Anti-seizure medications (ASMs) are the main therapy for epilepsy.There are many kinds of ASMs with complex mechanism of action, so it is difficult for pharmacists to examine prescriptions.This paper put forward some suggestions on the indications, dosage forms/routes of administration, appropriateness of usage and dosage, combined medication and drug interaction, long-term prescription review, individual differences in pathophysiology of children, and drug selection when complicated with common epilepsy, for the reference of doctors and pharmacists.

Objective:To analyze and summarize adverse reactions such as hypoglycemia, lactic acidosis and pancytopenia caused by Linezolid in elderly patients, in order to enhance clinicians' awareness of adverse reactions of Linezolid.Methods:One case with Linezolid-induced lactic acidosis, pancytopenia and hypoglycemia was reported in a patient receiving long-term and repeated use of Linezolid for recurrent urinary tract infections(RUTI)in Beijing Hospital.National and international literature on the three severe and rare adverse reactions caused by Linezolid before December 2018 was reviewed, and the risk factors, clinical characteristics and prognosis of the three severe adverse reactions caused by Linezolid were summarized and analyzed.Results:A total of 86 cases with Linezolid-induced adverse reactions such as hypoglycemia, lactic acidosis and pancytopenia were analyzed.Among them, the ratio of males to females was 1.8∶1.0, the median age was 64.5 years, and 44 cases were over 65 years, accounting for 51.2%.Among the 57 patients with lactic acidosis, 25 lactic acidosis cases were combined with liver and kidney diseases, which were the most commonly involved organs(43.9%, 25/57). The time of onset for lactic acidosis was 4 h-109 d, with a median value of 32 d, and the peak values of blood lactate were 2.6-38.1 mmol/L, with a median value of 13.3 mol/L.Pancytopenia occurred 4 h-120 days after the treatment, and the median value was 21 days.The time of onset for hypoglycemia was 8 h-26, and the median time was 10.3 days.The lowest value of blood glucose was 0.2 mmol/L.Of the 86 cases, 61(70.9%)patients improved, and 12 cases of 51 patients with lactic acidosis died, with a mortality rate of 23.5%.Conclusions:Clinicians should be aware of serious adverse reactions including hypoglycemia, lactic acidosis and pancytopenia during Linezolid treatment in elderly patients.It is recommended to monitor changes in blood glucose, blood lactate and blood cell count during Linezolid treatment, and to avoid long-term use of Linezolid, so as to maximize the benefits for patients.

Objective To study the relationship between hypertensive cerebral hemorrhage and microbleeds by analyzing the characteristics of magetic susceptibility-weighted imaging.Methods Fifty-one patients with mild hypertensive cerebral hemorrhage admitted to Shenzhen Nanshan District No.6 People's Hospital for MRI (T1WI,T2WI and T2FLAIR),susceptibility-weighted imaging,and magnetic resonance angiography from June 2016 to June 2017 were included in this study.Their MRI data were analyzed.Results Multiple foci of microbleeds and small vessel hyperplasia were detected in hemorrhage regions of the 51 patients included in this study,including ＞2 foci of microbleeds in intracranial basal area,thalamus,brain stem and cerebellar area of 40 patients (78.4％),and cerebral small vessel hyperplasia and VR space enlargement in 11 patients (21.6 ％).Magnetic resonance angiography showed cerebral middle artery and basal artery atheroclerosis in 15 patients but no vascular dissection,stenosis,aneurysm and vascular malformation in the other patients.Conclusion MRI can show the pathological changes in cerebral blood vessels of hypertensive hemorrhage patients,including cerebral microbleeds,cerebral small vessel hyperplasia and VR space enlargement.

Objective To investigate the expression characteristics of Golgi phosphoprotein 3(GOLPH3)in human hepatocellular carcinoma (HCC)and explore its clinicopathological significance. Methods The expressions of GOLPH3 protein was detected in 132 cases of paired paraf-fin embedded HCC specimens and pericarcinoma tissues using immunohistochemical staining ,and the relation of the expression of GOLPH3 to clinicopathologic features was analyzed. Meanwhile,the expression and distribution of GOLPH3 in HCC cells was observed by laser confocal mi-croscopy. Results The positive expression rates of GOLPH3 in HCC and pericarcinoma tissues were 70.0%(92/132)and 42.4%(56/132) (P<0.001),respectively. The incidence of portal vein tumor thrombus in high and low GOLPH3 expression groups of HCC were 21.2%(14/66) and 6.1%(4/66)(P<0.05),respectively. The expression rate of GOLPH3 in HCC was significantly higher than that in pericarcinoma tissues, and the expression of GOLPH3 in HCC was positively related to portal vein tumor thrombus. In addition ,GOLPH3 was mainly expressed in cyto-plasm of HCC cells,and there was also scattered distribution in the nucleus. Conclusion GOLPH3 acts as an oncogene and may play vital roles in the carcinogenesis and development of HCC.

Objective To elucidate the inhibitory effect of SGI-1027 on cell proliferation and apoptosis of Huh7 cells.Methods Huh7 cells were treated with different concentrations (0,5,10,15,20,25,30,and 35 μ mol/L) of SGI-1027 for 24 h.MTS assay was performed to detect cell proliferation.Huh7 cells treated with 0.1％ DMSO were used as the control group,and those treated with 30 μmol/L SGI-1027 as the experimental group.Flow cytometry was performed to study the cell cycle,and Annexin V-FITC/PI detection for studying cell apoptosis.TUNEL staining was performed to observe changes in cell morphology.Results The results of the MTS assay revealed that SGI-1027 significantly inhibited the proliferation of Huh7 cells in a dose-dependent manner,and the IC50 was 27.3 μmol/L.SGI-1027 did not block the cell cycle of Huh7 cells,but induced cell apoptosis in Huh7 cells.The rates of apoptosis were 3.242％ ± 0.204％ in the control group and 46.57％ ± 2.512％ in the experimental group (P ＜ 0.05).In the experimental group,typical apoptotic nucleus alterations were observed by fluorescence microscopy after TUNEL staining.The percentage of apoptotic cells was 1.077％ ± 0.407％ in the control group and 58.24％ ± 8.427％ in the experimental group (P ＜ 0.05).Condusion SGI-1027 inhibits Huh7 cell proliferation and induces apoptosis in vitro.

Objective To detect the genome-wide profiles of DNA methylation in human hepatocellular carcinoma (HCC) cells and to identify the distribution of differentially methylated sites and genes in order to explore the relationship between aberrant DNA methylation and hepatocellular carcinoma.Methods The Infinium Human Methylation 450K BeadChip was used to identify the genome-wide aberrant DNA methylation profiles in Huh7 and L02 cell lines.Results Totally 102 254 differentially methylated CpG sites and 26 511 genes,involving 43 signaling pathways,were detected when Huh7 and L02 cell lines were compared.The absolute β-difference in 57.3％ of the hypermethylated CpG sites and 39.4％ of the hypomethylated CpG sites was reported to be ≥ 50％.A total of 3 222 hypermethylated genes and 2 204 hypomethylated genes were identified.Conclusion We detected many aberrant methylated sites and genes in HCC cells.The abnormal DNA methylation exhibits an important role in the occurrence and development of HCC.

Objective To analyze the risk factors for the failure of noninvasive mechanical ventilation (NIV) in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD),and to help the clinical risk assessment and decision making.Methods A retrospective case control study was conducted.The patients with AECOPD undergoing NIV admitted to Kaifeng Emergency Center from June 2011 to March 2016 were enrolled,and they were divided into two groups according to whether NIV was successful or not within 12 hours.The nutritional status,blood gas analysis,serum electrolytes,D-dimer,renal function,serum pre-albumin,as well as kinetic vital signs,Glasgow coma scale (GCS) score,expression of respiratory distress,and spontaneous expectoration were recorded.Logistic forward stepwise regression analysis was used to analyze the factors for failure of NIV.Results 122 patients.with the initial NIV were enrolled,with NIV failure in 41 patients within 12 hours,accounted for 33.6％.Compared with NIV success group,the percents of respiratory rate ≥ 25 breaths/min (75.6％ vs.17.3％),expectoration disorders (78.0％ vs.19.8％),circulatory disorders (61.0％ vs.18.5％),malnutrition (61.0％ vs.11.1％),decreased serum pre-albumin (58.5％ vs.17.3％),and GCS score ＜ 12 (75.6％ vs.28.4％) in NIV failure group were significantly increased (all P ＜ 0.05).But there were no significant differences in gender,age,body temperature,blood gas analysis,D-dimer,serum creatinine between two groups.It was shown by the results of binary logistic regression analysis that respiratory rate,expectoration disorders,circulatory disorders,malnutrition,serum pre-albumin,and GCS score were the factors of NIV failure [odds ratio (OR) values were 10.879,6.338,9.860,23.273,8.862,6.774,and P values were 0.011,0.038,0.024,0.003,0.015,0.041,respectively].It was shown by the results of logistic stepwise regression analysis that respiratory rate ≥ 25 breaths/min,expectoration disorders,circulatory disorders,malnutrition,decreased serum pre-albumin,and GCS score ＜ 12 were independent risk factors of NIV failure (OR values were 6.610,5.403,5.138,8.153,4.979,5.100,and P values were 0.007,0.013,0.023,0.007,0.027,0.023,respectively).Conclusions The multiple independent risk factors can induce NIV failure within 12 hours in emergency patients with AECOPD,i.e.increased respiratory rate,expectoration dysfunction,circulatory disorders,malnutrition,decreased serum pre-albumin,and decreased GCS score.Emergency physicians should pay attention to these early risk factors in AECOPD patients,which can be taken as correct judgment and guide.

Oxidative stress is an important factor that can cause aging body, tissue damage and diseases.FoxO3a transcription factor is critical for the regulation of oxidative stress.Recently, there are some reports on the quite complex role of FoxO3a in regulating oxidative stress.Not only can it promote the survival of cells, but also induce cell apoptosis at some oxidative stress conditions.In this paper, the role of FoxO3a in oxidative stress, the possible signal pathway and the potential effect of target FoxO3a for oxidative stress diseases treatment are reviewed.

Objective To discuss the clinical symptoms of severe traumatic cerebral injury patients with paroxysmal sympathetic hyperactivity (PSH). These patients were given positive and effective prevention and treatment to reduce complications in order to improve prognosis. Methods Twenty patients with PSH were selected from October 2010 to October 2014 and were analyzed by gender, age, diagnosis, clinical symptoms, laboratory and equipment inspection to summary the treatment experiences of such patients. Results Of the 20 patients,14 were males and 6 were females,with age of 22-65 (35.4±9.5) years. Sixteen patients underwent unilateral or bilateral intracranial hematoma and decompressive craniectomy,and 4 patients were given conservative treatment. PSH occurred in these patients within 1 week after cerebral injury or surgery. However, the elderly might occur in the course of a few weeks or even months later. Each patient' s seizure frequency and duration had no significant regular pattern. The frequency varied from one time in several days to several times one day. Seizure duration was generally less than half an hour. All of the patients underwent CT and MRI examinations and showed different parts of the brain injury. But the damage of the brain stem, corpus callosum, basal ganglia and lateral ventricles beside sympathetic overactivity could lead to the occurrence of PSH. Most of the patients had a good effect after active drug treatment and symptomatic therapy. Conclusions PSH often occurs in severe traumatic cerebral injury patients. The doctor should pay attention to PSH. Early active and effective prevention and treatment can improve the prognosis of patients with PSH.

Objective To understand the development history and current situation of healthcare-associated infection(HAI)management in children’s hospitals in China during the past 30 years.Methods A retrospective survey was conducted in 20 children’s hospitals,the investigated contents included:basic situation of hospitals, HAI management organizations and professionals,the support of hospital leaders for the management of HAI, training on HAI knowledge,monitoring on HAI,and so on.Results Up to 2015,20 hospitals all set up independent HAI management departments and HAI management committees,46.15%(6/13)of hospitals with more than 1 000 beds were understaffed in HAI management.There were a total of 88 professionals in HAI management in 20 children’s hospitals in 2015,53.41% (n=47)of professionals had bachelor degree,34.09% (n=30)were with intermediate professional title,46.59%(n=41)were nursing staff.Up to 2015,incidences and missing report rates of HAI,antimicrobial usage rates,incidences of HAI in neonates all decreased compared with 2006.In 2015,20 (100.00%)hospitals all carried out monitoring on antimicrobial application,multidrug-resistant organisms,disin-fection and sterilization,and provided personnel protective equipment.In 2015,9(45.00%)hospitals used non-tou-ch faucets in all wards,19(95.00%)hospitals supplied hand-drying paper towel and alcohol-based hand rub in all wards.None of professionals in these hospitals participated in national-level training on HAI for ≥3 times in 1996, professionals in 11 hospitals (55.00%)participated in national-level training for ≥3 times in 2015.Conclusion In the past 30 years,the management of HAI in children’s hospitals in China has basically met the requirement,moni-toring on HAI gradually improved,but allocation of HAI professionals and personnel quality ability still need to be strengthened.