Anticonvulsants ; administration & dosage ; therapeutic use ; Drug Prescriptions ; Humans ; Off-Label Use

Humans ; Orthodontic Appliances ; Sleep Apnea, Obstructive ; therapy

Objective To explore the role of phosphatidylinositol 3-kinase/protein kinase B(PI3K/AKT) pathway in recombinant human erythropoietin( rhEPO) protecting new type BPD. Methods Injected LPS or PBS to 40 spra-gue-dawley (SD) rats, gestational sacs on 15th day of gestation, the newborn rats were divided into four groups:control group, hyperoxia group, rhEPO group, rhEPO+LY294002 group. To detect the expression of lung tissue BCL-2 and Caspase - 9 protein and mRNA by Western blot and RT-PCR. Results In the hyperoxia group and rhEPO+LY294002 group, BCL-2 expression was decreased,while Caspase-9 expression was increased apparently;in the rhEPO group, BCL-2 expression was increased, while Caspase-9 expression was decreased. The differences between each group were statistically significant on 1st,7th and 14th day of hyperoxia exposure (P<0. 05). Con-clusion Intrauterine inflammatory exposure combined with hyperoxia after birth can cause lung cell apoptosis in-creases. While rhEPO has certain control effects on BPD, possibly by reducing the pulmonary apoptosis. The mechanism may be associated with PI3K/AKT signaling pathway.

Wavefront-guided laser in situ keratomileusis(LASIK)is onekind of the customized surgeries.It not only can increase the postoperative uncorrected visual acuity(UCVA)and best corrected visual acuity(BCVA),but also can lessen the increase of the higher-order aberration.Meanwhile,wavefront-guided LASIK can improve the scotopic vision,decrease the incidence of the glare and halo and enhance contrast sensitivity(CS).This subject focus on the problems as follows:(1)How to understand the affection that wavefront aberration made on the visual quality after LASIK?(2)How to get the wavefront measurements accurately and choose the surgery adaptation?(3)How to ascertain the gold standard to design the wavefront-guided LASIK?(4)How to transform the wavefront measurements into the optimized surgery scheme?(5)What problems should be paid attention to during the surgery?(6)What results the wavefront-guided LASIK should attain?

Accommodation is a phenomenon that crystalline lens change its refractive power when human eyes see the near objects clearly.The article of A brief talk on ‘ A novel concept of accommodation:Human eyes optical system based on hyperfocal distance-micro zoom'.written by Luo Fu-ming introduces a concept of hyperfocal distance from the camera.Based on the characteristic of hyperfocal distance,the author proposes that there are actually three kinds of hyperfocal distances in human eyes:far-hyperfocal distance,near-hyperfocal distance and accommodative hyperfocal distance.It is important to understand this article that whether the ciliary muscles contract to push the zonules in accommodation,and then the zonules are forced to push the lens equator,or the ciliary muscles contract to relax the tensional zonules,then the posterior surface of the lens moves forward.In view of the anatomic structure,the possibility that the ciliary muscles contract to push the zonule and then the slim zonules push the lens equator is less than that the ciliary muscles contract to relax the tensional zonules and then the posterior surface of the lens moves forward in accommodation.In my opinion,the contraction of the ciliary muscles would startup actively in accommodation.So when the eyes transfer from near vision to distance vision,the ciliary muscles (contracting circular muscles) will return to the relaxed normal state immediately.The crystalline lens will immediately recover to its original relatively flatten state by traction of the zonules,rather than passive compression.Because the crystalline lens is not the startup body but a supporting body in accommodation.The accommodation of human eye is very complicated.During the whole process of accommodation,there are not only contraction of ciliary muscles and increase of refractive power in crystalline lens,but also accompanied reaction of miosis and convergence.So it is difficult to explain the complex activity of human eyes using any extreme,mechanical and single mode.

Objective To compare the effects of continuous veno-venous hemofiltration (CVVH) and intermittent hemofiltration (IHF) on the hemodynamics and clinical outcomes of patients with type 1 cardiorenal syndrome. Methods From May 2008 to June 2011, 34 patients diagnosed with type 1 cardiorenal syndrome were admitted to our hospital and received CVVHQ9 cases) or IHF (15 cases). The general data, acute hemodynamic changes before and after hemofiltration and clinical outcomes at 28 days after hemofiltration were evaluated. Results There were no significant differences in the heart rates, diastolic blood pressure between the two groups before and after hemofiltration (P>0.05). The systolic pressure was similar between the two groups before hemofiltration (P>0.05), but that in the IHF group was significantly lower than that in the CVVH group after hemofiltration (P<0.05). No significant difference was found in the maximal mean pressure or blood pressure changes between the two groups at 48 h after hemofiltration(P>0.05), but the minimal mean pressure in IHF group was significantly lower than that in the CVVH group (P<0.05). The improvement of cardiac function and the mortality rates at 28 d after hemofiltration were not significantly different between the two groups(P>0.05). Multivariate analysis suggested that APACHE II was the main influence factor of 28-day mortality of patients, and APACHE II and net ultrafiltration were the main influence factor of the minimal mean pressure. Conclusion Compared with IHF, CVVH fails to greatly reduce the mortality of patients with type 1 cardiorenal syndrome. The severity of the disease is the main influence factor for the hemodynamic changes and the 28-day mortality of patients with type 1 cardiorenal syndrome.

Objective: To analyze the correlation of intervetebral disc degeneration with the diffusion values of lumbar vertebral discs and lumbar blood supply in patients with suspected lumbar intervertebral problems, so as to assess ADC value in diagnosis of intervertebral degeneration and the related blood supply. Methods: Sixty-five patients with suspected lumbar intervertebral problems were included in the present study; they had a mean age of (52.3±28.5) years and an age range of 16-76 years. Eleven of them had low back pain complicated with sciatica, 16 had low back pain without sciatica, 33 had sciatica without low back pain, and 5 had intermittent claudication. The disease course was 1-57 weeks, with a mean of (13.4±6.3) weeks. MR angiography and diffusion imaging were performed to evaluate the status of lumbar arteries and to obtain the ADC values of L1-4, so as to analyze the correlation of ADC values, lumbar blood supply, and intervetebral disc degeneration. Results: The ADC values of L1-4 were negatively correlated with the degeneration of lumbar discs (P<0.05). There was a relation between the artery status of L1, L2 and L3 with the degeneration of corresponding lumbar discs of L1-2, L2-3, and L 3-4, (r3 = 0.823, P = 0.016 3 ; r5 = 0.791, P = 0.019 2; r, = 0.835, P = 0.010 3). The artery status of L4 and the L4-5 discs was not significantly correlated with degeneration of corresponding lumbar discs(r3 =0.306, P = 0.209 2). Conclusion: The ADC values of lumbar intervertebral disc can reflect the degeneration of L 1-4 , and degeneration of L1-2, L2-3 is and L3-4 is correlated with the artery status of corresponding discs.

Objective: To explore the association of inflammatory cytokines including CRP (C-reactive protein), IL-6 (interleukin 6), IL-10 (interleukin 10), NF-κB (nuclear factor-kappa B) and Es (E-selectin) with acute lower extremity DVT (deep venous thrombosis) developed in hospitalized postoperative patients with abdominal/pelvic malignancies. Methods: Serum samples were obtained to examine the serum levels of CRP, IL-6, IL-10, NF-κB and Es in hospitalized postoperative patients with abdominal/pelvic malignancies who initially developed acute lower extremity DVT (group A, n = 40), and these serum cytokine levels of group A were compared with those of hospitalized postoperative patients with abdominal/pelvic benign diseases who also developed acute lower extremity DVS (group B, n = 20), the hospitalized postoperative patients with abdominal/pelvic malignancies who did not develop acute lower extremity DVS (group C, n = 40), and the healthy subjects who volunteered as normal controls (group D, n = 20). Results: The serum levels of CRP, IL-6, IL-10, NF-κB and Es in group D were significantly lower than those in groups A, B and C (P < 0.01). There was no significant difference in CRP level among groups A, B and C (P > 0.05). The serum levels of IL-6, NF-κB and Es in group A were significantly higher than those in groups B and C (P < 0.05). The serum level of IL-10 in group A was significantly lower than those in groups B and C (P < 0.05). Conclusion: Serum CRP level may not be used as an early predictor for the diagnosis of acute lower extremity DVT developed in hospitalized postoperative patients with abdominal/pelvic malignancies, but the serum IL-6, NF-κB and Es levels can be used as early predictors for this diagnosis. Copyright © 2013 by TUMOR.

Objective To analyse the maternal and perinatal morbidity after 40 weeks and postdate pregnancy,and to research suitable time of labor induction. Methods Clinical data of 357 pregnant women after 40 weeks with normal menstrual period were analysed.They were divided into four groups according to the different weeks of gestation. Results There were no significant difference in the four groups for maternal and perinatal morbidity,the rate of spontaneons labor,the degree of cervical repine and the successful rate of labor induction.The successful rate of artificial rupture of membranes was higher in the groups with Bishop score ≥6(P

The idiopathic generalized epilepsies (IGE) comprise two major groups: the classical IGE and generalized epilepsy with febrile seizures plus (GEFS+). The classical IGE syndromes include childhood absence epilepsy; juvenile absence epilepsy; juvenile myoclonic epilepsy; and epilepsy with generalized tonic-clonic seizures alone. GEFS+ is a familial epilepsy syndrome, characterized by a spectrum of phenotypes. The phenotypes of GEFS+ include febrile seizures (FS), febrile seizures plus (FS+), FS/ FS+ and absences, myoclonic, atonic or partial seizures, myoclonic-astatic epilepsy and severe myoclonic epilepsy of infancy. Our study of 121 individuals in 20 families, where 84 had previously recognized GEFS+ phenotypes, expands the phenotypic spectrum of GEFS+ syndrome to include afebrile generalized tonic-clonic seizures with generalized spike wave or normal EEG in the absence of FS. To date, there are three ion channel genes (SCN1A, SCN1B and GABRG2) confi rmed as having a role in GEFS+, but none has been implicated in the majority of patients with GEFS+ phenotypes, such as those found in small families. Indeed it is likely that in most families, GEFS+ is a polygenic disorder resulting from the cumulative effect of a number of genes of lesser effect rather than the genes so far characterized in the few large families ascertained. Small GEFS+ families and bilineal inheritance in some add support for complex inheritance in a signifi cant proportion of families. The phenotypes of classical IGE occur in some GEFS+ families. The percentage of classical IGE phenotypes is 9% (11/121) of affected individuals in our study. This suggests that classical IGE phenotypes and GEFS+ phenotypes overlap in some GEFS+ families. Our study provides new insights into the inter-relationship of GEFS+ and classical IGE, where shared genetic determinants probably account for the overlap of these syndromes in some families.