Objective To investigate the 2-year retention rates and tolerability of levetiracetam (LEV), Lamotrigine(LTG), and Oxcarbazepine(OXC) in pediatric patients with epilepsy.Methods 310 pediatric patients with epilepsy were included in this study: LEV (n=145), LTG (n=101), and OXC (n=64). The clinical efficacy, first discontinuation time and discontinuation reasons were recorded and compared. The retention rates at 12, 24, 52 and 104 weeks were evaluated. Results At the two-year follow up:Clinical efficacy didn't significantly differ among the three groups (P = 0.190); The 2-year retention rates for LEV, LTG, and OXC, were 68.28%, 72.28%, and 48.44%, respectively (P = 0.002). LEV and LTG had equivalent retention rates, whereas OXC retention was significantly inferior to the LEV and LTG retention (P<0.05). The common reasons for drug discontinuation were adverse effects (47.66%) and lack of efficacy (42.10%), while the rate of adverse effects leading to drug withdrawal of OXC (66.77%) was higher than that of LEV (36.96%, P = 0.003) and LTG (42.86%, P = 0.023). Conclusion These results suggested that LEV, LTG and OXC had similar clinical efficacy. LEV and LTG had comparable retention profiles and long-term tolerability in the 2-year treatment, while OXC therapy seemed to be relatively less useful. If there are no specific contradictions, pediatric patients with epilepsy could be better receiving LEV and LTG antiepileptic treatment.

Objective To study the imaging diagnosis of tumors and tumor-like lesion of fibrous histiocyte origin in the femora.Methods Imaging features of femoral fibrous histiocyte neoplasm and tumor-like lesion were restrospectively analyzed in 17 cases ,including 16 cases proved by surgery and pathology, and one case was follow-up studied in five years.All cases were examined by plain X-ray flim, CT scan in 5 cases. Results There were fibrous dysplasia of bone in 8 cases,non-ossifying fibroma in 5cases ,fibrosarcoma of bone and benign fibrous histiocyte tumor of bone in 1 case respectively ,malignant fibrous histiocyte tumor of bone in 2 cases. They were diagnosed correctly before operation in 13 cases (13/17,76.5%) and misdiagnosed in 4 cases.Conclusion The most of femoral fibrogenic tumor and tumor-like lesion can be dingnosed correctly before operation ,because of they are of specific imaging features, while femoral fibrous histocyte original tumors are not of specific imaging findings, it must combine with clinical and pathologic data in diagnosis.

Objective To explore risk factors of poor early prognosis in the treatment of COVID-19 by nematevir and ritonavir tablets Paxlovid and establish the prediction model to provide reference for improving the effect of such patients. Methods 92 inpatients of COVID-19 treated with Paxlovid in three military tertiary hospital in southern Fujian from January 2023 to March 2023 were retrospectively analyzed. The clinical indicators of 92 inpatients were collected for univariate and multivariate analysis by single factor and multiple factors and the independent risk factors of poor early prognosis in Paxlovid were screened out. Logistic model equation was transformed to construct the combined predictors, and ROC curve was used to determine the area under the curve (AUC) and the optimal critical value of the combined predictors. Results Among 92 patients, 31 (33.70%) developed poor early prognosis, including 11 deaths (35.48%), 17 critical cases (54.84%) and 3 severe cases (9.68%). Multi-factor Logistic regression analysis showed that the disease days, lymphocyte count, aspartate aminotransferase(AST), C reactive protein(CRP) and ventilator-assisted ventilation were independent risk factors for poor early prognosis in Paxlovid. A formula for calculating the combined predictors (Y) was established as Y_{combinedpredictors}=7.875X_{disease days}+126.188X_{lymphocyte count}+1.438X_AST+X_CRP+220.500X_{ventilator-assisted ventilation} based on the above independent risk factors, and the ROC curve was drawn. With the maximum area under the ROC curve of the combined predictors being 0.939, the prediction value was best, and the optimal critical value of the ROC curve corresponding to the maximum Youden index (0.756) was 447.920.Theoretical accuracy of the model was 89.10%. Conclusion The disease days, lymphocyte count, AST, CRP and ventilator-assisted ventilation were independent risk factors for poor early prognosis in Paxlovid. Combined predictors could be calculated by the above risk factors before medication. The efficiency should be improved by taking more active treatment, including combining with other anti-COVID-19 drugs when the prediction result exceeds 447.920.