioxide gas embolism， and so on. The mortality of perioperative period was 0. The postoperative hospital stay was （6±2） d （4-9 d）. The follow-up time was （23±7） months （5-42 months）. Thirteen patients developed intrahepatic tumor recurrence during follow-up. The overall and recurrence-free survival rate one year after operation was 90.6% （29/32）and 75.0% （24/32）， respectively. Conclusions Laparoscopic hepatectomy is a safe， feasible， and minimal invasive approach for small HCC of non-peripheral type，and it can be considered as a alternative treatment of HCC.
Objective To investigate critical thinking disposition inventory on medical students to offer evidence for building a medical education model with core competency as guide, evidence-based medicine as carrier and lifelong learning as purpose. Methods Chinese Version of Critical Thinking Disposition Inventory was used to investigate the current status of critical thinking of 617 medical undergraduates and graduates of Sichuan University. Results The average total score was more than 280 points. Average total scores of medical students in different educational systems from high to low were 309 points (eight-year-program), 298 points (postgraduates), 287 points (seven-year-program) and 286 points (five-year-program), respectively. The scores of three items including “seek truth”, “systematicity” and “confidence” were lower than 40 points in students both of five-year-program and seven-year program. There was no significant difference in total scores and each item between genders and varied ages. Conclusion The main factors which influence critical thinking in medical students of China include education idea, teaching atmosphere, teaching methods and teaching evaluation system.
ObjectiveTo compare the effectiveness of partial versus intact posterior cruciate ligament (PCL)-retaining in total knee arthroplasty (TKA) with cruciate-retaining (CR) prosthesis.MethodsA total of 200 patients with osteoarthritis, who met the selection criteria and proposed unilateral TKA with CR prosthesis, were included in the study and randomly assigned into two groups (n=100). The patients were treated with intact retention of the double bundles of PCL in intact group and with partial resection of the anterior lateral bundle of PCL and the anterior bone island at the time of intraoperative tibial osteotomy in partial group. Patients with lost follow-up and re-fracture were excluded, and 84 cases in partial group and 88 cases in intact group were included in the final study. There was no significant difference between the two groups (P>0.05) in terms of gender, age, body mass index, course and grade of osteoarthritis, preoperative varus deformity of knee joint, flexion contracture, range of motion, clinical and functional scores of Knee Society Score (KSS). The operation time, wound drainage volume during 24 hours after operation, visual analogue scale (VAS) score at 24 hours after operation, range of motion of knee joint, clinical and functional scores of KSS, and the anteroposterior displacement of knee joint at 30° and 90° flexion positions were compared between the two groups.ResultsThere was no significant difference between the two groups in operation time, wound drainage volume during 24 hours after operation, and VAS score at 24 hours after operation (P>0.05). Patients in both groups were followed up after operation. The follow-up time was 25-40 months (mean, 30.2 months) in intact group and 24-40 months (mean, 31.8 months) in partial group. There was no significant difference in the range of motion and clinical scores of KSS between the two groups at 6, 12, and 24 months after operation (P>0.05). The functional scores of KSS were significantly higher in intact group than in partial group (P<0.05). There was no significant difference between the two groups in the anteroposterior displacement of knee joints at 30° flexion position at 6, 12, and 24 months after operation (P>0.05). When the knee was at 90° flexion position, there was no significant difference between the two groups at 6 and 12 months after operation (P>0.05), but the intact group was significantly smaller than partial group at 24 months after operation (P<0.05). Postoperative incision continued exudation in 4 patients (2 cases of partial group and 2 cases of intact group), and incision debridement in 2 patients (1 case of partial group and 1 case of intact group). No prosthesis loosening, excessive wear, or dislocation of gasket was found during follow-up.ConclusionThe double bundle of PCL plays an equally important role in maintaining the stability of the knee joint, and the integrity of PCL should be kept as much as possible when TKA is performed with CR prosthesis.
Speech feature learning is the core and key of speech recognition method for mental illness. Deep feature learning can automatically extract speech features, but it is limited by the problem of small samples. Traditional feature extraction (original features) can avoid the impact of small samples, but it relies heavily on experience and is poorly adaptive. To solve this problem, this paper proposes a deep embedded hybrid feature sparse stack autoencoder manifold ensemble algorithm. Firstly, based on the prior knowledge, the psychotic speech features are extracted, and the original features are constructed. Secondly, the original features are embedded in the sparse stack autoencoder (deep network), and the output of the hidden layer is filtered to enhance the complementarity between the deep features and the original features. Third, the L1 regularization feature selection mechanism is designed to compress the dimensions of the mixed feature set composed of deep features and original features. Finally, a weighted local preserving projection algorithm and an ensemble learning mechanism are designed, and a manifold projection classifier ensemble model is constructed, which further improves the classification stability of feature fusion under small samples. In addition, this paper designs a medium-to-large-scale psychotic speech collection program for the first time, collects and constructs a large-scale Chinese psychotic speech database for the verification of psychotic speech recognition algorithms. The experimental results show that the main innovation of the algorithm is effective, and the classification accuracy is better than other representative algorithms, and the maximum improvement is 3.3%. In conclusion, this paper proposes a new method of psychotic speech recognition based on embedded mixed sparse stack autoencoder and manifold ensemble, which effectively improves the recognition rate of psychotic speech.
Objective To explore the effects of evidence-based medicine (EBM) course on improvement of information consciousness and information morality for medical students.Methods A total of 288 medical undergraduates and postgraduates, who took EBM as an elective course in Sichuan University, were surveyed with ‘information consciousness and information morality questionnaire’ before and after that course. Results After the EBM course, the number of students surfing the Internet increased by 5%, of which postgraduates increased by 24% with significant differences (Plt;0.05), while their purpose for specialized knowledge increased by 7%; the number of students making plans in advance increased by 7%, and the number of students learning intellectual property and copyright law increased by 7%; the number of postgraduates knowing how to cite articles increased by 12% with significant differences (Plt;0.05); and the number of students not knowing how to get legitimate information decreased by 12% with significant differences (Plt;0.05). Conclusion Evidence-based medicine course is positive for the information consciousness and information morality of medical students.
Objective To investigate the information literacy status of medical students, so as to provide references for further developing information literacy education. Methods A total of 764 medical undergraduates and postgraduates in Sichuan University were investigated by using “information literacy questionnaire”. Results A total of 744 feedbacks among 764 distributed questionnaires were qualified, accounting for 97.4%. Among then, 37.2% students could easily tell the key words for required information, 26.1% students could make a plan before searching information, 25.5% students could choose appropriate databases for searching, 14.7% students could critically appraise the information, and only 12.4% students had received systematic trainings on intellectual property rights and copyrights. Conclusion Most students of West China School of Medicine of Sichuan University possess good information consciousness, but their critical appraisal for information and information morality need to be improved further.