Objectives To evaluate the valproate plasma l ev els,the clinical efficacy and adverse effects in patients with epilepsy treated with the conventional preparations and the sustained-release preparations of sodium valproate (VPA-Na?SR).Methods 33 patients received oral conventional formul ation of sodium valproate for over six months and a similar dosage of VPA-Na?SR for 4 weeks.After 12 or 24 hours,the valproate plasma concentr ations of the two formulations were measured respectively before taking drugs in the early mor ning.The valproate plasma concentrations and the clinical efficacy of the VPA-N a?SR were assessed by comparing with that of conventional valproate.The adverse effects were recorded.Results The average valproate plasma trough concentration was s ignificantly higher in patients receiving VPA-Na?SR than that of those receiving conventional valproate.Seizure free in patients was achi eved by 76%(n=25) with VPA-Na?SR and by 45%(n=15) with conventional valproate resp ectively.There was statistical difference between the two formulations.The seizu re frequency was significantly reduced in 5 patients treated with VPA-Na?SR.A dverse ef fects were observed in 2 patients with conventional valproate,5 patients with V PA-Na?SR whose valproate plasma levels were higher than that of conventional p reparations.Adverse effects were related to increased valproate plasm a levels and individual drugtolerance. Conclusions The advantage of VPA-Na?SR is that serum valproa te con centrations may increase smoothly and minimize fluctuation in serum dr ug concentrations during a dosing interval. It is a more effective and more convenient antiepileptic agent.

Objective To learn how well these items of Hubei Province meet the quality standards of allowed imprecision. Methods Collected the indoor quality control data of median concentration levels from the laboratories which participated the project of interlaboratory comparisons of clinical chemistry indoor quality control data in Hubei Province.This paper was to analyze the variation coefficient of indoor quality control for 21 routine clinical chemistry examination items which were K,Na,Cl,TCa,P,GLu,Urea,UA,Cr,TP,Alb,TC,TG,ALT,AST,TBil,ALP,AMS,CK,LDH andγ-GT.The other objec-tive was to learn how well these items of Hubei Province meet the quality standards of allowed imprecision.Then took the 1/3 TEa,1/4 TEa,WS/T-403-2012 and minimum imprecision derived from biological variation as quality specification.And an-alyzed the percentage of laboratories in meeting the quality standards.Results The TG,ALT,CK and TBil in more than 50% of the participated laboratories could meet the quality standards of the 1/3 TEa,1/4 TEa,WS/T-403-2012 and the low-est appropriate imprecision derived from biological variation.The Cl and Cr in more than 50% of laboratories couldn’t meet the all above quality standards.The Na and TCa in all laboratories couldn’t meet the quality standards of best imprecision derived from biological variation.The evaluation criterion for qualified items setted was that the variation coefficient in more than 80% laboratories was less than the quality standard.Thus,the percentage of the items which meet the lowest quality standard of biological variation and the all 21 items was the most (66.7%).While the percentage of the items which met the quality standards of the WS/T403-2012 and the best biological variation was the least (14.3%).Conclusion In short,the values of indoor variation coefficient of the 21 items in laboratories which participated the project of interlaboratory compari-sons of clinical chemistry indoor quality control data generally met the requirements.But some items had a little higher de-gree of dispersion.The laboratories should set the appropriate imprecision levels based on the detection capability and quality standards and improve the quality of examination through continuous efforts.

Objective To analyze the risk factors of pulmonary embolism in patients with negative Ddimer in serum in order to determine the need of pulmonary computed tomography angiograph (CTA) to confirm the final diagnosis in those patients for avoidance of misdiagnosis.Methods A retrospective analysis of 106 patients suspected to suffer from pulmonary embolism (PE) with serum negative D-dimer checked with pulmonary CTA was carried out.According to the results of CTA, the patients were divided into two groups, namely PE group (n =41) and non-PE group (n =65).The difference in clinic presentation, the time elapsed from onset to visit, N-terminal pro-brain natriuretic peptide (NT-proBNP), high risk factors (such as immobilization for 3 weeks, leg swelling and pain to palpation, history of deep vein thrombosis, malignancy) and Wells score (≥ 4 points indicates probability of PE).And logistic regression analysis was made to investigate the risk factors in PE with negative D-dimer.Results The analysis study showed that 38.6％ of total patients suspected to suffer from PE with serum negative D-dimer were checked by CTA to confirm the presence of PE.One important characteristics of the D-dimer negative PE patients was the longer time consumed from onset to visit [(9.51 ±2.01) d vs.(4.01 ±1.92) d, P＜ 0.05], and majority of the CTA positive patients suspected to suffer from PE with negative D-dimer had high risks of PE (P ＜0.01).Compared with the non-PE group, the Wells score ≥4 points and the level of serum NT-proBNP significantly increased in the PE group (P ＜ 0.01).Logistic regression analysis revealed that dyspnea, high NT-proBNP level and Wells sore ≥ 4 points were risk factors for D-dimer negative PE.Conclusion Delayed treatment was the main cause of misdiagnosis of D-dimer negative PE.Dyspnea, high NT-proBNP level and Wells sore ≥4 points were risk factors for suspected PE patients with negative D-dimer, and these patients should be confirmed by pulmonary CTA.On the contrary, PE could be excluded if patients with D-dimer negative had no these risk factors.

0.05),and the levels of Fib and D-dimer were obviously higher but AT-Ⅲ was obviously lower in 2 NS groups than those in normal control group(P

Purpose To evaluate the value of acoustic radiation force impulse (ARFI) imaging in the diagnosis of SjOgren's syndrome (SS).Materials and Methods Sixty-four cases of outpatients or inpatients with xerophthalmia or xerostomia in the Department of Rheumatology and Immunology of the First Affiliated Hospital of Nanchang University from September 2015 to April 2016 were collected.According to American-European Consensus Group criteria of 2002,the subjects were divided into SS group (n=38) and nonSS group (n=26).The bilateral parotid gland and submandibular gland were examined by ARFI imaging,and the shear wave velocity (SWV) value was obtained.The differences in SWV values between the left and right sides of the parotid gland or submandi-bular gland and between the SS group and the non-SS group were analyzed.Results ① The SWV values between two sides of parotid glands or submandibular gland in SS group or non-SS group showed no significant differences (P＞0.05).The difference of SWV between the two groups was statistically significant (P＜0.05).② According to the ARFI imaging of parotid gland,the optimal cutoffvalue,sensitivity,specificity,Youden index and ROC area under the curve were 1.99 m/s,86.3％,80.8％,0.671 and 0.879,respectively.③ According to the ARFI imaging of submandibular glands,the optimal cutoff value,sensitivity,specificity,Youden index and ROC area under the curve were 2.13 m/s,79.5％,80.8％,0.603 and 0.878,respectively.Conclusion The ARFI imaging can provide the SWV value of salivary glands to quantify the elasticity of salivary glands in SS,which has great value in the diagnosis of SS.

Objective In order to know the influence of psychological nursing intervention on rehabilitation of children with primary nocturnal ensuresis. Methods Divided 112 children with primary nocturnal ensuresis into the research group (40 cases) and the control group (72 cases). Routine treatment and nursing cares were used in the control group, while the psychological nursing was used in the research group in addition. Compared the treatment effect betweent the two groups. Results The efficient rate in the research group was 90.0%, which higher than that of in the control group significantly. Conclusions Psychological nursing intervention can effective promote the rehabilitation for children with primary nocturnal ensuresis.

Objective:To explore the proportions of Th17 cells in the peripheral blood and levels of IL-17,IL-23 in the serum of patients with Graves′disease ( GD ) and their clinical significance.Methods: We studied 29 patients with GD ( GD group ) , and reevaluated the GD group after therapy ( euthyroid GD group ).29 gender-and age-matched volunteers were selected as the normal control ( NC group).The proportions of Th17 cells were investigated by flow cytometry.The levels of IL-23,IL-17 in the serums were measured by ELISA.The levels of FT3,FT4,TSH were determined by ECLIA and the levels of TrAb were tested by RRA.Results:There were no significant difference among 3 study groups in sex and age match ( F=0.0075 , P>0.05;χ2=0.4213 , P>0.05 ).The proportions of Th17 cells and the levels of IL-17 , IL-23 were increased in the GD and euthyroid GD patients compared with the control group (respectively,P<0.05).The proportions of Th17 cells and the concentrations of IL-23 in euthyroid GD group were significantly lower than those of GD group ( respectively , P<0.05 ) , but there were no significance in the concentrations of IL-17 between euthyroid GD group and GD group(P>0.05).Correlation analysis revealed that the proportions of Th17 cells ,and the levels of IL-17,IL-23 were positively correlated with the levels of FT3,FT4,TrAb(r=0.588 2,0.337 2,0.371 0;0.549 6,0.287 5,0.342 7;0.361 0,0.420 8, 0.330 8;P<0.05 ,for all parameters ) ,and were negatively correlated with the levels of TSH ( r=-0.319 7 ,-0.472 8 ,-0.428 2;P<0.05,for all parameters).Conclusion:Th17 cells and their related cytokines IL-17,IL-23 are highly expressed in the serum of patients with GD.Th17 cells and their relative cytokines have certain relevance with 4 thyroid function parameters of the patients with GD , which can be used as biological markers for GD.

Objective To observe the clinical features and to identify γ-secretase gene mutations in a Chinese family with follicular occlusion triad (FOT).Methods Clinical evaluation was carried out in a family with FOT through field investigation.Peripheral blood samples were obtained from the family members and 100 unrelated healthy controls.DNA was extracted from the blood samples,and PCR was performed to amplify all the coding regions of PSEN1,PSENEN and NCSTN genes followed by DNA sequencing and comparative analysis.Results There were 14 members over 3 generations in this family,of whom,6 (4 males and 2 females) were affected by FOT.FOT was inherited in an autosomal dominant manner in this family.Clinical manifestations varied greatly among the 4 surviving affected members.DNA sequencing revealed a novel missense mutation,c.647A ＞ C (p.Q216P),in the exon 6 of NCSTN gene in the proband,which was cosegregated perfectly with affected,but not with unaffected,members in the family.The mutation was not found in any of the unrelated controls and had not been registered in the single nucleotide polymorphism (SNP) database in NCBI.Conclusions There is a novel heterozygous missense mutation,c.647A＞C in the exon 6 of NCSTN gene,which may be the molecular basis of pathogenesis of FOT in this family.

OBJECTIVE To discuss the related factors of toxigenic Helicobacter pylori(Hp) infection among adult population in Futian District,Shenzhen.METHODS A total of 1164 adults who had health examination in community centers were investigated through questionnaire and detected Hp antibodies.RESULTS The Hp and toxigenic Hp infection rates among them were 45.5% and 14.2%.Among them 46.3% and 14.8% were in males,and 44.7% and 13.4% in females.People less than 60 years old had higher incidence of Hp and toxigenic Hp,but decrease in people rnore than 60 years old.Hp and toxigenic Hp infection rate in married people were higher than those of unmarried.In workers,farmers and doctors were higher than staff and other occupations.The incidence were higher in drinking raw water than those drinking boiling water.in taking antibiotics before serologic examination were lower than no taking antibiotics;in peptic ulcer disease were higher than in no peptic ulcer disease;in per capita housing area over 6 m2 were higher than less 6 m2.CONCLUSIONS The infection rates of Hp and toxigenic Hp among our adult population are low,and positively correlated with age but gender.The social environment such as living condition,economic income,culture level and residential density maybe influence the infection of Hp.The route of transmission of Hp is unknown yet,water perhaps is an important dissemination medium.

OBJECTIVE:To investigate the neuropotective effect and anticoagulation effect of total Saponins of Radix Liriopes on focal cerebral ischemia in rats.METHODS:Chemical reagent Fecl3 was locally applied on the injured vessels to establish middle cerebral artery thrombosis model,and the effects of total Saponins of Radix Liriopes on rats' behavioral disturbance,brain infarct size,the histopathological changes in brain and the expression rate of nNOS immunoreactive positive neurons were measured,and the bleeding time and coagulation time were also detected with glass tube method and tail transection method.RESULTS:Due to the use of total Saponin of Radix Liriopes(10 and 40mg? kg-1),the brain infarct size was significantly decreased,the behavioral disturbance were improved and the expression rate of the nNOS immunoreactive positive neurons in rats were decreased.At doses of 20 and 60mg? kg-1,total Saponin of Radix Liriopes significantly prolonged the coagulation time and bleeding time.CONCLUSION:Total Saponin of Radix Liriopes has nuroprotective effect on focal cerebral ischemia induced by middle cerebral artery thrombosis and significant anticoagulation effect.