Résumé
Objective To evaluate the incidence and microbiology profile of infectious complications ( namely menin-gitis and/or bacteremia ) after trans-sphenoidal pituitary adenomectomies ( TSPA ) .Methods All hospitalized patients undergoing TSPA in Dept .Neurosurgery of Peking Union Medical College Hospital ( PUMC) between January 2012 and December 2016 were retrospective recorded .Results The incidence of postoperative meningitis and/or bacteremia was 1.2%( 59/5098) .27 cases of meningitis were documented for a total of 41 isolates, 26 cases of bacteremia for 34 isolates, and 6 cases of coinfection.Gram-positive organisms predominated (27 cases, 65.9%) in meningitis, among which Coagulase-negative staphylococci were the main isolates (14 cases).The most common organisms causing bacteremia were Gram-negative organisms (25 case,73.5%),including Klebsiella pneu-monia ( 9 cases ) , Enterobacter aerogenes ( 7 cases ) and Escherichia coli ( 5 cases ) , all of which were sensitive to amikacin, imipenem and meropenem .Fifty-two patients were cured after antibiotic treatment , whereas 7 died.The morality in patients with meningitis was relatively lower than those with bacteremia (21.2%vs 3.1%,P<0.001). Conclusions Postoperative meningitis and/or bacteremia can occur after TSPA .They differ in etiology profile and prognosis , and should be treated with proper antibiotics according to the drug resistance .
Résumé
The time phase of epileptic seizures has attracted more and more attention. Epileptic seizures have their own circadian rhythm. The same type of epilepsy has different seizure frequencies in different time periods and states (such as sleeping/awakening state and natural day/night cycle). The circadian rhythm of epileptic seizures has complex molecular and endocrine mechanisms, and currently there are several hypotheses. Clarification of the circadian rhythm of epileptic seizures and prevention and administration according to such circadian rhythm can effectively control seizures and reduce the adverse effects of drugs. The research on the circadian rhythm of epileptic seizures provides a new idea for the treatment of epilepsy.