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Please post your research questions here!

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Please post your research questions here!

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Click on the '+' plus sign below (bottom right corner of page), add in your name in the subject line, add in your research question below, click publish!

To edit your research question at any time, please click on the three dots menu on your post (top right corner) and click on Edit. Once you have made your changes, click "Update" to save.

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Efficacy and safety of HIF-PHI for Perioperative Anemia in Patients Undergoing Major Orthopedics surgery

P: Adult (≥18 years) anemic patients scheduled for elective major orthopedic surgery （hemoglobin <130g/L for males and <120g/L for females）

I: HIF-PHI treatment

C: Standard Clinical Treatment

O: Perioperative blood transfusion

T: At discharge or postoperative 4 weeks

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The impact of dupilumab on food allergies in children with moderate to severe atopic dermatitis.

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ALDH2 gene polymorphism and risk of atrial fibrillation recurrence after radiofrequency catheter ablations

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The relationship between DPP-4is and cognitive impairment on comorbidity of cerebral small vessel disease with type-2 diabetes mellitus

Background

*Cerebral small vessel disease (CSVD) accounts for nearly 20% of all ischemic strokes and is associated with a high risk of vascular dementia. Recent studies have suggested that Type-2 diabetes mellitus (T2DM) is one of the major risk factor for microangiopathy and that patients with diabetes mellitus are more likely to suffer from CSVD. Since the majority of diabetic patients take drugs to regulate their blood glucose levels, it is important to investigate whether long-term use of anti-diabetic medicines can prevent CSVD.

*Dipeptidyl peptidase-4 inhibitors (DPP-4is, incretin enhancers) are glucose-lowering therapies with proven cardiovascular safety, but their effect on microvascular disease is not fully understood. These therapies increase GLP-1 receptor agonism, which is associated with attenuation of numerous pathological processes that may lead to microvascular benefits, including decreased reactive oxygen species (ROS) production, decreased inflammation and improved vascular function. Rodent studies demonstrate several benefits of these agents in the prevention or reversal of nephropathy, retinopathy and neuropathy, but evidence from human populations is less clear. Evidence in less-established microvascular outcomes, such as microvascular angina, cerebral small vessel disease, skeletal muscle microvascular disease and autonomic neuropathies (e.g. cardiac autonomic neuropathy, gastroparesis, erectile dysfunction), is sparse.

*My goal is to elucidate the relationship between DPP-4is and cognitive impairment on comorbidity of cerebral small vessel disease with type-2 diabetes mellitus.

P: patients who have comorbidity of cerebral small vessel disease with type-2 diabetes mellitus

I: DPP-4is

C: non DPP-4is

O: cognitive impairment

T: 5 years (follow-up)

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The outcome of small airway dysfunction

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to explore the effect of papaverine for Chemotherapy-induced peripheral neuropathy

TAN YI NUO

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A prospective multicenter study using CURB-65 score to predict CIP mortality rate

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The role of ctDNA testing in the evaluation of the effectiveness of neoadjuvant therapy in patients with HR+/HER2- breast cancer.

P (Population): Patients with HR+/HER2- breast cancer undergoing neoadjuvant therapy

I (Intervention): Circulating tumor DNA (ctDNA) testing

C (Comparison): Traditional imaging and pathological assessment methods

O (Outcome):Evaluation of the effectiveness of neoadjuvant therapy, including pathological complete response (pCR), disease progression, risk of recurrence, and prognosis

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The Preventive Effect of Tea on Postoperative Recurrence in Patients with Urolithiasis

P: Postoperative Patients with Urolithiasis

The experimental group patients took 10 grams of tea leaves daily after surgery, while the control group took plain boiled water daily.

O: The recurrence rate of urolithiasis.

T: 6 months(follow up)

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Efficacy and safety of Roxadustat for Perioperative Anemia in Patients Undergoing Orthopedics surgery  

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Efficacy and safety of Roxadustat for Perioperative Anemia in Patients Undergoing Orthopedics surgery  

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Efficacy Analysis of Single-Stage Surgical Repair for Severe Pressure Injuries Guided by Comprehensive Assessment: A Retrospective Case-Control Study

PICO Components:

P - Population/Patient:

The study subjects are patients with severe pressure injuries who were hospitalized in our department and received surgical treatment in the past three years.

I - Intervention/Exposure:

The intervention is single-stage surgical repair guided by comprehensive assessment.

C - Comparison:

The control group consists of patients who underwent multiple-stage surgical repair.

O - Outcome:

The primary outcome measures are wound healing time and healing rate. Secondary outcome measures include hospital stay duration, hospitalization costs, surgery duration, intraoperative blood loss,and duration of antibiotic use.

T - Time:

The retrospective study period is the past three years.

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Backgrounds: Patients in the ICU with endotracheal intubation have a high incidence of oral mucosal pressure injuries (MPI). According to reports, the incidence of oral MPI ranges from 3% to 49%. Oral MPI causes severe pain and discomfort to patients, increases the risk of oral infections, and in turn affects oral care, communication, swallowing, and dietary aspects, extending hospital stays. However, at present, nurses tend to focus more on skin pressure injuries, and there is insufficient attention to the recognition and risk factors of MPI. Due to histological differences, the risk factors for pressure injuries in oral mucosa likely differ from those of the skin, making existing skin risk assessment tools unsuitable for mucosal tissues. Therefore, We aim to develop a risk assessment model or scoring system specifically for oral MPI in intubated patients. This system aims to help clinical staff identify and prevent these injuries early, thereby improving the quality of patient care.

Topic: What are the risk factors for oral MPI in intubated patients in ICU, and how can a risk assessment model or scoring system be developed to predict these injuries?

P: orotracheally intubated patients

E: Factors that may contribute to the development of oral MPI, such as duration of intubation, type of intubation, endotracheal tube fixation method, oral care practices, patient's nutritional status, and other clinical characteristics.

O: oral MPI

Time: Follow-up begins with endotracheal tube placement and concludes either with the occurrence of oral MPI or extubation

Study design: prospective cohort

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Tooth extraction results in bone loss during socket healing. Periodontal compromised teeth is characterzied by bone resorption, so after tooth extraction it would be quite difficult for the following implant surgery because of the severe bone defect. Bone defects in height and in width would bring huge risks like nerve ingury, maxillary sinus peforation, implant exposure and so on.

Therefore, we often utilize the technique of alveolar ridge preservation to minimalize bone loss after tooth extraction.

We develop a new technique for the alveolar ridge preservation, which is more cost-effective. Our research target is to compare the effect of new technique with the traditional one in the perspective of hard and soft tissue augmentation.

Patients: hopeless periodontal-compromised teeth

Intervetion: new material of sticky bone

Control: traditional material of Bio-oss Collagen (bone mineral with 10% collagen)

Outcome: bone preservation effect

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My research question is about CTVA, Chest Tight ness Variety Asthma. Actually, this includes two types of studies, one is for the national wide cross-sectional prevalance and incidence, another is about the treatment strategies for CTVA.

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•Proposed study title:

Efficacy of prolonged corticosteroid and steroid-sparing maintenance immunotherapy in anti-LGI1 encephalitis: a multi-center retrospective cohort study

•Study design: a multi-center retrospective cohort study

•Population: patients with anti-LGI1 encephalitis

•Intervention/Exposure: chronic treatment after immunotherapy in the acute stage

•Comparison: prolonged corticosteroids (>6 m) vs. steroid-sparing maintenance immunotherapies(eg, mycophenolate)

•Primary outcome: relapse of the encephalitis

•Second outcome: functional outcome (the modified Rankin scale, mRS), seizures

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Topic: Comparison of Intracerebral hemorrhage risk between dual antiplatelet therapy and single antiplatelet plate therapy

Population: Patients receiving antiplatelet therapy

Intervention: DAPT Group: Dual antiplatelet therapy were given

Control: SAPT Group: Treatment with a single antiplatelet agent

Outcome: The incidence of cerebral hemorrhage within two years was followed up.

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Combined of prone positioning and inhaled antibiotics administration in severe VAP: A potential therapeutic strategy

Population: VAP Patients caused by kelbsiella pneumonia

Intervention: prone position(16h) and Inhaled antibiotics(q8h,20min/each)

Control: VAP Patients caused by kelbsiella pneumonia ,multi-drug resistant to antibiotics(more than 3 types of antibiotics)

One group： the treatment of iv colistin

another group：the treatment of iv colistin combine prone position ventilation

Outcome: the morality of patients

The rate of bacterial clearance according to the result of bacteria culture in BALF

The rate of improvement for VAP in patients according to the score of CPIS

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Whether caspofungin combined with trimethoprim/sulfamethoxazole(TMP/SMZ) as first-line therapy has a more efficacy for non-HIV patients with severe pneumocystis pneumonia

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1.Research on the Predictive Role of Lymphatic Tertiary Structure in Tumor Pathological Tissues for Tumor Immunotherapy.

2.Assessment of the improvement in the timeliness of traditional pathology department management through full digitalization

3.Comparison of the consistency of immunohistochemical markers for molecular subtypes of breast cancer between rapid frozen immunohistochemistry and routine immunohistochemistry detection

4.Applying local multi-layer fusion scanning methods to reduce the false-negative rate of AI  in cervical cytology

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The Effect of Conjunctival Sac Cleaning on Inflammatory Factors in Tears and Prognosis in  Severe Dry Eye Patients with Sjögren's Syndrome

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ALS is a fatal disorder with progressive muscle atrophy. Most of patients died 3~5 years after the onset. Lipoic acid plays an important role in mitochondrial energy metabolism. The effect of lipoic acid in ALS patients is unknown.

P: ALS patients within 2 years duration

I: lipoic acid add-on therapy to Riluzole

C: patients with Riluzole alone

O: the decline of ALSFRS-R score

T: 48 weeks

T: randomized control

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P：Lung transplant recipients

I: Donor lungs are perfused with LPD solution which added with NAC during procurement.

C: Donor lungs are perfused with LPD solution which added with Saline during procurement.

O： Incidence of PGD within 72 hours post-transplant.

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Big question: How to reduce non-Suicidal Self Harm（NSSI） in adolescents

Q1. The incidence and prevalence of NSSI in adolescents？

Q2. Which factors are related to NSSI？

Q3. Which strategies can reduce NSSI？

Q4. How to prevent NSSI？

Qiaozhen CHEN

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Topic: Effects of impaired hypoglycemia awareness on cognitive function in patients with type 2 diabetes

Population: Type 2 diabetes patients with hypoglycemia

Exposure: Impaired Awareness of Hypoglycemia (IAH) (Gold score OR Clerk score >4)

Outcome: Montreal Cognitive Assessment (MoCA)、Mini-Mental State Examination(MMSE)

Time: Hypoglycemia occurs within 24 hours

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Hypnotic Use and the Risk of Cardiovascular Diseases in Insomnia Patients

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Small Airway Dysfunction (SAD) Cohort Outline

P:Population

SAD population from community in Zhejiang Province

I/C: Intervention/Control Meast(Exposure Factors)

O:Outcome

Primary outcome

Secondary outcome

Study Design

Prospective cohort study/observational study

Annual follow-up

T:Follow-up Period

3 years

Is this design feasible? Thanks!

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Papaverine for chemotherapy induced peripheral neuropathy

1. P: Adult cancer patientsundergoing chemotherapy that may lead to peripheral neurotoxicity.

2. I: duloxetine + Papaverine (80mg, ivgtt once) / placebo.

3. C: duloxetine + Papaverine VS duloxetine + placebo.

4. O: Improvement in chemotherapy-induced peripheral neurotoxicity, assessed by a neurotoxicity scale.

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The exploration of manometry in the treatment of mesenteric artery dissection 

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The exploration of manometry in the treatment of mesenteric artery dissection 

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The disease is lack of guidelines for its treatment, I hope through exploring study which can translate the experience clinical treatment currently to digital technology guiding treatment

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Adults undergoing colonoscopy during routine health check-ups in Zhejiang Province

P (Population): Adults undergoing colonoscopy during routine health check-ups in Zhejiang Province

I (Intervention): Colonoscopy examination to diagnose hemorrhoids

C (Comparison): Not applicable (cross-sectional study)

O (Outcome): Prevalence of hemorrhoids

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•The immune checkpoint inhibitor-associated pneumonitis (CIP) is a particularly worrisome and potentially lethal form of immune-related adverse events.

•An objective and evidence-based assessment tool for evaluating the severity of CIP is in urgent need. CURB65 (consciousness, urea nitrogen, respiratory rate, blood pressure, and age) is a potential candidate to meet the need.

•A retrospective study was conducted to explore preliminarily if CURB65 could predict the mortality in non-small cell lung carcinoma (NSCLC) patients with CIP. CURB65 accurately stratified the risk of mortality in NSCLC patients with CIP.

•

ØA prospective multicenter study using CURB-65 score to predict CIP mortality rate.

PFO

P：Patients with The immune checkpoint inhibitor-associated pneumonitis (CIP)

F(Prognostic Factor): CURB65   low-CURB65 group（0-1 score)；high-CURB65  group（≥2score）

O: the mortality of CIP.

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A comparative study of the methods and results of intracranial aneurysm embolization using MR vascular wall imaging and routine evaluation preembolization

P: Intracranial aneurysm with embolization

I: Preembolization evaluated by MRVWI combined with routine imaging

C: Preembolization evaluated by routine imaging

O: The result of aneurysm embolization and cerebarl infraction

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The efficacy and safety of Dorzagliatin in combination with GLP-1RAs in adult type 2 diabetes patients

P (Population): Adult patients diagnosed with type 2 diabetes mellitus (T2DM).

I (Intervention): Combination therapy involving GLP-1 Receptor Agonists (GLP-1RAs) and Dorzagliatin which is a glucokinase activator (GKAs) for 3 months.

C (Comparison):  Monotherapy with GLP-1RAs or Dorzagliatin for 3 months.

O (Outcomes):

1.Changes in the efficacy endpoints from baseline to weeks 12: the change of HbA1C level, fasting blood glucose level and 2h-Postprandial blood glucose level, the percentage of patients with HbA1C＜7%, body weight, BMI.

2.The safety profile of the combination therapy, including the incidence of adverse events such as gastrointestinal disturbances, hypoglycemia, hyperlipidemia, hyperuricemia, pancreatitis, the change of liver function and eGFR, as well as other potential side effects.

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How does remote CGA with nutritional and rehabilitation recommendations impact sarcopenia, frailty, nutrition, and ADL in elderly patients aged 60 and above?

PICO :

•Population (P): Elderly patients aged 60 and above

•Intervention (I): Remote Comprehensive Geriatric Assessment with Nutritional and Rehabilitation Recommendations

•Comparison (C): no remote CGA

•Outcome (O): Improvement in sarcopenia, frailty, nutrition status, and ADL

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RCT for DFUs

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Topic: Clinical feature of adult patients of allergic rhinitis and/or asthma with atopic dermatitis history before 2 yearsCross sectional survey, case control

Population adult patients allergic rhinitis and asthma, with AD history before 2 years

Exposure atopic dermatitis before 2 years

Control adult patients allergic rhinitis and asthma, without AD history before 2 years

Outcome Clinical feature including immunologic IgE IgG, diseases onset, seversity

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The association of high energy diet and early onset of gout in young patients.

a case control study

ØP: Young patients with gout

ØI:  High-energy diet

ØC: Young healthy volunteers

ØO: Early onset of gout

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Title: Diagnostic value of pepsinogen combined with gastrin 17 levels in gastric cancer and precancerous lesions

in Chinese health check-up population.

In this study, we evaluated the diagnositc value of pepsinogen (PG) level combined with gastrin 17 (G-17) level for gastric cancer and precancerous lesions based on multi-center data from China.

P(popultation)：Health check-up population in different regions of China

I(Index Test): PG combined G-17 level

R(Reference Test): endoscopy and pathology

O(Outcome): diagnositc value of gastric cancer and precanceous lesions

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Association between Sarcopenia and 1-year Morbidity and Mortality in Elderly Patients Undergoing Elective Endovascular Aortic Aneurysm Repair

PICO:

Population (P): Elderly patients undergoing elective endovascular aortic aneurysm repair;

Intervention (I): Presence of sarcopenia；

Comparison (C): Patients without sarcopenia；

Outcome (O): 1-year morbidity and mortality after EVAR；

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Comparing intrathecal administration of polymyxin B vs. intrathecal plus intravenous combination therapy for the treatment of Carbapenem-resistant Gram-negative bacteria (CRGNB)-induced intracranial infection——  a cohort study 

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Comparing intrathecal administration of polymyxin B vs. intrathecal plus intravenous combination therapy for the treatment of Carbapenem-resistant Gram-negative bacteria (CRGNB)-induced intracranial infection——  a cohort study 

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P: patients with intracranial infection caused by CRGNB,

I: intravaginal administration of polycolistin B (50,000 u, intravaginal administration)

C: intravenous administration (50,000 u, intravaginal plus intravenous polycolistin B)

O: 30-day all-cause mortality ( death within 30 days after the first positive culture of CSF bacteria)

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A Randomized Controlled Trial on the Impact of the Mirena IUD on Reproductive Health and Breast Cancer Recurrence Safety in Patients Undergoing Endocrine Therapy Post Breast Cancer Surgery

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A Randomized Controlled Trial on the Impact of the Mirena IUD on Reproductive Health and Breast Cancer Recurrence Safety in Patients Undergoing Endocrine Therapy Post Breast Cancer Surgery

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Breast cancer is the most common malignancy among women worldwide. Endocrine therapy, such as tamoxifen or aromatase inhibitors, is a cornerstone of maintenance treatment for many breast cancer patients, aiming to reduce recurrence rates and improve survival. However, endocrine therapy is associated with a range of estrogen-related side effects, such as endometrial hyperplasia, menstrual disorders, and an increased risk of endometrial cancer. Managing these reproductive health issues while simultaneously controlling the risk of breast cancer recurrence has become a critical concern for clinicians.

The Mirena IUD (levonorgestrel-releasing intrauterine device) is commonly used for contraception and the treatment of endometrial hyperplasia. It works by releasing local progestin to suppress endometrial growth and reduce menstrual bleeding. However, since the levonorgestrel released by the Mirena is a progestin, its long-term safety in post-breast cancer patients remains unclear.

Under the background, this randomized controlled trial is designed to assess the safety of the Mirena IUD in breast cancer survivors undergoing endocrine therapy, particularly focusing on the impact on breast cancer recurrence risk. Additionally, the study aims to investigate its potential benefits in mitigating endometrial hyperplasia caused by long-term endocrine therapy. This research not only provides scientific evidence for clinical practice but also offers new insights for improving the quality of life for post-breast cancer patients.

PICO:

· P (Population/Problem): Female breast cancer survivors (aged 18-55, sexually active, with previous childbirth and no further fertility needs) undergoing endocrine therapy

· I (Intervention): Placement of the Mirena IUD (levonorgestrel-releasing intrauterine device), with a 5-year follow-up

· C (Comparison):  endocrine therapy alone, with a 5-year follow-up

· O (Outcomes):

o Primary Outcome: Breast cancer recurrence rate

o Secondary Outcomes: Incidence of endometrial hyperplasia, occurrence of menstrual disorders, changes in hormone levels, and improvement in quality of life.

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Retrospective Study of 1-Year Outcomes: Anterior Temporal Lobectomy vs. SelectiveAmygdalohippocampectomy

Bachground

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Retrospective Study of 1-Year Outcomes: Anterior Temporal Lobectomy vs. SelectiveAmygdalohippocampectomy

Bachground

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Retrospective Study of 1-Year Outcomes: Anterior Temporal Lobectomy vs. SelectiveAmygdalohippocampectomy

Bachground

1.       Temporal lobe epilepsy (TLE) is commonly drug-resistant.

2.       Surgical treatments include Anterior Temporal Lobectomy (ATL) and Selective Amygdalohippocampectomy (SAH).

3.       The long-term effects of these surgeries, particularly in terms of seizure control, cognitive outcomes, and quality of life, require further investigation.

purpose：

Compare the 1-year outcomes between ATL and SAH to assess seizure control, cognitive function, and quality of life.

PICO

P (Population):

1.       Patients with drug-resistant TLE.

2.       Inclusion: Age ≥ 18, completed 1-year follow-up.

3.       Exclusion: Other epilepsy types or incomplete data.

I (Intervention):

ATL: Resection of anterior temporal lobe, hippocampus, and amygdala.

C (Control):

SAH: Targeted resection of hippocampus and amygdala, preserving the temporal lobe.

O (Outcomes):

1.       Primary: Seizure control (Engel classification), cognitive function changes (neuropsychological tests).

2.       Secondary: Quality of life (QOLIE-31), surgery-related complications.

Study Type

1.       Retrospective observational study

2.       Data from electronic medical records and follow-up reports.

Implications：

1.       Provides a direct comparison of ATL vs. SAH for drug-resistant TLE.

2.       Informs clinical decision-making regarding the most effective and least cognitively detrimental surgical approach.

3.       Aids in optimizing treatment strategies for improved patient outcomes.

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Investigating the life quality of survivors with/ without standard rehabilitation after extensive burns: a case-controld study

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Investigating the life quality of survivors with/ without standard rehabilitation after extensive burns: a case-controld study

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Treating extensively burned patients can be a challenging task due to the higher mortality and disability. Through a long period of treatment, the victims with severe burns survived and continued to receive the following procedures for preparing to return to society. Among them, some selected professional institutes for rehabilitation, sone returned home for self-help rehabilitation, others gave out the other selections.

P: survivors from extensive burns with the total burn area ≥50%

I: standard burn rehabilitation

C: survivors without standard burn rehabilitation

O: The life quality of survivors.

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Clinical significance of novel neutrophil-based biomarkers in the prediction of disease activity and response to Ustekinumab therapy in Crohn's disesase

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Comparing  efficacy and suicide between depression patients accompany NSSI vs. depression patients without NSSI by antidepressants treatment ——  a cohort study

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Comparing  efficacy and suicide between depression patients accompany NSSI vs. depression patients without NSSI by antidepressants treatment ——  a cohort study

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To evaluate the difference of efficacy and suicidal behavior between depression patients accompany NSSI and without NSSI by antidepressant treatment.

P: Depression patients accompany NSSI

I: Antidepressant treatment

C: Depression patients without NSSI

O: Efficacy and suicide

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Magnetic Resonance Real-Time Thermometry Laser Ablation vs. Anterior Temporal Lobectomy for Hippocampal Sclerosis in Refractory Temporal Lobe Epilepsy: A One-Year Prospective Randomized Controlled Trial

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Magnetic Resonance Real-Time Thermometry Laser Ablation vs. Anterior Temporal Lobectomy for Hippocampal Sclerosis in Refractory Temporal Lobe Epilepsy: A One-Year Prospective Randomized Controlled Trial

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Background:

Temporal lobe epilepsy (TLE) is one of the most common types of focal epilepsy, characterized by recurrent seizures originating from abnormal discharges in the temporal lobe of the brain. Among patients with TLE, hippocampal sclerosis (HS) is the most frequent structural abnormality, typically presenting as hippocampal atrophy and neuronal loss. This leads to poor responses to conventional drug therapy, with around 30%-40% of TLE patients developing refractory epilepsy, meaning their seizures cannot be controlled with medication.

Surgical intervention is an effective treatment for refractory temporal lobe epilepsy, especially in patients with hippocampal sclerosis. The standard procedure, anterior temporal lobectomy (ATL), involves resecting the epileptogenic focus and surrounding abnormal tissue, often resulting in a high rate of seizure control post-surgery. However, ATL is a highly invasive procedure, with associated risks such as postoperative cognitive decline and neurological deficits.

In recent years, magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) has emerged as a minimally invasive alternative treatment. MRgLITT uses laser fibers to heat and ablate the epileptogenic tissue, guided by real-time magnetic resonance thermometry. Compared to traditional ATL, MRgLITT offers the advantages of less invasiveness, quicker recovery, and fewer complications, making it particularly suitable for patients whose epileptogenic focus may be difficult to access via open surgery.

Currently, there is a lack of sufficient prospective randomized controlled trials (RCTs) directly comparing the clinical efficacy and safety of MRgLITT versus ATL in patients with refractory temporal lobe epilepsy caused by hippocampal sclerosis. Therefore, this study aims to design a prospective, two-arm randomized controlled trial to compare these two surgical methods. The study will evaluate key outcomes such as seizure control rates, changes in cognitive function, quality of life improvements, and complication rates, providing valuable evidence for clinical decision-making.

Study Design:

A two-arm, prospective randomized controlled trial (RCT) with stratification based on epilepsy history (>10 years) and gender (male/female).

PICO Framework:

Population (P):

Inclusion criteria:

Adults aged 18-60 years.

Diagnosis of hippocampal sclerosis with refractory temporal lobe epilepsy.

Epilepsy history of >10 years.

Failure of at least two antiepileptic drugs (AEDs).

Candidates for surgical intervention.

Stratified by gender (male and female).

Exclusion criteria:

Non-temporal lobe epilepsy.

Prior brain surgery for epilepsy.

Other structural brain abnormalities.

Significant comorbidities precluding surgery.

Intervention (I):

Magnetic Resonance Real-Time Thermometry-Guided Laser Ablation (MRgLITT):

Minimally invasive laser ablation of epileptogenic tissue in the hippocampus.

MRI thermometry used to guide real-time monitoring of temperature and control ablation area.

Comparison (C):

Anterior Temporal Lobectomy (ATL):

Conventional resective surgery to remove the anterior portion of the temporal lobe, including the hippocampus and amygdala.

Outcomes (O):

Primary outcome:

Seizure freedom rate (Engel class I) at 12 months post-surgery.

Secondary outcomes:

Cognitive outcomes (memory and executive function tests pre- and post-surgery).

Quality of life (measured by QOLIE-89).

Complication rates (e.g., neurological deficits, infections).

Length of hospital stay and recovery time.

Neuroimaging findings (volume of ablated or resected tissue, MRI follow-ups).

Time (T):

12-month follow-up period.

Methodology:

1. Randomization:

Participants will be randomized 1:1 to either the MRgLITT group or the ATL group, with stratification based on gender and epilepsy history (>10 years).

2. Blinding:

This is a single-blinded study where outcome assessors are blinded to the intervention type.

3. Sample Size:

The estimated sample size will be calculated based on power analysis, aiming for 80% power to detect a clinically significant difference in seizure freedom rates between the two groups at 12 months.

4. Data Analysis:

Statistical analysis will compare seizure outcomes, cognitive outcomes, and quality of life between the two groups using intention-to-treat and per-protocol analyses.

Covariate adjustments for gender and epilepsy history will be made.

5. Ethical Considerations:

Informed consent will be obtained from all participants.

The study will be approved by the Institutional Review Board (IRB).

This design allows for a direct comparison between a novel, minimally invasive intervention (MRgLITT) and the standard surgical procedure (ATL) in a carefully selected and stratified patient population.

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The association of high energy diet and early onset of gout in young patients.

a case control study

ØP: Young patients with gout

ØI:  High-energy diet

ØC: Young healthy volunteers

ØO: Early onset of gout