5 research outputs found

    A nomogram to predict the treatment benefit of perampanel in drug-resistant epilepsy patients

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    ObjectiveThe objective of this study was to identify the factors that affect the efficacy of added perampanel for the treatment of drug-resistant epilepsy (DRE), and to develop a reliable nomogram to predict the benefit of this addition.MethodsA retrospective clinical analysis was conducted on DRE patients who received perampanel treatment and who were followed up for at least 6 months from January 2020 and September 2023 at the Epilepsy Center of Fujian Medical University Union Hospital. Data from January 2020 to December 2021 were used as development dataset to build model, while the data from January 2022 to September 2023 were used as validation dataset for internal validation. The predictive factors that affected the efficacy of perampanel as DRE treatment were included in the final multivariate logistic regression model, and a derived nomogram was established.ResultsA total of 119 DRE patients who received perampanel treatment were included in this study (development datasets: n = 76; validation data: n = 43). Among them, 72.3% (n = 86) showed a 50% or greater reduction in seizure frequency after perampanel treatment. Of all the parameters of interest, sex, age, history of generalized tonic-clonic seizures, and the number of antiseizure medications were identified as significant predictors for estimating the benefit of adding perampanel for the treatment of DRE. A model incorporating these four variables was developed, and a nomogram was constructed to calculate the probability of benefit of adding perampanel using the model coefficients. The C-index of the predictive model was 0.838, and the validation C-index was 0.756. The goodness-of-fit test showed good calibration of the model (p = 0.920, 0.752 respectively).ConclusionThe proposed nomogram has significant clinical potential for predicting the probability of benefit of perampanel as DRE treatment. This nomogram can be used to identify DRE patients who could benefit from the early addition of perampanel to their treatment regimen

    Thymic Stromal Lymphopoietin Over-Expressed in Human Atherosclerosis: Potential Role in Th17 Differentiation

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    Background: Adaptive immunity plays a critical role in atherosclerosis and T helper 17 (Th17) cells, a new T-cell lineage, are recently reported to be involved in atherosclerosis. However, the mechanism underlying Th17 inflammation in atherosclerosis remains largely unknown. Thymic stromal lymphopoietin (TSLP) is a novel IL-7-like cytokine and mainly responsible for Th2 inflammation in many inflammatory diseases. Methods and Results: Immunohistochemistry showed that TSLP over-expressed in human atherosclerotic lesion and could be induced by ox-LDL in human vascular smooth muscle cells (HVSMCs) and human umbilical vein endothelial cells (HUVECs). TSLP, in turn, could activate dendritic cells (DCs) to differentiate Th17 inflammation in naive CD4+ T cells. Conclusion: TSLP induced by ox-LDL could promote Th17 immune response in vitro, which may be implicated in Th17 inflammation in atherosclerosis
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