Efficacy and safety of levetiracetam vs. oxcarbazepine in the treatment of children with epilepsy: a systematic review and meta-analysis.

Background: Levetiracetam (LEV) and oxcarbazepine (OXC) are new antiseizure medications (ASMs). In recent years, OXC monotherapy is widely used in children with epilepsy; however, no consensus exists on applying LEV monotherapy among children with epilepsy. Objective: The present work focused on comparing the efficacy and safety of LEV and OXC monotherapy in treating children with epilepsy. Methods: We conducted a comprehensive search across multiple databases including PubMed, Cochrane Library, Embase, Web of Science, CNKI, Wanfang Database, VIP, and China Biology Medicine disc, covering studies from inception to August 26, 2023. We included randomized controlled trials (RCTs) and cohort studies evaluating the efficacy and safety of LEV and OXC monotherapy for treating epilepsy in children. We utilized Cochrane Risk of Bias Tool in RevMan 5.3 software for assessing included RCTs quality. In addition, included cohort studies quality was determined using Newcastle-Ottawa Scale (NOS). A random-effects model was utilized to summarize the results. Results: This meta-analysis included altogether 14 studies, including 893 children with epilepsy. LEV and OXC monotherapy was not statistical different among children with epilepsy in seizure-free rate (relative risk [RR] = 1.010, 95% confidence interval [CI] [0.822, 1.242], P > 0.05) and seizure frequency decrease of ≥50% compared with baseline [RR = 0.938, 95% CI (0.676, 1.301), P > 0.05]. Differences in total adverse reaction rate [RR = 1.113, 95% CI (0.710, 1.744), P > 0.05] and failure rate because of serious adverse reaction [RR = 1.001, 95% CI (0.349, 2.871), P > 0.05] were not statistical different between LEV and OXC treatments among children with epilepsy. However, the effects of OXC monotherapy on thyroid among children with epilepsy was statistically correlated than that of LEV (thyroid stimulating hormone: standardized mean difference [SMD] = -0.144, 95% CI [-0.613, 0.325], P > 0.05; free thyroxine: SMD = 1.663, 95% CI [0.179, 3.147], P < 0.05). Conclusion: The efficacy of LEV and OXC monotherapy in treating children with epilepsy is similar. However, OXC having a more significant effect on the thyroid than that of LEV. Therefore, LEV may be safer for children with epilepsy who are predisposed to thyroid disease than OXC. Systematic Review Registration: https://www.crd.york.ac.uk/, PROSPERO (CRD42024514016).

Electroacupuncture alleviates neurological function via activating the Yap-OPA1 axis and mitochondrial fusion in rats with cerebral ischemia-reperfusion injury. / 电针通过Yesç›¸å ³è›‹ç™½-视神经萎缩蛋白1ä¿¡å·è½´æ¿€æ´»çº¿ç²’ä½“èžåˆåŠŸèƒ½å‡è½»å¤§é¼ è„‘ç¼ºè¡€å†çŒæ³¨æŸä¼¤çš„æœºåˆ¶ç ”ç©¶.

OBJECTIVES: To investigate the mechanism of electroacupuncture (EA) in alleviating cerebral ische-mia injury by activating the Yap-OPA1 signaling axis. METHODS: A total of 48 male SD rats were used in the present study. The focal CIRI model was established by occlusion of the middle cerebral artery and reperfusion (MCAO/R), followed by dividing the CIRI rats into model group, EA group and EA+Ver (Verteporfin, Yap antagonist) group (n=12 in each group). And another 12 normal rats were used as the sham operation group. For rats of the EA group, EA (4 Hz/20 Hz, 0.5 mA) was applied to "Baihui"(GV20) and "Shenting"(GV24) for 20 min, once daily for 7 days. The neurological deficit score (0 to 4 points) was given according to Longa's method. The infarct volume of rats in each group was assessed by TTC method, and the expression levels of Yes associated protein (Yap), Optic atrophy protein 1 (OPA1), mitofusin 1 (Mfn1), mitofusin 2 (Mfn2) proteins and mRNAs in cerebral cortex of infarcted side, as well as Bax (proapoptotic factor) and Bcl-1 (anti-apoptotic protein) proteins were detected by Westernblot, and real-time PCR, and the immunoactivity of Yap and OPA1 was detected by immunofluorescent staining. RESULTS: After modeling, the infarct volume, neurological deficit score and the expression of Bax were significantly increased (P<0.01), while the mRNA and protein expressions of Yap, OPA1, Mfn2, Mfn1, and Bcl-2 were significantly down-regulated in the model group relevant to the sham operation group (P<0.01, P<0.05). Compared with the model group, the neurological deficit score, infarct volume and the expression of Bax were significantly decreased (P<0.01), while the expression levels of Yap, OPA1, Mfn2, Mfn1 proteins and mRNAs and Bcl-2 protein, Yap and OPA1 immunofluorescence intensify were considerably up-regulated in the EA group (P<0.01, P<0.05). Following administration of Ver, the effects of EA in down-regulating the neurological score, infarct volume, and Bax expression and up-regulating the expressions of Yap, OPA1, Mfn1, Mfn2 proteins and mRNAs and Yap and OPA1 immunofluorescence intensify were eliminated. CONCLUSIONS: EA of GV20 and GV24 can improve the neurological function in rats with CIRI, which may be associated with its functions in activating mitochondrial fusion function and up-regulating Yap-OPA1 signaling axis.

[Electroacupuncture alleviates cerebral ischemia injury in rats by regulating melatonin-NLRP3 and inhibiting pyroptosis].

OBJECTIVE: To investigate the mechanism of electroacupuncture in alleviating cerebral ischemia injury in cerebral ischemia-reperfusion rats by regulating melatonin - NOD-like receptor protein 3 (NLRP3) mediated pyroptosis. METHODS: A total of 48 SD rats were randomly divided into sham operation group, model group, electroacupuncture (EA) group and EA +Luz group, with 12 rats in each group. The focal cerebral ischemia-reperfusion injury model was established by middle cerebral artery embolization. Rats of the EA group was treated with EA stimulation (4 Hz/20 Hz, 0.5 mA,20 min) at "Baihui" (GV20) and "Shenting" (GV24) once a day for 7 consecutive days; rats of EA+Luz group were given the same EA treatment and intraperitoneally administered melatonin receptor antagonist (luzindole, 30 mg/kg), once a day for 7 consecutive days. The neurological impairment was evaluated by Zea Longa score. The level of serum melatonin content at 12:00 and 24:00 was detected by ELISA. The percentage of cerebral infarction volume was evaluated by MRI of small animals. The apoptosis rate of nerve cells in cerebral cortex of infarct side was detected by TUNEL staining. The activation of microglia cells was detected by immunofluorescence staining. The expression levels of pyroptosis-related proteins NLRP3, Caspase-1 and interleukin (IL) -1ß were detected by Western blot. RESULTS: Compared with the sham operation group, the neural function score was significantly increased (P<0.01); the melatonin content was significantly decreased at 24:00 (P<0.01); the percentage of cerebral infarction volume, apoptosis rate of nerve cells in cerebral cortex area of infarction side, the expressions of NLRP3, Caspase-1 and IL-1ß proteins were significantly increased (P<0.01); and microglia cells were significantly activated in the model group.Compared with the model and EA +Luz groups, the nerve function score was significantly decreased (P<0.05); the percentage of cerebral infarction volume, the nerve cell apoptosis rate, the activation level of microglia cells, the expression levels of NLRP3, Caspase-1 and IL-1ß were significantly decreased (P<0.01, P<0.05) in the EA group. Compared with the model and EA+Luz groups, the melatonin content at 24:00 was significantly increased (P<0.01, P<0.05) in the EA group. CONCLUSION: EA at GV20 and GV24 can reduce the neurolo-gical injury in cerebral ischemia reperfusion model rats, which may be related to regulating the expression of endogenous melatonin, inhibiting cell scorchification and reducing cerebral ischemia injury.

[Electroacupuncture ameliorates ischemic injury in cerebral ischemia-reperfusion rats by regulating endogenous melatonin and inhibiting the activation of astrocytes].

OBJECTIVE: To observe the effect of electroacupuncture(EA)at "Baihui"(GV20) and "Shenting" (GV24) on the expression of melatonin synthesis rate-limiting enzyme-arylalkylamine N-acetyltransferase(AANAT)in pineal gland of rats with focal cerebral ischemia-reperfusion injury, so as to explore the mechanism of EA underlying improving ischemia-reperfusion injury. METHODS: Forty-eight SD rats were randomly divided into sham operation, model, EA and non-acupoint groups, with 12 rats in each group. The focal cerebral ischemia-reperfusion injury rat model was established by occlusion of the middle cerebral artery. Rats of the EA group received EA at GV20 and GV24, while those in the non-acupoint group received EA at non-acupoints below the costal margins on both sides for 20 min, once daily for 7 days. The neurological deficit score (0 to 4 points) was given after successful modeling according to Longa's method. Morris water maze test was used to assess the cognitive function of rat. ELISA was used to detect the plasma melatonin content, and PCR and Western blot were used to detect the mRNA and protein expressions of AANAT in the pineal gland, separately. Immunofluorescence staining was used to detect the activation of astrocytes and neuronal injury in the hippocampus. RESULTS: After focal cerebral ischemia-reperfusion injury and compared with the sham operation group, the neurological deficit score, the escape latency, and the expression of GFAP were significantly increased (P<0.01)，while the times of platform quadrant crossing, the secretion of melatonin at 24:00，AANAT mRNA and protein expression levels and NeuN protein expression were significantly down-regulated (P<0.01). After EA at GV20 and GV24, the above-mentioned indexes all reversed in the EA group relative to the model group, and there were significant differences between the two groups(P<0.01). Compared with the model group, the changes of the abovementioned indexes in the non-acupoint group were not statistically significant (P>0.05). CONCLUSION: EA at GV20 and GV24 can alleviate neurological deficit and improve cognitive function in cerebral ischemia-reperfusion rats，which may be related to its effects in up-regulating endogenous melatonin levels, inhibiting the activation of astrocytes and protecting damaged neurons in the hippocampus.

Development and Validation of an Effective CRISPR/Cas9 Vector for Efficiently Isolating Positive Transformants and Transgene-Free Mutants in a Wide Range of Plant Species.

The CRISPR/Cas9 technique is a highly valuable tool in creating new materials for both basic and applied researches. Previously, we succeeded in effectively generating mutations in Brassica napus using an available CRISPR/Cas9 vector pKSE401, while isolation of Cas9-free mutants is laborious and inefficient. Here, we inserted a fluorescence tag (sGFP) driven by the constitutive 35S promoter into pKSE401 to facilitate a visual screen of mutants. This modified vector was named pKSE401G and tested in several dicot plant species, including Arabidopsis, B. napus, Fragaria vesca (strawberry), and Glycine max (soybean). Consequently, GFP-positive plants were readily identified through fluorescence screening in all of these species. Among these GFP-positive plants, the average mutation frequency ranged from 20.4 to 52.5% in Arabidopsis and B. napus with stable transformation, and was 90.0% in strawberry and 75.0% in soybean with transient transformation, indicating that the editing efficiency resembles that of the original vector. Moreover, transgene-free mutants were sufficiently identified in Arabidopsis in the T2 generation and B. napus in the T1 generation based on the absence of GFP fluorescence, and these mutants were stably transmissible to next generation without newly induced mutations. Collectively, pKSE401G provides us an effective tool to readily identify positive primary transformants and transgene-free mutants in later generations in a wide range of dicot plant species.

Enhanced remediation of dioxins-spiked soil by a plant-microbe system using a dibenzofuran-degrading Comamonas sp. and Trifolium repens L.

In this study, rhizoremediation technology was applied to dioxins-spiked soil. A dibenzofuran-degrading bacterium Comamonas sp. strain KD7, reported in the previous paper, was used in combination with white clover (Trifolium repens L.). First, the effect of strain KD7 on clover seed germination and root elongation was examined in the presence of dioxins compounds. As a result, the white clover seeds inoculated with strain KD7 exhibited a higher germination efficiency and increased root elongation compared with uninoculated white clover. Next, the recovery efficiency of two extraction methods were considered for analyzing the dioxin concentration in soil samples, then, the potential of the plant-microbe combination was evaluated for the remediation of dioxins-spiked soil. After 12 week of growth, significant reductions in the soil were confirmed for most compounds. Our results demonstrated that clover can function as a carrier in order to increase the dioxin-degrading activity of strain KD7. The association of clover and strain KD7 is considered to be a potential tool in the remediation of dioxin-contaminated soil.

Root-determined hypernodulation mutant of Lotus japonicus shows high-yielding characteristics.

Here we report the phenotypic characteristics of a novel hypernodulation mutant, Ljrdh1 (root-determined hypernodulation 1) of Lotus japonicus. At 12 weeks after rhizobial inoculation, there were no differences between the growth of Ljrdh1 and, wild-type. However, Ljrdh1 showed 2 to 3 times higher nitrogen-fixing activity, and seed and pod yields, were approximately 50% higher than the wild-type. This is the first report of a legume hypernodulation mutant showing normal growth and a high-yielding characteristic under optimal cultivation conditions.

Evaluation of the phytoremediation potential of four plant species for dibenzofuran-contaminated soil.

In this experiment, three grasses, bermuda grass (Cynodon dactylon), bent grass (Agrostis palustris Huds.), lawn grass (Zoysia japonica), and a shallow-rooted legume, white clover (Trifolium repens L.) were planted into uncontaminated soil and dibenzofuran (DBF)-contaminated soil. The germination rates of all plants were investigated using contaminated soils to evaluate their sensitivities to DBF. During 2 months of growth, the root biomass and heterotrophic microbial numbers were measured in order to evaluate the potential of remediation. Furthermore, the number of DBF-degrading bacteria was counted to evaluate plants that enhance the microbial DBF degradation potential in contaminated soil. The DBF-removal performance of four plant species was also compared. Regardless of the contamination of DBF, white clover had not only the highest root biomass, but also the highest DBF-degrading bacterial numbers compared to those of the other three grasses. Moreover, white clover-planted contaminated soil exhibited the highest rate of DBF removal among all tested plants. These results suggest that microbial populations capable of degrading DBF were selectively increased by the addition of DBF in the rhizosphere, and also indicate that the presence of plants significantly enhances the reduction of DBF in soils. Based upon these results, white clover was selected for the further investigation of the phytoremediation of dioxin-contaminated soil.

Isolation and characterization of dibenzofuran-degrading Comamonas sp. strains isolated from white clover roots.

Three dibenzofuran (DF)-degrading strains were newly isolated from roots of white clover ( Trifolium repens L.) and poplar trees grown in DF-contaminated soil samples. These strains, designated KD2, KD7, and PD1, were characterized as Comamonas sp. on the basis of their 16S rDNA sequences and physiological characteristics. The metabolites produced when strain KD7 was incubated with DF were identified by gas chromatography-mass spectrometry (GC-MS) analysis. Interestingly, strain KD7 was found to have two pathways for DF degradation, beginning with angular dioxygenation at carbons 4 and 4a, and lateral dioxygenation at carbons 1 and 2, respectively. Furthermore, strains KD2 and KD7 not only achieved efficient root colonization in clover but also promoted clover growth. They are the first reported Comamonas sp. strains capable of utilizing DF as a sole carbon source. This provides additional information on the diversity of DF-degrading bacteria.