The incidence of epileptic seizures among allogeneic hematopoietic stem cell transplant (allo-HSCT) patients has been poorly described. No report has systematically studied epilepsy's possible causes, risk factors, and effect on prognosis among allo-HSCT patients. We retrospectively examined data from 1461 patients who underwent allo-HSCT within the past 6.5 yr at the Institute of Hematology and People's Hospital, Peking University. The cumulative incidence of all epileptic seizure complications was 7.1%. Of the 79 transplant patients who had epileptic seizures, 3 (3.8%) experienced a seizure during the conditioning stage, 52 (65.8%) between day 0 and day 100, 20 (25.3%) from day 100 to the first year, and 4 (5.1%) after the first year. Multivariate regression analysis identified the age of the recipient as (≤ 18 yr) (p < 0.001), donor type (p = 0.004), graft versus host disease (aGVHD) (p = 0.018), and hyponatremia (p = 0.003) as independent risk factors for epileptic seizures among allo-HSCT patients. The median survival time of patients with epileptic seizures was 246 d after transplantation (ranging between 18 and 2170 d). Survival after one yr and 6.5 yr was significantly reduced in patients who developed epileptic seizure complications compared with those who did not (57.2% vs. 75.7% at one yr, p = 0.015, and 31.1% vs. 71.4% at five yr, p < 0.001). Of the 79 patients who experienced epileptic seizure complications, 53.2% died (n = 42). The survival rate of these patients was relatively low, and cerebrovascular disorders or central nervous system infection-related epileptic seizures usually resulted in a high mortality and poor prognosis. A patient transplantation age which is younger than 18 yr, related mismatched transplants, aGVHD, and hyponatremia are risk factors for epileptic seizures in allo-HSCT recipients. Epileptic seizures among allo-HSCT patients are associated with a poor prognosis.

For CSP patients suitable for nonsurgical treatment, UAE combined with local MTX would be the superior option compared with systemic MTX in the cases with deep implantation of amniotic sac.

Background: Fetal growth abnormalities in hypoplastic left heart syndrome (HLHS) have been documented primarily by birth measurements. Fetal growth trajectory has not been described. We hypothesized that fetal growth trajectory declines across late gestation in this population. Methods: Infants with a prenatal diagnosis of HLHS and no history of prematurity or a genetic syndrome were identified. Fetal ultrasound measurements and birth anthropometrics were obtained from clinical records. z-Scores for estimated fetal weight (EFWz) and birth weight (BWTz) were compared. BWTz for three neonatal standards were compared. results: Paired fetal and neonatal data were identified in 33 cases of HLHS. Mean gestational age at ultrasound and birth were 27 and 38 wk, respectively. BWTz was lower than EFWz by a mean of 0.82 (SD: 0.72, P < 0.0001), with 64% of subjects demonstrating a decrease in z-score of >0.5. Umbilical artery (UA) Doppler found no evidence of significant placental insufficiency. Modest differences in BWTz were seen across BWT standards in this cohort. conclusion: The majority of fetuses with HLHS demonstrate decreased growth velocity during later pregnancy, suggesting growth abnormalities manifest in utero. The potential relationship to future clinical outcomes warrants further study.

BackgroundThe current study presents a technique (navigated posterior lumbar fusion) which takes a 5-cm incision to accomplish a 2-level posterior lumbar fusion (PLF) and compared its efficacy and efficiency with those of conventional PLF.MethodsForty patients who were indicated for 2-level lumbar fusion were included and randomized to either navigated PLF group or conventional PLF group. Blood loss, operation time, incision length, complications, bed rest period, and length of hospitalization were recorded. Oswestry Disability Index (ODI) scoring was also performed for each patient before surgery, 3 months after surgery, and 2 years after surgery.ResultsThe incision length was significantly shorter in the navigated PLF group than in the conventional PLF group (4.8 vs. 10.9 cm, p = 0.001). Accordingly, the blood loss was also significantly less in the navigated PLF group than in the conventional PLF group (209.0 vs. 334.0 ml, p = 0.047). There was no significant difference in total operation time between the two groups (160.7 vs. 144.4 min, p = 0.116). Compared to the conventional PLF group, the navigated PLF group showed significantly less postoperative blood loss, less time to mobilization, and shorter length of hospital stay. The ODI score improved significantly in the both groups immediately after surgery, and maintained well in the following 2 years.ConclusionCompared to conventional PLF, navigated PLF proved to be superior with regard to incision length, blood loss, time to mobilization, and shorter length of hospital stay.

A high rate of chronic HBV infection in China is mainly the result of perinatal or early childhood transmission. Therefore, universal vaccination against HBV in infants has been very successful in the control of chronic HBV infection, with the prevalence of hepatitis B surface antigen decreasing from nearly 10% to approximately 7% in the general population. Adoption of Good Clinical Practice and proper conduction of well-designed clinical trials on conventional and pegylated interferons and nucleos(t)ide analogs have generated important clinical data. The publication and promotion of the evidence-based national guidelines have greatly improved the standard of clinical practice on the prevention and treatment of chronic hepatitis B. The ongoing national key scientific projects on the optimization of vaccination strategy and current anti-HBV therapy will yield important clinical evidence. Inclusion of conventional and pegylated interferons and nucleos(t)ides into the new national reimbursement list will increase the availability and affordability of anti-HBV therapies, thereby further decreasing the morbidity and mortality associated with chronic HBV infection.

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