The article introduced advances of pharmacokinetic studies of topiramate, a new antiepileptic agent, in recent years. Topiramate pharmacokinetic parameters were determined after the administrations of single dose, multiple dose and concomitant therapy. The changes of its pharmacokinetic parameters were determined in the influence of the factors, for example, age, disease, and so on. These results have revealed the regulations of metabolism and excretion of topiramate in the healthy volunteers and patients. The data provide a basis of clinical rational medication for the patiens with epilepsy.

Objective: To develop parental punishment style the questionnaire. Methods: Based upon previous literature about parental punishment style and expert interview, data were collected for the parental punishment style questionnaire. A sample of 1028 junior high school students were asked to complete the questionnaire and 158 of them was given retest after a month. Results: Taken from the questionnaire by exploratory factor analysis four factors were compatible. The results of confirmatory factor analysis showed a good fit to the data. The internal consistency reliability of father and mother questionnaire was satisfactory, with Cronbach ? coefficient 0.91; and the test-retest reliability was also satisfactory, with test-retest correlation coefficient 0.88 and 0.89, which showed good content validity and high construct validity. Conclusion: The questionnaire has good reliability and validity, and meets the need of psychometrics.

As a technique which can assess both the micro-vascularization and macro-vascularization of the tumor,contrast-enhanced ultrasound have been developed rapidly,and its researches in thyroid nodules check and differentiation has became more and more widely.Different infusion modes in the diagnostic of thyroid nodules are really meaningful.The development of CEUS and identification of thyroid nodules will be reviewed in this article.

Objective To study the influence of carbon dioxide pneumoperitoneum on BIS and oxygen metabolism in patients underwent laparoscopic hysterectomy in propofol and sevoflurane anesthesia. Methods 100 cases undergoing laparoscopic hysterectomy were selected in the second hospital of Shandong university and were divided into group A and group B, 50 cases in each group. Group A were received propofol and group B were received sevoflurane anesthesia . The oxygen metabolism index in the two groups were compared before and after pneumoperitoneum. Results The PETCO2 of two groups at the time points after pneumoperitoneum were significantly higher than those before pneumoperitoneum (P<0.05). There was no significant difference of the SpO2 in two groups at the different time points during pneumoperitoneum, The HR and MAP of the group A were significantly lower than that of group B (P<0.05). There were no significant difference of the PETCO2、SpO2 between two groups. Bis in 2 groups maintained a stationary state before and after pneumoperitoneum. There was no significant difference in the period between the two groups. The CjvO2、Lac of two groups were significantly higher than that before pneumoperitoneum (all P<0.05).The CjvO2、Lac of two groups were significantly lower than that before pneumoperitoneum (all P<0.05). The CjvO2 of group A at 40 minutes after pneumoperitoneum were higher than that of group B (P<0.05), and the level of CERO2、Da-jvO2 were lower than that of group B (P<0.05). But there were no difference of the BIS、CaO2 and Lac between two groups. Conclusion Carbon dioxide pneumoperitoneum can affect the BIS and oxygen metabolism in patients underwent laparoscopic hysterectomy. The effect in propofol anesthesia was more significant than that in sevoflurane anesthesia.

Objective To evaluate the clinical effect of Liyanjiedu decoction for the prophylaxis and treatment of acute radiotherapy-induced oral mucositis of nasopharyngeal carcinoma(NPC)and the influence to the effect of the radiotherapy to NPC.Methods A total of 96 patients with NPC were randomly divided into treatment group and control group,48 cases for each group.The two groups were given radical radiotherapy.The treatment group was given Liyanjiedu decoction for buccal.The control group were given western medicine for mouthwash.The course of two groups was all from the beginning of radiotherapy to the end of it.Results The occurring time of radiotherapy-induced mucositis in treatment group and control group were(21?4.2)d and(16?3.6)d,and radiotherapeutic dose were(40.252?11.758)Gy and(29.625? 11.632)Gy,with significant difference between the tow groups(P

Objective To explore the methods of the hemorrhage prevention and the measures of hemostasis by CT guided after renal cancer cryoablation.Methods Retrospective analysis of 8 patients of renal cell carcinoma patienthave been done,all the patients were underwent cryoablation.The basic model included 10 min frozen,3 min thawed and 1 cycle were repeated.Before the cryoprobe puncture,a CT scan was taken to observe the blood supply of the tumor and the relationship between the border of the tumor and renal cortex,renal pelvis.Besides,the path of reducing the injury of normal renal cortex and renal pelvis was chosen,and the decreased number of probes was adopted by taking conformal cryoablation to reduce the damage to the renal capsule,in theensurance of the treatment efficacy.Intraoperative CT scan was performed discontinuously,to observe the covering status of the range of ice ball on the lesion and to monitor the perirenal bleeding.Postoperative ECG and blood pressure changes was observed 24 h after operation.Besides,CT scan or blood routine examination is necessary to monitor whether active bleeding happened.Results According enhanced CT image positioning puncture path,the path of probes were selected in the shortest path between the tumor margins and the renal cortical which avoid the renal pelvis.Probes were CT-guided conformal puncture into the lesion successfully for 8 patients,according to freezing basic mode to complete cryoablation.Timely intraoperative CT scan can clearly observe that a low-density ice ball wrapped lesion completely without involving the renal pelvis and normal tissue surrounding the kidney.There was no bleeding in the procedure of cryoablation.After the probe was pulled,CT scan showed:3 of the 8 patients didn't show any sign of henorrhage,in which 1 patient had heavily bleeding,about 150 ml due to the biopsy after cryoablation.The bleeding was stopped by interventional embolization.A little hemorrhage was found in two patients,about 10 ml outside renal capsule.Medium hemorrhage took place in two patients,30 nl in one patient which underwent several cycles of thawing and 60 ml in another.The patients of mild and medium hemorrhage was treated with intravenous injection of Reptilase and strict bed rest.There was a great hemorrhage in one patient,about 200 ml.The bleeding was stopped by interventional embolization.A small and moderate bleeding,it necessary to execute intravenous infusion 2 IU reptilase and strict bed rest.There was no significant active bleeding from the CT scan after 24 h operation and no change in the blood routine examination of blood hemoglobin and red blood cell count.Conclusions Before the puncture,it is necessary to perform an enhanced CT scan to understand the position,which can determine the path of the puncture.It can reduce the damage of renal cortex,renal capsule and surrounding tissue and prevent and reduce the risk of bleeding.For larger amounts of intraoperative and postoperative bleeding subjects,the embolization should be given immediately,as for the small or moderate amount of bleeding,the conservative treatment may be given firstly.

Objective To evaluate the clinical efficacy and safety of methotrexate(MTX) plus low dose glucocorticoid in the treatment of rheumatoid arthritis (RA) from thetarget control point of view.Methods Patients diagnosed as RA according to American College of Rheumatology(ACR)/European League against Rheumatism (EULAR) 2010 classification criteria were enrolled.All of the patients were prescribed with 15 mg/week MTX,5 mg/week folic acid and prednisone (not exceeding 10 mg/day) orally.At week 0,4,12,disease activity and clinical efficacy were recorded.Co-primary assessment criterion was disease activityscore (DAS28)-based on C-reactive protein (CRP).Secondary assessment criteria included EULAR response criteria,ACR response criteria,simplified disease activity index(SDAI),clinical disease activity index(CDAI).The tolerability and toxicity of MTX was recorded at week 4,12.All patients were evaluated for the occurrence of adverse drug reactions associated with prednisone at week 12.Results A total of 76 patients were enrolled in the study.At week 4 and 12,68 and 65 patients completed regular follow-up respectively.At week 12,there were 30(46.2％),9(13.8％),26(40.0％) patients who met DAS28-CRP remission,low disease activity,middle and high disease activity criterion respectively.Three of nine patients who grouped in low disease activity after therapy were early or intermediate patients and didn't reach the target.Thus 36 (55.4％) patients met the standard of target control.The percentage of patients who met the criteria of EULAR good response,the ACR criteria for 20％ improvement (ACR20),the ACR criteria for 50％ improvement (ACR50),the ACR criteria for 70％ improvement (ACR70) were 29.2％,75.4％,69.2％,64.6％,respectively.The proportion of patients meeting the standard of treat to target using SDAI and CDAI were 76.9％,58.5％ respectively.The rate of liver injury,abdominal pain,abdominal distention and acid reflux,nausea were 11.8％,4.4％,4.4％,2.9％ respectively at week 4.At week 12,4.6％ of patients reported abdominal distention.There was only one patient (1.5％) each who complained of abdominal pain,nausea,loss of hair,varicella zoster virus infection and pulmonary infection at week 12.No serious adverse event was observed during the study.Conclusions Based on the view of target control,drug efficacy and safety,MTX plus low dose prednisone is still a useful therapeutic regimen for RA at present.

The connotations of "du-fu" and "Sanli" in "Sanli acupoint for du-fu diseases" are discussed in this paper, which can provide theoretical foundation for the clinical application of "Sanli acupoint for du-fu diseases". Based on ancient literature combined with related theories in the Huangdi Neijing (Yellow Emperor's Canon of Internal Classic), a deep discussion is performed through the relationship between Zusanli (ST 36) and stomach, indication and mechanism of Zusanli (ST 36) on du-fu diseases and comparison between Zusanli (ST 36) and Shousanli (LI 10). It is believed that "du" should be pronounced as "dŭ", meaning stomach, and it indicates that Zusanli (ST 36) is closely related to stomach and spleen when it is used for du-fu diseases; "fu" means abdomen area, including liver-gallbladder, spleen, stomach-intestine, kidney, uterus, triple energizer; "sanli' means exclusively the acupoint of Zusanli (ST 36).
Abdominal Cavity ; anatomy & histology ; Acupuncture Points ; Acupuncture Therapy ; history ; Books ; history ; China ; History, Ancient ; Humans ; Medicine in Literature ; Meridians

This study is to investigate the inhibitory effect of lidamycin (LDM) and its combination with methotrexate (MTX) on lung metastasis of fibrosarcoma by bioluminescence imaging in athymic mice. A stable luciferase transfected HT-1080 cell line was constructed and the capability to establish experimental lung metastasis in athymic mice was confirmed. The optical imaging system was applied to evaluate the formation of lung metastasis in vivo. In addition, metastatic nodules were counted for the evaluation of inhibition rates. As shown, the fluorescent intensity of luciferase-transfected HT-1080 cells was colinear with the cell population and the minimal detected cell population was 100 cells/well. Optical imaging showed that the fluorescent intensity of treated group was apparently lower than that of the control. The inhibition rates of lung metastasis by LDM alone at 0.025 mg x kg(-1) and 0.05 mg x kg(-1) were 53.9% and 75.9%, respectively, while that of MTX alone at 0.5 mg x kg(-1) was 70.2%. The combination of LDM at 0.025 mg x kg(-1) and MTX at 0.5 mg x kg(-1) showed an inhibition rate of 88.7%. The coefficient of drug interaction (CDI) was 0.82. The results herein demonstrated that LDM alone had strong anti-metastasis effect on human fibrosarcoma HT-1080 and the inhibition efficacy is strengthened when combined with MTX.

Objective To investigate clinical significance of counting follicles classification by three-dimensional imaging with sonography based automated volume calculation(SonoAVC)in the diagnosis of polycystic ovary syndrome(PCOS).Methods Eighty cases with PCOS were counted classified follicles and determined ovarian volume by three-dimensional(3D)imaging with SonoAVC method matched with 60 infertile women with fallopian tube or male factors as control.Main clinical.biological and other ultrasonographic markers were assessed during the early follicular phase,and the relationship between the follicle number range per ovary or the volume per ovary and the major hormonal features of PCOS was studied.Results Three-dimensional ultrasound imaging with SonoAVC methed provides a new path for objective quantitative assessment of follicle count.ovarian volume,total follicle numbers.The volume of (11 ±8)ml,total numbers of 27 ±14 follicle and number of22 ±19 follicle with diameter of≥2-＜6 mm in PCOS patients were significantly higher than(6 ±4)ml in ovarian volume.6 ±4 in total follicles and 2 ±3 in follicle with diameter of≥2-＜6 mm in controls(P＜0.05).while follicles were similar for the≥6-≤9mm range(P＞0.05).Total follicle numbers and follicles≥2-＜6 mm had significantly positive relationships with ovarian volume ( r= 0. 600, 0. 618, P＜0. 01 ) and level of testosterones ( r= 0. 364,0. 291, P＜0.05), follicles ≥2-＜6 mm also had significantly positive relationships with total follicle number (r=0. 916,P＜0. 01 ). The follicles within the ≥6 - ≤9 mm range was significantly and negatively related to ovarian volume and total follicle numbers ( r = - 0. 618, - 0. 263, all P = 0. 001 ), but no significantly related to the major hormonal features of PCOS. The ovarian volume was significantly positively related with luteinizing hormone ( LH)/follicle stimulating hormone (FSH) ratio ( r= 0. 282, P = 0. 010)but negatively related to FSH level (r = - 0. 226, P = 0. 042). Conclusions Ovarian volume, total follicle numbers and follicles ≥2 - ＜6 mm in PCOS patients were significantly higher than those in controls. The larger ovarian volume might produce more total follicle and follicles ≥ 2 - ＜6 mm. The higher level of testosterone might produce more total follicle probably, which mainly result in more follicles ≥2 -＜6 mm.These morphologically ultrasonographic characteristics could reflect pathophysiological changes in PCOS. Obviously, it has important clinical significance to count follicles in patients with PCOS by the threedimensional ultrasound imaging with SonoAVC method.