ObjectiveTo summarize the manifestations of acute mesenteric ischemia (AMI) on multidetector computed tomography (MDCT) and the diagnostic value of MDCT in the prognosis of AMI. MethodRecent studies on pathophysiology, CT features, and prognosis of AMI were retrieved and reviewed. ResultsVascular insufficiency of AMI could occur as a result of mesenteric arterial embolism, arterial thrombosis, venous thrombosis, or nonocclusive. Two stages of AMI, early and late, were associated with distinct prognosis. In early ischemia, the lesions were reversible. The late AMI was characterized by the development of irreversible transmural necrosis. A delayed diagnosis leaded to considerable mortality. MDCT findings in AMI could be divided into imaging findings related to vascular insufficiency and ischemic intestinal injury. Pneumoperitoneum could be considered a sign of transmural necrosis in the AMI. While, other imaging features predicting transmural necrosis were controversial because of the heterogeneity of diagnostic tests. ConclusionsAMI is a life-threatening abdominal emergency. Early diagnosis can improve the prognosis of patient. It is important for radiologists to identify prognostic features for differentiating early from late forms of AMI.
Objective To assess the effectiveness and safety of flunarizine for refractory epilepsy. Methods Relevant randomized controlled trials (RCTs) were searched from the database of PubMed, EMbase, Cochrane Library, CNKI, CBM, and VIP, and the related references were traced to obtain the information. The methodological quality of included RCTs was assessed using Jadad scale and meta-analysis was performed using RevMan 5.0 software. Results A total of eight studies involving 545 patients were included. The results of meta-analyses showed that: based on the conventional therapy, compared with placebo and none-treatment, flunarizine was more effective on adults and children with refractory epilepsy (OR=2.98, 95%CI 1.88 to -4.73; OR=33.75, 95%CI 4.13 to -276.00). Major adverse events of flunarizine were fatigue, dizziness, headache, and weight gain etc. All those symptoms except for the weight gain were observed in the early stage of medication, which might get self-cured or could disappear by constant medication or reducing the dose or symptomatic treatment. Conclusion The present study shows that based on the conventional therapy, flunarizine is effective and safe for refractory epilepsy.