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AIM: To set up population pharmacokinetics/pharmacodynamics (PPK/PD) model of valproate (VPA) in children with epilepsy in China, and promote reasonable use of antiepileptic drugs(AEDs)in clinical practice. METHODS: Sparse data of VPA serum concentrations from 246 pediatric children were collected. These patients were divided into three groups: PPK-Model group ([WTBX]n=146), to calculate PPK parameter values of VPA and set up a PPK model; PPK-Valid group ([WTBX]n=100), to valid the PPK model; and PPD group ([WTBX]n=69), to set up PPK/PD model. Based on the data of PPK-Model group and PPK-Valid group, a PPK model of VPA in children with epilepsy in China was successfully set up by using NONMEM software by ourselves. Now, using the data of 69 patients in PPD group who were on VPA monotherapy and this PPK model, we set up PPK/PD model by NONMEM software. Efficacy of epilepsy treatment was divided into 5 grades according to the percentage of seizure frequency decreased (PSFD%): grade 1: PSFD% was 100%; grade 2: PSFD% was 75%-100%; grade 3: PSFD% was 50%-75%; grade 4: PSFD% was 25%-50%; grade 5: PSFD% was less than 25%. The quantitive relationship between the VPA serum concentrations and the probability for its efficacy score was characterized by Logistic regression analysis with NONMEM. RESULTS: Logistic regression analysis showed that, VPA serum concentrations and the probability for its efficacy grades 5, 4, 3, 2, and 1 were (23 ?g?ml -1, 5, 50%), (30 ?g?ml -1, 4, 32.3%), (50 ?g?ml -1, 3, 26.3%), (65 ?g?ml -1, 2, 36.5%), (78 ?g?ml -1, 1, 50%), and (100 ?g?ml -1, 1, 84.2%)respectively. CONCLUSION: A PPK/PD model of VPA in children with epilepsy in China is successfully established by using NONMEM software, and the probability of efficacy grade for any concentration can be calculated. It will be valuable to facilitate individualized dosage regimen.

Objective To investigate the effect of super-aged multilevel cervical spondylosis different surgical treatment op tions Abstract Objective.Methods Selected July 2010 Ultra old multilevel cervical spondylosis March 2015 in our hospital 80 ca ses,the anterior cervical corpectomy and fusion (ACCF) and by anterior discectomy and fusion (ACDF) included anterior group,the posterior laminoplasty (PCL) included in the posterior group,the clinical efficacy of two groups were compared,and postoperative conditions and cervical spinal cord injury rates before and after treatment (JOA score),cervical Disability index (NDI index),lordosis and cervical spine.Results Anterior group of 43 cases,including 28 cases of excellent(65.12％),5 cases of good (11.63％),7 cases of moderate(16.28％),3 cases of poor(6.98％),the good rate was 76.74％;posterior group 37 cases,including 24 cases of excellent(64.86％),3 cases of good(8.l1％),6 cases of moderate(16.22％),4 cases of poor(10.81％),the good rate was 72.97 ％.The difference has no statistically significant (P＞0.05) in good rate.Anterior operative time was significantly higher than the posterior group (P＜0.05),blood loss,hospital stay was significantly lower than the posterior group (P＜0.05),the time of symptoms disappeared has no significant difference in two groups(P＞0.05).After treatment,patients in posterior group,the JOA score,cervical activity significantly were higher than the anterior group,lordosis anterior group were significantly higher than the posterior group,the difference was statistically significant (P＜0.05).Conclusion Anterior super aged multilevel cervical disease,posterior approach has achieved good clinical efficacy but greater advantage posterior surgery in patients with long term im provement in the cervical spine function.

To study the changes in median frequency (MF) from a surface electromyogram of skeletal muscles and functional assessment of chronic illness therapy (FACIT) figure scale scores for patients with chronic fatigue syndrome (CFS) before and after Tuina treatment.

OBJECTIVE: To probe into the medication status of the elder patients in community so as to provide reference for pharmacists to promote rational medication for the elderly people in community. METHODS: The medication status of 484 cases in the community was investigated through questionnaire and interview. RESULTS: The principal diseases affecting the health of the elder people included hypertension, diabetes mellitus, coronary heart disease, cerebrovascular disease. The average number of drugs they used totaled 2.92 kinds; the higher the educational background, the higher proportion of the elder people who read drug package instruction but the lower ratio of medication compliance. The elder people commonly had poor knowledge about the drugs and adverse drug reactions(91.74% and 60.74%);21.11% responded that they had ever received medication guidance from pharmacists, only 3.10% responded that they had once consulted pharmacists about medication problems. CONCLUSION: The medication of the elder people in community is characterized by multiple drug varieties, poor ADR knowledge and lower cognition on pharmacists. It is urgent to improve the pharmaceutical care ability of medical institution and enhance the social influence of pharmacists.

Objective:To study the tuina effect on sleep disorder and emotional problems of chronic fatigue syndrome (CFS) cases.Method:Thirty CFS cases were treated in the treatment group,by applying one-thumb pushing,rolling and pressing-kneading manipulations along the Governor Vessel,Bladder and Yangming Meridians.The intended major points include Fengfu (GV 16),Yaoyangguan (GV 3),Xinshu (BL 15),Pishu (BL 20),Ganshu (BL 18),Hegu (LI 4) and Taixi (KI 3).The treatment was done once every other day;10 times constitute a course of treatment.Another 30 healthy cases were selected in the control group,without any intervention.The sleep quality and mental state in the two groups were evaluated by PSQI,HAMA and HAMD.In addition,the pre-treatment and post-treatment score changes were observed.Results:Before treatment,the total score of PSQI,sleep quality,time of falling asleep,sleep efficiency,sleep disorder,daytime functional impairment,and scores of HAMD and HAMA in treatment group were all substantially higher than the control group (P＜0.01).After 10 tuina treatments,the total score of PSQI,time of falling asleep,sleep disorder and daytime functional impairment as well as scores of HAMD and HAMA in treatment group were significantly changed,compared with before treatment,P＜0.05.Conclusion:Those with CFS may present with sleep disorder and mental or psychological abnormality,tuina can improve their sleep quality and adjust their mental conditions.

BACKGROUND:Psychological disorder and behavior disorders can affect the development of behavior and personality in children.OBJECTIVE:To investigate the behavior disorders and the personality in children with tic disorders (TD).DESIGN:A comparative investigation between TD children and the healthy controls.SETTING:It was conducted at the Department of Pediatrics,Daqing Oil Felid General Hospital in Heilongjiang ProvincePARTICIPANTS:Totally 110 outpatients including 92 males and 18females, diagnosed as TD at the Department of Pediatrics, Daqing Oil Felid General Hospital,were selected (TD group) from February 2003 to December 2004.According to the clinical manifestations,they were divided into transient tic disorder group (46 cases),chronic motor/vocal tic disorder group (34 cases) and Tourette Syndrom (TS) group(30 cases).All the patients were newly diagnosed without any medication and intracranial organic diseases. Meanwhile,30 children with normal physical examination findings, between the ages of 7 and 14,24 males and 6 females, were selected as controls. Informed consents were obtained from guardians of all the participants.used to measure the children's social skills and behaviors (It contains a 113-item behavior problems scale. According to the children's ages,the items were classified into 9 factors,including somatic complains,poor social skills,compulsions,undisciplined,hyperactivity,Asperger syndrome,immaturity,hostility and aggressiveness.The scores of referring items constitute the total score of each factor).Comparison of these scores between patients and healthy controls is helpful to determine if a factor in affected children is abnormal. The closer the relationship between the patients and the controls is, the less behavioral problems Personality Questionnaire (EPQ) was adopted in this study to evaluate the personality in the patients compared to healthy controls.{There were four major dimensions of personality including introversion/extraversion,neuroticism,psychoticism and validity questionnaire (construct validity).When the validity score was over 70,it represented that the EPQ was invalid.An over-61.5 neuroticism score represented an apparent neuroticism tendency. Once the neuroticism score and introversion/extraversion score were over 56.7,mental instability or instable tendency could be suspected. When introversion/extraversion score was over 56.7and the neuroticism (extraversion) score was less than 43.3,it represented a sanguine personality or such tendency. When both of the neuroticism score and introversion/extraversion score were less than43.3 (introversion),it revealed a phlegmatic personality or such tendency. And when the introversion/extraversion score was less than43.3 with neuroticism score over 56.7,it represented a melancholic personality or such tendency.}MAIN OUTCOME MEASURES:Comparison of Achenbach's CBCLand EPQ between patients and healthy controls .RESULTS:Totally 110 TD patients and 30 healthy children completed the control group (t=3.12-8.60, P ＜ 0.01).The hyperactivity score in the transient tic group was significantly higher than that in the control group (t=2.01, P ＜ 0.05). In the chronic motor tic disorder group and the TS group,the scores of depression/anxiety,poor social skills,compulsions,social withdrawal,hyperactivity and aggression were all higher than those in the control group(t=2.11-7.65, P ＜ 0.05-0.01).In all of these three TD groups, score factors relating to social functions,such as movements, social skills and school life were apparently lower than those in the control group (t= 1.97-7.31, P ＜ 0.05-0.01).(t=2.76-4.32, P ＜ 0.05-0.01), while the score of validity questionnaire was lower than that in control group (t=3.49-6.38, P ＜ 0.05).CONCLUSION:It reveals that TD patients have many behavioral problems,personality defects and poor social skills. Of all the TD groups,the transient tic group has a higher occurrence rate of disease and only one abnormal factor, hyperactivity. While,the chronic motor tic disorder group and the TS group have more abnormal behavioral factors.

Objective: To explore the diagnostic value of brachial-ankle artery pulse wave velocity (baPWv) in patients of heart failure with preserved ejection fraction (HFpEF). Methods: A total of 86 consecutive dyspnoea patients without coronary artery diseases (CAD) were studied and they were divided into 2 groups: HFpEF group,n=46 and Control group, the patients had no organic heart disease,n=40. The incremental diagnostic value of HFpEF by baPWv improving the echocardiographic index and plasma BNP level was assessed by logistic regression model, receiver operation curve (ROC) of multi-parameter combination and net reclassiifcation index analysis. Results: Multiple stepwise logistic regression analysis presented that the ratio of early mitral inlfow velocity to tissue Doppler velocity at the lateral mitral annulus, BNP level and baPWv had the independent predictive value for HFpEF diagnosis, P<0.05. The ROC for baPWv with the combination of 2 or 3 parameters was better than the ROC for a single parameter, P<0.05. The baPWv added with 2007 ESC consensus statement signiifcantly improved HFpEF diagnosis, NRI = 0.127,P<0.05. Conclusion: The baPWv combining with current diagnostic criteria could increase the diagnostic value in patients of HFpEF.

Objective To investigate the influence of Let-7f regulation on MMP-11 in migration and in-vasion of pancreatic cancer. Methods RT-qPCR was performed to assay the expression of Let7 and MMP-11 ex-pression in pancreatic cancer cells and normal pancreatic cells. Let-7f mimic and inhibitor were transfected to PANC-1 and Bx-PC3, respectively. The influence of Let-7f expression on migration and invasion of pancreatic cancer cells was analyzed by transwell. The influence of Let-7f intervention on MMP-11 expression was observed by RT-qPCR. Results Let-7f expression decreased in PANC-1 and Bx-PC3, compared to HPDE6c7, while MMP-11 expression up-regulated in PANC-1 and Bx-PC3 , compared to HPDE6c7 cells. Let-7f overexpression in-hibited the expression of MMP-11. Up-regulated Let-7f could significantly inhibit migration and invasion of PANC-1 and Bx-PC3 and Let-7f inhibitor enhanced MMP-11 expression. However , down-expression of Let-7f could not significantly promote migration and invasion abilities of PANC-1 and Bx-PC3cells. Conclusions Let-7f may affect migration and invasion by regulating MMP-11 expression in pancreatic cancer , suggesting that Let-7f might be a potential target for gene therapy in human pancreatic cancer.

BACKGROUND:CT-guided percutaneous intervention and rehabilitation techniques are both classic programs for diagnosis and treatment of lumbar disc herniation. Is the combination of CT-guided percutaneous intervention and rehabilitation techniques preferential y used for treatment of lumbar disc herniation?
OBJECTIVE:To evaluate the curative effect of CT-guided interventional injection combined with rehabilitation integration treatment for lumbar disc herniation and to analyze prognostic factors.
METHODS:Eighty-eight patients with lumbar disc herniation were subjected to CT-guided interventional injection combined with rehabilitation integration treatment from May 2010 to May 2013. Injection medicine consisted of betamethasone, tanshinone Ⅱ A sulfonate, neurotropin, normal saline and iohexol. Rehabilitation integration treatment included traction, manipulation, acupuncture, transcutaneous electrical nerve stimulation and thermal magnon. Macnab criteria and Chinese version of Oswestry low back pain disability questionnaire were used to assess the curative effects in comparison with the 112 patients receiving only CT-guided interventional injection that were reported previously. The prognostic factors, such as age, disease course time and herniation type of target segment were testified by correlation analysis.
RESULTS AND CONCLUSION:Total y 77 patients were completely fol owed up for 1 year. There were excellent outcomes in 64 cases, while favorable outcomes in 7 cases, fair outcomes in 5 case, poor outcome in 1 case, with a better outcome rate of 92%.There was a significantly decreased trend in Oswestry disability Index scores at 1, 6, 12 months during the fol ow-ups (P<0.01). No severe complications occurred in al the included patients. The curative effects were improved in term of better outcomes rate compared with the 112 patients receiving only CT-guided interventional injection, but there was no significant difference (P>0.05). The young group (≤ 45 years) had better outcomes than the older group (>45 years;P<0.01). In addition, disease course time and herniation type of target segment were not statistical y significant risk factors predicting clinical results (P>0.05). These findings indicate that CT-guided interventional injection combined with rehabilitation integration treatment could relieve lower back pain and radical leg pain effectively and decrease life disability level.