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With the proliferation of versatile mobile applications, offloading compute-intensive tasks to the MEC/Cloud becomes a dramatic technique due to the limited resources and high user experience requirements at mobile devices. However, most existing works design their task offloading schemes without considering the dependence of tasks and the orchestration of the MEC and Cloud, and thus may limit the system performance. In this paper, we propose a dependent task offloading framework for multiple mobile applications, named COFE, where mobile devices can offload their compute-intensive tasks with dependent constraints to the MEC-Cloud system. It can assign the offloaded tasks to the MEC and Cloud adaptively to improve the user experience. Based on COFE, we formulate the task offloading problem as an average makespan minimization problem, which is proved to be NP-hard. Then, we propose a heuristic ranking-based algorithm to assign the offloaded tasks according to their bottom levels. Theoretical analysis proves the stability of the system under the proposed algorithm and extensive simulations validate that the proposed algorithm can significantly reduce the average makespan and deadline violation probabilities of offloaded applications.

Bromodomain-Containing Protein 4 (BRD4) is a member of the BET family of bromodomains, which participates in gene transcription process and is closely related to tumor progression. We observed the up-regulated expression of BRD4 in colorectal cancer (CRC) after doxorubicin (DOX) treatment, which might be a potential mechanism for DOX resistance. This study constructed the tumor-targeting (cyclo (Arg-Gly-Asp-D-Phe-Lys)-poly(ethylene glycol)-poly(ε-caprolactone)) (cRGD-PEG-PCL) copolymer for co-delivery DOX and BRD4 PROTAC degrader ARV-825 (ARV-DOX/cRGD-P) for CRC treatment. The ARV-DOX/cRGD-P complexes elicited synergistic anti-tumor effect via cell cycle arrest and the increased cell apoptosis, and mechanism studies implicated the activation of proliferation- and apoptosis-related pathways in vitro. Moreover, the administration of ARV-DOX/cRGD-P significantly improved anti-tumor activity in subcutaneous colorectal tumors and colorectal intraperitoneal disseminated tumor models in mice by promoting apoptosis, suppressing proliferation and angiogenesis of tumors. Taken together, these data reveal that ARV-825 can heighten DOX sensitivity in CRC treatment and BRD4 is a potential therapeutic target for DOX-resistant CRC. The ARV-DOX/cRGD-P preparations have outstanding anti-cancer effects and may be used for clinical treatment of colorectal cancer in the future.

Cloud has become an important platform for executing numerous deadline-constrained scientific applications generally represented by workflow models. It provides scientists a simple and cost-efficient method of running workflows on their rental Virtual Machines (VMs) anytime and anywhere. Since pay-as-you-go is a dominating pricing solution in clouds, extensive research efforts have been devoted to minimizing the monetary cost of executing workflows by designing tailored VM allocation mechanisms. However, most of them assume that the task execution time in clouds is static and can be estimated in advance, which is impractical in real scenarios due to performance fluctuation of VMs. In this paper, we propose an onli N e multi-workfl O w S cheduling F ramework, named NOSF, to schedule deadline-constrained workflows with random arrivals and uncertain task execution time. In NOSF, workflow scheduling process consists of three phases, including workflow preprocessing, VM allocation and feedback process. Built upon the new framework, a deadline-aware heuristic algorithm is then developed to elastically provision suitable VMs for workflow execution, with the objective of minimizing the rental cost and improving resource utilization. Simulation results demonstrate that the proposed algorithm significantly outperforms two state-of-the-art algorithms in terms of reducing VM rental costs and deadline violation probability, as well as improving the resource utilization efficiency.

Glioma is a primary aggressive brain tumor with high recurrence rate. The poor efficiency of chemotherapeutic drugs crossing the blood‒brain barrier (BBB) is well-known as one of the main challenges for anti-glioma therapy. Moreover, massive infiltrated tumor-associated macrophages (TAMs) in glioma further thwart the drug efficacy. Herein, a therapeutic nanosystem (SPP-ARV-825) is constructed by incorporating the BRD4-degrading proteolytic targeting chimera (PROTAC) ARV-825 into the complex micelle (SPP) composed of substance P (SP) peptide-modified poly(ethylene glycol)-poly(d,l-lactic acid)(SP-PEG-PDLLA) and methoxy poly(ethylene glycol)-poly(d,l-lactic acid) (mPEG-PDLLA, PP), which could penetrate BBB and target brain tumor. Subsequently, released drug engenders antitumor effect

Background Glioblastoma mutliforme is the most common and has the poorest prognosis of any malignant tumor of the central nervous system. Luteolin, the most abundant xanthone extracted from vegetables and medicinal plants, has been shown to have treatment effects in various cancer cell types. Luteolin is however, hydrophobic and has poor biocompatibility, which leads to low bioavailability. Patients and methods In this study, folic acid modifiedpoly(ethylene glycol)-poly(e-caprolactone) (Fa-PEG-PCL) nano-micelles was used to encapsulate the luteolin, creating luteolin loaded PEG-PCL (Lut/Fa-PEG-PCL) micelles to treat glioma both in vitro and in vivo. Results When compared with the free luteolin and Lut/MPEG-PCL, Lut/Fa-PEG-PCL induced a significant cell growth inhibition and more apoptosis of GL261 cells both in vitro and in vivo. The safety assessment also showed no obvious side effects were observed in mice which were administrated with free luteolin or Lut/MPEG-PCL and Lut/Fa-PEG-PCL. Conclusion These results suggested Lut/Fa-PEG-PCL may be used as an excellent intravenously injectable formulation for the treatment and chemoprevention.

α-Mangostin, the most abundant xanthone extracted from pericarp of mangosteen fruits, has been shown potential treatment effects in various cancer cell types. This led us to explore the anti-tumor activity and related mechanisms of α-mangostin in colorectal cancer. In this study, poly(ethylene glycol)–poly(e-caprolactone)–poly(ethylene glycol) (PEG–PCL–PEG, PECE) nanoparticles was used to encapsulate free α-mangostin, creating α-mangostin loaded PECE (α-M/PECE) nanoparticles. When compared with free α-mangostin, α-M/PECE induced a significantly more apoptosis of both CT26 and HCT116 cells in vitro, leading to an obviously more loss of mitochondrial membrane potential (Δψm) in HCT116 cells. Results of western blot assay and caspase-inhibiting assay showed that cell apoptosis induced by α-mangostin might via activating both death receptor-mediated caspase-8 pathway and mitochondrial dependent cytochrome c/caspase-9, with simultaneously regulating expression levels of Bcl-2 family proteins, and ultimately activating caspase-3. Moreover, the administration of α-M/PECE nanoparticles also exhibited significantly stronger inhibition in tumor growth, tumor angiogenesis, tumor cell proliferation as well as inducted more tumor cell apoptosis in subcutaneous xenograft models. Especially, α-M/PECE nanoparticles showed excellent anti-metastasis efficacy in both pulmonary metastasis model and abdominal metastasis model of colorectal cancer. The safety assessment also showed no obvious side effects were detected in mice which were treated with free α-mangostin or α-M/PECE nanoparticles. These results suggested the potential of α-M/PECE nanoparticles as an excellent intravenously injectable formulation of free α-mangostin for the treatment of colorectal cancer.

Targeted drug delivery systems have currently demonstrated considerable potential clinical benefits in cancer treatment. Curcumin has become a candidate anti-tumor drug for the therapy of glioblastoma multiforme (GBM) by increasing cell apoptosis and suppressing cell proliferation. In current research, we explored a novel targeted drug delivery system with a self-assembly measure by curcumin, MPEG-PLA and Fa-PEG-PLA. Compared with free curcumin and Cur/MPEG-PLA, Cur/Fa-PEG-PLA can remarkably suppress the growth of GL261 cells and promote apoptotic rate. Moreover, after the procession of tumor-bearing mice with curcumin/Fa-PEG-PLA complex, tumor growth in subcutaneous and intracranial tumor models were repressed via suppressing angiogenesis and facilitating apoptosis in vivo. The Curcumin/Fa-PEG-PLA nanoparticle may be a novel drug for the therapy of GBM.

Constructed wetland is one of the effective ecological technologies for wastewater purification. The effects of different covering systems on nitrogen transformation were evaluated in small-scale surface flow constructed wetlands. The study revealed the effect mechanism of different covering systems and carbon nitrogen ratio on nitrogen removal for optimizing the structure of surface flow constructed wetlands to the maximum nitrogen removal. The temperature condition was set about 10 °C, and the experiments consisted of water tanks with plant coverings, a foam board covering, as well as no covering (blank). The waste water was supplemented with peptone to supply organic nitrogen, ammonium sulphate to supply ammonia nitrogen, or potassium nitrate to supply nitrate nitrogen, as well as carbon and phosphorus sources. The results showed that plants were conducive to organic nitrogen and ammonia nitrogen removal, and large coverage systems were favored of nitrate nitrogen removal. Nitrification was the key step in nitrogen removal. The amounts of ammonifying bacteria, nitrifying bacteria and denitrifying bacteria were significantly positive with removal rate of organic nitrogen, ammonia nitrogen and nitrate nitrogen, respectively. In the plant-based wetlands, organic nitrogen and ammonia nitrogen removal rates decreased and nitrate nitrogen one increased as carbon nitrogen ratio increased. These results provide a theoretical basis for optimizing the structure of small-scale surface flow constructed wetlands to control non-point source pollution.

Background Postcraniotomy meningitis is a severe complication in neurosurgery, and can result in high morbidity and mortality. Closed continuous lumbar drainage (CCLD) as an adjuvant method for treating postcraniotomy meningitis in adults is rarely assessed. This study aimed to evaluate the efficacy of CCLD in the treatment of postcraniotomy meningitis. Methods A total of 1062 patients older than 16 years with postcraniotomy meningitis were included, between January 2000 and December 2015. Of these, 474 received intravenous antibiotic therapy, steroid administration and adjuvant CCLD (experimental Group). The remaining 588 patients only received intravenous antibiotic and steroid therapies (control Group). Data were extracted from medical records. Results In the experimental group, meningitis-related mortality was 2.7%, and 77.4% individuals achieved a Glasgow Outcome Scale of 4–5. In the control group, meningitis-related mortality reached 11.6%, with only 61.1% of patients achieving a GOS of 4–5. The time to negative cerebrospinal fluid laboratory test and the duration of meningitis-related symptoms were significantly shorter in the experimental group compared with controls ( P Conclusions Intravenous antibiotic and steroid therapies, assisted by CCLD, can lead to lower mortality and improved Glasgow Outcome Scale score in patients with meningitis after craniotomy. Laboratory results negative for cerebrospinal fluid leak and meningitis-related symptom relief occurred faster in the experimental group. Intravenous antibiotic and steroid therapies combined with CCLD appear to be an effective and safe treatment for postcraniotomy meningitis.

The explosive growth of data volume and the ever-increasing demands of data value extraction have driven us into the era of big data. The “5V” (Variety, Velocity, Volume, Value, and Veracity) characteristics of big data pose great challenges to traditional computing paradigms and motivate the emergence of new solutions. Cloud computing is one of the representative technologies that can perform massive-scale and complex data computing by taking advantages of virtualized resources, parallel processing and data service integration with scalable data storage. However, as we are also experiencing the revolution of Internet-of-things (IoT), the limitations of cloud computing on supporting lightweight end devices significantly impede the flourish of cloud computing at the intersection of big data and IoT era. It also promotes the urgency of proposing new computing paradigms. We provide an overview on the topic of big data, and a comprehensive survey on how cloud computing as well as its related technologies can address the challenges arisen by big data. Then, we analyze the disadvantages of cloud computing when big data encounters IoT, and introduce two promising computing paradigms, including fog computing and transparent computing, to support the big data services of IoT. Finally, some open challenges and future directions are summarized to foster continued research efforts into this evolving field of study.

Background Glioblastoma mutliforme is the most common and has the poorest prognosis of any malignant tumor of the central nervous system. Luteolin, the most abundant xanthone extracted from vegetables and medicinal plants, has been shown to have treatment effects in various cancer cell types. Luteolin is however, hydrophobic and has poor biocompatibility, which leads to low bioavailability. Patients and methods In this study, folic acid modifiedpoly(ethylene glycol)-poly(e-caprolactone) (Fa-PEG-PCL) nano-micelles was used to encapsulate the luteolin, creating luteolin loaded PEG-PCL (Lut/Fa-PEG-PCL) micelles to treat glioma both in vitro and in vivo. Results When compared with the free luteolin and Lut/MPEG-PCL, Lut/Fa-PEG-PCL induced a significant cell growth inhibition and more apoptosis of GL261 cells both in vitro and in vivo. The safety assessment also showed no obvious side effects were observed in mice which were administrated with free luteolin or Lut/MPEG-PCL and Lut/Fa-PEG-PCL. Conclusion These results suggested Lut/Fa-PEG-PCL may be used as an excellent intravenously injectable formulation for the treatment and chemoprevention.

Rationale: Anterior spinal meningoceles are rare neuroanatomic abnormality formed by protrusion of the spinal meninges through a defect in the vertebral column. Presently, therapeutic options for anterior spinal meningoceles are still controversial. The objective of this study is to discuss the individualized management of giant anterior spinal meningoceles. Patient concerns and Diagnoses: We analyzed 4 patients with anterior spinal meningoceles between 2007 and 2014 in our department by retrospective chart review, two of whom were anterior sacral meningoceles (ASMs), and another2 were intrathoracic meningoceles (ITMs). Interventions and outcomes: Patients mainly presented with compressive symptoms including rectal irritation, dyspnea (patient 3) and fixed neurologic deficits (patient 4). Three out of 4 patients received surgical treatment, one of which underwent reoperation. After surgery, meningoceles in 1 patient completely disappeared. Two patients acquired the stability of the size of the meningoceles. Lessons: Management of anterior spinal meningoceles often requires precise treatment based on the different conditions of each patient. Surgical intervention has been proposed for the treatment of symptomatic anterior spinal meningoceles. The goal of surgery is to safely disconnect the linkage between the cyst and CSF from subarachnoid space to prevent further enlargement of the cyst or reaccumulating of cystic fluid.

Mangostin is a hydrophobic agent with potential anticancer activity. Molecular dynamics computer simulation indicated methoxy poly(ethylene glycol)-poly(lactide) (MPEG-PLA) and α-mangostin (α-M) have good compatibility. The α-M-loaded nano-particles acting as an anticancer agents against growth of glioma cells were prepared by self-assembly methods. In this study, the effects of α-M-loaded nano-particles, α-M/MPEG-PLA with drug loading of 15% and a mean particle size of 32 nm, on the growth of glioma cells were examined both in vitro and in vivo. The occurrence of changes in the cell signaling molecules and expression levels of various proteins related to cell death and glioma xenograft models (i.e., zebra fish, subcutaneous-mouse and orthotopic-mouse) growth following the administration of α-M/MPEG-PLA were investigated. The novel α-M/MPEG-PLA inhibited the growth of malignant glioma cells, induced cells apoptosis with cleaved caspases expression and DNA fragmentation, along with down-regulation of anti-apoptotic molecules and up-regulation of apoptotic molecules. Furthermore, decreased proliferation as well as vascularization of the tumor in vivo models were significantly achieved. A dramatic induction of programmed cell death was found in malignant glioma cells after treatment with synthetic α-M/MPEG-PLA. These results suggest that synthetic α-M/MPEG-PLA could be a promising novel anticancer agent for performing chemotherapy against malignant glioma.

Spinal extradural angiolipomas (SEALs) are extremely extraordinary benign extradural lesions. They are infrequently encountered in normal clinical practice although several authors have report single cases or case series. We present two cases of SEAL which we successfully surgical resected with no further neurological deficits. Our cases comprise of a male and a female with ages ranging from 30 to 60 years. Their principal presenting complains were numbness and pain at the lower extremity with associated fecal and urinary incontinence. In all our cases, MRI revealed extradural spinal lesions that exerted compressive effect on the spinal cord. The male patient had an infiltrating type while the female had non-infiltrating type. We attained total resection in both cases without any further neurological complication. The diagnosis of SEALs initially can be challenging radiologically since they may mimic other spinal lesions. The gold standard treatment modality should always be surgery although total resection may not be achievable in some cases.

Intratumoral hemorrhage (ITH) associated with vestibular schwannomas (VS) is very rare. We retrospectively analyzed VS patients presenting with ITH in our department to further gain a better understanding of this uncommon clinical presentation. We treated seven patients who had VS presenting with ITH between January 2012 and June 2017. All the patients had preoperative computed tomography (CT), computed tomography angiography (CTA), and magnetic resonance imaging(MRI) done which aided in the radiological diagnosis as well as postoperative MRI to confirm the resection extent of the VS. Continuous electrophysiological monitoring of cranial nerves was carried out during surgery. Of the seven patients, three were male and four were female. Their ages ranged from 42 to 71 years (average age, 57.4 years). Two patients reported a history of hypertension. Sudden onset or rapid worsening of clinical symptoms occurred in five patients at time of hemorrhage. The mean diameter of the lesions was 4.1 cm (range, 3.0–5.0 cm). No patient had a pretreatment of stereotactic radiosurgery. Gross total resection was achieved in four cases and subtotal resection in three cases. There were no surgery-related neurological deficits but one patient died 18 days after surgery. Follow-up visits were scheduled at 6 months postoperatively and two patients had tumor recurrence and received stereotactic radiosurgery again. The incidence of ITH in VS is relatively rare and hypertension may highly correlate with ITH in VS. In comparison with peritumoral adhesion caused by chronic inflammation in multicystic VS with microhemorrhage,ITH caused by acute massive hemorrhage will not increase the extent of peritumoral adhesion immediately. The prognosis of surgery for patients with acute hemorrhagic VS may be better than that for microhemorrhage in multicystic VS. Besides, timely microsurgical treatment is also important to relieve symptoms.

Chiari type I malformation with cervicothoracic syringomyelia although very common in clinical practice usually in children can progress slowly and mimic muscular dystrophies in adulthood. We present a rare adult case of Chiari type I malformation with cervicothoracic syringomyelia subterfuge as Flail arm syndrome. A 44- year-old man was diagnosed with congenital type I Chiari malformation with cervicothoracic syringomyelia about 21 years ago without surgery. His health status deteriorated over the years until 21 days prior to presentation when he had severe pain in the right knee. In his upper limbs, he had bilateral corresponding severe weakness of 0/5 proximal strength and 0/5 strength in his distal muscles. Magnetic resonance imaging (MRI) revealed an enlargement of the spinal cord from C1-C4 level with a mass that appeared hypo-dense on T1 and hyperdense on T2. Syringomyelia is a potentially serious neurologic condition that can mimic other neuromuscular disorders. Early detection and diagnosis with MRI is crucial to avoid irreversible neurological complications. We suggest that whether asymptomatic or symptomatic, decompressive surgery should be carried out to allow for free flow of cerebrospinal fluid thereby improving the quality of life for the patient.

Introduction: This is the first case report about a thoracic intraspinal schwannoma in twin pregnancy with aggressive clinical presentation. Clinical presence and diagnoses: A 21-year-old woman presented with a 2-month history of back pain and slight lower extremity numbness and weakness, and her symptoms were misdiagnosed as normal reactions to pregnancy until she progressed to complete paralysis and incontinence within 2 weeks. She was then confirmed to have thoracic intraspinal schwannoma through MRI. Interventions and outcomes: Surgery was performed using a unilateral hemilaminectomy approach with a comfortable lateral position during operation. The patient exhibited significant improvements in sensation and muscle strength after surgery. She delivered 2 healthy baby girls by eutocia in her 38th week of pregnancy. Lessons: The diagnosis of this disease and the 4 possible mechanisms of its aggravated clinical presence are discussed. Intraspinal schwannomas during pregnancy are rare but may cause critical consequences for both the mother and the fetus. Timely diagnosis and multidisciplinary treatment by obstetricians, anesthesiologists, surgeons, oncologists, and neonatologists are essential for the clinical management of this disease.

Melanotic schwannoma (MS) is rare, accounting for less than 1% of primary peripheral nerve sheath tumors, and most often occurs in the paraspinal nerve roots. Intramedullary MS is exceedingly rare, and to the best of our knowledge, only nine cases have been reported in literature. We present a 47-year-old male, who underwent excision of thoracic intraspinal space-occupying lesion 6 years ago, as the 10th known case to date of intradural intramedullary MS that had a more invasive growth pattern than those reported before, and we review the diagnosis, clinicopathologic features, treatment and prognosis of intramedullary MS. Intramedullary MS’ behavior is unpredictable and can have an aggressive clinical course such as recurrence and metastasis.

Background and Objective Primary spinal cord (PSC) glioblastoma multiforme (GBM) is extremely rare and accounts for only 1.5% of all spinal cord tumors. Therefore, its treatment is still ill defined. To elucidate prognostic factors, we performed a single-institutional retrospective review of the largest series to date of patients with PSC GBM who underwent surgical resection in West China Hospital between 2008 and 2014. A total of 14 patients with PSC GBM were reviewed. Methods Demographic, operative, and postoperative factors were recorded. Overall survival (OS) and progression-free survival (PFS) were calculated and compared with the Kaplan-Meier method. Results Eight males (57%) and 6 females (43%) were involved in the study. Their median age was 28 years (range, 14–56 years). Median Karnofsky Performance Status score was 60 (range, 20–90). Four patients (28.6%) received gross total resection, 5 (35.7%) partial resection, and the remaining 5 (35.7%) biopsy only. Nine patients (64.3%) received postoperative radiotherapy and chemotherapy, 3 (21.4%) chemotherapy only, and 2 (14.3%) neither. Median follow-up period was 15 months (range, 5–26 months). One-year and 2-year survival was 78.5% (11/14) and 7.1% (1/14), respectively. Median OS was 15 months, and median PFS 8 months. Univariate log-rank analysis showed that OS and PFS were significantly associated with patients' age (P = 0.007 and P = 0.04, respectively) and postoperative radiotherapy (P = 0.001 and P = 0.002, respectively). However, preoperative Karnofsky Performance Status score affected only OS and did not affect PFS (P = 0.033 and P = 0.106, respectively). Conclusions According to our study, the combination of postoperative radiotherapy and temozolomide chemotherapy can improve prognosis and may serve as a feasible postoperative adjuvant treatment of PSC GBM.

A 47-year-old woman presented with a 6-month history of occipital-cervical region pain, numbness of both upper limbs, and progressive bilateral hearing loss. Enhanced MRI revealed a lesion involving the intracranial dura mater and the right trigone area of the lateral ventricle (figure, A–J). Surgery to relieve the main symptoms was performed through a posterior midline approach (figure, K and L). Pathology suggested the diagnosis of lymphoplasmacyte-rich meningioma (figure, M–P). Lymphoplasmacyte-rich meningioma is a rare variant of meningioma and is categorized as a WHO grade I tumor and approximately 60 cases have been reported,1 but involvement of the entire intracranial dura mater is unusual. It is characterized by dense lymphoplasmacytic infiltration and usually treated with surgical resection1; however, total resection could not be achieved in our case. The patient received radiotherapy and postsurgery MRI at 3 months but demonstrated no progress.

Introduction: Chordomas are rare low-grade malignant lesions that are mostly seen in the spine. They constitute about 1% of intracranial tumors and 3-4% of all primary bone tumors. The principal spinal location is usually the sacrococcygeal and infrequently the sphenooccipital and cervical areas. Case Presentation: We present a 74-year-old man with a huge sacrococcygeal mass extending to both buttocks. Computerized tomography (CT-scan) and magnetic resonance imaging (MRI) as well as computerized tomographic angiography (CTA) evaluations were suggestive to chordoma. Immunohistochemical analysis confirmed the diagnosis after the patient was successfully operated on. All aggravating symptoms resolved after the operation. Conclusion: The management of giant sacrococcygeal chordomas can be very challenging but with all-inclusive treatment, complete cure is achievable although recurrence can occur. In our case, surgery alone was curative. Preoperative CTA aided us in achieving total tumor resection.

After reading Drs. Fukuhara and Makifuchi's comment on our NeuroImage,1 and more related literature,2–4 we agree that lymphoplasmacyte-rich meningioma mimics the whole intracranial pachymeningitis. However, we disagree with the viewpoint that lymphoplasmacyte-rich meningioma mimicking pachymeningitis is due to immunoglobulin G4 (IgG4)–related disease. The patient died during our last follow-up. The total survival time of our patient after the biopsy was about 11 months. In fact, we gave the patient steroid therapy when repeated MRI showed no progression 3 months after biopsy, which was inspired by our previous experience with the treatment of Rosai-Dorfman disease,5 but it was ineffective. Although no detailed serologic evaluations of immunoglobulin levels were performed, immunostainings for IgG4 for plasma cell counts demonstrated an IgG4 of 15 per high-powered field, which fell short of the diagnosis of IgG4-related disease.3 In addition, diffuse membranous epithelial membrane antigen expression highlighted the diagnosis of lymphoplasmacyte-rich meningioma.

Rationale: Rosai –Dorfman disease (RDD) is a rare, idiopathic, and non-neoplastic histioproliferative disease with distinctive entity of unknown etiology. Central nervous system (CNS) RDD is uncommon, hence, isolated intracranial RDD is extremely rare. So far only 6 cases of CNS RDD with the lesions originating from petroclival region have been reported. We present a case of isolated intracranial RDD mimicking petroclival meningioma. Patient concerns: A 14-year-old girl was admitted at our hospital with a 3-month history of dizziness, slowly progressing headache, and 2-month history of instability in walking. Cranial nerve deficits, including left facial paralysis, left facial numbness and left hearing loss, were evident on examination. Diagnoses: Initial diagnosis of petroclival meningioma was made according to preoperative magnetic resonance imaging. Interventions: The lesion was resected subtotally and pathology confirmed RDD. The patient received gamma-knife treatment for the residual lesion. Outcomes: The patient recovered well and the residual lesion significantly retrogressed on follow-up images. Lessons: Preoperative diagnosis of petroclival RDD is full of challenges. Although surgical resection of lesions is an effective treatment option, total resection is not highly recommended because the surgery-related defect must be minimal. Patient with residual lesion can be put on steroid therapy and/or radiotherapy, especially for IgG4 positive subset of RDD.

Honokiol (HK) can efficiently inhibit the growth of tumors. However, its clinical applications have been restricted by its extreme hydrophobicity. We hope to improve its water solubility by nanotechnology. And we wonder whether a novel honokiol nanoparticles-loaded thermosensitive poly(ethylene glycol)-poly(epsilon-caprolactone)-poly(ethylene glycol) (PEG-PCL-PEG, PECE) hydrogel (HK-hydrogel) could improve the therapeutic efficacy on malignant pleural effusion (MPE). To evaluate the therapeutic effects of HK-hydrogel on MPE, MPE-bearing mice were administered intrapleurally with HK-hydrogel, HK nanoparticles (HK-NP), blank hydrogel, or normal saline (NS) at days 4 and 11 after Lewis lung carcinoma (LLC) cells inoculation, respectively. Pleural tumor foci and survival time were observed, and antiangiogenesis of HK-hydrogel was determined by CD31. Histological analysis and assessment of apoptotic cells were also conducted in tumor tissues. HK-hydrogel reduced the number of pleural tumor foci, while prolonging the survival time of MPE-bearing mice, more effectively, as compared with control groups. In addition, HK-hydrogel successfully inhibited angiogenesis as assessed by CD31 (P < 0.05). Histological analysis of pleural tumors exhibited that HK-hydrogel led to the increased rate of apoptosis. This work is important for the further application of HK-hydrogel in the treatment of MPE.

The process of rainfall interception by an inhomogeneous forest canopy composed of tree crowns with some gaps among them were considered, and the previous theoretical models of rainfall interception were modified to model an inhomogeneous canopy instead of a statistically homogeneous canopy. The paper deals with the following. First, the process of rainfall interception in tree crowns and that of rainfall in the gaps among them are studied respectively to acquire the average rainfall interception of a forest canopy. Based on the model derived by Liu (1987) and setting the canopy density value, both the relevant partial equations and a formula to estimate rainfall interception were derived. Moreover, the new model was solved through a numerical method and was illustrated with typical values of some ecological factors; three groups of curves were acquired by calculation with the VisualBasic program. A model of rainfall interception by an inhomogeneous forest canopy is classified as a multi-layer model, which is different from previous models (models where all the parameters represent the whole canopy). The results from the model in this paper could be used to determine the relationship between interception and each ecological factor in detail.

To explore the clinical classification and selection of surgical approaches for cervical spinal dumbbell tumors.The clinical data of 87 patients with cervical spinal dumbbell tumors undergoing surgical operations from January 2005 to December 2012 at our hospital were analyzed retrospectively. According to the size of inner and outer parts of tumors and the presence or absence of spinal bone damage, the cervical spinal dumbbell tumors were divided into 4 types of intraspinal predominant (I, n = 48), extraspinal predominant (II, n = 1), intrapinal and extraspinal without damage of spinal bone (III, n = 15) and intrapinal and extraspinal type with damage of spinal bone (IV, n = 7). Different surgical approaches were selected on the basis of tumor classification: posterior median-hemilamina approaches for type I tumors, lateral-muscle gap approaches for type II tumors, ateral-muscle gap-hemilamina or lateral-muscle gap-posterior median-hemilamina approaches for type III tumors, posterior far lateral-muscle gap-hemilamina or posterior median-muscle gap-hemilamina approaches plus posterior occipital cervical or cervical spinal bone graft fusion and internal fixation for type IV tumors.Among them, 83 cases underwent total resection and another 4 subtotal resection in one-stage operation. The postoperative follow-up period had a range of 9 months to 6 years (mean, 3.2 years). There was no recurrence of tumors for total resection and 1 case of tumor recurrence for subtotal resection. During the follow-up period, the clinical manifestations of 85 patients improved while another 2 deteriorated. And there was no occurrence of spinal deformity.Clinical classification of cervical spinal dumbbell tumor plays an important guiding role in the selection of surgical approaches. Adopting appropriate surgical approaches based on tumor type can not only improve the rate of total resection of tumor but also reduce the incidence of postoperative spinal deformity.

An ordinary differential equation model for secondary succession of Korean pine broadleaf forest is presented. Monte Carlo models to simulate processes of tree death and seed sprouting are designed. Localization of the models and an ensemble counting method are suggested. Then the succession process of Korean pine broadleaf forest from disturbances, age structure and dynamic in the climax stage of the forest are described.

To investigate the peroperative treatment of cranio-orbital tumors and the method of the reconstruction of the skull base.Between April 2008 and April 2011, 35 patients with cranio-orbital tumor were treated. There were 21 males and 14 females, aged 17-73 years (mean, 46.3 years). The first symptoms were orbital pain in 13 cases, hypopsia in 12 cases, exophthalmos or abnormal eye position in 5 cases, headache and dizziness in 2 cases, diplopia in 2 cases, and pulsating eyeball in 1 case. Some of the patients needed resecting the zygomatic arch, superciliary arch, and orbit roof. The autogenous bone, titanium net, frontal bone periosteum, biogel, and artificial meninges were used to reconstruct the skull base.Tumors were resected by one-stage operation, and the anterior skull bases were reconstructed. Postoperative MRI indicated that total removal of tumors was achieved in 30 cases, subtotal in 3 cases, and partial in 2 cases at 3 days. There was no operative death. Cerebrospinal rhinorrhea and infection occurred at 1 week in 1 and 2 cases respectively, and were cured after lumbar drainage and antibiotics. The patients were followed up 6 to 36 months (mean, 18 months). In patients having hypopsia, the visual function was improved in 9 cases at 1 month; in patients having orbital pain, pain relief was achieved at 2 weeks after operation; in patients having exophthalmos or abnormal eye position and pulsating eyeball, sympotoms disappeared after operation. In 27 patients with benign tumor, 24 were cured, without recurrence during follow-up; in 8 patients with malignant tumor, 6 had recurrence within 18 months and underwent second operation or radiotherapy, 2 relapsed cases died of cerebral hernia and respiratory circulating failure at 24 months after operation. No complication of enophthalmos, pulsating exophthalmos, or collapse of zygomatic region occurred.Using the autogenous bone, titanium net, frontal bone periosteum, biogel, and artificial meninges to reconstruct the skull base has reliable foundation, simple operation, and easy anatomical reconstruction, so it is an effective method after the removal of cranio-orbital tumors; better effectiveness would be obtained when combining with the peroperative nursing.

AIM To explore the causes of scalp wound infection, pathogen distribution, characteristics of antimicrobial susceptibility and therapeutic measures following craniocerebral trauma caused by the 2008 Wenchuan earthquake. MATERIAL and METHODS We retrospectively analyzed the microbiology records of patients admitted with craniocerebral trauma to the Department of Neurosurgery, West China Hospital, Sichuan University. Scalp wound infections following craniocerebral trauma were caused by the Wenchuan earthquake. RESULTS A total of 82 patients suffered from scalp trauma in this study, including 52.4% cases (43/82) with wound infections, mostly accompanied by severe foreign body contamination, for which the time of first debridement was significantly delayed. There were 59 strains of infectious pathogenic bacteria. Gram-positive bacteria were the most common organisms found (64.4%), including strains of Staphylococcus aureus (26/59, 44.1%) and strains of Staphylococcus epidermidis (12/59, 20.3%). Gram-negative bacteria accounted for 35.6% of samples: 22.0% (13/59) were strains of Enterobacter cloacae; 5.1% (3/59) were strains of Klebsiella pneumoniae; and 8.5% (5/59) were strains of Serratia rubidaea. CONCLUSION The rate of scalp wound infections following earthquake-induced craniocerebral trauma, which was dominated by Grampositive Staphylococcus aureus infection, has been markedly elevated in recent years. Early debridement and suturing, nutritional support and application of sensitive antibiotics can augment the therapeutic effect.

Objective: To investigate the clinical value of a minimally-invasive treatment of communicating hydrocephalus using a percutaneous lumboperitoneal (LP) shunt. Method: The clinical and long-term follow-up data of 256 patients suffering from communicating hydrocephalus and undergoing percutaneous LP shunt during 1998 to 2008 were retrospectively analyzed. Results: After the follow-up, which lasted 6 months to 10 years, 219 cases of communicating hydrocephalus recovered well (ventricular size returned to normal and symptoms completely disappeared), 25 cases were brought under control (ventricle size reduced by 50% and symptoms partially abated), and 12 cases showed no obvious changes. Fifteen obese subjects needed modifications of the shunt due to the obstruction of the abdominal end following wrapping, and one subject underwent extubation as the subject was unable to tolerate stimulation of the cauda equina. The effectiveness of shunting was 91.40% and the probability of shunt-tube obstruction, which occurs predominantly in the abdominal end, was only 5.85%, far lower than that of ventriculoperitoneal (VP) shunt. Three subjects had a history of infection following VP shunting. Conclusion: LP shunting is minimally invasive and effective in treating communicating hydrocephalus, with fewer complications.