OBJECTIVE To compare the efficacy and safety of lacosamide （LCM） and carbamazepine （CAR） as monotherapy in the treatment of adult patients with newly diagnosed epilepsy. METHODS By methods of retrospective analysis， 84 adult patients with newly diagnosed epilepsy， were admitted to the Department of Neurology， Huaihe Hospital of Henan University during Sept. 2020-Jun. 2022， were divided into the control group （40 cases， receiving CAR treatment） and the observation group （44 cases， receiving LCM treatment） according to different medication regimens. Total response rate， epilepsy seizure frequency， blood lipid levels， and the occurrence of adverse events （AEs） of patients were compared between the 2 groups. RESULTS In the first month after treatment， there was no statistically significant difference in the total response rate between the observation group （63.64%） and the control group （55.00%， P＞0.05）； the frequency of epilepsy seizure in both groups was significantly reduced compared to before treatment （P＜0.05）， but there was no statistically significant difference between 2 groups （P＞0.05）. In the third month after treatment， the total response rate of the observation group （90.91%） was significantly higher than control group （67.50%， P＜0.05）； the frequencies of epilepsy seizure in both groups were significantly reduced compared to before treatment， and the observation group was significantly lower than the control group （P＜0.05）. In the third month after treatment， the levels of total cholesterol （TC）， triglyceride （TG） and low-density lipoprotein cholestrol （LDL-C） in the control group and the level of LDL-C in the observation group were significantly higher than before treatment， and the levels of TC， TG and LDL-C in the observation group were significantly lower than those in the control group （P＜0.05）. There was no statistically significant difference in the incidence of AEs between the observation group （15.91%） and the control group （17.50%， P＞0.05）. CONCLUSIONS Both LCM and CAR have certain effects in the treatment of newly diagnosed epilepsy in adults， which can reduce the frequency of epilepsy seizure in patients and have comparable safety. Meanwhile， LCM has better long-term efficacy than CAR in treating newly diagnosed epilepsy in adults， and its impact on the patient’s blood lipid is smaller than CAR.

ObjectiveTo analyze the epidemiological characteristics of pathogens in foodborne disease cases in Haining City， Zhejiang Province， and to provide a basis for the prevention and investigation of foodborne diseases and outbreak events. MethodsInformation on foodborne disease patients from 2014 to 2023 was collected， and stool or anal swab samples were tested for relevant pathogens. The χ² test was used to compare the differences in pathogen detection rates among different groups， and multivariate logistic regression analysis was used to analyze the risk factors for pathogen detection. ResultsA total of 5 814 samples were tested， with a positive detection rate of 15.36%. The detection rates were 4.95% for norovirus， 4.49% for Escherichia coli， 3.59% for Salmonella， 2.22% for Vibrio parahaemolyticus， and 0.11% for Shigella. The positive detection rates showed seasonal characteristics， with a minor peak in March-April dominated by norovirus and a major peak in July-September dominated by bacteria. The three groups with the highest detection rates were workers， white-collar workers and other groups. Multivariate logistic regression analysis showed that age， season， and antibiotic use before consultation were significant influencing factors for pathogen detection （P<0.05）. Total pathogen detection risk was lower in the group that took antibiotics before visiting the clinic compared to those who did not （OR=0.29， 95%CI： 0.15‒0.49）. The detection risk for norovirus was lower in the preschool age group （OR=0.19， 95%CI： 0.04‒1.00）， in summer and autumn （OR range 0.23‒0.41）， and in the group taking antibiotics （OR=0.42， 95%CI： 0.15‒0.92）， but higher in the adolescent group （OR=1.40， 95%CI： 1.05‒1.88）. The detection risk for enteropathogenic Escherichia coli was higher in summer （OR=1.82， 95%CI： 1.30‒2.60）. The detection risk for Salmonella increased in the elderly group and in summer （OR range 1.44‒2.21）， but decreased in the adolescent group， in winter， and in the group taking antibiotics （OR range 0.22‒0.65）. The detection risk for Vibrio parahaemolyticus increased in summer and autumn （OR range 1.80‒1.90）， but decreased in the primary and secondary school student group and in winter （OR range 0.10‒0.32）. ConclusionThe prevalence of foodborne disease pathogens in Haining City is relatively high. Age， season， and antibiotic use before consultation are independent influencing factors for pathogen detection. These findings suggest that specific hypotheses regarding pathogenic factors can be proposed based on the time of occurrence and the age distribution of cases during field investigations of foodborne outbreaks.

Intrahepatic cholangiocarcinoma (ICC) is a highly malignant tumor with poor prognosis. In the process of clinical diagnosis and treatment, only a small number of patients can receive surgical treatment in time, and the rest often have local infiltration or distant metastasis at the time of presentation, which can only prolong the overall survival by adjuvant therapy. At present, the main adjuvant treatments in clinical practice include chemotherapy, targeted therapy and immunotherapy. This article reviews the progress of systemic therapy and some clinical trials in patients with advanced unresectable ICC, to provide a reference for the clinical diagnosis and treatment of ICC.

AIM:To investigate whether Miaoyao Tongfeng prescription(MTP)attenuates oxidative stress in-jury in gouty arthritis rats by regulating Kelch-like epicklorohydrin-related protein 1(Keap1)/nuclear factor E2-related fac-tor 2(Nrf2)signaling pathway.METHODS:Fifty male Sprague-Dawley rats were randomly divided into control group,model group,MTP group,Nrf2 inhibitor all-trans retinoic acid(ATRA)group and MTP+ATRA group.The 3%potassium oxonate solution(10 mL/kg)was injected intraperitoneally twice a day for 1 week,and then 0.2 mL sodium urate suspen-sion(25 g/L)was injected into the right knee joints to establish the gouty arthritis model.All rats were sacrificed 48 h af-ter modeling.Grades of swelling in the knee joints were evaluated,and HE staining was used to observe the pathological changes of knee joints.Serum levels of superoxide dismutase(SOD),malondialdehyde(MDA)and interleukin-1β(IL-1β)were detected using kits.The mRNA levels of Nrf2,Keap1,heme oxygenase-1(HO-1),IL-1β,NAD(P)H:quinone oxidoreductase 1(NQO1)in the synovial membrane of the knee joints were detected by qRT-PCR.Western blot was used to detect the expression of Nrf2,Keap1 and NQO1 in the synovial membrane of the knee joints.RESULTS:Compared with model group,MTP significantly reduced the degree of knee joint swelling,and attenuated the pathological injury of knee synovial membrane.It also inhibited the expression of MDA and IL-1β,but increased the expression of SOD.The mRNA expression of HO-1,and the mRNA and protein expression of Nrf2 and NQO1 in synovium were up-regulated,while the levels of IL-1β mRNA,Keap1 mRNA and Keap1 protein were down-regulated.CONCLUSION:Miaoyao Tongfeng prescription shows promise in the prevention and treatment of gouty arthritis through regulating Nrf2 and down-stream anti-oxidation genes.

Objective To investigate the effect of intrarectal local anesthesia (IRLA) with heated oxybuprocaine gel on pain during transrectal ultrasound guided prostate biopsy (TRUSPB).Methods A total of 150 cases patients who underwent TRUSPB in Huzhou Central Hospital from January to June 2023 were prospectively taken into.The patients were randomly divided into group A (routine group),group B (oxybuprocaine gel for IRLA at room temperature) and group C (oxybuprocaine gel for IRLA at 40℃),with 50 cases in each group.Nurses who were unaware of the anesthesia type used visual analog scale (VAS) to score the pain level of patients at each stage (VAS Ⅰ:when the ultrasound probe was inserted into the rectum;VAS Ⅱ:during the biopsy;VAS Ⅲ:30 minutes after biopsy),and the incidence of complications after biopsy were compared.Results The VAS Ⅱ score of group C was lower than that of group A and group B,and the difference was statistically significant (P<0.05).There was no statistically significant difference (P>0.05) in the VAS Ⅰ,VAS Ⅲ scores,and incidence of complications after biopsy among the three groups.There was no allergic reaction to oxybuprocaine gel.Conclusion In TRUSPB,IRLA with heated oxybuprocaine gel can effectively control pain without increasing incidence of complications.

Linezolid is a n anti-infective drug commonly used in clinic. Considering the large difference of individual condition ， severe basic disease ，poor organ function and large variety and quantity of drugs ，standard dose of linezolid may not be suitable for all critically ill patients. This paper reviews the relevant researches on the application of linezolid in adult critically ill patients in recent years ，analyzes the pharmacokinetic characteristics of critically ill patients ，and summarizes the influence of common physiological and pathological changes in critically ill patients on drugs. When using linezolid ，the clinical comprehensive evaluation of this special group should be strengthened. In addition to appropriately reducing the drug dosage of patients with liver/ kidney function injury ，it is also necessary to consider appropriately increasing the drug dosage in other cases. After medication ，in order to avoid excessive or insufficient drug exposure ，clinical medication monitoring should be strengthened ，especially the important mean as therapeutic drug monitoring should be used well.

Objective: To describe the secular trend of BMI and its consistency with self-rated BMI status in Chinese children and adolescents, and to further investigate the related factors affecting self-rated BMI,so as to provide a scientific reference for interventional measures. Methods: A total of 6 238 children and adolescents aged 6-18 years were selected according to date from Chinese Health and Nutrition Svrvey during 2000-2015 and the criteria from National Health Commission of China.The Lambda-Mu-Sigma method(LMS) and Kappa consistency test were, respectively, applied to describe the percentiles for BMI and its agreement with self-rated BMI status. Multinomial Logistic model was used to assess the related factors influencing self-rated BMI status. Results: P50 and P85 percentiles showed an increasing trend, especially the increase of high percentile of BMI. Regardless of age and sex, the measured and self-rated BMI showed low agreement. More than 50% of over-weighted or underweighted children perceived themselves as normal-weight, and about 1/4 of normal weight students misclassified themselves as abnormal in weight. Urban boys were more likely to evaluate themselves as underweight [OR(95%CI) =1.43(1.18-1.73)]. Boys who favored popular showed[OR(95%CI)=1.80(1.23-2.55) and cartoon [OR (95%CI) =1.39(1.00-1.96)] were more likely to consider themselves as overweight. Girls in the older age group [OR (95%CI)=2.74(2.08-3.61)] and urban [1.53(1.21-1.94)] who favored popular programs [OR(95%CI) =1.74(1.27-2.38)] were more likely to perceived themselves as overweight. But girls who like anime/cartoons were more likely to think they were underweight [OR(95%CI)=1.78(1.33-2.40)]. Conclusion The trend of BMI has shown an increasing trend in the past decade and it demonstrated a large bias with perceived BMI. Age, area and type of video were significant factors that influenced the self-rated BMI status.

Objective To investigate the distribution and drug resistance of pathogens in elderly patients with gastric cancer complicated with diabetes mellitus.Methods 367 elderly patients with gastric cancer and diabetes mellitus were selected from the hospital from March 2010 to March 2017.The samples were isolated and cultured.The Gram positive bacteria were tested by GN201,the Gram negative bacteria susceptibility test was carried out by GP,and the drug susceptibility test was carried out by disk diffusion method.Results There were 68 cases of postoperative infection in gastric cancer patients with diabetes mellitus,and 79 strains were isolated and cultured.Among the gram negative bacteria,Escherichia coli,Klebsiella pneumoniae and Pseudomonas aeruginosa were the main pathogens.Among the Gram positive bacteria,Staphylococcus aureus and Staphylococcus epidermidis were the main pathogens.The main Gram negative bacteria,Escherichia coli to ceftazidime with levofloxacin resistance rates were 93.33% and 80.00%;Klebsiella pneumoniae had a higher drug resistance rate for cefoperazone and ciprofloxacin,76.92% and 69.23% respectively;a relatively high rate of Pseudomonas aeruginosa resistant to levofloxacin was 80.00%.Among the gram positive bacteria,the re-sistance rates of Staphylococcus aureus to penicillin and erythromycin were relatively high,respectively 91. 67% and 83.33%.Staphylococcus epidermidis had relatively high resistance rates to penicillin and erythromy-cin,100.00% and 77.78% respectively.Conclusion Gastric cancer complicated by diabetes mellitus elderly patients with postoperative infection of pathogenic bacteria distribution is given priority to with Gram-negative bacteria was the most common in,Pseudomonas aeruginosa,the main pathogenic bacteria of Escherichia coli to ceftazidime with levofloxacin resistant rate of Klebsiella pneumoniae was higher on cefoperazone and ciproflox-acin resistant Pseudomonas aeruginosa,the resistance rate of Pseudomonas aeruginosa to levofloxacin is high, and it is important to apply antibiotics rationally according to drug sensitivity test.

Objective:To develop an HPLC-MS/MS method for the determination of rosuvastatin in plasma and study the relative bioavailability and bioequivalence of the capsules and tablets in Chinese healthy volunteers. Methods: A single oral dose (20 mg of the test or reference preparation) was given to 24 male healthy volunteers in a randomized crossover study. The plasma concentration of rosuvastatin was determined by HPLC-MS/MS. The pharmacokinetic parameters were calculated and the bioavailability and bioequiva-lence of the two preparations were evaluated by DAS 3. 0 software. Results:After a single dose, the pharmacokinetic parameters of ro-suvastatin capsules and tablets were as follows:Tmax was (3. 56 ± 1. 68) h and (3. 63 ± 1. 56) h, Cmax was (21. 17 ± 13. 74) ng· ml-1 and (26.33 ±23.22) ng·ml-1, t1/2 was (10.68 ±5.50) h and (9.04 ±6.00) h, AUC0-t was (219.31 ±146.09) ng·h· ml-1 and (252. 43 ± 194. 96) ng·h·ml-1 , AUC0-∞ was (225. 32 ± 146. 76) ng·h·ml-1 and (257. 24 ± 194. 61) ng·h·ml-1 , respectively. The 90% confidential interval of AUC0-t, AUC0-∞ and Cmax was 81. 1%-106% , 81. 8%-105. 4% and 77. 9%-104. 5%, respectively. The mean relative bioavailability of the test preparation(the capsules) to the reference preparation(the tablets) was (100. 7 ± 54. 1)%. Conclusion:The test and reference preparations are bioequivalent.

Objective To investigate the short-cycle repeated transurethral resection ( Re-TURBT) combined pirarubicin treatment of T2 muscle invasive bladder tumor efficacy and safety.Methods From October 2010 to December 2013, 56 clinically diagnosed cases of bladder cancer were divided into two groups;the experimental group was taken a short-cycle repeat transurethral resection surgery, and the con-trol group taken along open surgery to remove the tumor and its surrounding 2cm bladder tissue, postopera-tive patients were given pirarubicin infusion therapy.Results Each patient completed the trial.For the ex-perimental group, blood loss and operative time was significantly lower than the control group ( P <0.05). For experimental group after 3 months, 6 months, and 12 months, maximum bladder capacity ( MBC) and patient perception of bladder condition ( PPBC) were significantly higher than control group ( P <0.05 ) . For experimental group after 3 months and 6 months, maximum urinary flow rate ( Qmax) was significantly higher than control group ( P <0.05) , but no significant difference between two groups at 12 months.The incidence of adverse events, vascular endothelial growth factor ( VEGF) , and a total recurrence rate showed no significant difference ( P >0.05).For experimental group, bladder perforation in 1 case, 1 case was forced to open surgery, the incidence rate was about 6.7%.Conclusions The short-cycle repeated trans-urethral resection combined pirarubicin treatment of T2 invasive bladder tumor was simple, effective and se-curity.