Objective To investigate the efficacy and optimal dose of adrenocorticotropic hormone(ACTH) in treatment of infantile spasms (IS).Methods Sixty patients with IS were randomly divided into group A (ACTH 20 IU/d,n =20),group B (ACTH 40 IU/d,n =20) and group C (Depakine syrup,n =20) in a prospective randomized study.Patients in group A and group B were given ACTH in the dose of 20 IU/d and 40 IU/d for 2 weeks,respectively.After 2 weeks of treatment,ACTH administration was replaced by oral prednisone if the seizure frequency decreased by 50.0％ or less.Patients showing incomplete control of epilepsy(seizure frequency reduction less than 50.0％) or failing to respond to treatment were continuously treated with the original amount of ACTH for another 2 weeks,then ACTH was replaced by oral prednisone.Patients in group C were treated with the combination regimen of oral clonazepam and Depakine syrup routinely.All participants were followed up by 0.5-3.0 years.The differences in clinical efficacy,changes in electroencephalogram(EEG) and adverse reactions in 3 groups were compared and analyzed.Results Mter 4 weeks of treatment,the total effective rates (TER) and EEG remission rate (ERR) in group A [TER:75.0％ (15/20 cases),ERR:40.0％ (8/20 cases)] and group B [TER:70.0％ (14/20 cases),ARE:45.0％ (9/20 cases)] were significantly higher than those in group C [TER:30.0％ (6/20 cases),ERR:10.0％ (2/20 cases)] (x2 =10.011,6.624,all P ＜ 0.05),respectively,while no significant difference was found between group A and group B as for seizure control,hypsarrhythmia EEG resolution,and cognitive function restoration (x2 =0.125,0.000,t =1.95,all P ＞ 0.05).During follow-up study,the TER and ERR in group A [TER:30.0％ (16/20 cases),ERR:35.3 ％ (6/17 cases)] and group B [TER:30.0％ (6/20 cases),ARE:37.5％ (6/16 cases)] were also significantly higher than those in group C [TER:5.0％ (1/20 cases),ARE:5.9％ (1/17 cases)] (x2 =4.329,6.455,all P ＜ 0.05),respectively.The incidence of adverse reactions in group A was lower than that in group B (x2 =3.956,P ＜ 0.05).Conclusions ACTH proves to be an effective drug for the treatment of IS.Administration of ACTH in the dose of 20 IU/d for 2 weeks seems to be an optimal treatment recipe with remarkable efficacy with fewer adverse effects and may be worthy of clinical trials in a larger cohort.

In terms of performance of piezoelectric micro pump, this paper explores the piezoelectric ceramic plate in different wave driven micro pump flow rate. The conclusion is that the square wave voltage gets the biggest micro pump velocity. The velocity and pressure of the micro pump is almost linear relationship, and having nothing to do with the different inner diameter pipes. The piezoelectric micro pump's stability is not good and exists attenuation.
Ceramics ; Insulin ; administration & dosage ; Insulin Infusion Systems

ABSTRACT:Objective To study the efficacy and safety of oxcarbazepine (OXC)oral suspension on children with different kinds of epilepsy.Methods A total of 83 children with epilepsy were selected from the Pediatric Department of the First Affiliated Hospital of Xi’an Jiaotong University and Xi’an Children’Hospital from June 201 1 to June 2014.They were treated with OXC monotherapy or adjunctive therapy.Use open-label and self-contrast method.The initial dose of OXC was 8 -10 mg/(kg·d),and then was added 10 mg/(kg·d)per 7 days until it reached the minimum effective dose.Generally,the maintenance dose was about 20-40 mg/(kg·d).The follow-up duration was 6 - 12 months.Results 83 cases were eventually included and 5 cases withdrew.We elvaluated the efficacy every 3 months.The results were as follows:the first stage (1,2,3 months)resulted in a 41.0% of full control rate and a 71.8% of total effective rate;the second stage (4,5,6 months)resulted in a 46.2% of full control rate and a 76.9% of total effective rate;the third stage (7,8,9 months)resulted in a 59.0%of full control rate and a 79.5% of total effective rate.There were no significant differences in the efficacy of the three stages.54 cases with partial seizures resulted in a 59.3% of full control rate and a 79.6% of total effective
rate;24 cases with generalized seizure resulted in a 45.8% of full control rate and a 62.5% of total effective rate. There was no statistical significant difference in the efficacy of the two seizure types.43 cases with monotherapy resulted in a 58% of full control rate and a 79% of total effective rate,35 cases with add-on therapy resulted in a 40.0% of full control rate and a 57.1% of total effective rate.24 cases with < 2 resulted in a 41.7% of full control rate and a 62.5% of total effective rate,54 cases with 2-6 resulted in a 59.3% of full control rate and a 83.3% of total effective rate.14 cases of children were reported to have at least one adverse drug reactions,the specific symptoms included emotional instability unstable, hypohidrosis, somnolence, dizzness, headache, vomiting, urorrhea,lack of appetite,aggressive behavior and hypomnesia.Adverse reactions were mild and most of them could subside over time.Conclusion OXC oral suspension has a good efficacy and safety when treating children with partial seizures or generalized tonic-clonic seizures of epilepsy.

Objective: To optimize the alcohol-extraction process and condition of Radix Pulsatillae.Methods: Alcohol concentration,the extraction time and number of extraction on effect of extraction rate of pulchinenoside B4 were evaluated by orthogonal design L9(34).Results: The optimum condition of the alcohol extraction was: 75% ethanol,3 times of extraction,3h for extraction process.Conclusion: The extraction method can be used for reference for the extraction process of Radix Pulsatillae.

Objective To investigate the clinical efficacy and improvement of patients' quality of life in tension-free vaginal tape(TVT)and tension-free vaginal tape obturator(TVT-O)for surgical treatment of severe female stress urinary incontinence.Methods This study was a randomized,singleblinded,controlled trial.Patients were randomized by a computer-generated randomization schedule with allocation to either TVT or TVT-O procedure.TVT procedure was performed in 35 cases and TVT-O in 34 cases.None had received surgery for urinary incontinence or was in pregnancy.Transvaginal hysterectomy and prolapse reparation were done simultaneously in some of the patients.All patients were requested to complete the Urinary Distress Inventory(UDI-6)and Incontinence Impact Questionnaire(ⅡQ-7)as part of their pre-and postoperative assessment.Results All patients were evaluable and the mean follow-up was 14.5 months.The mean operative time was(18±5)min in the TVT-O group,Significantly shorter than in the TVT group(27±5)min(P＜0.01).The two groups did not differ significantly in perioperative blood loss,postoperative complications(including tape erosion,pain in thigh or behind pubis),postvoid residual volume,hospital stays or expenses(all P＞ 0.05).Sixty patients were successfully treated for stress urinary incontinence(88.6%and 85.3%for TVT and TVT-O groups,respectively).There were significant improvements in postoperative scores for both the ⅡQ-7 and the UDI-6(P＜0.01),except in subscale measuring symptoms of voiding dysfunction(P＞0.05).Conclusions Both techniques appear to be equally effective in the surgical treatment of severe stress urinary incontinence in a short term review.Significant improvements could also be seen in patients' quality of life.However.TVT-O has a shorter operative time.No evidence of increasing risk of urethral obstruction after the operation could be found.Long term followups axe necessary to evaluate outcomes of different types of surgery for stress urinary incontinence.

To investigate the relationship of the variation of virulence and the external capsid proteins of the pandemic duck hepatitis A virus type 1(DHAV-1) isolates,the virulence,cross neutralization assays and the complete sequence of the virion protein 1(VP1) gene of nine virulent DHAV-1 strains,which were isolated from infected ducklings with clinical symptoms in Shandong province of China in 2007-2008,were tested.The fifth generation duck embryo allantoic liquids of the 9 isolates were tested on 12-day-old duck embryos and on 7-day-old ducklings for the median embryonal lethal doses(ELD50s) and the median lethal doses(LD50s),respectively.The results showed that the ELD5s of embryonic duck eggs of the 9 DHAV-1 isolates were between 1.9 × 106/mL to 1.44 × 107/mL,while the LD50s were 2.39 × 105/mL to 6.15 × 106/mL.Cross-neutralization tests revealed that the 9 DHAV-1 isolates were completely neutralized by the standard serum and the hyperimmune sera against the 9 DHAV-1 isolates,respectively.Compared with other virulent,moderate virulent,attenuated vaccine and mild strains,the VP1 genes of the 9 strains shared 89.8％-99.7％ similarity at the nucleotide level and 92.4％-99.6％ at amino acid level with other DHAV-1 strains.There were three hypervariable regions at the C-terminus(as 158-160,180-193 and 205-219) and other variable points in VPI protein,but which didn't cause virulence of DHAV-1 change.

Objective To compare the traumatic indicators of complete video-assisted thoracoscopic surgery (c-VATS) with traditional open surgery (TOS) for lung cancer patients, and further explore the minimal invasiveness of c-VATS. Methods From January 2010 to February 2013, 45 cases with complete video-assisted thoracoscopic surgery (c-VATS gurop) and 42 cases with traditional open surgery (TOS group) were compared in operation time, intraoperative blood loss, duration of chest drainage, the perioperative cytokine and immune cells (CRP,WBC,N,L),pain score and shoulder function score. Results There was no significant difference between groups in sex, age, pathological type, stage,operating time and the perioperative cytokine and immune cells (CRP, WBC, N, L) ( >0.05);Compared with TOS group, c-VATS group intraoperative blood loss was significantly reduced [(167.4±68.5) mL vs (288.6±84.0) mL, =0.000];Drainage time of TOS group was significantly longer than that of c-VATS group [(4.64±2.10) days vs (3.20±1.20) days, =0.000];The postoperative pain measurements in c-VATS group were less than that in TOS group, but the difference between groups was not significant on postoperative 1 day ( =0.542) and significant on postoperative 3 day,7 day,30 day ( = 0.034, 0.000, 0.000) . Patients activities of daily living scores at postoperative 7 day and 30 day in c-VATS group were significantly better than those in TOS group, with statistically significant differences ( =0.000,0.000) . Conclusion Whether the short-term effect or the long-term results,the VATS lung resection is better than the traditional open surgery. c-VATS resection of lung cancer is more invasive.

Objective: To investigate the relationship between the expression of glucose-regulated protein 78 (GRP78) and gemcitabine chemotherapy in the patients with non-small cell lung cancer (NSCLC) and the effects of GRP78 on the viability of lung adenocarcinoma SPCA1 cells and the chemosensitivity of gemcitabine, and to elucidate its mechanisms. Methods: The positive expression rates of GRP78 in 32 cases of cancer tissue of the NSCLC patients were detected by immunohistochemical staining. The SPCA1 cells with high expression of GRP78 were selected as the subjects. RNA interference technique was used to down-regulate the expression of GRP78 in SPCA1 cells (interference group) and the cells treated with shNC were used as control group. MTT assay was used to detect the viabilities of SPCA1 cells in various groups. Negative control group, interference group, control + gemcitabine group, and interference+ gemcitabine group were set up; colone formation assay was used to detect the colone formation rates of SPCA1 cells in various groups; Western blotting method was used to detect the expression amount of Akt, p-Akt, PI3K, and p-PI3K in the SPCA1 cells in various groups. Results: The immunohistochemical staining results showed that the positive expression rate of GRP78 in cancer tissue in the remission NSCLC patients was significantly higher than that in the no-remission NSCLC patients after treated with gemcitabine (P<0. 05). The MTT assay results showed that compared with negative control group, the viability of SPCA1 cells in interference group was decreased significantly (P<0. 05), and the viability of SPCA1 cells in interference + gemcitabine group was significantly decresed (P<0. 05). The Western blotting results showed that compared with negative control group, the expression amounts of p-Akt and p-PI3K in the SPCA1 cells in interference group were decreased, and the expression amounts of p-Akt and p-PI3K in the SPCA1 cells in interference+gemcitabine group were decreased significantly. Conclusion: Interference of GRP78 may increase the sensitivity of gemcitabine to chemotherapy, and GRP78 may reduce the sensitivity of NSCLC patients to gemcitabine through PI3K/Akt pathway.

Objective To evaluate continuous improvement of portable domestic pelvic floor neuromuscular electrical stimulation on the pelvic floor function of patients with stress urinary incontinence after short-term pelvic floor electrophysiological treatment in hospital.Methods Totally 60 women with stress urinary incontinence were recruited for this randomized controlled trial.The control group including a total of 30 patients,only received 4 weeks pelvic floor electrophysiological treatment in the hospital.Family consolidation treatment group (experimental group) including 30 patients,after 4-week treatment in hospital,received 12-week of pelvic floor neuromnuscular electrical stimulation using portable electrical stimulator at home under the guidance of doctors.In post-treatment 6 months and 9 months,1-hour pad test was measured for urine leakage,pelvic floor electrical physiological parameters were assessed,and subjective improvement of symptoms of urinary incontinence were evaluated.All these data were analysed to compare the effect of the two groups.Results In 9 months after treatment,average change of urine leakage,the control group and experiment group were (75±24)％ versus (99±3)％,the difference was statistically significant (P＜0.01).In the experiment group,strength of type Ⅰ muscle (4.4±0.7),strength of type Ⅱ muscle (4.8±0.4) and pelvic floor dynamic pressure [(96± 12) cmH2O,1 cmH2O=0.098 kPa] were better than those of control group [3.2± 1.0,4.3 ± 0.9,(86 ± 10) cmH2O,respectively],the differences were statistically significant (P＜0.01).Subjective outcome,the control group and experiment group were (6.5 ±2.9) versus (1.8 ± 1.7),subjective outcome between the two groups had significant difference (P＜0.01).Conclusion After short-term pelvic floor electrophysiological treatment in hospital,the portable domestic pelvic floor neuromuscular electrical stimulation in patients with stress urinary incontinence is helpful to continuous improvement of pelvic floor function.

Objective To explore the correlation between NF-κB signaling pathways activated by IL-18 in CD4+ T cells and the pathogenesis of PBC.Methods We detected the expression of IL-18 mRNA in PBMCs,IL-18 level in plasma,receptor IL-18R on surface of CD4+ T cell,proliferation rate of CD4+T cell and its NF-κB signaling pathway protein IκBα and NF-κB p65 by qRT-PCR,ELISA,flow cytometry,MACS and Western blot on 32 cases of patients with PBC (PBC group) and 32 healthy people (control group) in Guizhou provincial people′s hospital.Results The level of IL-18 in PBC group was significantly higher than that in control group (P<0.05).The relative expression of IL-18 mRNA in PBC group was significantly higher than that in control group (P<0.05).The percentage of CD4+T cells expressing IL-18Rα in PBC group was higher than that in control group (P<0.05).The proliferation rate of CD4+T cells stimulated by IL-18 in PBC group was significantly higher than that in healthy control group (P<0.01).The relative expression levels of NF-κB p65 protein were up-regulated in IL-18,and the expression of IκBα protein in each group was significantly increased,especially in PBC group (P<0.01).Conclusion IL-18 can activate NF-κB signal pathway in CD4+ T cells and participate in the pathogenesis of primary biliary cirrhosis.