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Objective The objective of this study was to investigate the efficacy and safety profile of levetiracetam as add-on therapy in patients with refractory epilepsy. Methods Web of Science, MEDLINE (Ovid and PubMed), Cochrane Library, EMBASE, and Google Scholar were systematically searched to identify potential eligible randomized controlled trials by two reviewers independently. Pooled estimates of risk ratios (RRs) for 50%, 75%, and 100% reduction from baseline were calculated using the fixed-effect model or random-effect model. Quality of included studies was assessed with the Cochrane Collaboration’s Risk of Bias tool. Serious adverse events and withdrawals induced by interventions and the most common side effects were analyzed. Results Seventeen trials with a total of 3,205 participants were included in this meta-analysis, including 14 trials for adulthood and three trials for children. Pooled estimates suggested that levetiracetam was an effective anti-epileptic drug at 1,000–3,000 mg/day (RR =2.00 for 1,000 mg/day, RR =2.68 for 2,000 mg/day, RR =2.18 for 3,000 mg/day) for adults and 60 mg/kg/day (RR =2.00) for children compared to placebo in terms of 50% reduction from baseline. Likewise, as for seizure freedom rate, levetiracetam had an advantage over placebo at 1,000–3,000 mg/day (RR =5.84 for 1,000 mg/day, RR =4.55 for 2,000 mg/day, RR =4.57 for 3,000 mg/day, respectively) for adults and 60 mg/kg/day (RR =4.52) for children. Regarding safety profile, patients treated with levetiracetam had significantly higher occurrence than placebo for somnolence, asthenia, dizziness, infection, nasopharyngitis, anxiety, and irritability; however, most studies reported that these adverse events were mild and transient. Conclusion Levetiracetam is an effective anti-epileptic drug for both adults and children with generalized or partial-onset refractory seizures at 1,000–3,000 or 60 mg/kg/day, with a favorable adverse event profile.

The Lower Cretaceous Shahai and Jiufotang Formation in Fuxin Basin, located northwest of Liaoning Province, with stable planar distribution contains abundant shale gas reserves, which are key horizons in the exploration breakthrough of the Mesozoic continental shale gas in northeastern China. FuYe-1 (FY-1) well was recently drilled, and it is an important shale gas parameter well in the Fuxin Basin area. A total of 60 shale samples were collected from Shahai and Jiufotang Formation of FuYe-1 well and DY-1 well in this work. A series of experiments including organic matter vitrinite reflectance, X-ray Diffraction (XRD) analysis, total carbonate content (TOC) measurement, scanning electron microscopy, low-temperature nitrogen adsorption, and methane isothermal adsorption were conducted through the samples. The final results revealed that in FuYe-1 well, the shale of the Lower Cretaceous Shahai and Jiufotang Formations has a maturity of 0.46−1.68% (average of 0.92%), which is at the immature-high maturity stage. The kerogens are mostly of types II−III. The mineral components are dominated by clay minerals and quartz, with an average of 21.39% and 30.89%, respectively. The main controlling factors of the methane adsorption capacity are the TOC content, the total clay content, and the shale pore structure. Langmuir's volume (V L ) of the shale ranges between 0.17 and 1.98m 3 /t (with an average of 1.21 m 3 /t). The methane adsorption capacity is positively correlated with the content of the total clay minerals and quartz, but varies in different clay minerals. The specific surface area of the shale and the total pore volume were calculated by BET and BJH, the macropore ratio of which is negatively correlated with the methane adsorption capacity, whereas the specific surface area and the total pore volume of the mesopores and micropores ratio are positively correlated with the methane adsorption capacity, indicating that the content of the micropores and mesopores is the major contributor to the specific surface area of shale.

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