OBJECTIVE:To provide reference for clinical rational use of anti-epileptic drugs. METHODS:In this retrospective review,serum concentrations of anti-epileptic drugs in a total of 499 patients who were treated with anti-epileptic drugs (such as sodium phenytoin,phenobarbital,carbamazepine and valproate sodium) in our hospital during 2007 were analyzed statistically. RESULTS:Among the patients receiving one kind of anti-epileptic drugs,206 cases (61.49%) were within normal range in blood concentration versus only 45 cases (44.12%) for patients receiving combined drugs. In addition,the above four drugs (sodium phenytoin,phenobarbital,carbamazepine and valproate sodium) were detected in 59.68% of the patients who took Chinese medicines,and among them,3.23% were within normal range in blood concentration. CONCLUSION:Monitoring on serum concentrations of anti-epileptic drugs is conducive to a better control of therapeutic concentration. It is advisable to refrain from using anti-epileptic drugs in combination but to adopt individualized administration. In addition,great importance should be attached to whether there are chemo-synthetic drug components contained in Chinese medicine.

Objective To analyze the rented factors leading to successful treatment of ectopic pregnancy by conservative therapy and to explore importance of this therapy. Methods 152 patients with ectopic pregnancy performed with conservative treatment were randomly recruited into a methotrexate plus Chinese medicine group, a 5-fluorouracil plus Chinese medicine group and a exclusive Chinese medicine group. The curative rate and side effect were observed in groups, and the relation between the treatment condition and the curative rate was analyzed. Results There was no difference in curative rate among groups, while the side effect in the exclusive Chinese medicine group was lower than other groups. It showed high curative rate in patients with two or more conditions of having mass less than 3 cm, the level of bloodβ-hCG less than 1000 IU/L, and the depth of posterior fomix effusion less than 1 cm. Conclusion Among the treatments of ectopic pregnancy, Chinese medicine has fewer side effects. Fully evaluation on the treatment condition can improve the curative rate.

Objective To study the roles of hepatocyte cytochrome P450 2E1 in model of nonalcoholic steatosis in rats Methods A total of 40 Wistar rats were randomly divided into two groups: control group (C) and high fat diet induced fatty liver group (H) The expression of hepatocyte cytochrome P450 2E1 antigen in rat model of nonalcoholic steatosis was detected by immunohistochemical method and Western blotting Malondialdehyde (MDA) contents were also determined Results MDA contents and the expression of hepatocyte cytochrome P450 2E1 antigen in rat model of nonalcoholic steatosis induced by high fat diet were higher than those in the normal controls ( P

Objective To investigate the effect of microRNA (miRNA )‐548ah targeting histone deacetylase‐4 (HDAC4) on the replication and expression of hepatitis B virus (HBV) .Methods HepG2 , 2 ,15 cells were transfected by mimics and inhibitors . The expressions of miRNA‐548ah and HDAC4 before and after transfection were detected by fluorescent quantitative polymerase chain reaction (PCR) . The expression of HDAC4 protein in HepG2 ,2 ,15 cells was detected by Western blotting .The target gene of miRNA‐548ah was analyzed by bioinformatics methods .3′UTR dual‐luciferase expression vector containing candidate HDAC4 target genes was built to test the luciferase activity .The levels of hepatitis B e antigen (HBeAg) and hepatitis B surface antigen (HBsAg) in the supernatant of cultured HepG2 ,2 ,15 cells were detected by enzyme‐linked immunosorbent assay (ELISA) .The level of HBV DNA in the supernatant of HepG2 ,2 ,15 cells was detected by fluorescent quantitative PCR .The t‐test was used for comparison between two groups ,SNK‐q tests were used for multiple groups comparisons .Results The expressions of miRNA‐548ah in HepG2 ,2 ,15 and HepG2 cells were 5 .74 ± 0 .02 and 2 .96 ± 0 .40 , respectively (t= 11 .89 ,P< 0 .01) ,and the expressions of HDAC4 mRNA were 9 .38 ± 0 .39 and 18 .13 ±0 .34 ,respectively (t = 29 .39 , P < 0 .01) . The expression of miRNA‐548ah in HepG2 ,2 ,15 cells was inhibited by transfection of miRNA‐548ah inhibitors (1 .01 ± 0 .13 ,t= 15 .48 , P< 0 .01) .Compared with control group ,the levels of HBsAg ([6 .45 ± 0 .46 ] IU/mL vs [2 .60 ± 0 .20 ] IU/mL , t = 7 .48 , P <0 .01) ,HBeAg ([5 .49 ± 0 .27] NCU/mL vs [4 .15 ± 0 .34 ] NCU/mL , t = 3 .10 , P < 0 .05 ) and HBV DNA ([3 .93 ± 0 .06] lg copy/mL vs[2 .04 ± 0 .07] lg copy/mL ,t = 18 .89 , P< 0 .01) in the supernatant of cultured HepG2 ,2 ,15 cells significantly decreased in inhibitor group . The expression of HDAC4 in HepG2 ,2 ,15 cells significantly decreased after transfection of miRNA‐548ah mimics (2 .98 ± 0 .94) ,but significantly increased after transfection of miRNA‐548ah inhibitors (23 .77 ± 6 .74 ) , with statistical significance (F= 9 .34 , P< 0 .01) .The expression of HDAC4 protein was also significantly inhibited after transfection of miRNA‐548ah mimics (0 .53 ± 0 .14 vs 0 .23 ± 0 .02 , t = 3 .58 , P = 0 .02) .The activity of luciferase was significantly inhibited by transfection of miRNA‐548ah mimics (7 .62 ± 0 .45 vs 6 .65 ±0 .27 ,t = 3 .18 , P = 0 .03 ) .Conclusion miRNA‐548ah may promote the replication and expression of HBV through the regulation of target gene HDAC4 .

Objective To investigate the clinical application of pancreatic head resection with the second portion duodenectomy (PHRSPD). MethodsThe clinical data of 4 PHRSPD cases were analyzed retrospectively. ResultsThere were 3 benign and 1 low-grade malignant periampullary tumors. The mean surgical time was 417 min, mean blood transfusion was 533 ml, mean hospital stay was 28.6 days. Delayed gastric emptying was encounted in one case. There was no hospital morality or major surgical complications. All cases were alive in the follow-up ranging from 6 to 36 months. There was no newly developed diabetes mellitus or severe gastroenteral symptoms. No reccurrence was found in the case with low-grade malignant duodenal tumor after 26 months. ConclusionsPHRSPD is an efficient way to treat benign and low-grade periampullary neoplasm and accompanying massive bleeding episodes.

Objective To investigate the effect of quorum sensing autoinducer 3OC12-HSL of Pseudomonas aeruginosa on the apoptosis of Caco-2 cells and its mechanism. Methods Caco-2 cells were incubated with 3OC12-HSL for 4 h and then examined by MTT method for cytoactivities. Flow cytometry was used to analyze apoptosis rate of Caco-2 cells. Expression of apoptosis associated proteins p-p38/MAPK and NF-κB were detected by Western blot. Results After exposure to 3OC12-HSL for 4 h, cytoactivities of Caco-2 cells was reduced(P<0.05) with dose-dependent pattern, and higher dose of 3OC12-HSL leaded to increasing apoptosis rate of Caco-2 cells(P<0.05). 3OC12-HSL raised expression of apoptosis associated proteins p-p38/MAPK and NF-κB detected by Western blot. Conclusion Quorum sensing autoinducer 3OC12-HSL can effect cytoactivities of Caco-2 cells and may induce its apoptosis by enhancing the expression of p-p38/MAPK and NF-κB protein.

Objective To measure plasma microRNAs dysregulated in patients with pancreatic cancer and to assess the potential of these miRNAs as biomarkers for pancreatic cancer.Methods Thirty-seven patients with pancreatic cancer who underwent pancreatic resection between June 2010 to July 2011 were enrolled in the Lihuili Hospital,and ten healthy volunteers were used as control in this study.The expression levels of miR-190,miR-196a,miR-221 and miR-222 were analyzed using quantitative real time polymerase chain reaction (qRT-PCR).U6 was used as an internal control.The relationships between clinicopathoiogic characteristics of pancreatic cancer and microRNA expression levels were analyzed.Results The relative abundances of plasma microRNAs were significantly higher in pancreatic cancer patients than in the control group.The highly expressed plasma miR-190,miR-196a,miR-221,miR-222 levels did not correlate with clinicopathologic characteristics of patients such as sex,age,tumor maximal diameter,and level of serum CA199.The plasma miR-196a levels showed a positive correlation with TNM stage in pancreatic cancer patients.Conclusions The plasma levels ofmiR-190,miR-196a,miR-221 and miR-222 were highly upregulated in pancreatic cancer patients.These microRNAs in plasma may provide a new method in the early diagnosis of pancreatic cancer.

Objective To investigate needs of caregivers of patients with schizophrenia for mental health knowledge and provide the scientific evidence for formulating the general intervention to improve the caregivers′mental health knowledge and skills . Methods Sixty-five caregivers of the patients with schizophrenia participated in the survey by a general state questionnaire and the requirement to mental health knowledge and skill questionnaire using the convenience sampling method. The survey included mental illness knowledge drug, knowledge rehabilitative therapy and self-adjustment. Results Among all the items of the questionnaire, the 3 items they needed most was mental illness knowledge, the preventing method and the symptoms of the recurrent diseases. The 3 items they needed most in respect of drug knowledge were what examinations are needed when taking special drugs, the adverse reactions of the antipsychotic drugs and the importance of persisting in taking drugs. The 3 they needed most in respect of rehabilitative therapy were the relationship between psychology and disease rehabilitation, the role of mental treatment and the role of work-entertainment therapy. The 3 items they needed most in respect of self-adjustment included sleep adjustment, self-adjustment of affects and self-management of daily life and instructions on dieting. Conclusions The caregivers′mental health knowledge and skills are not enough. Therefore, their mental health knowledge and skills should be strengthened so that they can take better care of the patients to realize comprehensive rehabilitation of patients.

Objective To evaluate the efficacy and safety of different concentrations of propranolol gel in treatment of infantile hemangiomas(IH).Methods Sixty-three consecutive infants with hemangiomas from Mar.2011to Sep.2012 in Department of General Surgery,Fuzhou General Hospital of Nanjing Military Command,were divided randomly into A,B,C groups and respectively treated with propranolol hydrochloride 1％ (20 g ∶ 200 mg,A group),2％ (20 g:400 mg,B group),3％ (20 g:600 mg,C group),evenly applied to the surface of the hemangiomas,3 times a day.Follow-up treatment was performed for 6 months.Details of adverse reactions,gender,age,tumor location,complications,and hemangioma size,texture,color and recurrence after stopping were recorded,and hospital review and efficacy evaluation were performed every month.Results After 6 months of treatment,A group had effective treatment in 11 patients(52.38％),ineffective treatment in 10 patients (47.62％),B group had effective treatment in 12 patients (57.14％),ineffective treatment in 9 patients (42.86％),and C group had effective treatment in 19 patients (90.48％),ineffective treatment in 2 patients(9.52％).After taking color Doppler ultrasound examination revealed IH thickness revealed significantly thinner.Conclusions External use of propranolol hydrochloride gel is an effective option for superficial hemangiomas,And 3％ concentration of propranolol gel is superior to the efficacy of the other 2 drugs.

Objective To investigate the biological effects of Pseudomonas aeruginosa quorum sensing molecule OdDHL on murine mast cells. Methods The molecule structure and purity of synthesized OdDHL were confirmed by mass spectrum or proton nuclear magnetic resonance (NMR) and high-performance liquid chromatography, respectively. Its biological activity was checked using a quorum sensing sensor bacterial strain. The viability, apoptosis and intracellular calcium changes of P815 cell line in response to different concentration of OdDHL were determined. Results The biological active OdDHL was synthesized successfully. OdDHL inhibited proliferation of P815 cells in a dose, and time dependent manner. It also induced apoptasis and intracellular calcium release in P815 cells. Conclusion Psendomonas aeruginosa quorum sensing molecule OdDHL induces apoptosis and intracellular calcium release in murine mast cell line P815.