Epilepsy is one of the five major neuropsychiatric diseases on which the World Health Organization focuses. New treatment methods are emerging, such as neuromodulation and radiofrequency ablation to remove lesions and precise treatment for gene mutation. However, antiepileptic drug therapy is still the first choice mostly. Since potassium bromide was applicated in epilepsy in 1857, which opened the prelude to the development of modern antiepileptic drugs, more than 20 kinds of antiepileptic drugs have been used in clinical practice. This article reviews the present status and future development of antiepileptic drugs at home and abroad.

Objective To evaluate the efficacy and safty of Polymer-free sirolimus eluting-stents(PFSES) in preventing restenosis in porcine coronary model.Methods Bare metal stents(BMS)(n=13),polymer-free bare metal stents(PFBMS)(n=13),polymeric sirolimus-eluting stents(PSES)(n=13) and PFSES(n=13) were implanted in left anterior descending coronary arteries(n=26) and left circumflex coronary(n=26) of 27 swines randomly.Coronary angiography was performed 28 days and 90 days after the procedure.Twelve animals were sacrificed for histomorphologic analysis after 90 days.Results The 28-day(n=24) and 90-day(n=12) outcome by quantitative coronary angiography(QCA) showed significant reduction in luminal loss(LL) in PFSES(LL:0.69?0.49 mm vs 1.27?0.36 mm,P=0.041;0.77?0.44 mm vs 1.33?0.29 mm,P

Objective To evaluate the efficacy and safty of bioabsorbable polylactic acid sirolimus eluting-stents(BPSES) in inhibiting neointimal hyperplasia in porcine coronary model.Methods Bare metal stents(BMS)(n=18),mere bioabsorbable polylactic acid polymer coated stents(BPOS)(n=18) and BPSES(n=18) were implanted in left anterior descending(n=18),left circumflex coronary(n=18) and right coronary artery(n=18) of 18 swines in random.Coronary angiography was performed 28 days and 90 days after the stenting procedure and histomorphologic analysis was done in a certain number of animals after 7 days(n=4),18 days(n=6) and 90 days(n=6),respectively.Results The 28-day(n=6) and 90-day(n=6) outcome by quantitative coronary angiography(QCA) showed significant reduction in luminal loss(LL) in BPSES(28-day-LL: 0.54?0.45 mm vs 1.11?0.45mm,P=0.048;90-day-LL:0.42?0.34 mm vs 0.96?0.41 mm,P=0.024)compared with BMS.With similar injury scores,histomorphologic analysis on day 28 showed there was a significant reduction in neointimal tissue proliferation with BPSES compared with BMS control(average neointimal area: 0.90?0.40 mm2 vs 1.88?0.71 mm2,P=0.015).High magnification histomorphologic examination revealed similar inflammation score and endothelialization score between BPSES and BMS.Conclusion Bioabsorbable polymeric sirolimus-eluting stents showed reduction in neointimal hyperplasia with good biocompatibility in porcine coronary model.

Objective To identify objective methods for medical service performance evaluation,and means to improve the efficiency of medical services.Methods By means of collection of medical records from 10 tertiary hospitals in Yunnan in 2012,and Diagnosis-related groups of Beijing version(BJDRGs)as a risk-adjustment tool,medical service performance was made to such hospitals.Results The capacity,efficiency and medical safety of hospital of the hospitals were subject to a comprehensive evaluation of their medical service capabilities.In terms of discharged inpatients and total weight,hospital A were found to be the highest(77 458 cases,104 227.5 respectively),and hospital I the lowest(25 450 cases,38 162.28)among these hospitals in 2012; compared with other hospitals,DRG groups of hospitals A,b and D were found higher,while the case mix index(CMI)of hospitals e and I were higher.The expenditure index of hospital C is the lowest(0.9359,0.8514); the mortality in cases of low risk of hospitals B,c and D were the lowest,while hospital F was the highest.Conclusion DRGs as a risk adjustment tool,can significantly improve the reliability,science and continuity of medical service performance evaluation,providing reliable basic data for hospitals accreditation in Yunnan.

Objective To comparatively analyze effect of different cooling temperature on postoperative results of patients with Stanford type A aortic disaection underwent surgical treatment.Methods Clinical data of 65 patients with Stanford type A aortic dissection perforred aortic root shaping,ascending aorta and total aortic arch replacement combined with stented elephant trunk technique from April 2007 to March 2012 were retrospectively analyzed.According to the cooling temperature,the patients were divided into two groups:group A and group B.The cooling temperature was 20 ℃ to 24 ℃ in group A and 25 ℃ to 2.8 ℃ in group B.Extracorporeal circulation time,circulatory arrest periods,volume of postoperative drainage,ventilation time and cerebral complications incidence after operation were analyzed contrastively.Results There was significant difference between two groups about extracorporeal circulation time,circulatory arrest periods,volume of postoperative drainage,ventilationtime and transient neurological dysfunction(TND) incidence after operation.There was no significant difference between two groups in postoperative pemunent neurological dysfunction (PND),use of continuous renal replacement therapy (CRRT) and mortality.Conclusion It is safe to appropriately increase the standard of cooling temperature through operating skillfully under the circumstance of deep hypothermic circulatory arrest.It,to some extent,shortens operating time and decreases injuries on patients,time of recovery,volume of blood transfusion and complications.

Objective To summarize the clinical experience and significance of 101 cases of thoracic endovascular aortic repair(TEVAR).Methods From October 2008 to August 2013,101 patients received endovascular repair.Among the cases,81 patients were male,and 20 were female.Before operation,all patients underwent thoracoabdominal aortic CTA examination,there were 5 cases of traumatic aortic diseases,10 cases of severe aortic penetrating ulcer,86 cases of Stanford type B aortic dissection.All patients follow up with CTA 1 weeks,3 months,half a year,and annually postoperatively.Postoperative complications,efficacy,morphology and its vascular stent were observed.Results All cases received TEVAR,there were 90 cases of simple repair of aortic lumen (89.11％),11 cases of brachiocephalic vessels bypass (10.89％),2 cases of death (1.98％),1 case of type Ⅰ endoleak(0.99％),3 cases of the application of lumbar cistern drainage(2.97％),1 case of severe stress ulcer(0.99％),1 patient died after surgery with paraplegia,acute renal failure,stroke,lower limb artery embolization,dissection rupture.Conclusion Thoracic endovascular aortic repair has obvious advantage,risks and complications incidence of preoperative period is low,the technology is worth popularizing widely,but needed to pay attention to strictly control the indications of operation and ensure the brain blood supply.

Objective: To optimize the extraction technology of Panax notoginseng and Scrophulariae radix from Rupixiao granule.Methods: With the dry extract rate and transfer rates of ginsenoside Rg1, ginsenoside Rb1 and harpagoside as the comprehensive index, the orthogonal design was adopted to investigate the effects of the amount and concentration of ethanol, extracting duration and times on the extraction technology.The contents of ginsenoside Rg1, ginsenoside Rb1 and harpagoside were determined by HPLC.Results: The optimal extraction technology was extracted twice with 8-fold amount of 60% ethanol with 2 h per time.The transfer rate of ginsenoside Rg1, ginsenoside Rb1 and harpagoside was (79.4%±1.56%), (42.62%±0.68%) and (44.89%±0.58%)(n=3), respectively.The dry extract rate was (20.99%±0.411%).Conclusion: The optimized extraction technology is stable and feasible, which can be used for extracting Panax notoginseng and Scrophulariae radix from Rupixiao granule.

Objective:To optimize the formula of film-forming materials for compound rhizoma corydalis plastics. Methods:Poly-vinyl alcohol 124 (PVA124) and bletilla striata gum were selected as the film-forming materials. The amounts of PVA 124, bletilla striata gum, glycerol and absolute ethanol were used as the influencing factors in an orthogonal test with the composite score of film-forming time and appearance as the indices to screen out the best composition of film-forming materials. Results:The best composition of film-forming materials was as follows:8 g PVA 124, 1 g bletilla striata gum, 2 ml glycerol and 15 ml ethanol. Conclusion:The op-timized film-forming materials can be used for the preparation of compound rhizoma corydalis plastics.

Objective To set up a clean-up method using gel permeation chromatography(GPC)and ENVI-Carb-SPE.The residues of triadimefon and its metablites,triadimenol A and triadimenol B in ginseng were detected by GC-MS with negative chemical ionization(NCI).Methods The sample was extracted with acetone and the extract was cleaned using GPC and ENVI-Carb-SPE.Based on GC-MS(NCI)the pesticides were separated on a DB-5MS column using a temperature program and were detected with a mass selective detector in selective ion monitoring(SIM)mode.The reference solution was prepared by the blank sample extract to overcome the matrix effect,the external reference method was used to detect.Results Three pesticides were separated within 10 min.The average spiked recoveries in three levels were 90%—105% with relative standard deviations(RSD)below 6%(n=6)in roots and stems.The limits of detection(LOD)of triadimefon and triadimenols were 0.1 and 10 ?g/L.The precision was below 2%(n=6).Conclusion The method is sensitive for the residue analysis of three pesticides and could be used to the triadimefon and triadimenols detection and security control in ginseng.

Objective To develop a blood gas,acid-base imbalance analysis computer software to diagnose systematically,rapidly,accurately and automatically determine acid-base imbalance type,and evaluate the clinical application. Methods Using VBA programming language,a computer aided diagnostic software for the judgment of acid-base balance was developed. The clinical data of 220 patients admitted to the Second Affiliated Hospital of Guangzhou Medical University were retrospectively analyzed. The arterial blood gas〔pH value,HCO3-,arterial partial pressure of carbon dioxide(PaCO2)〕and electrolytes included data(Na+and Cl-)were collected. Data were entered into the software for acid-base imbalances judgment. At the same time the data generation was calculated manually by H-H compensation formula for determining the type of acid-base imbalance. The consistency of judgment results from software and manual calculation was evaluated,and the judgment time of two methods was compared. Results The clinical diagnosis of the types of acid-base imbalance for the 220 patients:65 cases were normal,90 cases with simple type,mixed type in 41 cases,and triplex type in 24 cases. The accuracy of the judgment results of the normal and triplex types from computer software compared with which were calculated manually was 100%,the accuracy of the simple type judgment was 98.9% and 78.0% for the mixed type,and the total accuracy was 95.5%. The Kappa value of judgment result from software and manual judgment was 0.935,P=0.000. It was demonstrated that the consistency was very good. The time for software to determine acid-base imbalances was significantly shorter than the manual judgment(seconds:18.14±3.80 vs. 43.79±23.86,t=7.466,P=0.000),so the method of software was much faster than the manual method. Conclusion Software judgment can replace manual judgment with the characteristics of rapid,accurate and convenient,can improve work efficiency and quality of clinical doctors and has great clinical application promotion value.