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Abstract Objective The objective of the present study was to explore the correlation between the advanced lung cancer inflammation index (ALI) and in‐hospital mortality among patients diagnosed with community‐acquired pneumonia (CAP). Methods Data from the Medical Information Mart for Intensive Care‐IV database were adopted to analyze the in‐hospital mortality of ICU patients with CAP. Upon admission to the ICU, fundamental data including vital signs, critical illness scores, comorbidities, and laboratory results, were collected. The in‐hospital mortality of all CAP patients was documented. Multivariate logistic regression (MLR) models and restricted cubic spline (RCS) analysis together with subgroup analyses were conducted. Results This study includes 311 CAP individuals, involving 218 survivors as well as 93 nonsurvivors. The participants had an average age of 63.57 years, and the females accounted for approximately 45.33%. The in‐hospital mortality was documented to be 29.90%. MLR analysis found that ALI was identified as an independent predictor for in‐hospital mortality among patients with CAP solely in the Q1 group with ALI ≤ 39.38 (HR: 2.227, 95% CI: 1.026–4.831, P = 0.043). RCS analysis showed a nonlinear relationship between the ALI and in‐hospital mortality, with a turning point at 81, and on the left side of the inflection point, a negative correlation was observed between ALI and in‐hospital mortality (HR: 0.984, 95% CI: 0.975–0.994, P = 0.002). The subgroup with high blood pressure showed significant interaction with the ALI. Conclusion The present study demonstrated a nonlinear correlation of the ALI with in‐hospital mortality among individuals with CAP. Additional confirmation of these findings requires conducting larger prospective investigations.

Abstract Empathy enables understanding and sharing of others’ feelings. Human neuroimaging studies have identified critical brain regions supporting empathy for pain, including the anterior insula (AI), anterior cingulate (ACC), amygdala, and inferior frontal gyrus (IFG). However, to date, the precise spatio-temporal profiles of empathic neural responses and inter-regional communications remain elusive. Here, using intracranial electroencephalography, we investigated electrophysiological signatures of vicarious pain perception. Others’ pain perception induced early increases in high-gamma activity in IFG, beta power increases in ACC, but decreased beta power in AI and amygdala. Vicarious pain perception also altered the beta-band-coordinated coupling between ACC, AI, and amygdala, as well as increased modulation of IFG high-gamma amplitudes by beta phases of amygdala/AI/ACC. We identified a necessary combination of neural features for decoding vicarious pain perception. These spatio-temporally specific regional activities and inter-regional interactions within the empathy network suggest a neurodynamic model of human pain empathy.

BackgroundThe rising incidence of drug abuse among pregnant women has rendered neonatal opioid withdrawal syndrome a significant global health concern.MethodsDatabases including PubMed, Web of Science, the Cochrane Library, Embase, Elton B. Stephens. Company (EBSCO), China National Knowledge Infrastructure (CNKI), and Wanfang were searched for comparative studies of the Eat, Sleep, Console model vs. traditional assessment tools for neonatal opioid withdrawal syndrome. Two reviewers conducted literature searches, screened according to the inclusion criteria, extracted data, and independently verified accuracy. All meta-analyses were conducted using Review Manager Version 5.4.ResultsIn total, 18 studies involving 4,639 neonates were included in the meta-analysis. The Eat, Sleep, Console model demonstrated superior outcomes in assessing neonatal opioid withdrawal syndrome, significantly reducing the need for pharmacological treatment [risk ratio = 0.44, 95% confidence interval (CI) = 0.34–0.56, P

Abstract Background Neuromuscular electrical stimulation (NMES) is widely used as a rehabilitation methods to restore muscle mass and function in prolonged immobilization individuals. However, its effect in mechanically ventilated patients to improve clinical outcomes remains unclear. Methods A comprehensive search was conducted using PubMed, Embase, Web of Science, PEDro, and the Cochrane Library from their inception until December 24th, 2023. The search targeted randomized controlled trials (RCTs) comparing NMES with physical therapy (PT) or usual ICU care (CG), for improving clinical outcomes in mechanically ventilated patients. We performed a network meta-analysis utilizing Stata version 14.0 and R 4.3.1. Results We included 23 RCTs comprising 1312 mechanically ventilated adults. The treatments analyzed were NMES, PT, NMES combined with PT (NMES+PT), and CG. Network meta-analyses revealed that NMES or NMES+PT significantly improved extubation success rate compared to CG, with ORs of 1.85 (95% CI: 1.11, 3.08) and 5.89 (95% CI: 1.77, 19.65), respectively. Additionally, NMES exhibited a slight decrease in extubation success rate compared with NMES+PT, with OR of 0.31 (95% CI: 0.11, 0.93). Nevertheless, neither NMES nor NMES+PT showed any significant improvement in ICU length of stay (LOS), ventilation duration, or mortality when compared with PT or CG. NMES+PT emerged as the most effective strategy for all considered clinical outcomes according to the ranking probabilities. The evidence quality ranged from “low” to “very low” in this network meta-analysis. Conclusions NMES appears to be a straightforward and safe modality for critically ill, mechanically ventilated patients. When combined with PT, it significantly improved the extubation success rate against standard ICU care and NMES alone, and showed a better ranking over PT or NMES alone for clinical outcomes. Therefore, NMES combined with PT may be a superior rehabilitation strategy for this patient group.

Background: Deep brain stimulation of the anterior nucleus of the thalamus (ANT-DBS) is an effective treatment for refractory epilepsy; however, seizure outcome varies among individuals. Identifying a reliable noninvasive biomarker to predict good responders would be helpful. Objectives: To test whether the functional connectivity between the ANT-DBS sites and the seizure foci correlates with effective seizure control in refractory epilepsy. Methods: We performed a proof-of-concept pilot study of patients with focal refractory epilepsy receiving ANT-DBS. Using normative human connectome data derived from 1000 healthy participants, we investigated whether intrinsic functional connectivity between the seizure foci and the DBS site was associated with seizure outcome. We repeated this analysis controlling for the extent of seizure foci, distance between the seizure foci and DBS site, and using functional connectivity of the ANT instead of the DBS site to test the contribution of variance in DBS sites. Results: Eighteen patients with two or more seizure foci were included. Greater functional connectivity between the seizure foci and the DBS site correlated with more favorable outcome. The degree of functional connectivity accounted for significant variance in clinical outcomes (DBS site: |r| = 0.773, p

Abstract Aim To evaluate the relationship between healthy work environment and work engagement considering the effect of psychological capital among ICU nurses. Design The study was cross‐sectional design. Methods The subjects were 671 registered nurses from 20 ICUs in 18 general hospitals in Shandong province between October 2021 and December 2021. The questionnaires testing nurses' perception of healthy work environment, their work engagement, and psychological capital were used. Structural equation modeling was used to explore their relationship. Results Work engagement was positively affected by a healthy work environment and psychological capital. The structural equation modeling showed psychological capital mediated the relationship between healthy work environment and their work engagement. Patient or Public Contribution There were 681 clinical nurses reported at public contribution for responding to the questionnaires and providing valuable data for the study and there was no patient contribution in this study.

Lung cancer (LC) produces some of the most malignant tumors in the world, with high morbidity and mortality. Tumor immune microenvironment (TIME), a component of the tumor microenvironment (TME), are critical in tumor development, immune escape, and drug resistance. The TIME is composed of various immune cells, immune cytokines, etc, which are important biological characteristics and determinants of tumor progression and outcomes. In this paper, we reviewed the recently published literature and discussed the potential uses of natural products in regulating TIME. We observed that a total of 37 natural compounds have been reported to exert anti-cancer effects by targeting the TIME. In different classes of natural products, terpenoids are the most frequently mentioned compounds. TAMs are one of the most investigated immune cells about therapies with natural products in TIME, with 9 natural products acting through it. 17 natural products exhibit anti-cancer properties in LC by modulating PD-1 and PD-L1 protein activity. These natural products have been extensively evaluated in animal and cellular LC models, but their clinical trials in LC patients are lacking. Based on the current review, we have revealed that the mechanisms of LC can be treated with natural products through TIME intervention, resulting in a new perspective and potential therapeutic drugs.

Abstract Objectives We investigated both the metabolic differences and interictal/ictal discharges of the anterior nucleus of the thalamus (ANT) in patients with epilepsy to clarify the relationship between the ANT and the epileptic network. Methods Nineteen patients with drug‐resistant epilepsy who underwent stereoelectroencephalography were studied. Metabolic differences in ANT were analyzed using [18F] fluorodeoxyglucose–positron emission tomography with three‐dimensional (3D) visual and quantitative analyses. Interictal and ictal discharges in the ANT were analyzed using visual and time‐frequency analyses. The relationship between interictal discharge and metabolic differences was analyzed. Results We found that patients with temporal lobe epilepsy (TLE) showed significant metabolic differences in bilateral ANT compared with extratemporal lobe epilepsy in 3D visual and quantitative analyses. Four types of interictal activities were recorded from the ANT: spike, high‐frequency oscillation (HFO), slow‐wave, and α‐rhythmic activity. Spike and HFO waveforms were recorded mainly in patients with TLE. Two spike patterns were recorded: synchronous and independent. In 83.3% of patients, ANT was involved during seizures. Three seizure onset types of ANT were recorded: low‐voltage fast activity, rhythmic spikes, and theta band discharge. The time interval of seizure onset between the seizure onset zone and ANT showed two patterns: immediate and delayed. Interpretation ANT can receive either interictal discharges or ictal discharges which propagate from the epileptogenic zones. Independent epileptic discharges can also be recorded from the ANT in some patients. Metabolic anomalies and epileptic discharges in the ANT indicate that the ANT plays a role in the epileptic network in most patients with epilepsy, especially TLE.

Direct electrical stimulation of the basal ganglia using implanted SEEG electrodes produced a variety of motor and non-motor effects in human participants, providing insight into the functional architecture of this key brain region.

Abstract Background Vagus nerve stimulation (VNS) is an effective treatment for patients with refractory epilepsy, yet with varied predictive factors and heterogeneous long-term outcomes. Adjustment of VNS parameters is critical for obtaining favorable efficacy. In this study, we aimed to investigate the long-term outcomes and the possible predictive factors of VNS in patients with refractory epilepsy. Methods Eighty-six patients (59 males and 27 females) who underwent VNS implantation for treatment of refractory epilepsy between May 2016 and May 2017 at five Epilepsy Centers were enrolled. The clinical data, including sex, age at epilepsy onset, VNS implantation, epilepsy duration, seizure type, MRI findings, history of neurosurgical operations, and responder rate (responders were those with ≥50% seizure reduction), were analyzed. Results Four-year follow-up data were available for 76 patients (53 males and 23 females). The mean current intensity at the last follow-up was 1.8 ± 0.3 mA (range: 0.75–2.5 mA). The mean seizure reduction was 36.2% at 6 months, 38.5% at 1 year, 69.4% at 3 years, and 56.7% at 4 years. A favorable outcome of ≥50% reduction in seizure frequency occurred in 40.0% of the patients at 6 months, 55.9% at 1 year with 4 patients being seizure-free, 63.2% at 3 years with 5 patients being seizure-free, and 68.4% at 4 years with 5 patients being seizure-free. Earlier onset age (P

Characterizing human thalamocortical network is fundamental for understanding a vast array of human behaviors since the thalamus plays a central role in cortico-subcortical communication. Over the past few decades, advances in functional magnetic resonance imaging have allowed for spatial mapping of intrinsic resting-state functional connectivity (RSFC) between both cortical regions and in cortico-subcortical networks. Despite these advances, identifying the electrophysiological basis of human thalamocortical network architecture remains challenging. By leveraging stereoelectroencephalography electrodes temporarily implanted into distributed cortical regions and the anterior nucleus of the thalamus (ANT) of 10 patients with refractory focal epilepsy, we tested whether ANT stimulation evoked cortical potentials align with RSFC from the stimulation site, derived from a normative functional connectome (n = 1000). Our study identifies spatial convergence of ANT stimulation evoked cortical potentials and normative RSFC. Other than connections to the Papez circuit, the ANT was found to be closely connected to several distinct higher-order association cortices, including the precuneus, angular gyrus, dorsal lateral prefrontal cortex, and anterior insula. Remarkably, we found that the spatial distribution and magnitude of cortical-evoked responses to single-pulse electrical stimulation of the ANT aligned with the spatial pattern and strength of normative RSFC of the stimulation site. The present study provides electrophysiological evidence that stimulation evoked electrical activity flows along intrinsic brain networks connected on a thalamocortical level.

ObjectiveBy studying the surgical outcome of deep brain stimulation (DBS) of different target nuclei for patients with refractory epilepsy, we aimed to explore a clinically feasible target nucleus selection strategy.MethodsWe selected patients with refractory epilepsy who were not eligible for resective surgery. For each patient, we performed DBS on a thalamic nucleus [anterior nucleus of the thalamus (ANT), subthalamic nucleus (STN), centromedian nucleus (CMN), or pulvinar nucleus (PN)] selected based on the location of the patient's epileptogenic zone (EZ) and the possible epileptic network involved. We monitored the clinical outcomes for at least 12 months and analyzed the clinical characteristics and seizure frequency changes to assess the postoperative efficacy of DBS on the different target nuclei.ResultsOut of the 65 included patients, 46 (70.8%) responded to DBS. Among the 65 patients, 45 underwent ANT-DBS, 29 (64.4%) responded to the treatment, and four (8.9%) of them reported being seizure-free for at least 1 year. Among the patients with temporal lobe epilepsy (TLE, n = 36) and extratemporal lobe epilepsy (ETLE, n = 9), 22 (61.1%) and 7 (77.8%) responded to the treatment, respectively. Among the 45 patients who underwent ANT-DBS, 28 (62%) had focal to bilateral tonic-clonic seizures (FBTCS). Of these 28 patients, 18 (64%) responded to the treatment. Out of the 65 included patients, 16 had EZ related to the sensorimotor cortex and underwent STN-DBS. Among them, 13 (81.3%) responded to the treatment, and two (12.5%) were seizure-free for at least 6 months. Three patients had Lennox–Gastaut syndrome (LGS)-like epilepsy and underwent CMN-DBS; all of them responded to the treatment (seizure frequency reductions: 51.6%, 79.6%, and 79.5%). Finally, one patient with bilateral occipital lobe epilepsy underwent PN-DBS, reducing the seizure frequency by 69.7%.SignificanceANT-DBS is effective for patients with TLE or ETLE. In addition, ANT-DBS is effective for patients with FBTCS. STN-DBS might be an optimal treatment for patients with motor seizures, especially when the EZ overlaps the sensorimotor cortex. CMN and PN may be considered modulating targets for patients with LGS-like epilepsy or occipital lobe epilepsy, respectively.

Abstract. Background:. The combination of high-frequency oscillations (HFOs) with single-mode imaging methods has been proved useful in identifying epileptogenic zones, whereas few studies have examined HFOs combined with multimodal imaging methods. The aim of this study was to evaluate the prognostic value of ripples, an HFO subtype with a frequency of 80 to 200 Hz is combined with multimodal imaging methods in predicting epilepsy surgery outcome. Methods:. HFOs were analyzed in 21 consecutive medically refractory epilepsy patients who underwent epilepsy surgery. All patients underwent positron emission tomography (PET) and deep electrode implantation for stereo-electroencephalography (SEEG); 11 patients underwent magnetoencephalography (MEG). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy in predicting surgical outcome were calculated for ripples combined with PET, MEG, both PET and MEG, and PET combined with MEG. Kaplan-Meier survival analyses were conducted in each group to estimate prognostic value. Results:. The study included 13 men and 8 women. Accuracy for ripples, PET, and MEG alone in predicting surgical outcome was 42.9%, 42.9%, and 81.8%, respectively. Accuracy for ripples combined with PET and MEG was the highest. Resection of regions identified by ripples, MEG dipoles, and combined PET findings was significantly associated with better surgical outcome (P

ObjectiveTo investigate the prevalence of depression or anxiety in patient with multiple myeloma (MM) in China during maintenance treatment and its associated influencing factors.MethodsPatients with MM (n = 160) received maintenance therapy, and control subjects (without MM, n = 160) matched on age, sex, and BMI were recruited. Patients completed questionnaires, including the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder 7-item Scale (GAD-7), and the Verbal Pain Rating Scale (VPRS). Data on the Clinical characteristics, biochemical indicators of de novo MM were from the database of the Hematology Department of Beijing Chao-yang Hospital. Multiple linear regression model analysis was used to compare the differences in PHQ-9 and GAD-7 scale scores between the control group and the case group after correction for relevant variables. Multiple logistic regression models were subsequently used to analyze the correlation between the presence or absence of anxiety and depression and clinical indicators in the MM groups.ResultsDepression symptoms was present in 33.33% and anxiety symptoms in 24.68% of first-episode MM in the maintenance phase of treatment, and depression symptoms in the index-corrected MM group was significantly different from that in the control group (t = 2.54, P < 0.05). Analyses of multiple logistic regressions: biochemical indicators and clinical typing were not significantly associated with anxiety and depression. Compared to the pain rating 1, the risk of depressive mood was greater in the case group with the pain rating 2 (OR = 2.38) and the pain rating ≥ 3 (OR = 4.32). The risk of anxiety was greater in the case group with the pain rating ≥ 3 than the pain rating 1 (OR = 2.89).ConclusionDespite being in clinical remission, depressive mood problems in patients with MM remain prominent. Clinicians should enhance mood assessment and management in patients with concomitant pain.

The structure, and the electronic properties, caused by alkaline earth metals and transition metals substituting for Pb in CsPbBr3 (CPB) are studied by the first principal calculations. Obtained results show that with increasing the dopants concentration, the substitution of Pb with alkali earth metals in CsPbBr3 induces an increase of the electronic band gap, and the direct band gap turns to be the indirect band gap; On the other hand, the substitution of Pb by transition metal elements in CsPbBr3 induces a decrease of the band gap, and the band gap becomes indirect band gap. Doping for Pb may adjust the bandgap of the CsPbBr3 to be 1.3∼1.5eV for fabricating the high efficiency solar cells. The calculated results also prove that the electronegativity of the metal is related the band gap of the doped CPB, which may be related to the outermost s-orbital electrons in the band. The average energy of the s-orbital electrons of the doped metal is highly consistent with the electronegativity of the metal and the change of the band gap after doping. This may open a new way to design the dopants for CPB.

ObjectiveAltered expression patterns of Na+-K+-2Cl– (NKCC1) and K+-Cl– (KCC2) co-transporters have been implicated in the pathogenesis of epilepsy. Here, we assessed the effects of imbalanced NKCC1 and KCC2 on γ-aminobutyric acidergic (GABAergic) neurotransmission in certain brain regions involved in human focal cortical dysplasia (FCD).Materials and methodsWe sought to map a micro-macro neuronal network to better understand the epileptogenesis mechanism. In patients with FCD, we resected cortical tissue from the seizure the onset zone (SOZ) and the non-seizure onset zone (non-SOZ) inside the epileptogenic zone (EZ). Additionally, we resected non-epileptic neocortical tissue from the patients with mesial temporal lobe epilepsy (MTLE) as control. All of tissues were analyzed using perforated patch recordings. NKCC1 and KCC2 co-transporters expression and distribution were analyzed by immunohistochemistry and western blotting.ResultsResults revealed that depolarized GABAergic signals were observed in pyramidal neurons in the SOZ and non-SOZ groups compared with the control group. The total number of pyramidal neurons showing GABAergic spontaneous postsynaptic currents was 11/14, 7/17, and 0/12 in the SOZ, non-SOZ, and control groups, respectively. The depolarizing GABAergic response was significantly dampened by the specific NKCC1 inhibitor bumetanide (BUM). Patients with FCD exhibited higher expression and internalized distribution of KCC2, particularly in the SOZ group.ConclusionOur results provide evidence of a potential neurocircuit underpinning SOZ epileptogenesis and non-SOZ seizure susceptibility. Imbalanced function of NKCC1 and KCC2 may affect chloride ion homeostasis in neurons and alter GABAergic inhibitory action, thereby contributing to epileptogenesis in FCDs. Maintaining chloride ion homeostasis in the neurons may represent a new avenue for the development of novel anti-seizure medications (ASMs).

Purpose: Nurses’ musculoskeletal diseases (MSDs) are worldwide prevalent and are considered to be a costly occupational injury. This study aims to investigate the relationship between exposure to occupation-related psychosocial factors, physical workload, and upper body musculoskeletal diseases among hospital nurses. Methods: An electronic search was implemented using nine databases with June 2019 as the latest search date. English and Chinese studies were chosen, and data were independently and separately extracted by two investigators. Pooled odds ratio (OR) and its 95% confidence interval (CI) were estimated for each subset, using the fixed or random-effects model, following heterogeneity between studies for research synthesis. The source of heterogeneity was explored through subgroup, sensitivity, and meta-analyses. Results: Eighteen studies were included in the meta-analysis. Most participants were women (51.4%–100.0%), aged between 20 and 60. A correlation was found between high job demand and the prevalence of low back pain (OR = 1.41; 95% CI = 1.23-1.62). Total job strain was related to the risk of low back pain (OR = 1.71; 95% CI = 1.15-2.55), neck pain (OR = 1.67; 95% CI = 1.26-2.20), shoulder pain (OR = 1.62; 95% CI = 1.06-2.48) and back pain (OR = 1.45; 95% CI = 1.10-1.91). Furthermore, the physical workload was significantly associated with the prevalence of low back pain (OR = 1.76; 95% CI = 1.32-2.35), neck pain (OR = 1.17; 95% CI = 1.08-1.27), shoulder pain (OR = 1.59; 95% CI = 1.37-1.85) and back pain (OR = 1.66; 95% CI = 1.45-1.90). Conclusion: There were significant associations between occupational strain, more physical workload and upper body MSDs, but the evidence advocating a growth risk in MSDs due to low levels of social support is quite weak.

BackgroundThe outbreak of the highly infectious coronavirus disease 2019 (COVID-19) renders a huge physical and psychological risk to the public, especially to the medics. Additionally, self-leadership has proven to improve self-efficacy and mediate tension, such as nervousness and depression. Therefore, a cross-sectional survey was conducted to explore the association of self-leadership with acute stress responses (ASRs) and acute stress disorders (ASDs) in medics during the COVID-19 epidemic.MethodsSelf-reported online questionnaires were administered, and 627 participants were finally included. The data were analyzed using the univariate analysis and the logistical regression model to identify whether self-leadership and sociodemographic and epidemic characteristics were associated with mental health, including ASRs and ASDs.ResultsInitially, 790 medics responded. Of these, 627 remained after excluding for invalid questionnaires and those with a substantial amount of missing data. Therefore, the participation validity rate was 79.37%. Frontline medical staff (β = 0.338; p < 0.001), possibility of infection among people around the medic being mild (β = 0.141; p < 0.001), subjective estimation of epidemic duration being 3–6 months (β = 0.074; p < 0.05), self-sets (β = −0.022; p < 0.001), self-punishment (β = 0.229; p < 0.001), belief hypothesis and evaluation (β = −0.147; p < 0.05), and successful foresight (β = 0.105; p < 0.05) were statistically significant with ASRs. Marital status [adjusted odds ratio (AOR) =1.813; 95% CI (1.141, 2.881); p = 0.012], being a frontline worker [AOR = 25.760; 95% CI (14.220, 46.667); p < 0.001], visiting Hubei in the previous 14 days [AOR = 3.656; 95% CI (1.500, 8.911); p = 0.004], self-punishment [AOR = 1.352; 95% CI (1.180, 1.548); p < 0.001], and self-dialogue [AOR = 1.256; 95% CI (11.063, 1.483); p = 0.007] were the risk factors for ASD. Conversely, having frontline medical staff in one's family [AOR = 0.523; 95% CI (0.297, 0.923); p = 0.025], self-sets [AOR = 0.814; 95% CI (0.715, 0.826); p = 0.002], and belief hypothesis and evaluation [AOR = 0.796; 95% CI (0.672, 0.943); p = 0.038] were the protective factors.ConclusionThe special working environment of the COVID-19 epidemic resulted in ASR and ASD. Notably, findings revealed a positive association between ASR symptoms and frontline medical staff, the subjective estimation of epidemic duration, self-punishment, and successful foresight. Nevertheless, marital status, having visited Hubei in the previous 14 days, and self-dialogue were the risk factors accounting for ASD symptoms. Surprisingly, having frontline medical staff in one's family, self-sets, and belief hypothesis and evaluation had potential benefits for ASD symptoms.

Abstract Background Surgical treatment for patients with adult-onset Rasmussen’s encephalitis (A-RE) is rarely reported. We investigated the clinical and surgical features of two patients with A-RE who underwent functional hemispherectomy. Case presentation The data of clinical manifestations, neuroimaging, surgical treatment and surgical outcomes of two patients with A-RE was reviewed. The two patients initially presented with recurrent partial seizures or secondly generalized tonic clonic seizures. Gradually, the patients showed unilateral limb paralysis as well as chronic focal epileptic status. Both patients underwent functional hemispherectomy and achieved seizure freedom in the follow-up. The contralateral neurological deficits improved gradually after rehabilitation and were acceptable for the self-care of daily living. The living quality improved prominently after surgery. Conclusions Despite the risk of hemiplegia, functional hemispherectomy may be a choice for patients with A-RE for favorable seizure control and improved quality of life in selected patients.

Abstract Background Ulcerative colitis (UC) is a chronic, non-specific inflammatory bowel disease (IBD) with unknown etiology. The lack of specific clinical manifestations, standard diagnostic criteria, objective and accurate indicators to the severity of the disease and the efficacy of the treatment, often results in difficulties in diagnosis and timely treatment of UC. Therefore, there is a need to develop a clinically suitable serum biomarker assay with high specificity and sensitivity. Objective and methods To explore the significance of anti-neutrophil cytoplasmic antibodies (ANCA) and anti-saccharomyces cerevisiae antibodies (ASCA) in the diagnosis, differential diagnosis and treatment assessment in patients with ulcerative colitis (UC). Serum levels of ANCA-IgG, ASCA-IgA and ASCA-IgG were measured by an enzyme-linked immunosorbent assay (ELISA) in 105 UC patients, 52 non-UC patients and 100 healthy controls. Results (1) Both the ANCA-IgG level and its positive rate in UC patients were significantly higher than those in non-UC controls and healthy controls (p 0.05). (2) The sensitivity of ANCA+ and ANCA+/ASCA− in detecting UC patients was 61.90% and 55.24%, respectively, whereas the specificity was 91.45% and 94.08%, respectively. The sensitivity of ASCA+ and ASCA+/ANCA− in non-UC disease controls was 5.33% and 3.85%, respectively, and specificity was 83.9% and 88.78%, respectively. (3) When UC patients were grouped into mild, moderate or severe subtypes, the ANCA-IgG levels were correlated with the severity of UC, and the differences of the ANCA-IgG levels were statistically different among the three subtypes (p

Background: Transcranial direct current stimulation (tDCS) has been explored in epilepsy with limited samples, varied parameters, and inconclusive results. We aimed to study the efficacy of tDCS for patients with refractory focal epilepsy. Method: We conducted a randomized, double-blind, sham-controlled, and three-arm (Group 1 (sham), Group 2 (20-min), and Group 3 (2 × 20-min)) tDCS parallel multicenter study. The primary outcome measurement was seizure frequencies (SFs). The study consisted of 28-days baseline, 14-days treatment, and 56-days follow-up. The cathode was placed over the epileptogenic focus, and the current intensity was 2 mA. The generalized estimating equations model, one-way analysis of variance, chi-square and Kruskal-Wallis test were used for analysis. Results: Of the 82 enrolled patients, 70 patients were included for final analysis (Group 1, n = 21; Group 2, n = 24; and Group 3, n = 25). There was a significant reduction in SFs for both active tDCS groups compared with the sham group. Patients in Group 2 showed a significantly 50.73–21.91% greater reduction in SFs that lasted for 4 weeks (p = 0.008–0.060). Patients in Group 3 showed a significantly 63.19–49.79% greater reduction in SFs compared with the sham group that lasted for 5 weeks (p = 0.011–0.045). Patients in Group 3 had a 64.98–66.32% greater reduction in SFs at W9–W10, when compared with Group 2 (p = 0.021–0.022). Conclusion: Fourteen consecutive days tDCS significantly decreased SFs in patients with refractory focal epilepsy, with 2 × 20-min daily stimulation protocol being superior to 20-min daily stimulation protocol.

Abstract Purpose To evaluate the clinical and stereoelectroencephalography (SEEG) features and postsurgical outcome in a uniform series of patients who underwent epilepsy surgery and had pathologically confirmation of focal cortical dysplasia (FCD). Methods We studied consecutive patients with drug‐refractory epilepsy who underwent SEEG recording. The high‐frequency oscillations (HFOs) features of SEEG, clinical characteristics, and surgical outcome were evaluated. Results Sixty patients (31 FCD type I, 13 II, and 16 III) were analyzed retrospectively. Patients with type II tended to have their seizures at an earlier age than those with I and III (p

This study aimed to determine the relationship between acute stress and quality of life and explore their influencing factors on health care workers. A descriptive cross-sectional study was conducted, and a sample of 525 health care workers was recruited from 15 hospitals through a convenient sampling method. Participants completed an online self-report questionnaire to assess their acute stress and quality of life. Descriptive and multiple linear regression statistics were used for this analysis. The results regarding acute stress responses varied significantly among the differences in marital status, physical activity, work status, perceived risk of contracting COVID-19, and the expected duration of the pandemic. Moreover, a younger age, lack of physical activity, being a front-line medical staff, and higher acute stress scores indicated a worse quality of life. Healthcare workers’ acute stress was negatively correlated with their quality of life. Therefore, the authorities should pay special attention to health care workers’ mental health and provide them with timely protection during the pandemic.

Objective: The aim of this study was to use voxel-based MRI post-processing in detection of subtle FCD in drug-resistant operculoinsular epilepsy patients with negative presurgical MRI, and by combining magnetoencephalography (MEG) to improve the localization of epileptogenic zone.Methods: Operculoinsular epilepsy patients with a negative presurgical MRI were included in this study. MRI post-processing was performed using a Morphometric Analysis Program (MAP) on T1-weighted volumetric MRI. Clinical information including semiology, MEG, scalp electroencephalogram (EEG), intracranial EEG and surgical strategy was retrospectively reviewed. The pertinence of MAP-positive areas was confirmed by surgical outcome and pathology.Results: A total of 20 patients were diagnosed with operculoinsular epilepsy had non-lesional MRI during 2010–2018, of which 11 patients with resective surgeries were included. MEG showed clusters of single equivalent current dipole (SECD) in inferior frontal regions in five patients and temporal-insular/ frontal-temporal-insular/parietal-insular regions in five patients. Four out of 11 patients had positive MAP results. The MAP positive rate was 36.4%. The positive regions were in insular in one patient and operculoinsular regions in three patients. Three of the four patients who were MAP-positive got seizure-free after successfully resect the MAP-positive and MEG-positive regions (the pathology results were FCD IIb in two patients and FCD IIa in one patient).Conclusions: MAP is a useful tool in detection the epileptogenic lesions in patients with MRI-negative operculoinsular epilepsy. Notably, in order to make a right surgical regime decision, MAP results should always be interpreted in the context of the patient's anatomo-electroclinical presentation.

Background and purpose: Subthalamic nucleus deep brain stimulation (STN DBS) is well established for the treatment of advanced Parkinson’s disease (PD), substantially improving motor symptoms, quality of life, and reducing the long-term need for dopaminergic medication. However, whether chronic STN DBS produces different effects on PD motor subtypes is unknown. This retrospective study aimed to evaluate the long-term effects of STN DBS on the PD motor subtypes.Methods: Eighty patients undergoing STN DBS were included. The Unified Parkinson’s Disease Rating Scale (UPDRS) analysis was performed in “On” and “Off” medication/“On” and “Off” stimulation conditions. The patients were classified as akinetic-rigid type (ART), tremor-dominant type (TDT), and mixed type (MT) based on the preoperative UPDRS III subscores in the “Off” medication state. Preoperative and postoperative comparisons were performed.Results: After 4.9 years, STN DBS produced significant improvement in the UPDRS III total scores and subscores of tremor, rigidity, and bradykinesia in the “Off” medication state in the ART group, less improvement in the MT group, and the least improvement in the TDT group. The UPDRS II and III total scores and other subscores failed to improve during the “On” medication state. However, all groups improved substantially, and the improvement in tremor was sustained for both the “On” and “Off” medication states after years. Long-term STN DBS failed to improve swallowing and speech in all the subtypes.Conclusion: The data confirms that PD is heterogeneous. Long-term STN DBS produced the best effects on bradykinesia/rigidity in the “Off” medication state and on tremor in the “On” and “Off” medication states. There were differences in the response by each group, but some of the differences could be explained by the fact that more severe symptoms at baseline tend to have greater improvement. The findings support the idea that ART mainly involves the basal ganglia-thalamo-cortical pathway, whereas TDT involves a different circuit, likely the cerebellar-thalamo-cortical pathway.

Tuberculosis (TB) is a chronic infectious disease that has been threatening public health for many centuries. The clinical diagnostic procedure for TB is time-consuming and laborious. In the last 20 years, real-time fluorescence-based quantitative PCR (real-time PCR) has become a better alternative for TB diagnosis in clinics due to its sensitivity and specificity. Recently, digital droplet PCR (ddPCR) has been developed, and it might be an ideal alternative to conventional real-time PCR for microorganism detection. In this study, we aimed to assess the capacity of ddPCR and real-time PCR for detecting low levels of circulating Mycobacterium tuberculosis (MTB) DNA. The study involved testing whole blood samples for an MTB DNA target (known as IS6110). Blood samples were obtained from 28 patients with pulmonary TB, 28 patients with extrapulmonary TB, and 28 healthy individuals. The results show that ddPCR could be used to measure low levels of MTB DNA, and it has the potential to be used to diagnose pulmonary and extrapulmonary TB based on clinical samples.

Abstract Type I interferon (IFN-I) plays a crucial role in the antiviral immune response and inflammatory autoimmune diseases by inducing the expression of IFN-stimulated genes (ISGs). Hence, the regulation of ISG expression is fundamental for maintaining immune homeostasis. In this study, we found that PCGF3 negatively regulates the antiviral response by suppressing the expression of ISGs. The deficiency of PCGF3 in innate immune cells results in an augmented expression of ISGs in response to IFN-I stimulation. Mechanistically, PCGF3 is recruited to interferon-stimulated response elements (ISREs) region in an IFN-dependent way, precluding STAT1 from binding to the ISG promoter and diminishing ISRE activity. Additionally, we observed a negative correlation between decreased PCGF3 expression and elevated ISG expression in peripheral blood mononuclear cells (PBMCs) of patients with dermatomyositis (DM). Our findings clarified the epigenetic regulatory role of PCGF3 in inhibiting the excessive expression of ISGs induced by IFN-I under pathological circumstances.