OBJECTIVE: To analyze the therapeutic drug monitoring results of valproic acid( anti- epileptic drug) . METH-ODS: The concentrations of valproic acid in 226 cases in our hospital were determined by fluorescence polarization immunoassay. RESULTS: The results showed that 47. 79% were within the normal referenced concentration range, with average concentration at( 66. 19? 12. 13) ? g? mL- 1, 46. 90% were below the lower limit and 5. 31% were above the upper limit. CONCLUS-ION: The monitoring results are far from satisfactory. It is advisable to adopt individualized administration so as to achieve the goal of treatment.

Objective To detect genetic causes of idiopathic mental retardation/developmental delay in 20 male patients with epilepsy and to analyze their clinical characteristics of positive mutation carriers.Methods The families,consisted of the patient and his parents were recruited.Genomic DNA was extracted from peripheral blood,and candidate gene mutation screening was carried out by next-generation sequencing technology.Mutations in positive gene were verified by polymerase chain reaction(PCR) and direct sequencing.Results Three missense mutations were identified among 3 patients out of 20 cases,with a detection rate of 15％.They were:OPHN1 gene c.1996 C ＞ G,RAB39B gene c.542 C ＞ T and AFF2 gene c.427 A ＞ T,none of which had been reported before.All of these mutations were likely to be pathogenic based on gene function,evolutionary conservation,variant frequency in normal population (NHLBI Exome Sequencing Project and 1 000 Genomes),bioinformatics prediction and inheritance patterns.In addition,all 3 genes disrupted were residing on the X chromosome previously demonstrated to be associated with X-linked mental retardation(XLMR),indicating that they were probably pathogenic or might serve as one of the risk factors.Conclusions Abnormal function of genes on the X chromosomal is one of the most impotent causes of XLMR.X chromosomal gene mutation screening would be recommended for male children suffering from idiopathic mental retardation with epilepsy.

Objective To evaluate and compare the results of air-conduct and bone-conduct auditory brainstem response(ABR)for the purpose of clinical application of the bone-conduct ABR.Methods A group of normal hearing young adults(61 ears)were measured with click stimulation air-conduct ABR and bone-conduct ABR in a soundproof chamber.Results The waveforms of bone-conduct ABR were almost the same as those of air-conduct ones with the threshold of 26.08?7.71 dB(nHL),but with a lower rate of wave derivation.There were no significant differences between male and female for both air-conduct and bone-conduct ABR testing.The threshold for bone-conduct ABR was higher than that of air-conduct one with a very high positive correlation(r=0.7740)and there were significant differences (P0.05) for the wave intervals.Conclusion The limitation of the bone-conduct ABR application and the differences from air-conduct should be considered when it was used clinically.

Objective To investigate the effect of ketamine on c-fos gene expression in the glutamate induced injury of neuronal PC12 cells line. Methods The differentiated PC12 cells were seeded in 6-well plates(2?10~6/well) and incubated for 18 h,and then were randomly allocated to receive fresh medium(group C)or(10 mmol/L) glutamate(group G) or 0.1 mmol/L ketamine plus 10 mmol/L glutamate(group K1) or 0.5 mmol/L ketamine plus 10 mmol/L glutamate(group K2) or 1.0 mmol/L ketamine plus 10 mmol/L glutamate(group K3).At 5,15,30,60,120,240 and 360 min after administration of these drugs,the cells were collected respectively.(Total) cellular RNA was extracted.Reverse transcriptase-polymerase chain reaction was applied to determine cDNA amplification products with GAPDH mRNA as an internal control.Densities of DNA bands were quantified using the image analysis system.(Results)c-fos mRNA increased at 15 min,peaked at 30 min and 60 min,decreased at 120 min,reco-(vered) to the base level at 360 min among group G,K1 and K2.The c-fos mRNA levels were markedly elevated in group G as compared with the control levels(P

Objective To investigate the clinical efficacy of hemodialysis (HD) combined with hemoperfusion (HP) versus HD combined with hemodiafiltration(HDF) in treating uremic pruritus .Methods The randomized controlled trials(RCTs) on HD combined HP versus HDF in treating uremic pruritus were retrieved from the electronic databases of Cochrane library ,PubMed , Science ,CNKI ,Chinese Biological Medicine ,Wanfang and CNKI by computer .The domestic medical journals ,monographs ,meeting documents and academic dissertations were manually retrieved .The retrieval time limit was from their establishment to October 2015 .Meanwhile the obtained reference literature indexes were consulted .The two researchers independently screened the collected literatures according to the formulated inclusion and exclusion standards .The visual analogue scale (VAS) ,skin itchy effect judg‐ment criteria ,Dirk R Kuypers score ,PTH ,Ca2+ and P3 - were adopted as the evaluation standards .The Review Manager 5 .3 soft‐ware was used to conduct the meta‐analysis .Results Nine RCTs were finally included ,involving 405 patients .The meta analysis showed that HD+ HP had better effect than HD+ HDF in treating uremic pruritus and clearing blood BUN ,HD+ HDF had better effect than HD+ HP for maintaining Scr and P3 - clearing effect ,while no statistically significant difference was found in terms of PTH decrease and Ca2+ influence (P>0 .05) .Conclusion The dialysis mode of HD+ HP is more effective in treating uremic pruri‐tus .

Objective To evaluated the effect of first-line epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI)on advanced non-small cell lung cancer (NSCLC)patients with different EGFR mutation status (exon 1 9 deletion and exon 21 mutation).Methods Seventy-two advanced NSCLC patients with EGFR mutation confirmed by histopathology were enrolled.All of the patients received first-line EGFR-TKI.The relationships between EGFR mutation status and objective response rate (ORR),disease control rate (DCR),progression free survival (PFS ) and overall survival (OS ) were analyzed.Results Of the 72 patients,37 patients expressed exon 1 9 deletion,35 patients expressed exon 21 mutation,and all of them could be evaluated.The ORR and DCR of patients with exon 1 9 deletion were higher than those of patients with exon 21 mutation (75.7%vs.51 .4%,χ2 =4.583,P=0.032;89.2%vs.68.6%,χ2 =4.636,P=0.031 ).The modified median PFS of patients with exon 1 9 deletion was significantly higher than that of patients with exon 21 mutation (1 3.2 month vs.1 0.8 month,χ2 =4.700,P=0.030).The median OS of patients with exon 1 9 deletion was significantly higher than that of patients with exon 21 mutation (30.2 month vs.25.6 month,χ2 =4.686,P=0.030).The side effects were similar between the two groups.The most common adverse reaction was rash,and the incidence had no significant difference between the two groups (48.7% vs.48.6%,χ2 =0.000,P=0.995 ).Conclusion EGFR mutation status is a predictor for PFS,OS and ORR of first-line EGFR-TKI in patients with advanced NSCLC.NSCLC patients with EGFR exon 1 9 deletion are associated with longer survival time and better response rate compared with those with exon 21 mutation.

Objective:To discuss the significance of standardized treatment for cancer pain, according to the Cancer Pain Treat-ment Specification (2011 Edition) issued by the Ministry of Health, PR China. Methods:Clinical data of 126 patients with cancer pain, who were admitted to the Department of Medical Oncology, The Fourth Hospital of Hebei Medical University, were collected to com-pare the improvement of the Numeric Rating Scale (NRS) score, number of breakthrough pain, and quality of life score after treatment. The relationships between different pain grades, disease entities, and treatment effect were analyzed. The influence factors of pain relief were also analyzed by using Logistic regression analysis. Results:1). Following standardized treatment, the improvement rate of NRS score has shown significant differences in pain grading (P=0.001) and gender (P=0.000). However, no significant differences were ob-served between different diseases (P=0.112). The improvement rate of the life quality score and the number of breakthrough pain had no significant difference after standardized treatment. 2). The grading of cancer pain and the disease entities had little effect on cancer pain relief. 3). The anti-tumor treatment and“no distant metastasis”were the independent factors that brought about the decrease in NRS and quality of life scores.“No distant metastasis”(P=0.046) was the independent factor that reduced the number of pain out-breaks. Conclusion: The standardized treatment positively affects the NRS score, number of breakthrough pain, and quality of life score. Patients who received anti-neoplastic therapy and who had no distant metastasis showed significant treatment effectiveness in pain management.

Altitude ; Altitude Sickness ; Animals ; Hypoxia ; Iron ; Mice ; Spleen

The cloning and expression of a?-galactosidase gene(TM_0310)from Thermotoga maritima MSB8 was studied.The gene consists of 2019 bp,and the translated protein encodes 672 amino acids and its molecular mass is approximately 78.972 kD.The homology analysis of the deduced amino acid sequences showed that the enzyme shared 95%identity with a putative?-galactosidase from Thermotoga petrophila RKU-1 and a?-galactosidase from Thermotoga sp.RQ2.The galactosidase activity was up to 2.08 U/mg after the recombinant E.coli BL21 was induced by IPTG.The crude lysate remained about 70%activity after treated at 80℃for 10 min,indicating that the recombinant enzyme is thermostable and may be used at high temperatures.

Objective To explore the effect of erlotinib in patients with non-small-cell lung cancer (NSCLC)in stage ⅢA before operation and the relation with the rate of resection,good operability and postoperative complications.Methods 31 patients with NSCLC in stage ⅢA in group A were treated with erlotinib before operation;34 patients with NSCLC in stage ⅢA in group B only were treated with operation.Results The condition of 64.5%patients were improved.The operability in group A was more than that in group B(P=0.008),the good operability in group A was more than that in group B(P=0.011),the postoperative complications do not have statistical significance (P=0.07).Conclusion The erlotinib can increase the rate of resection in patients with NSCLC in stage ⅢA,and increase good operability in patients with NSCLC in stage ⅢA,but not increase the postoperative complications.