ObjectiveTo compare the efficacy and compliance of children children with refractory epilepsy receiving ketogenic diet (KD) in outpatient department with children receiving KD treatment in inpatient department. MethodsA retrospective study of 44 children with intractable epilepsy receiving the modified classical ketogenic diets in outpatient department from June 2014 to December 2015, who were followed-up during the third, sixth and twelfth month. Records of epileptic seizures and adverse reactions were used to evaluate the efficacy and retention rate of inpatient department KD treatment in children with refractory epilepsy, and compared with 104 children receiving KD treatment in inpatient department at the same period. ResultsThirty-four of the forty-four children comleted observation after 12-month follow-up, 15 cases had been seizure freedom, 22 cases had more than 50% reduction in seizure frequency, 12 patients had less than 50% reduction in seizure frequency.The total effective rate of the KD therapy in outpatient department was 64.7%, and the retention rate was 71%. 18 of of the 104 children with KD treatment in inpatient department at the same period comleted observation after 12-month follow-up, 3 cases had been seizure freedom, 5 cases had more than 50% reduction in seizure frequency, 13 cases had less than 50% reduction in seizure frequency.The total effective rate of the KD therapy in inpatient department was 27.8%, and the retention rate was 17.3%. ConclusionThe KD therapy in outpatient department is effective to children with intractable epilepsy, and there is a highly efficacy and compliance of children receiving KD in outpatient department comparing with children receiving KD in inpatient department. Therefore, it's optional to children with refractory epilepsy who can't received KD by inpatient department because of insufficient number of beds.
Objective To systematically review the effects of various exercise modalities on obese children and adolescents with metabolic syndrome (MetS). MethodsChinese and English databases such as CNKI, WanFang Data, VIP, PubMed and Web of Science were selected to search for RCTs on the effects of exercise on obese children and adolescents with MetS, and the search period was from January 2000 to November 2024 And two researchers independently screened the literature, extracted data and evaluated the risk of bias of the included studies, and net meta−analysis was performed using Stata 17.0 and RevMan 5.4 software. Results A total of 15 RCT trials involving 968 obese children and adolescents with MetS were included. The results of reticulated meta−analysis showed that compared with the non−exercise intervention group, aerobic exercise was effective in improving the patients' body mass index (BMI) (SMD=−1.21, 95% CI −2.31 to −0.11, P=0.031), total cholesterol (TC) (SMD=−0.44, 95% CI −0.82 to −0.05, P=0.028), triglyceride (TG) (SMD=−1.10, 95% CI −1.98 to −0.22, P=0.014), fasting blood glucose (FBG) (SMD=−0.70, 95% CI −1.34 to −0.07, P=0.030), systolic blood pressure (SBP) (SMD=−1.10, 95% CI −1.83 to −0.38, P=0.003), diastolic blood pressure (DBP) (SMD=−0.93, 95% CI −1.49 to −0.37, P=0.001); Resistance exercise can effectively improve the HDL cholesterol (SMD=0.55, 95% CI 0.09 to 1.02, P=0.020) and SBP (SMD=−1.16, 95% CI −2.18 to −0.14, P=0.025); aerobic combined with resistance exercise can effectively improve waist circumference (WC) (SMD=−1.09, 95% CI −1.74 to −0.44, P=0.001), BMI (SMD=−1.22, 95% CI −2.32 to −0.12, P=0.030), HDL (SMD=0.56, 95% CI 0.13 to 1.00, P=0.011), and FBG (SMD=−0.57, 95% CI −1.13 to −0.02, P=0.044). The results of cumulative probability ranking showed that aerobic exercise was the most effective in improving TG, TC, FBG and DBP; resistance exercise was the most effective in improving SBP; and aerobic combined with resistance exercise was the most effective in improving WC, BMI and HDL. ConclusionDifferent exercise modes have different improvement effects on various body indexes in obese children and adolescents with MetS. Due to the limitation of the number and quality of included studies, more high−quality studies are needed to verify the above conclusions.