OBJECTIVE:To study the identification problems of pharmacokinetic compartment models.METHODS:Problems of the identification of classical compartment models in single administration were systematically discussed by Laplace transformation method.RESULTS:The classical compartment models in single administration don't have the character of u-niqueness and the identification for which is a problem.CONCLUSION:The drug level in plasma and the concentration of drugs that distributed in organs were in a direct ratio under the condition of two kinds of unidentifiable classical compartment models,in that case,it has theoretic bases and significance to predict the concentration of drugs that distributed in organs or target organs by means of determining the drug concentration in plasma;if on the other hand,if two kinds of classical com-partment models are identifiable,the drug level in plasma and the concentration of drugs that distributed in organs or target organs wouldn't be in a proportional relationship,in this case,it is advisable to make sure the relationship between the drug le_ vel in plasma and the concentration of drugs that distributed in organs or target organs before predicting drug concentration that distributed in organs or target organs by means of monitoring the drug concentration in plasma;otherwise,it is baseless and meaningless.

Objective To explore the characteristics of childhood tuberculosis and recent advances in the diagnosis and treatment of this disease in order to improve its diagnosis and treatment. Methods Key words“child”“tuberculosis”“diagno-sis” and “treatment” were used to retrieve relevant literatures from Pubmed,Web of Science,CNKI and Wanfang databases.The literatures were reviewed and clinical experience summarized. Results Disseminated tuberculosis and extrapulmonary tubercu-losis were common in children with tuberculosis. It was difficult to collect with samples of diagnostic value for detection. There counterparts were no systematic diagnosis and treatment programs available for children with drug-resistant tuberculosis,and phar-maceutical dosage forms tailored for children were lacking. Conclusion Tuberculosis in children is more complex to diagnose and treat than in adult counterpart.Diagnosis of this disease relies on a variety of diagnostic methods.It's still challenging to control childhood tuberculosis.

Objective To investigate the incidence of adult epilepsy patients with attention-deficit hyperactivity disorder (ADHD) and the characteristics of ADHD subtypes, and to explore the correlations between several epilepsy-related factors with ADHD.Methods According to corresponding inclusion criteria and exclusion criteria, 156 adult epilepsy patients who visited to Neurology Clinic of Zhejiang Hospital and the First Affiliated Hospital of Anhui Medical University from March 2014 to October 2014 were enrolled as a study group to enter this test.Eighty-six nomal adults were enrolled as the control group who matched for the age, gender, inteligence quotient with the study group.Using the chi-square test and Logistic regression analysis and the other statistical methods to analyze the phenomenon of ADHD in adults with epilepsy and the factors that may contribute to the phenomenon.Results The detection rate of ADHD in 156 adult patients with epilepsy was 26.9％ (42/156), significantly higher than that in the heathly control group which was 4.7％ (4/86, x2 =17.862, P ＜ 0.05).Symptomatic epilepsy and the electroencephalogram showed multifocal discharge had higher detection rate of comorbid ADHD and the difference was statistically significant (The detection rate of idiophathic epilepsy was 22.1％ (21/95), symptomatic epilepsy was 46.7％ (14/30), cryptogenic epilepsy was 22.6％ (7/31), x2 =7.362, P =0.025.The detection rate of frontal epileptiform discharges was 30.6％ (11/36), temporal area was 25.9％ (14/54), central area was 18.2％ (4/22), multifocal epileptiform discharges was 46.2％ (12/26), the normal was 1/18, x2 =10.187, P =0.037).The results of binary Logistic regression analysis showed that epilepsy age of onset (B =-0.889, P =0.049) was possibly an important factor for epilepsy with ADHD.Conclusions The risk of ADHD occurred in adults with epilepsy is higher than that in the healthy adults and attention-deficit is the common subtype.The etiology, age of onset and electroencephalogram features of adults with epilepsy may be associated with the occurrence of ADHD.

The pathogenesis of drug-induced Iiver injury( DILI)remains uncIear. AccumuIating evidences in recent years showed that immunoIogicaI factors pIay important roIe in the pathogenesis of DILI. In this articIe,we summarized recent studies on immunoIogicaI factors invoIved in pathogenesis of DILI and compared the immunity mediated DILI with drug induced autoimmune hepatitis. The advances in study on immunoIogicaI factors in DILI wiII have significant impact on prevention and treatment of DILI and autoimmune hepatitis.

Objective To study changes and meaning of serum IL -4,IL -10,IFN -gamma,TGF -beta 1 level in patients with delayed encephalopathy after carbon monoxide poisoning.Methods From January 2011 and June 2014 in our hospital,40 cases of DEACMP patients were selected as group A;the 40 patients with DEACMP was divided into 12 cases of mild cognitive dysfunction,mild cognitive dysfunction in 20 cases,8 cases of severe cognitive dysfunction.40 cases with acute carbon monoxide poisoning (ACMP)patients were selected as group B;40 cases of healthy subjects were selected as healthy controls.Serum interleukin 4 and interleukin 10(IL -4)(IL -10),interfer-on gamma (IFN -gamma),conversion,growth factor beta 1 (TGF -beta 1)content were tested.Results In Group A and group B serum IL -4 levels were lower than that of healthy controls (P <0.01),and serum levels of IL -10 in group B were higher than that in group A and healthy controls (P <0.01),serum level of IFN -gamma in group A and group B was higher than the healthy controls (P <0.01),and in group A IFN -gamma levels were higher than group B (P <0.01),while in group A serum TGF -beta 1 level was lower than B group and the control group (P <0.01),and in group B TGF -beta 1 level was higher than the control group (P <0.01);With cognitive impairment aggravating of DEACMP patients,IL -4,IL -10,TGF -beta 1 levels were on the decline,and IFN -gamma level was increasing (P <0.01).Conclusion DEACMP patients serum and cerebrospinal fluid of IL -4,IL -10,IFN -gam-ma,TGF -beta measures such as abnormal expression,showed that the onset of DEACMP may be related to neural immune injury.Serum IL -4,IL -10,IFN -gamma and TGF -beta of DEACMP patients exists abnormal expression Serum IL -4,IL -10,IFN -gamma and TGF -beta levels are also related to the degree of cognitive impairment of DEACMP patients.The onset and progress of DEACMP may be associated with neural immune injury.

Objective To analyze the causes and results of treatment of periprosthetic femoral frac-tures after total hip arthroplasty and to explore the best operative methods for fractures. Methods 11 cases treated for periprosthetic femoral fracture after total hip arthroplasty were subjected to a retrospective fol-low-up study from December 1998 to March 2003. There were 8 men and 3 women, the mean age was 56 years (range, 43 to 75 years). There were 2 Vancouver A type fractures, 7 B2 type, 1 B3 type, 1 C type. 5 fractures were treated by nonoperative methods and other 6 by operative methods, including one fracture malunion treated initially by skin traction. There were 5 revisions using long stem supplemented with cortical allograft strut, including 4 uncemented stems with distal fixation and one cemented stem; the remaining one fracture treated by open reduction and internal fixation. Results None was lost for follow-up. The mean follow-up period was 25.6 months (range, 7 to 50 months). 9 fractures united at a mean of 4 months (range, 3 to 6 months). Nonunion was found in 2 fractures, both were treated nonoperatively. All the 6 fractures treated by operative methods united. Up to now, 7 stems were well-fixed, continuous radiolucent line was seen in one revision case, 3 stems were loosened. The function of the patients with well-fixed stems was bet-ter than those with loosened stems, the mean Harris score of the former was 91. All the cortical allograft struts were incorporated with host bone within one year. No strut fracture happened. Conclusion Type A fractures with well-fixed stems can be treated by nonoperative methods, while type B1 and type C fractures should be treated by open reduction and internal fixation, on condition there is no surgical contraindication. For fractures with loosened stems, use of an uncemented long stem with distal fixation supplemented with cortical allograft strut is the best choice.

Objective: To investigate the effects of hepatitis B virus (HBV) X protein (HBx) on the expression of tumor necrosis factor-α (TNF-α) in glomerular mesangial cells (GMCs) and the underlying intracellular signal pathways. Methods: The plasmid pCI-neo-X that carries the X gene of hepatitis B virus was transfected into cultured GMCs. HBx expression in the transfected GMCs was assessed by Western-blot. TNF-α protein and mRNA were assessed by ELISA and semi-quantitative RT-PCR, respectively. Three kinase inhibitors-U0126, an inhibitor of extracellular signal-regulated kinases (ERKs);lactacystin, an inhibitor of nuclear factor-κB (NF-κB);and SB203580, a selective inhibitor of p38 MAP kinase (p38 MAPK) were used to determine which intracellular signal pathways may underlie the action of HBx on TNF-αexpression in transfected GMCs. Results:A significant increase in HBx expression in pCI-neo-X transfected GMCs was detected at 36 h and 48 h, which was not affected by any of those kinase inhibitors mentioned above. A similar increase in the expression of both TNF-αprotein and mRNA was also observed at 36 h and 48 h, which was significantly decreased in the presence of U0126 or lactacytin, but not SB203580. Conclusions:HBx upregulates TNF-αexpression in cultured GMCs, possibly through ERKs and NF-κB pathway, but not p38 MAPK pathway.

Objective To determine the correlations between breast ultrasonic and mammographic features and molecular classification of breast infiltrating ductal carcinoma in young women.Methods A retrospective review of radiological,clinic-pathology features of breast cancers for women under 40 years at our hospital between January 2011 and May 2016 covering 94 patients.Mammography and ultrasound were available for all 94 patients.Results On sonography,basal like type tumours more often appeared as oval or round masses and microlobulated or indistinct margins luminal type irregular mass and angular or spiculated margins(P =0.000,P =0.000).Basal like type masses were often with abrupt interface,luminal A type with echogenic halo (P =0.000).On mamography,HER-2 enriched type cancers more presented as microcal cification only,basal likc type more masses(P =0.002).Luminal typc masses were more often with spiculated or obscured margins,basal like with indistinct margins(P =0.000).Conclusion The imaging charasteristics of breast infiltrating ductal carcinoma in patients under 40 years appear correlated to breast infiltrating ductal carcinoma.

Objective To investigate the clinical diagnosis and treatment of incomplete Beh et′s disease. Methods The clinical data of 52 patients (83 eyes ) with incomplete Beh et′s disease were retrospectively analysed. Visual acuity and results of examination of slit-lamp microscope, ocular fundus, and fundus fluorescein angiography (FFA) were observed and analysed. All of patients were treated by local cycloplegic, systemic treatment with glucocorticoid and cytoxan. The followed-up period was 1 year or more. Results Recurrent hypopyon or empyema of anterior chamber angle, and hyperaemia of optic papilla was found in 54 and 41 eyes, respectively. The results of FFA showed that abnormal changes were found in all of the eyes. There was vascular leakage and staining of optic papilla at the early and late stage in 83 eyes (100%), diffuse leakage of retinal capillary vessel in 83 eyes (100%), and leakage of affected branch of retinal vessel and staining of the vascular wall at the late stage in 71 eyes (85.54%).After the treatment, the disease recovered completely in 20 patients (26 eyes), recovered partly in 20 (33 eyes), and alleviated in 12 (24 eyes). No patients suffered from hypopyon or empyema of anterior chamber angle and hyperemia of optic papilla. None of the patients had oral ulcer, genital ulcer or arthritis until the last day of the follow-up. Conclusions Recurrent hypopyon, papillitis, and retinal vasculitis were the main clinical manifestations of incomplete Beh et′s disease. FFA redounds to the diagnosis of the disease and timely application of cycloplegic and systemic application of glucocorticoid and cytoxan may inhibit the aggravation of the disease effectively.

Objective To explore the clinical value of early diagnosis of ovarian cancer by serum lysophosphatidic acid(LPA) and CA-125.Methods 50 patients with ovarian cancer from October 2005 to February 2008 were selected as ovarian cancer group,at the same period selected 44 patients with ovarian benign tumor(ovarian benign disease group),and 50 healthy women as the healthy control group.All patients were diagnosed and confirmed by preoperative blood and pathology.The serum LPA and CA-125 of two groups were detected.Results The serum LPA level and the positive rate in the ovarian cancer group was higher than that of the ovaries benign group or the control group(P＜0.05).The CA-125 level in the ovarian cancer group was similar to that of the ovaries benign group(P＞0.05),while the CA-125 level in the ovarian cancer group or the ovaries benign group was higher than that of the control group(P＜0.05).The specificity of the LPA was better than that of the CA-125 detection.In the early diagnosis of ovarian cancer,the sensitivity of the combination(85.7%) was better than either of them(P＜0.01);the plasma LPA level and positive rate of CA-125 of the phase Ⅱ～Ⅳ ovarian cancer patients were higher than that of phase Ⅰ (P＜0.01);the CA-125 positive rate of the serious cystadenocarcinoma was higher than that of the cystadenocarcinoma(P＜0.01).Conclusion LPA is a sensitive biomarker for the early diagnosis of ovarian cancer,especially combined with CA-125.It should be widely used in clinic.