OBJECTIVE:To guide the rational use of anti-epileptic drugs(AEDs)in clinical practice.METHODS:In a retrospective review,there were733patients in Xuanwu hospital who suffered from poor curative effect or intoxication of AEDs from March2000to March2001.The results of blood concentration of anti-epileptic drugs(AEDs Css)were ana?lyzed.RESULTS:The Css of37.6%of the patients were within the normal Css range,and6.4%were higher and55.9%were lower than the normal.In combined use of AEDs and other drugs,79.1%of the patients had higher or lower Css than nor?mal.In addition,chemosynthetic components were detected in90%of the patients who took Chinese medicine.Among them,86%of the patients had abnormal Css.CONCLUSION:Css monitoring should be done when AEDs were administrated.It is advisable to use only one or two kinds of AEDs,and to pay attention of the chemosynthetic components in Chinese medicine.

Atrial fibrillation is one of the commonest cardiac arrhythmia in the elderly, the incidence increased with increasing ages. Atrial fibrillation can induce severe cardiac insufficiency and thromboembolism, stroke is also a very important complication with high morbidity and mortality. Thus it is very necessary to pay special attention to the study of atrial fibrillation in the field of geriatric cardiovascular diseases.

OBJECTIVE:To understand the safety of Puerarin injection in clinical use.METHODS:The adverse drug re?actions(ADRs)and administration of Puerarin injection at Xuanwu Hospital from Oct.2002to Feb.2003were investigat?ed.RESULTS:According to the dosage in drug intruction,the Puerarin injection was diluted in0.9%sodium chloride of5%glucose solution and infused alone with a infusion rate of40～60drops/min,which would be safe and induce less ADRs,and use in overdose markedly increased the incidence of ADRs.CONCLUSION:Use of this preparation should strictly be in accordance with the specification.

Metabolic syndrome was once regarded as deadly quartet.This is make up by diseases of various metabolism.The incidence is increased with age.This review is to introduce recent advances in the epidemic,major risk factors,clinical symptoms and diagnosis.Early health education,diet therapy,exercises and drugs can prevent or delay the occurrence and progress of metabolic syndrome.

Hypertrophic cardiomyopathy is one of the most common inherited cardiovascular diseases and characterized by ventricular hypertrophy and myofibrillar disarrays. HCM affects patients of all ages, but is frequently diagnosed in patients over age 50. The pathology, genetics, diagnosis and treatment of HCM are reviewed.

The clinical manifestations and CT findings of 26 patients,who were full-time cooks working in small restaurants,were analyzed retrospectively.The main clinical manifestations were chest congestion,shortness of breath,chest pain,cough and hemoptysis.Lung CT scanning revealed lung carcinoma in 1 case,pulmonary nodules in 16 cases including 2 cancerous nodules confirmed in the followup review,puhnonary bulla in 6 cases,emphysema in 4 cases,fibro-proliferative lesions in 8 cases,interstitial pneumonia in 4 cases and fungal ball in 1 case.Among 26 patients,12 had two or more concurrent intrapulmonary lesions.The results suggest that long-term exposure to cooking oil fume may lead to a series of pulmonary pathological changes,and attention should be paid to the occupational hazards of cooks.

There are disadvantages in examination in basic medical stage. For example, there is too much quantity of work in written examination and the time is short for preparation for oral examination. Basic medical college reforms the examination in the first stage. The exam is composed of two parts. One is performed in computer instead of being written on paper,the oth-er is oral test whose topic is informed one term ahead of time. These can improve the students’ ability to summarize what they have learned in class.

Objective: To evaluate the effect and safety of continuous veno-venous hemofiltration(CVVH) in the treatment of multiple organ failure(MOF) in senile patients.Methods: Sixteen patients with multiple organ failure,aged over 80 years,were divided into a survival group,who lived more than 20 days,and a non-survival group,less than 20 days after CVVH,and observed for such clinical indexes as of renal function,K+and blood gas analysis,APACHEⅡ scores and complications.Results: After CVVH,eleven of the patients survived for over 20 days,with 1 case up to 3 years.CVVH effected a significant improvement in BUN,Scr,K+and blood gas as well as a marked reduction in complications.APACHE Ⅱ scores decreased significantly after CVVH in the survival group though not in the non-survival group,as compared with those before CVVH,which were significantly lower in the former than in the latter.Conclusion: CVVH is a safe,effective and well-tolerated method for the treatment of MOF in senile patients.Patients with higher APACHEⅡscores have a poor prognosis.

Objective To verify the application of anterior segment perfusion culture and trabecular meshwork (TM) organ culture for glaucoma study. Methods TM tissue was cultured by perfused anterior segment and TM organ culture, light microscopy was used to observe the TM cells and intercellular spaces.Results IOP of the porcine anterior segments perfused under constant flow at 0.1 mL/h could bekept in normal range(10～12 mmHg). The IOP was elevated with the increasing of perfusion rate, while the morphology and structure of the tissue were well preserved. TM cultured by TM organ culture could also reserve the tissues well, but the intercelluar spaces collapsed. Conclusion Anterior segment perfusion model could be a short-term high-pressure model and may simulate the normal physical state. Adequate perfusion was necessary for normal TM.