Objective To investigate the correlation between the alleles polymorphism of CYP2A6 and CYP2B6 and blood concentration of Valproate sodium(VPA).Methods The 165 epilepsy patients received simplex VPA and without dysfunction of liver and kidney were chose in this study.The alleles polymorphism of CYP2A6 in 95 cases and CYP2B6 in 70 cases were detected by polymerase chain reaction(PCR).Fluorescence polarization immunoassay(FPIA) was used to measure the blood concentration of VPA.Results The frequence of allele CYP2A6*4 in 95 cases was 13.2%.The blood concentration of VPA in patients with allele CYP2A6*4[(4.23?0.27)mg/ml]was significantly higher than that in patients without allele CYP2A6*4[(3.35?0.38)mg/ml](P

The effect of HLA-DR matching was retrospectively examined at DNA level on rejection and graft survival of cadaver renal transplantation. HLA-DR matching was typed by PCR-SSP technique in 318 cyclosporine-treated primary cadaveric renal recipients. The recipients were divided into three groups:no DR mismatching (0MM), one DR mismatching (1MM) and two DR mismatching (2MM). The effect of genomic HLA-DR compatibility on early kidney function, acute rejection, steroid pulses and 1 year graft survival was retrospectively analyzed. HLA-DR alleles in all samples were successfully genotyped by PCR-SSP. The overall time of DNA typing was 4 hours. The patients well-matched(0MM),moderately-matched(1MM) and poorly-matched(2MM) were 11.6%, 51.9% and 36.5%, respectively. The total rejection rate, 1 year patient survival and graft survival in 318 recipients were 49.1%, 94.3% and 90.3%. Early graft function, acute rejection episodes, steroid pulses and graft survival in well-matched recipients were better than those in poorly-matched patients. In particular, significant difference was found in acute rejection episodes and 1 year graft survival,suggesting genomic compatibility of HLA-DR has effect on acute rejection and graft survival in cadaver kidney transplantation.

Objective To evaluate the feasibility and clinical effect of stage Ⅰ posterior vertebral corpectomy filled with titanium mesh cages plus long-segmental instrumentation for treatment of Denis type D and E severe unstable thoracolumbar burst fracture.Methods A retrospectively review was made on 14 patients with Denis type D and E severe unstable thoracolumbar burst fracture,having had posterior vertebral corpectomy,titanium mesh bone grafting and long-segmental pedicle screw fixation.Parameters recorded were operation time,amount of bleeding,bone fusion and reduction,postoperative complications,low back pain,neurological performance,restoration and loss of anterior vertebral height,correction and loss of kyphosis,and intraspinal space occupying lesion.Results Mean operation time was 207.1 min (range,148-306 min) and blood loss was 585 ml (range,300-1,500 ml).Intraoperative fracture reduction was satisfactory.Follow-up ranged from 18 to 54 months (mean,28 months),which showed no complications of infection,screw-rod breakage,loosening or shifting of the internal fixation device,titanium mesh subsidence and pseudarthrosis,and no signs of adjacent segment degeneration.Six months after operation,CT scan showed bony fusion of the bone-implant interface.At the final follow-up,the Denis pain scale improved significantly including 12 patients with completely relieve of pain (P1) and 2 ache slightly but no need of taking painkiller (P2).Neurological functions were improved by 1-3 degree in all patients.Percentage of anterior vertebral height was (41.2 ± 8.9)％ before operation,significantly reduced to (8.3 ± 4.8) ％ one week after operation and to (8.9 ± 5.1) ％ at the final follow-up (P ＜0.01).Mean loss of anterior vertebral height was 0.6％.Sagittal kyphotic angle was (36.9 ± 4.9) °before operation,significantly reduced to (8.1 ± 3.4) ° one week after operation and (8.5 ± 3.8) °at the final follow-up (P ＜0.01).Mean loss of kyphotic angle was 0.9°.Ratio of intraspinal space occupancy was (74.9 ± 11.3) ％ before operation but recovered to (4.1 ± 1.6) ％ one week after operation and (1.8 ± 1.4) ％ at the final follow-up,with significant differences in pair comparison (P ＜ 0.01).Conclusion The use of posterior vertebral corpectomy and fusion with titanium mesh cage fusion in conjunction with long-segment instrumentation are effective for spinal canal decompression,fracture reduction,three-column reconstruction as well as rigid fusion at one stage,lumbar pain relief,neurological function recovery,prevention of correction loss and vertebral height restoration.

Objective:To observe the clinical effects of targeted percutanous ozone ablation on lumbar disc herniation (LDH) patients with high intensity zone (HIZ) in lumbar disc annulus fibrosus on MRI T2 weighted imaging.Methods:136 LDH patients with HIZ in lumbar disc annulus fibrosus on MRI T2 were divided into two groups according to therapy methods.In group A,75 patients were injected with 2 ～5 mL of 40 μg/mL mixture of O3 and O2 after targeted percutanous puncturing under the guidance of X-Ray machine with C-type arm.In group B,61 patients were treated with conservative treatment.MacNab score criterion and Oswestry disability index (ODI) were used in assessment of the efficacy.Results:Except 24 patients,all the other cases were followed up for 18 ～ 44 months.At the postoperative 1st,2nd,3rd,6th,9th,12th and 18th month,according to MacNab score criterion,the effective rates were respectively 88.00 ％,90.67 ％,93.33 ％,89.39 ％,84.85 ％,78.13 ％ and 73.44 ％ in group A and respectively 68.85 ％,62.30 ％ 55.74 ％,61.82 ％,58.12 ％,54.17 ％ and 47.92 ％ in group B.There were significant differences between two groups at the same time point (P＜0.05).At the postoperative 12th and 18th month,ODI was lower in group A,and there was no significant difference between two time points (P＞0.05).But it was significant different with that preoperatively and in group B at the same time point (P＜0.05).Conclusion:Targeted percutanous ozone ablation is an effective method with stable clinical efficacy in treating LDH with HIZ in lumbar disc annulus fibrosus on MRI T2 weighted imaging.

Objective To analyze the change trend of hospitalized patients with pulmonary embolism in Wuzhou city during 2004-2014,and analysis of its risk factors.Methods From January 2004 to January 2014,from four comprehensive tertiary hospitals of Wuzhou city,we selected hospitalized cases of pulmonary embolism as investigation subjects,which from 2004 to 2008 were selected as control group,and from January 2009 to January 2014 were selected as observation group.The hospitalization rate,mortality rate and risk factors were compared between the two groups.Results From 2004 to 2008,there were 257 370 cases of hospitalized,pulmonary embolism hospitalized in 52 cases at the same period,accounting for 0.02％ of the total hospitalized cases.From January 2009 to January 2014,there were 367 728 cases of hospitalized,pulmonary embolism hospitalized in 115 cases at the same period,accounting for 0.03％ of the total hospitalized cases.The proportion of pulmonary embolism in total hospitalization between the two groups had statistically significant difference (P ＜ 0.05).From 2004 to 2008,in 52 cases of pulmonary embolism,24 cases (46.15％) died,includef 16 cases(30.7％) died of pulmonary embolism,and the rest 8 cases(15.38％) died of the complication.From 2009 to 2014,in 115 cases of pulmonary embolism,30 cases (26.08％) died,included 23 cases(20.00％) died of pulmonary embolism,and the rest 7 cases(6.08％) died of complications.The difference of the mortality rate in the two periods was statistically significant (x2 =3.879,P ＜ 0.05).52 cases of pulmonary embolism of the control group were selected to study risk factors and basic diseases,the risk factors and basic diseases of pulmonary embolism had 11 kinds,the highest frequency was in lower limb venous thrombosis,followed by surgery and lie in bed for a long time,again for malignant tumor,smoking,fracture,hyperlipidemia,arrhythmia(atrial fibrillation,etc.) and diabetes,etc.Conclusion The hospitalization proportion and mortality trend of hospitalized patients with pulmonary embolism in Wuzhou city remains unchanged,to study the risk factors in order to get a better prevention and treatment measures.

Objective To investigate the prevalence rate and related factors of excessive daytime sleepiness (EDS) in the elderly. Methods Epworth Sleep Scales (ESS) was used to make a randomized questionnaire among the retired elderly. Results 1 000 questionnaires were released and totally 768 qualified answers were returned. The mean score of ESS was 4.22?0.10 and the score ≥8 was used as an abmormal value. The prevlence rate of EDS in the elderly group was 10.9%. Regression analysis was done based on ESS score as dependent variable, and age, sex, duration of sleep, difficulty in falling asleep, early wakeup, daytime sleepiness, habitual snoring and loud unstable snoring as independent variables. It was showed that daytime tiredness(r=1.458, P

Objective To clear, amplify and detect the activity of the recombinant adeno-assoeiated virus vector with adiponectin( rAAV2/1-Aerp30 ). Methods Recombinant plasmid pSNAV2.0-Acrp30 was obtained. The recombinant plasmid was then transfected into BHK21 cells using LipofectAMINETM 2000. The G418 resistant cells were obtained consequently. These cells were infected with HSVI-rc/△UL2 which has the function of packaging and copying recombinant AAV. After purification, the construction of recombinant rAAV2/1-Aerp30 was collected. Results The construction of recombinant pSNAV2.0-Acrp30 was confirmed by PCR electrophoresis and digestion with restriction enzyme. The gene sequencing showed that the recombinant pSNAV2.0-Acrp30 was correct. The virus titer was about 1.0×1012 μg/ml. The purity f the recombinant AAV2/1 was fairly high using the SDS-PAGE method. Conclusion With this method, rAAV2/-Aerp30 with high virus titers and purity can be acquired successfully and it can meet the demands of the experimental study of Acrp30 gene therapy of GK rats.

Objective To evaluate the diagnostic significance oftransepidermal water loss (TEWL), skin capacitance (CAP) and skin surface pH in subclinical irritant dermatitis. Methods Thirty healthy females took part in the 8-day study. Four areas were delineated on the flexor side of both forearms of each subject: one area received no irritation and served as the control, one was challenged by 1% sodium lauryl sulphate (SLS), one by repeated tape stripping, and one by irradiation with 0.75 MED UVB. Irritations were continuously given for 5 days. Clinical evaluation was performed everyday before irritation. TEWL, CAP and skin surface pH were measured at baseline, on day 6, 7 and 8 after the first irritation. Results Clinical score maintained at 0 for all subjects through the 8-day study. After SLS irritation, TEWL was 3.17 ± 3.07 g/m2h on day 6, 3.32 ± 2.84 g/m2h on day 7 and 3.22 ± 2.36 g/m,Zh on day 8, and all were significantly higher than that on day 0 (0.40 ± 1.35 g/m2h, P < 0.01). Similarly, increased skin surface pH was observed on day 6, 7 and 8 after SLS irritation compared with that at baseline (all P < 0.05). On the contrast, CAP decreased on day 6, 7 and 8 after SLS irritation (all P < 0.05). After tape-stripping, a significant increase was observed in TEWL on day 6, 7 and 8 compared with that at baseline (2.54 ± 1.85 g/m2h, 2.40 ± 2.16 g/m2h and 2.17 ± 1.99 g/m2h vs 0.11 ± 1.10 g/m2h, all P < 0.01); significant increase of pH was noted only on day 8; meanwhile, there was no any significant change in CAP. UVB irradiation induced no obvious changes in any of these physiological parameters. Conclusions These three physiological parameters can be applied m the diagnosis of subclinical irritant contact dermatitis, and their diagnostic value varies with the pattern of irritation.

Objective To compare the effect of Acetate Sodium Potassium Magnesium Calcium and lactate ringers′ as priming solution in pediatrics with cardiopulmonary bypass (CPB) during congenital heart surgery. Methods Sixty children, aged 1-6 years, weighting 8 to 20 kg, with ASA Ⅱ to Ⅲ class and with ventricular or atrial septal defect elective , received heart surgery with CPB. They were randomly divided into two groups: the lactate ringers′ group (R) and the sodium acetate, potassium, magnesium and calcium glucose injection pre-filled group (L). Levels of artery blood gas, lactic, gluclose, electrolytes were detected at the time points of induction of anesthesia (T1), aortic cross damping (T2), stopping before (T3), and closing chest later (T4). Results Levels of the blood glucose and lactic acid in the two groups post-CPB were increased (P <0.01) at T2 and T3. Lactic acid level in group L was lower than that in group R (P < 0.05), and the blood glucose level in group L was higher than that in group R (P < 0.01). No significant difference was found in the lactic acid and blood glucose post-closing chestbetween the two groups (P > 0.05). Conclusion Sodium, potassium , magnesium , calcium and glucose injection as children CPB priming crystalloid fluid could provide energy substrate, reduce lactic acid concentration, with little effect on electrolyte and blood gas.

AIM: To investigate the effect of Chinese herbs, Ganxianfang(GXF), on rat hepatic stellate cells (HSC) proliferation and collagen synthesis. METHODS: Two types of herb serum, portal venous serum and circumferential venous serum, were prepared from rats infused intragastrically with 16,8,4 times adult dose of GXF decoction. HSC isolated from rat liver were processed with the above sera in vitro . Then we mensurated the radioactivity of HSC admixed with [ 3H]proline and [ 3H]thymine to judge the effect on proliferation and collagen synthesis of HSC. RESULTS: Both two types of serum collected 0 5, 1, 2 h after intragastrical infusion inhibited HSC proliferation ( P 0 05). CONCLUSION: Inhibition of HSC proliferation and decrease of collagen synthesis may contribute to the GXF antifibrotic action.