女性癲癇患者妊娠期的藥物治療缺乏等級較高的臨床證據支持，而單中心研究很難納入足夠大的樣本，并且對妊娠期癲癇患者進行隨機對照試驗也不符合醫學倫理，因而多國家、多中心合作的癲癇妊娠登記系統應運而生。目前國際上最大三個癲癇妊娠登記分別為英國及愛爾蘭癲癇妊娠登記（the UK and Ireland Epilepsy and Pregnancy Registers，UKIEPR）、北美抗癲癇藥物妊娠登記（the North American AED Pregnancy Registry）和國際抗癲癇藥物妊娠登記（International Registry of Antiepileptic Drugs and Pregnancy，EURAP）。文章首先簡要介紹上述三大癲癇妊娠登記，并對這三大登記系統的方法學等特點進行比較，其次從多角度總結國外癲癇妊娠登記的研究成果，最后簡述癲癇與妊娠登記的延伸研究，以期為我國抗癲癇藥物妊娠登記的開展提供有益借鑒。
Heart valve replacement is the major surgical treatment of severe valvular diseases. Due to the durability and reoperation-free, mechanical valves are widely used. Bioprosthesis valves became popular recently because of long service life and no demand for lifelong anticoagulation. However, how to choose the appropriate prosthetic heart valves, especially the application of bioprosthesis valves for patients at 55 to 65 years is still a major problem. This review focuses on more effective and scientific basis for rational choice of mechanical and bioprosthesis valve.
Objective To investigate the current status and needs of epilepsy management among patients and primary healthcare workers in rural Northwest China, providing data support for the development of an intelligent medical assistant tailored for rural epilepsy care. Methods A questionnaire survey was conducted from March 22 to April 22, 2025, targeting patients (or their caregivers) and healthcare workers in eight regions of the Shaanxi Rural Epilepsy Prevention and Management Project. The patient/caregiver questionnaire covered basic information, disease-related information, and functional needs; the healthcare worker questionnaire included basic information, job responsibilities, and functional suggestions. Questionnaires were distributed via the Wenjuanxing platform. Python was used for descriptive statistics and correlation analysis. Results A total of 1 154 valid patient/caregiver questionnaires (response rate 59.45%) and 337 valid healthcare worker questionnaires (response rate 100%) were collected. The main difficulties reported by patients/caregivers were psychological stress (58.75%), financial burden (47.05%), and lack of disease knowledge (38.82%). 87.09% of respondents expressed willingness to use an intelligent assistant, with the highest demand for psychological support (56.33%), medication reminders (52.51%), and condition monitoring (45.06%). The primary difficulties reported by healthcare workers were poor patient adherence (75.96%), insufficient professional training (62.62%), and ineffective communication (55.79%). 87.83% of healthcare workers were willing to use an intelligent assistant and expected it to feature patient information management (92.58%), remote follow-up (77.15%), and condition monitoring (74.48%) to improve work efficiency. Conclusion Patients and healthcare workers in rural Northwest China show high acceptance and clear demand for an intelligent medical assistant for epilepsy. Future development should prioritize core modules such as medication management, health education, and psychological support, adopting a minimalist design to enhance the accessibility and effectiveness of long-term epilepsy management.
