BACKGROUND: To evaluate the efficacy and safety of the first cohort of people in China treated with a responsive neurostimulation system (Epilcure TM , GenLight MedTech, Hangzhou, China) for focal drug-resistant epilepsy in this study. METHODS: This multicenter, before-and-after self-controlled study was conducted across 8 centers from March 2022 to June 2023, involving patients with drug-resistant epilepsy who were undergoing responsive neurostimulation (RNS). The study was based on an ongoing multi-center, single-blind, randomized controlled study. Efficacy was assessed through metrics including median seizure count, seizure frequency reduction (SFR), and response rate. Multivariable linear regression analysis was conducted to explore the relationships of basic clinical factors and intracranial electrophysiological characteristics with SFR. The postoperative quality of life, cognitive function, depression, and anxiety were evaluated as well. RESULTS: The follow-up period for the 19 participants was 10.7 ± 3.4 months. Seizure counts decreased significantly 6 months after device activation, with median SFR of 48% at the 6th month (M6) and 58% at M12 ( P  <0.05). The average response rate after 13 months of treatment was 42%, with 21% ( n  = 4) of the participants achieving seizure freedom. Patients who have previously undergone resective surgery appear to achieve better therapeutic outcomes at M11, M12 and M13 ( β  <0, P  <0.05). No statistically significant differences were observed in patients' scores of quality of life, cognition, depression and anxiety following stimulation when compared to baseline measurements. No serious adverse events related to the devices were observed. CONCLUSIONS: The preliminary findings suggest that Epilcure TM exhibits promising therapeutic potential in reducing the frequency of epileptic seizures. However, to further validate its efficacy, larger-scale randomized controlled trials are required. REGISTRATION Chinese Clinical Trial Registry (No. ChiCTR2200055247).
Humans ; Female ; Male ; Drug Resistant Epilepsy/therapy* ; Adult ; Young Adult ; Middle Aged ; China ; Adolescent ; Treatment Outcome ; Quality of Life ; Single-Blind Method ; Seizures ; Electric Stimulation Therapy/methods*

OBJECTIVE:To observe the effects of dexmedetomidine (Dex) on postoperative agitation of Wilson's disease patients with secondary hypersplenism after genernl anesthesia of splenectomy.METHODS:A total of 60 Wilson's disease patients with secondary hypersplenism underwent general anesthesia of splenectomy duning Jan.-Dec.2016 were divided into control group and observation group according to random number table,with 30 cases in each group.Observation group was given intravenous pump of Dex 0.4 μg/kg at constant speed 15 min before anesthesia induction,and then maintained at 0.4 tg/(kg·h)till splenectomy completed.Control group was given constant volume of normal saline.Other anesthesia plans were same in 2 groups.Mean arterial pressure (MAP),heart rate (HR) and pulse oxygen saturation (SpO2) of 2 groups were observed before pumping (T0),before intubation (T1),1 min after intubation (T2),before extubation (T3),3 min after extubation (T4).Riker sedation-agitation score (SAS) were recorded in 2 groups at T3 and T4.The duration of stay in postanesthesia intensive care unit (PACU) and the occurrence of bradycardia were compared between 2 groups.RESULTS:At T0,there was no statistical significance in MAP,HR or SpO2 levels between 2 groups (P＞0.05).At T1,T2,T3 and T4,MAP and HR levels of 2 groups were decreased significantly,and the observation group was significantly lower than the control group,with statistical significance (P＜0.05).SpO2 were 100％ at each time point,there was no statistical significance between 2 groups (P＞0.05).Riker SAS scores of observation group was significantly lower than that of control group,with statistical significance (P＜0.05).The incidence of bradycardia in observation group was 26.67％,which was significantly higher than 3.33％ of control group,with statistical significance (P＜0.05).But this symptom was corrected after intravenous injection of atropine.The duration of stay in PACU in observation group was significantly shorter than control group,with statistical significance (P＜0.05).CONCLUSIONS:Dex can keep postoperative hemodynamics stable in Wilson's disease patients with secondary hypersplenism,reduce agitation and shorten the time of the patients transferring from PACU.

Objective To explore the effects of two methods for deep endotracheal suction.Methods Forty patients who had ineffective airway clearance or lung infections or refused suction were randomly divided into observation group (n=21) and control group (n=19).Temporay airway was established by using oropharyngeal airway.Then,the control group received subglottic suction after pading the shoulder with ordinary pillow (≤10cm),while the observation group received subglottic suction after pading the shoulder with homemade pillow (=15cm).The two groups were compared in terms of sputum suction effect and mucosal injury.Results There was no incidence of mucosal injury in the observation group but three in the control group.The times of suctioning in the observation group were fewer than those of the control group and the volume for suctioning was larger as well (allP<0.05).Conclusion Deep endotracheal suction through oropharyngeal airway,shoulder elevation for 15cm,temporary indwelling of suction tubes can achieve better suction effect without corresponding complications.

Objective To establish the method for detemining the content of Paeonolum in Fufang Yuanhu Zhitong Pian by HPLC. Methods Hypersil BDS C_(18) column was used with methyl alcohol-ware (1 : 1) as the mobile phase, detection wavelength as 274 nm, and flow rate was 1.0 mL/min. Results The calibration curve was linear at the range of 0.103～0.824 ?g for aeonolum, and linear equation was Y= 5 043.774 9X+275.5915, r=0.9997. The average recovery was 98.59% and the related standard deviation (RSD) was 0.68% (n =6). Conclusion This method was simple, accurate and proper, which provide scientific quantitative analysis method of Paeonolum in Fufang Yuanhu Zhitong pian and the repeatability was good.

Objective To establish the method for detemining the content of Icariin in Chuanlong Guci Pian by HPLC. Methods Diamonsil ODS1 C18 Column was used with acetonitrile-water (27∶73) as the mobile phase, detection wavelength as 270 nm, and flow rate was 1.0 mL/min. Results The calibration curve was linear at the range of 0.125～1.00 ?g for Icariin and linear equation was Y=81 601X+10 356, r 2=0.999 7. The average recovery was 99.12% and RSD was 0.65% (n=6). Conclusion This method was simple, accurate and proper, and the reduplication of the result was good, which provides scientific quantitative analysis of Icariin in Chuanlong Guci Pian.

Purpose:To determine the long-term safety and efficacy of the MemothermTM endoprosthesis as a therapeutic alternative in the management of men with BPH.Method:MemothermTM urethral stent was applied to thirty-eight men (mean age 77 years. Range 62-87 ) with symptoms and urodynamics suggestive of BPH.Results:Follow-up was lost in five patients. All but two patients with follow-up were eventually able to have spontaneous urination. Stents were removed from two patients because of dislocation. Prostatectomy was required in three patients at 15, 30 and 32 months respectively. Three patients resorted to indwelling catheterization after two years due to recurrence of symptoms. Information on 15 patients between 31 and 48 months follow-up was obtained. IPSS score was21.2±4.3.Conclusion:The long-term results from our trial unveiled that the Titanium-alloy memorial stents was an effective therapeutic alternative for patients having urinary retention with short life expectancy or operative contraindication.