Objective To investigate the relationship between the mutagenicity of carbamazepine (CBZ) and folic acid (FA), and to explore the mechanism of CBZ teratogensis and the prevention effect of the folic acid. Methods Peripheral blood lymphocyte chromosome aberration rate (CAR), sister chromatid exchange (SCE)frequencies, and serum FA levels have been studied in 15 CBZ -treated epileptic patients, 15 CBZ plus FA-treated epileptic patients The untreated epileptic patients and the health subjects were served as controls Results CAR and SCE frequencies were significantly higher in CBZ group as compared with the CBZ plus FA group and the controls ( P

Objective To investigate the impact of hepatic steatosis on the outcome of adefovir therapy in chronic hepatitis B patients with HBeAg positive. Methods The medical records of 154 patients who were diagnosed with CHB positive for hepatitis B e antigen (HBeAg) and received adefovir therapy for 24 weeks between January, 2011 and December, 2013 were analyzed retrospectively. Baseline status and virologic response, biochemical response and serology response between patient with (n = 68) and without (n = 86) steatosis who were proven by ultrasound. Both groups were given oral adefovir dipivoxil 10 mg/d for 24 weeks , recovery rate in ALT/AST, negative conversion rate of HBV DNA and HBeAg were recorded and compared. Results Recovery rate in ALT/AST in observation group was 67.7%, which is lower than control group (83.7%), and the difference is significant(P < 0.05). Negative conversion rate of HBV DNA and HBeAg in control group is 81.4%and 83.7%, which is significantly higher than observation group (whose values are 58.8% and 44.1%, P < 0.05). Conclusion Hepatic steatosis has significant impact on the outcome of adefovir treatment.

Eighty-three patients with transient ischemic attack (TIA) were randomly divided into study group (n =42) and control group (n =41) from July,2011 to Mar,2015.Patients in both groups were given aspirin 100 mg/d ; in addition,patients in study group received intravenous infusion of argatroban 10 mg,q12h,for 7 days and those in control group received subcutaneous injection of low molecular weight heparin (LMWH) 2 050 AXa IU,b.i.d for 7 days.The cases with cure,significantly effectiveness and effectiveness in study group and control group were 10,14,16 and 6,12 16,respectively.Compared with the control group,argatroban shows superiority in treatment of TIA with higher safety and lower side effect.

Objective To investigate the impact of fatty liver on antiviral effect in the patients with chronic hepatitis B (CHB) .Methods A total of 204 patients with hepatitis Be antigen (HBeAg ) positive CHB in the outpatient department of our hospital from January 2011 to April 2014 were selected as the research subjects and divided into the two groups according to wheth‐er complicating fatty liver :the simple CHB group(control group ,122 cases) and CHB complicating nonalcoholic fatty liver disease (NAFID) group(observation group ,82 cases) .The two groups all received the 24‐week antiviral therapy of adefovir (10 mg/d) . The differences in the normalization rate of ALT/AST (biochemical response) ,HBeAg negative conversion rate (serological re‐sponse) and HBV DNA negative conversion rate(virological response) were compared between the two groups .Then the cases ob‐taining the virological response after treatment in the two groups were compared again .Among the cases obtaining virological re‐sponse,thedifferencesinthenormalizationrateofALT/AST(biochemicalresponse)andHBeAgnegativeconversionrate(serologi‐cal response) were compared between the simple CHB group and CHB complicating NAFID group .Results The normalization rate of ALT/AST after 24‐week treatment in the CHB complicating NAFID group was 58 .5% ,which was significantly lower than 72 .1% in the simple CHB group ,the difference was statistically significant ;the negative conversion rate of HBV DNA and HBeAg after 24‐week treatment in the simple CHB group was 67 .2% and 52 .5% ,which were significantly higher than 51 .2% and 37 .8%respectively ,the differences were statistically significant ;among the cases obtaining the virological response ,the normalization rate of ALT/AST in the simple CHB group was 96 .3% ,which was significantly higher than 66 .7% in the CHB complicating NAFID group ,the difference was statistically significant .But among the cases obtaining the virological response ,the negative conversion rate of HBeAg was 78 .0% in the simple CHB group and 73 .8% in the CHB complicating NAFID group ,the simple CHB group was slightly higher than the CHB complicating NAFID group without statistical difference .Conclusion NAFLD has impact on the antiviral effect of adefovir treatment in CHB patients with positive HBeAg ,whereas complicating NAFLD is an important reason for reaching the virological response and serological response ,but without reaching the biochemical response in the antiviral treatment of CHB complicating NAFID .

Objective To investigate the influence of neutrophil-lymphocyte ratio (NLR) on radiosensitivity and prognosis,the relationship between NLR and clinical features,and the clinical value of NLR in patients with nasopharyngeal carcinoma (NPC).Methods 2006 to 2011 in the cancer center of Zhongshan University admitted to the newly diagnosed nasopharyngeal cancer patients in 266 cases.The association of pretreatment NLR with radiotherapy doses 20,40,and 60 Gy and therapeutic effect at 3 months after radiotherapy was analyzed,as well as the influence of NLR on overall survival (OS),local recurrence-free (LRF),and distant metastasis-free (DMF) rates.The Kaplan-Meier method was used to calculate survival rates and the log-rank test was used for survival difference analysis.Results NLR showed differences across patients with different T stages and sexes (P=0.039,0.032).The patients with NLR≤3 had significantly higher OS,LRF,and DMF rates compared with those with NLR＞ 3 (P=0.004,0.025,0.045).As NLR increased,the radiosensitivity in patients with NPC was reduced gradually,and radiosensitivity showed a significant difference between sensitive group and moderately sensitive group (P=0.043).When the radiotherapy dose was 40 Gy,the tumor regression group had a lower NLR than the residual tumor group (P=0.025).Conclusions In patients with NPC,an increased pretreatment NLR is an adverse prognostic factor,and NLR can be used as a simple and convenient method to evaluate the prognosis of patients with NPC.

Objective To establish TaqMan real-time PCR method for detection and identification of Haemophilus influenzae and Streptococcus pneumonia. Methods Two sets of primers and FAM-labeled probes targeting different genes of Haemophilus influenzae and Streptococcus pneumoniae were designed and synthesized. The bexA gene was used for identification of Haemophilus influenzae and lytA for Streptococcus pneumoniae. The sensitivity and specificity of real-time PCR were assessed for different primers and probes. Cut-off values of cycle threshold (Ct) were determined. Two hundred and seventy-eight cerebrospinal fluid (CSF) specimens from suspected bacterial meningitis cases were detected by real-time PCR assay, latex agglutination test and bacteria culture simultaneously. Results Haemophilus influenzae isolates of serotype a to d could be detected and identified by bexA primers and probe. All Streptococcus pneumoniae isolates of different serotypes could be detected and identified by lytA primers and probe. The respective sensitivities for Haemophilus influenzae and Streptococcus pneumoniae were 10 and 90 genome DNA copies in each PCR reaction. Of the 278 CSF specimens, four were positive by Haemophilus influenzae and seven positive by Streptococcus pneumoniae when detected by real-time PCR. Of the four Haemophilus influenzae positive specimens, two were positive by culture and one positive hy latex. Of the seven Streptococcus pneumonia positive specimens, two were positive by culture and two positive by latex. Conclusions Real-time PCR could rapidly detect and identify Haemophilus influenzae of serotype a to d and Streptococcus pneumoniae of different serotypes with high sensitivity. TaqMan real-time PCR could be widely used for the diagnosis of invasive meningitis caused by Haemophilus influenzae and Streptococcus pneumoniae. It can improve the rate of positivity for diagnosis of suspicious bacterial meningitis cases.

ObjectiveTo explore the effects of hyperbaric oxygen on neurological behavior and vascular endothelial growth factor (VEGF) in rats with traumatic brain injury (TBI). MethodsThirty rats were randomly divided into three groups, ie, control group, TBI group ( a 50 g weight-drop device was employed and fell from 30 cm height to induce the injury) and hyperbaric oxygen group ( HBO group,treated with hyperbaric oxygen once per day for seven days after TBI), 10 rats per group. Neurological severity score (NSS) was used to evaluate the movement and balance impairment in all groups. Expression of VEGF was detected by means of immunocytochemical staining.ResultsAfter TBI, the rats presented different degrees of convulsions, paralysis and balance dysfunction. The NSS score was (5.6 ±1.1 ) points in the TBI group and (0.3 ± O. 1 ) in the control group, with statistical difference ( P ＜0.05). While NSS score was (3.7 ± O. 7) points in the HBO group, showing a significant decrease compared with that in the TBI group (P ＜ 0. O1 ). Immunohistochemical staining showed 15 ± 3 positive neurons of VEGF in the TBI group, significantly less than 27 ± 2 in the control group ( P ＜ 0.05 ). There were 21 ±2 positive neurons of VEGF in the HBO group, significantly less than 21 ±2 in the TBI group (P ＜0.05). Conclusion Hyperbaric oxygen may attenuate experimental traumatic brain injury by stimulating production of VEGF.

Objective To explore the relationship between the polymophisms of interleukin?17 (IL?17)?197A/G and the outcomes of hepatitis B virus (HBV) infections. Methods The polymorphism of genotypes and al?leles of IL?17?197A/G in 222 chronic HBV infected patients and 88 HBV infected ones as controls. The contains of serum HBV DNA were detected using PCR combined with DNA amplification in vitro, serum IL?17 expression was detected with ELISA and genotype and allele frequency of IL?17?197A/G locus was detected by Beckman SNP kit. Results There was a significant difference in the serum IL?17 expression (F=158.1, r2=0.61, P<0.000 1) among all the groups. For IL?17?197A/G, there were significant differences for the comparison between the two groups, and the frequency of AA genotype was 47.72%in liver cirrhosis group. Moreover, the highest frequency of GG was in HBV clear?ance group (74.81%);and the lowest group was in chronic HBV liver cirrohosis group (19.05%). Conclusion IL?17?197A/G AA genotype and allele might be associated with susceptibility of HBV infection in Han population in Hei?bei Province.

Objective To observe the effect of flexible laryngeal mask (FLMA) in transnaso-sphenoidal microsurgery for pituitary adenoma on airway management and variation of stress response.Methods One hundred patients (71 males, 29 females, aged 18-65 years, BMI 21-28 kg/m2, ASA physical status Ⅰ or Ⅱ) undergoing transnaso-sphenoidal microsurgery for pituitary adenoma were randomly divided into two groups: the FLMA group (group F) and the reinforced endotracheal tube group (group T) using a random number table, 50 cases in each group.The plasma concentration of epinephrine and norepinephrine were measured before anesthesia induction (T0), at the time of inserting the FLMA or reinforced endotracheal tube (T1), 1 min (T2) and 5 min (T3) after insertion.The Berry scores of the preoperative and postoperative airway exposure by branchofiberoscope in group F were assessed.The time of removal of FLMA (endotracheal tube) and the occurrence of choking, laryngeal spasm, sore throat, hoarseness and other adverse reactions were recorded.Results The levels of epinephrine and norepinephrine were were significantly lower at T2 and T3 in group F than those in group T (P<0.05).There was no significant difference in airway Berry scores.The time of extubation was shorter in group F than that in group T [(9±3) min vs (17±6) min] (P<0.05).The incidence of choking (2% vs 22%) and sore throat (4% vs 30%) were significantly lower in group F than those in group T (P<0.05).Conclusion Compared with the reinforced endotracheal tube, FLMA can be applied safely and effectively to transnaso-sphenoidal microsurgery for pituitary adenoma, reduces stress respond associated with anesthesia and post-extubation complications, improves the recovery of patients.

Objective To analyze relation of comprehensive parameters of the dose-volume V5,V10 and V20 with radiation pneumonitis (RP) in patients with advanced stage non-small-cell lung cancer (NSCLC) treated with three-dimensional conformal (3DCRT) or intensity-modulated radiation therapy (IMRT).Methods Data of 90 patients with histologically proved NSCLC treated with 3DCRT or IMRT between November 2006 and July 2009 were collected.The median radiation dose of 70 Gy (range, 61 - 80 Gy) was delivered with late-course accelerated hyperfractionated radiotherapy (LAHRT).The V5 ,V10 ,V20,V30 and mean lung dose (MLD) were calculated from the dose-volume histogram system.The RP was evaluated according to the common toxicity criteria 3.0(CTC 3.0).Results The range of V5 ,V10 and V20 was 36% - 98%, 27% - 78% and 19% - 54%, respectively, with a median value of 66%, 48% and 31%, respectively.The RP of grade 1,2,3,4 and 5 was observed in 29,23,5,1 and 1 patients.The V5,V10 ,V20, contralateral V10, GTV,PTV, and numbers of fields were all significantly associated with RP of ≥grade 1 (χ2=2.04, 2.05, 2.01, 4.62, 6.50, 5.61, 5.61, and P= 0.044, 0.043, 0.047, 0.030,0.010,0.020,0.020).The V5, V10, V20, V30, and MLD were all significantly associated with RP of ≥ grade 2 (χ2= 2.05,2.20,2.96,4.96,5.20, and P = 0.040,0.030,0.000,0.030,0.020).In Logistic regression analysis, GTV was the only factor significantly associated with RP of ≥ grade 1 (χ2= 4.06, P =0.044).The V20 was the only factor significantly associated with RP of ≥grade 2(χ2=9.61,P=0.002).The RP of ≥grade 2 was significantly increased when V20 was more than 31%.The RP of ≥grade 2 was significantly increased when V20, V10 and V5 were more than 31%, 48% and 66%, respectively.The RP of ≥ grade 2 was significantly increased when V20 was more than 31% and V5 was more than 66%.Conclusions The comprehensive parameters combined with V5, V10 and V20 are effective in predicting RP.