In the use of antiepileptic drugs in patients with epilepsy,1/3 of the patients with epilepsy can not get effective control,showing resistance to antiepileptic drugs.Now the mechanism of drug resistance is considered to be caused by multiple factors work together.The concept and connotation between drug-resistant epilepsy and refractory epilepsy are different.Since 2010,the international union of antiepileptic proposeddrug-resistant epilepsy expert consensus,different medical centers use the new defition to study different populations and confirm that the new definition is effective and reliable.However,there are some controversier about the drug dosage,drug kinds,judge for determining evaluation index and the treatment judgement in that definition.

Objective To construct the eukaryotic expression plasmids of Mycobacterium tuberculosis ESAT-6 antigen and to investigate its immunogenicity in mice. Methods The sequence encoding ESAT-6 was amplified by PCR from Mycobacterium tuberculosis H37Rv genomic DNA. Then, the amplified fragment was sub-cloned into pVAC expression vector. The eukaryotic expression plasmid pVAC-ESAT-6 was transfected into Vero E6 cells with liposome. The mRNA expression of pVAC-esat-6 in Vero E6 cells was detected by RT-PCR and its expression product was analyzed by Western-blot. The plasmid pVAC-esat-6 was introduced into the mice by gene gun injection. The specific antibody to ESAT-6 and the level of IFN-? in supernatant of spleno-lymphocyte cultures were detected by ELISA methods. Results The recombinant plasmid pVAC-esat-6 was successfully constructed, and the expression of ESAT-6 was also detected in vitro. After vaccinated three times, the mice produced specific antibody and the level of IFN-? in supernatant of spleno-lymphocyte cultures in group of pVAC-esat-6 was significantly higher than group of vector alone (P

Objective To investigate the effect of fluvastatin on ventricular remodeling and serum tumor necrosis factor alpha(TNF-α)level in elderly patients with acute myocardial infarction.Methods 87 elderly patients with acute myocardial infarction were chosen in Jiande Hospital of Integrated Traditional Chinese and Western Medicine from October 2014 to October 2016,were randomly divided into control group(42 cases)and observation group(45 cases),the control group received aspirin,PI Gray chlorine and other conventional treatment,the observation group were given fluvastatinon the basis of the control group treatment.The changes of cardiac function and serum inflammatory factor TNF-α levels were observed before and after treatment.Results After the treatment,left ventricular weight index such asleft ventricular systolic volume index,left ventricular diastolic membrane membrane volume index,left ventricular ejection fraction in the two groups were improved in different degree,but the observation group improved significantly(P<0.05).In the control group,there was no significant improvement; and after treatment,the indexes of the observation group were significantly better than those of the control group(P<0.05).The effective rate in the observation groupwas 93.33％,was significantly higher than the control group(P<0.05).After treatment,the levels of serum TNF-α were significantly improved in the observation group,and the level of serum was significantly decreased compared with before treatment(P<0.05),and the observation group after the treatment was obviously lower than the control group(P<0.05).Conclusion For elderly patients with acute myocardial infarction with fluvastatin can better improve the patient's heart function,improve the body's inflammatory level,effectively improve the treatment effect,inhibit ventricular remodeling.

Objective To investigate the levels and distribution of radon concentrations in groundwater in some representative cities in China,and estimate the effective dose from inhaled radon released from domestic groundwater.Methods A total of 12 cities in 7 provinces (municipalities) were selected,including Beijing,Inner Mongolia,Ningxia,Shaanxi,Henan,Liaoning and Heilongjiang.In total,73 water samples from groundwater supply were taken.Radon concentrations in water samples were determined by using a continuous radon monitor with air-water exchanger.Results The average radon content in groundwater for drinking was 11.8 Bq/L in 12 cities in 7 provinces,ranging from 1.0 to 63.8 Bq/L.The radon concentrations in 37％ water samples exceeded 1 1.1 Bq/L,the safe limit recommended for drinking water by the United States Environmental Protection Agency (EPA).The radon contents in all of the water samples was lower than the reference level 100 Bq/L recommended by World Health Organization (WHO).The average annual effective dose arising from inhaled radon released from groundwater was 29 μSv (2.4 to 160 μSv).Conclusions Generally,the effective dose from inhaled radon released from groundwater is negligibly low.However,in some areas dominated by granite bedrock,the dose contribution from radon released from groundwater to residents should be routinely monitored.

Objective To investigate the expressions of miR-210-3p,miR-221-3p,miR-21-5p and miR-150-Sp in the plasma of breast cancer patients before and after radiotherapy in order to establish reliable early biomarkers of non-uniform radiation injuries.Methods Blood samples were collected from 13 patients before radiotherapy (0 Gy) and 24 h after radiotherapy of 2,10,20,30 Gy.The miRNAs in the blood plasma were detected with qRT-PCR.Results The levels of miR-210-3p,miR-221-3p,miR-21-5p had no significant difference among different dosage groups after radiotherapy(P ＞ 0.05).There was no significant difference between the expression of miR-150-5p before and after 2 Gy radiotherapy (P ＞ 0.05).While the relative level of miR-150-5p gradually decreased to 0.808,0.605,0.565 (x2 =18.76,P ＜ 0.05) with increased accumulative dosage of 10,20,and 30 Gy,respectively.In addition,the miR-150-5p expression levels had no relationship (P ＞ 0.05) with situations (positive or negative group) of human epidermal growth factor receptor 2 (HER2),estrogen receptor (ER) and progesterone receptor (PR) in the breast cancer cells.Conclusions Ionizing radiation could reduce the expression of miR-150 in the plasma of breast cancer patients in a dose-dependent manner.

Objective To observe the effects of acute normovolemic hemodilution(ANH) plus tranexamic acid on blood loss and blood transfusion in patients with total knee replacement.Methods 98 cases of patients with total knee replacement were divided into ANH group and combination group by computer randomization,49 cases in each group.ANH was performed in ANH group,and ANH plus tranexamic acid was given in combination group.The changes of hemoglobin(Hb),red blood cells deposited(Hct),platelet count(PLT) were observed before and after autologous blood transfusion in two group.The changes of prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB),D-dimer were observed at preoperative and postoperative in two group.The amount of blood loss and allogeneic blood infusion,the urine volume and the postoperative flow volume were recorded in two groups.Results The average levels of Hb,Hct after autologous blood transfusion in combination group were higher than those in ANH group,the differences were statistically significant(P<0.05).The average level of D-dimer at postoperative in combination group were higher than that in ANH group,the difference was statistically significant(P<0.05).The amounts of blood loss and allogeneic blood infusion,the postoperative flow volume were lower than those in ANH group,the differences were statistically significant(P<0.05).Conclusion The joint application of ANH and tranexamic acid can effectively reduce the amounts of blood loss and allogeneic blood infusion in patients with total knee replacement,and has a certain clinical value.

Objectives To investigate the clinical and pathological characters , treatment of patients with Angioimmunoblastic T cell lymphoma(AITL). Methods From 1997 to 2004, 14 patients with AITL were reviewed retrospectively in our hospital. Results The most common symptoms at the presentation included general lymphadenopathy. 9 patients had fever. 3 patients had autoimmune hemolytic anemia.The histopathologic characteristics of AITL was generalized as:the damage of normal structure of lymphonodus,the proliferation of immunoblastic cell and arborescent supervascularization. All immunophenotyping were T cell type.14 patients were with ProMACE-CytaBOM regimen.The overall response rate was 57% and CR 3 cases, PR 5 cases. Median survival times was 25 months. 2-year survival was 60 %. Conclusions The most cases with AITL runs an aggressive course.The disease may progress rapidly and have unfavorable prognosis. Therefore further studies are repuired to improve the outcome.

Objective To explore the role of γ-synuclein(SNCG) siRNA in the radiosensitivity of breast cancer T47D cells.Methods SNCG siRNA was synthesized according to the coding sequence of SNCG mRNA and then transiently transferred into T 47D cell with lipofectamine .The expression of SNCG gene and protein was detected by RT-PCR and Western-blot, respectively.Cells were divided into three groups, SNCG siRNA interference group , negative control group and blank control group , which were irradiated with different doses of 60 Coγ-rays.Cell radiosensitivity was evaluated by colony formation assay , cell proliferation was assayed by CCK-8 kit, and the protein expressions of phosphorylated-AKT and mTOR were detected by Western blot assay .Results Compared with blank control cells , the expressions of SNCG gene and protein in the SNCG siRNA transferred T 47D cells were efficiently diminished .Cell colony formation results showed that , under 4, 6, 8 Gy irradiation, the cell survival of siRNA transfection group was lower than that of control group (t=5.449, 8.882, 21.503, P<0.05).CCK-8 experiments showed that the cell proliferation abilities of siRNA group at 24, 48, 72 h after 6 Gy irradiation were lower than those of control group (t=5.603, 4.839, 6.115, P<0.05).In addition, after 6 Gy irraddaition, the AKT and mTOR phosphorylation levels in the siRNA group were more obviously reduced compared with blank groups , but the total AKT and mTOR had no changes .Conclusions Transfection of SNCG siRNA can enhance the radiosensitivity of breast cancer cells probably by inhibiting p -AKT signal pathway .

OBJECTIVE: To observe the self-developed horn type of titanium clamp used for inferior turbinate resection from filling effect. METHOD: Choose the cases of inferior turbinate resection of 152 cases randomly selected 92 cases (group) in 2-4 angle type titanium clip head-tail closed wound middle turbinate, and therefore more than nasal passages in the surgical wound, just as in the nasal passages above micro tamponade, bare breathing zone, keep the ventilation, 1- 3 days to take out the angle titanium clamp; 60 cases (control group) with vaseline oil gauze or postoperative Merocel hemostatic sponge tamponade nasal bleeding. Observation of 1-3 days after nasal ventilation, headache, nasal bleeding, dry mouth, tolerance is painful, aural fullness tinnitus, a total of 7 indicators of sleep. RESULT: The team outside the there was no difference in blood loss and the control group, the rest of the indicators is better than the control group. CONCLUSION The angle of titanium clamp used in inferior turbinate resection from stuffing, patients get better comfort, avoid drawn yarn of pain, improve the quality of perioperative patients with life.
Bandages ; Blood Loss, Surgical ; prevention & control ; Epistaxis ; prevention & control ; Female ; Formaldehyde ; administration & dosage ; Hemostatics ; administration & dosage ; Humans ; Male ; Microsurgery ; Nasal Cavity ; Polyvinyl Alcohol ; administration & dosage ; Postoperative Hemorrhage ; prevention & control ; Surgical Instruments ; Titanium ; Turbinates ; surgery

Objective To investigate the radiation level around Jiangzha hot spring,and to analyze the sources of pollution.Methods The radon and its progeny concentration,γ dose rate in hot spring living district and surrounding area were measured with ATD monitors,radon and WL continuous measurement devices,γ dose rate meter.Results The radon concentration in water was 23 -764 Bq/L.Radon concentration indoors,outdoor and in bathing place were 254 -876 799,688 -709 and 3590-15 299 Bq/m3,respectively.γ dose rate were 205 -28718 nGy/h indoor,4104- 18254 n Gy/h outdoors.Conclusions Jiangzha hot spring is an area with rare high radon and high nature radiation.Its radiation level and health effects are worthy for further attention.