SummaryObjectiveThis study was undertaken to investigate the COVID‐19 vaccine uptake rate and possible postvaccination effects in adults with epilepsy.MethodsWe invited adults with epilepsy attending three centers in China from July 24 to August 31, 2021 to participate in this study. We also asked age‐ and sex‐matched controls among people attending for other chronic neuropsychiatric conditions and healthy controls accompanying people with illness attending the hospitals to participate. We excluded people who, under the national guidelines, had evident contradictions to vaccination. Participants were interviewed face‐to‐face using questionnaires. Vaccine uptake and postvaccine adverse events among the people with epilepsy were compared with those with neuropsychiatric conditions and controls. We also compared the willingness and reasons for hesitancy among unvaccinated participants.ResultsWe enrolled 981 people, of whom 491 had epilepsy, 217 had other neuropsychiatric conditions, and 273 were controls. Forty‐two percent of those with epilepsy had had the first dose of a vaccine, compared with 93% of controls and 84% of the people with neuropsychiatric conditions (p < .0001). The majority (93.8%) of those immunized had inactivated vaccines. Among the unvaccinated people with epilepsy, 59.6% were willing to have the vaccine. Their main reasons for hesitation were potential adverse effects (53.3%) and concerns about losing seizure control (47.0%). The incidence of adverse events in the epilepsy group was similar to controls. Nineteen people with epilepsy reported an increase in seizure frequency. No episode of status epilepticus or prolonged seizures was reported. Two controls had their first‐ever seizure, which was unlikely related to the vaccine.SignificanceThe vaccine uptake rate in people with epilepsy was lower than in their same‐age controls. The postvaccination effect was no higher than in controls. We found no evidence suggesting worsening seizures after vaccination. Measurement and education focused on increasing the vaccination rate in epilepsy are warranted.
Our results suggested that CCAT1 functions as an oncogenic lncRNA in ICC, which could serve as a potential diagnostic and therapeutic target for ICC patients.
Radiotherapy is the main treatment strategy for nasopharyngeal carcinoma. A major factor affecting radiotherapy outcome is the accuracy of target delineation. Target delineation is time-consuming, and the results can vary depending on the experience of the oncologist. Using deep learning methods to automate target delineation may increase its efficiency. We used a modified deep learning model called U-Net to automatically segment and delineate tumor targets in patients with nasopharyngeal carcinoma. Patients were randomly divided into a training set (302 patients), validation set (100 patients), and test set (100 patients). The U-Net model was trained using labeled computed tomography images from the training set. The U-Net was able to delineate nasopharyngeal carcinoma tumors with an overall dice similarity coefficient of 65.86% for lymph nodes and 74.00% for primary tumor, with respective Hausdorff distances of 32.10 and 12.85 mm. Delineation accuracy decreased with increasing cancer stage. Automatic delineation took approximately 2.6 hours, compared to 3 hours, using an entirely manual procedure. Deep learning models can therefore improve accuracy, consistency, and efficiency of target delineation in T stage, but additional physician input may be required for lymph nodes.
To investigate the clinical features, risk factors, and bacterial spectrum of liver abscess following transarterial chemoembolization (TACE) and evaluate the therapeutic effect of percutaneous catheter drainage (PCD) on the abscesses.A retrospective review of patient charts was performed in 3613 patients who suffered from liver malignancies (2832 patients with hepatocellular carcinoma and 781 with metastatic hepatic tumor) and had undergone 11,054 TACE procedures from January 2005 to October 2013. Liver abscesses were found in 21 patients. PCD was performed in all abscess patients. The clinical features, risk factors, and bacterial spectrum of liver abscess following TACE were investigated and the therapeutic effect of PCD was evaluated.The incidence of liver abscess was 0.58% per patient and 0.19% per procedure. Approximately 57.1% of the patients had a medical history of bilioenteric anastomosis or biliary stent implantation. On computed tomography scans, the abscesses appeared as low-attenuation lesions and high-density iodinate oil scattered in the abscesses. The ultrasound showed the well defined, heterogeneously hypoechoic lesions. Positive microbiological isolates were obtained in all pus cultures and in 47.6% of blood cultures. The most common bacterium was Escherichia coli (52.4%). Twenty patients (95.2%) were cured from abscesses by using PCD, and 1 died of sepsis.Patients with predisposing factors are prone to an increased risk of liver abscess following TACE. Bacterial culture and antibiotic sensitivity tests on pus and blood help on the antibiotics selection. PCD combined with aggressive antibiotics can be recommended as the first-line therapeutic regimen.
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