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Asymmetric cortical vessel sign (ACVS) on susceptibility-weighted imaging (SWI) indicates elevated concentration of deoxyhemoglobin and elevated oxygen extraction fraction in patients with cerebral ischemia. This study aimed to clarify whether ACVS is associated with impaired hemodynamics and hyperperfusion syndrome in patients with moyamoya disease (MMD).Consecutive adult patients with MMD were enrolled. ACVS data on SWI and perfusion data using dynamic perfusion computed tomography were obtained and evaluated preoperatively and on postoperative days 2 and 180.A total of 24 patients with MMD were enrolled. Of 11 (45.83%) patients showing positive ACVS before surgery, 8 turned negative on postoperative day 2 and 9 showed absence of ACVS 180 days after surgery. Regions of interest showing positive ACVS had lower cerebral blood flow (CBF, P0.001), increased cerebral blood volume (P = 0.021), prolonged time to peak (P0.001), and mean transit time (P = 0.009). No patients with hemorrhagic symptoms showed positive ACVS(P = 0.041) and patients with positive ACVS showed more increase in CBF (P0.004).In patients with MMD, ACVS on SWI indicates severe impairment in hemodynamics and is associated with more increase in CBF after bypass surgery. Hence, ACVS on SWI might be considered as a neuroimaging marker for the evaluation of hemodynamics in patients with MMD.

BACKGROUND It is challenging to distinguish intestinal tuberculosis from Crohn’s disease due to dynamic changes in epidemiology and similar clinical characteristics. Recent studies have shown that polymorphisms in genes involved in the interleukin (IL)-23/IL-17 axis may affect intestinal mucosal immunity by affecting the differentiation of Th17 cells. AIM To investigate the specific single-nucleotide polymorphisms (SNPs) in genes involved in the IL-23/IL-17 axis and possible pathways that affect susceptibility to intestinal tuberculosis and Crohn's disease. METHODS We analysed 133 patients with intestinal tuberculosis, 128 with Crohn’s disease, and 500 normal controls. DNA was extracted from paraffin-embedded specimens or whole blood. Four SNPs in the IL23/Th17 axis (IL22 rs2227473, IL1β rs1143627, TGFβ rs4803455, and IL17 rs8193036) were genotyped with TaqMan assays. The transcriptional activity levels of different genotypes of rs2227473 were detected by dual luciferase reporter gene assay. The expression of IL-22R1 in different intestinal diseases was detected by immunohistochemistry. RESULTS The A allele frequency of rs2227473 (P = 0.030, odds ratio = 0.60, 95% confidence interval: 0.37-0.95) showed an abnormal distribution between intestinal tuberculosis and healthy controls. The presence of the A allele was associated with a higher IL-22 transcriptional activity (P < 0.05). In addition, IL-22R1 was expressed in intestinal lymphoid tissues, especially under conditions of intestinal tuberculosis, and highly expressed in macrophage-derived Langhans giant cells. The results of immunohistochemistry showed that the expression of IL-22R1 in patients with Crohn's disease and intestinal tuberculosis was significantly higher than that in patients with intestinal polyps and colon cancer (P < 0.01). CONCLUSION High IL-22 expression seems to be a protective factor for intestinal tuberculosis. IL-22R1 is expressed in Langhans giant cells, suggesting that the IL-22/IL-22R1 system links adaptive and innate immunity.

Objective The aim of this study is to detail the background, training, and career of Dr. Georgette Kidess, the first and still the only female neurosurgeon in Palestine. In addition, we mention the obstacles that women face during their neurosurgical career and how to overcome them. Also, we discuss different methods to attract female medical students to neurosurgery. Methods Information was gathered only from direct face-to-face interviews with Dr. Kidess. Results Georgette Kidess was born on May 2, 1952, in Nablus, Palestine. She received the degree of Doctor of Medicine (M.D.) at Eberhard Karls Universitat, Tubingen, Germany in 1979. She worked as a neurosurgeon at the Hadassah EinKarem Hospital in Jerusalem and subsequently established the first neurosurgical department at the Ramallah Governmental Hospital in Ramallah in 1986. Thereafter, she has continued a career in private practice, currently at Saint Luke's Hospital, Nablus. Dr. Kidess played a major part in establishing neurosurgery in Palestine. She was among the founders of the Palestinian Neurosurgical Society in 2014. Conclusions In this article, we recount Dr. Kidess's contributions and achievements to neurosurgery in Palestine. Her commitment, persistence, and diligence enabled her to overcome great odds and become the first female neurosurgeon in Palestine. We hope that her story will inspire and open the doors for subsequent women to enter and enhance neurosurgery, especially in the Middle East.

Magnesium phosphate cements (MPCs) are clinker-free materials using a blend of calcined magnesium oxide and hydrophosphates, together with specific additives and fillers in most cases, generally binding through both acid-base and hydration reactions. In the past decades, especially the last 20 years, MPCs have made major strides in the aspects of theoretical research, laboratory investigation and field application. This chapter briefly reviews that evolution of MPCs, and presents the general compositions, theories, and technologies with an emphasis on recent development and applications. Much of the focus is on the comprehension of the role of key components in fabricating MPCs, the elaboration of reaction theory and hydration behaviors, the exploitation of unique properties, and the improvement of applicability. Some cases that MPCs have been and are being developed as rapid-setting cements for structure repair and reinforcement, hazardous and radioactive waste stabilization, biomedical applications, and other potential usages, are also introduced in the end of the chapter. It is hoped that the fundamental information and key findings reported will lead to wider curiosity in MPCs and further research and development in this field.

A series-fed linear substrate-integrated dielectric resonator antenna array (SIDRAA) is presented for millimeter-wave applications, in which the substrate-integrated dielectric resonator antenna (SIDRA) elements and the feeding structure can be codesigned and fabricated using the same planar process. A prototype 4 × 1 SIDRAA is designed at Ka-band and fabricated with a two-layer printed circuit board (PCB) technology. Four SIDRAs are implemented in the Rogers RT6010 substrate using the perforation technique and fed by a compact substrate-integrated waveguide (SIW) through four longitudinal coupling slots within the Rogers RT5880 substrate. The return loss, radiation patterns, and antenna gain were experimentally studied, and good agreement between the measured and simulated results is observed. The SIDRAA example provides a bandwidth of about 10% around 34.5 GHz for 10 dB return loss and stable broadside radiation patterns with the peak gain of 10.5–11.5 dBi across the band.

Dendritic cell (DC) plays an important role in the immune response against pulmonary tuberculosis. However, the phenotypic profile of DC subsets in peripheral blood in individuals with active pulmonary tuberculosis (APT) is still inconclusive. Here, we demonstrated that the absolute numbers of total DC (tDC), myeloid DC (mDC) and plasmacytoid DC (pDC) in individuals with APT were decreased compared to healthy controls (HCs). The decreased number of DCs, especially of pDC, seems to be a useful diagnostic marker of APT. Meanwhile, the number of DCs was associated with the prolonged/complicated TB, ATD treatment effect and lymphocyte immune reactions, as manifested that relapsed APT patients with a higher number of tDC and lower number of pDC compared to newly diagnosed patients. Interestingly, mDC from APT patients displayed high expressions of CD83 and CCR7, but pDC displayed low expressions of CD83 and CCR7. Moreover, DCs from APT patients expressed lower levels of HLA-DR and CD80, but expressed a higher level of CD86 than those from HCs. However, the antigen uptake capacity of DC subsets was not different between APT and HCs, despite the antigen uptake capacity of pDC was much lower than that of mDC in both APT patients and HCs. Our data represent a systematic profile of DC subsets in the blood of APT patients, and would represent a useful biomarker for APT.

Roles of human IL-37 in infections remain poorly characterized. Although plasma IL-37 is elevated in patients with tuberculosis (TB), IL-37 source and immune correlate in TB have not been investigated. It is also unknown whether and how TB can influence the ability of immune cells to mount innate responses of IL-37 and pre-inflammatory cytokines. Here, we demonstrated that IL-37b-producing monocytes coincided with a source of elevated plasma IL-37b in TB patients. While IL-37b production in TB was associated with prolonged/complicated TB, TB burdens and inflammatory reactions, it negatively correlated with immune responses of pro-inflammatory cytokines IL-1β, IL-6 and TNF-α or IL-10. Interestingly, mycobacterial re-infection of monocytes from TB patients, but not healthy BCG-vaccinated controls, enhanced or sustained IL-37b production by cultured monocytes. TB-sensitized monocytes from TB patients mounted more robust immune responses of IL-37b than those of pre-inflammatory cytokines during mycobacterial re-infection in culture. Our data represent new findings in terms of IL-37b responses, immune correlates and potential mechanisms in TB patients.

High hemoglobin (HGB) concentration is frequently seen in Tibetans in clinical practice; however, the impact on postsurgical prognosis in patients with poor-grade aneurysmal subarachnoid hemorrhage (aSAH) is not precisely known. Thus, we sought to understand the association between high HGB level and postoperative outcome in Tibetans with poor-grade aSAH.Results of clipping in consecutive Tibetan patients with poor-grade aSAH were analyzed retrospectively for the period January 2012 to January 2017. Based on the upper limit (160g/L) of normal hemoglobin levels, patients were divided to a high (HHC) and a normal (NHC) HGB-level cohort according to the first routine blood result on admission. Propensity score matching was used for baseline matching in the 2 cohorts. Postoperative complications in the 2 groups were compared. Prognosis after ictus, including 6-month neurological functional status and mortality at 30 days and 6 months were also assessed.Risk of ischemia, pulmonary embolism and lower-limb deep venous thrombosis (DVT) was higher in HHC than NHC (62.88% vs. 21.64%; P0.001; 10.30% vs. 1.31%, P0.005; 24.74% vs. 7.21%, P0.001, respectively). Hospital stay also differed significantly (15.82±3.86 vs. 10.37±4.80 days; P0.001). Out of the 194 patients, 150 survived at 6 months. At 6-month neurological functional follow-up, 8 NHC patients had favorable modified Rankin scale (mRS) scores ≤2 at discharge, versus only 1 HHC patient, showing better outcome in NHC than HHC (8.25% vs. 1.03%; P=0.035). In-hospital mortality was significantly greater in HHC than NHC (17.52% vs. 7.22%; P=0.029). 30-day post-ictus mortality was 30.93% in HHC versus 14.43% in NHC (P0.006). There was also a significant difference in mortality at 6 months post-ictus (47.42% vs. 18.56%; P0.001).High HGB level was associated with increased risk of postsurgical cerebral ischemia, pulmonary embolism and lower-limb DVT and poor prognosis in poor-grade aSAH patients. Preoperative hemodilution therapy might be beneficial in reducing operative complications, reducing hospital stay and improving short-term prognosis for neurological functional recovery in aSAH patients with high HGB concentration, but further detailed research is needed.

The occurrence of intracerebral hemorrhage (ICH) costs long-standing neurologic deficits in ICH survivors, elderly ones in particular. Recent researches have proved rejuvenating effect of Growth Differentiation Factor 11 (GDF11) in improving multiple systemic diseases on old individuals. Thus, we designed this study to explore the neuroprotective effect and mechanisms of GDF11 in elderly ICH. 45 aged male Sprague-Dawley (SD) rats were randomly divided into sham + vehicle, ICH + vehicle and ICH + rGDF11 groups. ICH models were induced via injection of autologous whole blood into right basal ganglia of rats. ICH rats were given a daily injection of either recombinant (r) GDF11 at 0.1 mg/kg or vehicle for 28 days prior to operation and continued till the experiment completed. Neurological deficits, brain edema, cell apoptosis, microglial activation and heme oxygenase-1 (HO-1) positive cells were compared among each group. In addition, cytochrome c release, mitochondrial calcium buffering capacity and ATP level were monitored to explore the level of mitochondrial injury. Seen in the result, behavior disorders, severe perihematomal edema, inflammation, apoptosis, oxidative stress and mitochondria damage indicated a significant increase in ICH + vehicle group. While in ICH + rGDF11 group, administration of rGDF11 successfully reduced neurological deficits and alleviated ICH-induced edema, inflammation, apoptosis, oxidative stress, and mitochondria damage in perihematomal tissues. Collectively, our study showed that GDF11 ameliorated ICH-induced neurological deficits in elderly individuals via reducing perihematomal edema, apoptosis, inflammatory reaction, oxidative stress and improving mitochondrial dysfunction, indicating neuroprotective effect of GDF11 in elderly ICH.

This paper proposes a kind of low-profile substrate integrated dielectric resonator antenna array (SIDRAA) for millimeter-wave applications, which composed of eight SIDRA elements and a co-designed substrate integrated waveguide (SIW) feeding structure. A 4 x 2 SIDRAA is designed and simulated in Ka-band employing the substrate of Rogers RT6010 and RT5880. The performances of the array were examined in respect to its impedance matching, radiation performances of the patterns and gain. The 4 x 2 SIDRAA prototype exhibits a 10-dB impedance bandwidth of around 8.4% from 32.9 to 35.8 GHz, and it shows an average gain of 12.8 dBi with the broadside radiation patterns. The proposed SIDRAA is lost cost, compact size, high reproducibility, and easy accommodation to other circuits.

A kind of low-profile substrate integrated dielectric resonator antenna (SIDRA) is presented in this paper. The SIDRAs can be implemented with a two-layer printed circuit board (PCB) process conveniently, in which the integrated dielectric resonators are fabricated in the top layer and fed by the compact substrate integrated waveguide (SIW) through the transverse coupling slots within the bottom layer. The prototypes exhibit good radiation performances in Ka band, and the 10-dB bandwidth can be easily extended from around 12% to 25% with stable broadside radiation patterns. These antennas show the advantages of low profile, high radiation efficiency, easy manufacture, etc.

A $4\times 1$ substrate integrated dielectric resonator antenna array (SIDRAA) is presented for Ka-band application, in which the substrate integrated dielectric resonator antenna (SIDRA) elements and the feeding structure can be codesigned using a two-layer printed circuit board (PCB) process. Four SIDRAs are designed in the Rogers RT6010 substrate using the perforation technique and fed by a compact substrate integrated waveguide (SIW) through four longitudinal coupling slots within the Rogers RT5880 substrate. The return loss, radiation patterns, and antenna gain were studied. The SIDRAA provides a bandwidth of about 10% around 34.5 GHz for 10 dB return loss and stable broadside radiation patterns with the simulated gain of11.2 –12.5dBi across the band.

Brainstem ganglioglioma is rarely reported. Due to its low incidence and atypical site, a brainstem ganglioglioma could easily be misdiagnosed as occurs with other pathological neoplasms radiologically. Here, we report an 8-year-old girl with a brainstem tumor confirmed as a ganglioglioma based on postoperative pathology results. We suggest that when a tumor located in the lower brainstem with benign radiological characteristics occurs in a child with a long-term history, the possibility of brainstem ganglioglioma should be considered in the preoperative diagnosis in addition to other low-grade neoplasms. Early stage diagnosis of brainstem ganglioglioma based on the clinical and imaging features is valuable for clinicians in order to perform effective treatment and achieve a good prognosis.

Object To investigate the imaging features of cavernous sinus cavernous hemangioma (CSCH) and evaluate the therapeutic effect of Gamma Knife radiosurgery (GKRS) in treatment of CSCH. Methods and materials Fifteen patients with CSCH treated by GKRS in our institute, including 6 males and 9 females, age range 20–77 years old, were analyzed retrospectively. Three of them were given craniotomies as the initial therapy. All cases had performed conventional and contrast-enhanced MRI and 5 patients underwent dynamic enhanced MRI preoperatively. In 6 cases, the multi-directional continuous data of axial, coronal and sagittal enhanced MRI were acquired. Three cases performed digital subtraction angiography (DSA) simultaneously. The diagnoses of lesions were determined mainly depending on typical imaging features. In 3 patients, the diagnoses of CSCH were confirmed histopathologically. The radiation dosimetry was done with a goal of conformal and selective coverage of the lesion with a 50% prescription isodose line. The mean marginal dose constituted 13.4 Gy (range 10–16 Gy). After GKRS was performed, all patients were arranged regular clinical and MRI follow-up every 6 months during the first 12 months, and once per year thereafter. Results On MRI, the lesions were typically demonstrated as iso/hypo-intensities on T1WI and remarkable hyper-intensities on T2WI, and apparent homogeneous enhancement. The phenomenon of dynamic enhancement was found in 11 cases. The progressive enhancing process from heterogeneous to uniform was displayed in the 5 patients performed same-slice dynamic MRI, including imaging characteristics of ‘edge to center’ enhancement in 2 case. In the other 6 cases, the delayed homogeneous enhancement of lesion was observed. Ten patients obtained radiological follow-up results after GKRS. Reviewing the follow-up data of 8 patients during the period of 3–6 months, the lesions were apparently shrunk in 5 patients with shrinkage rate of 20.8–46.8%. In 4 patients with imaging follow-up during the period of 6–12 months, the lesions of 3 patients were remarkably shrunk with shrinkage rate of 53.5–81.7%. Four patients had imaging follow-up data over 12 months, and all their lesion sizes were reduced with shrinkage rate of 19–83.6%. The clinical presentations of all patients after GKRS were followed up during the period of 1–30 months. In 7 of 9 cases with headache, the symptom was improved; in 5 of 6 cases, facial hypesthesia was improved; in 6 of 9 cases with visual impairments, the visions were markedly improved; and in 8 cases with preoperative diplopia, the symptoms were all resolved. Conclusion Although bright hyper-intensities on T2WI and significant homogeneous enhancement on contrast-enhanced T1WI are considered as typical imaging characteristics of CSCH, the dynamic process of progressive delayed enhancement on contrast-enhanced MR is more persuasive in diagnosis. According to our study, GKRS could be chosen as an effective and safe alternative treatment for CSCH. We consider that using relatively low marginal dose may get better effects in tumor shrinkage and protection of cranial nerves.

The band structures, density of states, and absorption spectra of pure and Cd doped single-walled (8, 0) ZnO nanotubes are calculated using first-principles based on density functional theory. The calculation results show that the import of Cd leads a remarkable decrease to the forbidden bandwidth of ZnO. Consequently, more electrons in the valence band can be motivated to the conduction band by the visible light, which results in a further enhancement of visible light absorption and a wider absorption range.

A broadband substrate integrated dielectric resonator antenna (BSIDRA) is presented and investigated experimentally. The proposed BSIDRA consists of a substrate integrated dielectric resonator (SIDR) fed by a substrate integrated waveguide with an exciting slot. Dual resonances of the SIDR and the exciting slot radiator are merged to expand the antenna bandwidth. To validate the proposed concept, a prototype antenna is designed at Ka-band and fabricated with two different substrates using printed circuit board process. The return loss, radiation patterns, and antenna gain are studied, and good agreement between the measured and simulated results is observed. The proposed BSIDRA provides a bandwidth of about 25% around 35 GHz for 10 dB return loss and stable broadside radiation patterns with an average gain of 4.6 dBi across the band.

Recent studies suggest that tumor-associated macrophage-produced IL-6 is an important mediator within the tumor microenvironment that promotes tumor growth. The activation of IL-6/STAT3 axis has been associated with chemoresistance and poor prognosis of a variety of cancers including colorectal carcinoma and thus serves as a potential immunotherapeutic target for cancer treatment. However, it is not fully understood whether anticytokine therapy could reverse chemosensitivity and enhance the suppressive effect of chemotherapy on tumor growth. In this study, we aimed to investigate the effect of IL-6 inhibition therapy on the antitumor effect of carboplatin. Enhanced expression of IL-6 and activation of STAT3 were observed in human colorectal carcinoma samples compared to normal colorectal tissue, with higher levels of IL-6/STAT3 in low grade carcinomas. Treatment of carboplatin (CBP) dose-dependently increased IL-6 production and STAT3 activation in human colorectal LoVo cells. Blockade of IL-6 with neutralizing antibody enhanced chemosensitivity of LoVo cells to carboplatin as evidenced by increased cell apoptosis. IL-6 blockade abolished carboplatin-induced STAT3 activation. IL-6 blockade and carboplatin synergistically reduced cyclin D1 expression and enhanced caspase-3 activity in LoVo cells. Our results suggest that inhibition of IL-6 may enhance chemosensitivity of colon cancers with overactive STAT3 to platinum agents.

Meningiomas are one of the most common clinical entities in everyday neurosurgical practice. Most meningiomas are extra-axial dural-based lesions. They typically occur along intradural venous sinuses, at the confluences of multiple cranial sutures and also others sites where arachnoid granulations and arachnoid cell rests occur. Most of these tumors also do occur within the lateral ventricles than third ventricle but they are exceptional in fourth ventricle thought to arise from the choroid plexus without dural attachment. Here we present two cases of fourth ventricle meningiomas.

The optimal solution of a multi-objective optimization problem (MOP) corresponds to a Pareto set that is characterized by a tradeoff between objectives. Genetic Pareto Set Identification Algorithm (GPSIA) proposed for reliability-redundant MOPs is a hybrid technique which combines genetic and heuristic principles to generate non-dominated solutions. Series–parallel system with active redundancy is studied in this paper. Reliability and cost were the research objective functions subject to cost and weight constraints. The results reveal an evenly distributed non-dominated front. The distances between successive Pareto points were used to evaluate the general performance of the method. Plots were also used to show the computational results for the type of system studied and the robustness of the technique is discussed in comparison with NSGA-II and SPEA-2.

Overall scheme for large-aircraft Intelligence Virtual Maintenance Training System (IVMTS) information model which integrates the Standard for the Exchange of Product model data (STEP) standard geometric model with agent model is presented in this paper. Firstly, the system multi-agent model architecture are constructed. Secondly, Integrated STEP standard geometric model with agent model and maintenance applying information, the maintenance object agent IP(intelligence part) ,IB(intelligence body) and IT(intelligence tool) are constructed utilizing the EPRESS-G language. Thirdly, the communication method between components and system level agents is presented based on Blackboard model each other. Finally, how to realize the model under catia-caa secondary development method is described, and the intelligence maintenance process simulation, maintenance of the elements of the intelligent interaction, intelligence collision detection and maintenance sequence optimization simulation can be realized in this method in IVMTS.

ObjectAn extensive sacrococcygeal chordoma is considered a challenge for neurosurgeons. Because of the complex anatomy of the sacral region, the risk of uncontrollable intraoperative hemorrhage, and the typically large tumor size at presentation, complete resections are technically difficult and the tumor recurrence rate is high. The aim of this study was to assess the value of using occlusion of the abdominal aorta by means of a balloon dilation catheter and electrophysiological monitoring when an extensive sacrococcygeal chordoma is removed.MethodsBetween 2004 and 2008, 9 patients underwent resection of extensive sacrococcygeal chordomas in the authors' department with the aid of occlusion of the abdominal aorta and electrophysiological monitoring. All of these operations were performed via the posterior approach. The records of the 9 patients were reviewed retrospectively.ResultsWide resections were performed in 6 cases and marginal excisions in the other 3. Five patients underwent postoperative radiotherapy. Intraoperative hemorrhage was controlled at 100–400 ml. Postoperatively, none of the patients had any new neurological dysfunction, and 2 patients regained normal urinary and bowel function. The mean follow-up period was 31.4 months (range 10–57 months). No patient developed local recurrence or had metastatic spread of tumor during follow-up.ConclusionsOcclusion of the abdominal aorta and electrophysiological monitoring are useful methods for assisting in resection of sacrococcygeal chordoma. They can reduce intraoperative hemorrhage and entail little chance of tumor cell contamination. They can also help surgeons to protect the organs in the pelvic cavity and neurological function. Use of these methods could give patients better quality of life.

Objective The aim of this study was to develop a feasible approach to promote bone healing in osteoporotic rats using autogenous bone tissue-engineering and gene transfection of human bone morphogenetic protein 2 (hBMP-2). Methods Bone marrow stromal cells (BMSCs) from the left tibia of osteoporotic rats were transfected with the hBMP-2 gene in vitro which was confirmed by immunohistochemistry, in situ hybridization and Western blotting. Autogenous transfected or untransfected BMSCs were seeded on macroporous coral hydroxyapatite (CHA) scaffolds. Each cell-scaffold construct was implanted into a defect site which was created in the ramus of the mandible of osteoporotic rats. Four or eight weeks after implantation in situ hybridization was performed in BMSCs transfected with hBMP-2, X-ray examinations, histological and histomorphological analyses were used to evaluate the effect of tissue-engineered bone on osseous defect repair. Results Newly formed bone was observed at the margin of the defect 4 weeks after implantation with BMSCs transfected with BMP-2. Mature bone was observed 8 weeks after treatment. In the control group there was considerably less new bone and some adipose tissue was observed at the defect margins 8 weeks after implantation. Conclusions Autogenous cells transfected with hBMP-2 promote bone formation in osteoporotic rats. BMSC-mediated BMP-2 gene therapy used in conjunction with bone tissue engineering may be used to successfully treat bone defects in osteoporotic rats. This method provides a powerful tool for bone regeneration and other tissue engineering.

By virtual reality technology and ergonomics theory, a basic method of ergonomic analysis on virtual maintenance of civil airplane is herein presented based on DELMIA modeling tool. The method is characterized by two steps: (1) establish the appraisal indexes of ergonomics on virtual maintenance of civil airplane; (2) give a quite complete ergonomic analysis and confirmation system flow chart. By defining maintenance cases and simulating the virtual maintenance process under the DELMIA platform, it is possible to accomplish the ergonomic analysis and evaluation with respect to the ergonomics indexes. The strengths of this method are in its ability to provide the available data and experience for further ergonomic design research and in its broadly applicable 3-D digital human model well suited for computer simulation. Furthermore, because the ergonomic analysis problem in maintainability design is indeed a simulation and confirmation process, the use of simulation techniques and confirmation techniques in this work lends itself to maintainability concurrent design of civil airplane. The ergonomic analysis method is demonstrated using vision analysis as an example.

Complex multiple arteriovenous fistula (AVF) of the scalp is an extremely rare disease and the traditional treatment is either endovascular embolization or surgical resection with preoperative endovascular embolization. Here, a 34-year-old male with pulsating mass and multiple tortuous vessels in front of the left tragus and scalp who was diagnosed as complex multiple arteriovenous fistula of the scalp is presented. Nearly total surgical resection of the lesion without preoperative intervention was performed. The deformity appearance and the buzzing sound in the patient's left ear were eradicated after operation. Therefore, surgical resection without preoperative embolization is still a promising method to treat complex multiple scalp AVF.

AIM To evaluate the utility of 3D-magnetic resonance cisternography(MRC) of posterior cranial fossa in visualizing trigeminal neurovascular compression in patients with trigeminal neuralgia. MATERIAL AND METHODS 146 consecutive patients in the period from June 2010 to July 2011 in our institute diagnosed with trigeminal neuralgia underwent MRC on the posterior cranial fossa. MR devices used for MRC included two sets of 3.0 tesla and one set of 1.5 tesla. The hydrography sequences for MRC included 3D-SPACE and 3D-DRIVE. RESULTS In total, 75 patients (51.4%) were found with trigeminal neurovascular compression on MRC. Among them, 25 patients underwent microvascular decompression. Intraoperatively, 20 patients (80%) had related arteries consistent with imaging manifestations on MRC. Nevertheless, the arterial compression combined with petrosal vein could not be identified on MRC in 3 of the 20 patients. In the inconsistent 5 cases, the involved vessels were confirmed as superior petrosal veins during the surgery. CONCLUSION 3D-MRC has prominent clinical value in determining the trigeminal neurovascular compression and identifying the related vessels. However, MRC does have certain limitations on identifying petrosal vein compression.

The aim of this study is to describe the sequential software processing of computed tomography (CT) dataset for reconstructing the finite element analysis (FEA) mandibular model with custom-made plate, and to provide a theoretical basis for clinical usage of this reconstruction method. A CT scan was done on one patient who had mandibular continuity defects. This CT dataset in DICOM format was imported into Mimics 10.0 software in which a three-dimensional (3-D) model of the facial skeleton was reconstructed and the mandible was segmented out. With Geomagic Studio 11.0, one custom-made plate and nine virtual screws were designed. All parts of the reconstructed mandible were converted into NURBS and saved as IGES format for importing into pro/E 4.0. After Boolean operation and assembly, the model was switched to ANSYS Workbench 12.0. Finally, after applying the boundary conditions and material properties, an analysis was performed. As results, a 3-D FEA model was successfully developed using the softwares above. The stress-strain distribution precisely indicated biomechanical performance of the reconstructed mandible on the normal occlusion load, without stress concentrated areas. The Von-Mises stress in all parts of the model, from the maximum value of 50.9MPa to the minimum value of 0.1MPa, was lower than the ultimate tensile strength. In conclusion, the described strategy could speedily and successfully produce a biomechanical model of a reconstructed mandible with custom-made plate. Using this FEA foundation, the custom-made plate may be improved for an optimal clinical outcome.

Myeloid sarcoma initially occurring in the sacral canal is often misdiagnosed as other pathological tumors on MRI due to the lack of a definite history or clinical evidence of granulocytic leukemia. Here, we report a case of 24-year-old male patient with myeloid sarcoma misdiagnosed radiologically. On MRI, sacral myeloid sarcoma is characterized by homogeneous signal intensity, marked enhancement, and the lack of cystic degeneration, calcification and necrosis. Based on our study of this patient and review of the relevant literature, we believe that these MRI features in the sacral region may help us differentiate it from other pathological tumors, which could prompt further clinical examinations to confirm the diagnosis of granulocytic leukemia.

Aim To provide a quick evaluation of rebleeding risk based on the on-admission patient information and to guide the management of patients for better outcome. Material and methods A retrospective review of 630 consecutive cases of subarachnoid hemorrhage (SAH) at a major medical center was conducted, of which 458 were included for analysis. Sixty three cases of in-hospital pre-intervention rebleeding were identified. Chi-square or Mann-Whitney tests were used to screen for possible risk factors and values of the associated risk factors were assessed by logistic multivariate regression. Results The identified risk factors were: short time interval between the first attack and hospitalization, gender (males were more susceptible), poor Hunt-Hess grade (III~V), high systolic pressure ( > 140 mmHg), intracerebral or intraventricular hematoma, high level of serum glucose ( > 6.32 mmol/L) and high white blood cell count ( > 12 x 10^9/L). Use of antifibrinolysis medication did not differ between groups. Subgroup analysis showed that posterior circulation aneurysms had a significantly higher rebleeding rate. Logistic regression analysis showed that intracerebral or intraventricular hematoma (p=0.010, OR=1.478) and blood glucose level above 6.32 mmol/L (p=0.011, OR=2.126) were independent risk factors. Conclusion We found a particularly high risk of rebleeding in patients with intracerebral or intraventricular hematoma or relatively high serum glucose level on admission. Posterior circulation aneurysms rebleed seemed more prominently manifested. An earlier and more aggressive intervention may be applied to patients at high risk.

We describe a patient presented with sequential events of hemifacial spasm, cerebral infarction and fatal subarachnoid hemorrhage. All of them are seemingly separate entities. Radiological examination revealed that the cause was vertebrobasilar dolichoectasia (VBD) coexisting with a giant saccular aneurysm of basilar artery. VBD is a dilatation and elongation of vertebral artery (VA) and basilar artery (BA) which is of different mechanism from saccular aneurysm. The condition is very rare and its progression may result in compression of brainstem and cranial nerves, ischemic and/or hemorrhagic stroke. The treatment of such condition is difficult and further research on the risk stratification of VBD for predicting stroke. Close monitoring and aggressive surgical interventions might be needed for high-risk patients.

The changes of endogenous Fas/FasL in injured spinal cord, mostly in primates, are not well known. In this study, we investigated the temporal changes in the expression of Fas and FasL and explored their possible roles in the ventral horn of the spinal cord and associated precentral gyrus following T11 spinal cord hemisection in the adult rhesus monkey. A significant functional improvement was seen with the time going on in monkeys subjected to cord hemisection. Apoptotic cells were also seen in the ventral horn of injured spinal cord with TUNEL staining, and a marked increase presents at 7 days post operation (dpo). Simultaneously, the number of Fas and FasL immunoreactive neurons in the spinal cords caudal and rostral to injury site and their intracellular optical density (OD) in the ipsilateral side of injury site at 7 dpo increased significantly more than that of control group and contralateral sides. This was followed by a decrease and returned to normal level at 60 dpo. No positive neurons were observed in precentral gyrus. The present results may provide some insights to understand the role of Fas/FasL in the spinal cord but not motor cortex with neuronal apoptosis and neuroplasticity in monkeys subjected to hemisection spinal cord injury. Refereed/Peer-reviewed

Spontaneous extradural hematoma (EDH) is an uncommon form of intracranial hematoma and is caused by the adjacent sinus and otic infections, dural vascular malformations and disorders of blood coagulation. We report spontaneous EDH in a 54-year old women with chronic kidney disease (CKD) on intermittent hemodialysis. She was successfully managed by conservative treatment. The EDH in her was probably related to the coagulation abnormalities associated with CKD, hemodialysis or heparin use during the dialysis.

Maintainability evaluation is the main method to assess the maintainability level of product. Maintainability design attributes of civil aircraft are determined by analysis of maintainability influencing factors; and the calculation method of each attribute is proposed by the means of maintenance task virtual simulation, rapid upper limb assessment and maintainability checklist. In terms of multiple attribute decision-making theory, the pretreatment methods of maintainability attributes are proposed, and the comprehensive maintainability evaluation model of civil aircraft system is established based on fuzzy theory and multiple attribute decision making method in this paper. Moreover, an instance combined with comprehensive evaluation of two different types of nose landing gear system is given to illustrate the effectiveness of the model.

Aspergillus sellar abscess is a very rare form of fungal infections of the central nervous system (CNS). In this report, we describe the successful treatment of a patient with aspergillus sellar abscess. A 65-year-old woman presented with headache, nasal discharge and decreased visual acuity. The diagnosis of sellar mass was made on the basis of magnetic resonance imaging (MRI) examination. The computed tomography (CT) scan revealed sellar enlargement and sellar floor bony destruction. After hospitalization the patient underwent transsphenoidal surgery. Histopathological examination of the sellar mass revealed aspergillosis. Postoperatively, amphotericine-B and itraconazole therapy was started. During a six-month follow-up, the patient's headache and inertia disappeared, visual acuity improved. Aspergillus sellar abscess must be considered in the differential diagnosis of a sellar mass. The correct diagnosis of pituitary aspergillosis can only be achieved by histopathological examination. Surgical intervention and antifungal therapy should be considered the optimal treatment.

The performance of anti aiming noise AM jamming for the pseudo-random code phase modulation and PAM combined fuze is discussed in this paper. First, the principle of the combined fuze is introduced briefly, then, the signal to jamming ratio (SJR) and SJR gain of its receiver are deduced in detail when there exists the aiming noise AM jamming. Finally, its performance of anti aiming noise AM jamming is analyzed. The results show that the combined fuze not only has stronger performance of anti aiming noise AM jamming, but the performance can be improved further through designing appropriate parameters such as pseudo-random code period, code-element width and high frequency pulse width.