Objective To evaluate the efficacy and safety of topiramate(TPM) as add - on drug treating infants with severe epilepsy. Methods We performed prospective label add - on study in 12 infants (aged 4 to 19 months) with sever seizures of different types. TPM was add - on one or more other baseline drugs and the efficacy was evaluated according to seizure type and frequency Results TPM initiated in a daily dose of 0.5 - 1 0 mg/kg, followed by a 1 - 2 weeks titration on the increase of 0 5 - 1.0 mg/kg up to a maximum daily dose of 4 - 10 mg/kg. After a mean period of 6 2 months (range 3- 13 montks), Total efficacy was 75 % and 50 % were controlled completely. Seizure frequency was unchanged in 3 patients (25 % ). As for seizure type, TPM was more effective in complex partial as compared with generalized tonic-conic seizures. Mild adverse events were present in 3 patients (25 %), represented hypersonia, fever and decreased speech. Conclusions TPM may be a available drug in infants with severe epilepsy. It is safe, with mild adverse effect in fewer patients.JAppl Clin Pediatr,2004,19(11):986-987

Child ; Humans ; Lung Diseases ; diagnosis ; etiology ; Male ; Radiography, Thoracic ; Tomography, X-Ray Computed

Objective Quality control of Angelica dahurica by standard-ized reference extract qualification and single compound quantitative eval-uation.Methods The samples were analyzed by HPLC after pressurized liquid extraction ( PLE).The chromatographic conditions were as follow-ing:The column was ACE UltraCore C 18 (50 mm ×2.1 mm, 2.5 μm);the mobile phase consisted of acetonitrile -water using gradient elution;the flow rate was 1.0 mL · min-1 and the column temperature was 30℃.The detection wavelength was set at 310 nm and the sample injection volume was 5μL.The method was validated by investigating its specifici-ty, linearities and limit of detection , precision , extraction recovery , sta-bility and repeatability.Results Five components including bergapten , oxypeucedanin , imperatorin, cinidilin and isoimperatorin were deter-mined by HPLC.The linearities of them were good ( r≥0.999 4 ) in the concentration ranges of 0.50 -10.00 , 1.00 -20.00 , 1.00 -20.0 , 1.00-20.00 , 1.00 -20.00 mL · L-1 , respectively.The coumarins showed the overall recoveries ranging from 96.4%-100.0%.The peaks of determined compounds were identified by standardized reference ex-tract.The contents of coumarins in samples were respectively determined by individual calibration curve method and single compound quantitative evaluation.The results had a good consistence , but the contents of five compounds of Angelica dahurica from different areas had obvious differences.Conclusion The strategy is feasible and credible, which is easily and effectively adapted for the quality control of Angelica dahurica.

OBJECTIVETo explore the prognostic markers in osteosarcoma.

METHODSExpressions of p53, c-myc, bcl-2 and apoptosis index (AI) in 28 osteosarcoma specimens were detected by ABC immunohistochemistry and terminal deoxynucleotidyl transferase (TdT)-mediated dUTP-digoxigenin nick end labelling (TUNEL). The relationship between gene expression and apoptosis, and their correlations with pathologic classification and prognostic factors were analyzed.

RESULTSThere was negative correlation between the expressions of p53, c-myc, bcl-2 protein and AI, which was closely related to the long term survival of patients but was not related to pathologic types of the tumor.

CONCLUSIONThe expressions of p53, c-myc, bcl-2 protein and AI can be used as an index for predicting the progression and prognosis of osteosarcoma.

Adolescent ; Adult ; Apoptosis ; Biomarkers, Tumor ; Bone Neoplasms ; metabolism ; pathology ; Disease Progression ; Female ; Follow-Up Studies ; Humans ; Male ; Osteosarcoma ; metabolism ; pathology ; Prognosis ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Survival Rate ; Tumor Suppressor Protein p53 ; metabolism ; bcl-2-Associated X Protein

Background Epidemiological surveys showed that the types of bacteria are different in the conjunvical sac from different nationalities,which possibly is associated with living environment.To characterize the types of conjunctival bacteria involved is important for the prevention and treatment of infectious eye diseases.Objective The present survey was to obtain data about bacterial species in the conjunctival sac in the Tibetan minority population aged over 40 years old and compared with the matched Han nationality population.Methods The standardized training and protocol were performed before this survey.A total of 290 eyes of 145 individuals from the Tibetan minority and 346 eyes of 173 subjects from the Han nationality were enrolled in this study in Ganzi Autonomous Prefecture,who had received questionnaire surveys and ophthalmological examinations.The secretion of the inferior palpebral conjunctival sac was embrocated and inoculated and grown on blood plates for 48-72 hours.The bacteria were isolated and identified.This study was approved by the Medical Ethic Committee of the Sichuan People Hospital.Oral informed consent was obtained from the subjects.Results No significant differences were seen in the constituent ratio of the gender as well as the age between the Tibetan minority and Han nationality in this study (x2 =0.987,P=0.3202;t=1.142,P=0.254).There was a significant difference in the proportions of farmers and herdsmen between the two groups(x2 =8.557,P =0.000).The positive rate of bacterial cultivation in Tibetan individuals was 50.74％,showing a statistically significant decrease in comparison with the Han people(60.4％)(x2=6.042,P=0.014).There was no statistical difference in the multiple bacterial species between the two groups (11.0％ in Tibetan,11.6％ in Han people)(x2 =0.0271,P =0.869).The rate of staphylococcus epidemics was 26.6％ in the Tibetan minority and that of Han population was 33.2％,without a significant difference between them (x2 =3.350,P=0.060).No significant difference was seen in the ratio of corynbacterium infection between the two population(15.9％ vs.17.3％)(x2 =0.248,P =0.618).Conclusions The ratio of bacterial cultivation in Tibetans is statistically lower than that of the Han people.The types and distribution of bacteria are similar in the Tibetan and Han nationality.

Objective To investigate the status of control of endemic fluorosis in Liaoning Province.Methods To investigate the prevalence rate of endemic fluorosis and water fluoride content in regions with different extent of endemic fluorosis,dental fluomsis among 8-12 years old children and clinical fluorosis at adult above 16 years old were extensively surveyed,urinary fluoride among 8-12 years old children was detected.Results We surveyed 842 undefluorided drinking water in endemic fluorosis villages and 1234 projects of improving drinking water in 1829 endemic fluorosis viflages.Water fluoride content was 0.01-7.10 mg/L in unimproved drinking water in endemic fluorosis resions,averaging(0.96±0.64)mg/L;29.2%(246/842)of the endemic fluorosis regions had a fluoride content more than 1.2 mg/L In 1234 projects of improving drinking water.drinking water fluoride content was between 0.06-7.67 mg/L.The project normally operated and having a fluoride content≤1.2 mg/L accounted for 68.31%(843/1234),while 31.69%(391/1234)of the projects did not function well.The prevalence of dental fluomsis in 8-12 years old child ren in endemic fluorosis regions was 24.4%(2960/12 127),the prevalence of clinical fluorosis among adults was 2.22%(1900/85 636).The prevalente of dental fluorosis in slight,moderate and serious fluorosis regions had remarkable statistics differences(X2＝19.25,P＜0.01).The prevalence of dental fluorosis of children in serious fluorosis regions was the highest,reaching 100%,while the prevalence of skeletal fluorosis wns 18.03%(97/538).The median of urinary fluoride was 2.01.2.00mg/L in serious and slight fluomsis regions,respectively.Conclusions Endemic fluorosis is still serious.so we need urgently to improve water in serious fluorosis regions without defluoridaton of drinking water.Endemic fluomsis resions where worn-out and closed defluoriding projects exist need defluoriding management.

BACKGROUNDThe relationship between monosymptomatic resting tremor (mRT) and Parkinson's disease (PD) remains controversial. In this study, we aimed to assess the function of presynaptic dopaminergic neurons in patients with mRT by dopamine transporter positron emission tomography (DAT-PET) and to evaluate the utility of clinical features or electrophysiological studies in differential diagnosis.

METHODSThirty-three consecutive patients with mRT were enrolled prospectively. The Unified Parkinson's Disease Rating Scale and electromyography were tested before DAT-PET. Striatal asymmetry index (SAI) was calculated, and a normal DAT-PET was defined as a SAI of <15%. Scans without evidence of dopaminergic deficits (SWEDDs) were diagnosed in patients with a subsequent normal DAT-PET and structural magnetic resonance imaging.

RESULTSTwenty-eight mRT patients with a significant reduction in uptake of DAT binding in the striatum were diagnosed with PD, while the remained 5 with a normal DAT-PET scan were SWEDDs. As for UPRDS, the dressing and hygiene score, walking in motor experiences of daily living (Part II) and motor examination (Part III) were significant different between two groups (P < 0.05 and P < 0.01, respectively). Bilateral tremor was more frequent in the SWEDDs group (P < 0.05). The frequency of resting tremor and the amplitude of postural tremor tend to be higher in the SWEDDs group (P = 0.08 and P = 0.05, respectively).

CONCLUSIONSmRT is heterogeneous in presynaptic nigrostriatal dopaminergic degeneration, which can be determined by DAT-PET brain imaging. Clinical and electrophysiological features may provide clues to distinguish PD from SWEDDs.

Adult ; Aged ; Dopamine Plasma Membrane Transport Proteins ; Female ; Humans ; Male ; Middle Aged ; Parkinson Disease ; diagnosis ; Positron-Emission Tomography ; methods ; Prospective Studies ; Tremor ; diagnosis

OBJECTIVETo study the clinical characteristics of acute myocardial infarction (AMI) among younger adults and to explore the possible mechanisms of early myocardial infarction, combined with the newly discovered risk factors of coronary heart disease.

METHODSData on comparative analysis to the exposure rates of the risk factors and inducing factors of non-CAD patients with two groups of AMI patients including younger adults group (< or =40 years old) and aged adults group (> or =50 years old). Coronary angiography was applied.

RESULTSThere were differences noticed between the frequencies of risk factors of the two AMI groups. In younger adults group the exposure rates of smoking, hyperlipidemia, positive family history, C-reactive protein (CRP) and fibrinogen were markedly higher, while in elderly group the exposure rates of hypertension, smoking, hyperlipidemia, diabetes, CRP, fibrinogen and homocysteine (HCY) were markedly higher (P < 0.05). Although the clustering status of risk factors of the younger adult group was not higher than that of the elderly group. There were obvious inducing factors before the patients were attacked by AMI and the inducing factors inclined to cluster, which had obvious dose-reaction relationships with the occurrence of AMI in young people.

CONCLUSIONEarly AMI of younger adults might relate to the clustering status of inducing factors. The coexistence of several kinds of inducing factors was resulted in the occurrence of AMI of the atherosclerosis (As) and non-As patients by means of myocardial ischemia accumulation effect.

Adult ; Age Factors ; Aged ; Atherosclerosis ; epidemiology ; China ; epidemiology ; Coronary Angiography ; Humans ; Middle Aged ; Myocardial Infarction ; epidemiology ; pathology ; Myocardial Ischemia ; epidemiology ; Risk Factors

OBJECTIVETo evaluate the effect of pirarubicin (THP) in combination with hyperthermia on gastric cancer tissues in vitro and explore the underlying mechanisms.

METHODSIn vitro three-dimensional culture models were established with tissue biopsies from 36 patients with pathologically confirmed gastric cancer. The tumor cell viability was measured by MTS-PMS assay, and HE staining was used to study the histomorphological changes of the tissues following chemotherapy and hyperthermia.

RESULTSSynergistic tumor cell-killing effects of cisplatin, THP, and mitomycin with hyperthermia was observed in the tumor tissues (P=0.000), and THP exhibited stronger cytotoxic effects than the other drugs. Histomorphological study suggested strong killing effects of THP on the tumor tissues, which displayed disrupted tissue structure, cellular degradation and necrosis, karyopyknosis and karyolysis, with cytoplasm loss. The anti-tumor effects of THP were associated with clinical staging and pathological grading of the tumors (P=0.000), but not with the patients' gender, age, tumor size and preoperative CEA levels (P>0.05).

CONCLUSIONPirarubicin shows good synergistic effects with hyperthermia, and the cytotoxicity of pirarubicin against gastric cancer tissue is enhanced considerably by mild hyperthermia. THP can be a potential therapeutic drug for intraperitoneal chemohyperthermia.

Adenocarcinoma ; drug therapy ; pathology ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents ; pharmacology ; Cell Survival ; drug effects ; Cisplatin ; pharmacology ; Doxorubicin ; analogs & derivatives ; pharmacology ; Drug Synergism ; Female ; Hot Temperature ; Humans ; Hyperthermia, Induced ; Male ; Middle Aged ; Mitomycin ; pharmacology ; Stomach Neoplasms ; drug therapy ; pathology ; Tissue Culture Techniques ; Tumor Cells, Cultured

OBJECTIVETo explore the effective skills of reconstruction and balance of soft tissue in hemi-shoulder replacement for patients with four-part fracture of the proximal humerus in order to avoid postoperative complications of joint instability and great tubercle displacement.

METHODSFrom June 2002 to June 2006, 25 patients with Neer four-part fracture of the proximal humerus were adopted in the study which included 15 females and 10 males, with the mean age of 66 years (ranged from 56 years to 80 years). They were treated with humeral head replacement and should joint reparation simultaneously by modified operation approach and reconstruction and balance skills of soft tissue.

RESULTSThe mean duration of follow-up was 2.3 years (ranged from 1 to 4.5 years). No infection, nerve damage and prosthesis loosing were found in all cases. Two cases of infra-forward dislocation or subluxation occurred due to affected limb placed on abduction splint postoperatively. One case occurred prosthesis upward displacement due to early active abduction exercise but no complains. Neither joint instability nor displacement and malunion of great tubercle were found in other patients. According to Neer scoring system, 6 cases were rated as excellent, 15 as good and 5 as fair. The good and excellent rate was 84%.

CONCLUSIONIn hemi-shoulder replacement for patients with Neer four-part fracture the modified operation approach and reconstruction and balance of soft tissue skills combined with rational rehabilitation exercise can prevent postoperative shoulder joint instability and displacement and malunion of great tubercle.

Aged ; Aged, 80 and over ; Arthroplasty, Replacement ; methods ; Connective Tissue ; surgery ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Postoperative Complications ; prevention & control ; Shoulder Fractures ; surgery ; Shoulder Joint ; surgery