[Diagnostic value of 3D fast spin-echo sequence scanning combined with multislice spiral CT in knee cruciate ligament injury].

OBJECTIVE: To explore the potential value of three-dimensional fast spin echo（3D-SPACE） combined with multilayer spiral CT （MSCT） in the diagnosis of knee cruciate ligament injury, to provide a new direction for the optimization of subsequent clinical diagnosis. METHODS: A total of 120 patients with knee cruciate ligament injury were treated from April 2020 to April 2021, aged from 21 to 68 with an average of（41.52±4.13） years old. For all patients, separate MSCT scanner scans, 3D-SPACE sequence scans alone and 3D-SPACE sequence combined with MSCT scans were used. The injury and classification of the anterior and posterior cruciate ligament of the knee were compared, the length of the anterior-medial bundle and posterolateral bundle and its angle of the knee with the horizontal plane were observed, the diagnostic value of 3 diagnostic methods in knee cruciate ligament injury were determined. RESULTS: There was no significant difference between the 3D-SPACE sequence scan alone and the MSCT test alone on the total diagnostic rate and grading total diagnostic rate（P>0.05）. The total diagnostic rate and grading total diagnostic rate of 3D-SPACE scan combined with MSCT were significantly higher than those of 3D-SPACE scan or MSCT alone（P<0.05）. The 3D-SPACE sequence scan alone and the MSCT detection alone had no significant difference in the measurement values related to the anterior and posterior cruciate ligaments of the knee joint（P>0.05）. 3D-SPACE sequence scanning combined with MSCT detection on the knee joint anterior and posterior cruciate ligament related measurements were significantly higher than the 3D-SPACE sequence scan or MSCT detection alone（P<0.05）. The area under the ROC curve estimated by 3D-SPACE sequence scanning combined with MSCT was 0.960, which was significantly higher than that of 3D-SPACE sequence scanning and MSCT alone evaluating the area under the ROC curve line of 0.756 and 0.795. The combined 3D-SPACE sequence scanning and 3D-SPACE sequence scanning MSCT analysis and prediction models were statistically different（Z=2.236, P<0.05）, and MSCT alone and 3D-SPACE sequence scanning combined with MSCT analysis and prediction models were statistically different（Z=2.653, P<0.05）. CONCLUSION: The application of 3D-SPACE sequence combined with MSCT scanning for knee cruciate ligament injury can improve the diagnosis rate of patients with knee cruciate ligament injury.It can be used as a diagnostic tool for patients with knee cruciate ligament injury and is worthy of clinical application.

Using Piezosurgery in Anterior Cervical Discectomy and Fusion to Treat Complex Cervical Spondylotic Myelopathy Is Safe and Effective.

Objective: To investigate the safety and efficacy of piezosurgery in anterior cervical discectomy and fusion (ACDF) for cervical spondylotic myelopathy (CSM). Methods: 47 patients with complex CSM (cCSM) underwent ACDF surgery from 2014 to 2017. Among these patients, 26 underwent ACDF using piezosurgery (group A) and 21 underwent ACDF by using traditional tools such as high-speed air drill, bone curette, and Kerrison bone punch (group B). Average surgical time, intraoperative blood loss, surgical complications, preoperative and postoperative Japanese Orthopaedic Association (JOA) scores, and improvement rate were measured. Results: Average surgical time and intraoperative blood loss were significantly lower in group A than those in group B (P < 0.01). The incidences of surgical complications were 3.8% and 23.8% in the A and B groups (P < 0.05), respectively. There were no significant differences in JOA scores and improvement rates between data collection periods at preoperative, 3-day postoperative, and 1-year postoperative follow-ups (P > 0.05). Conclusion: For treating cCSM, both the piezosurgery and traditional tools led to significant neurological improvement. However, the piezosurgery was superior to the traditional tools in terms of surgical time, blood loss, and complication rate. Hence, piezosurgery was a safe and effective adjunct for ACDF treating cCSM.

[Comparison of multislice spiral CT and MRI in diagnosis of occult fracture of knee joint with meniscus and ligament injury].

OBJECTIVE: To investigate the diagnostic value of multislice spiral CT (MSCT) and MRI in occult fracture of knee joint with meniscus and ligament injury. METHODS: From January 2020 to March 2021, 63 patients with knee occult fracture with meniscus and ligament injury, including 41 males and 22 females, aged from 21 to 67 years old, with an average of (44.35±8.77) years old, the course of disease ranged from 1 to 6 days, with an average of (4.64±1.75) days, the body mass index (BMI) was (19.85±2.78) kg/m2. MSCT and MRI data of 63 patients were collected and statistically analyzed to evaluage their diagnist value. RESULTS: The detection of MRI for occult knee fravtures with meniscus and ligament injury, joint cavity effusion, bone marrow edema, and articular surface injury were 100.00% (63/63), 95.24% (60/63), 42.86% (27/63) and 36.51% (23/63), respectively. The detection rates of MSCT were 49.21% (31/63), 41.27% (26/63), 0.00% (0/63) and 1.59% (1/63), respectively, significantly lwver than that of MRI (P<0.05). The diagnostic sensitivity, specificity and accuracy of MRI were significantly higher than those of MSCT(P<0.05). CONCLUSION: The sensitivity, specificity and accuracy of magnetic resonance imaging in the diagnosis of occult fracture of knee joint with meniscus and ligament injury are significantly better than that of MSCT. MRI has higher accuracy in the diagnosis of peripheral tissue diseases such as joint cavity, articular surface and bone marrow, and can reduce the risk of clinical misdiagnosis.

Construction of healthy enterprises in coal industry / 中国职业医学

@#Promoting the construction of healthy enterprises in the China's coal industry will help coal enterprises to fulfill their ， ， legal and social responsibilities contribute to the construction of healthy cities and protect the health of occupational ， ， individuals from various aspects. In recent years the patriotic health campaign the health promotion project of industrial and ， ， ， mining enterprises the construction of standardized management system of coal mine safety the construction of green mines and the construction project of staff quality have laid the foundation for the construction of healthy enterprises in China's coal ， industry. However the development of coal industry in China is unbalanced and insufficient. There are many problems such as a ， general lack of professional talents the exist of a large number of small coal mines and the underprivileged technology of coal ， ， ， mining poor working environment in underground coal mines many occupational hazards in workplace and relatively few special incentive measures for the construction of healthy enterprises in the coal industry. It is recommended that coal ， enterprises with advanced productivity take the lead to demonstrate coal mine industry construction actively promote advanced ， ， and applicable technology and equipment steadily improve the professional level of coal industry workers comprehensively ， ， improve the environment of mining areas strengthen the monitoring and treatment of occupational hazards improve and ， - implement special incentive measures for healthy enterprises and comprehensively promote the high quality development of coal industry and the construction of healthy enterprises. So as to effectively protect the health occupational rights and interests of workers and provide assistance for occupational health work in the new era.

The facile preparation of solid-state fluorescent carbon dots with a high fluorescence quantum yield and their application in rapid latent fingerprint detection.

Because of direct π-π interactions and excessive energy resonance transfer, it is very challenging to prepare carbon dots (CDs) with a high fluorescence quantum yield (QY) in the solid state. In this study, novel CDs which gave solid-state fluorescence (SSF) with high brightness were successfully prepared via a simple microwave-assisted method. The prepared ScCDs can emit strong blue fluorescence in the solid state, and the absolute QY of this ScCDs powder reaches 51.7%. Such a high QY means that the ScCDs powder could be successfully applied in rapid latent fingerprint (LFP) detection. The LFP detection performance of this ScCDs powder was studied in detail, and the results show that the LFPs developed using the ScCDs powder can be visualized with high definition and contrast under different conditions. This research not only developed a new type of SSF-emitting CDs, but it also proved that the developed CDs have great potential for applications in LFP detection, and this research may also provide inspiration and ideas for the design of new SSF-emitting CDs.

Development and external validation of a predictive nomogram model of posttraumatic epilepsy: A retrospective analysis.

OBJECTIVE: We aimed to develop and validate a predictive model of posttraumatic epilepsy (PTE). METHODS: The training cohort was patients registered at West China Hospital and diagnosed as traumatic brain injury (TBI) between January 1, 2011, and December 31, 2017. On the basis of multivariable cox proportional hazards model using a forward stepwise method, the nomogram was generated. We externally validated this instrument in 834 participants from two independent cohorts to assess its performance. RESULTS: The nomogram was built based on the results of multivariable cox proportional hazards regression analysis of 1301patients from West China Hospital. The prevalence of PTE was 12.8% (95% confidence interval [CI], 10.9-14.6%) in training cohort, 10.5% (95% CI, 7.5-13.4%) in the testing 1 cohort, and 6.1% (95% CI, 3.7-8.4%) in the testing 2 cohort. 7 independent predictors of PTE composed the nomogram (sex, time of loss of consciousness, subdural hemorrhage, contusion sites, early posttraumatic seizures, TBI severity, and treatment). The C-index was 0.846 (95% CI, 0.817-0.876), and the corresponding sensitivity and specificity were 0.867 and 0.738. External validations showed good discrimination in overall testing cohorts with a C-index of 0.895 (95% CI, 0.859-0.930), in the testing 1 cohort (C-index 0.897, 95% CI, 0.855-0.938) and testing 2 cohort (C-index, 0.883, 95% CI, 0.814-0.952). Calibration of this model was also good since the calibration plots were close to the ideal line. CONCLUSIONS: This nomogram was developed and validated in a large cohort for individualized prediction of PTE, which can identify individuals at high risk of epilepsy and help us find preventive drugs based on these targeted population.

Novel yellow solid-state fluorescent-emitting carbon dots with high quantum yield for white light-emitting diodes.

Fluorescence quenching of carbon dots (CDs) occurs in their aggregated state ascribed to direct π-π interactions or excessive resonance energy transfer (RET). Thus, CDs have been severely restricted for applications requiring phosphors that emit in the solid state, such as the fabrication of white light-emitting diodes (WLEDs). In this report, novel CDs with bright solid-state fluorescence (SSF) were synthesized by simple microwave-assisted synthesis method, using 1,4,7,10-tetraazacyclododecane (cyclen) and citric acid as precursors. Under 365 nm UV light, these CDs emit bright yellow SSF, indicating they successfully overcome the aggregation-induced fluorescence quenching (ACQ) effect. When the excitation wavelength (λex) is fixed at 450 nm, the emission peak of the CDs is centered at 546 nm with the Commission Internationale de l'Eclairage chromaticity (CIE) coordinates of (0.43, 0.55), which means that they can be combined with a blue-emitting chip in order to fabricate WLEDs. More importantly, the absolute quantum yield (QY) of these CDs powder reached 48% at λex of 450 nm, which was much higher than many previously reported SSF-emitting CDs and indicating their high light conversion ability in solid-state. Thanks to the excellent optical property of these CDs powder, they were successfully used in the preparation of high-performance WLEDs. This study not only enriches SSF-emitting CD-based nanomaterials with good prospects for application, but also provides valuable reference for subsequent research on the synthesis of solid-state fluorescent CDs.

Amphiphilic BODIPY-based nanoparticles as "light-up" fluorescent probe for PAEs detection by an aggregation/disaggregation approach.

Phthalic acid eaters (PAEs) play the role of plasticizer and have been widely used in the industrial and plastic production process. But due to not chemically bound in the polymeric matrix, PAEs can be easily released directly and/or indirectly into the environment, and pose a threat the ecosystem and human health. Small-molecule self-assembled nanoparticles have drawn more and more attention due to advantages of precise molecular structure, biocompatibility, great diversity, and tunability in optical properties and functionalities. Here we report the use of disaggregation-induced emission (DIE) based supramolecular assembly to design organic nanoprobe for detection PAEs. In the water solution, the designed small organic fluorophore AJ-1 was aggregated via noncovalent forces to form fluorescence off nanoparticles, but in the presence of PAEs, they disaggregated and produced a clear light-up fluorescent signal. The detection of PAEs with selectivity, sensitivity and rapid response were further achieved. The experiment of recovery of PAEs in real-water sample illustrated the practicability of probe AJ-1 in real-world applications. Besides, cellular uptake assay suggested that AJ-1 could pass through membrane and gather in the cytoplasm.

Epidemiology of traumatic brain injury-associated epilepsy in western China: An analysis of multicenter data.

OBJECTIVES: This study aims to explore the probability of developing posttraumatic epilepsy (PTE) in the following 8 years after traumatic brain injury (TBI), the risk factors associated with PTE and its cumulative prevalence. METHODS: This is a retrospective follow-up study of patients with traumatic brain injury (TBI) discharged from the West China Hospital between January 1, 2011 and December 31, 2017, Chengdu Shang Jin Nan Fu Hospital and Sichuan Provincial People's Hospital from January 1, 2013 to March 1, 2015. We used forward stepwise method to build the final multivariate cox proportional hazard regression model to obtain estimates of hazard ratio (HR) of PTE and 95% confidence intervals (CI). We also conducted Kaplan-Meier survival analysis to investigate the cumulative prevalence of PTE. RESULTS: The cumulative incidence of PTE rose from 6.2% in one year to 10.6% in eight years. There were more male patients in PTE group and generally older. Besides, patients with PTE tended to have abnormal CT scan results. The risk factors of PTE were male (HR = 1.6, 95% CI: 1.1-2.2, P = 0.009), early posttraumatic seizures (HR = 2.9, 95% CI: 2.2-4.1, P < 0.001), TBI severity (moderate TBI: HR = 3.0, 95% CI: 1.8-5.0, P = 0.001; severe TBI: HR = 4.3, 95% CI: 2.3-7.6, P < 0.029), loss of consciousness (LOC) more than 30 min (30 min-24 h: HR = 1.8, 95% CI: 1.02-3.1, P = 0.041; >24 h: HR = 2.4, 95% CI: 1.4-2.4, P = 0.001), subdural hematoma (SDH) (HR = 1.9, 95% CI: 1.4-2.5, P < 0.001), brain contusion sites (frontal-temporal lobe: HR = 2.7, 95% CI: 1.9-3.9, P < 0.001; other sites: HR = 1.5, 95% CI: 1.01-2.3, P = 0.042) and cranial surgery (HR = 1.7, 95% CI: 1.3-2.3, P < 0.001). SIGNIFICANCE: The probability of developing PTE increased during the study period. In addition, the risk of developing PTE was significantly associated with gender, EPTS, LOC time, SDH, brain contusion sites, surgery and TBI severity. However, further researches may be needed to predict the risk of PTE in combination with quantitative factors.

The tolerability and safety profile of eslicarbazepine acetate in neurological disorders.

OBJECTIVES: This study aimed to assess the tolerability and safety profile of eslicarbazepine acetate (ESL). METHODS: Placebo controlled, double-blind randomized controlled trials (RCTs) were enrolled by searching Pubmed, Embase, Cochrane Online Library, and clinicaltrial.gov. Studies evaluating the safety of ESL on any neurological disorders were included. Adverse events (AEs), serious AEs and AEs-related withdrawals were pooled by direct or indirect meta-analysis. RESULTS: A total of 4067 patients in 13 RCTs (5 for refractory partial epilepsy, 2 for bipolar I disorder, 1 for migraine, 1 for fibromyalgia, 2 for diabetic neuropathic pain, and 2 for post-herpetic neuralgia) were included. Meta-analysis revealed that ESL treatment had a higher incidence of serious AEs and AEs-related withdrawals than the placebo. Of 35 reported AEs, 13 were significantly associated with ESL treatment, including blurred vision, diplopia, vertigo, nausea, vomiting, fatigue, dizziness, somnolence, headache, rash, hyponatraemia, increased gamma-glutamyl transferase, and dysarthria. Subgroup analysis revealed that dizziness was the only AE significant at 400 mg/day, while diplopia, nausea, vomiting, dizziness, somnolence, rash, and hyponatremia at 800 mg/day, and blurred vision, diplopia, vertigo, nausea, vomiting, fatigue, dizziness, somnolence, headache, rash, and hyponatremia at 1200 mg/day were significant. Adjunctive use of ESL in refractory epilepsy significantly led to higher risk for vestibulocerebellar AEs than other disorders. CONCLUSIONS: ESL treatment was related to a range of AEs, especially at high doses or when used as adjunctive therapy in epilepsy. While the majority of AEs of ESL were related to the vestibulocerebellar system, hyponatremia and rash should also be noted by clinicians.

Therapeutic effect of intravenous levetiracetam in status epilepticus: A meta-analysis and systematic review.

PURPOSE: We performed this analysis to evaluate the efficacy and safety of intravenous levetiracetam (IV LEV) in patients with status epilepticus. METHOD: Studies were searched in MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials for available randomized controlled trials(RCTs) comparing the efficacy and/or safety of IV LEV with other antiepileptic drugs (AEDs). Meta-analysis was performed using the random-effects model to calculate risk ratio with the RevMan 5.3 software. RESULTS: Six RCTs with a total of 543 patients were included. There was no significant differences in clinical seizure cessation and hospital mortality, either between IV LEV and IV phenytoin (PHT) or between IV LEV and IV valproate (VPA). Compared with IV PHT, IV LEV had a lower risk of poor neurological outcome. For IV LEV compared with IV lorazepam (LOR), no significant difference in efficacy was found, but IV LEV patients had significantly lower need for ventilatory assistance. Adding IV LEV to clonazepam (CNP), compared with adding placebo showed no significant differences in seizure cessation at 15 min. CONCLUSIONS: Our results suggested that IV LEV was comparable to IV PHT,VPA, or LOR in efficacy, and IV LEV as add-on therapy of CNP had no superiority in seizure cessation than CNP plus placebo. IV LEV may have a better tolerability than other AEDs do. More RCTs are needed to validate the role of IV LEV in status epilepticus.

Gadolinium-doped carbon dots as nano-theranostic agents for MR/FL diagnosis and gene delivery.

Nano-theranostic agents play important roles in the development of therapeutic methods for serious diseases. In this study, novel carbon dots (CDs) L-CD/C-CD were prepared from Gd(iii) salt/complexes, cationic polymers and citric acid in the hope that they would combine the abilities of gene delivery and multi-modal (MR/FL) imaging. The CDs inherited the properties of good water-solubility and positive charge from their precursor polymers. In vitro gene transfection results showed that the CDs have good transfection efficiency and anti-serum ability, especially for L-CD, which has 74 times higher transfection efficiency than PEI 25 kDa in the presence of 10% serum. The CDs exhibited bright fluorescence, which was stable for several days under various pH. Confocal laser scanning microscopy revealed that the CDs could image HeLa cells with blue or green fluorescence well, and realize the monitoring of the gene delivery process. Besides, the CDs showed favorable biocompatibility with excellent performance in longitudinal relaxivity rates (r1) of 11.4 mM-1 s-1 for L-CD and 57.6 mM-1 s-1 for C-CD, which were about 3-15 times higher than that of the clinical Gd reagent Gd-DTPA (3.75 mM-1 s-1). Furthermore, the CDs could perform in vivo tumor-specific MR-imaging more clearly than Gd-DTPA, which is attributed to their suitable particle size and their resulting greater accumulation at tumor site via the EPR effect. This study provides a promising strategy for constructing multi-functional CDs for tumor theranostics.

Validation of the Neurological Disorders Depression Inventory for Epilepsy (NDDIE) as a rapid suicidality screening tool in Chinese people with epilepsy.

OBJECTIVE: The objective of this study was to validate the Chinese version of the Neurological Disorders Depression Inventory for Epilepsy (NDDIE) as a suicidality screening tool in Chinese people with epilepsy (PWE). METHODS: A consecutive cohort of PWE was recruited from West China Hospital and 363 Hospital. Each patient received a psychiatric evaluation with the Mini International Neuropsychiatric Interview (MINI) and the Chinese version of the NDDIE (C-NDDIE). Demographic and clinical characteristics were collected. Receiver operating characteristic (ROC) curve analysis was conducted. The best possible cutoff was identified with the highest Youden index. Specificity, sensitivity, positive, and negative predictive values were calculated. RESULTS: Among a total of 355 participants, 41 (11.5%) had a moderate to high suicide risk according to the Suicidality Module (SM) of the MINI. Receiver operating characteristic (ROC) curve analysis showed that item 4 ("I'd be better off dead") of the NDDIE had an area under the curve (AUC) of 0.930 (95% confidence interval [CI] = 0.884-0.977), a sensitivity of 80.5%, a specificity of 94.9%, a positive predictive value (PPV) of 68.0%, a negative predictive value (NPV) of 97.7%, and the largest Youden index of 0.754 for a cutoff score of >2. CONCLUSION: Item 4 of the NDDIE is a valuable tool for screening suicidality in Chinese PWE.

Depression in people with epilepsy in West China: Status, risk factors and treatment gap.

PURPOSE: To evaluate the prevalence, suicidality and treatment gap (TG) of depression in people with epilepsy (PWE) in West China, and to explore the related risk factors. METHODS: A consecutive cohort of PWE from West China Hospital was recruited. The Chinese version of the Neurological Disorders Depression Inventory for Epilepsy scale was used to assess depression and suicidality. Prevalence and TG of depression were calculated. Logistic regression analysis was used to assess risk factors of depression and suicidality. RESULTS: Among a total of 461 participants, there were 29.9% with depression and 15.8% had suicidality. Being female, an unmarried status, disease course, seizure frequency, seizure occurrence in the last 6 months, and focal impaired awareness seizure were risk factors for depression. Depression was an independent risk factor for suicidality. The TG of depression was 72.5%. The TG was larger in the 30-40 year age group, in rural populations, and among those with a disease course between 5 and 10 years. The TG figures dropped with increasing annual family income. CONCLUSIONS: The prevalence of depression and the rate of suicide risk for PWE in West China are high. A large TG for depression exists in PWE. Clinicians should focus on depression and suicidality for PWE and identify the related risk factors in a timely manner so as to reduce the incidence of depression and suicide. Management including public education as well as professional training of neurologists are necessary to fill the TG.

Predictors of seizure reduction outcome after vagus nerve stimulation in drug-resistant epilepsy.

PURPOSE: To evaluate the predictors of seizure reduction outcome after vagus nerve stimulation (VNS) in patients with drug-resistant epilepsy (DRE). METHODS: A meta-analysis was performed using relevant research from databases such as PubMed, Embase, Cochrane Online Library, and Clinicaltrials.gov. Studies were selected according to predefined inclusion and exclusion criteria. The quality of studies was evaluated by using the Newcastle-Ottawa Scale (NOS) scale. All data was pooled by STATA 12.0 software for meta-analysis. RESULTS: The review considered 1281 articles, and 16 articles with NOS score ≥6 were included in the analysis. The meta-analysis showed that at 6 m, 1, 2, 3, 4, 6 and 12 years after implantation, 33.99, 43.42, 46.50, 63.31, 52.71, 54.64, 70.37 and 82.90% of patients exhibited >50% reduction of seizure frequency after VNS. The duration of epilepsy showed a significant difference between the good responders and poor responders (p = 0.038), whereas age at VNS implantation (p = 0.305), age at seizure onset (p = 0.530), seizure type (p = 0.11), etiology (p = 0.187), and history of previous epilepsy surgery (p = 0.075) were not predictors of seizure reduction outcome after VNS. Several features about the electroencephalogram (EEG) feature and heart rhythm complexity (HRV) have not been analyzed by a sufficient number of studies. CONCLUSIONS: DRE patients with shorter duration of epilepsy may be better candidates for VNS rather than those who are younger at onset and implantation. Several EEG or HRV features may have predictive value but more research is needed.

Safety and tolerability of calcitonin-gene-related peptide binding monoclonal antibodies for the prevention of episodic migraine - a meta-analysis of randomized controlled trials.

AIM: To systematically evaluate the safety and tolerability of calcitonin-gene-related peptide binding monoclonal antibodies from the results of randomized controlled trials. METHODS: Online databases were searched on calcitonin-gene-related peptide binding monoclonal antibodies for the prevention of episodic migraine. Overall withdrawal, withdrawal due to adverse events, adverse events, serious adverse events and specific adverse events were extracted from the included studies. A meta-analysis was performed with Revman 5.3.0 software. RESULTS: Ten studies that investigated four drugs (galcanezumab, erenumab, fremanezumab and eptinezumab) with 5817 participants were included in this study. Serious adverse events, overall withdrawals, withdrawal due to adverse events and any adverse events were not significantly associated with monoclonal antibody treatment. Injection site pain and erythema were significantly higher in the calcitonin-gene-related peptide binding monoclonal antibodies treatment group than in the placebo group. The rates of serious adverse events were significantly higher in the galcanezumab 120 mg group. Injection site erythema was associated with galcanezumab 120 mg and 240 mg. Injection site pain and nasopharyngitis were associated with galcanezumab 150 mg and 5 mg, respectively. Overall adverse events were significantly higher with erenumab 70 mg and 140 mg. Treatment-related adverse events were significantly higher with fremanezumab 225 mg/month and 675 mg/quarter. CONCLUSIONS: This study provides data on the safety and tolerability profiles of calcitonin-gene-related peptide binding monoclonal antibodies and confirms their potential use as preventive treatments for episodic migraine. In addition to the acceptable withdrawal rates, serious adverse events were rare, and the severity of most adverse events was mild to moderate. Injection site reaction may be the major adverse event associated with galcanezumab.

Cationic polymer-derived carbon dots for enhanced gene delivery and cell imaging.

Carbon dots have attracted rapidly growing interest in recent years. In this report, we prepared two cationic polymer-derived carbon dots (Taea-CD and Cyclen-CD, collectively called C-dots) via a hydrothermal method. Transmission electron microscopy (TEM) results show that the C-dots were sphere-like and the size distribution was 1.8 ± 0.4 nm for Taea-CD and 5.4 ± 2 nm for Cyclen-CD. The C-dots emitted bright blue fluorescence under UV light (365 nm). Confocal laser scanning microscopy (CLSM) assay indicates that the C-dots-mediated transfection process could be detected in real time, and their tunable fluorescence emission under different wavelengths could satisfy varying requirements. Luciferase assay indicates that the transformation from the polymer to CD is an effective strategy to improve the transfection efficiency (TE) of the materials. Moreover, the C-dots also exhibit higher serum tolerance and cell viability than commercially available polyethyleneimine (PEI). These results demonstrate that the preparation of carbon dots from polymers is a promising method for developing multifunctional gene vectors with high TE and biocompatibility.

Prevalence and risk factors of depression and anxiety among patients with convulsive epilepsy in rural West China.

OBJECTIVES: To explore the prevalence and risk factors of depression and anxiety in patients with convulsive epilepsy (PWE) in rural West China. METHODS: PWE from rural West China were evaluated for depression and anxiety with the Neurological Disorders Depression Inventory for Epilepsy (C-NDDI-E; Chinese version) and the Generalized Anxiety Disorder-7 (GAD-7; Chinese version). We also assessed their quality of life using the Quality of Life in Epilepsy Inventory (QOLIE-31) and their level of social support using the Social Support Rating Scale (SSRS). We used logistic regression analysis to identify independent risk factors of depression and anxiety and analysis of variance (ANOVA) to investigate the association between quality of life and depression and anxiety. RESULTS: Of the 458 PWE in our study, 33.4% have anxiety and 52.6% have depression. SSRS (P = 0.03) and seizure frequency (P = 0.007) are independent risk factors of anxiety, and annual income of the patients (P < 0.001) is an independent risk factor of depression. PWE with both depression and anxiety have significantly lower QOLIE-31 total and subtotal scores. CONCLUSIONS: PWE have a high prevalence of depression and anxiety in rural West China, which may be impacting their quality of life. PWE with depression and anxiety got a worse quality of life, and depression had a greater impact on quality of life for PWE than anxiety. The risk factors of depression and anxiety include seizure frequency and social support, while annual income is an additional risk factor of depression. Identifying risk factors early may be helpful in the timely management of these symptoms.

Photoluminescent F-doped carbon dots prepared by ring-opening reaction for gene delivery and cell imaging.

Carbon dots (CDs) are photoluminescent nanoparticles with distinctive properties, having great potential in nano-biomaterial systems such as gene/drug delivery vectors and cell imaging agents. Fluorine-doped CD C-6F was prepared by a one-step ring-opening polymerization-dehydrative carbonization (RPDC) approach based on low molecular weight polyethyleneimine (PEI, 600 Da) and fluorinated diglycidyl ethers, while the non-fluorinated counterpart C-6H and the CD prepared from PEI 600 Da solely (C-600) were also prepared for comparison. TEM, FT-IR and XPS were performed to determine the compositions and surface states of the CDs. In vitro cell experiment results reveal that the CDs prepared from RPDC approach have much higher transfection efficiency and cellular uptake than PEI 600 contrasts in various cell lines. Compared to non-fluorinated C-6H, C-6F exhibited distinctly higher transfection efficiency, and up to 30 and 260 times higher efficiency than PEI 25 kDa could be achieved in the absence and presence of serum, respectively, indicating the advantage of F-doping. Besides, these CDs exhibit good cell imaging capability under single wavelength excitation, making the materials suitable for cellular tracking and transfection mechanism studies. These results demonstrate that fluorine-doping is an efficient approach to obtained CD gene vectors with high efficiency and serum tolerance.

Newer antiepileptic drugs compared to levetiracetam as adjunctive treatments for uncontrolled focal epilepsy: An indirect comparison.

PURPOSE: Newer antiepileptic drugs (AEDs), such as Eslicarbazepine (ESL), Lacosamide (LAC), Perampanel (PER) and Brivaracetam (BRV), have been marketed as adjunctive treatments for partial-onset seizures. Our aim was to compare the efficacy and tolerability of newer AEDs with Levetiracetam (LEV), when used as add-on treatments for uncontrolled focal epilepsy. METHOD: We conducted an online database search on PubMed, Embase, Cochrane Online Library and Clinicaltrials.gov for all available randomized controlled trials (RCTs) investigating the therapeutic effects of newer AEDs or LEV vs placebo. Indirect comparisons for clinical efficacy and tolerability at different doses between the newer AEDs and LEV were then performed using Indirect Treatment Comparison (ITC) software. RESULTS: Twenty-four RCTs with a total of 8540 patients were included. Compared to LEV, ESL, LAC and BRV did not showed significant difference in efficacy at all dose level. PER showed lower 50% response rates and seizure-free rates at the highest effective recommended dosages. Treatment-emergent adverse events (TEAEs) and withdrawal rates due to adverse events (AEs) of LAC and PER were higher than LEV at the highest effective recommended dosages, and overall AE rates from ESL were higher than LEV. CONCLUSIONS: Indirect comparisons suggested that ESL, LAC and BRV were not inferior to LEV in efficacy. ESL, LAC and PER may have a possible worse tolerability profile compared to LEV at high dose. But BRV may exhibit a similar tolerability to LEV. Newer AEDs cannot exceed the LEV on efficacy and tolerability.