OBJECTIVE:To observe the factors that influence the fluctuation of serum concentrations of valproic acid and to improve the effectiveness and usefulness of monitoring the serum concentration.METHODS:The factors that influence the serum concentration of valproic acid were summed up and the countermeasures were put forward.RESULTS:These influencing factors included the drug administration time;the blood sampling time;the right moment for monitoring;the dosage forms and quality of drug;the obedience of patient;combining use of drugs and the physiological and pathological conditions of pa?tients.CONCLUSION:When epileptic patients receive long-term medical treatment,the doctor,the patient and the pharma?cist should communicate mutually,establish the relevant data,pay attention to those factors and ensure the patients safe and effective in use of drug.

Objective To explore the effects of antidepressant combined with improved Morita therapy in the treatment of somatoform disorder. Methods 78 patients with somatoform disorder were randomly divided into study group (medication combined with improved Morita therapy,39 cases) and control group (medication,39 cases). Both groups were assessed with symptom checklist 90 (SCL-90), Eysenck personality questionnaire ( EPQ )and global assessment scale ( GAS ) before and after treatment. Results After treatment, the factor scores in SCL-90 of the study group were (1. 14±0.41),(1.81 ±0.44),(1.27 ±0.41),(1.20±0.54),(1.49 ±0. 66 ), ( 1.25 ± 0. 42 ), ( 1. 09 ± 0.48), ( 1.07 ± 0. 42 ), ( 1.16 ± 0. 42 ), and that of the control group were ( 1. 46±0.44) ,(2.19±0.50),(1.56±0.40),(1.54±0.56),(1.85 ±0.48),(1.47±0.44),(1.33±0.54),( 1.38 ± 0. 58 ), ( 1.38 ± 0. 45 ), there were significant differences ( P ＜ 0. 05, P ＜ 0. 01 ). EPQ-E and EPQ-N of the study group were 7.02 ±4.06 and 12.7 ±3.89 respectively ,EPQ-E and EPQ-N of the control group were 14.8± 4.3 and 8.97 ± 4.32 respectively, there were significant differences ( P ＜ 0.05 ). The obvious effective rates of two groups were 82. 05% and 56.41% (x2 =4.875, P＜0. 05 ). Conclusion The effects of antidepressant combined with improved Morita therapy is much better in the treatment of somatoform disorder.

Objective:Concentrated growth factors (CGF),a new generation of platelet concentrate products,appears to have more abundant growth factors because of its special centrifugation process.However,there are few studies supporting this.This study was designed to evaluate the effect of CGFs in the treatment of Ⅱ ° furcations of mandibular molars.Methods:In the present study,thirty-one Ⅱ ° furcation involvements in twenty mandiblular molars were included and randomly divided into two groups.The furcation involvements in the experimental group were treated with bone graft therapy combined with CGFs,and the furcation involvements in the control group were treated with bone graft therapy alone.The clinical examination and cone beam computed tomography (CBCT) were performed at baseline and 1 year post-surgery for the two groups.The changes of clinical and CBCT data at baseline and 1 year postsurgery were compared between the experimental group and the control group.Results:At baseline,there were no significant differences between the two groups in the probing depth (PD),vertical clinical attachment loss (CAL-V) and horizontal clinical attachment loss (CAL-H):PD (7.36 ± 2.32) mm (the experimental group) vs.(7.53 ±2.06) mm (the control group);CAL-V (8.69 ± 1.65) mm (the experimental group) vs.(8.81 ±1.53) mm (the control group);CAL-H (5.24 ±2.01) mm (the experimental group) vs.(5.35 ±2.14) mm (the control group).At the end of 1 year post-surgery,the clinical parameters of both groups were significantly improved (P ＜ 0.001).For the experimental group,the average vertical attachment gain was (2.78 ± 1.66) mm,and the vertical attachment loss was improved significantly compared with the baseline (P ＜ 0.001);the average horizontal attachment gain was (2.10 ± 1.89) mm,and the horizontal attachment loss were improved significantly compared with the baseline (P ＜ 0.001).Furthermore,the improvement degree of the experimental group was significantly higher than that of the control group (P ＜ 0.001).At baseline,there were no statistical differences in the vertical bone loss (BL-V) or horizontal bone loss (BL-H) between the two groups (P ＞ 0.05):BL-V (5.08 ± 2.17) mm (the experimental group) vs.(5.84 ± 2.65) mm (the control group);BL-H (5.85 ±2.13) mm (the experimental group) vs.(6.01 ±2.27) mm (the control group).At 1 year post-surgery,both groups showed significant radiographic bone gain at vertical and horizontal directions compared with baseline (P ＜ 0.001).For the experimental group,the average vertical radiographic bone gain was (2.20 ± 1.98) mm,the horizontal radiographic bone gain was (2.51 ±2.18) mm,the vertical and horizontal radiographic bone loss were both significantly reduced compared with the baseline (P ＜ 0.001).For the control group,the average vertical radiographic bone gain was (1.89 ± 2.15) mm,the horizontal radiographic bone gain was (1.30 ± 2.47) mm,the vertical and horizontal radiographic bone losses were both significantly reduced compared with the baseline (P ＜ 0.001).And the experimental group showed significantly higher bone gain at vertical and horizontal directions compared with the control group (P ＜ 0.001).Conclusion:Within the limitation of the present study,CGFs showed positive role in the treatment of Ⅱ° furcation involvements of mandibular molars.

OBJECTIVE To investigate the distribution and resistance of commonly encountered pathogens,and provide reference of antimicrobial agents.METHODS For the clinical specimens during the last three years,flora identification and bacteriostatic test were operated with Microscan WalkAway-40.RESULTS Gram-negative bacteria were 252,507 and 742 strains,Gram-positive bacteria were 142,166,and 243 strains,fung were 0,26,and 229 strains from 2002 to 2004,respectively,the most commonly encountered Gram-negative bacteria were Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa,Enterobacter cloacae,and Acinetobacter baumannii;the Gram positive bacteria were Staphylococcus aureus,S.epidermidis,S.haemolyticus,and Enterococcus.CONCLUSIONS It is important for reasonable drug application to know the distribution and resistance of commonly encountered bacteria.

The relationship between thyroid diseases and cerebrovascular diseases is getting increasingly attention. Studies have shown that thyroid diseases are associated with many kinds of cerebrovascular diseases, such as ischemic cerebrovascular disease, moyamoya disease, cerebral venous thrombosis, and artery dissection. This article review the advances in research on the correlation between thyroid diseases and cerebrovascular diseases.

In order to understand metabolic functions essential for methane assimilation, we investigate dribulose monophosphate pathway and adjacent pathways in gammaproteobacterial Methylomicrobium alcaliphilum 20Z by using combined approaches of RNA-seq, LC-MS, and 13C-labeled techniques. The absolute quantification of metabolome showed that the concentrations of intermediates, such as glucose-6-phosphate and 2-dehydro-3-deoxy-phosphogluconate, involved in Entner-Doudoroff (EDD) pathway were (150.95 +/- 28.75) micromol/L and below the limit of detection of mass spectrometry. In contrast, fructose-1, 6-bisphosphate, glyceraldehyde-3-phosphate/dihydroxyacetone and phosphoenolpyruvate in Embden-Meyerhof-Parnas (EMP) pathway had significantly higher concentrations with (1 142.02 +/- 302.88) micromol/L, (1 866.76 +/- 388.55) micromol/L and (3 067.57 +/- 898.13) micromol/L, respectively. 13C-labeling experiment further indicated that the enrichment of [3-13C1]-pyruvate involved in EMP pathway was 4-6 fold higher than [1,13C1]-pyruvate in EDD pathway in a dynamic course. Moreover, gene expression profile showed that the expression levels of genes in EMP pathway (e.g. fbaA, tpiA, gap and pykA) were 2 479.2, 2 493.9, 2 274.6 and 1 846.0, respectively, but gene expressionlevels in EDD pathway (e.g. pgi, eda and edd) were only 263.8, 341.2 and 225.4, respectively. Overall our current results demonstrated that EMP pathway was the main route for methane assimilation in M. alcaliphilum 20Z. This discovery challenged our understanding of methane assimilation pathway in gammaproteobacterial methanotrophic bacteria, and further provided an important insight for efficient methane biocatalysis in the future.
Glycolysis ; Industrial Microbiology ; Methane ; metabolism ; Methylococcaceae ; metabolism ; Pyruvic Acid ; metabolism

Abstract To explore the association between a digital lifestyle and digital eye strain among adolescents, the present study analyses that a digital lifestyle has direct, mediating and moderating effects on digital eye strain of adolescents, and explores that visual load, attention and cognitive load are identified as the associated mechanisms of digital eye strain. In terms of management, the article highlights the need to raise awareness and promote healthy behavior in respect to the use of digital devices, as well as the importance of diversifying lifestyles, ensuring family and school support, and engaging in multidisciplinary cooperation to promote visual health and digital literacy among adolescents.

Objective To study the effects of exercises training on the recovery of neurological function and the expression of matrix metalloproteinase-9 (MMP-9) in perihematomal brain tissue after intra cerebral hemorrhage (ICH) in rats. Methods Sixty-four male adult Sprague-Dawley rats were randomly divided into exercises group and control group. ICH model was induced by autobiood injection. The rats in exercises group were given balance, grasping and walking exercises every day. The rats in control group exercised freely in standard cages. Neurological function in both groups was measured at the 3rd, 7th, 14th and 21st d. All the rats were sacrificed and the concentration of MMP-9 was measured with immunohistochemical method and in situhybridization. Results In both groups neurological function scores was lowest at the 3rd d, were highest at the 21st d. There was no significant difference between two groups at the 3rd d, but at the 7th, 14th and 21st d the differences between two groups were significant ( P < 0.05 ). In exercises group, MMP-9 expressed weakly at the 3rd d, and peaked at the 7th d, then declined gradually. In control group, MMP-9 expression peaked at the 3rd d, then decreased slowly. MMP-9 protein expression was in accord with mRNA. MMP-9 expression in exer-cises group was significantly different from control group on the 3rd and 7th d (P < 0.05 ) , but not at the 14th and 21st d ( P > 0.05 ). Conclusions Early exercises can inhibit the expression of MMP-9 that could play a role in protecting neurons. Daily exercises can stimulates the expression of MMP-9 so as to have a positive role in midstage of disease. MMP-9 may be involved in tissue remodelling and vascular repairing, which prompt neu-rofunction recovery.

OBJECTIVETo investigate the prognostic factors of patients with lymph node-negative metastasis gastric cancer (pN0).

METHODSClinicopathological data of patients with pN0 gastric cancer who underwent radical operation at the Department of Surgical Oncology, The First Hospital of China Medical University from May 1980 to August 2012 were collected and analyzed retrospectively.

INCLUSION CRITERIA(1) Patients were diagnosed as gastric adenocarcinoma; (2) Postoperative pathology confirmed T1a to 4bN0M0 gastric cancer; (3) Total number of harvested lymph node was more than 15. The patients, who died within 1 month after the operation, died of other diseases, had remnant gastric cancer, or had incomplete follow-up data, were excluded. Univariate analysis was used to analyze the clinical factors that may influence the prognosis of patients with stage pN0 gastric cancer, then, those significant variables were entered into the Cox's proportional hazards regression model for multivariate analysis to obtain the independent prognostic factors for patients with pN0 gastric cancer finally. Furthermore, the prognosis of patients with pN0 advanced gastric cancer (invasive depth ≥ T2) were analyzed using the same method.

RESULTSA total of 610 patients with pN0 gastric cancer were enrolled in the study, including 441 males and 169 females with age ranging from 19 to 83 (mean 56.4±11.0) years, D1 lymph node dissection in 45 cases, D2 lymph node dissection in 543 cases, D3 lymph node dissection in 22 cases, and 384 cases of advanced gastric cancer. The overall followed-up was 1 to 372 (median 32) months. Ninety cases (14.8%) were dead during the follow-up. The median survival was 277.7(95%CI: 257.6 to 297.8) months, and the 1-, 3-, 5-year survival rates were 96.5%, 87%, 83.2%. Univariate analysis showed that tumor diameter, depth of invasion, gross type, lymph node dissection and lymph vessel cancer embolus were related to the prognosis (all P<0.05). The 5-year survival rate of patients with tumor diameter >4 cm was significantly lower than those with tumor diameter ≤4 cm (75.6% vs. 87.8%, P=0.000). The 5-year survival rates of T1a, T1b, T2, T3 and T4 were 98.4%, 92.8%, 84.2%, 61.0% and 31.4% respectively, and the difference was statistically significant (P=0.000). In gross type, 5-year survival rate of early gastric cancer was 96.0%, and of Borrmann I( to IIII( type gastric cancer was 100%, 83.4%, 73.7% and 68.9% respectively, whose difference was statistically significant(P=0.000). The 5-year survival rates in patients undergoing lymph node dissection D1, D2 and D3 were 100%, 83.3% and 58.7%, and the difference was significant (P=0.005). The 5-year survival rate of patients with positive lymphatic cancer embolus was lower than those with negative ones (69.4% vs. 86.9%, P=0.000). Multivariate analysis showed that the gross type [Borrmann II(/early gastric cancer: HR(95% CI)=15.129(3.284 to 69.699), Borrmann III(/early gastric cancer: HR(95% CI)=14.613 (3.292 to 64.875), Borrmann IIII(/early gastric cancer: HR (95% CI)=15.430 (2.778 to 85.718),Borrmann IIIII(/early gastric cancer: HR(95%CI)=12.604 (1.055 to 150.642), P=0.025] and the positive lymphatic cancer embolus [HR(95% CI)=3.241 (2.056 to 5.108), P=0.000] were the independent prognostic factors of patients with pN0 gastric cancer. For pN0 patients with advanced gastric cancer, multivariate analysis showed that the depth of invasion [stage T3/stage T2: HR(95%CI)=1.520 (0.888 to 2.601), stage T4/stage T2: HR(95%CI)=2.235(1.227 to 4.070); P=0.031] and the positive lymphatic cancer embolus [HR(95%CI)=3.065 (1.930 to 4.868); P=0.000] were the independent risk factors influencing the prognosis.

CONCLUSIONSPositive lymphatic cancer embolus and worse gross pattern indicate poorer prognosis of patients with pN0 gastric cancer, which may be used as effective markers in evaluating the prognosis. As for pN0 advanced gastric cancer, invasion depth and positive lymphatic cancer embolus can play a more important role in the prediction.

Adenocarcinoma ; classification ; diagnosis ; mortality ; Adult ; Aged ; Aged, 80 and over ; China ; Female ; Humans ; Lymph Node Excision ; statistics & numerical data ; Lymph Nodes ; pathology ; surgery ; Lymphatic Metastasis ; physiopathology ; Lymphatic Vessels ; pathology ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Invasiveness ; pathology ; physiopathology ; Neoplasm Staging ; statistics & numerical data ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Stomach Neoplasms ; classification ; diagnosis ; mortality ; Survival Rate

Objective To evaluate laparoscopic appendicostomy in Malone antegrade continence enema (MACE).Methods 25 children with fecal incontinence undergoing MACE were divided into by laparoscopic technique (14 cases) and by laparotomy (11 patients).Results The operation time [(38.3 ±2.5) min vs.(60.5 ±3.6) min,t =13.7,P =0.00] was shorter in the laparoscopy group.All patients were followed up for 6 months to 3 years.No intestinal obstruction,fecal leakage in stoma and anal fecal incontinence or soiling happened.In laparoscopy group,the stomal stricture developed in 1 patient.The mucosa prolapse developed in 2 patients.In the laparotomy group,the stomal stricture developed in 2 patients.The mucosa prolapse in 1 patient.The symptom severity scoring for constipation and fecal incontinence after operation decreased in the laparoscopy group (12.1 ± 1.4 vs.33.7 ± 1.5,t =28.4,P =0.00),laparotomy group (12.5 ± 1.6 vs.33.3 ± 1.7,t =25.36,P =0.00).While the irrigation volume [(607±151) mlvs.(594±161) ml,t=0.17,P=0.87],MACE scoring (22.1 ±1.4vs.22.0±1.7,t =0.18,P =0.86) and symptom severity scoring for constipation and fecal incontinence (12.1 ± 1.4 vs.12.5 ± 1.6,t =0.46,P =0.65) were not statistically different.Conclusions The laparoscopic technique can make the MACE easier to operate and less traumatic.