ABSTRACT
<p><b>OBJECTIVE</b>To investigate the recurrence rate and risk factors of spontaneous symptomatic epileptic seizures after the first episode in infants and young children.</p><p><b>METHODS</b>The clinical data of infants and young children who experienced the first episode of spontaneous symptomatic epileptic seizures between April 2009 and April 2011 in Suzhou Children's Hospital were collected. Follow-up visits were performed once every 1-3 months, and the follow-up time was 1-60 months. The Kaplan-Meier method and Cox proportional hazards model were applied to calculate the recurrence rate of spontaneous symptomatic epileptic seizures and analyze the risk factors for seizure recurrence.</p><p><b>RESULTS</b>Sixty-three children experiencing a first episode of spontaneous symptomatic epileptic seizures were enrolled. Within 5 years after the first episode, 43 children experienced the recurrence of spontaneous symptomatic epileptic seizures, with a 5-year cumulative recurrence rate of 69.4%. Among all recurrent cases, 86% experienced recurrence within 1 year after the first episode. The multivariate analysis with the Cox proportional hazards model showed that epileptiform discharges on electroencephalography were the independent risk factor for recurrence of spontaneous symptomatic epileptic seizures (HR=5.349, 95%CI: 2.375-12.048).</p><p><b>CONCLUSIONS</b>The recurrence rate of spontaneous symptomatic epileptic seizures after the first episode is high in infants and young children. Epileptiform discharges on electroencephalography are the independent risk factor for the recurrence, and thus it is suggested to perform antiepileptic therapy for these children.</p>
Subject(s)
Child, Preschool , Female , Humans , Infant , Male , Epilepsy , Proportional Hazards Models , Recurrence , Risk FactorsABSTRACT
Objective To explore the surgical treatment of refractory cerebrospinal fluid rhinorrhea with recurrent bacterial meningitis.Methods The clinical data of 1 case of a 10-year-old boy who had 9 episodes of bacterial meningitis and underwent 4 surgical repair procedures for congenital cerebrospinal fluid rhinorrhea at the Children's Hospital Affiliated to Soochow University were analyzed,and the related literatures were reviewed.Results During the intervals of 9 episodes of bacterial meningitis,the patient experienced 4 neurosurgical repairs of cerebrospinal fluid rhinorrhea,including 2 endoscopic repairs via the lateral nasal cavity,a craniotomy approach repair via forehead epidural,and an endoscopic repair in combination with a ventriculo-peritoneal shunt.The first 3 surgeries were all failed,but the final surgery was successful,with no recurrence of cerebrospinal fluid rhinorrhea or bacterial meningitis in 3.5 years of follow-up.Conclusions For recurrent meningitis and refractory cerebrospinal fluid rhinorrhea,the ventriculo-peritoneal shunt can be considered in addition to conventional nasal endoscopic cerebrospinal fluid repair to eliminate the increased cerebrospinal fluid attributable to long-term chronic compensation,and effectively reduce postoperative intracranial hypertension to make the operation success.
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the clinical efficacy of capecitabine combined with transcatheter arterial chemoembolization (TACE) for advanced liver cancer.</p><p><b>METHODS</b>Forty-nine patients with liver cancer were retrospectively divided into two groups: Treatment group, on the basis of TACE, 23 patients received oral capecitabine at 2500 mg/m(2), twice-daily for 14 days followed by 7-day rest period and repeated in every three week intervals for more than two cycles. Control group, 26 patients received TACE only at 2-month intervals for at least two cycles.</p><p><b>RESULTS</b>In capecitabine and TACE group: there were 1 CR, 14 PR, 5 SD and 3 PD; the overall response rate was 65.2%; the AFP and tumor reduction rates were 68.8% and 73.9%; the median survival time was 11.9 months. In the TACE only group: there were 0 CR, 7 PR, 12 SD and 7 PD; the overall response rate was 26.9%; the AFP and tumor reduction rates were 31.6 % and 30.8%; the median survival time was 8.3 months. The most common side-effects of capecitabine were hand-foot syndrome and diarrhea.</p><p><b>CONCLUSION</b>Capecitabine combined with TACE is safe and effective for advanced liver cancer.</p>