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 evaluate and synthesize the available experiences related to laparoscopic duodenum-preserving pancreatic head resection (LDPPHR) in the management of benign pancreatic head lesions. MethodsA retrospective review of the clinical data was conducted for 12 patients who underwent LDPPHR at the Department of Hepatobiliary and Pancreatic Surgery, Second Affiliated Hospital of Kunming Medical University (between January 2020 and December 2024). ResultsAll 12 patients successfully underwent LDPPHR. The surgical duration ranged from 138 to 479 min, with a mean of 336 min. Intraoperative blood loss varied between 40 and 700 mL, averaging 270 mL. The hospital stay varied from 11 to 51 d, with a mean duration of 21.5 d. Notably, none of the 12 patients required blood transfusions during the procedure. Of the 12 patients, 6 were diagnosed with a pancreatic fistula postoperatively, including 5 cases classified as grade A pancreatic fistula, and 1 cases of grade B pancreatic leakage. There were 2 cases of bile leakage and 1 case of gastric emptying disorder. No deaths occurred during the perioperative period. Postoperative pathological examination revealed: chronic pancreatitis witch main pancreatic duct stones in 8 cases, intraductal papillary mucinous neoplasms with low-grade epithelial intraepithelial neoplasia in 3 cases, serous cystadenoma in 1 case. Postoperative follow-up was conducted for 10 patients, with follow-up durations ranging from 6 to 24 months. No recurrence was observed during the follow-up period, and no long-term complications such as diabetes, gastric emptying dysfunction, etc. were reported. ConclusionsLDPPHR offers several benefits, including minimal invasiveness, faster recovery, and enhanced postoperative quality of life for patients. It is safe and feasible for the treatment of benign lesions in the head of the pancreas.