ABSTRACT
Objective@#To investigate the efficacy and safety of ketogenic diet (KD) and antiepileptic drugs(AEDs) in the children with drug refractory Dravet syndrome (DS).@*Methods@#Thirty-two cases of drug refractory DS were enrolled into the Department of Neurology, Shenzhen Children′s Hospital Affiliated to Shantou University Medical School from July 2016 to December 2017, and they were divided into 2 groups: KD group and AEDs group (16 cases for each group), respectively.KD was added to as an additional therapy for KD group, and oral AEDs were administered only in AEDs group.In KD group, oral AEDs were not adjusted for the first 3 months.AEDs could be adjusted within a limited range in 2 groups after 3 months.The clinical efficacy, improvement of cognitive function, retention rate and side effects were observed and compared after 3, 6, 12 months of treatment.The average monthly seizure frequency within 3 months before enrollment was recorded as the baseline.The clinical efficacy was assessed by comparing the seizure frequency of each observation period with the baseline.@*Results@#In KD group, after 3, 6, 12 months′ follow-up, KD the-rapy was maintained in 15, 14, 12 patients.The number of patients whose seizure reduction over 50% was 10, 12, 11 cases, respectively.The number of patients whose seizure reduction over 90% was 7, 9, 10 cases, respectively.The number of patients who were seizure free was 3, 6, 8 cases, respectively.In AEDs group, after 3, 6, 12 months′ therapy, the number of patients whose seizure reduction over 50% was 6, 7, 8 cases, respectively, the number of patients whose seizure reduction over 90% was 3, 3, 4 cases, respectively.The number of patients who were seizure-free was 2, 1, 2 cases, respectively.There was a significant difference in the seizure reduction between 2 groups after 6, 12 months (P<0.05). Furthermore, the incidence of status epilepticus (SE) was significantly reduced in KD group, and non-fever related status epilepticus (NFSE) was preferentially improved.There was a significant difference in the incidence of SE between before and after treatment in the KD group (P<0.05). After 12 months, there was a significant difference in the incidence of SE between 2 groups (P<0.05). After 6, 12 months of treatment, the patients in KD group had significant improvements in adaption, gross motor and language quotients by Gesell Developmental Scale compared to the AEDs group (all P<0.05). Eleven of 12 children who adhered to the therapy for 1 year in KD group had improvement of developmental quotient ≥ 1 grade, however, 7 cases of 16 children in AEDs group had this improvement.The incidence of adverse effect in the KD group and the AEDs group was 37.5%(6/16 cases) and 56.3%(9/16 cases), respectively, and the difference was not significant (P>0.05).@*Conclusions@#KD can not only reduce seizure frequency and relieve SE, but also improve the cognitive function of drug refractory DS.The adverse reaction ratio of KD does not increase significantly compared to AEDs.Therefore, KD is effective and safe therapy for children with drug-resistant DS.
ABSTRACT
Objective To investigate the efficacy and safety of ketogenic diet (KD) and antiepileptic drugs (AEDs) in the children with drug refractory Dravet syndrome (DS).Methods Thirty-two cases of drug refractory DS were enrolled into the Department of Neurology,Shenzhen Children's Hospital Affiliated to Shantou University Medical School from July 2016 to December 2017,and they were divided into 2 groups:KD group and AEDs group (16 cases for each group),respectively.KD was added to as an additional therapy for KD group,and oral AEDs were administered only in AEDs group.In KD group,oral AEDs were not adjusted for the first 3 months.AEDs could be adjusted within a limited range in 2 groups after 3 months.The clinical efficacy,improvement of cognitive function,retention rate and side effects were observed and compared after 3,6,12 months of treatment.The average monthly seizure frequency within 3 months before enrollment was recorded as the baseline.The clinical efficacy was assessed by comparing the seizure frequency of each observation period with the baseline.Results In KD group,after 3,6,12 months' follow-up,KD therapy was maintained in 15,14,12 patients.The number of patients whose seizure reduction over 50％ was 10,12,11 cases,respectively.The number of patients whose seizure reduction over 90％ was 7,9,10 cases,respectively.The number of patients who were seizure free was 3,6,8 cases,respectively.In AEDs group,after 3,6,12 months' therapy,the number of patients whose seizure reduction over 50％ was 6,7,8 cases,respectively,the number of patients whose seizure reduction over 90％ was 3,3,4 cases,respectively.The number of patients who were seizure-free was 2,1,2 cases,respectively.There was a significant difference in the seizure reduction between 2 groups after 6,12 months (P ＜ 0.05).Furthermore,the incidence of status epilepticus (SE) was significantly reduced in KD group,and non-fever related status epilepticus (NFSE) was preferentially improved.There was a significant difference in the incidence of SE between before and after treatment in the KD group (P ＜ 0.05).After 12 months,there was a significant difference in the incidence of SE between 2 groups (P ＜ 0.05).After 6,12 months of treatment,the patients in KD group had significant improvements in adaption,gross motor and language quotients by Gesell Developmental Scale compared to the AEDs group (all P ＜ 0.05).Eleven of 12 children who adhered to the therapy for 1 year in KD group had improvement of developmental quotient ≥ 1 grade,however,7 cases of 16 children in AEDs group had this improvement.The incidence of adverse effect in the KD group and the AEDs group was 37.5％ (6/16 cases) and 56.3％ (9/16 cases),respectively,and the difference was not significant (P ＞ 0.05).Conclusions KD can not only reduce seizure frequency and relieve SE,but also improve the cognitive function of drug refractory DS.The adverse reaction ratio of KD does not increase significantly compared to AEDs.Therefore,KD is effective and safe therapy for children with drug-resistant DS.
ABSTRACT
Patrolling monocyte (PMo) is a subset of monocytes.Its main function is patrolling vascular endothelium and removing cellular debris from the microvasculature.Studies have revealed that PMo can inhibit the growth of tumor cells,recruiting NK cells to kill tumor cells.PMo can prevent tumor cells metastasis to the lung,which plays a role of immunosurveillance.PMo may be a target for cancer immunotherapy.
ABSTRACT
OBJECTIVE: To explore the effect of the traditional Chinese medicine Yifei Kangliu (YFKL) Oral Liquid on the proliferation, cell cycle and protein-nucleic acid synthesis of murine Lewis lung cancer cell and human lung adenocarcinoma cell line SPC-A-1. METHODS: The inhibiting rates of tumor growth were calculated by weighing the weight of tumor inoculated in vivo, combined by counting cancer cells in vitro. The ratio of the cell cycle and exponents of DNA, RNA, and protein were measured by flow cytometry (FCM). RESULTS: The inhibiting rate of tumor growth in the treated group with YFKL Oral Liquid was 30.38% (P<0.05). The proportion of cells in S phase of the treated groups with YFKL Oral Liquid was lower than that of the control group. In the group with most significant result, 72% of the cells were stagnated in G0/G1 phase. The inhibiting rates of DNA, RNA and protein in murine Lewis lung cancer were 7.4%, 23.73% and 23.31% respectively. In SPC-A-1 cell line, the inhibiting rates were 9.3%, 10.1% and 14.7% respectively, demonstrating amplified effects on lower levels. CONCLUSION: YFKL Oral Liquid significantly inhibited the proliferation of murine Lewis lung cancer cell and human lung adenocarcinoma cell line SPC-A-1 by blocking the cancer cells entering the proliferative phase resulted from its inhibition of DNA.