Objective To explore the effect and adverse reaction of topiramate(TPM) on treating Lennox-Gastaut syndrome(LGS)(including therapeutic alliance or single ). Methods Twenty-four cases with LGS whose attacks could not be controlled by re-(gular) therapy were selected.TPM was gradually increased from low dosage till its showing effect or untolerant adverse reaction.Results Two cases were excluded because of adverse reaction and increase of attacks. The remained cases were followed up from 6 months to 15 months (average: 9 months). The total effective rate was 82.6%, 11 cases accounting for 45.8% free of attack. The tonic-clonic seizure reduced more than 50% accounting for 82.2%, the full control accounting for 66.7%. The myoclonic seizure reduced more than 50% accounting for 81.8%,the full control accounting for 58.8%.The atypical absence seizure reduced more than 50% accounting for 81.8%, the full control accounting for 63.6%. The maximum effect occurred about 2-40 weeks following TPM used, the dosage about 2-10 mg/(kg?d).The adverse reaction included anorexia (8 cases), language disorder (5 cases), drowsiness (4 cases), decrease of anamnesis (3 cases), weight loss or unchanged(3 cases), inattention (3 cases), depression (3 cases), mental bradypraxia (2 cases ), skin damage (1 case), stupor (1 case), gross hematuria(1 case).The hepatic and renal function were normal during therapy. Conclusion TPM is a new, broad-spectrum, effective and safe antiepileptics drug on treating LGS.

The interaction between water-soluble CdS and gelatin 5n aqueous solution was explored using fluorescence,infrared (IR)and UV-Vis spectra at pH 12.0 and different temperatures.Results show that the formed complex had a strong ability to quench the fluorescence launched from gelatin.The fluorescence quenching data were analvzed according to Lineweave-Burk double-reciprocal equation and the gelatin had reacted with CdS to form a complex.This kind of static fluorescence quenching goes with non-radiation energy transfer happening within single molecule According to Lineweave-Burk equation,K(285 K:1.07×10~4 L/mol;292 K:9 69×10~3 L/mol;299 K:8.06×10~3 L/mol),the formation constants of the compound at different temperatures and the thermodynamic parameters(△H=-14.18 kJ/mol;△G=-21.98/-22.28/-22.36 kJ/mol;△S=27.36/27.74/27.36 J/K·mol) at certain temperatures were obtained,indicating that the binding force between them is mainly the static in nature.The binding locality was an area of 4.09 nm away from tryptophan residue in gelatin based on F(o)rster's non-radiation energy transfer mechanism.The results provide information for exploring the chemical mechanism of interaction between nanoparticle and this kind of biological macromolecule.

In this paper, the effect of 5% (V/V) n-alkanes (e.g, n-Heptane, n-Octane, n-Decane, n-Dodecanen-Tetradecane and n-Hexadecane) on the growth and protease production of organic-solvent-tolerant- bacte-rium Bacillus licheniformis YP1 was studied. 5%(V/V) n-alkanes had no effect on the stability of YP1 prote-ase. 5% (V/V) n-alkanes had no notable influence on the yield of strain YP1 but dramatically affected theprotease production. The presence of n-Heptane, n-Octane and n-Decane deeply repressed the protease pro-duction; however n-Dodecane, n-Tetradecane and n-Hexadecane enhanced the protease production promi-nencely. The concentration of n-Tetradecane (1%-8%, V/V) had a direct ration with the protease production.The detailed experiments showed that the notable increase of protease activity appeared at the late logarithmof cultivation compared with the blank. The cell shape of YP1 strain remarkably decreased when grown inthe presence of n-Tetradecane. This is the first report about the effect of n-alkanes on the protease productionby the solvent tolerant bacterium.

Objective To explore the relationship between dynamic changes in ultra-micro-structural of pulmonary arteries and endogenous hydrogen sulfide in rats with left-right shunt.Methods Rats in shunt group were subjected to an abdominal aorta-inferior vena cava shunt to create an animal model of pulmonary artery structural remodeling. After 1 day, 3 days, 1 week, 4 weeks and 8 weeks of experiment, the ultra-micro-morphologic changes of pulmonary arteries of rats were observed under electronic microscope and H_2S concentration in serum was evaluated by modified sulfide electrode method.Results The changes of ultra-micro-structure of pulmonary arteries were progressively exacerbated, endothelial cells became swollen and large in size on 3 days, smooth muscular cells increased in size as well as the change of endothelial cells in 1 week, and they changed from contractile phenotype to synthetic phenotype in 4 weeks.Conclusions Shunt exhibited changes of ultra-micro-structure of pulmonary arteries are accompanied by the changes of endogenous H_2S. It is suggested that endogenous H_2S might play a protective role in changes of ultra-micro-structure of pulmonary artery.

Objective To explore the clinical features of transbronchial tuberculous mediastinal lymph-adenitis and value of bronchoscopic interventional therapy. Methods The clinical data of 50 patients who had been diagnosed as tuberculous mediastinal lymphadenitis and had received bronchoscopic interventional therapy in our hospital during the period from January 2008 to January 2013 were retrospectively analyzed. The bronchoscopic change , improvement in symptoms , and time to sputum smear and culture conversion were used to assess the therapeutic effect. The patients were followed up for six months. Results The mean age of the patients was (35 ± 15) years and the male to female ratio was 1:1.2. The lesions occurred mostly at the right middle lobe in 24% (12/50) of the patients. The total effectiveness rate was up to 98% (49/50) after chemotherapy and bronchoscopic interventional therapy. The major complication associated with interventional therapy was hemoptysis (8%, 4/50). After follow-up of 6 months , 49 patients with active lesions were stable , with smooth bronchial mucosa and no obvious obstruction by granulation and caseous necrosis tissues. Conclusions The relavent clinical symptoms of transbronchial tuberculous mediastinal lymphadenitis is mainly caused by tuberculosis inflammation which destroys and blocks the airway. The fiber bronchoscopic therapy with forceps clip and drug infusion has a definite effect and fewer complications.

OBJECTIVETo investigate the effect of compound Coptidis Rhizoma capsule (CCRC) on unbalanced expression of renal tissue TGF-β1/BMP-7 and Smad signaling pathway in rats with early diabetic nephropathy (DN), and discuss CCRC's effect on DN rats with early diabetic nephropathy and its possible mechanism.

METHODDN model rats were established by injecting streptozotocin (STZ). The rats were randomly divided into seven groups: the normal group, the model group, the enalapril treatment group, the xiaoke pill treatment group and three CRCC treatment groups. They were orally administered once a day for five weeks. The fasting blood glucose (FBG), blood urea nitrogen (BUN), serum creatinine (Scr), insulin (Ins), 24 h urinary protein (24 h Upro) and 24 h urinary microalbumin (24 h UmAlb) were tested. The pathological changes in renal tissues were examined by optical microscopy. Immuno- histochemical measures were used to detect the expressions of TGF-β1, BMP-7, Smad2/3, Smad1/5, and Smad7 protein, and RT-PCR was used to detect TGF-β1 mRNA and BMP-7 mRNA in renal tissues.

RESULTCompared with model group, BUN, Scr, Ins, 24 h Upro and 24 h UmAlb levels decreased at different degrees in CCRC treatment groups; the abnormal pathomorphology in renal tissue was improved; immunohistochemistry results showed that the expression of TGF-β1 and Smad2/3 were reduced, while the expression of BMP-7, Smad1/5 and Smad7 increased in CRCC treatment groups; the expression of TGF-β1 mRNA were reduced, but the expression of BMP-7 mRNA had no obvious change in CRCC treatment groups.

CONCLUSIONCRCC can improve the early renal function, delay the progression of chronic renal pathology and maintain the dynamic balance of TGF-β1/BMP-7 expression in renal tissues of DN rats. The mechanism may be related to down-regulation of renal TGF-β1 and up-regulation of BMP-7 through Smad signaling pathway.

Animals ; Bone Morphogenetic Protein 7 ; genetics ; metabolism ; Coptis ; chemistry ; Diabetic Nephropathies ; drug therapy ; genetics ; metabolism ; Gene Expression Regulation ; drug effects ; Humans ; Kidney ; drug effects ; metabolism ; Male ; Rats ; Rats, Sprague-Dawley ; Rhizome ; chemistry ; Signal Transduction ; drug effects ; Smad Proteins ; genetics ; metabolism ; Transforming Growth Factor beta1 ; metabolism

Emergency medicine and critical care medicine are the new contents in standardized training of residency.The system of standardized training residency lacks for a traditional way to refer.According to the characteristic of the subjects and the practical situation,this paper discusses the methods of training in studying basic theory,idea education,improving technology and strain capability on improving the capability of standardized training residency in internal intensive medicine.

Objective To evaluate the ability of ultra-high-b-value diffusion weighted imaging (DWI) in diagnosis of the prostate cancer (PCa) at 1.5T MR.Methods 12 patients with PCa and 17 patients with benign prostate hyperplasia (BPH) proved by histopathology underwent MRI and DWI examinations (b=400, 800,1 400 s/mm2).The signal intensity and visual degree of region of interest (ROI) in all DWI with different b values were respectively measured.The signal intensity and visual degree of ROI between high-b-value DWI and ultra-high-b-value DWI were compared,respectively.Results The difference of signal intensity of PCa between high-b-value DWI and ultra-high-b-value DWI was statistically significant (χ2=220.957,P=0.000<0.05).The signal intensity of PCa was getting brighter in DWI with higher b value.The difference of visual degree between these two groups was also statistically significant (χ2=11.378,P=0.003<0.05).The difference among PCa, BPH and normal prostate peripheral zone was statistically significant in ultra-high-b-value DWI (χ2=25.913, P=0.000<0.05).The brightness of PCa in ultra-high-b-value DWI mainly was bright or grey-bright (71.4%), while the brightness of BPH and normal prostate peripheral zone were mainly dark or grey-dark (BPH 63.0%, normal prostate peripheral zone 73.3%).The difference of visual degree among PCa, BPH and normal prostate peripheral zone was statistically significant difference as well (Z=-6.908,-6.110,P=0.000<0.017).The diagnostic efficiency of the signal intensity and visual degree were highest with b=1 400 s/mm2.Conclusion DWI with ultra-high-b-value can improve the display rate of the PCa at 1.5T MR, making easier the detection and diagnosis of PCa.

To investigate the feasibility to produce crocetin in tobacco plants.The coding region of zeaxanthin cleavage dioxygenase (CSzCD) gene from Crocus sativus L. was inserted into the downstream of the cauliflower mosaic virus (CaMV) 35S promoter of a binary vector pBI121, and integrated into the genome of Nicotiana tabacum L. Twenty-one transgenic lines were identified by genomic southern blotting analysis. Western blotting and HPLC analysis of the leaf extracts of transgenic tobacco showed that crocetin was produced in CSzCD gene-transformed plants, while no crocetin was found in the untransformed tobacco.