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In this paper, the Lightweight Gradient Boosting Tree Model (LGB) is employed to simulate and forecast monthly runoff sequences of the Three Gorges Reservoir, and the forecasting uncertainties are analyzed by using the Hydrological Uncertainty Processor (HUP). The findings of this paper are as follows: ① the comparison between predictions of GBDT and LGB models indicates that the LGB model has higher accuracy than the GBDT model for both calibration and validation periods; ② the preferred forecasts (Q50 values) generated by the HUP model present a higher accuracy than the deterministic prediction generated by the LGB model, especially for the flood season; ③ the 90% uncertainty confidence interval with a narrow bandwidth for both calibration and validation periods can cover most observed points, which suggests that the result of uncertainty analysis is accurate and reasonable. [ABSTRACT FROM AUTHOR]

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Background and objective Xuanwei and Fuyuan are rural counties, located in the late Permian coal poly area of eastern Yunnan and western Guizhou, where lung cancer mortality rates are among the highest in the China, with similarity for both men and women, younger age at diagnosis and death, and higher in rural areas than in urban areas. In this paper, long-term follow-up of lung cancer cases in local peasants was conducted to observe their survival prognosis and its influencing factors. Methods Data of patients diagnosed with lung cancer from January 2005 to June 2011, who had lived in Xuanwei and Fuyuan counties for many years, were collected from 20 hospitals at the local provincial, municipal and county levels. To estimate survival outcomes, individuals were followed up until the end of 2021. The 5-year, 10-year and 15-year survival rates were estimated using the Kaplan-Meier method. Survival differences were examined with Kaplan-Meier curves and Cox proportional hazards models. Results A total of 3,017 cases were effectively followed up (2,537 peasants and 480 non-peasants). The median age at diagnosis was 57 years, and the median follow-up time was 122 months. During the follow-up period, 2,493 cases (82.6%) died. The distribution of cases by clinical stage was as follows: stage I (3.7%), stage II (6.7%), stage III (15.8%), stage IV (21.1%) and unknown stage (52.7%). Treatment at the provincial, municipal and county-level hospitals accounted for 32.5%, 22.2% and 45.3%, respectively, and surgical treatment was performed in 23.3% of cases. The median survival time was 15.4 months (95%CI: 13.9-16.1), and the 5-year, 10-year and 15-year overall survival rates were 19.5% (95%CI: 18.0%-21.1%), 7.7% (95%CI: 6.5%-8.8%) and 2.0% (95%CI: 0.8%-3.9%), respectively. Peasants with lung cancer had a lower median age at diagnosis, higher proportion residing in remote rural areas, and higher use of bituminous coal as a household fuel. They also have a lower proportion of early-stage cases, treatment at provincial or municipal hospitals, and surgical treatment, leading to poorer survival outcomes (HR=1.57). Even when considering factors such as gender, age, residential location, clinical stage at diagnosis, histological type, hospital level of service, and surgical intervention, peasants still exhibit a survival disadvantage. Multivariable Cox model analysis comparing peasants and non-peasants reveals that surgical intervention, tumor-node-metastasis (TNM) stage, and hospital level of service are common factors influencing survival prognosis, while the use of bituminous coal as a household fuel, hospital level of service and adenocarcinoma (compared to squamous cell carcinoma) are independent prognostic factors for lung cancer survival among peasants. Conclusion The lower lung cancer survival rate among peasants is associated with their lower socioeconomic status, lower proportion of early-stage diagnoses, lower proportion of surgical interventions, and treatment at provincial-level hospitals. Furthermore, the impact of other factors such as high-risk exposure to bituminous coal pollution on survival prognosis requires further investigation. [ABSTRACT FROM AUTHOR]

Background and objective Immune checkpoint inhibitors (ICIS) have good efficacy on most advanced tumors, which brings new hope to patients with advanced tumors. However, the immune system activated by ICIs may attack human normal tissues and organs, resulting in corresponding immunotoxicity, such as checkpoint inhibitor pneumonitis. This article carried out a meta-analysis on the incidence and risk of programmed cell death protein 1 (PD-1) and programmed cell death protein ligand 1 (PD-L1) inhibitor-associated pneumonia in advanced tumors patients. Methods The computer retrieval of PubMed, Cochrane Library, EMbase and CNKI was performed, and the studies on the occurrence rate of PD-1/PD-L1 inhibitor-associated pneumonia in terminal cancer patients were collected, with the retrieval time limit of January 2000 to January 2020. Statistical analysis was conducted by using Revman 5.3 and R 3.6.2 software to compare the occurrence rate of pneumonia under different circumstances. Results 15 studies were included, involving 8,642 patients, of which those with PD-1/PD-L1 inhibitor were treatment group, and those with chemotherapy were control group. The odds radio of all grades of immune pneumonia was 6.63, and that of high grade was 4.87. The occurrence rate of all grades of pneumonia in the ICI group with non-small cell lung cancer (NSCLC) was 1.658 times than other tumors, and that of high grade was 2.299 times. The occurrence rate of all grades of pneumonia in second-line or more treatment with ICI was 0.489 times than that in first-line, and that of high grade was 0.449 times than that in first-line or more treatment with ICI. Conclusion Compared with chemotherapy, the risk of immune-associated pneumonia is higher in PD-1 and PD-L1 inhibitors, and its occurrence risk is high in the ICI group with NSCLC and the first-line treatment with ICI. This paper provides guidance for clinic treatment of terminal cancers and prevention of complications. [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]

This paper aims to investigate the relationship between the ratio of low - density lipoprotein cholesterol (LDL-C) to high-density lipoprotein cholesterol (HDL-C) and risk factors for acute ischemic stroke, and to investigate the effect of LDL-C/HDL-C on the 3-month outcome of acute ischemic stroke. Based on baseline characteristics and laboratory data on admission, 150 patients with non-cardiac acute ischemic stroke were divided into 2 groups (LDL-C/HDL-C ⩽ 3 and LDL-C/HDL-C > 3). The outcome of 3 months after stroke was analyzed, and the risk factors were compared between 2 groups. There was significant difference in history of diabetes, history of coronary artery disease, history of smoking and atherosclerotic lesions between 2 groups (P < 0.05, for all). After using multifactor stepwise Logistic regression analysis, only the LDL-C/HDL-C ratio > 3 (OR = 1.781, 95%CI: 1.343-2.374; P = 0.001) and National Institute of Health Stroke Scale (NIHSS) score on admission (OR = 1.923, 95%CI: 1.232-5.944; P = 0.032) were significantly and independently predictive for 3-month outcome. Therefore, the ratio of LDL-C to HDL-C serves as a positive predictor of the 3-month clinical outcome of acute ischemic stroke. [ABSTRACT FROM AUTHOR]

Objective To investigate the risk factors of anti - N - methyl - D - aspartate receptor (NMDAR) encephalitis with acute symptomatic seizure (ASS), and establish a Nomogram model based on clinical indicators. Methods A retrospective analysis was performed on 84 patients with anti-NMDAR encephalitis who were diagnosed in Beijing Tiantan Hospital, Capital Medical University from May 2012 to October 2020. Univariate and multivariate Logistic regression analyses were used to determine the risk factors of anti - NMDAR encephalitis with ASS, and a Nomogram model was constructed. The receiver operating characteristic (ROC) curve and calibration curve of the model were plotted, and Hosmer - Lemeshow goodness of fit test was performed. Results In all 84 patients, 63 cases (75%) presented with ASS, and 35 cases (41.67%) had ASS as the initial symptom. Logistic regression analysis showed male (OR = 7.680, 95%CI: 1.811-32.562; P = 0.006), psychosis and abnormal behavior (OR = 6.486, 95%CI: 1.818-23.141; P = 0.004), anti-NMDAR antibody titer in cerebrospinal fluid (CSF) ≥ 1:32 (OR = 9.322, 95%CI: 2.132-40.766; P = 0.003) were the risk factors of anti-NMDAR encephalitis with ASS, older age was the protective factor (OR = 0.942, 95%CI: 0.903-0.983; P = 0.006). A Nomogram model was established based on the 4 risk factors, and the area under curve (AUC) of ROC was 0.862 (95%CI: 0.776-0.949, P = 0.000). Calibration curve showed a good agreement between the predicted probability and the actual probability of ASS occurrence, and Hosmer-Lemeshow test showed there was no statistical difference (χ² = 4.318, P = 0.827). Conclusions Male, young age, psychosis and abnormal behavior, and anti-NMDAR antibody titer in CSF ≥ 1:32 are more likely to have ASS in patients with anti-NMDAR encephalitis. This Nomogram model constructed based on the above 4 indicators may accurately and conveniently predict ASS and provide a reference for clinical diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Objective To evaluate the efficacy and safety of lamotrigine in the treatment of juvenile myoclonic epilepsy (JME). Methods Retrieve relevant clinical guidelines, systematic review (including Meta - analysis), randomized controlled clinical trials, case - control studies, retrospective cohort studies and case observation studies on lamotrigine treating JME from online databases (January 1, 1980-December 31, 2017) as PubMed, EBMASE/SCOPUS and Cochrane Library with key words: juvenile myoclonic epilepsy, idiopathic generalized epilepsies, lamotrigine, antiepileptic drugs, random. Jadad Scale, Cochrane System Evaluation Handbook and RevMan 5.3 statistical software were used for quality assessment and Meta-analysis. Results The research enrolled 1220 articles, from which 6 studies with Jadad score ≥ 4 (4 randomized controlled clinical trials and 2 case observation studies) were chosen after excluding duplicates and those not meeting the inclusion criteria. A total of 314 JME patients (166 cases treated by lamotrigine and 148 cases treated by valproate) were enrolled in 6 studies. Meta-analysis showed the occurrence rate of adverse reaction in lamotrigine group was significantly lower than that in valproate group (RR = 0.540, 95% CI: 0.320-0.910; P = 0.020), but there was no significant difference on rate of epileptic seizures decreasing > 50% (RR = 1.200, 95% CI: 0.870-1.650; P = 0.260). Conclusions Lamotrigine is safe and effective in the treatment of JME. It has better tolerance and less adverse reaction, and its effect is similar to that of valproate. It is the first choice for patients with JME, especially for adolescent female patients with JME. However, there is still lack of high-quality trials to confirm whether the combination with other drugs has any benefit in terms of efficacy. [ABSTRACT FROM AUTHOR]

Objective To evaluate the safety of valproate (VPA) on bone mineral density and bone metabolism in children with epilepsy. Methods Retrieve relevant research from online databases (January 1, 1980-March 1, 2018) as PubMed, EBMASE/SCOPUS and Cochrane Library with key words: epilepsy, bone, child. Selection of studies was performed according to pre - designed inclusion and exclusion criteria. Quality of studies was evaluated by using Newcastle-Ottawa Scale (NOS). All data were pooled by RevMan 5.2 software for Meta- analysis. Results The research enrolled 1455 articles, from which 13 studies with NOS score ≽ 6 were chosen after excluding duplicates and those not meeting the inclusion criteria. A total of 683 children with epilepsy using VPA and 436 children in control group were included. Meta - analysis showed that comparing with control group, bone mineral density of lumbar (BMDL) in children treated with VPA has no significant difference (MD = - 0.019, 95% CI: - 0.044-0.006; P = 0.140), but there was a significant decrease in bone mineral density of femur (BMDF; MD = - 0.037, 95% CI: - 0.069-- 0.005, P = 0.020). There was no significant change in serum calcium (SMD = - 0.284, 95% CI: - 0.951-0.382; P = 0.400), phosphorus (SMD = - 0.164, 95%CI: - 0.457-0.129; P = 0.270), alkaline phosphatase (ALP; SMD = 0.363, 95%CI: - 0.294-1.020, P = 0.280), parathyroid hormone (PTH; SMD = 0.102, 95%CI: - 0.291-0.495, P =0.610) and 25 - hydroxy vitamin D [25(OH)D; SMD = - 0.104, 95%CI:- 0.620-0.413, P = 0.690] in bone metabolic markers. Sensitivity analysis showed Meta - analysis of BMDF, serum phosphorus and 25(OH)D was unstable, therefore, it should be cautious when explaining the results. Conclusions VPA has less effect on bone mineral density and bone metabolism, but for children with epilepsy using VPA, their BMDF should be monitored. [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.)