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.

ITS2 sequence was used as a barcode to identify herbal tea ingredient Plumeria rubra and its adulterants. Genomic DNAs from forty eight samples were extracted, the ITS2 sequences were amplified and sequenced bi-direstionlly, and then assembled and obtained using CodonCode Aligner. The sequences were aligned using ClustalW, the genetic distances were computed by kimura 2-parameter (K2P) model and the Neighbor-joining (NJ) phylogenetic trees were constructed using MEGA5.0. Results showed that the length of ITS2 sequence of P. rubra were 244 bp. The intra-specific genetic distances (0-0. 016 6) were much smaller than inter-specific ones between P. rubra and its adulterants(0.320 8-0.650 4). The NJ tree indicated that P. rubra and its adulterants could be distinguished clearly. Therefore, Using ITS2 barcode can accurately andeffectively distinguish herbal tea ingredient P. rubra from its adulterants, which providesa new molecular method to identify P. rubra and ensure its safety in use.
Apocynaceae ; classification ; genetics ; DNA Barcoding, Taxonomic ; methods ; DNA, Plant ; genetics ; DNA, Ribosomal Spacer ; genetics ; Drug Contamination ; prevention & control ; Drugs, Chinese Herbal ; chemistry ; classification ; Flowers ; chemistry ; classification ; Molecular Sequence Data ; Phylogeny ; Quality Control

OBJECTIVETo Explore the significance of preoperative screening of deep vein thrombosis (DVT) on the prevention from pulmonary embolism (PE) with color Doppler flow imaging (CDFI) in patients of lower limb fractures.

METHODSA total of 2 000 patients with lower limb fractures were retrospectively analyzed from January to September in 2010. All the patients were scheduled to be operated. There were 1 140 males and 860 females, ranging in age from 18 to 94 years, with a mean of (54.78 +/- 21.45) years. Swollen limbs could be observed in all patients when admitted and traditional Chinese medicine therapies were given by both internal and external administrations. Selective internal or external fixations were scheduled 3 to 14 days after injured and the swell relieved. CDFI screenings for DVT were applied to all the patients one day before operations and clinical data, such as gender, age, fracture site and course of diseases, were analyzed.

RESULTSOf all the 2 000 patients, 128 patients had lower limbs DVTs (6.4%). Among all the DVT patients, 52 patients had DVT within vena iliacas or femoral veins,20 patients had DVT within popliteal veins or vena crualis, 56 patients had DVT within small muscular veins of legs. Thrombolytic therapies or inferior vena cava filters were taken to 72 patients with DVTs proximal to vena cruralises and thrombi disappeared in 20 cases. Inferior vena cava filters were placed in 17 patients. There were 28 patients with either failed thrombolytic or no filters placement. All above 65 patients were treated with fracture reduction, and other 7 patients were treated with conservative methods. Of all the operated patients, one patient had PE during operation and recovered after immediately rescue. Among 56 patients with DVT within small muscular veins of legs, 51 patients were treated with reduction without other special treatment, and other 5 patients were treated with conservative methods. There was no relationship between DVT occurrence and gender. The youngest sufferer was 22 years old. DVT occurrences of patients over 41 years old were significantly higher than that of patients under 40 years old. Higher occurrences were also observed in patients with multiple fractures, fracture of femurs compared with those with tibia or fibula fractures. DVT was found as early as 3 days after injury in one case. The longer the time from injuries to operations, the higher the occurrences of DVTs.

CONCLUSIONRoutine CDFI screenings should be applied to traumatic fractured patients before operations no matter whether there are DVTs existing or not. That is very important for the prevention of fatal PE during both anesthesias and operations.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Preoperative Period ; Pulmonary Embolism ; prevention & control ; Ultrasonography ; Venous Thrombosis ; diagnosis ; diagnostic imaging ; Young Adult

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

OBJECTIVETo explore biological exposure markers, we investigated the chromium content in peripheral erythrocytes from occupational population with broad ranges of soluble chromate exposure, as the candidate biomarker may provide the scientific evidence for health risk assessment in occupational chromate-exposed population.

METHODSA cross-sectional study was conducted in chromate exposed workers employed at a chromate factory in a district of Jinan city, Shandong Province. The studied population contained 114 workers from different processes of the chromate plants, which included 74 males and 40 females, with an age range from 25 to 52 years old, averaging at (35.83 +/- 6.14) years old; the length of service was ranging from 1 year to 37 years, an average of (14.20 +/- 6.77) years. In addition, 30 farmers in the countryside one hundred kilometers away from the factory, without exposure to chromate matched with exposed subjects by age, gender and smoking status were identified as a control group, which included 22 men and 8 women, with age ranging from 25 years old to 47 years old, having an average age of (36.13 +/- 6.17) years old. Personal information on age, chromate exposure, medical history, smoking habit and alcohol consumption was obtained at an interview. The air concentration of personal exposure was determined by individual sampling for 8 hours per day as shift work, and chromium was assayed by atomic absorption spectrometry. The chromium content in the erythrocytes from peripheral blood was determined by graphite furnace atomic absorption spectrometry. The potential plasma reduction capacity was determined by dibenzene anthracoamid dihydrazide spectrophotometry. The content of total vitamin C and reductive ascorbic acid were determined by 2, 4-dinitrobenzene hydrazine. The data were analyzed by SPSS10.0 software for statistical significance.

RESULTS(1) The results showed that the chromium levels in erythrocytes in the exposed group [(15.79 +/- 31.01) microg/L] were significantly higher than those in the control group [(3.21 +/- 2.20) microg/L] (P < 0.01). (2) There existed a dose-response relationship between the personal airborne chromate concentration and the chromium content in erythrocytes. As airborne chromate concentration lowered to 106.00 microg/m(3), the chromium content in erythrocytes increased, depending on the air concentration of chromate. (3) Correlation analysis showed that there was a significant positive correlation between airborne chromate concentration and the chromium content in erythrocytes (P < 0.01). (4) In multiple regression analysis, it was found that the potential plasma reduction capacity and reductive ascorbic acid may be a good indicator for oxidative stress produced by chromate exposure and be used to evaluate the effects on intracellular uptake of chromium (VI).

CONCLUSIONOur findings suggested that the chromium content in erythrocytes should be used as an effective exposed biomarker in the risk assessment for occupational chromate-exposure.

Adult ; Air Pollutants, Occupational ; analysis ; Biomarkers ; blood ; Chromates ; analysis ; Chromium ; blood ; Erythrocytes ; chemistry ; Female ; Humans ; Male ; Middle Aged ; Occupational Exposure ; analysis