Objective:To study the efficacy of single itraconazole and combination with interferon-? against Candida albicans infection.Methods:Murine models of systemic candida albicans infection were established, and treated with different concentrations of itraconazol alone and combination with INF-?. Then the concentrations of colonyforming units(cfu) and histolo gical sections were observed to evaluate the emcacy. Results:The combination of 105U INF-? and itraconazole at the dosage of 10mg/kg showed better effect against Candida albicans than the combination of itraconazole at the dosage of 50mg/kg with 105U INF-?. Conclusion:The combination of itraconazole at a low dose with INF-? shows a good effect against Candida albicans.The single use of itraconazole at a high dose is also anti-infection.

AIM: To observe the efficacy, feasibility and safety of endovascular stent-grafts in treating aortic dissection.METHODS: Six patients with aortic dissecting aneurysm (3 males and 3 females, aged 32-67 years, average of 50 years old) were selected from Department of Cardiology, First Affiliated Hospital of Gannan Medical College between March 2005 and March 2006. They were diagnosed by transthoracic magnetic resonance imaging (MRI) and aortic angiography, and as type Ⅲ aortic dissecting aneurysm according to Debakey typing. The tumor diameter was ranged from 3.2 to 4.3 cm. The informed consent was obtained from all patients. Two weeks after the onset, the blood pressure was control between 90-110 and 60-70 mm Hg and heart rate at 60-65 times/min, then the straight circular and bifurcated stents, the product of Yuhengjia Company, composed of single naked membrane, straight circular and bifurcated stents made of nickel-titanium memory alloy, and cover of domestic artificial blood vessel were implanted with the patients generally anesthetized. The aortic dissection and general condition of patients after operation were observed with angiography, and the patient recovery condition was examined by spiral CT at postoperative months 3 and 12.RESULTS: All 6 cases were involved in the result analysis.①The diameters of stents for the patients were appropriate. The angiography showed that the thoracic aortic dissection in 4 cases disappeared, and thrombogenesis was found in false lumen; the thoracic aortic dissections in 2 cases disappeared, however, a little contrast agent was found in false lumen, but the blood flow was very slow. The general condition of all patients was good with stable vital signs, all patients discharged after 7-10 days.②CT results at 3 month after operation suggested that the original false lumen significantly contracted, and the true lumen restored to normal level. In case 3, there was mural thrombus in the distal stent that connected with stent vessel wall, and the thrombus hyperplasia was not obvious during follow up. At 12 months after operation, there was no distinct alteration in the stent location and appearance, and the life quality of patients was significantly improved.CONCLUSION: Endovascular stent-grafts are effective and safe in treating aortic dissection.

Objective To observe the clinical efficacy of filiform fire-needle therapy plus mild moxibustion in treating flat warts.Method Ninety patients with flat warts were randomized into group A, group B and group C, 30 cases in each group. Group A was intervened by filiform fire-needle therapy plus mild moxibustion, group B was intervened by filiform fire-needle therapy alone and group C by mild moxibustion alone. The three groups all received treatment 3 times a week, 2 weeks as a treatment course, for 2 courses in total. The clinical efficacies of the three groups were compared.Result In group A, 12 subjects were recovered, 13 showed improved, and 5 cases failed; in group B, 7 subjects were recovered, 12 showed improved, and 11 failed; in group C, 5 cases showed recovered, 10 were improved, and 15 failed. The total effective rates were respectively 83.3% in group A, 63.3% in group B, and 50.0% in group C, and the total effective rate in group A was significantly higher than that in group B and C (P<0.05). Conclusion Filiform fire-needle therapy plus mild moxibustion can significantly help the skin rashes subside in treating flat warts, and the therapeutic efficacy is obviously superior to that of either of the two methods used alone.

Objective To study the effects of insulin resistance on the occurance of hypertension in uremia. Methods With use of the oral glucose tolerance test (OGTT) and the insulin release test (IRT) , insulin glycoregulatory activity, including insulin sensitivity index (ISI) , glucose uptake rate (M) and the total areas under the glucose and insulin curves during OGTTs (AUCG, AUCINS) were investigated in 29 hypertensive (CRF-H) and 21 normotensive (CRF-NH) urernic patients and 12 healthy controls (C), and their plasma renin activity (PRA), angiotensin Ⅱ (AT Ⅱ) levels were investigated too. Results (1) Uremic patients had significantly higher blood glucose and serum insulin levels after glucose load, much higher AUCG and AUCINS values and significantly lower ISI and M values than the controls, compared with the CRF-NH patients, CRF-H patients had significantly higher blood glucose levels at 30', 60', 120', and higher serum insulin levels at 120' during OGTTS, significantly higher AUCG and AUCINS values, significantly lower ISI and M values and significantly increased incidences of insulin resistance and glucose intolerance; (2) Insulin resistant patients had more frequency and severe hypertension than the non-insulin resistant ones; simple regression showed that arterial blood pressure (SBP, DBF, MBP) had significant negative correlation with ISI and M, significant positive correlation with AUCG and AUCINS; (3) The levels of PRA, ATⅡbetween two CRT groups were not different; (4) Multiple linear regression showed that AUCG and AUCINS had significant positive correlation with MBP independent of age、 sex、 obesity、 the degree of real failure and plasma renin-angiotensin activity. Conclusion Insulin resistance 、 hyperinsulinemia and glucose intolerance or hyperglycemia may be one of the important mechanisms of uremic hypertension.

In order to improve the quality of epilepsy teaching,the appropriate version of the international classification of epilepsy and epileptic syndrome were selected to teach in the different level students by the way of PBL and clinical case analysis.The clinical thoughts and enthusiasm were improved.The classification of epilepsy could be grasped and easily used in their clinical work.

Objective To define the MRI features of biliary postoperative disoders,so as to find its exact causes.Methods MRI informations of 41 patients with biliary postoperative disoders were retrospectively evaluated to find whether there were such disorders as biliary dilatation,stricture,cholangeitis,remnant stones,remnant gallbladder,etc.Results The biliary abnormality was found in thirty-eight of the 41 patients,including ductal dilatation in 20,intraductal stones in 16,cholangietis in 13,ductal stricture in 7,tumors in hepatic hila in 3.The biliary dilatation commonly presented within 3 months after operation while the biliary stricture and cholangeitis presented commonly 6 months after operation.Conclusion The biliary postoperative disoders is mainly caused by biliary dilatation,stricture and remnant stone,MRI is the sensitive and effective method for diagnosis of biliary abnormalities.

Objective The aim of this study was to determine the research ability,explore the reasons and point out the direction to improve the research ability of nurses in our hospital.Methods 375 cases of nurses in clinical work in our hospital were chosen with random sampling method to investigate the research ability.Results The variability of research ability score of nurses under investigation was comparatively large.The minimum of scores was 10,the maximum was 113 and the average score was 55.34±25.01.Various scores were all relatively low.The general trend is that the higher the academic and professional titles,the better the research ability.The various scores were independent of administrative rank.Conclusion General research ability of nurses in our hospital was relatively weak.It is necessary to train nurses in our hospital,especially those with lower academic and professional titles to improve the general research ability.

Objective To explore the inheritance characteristics of SCN1A gene in familial severe myoclome epilepsy in infancy.Methods The clinical information and blood of the patients and their relatives who had febrile seizure(FS)or epilepsy history were collected.Blood genome DNA were extracted.All exons of SeN1A gene were PCR amplified and screened with denaturing high Performance liquid chromatography(DHPLC)technology,and sequence analysis was performed.Results Fourteen SME patients had FS or epilepsy family history.Five were found positive history in first class relatives and 2 of them had inherited mutations of SCN1A(C.4284+2T>C and e.1216G>T):Other9 were found positive history in second class relatives and 2 of them had de novo mutations of SCN1A.Condusions SCN1A is the pathogenic gene for SME.The same muatation of SCN1A gene can be related to different clinical phenotypes.SME patients whose first class relatives with FS or epilepsy history should be taken as the focus of SCN1A inherited mutation screening.

Objective To screen and analyze nucleotide variants in 5'-untranslated region(5'-UTR)in voltage-gated sodium channel α1-subunit gene(SCN1A)in patients with Dravet syndrome and to evaluate the association of the variants with disease.Methods Peripheral blood of 24 patients with Dravet syndrome and 100 unrelated normal persons were collected and genomic DNA was extracted.PCR-sequencing of SCN1 A 5'-UTR in these DNA was performed.To evaluate the possibility of mutation inducing disease,bioinformatics analysis was applied to analyze the conservation of the sequences around the mutation site and predict the potential transcription elements.Results The nucleotide variant of 166.642.520G→A in exon 2 was identified in two patients,but not in normal controls.The mutation was a de novo mutation in a patient with early-onset.In the second proband,the mutation was also carried by his clinically asymptomatic mother.The nucleotide site 166.642.520 was moderately conserved in mammals(62.5%).The average nucleotide identity rate between human and other mammals species in the region adjacent to 166.642.520 was 88.5%.Two potential transcription regulatory elements were predicted on the sequence with the mutation of 166.642.520G>A,and only one on the sequence with wild-type.Conclusions The mutation 166.642.520G>A may be associated with Dravet syndrome and further studied should be performed to verify it and demonstrate its pathogenic mechanisms.

Objective To analyze the causes of misdiagnosis and mistreatment of Dravet syndrome. Methods Patients with Dravet syndrome diagnosed according to clinical features and SCN1A gene mutation detection were recruited within recent 3 years. The patients were grouped into correct diagnosis-treatment group and misdiagnosis-mistreatment group according to whether the patients had ever been misdiagnosed and mistreated by sodium channel blockers. The clinical features were compared between two groups. Results Thirty-five cases with Dravet syndrome were collected and the rate of misdiagnosis reached 40%, Nine cases were misdiagnosed as symptomatic focal epilepsy, 4 as Lennox-Gastaut syndrome and 1 as Doose syndrome. The average age of onset in misdiagnosis-mistreatment group was (5.50 ± 3.56) months,and the age of confirmed diagnosis was (83.57 ± 105.62) months. The percentage of abnormal EEG, onset seizure with partial seizure, the seizure frequency within the first year from onset, onset with afebrile seizure, patients with status epilepticus or cluster seizures was higher in misdiagnosis-mistreatment group but it showed no significant statistical significance when compared with that of correct diagnosis-treatment group. The percentage of patients with mental retardation and focal neurological signs was significantly higher in misdiagnosis-mistreatment group (P=0.005 and 0.002, respectively). Conclusions Dravet syndrome is frequently misdiagnosed as symptomatic focal epilepsy. The appearance of focal neurological signs and mental retardation before confirmed diagnosis are important factors for misdiagnosis. Gene mutation screening will be helpful for differential diagnosis of Dravet syndrome.