Efficacy of perampanel in pediatric epilepsy with known and presumed genetic etiology.

OBJECTIVE: The efficacy of perampanel (PER) in pediatric epilepsy with specific etiologies has not been well established. Here, we investigated outcome and predictors of PER treatment in a pediatric cohort with known and presumed genetic etiology. METHODS: We included pediatric patients with potential genetic epilepsy who received PER treatment and underwent whole-exome sequencing (WES) from January 2020 to September 2021. All patients were followed up for >12 months. RESULTS: A total of 124 patients were included. Overall response rates were 51.6% and 49.6% at 6 months and 12 months, respectively. Pathogenic or likely pathogenic variants in 27 multiple genes were detected among 58 patients (46.8%) by WES. On performing multivariate logistic regression analysis, only developmental delay (OR = 0.406, P = 0.042) was a negative predictor of treatment response. However, the seizure onset age, positive WES results, and number of ASMs before PER administration were not significantly. Thirteen carriers with variants in the SCN1A gene showed a better response compared to eight patients with other sodium channels (P = 0.007), and to the other 45 patients with positive WES results (OR = 7.124, 95% CI = 1.306-38.860, P = 0.023). Adverse events were only reported in 23 patients, the most common being emotional problems. INTERPRETATION: PER is safe and efficacious in pediatric patients with known and presumed genetic etiology. The response rate is comparable to that reported in other pediatric populations, and lower among those with developmental delay. A gene-specific response to PER is found along with better efficacy links to pathogenic variants in the SCN1A gene.

Preclinical evidence of probiotics in ulcerative colitis: a systematic review and network meta-analysis.

The imbalance of gastrointestinal microbial composition has been identified as the main factor of chronic inflammatory diseases. At present, probiotics have a beneficial effect on the microbial composition of the human gastrointestinal tract, but it is still controversial and the specific mechanism is unknown. The purpose of this network meta-analysis is to compare the mechanism of different probiotics on ulcerative colitis. PubMed, Embase, and Web of Science were searched till 16 November 2022. The SYRCLE risk bias assessment tool was used to assess the quality of the research studies. A total of 42 studies, 839 ulcerative colitis models, and 24 kinds of probiotics were finally included. The results showed that L. rhamnosus has the best effect in relieving weight loss and improving the Shannon index in the ulcerative colitis model. E. faecium has the best effect in reducing colon injury; L. reuteri has the best effect in reducing the DAI; L. acidophilus has the best effect in reducing the HIS index and increasing the expression of tight junction protein ZO-1; and L. coryniformis has the best effect in reducing the content of serum pro-inflammatory factor TNF-α. It indicated that probiotics can improve ulcerative colitis by improving histopathological manifestations, reducing inflammatory reaction, and repairing the mucosal barrier, and different probiotics showed different effects. However, considering the limitations of this study, preclinical studies that require more large samples and high-quality and more reliable and rigorous experimental designs and reports need to be conducted in the future. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/#record details, identifier CRD42022383383.

Efficacy and Safety of Traditional Chinese Medicine Based on the Method of "Nourishing Kidney and Clearing Heat" as Adjuvant in the Treatment of Diabetes Mellitus Patients with Periodontitis: A Systematic Review and Meta-Analysis.

Objective: The aim of this systematic review and meta-analysis was to assess the efficacy and safety of traditional Chinese medicine based on the method of "nourishing kidney and clearing heat" as an adjuvant in the treatment of diabetes mellitus patients with periodontitis. Methods: An electronic literature search was conducted in the China National Knowledge Infrastructure (CNKI), Wanfang Data, Chinese Scientific Journals Database (VIP), Chinese Biomedical Literature Database (CBM), PubMed, EMBASE, Web of Science, and Cochrane Library databases for articles published until October 2021. The primary outcomes were probing pocket depth (PPD), clinical attachment loss (CAL), plaque index (PLI), and sulcular bleeding index (SBI), while the secondary outcomes were tooth mobility (TM), glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG), total effective rate, and adverse effects. Results: Eleven randomized controlled trials (RCT) were included in the meta-analysis. The pooled results showed PPD (WMD = 1.07, 95%CI: (0.82, 1.33), P < 0.00001, I 2 = 89%), CAL (WMD = 0.78, 95%CI: (0.62, 0.93), P < 0.00001, I 2 = 58%), PLI (WMD = 0.44, 95%CI: (0.09, 0.79), P=0.01, I2 = 97%), SBI (WMD = 0.87, 95%CI: (0.79, 0.95), P < 0.00001, I 2 = 37%), TM (WMD = 0.26, 95%CI: (0.21, 0.30), P < 0.00001, I 2 = 31%), HbA1c (WMD = 0.48, 95%CI: (0.28, 0.67), P < 0.00001, I2 = 26%), FBG (WMD = 1.34, 95%CI: (0.96, 1.72), P < 0.00001, I 2 = 52%), total effective rate (RR = 1.24, 95%CI: (1.14, 1.34), P < 0.00001, I 2 = 0%), and adverse effects (RR = 0.78, 95%CI: (0.20, 3.03), P=0.72, I 2 = 0%) in the traditional Chinese medicine based on the method of "nourishing kidney and clearing heat" + routine western medicine treatment (periodontal basic treatment, PBT, with or without antibiotic) group were significantly improved compared to control group, but no significant difference was observed for PLI at 2-3 months and 6 months. Conclusions: This review supports traditional Chinese medicine based on the method of "nourishing kidney and clearing heat" as an adjuvant to routine western medicine treatment in the management of diabetes mellitus patients with periodontitis. Within the limits of the evidence, the well-designed, long-term efficacy, and high-quality multicenter RCTs need to be further confirmed.

A systematic review and meta-analysis of acupuncture treatment for oral ulcer.

BACKGROUND: Oral ulcers (OU) is a common oral mucosal disease manifested with obvious pain; in some studies, the efficacy of acupuncture in OU has been confirmed, but the systematic reviews and meta-analyses for them are lacking. Our aim is to evaluate the efficacy and safety of acupuncture in the treatment of OU. METHODS: Relevant randomized controlled trials (RCTs), quasi RCTs and non-RCTs will be identified by systematic searching from the following electronic databases: PubMed, Embase, the Cochrane Library, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, China Science and Technology Journal database, and Wanfang Data (since inception of the databases to present). In addition, ongoing trials will be retrieved from the Chinese Clinical Trial Register, World Health Organization International Clinical Trials Registry Platform, Clinical Trials, and The Clinical Trials Register. Grey literature will be also taken into consideration, including academic dissertation, minutes of the meeting from Chinese Biomedical Literature Database, China National Knowledge Infrastructure, China Science and Technology Journal database, and Wanfang Data. There are no language restrictions. RESULTS: Ethical approval is not required because this study is based on published papers. After peer-review, the study will be disseminated in scientific journals and conferences. CONCLUSION: This systematic review will provide evidence for the efficacy and safety of acupuncture for Oral ulcers. TRIAL REGISTRATION NUMBER: CRD42020144911.

Multifunctional cyclotriphosphazene/hexagonal boron nitride hybrids and their flame retarding bismaleimide resins with high thermal conductivity and thermal stability.

A novel hybridized multifunctional filler (CPBN), cyclotriphosphazene/hexagonal boron nitride (hBN) hybrid, was synthesized by chemically coating hBN with hexachlorocyclotriphosphazene and p-phenylenediamine, its structure was systemically characterized. Besides, CPBN was used to develop new flame retarding bismaleimide/o,o'-diallylbisphenol A (BD) resins with simultaneously high thermal conductivity and thermal stability. The nature of CPBN has a strong influence on the flame behavior of the composites. With the addition of only 5 wt % CPBN to BD resin, the thermal conductivity increases 2 times; meanwhile the flame retardancy of BD resin is remarkably increased, reflected by the increased limited oxygen index, much longer time to ignition, significantly reduced heat release rate. The thermogravimetric kinetics, structures of chars and pyrolysis gases, and cone calorimeter tests were investigated to reveal the unique flame retarding mechanism of CPBN/BD composites. CPBN provides multieffects on improving the flame retardancy, especially in forming a protective char layer, which means a more thermally stable and condensed barrier for heat and mass transfer, and thus protecting the resin from further combustion.