Objective To study the effect of night large dose of sodium valproate on epileptiform discharges,and cognitive function of benign childhood epilepsy with centrotemporal spikes. Methods Ninety cases of benign childhood epilepsy with centrotemporal spikes were randomly divided into treatment group and control group (n= 45), both groups received regular total doses of sodium valproate therapy 25-30 mg?kg-1 ?d-1 . Patients in the treatment group received treatment that night doses of sodium valproate was double of morning doses. Every night dose was (17.96±1.21) mg?kg-1 , and every morning dose was (8.92±0.62) mg?kg-1 . The control group received the same dose [(13.37±0.80) mg?kg-1 ] of sodium alproate therapy twice a day, morning and evening. The epileptiform discharges, cognitive function, therapy effect were compared between two groups. Results Total effective rate of treatment group was 82.22% which were was significantly higher than that of the control group 62.22%(P<0.05);Epileptiform discharges reduction of treatment group was significantly higher than that of the control group (P<0.05), the effective rate of EEG improvement (84.44%)in treatment group was significantly higher than that in the control group 66.67% (P<0.05); FIQ, VIQ, PIQ in treatment group were significantly higher than those in the control group (P<0.05); There were no statistical differences of adverse reactions between two groups. Conclusion Night large dose of sodium valproate treatment can help control epileptic discharge, increase the plasma concentration, improve cognitive function, and therapy effect.

Objective To investigate knowledge and attitudes of healthcare workers with respect to HIV/AIDS in Fugong County,Nujiang District and to highlight the difficulties facing local healthcare workers in HIV/AIDS health education in order to help them improve their skills and capability of health education through participatory learning.(note:the major inhabitants in NuJiang are the Lisu ethnic).Methods A survey with questionnaires was carried out before starting a HIV/AIDS health education training course for healthcare workers in Fugong County.Then an interactive and participative HIV/AIDS training was provided for these healthcare workers.A post-training survey was followed.Results Before the training course,the score of HIV/AIDS related knowledge was 56.71 on average.The average score increased to 83.93 after the participatory HIV/AIDS health education,(by SPSS analysis).Such an increase was obviously associated with their participation in the training course.The knowledge the participants learned during the training course was effectively used for conducting health education among local inhabitants.Conclusion We found that a participatory/interactive HIV health education training course is useful in raising the awareness and understanding of HIV/AIDS among healthcare workers in areas such as Fugong.We encourage more efforts to hold such courses in order to prevent the spread of HIV/AIDS.

Objective To evaluate the clinical value of serum high density lipoprotein cholesterol (HDL-C)in the evaluation of synthetic function of the patients with liver diseases.Methods Abbott Aeroset automatic biochemical analyzer was used to detect serum HDL-C level in control group (30 cases) and liver disease group(87 cases).T test was used to analyze the differences of serum HDL-C level in liver disease group and control group,different liver disease groups and control group,and different liver disease groups.Results HDL-C level was (1.28 ±0.20)mmol/L in the control group,(0.77 ± 0.15)mmol/L in the liver disease group,and (0.81 ± 0.13)mmol/L in the hepatitis group,(0.68 ± 0.14)mmol/L in the liver cirrhosis group,(0.54 ± 0.05)mmol/L in the liver cancer group.The HDL-C level in liver disease group and hepatitis group,liver cirrhosis group,liver cancer group was significantly lower than that in the control group(t =15.5569,14.2463,45.4393,25.6344,all P ＜ 0.01).The HDL-C level in liver cirrhosis group and liver cancer group was significantly lower than that in hepatitis group (t =3.6583,16.9057,all P ＜ 0.01).The HDL-C level in liver cancer group was significantly lower than that in liver cirrhosis group(t =4.4103,P ＜ 0.01).Conclusion Serum HDL-C level can be used to evaluate synthetic function of the liver,the lower of serum HDL-C level,the more serious liver synthesis function is impaired.

Objective To analyze the related factors of surgical site infections after spine surgery so as to provide basis for clinical prevention. Methods We retrospectively reviewed the clinical data on 2,083 patients who had undergone spine surgery during the period of June 2010 to May 2013, and then conducted a statistica analysis. Results A total of 38 patients developed surgical site infections. The incidence of surgical site infections after spine surgery was 1.8%. 11 risk factors including gender, history of smoking, and history of prolonged uses of medications were related to surgical site infections The logistic regression analysis indicated that surgical site infections were more closely related to gender, length of hospital stay, and spine surgical invasiveness index. Conclusions Multiple factors can be attributed to surgical site infections after spine surgery. Gender , length of hospital stay, and spine surgical invasiveness index are the independent risk factors.

Objective To assess the diagnostic value of chronotropic index in identifying coronary artery disease (CAD). Methods One hundred and sixty two patients with suspected CAD were referred for a routine treadmill exercise electrocardiogram and subsequently underwent selective coronary angiography within 3 weeks. The magnitude of ST segment depression and chronotropic index were measured by a computerized ECG system. CAD was defined by coronary angiography. Results In detecting CAD, the sensitivity was 70. 1% versus 60.9% (P< 0.05) ,the specificity was 84.0% versus 73.3% (P<0.05), and the accuracy was 76.5% versus 66.7% (P< 0.05) by chronotropic index and standard electrocardiographic test criteria. The value of Kappa statistic for chrono-tropic index consistency in our experiment was 0.534(>0.4). The number of diseased vessels was correlated with the mean value of chronotropic index. The chronotropic index decreased from 0.88±0.09 in patients without coro-nary disease to 0.68±0.06 in those with 3 vessels involved (P<0.01). A more closed relationship was found be-tween chronotropic index and lesion in the fight coronary artery. Conclusions Chronotropic index is possibly a valu-able positive index for the diagnosis of CAD. The sensitivity,specificity and accuracy of chronotropic index are signif-icandy higher than those of standard electrocardiographic test criteria in identifying CAD.

The object of medical research is human life,thus the understanding level of human being determines medical mode and the development of medical science.The origin of Marx's theory on human being is the realistic human,which provides methodological basis for reflecting on the biomedical faults from a logical perspective.Marx held that technology is the objectization of the essential power of human being,while technology under the context of capitalist production relations has been turned into certain means to control workers.Tend of dissimilation also arises in some modern medical fields,thus serious reflection and criticism are in great need.The overall development of human being is the core content in Marx's theory on human being.Since modern medicine is during the transition from bio-medical model to bio-psycho-social medial model,the new medical model calls for an overall development of main body in all aspects including qualification,ability,and social relations,etc.

Objective To analyze the relationship of the serum concentration of TSH in pregestational women with pregnancy and pregnant outcome,and to investigate the high risk value of TSH in eugenic and healthy examination before pregnancy.Methods The distribution of TSH in fertile woman and the relationship of serum TSH level with sex hormone levels,rate of pregnancy,and adverse pregnant outcomes (no healthy infants were born,abortion,premature delivery,and malformation) were investigated in national-free pregestational eugenic and healthy examination during 2013.The high risk level of TSH in pregestational women was determined.Results The average level of TSH in 5 798 prepregnant women was 2.36 mIU/L with the median of 2.01 mIU/L,and the serum level of TSH showed abnormal distribution with long tail.The pregnant rate of fertile women within one year was 76.1％.The beneficial range of TSH levels for pregnancy was 0.35-3.5 mIU/L,while the pregnant rate in other ranges of TSH level was decreased with statistically significant difference (P＜0.01).When the concentration of TSH was below 0.35 mIU/L or above 5.5 mIU/L,abnormal pregnant outcomes were significantly increased (P＜0.01).Logistic regression analysis indicated that the relative risks of infertility and abnormal pregnant outcomes were significantly increased.Compared with TSH 0.35-2.5 mIU/L group,there were significantly differences in FSH,LH,and estradiol (E2) in TSH＞4.5 mIU/L or＜0.35 mIU/L group (P＜0.01).TSH was related with LH,E2,progesterone,and prolactin (r=0.29,-0.28,-0.37,0.36).Conclusion The high risk value of serum TSH in prepregnant women should be below 0.35 mIU/L or above 5.5 mIU/L.

BACKGROUND:It is confirmed that astrocytes can differentiate into neurons by Neurogenin2 gene regulation, suggesting that Schwann cells may also differentiate into neurons by gene regulation.
OBJECTIVE:To evaluate the feasibility of Schwann cells differentiating into neurons by Neurogenin2 gene regulation.
METHODS:Rats Schwann cells were isolated, purified and identified. Then the Schwann cells were transfected with Neurogenin2 via green fluorescent protein gene-plentivirus. To induce neuronal differentiation, the Schwann cells were cultured in serum-free Dulbecco’s modified Eagle’s medium containing epidermal growth factor, basic fibroblast growth factor and brain-derived neurotrophic factor for 2 weeks. The morphology of induced cells was observed by microscope, and myelin basic protein and neuron-specific enolase were detected by immunocytochemistry.
RESULTS AND CONCLUSION:After transfection with Neurogenin2 via green fluorescent protein gene-plentivirus and induced differentiation, immunofluorescence assay demonstrated that 12.56%of the induced cellexpressed neuron-specific enolase, but the control group did not express neuron-specific enolase. Neurogenin2 gene-transfected Schwann cells can express neuron-specific enolase, suggesting Neurogenin2 gene may regulate transdifferentiation of Schwann cells into neurons.

Objective To investigate the influence of Smac to the chemosensitivity of cyclophosphamide (CTX) and doxorubicin (DOX) in MCF-7 cells.Methods MCF-7 cells were exposed to CTX,DOX and the combination of both.3-(4,5-dimethyl-2-thiazoly)-2,5-diphenyl-2 H-tetrazolium bromide (MTT) assay was used to estimate the cell viability.Apoptosis was measured by acridine orange staining and Ho.33342/PI dou-ble staining.The mRNA and protein expressions of Smac were determined by RT-PCR and Western blotting.The study also analyzed the changes of pro-apoptotic proteins active caspase-3 and active caspase-9.Results CTX,DOX and the combination of both drugs reduced the cell survival rates in a concentration-dependent manner.The cell viability after being treated with 4.0 μg/ml CTX or 0.2 μg/ml DOX or 2.0 μg/ml CTX and 0.1 μg/ml DOX for 48 hours was (52.90 ± 8.78) ％,(53.35 ± 6.29) ％ and (34.19 ± 5.43) ％,respectively.The drug combination developed a stronger inhibitory effect compared to the single drugs (t =9.051,P=0.014;t =9.074,P =0.014).The Smac mRNA and protein levels in 2.0 μg/ml CTX and 0.1 μg/ml DOX group were 7.47 ± 0.82 and 4.13 ± 0.36,which were higher than those in 4.0 μg/ml CTX group (3.27 ± 0.40 and 2.28 ± 0.27;t =-50.120,P =0.000;t =-42.588,P =0.000) and 0.2 μg/ml DOXgroup (3.34±0.62and2.45±0.40;t=-46.233,P=0.000;t=-39.541,P=0.000).Furthermore,pro-apoptotic proteins active caspase-3 and active caspase-9 increased activity was confirmed by Western blotting.Conclusion Smac plays a vital role in enhancing the sensitivity of chemotherapeutic drugs CTX and DOX in MCF-7 cell line.

Objective:To study the related factors of severe acute radiation-induced lung injury (SAR) caused by IMRT and concurrent chemotherapy for non-small cell lung cancer. Methods:We retrospectively analyzed the data of 2 323 non-small cell lung cancer pa-tients who underwent IMRT radiotherapy and concurrent chemotherapy at the Department of Radiotherapy of Tianjin Medical Univer-sity Cancer Institute and Hospital from January 2010 to January 2014. We analyzed the clinical factors and parameters that affect dose by univariate and multivariate analysis. Results:A total of 2 323 patients enrolled and 1 241 cases suffering from acute radiation-in-duced lung injury with the rate of 53.4%. Only 185 cases suffered from SARP with a rate of 7.96%. Univariate analysis showed that the gender, histopathological type, total radiation dose, V5 (%), and average dose rate are not related to SARP (P>0.05). By contrast an age of>60 years, 1%predicted FEV, docetaxel+carboplatin/cisplatin chemotherapy, V20 (%), V30 (%), and mean lung dose (MLD) are sig-nificantly related to SARP (P<0.05). Multivariate analysis showed that a patient age of>60 years, docetaxel+carboplatin/cisplatin che-motherapy, V20 (%), and V30 (%) are the independent risk factors of SARP. Conclusion:Among the non-small cell lung cancer patients undergoing IMRT radiotherapy and concurrent chemotherapy, further attention should be given to elderly patients, patients receiving docetaxel and platinum chemotherapy, as well as V20 and V30 with high doses. The necessary preventive treatment should be given to reduce the incidence of SARP, improve the quality of life of patients, and reduce the incidence of respiratory failure and mortality.