Objective To evaluate long-term efficacy and safety of Topiramate in patients with various types of epilepsy.Methods 115 patients with epilepsy were underwent open-label experience with Topiramate as monotherapy or add-on therapy. The efficacy was assessed after 6 months. The rates of seizure-free and Topiramate retention were estimated after 1 and 2 years, and side effect were also evaluated during open-label treatment period.Results (1) After 6 months, total effective rate was 83.9% in monotherapy group and 66.1% in add-on therapy group. Topiramate was proved to be effective on various types of epilepsy, but there were not significant differences in seizure-free rate and total effective rate between the different types. (2) The optimal dosage was ( 105.72?48.28) mg/d in children and ( 176.26?62.81) mg/d in adults. (3) The seizure-free rate was 40.0% at 1 year and 28.7% at 2 years, and retention rate was 67.8% at 1 year and 46.1% at 2 years. (4) Side effects were observed in 34 patients (29.6%), including mild to moderate events related to central nervous system, anorexia and weight decrease.Conclusion Topiramate is a widespread antiepileptic drug with high efficacy and safety for long-term administration.

Objective To study the changes of plasma renin activity(PRA) and angiotensin Ⅱ(Ang Ⅱ) concentration in patients with acute cerebral infarction(ACI) as well as their clinical significance.Methods Radioimmunoassay was used to detect PRA and Ang Ⅱ concentration in 55 patients with ACI in the acute,convalescent phrase,and carried out correlative analysis with focal size and the degree of neurological deficit.Results (1) PRA and Ang Ⅱ in 3d of the acute phase of ACI were significantly higher than those in the controls ( P 3.0 cm 2) and the focus of middle infarct group(1.5 to 3.0 cm 2),but PRA and Ang Ⅱ in both groups were significantly higher than those in lacunar infarction group(

Objective To verify the efficacy and safety of Edaravone,a novel hydroxy-free radical scavenger,on acute cerebral infarction(ACI).Methods We performed a randomized,placebo-controlled,parallel-group,double-blind study on ACI patients. 63 patients,enrolled within 48h of onset,were allocated to Edaravone group( n = 31) or the placebo group( n = 32) randomly. Edaravone was infused at a dose of 30 mg,twice a day,for 14 days. Meanwhile,Hydroxyethylrutin and Aspirin were taken as basic treatment. The therapies of the placebo group were similar to those of Edaravone group except for Edaravone.Before treatment and at 7th,14th and 21th day after treatment,the neurological deficits and activities of daily living (ADL) were evaluated using European Stroke Scale (ESS) and Barthel Index respectively. 3 months later,all the patients were followed up for survival and ADL.Results At 21th day the increase rate of ESS was evaluted.There were significan difference between Edaravone group[(60.3?28.2)%] and the placebo group[( 35.1? 23.6)%]( P

Objective To establish a method to measure Angiotensin Converting Enzyme activity in serum by MECC. Method Mixture of serum and substrate Hip-His-Leu had been incubated for 120 min at 37℃, substrate Hip-His-Leu was digested into two parts, Hip and His-Leu. The reaction was ended by 0. 1 mmol/L HC1 , the production was analyzed by MECC directly to detecte content of Hip in production, and calculated ACE activity. Running buffer was 20 mmol/L pH 9. 0 boric acid-borate buffer (including SDS 50 mmol/L) , capillary column was 75?m i. d.?37 cm, injection was 3s by press, voltage was 16 kV, running time was 7. 5 min, detected by UV detector at 200 nm, tempreture was 20℃. Result The within-run and between-run CV was 2. 7% and 5. 2%. The detection limits of ACE activity was 0. 2 IU/L ( singal/noise = 3). The ACE activity and absorption was linearly related from 2. 4 to 72 IU/L. The mean value of ACE was 5. 2-21. 9 IU/L (x?1. 96 s) in 50 normals. Conclusion It was a one of rapid, precise methods for determination of ACE activity in serum.

Objective To investigate the features of clinical,electroencephalogram(EEG)and imaging in the patients with sporadic Creutzfeldt-Jakob disease(sCJD).Methods The clinical data of 30 patients with sCJD were analyzed retrospectively.Results 6 patients were acute onset,18 patients were subacute onset,which followed by conscious disturbance,myoclonus and decorticate rigidity in 1～3 months.6 patients were chronic onset,which followed by above described typical symptoms in 1～2 years.All the patients showed generally persistent slow waves on EEG in the early stage.18 patients showed typical triphasic wave on EEG and 8 patients presented atypical triphasic wave,which were almost in the intermediate-advandced stage.There were 10 patients in bilateral basal ganglia,and 1 patient in right lenticular nucleus showed hypersignal in MRI T2WI.17 patients carryed out MR diffusion-weighted images(DWI).All the images showed the hypersignal in frontal,temporal,occipital cortex,and 8 patients of them accompanied symmetric hypersignal in bilateral basal ganglia.Conclusions Almost of sCJDs are subacute onset.DWI show typical hypersignal lesions in occipital,frontal,temporal cortex and /or basal ganglia in their early course of disease,which are useful in early diagnosis of CJD.All the patients in the intermediate-advandced stage shows conscious disturbance,myoclonus and decorticate rigidity.The character of EEG is typical triphasic wave.

Objective To investigate the clinical appliance value of plantar pressure measurement in hemiplegic patients with acute cerebral infarction(ACI).Methods Plantar pressure was measurered and recorded by the means of Germany-made Zebris in 21 hemiplegic patients with ACI before and 30 d after treatment.Results Although plantar pressure on foot of the paralysed side was found remarkably decreased compared to that of the contralateral side before treatment(all P

Objective To explore the effects of Irbesartan on the plasma concentrations of lysophosphatidic acid(LPA), endothelin-1(ET-1),serum concentration of nitric oxcide (NO) in the patients with acute cerebral infarction(CI).Methods All of the 53 patients were randomly assigned to Irbesartan therapy group(n=25) treated with Irbesartan 150 mg/d and Aspirin 100 mg/d and conventional therapy group(n=28) treated with Aspirin 100 mg/d.Both groups were treated for 14 days and the other measures of symptomatic therepy were the same. And another 23 patients without cerebrovascular diseases and 7 health volunteers were taken as control group.The venous blood samples were taken for measureing the levels of LPA,ET-1,NO while the scorces of neurological deficit (NDS)were evaluated before and after treatment. Results (1)Before treatment the levels of LPA,ET-1 in CI group were significantly higher and the level of NO was significantly lower than that in control group (all P

From May 2012 to May 2013, 60 chronic male smokers received an intravenous infusion of dexmedetomidine 1 μg/kg (Group D, n=30) or an equal volume of normal saline (Group C, n=30) before anesthesia induction.At time of dexmedetomidine or normal saline dosing , after induction of anesthesia, 1 and 3 min after intubation, the heart rates and rate-pressure products were significantly lower in Group D than Group C ( P<0.05 ).Thus the dosing of dexmedetomidine before anesthesia induction could suppress the cardiovascular responses of endotracheal intubation in chronic smokers and avoid increasing myocardial oxygen consumption so as to protect heart functions.

ObjectiveTo determine whether prophylactic cranial irradiation (PCI) has a role in the management of patients with non-small cell lung carcinoma (NSCLC)treated with radical intent.MethodsWe searched The Cochrane Library,MEDLINE,EMbase,CBM,CNKI and VIP.The quality of the includedstudieswascriticallyevaluated.Dataanalyseswereperformed usingtheCochrane Collaboration's RevMan 5.1 software.ResultsFour randomized controlled trials involving 905 patients met the inclusion criteria.The results meta-analyses showed the incidence of brain metastases was lower in PCI group compared with the observation group ( x2 =1.98,P =0.000 ) ; but there is no evidence of 1-year overall survival (OS) benefit ( x2 =1.12,P =0.880).Only RTOG 2009 provides prospective data:There were no significant differences in global cognitive function (P =0.600) or ADL ( P =0.880) after PCI,but there was a significant decline in immediate recall (P=0.030) and delayed recall (P =0.008 ) at 1 year,At 1 year,there was no significant differences in QOL after PCI ( P =0.050).Conclusions This systematic review show significantly decreases the risk of BM without improving 1-year OS in NSCLC patient receiving prophylactic cranial irradiation.There is insufficient evidence to support the use of PCI in clinical practice.Where possible,patients should be offered entry into a clinical trial.

Objective To systematically evaluate the influence of radiotherapy on triple-negative breast cancer (TNBC) patients treated with breast conservation surgery.Methods Electronic databases including PubMed,Ovid,CBM,VIP and CNKI and seven journals in Chinese (including the Chin J Breast Cancer,Chin J Clin Oncol,Chin J Radiat Oncol,Chin J Cancer,Chin J Oncol,J Pract Oncol and Tumor)were searched.Clinical trials comparing survival rates of patients with TNBC and non TNBC treated with breast conservation surgery and radiotherapy were reviewed.The quality assessment and data extraction were performed by two reviewers independently.RevMan5.1 software developed by the Cochrane collaboration was used for Meta-analysis.The 5-year distant metastasis-free survival (DMFS),overall survival (OS) and local recurrence-free survival (LRFS) rates were the primary end points.Results Five trials including 2345 patients with breast cancer were included in this systematic review.417 patients had TNBC and 1928 patients had non TNBC.Meta-analysis showed that the 5-year DMFS and OS rates of patients with TNBC were lower compared with non TNBC (Z =5.29,P =0.000 and Z =3.35,P =0.001).There was no statistical significant difference in 5-year LRFS rate between patients with TNBC and non TNBC (Z =1.35,P =0.180).Conclusion Radiotherapy provides good local control for patients with TNBC after breast conservation surgery.