Substitution of Yor1p NBD1 residues improves the thermal stability of Human Cystic Fibrosis Transmembrane Conductance Regulator

The Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) is a plasma membrane chloride channel protein that regulates vertebrate fluid homeostasis. The inefficiency of wild type human CFTR protein folding/trafficking is exacerbated by genetic mutations that can cause protein misfolding in the endoplasmic reticulum (ER) and subsequent degradation. This project investigates small changes in protein sequence that can alter the thermal stability of the large multi-domain CFTR protein. We target a conserved 70-residue α-subdomain located in the first nucleotide-binding domain that hosts the common misfolding mutation ∆F508. To investigate substitutions that can stabilize this domain, we constructed chimeras between human CFTR and its closest yeast homolog Yor1p. The α-subdomain of Yor1p was replaced with that of CFTR in Saccharomyces cerevisiae. Cellular localization of green fluorescence protein-tagged Yor1p-CFTR chimeras was analyzed by fluorescence microscopy and quantitative multispectral imaging flow cytometry, steady-state protein levels were compared by SDS-PAGE and protein function probed by a phenotypic oligomycin resistance assay. The chimeras exhibited ER retention in yeast characteristic of defective protein folding/processing. Substitution of seven CFTR α-subdomain residues that are highly conserved in Yor1p and other transporters but differ in CFTR (S495P/R516K/F533L/A534P/K536G/I539T/R553K) improved Yor1p-CFTR chimera localization to the yeast plasma membrane. When introduced into human CFTR expressed in mammalian cells, the same substitutions improve the purified protein thermal stability. This stabilized human CFTR protein will be directly useful for structural and biophysical studies that have been limited by the thermal sensitivity of wild type CFTR. The insights into critical structural residues within CFTR could facilitate development of effective therapeutics for CF-causing mutations.

Tracing nitrate sources with dual isotopes and long term monitoring of nitrogen species in the Yellow River, China

A heavy load of nitrogenous compounds reflects nutrient loss and influences water quality in large rivers. Nitrogenous concentrations and dual isotopes of nitrate were measured to ascertain the spatial and temporal distributions of nitrate transformation in the Yellow River, the second-longest river in China. Assessment of the long-term record indicates that [NO₃^--N] has increased by two-fold over the past three decades. Weekly observation of ammonium over a twelve-year period revealed high concentrations and suggests impairment of water quality, particularly since 2011. The estimated total dissolved nitrogen flux was 7.2 times higher in middle reaches than that at head waters. Anthropogenic nitrogen sources become more important in lower section of the upper reaches and middle reaches because of intensive agricultural activities and urban input. Nitrate in the lower reaches was mainly derived from transportation of upstream nitrate and point sources from cities. The spatial variation of ammonium and nitrate isotopes show that nitrification is a key process governing nitrogen transformation. Riverine biological processes could potentially be responsible for the shift of nitrate isotope signature. The first step to reducing nitrogen load and improving water quality will be containment and careful management of sources from urban input, sewage waste and irrigation runoff.

[The association between single-nucleotide polymorphisms in IL6, IL10 genes and the susceptibility to primary hepatic carcinoma in Shunde District of Foshan City]

Objective: To investigate the association between single nucleotide polymorphisms (SNP) in cytokine IL6, IL10 genes and the susceptibility to primary hepatic carcinoma(PHC) of Shunde district in Guangdong Province. Methods: Patients from two hospitals in Shunde District of Foshan City were selected from October 2010 to October 2012. Case group inclusion criteria includedprimary liver cancer; local residents of Shunde or living in Shunde for more than 10 years. The control group inclusion criteria included: patients visited ENT, general surgery and physical examination department in the same hospital during the same period; Local residents or living in Shunde for 10 years and above. The control group was matched 1∶1 by gender, and age (±3 years old) with case group. A total of 306 subjects were collected. Questionnaires were used to investigate the information including demographic characteristics, PHC status survey and so on. The venous blood was collected from each subject to extract DNA, and to detect label SNP site and genotype. Hardy-Weinberg equilibrium was detected in the control group by the goodness-of-fit χ(2) test. Multivariate conditional logistic regression was used to estimate the relationship between IL6 (rs1800796), IL10 (rs1800871, rs1800872)genes polymorphisms and susceptibility to PHC. Results: There were 264 males and 42 females both in the case group and the control group, with an average age of (55.84±11.49) and (55.83±11.67) years old respectively (t=0.011, P=0.992). The frequencies of IL6 (rs1800796), IL10 (rs1800871) and IL10 (rs1800872) genotypes in the control group were in accordance with the Hardy-Weinberg equilibrium, which indicated the population was representative (all P values>0.05). Conditional logistic regression analysis showed that compared with the AA genotype and AA+AC genotype of IL10(rs1800872), CC genotype increased the risk of PHC by 2.02 times (OR=3.02, 95%CI:1.21-7.56)and 1.89 times (OR=2.89, 95%CI:1.19-7.04)respectively after the smoking history, eating fish history, drinking history, chronic hepatitis B infection, and family history of liver cancer adjusted. No statistical association was found between SNP in cytokine IL6 (rs1800796) and the susceptibility to PHC (P>0.05). Conclusion: The results indicated that people who carried CC genotype in rs1800872 of IL10 gene have an increasing risk of PHC.

Impacts of hydrologic variations on chemical weathering and solute sources in the Min River basin, Himalayan-Tibetan region

Feedback between hydrologic variations and chemical weathering is thought to play a crucial role in modulating global carbon cycling. The mechanisms associated with the impacts of hydrologic variations on solute sources and chemical weathering were evaluated by examining the relationships between river discharge and hydrochemistry based on high-frequency sampling of the Min River, which originates in the Himalayan-Tibetan region. Fluid transit times and flow pathways vary with changes in discharge, thereby affecting various biogeochemical processes. Although shorter transit times occur during the high-flow season than during the low-flow season, concentrations of chemical weathering products exhibit chemostatic behaviour (less variation than changes in discharge) in response to increasing discharge due to hydrologic flushing of minerals, which increases the amount of reactive mineral surface area. The contributions of various sources to dissolved loads in the Min River were estimated using a forward model. The calculated annual carbonate and silicate weathering fluxes are 24.1 and 9.6 t/km² year, respectively. Atmospheric contributions increase with increasing discharge, whereas the contributions of silicate weathering decrease with increasing discharge. Both the carbonate weathering flux (F_Carb) and silicate weathering flux (F_Sil) are positively correlated with the discharge, indicating that temporal variations in chemical weathering fluxes in the Min River are highly affected by hydrologic variations. The slope of the relationship between F_Carb and discharge is much greater than that between F_Sil and discharge due to the rapid dissolution of carbonate minerals, suggesting that carbonate weathering is more sensitive than silicate weathering to hydrologic variations. This study demonstrates that high-frequency sampling is necessary when investigating solute sources and chemical weathering processes in river basins influenced by a monsoon climate.

Electronic structure of SrSn2As2 near the topological critical point

Topological materials with exotic quantum properties are promising candidates for quantum spin electronics. Different classes of topological materials, including Weyl semimetal, topological superconductor, topological insulator and Axion insulator, etc., can be connected to each other via quantum phase transition. For example, it is believed that a trivial band insulator can be twisted into topological phase by increasing spin-orbital coupling or changing the parameters of crystal lattice. With the results of LDA calculation and measurement by angle-resolved photoemission spectroscopy (ARPES), we demonstrate in this work that the electronic structure of SrSn₂As₂ single crystal has the texture of band inversion near the critical point. The results indicate the possibility of realizing topological quantum phase transition in SrSn₂As₂ single crystal and obtaining different exotic quantum states.

Joint Effects of GWAS SNPs in Coagulation System Confer Risk to Hypertensive Intracerebral Hemorrhage

Recent genome-wide association studies (GWAS) have identified numerous single nucleotide polymorphisms (SNPs) associated with coagulation system, including hemostatic factors and hematological phenotypes. However, few articles described the relationships between these SNPs and the risk of hemorrhagic stroke. The aim of our study was to evaluate the roles of these SNPs as risk factors and survival predictors for hemorrhagic stroke. Thirteen SNPs from GWAS in coagulation system were genotyped in a Chinese Han population including 1000 patients with hemorrhagic stroke (intracerebral hemorrhage, ICH = 743; subarachnoid hemorrhage, SAH = 257) and 1044 population-based controls. The associations between the genetics risk score (GRS) and risk of hemorrhagic stroke as well as post-stroke adverse outcomes were determined. No individual SNP was associated with the risk of hemorrhagic stroke. The GRS was calculated by summing the number of risk alleles of each SNP, and a total of 13 SNPs were included. Meanwhile, the GRS cutoffs values were defined to be close to quartiles or tertiles in control subjects. For quartiles, individuals with GRS about 8-9, 10-11, ≥12 had 1.28 (OR 1.28, 95% CI 0.98-1.68, p = 0.067)-, 1.36 (OR 1.36, 95% CI 1.04-1.79, p = 0.026)-, 1.53 (OR 1.53, 95% CI 1.13-2.07, p = 0.006)-fold increase in ICH risk compared to those with GRS ≤7, respectively; for tertiles, individuals with GRS about GRS 9-10, ≥11 had 0.98 (OR 0.98, 95% CI 0.78-1.23, p = 0.067)- and 1.26 (OR 1.26, 95% CI 1.00-1.59, p = 0.048)-fold increase in ICH risk compared to those with GRS ≤8, respectively. Further stratification analyses indicated that this association was only found in hypertensive ICH subjects. However, no statistical difference was found in the volume of hematoma, activities of daily living scale as well as hospital death in the ICH patients based on GRS values. Joint effects of SNPs associated with low coagulation factor levels might confer risk to ICH patients with hypertension. However, the clinical value on risk stratification and survival prediction was limited.

Cost-effectiveness analysis of fulvestrant versus anastrozole as first-line treatment for hormone receptor-positive advanced breast cancer

Although recent studies demonstrated that fulvestrant is superior to anastrozole as first-line treatment for hormone receptor (HR)-positive advanced breast cancer, the cost-effectiveness of fulvestrant versus anastrozole remained uncertain. Thus, the current study aimed to evaluate the cost-effectiveness of fulvestrant compared with anastrozole in the first-line setting. A Markov model consisting of three health states (stable, progressive and dead) was constructed to simulate a hypothetical cohort of patients with HR-positive advanced breast cancer. Costs were calculated from a Chinese societal perspective. Health outcomes were measured in quality-adjusted life-year (QALY). The incremental cost-effectiveness ratio (ICER) was expressed as incremental cost per QALY gained. Model results suggested that fulvestrant provides an additional effectiveness gain of 0.11 QALYs at an incremental cost of $32,654 compared with anastrozole, resulting in an ICER of $296,855/QALY exceeding the willingness-to-pay threshold of $23,700/QALY. Hence, fulvestrant is not a cost-effective strategy compared with anastrozole as first-line treatment for HR-positive advanced breast cancer.

[Clinicopathologic features of dermal nerve sheath myxoma and neurothekeoma: a comparative study]

Objective: To investigate the clinicopathologic characteristics and differential diagnosis of dermal nerve sheath myxoma (DNSM) and neurothekeoma (NTK). Methods: Clinical, pathological features and immunohistochemical profiles in 9 cases of DNSM and 8 cases of NTK were comparatively studied. The literature was reviewed. Results: The involved site of 9 DNSMs included the hand/fingers (n=3), ear (n=2), face, back, abdominal wall and waist (1 case each). Two of 8 NTKs arose in the forearm (n=2), one each in the nose, lip, shoulder, supraclavicular region, leg and hand. The most common presentation was a painless cutaneous nodule or plaque which grew slowly. Grossly, DNSM was often gelatinous, whereas NTK appeared relatively solid. Microscopically, both tumors were located in the dermis and/or subcutis. DNSM was composed of well-defined multiple lobules separated by fibrous septa. NTK also exhibited lobular or multinodular architecture, but was relatively ill-defined. Besides, fascicular or whorl-like arrangement was present in 3 cases of NTK. The lobules in DNSM consisted of a paucicellular proliferation of spindled, stellate and epithelioid cells forming interconnecting cords within abundant myxoid matrix. Small syncytial-like aggregates were readily noted. The constituted neoplastic cells in NTK were composed of ovoid to round epithelioid or histiocytoid cells. Scattered multinucleated giant cells were present in 2 cases. Based on the amount of myxoid matrix, 8 NTKs were further classified into cellular (5 cases), mixed (2 cases) and myxoid (1 case). By immunohistochemistry, neoplastic cells in DNSM were diffusely positive for S-100 protein, CD68, glial fibrillary acidic protein and SOX10, whereas neoplastic cells in NTK consistently expressed CD10 and microphthalmia transcription factor, with negativity for S-100 protein and SOX10. One patient each with DNSM and NTK experienced local recurrence due to incomplete excision. Conclusions: Although DNSM and NTK share clinical and pathological features, they belong to different entities. Whereas the former is consistent with a peripheral nerve sheath tumor, the latter is more akin to fibrous histiocytic tumor. Familiarity with their cliniopathologic characteristics and distinctive immunophenotypes will help distinguishing these two entities, as well as in the differential diagnosis of cutaneous neoplasms with similar features.

Research on the A549 cell apoptosis mechanism of the nude mouse model using MenSC-sTRAIL

OBJECTIVE

To investigate the inhibitory effect of MenSC-sTRAIL on the apoptosis of A549 cells of lung cancer in a nude mouse model and the relevant molecular mechanism.

MATERIALS AND METHODS

The tumorigenesis curve of A549 cells in the nude mouse model was assayed using the growth curve plotted by the growth rate of tumor of the A549 cell nude mouse model. Cellular apoptosis was assayed using flow cytometer and Annexin V-FITC, and the effect of MenSC-sTRAIL on the expression of Bax was measured using Western blot.

RESULTS

MenSC-sTRAIL promoted the apoptosis of A549 cells. Results of the quantitative assay using Annexin V-FITC further confirmed the effect of MenSC-sTRAIL on inducing the cellular apoptosis. Western-blot results showed that MenSC-sTRAIL increased the expression of Bax.

CONCLUSIONS

MenSC-sTRAIL may vary the balance of regulation of heterodimer of Bcl-2 and Bax, which can induce the apoptosis of A549 cells.

Enhanced superconductivity accompanying a Lifshitz transition in electron-doped FeSe monolayer

The origin of enhanced superconductivity over 50 K in the recently discovered FeSe monolayer films grown on SrTiO₃ (STO), as compared to 8 K in bulk FeSe, is intensely debated. As with the ferrochalcogenides A_xFe_2−ySe₂ and potassium-doped FeSe, which also have a relatively high-superconducting critical temperature (T_c), the Fermi surface (FS) of the FeSe/STO monolayer films is free of hole-like FS, suggesting that a Lifshitz transition by which these hole FSs vanish may help increasing T_c. However, the fundamental reasons explaining this increase of T_c remain unclear. Here we report a 15 K jump of T_c accompanying a second Lifshitz transition characterized by the emergence of an electron pocket at the Brillouin zone centre, which is triggered by high-electron doping following in situ deposition of potassium on FeSe/STO monolayer films. Our results suggest that the pairing interactions are orbital dependent in generating enhanced superconductivity in FeSe.

The origin of superconductivity enhancement in FeSe monolayer grown on SrTiO₃ compared to bulk FeSe is still a debated issue. Here, Shi et al. report a further 15 K jump of T_c accompanying a second Lifshitz transition triggered by electron doping in FeSe/SrTiO₃ monolayer films.

Distinct Evolutions of Weyl Fermion Quasiparticles and Fermi Arcs with Bulk Band Topology in Weyl Semimetals

The Weyl semimetal phase is a recently discovered topological quantum state of matter characterized by the presence of topologically protected degeneracies near the Fermi level. These degeneracies are the source of exotic phenomena, including the realization of chiral Weyl fermions as quasiparticles in the bulk and the formation of Fermi arc states on the surfaces. Here, we demonstrate that these two key signatures show distinct evolutions with the bulk band topology by performing angle-resolved photoemission spectroscopy, supported by first-principles calculations, on transition-metal monophosphides. While Weyl fermion quasiparticles exist only when the chemical potential is located between two saddle points of the Weyl cone features, the Fermi arc states extend in a larger energy scale and are robust across the bulk Lifshitz transitions associated with the recombination of two nontrivial Fermi surfaces enclosing one Weyl point into a single trivial Fermi surface enclosing two Weyl points of opposite chirality. Therefore, in some systems (e.g., NbP), topological Fermi arc states are preserved even if Weyl fermion quasiparticles are absent in the bulk. Our findings not only provide insight into the relationship between the exotic physical phenomena and the intrinsic bulk band topology in Weyl semimetals, but also resolve the apparent puzzle of the different magnetotransport properties observed in TaAs, TaP, and NbP, where the Fermi arc states are similar.

Engineering the Structural and Electronic Phases of MoTe2 through W Substitution

MoTe₂ is an exfoliable transition metal dichalcogenide (TMD) that crystallizes in three symmetries: the semiconducting trigonal-prismatic 2H- or α-phase, the semimetallic and monoclinic 1T^'- or β-phase, and the semimetallic orthorhombic γ-structure. The 2H-phase displays a band gap of ∼1 eV making it appealing for flexible and transparent optoelectronics. The γ-phase is predicted to possess unique topological properties that might lead to topologically protected nondissipative transport channels. Recently, it was argued that it is possible to locally induce phase-transformations in TMDs, through chemical doping, local heating, or electric-field to achieve ohmic contacts or to induce useful functionalities such as electronic phase-change memory elements. The combination of semiconducting and topological elements based upon the same compound might produce a new generation of high performance, low dissipation optoelectronic elements. Here, we show that it is possible to engineer the phases of MoTe₂ through W substitution by unveiling the phase-diagram of the Mo_1-xW_xTe₂ solid solution, which displays a semiconducting to semimetallic transition as a function of x. We find that a small critical W concentration x_c ∼ 8% stabilizes the γ-phase at room temperature. This suggests that crystals with x close to x_c might be particularly susceptible to phase transformations induced by an external perturbation, for example, an electric field. Photoemission spectroscopy, indicates that the γ-phase possesses a Fermi surface akin to that of WTe₂.

Abstract P3-03-14: ERα propelled drug-resistance-facilitating global DNA hypermethylation by promoting the DNMT1 gene expression

This abstract was not presented at the symposium.

Topologically Entangled Rashba-Split Shockley States on the Surface of Grey Arsenic

We discover a pair of spin-polarized surface bands on the (111) face of grey arsenic by using angle-resolved photoemission spectroscopy (ARPES). In the occupied side, the pair resembles typical nearly-free-electron Shockley states observed on noble-metal surfaces. However, pump-probe ARPES reveals that the spin-polarized pair traverses the bulk band gap and that the crossing of the pair at Γ[over ¯] is topologically unavoidable. First-principles calculations well reproduce the bands and their nontrivial topology; the calculations also support that the surface states are of Shockley type because they arise from a band inversion caused by crystal field. The results provide compelling evidence that topological Shockley states are realized on As(111).

Joint Association of Obesity and Hypertension with Disability in the Elderly-- A Community-Based Study of Residents in Shanghai, China

BACKGROUND

Although both obesity and hypertension are known risk factors for disability, the joint association of obesity and hypertension with risk of disability is unknown. This paper is aim to examine the joint association of obesity and hypertension with risk of disability.

METHODS

Cross-sectional study with 8060 elderly community-dwelling individuals participating in the survey initiated by Shanghai Health and Family Planning Commission from March to September 2013. Obesity was measured using the body mass index (BMI) in World Health Organization (WHO) Asia criteria. Hypertension, based on the doctor's diagnosis, was obtained through face-to-face interview. Disability was measured using the self-reported physical self-maintenance scale (PSMS) and the instrumental activities of daily living (IADL) scale developed by Lawton and Brody.

RESULTS

A total of 8.97% of participants reported ADL disability, and 15.18% for IADL disability. After adjusting social demographics and chronic conditions, the risk of ADL disability was progressively greater in obese persons with hypertension (OR=1.40, 95% CI=1.05-1.89), underweight persons without hypertension (OR=2.05, 95% CI=1.29-3.25), and underweight persons with hypertension (OR=2.14, 95% CI=1.36-3.36). For IADL disability, only underweight persons with hypertension were significantly associated (OR=1.65, 95% CI=1.23-2.21).

CONCLUSIONS

Low or extremely high BMI, independent of its metabolic consequences, is a risk factor for disability among the elderly. Simple hypertension wasn't significantly associated with disability. In addition, having hypertension significantly increased the risk of ADL disability in obese individuals and IADL disability in underweight individuals.

Metformin is not just an antihyperglycaemic drug but also has protective effects on the vascular endothelium

Metformin, a synthetic dimethyl biguanide, has been in clinical use for over 55 years, and today is considered the first-choice drug for the treatment of type 2 diabetes used by an estimated 125 million people worldwide. Metformin is orally effective, not metabolized, excreted unchanged by the kidney, relatively free of side effects and well tolerated by the majority of patients. Of importance is that the United Kingdom Prospective Diabetes Study 20-year study of type 2 diabetics, completed in 1998, compared patients treated with insulin, sulfonylureas and metformin and concluded that metformin provided vascular protective actions. Cardiovascular disease is the primary basis for the high morbidity and mortality that is associated with diabetes and that metformin proved to be protective resulted in a dramatic increase in its use. The vascular protective actions of metformin are thought to be secondary to the antihyperglycaemic effects of metformin that are mediated via activation of AMP kinase and subsequent inhibition of hepatic gluconeogenesis, fatty acid oxidation as well as an insulin sensitizing action in striated muscle and adipose tissue. As reflected by a number of clinical studies, patients treated with metformin also have improvement in endothelial function as measured by the use of plethysmography and measurement of flow-mediated vasodilatation. These data as well as data from animal studies are supportive that metformin has a direct protective action on the vascular endothelium. In this review article, we discuss the pharmacology of metformin and critique the literature as to its cellular sites and mechanism(s) of action.

Serum soluble tumour necrosis factor receptor-2 (sTNFR2) as a biomarker of kidney tissue damage and long-term renal outcome in lupus nephritis

OBJECTIVES

We investigated the performance of soluble tumour necrosis factor receptor-2 (sTNFR2) as a biomarker of renal activity, damage, treatment response, and long-term outcome in lupus nephritis (LN).

METHOD

Serum sTNFR2 levels were assessed in 64 LN patients (52 proliferative, 12 membranous) before and after induction treatment, and in 314 non-lupus controls. In LN patients, renal biopsies were performed at baseline and post-treatment. Patients with ≥ 50% reduced proteinuria, normal or improved estimated glomerular filtration rate (eGFR) by ≥ 25%, and inactive urinary sediment were considered clinical responders (CRs). Patients with ≥ 50% improved renal activity index were considered histopathological responders (HRs). Long-term renal outcome was determined using the chronic kidney disease (CKD) stage after a median follow-up of 11.3 years.

RESULTS

sTNFR2 levels were elevated in LN patients versus controls both at baseline (p < 0.001) and post-treatment (p < 0.001), and decreased following treatment (p < 0.001). Baseline sTNFR2 correlated with Chronicity Index scores in both baseline (r = 0.34, p = 0.006) and post-treatment (r = 0.43, p < 0.001) biopsies. In membranous LN, baseline sTNFR2 levels were higher in CRs (p = 0.048) and HRs (p = 0.03) than in non-responders, and decreased only in CRs (p = 0.03). Both baseline (p = 0.02) and post-treatment (p = 0.03) sTNFR2 levels were associated with decreasing eGFR throughout long-term follow-up, and post-treatment levels were higher in patients with long-term follow-up CKD stage ≥ 3 versus 1-2 (p = 0.008).

CONCLUSIONS

Our data suggest serum sTNFR2 as a marker of kidney tissue damage and a predictor of long-term prognosis in LN, and merit further evaluation of sTNFR2 as a predictor of clinical and histopathological treatment outcomes in membranous LN.

Chinese Internet Searches Provide Inaccurate and Misleading Information to Epilepsy Patients

Background:

Most patients with epilepsy want to learn as much as possible about the disease, and many have turned to the internet for information. Patients are likely to use information obtained from the internet to control their epilepsy, but little is known about the accuracy of this information. In this survey, we have assessed the feasibility and usability of internet-based interventions for the treatment of epilepsy.

Methods:

Data were collected from an internet search. Different search terms were used to obtain general information on epilepsy together with information about medication, types of epilepsy, treatment, women's health, and other information. The accuracy of the information was evaluated by a group of experts.

Results:

A total of 1320 web pages were assessed. The majority were websites related to health. A large number (80.2%) of web pages contained content related to the search term. A significant number of web pages 450/1058 (42.5%) claimed to provide information from a credible source; however, only 206/1058 (19.5%) of the information was accurate and complete; 326/1058 (30.8%) was accurate but incomplete; 328/1058 (31.0%) was correct but nonstandard, and 198/1058 (18.8%) was inaccurate. The authenticity of the information was not significantly different between the two search engines (χ² = 0.009, P = 0.924). No significant difference was observed in the information obtained from a specialist or nonspecialist source (χ² = 7.538, P = 0.057). There was also no correlation between the quality of the information and the priority (χ² = 6.880, P = 0.076).

Conclusions:

Searching for information about epilepsy on the internet is convenient, but the information provided is not reliable. Too much information is inaccurate or for advertisement purposes, and it is difficult for patients to find the useful information. Turning to the internet for medical knowledge may be harmful. Physicians should be aware that their patients may search for information on the internet and guide them to safe, reputable websites.