ObjectiveIt has been reported that many different kinds of antiepileptic drugs (AEDs) induced cutaneous adverse drug reactions (cADRs) are associated with human leukocyte antigen (HLA) genes. However, previous studies mainly focused on the traditional AEDs. There are very few research focused on the new AEDs, especially levetiracetam (LEV). This study aimed to evaluate the clinical characteristics of LEV-induced cADRs and to explore its possible genetic association with the HLA alleles. MethodsNine cases with LEV-induced cADRsfrom September 2011 to December 2014 were recruited. Demographic and clinical information of these cases was summarized. Additionally, cases were matched with LEV-tolerant controls (1 : 4).High-resolution HLA-A, -B, -DRB1 genotyping were performed for each subject. The allele frequencies between the cases and controls were compared. ResultsNine cases with LEV-induced cADRs formed the LEV-cADRs group. And 36 epilepsy patients who had received or have been receiving LEV treatment for at least 3 months without any adverse drug reactions formed the LEV-tolerant controls group. All LEV-induced cADRs were mild skin rashes whichoccurred within 30 days of LEV exposure. The mean latency from LEV exposure to skin rash was (15.67±5.41) days (ranging 6~27). Two patients in the LEV-cADRs group carried the HLA-DRB1*0405allele, while none subjects in the control group carried this allele. The carrier rate of HLA-DRB1*0405 allele between the LEV-cADRs group and control group was statistical significant [P=0.036, OR=13.875, 95%CI(1.273, 151.230)]. ConclusionsSafety monitoring was necessary within four weeks after the initiation of LEV treatment, although it has been regarded as a safe AED.Our study suggested thatHLA-DRB1*0405 allele may be a risk factor for LEV-induced cADRs. However, the Further studies with large samples are needed to clarify this hypothesis and the genetic and immunological mechanisms of LEV-induced cADRs should also be further explored in the future.
Objective To investigate the rebuilding status of community health service (CHS) system after Wenchuan earthquake in Mianzhu, improve service ability and provide data for better reconstruction of CHS system after natural disaster. Methods The interview was conducted with local health system officials, and self-designed questionnaire for face-to-face interview was distributed to 508 community residents in Mianzhu who were selected by convenience sampling. Data entry and statistical analysis were completed using Microsoft Office Excel 2007 and SPSS 16.0 respectively. Results A total of 508 questionnaires were distributed, and then 486 questionnaires were retrieved effectively (response rate 95.7%). The analysis on 486 respondents in CHS after rebuilding showed the rate of respondents with health files rose from 20.1% to 43.8%, the rate of having regular health check-up rose from 7.4% to 46.7%, the rate of health education rose from 20.1% to 39.7%, the rate of chronic disease monitoring rose from 0.9% to 35.4%, the rate of knowing referral pattern rose from 15.7% to 51.2%, the rate of propaganda for disaster relief rose from 33.6% to 58.6%, and the rate of doing disaster emergency response exercise was 21.8% currently. 62.3% of residents chose CHS on the first visit. The satisfactory degree to CHS rose from 45.4% to 76.1% after earthquake. Both popularization of regular health check-up and propaganda for disaster relief were major factors with influence on residents’ satisfaction to CHS (Plt;0.001, P=0.010, respectively). Conclusion The residents’ satisfactory degree to the rebuilding status of CHS system is encouraging. It is necessary to strengthen the popularization of regular health check-up and propaganda for disaster relief in order to improve the quality of community health service.
ObjectiveTo reveal impairments in the perceptual networks in tuberous sclerosis complex (TSC) with epilepsy by functional connectivity MRI (fcMRI). MethodsThe fcMRI-based independent component analysis (ICA) was used to measure the resting state functional connectivity in nine TSC patients with epilepsy recruited from June 2010 to June 2012 and perceptual networks including the sensorimotor network (SMN), visual network (VN), and auditory network (AN) were investigated. The correlation between Z values in regions of interest (ROIs) and age of seizure onset or duration of epilepsy were analyzed. ResultsCompared with the controls, the TSC patients with epilepsy presented decreased functional connectivity in primary visual cortex within the VN networks and there were no increased connectivity. Increased connectivity in left middle temporal gyrus and inferior temporal gyrus was found and decreased connectivity was detected in right inferior frontal gyrus within AN networks. Decreased connectivity was detected at the right inferior frontal gyrus and the increase in connectivity was found in right thalamus within SMN netwoks. No significant correlations were found between Z values in ROIs including the primary visual cortex within the VN, right thalamus and inferior frontal gyrus within SMN, left temporal lobe and right inferior frontal gyrus within AN and the duration of the disease or the age of onset. ConclusionFhere is altered (both increased and decreased) functional connectivity in the perceptual networks of TSC patients with epilepsy. The decreased functional connectivity may reflect the dysfunction of correlative perceptual networks in TSC patients, and the increased functional connectivity may indicate the compensatory mechanism or reorganization of cortical networks. Our fcMRI study may contribute to the understanding of neuropathophysiological mechanisms underlying perceptual impairments in TSC patients with epilepsy.