Epilepsy is the common neurological disease, and antiepileptic drugs are the main means for the treatment of epilepsy. However, there is no conclusion on the timing of drug withdrawal in patients with epilepsy. In recent years, some large-scale prospective studies have provided some guidance on anti-epileptic drugs withdrawal. This article focused on the factors affecting the prognosis and timing of drug withdrawal, hoping to further the understanding of anti-epileptic drugs withdrawal and instruct clinical practise.

Objective To study the effect of perinatal exposure to sulphamethazine on the expression of neurotrophs(NGF and BDNF) in the hippocampus of offspring in rats.Methods The dams(SD rats) were fed with sulphamethazine at the doses of 50,100 and 200 mg/(kg.d) respectively from gestational day 7 to postpartum day 21.The brains of the pups aged 30 days were collected and the expression of NGF and BDNF was determined by immunohistochemistry staining.Results The expression of NGF in CA1 and CA3 of hippocampus significantly decreased in all pups of perinatal exposure to sulfamethazine(P

Objective: To evaluate the properties of PLA-PEG as a biodegradable scaffold material combined with rhBMP-2 for bone construction.Methods:PLA-PEG/rhBMP-2 multipore compound was prepared,then compression intensity and compression module were tested.The mandibular defect model was made in 20 rabbits,then PLA-PEG/rhBMP-2 was implanted into the defects on one side,and PLA-PEG without rhBMP-2 was implanted into the defect on another side as the control.The bone specimens were retrieved to make density analysis with X-ray photogram following sacrifice of the rabbits 2,4,8 and 16 weeks respectively after operation,then the specimens were decalcified to make histopathological observation by means of HE stain.Results:Compression intensity(MPa) of the PLA-PEG/(rhBMP)-2 compound was 30.05?3.12,and compression module(MPa) was 371.67?12.37.At 2,4,8 and 16 weeks,more new bone was observed,and higher intensity(P

AIM To study the pharmacokinetics of SJ SPM. METHOD The pharmacokinetics of SJ SPM was studied after oral doses in dog and in rat, compared with the pharmacokinetics of ASPM. Rat orally administed 40 mg?kg -1 SJ SPM, 72 h urine and bile recoveries were studied. Blood,urine and bile concentrations were tested with agar diffusion method. Pharmacokinetic parameters were calculated by 3p87 program in computer. RESULTS The plasma drug concentration time data for each subject were analyzed and fitted with a linear two compartment model. Following oral doses of 30,20,10 mg?kg -1 SJ SPM in dog, drug is rapidly and widely distributed throughout the body and lag time are 18～30 min; T max 1 43～2 44 h; C max 1 02～2 94 ?g?ml -1 ; T 1/2? 0 48～1 81 h; T 1/2? 8 40～10 52 h; Oral doses of 30,20,10 mg?kg -1 SJ SPM in dog and 120,80,40 mg?kg -1 in rat resulted in linear increase in the peak serum levels and areas under the serum concentration time curve. The MRT of SJ SPM,ASPM in rat and dog did not change significantly with an increase in oral dosage. Under the same conditions, the pharmacokinetics of ASPM was studied in dog, Oral doses of 30,20,10 mg?kg -1 ASPM in dog, lag time are 0 37～0 44 h; C max 0 87～3 34 ?g?ml -1 ; T max 1 49～2 26 h; T 1/2? 0 59～1 17 h; T 1/2? 7 42～12 04 h; MRT 7 56 h; AUC 7 65, 17 44, 26 25 ?g?ml -1 ?h -1 respectively. Following oral doses of 120,80,40 mg?kg -1 SJ SPM in rat, T max 1 57～2 45 h; C max 0 39～3 14 ?g?ml -1 ; T 1/2? 1 36～1 77 h; T 1/2? 15 63～20 64 h;MRT 13 0 h; AUC 8 44,16 54,37 58 ?g?ml -1 ?h -1 .Rat orally administered 40 mg?kg -1 SJ SPM, 72 h urine and bile recoveries are 2 18% and 4 70% respectively. CONCLUSION There are no significantal difference between SJ SPM and ASPM statistic.

Objective To explore the role of Bcl-2 and Caspase-3 in modulating apoptosis of ER-negative breast cancer cells induced by tamoxifen. Methods ER-negative breast cancer cell lines MDA-MB-231 were treated with 10.0?M tamoxifen for 12, 24, 36,48, 60 hours. The rate of cell apoptosis with or without caspase-3 inhibitor Ac-DEVD-CHO, and protein expression of Bcl-2,Bax were determined by flow cytometry, and the activity of Caspase-3 was examined with fluorophotometry. Results The expression of Bcl-2 was down-regulated, the activity of Caspase-3 and the rate of cell apoptosis were increased by TAM time-dependently, and the rate of apoptosis reached its peak at 48 hours. The expression of Bcl-2 was (negatively) correlated with activity of caspase-3. Tamoxifen, however, did not affect Bax protein expression. Ac-DEVD-CHO, a caspase-3 inhibitor, blocked the activation of caspase-3 and inhibited cell apoptosis (induced) by tamoxifen. Conclusions TAM could induce apoptosis in ER-negative breast cancer cells via (mitochondria) pathway by down-regulating Bcl-2 expression, and the activation of Caspase-3 might play an (important) role in the process of tamoxifen-induced apoptosis of ER-negative breast cancer cells.

ObjectiveThe efficacy and safety of nitrous oxide-sedated transnasal gastroscopy for high-risk patients of intravenous anesthesia were evaluated. MethodsA total of 157 patients were randomly assigned to the nitrous oxide group ( n =80) and the oxygen group ( n =77). Heart rate, blood oxygen saturation, blood pressure and electrocardiogram were monitored. Complications in both groups were recorded.Satisfaction degrees of patients and endoscopy physicians were evaluated with a questionnaire and visual analog scale (VAS) score. The questionnaire questions for physicians included the procedure evaluation ( steady, ok, unsteady). Patients' questionnaire questions included discomfort (light, moderate, severe), the patients' tolerance ( fine, moderate, weak) and the patients' willingness to undergo a second procedure. Statistical analysis was performed between the two groups. ResultsSix of the toal 157 patients were removed because of the operation failure (difficulty in access to nasal cavity in 5 patients and nose bleeding in one patient), 151 patients underwent the transnasal gastroscopy successfully and completed the questionnaires. In experimental group, there were 37 males and 41 females (mean age was 67.7 years, ranging 16-88 years, 7 patients were grade 1 of ASA, 61 were grade 2, and 11 were grade 3). In the control group, there were 36 males and 37 females (mean age was 67.9 years, ranging 17-86 years, 6 patients were grade 1 of ASA, 57 were grade 2, and 9 were grade 3). There was no differences in sex, average age and ASA grade between the two groups (P ＞ 0. 05 ). There was no difference in the mean operation time between the two groups, either (200. 1 s vs 200. 3 s) ( P ＞ 0. 05 ). There were no significant differences between the two groups in changes of blood oxygen saturation, blood pressure, electrocardiogram and complication rates ( P ＞ 0. 05 ).Both physicians' and patients' positive evaluations of the experimental group were more than that of the control (P ＜ 0. 05 ), while physicians' and patients' negative evaluations of the experimental group were less than the control (P ＜0. 05). VAS of physicians' satisfaction in the experimental group was higher than that of the control group (84 vs 70, t =14. 67, P ＜ 0. 05), and VAS of patients' satisfaction in the experimental group was superior to the control group (82 vs 71, t =11.56, P ＜ 0. 05). The number of patients wiring to undergo a second procedure in the experimental group was higher than that of the control (89. 7％ vs 69. 9％, P ＜ 0. 05). ConclusionNitrous oxide-sedated transnasal endoscopy is an effective and safe procedure for high risk patients of intravenous anesthesia.

ObjectiveTo assess the diagnostic value of EUS for pancreatic neuroendocrine tumors.MethodsClinical data of 26 patients with final diagnosis of pancreatic neuroendocrine tumors,who had underwent EUS and EUS-FNA,were retrospectively analyzed.Results On EUS,pancreatic neuroendocrine tumors presented as hypoechoic masses with clear margins and rich blood flow.Of the 26 pancreatic lesions,3 were in the head,2 in unicate process,2 in neck,11 in body and 8 in tail.The tumors presented with function in 16 ( mean size 9 mm),and on function in 10 ( mean size 29 mm).EUS-FNA yeilded positive results in 22 patients and negative in 4.The accuracy rate of EUS for preoperative localization was 100％ in 23 patients who underwent surgery.ConclusionEUS can provide accurate preoperative localization and pathologic evidence for pancreatic neuroendocrine tumors.

Objective To explore the utilization and effectiveness of ultrasound screening for neural tube defects (NTDs),so that to provide scientific evidences for the secondary prevention of NTDs.MethodsFour hundred and fifty-nine women who delivered or gestated NTDs babies or fetuses were randomly selected from Shandong Province and Shanxi Province,and the related information was collected with structured questionnaire by trained interviewers.Results Of the 459 cases,the ultrasonography utilization rate was 98.7%,and 6 cases (1.3%) never took examinations by ultrasonography during the whole pregnancy period.The total diagnosis rate of ultrasound screening for NTDs was 85.9%,and those of anencephalus,spina bifida and encephalocele were 96.4%,79.6% and 73.8% respectively (P<0.05).The average diagnosis week of NTDs was 24.0 and those of anencephalus,spina bifida and encephalocele were 21.2,27.1 and 24.7 respectively (P<0.05).The detection rates of NTDs before 16 weeks,16-20 weeks,20-24 weeks,24-28 weeks and after 28 weeks were 14.1%,49.4%,46.3%,49.2% and 52.1% respectively (P<0.05).The detection rates of NTDs in hospitals,maternal and child care service centers and family planning centers were 46.4%,52.0% and 28.1% respectively (P<0.05).The detection rate of NTDs by two-dimensional ultrasound equipment was 41.3% and 83.3% by three-dimensional ultrasound equipment (P>0.05).Conclusions The detection rates of NTDs and the subtypes by ultrasonography are low at different pregnant periods and in different medical institutions.It is important to increase the utilization rate of ultrasound screening by pregnant women and improve the NTDs diagnostic level of primary health care institutions,so that to improve the efficacy of secondary prevention strategy for NTDs in China.

Objective To investigate the effects of retrograde cardioplegia on serum soluble inter cellular adhesion molecule (sICAM)-1,soluble P-selectin (sPs) and cardiac troponin Ⅰ(cTnI) in the process of heart valve replacement operation.Methods Fifty-six cases undergoing heart valve replacement with cardiopulmonary bypass (CPB) were divided into antegrade cardioplegia (AC) group and retrograde cardioplegia (RC) group.Serum levels of sICAM-1,sPs and cTnI were measured using enzyme-linked immunosorbent assayd (ELISA) at six times.Results After the CPB,the levels of sICAM-1,sPs and cTnI ascended quickly,at the time of 8-hour after operation achieved the peak value.The peak value of RC group were lower than those of AC group[sICAM-1 (817.9±133.2)μg/L vs(901.1±132.0)μg/L,sPs(83.46±16.24)μg/L vs(107.82±19.68) μg/L,cTnI(10.50±2.03) μg/L vs (14.45±2.26)μg/L],and the dedined degree of RC group were faster than those of AC group.Conclusion Retroperfusion has a better myocardial protection to the patients suffering heart valve replacement operation through active suppressed expression of sICAM-1,sPs and cTnI palliated inflammatory reaction.

Objective To evaluate the efficacy of endoscopic metal stent implantation for afferent limb obstruction after pancreaticoduodenectomy(PD). Methods A retrospective analysis of 5 patients with afferent limb obstruction after PD treated by endoscopic metal stent implantation was performed.Data of each patient was reviewed including the records of the endoscopic procedure,the complications and the clinical outcomes. Results All the metal stents were implanted successfully in the 5 patients. The abdominal disten-sion and cholangeitis were well relieved in all the patients. The liver function improved in all the patients in 3 to 5 days.No abdominal discomfort,bleeding,perforation,or stent dislocation occurred.CT scan showed that all stents were well expanded.The survival time of the 5 patients were 3 to 8 months,and 4. 6 months on av-erage. There was no recurrence of afferent limb obstruction. Conclusion For afferent limb obstruction after PD,endoscopic metal stent implantation is effective in relieving obstruction,the symptoms,and improving the quality of life.