Objectives To evaluate the valproate plasma l ev els,the clinical efficacy and adverse effects in patients with epilepsy treated with the conventional preparations and the sustained-release preparations of sodium valproate (VPA-Na?SR).Methods 33 patients received oral conventional formul ation of sodium valproate for over six months and a similar dosage of VPA-Na?SR for 4 weeks.After 12 or 24 hours,the valproate plasma concentr ations of the two formulations were measured respectively before taking drugs in the early mor ning.The valproate plasma concentrations and the clinical efficacy of the VPA-N a?SR were assessed by comparing with that of conventional valproate.The adverse effects were recorded.Results The average valproate plasma trough concentration was s ignificantly higher in patients receiving VPA-Na?SR than that of those receiving conventional valproate.Seizure free in patients was achi eved by 76%(n=25) with VPA-Na?SR and by 45%(n=15) with conventional valproate resp ectively.There was statistical difference between the two formulations.The seizu re frequency was significantly reduced in 5 patients treated with VPA-Na?SR.A dverse ef fects were observed in 2 patients with conventional valproate,5 patients with V PA-Na?SR whose valproate plasma levels were higher than that of conventional p reparations.Adverse effects were related to increased valproate plasm a levels and individual drugtolerance. Conclusions The advantage of VPA-Na?SR is that serum valproa te con centrations may increase smoothly and minimize fluctuation in serum dr ug concentrations during a dosing interval. It is a more effective and more convenient antiepileptic agent.

Objective To study the levels of serum C -reactive protein (CRP),plasma fibrinogen (Fib),D-dimmer(DD)in the first onset young patients with acute progressive cerebral infarction.Methods 42 first onset young patients with acute progressive cerebral infarction(PIS group),50 cases of non -acute progressive cerebral infarction(N -PIS group)and 90 healthy people(health control group)were enrolled.The levels of serum CRP, plasma Fib and DD were detected and compared.Results PIS group:CRP (3.764 ±0.832)mg /L,Fib (3.994 ± 0.851)g/L,DD (1.560 ±0.225)μg/mL;N -PIS group:CRP (2.573 ±0.657)mg/L,Fib (2.468 ±0.739)g/L, DD (0.740 ±0.162)μg/mL;health control group:CRP (1.725 ±0.326)mg/L,Fib (2.103 ±0.584)g/L,DD (0.450 ±0.131)μg/mL.The levels of serum CRP,plasma Fib and DD of PIS group were higher than the other two groups(CRP:PIS group vs.N -PIS group t =8.89,PIS group vs.health control group t =13.99,N -PIS vs.health control group t =8.55,all P <0.01;D -D:PIS group vs.N -PIS group t =23.82,PIS group vs.health control group t =29.46,N -PIS group vs.health control group t =12.59,all P <0.01;FIB:N -PIS group vs.health control group t =2.85,P <0.05,PIS group vs.N -PIS group t =10.06,PIS group vs.health control group t =13.48,all P <0.01).Conclusion The levels of serum CRP,plasma Fib and DD are related to acute progressive cerebral infarction.

The medication characteristics of doctor ZHENG Chong-guang in Qing Dynasty was studied from prescription metrology range index,including properties,tastes,channel tropism and function index.It was found that his clinic prescription practice was different from other doctors in Jiangzhe province which originated from his territory character,the territory character of Xin'an school was disclosed,it was suggested that prescription metrology range index was an valuable impersonal index for doctor's territory character.

Objective To explore the effect of Shen-Fu injection(SFI,参附注射液) on expressions of heme oxygenase-1(HO-1) and inducible nitric oxide synthase(iNOS) in renal failure induced by intestinal ischemia-reperfusion injury(IRI) in rats and its possible mechanism in the protection of kidney.Methods The model of intestinal IRI was induced by clamping superior mesenteric artery(SMA) for 1 hour and then releasing the arterial clamp for 6 hours.Thirty-six male Wistar rats were randomly divided into three groups: IRI model group,SFI pretreatment group and sham operation group.In the SFI pretreatment group,10 ml/kg of SFI was pumped in at constant rate 30 minutes before the ischemia,the SMA was clumped for 1 hour and then released,while in the IRI model group,an equal volume of normal saline was pumped in continuously 30 minutes before the ischemia.The serum creatinine(SCr) and blood urea nitrogen(BUN) were observed respectively.Expressions and distributions of HO-1 and iNOS in the rat kidney tissue were detected by immunohistochemitry and morphometry computer image analysis.The histological changes of kidney were observed under light microscope.Results The expressions of HO-1 and iNOS were markedly higher,and the levels of SCr and BUN were also significantly higher in intestinal IRI model group than those in the sham operation group(all P

Objective To compare the characteristics of digital subtraction angiography ( DSA) and compu-ted tomography angiography ( CTA) of moyamoya disease .Methods To analyze the characteristic of DSA and CTA in 29 cases with moyamoya disease ,including arterial occlusion ,arteriarctia,abnormal proliferation of vascular ,collat-eral circulation.Results There were no statistically significant differences between DSA and CTA in detecting arteri-al occlusion,arteriarctia(CTA 53 hemicerebrum,DSA 57 hemicerebrum)(χ2 =2.167,P>0.05),abnormal prolifera-tion of vascular (abnormal:CTA 41 hemicerebrum,DSA 45 hemicerebrum;normal:CTA 16 hemicerebrum,DSA 12 hemicerebrum)(χ2 =0.757,P>0.05).But there was statistically significant difference between DSA and CTA in detecting collateral circulation .Conclusion CTA is a good method to find out moyamoya disease .But DSA is better in discovery collateral circulation of moyamoya disease .

Objective To explore the therapeutic effect of choledochojejunostomy with a subcutaneous blind loop of interposed jejunum for treating postoperative residual biliary stones.Methods The clinical data of 72 cases of choledochojejunostomy with subcutataneous blind loop of interposed jejunum were retrospectively analysed.Results After exploration of distal common bole duct,and when a No.8-10 bougie could pass through the sphincter of Oddi,a 10-15 cm segment of jejunum with its vascular pedicle was mobilized,and an end to-side choledochojejunal anastomosis was performed at the proximal side of the jejunal segment and its distal end was converted to a blind loop and fixed subcutaneously to relevant abdominal wall.A T-tube for external drainage was inserted across the choledochojejunal anastomosis and exited through the blind jejunal loop.Seventy-two patients were cured without any complication or mortality.Conclusions The procedure is simple and minimally invasive,so that it could be carried out very easily and quickly by general surgeons with basic choledochojejunostomy skill.

Objective To investigate the protective effect of N-acetylcysteine(NAC) on the development of myocardial hypertrophy in diabetic rats induced by streptozotocin. Methods Male SD rats were randomly divided into normal control (NC), control treatment (NCT), diabetic (DM) and diabetes treatment (DMT) groups. NAC was administered at dose of 1.4～1.5g·kg~(-1)·d~(-1) to NCT and DMT groups in the drinking water for 8 weeks. At termination the rats were surgically prepared for hemodynamic measurement, such as systolic blood pressure, heart rate, the rate of left ventricle relaxation (-dp/dt) and the time to maximum relaxation (T). Subsequently, the hearts were removed to assay relative ratio of left ventricle weight versus body weight (LVW/BW) and cardiomyocyte cross sectional areas.Plasma glucose, insulin, 15-F_(2t)-isoprostane(15-F_(2t)-Isop) concentration and superoxide dismutase (SOD) activity were analyzed. Results The LVW/BW ratio and cardiomyocyte areas were significantly attenuated by NAC treatment as compared to DM group (P＜ 0.05). Increases in -dp/dt and SOD activity and the decreases in glucose, 15-F_(2t)-Isop T (P＜ 0.05) were found at the same time. Conclusions NAC can effectively prevent the development of myocardial hypertrophy and improve diastolic function in diabetic rats, which may be related to its antioxidant capacity.

Objective To summarize the experience of nursing patients undergoing NovaSure endometrial ablation. Methods Two hundred and eleven patients with abnormal uterine bleeding claiming no need of giving birth,who were hospitalized in our hospital during August 2011 to April 2013,were managed with NovaSure endometrial ablation and nursing care was performed.Follow-ups were conducted for investigating the curative effects.Results All the patients lived through the operations,their life signs were stable.As for the adverse effects,124 of them had mild abdominal pains,7 medium-level or severe hypogastralgia,1 dizziness and nausea,10 uterial hematocele,and 1 cystitis.All of them got recovered after treatment.One-month follow-up after hospitalization showed a success rate of 98.0%.Conclusions NovaSure is a new approach to abnormal uterine bleeding.It is advantageous for its simplicity,shortness in operation duration,less trauma to patients and good effects.Meanwhile,preoperative mental care and cooperative care during operation may facilitate their recoveries.

Objective To evaluate the changes in water, electrolyte and acid-base balance after seawater immersion in cases of open abdominal trauma associated with intestinal rupture, and to obtain a theoretical basis for the early treatment of open abdominal injury with intestinal rupture in naval combat. Methods A canine model of open abdominal trauma with intestinal rupture was established in 26 healthy adult dogs, and they were divided randomly into three groups. All animals were subjected to abdominal wall incision and intestinal rupture. Seawater immersion group(n=10) was immersed into artificial seawater after trauma; normal saline solution group(n=6) was immersed into normal saline solution after trauma; control group (n=10) had no immersion. The 3 groups were observed for changes in water, electrolyte and acid-base balance, and the results were analysed and compared. Results Signficant disturbance of water, electrolyte and acid-base imbalance were observed in the seawater immersion groups, but no significant changes of these parameters were seen in the control group and normal saline group. Conclusion Seawater immersion is the main factor leading to the disturbance of body metabolism after open abdominal trauma with intestinal rupture.

OBJECTIVE To evaluate the clinical effects and toxicity of netilmicin with different administrations by de?termining its serum concentration in the treatment of lower respiratory tract infection.METHODS:22cases of lower respi?ratory tract infection were randomly divided into two groups.The drug serum concentrations were determined by TDx system.Clinical effects were compared;renal function and hearing ability were monitored.RESULTS:On the condition of the same total daily dosage,the peak concentrations in once-daily group(group QD)were significantly higher than those in twice-daily group(group BD)(P