The postictal state which describes changes in behavior, motor function, and neuropsychological performance that occur after a seizure and persist until these variables return to their normal baseline, which can take anywhere from a few seconds to a few hours to a few days. The degree and intensity of the postictal state significantly affects the patient's quality of life and is strongly associated with the patient's rating of the severity of the seizure, but receives little attention in the treatment of epilepsy, and anti-seizure medications prevent postictal events by making the patient seizures-free, or will attenuate or shorten the time after the seizure. Therefore, it is of great clinical significance to evaluate the efficacy of anti-seizure medications in the post-seizure state. This article reviews the effects of the main anti-seizure medications on the postictal state
Objective To establish a prediction model for the 1-, 3-, and 5-year survival rates in patients with gastric cancer liver metastases (GCLM) by analyzing prognostic factors based on the Surveillance, Epidemiology, and End Results (SEER) database. Methods Clinical and pathological data from 591 patients diagnosed with GCLM between 2010 and 2015 were obtained from the SEER database. The population was randomly divided into a training cohort and an internal validation cohort at a 7 to 3 ratio. Independent predictors of GCLM were analyzed using univariate and multifactorial Cox regression. Consequently, nomograms were constructed. The model's accuracy was verified by calibration curve, ROC curve, and the C-index, and the clinical utility of the model was analyzed through decision curve analysis. Results Tumor differentiation grade, surgical status, and chemotherapy were significantly associated with the prognosis of GCLM patients, and these three factors were included in constructing the prognostic model and plotting the nomogram. The C-index was 0.706 (95%CI 0.677 to 0.735) and 0.749 (95%CI 0.710 to 0.788) for the training set and the internal validation cohort, respectively. The results of the ROC curve analysis indicated that the area under the curve (AUC) was over 0.7 at 1, 3, and 5 years for both the training and validation cohorts. Conclusion The prediction model of the GCLM is developed based on the 3 factors, i.e., tumor differentiation grade, surgery, and chemotherapy, and shows good prediction accuracy and thus may promote clinical decision making and individualized treatment of GCLM patients.
ObjectiveTo explore the osteogenesis effect of advanced-platelet-rich fibrin (A-PRF) and β-tricalcium phosphate (β-TCP) composite. MethodsThirty-two healthy female New Zealand rabbits were randomly selected. A-PRF was prepared by collecting blood from middle auricular artery. Rabbits were randomly divided into 6 groups: groups A, B, C, D, and E (6 rabbits in each group) and group F (2 rabbits). Bone defects (6 mm in diameter, 8 mm in depth) were drilled into femur condyle of each rabbit’s both back legs. Then A-PRF and β-TCP composites manufactured by different proportion were planted into bone defects of group A (1∶1), group B (2∶1), group C (4∶1), group D (1∶2) and group E (1∶4) (V/V). The bone defect was not repaired in group F. The specimens were collected at 8 and at 12 weeks after operation. Then gross observation, X-ray examination, Micro-CT examination, and biomechanical test were performed. The bone volume/total volume (BV/TV), trabecular number (Tb.N), trabecular thickness (Tb.Th), and trabecular spacing (Tb.Sp), compressive strength, and modulus of elasticity were calculated. ResultsThe gross observation and X-ray examination showed that the osteogenesis effect at 12 weeks was better than that at 8 weeks. At the same time point, the repair of bone defect and the formation of new bone in group B were better than those in other groups. Micro-CT examination showed that the trabeculae of new bone in group B were the most and the trabeculae arranged closely at 8 and 12 weeks. Besides there were significant differences in BV/TV, Tb.N, and Tb.Sp between group B and the other groups (P<0.05). There were significant differences in Tb.N and Tb.Th in group B, BV/TV and Tb.Sp in group C, Tb.Sp in group D between 8 weeks and 12 weeks (P<0.05). Biomechanical tests showed that the compression strength and elastic modulus of group B were the highest, and the compression strength and elastic modulus of group C were the lowest at 8 and at 12 weeks, showing significant differences (P<0.05). There were significant differences in compression strength and elastic modulus of each group between 8 weeks and 12 weeks (P<0.05). ConclusionThe A-PRF and β-TCP composite can repair femoral condylar defects in rabbits, and the osteogenesis is better in proportion of 2∶1.
ObjectiveTo evaluate the efficacy and safety of 177Lu-FAP-2286 radioligand therapy in treatment of advanced digestive system tumors and explore its clinical potential as a novel targeted therapeutic approach. MethodsThis retrospective analysis examined clinical data from 19 patients with advanced digestive system tumors who received 177Lu-FAP-2286 treatment at the Affiliated Hospital of Southwest Medical University between June 2023 and December 2024. Treatment response was assessed using response evaluation criteria in solid tumor (RECIST) 1.1 and modified PET response criteria in solid tumor（PERCIST）1.0 guidelines. Adverse events (AEs) were graded according to CTCAE v5.0. ResultsAt the last follow-up, consistent therapeutic outcomes were observed between RECIST 1.1 and modified PERCIST 1.0 guidelines, we observed 2 cases of partial response / partial metabolic response, 4 cases of stable disease/ stable metabolic disease, and 13 cases of progressive disease / progressive metabolic disease, demonstrating an objective response rate of 10.5% (2/19) and disease control rate of 31.6% (6/19). Post-treatment monitoring revealed 7 AEs of grade 2 and 1 AE of grade 1, with no occurrence of grade 3–4 haematological or hepatorenal toxicities. Common treatment-related symptoms, including nausea, decreased appetite, and fatigue, showed spontaneous resolution over time.ConclusionsPreliminary findings indicate that 177Lu-FAP-2286 exhibits favourable safety and tolerability in patients with advanced digestive system tumors while demonstrating efficacy in controlling disease progression for a subset of patients. However, multicenter prospective studies with larger cohorts are warranted to further validate its long-term efficacy and identify clinical characteristics of digestive system tumors patients who may benefit.
Objective To investigate the predictive value of mechanical power (MP) in the weaning outcome of adaptive mechanical ventilation plus intelligent trigger (AMV+IntelliCycle, simply called AMV) mode for acute respiratory distress syndrome (ARDS) patients. Methods From November 2019 to March 2021, patients with mild to moderate ARDS who were treated with invasive mechanical ventilation in the intensive care unit of the First Affiliated Hospital of Jinzhou Medical University were divided into successful weaning group and failed weaning group according to the outcome of weaning. All patients were treated with AMV mode during the trial. The MP, oral closure pressure (P0.1), respiratory rate (RR) and tidal volume (VT) of the two groups were compared 30 min and 2 h after spontaneous breathing trial (SBT). The correlation between 30 min and 2 h MP and shallow rapid respiratory index (RSBI) was analyzed by Pearson correlation. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of 30 min MP in ARDS patients with AMV mode weaning failure. Results Sixty-eight patients were included in the study, 49 of them were successfully removed and 19 of them failed. There was no statistical significance in age, gender, body mass index, oxygenation index, acute physiology and chronic health evaluation Ⅱ score, reasons for mechanical ventilation (respiratory failure, sepsis, intracranial lesions, and others) between the two groups (all P>0.05). The MP, P0.1 and RR at SBT 30 min and 2 h of the successful weaning group was lower than those of the failed weaning group (all P<0.05), but the VT of the successful weaning group was higher than the failed weaning group (all P<0.05). There was a significant relation between the MP at SBT 30 min and 2 h and RSBI (r value was 0.640 and 0.702 respectively, both P<0.05). The area under ROC curve of MP was 0.674, 95% confidence interval was 0.531 - 0.817, P value was 0.027, sensitivity was 71.73%, specificity was 91.49%, positive predictive value was 0.789, negative predictive value was 0.878, optimal cutoff value was 16.500. The results showed that 30 min MP had a good predictive value for the failure of weaning in AMV mode in ARDS patients. Conclusion MP can be used as an accurate index to predict the outcome of weaning in ARDS patients with AMV mode.
