Objective To study the curative effect and influence on memory function of Gabapentin (GBP) as add-on therapy for treatment of focal seizures in refractory epilepsy. Methods 96 patients with focal seizures in refractory epilepsy were randomly divided into groups GBP and Topiramate (TPM). Beside the normal medicaments, GBP or TPM as add-on therapy for certain group. According to the Clinical Memory Scale (CMS), the patient's memory function was evaluated before and after treatment. Results There was no significantly difference of total effective rate between groups GBP (75.0%) and TPM (72.9%). The scores of CMS showed almost same between before or after add-on therapy in GBP group. In TPM group, the scores of meaningless image recognition, free recall, phase portrait characteristics and memory quotient were significantly reduced after add TPM(allP

Objective To observe the expression of thioredoxin (Trx) and thioredoxin-interacting protein (Txnip) in the kidney of type 2 diabetic rats induced by streptozotocin and the effect of probucol treatment on thioredoxin system. Methods Thirty male SD rats were divided into control group( C, n = 10), diabetes group ( D, n =10), and probucol treated diabetic group ( P, n = 10). After eight weeks of probucol treatment, the expressions of Trx and Txnip in the kidney of three groups were measured by RT-PCR, Western blot, and immunohistochemistry. Body weight,24 h microalbuminuria( ALB), fasting plasma glucose( FPG), fasting insulin( HNS), blood urea nitrogen (BUN), creatinine (Cr), malondialdehyde ( MDA ), superoxide dismutase ( SOD ), and catalase (CAT) were determined. Results Compared with group C, Trx was markedly decreased in group P (0. 162 ±0. 008 vs 0. 239 ±0. 006, P＜0.05 ), while Txnip was significantly increased (0. 159±0.003 vs 0. 091 ±0.016, P＜0.05 ). Trx in group P was increased as compared with group D (0. 162 ±0. 008 vs 0. 108 ± 0. 013, P ＜ 0. 05 ), while Txnip was lowered (0. 159±0.003 vs 0. 236±0.009 ,P＜0.05 ). FPG, 24 h ALB, BUN, Cr,and MDA levels in group D were markedly increased as compared with group C (P＜0. 05), while the activity of SOD, CAT, and FINS levels were decreased apparently (P＜0.05). The above markers except for FPG in group P were ameliorated (P＜0. 05 ).Conclusions Probucol attenuated oxidative stress by means of partially restoring Trx function and reducing Txnip expression, and thus played a major role in renoprotection of type 2 diabetic nephropathy.

Objective:To explore the correlation between the characteristics of contrast-enhanced sonography of intraoperative glioblastoma multiform (GBM) and molecular markers of isocitrate dehydrogenase-1(IDH1).Methods:A retrospective analysis were performed in 30 patients who underwent neurosurgery and pathologically confirmed to be GBM at Beijing Tiantan Hospital from May 2018 to April 2019. All neurosurgical glioblastoma patients after craniotomy underwent conventional ultrasound and contrast-enhanced ultrasound(CEUS) guided navigation. The characteristics of the ultrasound imaging (whether the tumor involves the structure of the corpus callosum, the clarity of the tumor boundary after enhanced ultrasound and whether the tumor has necrotic areas with enhanced ultrasound images) were analyzed. The ratio between tumor necrosis area and whole tumor area (N/W) was measured, and the correlation with IDH1 gene expression was analyzed.Results:There were statistical differences in clarity of tumor boundary after CEUS and tumor necrosis after CEUS between positive IDH1 and negative IDH1 groups(all P<0.05). The positive expression of IDH1 was negatively correlated with the N/W area of the contrast-enhanced ultrasound mode( r=-0.756, P<0.05), suggesting that the expression level of IDH1 gene was negatively correlated with the area of tumor necrosis. Conclusions:Ultrasound contrast agent examination can more accurately distinguish the active proliferation area, hemorrhagic necrosis area and peripheral edema area of glioblastoma. Accurately identifying the extent of tumor necrosis area through ultrasound contrast agent examination can predict expression of IDH1.

Objective To investigate the clinical and pathological characteristics of bacterial infectious diarrhea.Methods The clinical and pathological characteristics of 2380 cases of bacterial infectious diarrhea in Jinshan Hospital,Fudan University from 1998 to 2007 were analyzed retrospectively.Enumeration data were analyzed by X~2 test.Results Among the 20 169 patients who went to hospital because of diarrhea in 10 years,2380 cases fecal bacterial culture were positive,including Vibrio parahaemolyticus(2247 cases,94.4%),Shigella(99 cases,4.2%),Salmonella (29 cases,1.2%),Vibrio alginolyticus(3 cases),pathogenic Escherichia coli(2 cases).Patients with diarrhea were common from June to 0ctober in each year.The main manifestations of Vibrio parahaemolyticus infection were abdominal pain,diarrhea,nausea,vomit or dehydration.The main manifestations of Shigella infection were fever,abdominal pain and diarrhea.Conclusions The bacterial culture positive rate of stool samples from patients with bacterial infectious diarrhea is not high in Jinshan district.Shanghai.The major pathogens are Wbrio parahaemolyticus and Shigella.

Objective To evaluate the survival benefit of amphotericin B (AmB) plus flucytosine or fluconazole for treatment of patients with acquired immunodeficiency syndrome (AIDS)-associated cryptococcal meningitis.Methods The following database were searched from the beginning to October 2013,including Cochrane library,PubMed,OVID,Embase,Wanfang Date,CNKI and Chinese Biomedical Database,and the references of eligible studies were manually screened.Reference lists of relevant articles were screened according to selection and extraction criteria.Meta-analysis was performed using RevMan 5.2.Results Four prospective controlled studies with a total of 399 patients with cryptococcal meningitis were identified,including 386 patients with AIDS-associated cryptococcal meningitis and 13 human immunodeficiency virus (HIV)-negative patients.Two hundred and twentyseven patients were treated with AmB and flucytosine combination therapy,including 217 patients with AIDS-associated cryptococcal meningitis and 10 HIV-negative patients.One hundred and seventy-two patients were treated with AmB and fluconazole combination therapy,including 169 patients with AIDS-associated cryptococcal meningitis and 3 HIV-negative patients.The Meta-analysis revealed that the mortality rate in AmB plus flucytosine combination therapy group was 6.6％ (95％ CI:18.5％-31.6 ％) at two weeks point,which was significantly lower than that in AmB plus fluconazole combination group (19.7％,95％CI:-23.6％-62.9％; OR=0.51,95％CI:0.27-0.93,P＜0.05).But at 10 weeks point,the mortality rate in flucytosine combination group was 12.9％ (95％oo CI:-22.2％-48.0％),which was lower than that in fluconazole combination group (31.4％,95％ CI:-23.1％-85.9 ％).However,there was no statistically significant difference between these two groups at 10 weeks point (OR=0.70,95％CI:0.44-1.13,P=0.15).Conclusion Administration of AmB plus flucytosine at early stage can reduce the mortality rate in patients with AIDS-associated cryptococcal meningitis.

Objective To understand the clinical features of candidemia.Methods A retrospective analysis was performed based on the data of 88 candidemia cases treated in Huashan Hospital during the period from 2007 to 2012.The clinical data were re-viewed in terms of species distribution,underlying diseases,clinical manifestations,treatment and outcomes.The prognostic factors were analyzed by chi-square test or Fisher exact probability test.Multivariate analysis was conducted by multiple Logis-tic regression.Results Candida albicans (40/88,45.5%)was the most common pathogen isolated from these candidemia ca-ses,followed by Candida tropicalis (20/88,22.7%),Candida parapsilosis (17/88,19.3%),Candida glabrata (10/88, 11 .4%),and Candida krusei (1/88,1 .1 %).Solid malignancy,diabetes,and surgical procedure were the most frequently identified underlying diseases.Fatal or deteriorative outcome was reported in 28 cases.The attributable mortality was 18.2%. Multivariate prognostic analysis indicated that presence of central venous catheter (OR:6.322,95% CI :1 .055-37.891 ,P =0.044)was independently correlated to increased mortality.Appropriate antifungal therapy was an independent predictor of de-creased overall mortality (OR:0.137,95% CI :0.039-0.480,P =0.002).Conclusions The pathogen distribution of candi-demia has changed slightly.Appropriate antifungal therapy plays a key role in the treatment of candidemia.

Objective Establishment of two experimental models for osteoclast differentiation from monocyte in vitro,and to study the potential of osteoclast differentiation induced by cytokines.Methods Direct model of osteoclast differentiation: CD14+ monocyte fraction of peripheral blood mononuclear cell(PBMC) stimulated by(25 ?g/L) M-CSF+(10~(-8)mol/L) LTB4 for two weeks.Indirect model of osteoclast differentiation: Utilize the coculture model of RAFLs and monocyte that were stimulated in the presence of 25 g/L M-CSF+(10~(-8)mol/L) LTB4 for three weeks.In TRAP staining the multinucleated TRAP staining positive osteoclast-like cells were counted as marker of as differentiation effect of each group.Results Osteoclast-like cells can be induced by both direct and indirect models.Conclusion Two experimental models for osteoclast differentiation can be separately used to study the effect of various cytokines for direct and indirect OC differentiation.

Objective To evaluate the clinical efficacy and safety of the Huhang Burn Liniment in the treatment of Ⅱ degree burn wounds.Methods 400 cases of Ⅱ[degree burn patients admitted to the 4 research centers were divided into two groups(n=200).The treatment group was treated with external Huhang Burn Liniment and the control group was treated with topical silver sulfadiazine silver paste.The wound healing,safety and effect of treatment were compared between two groups.Results The wound healing time in treatment group was significantly better than that of control group (P＜0.05).Before treatment,there was no significant difference in bacterial infection rate and VAS score between two groups.After treatment,the bacterial infection rate and the degree of pain relief in the treatment group were significantly better than those in control group(P＜0.05).The cure rate and total effective rate in treatment group were 84.0 ％ and 97.5 ％ respectively,while the control group were 72 ％ and 87 ％,the difference were statistically significant (P＜0.05).Conclusion The Huhang Burn Liniment can effectively promote wound healing,inhibit the growth of bacteria,it's safe and reliable.

Objective To develop a multiple polymerase chain reaction (PCR) technique based assay for rapid detection of vanA, vanB, vanD and vanM in high-level vancomycin-resistant enterococci.Methods After analyzing the uncleotide sequence divergence among D-Ala∶D-Lac ligase genes, an multiplex PCR assay for vanA, vanB, vanD and vanM genes in high-level vancomycin-resistant enterococci were designed.By using recombination plasmids containing vanA, vanB, vanD and vanM genes as positive control, and non-vancomycin resistant enterococci (non-VRE) common pathogenic bacterial DNA as negative control, the sensitivity and specificity of the assay were evaluated.Fifty vancomycin-resistant enterococci (VRE) isolates were detected by the assay.Fifty clinical strains of VRE were isolated from 9 hospitals in Shanghai from January 2006 to December 2014.The results were compared with the conventional PCR and sequencing methods.Results The identity of the D-Ala∶D-Lac ligase genes were 60.8%-71.3% of vanA, vanB, vanD and vanM genes.The multiplex PCR assay could identify the genotypes of the positive control samples accurately.No false positive results were found in negative control samples.Among fifty VRE strains detected by the assay, 18 were vanA genotype and 32 were vanM genotype.Comparison of the multiplex PCR assay and sequencing methods revealed sensitivity and specificity of 100%.The detection limit of the assay was 2×10 copies/PCR reaction.The experiment could be done within 3.5 h.Conclusions A multiplex PCR assay is developed to rapid identify the genotype of the high-level vancomycin-resistant enterococci, which can be used for the molecular epidemiology research and detection of VRE.

Objective To analyze the 23S rRNA gene partial sequences of common bacteria, and establish molecular biologic techniques to identify bacteria by the difference of gene sequences. Methods Analyzing the sequences of variable region of bacterial 23S rRNA genes, primers and oligonucleotide probes were designed accordingly. Thereafter, bacteria were identified by PCR gel electrophoresis and PCR reverse hybridization. Results There exists significant sequence difference between Gram negative bacteria and Gram positive bacteria and it could be used to differentiate these 2 kinds of bacteria quickly with PCR gel electrophoresis. Meanwhile, sequence variety in different species of bacteria was also observed and PCR reverse hybridization could be used to identify different bacterial species further.Conclusions There exist significant sequence differences among 23S rRNA genes in different common bacteria. By the sequence differences, a specific, sensitive and rapid molecular biologic techniques could be established to quickly identify the pathogens of bacterial infections.