ObjectiveTo assess the effects of the Coronavirus disease 2019 (COVID-19) epidemic on patients with infantile epileptic spasms syndrome and their parents through an online questionnaire survey.MethodsThis study was a cross-sectional study conducted from May to June 2022. The questionnaire focused on seizure attacks, medical visits, and the mental health assessment of parents. ResultsA total of 67 patients with infantile epileptic spasms syndrome were included in this study. During the epidemic, 25.37% of the patients experienced increased spasms, and 73.13% of the patients had limited commercial availability of anti-seizure medications, mainly vigabatrin and clobazam. All patients had difficulty seeking medical services, and about 73.13% of them used telemedicine service. In addition, 31.34% of parents felt anxious, and 73.14% had different degrees of depressive symptoms. ConclusionThe difficulty in seeking medical services, limited commercial availability of anti-seizure medications, and the anxiety and depressive states of parents during the COVID-19 pandemic aggravate the difficulty in management of patients with infantile epileptic spasms syndrome. Improvement of the health care system and medication management strategy, as well as reasonable use of telemedicine service, may help solve this problem.
Epilepsy is a common neurological disease with complex etiology and various seizure forms. It can affect people of all ages. Although a variety of antiseizure medications are available, one-third of patients still have poor drug treatment. Therefore, better methods for the diagnosis and treatment of epilepsy are particularly important. Exosomes are extracellular vesicles with a diameter of 30 ~ 150 nm that have powerful intercellular information transmission functions and also play an important role in the central nervous system. Exosomes released by nerve cells in the local microenvironment can participate in nerve development and plasticity, regulate neuroinflammation, and reduce neuronal loss. Moreover, some proteins or micro ribonucleic acid (miRNA) in exosomes are highly correlated with epilepsy and are changed in epileptogenesis, so they play an important role in the prevention and early diagnosis of epilepsy. In addition, exosomes have better biocompatibility and lower immunogenicity. Its small size can effectively avoid the phagocytosis of mononuclear macrophages. Moreover, the proteins carried on its surface have a strong homing ability to target tissues or cells and can penetrate the blood-brain barrier to the intracranial, so exosomes have the advantage of natural drug delivery. Therefore, this study reviews the application of exosomes in epilepsy to improve the understanding of exosomes in scientific research and clinical workers.
The acid-base balance of the brain is critical to the functioning of the nervous system. The mechanisms that maintain acid-base homeostasis in the brain are complex and regulated by a variety of transporter proteins and enzymes. Slight changes in acid-base balance can affect neuronal excitability and even lead to epilepsy. Epilepsy is a common neurological disease with complex pathogenesis and numerous causes. Drug therapy is still the main method, but the treatment effect is limited. Therefore, it is urgent to clarify the pathological mechanism of epilepsy and explore new treatment directions This study provides an overview of the transporter proteins (acid-sensing ion channel, Na+/H+ exchanger, Na+/HCO3- cotransporters, anion exchangers, carbonic anhydrases) and the regulation of acid-base balance in the lungs. This study also introduces how these transporters participate in the stable maintenance of brain acid-base balance and their influence in epileptogenesis from both basic and clinical aspects in detail, providing new targets for epilepsy treatment and intervention.
ObjectiveTo study the clinical characteristics of overseas imported and related local COVID-19 patients in Chengdu.MethodsFifty overseas imported patients who were Chinese and 14 related local patients with COVID-19 who were admitted to Public Health Clinical Center of Chengdu from November to December 2020 were selected. The epidemiological characteristics, clinical manifestations, auxiliary examination, treatment and prognosis were summarized and analyzed.ResultsThe local group were older, and they were mostly elderly and females (P≤0.05). Compared with the imported group, the proportion of the local group was higher in heart disease and tumor. More patients had cough, fever and expectoration symptoms (P≤0.05). C-reactive protein, fasting blood glucose and fibrinogen were higher, and the lymphocyte count, blood platelet count, CD3+ T lymphocyte count, CD4+ T lymphocyte count, CD8+ T lymphocyte count were lower. The positive rate of novel coronavirus total antibody, IgG antibody and IgM antibody in the imported group were higher than those in the local group (P≤0.05). The negative conversion time of the median nucleic acid was shorter than that of local patients (P≤0.05).ConclusionThere are differences in sex ratio, age, complications, clinical manifestations, lymphocyte measurement value, T lymphocyte count and negative conversion time of nucleic acid between overseas imported and local COVID-19 patients in Chengdu. The local patients are mostly elderly and have more complicated conditions, but all of them have good prognosis.
Objective The current study aimed to compare the differences in clinical characteristics and prognosis of elderly patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection between patients who were vaccinated and those not and to explore the clinical significance of vaccination for the elderly.Methods A total of 92 elderly patients (≥60 years old) with SARS-CoV-2 infection who were admitted to Chengdu Public Health Clinical Center from December 10, 2020, to May 2, 2022, were included, and they were grouped according to whether vaccinated. The differences in clinical manifestations, laboratory examinations, imaging, treatment, prognosis, hospitalization time, and nucleic acid conversion time between the two groups were compared in this study. Results A total of 92 elderly patients were included, with a male-to-female ratio of 1.3:1, and a median age of 66 (62, 71) years old. There were 79 patients in the vaccinated group and 13 in the unvaccinated group. The positive rate of total SARS-CoV-2 antibody in 92 patients was 91.3%, and those of IgG and IgM of SARS-CoV-2 antibody were 89.1% and 37%, respectively. The positive rates of total SARS-CoV-2 antibody and IgG of SARS-CoV-2 antibody in the vaccinated group were higher than those in the unvaccinated group (97.5% vs. 53.8%, 96.2% vs. 46.2%) (P<0.01), and COI values of total antibody, IgM and IgG were higher than those of unvaccinated group (P<0.01). The proportions of the initial symptoms of sputum, ground-glass opacity or patchy opacity involving both lungs in chest CT in the unvaccinated group were higher than those in the vaccinated group (P<0.05). The white blood cell counts and platelet counts in the vaccinated group were higher than those in the unvaccinated group, whereas the prothrombin time and D-dimer were lower than those in the unvaccinated group (P<0.05). COI values of total antibody in the 3-doses group were higher than those in the 2-doses group, and the white blood cell counts in the 3-doses group were higher than those in the 2-doses group (all P<0.05). During hospitalization, asymptomatic infection (58.2%) and general type (53.8%) was the most common in the vaccinated and unvaccinated group, respectively. Patients in the unvaccinated group were more likely to progress to severe status than the vaccinated group during hospitalization (15.4% vs. 0%, P=0.019). The unvaccinated group received more treatments of intravenous immune globulin, non-invasive and invasive mechanical ventilation, plasma after immunization of vaccine and convalescent plasma of SARS-CoV-2 infected patients than those of the vaccinated group (P<0.05). Patients in the unvaccinated group developed a higher proportion of respiratory failure, secondary infection, acute respiratory distress syndrome, and heart failure than in the vaccinated group (P< 0.05). The median lengths of hospitalization and nucleic acid conversion in the unvaccinated group were 22 (7, 32) days and 13 (2, 20) days, which were longer than those in the vaccinated group [8 (7, 12) days, 2 (2, 7) days] (all P<0.05). Conclusions Vaccination of SARS-CoV-2 can improve the positive rate of total SARS-CoV-2 antibody and IgG of SARS-CoV-2 antibody in elderly patients with SARS-CoV-2 infection, milder disease status, and can shorten the time of hospitalization and nucleic acid conversion. These results suggest that the COVID-19 vaccine can reduce the disease and improve the prognosis in the elderly.