摘要
Objective:To investigate the clinical features of patients with epilepsy in Neurosurgery Outpatient and influencing factors for their seizure control.Methods:Six hundred and seventy-three epilepsy patients admitted to Neurosurgery Outpatient of 6 hospitals including Fifth Affiliated Hospital of Zhengzhou University from September 2017 to December 2022 were chosen. Clinical data (including general demographic data, education level, onset age, onset cycle and duration, course of onset, family annual income and seizure control) were collected using a questionnaire prepared by He'nan Epilepsy Systematic Diagnosis and Treatment Center to summarize the clinical features. Univariate and multivariate Logistic regressions were used to analyze the influencing factors for their seizure control.Results:(1) In these 673 epilepsy patients, 50 (7.4%), 78 (11.6%), 192 (28.5%), 100 (14.9%), 68 (10.1%), 72 (10.7%) and 113 (16.8%), respectively, were <1 year old (infant stage), 1-2 years old (children stage), 3-5 years old (preschool stage), 6-16 years old (juvenile stage), 17-39 years old (young stage), 40-64 years old (middle-aged stage) and ≥65 years old (elderly stage). In the past medical treatment history, 23.0% (155/673) patients did not receive intervention, 72.4% (487/673) received medication, and 4.6% (31/673) received surgical treatment; 55.9% (376/673) had good seizure control and 44.1% (297/673) had poor seizure control. (2) Secondary education ( OR=2.199, 95% CI: 1.037-15.221, P=0.033), primary education or below ( OR=3.544, 95% CI: 2.101-21.343, P=0.012), daily seizures ( OR=4.788, 95% CI: 1.369-33.103, P=0.011), each seizure lasted ≥3 min ( OR=4.179, 95% CI: 3.338-18.550, P=0.003), course of disease≥3 years ( OR=0.199, 95% CI: 0.077-0.602, P=0.001), course of disease for 1-3 years ( OR=0.379, 95% CI: 0.108-0.882, P=0.031), and currently taken antiepileptic drugs for 3 or more ( OR=6.237, 95% CI: 2.195-17.837, P=0.001) were independent risk factors for poor seizure control in epilepsy patients. Conclusion:In Neurosurgery Outpatient, children with diseases before childhood enjoy the largest proportion; drug therapy remains the main treatment; low education level, short seizure cycle, long duration of attack, long course of disease, and multiple drugs used in these patients imply poor anti-epileptic effecacy.
摘要
Objective To investigate the influence of radiotherapy with concurrent oral epidermal growth factor receptor ( EGFR) and tyrosine kinase inhibitor ( TKI) for advanced non-small cell lung cancer ( NSCLC) on the incidence of interstitial lung disease ( ILD ) , and to analyze the risk factors for the pathogenesis of ILD. Methods The incidence of ILD in 72 patients with NSCLC who were admitted to Department of Radiotherapy Oncology of Lu′an Hospital of Traditional Chinese Medicine and treated with radiotherapy with concurrent oral EGFR-TKI from January 2010 to January 2014 was analyzed retrospectively,and some patients were selected as controls to compare the difference in the incidence of ILD between the TKI concurrent radiotherapy group and the other groups. The univariate analysis using chi-square test and multivariate logistic regression analysis were applied to analyze the risk factors for the incidence of ILD in the patients receiving TKI concurrent radiotherapy. Results The TKI concurrent radiotherapy group had a significantly higher incidence rate of ILD than the palliative chemotherapy group,single TKI group,and concurrent chemoradiotherapy group ( 19. 4% vs. 2. 5%, 12%, and 7. 5%, P= 0. 045 ) . The multivariate regression analysis showed that male sex,long-term smoking,underlying lung disease,tumor volume>5 cm, and application of conventional radiotherapy were the risk factors for the pathogenesis of ILD in the TKI concurrent radiotherapy group. Conclusions Radiotherapy with concurrent TKI for advanced NSCLC may increase the incidence of ILD.
摘要
Objective To evaluate the diagnostic and prognostic value of BRAF V600E mutation screening of ultrasound-guided fine-needle aspiration (FNA)specimens in patients with thyroid nodule. Methods The BRAF V600E mutation status were assessed in FNA specimens of 104 patients with thyroid nodules before operations.The BRAF mutation status,clinical,and pathology records of the patients were reviewed and the associations between these characteristics and papillary thyroid cancer (PTC ) were analyzed.Results Seventy-one PTC and 14 benign thyroid nodules were included in this study.BRAF V600E mutations were found in 57/71 (80%)PTC.All benign thyroid nodules had no BRAF V600E mutation.The sensitivity,specificity,positive predictive value and negative predictive value of BRAF V600E mutations in differentiation between PTC and benign thyroid nodules were 80%,100%,100% and 50%(P < 0.001 ).In 44 patients with PTC who underwent surgery,the central compartment lymph node metastases and extrathyroidal invasion were not significantly different between BRAF-positive and BRAF-negative PTC (P = 0.283 and 0.307 ).Conclusions BRAF V600E mutation may be a potential tool to facilitate ultrasound in diagnosis of PTC.In patients with PTC,the presence of the BRAFV600E mutation was not significantly associated with prognostic factors.