OBJECTIVE To evaluate the efficacy， safety， and cost-effectiveness of brivaracetam （BRV） as adjunctive therapy in patients with drug-resistant focal epilepsy.METHODS PubMed， Embase， Cochrane Library， Web of Science， CNKI， Wanfang， and official health technology assessment （HTA） agency websites were searched from inception to January 31， 2026 for HTA reports， systematic reviews/meta-analyses， and pharmacoeconomic studies on BRV. After literature screening and quality assessment， a descriptive analysis was performed.RESULTS A total of 21 publications were included： 13 systematic reviews/meta-analyses， 7 pharmacoeconomic studies （including one study that simultaneously conducted a systematic review/meta-analysis）， and 2 HTA reports. Regarding efficacy， BRV significantly improved the 50% responder rate [risk ratio （RR）＝1.81] and seizure-freedom rate （RR＝5.89） versus placebo. Among third-generation anti-seizure medications （ASMs）， BRV ranked 1st-2nd for seizure freedom， while its 50% responder rate was at a moderate level. The optimal adult dose for seizure freedom was 100 mg/d. Regarding safety， BRV was well tolerated， overall adverse event rates did not differ from placebo， though withdrawal due to adverse event rates were higher than with placebo. Tolerability ranked 1st-2nd among the third-generation ASMs. Psychiatric/behavioral adverse event rates were lower with BRV （6.4%） than with levetiracetam （14.1%）. Regarding cost-effectiveness， BRV showed pharmacoeconomic advantages in countries with lower drug pricing （Australia， Finland） and only in high-risk subgroups in Japan， but did not show such advantages at current prices in the US or Italy. BRV has been included in China’s national reimbursement drug list in 2025， and the economic conclusions drawn during its initial market launch are outdated and require re-evaluation.CONCLUSIONS BRV has proven efficacy and good safety， especially suitable for patients intolerant to levetiracetam. However， due to pricing and medical insurance policies， the cost-effectiveness of BRV after its inclusion in China’s national reimbursement drug list still needs to be re-evaluated.

OBJECTIVE To analyze the effects of biapenem on the blood concentration of sodium valproate （VPA） in patients with severe infections. METHODS A retrospective collection of patient data was conducted， encompassing individuals admitted to our hospital from January 2021 to May 2024 who were treated with biapenem for severe infections and concurrently or sequentially administered VPA for the prevention or treatment of epilepsy. The effects of various factors on the blood concentration of VPA， including the combination of biapenem， the sequence of biapenem administration， the number of days of biapenem combination， the dosage of biapenem， and the time after biapenem discontinuation. RESULTS A total of 70 patients with 117 VPA blood concentration results were included in this study. When VPA was used alone， no statistically significant difference was observed in the steady-state blood concentrations of VPA between patients who received biapenem first and those who received it later （P＞ 0.05）. There was no statistically significant difference between the steady-state concentration of VPA in patients who received biapenem in combination for 1 to 3 days and those who did not receive the combination therapy （P＞0.05）. The steady-state concentration of VPA in patients not receiving biapenem combination therapy was significantly higher than that of the patients who received combination therapy for 4 to 7 days and more than 7 days （P＜0.001）. With the prolonged duration of combination therapy， the blood concentration of VPA gradually decreased （P＜0.001）. However， no statistically significant difference was observed between the group receiving combination therapy for more than 7 days and the group receiving it for 4 to 7 days （P＞ 0.05）. After 1 to 3 days of combination therapy， no statistically significant differences in VPA blood concentrations were observed among patients with different discontinuation times of biapenem （P＞0.05）. The blood concentration of VPA in patients who received combination therapy for more than 3 days was significantly lower than those who discontinued biapenem 4 to 7 days or more than 7 days after more than 3 days of combination therapy（P＜0.001）. There was no statistically significant difference in VPA blood concentrations between patients receiving a daily biapenem dose ＞1.0 g and those receiving a daily dose ＜1.0 g （P＞0.05）. CONCLUSIONS The concomitant administration of biapenem for 1-3 days has a minimal impact on the blood concentration of VPA. In patients receiving combination therapy for longer than 3 days， VPA blood concentrations return to baseline levels chouxiaoh@163.com within 4-7 days after biapenem discontinuation.

Objective To investigate the therapeutic effect of continuous blood purification on diabetic lactic acidosis(DLA).Methods 60 DLA patients who were treated at our hospital Blood Purification Center from January 2020 to January 2023 were randomly divided into conventional treatment group(Con)and continuous blood purification group(CBP),with 30 cases in each group.The changes of anion gap(AG),pH,lactic acid(Lac),FPG,2 hPG,HbA1c,alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),serum creatinine(Scr),urea nitrogen(BUN),cystatin C(CysC),blood potassium(K+),C-reactive protein(C-RP),acute and chronic health evaluation scoring system Ⅱ(APACHEⅡ)and mortality within 28 days were compared between the two groups.Results After 48 h of treatment,the clearance rate of Lac in CBP group was higher than that in Con group(P<0.05).The pH value of CBP group was higher than Con group.The levels of AG,Lac,FPG,2 hPG,HbA1c,ALT,AST,TBIL,Scr,BUN,CysC,K+,C-RP and APACHEⅡ score were lower in CBP group than those in Con group(P<0.05).The 28-day mortality rate of the CBP group was lower than that of the Con group(P<0.05).Conclusion Continuous blood purification combined with routine treatment in DLA patients can increase Lac clearance and improve the prognosis.

AIM: To describe and evaluate the clinical characteristics, treatment management and clinical outcomes of ceftazidime-avibactam (CZA) in the treatment of patients with multidrug-resistant gram-negative bacterial (MDR-GNB) infections. METHODS: A retrospective cohort study was performed on patients hospitalized in the Affiliated Hospital of Xuzhou Medical University from September 2019 to December 2021. Adult patients who received CZA for ≥ 72 hours consecutively were eligible for inclusion. The primary outcome was clinical failure, defined as a composite of 30-day all-cause mortality, microbiological failure and / or failure to resolve or improve signs and symptoms of infection during treatment with CZA. RESULTS: A total of 198 patients with MDR-GNB infections were described and evaluated, including 132 in the carbapenem-resistant Enterobatceriaceae (CRE) cohort and 66 in the Pseudomonas spp. cohort. The main infection sites were lung infection (92.42%), abdominal infection (10.61%), and intracranial infection (10.61%), among which 63 patients (31.82%) were positive for blood culture. Clinical failure, 30-day all-cause mortality and microbiological failure occurred in 61 (30.81%), 33(16.67%) and 11(5.56%) patients, respectively. Body mass index (BMI), acute physiology and chronic health evaluation scoring system (APACHE Ⅱ) and polymicrobial infections were positively associated with clinical outcome failureadjusted OR 1.109, 95%CI 1.017, 1.209; adjusted OR 1.071, 95%CI 1.015, 1.129; adjusted OR 2.844, 95%CI 1.391, 5.814, however, initiation of CZA within 48 hours of admission was protective (adjusted OR 0.424, 95%CI 0.205, 0.879). A total of 15 patients had adverse reactions possibly related to CZA, including 2 cases of rash, 6 cases of nausea and vomiting, and 7 cases of antibiotic-related diarrhea. CONCLUSION: CZA can be used to treat infections caused by a range of MDR-GNB, including Pseudomonas spp. and CRE.

Objective:To understand the basic characteristics of COVID-19 cases and the virus carrying status of different samples in Ma′anshan.Methods:Descriptive epidemiological method was used to describe the distribution of 2019-nCoV infections in Ma′anshan. Real-time fluorescence RT-PCR was used to detect 2019-nCoV nucleic acid in sputum and/or throat swabs. Data was analyzed by EXCEL and SPSS 20.0. P<0.05 was considered to be statistically significant by using χ2 test. Results:Until 14 March 2020, 38 confirmed cases and no death had been reported in Ma′anshan, there were also 11 asymptomatic infections. 2019-nCoV infection was first detected on January 23, and the last was on February 20. No new infections have been found for 23 consecutive days until March 14; 77.55%(38/49)of the infections were in He county. Among the 1 447 subjects, the positive rate was 4.50% (27/600) in females and 2.60% (22/847) in males (χ 2=3.886, P=0.049). The minimum age of the infections was 4 years and the maximum was 85. There was no significant difference between age groups ( χ2=10.675, P=0.058). Among the 49 infections, 20 of them (40.82%) were from Wuhan, 24 (48.98%) were locally infected, and 5 (10.20%) were imported from other places. For the first positive infections, the positive rate of sputum (100%, 36/36) was higher than the throat swab (77.78%, 28/36), and the difference was statistically significant (χ 2=6.125, P<0.05). Conclusions:In Ma′anshan, 2019-nCoV infections were concentrated in He county, sputum was beneficial to the detection of 2019-nCoV.

Objective: To understand the infection status and genetic characteristics of Norovirus from foodborne diseases in sentinel hospital of Ma′anshan city. Methods: The 911 stool samples and epidemiological data of the patients with foodborne disease were collected from three hospitals of Ma′anshan city during January 2015 to June 2018. The G Ⅰ and G Ⅱ Norovirus were detected by real-time reverse transcription PCR. Some of the positive specimens were amplified by conventional reverse transcription PCR, and the PCR products were sequenced for sequence alignment and phylogenetic analysis. Results: The positive rate of Norovirus was 14.7% (134/911), in which 7 strains were G Ⅰ, 124 strains were G Ⅱ and 3 strains were mixed infection. Norovirus can be detected throughout the year, with high positive rate from December to April of the next year [24.4%(20/82)-45.3%(24/53)]. The 78 males (15.5%) and 55 females (13.7%) were positive for Norovirus (χ²=0.58,P=0.448). There was no significant difference in different age groups (χ²=9.55, P=0.089). A total of 79 strains were successfully sequenced, 4 strains were G Ⅰ group(5.1%), 75 strains were G Ⅱ group (94.9%). The predominant strains were GⅡ.17 and GⅡ.4, aud the number were 35 and 15 respectively. The predominant strains were different in different years. The main strain was GⅡ.17 in 2015 (30, 68.2%),GⅡ.4 in 2016 (5/9) and 2017 (8/16), but GⅡ.3 in 2018 (3/6). Conclusion Norovirus diarrhea was popular in Ma′anshan city throughout the year,especially in winter and spring. The prevalent strain was GⅡ,genotypes were diversified distribution,the dominant strains were GⅡ.17 and GⅡ.4. The predominant strains were different in different years.

Objective To understand the infection status and genetic characteristics of Norovirus from foodborne diseases in sentinel hospital of Ma′anshan city. Methods The 911 stool samples and epidemiological data of the patients with foodborne disease were collected from three hospitals of Ma′anshan city during January 2015 to June 2018. The GⅠ and GⅡ Norovirus were detected by real?time reverse transcription PCR. Some of the positive specimens were amplified by conventional reverse transcription PCR, and the PCR products were sequenced for sequence alignment and phylogenetic analysis. Results The positive rate of Norovirus was 14.7% (134/911), in which 7 strains were GⅠ, 124 strains were GⅡ and 3 strains were mixed infection. Norovirus can be detected throughout the year, with high positive rate from December to April of the next year [24.4%(20/82)-45.3%(24/53)]. The 78 males (15.5%) and 55 females (13.7%) were positive for Norovirus (χ2=0.58, P=0.448). There was no significant difference in different age groups (χ2=9.55, P=0.089). A total of 79 strains were successfully sequenced, 4 strains were GⅠ group (5.1%), 75 strains were GⅡ group (94.9%). The predominant strains were GⅡ. 17 and GⅡ. 4, aud the number were 35 and 15 respectively. The predominant strains were different in different years. The main strain was GⅡ.17 in 2015 (30, 68.2%),GⅡ.4 in 2016 (5/9) and 2017 (8/16),but GⅡ.3 in 2018 (3/6). Conclusion Norovirus diarrhea was popular in Ma′anshan city throughout the year,especially in winter and spring.Theprevalent strain was GⅡ,genotypes were diversified distribution,the dominant strains were GⅡ.17 and GⅡ.4. The predominant strains were different in different years.

Objective To understand the infection status and genetic characteristics of Norovirus from foodborne diseases in sentinel hospital of Ma′anshan city. Methods The 911 stool samples and epidemiological data of the patients with foodborne disease were collected from three hospitals of Ma′anshan city during January 2015 to June 2018. The GⅠ and GⅡ Norovirus were detected by real?time reverse transcription PCR. Some of the positive specimens were amplified by conventional reverse transcription PCR, and the PCR products were sequenced for sequence alignment and phylogenetic analysis. Results The positive rate of Norovirus was 14.7% (134/911), in which 7 strains were GⅠ, 124 strains were GⅡ and 3 strains were mixed infection. Norovirus can be detected throughout the year, with high positive rate from December to April of the next year [24.4%(20/82)-45.3%(24/53)]. The 78 males (15.5%) and 55 females (13.7%) were positive for Norovirus (χ2=0.58, P=0.448). There was no significant difference in different age groups (χ2=9.55, P=0.089). A total of 79 strains were successfully sequenced, 4 strains were GⅠ group (5.1%), 75 strains were GⅡ group (94.9%). The predominant strains were GⅡ. 17 and GⅡ. 4, aud the number were 35 and 15 respectively. The predominant strains were different in different years. The main strain was GⅡ.17 in 2015 (30, 68.2%),GⅡ.4 in 2016 (5/9) and 2017 (8/16),but GⅡ.3 in 2018 (3/6). Conclusion Norovirus diarrhea was popular in Ma′anshan city throughout the year,especially in winter and spring.Theprevalent strain was GⅡ,genotypes were diversified distribution,the dominant strains were GⅡ.17 and GⅡ.4. The predominant strains were different in different years.

The present study aimed to explore the neuroprotective effect and possible mechanisms of rhGLP-1 (7–36) against transient ischemia/reperfusion injuries induced by middle cerebral artery occlusion (MCAO) in type 2 diabetic rats. First, diabetic rats were established by a combination of a high-fat diet and low-dose streptozotocin (STZ) (30 mg/kg, intraperitoneally). Second, they were subjected to MCAO for 2 h, then treated with rhGLP-1 (7–36) (10, 20, 40 µg/kg i.p.) at the same time of reperfusion. In the following 3 days, they were injected with rhGLP-1 (7–36) at the same dose and route for three times each day. After 72 h, hypoglycemic effects were assessed by blood glucose changes, and neuroprotective effects were evaluated by neurological deficits, infarct volume and histomorphology. Mechanisms were investigated by detecting the distribution and expression of the nuclear factor erythroid-derived factor 2 related factor 2 (Nrf2) in ischemic brain tissue, the levels of phospho-PI3 kinase (PI3K)/PI3K ratio and heme-oxygenase-1 (HO-l), as well as the activities of superoxide dismutase (SOD) and the contents of malondialdehyde (MDA). Our results showed that rhGLP-1 (7–36) significantly reduced blood glucose and infarction volume, alleviated neurological deficits, enhanced the density of surviving neurons and vascular proliferation. The nuclear positive cells ratio and expression of Nrf2, the levels of P-PI3K/PI3K ratio and HO-l increased, the activities of SOD increased and the contents of MDA decreased. The current results indicated the protective effect of rhGLP-1 (7–36) in diabetic rats following MCAO/R that may be concerned with reducing blood glucose, up-regulating expression of Nrf2/HO-1 and increasing the activities of SOD.
Animals ; Blood Glucose ; Brain ; Diet, High-Fat ; Hypoglycemic Agents ; Infarction ; Infarction, Middle Cerebral Artery ; Malondialdehyde ; Neurons ; Neuroprotective Agents ; Phosphotransferases ; Rats* ; Reperfusion ; Reperfusion Injury* ; Streptozocin ; Superoxide Dismutase

Objective To observe the efficacy and adverse reaction of Durogesic (thansdermal fenfanul) for analgesia in patients with malignant tumors, who occur moderate or severe pain from mucosal response during radiochemotherapy. Methods 50 patients were divided into two groups randomly. The treatment group received Durogesic and normal therapy, the contrast group received normal therapy. The analgesic effects, the quality of life and the side effects after medicine were observed. Results The pain remission rates of treatment group and control group were 100 % (25/25) and 52 % (13/25), respectively (χ2 =15.78, P ＜ 0.01)[(9.66±0.35), (10.01±0.34) min]and[(18.12±0.46), (14.68±0.19) min].The quality of life in treatment group was improved significantly (t = 8.11, P ＜0.01).The main adverse reactions of Durogesic included constipation, itch of skin, drowsiness, nausea, vomiting and so on. All of adverse reactions were tolerable. Conclusion Durogesic for analgesia have high curative effect and slight adverse effects in pain of oral cavity and laryngeal pharynx in patients with malignant tumors during radiochemotherapy which make patients complete radiochemotherapy successfully.