Objective To assess the clinical efficacy and safety of topiramate in adult and children patients with epilepsy. Methods Open-label experience with topiramate as adjunctive, added-on to monotherapy and monotherapy were analyzed.The efficacy was assessed by comparing the average frequency per month for 3 months after topiramate added to the maintenance period of the baseline therapy. Results Topiramate was proven to be a valuable new antiepileptic drug either in monotherapy (86%) or in added-on therapy (70%) on partial onset epilepsy, West syndrome and Lennox-Gastaut syndrome, and showed no tolerance.The topiramate dosage in patients with monotherapy [(85.87?29.19)mg/d in adult] is lower than in those using added-on therapy [(161.11?58.18)mg/d] significantly, and the most common adverse events were CNS-related, but few patients had discontinued the therapy.Conclusions The topiramate used for monotherapy or added-on therapy should be regarded as an effective and widespread antiepileptic drug, without tolerance and severe adverse actions.

Objective To explore ways for the supervision of department directors. Methods Job responsibility agreements with department directors were signed and a series of assessment standards were established. Results The methods adopted were standardized, individualized and easy to use. Conclusion Job responsibility agreements with department directors and a standard assessment system are currently effective measures for the supervision of department directors.

Objective To investigate the complications of laparoscopic exploration of the common bile duct,and its prevention.Methods From June 2003 to June 2007,a total of 124 patients received laparoscopic exploration of the common bile duct in our department,13 of them developed complications.The data of these 13 patient were analyzed retrospectively.Results Among the 13 cases,3 had intraoperative perforation of the common bile duct(one of them was complicated with perforation of the duodenum),2 had intraoperative hemorrhage;1 had postoperative perforation of the duodenum,2 had biliary leakage(treated by primary suture),1 had postoperative intra-abdominal hemorrhage,and 4 had residual stones in the bile duct.All the complications were cured.Conclusions Strict indications and high-level techniques are important factors for laparoscopic exploration of the common bile duct.The prognosis of the patients can be good as long as open surgery is carried out at proper time and the complications are treated appropriately.

Objective To compare the ischemia-modified albumin(IMA)level between T2DM and AMI,and to discuss the possible mechanism and pathology process.Methods According to the decrease of power of albumin binding cobalt along with the increase of ischemia-modified albumin,the automated continuous detection of free cobalt in reactive system were conducted using the 480nm wavelength and the results were reported as absorbance unit(ABSU)and coloration rate of free cobalt.Results There were significant differences in serum free cobalt between the control and groups of acute coronary syndrome(ACS)and type 2 diabetes and between ACS and type 2 diabetes(P

AIM: To investigate the expression of phosphatidylinositol 3-kinase (PI-3K) during the proliferation of the hypoxic pulmonary arterial smooth muscle cells(PASMC). METHODS: The cultured PASMC was divided into two groups: serum-free medium (SFM) group and 48 hours hypoxia (H48h) group. Immunohistochmistry(IHC) and Flowcytometer(FCM) were used to detect the cultured PASMC. RESULTS: The positive expression of PI-3K p110 existed in both cultured PASMC groups. The staining intensity in H48h group (0 1891?0 0301) was significantly stronger than that in SFM group (0 1025?0 0164, P

[ABSTRACT]OBJECTIVETo investigate the effect of accurate airway humidification on hemorrhage, pharyngalgia, mucosal edema and sputum viscosity in patients with low-temperature plasma coblation-assisted tonsillectomy.METHODS58 cases were divided into three groups by using random numbers.In accurate airway humidification group, atomizing inhalation was carried out by AIRVOTM series apparatus; in oxygen atomizing group, budesonide suspension was used; in control group, saline was used. We evaluated the hemorrhage, pharyngalgia, mucosal edema and sputum viscosity in 3 consecutive postoperative days.RESULTSPharyngalgia in accurate airway humidification group and in oxygen atomizing group were both significantly reduced than that of the control group (P<0.001). Besides, in accurate airway humidification group, mucosal edema and sputum viscosity were significantly improved than that of the oxygen atomizing group (P<0.05) and control group (P<0.05).CONCLUSIONAccurate airway humidification could reduce the complications such as pharyngalgia, mucosal edema and purulent sputum after low-temperature plasma coblation-assisted tonsillectomy, and could accelerate recovery from surgery.

Objective To investigate the therapeutic effects of botulinum toxin type A (BTX-A) in elderly patients with primary intractable trigeminal neuralgia.Methods 27 elderly patients with primary intractable trigeminal neuralgia were treated with BTX-A local multiple point injection.The efficacy was assessed by visual analog scores (VAS) before and 1 week,2 weeks,1 month,3 months and 6 months after the treatment.Results VAS scores was (9.2±1.1),(5.8±3.0),(3.6± 2.3),(2.3±2.3),(3.2±2.9) and (4.6±3.2) before and 1 week,2 weeks,1 month,3 months and 6 months after BTX-A treatment respectively.VAS score was gradually decreased,reached the lowest at 1 month after BTX-A injection,and then was gradually increased.There were significant differences in VAS scores between between pre-and post-treatment (P＜0.05).The efficiency was 37.0％,85.2％,92.6％,70.4％ and 59.3％ at 1 week,2 weeks,1 month,3 months and 6 months after the treatment respectively.There were significant differences in efficacy between different time points after the treatment (all P＜0.05).3 patients had the transient numbness of mouth askew and incomplete eyelid closure and recovered spontaneously after 4-8 weeks.No severe adverse effects were found in the other 27 patients.Conclusions BTX-A is safe and effective in the treatment of primary intractable trigeminal neuralgia in elderly patients.

Objective:To explore the functional mechanism of moxibustion and its enlightenment to the design and manufacture of moxibustion apparatus.Methods:The functional mechanism of moxibustion is explored from its pharmaceutical properties,warming stimulation,spectrum,radiation features,and penetrating effects of moxa products.Result:The mechanism of moxibustion is a combined action of moxa'medicinal properties,warming effect and non-thermal effect.Conclusion:It is necessary to combine with the functional mechanism to design and manufacture moxibustion apparatus.

Objective To investigate the operative indications for polypoid lesions of gallbladder(PLG) and avoid cholecystectomy for PLG without operation signs.Methods Retrospective analysis of 828 cases of PLG confirmed by pathologic examination was made.Results (1)Cancer should be suspected when a patient is older than 50 years or has a polypoid lesion larger than 1.0 cm.(2)The cholecystectomies for PLG accounted for 2.7%-7.1%of all cholecystectomies in the corresponding period,and cholesterol polyps accounted for 86.11%of all PLG,and carcinoma of gallbladder accounted for 1.92%of all PLG.Conclusion At present most of PLG accepting cholecystectomy are cholesterol polyps,so the high-risk factors of the neoplastic polyps and the operative indications for PLG should be considered deliberately.

Objective To report the experience of the arterial switch operation(ASO) for Taussig-Bing anomaly and late outcomes.Methods From January 2001 to December 2015,57 patients were underwent arterial switch operation for Taussig-Bing anomaly in Fudan university affiliated children's hospital cardiac center,Median age and weight at operation was 63(37.5-88.5)days, 4.1(3.4-5.0)kg, respectively.29 patients with Arch anomalies(50.9%), 23 patients with unusual coronaries(40.3%),according to have arch anomaly or not and surgery time, dividing the patients into two groups, group A(have, n=29)and group B(not have, n=28), earlier experience into group 1(2001-2008, n=27), later experience into group 2(2009-2015, n=30), respectively.Results The Mortality was12.3%, the mortality of group A and group B was 13.8%, 10.7%(P>0.05),group 1 and group 2 was 22.2%, 3.3%(P<0.05) respectively, follow up was complete in 47 patients with a mean follow-up of(6.2±3.5) years , three patients lost, there was no late mortality, the actual survival at 1, 5year was 87%, 87%, respectively.Reintervention was required in 10 patients(21.3%), the aorta-PA valve diameter ratio was a risk factor for reintervention(group A P=0.02, group B P=0.04) ,and 1,2,5year free of reintervention was 95.6%, 86.6%, 77.2%, respectively.Conclusion The ASO approach can be applied to Taussig-Bing anomaly with acceptable mortality , and it is the procedure of choice at our institution.One stage to repair TBA with aortic arch abnormalities did not influence outcomes.The aorta-PA valve diameter ratio<0.5 was a risk factor for reintervention.