1.The clinical and neuroelectrophysiological characteristics of patients with sudden unexpected death in epilepsy
Wenna AN ; Shi XIAODAN ; Bi WANG ; Xiaoli WANG ; Zezhi WANG ; Xinbo ZHANG ; Qinpeng WANG ; Jiang ZHU ; Yonghong LIU
Chinese Journal of Neurology 2023;56(6):679-685
Objective:To investigate the clinical and electrophysiological characteristics of patients with sudden unexpected death of epilepsy (SUDEP).Methods:Using "epilepsy" as the keyword, the relevant cases entered from October 2011 to March 2012 were searched in the database of the Electroencephalogram (EEG) Monitoring Center, Xijing Hospital, the Air Force Military Medical University. Telephone follow-up was conducted for all confirmed epilepsy patients, and for the death cases confirmed by telephone follow-up, the patients identified as consistent with SUDEP diagnosis were included in this study based on their past medical history, clinical data, death details, etc, and their clinical and neuroelectrophysiological characteristics were summarized and analyzed.Results:Among the 1 232 patients who underwent 24-hour video-EEG monitoring during the study period, 354 patients were successfully followed up by telephone interview, of whom 17 patients were died (4.8%), 12 individuals met the diagnosis of SUDEP (7 men, 5 women). The duration of the disease in 9 patients exceeded 10 years. Eight cases presented with focal-bilateral tonic clonic seizures. Nine patients were treated with anti-seizure drug monotherapy. All the 24-hour video EEG of 12 patients were abnormal. There were 8 occasions when the EEG occipital α background rhythm slowed down compared with the standard frequency of peers or was dominated by slow waves. Interictal epileptic discharge (IED) located in temporal lobe were found in 12 EEG records, of which 9 EEG records were found with frontal IED. One of the 12 cases received 24-hour video EEG twice within 6 years, and his EEG background rhythm was significantly slower and the IED region was expanded compared with the first EEG record. At the third year after reexamination of EEG, SUDEP developed in this patient.Conclusions:SUDEP patients have a long course of disease and bilateral tonic-clonic seizure. The interictal EEG shows occipital slow α activity and temporofrontal epileptiform discharges, which may increase the risk of SUDEP.
2.Simultaneous Determination of 6 Components in Chaihuang Tablets by HPLC-DAD
Changling DING ; Junfeng CUI ; Xiaorong SHI ; Yangyang XU ; Wenna CHENG ; Jinjie ZHANG ; Li ZHAO
China Pharmacy 2019;30(11):1477-1481
OBJECTIVE: To establish a method for simultaneous determination of 6 components in Chaihuang tablets, such as baicalin, wogonoside, baicalein, wogonin, saikosaponin a and saikosaponin d in Chaihuang tablets. METHODS: HPLC-DAD method was used to detect 3 batches of Chaihuang tablets from same manufacturers. The determination was performed on Agilent Eclipse XDB-C18 column with mobile phase consisted of acetonitrile-triethylamine phosphate aqueous solution (pH adjusted to 7.0, gradient elution) at flow rate of 1.0 mL/min. The detection wavelengths were set at 210 nm (saikosaponin a, saikosaponin d) and 277 nm (baicalin, wogonoside, baicalein, wogonin). The column temperature was 30 ℃, and sample size was 5 μL. RESULTS: The linear ranges of baicalin, wogonoside, baicalein, wogonin, saikosaponin a and saikosaponin d were 0.379 5-7.590 4 μg, 0.082 96-1.659 2 μg, 0.039 39-0.787 8 μg, 0.040 72-0.814 4 μg, 0.040 45-0.809 0 μg, 0.038 63-0.772 6 μg (all r≥0.999 3), respectively. The limits of detection were 0.008, 0.007, 0.005, 0.005, 0.020 and 0.018 μg/mL. The limits of quantitation were 0.025, 0.022, 0.015, 0.015, 0.060, 0.054 μg/mL. RSDs of precision, reproducibility and stability tests (48 h) were all lower than 1.5% (n=6). Average recoveries were 98.46%, 97.06%, 100.90%, 96.13%, 96.91%, 96.57% (RSD<2.0%, n=6). CONCLUSIONS: Established method is simple, accurate and reproducible for 6 components in Chaihuang tablets, and can be used for quality control of the tablet.
3.Clinical Analysis of Docetaxel Combined with PD-1/PD-L1 Inhibitor in Second-line Treatment of Advanced Non-small Cell Lung Cancer.
Qing CHEN ; Yan LI ; Wenjie ZHANG ; Shengjie YANG ; Chen WANG ; Qisen GUO ; Wenna SHI
Chinese Journal of Lung Cancer 2021;24(9):605-612
BACKGROUND:
Programmed cell death 1 or programmed cell death ligand 1 inhibitor (PD-1/PD-L1 inhibitor) and docetaxel, as the standard second-line treatments of advanced non-small cell lung cancer (NSCLC) patients, have limited effects. There are few studies on whether docetaxel combined with PD-1/PD-L1 inhibitor can increase the efficacy and make patients better benefit. The aim of this study is to evaluate the efficacy and safety of docetaxel combined with PD-1/PD-L1 inhibitor for the second-line treatment of stage IV NSCLC patients.
METHODS:
Stage IV NSCLC patients (n=118) who received treatment at Shandong Cancer Hospital between October 1, 2018, and December 31, 2020, were retrospectively analyzed. They were divided into observation group (n=69) and control group (n=49) according to different treatment plan. Observation group was given docetaxel plus PD-1/PD-L1 inhibitor, while control group was given PD-1/PD-L1 inhibitor. The clinical curative effect and the incidence of adverse reactions of grade 3 and above were compared between the two groups.
RESULTS:
The disease control rate (DCR) was higher in the observation group (89.9%) than that in the control group (73.5%) (P=0.019), and the objective response rate (ORR) showed no significant difference between observation group (24.6%) and control group (16.3%) (P=0.276). Till June 22, 2021, the 1-year PFS rate showed no difference between observation group (16.5%) and control group (7.7%) (P=0.205). During the treatment period, the adverse reactions of the two groups were mostly grade 1 to 2, and could be tolerated. The incidence of bone marrow suppression in observation group was higher than that in the control group (P<0.05), and the remaining adverse reactions were not statistically different from control group. Cox regression analysis showed that performance status (PS) (P=0.020) and age (P=0.049) were independent prognostic factors for the effect of docetaxel combined with PD-1/PD-L1 inhibitor.
CONCLUSIONS
The second-line treatment with docetaxel plus PD-1/PD-L1 inhibitor in patients with stage IV NSCLC can improve the DCR and prolong the PFS, and the adverse reactions are tolerable.