OBJECTIVE:To observe the efficacy and safety of topiramate in treatment of epilepsy METHODS:15 patients with refractory epilepsy treated with topiramate as additive drug and 61 newly-diagnosed epileptic patients with topiramate as monotherapeutic agent entered the open-label trial and were followed-up RESULTS:Among 15 patients with refractory epilepsy, the frequency of seizure decreased by 50% or greater in 10 cases with an effective rate of 66 7%, and 2 patients were free from seizure;among 61 newly-diagnosed cases, the frequency of seizure reduced by 50% or more in 45 cases(73 8%), and 16 cases were free from seizure(26 2%) The ARDs were lower in incidence and mild in severity CONCLUSION:Topiramate was safe and effective as additive or monotherapeutic agent for multiple types of seizure

OBJECTIVE: To establish a HPLC assay for determining cassiaside B in rabbit plasma .METHODS: The proteinin sample was first denatured with methanol .The ?-- Bondapak C_(18) colurnn(3.9mm?300mm, 10?m) was used with a mobilephase of acetonitrile -- water -- THF -- glacial acetic acid(20:76.5:3.0:0.5) .The flow rate was 1.0ml/ min .Detecting wave-length was 278nm .RESULTS: The caliblation curve of cassiaside B was C=9.102?10~(-2)+4.871?10~(-5)R(r=0.9999) .Theaverage recovery of cassiaside B in plasma was (100.8?1.139)% .The relative standard deviations of intra -- day and inter -- dayassay were less than 2.08% .The detection limit in plasma was 0.05?g/ml .CONCLUSION: The method is sensitive and accu-rate. It is suitable for the pharmacokinetic study of cassiaside B.

BACKGROUND: Distally based flap pedicled with the distal nutritional vessels in forearm is especially suitable for reconstructing the tissue defects in the distal end of hands, while high rotation point cannot satisfy the requirements of reconstructing the distal injuries or defects in hands, and severer lesion may even be caused in the donor site.OBJECTIVE: To study the anatomic proceeding of artery perforators in distal radial margin of forearms, so as to provide anatomic basis for the design of distally based compound flap pedicled with the nutrient vessel of cephalic vein in distal radial margin of forearms.DESIGN: Single sample experiment.SETTING: Center for Clinical Anatomy of the Department of Orthopedics,Fuzhou General Hospital of Chinese PLA of Nanjing Military Area Command.MATERIALS: The experiment was conducted in the Laboratory of Center for Clinical Anatomy of Department of Orthopedics, Fuzhou General Hospital of Chinese PLA of Nanjing Military Area Command between August and December 2004. The upper extremities of 30 cadavers injected with a mixture of red gelatin into the artery (provided by the Center for Clinical Anatomy of Department of Orthopedics, Fuzhou General Hospital of Chinese PLA of Nanjing Military Area Command) were adopted.METHODS: The vascular external diameter and distance were measured with sliding caliper and ruler with radial styloid process as the marker.MAIN OUTCOME MEASURES: ① The perforator artery in distal radial margin of forearms. ② The nutrient vessels of cephalic vein. ③ The relationship of blood supply between the nutrient vessels and vicinal bone and skin as well as the lateral antebrachial cutaneous nerve. ④ The superficial and deep communicating branches of cephalic vein.RESULTS: The perforator artery in distal radial margin of forearms derived from: 6-11 cutaneous branches of radial artery with external diameter of (0.7±0.3) mm; 2-6 cutaneous branches of superficial palma with the external diameter of (0.5±0.3) mm; 1-2 recurrent cutaneous branches of the styloid process of radius with the external diameter of (0.5±0.1) mm; 1-2 cutaneous branches of snuff tobacco with the external diameter of (0.6±0.2) mm. At 8.0-15.0 cm above radius styloid process there were 1-3 intermuscular cutaneous branches of radial artery with an initial external diameter of (1.1±0.2) mm, distributing in the exposureregion and corresponding skin of middle and inferior segments in radius. The above-mentioned perforator arteries all developed into cutaneous branch, fascia branch, periosteum branch, cephalic vein and nutrient vessel branch of distal cutaneous nerve,and constituted the vascular chain, the by-pass of cephalic vein, vascular chain of cutaneous nerve stem as well as superficial, deep fascias and periosteal vascular net.CONCLUSION: The perforator artery in distal radial margin of forearms is the source of nutrient vessels in cephalic vein, while the nutrient vessels share an isogeny with the nutrient vessels derived from vicinal bone, skin and lateral antebrachial cutaneous nerve, which provide an anatomic basis for designing the distally based compound flap pedicled with the nutrient vessels of cephalic vein. The rotation point of compound flap pedicled with the recurrent branch of radius styloid process (or branch of snuff tobacco) can reach the surface of rotation joint, which can be adopted in the transposition and reconstruction of distal tissue defects in hands.

Employed staffs in military hospital are the basic power in the development of hospital, and they are playing an im-portant role in the military medical security.The article gives a detailed elaboration on the innovation and practice of employed staff man-agement in our hospital.In order to improve the efficiency and scientific management level of employed staffs, the innovative measure-ments in employment pattern, post management, education development, policy system, promotion passage are put forward in combination with current situation of employed staff in order to promote the construction of employed staffs and the development of the hospital.

Objective:To establish an HPLC method for the determination of the content of magnolol and honokiol in Cortex mag-noliae Officinalis formula granules and compare the content of the formula granules from different manufacturers. Methods:An HPLC was used to determine the content of magnolol and honokiol in Cortex magnoliae Officinalis formula granules. The analysis was carried out on a Hypersil C18 (250 mm × 4. 6 mm, 5 μm) chromatographic column. Acetonitrile-water was used as the mobile phase with gra-dient elution and the flow rate was 1. 0 ml·min-1 . The detection wavelength was set at 294 nm, the sample size was 20 μl and the column temperature was 25℃. Results:The linear range was 0. 873-26. 190μg·ml-1(r=0. 999 5) for magnolol, the average recov-ery was 99. 24% with RSD of 2. 00%(n=6) and that was 0. 732-21. 980μg·ml-1(r=0. 999 0) for honokiol,and the average recov-ery was 99. 89% with RSD of 1. 33%(n=6). The difference in the content of magnolol and honokiol in Cortex magnoliae Officinalis formula granules from different manufacturers was notable. Conclusion: The method is simple, repeatable and feasible, and can be used for the quality control of magnolol and honokiol in Cortex magnoliae Officinalis formula granules. The content difference in magno-lol and honokiol in Cortex magnoliae Officinalis formula granules from different manufacturers suggests that it is necessary to standardize the planting and selecting of Chinese medicine, and develop scientific and unified production technology and quality standard for the formula granules.

Objective To investigate the relationship between the polymorphisms of plasminogen activator inhibitor-1(PAI-1)gene and the level of endothelium-dependent vasodilatation (EDF) in patients with type 2 diabe- tes(T2DM).Methods The polymorphisms of PAI-1(4G/5G)gene were determined by polymerase chain reaction (PCR)and the EDF was assessed by non-invasive hish resolution B-mode ultrasonography in 66 T2DM patients and 33 controls.Plasma plasminogen activator inhibitor type-1(PAI-1)and fibrinogen(Fg)were measured.Results Frequencies of PAI-1 alleles and genotypes in T2DM patients and controls were all in accordance with the Hardy Weinberge quilibrium,without significant differences between T2DM patients and controls(P>0.05).PAI-1 and Fg were significantly higher in T2DM patients than in controls.There were significant differences in EDF and PAI- lamong different genotypes of PAI-1(P<0.05).Conclusion The PAI-1 genotype may affect EDF in T2DM pa- tients.

ObjectiveTo investigate anatomical characteristics of the medial foot vessels and effects of different vascular pedicle skin flaps in repair of foot and ankle trauma.MethodsThirty adult cadaveric lower limbs were injected with red latex through the popliteal artery and posterior tibial artery to anatomically observe the cutaneous arterial origin,branches,distribution and anastomosis of the medial foot.Then,anterior medial malleolar artery perforator flaps and distally-based medial foot flaps were harvested and used for repairing foot and ankle trauma of 16 patients.Results The origin of cutaneous blood vessels of the medial foot was diversified and mainly included the anterior medial malleolar artery,medial tarsal artery,and arterial arcades anastomosing with anterior posterior branches of the two former arteries and the superficial branches of plantar digital artery and the medial plantar artery.According to distribution area of the anterior medial malleolar artery and the medial tarsal artery,the vascular anatomy of the medial foot skin was classified into three types.Clinically,all the flaps survived.Follow-up ranged from 2 weeks to 20 months,which showed normal color,good shape and good pain and warm sensation of the flaps.ConclusionThe anterior medial malleolar artery perforator flaps present good reconstruction of soft tissue defects around the ankle,whereas the distally-based medial foot flaps present good reconstruction of soft tissue defects of the mid-forefoot.

Objective: To explore influence of rehabilitative exercise on left ventricular hypertrophy (LVH), diastolic function and blood pressure in patients with hypertension.Methods: A total of 120 patients diagnosed as essential hypertension complicated LVH in our hospital were enrolled.They were randomly and equally divided into routine treatment group (received routine antihypertensive treatment) and rehabilitative exercise group (received rehabilitative exercise based on routine antihypertensive medication).Blood pressure control rate on four, eight and 12 weeks after treatment, color Doppler echocardiographic outcomes before and 12 weeks after treatment were compared between two groups.Results: Blood pressure control rate after 12 weeks in rehabilitative exercise group was significantly higher than that of routine treatment group (76.7% vs.58.3%, P=0.03).Echocardiography indicated that compared with before treatment, there were significant improvements in left ventricular diastolic function and LVH indexes except left ventricular end-diastolic dimension in both groups after treatment, P<0.01 all;but there were no significant difference in left ventricular diastolic function and LVH indexes between two groups after treatment, P>0.05 all.Conclusion: Rehabilitative exercise training can significantly improve blood pressure control rate in patients with essential hypertension.Short-medium term exercise training fails to significantly improve left ventricular hypertrophy and diastolic function than routine treatment group, the effect of long-term training needs to be confirmed by more researches.

Objective To explore the improving way to repair the lower one-third of leg soft tissue defect transferred the adjacent flap with non-main vessel pedicle. Methods Analyzing 42 cases.using 4 kinds flaps with nonmain vessel pedicle.If it is fine the skin around soft tissue defect of the lower one-third shank,choosing adjacent adversed sural neurotaneous vascular flap or sapheenous nerve vascular flap.If the skin damaged,chosing gastrocnemius flap.If the soft tissue defect was large,combined adversed sural neurotaneous vascular flap with gastrocnemius flap.Osteomyelitis and peroneus previs musculocutaneous flaps were choosed for small soft tissue defect. Results All case observed 6 to 12 months,37 cases were survived completely,5 cases distal part necrsis partly,among them,2 cases transferred flap repaired;1 case musculocutaneous flap transferred, 2 cases after granulation tissue grown,skin grafted. Conclusion The flap transferred adjacent non-main vessel pedicle is the best way to repaire soft tissue defect of one-third lower leg.Different flap can fit with kinds of soft tissue defect.

OBJECTIVE:To explore the changes of serum phenytoin levels and its pharmacokinetics in menstrual epilepsy.METHODS:9cases of menstrual epilepsy patients who were treated with phenytoin were collected,whose blood concentra?tions of phenytoin in menstrual period and ovulation period were respectively determined by HPLC,pharmacokinetics study was performed in three of them.RESULTS:The mean serum phenytoin levels in menstrual period and ovulation period were(9.25?2.71)?g/ml and(13.33?3.22)?g/ml,respectively(P