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With rapid aging worldwide, stroke disease has become the second leading cause of death in people over 60 years old, following the cancer disease. The large-scale medical database provides epidemiological data by systematically integrating medical data and transforming research hypotheses into evidence-based medicine evidence to guide clinical practice, widely used in clinical medical research. This article describes different stroke databases to explain their application and research progress in stroke diseases, and describes the application of artificial intelligence (AI) in database construction, aiming to promote the construction of stroke databases and conduct high-quality stroke research. [ABSTRACT FROM AUTHOR]

With the development of molecular biology technology, the era of precision medicine is gradually coming. Standardized clinical database can provide a platform for clinicians to integrate clinical and molecular data, so as to make diagnosis and treatment plans more effectively. This paper summarizes the research progress of pituitary adenoma databases at home and abroad in recent years, expounds the management and application of database, and prospects the development of big data of pituitary adenoma. [ABSTRACT FROM AUTHOR]

Objective To establish an automatic segmentation algorithm using convolution neural network, and to validate the consistency between the algorithm and manual segmentation. Methods One hundred and forty-six CT scans of intracerebral hemorrhage (ICH) were included from Chinese Intracranial Hemorrhage Image Database (CICHID). They were randomly divided into training set (n = 90), testing set (n = 26) and validation set (n = 30). All CT scans were manual segmentation. Training set and testing set were used for algorithm training. The validation set was measured by four methods including manual segmentation, algorithm segmentation, accurate Tada formula and traditional Tada formula. The consistency test was performed. Results Compared with the Tada formula methods, the percentage error of algorithm values was the smallest 15.54 (8.41, 23.18) %, and algorithm agreement with the manual reference was the strongest (correlation coefficient 0.983). Bland-Altman analysis showed that 93.33% of the data was within the 95% limits of agreement (95% LoA), and 95% LoA was narrow ( - 6.46-5.97 ml). No significant differences were found in size and shape (P > 0.05, for all). Conclusions The algorithm using convolutional neural network has a certain application prospect, but it needs still more validation in large sample research. [ABSTRACT FROM AUTHOR]

Objective To investigate the expression heterogeneity of transforming growth factor-β-induced protein (TGFBI) in glioblastoma (GBM) multiform and the mechanism of its promotion on malignancy of glioma stem cells (GSCs) in vitro. Methods Using The Cancer Genome Atlas (TCGA), Chinese Glioma Genome Atlas (CGGA), REMBRANDT and Oncomine database to analyse the potential associations between grades, subtypes, overall survival (OS) of GBM and the expression level of TGFBI and the correlation between TGFBI and tumor-associated macrophages (TAMs) marker CD11b and CD163. Treating human monocytes cell line U937 with sequential peripheral blood mononuclear cells and IL-4 to get Primed- and M2-TAMs, quantitative real-time polymerase chain reaction (qRT-PCR) were used to detect the expression level of markers for M1 -, M2 - TAMs and TGFBI. Performing immunofluorescent and immunohistochemical stain to reveal the distribution of TGFBI, M2-TAMs and GSCs in specimen of GBM patients, adding rhTGFBI to the culture medium to see its impacts on the sphere formation and invasion capacity of NCH-421K. Results According to the RNA-seq and microarray data of GBM patients in each database, expression level of TGFBI positively correlated to GBM grades and negatively to OS, Furthermore, expression level of TGFBI were strongly correlate with either pan TAMs marker CD11b or M2-TAMs marker CD163, and as the induction of U937-derived M2-TAMs, the expression level of M2-TAMs marker and TGFBI increased accompanied by decreasingly M1-TAMs marker. Also, we found an obvious co-location between TGFBI and CD163, SOX2 in frozen and paraffin sections of GBM specimens. Lastly, we demonstrate that rhTGF86BI could enhance the sphere formation and invasion capacity of NCH-421K in vitro. Conclusions M2-TAMs secrete TGFBI to promote the sphere formation and invasion capacity of GSCs in GBM. [ABSTRACT FROM AUTHOR]

Parkinson's disease (PD) is one of the most common neurodegenerative diseases. Because of its high prevalence, severe disability and chronic course of disease, it has become one of the most important research focuses in modern medicine ranging from early diagnosis and treatment to prevention. During the period of Twelfth Five-Year Plan for National Economic and Social Development, our team made use of previously established PD Clinical Databse and applying basic research platform, focused on clinical and basic development of PD, and further extended our investigation into the field of pathogenesis, diagnosis and treatment in PD with characteristics of translational medicine. Several progresses have been made in a multiple of aspects: 1) a novel cellular mechanism of mitochondrial fission with the involvement of VPS35 gene, dysregulation of which might be involved in the pathogenesis of familial and sporadic PD. 2) The predictive value of autonomic dysfunction and dopamine transporter (DAT) PET in identifying patients with idiopathic rapid eye movement sleep behavior disorder (iRBD) with a high risk of progressing into neurodegenerative synucleinopathy diseases could form a basis for future disease - prevention trials. Additionally, we initiated the research on PD mortality rate and analyzed the common reasons of death, which added to the evidence of clinical prognosis and progression. 3) We issued the first, second and third versions of "Chinese guidelines for treatment of Parkinson's disease", as well as the "Diagnostic criteria of Parkinson's disease in China (2016 edition)", which could help improve the diagnostic ability and optimize the clinical treatment of PD in China. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Contemporary Neurology & Neurosurgery is the property of Chinese Journal of Contemporary Neurology & Neurosurgery and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Contemporary Neurology & Neurosurgery is the property of Chinese Journal of Contemporary Neurology & Neurosurgery and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Contemporary Neurology & Neurosurgery is the property of Chinese Journal of Contemporary Neurology & Neurosurgery and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Contemporary Neurology & Neurosurgery is the property of Chinese Journal of Contemporary Neurology & Neurosurgery and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Contemporary Neurology & Neurosurgery is the property of Chinese Journal of Contemporary Neurology & Neurosurgery and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Contemporary Neurology & Neurosurgery is the property of Chinese Journal of Contemporary Neurology & Neurosurgery and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To systematically evaluate the clinical efficacy and safety of nimodipine in treating vascular dementia (VaD). Methods Taking "nimodipine AND vascular dementia" as search terms, retrieve in databases such as PubMed, Cochrane Library, EMBASE/SCOPUS, Science Citation Index (SCI), China National Knowledge Infrastructure (CNKI), VIP and Wanfang Data (January 1995-March 2015). Annual searching was applied to retrieve partial periodical literatures and unpublished studies. Google Scholar was used for randomized controlled trials (RCTs) about nimodipine in treating VaD. Jadad scale was used to evaluate the quality of literature, and Meta-analyses were performed by using RevMan 5.3 software. Results Eleven literatures met inclusion criteria, including 10 clinical studies (1333 patients). All 10 studies were RCTs, including 4 nimodipine vs placebo, 5 nimodipine vs donepezil and one nimodipne vs hydergine, but only 2 described randomization methods. The results of Meta-analysis showed: nimodipine had better Mini - Mental State Examination (MMSE) score than before treatment and placebo group (3 studies, MD = 0.270, 95%CI: 0.070-0.460, P = 0.007); one study of blank control, MD = 2.950, 95% CI: 1.670-4.200, P = 0.000). Patients treated with nimodipne had no significantly improved Activities of Daily Living (ADL) score than placebo group [one study of ADL, MD = 5.800, 95% CI: 2.480-9.120, P = 0.000; one study of ADL Index, MD = - 0.040, 95% CI: - 0.110-0.030, P = 0.230; one study of instrumental ADL (IADL), MD = -0.080, 95%CI: -0.110-0.000, P = 0.060]. Both nimodipine and donepezil can improve MMSE and ADL scores, but the efficacy of nimodipine was not superior to donepezil [4 studies of MMSE (12-week observation), MD = - 4.400, 95% CI: - 4.870- 3.920, P = 0.000; one study of MMSE (24-week observation), MD = - 8.800, 95% CI: - 8.970- 7.430, P = 0.000; 2 studies of ADL, MD = 1.800, 95% CI: 1.360-2.230, P = 0.000]. Compared with hydergine, nimodipine had better scores in MMSE (MD = 2.170, 95%CI: 0.890-3.450, P = 0.001) and ADL (MD = -5.160, 95%CI: - 7.480-2.840, P = 0.000) in one study. The main side effects of nimodipine were cardio - cerebrovascular diseases, neuropsychiatric symptoms, abnormal skin reaction, gastrointestinal reactions and joint edema, et al. Conclusions Current study shows that the effect of nimodipine in the treatment of VaD may be superior to placebo and hydergine, but not better than donepezil. The results of systematic review still need more high-quality, multi-center and large-sample RCTs to further prove. [ABSTRACT FROM AUTHOR]

Background Vascular mild cognitive impairment (VaMCI) is the prodromal syndrome of vascular dementia (VaD) and key target for drug treatment. There is controversy over the diagnostic criteria and screening tools of VaMCI, which affects its clinical diagnosis. This paper aims to explore the clinical features, diagnostic criteria and screening technique of VaMCI. Methods Taking "vascular mild cognitive impairment OR vascular cognitive impairment no dementia" as retrieval terms, search in PubMed database from January 1997 to March 2015 and screen relevant literatures concerning VaMCI. According to Guidance for the Preparation of Neurological Management Guidelines revised by European Federation of Neurological Societies (EFNS) in 2004, evidence grading was performed on literatures. Results A total of 32 literatures in English were selected according to inclusion and exclusion criteria, including 3 guidelines and consensus and 29 clinical studies. Seven literatures (2 on Level I, 5 on Level II) studied on neuropsychological features in VaMCI patients and found reduced processing speed and executive function impairment were main features. Two literatures reported the diagnostic criteria of VaMCI, including VaMCI criteria published by American Heart Association (AHA)/American Stroke Association (ASA) in 2011 and "Diagnostic Criteria for Vascular Cognitive Disorders" published by International Society for Vascular Behavioral and Cognitive Disorders (VASCOG) in 2014. Fifteen literatures (4 on Level I, II on Level II) described the diagnostic criteria of VaMCI used in clinical research, from which 6 operational diagnostic items were extracted. Fourteen literatures (4 on Level I, 10 on Level II) described neuropsychological assessment tools for VaMCI screening, and found the 5-minute protocol recommended by National Institute of Neurological Disorders and Stroke - Canadian Stroke Network (NINDS- CSN) was being good consistency with other neuropsychological assessment tools. Conclusions The neuropsychological features of VaMCI have guiding significance for diagnosis. VASCOG diagnostic criteria for VaMCI is practical in clinical practice, and 5-minute protocol is suitable for clinical rapid screening of VaMCI. [ABSTRACT FROM AUTHOR]

Background China is one of the countries that have the largest number of patients suffering from Duchenne and Becker muscular dystrophy (DMD/BMD). Although the building of international DMD/BMD databases has laid a foundation for clinical drug development and clinical trials, it has not yet been carried out in China. In this study, a modified registry form of Remudy was applied to 229 DMD/BMD patients in order to establish a comprehensive database, which will lay the groundwork for international cooperation. Methods A total of 229 DMD/BMD patients diagnosed by genetic testing or muscle biopsy admitted in Children's Hospital of Fudan University (CHFU) during the period of August 2011 to December 2013 were enrolled in this study. The data included sex, age, age at diagnosis, geographic distribution of patients, DMD gene mutation types, family history, walking capability, cardiac and respiratory function, steroid treatment and rehabilitation intervention. Results There were 194 DMD and 35 BMD male patients who were diagnosed at the age of 0-18 years, and among them, most patients were diagnosed at the age of > 3-4 (16.59%, 38/229) and > 7-8 (14.85%, 34/229) years. Exon deletion was the most frequent genetic mutations for DMD/BMD [65.46% (127/194) and 74.29% (26/35)], respectively. Patients with a family history accounted for 23.14% (53/229). The rate of DMD registrants losing walking capability was 17.53% (34/194), and all the BMD registrants were able to walk. Cardiac functions were examined in 46.29% (106/229) DMD/BMD boys and respiratory functions were examined in 17.90% (41/229) DMD/BMD boys. The proportion of DMD patients receiving prednisone with dosage of 0.75 mg/(kg ⋅ d) was 26.29% (51/194). Conclusions This database describes in detail the genotype, clinical manifestation, diagnosis and treatment and rehabilitation status of 229 DMD/BMD patients in China. The database not only provides comprehensive information for DMD/BMD patient management, but also will make significant contribution to the development of clinical trials, prospective therapeutic research and better management of DMD/BMD patients and families in China. [ABSTRACT FROM AUTHOR]

Objective To investigate the clinical effect of repetitive transcranial magnetic stimulation (rTMS) therapy on Parkinson's disease (PD) using Meta - analysis. Methods Taking transcranial magnetic stimulation or TMS, Parkinson's disease or PD and randomized controlled trial as retrival words, search related articles during 1999 to 2013 from databases such as PubMed, EMBASE, Ovid MEDLINE, VIP, Wanfang and China National Knowledge Intrastructure (CNKI). Finally 16 articles (4 in Chinese and 12 in English) were included for Meta-analysis according to high-frequency stimulation (HFS > 1 Hz) and low-frequency stimulation (LFS ≤ 1 Hz) respectively. Results A total pf 455 PD patients were enrolled and divided into TMS group (N = 236) and control group (N = 219). After HFS and LFS therapies, the Unified Parkinson's Disease Rating Scale (UPDRS) score in TMS group was significantly different from control group (WMD = -5.010, 95%C1: -7.370--2.650, P = 0.000; WMD = -6.140, 95%C1: - 8.750-- 3.530, P = 0.000). After HFS therapy, the UPDRS H motor (WMD = -4.380, 95%C1: - 8.260-- 0.500; P = 0.003) and activities of daily living (ADL) scores (WMD = -3.740, 95%C1: -4.660-2.820; P = 0.000) in TMS group were significantly different from that in control group. There were no significant differences in UPDRS H motor score with LFS therapy (WMD = -2.160, 95%C1: -5.010-0.690; P = 0.370) and the Mini-Mental State Examination (MMSE) score with HFS therapy between 2 groups (WMD = 0.260, 95%C1: -0.660-1.180; P = 0.580). Conclusions Repetitive transcranial magnetic stimulation therapy can ameliorate partial symptoms of Parkinson's disease for enhancing the quality of life, however, the improvement for mental disability was not found. [ABSTRACT FROM AUTHOR]

Objective To evaluate the efficiency, safety and indications of dabigatran for the secondary prevention of stroke. Methods Taking dabigatran, stroke, ischemia, hemorrhagic, TIA, transient ischemic attack, prevention, secondary prevention, treatment as search terms, retrieve in databases such as PubMed, ScienceDirect and Cochrane Library, assisted by manual searching, in order to collect relevant literatures including clinical guidelines, systematic reviews (including Meta-analyses), randomized controlled trials (RCTs), retrospective case analyses, case-observation studies and reviews. Jadad Scale was applied for scoring clinical researches while PRISMA statement was for evaluating the quality of systematic reviews (including Meta-analyses) and reviews. Results A total of 23 articles were selected out of 1067 search results, in which 2 clinical guidelines, 6 systematic reviews (including Meta-analyses) and reviews, 8 RCTs, 3 retrospective case analyses, and 4 case-observation studies were enrolled. According to the Jadad Scale, 8 clinical studies were evaluated as high-quality literature (score ⩾ 4), and the remaining 7 were low-quality literature (score < 4). All of systematic reviews (including Meta-analyses) and reviews were of high quality. The results were as follows: 1) the use of dabigatran in stroke patients, especially Asian patients, with non- valvular atrial fibrillation showed no inferior efficiency and lower risk for major bleeding for the secondary prevention of stroke than warfarin, while the elder should be given lower dosage and blood concentration of drug might be in need of monitoring. 2) Applying dabigatran for the secondary prevention of stroke in patients with mechanical valve replacement must be cautious. Insufficient evidence had shown its inferiority in both efficiency and safety when compared to warfarin. 3) Large-scale clinical trials are needed to provide evidence for the application of dabigatran in valvular heart disease, cardiomyopathy, myocardial infarction, and other diseases in need of anticoagulants for secondary prevention of stroke. 4) Current evidence is limited for the regular usage of dabigatran for secondary prevention of stroke. Conclusions Critical findings have been demonstrated in the evidence-based evaluation on dabigatran in the secondary prevention of stroke. Decision making on the clinical application of dabigatran in the secondary prevention of stroke should be cautious. [ABSTRACT FROM AUTHOR]

Objective To evaluate the evidence of migraine increasing the risk of stroke, so as to provide evidence - based foundation for primary prevention of stroke in patients with migraine. Methods Taking migraine or migraine with aura, prevention and control, ischemia, hemorrhagic stroke, treatment or therapy as search terms, retrieve in databases such as PubMed and ScienceDirect, assisted by manual searching, in order to collect relevant literatures including clinical guidelines, systematic reviews, Meta - analysis, randomized controlled trials, clinical controlled trials, retrospective case analysis, case-observation studies and reviews. Jadad Scale was used to evaluate the quality of literature. Results Twenty - four related articles were finally selected, including 5 clinical guidelines, 2 systematic reviews, 4 Meta-analyses, 2 randomized controlled trials, 10 case-observation studies and 1 review. Among them 20 were of high quality, while 4 were of low quality. The results were as follows: 1) migraine, particularly migraine with aura, significantly increased the risk of ischemic stroke, and the risk of women was higher than men. Smoking and oral contraceptives further increased the risk of stroke. 2) The risk of hemorrhagic stroke in migraine with aura patients was higher than that in general population. Migraine without aura did not appear to increase the risk of hemorrhagic stroke, and migraine was an independent risk factor for aneurysm rupture. 3) Frequency of migraine attacks, especially migraine with aura, and risk of ischemic stroke was positively correlated. 4) Patent foramen ovale (PFO) was more common in young patients with cryptogenic stroke and migraineurs. However, closure of PFO was not indicated for preventing stroke in migraineurs. 5) Triptans, which was used to treat acute migraine, with a vasoconstrictor effect, may increase the risk of stroke, therefore prophylactic treatment of migraine was very important. Conclusions Smoking cessation and alternatives to oral contraceptives are recommended in women with migraine. Treatment to reduce migraine frequency might be reasonable, however, there is no evidence showing that this treatment approach would reduce the risk of first stroke. Due to the vasoconstrictor effect of triptans, prophylactic treatment should be the priority of migraineurs. [ABSTRACT FROM AUTHOR]

Background Epilepsy is a chronic neurological condition characterized by paroxysm of seizures due to abnormal electrical discharge from central nervous system neurons. Several new antiepileptic drugs (AEDs) were listed over the past two decades, and they were believed to be equally effective and have better tolerability and side effect profiles. This paper aims to evaluate the efficacy and safety of adjunctive topiramate in refractory partial seizures. Methods Relevant research articles about randomized controlled trials of adjunctive topiramate in refractory partial seizures, with topiramate, Topamax, add - on treatment, adjunctive treatment, add - on therapy, adjunctive therapy, refractory partial seizure, refractory partial epilepsy both in Chinese and English as retrieval words, were retrieved from PubMed (1995-2014), Cochrane Central Register of Controlled Trials (CENTRAL, 1995-2014), The Cochrane Database of Systematic Reviews (CDSR, 1995-2014), China National Knowledge Infrastructure (CNKI, 1995-2014) and Wanfang Data (1999-2014). Two reviewers independently evaluated the quality of the included articles and abstracted the data. A Meta-analysis was conducted using RevMan 5.0 software. Results According to the enrollment criteria, 13 prospective, randomized controlled clinical trials with a total of 1622 patients were finally selected. The proportions of patients with reduction in seizure frequency ⩾ 50% (OR = 3.710, 95% CI: 2.870-4.810; P = 0.000), ⩾ 75% (OR = 7.220, 95% CI: 3.310-15.750; P = 0.000) and seizure free (OR = 3.380, 95%CI: 1.720-6.640; P = 0.000) in topiramate group were significantly higher than that in control group. The treatment withdrawal ratio was significantly higher compared to placebo in 600 mg/d and 800 mg/d subgroups, but not in 200 mg/d subgroup (200 mg/d: OR = 2.170, 95%CI: 0.470-9.950, P = 0.320; 600 mg/d: OR = 2.090, 95%CI: 1.020-4.270, P = 0.040; 800 mg/d: OR = 8.000, 95%CI: 1.390-46.140, P = 0.020). The common side effects included somnolence, anorexia, ataxia, aprosexia, dizziness, fatigue, nausea, thinking abnormality, paraesthesia and weight loss. The occurrence rate of side effects in topiramate group was higher than that in control group. Conclusions Topiramate is effective when added to existing therapy in patients with refractory partial seizures. The withdrawal rate of 200 mg/d topiramate is similar to control group. Compared with the control group, adverse effects are more common but mild or moderate, mainly related with the central nervous system. However, trials included in this study are of relatively short duration, and provide no evidence for the long- term efficacy of topiramate. [ABSTRACT FROM AUTHOR]

Objective To assess the efficacy and safety of interferon-beta (IFN-β) as monotherapy versus placebo for patients with relapsing-remitting multiple sclerosis (RRMS). Methods We searched Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, EMBASE, CINAHL, LILACS, PEDRO, China Biology Medicine Disc (CBMDisc), as well as clinical trial registries and the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP, retrieval deadline: June 2014). Furthermore, we checked reference lists of published reviews and retrieved articles, and communicated personally with investigators and biotechnology companies participating in trials of IFN-β in an effort to identify further studies or unpublished data. Two review authors independently screened studies, extracted data and evaluated the risk of bias. Formal Meta - analysis were conducted by using Review Manager software (Version 5.3.3) and the impacts of limitations in study design or execution (risk of bias), inconsistency in results, imprecision of results, indirectness of evidence and publication bias on the quality of the body of evidence were assessed. Results A total of 576 articles were retrieved. After screening of titles and abstracts, 26 studies were provisionally selected. The full text of papers were obtained for further assessment of eligibility. Finally, 5 studies were included, involving 2129 patients with RRMS (high-dose IFN-β group: N = 1076; placebo group: N = 1053). All studies were randomized, double-blind, controlled, parallel-group clinical trials with a follow-up for at least one year, evaluating IFN-β versus placebo as monotherapy for patients with RRMS. Most studies had methodological limitations, mainly on a high risk of attrition bias. Moreover, the intention to treat (ITT) principle was not used in data analysis. Data from only 919 patients (43.17%) were available to calculate the primary outcomes at 2 years of follow-up. Meta- analysis indicated IFN-β slightly reduced the number of patients with at least one relapse [risk ratio (RR) = 0.810, 95%CI: 0.740-0.890; P = 0.000] and the number of patients with disability progression during the first 2 years of follow-up (RR = 0.700, 95%CI: 0.550-0.880; P = 0.002). However, the sensitivity analysis (worst-case scenario analysis) showed no treatment effect (RR = 1.110, 95%CI: 0.730-1.680, P = 0.620; RR = 1.310, 95%CI: 0.600-2.890, P = 0.500, respectively). Data from 1581 patients (74.26%) were available to analyze the number of patients with at least one relapse during the first year of follow-up (RR = 0.740, 95% CI: 0.590-0.930; P = 0.010). Absolute risk reduction (ARR) was 13.24% and number needed to treat (NNT) was 8, which meant 8 patients were needed to treat to prevent one patient against relapse. However, the pooled results showed no treatment effect on the annualized relapse rate. The adverse events frequently caused by IFN - β included injection - site reactions, chills, pyrexia, myalgia, influenza - like symptoms, headache, increased alanine aminotransferase (ALT) and increased aspartate aminotransferase (AST). However, the incidences of lymphocytopenia, leucopenia, depression and committed or attempted suicide were not significantly increased by IFN-β. Conclusions There is high-quality evidence to support that IFN-β slightly reduces the number of patients with RRMS having relapse during the first year of follow-up, but the clinical effect beyond one year is uncertain. There is insufficient evidence to determine the efficacy of IFN-β in reducing the number of patients with disability progression. New randomized controlled trials of high quality are needed to assess the long-term efficacy. [ABSTRACT FROM AUTHOR]

Objective To evaluate the current treatments and possible adverse reactions of metabolic myopathy, and to develop the best solution for evidence - based treatment. Methods Taking metabolic myopathy, mitochondrial myopathy, lipid storage myopathy, glycogen storage diseases, endocrine myopathy, drug toxicity myopathy and treatment as search terms, retrieve in databases such as PubMed, Cochrane Library, ClinicalKey database, National Science and Technology Library (NSTL), in order to collect the relevant literature database including clinical guidelines, systematic reviews (SR), randomized controlled trials (RCT), controlled clinical trials, retrospective case analysis and case study. Jadad Scale was used to evaluate the quality of literature. Results Twenty - eight related articles were selected, including 6 clinical guidelines, 5 systematic reviews, 10 randomized controlled trials and 7 clinical controlled trials. According to Jadad Scale, 23 articles were evaluated as high-quality literature (≥S 4), and the remaining 5 were evaluated as low-quality literature (< 4). Treatment principles of these clinical trials, efficacy of different therapies and drug safety evaluation suggest that: 1) Acid a-glycosidase (GAA) enzyme replacement therapy (ERT) is the main treatment for glycogen storage diseases, with taking a high-protein diet, exercising before taking a small amount of fructose orally and reducing the patient's physical activity gradually. 2) Carnitine supplementation is used in the treatment of lipid storage myopathy, with carbohydrate and low fat diet provided before exercise or sports. 3) Patients with mitochondrial myopathy can take coenzyme Q10, vitamin B, vitamin K, vitamin C, etc. Proper aerobic exercise combined with strength training is safe, and it can also enhance the exercise tolerance of patients effectively. 4) The first choice to treat the endocrine myopathy is treating primary affection. 5) Myopathies due to drugs and toxins should remove pathogenic drugs and toxins. Conclusions Most of metabolic myopathies are genetic diseases, and they cannot achieve a radical cure at present. Gene therapy is the fundamental way. Endocrine myopathy and drug toxicity myopathy need to remove the primary affection or pathogenic drugs. Evidence-based medicine can provide the best clinical evidence assessment method for metabolic myopathy. [ABSTRACT FROM AUTHOR]

In order to understand the latest progression on neuromuscular disorders for clinicians, this review screened and systemized the papers on neuromuscular disorders which were collected by PubMed from January 2013 to February 2014. This review also introduced the clinical diagnosis and treatment hightlights on glycogen storage disease type II (GSD II), Duchenne muscular dystrophy (DMD), amyotrophic lateral sclerosis (ALS) and spinal muscular atrophy (SMA). The important references will be useful for clinicians. [ABSTRACT FROM AUTHOR]

To evaluate the effects and tolerability of gabapentin in the treatment of postherpetic neuralgia (PHN). Methods The randomized controlled trials (RCTs) of gabapentin for the treatment of PHN were retrieved from PubMed, Cochrane Central Register of Controlled Trials, EMBASE, Chinese Biology Medicine (CBM), VIP, China National Knowledge Infrastructure (CNKI) and Wanfang Data. Two reviewers independently evaluated the quality of the included articles and abstracted the data. Meta - analysis was performed using RevMan 5.0. Results According to the enrollment criteria, 5 prospective, randomized controlled clinical trials including 1225 subjects were finally selected. The mean changes for average daily pain score were significant in gabapentin group compared with placebo group (SMD = - 0.920, 95%CI: - 1.330-- 0.520; P = 0.000), as well as the mean change for Short-Form McGill Pain Questionnaire (SF-MPQ) visual analogue scale (SMD = - 2.650, 95%CI: - 3.410- - 1.890; P = 0.000) and average daily sleep intervention score (SMD = - 2.480, 95%CI: - 3.750-- 1.200; P = 0.000). There was no significance between gabapentin group and placebo group in the withdrawl rate (P > 0.05). The common adverse reactions during gabapentin treatment included dizziness (OR = 3.710, 95%CI: 2.530-5.430; P = 0.000), somnolence (OR = 2.430, 95%CI: 1.530-3.860; P = 0.000) and peripheral edema (OR = 13.570, 95%CI: 4.190-43.970; P = 0.000). Conclusion It is indicated clinically that gabapentin is effective and well tolerated for the treatment of postherpetic neuralgia with high retention rate. However, adverse reactions, such as dizziness, somnolence and edema, should be paid attention. [ABSTRACT FROM AUTHOR]

Objective To compare the clinical differences between Parkinson's disease (PD) patients with and without rapid eye movement sleep behavior disorder (RBD). Methods PubMed, EMBASE, Cochrane Library, Chinese Biology Medicine (CBM) and China National Knowledge Infrastructure (CNKI) databases were used to search for studies on RBD in PD patients. Meticulous data were extracted and Meta-analysis was performed. All analyses were conducted with the software of Revman Manager 5.2.4. Results Five clinical studies involving total 650 PD patients were included. The Meta-analysis showed that PD patients with RBD had an older mean age (WMD = 2.870, 95%CI: 1.490-4.260; P = 0.000), a higher Hoehn - Yahr stage (WMD = 0.300, 95% CI: 0.160-0.450; P = 0.000), higher Unified Parkinson's Disease Rating Scale (UPDRS) motor scores during the "on" state (WMD = 2.370, 95%CI: 0.260-4.490; P = 0.030), and larger levodopa dose (WMD = 90.550, 95% CI: 31.040-150.060; P = 0.003) in comparison with PD patients without RBD. In addition, PD patients with RBD were more likely to develop motor fluctuation (OR = 1.520, 95% CI: 1.080-2.140; P = 0.020) and orthostatic hypotension (OR = 11.390, 95% CI: 4.790-27.090; P = 0.000) as compared to PD patients without RBD. However, gender (OR = 1.850, 95%CI: 0.810-4.230; P = 0.150), disease duration (WMD = 0.130, 95% CI: - 1.230-1.500; P = 0.850) and Mini - Mental State Examination (MMSE) scores (WMD = - 0.220, 95%CI: - 0.600-0.160; P = 0.260) did not differ between PD patients with and without RBD. Conclusion PD patients with RBD were more likely to be associated with older age, more severe motor disability, higher levodopa usage, higher incidence of motor fluctuation and orthostatic hypotension, indicating that PD with RBD might be at an advanced stage and had more widespread and severe neurodegeneration. [ABSTRACT FROM AUTHOR]

Background The difference of diagnostic accuracy of 64-slice computed tomography angiography (CTA) with 3D digital subtraction angiography (3D - DSA) in the detection of intracranial aneurysms is not clear yet. This study compares the diagnostic value of 64-slice CTA with 3D-DSA in the diagnosis of intracranial aneurysms via a Meta-analysis. Methods In this study, 64-slice, 64-row, CT, angiography, intracranial aneurysms, cerebral aneurysms, subarachnoid hemorrhage, etc. were used as key words, and searched in the electronic databases including Embase, MEDLINE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), and Wanfang Data, assisted by manual searching, in order to retrieve articles both in English and Chinese that reported on comparisons of 64-slice CTA and 3D-DSA in the evaluation of suspected intracranial aneurysms. Meta-disc Version 1.4 was used for the Meta-analysis, and Quality Assessment of Diagnostic Accuracy Studies (QUADAS) was applied to assess the quality of these research studies. Results Four clinical trials were selected. According to the Meta-analysis, the pooled sensitivity, specificity, diagnostic odds ratios (DOR) and summary receiver operating characteristics (SROC) area under curve (AUC) was 97% (95% CI: 0.950-0.980), 91% (95% CI: 0.860-0.950), 269.640 (95% CI: 137.250-529.720) and 0.993 respectively. Conclusion On the basis of Meta-analysis, 64-slice CTA has a high level of sensitivity and specificity for diagnoses of intracranial aneurysms and it can be used as an important examination tool in the diagnoses of intracranial aneurysms. Because the sample size of selected studies is small, it is necessary to perform well-designed and larger sample studies to further assess the diagnostic value of intracranial aneurysms by 64-slice CTA. [ABSTRACT FROM AUTHOR]