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The management of epilepsy during pregnancy presents particular challenges for neurologists worldwide. Currently, there are no clear recommendations for oxcarbazepine (OXC) specific target concentration during pregnancy. We conducted this retrospective observational cohort study on pregnant women with epilepsy (WWE) who received OXC monotherapy or polytherapy, at the epilepsy outpatient clinic of a tertiary hospital in eastern China. Sixteen pregnancies of 16 WWE were split into the seizure-free group or the non-seizure-free group, according to whether they had been seizure free for more than one year prior to conception or not. There was a significantly decrease in OXC concentration throughout pregnancy, as indicated by the concentration/dose ratio and the ratio of target concentration (RTC). The second trimester of pregnancy was the period when seizure deterioration occurred the most, particularly in the non-seizure-free group. Lower RTC_OXC was identified to be a risk factor for increasing seizure frequency in both the total group and the non-seizure-free group in both univariate and multivariate analysis, with a threshold of 0.575 for differentiating patients at high-risk and low-risk for seizure deterioration. In conclusion, this study suggested an OXC concentration threshold of 0.575 during pregnancy for assisting neurologists in OXC drug monitoring and dose adaptation.

Leucocytoclastic vasculitis is a rare type of allergic disease caused by immune complexes. IgA nephropathy is a glomerulopathy characterized by recurrent episodes of gross haematuria or microscopic haematuria and IgA deposition in the glomerular mesangial region. IgA nephropathy complicating leucocytoclastic vasculitis is rare documented. We present a case of IgA nephropathy in a 47-year-old woman with leucocytoclastic vasculitis and discuss the clinical and pathological data, aiming to promote the diagnosis and treatment of this specific clinical manifestation.

The conventional soft decision decoding (SDD) methods require various hard decision decoders (HDDs) based on different codes or re-manipulate the generator matrix by the complicated Gaussian elimination technique according to the bit reliability. This paper presents a general multi-class neural network (NN)-based decoder for the short linear block codes, where no HDD and Gaussian elimination are required once the NN is constructed. This network architecture performs multi-classification to select the messages with high occurrence probabilities and chooses the best codeword on a maximum likelihood basis. Simulation results show that the developed approach outperforms the existing deep neural network (DNN)-based decoders in terms of decoding time and bit error rate (BER). The error-correcting performance is also superior to the conventional Chase-II algorithm and is close to the ordered statistics decoding (OSD) in most cases. For Bose–Chaudhuri–Hocquenghem (BCH) codes, the SNR is improved by 1dB to 4dB as the BER is 10−4. For the (23, 12) quadratic residue (QR) code, the SNR is improved by 2dB when the BER is 10−3. The developed NN-based decoder is quite general and applicable to various short linear block codes with good BER performance. [ABSTRACT FROM AUTHOR]

Abstract Background Whether Folic acid is a potential drug that may prevent the progression of colorectal carcinoma and when to use are important healthy issues we focus on. Our study is to examine the effect of folic acid on the development of the CRC and the optimal time folic acid should be provided in a mouse-ICR model induced by 1, 2-Dimethylhydrazine. Also, we investigated the gene expression profile of this model related to folic acid. Method Female ICR mouse (n = 130) were divided into 7 groups either with the treatment of 1, 2-Dimethylhydrazine (20 mg/kg bodyweight) weekly or folic acid (8 mg/kg bodyweight) twice a week for 12 or 24 weeks. Using a 4 × 44 K Agilent whole genome oligo microarray assay, different gene expression among groups (NS, DMH, FA2, FA3) were identified and selected genes were validated by real-time polymerase chain reaction. Results Animals with a supplementary of folic acid showed a significant decrease in the incidence, the maximum diameter and multiplicity of adenocarcinomas (P < 0.05). Furthermore, there were fewer adenomas or adenocarcinomas developed in the group of folic acid supplementation in pre-adenoma stage compared to group of post-adenoma stage. Meanwhile, about 1070 genes that were changed by 1, 2-Dimethylhydrazine can be reversed by folic acid and 172 differentially genes were identified between the groups of pre- and post- adenoma stage using microarray gene expression analysis. Conclusion Our study demonstrated that folic acid supplementary was significantly associated with the decrease risk of CRC. And the subgroup of providing folic acid without precancerous lesions was more effective than that with precancerous lesions.

Abstract Background It was still unclear whether the methodological reporting quality of randomized controlled trials (RCTs) in major hepato-gastroenterology journals improved after the Consolidated Standards of Reporting Trials (CONSORT) Statement was revised in 2001. Methods RCTs in five major hepato-gastroenterology journals published in 1998 or 2008 were retrieved from MEDLINE using a high sensitivity search method and their reporting quality of methodological details were evaluated based on the CONSORT Statement and Cochrane Handbook for Systematic Reviews of interventions. Changes of the methodological reporting quality between 2008 and 1998 were calculated by risk ratios with 95% confidence intervals. Results A total of 107 RCTs published in 2008 and 99 RCTs published in 1998 were found. Compared to those in 1998, the proportion of RCTs that reported sequence generation (RR, 5.70; 95%CI 3.11-10.42), allocation concealment (RR, 4.08; 95%CI 2.25-7.39), sample size calculation (RR, 3.83; 95%CI 2.10-6.98), incomplete outecome data addressed (RR, 1.81; 95%CI, 1.03-3.17), intention-to-treat analyses (RR, 3.04; 95%CI 1.72-5.39) increased in 2008. Blinding and intent-to-treat analysis were reported better in multi-center trials than in single-center trials. The reporting of allocation concealment and blinding were better in industry-sponsored trials than in public-funded trials. Compared with historical studies, the methodological reporting quality improved with time. Conclusion Although the reporting of several important methodological aspects improved in 2008 compared with those published in 1998, which may indicate the researchers had increased awareness of and compliance with the revised CONSORT statement, some items were still reported badly. There is much room for future improvement.

CD44v6 has recently been reported as a biomarker for colorectal cancer. However, the clinical and prognostic significance of CD44v6 in colorectal cancer remains controversial. Therefore, we performed a meta-analysis to clarify this issue. A comprehensive literature search was performed using Medline, Embase and Web of Science, and the statistical analysis was conducted using Stata software. A total of twenty-one studies including 3918 colorectal cancer cases were included. The pooled analysis showed that CD44v6 overexpression in colorectal cancer was an independent prognostic marker correlating with lower 5-year overall survival rate (OR=0.78, 95%CI =0.67-0.91, p=0.001). CD44v6 overexpression was also associated with more lymph node invasion (OR=1.48, 95%CI= 1.02-2.15, p=0.04), and advanced Dukes stage (OR=2.47, 95%CI= 1.29-4.73, p=0.01). In addition, while excluding Zolbec's study, CD44v6 overexpression was associated with distance metastasis (OR=1.65, 95%CI =1.13-2.40, p=0.01). Taken together, this meta-analysis suggested that CD44v6 is an efficient prognostic factor in colorectal cancer.

Objective: To investigate the trend of cardiac reserve function during the normal labor., Methods: Sixty-three cases were chosen randomly from hospitalized maternal women in the First Affiliated Hospital of Chongqing Medical University from 2010 June to December (six months). The digital technique of heart sound signal processing was used to analyze cardiac reserve function parameters including the heart rate (HR), the ratio of the amplitude of the first heart sound to the second heart sound (S1/S2) and the ratio of diastolic to systolic duration (D/S) of pregnant women., Results: (1) Comparisons of cardiac reserve function between uterine contractions and relaxations during labor: 1) Latent phase of labor (cervix dilation < 3 cm):HR was (87.3 ± 14.0) beats/min in uterine contractions and (82.8 ± 12.5) beats/min in uterine relaxations, the ratio of D/S was 1.14 ± 0.27 in uterine contractions and 1.21 ± 0.22 in uterine relaxations, the comparisons of the above two were statistically significant, P < 0.05; But the ratio of S1/S2 was 2.19 ± 0.82 in uterine contractions and 2.28 ± 0.81 in uterine relaxations, the comparison was not statistically significant, P > 0.05. 2) During early active stage of labor (cervix dilation 3 - 6 cm):HR was (89.3 ± 15.4) beats/min in uterine contractions and (83.1 ± 13.5) beats/min in uterine relaxations, the ratio of D/S was 1.09 ± 0.30 in uterine contractions and 1.20 ± 0.27 in uterine relaxations, the comparisons of the above two were statistically significant, (P < 0.05); But the ratio of S1/S2 was 2.42 ± 1.08 in uterine contractions and 2.29 ± 0.83 in uterine relaxations, the comparison was not statistically significant (P > 0.05); 3) During late active stage of labor (cervix dilation 6 - 10 cm), HR was (95.4 ± 18.7) beats/min in uterine contractions and (86.2 ± 15.6) beats/min in uterine relaxations, the ratio of D/S was 1.01 ± 0.25 in uterine contractions and 1.18 ± 0.25 in uterine relaxations, the comparisons of the above two were statistically significant, (P < 0.05); But the ratio of S1/S2 was 2.61 ± 1.26 in uterine contractions and 2.67 ± 1.19 in uterine relaxations, the comparison was not statistically significant (P > 0.05). 4) The second stage of labor (cervical dilation ≥ 10 cm):HR was (109.4 ± 19.7) beats/min in uterine contractions and (93.5 ± 16.7) beats/min in uterine relaxations, the ratio of D/S was 0.89 ± 0.23 in uterine contractions and 1.14 ± 0.26 in uterine relaxations, the ratio of S1/S2 was 3.66 ± 1.37 in uterine contractions and (2.81 ± 1.07) in uterine relaxations, the comparisons of all were statistically significant (P < 0.05). (2) Comparison of cardiac reserve function in uterine relaxations of each stage of labor: 1) Maternal heart rate gradually increased from latent stage of labor to the second stage of labor, and decreased postpartum, the comparison was statistically significant (P < 0.05); 2) The ratio of S1/S2 of maternal gradually increased from latent stage of labor to the second stage of labor, and decreased postpartum, the comparison was statistically significant (P < 0.05); 3) The ratio of D/S gradually decreased from latency to the second stage of labor, and increased postpartum, the comparison was statistically significant (P < 0.05). (3) Comparison of cardiac reserve function in uterine contractions of each stage of labor: 1) Maternal heart rate gradually decreased from latent stage of labor to the second stage of labor, the comparison was statistically significant (P < 0.05); 2) The ratio of S1/S2 of maternal gradually increased from latent stage of labor to the second stage of labor, the comparison was statistically significant (P < 0.05); 3) The ratio of D/S gradually decreased from latency to the second stage of labor, the comparison was statistically significant (P < 0.05)., Conclusions: The maternal cardiac reserve function decreased in uterine contractions than relaxation during labor; With the progress of labor, the maternal cardiac reserve function declined, especially in the second stage of labor, and recovered in postpartum stage.