Objective To analysis the clinical features of valproate (VPA)-induced encephalopathy in elderly people in order to improve our cognition toward it.Methods From March 2003 to March 2011,a total of 10 cases with VPA-induced encephalopathy were retrospectively reviewed and summarized.The data collected included clinical manifestations,biochemistry,EEG and therapeutic effects.Results In the 10 cases,8 were males and 2 females.The age ranged from 65-88 years old (mean age 75.4±10.3 years).7 subjects were on treatment with VPA alone,and the other 3 in combination with other anti-epileptic drugs.The serum VPA level in this study ranged from 62.1-122.7 μg/ml with mean of (92.3 ± 30.1) mg/L (normal range 50-100 mg/L).All subjects presented with confusion and cognitive impairment.The serum ammonia level in this study ranged from 56.7-225.1 μmol/L with mean of (101.4±55.2) μmol/L (normal range 11-32 μmol/L).All cases were with normal liver function.Electroencephalography was characterized by signs of severe encephalopathy with continuous generalized slowing,a predominance of θ and δ activity,occasional bursts of epileptiform discharges and triphasic waves.All cases were improved 3-21 days after VPA withdrawal.Conclusions VPA-induced encephalopathy that manifested in confusion and cognitive impairment is not uncommon in elderly patients and it has a good prognosis and the early withdrawal of VPA lads to improvement in almost all cases.

Semont maneuver was performed in 97 patients with benign paroxysmal positional vertigo involving the posterior semicircular canal.Among 97 patients the Semont maneuver was successful in 69 cases and failed in 28 cases.There were three nystagmus patterns during the third position of the Semont maneuver:orthotropic nystagmus (n=45), no nystagmus (n=42) and reversed nystagmus (n=10);and the effective rates in three groups were 93%, 64% and 0%, respectively (P<0.05).The duration of latency period and nystagmus status in Dix-Hallpike test has no effect on repositioning efficacy ( P>0.05) .

ObjectiveTo investigate the antiviral effect of siRNA on herpes simplex virus type 2 (HSV-2) in vitro.MethodsDifferent siRNA duplexes targeting HSV-2 VP16 and DNA polymerase genes were designed and chemically synthesized.The antiviral effect of siRNA duplexes was evaluated by virus yield reduction assay.In detail,Vero cells cultured in 24-well plates were transfected with different siRNAs 4 hours before(preventive effect experiment) or 1 hour after(therapeutic effect experiment) the inoculation with HSV-2(0.02 to 0.05 plaque forming unit/cell).After additional culture for 40 to 48 hours,the expression of target genes in Vero cells was measured by real-time quantitative reverse transcription(RT)-PCR.Results Both the siRNA duplex VP2-1 targeting HSV-2 VP16 and DP2-1 targeting DNA polymerase gene resulted in a remarkable decrease in viral titer by about 1 log10 in both the preventive and therapeutic effect experiment.As the preventive effect experiment showed,the expression of HSV-2 VP16 mRNA was decreased markedly by 58.6％ and 79.5％ by VP2-1,respectively,and that of HSV-2 DNA polymerase mRNA by 59.8％and 77.4％ by DP2-1,respectively,at 6 and 12 hours after the infection.ConclusionsThe siRNA duplexes targeting HSV-2 VP16 and DNA polymerase genes could inhibit the proliferation of HSV-2.Hence,HSV-2 VP16 and DNA polymerase genes may serve as the target genes of RNA interference to inhibit HSV-2 replication.

AIM: To investigate the chromatographic fingerprints of Guangyanling Injection(Syringa oblata Lindl) by HPLC. METHODS: The separation was performed on a Water SunFire~ TM C_ 18 4.6 mm?250 mm 5 ?m analytical column with the mobile phase consisting of methanol-water as gradient eluent at the flow rate of 1 mL/min. The UV detection was set at 280 nm. RESULTS: The HPLC-UV fingerprints of Guangyanling Injection was obtained with perfect isolation. CONCLUSION: The fingerprints could be used for the control of Guangyanling Injection.

Objective To investigate the expression changes of aspartic proteinase (cathepsin D) and cysteine proteinase (cathepsin K) in photoaged fibroblasts. Methods The senescence of human fibroblasts was induced via culture in the presence of 8-methoxypsralen (MOP) of 50 mg/L in darkness for 24 hours followed by irradiation with UVA of 80 kJ/m~2. Then, aged fibroblasts were confirmed by senescence-associated β-galactosidase (SA-β-gal) staining. Real-time RT-PCR and Western blot were carried out to detect the mRNA and protein expressions of cathepsin D and cathepsin K in photoaged and normal control fibroblasts, respectively. Results Western blot showed a significant difference between photoaged and control fibroblasts in the grey scale of cathepsin D and cathepsin K (3.25 ± 0.33 vs 14.18 ± 2.25, f = 30.61, P < 0.01; 2.39 ± 0.66 vs 29.38 ± 4.62, t = 12.63, P< 0.01). The △Ct values for cathepsin D and cathepsin K mRNA were 2.79 ± 0.17 and -0.92 ± 0.06, respectively, in photoaged fibroblasts, significantly lower than those in the control fibroblasts (4.54 ± 0.34, 2.57 ± 0.13, t = 20.78, 28.50, respectively, both P < 0.01). According to the value of 2~(-△△Ct), the expression of cathepsin D and cathepsin K mRNA decreased 0.24 ± 0.021 and 0.09 ± 0.005 folds, respectively, in photoaged fibroblasts compared with the control fibroblasts. Conclusion The expression of cathepsin D and cathepsin K is decreased in photoaged fibroblasts.

Objective:To study the time consumption of clinical trial projects in each link of contract signing in medical institutions and its influencing factors, to provide a reference for further optimizing the clinical trial management process and improving the efficiency of contract signing.Methods:All of the review records of projects that signed clinical trial contracts at Peking Union Medical College Hospital from January 1st, 2018 to December 31st, 2021 were retrospectively analyzed by comparing the time consumption in each link before signing the contracts and the frequency of contract reviews. Multiple linear regressions were applied to multivariate analyze the influence of different factors on contract signing.Results:A total of 761 clinical trial contracts signed at Peking Union Medical College Hospital from 2018 to 2021 were included in this study, and the average time consumption of contract signing was 127.0 days, among which the consumption of contract review by the hospital was 10.5 days and by sponsors was 99.0 days. The time consumption of contract signing has been decreasing in recent 4 years, from 154.0 days in 2018 to 104.0 days in 2021. The phase of clinical trials, category of sponsors, frequency of contract reviews, and different policies of the institutions were the main influencing factors for contract signing time ( P<0.05). Conclusions:Clinical trial institutions should optimize the contract approval progress, provide agreement templates and targeted service, and strengthen propaganda and information system construction, to improve the efficiency of reviewing and signing clinical trial contracts.