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Sleep disorder, migraine, cognitive and behavioral disorders, anxiety and depression are common comorbidities of epilepsy. The comorbidity rate of epilepsy patients is eight times that of the general population, which affects the prognosis and quality of life of epilepsy patients. Perampanel (PER), as a third-generation antiseizure medication, has shown promising clinical research and application in the treatment of comorbidities in epilepsy. PER can improve the total sleep time, sleep latency and sleep efficiency of patients with epilepsy comorbid sleep disorder. PER also shows good efficacy in reducing seizure and migraine attacks of patients with epilepsy comorbid migraine. Meanwhile, the impact of PER on overall cognitive characteristics is neutral, with no systematic cognitive deterioration or improvement, but behavioral changes are one of the most common adverse events related to PER. For patients with comorbid anxiety and depression, PER does not exacerbate the anxiety and depression of epilepsy patients, and the severity of anxiety and depression in some patients will improve. This article will review the mechanism of action and clinical treatment research progress of PER on comorbidities of epilepsy.
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Progressive myoclonic epilepsy (PME) is a rare epileptic syndrome closely associated with genetic factors. The disease is primarily inherited in an autosomal recessive manner, although there are rare cases that demonstrate autosomal dominant or mitochondrial inheritance. Common clinical features include myoclonus, multiple seizure types, and progressive decline in neurological and cognitive function. PME typically manifests in late childhood or adolescence but can occur at any age. It accounts for approximately 1% of epileptic syndromes among children and adolescents worldwide. In recent years, in addition to antiseizure medications, numerous non-pharmacological treatments have emerged, including dietary therapy, neuromodulatory therapy, immunomodulatory therapy, enzyme replacement therapy, gene therapy, etc. This article aims to review the research progress in the treatment of PME.
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OBJECTIVE： To compare low-polarity volatile constituents in supercritical CO2 extract from the roots and stem of Ilex asprella and its effects on the proliferation of IEC-6 in vitro， and to provide reference for making full use of wild resources of I. asprella and expanding its medicinal parts. METHODS： The low-polarity volatile constituents were extracted from the root and stem of I. asprella with supercritical fluid CO2 extraction（SFE-CO2）. The chemical constituents were analyzed by GC-MS. IEC-6 cells were treated with different concentrations of supercritical CO2 extracts （0， 1， 5， 10， 20， 40， 60， 80， 100 μg/mL） from roots or stems of I. asprella. MTT assay was used to detect the relative viability， and cell proliferation curve was drawn and EC50 of each extract were calculated. RESULTS： Sixty-two and forty-six low-polarity volatile constituents were identified from supercritical CO2 extract in the roots and stem of I. asprella with GC-MS； there were 24 common constituents totally， mainly including pelargonic acid（14.18％ and 6.14％），octanoic acid（10.59％ and 4.35％），hexanoic acid（8.63％ and 10.86％），paeonol（7.79％ and 6.00％），2-methyl-3-phenyl-propanal（6.3％ and 0.58％），acetic acid（1.72％ and 33.77％） in root and stem， respectively. The results of cell culture in vitro showed that when the concentration of supercritical CO2 extract from the roots and stems of I. asprella was lower （≤60 μg/mL）， it could significantly promote the proliferation of IEC-6 cells and their EC50 were 16.35， 20.20 μg/mL， respectively； when the concentration of the extract was higher （≥80 μg/mL）， it showed cytotoxicity and inhibited the proliferation of IEC-6 cells. CONCLUSIONS： There are similar species of volatile constituents in roots and stems of I. asprella and similar in vitro bioactivity of the supercritical CO2 extracts to IEC-6 cells. The short-chain fatty acids may be the active ingredient to promote cell proliferation， while paeonol may be the cytotoxic active ingredient.
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Objective The aim of this study was to investigate and analyze the etiology, seizure type and anti-epileptic drugs (AEDs) utilization of in-patients with epilepsy Methods The study included 5563 cases in-patients with epilepsy. The etiology and seizure type and the date of type, quantity of AEDs in-patient department were collected and their usage frequency were analyzed statistically. Results The most common etiology of epilepsy was traumatic brain injury(13.64%), followed by hippocampal sclerosis (11.52%), stroke (5.24%), nervous system infection (4.98%), perinatal injury ( 5 . 28 % ) and undefined etiology ( 40 . 80 % ) . The most common seizure type was partial seizures (45.43% ). The AEDs of carbamazepine and valproate were the most common used drugs in the clinical and their average usage frequency were 36.88% and 30.80%, respectively. The newer AEDs of Lamotrigine and Levetiracetam were used more frequently. The use of Lamotrigine increased from 16.16% to 28.44% and the Levetiracetam from 0.61% to 20.87% whereas the use of Oxcarbazepine and Topiramate remained a stable level of 15.07% and 9.42%. Conclusion The etiology of epilepsy is complicated and the seizure type of epilepsy was diverse. Among a great variety of anti-epileptic drugs, the newanti-epileptic drugs are being increasingly used.
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Objective To determine the prevalence and risk factors of Epstein-Barr virus (EBV) infection after pediatric liver transplantation for patients with biliary atresia. Methods Clinical data of 65 pediatric patients with biliary atresia, who underwent liver transplantation, were retrospectively analyzed. Patients were divided into EBV infection group (n=30) and non-EBV infection group (n=35). The univariate analysis was used to analyse the preoperative, intraoperative and postoperative data of patients included. The variables with a P <0.1 were included in the multivariate Logistic regression analysis of EBV infections after pediatric liver transplantation for patients with biliary atresia. Results A total of 30 cases (46.15%) of pediatric recipients showed EBV infection in 65 cases, of which 23 cases (76.67%) occurred within 3 months after operation. The univariate analysis showed that there were significant differences in the ratio of patients younger than 1 year preoperation, EBV serology D+/R-, acute rejection, the usage of mycophenolate mofetil and supratheraputic tacrolimus level between two groups (P<0.05) . The type of graft (P=0.060), input quantity of red blood cell intraoperation (P=0.063) and factors mentioned above were included in the multivariate Logistic regression analysis. It revealed that donor EBV serology positive but recipient negative, acute rejection and supratheraputic tacrolimus level were risk factors of EBV infection for pediatric liver transplantation recipients with biliary atresia. Conclusion Donor EBV serology positive but recipient negative, acute rejection, supratheraputic tacrolimus level are closely related to EBV infection in pediatric recipients with biliary atresia after liver transplantation. Appropriate antiviral drugs should be adopted to prevent EBV infection in high risk patients.
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Objective To explore the value of Chinese ink in identifying sentinel lymph nodes(SLN) during radical resection of cervical carcinoma.Methods After sterilized Chinese ink(1ml) was infused in normal tissue at four points,extensive cervical resection and cleaning operation of pelvic lymph nodes were performed.Lymph nodes staining black in drainage field of pelvic lymph system were investigated.Results Lymph nodes staining black were found in 15 cases.The identifying rate was 100%(15/15).Positive lymph nodes were found in 2 cases with lymph node metastasis.The accurate rate of pelvic lymph nodes metastasis was 100%.Conclusion The effect is reliable by using Chinese ink as tracer of SLNs in cervical carcinoma.
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Objective:We investigated the changes of the proteins in the rat arterial smooth muscle cells induced by homocysteine.Detected the mechanism by which homocysteinemia leads to atherosclerosis. Methods:The rat arterial smooth muscle cells of primary culture were planned to be the experimental systems.Extracted the proteins from the smooth muscle cells which were induced by homocysteine and control.After 2-D electrophoresis,the map was analyzed by imaging systems. Results:After cells promoted by homocysteine, twenty-eight proteins of the smooth muscle cells changed.Twelve proteins were found to differ in quantity(11 higher and 1 lower).Sixteen proteins were seen to be unique in one region or the others(12 points of protein appear after Hcy stimulating,4 points of protein disapear after Hcy stimulating). Conclusion:The protein of rat arterial muscle cells changed after promoted by homocysteine.We considered that the proteins were related to the proliferation of the smooth muscle cells.
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Objective To investigate the significance of homocysteine (Hcy) in pathogenesis of coronary heart disease (CHD) and the relationship among serum homocysteine , age, type of CHD and the branches of coronary arteriopathy. Methods In a cross sectional test, serum Hcy levels of 166 old cases (age≥60 years) and 161 non old cases(age
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Objective To investigate the effects of lanthanum(La)subchronic exposure on the metabolism of calcium(Ca),magnesium(Mg)and iron(Fe)in the liver tissue and serum in rats.Methods 36 Wistar rats were treated with lanthanum chloride(LaCl3)through oral exposure at 0.1,2 and 40 mg/kg respectively.After 90 days of treatment,the rats were sacrificed and the La,Ca,Mg and Fe in the liver tissue were determined,the serum was collected for analysis of Ca,phosphorus(P),Mg,Fe,unsaturated iron-binding capacity(UIBC)and total iron binding capacity(TIBC).Results The La levels in the liver tissue in all LaCl3 exposed dose groups rats were higher obviously than those in the control group(P0.05).Conclusion The result suggests that La subchronic exposure may have some effects on the level and distribution of Ca,Mg and Fe in the liver tissue and serum,which may be a part of its biological effects.