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Background: The present study aimed to assess the risk factors of cholesterol and premalignancy in polypoid lesions of the gallbladder (PLGs) and to establish an appropriate treatment strategy. Methods: Data from patients who underwent cholecystectomy at the First Affiliated Hospital, School of Medicine, Zhejiang University, between January 2011 and July 2017, were collected retrospectively. Results: A total of 1561 patients were included in the present study. The cohort comprised of 636 (40.7%) males and 925 (59.3%) females, with a mean age of 49.5 (range 16–88) years; 65.6% (1024/1561) demonstrated cholesterol lesions in this cohort, among which cholesterol polyps accounted for 81.0%. Age younger than 50 years and multiple number of polyps were found to be independent predictive variables for cholesterol lesions (odds ratio (OR) 3.461, 95% confidence interval (CI) 2.058–5.820, P < 0.001 and OR 3.321, 95% CI 1.988–5.547, P < 0.001, respectively). The presence of polyp growth was associated with premalignancy (OR 5.366, 95% CI 1.466–19.637, P = 0.011), and the presence of clinical symptoms indicated benign non‐cholesterol lesions (OR 0.368, 95% CI 0.153–0.885, P = 0.026). Conclusion: In the case of patients ≥50 years old with single asymptomatic polyp, cholecystectomy was recommended if the polyp presented growth at a rate above 3–4 mm within 6 months. If not, trimonthly ultrasound follow up was recommended, and clinicians should carefully assess the risk factors for premalignancy in PLGs. This study aimed to develop a strategy to discriminate cholesterol and premalignancy in polypoid lesions of the gallbladder. In the case of patients aged ≥50 years with single asymptomatic polyp, cholecystectomy was recommended if the polyp presented growth at a rate above 3–4 mm within 6 months. [ABSTRACT FROM AUTHOR]

Purpose:To investigate the current status of epilepsy treatment and the efficacy and adverse effects of phenobarbital therapy in rural areas of Northern China.Methods:A total of 2192 patients diagnosed with convulsive epilepsy were recruited from seven different rural regions in Jilin Province, China to investigate the current status of epilepsy treatment, and 1379 of them were enrolled in a standard phenobarbital therapy trial. Patients were selected according to strict inclusion and exclusion criteria, and medical records for all patients were collected and analyzed before the standard treatment was started. Patients were followed up monthly, and efficacy in 1218 patients was analyzed at 1, 3, 6 and 12 months of treatment.Results:More patients had the initial seizure in juveniles than in adults, and 40.72% of the 2192 patients were not receiving any treatment before the treatment trial. The efficacy of phenobarbital increased and adverse effects decreased within the treatment period. Among the 349 patients who were followed up for 12 months from the beginning of the phenobarbital treatment, seizures were decreased by more than 75% in 71.3% of patients using a low-to-medium dose of phenobarbital. Major adverse effects of phenobarbital included mild exhaustion, drowsiness, dizziness and headache.Conclusions:Standardized long-term and regular administration of phenobarbital at a low-to-medium dose can be used as an effective, economic and safe treatment against epilepsy in rural areas. [ABSTRACT FROM AUTHOR]

Objective: This study aims to retrospectively study clinical characteristics, diagnosis, treatment and follow-up visits in patients with anti-leucine-rich glioma inactivated-1 (LGI1) limbic encephalitis (LE) for prompting the early diagnosis and efficacious treatment of this disease. Methods: Four anti-LGI1 LE patients were hospitalized in the Department of Neurology at the First Hospital of Jilin University. Data from their clinical manifestations, diagnoses, treatments and follow-up visits were analyzed. Results: Four patients with anti-LGI1 LE were characterized by hypomnesia, mental and behavior disorder, faciobrachial dystonic seizures (FBDS), seizures accompanied by pathological changes in the limbic system, obstinate hyponatremia and positive detection of anti-LGI1 antibody. In this study, we found that 1 patient initially presented with an abnormal sensation and had a subsequent FBDS, inconsistent with normal cases of anti-LGI1 LE. This patient had abnormalities in the basal ganglia region identified with head MRI, unlike most cases, which report abnormalities in the limbic system by positron emission tomography/CT scan. Finally, 3 of our patients with FBDS were treated with antiepileptic drugs as well as immune modulatory treatment, and they responded well. Conclusions: We identified new characteristics in clinical manifestation, diagnosis and treatment of anti-LGI1 LE, which contribute to a better understanding of this disease and help improve its early diagnosis and efficacious treatment. [ABSTRACT FROM AUTHOR]