Wernicke's encephalopathy in a rectal cancer patient with atypical radiological features:A case report

BACKGROUND Wernicke's encephalopathy is a disease caused by thiamine deficiency.The lesions usually involve the periphery of the aqueduct,midbrain,tectum,third ventricle,papillary body,and thalamus.It is very rare to affect the vermis and cerebellar hemispheres.CASE SUMMARY We report a 77-year-old female patient admitted to the emergency department of our hospital for 2 d of unconsciousness.Brain magnetic resonance imaging showed increased diffusion weighted imaging signals in the bilateral thalamus,periventricular regions of the third ventricle,corpora quadrigemina,vermis,and cerebellar hemispheres.Wernicke's encephalopathy was considered.She was given thiamine therapy and became conscious after the treatment.CONCLUSION Wernicke's encephalopathy may have various imaging manifestations.Clinicians should keep in mind that Wernicke’s encephalopathy may occur in patients who experience prolonged periods of malnutrition.

Influence of adjuvant levetiracetam therapy on serum nerve cytokines and apoptosis molecules in patients with refractory partial epileptic seizure

Objective:To study the influence of adjuvant levetiracetam therapy on serum nerve cytokines and apoptosis molecules in patients with refractory partial epileptic seizure.Methods: A total of 92 patients with refractory partial epileptic seizure treated in our hospital between July 2012 and January 2016 were divided into control group (n=46) and observation group (n=46) according to random number table. Patients in the control group were treated with routine treatment, those in observation group were treated with routine treatment plus adjuvant levetiracetam therapy, and the treatment lasted for 20 weeks. Serum contents of nerve cytokines and apoptosis molecules were compared between two groups before and after treatment.Results:Before treatment, differences in serum levels of nerve injury indexes, nerve protection indexes, monoamine neurotransmitters and apoptosis molecules were not statistically significant between two groups of patients. After treatment, serum contents of nerve injury indexes S-100β, GFAP, NSE and MBP in both groups were significantly lower than those before treatment, contents of nerve protection indexes BDNF and IGF-1 were significantly higher than those before treatment, contents of monoamine neurotransmitters DA, 5-HT and NE were significantly higher than those before treatment, contents of apoptosis molecules Bcl-2, Fas and FasL were significantly lower than those before treatment, and the changes in contents of above indexes in observation group were larger than those in control group.Conclusion:The adjunctive therapy of levetiracetam can reduce the nerve injury in patients with refractory partial epileptic seizure and exert active cerebral protective effect.

Ductile Fracture Prediction of 316LN Stainless Steel in Hot Deformation Process

A ductile fracture criterion of 316LN stainless steel, combined with the plastic deformation capacity of ma- terial and the stress state dependent damages, was proposed to predict ductile fracture during hot deformation. To the end, tensile tests at high temperatures were first performed to investigate the fracture behavior of 316LN stain- less steel. The experimental results show the variation of the critical fracture strain as a function of temperature and strain rate. Second, the criterion was calibrated by using the upsetting tests and the corresponding numerical simula- tions. Finally, the proposed fracture criterion was validated by the designed tests and the corresponding finite ele- ment （FE） simulation. The results show that the criterion can successfully predict the onset of ductile fracture at ele- vated temperatures.