Objective To explore the effects of lamotrigine on the cognitive function and the quality of life in epilepsy patients.Methods This was a prospective study and 91 newly diagnosed epilepsy patients were enrolled.The neuropsychological tests score and the quality of life in epilepsy inventory(QOLIE-31) were obtained before and after the treatment with lamotrigine.A battery of neuropsychological tests comprised the auditory verbal learning test(AVLT), the logical memory test(LMT), the digital symbol test(DST), the stroop color word test(SCWT), the trail making test(TMT), the verbal fluency test(VFT), the WAIS block design test(WBDT), the WAIS digital span test(WDST)and the Boston naming test(BNT). Results The repeated assessments in the patients taking lamotrigine were associated with significant improvements in many domains.The greatest changes were observed in the immediate and delayed recall of AVLT, DST, the time consuming of SCWT card C and TMT test A and B, the immediate and delayed recall of LMT, VFT, WBDT and BNT.For the quality of life, significant improvements were recorded in the fields of the seizure worry(38.81?16.06 vs 45.68?15.18), the overall quality of life(59.12?13.50 vs 64.99?13.33), the social function(64.59?25.14 vs 69.41?22.70)and the self-health evaluation (71.18?13.73 vs 76.75?11.30).Conclusion Improvements of the cognitive function and the quality of life can be observed in the initial period of medication with lamotrigine in epilepsy patients.

Objective To explore the feasibility of evaluating the lung function by MSCT in emphysema.Methods The MSCT scan and pulmonary function tests(PFF)were respectively performed in 147 receptors within one week.They were randomly divided into 2 groups:group A(120 receptors), including normal,mild,moderate and severe abnormal pulmonary function based on the PFT,for comparing the correlation between pulmonary quantitative indexes of MSCT pulmonary function and PFT and settingup the primary grade criteria of abnormal pulmonary function in emphysema,group B(27 receptors)for evaluating the diagnostic accuracy in group A.The total lung was respectively scanned at the full inspiration and full expiration with MSCT.The pulmonary quantitative indexes of MSCT were measured with Siemens Pulmo pulmonary quantitative software.Results There was correlation between pulmonary quantitative indexes of MSCT and PFF.The Piex/in_(-910)showed best correlation with FEV_1%(r=-0.905,P

Objective:To investigate the efficacy and safety of a treatment regimen based on daratumumab in patients with high-risk relapsed refractory multiple myeloma(MM)with mSMART 3.0 score.Methods:Clinical data were collected from 16 patients with mSMART3.0 score high-risk relapsed refractory MM treated at the Affiliated Hospital of Shandong University of Traditional Chinese Medicine from May 2020 to May 2023,all of whom received daltezumab-based regimen(regimen drugs including dexamethasone,isazomib,bortezomib,lenalidomide).The efficacy and safety of the treatment were retrospectively analyzed.Results:The median age of 16 patients was 63.5(47-70)years old,including 10 cases of IgG type,2 cases of IgA type,and 4 cases of light chain type.The curative efficacy was judged in all 16 patients,with an overall response rate of 93.75％(15/16),including 4 cases of strict complete remission(sCR),1 case of complete remission(CR),2 case of very good partial remission(VGPR),partial remission(PR)in 5 cases,and minor remission(MR)in 3 cases.The median follow-up time was 11(2-30)months,and the median progression-free survival and median overall survival were not achieved in 16 patients at the median follow-up period.The hematologic adverse effects of the treatment regimen using daratumumab-based were mainly neutropenia,and the non-hematologic adverse effects were mainly infusion-related adverse reactions and infections.Conclusion:Daratumumab-based regimen for the treatment of relapsed refractory MM patients with high risk of mSMART3.0 score has better efficacy and safety.

OBJECTIVETo study the correlation between the lung pixel indexes of multi-slice spiral CT (MSCT) and pulmonary function test (PFT), and to explore the CT features of histograms of lung attenuation.

METHODSMSCT scan and pulmonary function test (PFT) were separately performed in 127 subjects within one week. The total lung was scanned with MSCT at full inspiration, full expiration, and normal respiration. The lung pixel indexes were measured by Pulmo pulmonary quantitative software. These indexes include PI(-910Huin), PI(-960HUEX), PI(-910Huin), PI(-960Huex), PI(-910(Hun), PI(-960Hun), PI(910Huex/in), and the histograms of lung attenuation.

RESULTSCorrelation existed between all the lung pixel indexes of MSCT and PFT. PI(-910Huex/in showed the best correlation with FEV1/FVC (r = 0.901, P < 0.01). Three distribution patterns were found in the histograms of lung attenuation of total lung, including double-peak distribution (n = 28), similar normal distribution (n = 81), and partial distribution (n = 18).

CONCLUSIONThe lung pixel indexes of MSCT have significant correlation with PFT and can be used to assess the pulmonary function.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Lung ; diagnostic imaging ; Male ; Middle Aged ; Respiratory Function Tests ; Tomography, Spiral Computed

Comminuted fracture of distal femur is a common lower limb injury from traffic accidents, especially from motor accidents. Routine dynamic condylar screw (DCS) or 95-degree condylar plate (CP) sometimes cannot solve the bone defect in the center of alignment and contralateral diaphysis for the reason of absent screw anchor point, especially for AO C2.2-2.3 types. Many authors recommended open reduction and fixation with less invasive stabilization system (LISS) as the treatment of choice, but there are still problems in fusion and alignment. In this study, we reported our experiences with the use of bone splint technique in the high-energy commimuted fracture of distal femur with central and medial bone defect in adolescents.
Adolescent ; Adult ; Bone Plates ; Female ; Femoral Fractures ; surgery ; Fracture Fixation, Internal ; methods ; Fractures, Comminuted ; surgery ; Humans ; Male ; Splints

OBJECTIVETo investigate the feasibility and safety of the treatment for thoracolumbar fractures with transpedicular intracorporeal hydroxyapatite grafting and pedicle screw fixation via paraspinal approach.

METHODSFrom June 2007 to December 2008, 19 cases of thoracolumbar fractures were treated with transpedicular intracorporeal hydroxyapatite grafting and pedicle screw fixation via paraspinal approach. There were 7 female and 12 male, ranging from 21 to 57 years of age (mean 40.8 years) at surgery. The time from injury to surgery varied from 1 d to 5 d (mean 2.9 d). Nineteen patients all suffered from single thoracolumbar fracture with the distribution of injury level being T(11) in 1, T(12) in 5, L(1) in 9, and L(2) in 4. According to Denis fracture classification, there were 5 compression fractures and 14 burst fractures. The mean preoperative ratio of the anterior height of the body was 57.2%, kyphosis angle was 17.6° and occupation of spinal canal was 27.7%. The mean preoperative load-sharing classification of spine fractures was 5.2. Based on the ASIA neurologic grading system, preoperative neurological function was grade B in 2 cases, C in 9 and D in 8.

RESULTSMedian operating time was 83.8 min (range 60-95 min) and median blood loss was 133 ml (range 90 - 200 ml). Infection did not occur in any of the patients and the operative incisions were healing well. Average follow-up time was 19.2 months (range 12 - 36 months). At the latest follow-up, the height of the anterior border was corrected to 88.4%, the kyphosis angle was 6.1°, and the occupation of spinal canal was 8.2% on average. The postoperative neurologic function of all 19 patients was improved with grade D in 2 cases and E in 17. There were no instances of instrumentation failure and no patient had persistent postoperative back pain.

CONCLUSIONSTranspedicular intracorporeal hydroxyapatite grafting and pedicle screw fixation via paraspinal approach could provide reliable neurologic improvement in patients with incomplete neurologic deficit, and could prevent the development of kyphosis.Furthermore, it has the obvious advantages of less invasive and blood loss, and decreases the risks of postoperative lumbodorsal pain.

Adult ; Bone Screws ; Bone Transplantation ; methods ; Durapatite ; Feasibility Studies ; Female ; Follow-Up Studies ; Fracture Fixation, Internal ; methods ; Humans ; Lumbar Vertebrae ; injuries ; Male ; Middle Aged ; Spinal Fractures ; surgery ; Thoracic Vertebrae ; injuries ; Treatment Outcome ; Young Adult

OBJECTIVETo investigate the role of bone morphogenetic protein 4 (BMP4) in culturing induced pluripotent stem cells (iPSCs) and the related signal pathways.

METHODSWe amplified the mature peptide of BMP4 from the placenta through RT-PCR, and IgK secretion peptide was ligated to the N-terminal of BMP4 mature peptide. The recombinant plasmid pPYCAG-IgK-BMP4 was transfected into 293T cells and screened with puromycin, and the positive clones for expressing BMP4 were verified by cell immunofluorescence and Western blotting. To test the bioactivity of BMP4, iPSCs were cultured in the medium supplemented with leukemia inhibitory factor (LIF) plus the supernatant containing BMP4, and the cell phenotype, cell differentiation capacity into lineages of the 3 germ layers and expression levels of pluripotency-associated genes were investigated.

RESULTSSmad1 was phosphorylated by BMP4 from the culture medium. iPSCs cultured in the medium supplemented with LIF plus the supernatant containing BMP4 for 3 passages maintained the phenotype of stem cells with the expression levels of pluripotency-associated genes not affected. These iPSCs also maintained the capacity to differentiate into cell lineages of the 3 germ layers.

CONCLUSIONBMP4 can be efficiently expressed in mammalian cells to maintain the multipotent differentiation capacity of the iPSCs in in vitro culture.

Animals ; Bone Morphogenetic Protein 4 ; genetics ; Cell Differentiation ; genetics ; Cells, Cultured ; Female ; Gene Expression ; HEK293 Cells ; Humans ; Immunoglobulin kappa-Chains ; genetics ; Induced Pluripotent Stem Cells ; cytology ; Mice

OBJECTIVETo compare the clinical effects of three methods of internal fixations in treating intertrochanteric fractures in elderly patients.

METHODSFrom 2004 to 2008, the clinical data of 112 patients with intertrochanteric fractures were retrospectively analyzed. There were 63 males and 49 females, aged from 60 to 80 years with an average of 66.2 years. The patients were treated respectively with dynamic hip screws (DHS group, 40 cases), anatomic plate (anatomic plate group, 36 cases) and proximal femoral intramedullary nails (PFN group, 36 cases). The data of each group were collected for statistical analysis on the following aspects: operative time, blood loss volume, clinical healing time of fracture, postoperative complications, and hip functional score of Harris.

RESULTSAll these patients were followed up from 20 to 24 months with an average of 22.6 months. There was no significant difference in operative time, blood loss volume among three groups; there was significant difference in clinical healing time of fracture, Harris score and postoperative complications among three groups (P < 0.05). In the healing time, the PFN group was significantly less than that of other groups (P = 0.001), but there was no differences between DHS group and anatomic plate group. In the Harris score, the PFN group was significantly higher than that of other groups (P = 0.001), but there was no differences between DHS group and anatomic plate group. In the aspect of postoperation complication, there was 2 cases of coxa vara, 1 case of internal fixation loosening and 1 case of deep venous thrombosis in the DHS group; there were 2 cases of deep venous thrombosis in the PFN group; there were 2 cases of coxa vara and 1 case of internal fixation loosening in the anatomic plate group (P = 0.001).

CONCLUSIONIn the treatment of intertronchanteric fractures, proximal femoral intramedullary nail may be the best choice, which can decrease healing time as well as complications postoperatively.

Aged ; Aged, 80 and over ; Female ; Femoral Fractures ; surgery ; Fracture Fixation, Internal ; adverse effects ; methods ; Fracture Healing ; Hip Fractures ; surgery ; Humans ; Male ; Middle Aged ; Postoperative Complications ; epidemiology ; Retrospective Studies

OBJECTIVETo evaluate curative effect of plate and xenogenic bony plate were applied in refracture in plate-screw fixation of femoral shaft.

METHODSThirteen cases of refracture in plate-screw fixation of femoral shaft included 8 males and 5 females, average age was 31.2 years ranging from 14 to 57. Fracture type was comminuted fracture in 7 cases, oblique fracture in 4 cases, transverse fracture in 2 cases. Fixation type used eight holes femoral LC-DCP in 5 cases, eight holes epipodite LC-DCP in 2 cases, six holes femoral LC-DCP in 2 cases, 8 holes La-Plate in 4 cases. All the patients were treated by femoral LC-DCP and xenogenic bony plate.

RESULTSAll of the patients were followed up from 16 to 40 months with average of 32 months. All cases had undergone only one operation and achieved bony union. Average time of bony union was 9 months. The lower limbs resumed walk and beared a heavy burden. According to criterion of Merchan, the results were excellent in 7 cases,good in 4,fair in 1 and poor in 1, the excellent and good rate of knee function was 84.6% (11/13) in one year after operation.

CONCLUSIONTreatment of refracture in plate-screw fixation of femoral shaft with armor plate and xenogenic bony plate is a reliable treatment.

Adolescent ; Adult ; Bone Plates ; Bone Screws ; Female ; Femoral Fractures ; pathology ; physiopathology ; prevention & control ; surgery ; Follow-Up Studies ; Fracture Fixation, Internal ; instrumentation ; Humans ; Male ; Middle Aged ; Recurrence ; Time Factors ; Young Adult

OBJECTIVETo investigate the beta-lactamase TEM gene of isolated Streptococcus pneumoniae (Sp) in Suzhou area.

METHODSTwenty-three strains of Sp were collected from respiratory tract secretions of children with respiratory diseases in Nov 2002 to Apr 2003 at Children's Hospital of Suzhou University (reference strain ATCC49619) to build TEM polymerase chain reaction (PCR) system (reference strain E. coli. 9-j53R1 with TEM gene) TEM gene of 23 strains was detected to comparo the sequences with published TEM gene sequences in GenBank for analyzing TEM gene model.

RESULTSTwenty-one strains had TEM gene with a positive rate of 91.3% (21/23). TEM-129 gene were confirmed from No.17 (SR017, penicillin resistance) TEM sequence. New discovered TEM-129 sequence had a modification (ATG[M]-->ATA[I]) at No.182 code and published (GenBank: www.ncbi.nlm.nih.gov/nucleotide, AY452662). TEM-1 genes were confirmed from other TEM sequences. New discovered TEM-1 gene of isolated Sp had been published (GenBank: www.ncbi.nlm.nih.gov/nucleotide, AY392531) too.

CONCLUSIONIsolated Sp had TEM gene (TEM-129, EM-1 genotype) with a positive rate of 91.3%. The result enriched the understanding of isolated Sp with penicillin resistance.

Base Sequence ; China ; epidemiology ; Drug Resistance, Bacterial ; genetics ; Female ; Genes, Bacterial ; genetics ; Humans ; Male ; Molecular Epidemiology ; Molecular Sequence Data ; Pneumonia, Bacterial ; epidemiology ; genetics ; microbiology ; Point Mutation ; Streptococcus pneumoniae ; enzymology ; genetics ; beta-Lactam Resistance ; beta-Lactamases ; genetics