Purpose: To evaluate the efficacy and tolerability of adjunctive perampanel (PER) in Chinese patients with focal-onset seizures, with or without secondarily generalized tonic-clonic seizures.Methods: Fifty-six patients aged 14–72 years were recruited consecutively in this single-center prospective observational study. All patients received PER as add-on treatment on the basis of clinical judgment. Seizure frequency, adverse events (AEs), and retention rates were obtained at 3 and 6 months after PER introduction.Results: The overall response rates were 60 and 71.1% after 3 and 6 months, respectively, and the freedom of seizures at the same points were reached in 8 and 15.8%. The retention rates were 89.3% at the 3-month follow-up and 67.9% at the 6-month follow-up. The overall incidence of adverse events was 55.4%. The leading reported AEs were dizziness (39.3%) and somnolence (25%).Conclusions: Our study confirmed the efficacy and tolerability of adjunctive PER in Chinese patients in real-life conditions. Based on our treatment experience, a lower maintenance dose of PER would be needed in Chinese patients.

The problem of global warming is becoming more and more serious. N2O is a potent greenhouse gas. Most current studies on dissolved N2O concentration have focused on inland freshwater and seawater while paying less attention to coastal agricultural catchment areas. The coastal agricultural catchment area is the link between the farmland ecosystem and the aquatic ecosystem, which is shallow in water depth. Moreover, due to the high salt content and obvious periodic change, it is highly sensitive to environmental changes and human activities and has strong potential for N2O emission. Therefore, it is of great significance to understand the characteristics of the changes in the dissolved N2O concentration in the shallow-water ecosystem under the saline-alkali environment of the coastal reclamation area and to identify the main controlling factors. The soil of Yudong reclamation area in Rudong County, Jiangsu Province was collected to carry out the submerged cultivation experiment. In order to simulate the saline-alkali situation of the coastal reclamation area, four salt gradients (S1–S4), four alkali gradients (A1–A4), and three levels of exogenous nitrogen concentration (N1–N3). In addition, the experiment set a control treatment (CK) without salt and alkali addition. After 2 weeks of cultivation in a shallow water layer of about 5 cm, the dissolved N2O concentration and its influencing factors were measured and analyzed by collecting the overlying water sample and sediment after 24 h of fertilization. The results showed that changes in the saline-alkali environment in shallow-water ecosystems significantly affected the changes in dissolved N2O concentration. The saline-alkali indicators (EC and pH of the overlying water and sediment), DO of the overlying water, and the microbial genes nirS, nirK, and nosZ were the key influencing factors of N2O production in shallow-water systems. The correlation between nirS gene abundance and the dissolved N2O concentration was the highest. The BP neural network model can be used to simulate and predict the dissolved N2O concentration in overlying water under saline-alkali environment. Based on the experimental results, this study can provide a scientific basis for understanding the nitrogen cycling process in shallow-water ecosystems in the coastal reclamation area, improving the absorption of non-point-source nitrogen and reducing N2O emissions in shallow-water wetlands.

Purpose: Autoimmune encephalitis (AE) is a heterogeneous neurological autoimmune disorder associated with cognitive and psychiatric symptoms. It can be divided into several subtypes based on autoantibodies. Anti-α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor encephalitis (AMPAR-E) is one of the recently discovered AE subtypes, usually manifesting limbic encephalitis and with a good prognosis. Considering AMPAR-E has been described for the first time, only a few cases with similar antibodies have been reported clinically. We aimed to clarify the clinical course and prognosis of the disease in the light of previous reports.Patients and Methods: We collected data on the diagnosis and treatment of six cases of AMPAR-E, diagnosed at the Qilu Hospital of Shandong University in the past 5 years. We retrospectively analyzed the clinical characteristics of the patients and performed a follow-up of the disease.Results: The patients often presented with limbic encephalitis, which sometimes coexisted with tumors. In addition, immunotherapy had a significant effect on the disease. The clinical outcome was related to factors such as the age of onset, timing of treatment, and presence of tumors.Conclusion: In conclusion, specific antibody tests should be performed as early as possible in suspected cases. Clinicians should actively administer immunotherapy and the management of the co-tumor. In addition, repeat antibody tests and image examinations following discharge from the hospital guide the maintenance protocol of immunotherapy.