1.The random and comparative study on therapeutic effect and safety between Levetiracetam and Phenobarbitaladministration for neonatal seizures
Jie LI ; Yuexia YANG ; Xi CHEN ; Xiaoxi WANG ; Lan JIANG
Chinese Journal of Applied Clinical Pediatrics 2016;31(12):910-914
Objective To randomly compare the therapeutic effect and safety between Levetiracetam (LEV) and Phenobarbital (PB) in the treatment of neonatal seizures.Methods A total of 61 infants with acute convulsion were randomly divided into 2 groups:LEV group (n =30) and PB group (n =31) during January 2013 to December 2014 in Urumqi Children's Hospital.All neonates received routine management including etiology treatment and adverse drug reaction monitoring.In the LEV group,subjects received oral formulation of LEV with initial loading dose 30 mg/kg,followed by 15 mg/kg twice a day.If the seizures were not controlled completely,PB treatment was added until seizures were completed controlled.If seizures were controlled quickly,the dose of PB was gradually reduced and LEV was used as monotherapy.The subjects in PB group received intramuscular or intravenous injection of PB with 10 mg/kg as the first dose,then 5 mg/(kg · d) oral PB was administered,if seizures were not controlled,LEV treatment was added,then dose of PB was gradually reduced until seizures were controlled completely,and then patients were switched to LEV monotherapy gradually.The drug adverse reactions were observed.Results (1) After LEV or PB monotherapy,66.7% (20/30 cases) and 54.8% (17/31 cases) of the subjects obtained sustainable seizure free respectively.Although,there was a higher control ratio in LEV group,but no significant difference was observed between the 2 groups (P >0.05).(2) LEV group (16/30 cases,53.33%) had higher rapid seizure control ratio with seizure controlled within 24 h after first dosage administration than that of PB group (8/31 cases,25.80%),and there was significant difference (x2 =4.841,P =0.028).Further more,if adding the cases who had to change to use another comparative one (LEV or PB) due to their seizures failure control with the first one treated,LEV group (21/44 cases,47.72%) still had higher rapid seizure control ratio in total patients than that of PB group(10/41 cases,24.39%),and there was significant difference (x2 =4.988,P =0.026).(3) Eight cases who changed to LEV after PB as the first treatment drug failed obtained sustainable seizure free.(4) One case in PB group with transient urinary retention was observed but the symptom disappeared 36 h after PB withdrawal,and no significant drug adverse reaction was observed in LEV group.Conclusion LEV is more rapid and safe for seizure control of neonates than PB.
2.Identification of Eupatorii Herba and Its Adulterants by ITS2 Sequence
Lan WU ; Keli CHEN ; Wei SUN ; Zhigang HU ; Yuan TU ; Xiaoxi MA ; Yunhan LIN ; Hong ZHOU
World Science and Technology-Modernization of Traditional Chinese Medicine 2013;(3):410-414
Objective: This study aimed to discriminate between Eupatorii Herba and its adulterants in order to guarantee the quality and clinical curative effect of this medicinal material. Methods: Genomic DNA extracted from Eupatorii Herba was used as templates. The internal transcribed spacer 2 (ITS2) of nuclear ribosomal DNA was amplified. Sequence assembly and consensus sequence generation were performed by CodonCode Aligner. The intraspecific and interspecific genetic distances of Eupatorii Herba and its adulterants were computed by MEGA5 and the phylogenetic tree was constructed using the neighbor-joining (NJ) method. Results: The length of ITS2 sequence of Eupatorii Herba was 218 bp. The maximum intraspecific genetic distance (K2P distance) of Eupatorii Herba was 0.0092. The minimum interspecific genetic distance of Eupatorii Herba and its adulterants was 0.024. The NJ trees showed that the ITS2 sequence would be used to identify Eupatorii Herba and its adulterants. Con-clusion: ITS2 sequence was able to identify Eupatorii Herba and its adulterants correctly and it provided a new technique to ensure clinical safety in utilization of traditional Chinese medicines.
3.Levetiracetam treatment for neonatal intractable seizure
Jie LI ; Xi CHEN ; Yuexia YANG ; Lan JIANG ; Wumaier HASIYET ; Xiaoxi WANG
Chinese Journal of Applied Clinical Pediatrics 2015;30(24):1912-1914
Objective To investigate the efficacy and safety of Levertiracetam (LEV) in treating the neonates with intractable seizure, those who had under gone failed Phenobarbital (PB) treatment previously switched to or added LEV treatment currently.Methods Totally 14 neonates,designed as intractable seizure by clinical data and video electroencephalography(VEEG) and failed to PB treatment were enrolled in the study, and all neonates were switched to LEV or LEV + PB treatment.The initial loading dose of LEV was 30 mg/kg, followed by 15 mg/kg twice a day if symptoms were controlled 8-12 h,if not, followed by 30 mg/kg once.All neonates were switched to LEV monotherapy after the symptoms were controlled 48-72 h,if the symptoms could not be controlled by combined therapy of PB and LEV after 72 h, other therapies were administered.Electrocardiogram breath synchronous monitoring was performed during the first 72 h treatment.VEEG was performed during 1-3 months follow-up.Results (1) The symptoms of 8 (57.14%) out of 14 cases were completely controlled,2 neonates(14.29%) reduced seizure more than 50% ,4 neonates(28.57%) failed to LEV or LEV + PB treatment,as a result,all of those neonates were switched to other treatments.(2) No drug adverse effect was observed.(3) One neonate died of hypoxic-ischemic encephalopathy combined with multiple organ failure during follow-up period, 7 cases were seizure-free with normal VEEG, 5 cases were switched to or added other antiepileptic drugs because of uncontrolled symptoms, and one neonate discontinued the follow-ups.Conclusions The high efficiency and safety of LEV for the treatment of the newborn seizures were proved by small samples of patients.And currently there is no evidence to prove PB might increase neuronal excessive apoptosis of the brain and the cognitive impairment, and more clinical researches are needed to promote LEV as a gleam of rescue medications of neonatal seizure as soon as possible.
4.Identification of Anemone raddeana and Its Adulterants by ITS2 Sequence
Weichao REN ; Wei MA ; Chao AN ; Xiaoxi MA ; Lan WU ; Wei SUN
World Science and Technology-Modernization of Traditional Chinese Medicine 2014;(2):301-306
In this study, the internal transcribed spacer 2 of nuclear ribosomal DNA (ITS2) sequence was used for i-dentifying A nemone raddeana and its adulterants to ensure the quality of medicines and clinical efficacy. Genomic DNA was extracted from 36 samples using Genomic DNA kit and used as templates for Polymerase Chain Reaction (PCR). Sequence assembly and consensus sequence generation were performed by CodonCode Aligner. The intraspe-cific and interspecific genetic distances were computed and the neighbor-joining tree was constructed by MEGA 5.1 in accordance with the Kimura 2-Parameter (K-2P) model. Results: The length of ITS2 sequence of A nemone rad-deana was 216 bp. The Maximum intraspecific genetic distance was 0.014, the minimum interspecific genetic dis-tance was 0.021. The NJ tree showed that A . raddeana differ from its adulterants obviously. Conclusion: ITS2 se-quence was able to identify A . raddeana and its adulterants correctly stably and correctly, which provides a new tech-nique to its identification.
5.Highly Specific DNA Barcoding Primers of ITS2 for Gastrodia elata
Xiaoxi MA ; Wei SUN ; Qini QIAN ; Weichao REN ; Lan WU ; Yaqin ZHANG ; Ming SONG
World Science and Technology-Modernization of Traditional Chinese Medicine 2014;(2):325-328
This study aimed to design a pair of primers for amplifying internal transcribed spacer 2 region which was used to identify Gastrodia elata through optimizing of DNA extraction and PCR amplification process. Two sequences are used for research object by amplification of universal primers. Design three pairs of specific primers by Primer Premier 5.0 and select the highest specificity through the study of 22 samples. The results showed that identification efficiency of the primer named TM2F-2R is as high as 90.9% when Annealing Temperature is equal to 54 degrees Celsius. Therefore, TM2F-2R can be used as primers ITS2 sequences of G. elata, this article provides a set of accu-rate and stable identification methods for G. elata in the molecular identification.
6.Identification of Xanthii Fructus and Its Adulterants Based on ITS2 Sequence
Jun WANG ; Xia LIU ; Yaqin ZHANG ; Ming SONG ; Yunhan LIN ; Xiaoxi MA ; Wei SUN ; Li XIANG ; Zhigang HU ; Lan WU ; Xueqiong ZHANG ; Weiyi HU
World Science and Technology-Modernization of Traditional Chinese Medicine 2014;(2):329-334
Objective: To identify Xanthii Fructus and secure its quality and safety in medication. Methods: Total ge-nomic DNA was extracted from Xanthii Fructus and its adulterants. ITS2 sequences were amplified, and purified PCR products were sequenced. Sequence assembly and consensus sequence generation were performed using the CodonCode Aligner V 4.2. The Kimura 2-Parameter (K2P) distances were calculated using MEGA 5.0. The neigh-bor-joining (NJ) phylogenetic trees were constructed. Results: The intraspecific genetic distances of Xanthii Fructus were 0. The interspecific genetic distances between Xanthii Fructus and its adulterants were ranged from 0.009 to 0.542. The NJ tree showed that Xanthii Fructus could differ from its adulterants obviously. Conclusion: ITS2 can be used to identify Xanthii Fructus from its adulterants effectively, and our study further confirmed the effectiveness of ITS2 to identify traditional Chinese medicinal materials.
7.Patterns of Failure After Minimally Invasive Esophagectomy and Evaluation of Value of Adjuvant Therapy for Esophageal Cancer
Rutian CHENG ; Jian LIANG ; Chun HAN ; Qi WANG ; Xiaoxi CHEN ; Shutang LIU ; Lan WANG
Cancer Research on Prevention and Treatment 2023;50(9):895-901
The current recommendation for postoperative radiotherapy for esophageal cancer in China is mainly based on the data of incomplete two-field dissection of open left thoracotomy. At present, the type of surgery for esophageal cancer gradually transitions from open left thoracotomy to open right thoracotomy and from open esophagectomy to minimally invasive esophagectomy (MIE). Patients with early-stage esophageal cancer are selected as candidates for MIE. MIE is less invasive than open esophagectomy, and the right thoracic approach is conducive to more thorough lymph node dissection. However, few data and related studies are available on the patterns of failure after MIE in esophageal cancer, and guiding an adjuvant therapy is difficult. The feasibility of an adjuvant therapy for selective high-risk patients and the optimized treatment after MIE remains to be explored in clinical practice. In this regard, this article aims to review the safety of MIE, long-term survival outcomes, postoperative recurrence patterns, and recurrence rates of patients to discuss the value of postoperative adjuvant therapy and guide clinical treatment.