Safety and tolerability of calcitonin-gene-related peptide binding monoclonal antibodies for the prevention of episodic migraine - a meta-analysis of randomized controlled trials.

AIM: To systematically evaluate the safety and tolerability of calcitonin-gene-related peptide binding monoclonal antibodies from the results of randomized controlled trials. METHODS: Online databases were searched on calcitonin-gene-related peptide binding monoclonal antibodies for the prevention of episodic migraine. Overall withdrawal, withdrawal due to adverse events, adverse events, serious adverse events and specific adverse events were extracted from the included studies. A meta-analysis was performed with Revman 5.3.0 software. RESULTS: Ten studies that investigated four drugs (galcanezumab, erenumab, fremanezumab and eptinezumab) with 5817 participants were included in this study. Serious adverse events, overall withdrawals, withdrawal due to adverse events and any adverse events were not significantly associated with monoclonal antibody treatment. Injection site pain and erythema were significantly higher in the calcitonin-gene-related peptide binding monoclonal antibodies treatment group than in the placebo group. The rates of serious adverse events were significantly higher in the galcanezumab 120 mg group. Injection site erythema was associated with galcanezumab 120 mg and 240 mg. Injection site pain and nasopharyngitis were associated with galcanezumab 150 mg and 5 mg, respectively. Overall adverse events were significantly higher with erenumab 70 mg and 140 mg. Treatment-related adverse events were significantly higher with fremanezumab 225 mg/month and 675 mg/quarter. CONCLUSIONS: This study provides data on the safety and tolerability profiles of calcitonin-gene-related peptide binding monoclonal antibodies and confirms their potential use as preventive treatments for episodic migraine. In addition to the acceptable withdrawal rates, serious adverse events were rare, and the severity of most adverse events was mild to moderate. Injection site reaction may be the major adverse event associated with galcanezumab.

Validation of the Neurological Disorders Depression Inventory for Epilepsy (NDDIE) as a rapid suicidality screening tool in Chinese people with epilepsy.

OBJECTIVE: The objective of this study was to validate the Chinese version of the Neurological Disorders Depression Inventory for Epilepsy (NDDIE) as a suicidality screening tool in Chinese people with epilepsy (PWE). METHODS: A consecutive cohort of PWE was recruited from West China Hospital and 363 Hospital. Each patient received a psychiatric evaluation with the Mini International Neuropsychiatric Interview (MINI) and the Chinese version of the NDDIE (C-NDDIE). Demographic and clinical characteristics were collected. Receiver operating characteristic (ROC) curve analysis was conducted. The best possible cutoff was identified with the highest Youden index. Specificity, sensitivity, positive, and negative predictive values were calculated. RESULTS: Among a total of 355 participants, 41 (11.5%) had a moderate to high suicide risk according to the Suicidality Module (SM) of the MINI. Receiver operating characteristic (ROC) curve analysis showed that item 4 ("I'd be better off dead") of the NDDIE had an area under the curve (AUC) of 0.930 (95% confidence interval [CI] = 0.884-0.977), a sensitivity of 80.5%, a specificity of 94.9%, a positive predictive value (PPV) of 68.0%, a negative predictive value (NPV) of 97.7%, and the largest Youden index of 0.754 for a cutoff score of >2. CONCLUSION: Item 4 of the NDDIE is a valuable tool for screening suicidality in Chinese PWE.

Prevalence and risk factors of depression and anxiety among patients with convulsive epilepsy in rural West China.

OBJECTIVES: To explore the prevalence and risk factors of depression and anxiety in patients with convulsive epilepsy (PWE) in rural West China. METHODS: PWE from rural West China were evaluated for depression and anxiety with the Neurological Disorders Depression Inventory for Epilepsy (C-NDDI-E; Chinese version) and the Generalized Anxiety Disorder-7 (GAD-7; Chinese version). We also assessed their quality of life using the Quality of Life in Epilepsy Inventory (QOLIE-31) and their level of social support using the Social Support Rating Scale (SSRS). We used logistic regression analysis to identify independent risk factors of depression and anxiety and analysis of variance (ANOVA) to investigate the association between quality of life and depression and anxiety. RESULTS: Of the 458 PWE in our study, 33.4% have anxiety and 52.6% have depression. SSRS (P = 0.03) and seizure frequency (P = 0.007) are independent risk factors of anxiety, and annual income of the patients (P < 0.001) is an independent risk factor of depression. PWE with both depression and anxiety have significantly lower QOLIE-31 total and subtotal scores. CONCLUSIONS: PWE have a high prevalence of depression and anxiety in rural West China, which may be impacting their quality of life. PWE with depression and anxiety got a worse quality of life, and depression had a greater impact on quality of life for PWE than anxiety. The risk factors of depression and anxiety include seizure frequency and social support, while annual income is an additional risk factor of depression. Identifying risk factors early may be helpful in the timely management of these symptoms.

[Diagnostic value of 3D fast spin-echo sequence scanning combined with multislice spiral CT in knee cruciate ligament injury].

OBJECTIVE: To explore the potential value of three-dimensional fast spin echo（3D-SPACE） combined with multilayer spiral CT （MSCT） in the diagnosis of knee cruciate ligament injury, to provide a new direction for the optimization of subsequent clinical diagnosis. METHODS: A total of 120 patients with knee cruciate ligament injury were treated from April 2020 to April 2021, aged from 21 to 68 with an average of（41.52±4.13） years old. For all patients, separate MSCT scanner scans, 3D-SPACE sequence scans alone and 3D-SPACE sequence combined with MSCT scans were used. The injury and classification of the anterior and posterior cruciate ligament of the knee were compared, the length of the anterior-medial bundle and posterolateral bundle and its angle of the knee with the horizontal plane were observed, the diagnostic value of 3 diagnostic methods in knee cruciate ligament injury were determined. RESULTS: There was no significant difference between the 3D-SPACE sequence scan alone and the MSCT test alone on the total diagnostic rate and grading total diagnostic rate（P>0.05）. The total diagnostic rate and grading total diagnostic rate of 3D-SPACE scan combined with MSCT were significantly higher than those of 3D-SPACE scan or MSCT alone（P<0.05）. The 3D-SPACE sequence scan alone and the MSCT detection alone had no significant difference in the measurement values related to the anterior and posterior cruciate ligaments of the knee joint（P>0.05）. 3D-SPACE sequence scanning combined with MSCT detection on the knee joint anterior and posterior cruciate ligament related measurements were significantly higher than the 3D-SPACE sequence scan or MSCT detection alone（P<0.05）. The area under the ROC curve estimated by 3D-SPACE sequence scanning combined with MSCT was 0.960, which was significantly higher than that of 3D-SPACE sequence scanning and MSCT alone evaluating the area under the ROC curve line of 0.756 and 0.795. The combined 3D-SPACE sequence scanning and 3D-SPACE sequence scanning MSCT analysis and prediction models were statistically different（Z=2.236, P<0.05）, and MSCT alone and 3D-SPACE sequence scanning combined with MSCT analysis and prediction models were statistically different（Z=2.653, P<0.05）. CONCLUSION: The application of 3D-SPACE sequence combined with MSCT scanning for knee cruciate ligament injury can improve the diagnosis rate of patients with knee cruciate ligament injury.It can be used as a diagnostic tool for patients with knee cruciate ligament injury and is worthy of clinical application.

Peroxiredoxin III protein expression is associated with platinum resistance in epithelial ovarian cancer.

We investigated the association between peroxiredoxin III (PRX III) and chemotherapy resistance in ovarian cancer. Patient's specimens were taken at the time of surgery. Determination of resistance is based on whether first diagnosis of relapse occurred within 6 months after the cessation of chemotherapy. PRX III expression was immunohistochemically determined in paraffin-embedded specimens from platinum-resistant (Pt-resistant) and platinum-sensitive (Pt-sensitive) patients. The Pt-resistant group had significantly higher PRX III protein compared to the Pt-sensitive group. The two groups showed no significant differences in pathological classification and age, although they differed significantly in tissue differentiation and stage. PRX III protein was significantly higher in the Pt-resistant serous carcinomas, in moderately and poorly differentiated, and in stage III and IV ovarian cancer tissues compared to the Pt-sensitive group. PRX III may be associated with drug resistance in ovarian cancer.

Using Piezosurgery in Anterior Cervical Discectomy and Fusion to Treat Complex Cervical Spondylotic Myelopathy Is Safe and Effective.

Objective: To investigate the safety and efficacy of piezosurgery in anterior cervical discectomy and fusion (ACDF) for cervical spondylotic myelopathy (CSM). Methods: 47 patients with complex CSM (cCSM) underwent ACDF surgery from 2014 to 2017. Among these patients, 26 underwent ACDF using piezosurgery (group A) and 21 underwent ACDF by using traditional tools such as high-speed air drill, bone curette, and Kerrison bone punch (group B). Average surgical time, intraoperative blood loss, surgical complications, preoperative and postoperative Japanese Orthopaedic Association (JOA) scores, and improvement rate were measured. Results: Average surgical time and intraoperative blood loss were significantly lower in group A than those in group B (P < 0.01). The incidences of surgical complications were 3.8% and 23.8% in the A and B groups (P < 0.05), respectively. There were no significant differences in JOA scores and improvement rates between data collection periods at preoperative, 3-day postoperative, and 1-year postoperative follow-ups (P > 0.05). Conclusion: For treating cCSM, both the piezosurgery and traditional tools led to significant neurological improvement. However, the piezosurgery was superior to the traditional tools in terms of surgical time, blood loss, and complication rate. Hence, piezosurgery was a safe and effective adjunct for ACDF treating cCSM.

[Comparison of multislice spiral CT and MRI in diagnosis of occult fracture of knee joint with meniscus and ligament injury].

OBJECTIVE: To investigate the diagnostic value of multislice spiral CT (MSCT) and MRI in occult fracture of knee joint with meniscus and ligament injury. METHODS: From January 2020 to March 2021, 63 patients with knee occult fracture with meniscus and ligament injury, including 41 males and 22 females, aged from 21 to 67 years old, with an average of (44.35±8.77) years old, the course of disease ranged from 1 to 6 days, with an average of (4.64±1.75) days, the body mass index (BMI) was (19.85±2.78) kg/m2. MSCT and MRI data of 63 patients were collected and statistically analyzed to evaluage their diagnist value. RESULTS: The detection of MRI for occult knee fravtures with meniscus and ligament injury, joint cavity effusion, bone marrow edema, and articular surface injury were 100.00% (63/63), 95.24% (60/63), 42.86% (27/63) and 36.51% (23/63), respectively. The detection rates of MSCT were 49.21% (31/63), 41.27% (26/63), 0.00% (0/63) and 1.59% (1/63), respectively, significantly lwver than that of MRI (P<0.05). The diagnostic sensitivity, specificity and accuracy of MRI were significantly higher than those of MSCT(P<0.05). CONCLUSION: The sensitivity, specificity and accuracy of magnetic resonance imaging in the diagnosis of occult fracture of knee joint with meniscus and ligament injury are significantly better than that of MSCT. MRI has higher accuracy in the diagnosis of peripheral tissue diseases such as joint cavity, articular surface and bone marrow, and can reduce the risk of clinical misdiagnosis.

[Prevalence and risk factors of bronchial asthma among Li nationality in Hainan province].

OBJECTIVE: To study the risk factors of bronchial asthma of Li nationality in Hainan. METHODS: A total of 13 050 subjects of Li nationality were selected by random unequal ratio stratified cluster sampling method from southern, central and western part of Hainan and investigated with Hainan Epidemiological Asthma Survey Questionnaire of Li Nationality. There were 441 cases of bronchial asthma, and 1296 cases of control that were sampled by random number table method. The logistic regression method was used to analyze risk factors. RESULTS: The asthma prevalence of Li nationality in Hainan was 3.38%(441/13 050). The main risk factors of asthma were family asthma (OR = 4.323, 95%CI = 3.259 - 5.735), hypersensitiveness (OR = 7.775, 95%CI = 5.686 - 10.632), smoking (OR = 1.494, 95%CI = 1.174 - 1.902), cooking fuels and living environment. Cold air change (OR = 1.604, 95%CI = 1.286 - 2.001) and respirable dust or irritant gas (OR = 2.123, 95%CI = 1.702 - 2.648) were the important incentives. CONCLUSION: The main risk factors of asthma among Li nationality were family asthma, hypersensitiveness, smoking, cooking fuels by means of fuel oil, hay or wood, living environment by means of couch grass room and human-livestock mix live, cold air change, respirable dust or irritant gas.

[The analysis of adverse health effects of occupational hazards factors in one solid waste landfill].

OBJECTIVE: To determine occupational hazards in work sites of a large solid waste landfill and analyze their adverse health effects. METHOD: The national standardized detection methods were used to determine dust concentration, harmful gas and physical factors in worksites. Routine physical examination, pulmonary function, hearing tests and nervous system test were performed in workers for 2 consecutive years. Urine lead, cadmium and mercury contents were detected. The comet assay was use to measure DNA damage in peripheral blood lymphocytes among workers. RESULT: The main occupational hazard factors in this solid landfill are dust, harmful gas, high temperature and noise. The oxides, carbon monoxide, and noise and high temperatures in summer at some work sites exceeded the national occupational exposure limits. The prevalence of respiratory inflammation and rate of pulmonary function decrease among front-line workers and on-site technical managers are 21.2% and 11.5%, which are significantly higher than those among administrative staff (7.1% and 0) (P < 0.05). Nervous system abnormalities rate of front-line workers and on-site technical managers was 50.0%, which is significantly higher than that (26.7%) of administrative staff (P < 0.05). Because of long-term exposure to high intensity noice, hearing loss rate of bulldozer drivers was 10.3%. In addition, about 75% of workers with DNA damage in peripheral blood lymphocyte are front-line workers. CONCLUSION: Adverse health effects from occupational hazards were observed among workers in this solid waste landfill.

Novel yellow solid-state fluorescent-emitting carbon dots with high quantum yield for white light-emitting diodes.

Fluorescence quenching of carbon dots (CDs) occurs in their aggregated state ascribed to direct π-π interactions or excessive resonance energy transfer (RET). Thus, CDs have been severely restricted for applications requiring phosphors that emit in the solid state, such as the fabrication of white light-emitting diodes (WLEDs). In this report, novel CDs with bright solid-state fluorescence (SSF) were synthesized by simple microwave-assisted synthesis method, using 1,4,7,10-tetraazacyclododecane (cyclen) and citric acid as precursors. Under 365 nm UV light, these CDs emit bright yellow SSF, indicating they successfully overcome the aggregation-induced fluorescence quenching (ACQ) effect. When the excitation wavelength (λex) is fixed at 450 nm, the emission peak of the CDs is centered at 546 nm with the Commission Internationale de l'Eclairage chromaticity (CIE) coordinates of (0.43, 0.55), which means that they can be combined with a blue-emitting chip in order to fabricate WLEDs. More importantly, the absolute quantum yield (QY) of these CDs powder reached 48% at λex of 450 nm, which was much higher than many previously reported SSF-emitting CDs and indicating their high light conversion ability in solid-state. Thanks to the excellent optical property of these CDs powder, they were successfully used in the preparation of high-performance WLEDs. This study not only enriches SSF-emitting CD-based nanomaterials with good prospects for application, but also provides valuable reference for subsequent research on the synthesis of solid-state fluorescent CDs.

The facile preparation of solid-state fluorescent carbon dots with a high fluorescence quantum yield and their application in rapid latent fingerprint detection.

Because of direct π-π interactions and excessive energy resonance transfer, it is very challenging to prepare carbon dots (CDs) with a high fluorescence quantum yield (QY) in the solid state. In this study, novel CDs which gave solid-state fluorescence (SSF) with high brightness were successfully prepared via a simple microwave-assisted method. The prepared ScCDs can emit strong blue fluorescence in the solid state, and the absolute QY of this ScCDs powder reaches 51.7%. Such a high QY means that the ScCDs powder could be successfully applied in rapid latent fingerprint (LFP) detection. The LFP detection performance of this ScCDs powder was studied in detail, and the results show that the LFPs developed using the ScCDs powder can be visualized with high definition and contrast under different conditions. This research not only developed a new type of SSF-emitting CDs, but it also proved that the developed CDs have great potential for applications in LFP detection, and this research may also provide inspiration and ideas for the design of new SSF-emitting CDs.

Development and external validation of a predictive nomogram model of posttraumatic epilepsy: A retrospective analysis.

OBJECTIVE: We aimed to develop and validate a predictive model of posttraumatic epilepsy (PTE). METHODS: The training cohort was patients registered at West China Hospital and diagnosed as traumatic brain injury (TBI) between January 1, 2011, and December 31, 2017. On the basis of multivariable cox proportional hazards model using a forward stepwise method, the nomogram was generated. We externally validated this instrument in 834 participants from two independent cohorts to assess its performance. RESULTS: The nomogram was built based on the results of multivariable cox proportional hazards regression analysis of 1301patients from West China Hospital. The prevalence of PTE was 12.8% (95% confidence interval [CI], 10.9-14.6%) in training cohort, 10.5% (95% CI, 7.5-13.4%) in the testing 1 cohort, and 6.1% (95% CI, 3.7-8.4%) in the testing 2 cohort. 7 independent predictors of PTE composed the nomogram (sex, time of loss of consciousness, subdural hemorrhage, contusion sites, early posttraumatic seizures, TBI severity, and treatment). The C-index was 0.846 (95% CI, 0.817-0.876), and the corresponding sensitivity and specificity were 0.867 and 0.738. External validations showed good discrimination in overall testing cohorts with a C-index of 0.895 (95% CI, 0.859-0.930), in the testing 1 cohort (C-index 0.897, 95% CI, 0.855-0.938) and testing 2 cohort (C-index, 0.883, 95% CI, 0.814-0.952). Calibration of this model was also good since the calibration plots were close to the ideal line. CONCLUSIONS: This nomogram was developed and validated in a large cohort for individualized prediction of PTE, which can identify individuals at high risk of epilepsy and help us find preventive drugs based on these targeted population.

Amphiphilic BODIPY-based nanoparticles as "light-up" fluorescent probe for PAEs detection by an aggregation/disaggregation approach.

Phthalic acid eaters (PAEs) play the role of plasticizer and have been widely used in the industrial and plastic production process. But due to not chemically bound in the polymeric matrix, PAEs can be easily released directly and/or indirectly into the environment, and pose a threat the ecosystem and human health. Small-molecule self-assembled nanoparticles have drawn more and more attention due to advantages of precise molecular structure, biocompatibility, great diversity, and tunability in optical properties and functionalities. Here we report the use of disaggregation-induced emission (DIE) based supramolecular assembly to design organic nanoprobe for detection PAEs. In the water solution, the designed small organic fluorophore AJ-1 was aggregated via noncovalent forces to form fluorescence off nanoparticles, but in the presence of PAEs, they disaggregated and produced a clear light-up fluorescent signal. The detection of PAEs with selectivity, sensitivity and rapid response were further achieved. The experiment of recovery of PAEs in real-water sample illustrated the practicability of probe AJ-1 in real-world applications. Besides, cellular uptake assay suggested that AJ-1 could pass through membrane and gather in the cytoplasm.

[Prevalence survey on bronchial asthma of Li nationality in Hainan from 2003 to 2007].

OBJECTIVE: To learn the prevalence rate and distribution of bronchial asthma of Li nationality in Hainan by epidemiological survey so as to provide rationales for preventing and treating asthma. METHODS: A total of 13 050 subjects of Li nationality in Hainan were investigated by random sampling of stratified cluster method with an unequal ratio according to the medical records, physical signs and symptoms and pulmonary function tests. Then the prevalence was analyzed according to different population characteristics. RESULTS: The prevalence rate of asthma was 3.38% for Li nationality in Hainan. And it increased with an advancing age. It was much higher in agricultural population (4.08%) than that in cultivation and commercial populations (2.52% and 1.97%, P < 0.01). The asthma prevalence rate was in the highest at 4.62% in rubber workers. And it was much higher in rural areas than that in urban areas (3.85% vs 2.63%, P < 0.01). CONCLUSIONS: The epidemiological distribution of asthma of Li nationality in Hainan has been determined. And asthma remains a severe problem locally. The efforts of preventing and treating asthma and its education should be strengthened.

[Study on the injury of vascular endothelial cells affected by dust particles from workplaces in pottery factories and tungsten mines].

OBJECTIVE: to assess direct adverse effects of occupational dusts from pottery factories and tungsten mines on vascular endothelial cells in vitro test. METHODS: human umbilical vein endothelial cell (HUVEC) line HUV-EC-C were used as target cells. HUVEC were then treated with respirable dust particles from workplaces in pottery factories and tungsten mines in concentrations of 25, 50, 100, 200 and 400 microg/ml for 24 h. Standard quartz was used as control. LDH activity, cell viability, the release of NO and TNF-α levels were determined to assess the biological responses of the dust particles. RESULTS: dose-response relationships between the dust concentrations and the enhancement of the LDH activity, the release of NO and TNF-α were found in both dust particles from pottery factories and tungsten mines. The cell viability decreased with the increase of dust concentration from 25 to 400 microg/ml. Compared with the dust particles from workplaces, the quartz dust induced significantly higher LDH activity (P < 0.05) after cultured with HUVEC. No significant difference of releases of NO were observed among the dust particles from workplaces and standard quartz. However, significantly higher levels of TNF-α were induced by standard quartz compared with dust samples from workplaces at concentrations of 200, 400 microg/ml. CONCLUSION: occupational dust particles from workplaces and quartz could induce the injury and the releases of TNF-α from HUVEC.

The tolerability and safety profile of eslicarbazepine acetate in neurological disorders.

OBJECTIVES: This study aimed to assess the tolerability and safety profile of eslicarbazepine acetate (ESL). METHODS: Placebo controlled, double-blind randomized controlled trials (RCTs) were enrolled by searching Pubmed, Embase, Cochrane Online Library, and clinicaltrial.gov. Studies evaluating the safety of ESL on any neurological disorders were included. Adverse events (AEs), serious AEs and AEs-related withdrawals were pooled by direct or indirect meta-analysis. RESULTS: A total of 4067 patients in 13 RCTs (5 for refractory partial epilepsy, 2 for bipolar I disorder, 1 for migraine, 1 for fibromyalgia, 2 for diabetic neuropathic pain, and 2 for post-herpetic neuralgia) were included. Meta-analysis revealed that ESL treatment had a higher incidence of serious AEs and AEs-related withdrawals than the placebo. Of 35 reported AEs, 13 were significantly associated with ESL treatment, including blurred vision, diplopia, vertigo, nausea, vomiting, fatigue, dizziness, somnolence, headache, rash, hyponatraemia, increased gamma-glutamyl transferase, and dysarthria. Subgroup analysis revealed that dizziness was the only AE significant at 400 mg/day, while diplopia, nausea, vomiting, dizziness, somnolence, rash, and hyponatremia at 800 mg/day, and blurred vision, diplopia, vertigo, nausea, vomiting, fatigue, dizziness, somnolence, headache, rash, and hyponatremia at 1200 mg/day were significant. Adjunctive use of ESL in refractory epilepsy significantly led to higher risk for vestibulocerebellar AEs than other disorders. CONCLUSIONS: ESL treatment was related to a range of AEs, especially at high doses or when used as adjunctive therapy in epilepsy. While the majority of AEs of ESL were related to the vestibulocerebellar system, hyponatremia and rash should also be noted by clinicians.

Epidemiology of traumatic brain injury-associated epilepsy in western China: An analysis of multicenter data.

OBJECTIVES: This study aims to explore the probability of developing posttraumatic epilepsy (PTE) in the following 8 years after traumatic brain injury (TBI), the risk factors associated with PTE and its cumulative prevalence. METHODS: This is a retrospective follow-up study of patients with traumatic brain injury (TBI) discharged from the West China Hospital between January 1, 2011 and December 31, 2017, Chengdu Shang Jin Nan Fu Hospital and Sichuan Provincial People's Hospital from January 1, 2013 to March 1, 2015. We used forward stepwise method to build the final multivariate cox proportional hazard regression model to obtain estimates of hazard ratio (HR) of PTE and 95% confidence intervals (CI). We also conducted Kaplan-Meier survival analysis to investigate the cumulative prevalence of PTE. RESULTS: The cumulative incidence of PTE rose from 6.2% in one year to 10.6% in eight years. There were more male patients in PTE group and generally older. Besides, patients with PTE tended to have abnormal CT scan results. The risk factors of PTE were male (HR = 1.6, 95% CI: 1.1-2.2, P = 0.009), early posttraumatic seizures (HR = 2.9, 95% CI: 2.2-4.1, P < 0.001), TBI severity (moderate TBI: HR = 3.0, 95% CI: 1.8-5.0, P = 0.001; severe TBI: HR = 4.3, 95% CI: 2.3-7.6, P < 0.029), loss of consciousness (LOC) more than 30 min (30 min-24 h: HR = 1.8, 95% CI: 1.02-3.1, P = 0.041; >24 h: HR = 2.4, 95% CI: 1.4-2.4, P = 0.001), subdural hematoma (SDH) (HR = 1.9, 95% CI: 1.4-2.5, P < 0.001), brain contusion sites (frontal-temporal lobe: HR = 2.7, 95% CI: 1.9-3.9, P < 0.001; other sites: HR = 1.5, 95% CI: 1.01-2.3, P = 0.042) and cranial surgery (HR = 1.7, 95% CI: 1.3-2.3, P < 0.001). SIGNIFICANCE: The probability of developing PTE increased during the study period. In addition, the risk of developing PTE was significantly associated with gender, EPTS, LOC time, SDH, brain contusion sites, surgery and TBI severity. However, further researches may be needed to predict the risk of PTE in combination with quantitative factors.

Therapeutic effect of intravenous levetiracetam in status epilepticus: A meta-analysis and systematic review.

PURPOSE: We performed this analysis to evaluate the efficacy and safety of intravenous levetiracetam (IV LEV) in patients with status epilepticus. METHOD: Studies were searched in MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials for available randomized controlled trials(RCTs) comparing the efficacy and/or safety of IV LEV with other antiepileptic drugs (AEDs). Meta-analysis was performed using the random-effects model to calculate risk ratio with the RevMan 5.3 software. RESULTS: Six RCTs with a total of 543 patients were included. There was no significant differences in clinical seizure cessation and hospital mortality, either between IV LEV and IV phenytoin (PHT) or between IV LEV and IV valproate (VPA). Compared with IV PHT, IV LEV had a lower risk of poor neurological outcome. For IV LEV compared with IV lorazepam (LOR), no significant difference in efficacy was found, but IV LEV patients had significantly lower need for ventilatory assistance. Adding IV LEV to clonazepam (CNP), compared with adding placebo showed no significant differences in seizure cessation at 15 min. CONCLUSIONS: Our results suggested that IV LEV was comparable to IV PHT,VPA, or LOR in efficacy, and IV LEV as add-on therapy of CNP had no superiority in seizure cessation than CNP plus placebo. IV LEV may have a better tolerability than other AEDs do. More RCTs are needed to validate the role of IV LEV in status epilepticus.

[Experimental research on biological responses of productive dusts from pottery factories and tungsten mines].

OBJECTIVE: To assess biological response and health adverse effects of industrial dusts from pottery factories and tungsten mines on alveolar macrophages (AM) in vitro. METHODS: AM acquired from bronchoalveolar lavage of guinea pigs were used as the target cells. AM were then co-cultured with respirable dust particles (15, 30, 60 and 120 µg/106) from pottery factories and tungsten mines. LDH activity, cell viability, the release of ROS and TNF-α were determined to assess the biological responses of the dusts. China Standard Quartz was used as control. RESULTS: Dose- response relationships between the dust concentrations and the enhancement of LDH activity, the release of ROS and TNF-α were found in both dusts from pottery factories and tungsten mines. The cell viability decreased when the dusts' concentrations increased. Differences of biological response were observed in the dust particles from different mines or factories. Compared with the pottery dusts, higher LDH activity and the release of TNF-α induced by tungsten dust were observed. In the 120 µg/106 group, the TNF-α induced by tungsten dust, pottery dusts and China Standard Quartz was (5.2 +/- 2.0) ng/ml, (3.3 +/- 1.6) ng/ml and (2.8 +/- 0.5) ng/ml respectively. However, the impact on the cell viability induced by pottery dust was higher than that by tungsten mine. CONCLUSION: Industrial dusts from various sources could induce different biological effects. The results of the biological effects of dusts in laboratory tests may be of potential use to provide base data for their adverse effects evaluation.

Predictors of seizure reduction outcome after vagus nerve stimulation in drug-resistant epilepsy.

PURPOSE: To evaluate the predictors of seizure reduction outcome after vagus nerve stimulation (VNS) in patients with drug-resistant epilepsy (DRE). METHODS: A meta-analysis was performed using relevant research from databases such as PubMed, Embase, Cochrane Online Library, and Clinicaltrials.gov. Studies were selected according to predefined inclusion and exclusion criteria. The quality of studies was evaluated by using the Newcastle-Ottawa Scale (NOS) scale. All data was pooled by STATA 12.0 software for meta-analysis. RESULTS: The review considered 1281 articles, and 16 articles with NOS score ≥6 were included in the analysis. The meta-analysis showed that at 6 m, 1, 2, 3, 4, 6 and 12 years after implantation, 33.99, 43.42, 46.50, 63.31, 52.71, 54.64, 70.37 and 82.90% of patients exhibited >50% reduction of seizure frequency after VNS. The duration of epilepsy showed a significant difference between the good responders and poor responders (p = 0.038), whereas age at VNS implantation (p = 0.305), age at seizure onset (p = 0.530), seizure type (p = 0.11), etiology (p = 0.187), and history of previous epilepsy surgery (p = 0.075) were not predictors of seizure reduction outcome after VNS. Several features about the electroencephalogram (EEG) feature and heart rhythm complexity (HRV) have not been analyzed by a sufficient number of studies. CONCLUSIONS: DRE patients with shorter duration of epilepsy may be better candidates for VNS rather than those who are younger at onset and implantation. Several EEG or HRV features may have predictive value but more research is needed.