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A formal [1 + 2 + 3] annulation of methyleneindolinones with o-alkenyl arylisocyanides has been developed for the general and efficient synthesis of both symmetrical and unsymmetrical indolo[3,2- b]carbazoles. The chemoselectivity of this domino reaction was tuned by a tethered alkenyl group, which enables successive formation of three new bonds and two rings from readily accessible starting materials in a single operation. Furthermore, this methodology was used as a key step in the synthesis of the alkaloid malasseziazole C.

Aim: Aseptic meningitis is an unfortunate complication after craniotomy. Continuous lumbar drainage is a safe and effective method for treating postcraniotomy aseptic meningitis. This study compared the incidence of cerebrospinal fluid (CSF) leakage around the tube at the skin exit site and infection associated with tubes placed in two different ways. Patients and Methods: The study enrolled 140 consecutive patients with postoperative aseptic meningitis manifesting as headache and fever and managed by lumbar external drainage (LED) between June 2014 and July 2018. From June 2014 to Jan 2016, an LED catheter was set in a conventional fashion without a subcutaneous tunnel. From Feb 2016 to July 2018, we adopted a modified mode of placing the LED catheter with a subcutaneous tunnel. Drain-related CSF leakage and infection were analyzed between the two groups. Results: Postoperative aseptic meningitis can be easily managed through lumbar CSF drainage. The incidences of drain-associated infection and CSF leakage were 20% and 7.14%, respectively, in group 1 (without subcutaneous tunnels) and 7.14% and 4.28%, respectively, in group 2 (with subcutaneous tunnels). CSF leakage was significantly reduced in group 2 compared to group 1 (P

Dongni Chen,1,* Weidong Wang,1,* Youfang Chen,1 Jia Hu,1 Men Yang,2 Junxian Mo,3 Zhesheng Wen1 1Department of Thoracic Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China; 2Department of Cardio-Thoracic Surgery, The Eighth Affiliated Hospital of Sun Yat-sen University, Shenzhen, Guangdong 518000, China; 3Department of Cardio-Thoracic Surgery, The Seventh Affiliated Hospital of Guangxi Medical University, Wuzhou, Guangxi 543000, China *These authors contributed equally to this work Objective: The aim of this study was to construct a risk model to assess overall survival (OS) and disease-free survival (DFS) in patients with esophageal cancer (EC) after surgery.Patients and methods: A total of 872 consecutive EC patients who had undergone surgery between February 2009 and October 2012 were retrospectively analyzed. The cutoff for risk value (RV) was inferred by receiver operating characteristic curves and the Youden index. A log-rank test was used to compare the survival curves, and a Cox regression analysis was performed to clarify the significant prognostic factors.Results: The area under the curve was 0.688 for OS and 0.645 for DFS. The survival rates were 69.4% (259/373) and 39.1% (195/499), and the rates of recurrence were 19.2% (70/364) and 27.6% (132/479), respectively, for RV

Esophageal neurofibroma is a rare type of benign esophageal tumor. We presented a case of a 63-year-old man with a 12-cm diameter upper-thoracic esophageal submucosal tumor. Surgery of a thoracotomy was performed to remove the lesion. The postoperative course was uneventful and the patient was discharged on the postoperative day 10. Immunohistochemical staining confirmed the diagnosis of esophageal neurofibroma.

Background Pilocytic astrocytomas (PAs) are slow growing neoplasms and usually located at the cerebellum. There has been certainty regarding the truthful benefit of surgical resection for patients with PA. Gross total resection (GTR) of PAs, especially those being situated in deep regions, remains a surgical challenge. Generally, they are considered as benign and usually develop in young patients. PAs, belonging to WHO I can be cured by radical resection. The patients with PA have excellent prognosis if complete resection can be conducted. The use of fluorescein in vermis PA surgery has not been yet reported. Our data presents fluorescein facilitates surgical resection of vermis PA. Methods Five milligrams per kilogram of fluorescein sodium was intravenously injected directly before general anesthesia for the three patients with PA. The yellow 560 filter was employed for microsurgical tumor resection. Surgical outcomes were assessed concerning the extent of resection. Results Most portion of PA in the three cases was found to be highly fluorescent after intravenous fluorescein sodium injection, which markedly enhanced tumor visibility. Gross total resection in all of the patients was achieved without further neurological deficits. No adverse effects and complications resulting from fluorescein sodium were observed over the postoperative course. Conclusions Intraoperative guidance by fluorescein sodium as a new, simple, safe, and practical procedure can enhance the fidelity of tumor tissue and increase the possibility of completely resecting PAs.

There are a large number of in-service water resources and hydropower engineering in the aging stage. It is an urgent problem how to assess and predict service life of water resources and hydropower engineering. The related theory and method need to be proposed to improve the safety management level and make the reinforcing, removing or downgrading decisions. The current achievements in the research are reviewed. The assessment criteria and system are analyzed. The methodological progress for assessment and prediction of service life is summarized. The future development direction is stated. The key problems and their approaches are related and analyzed. It is shown that the assessment and prediction for service life of water resources and hydropower engineering is a comprehensive research topic. To solve the problems in above field, it is necessary to integrate many theories, methods and techniques in other fields such as water resources and hydropower engineering, geotechnical engineering, construction materials, environmental engineering, cybernetics and computer engineering.

In this paper, we study the maximal length of cycle embedding in a faulty wrapped butterfly graph BFn with at most two faults in vertices and/or edges. When there is one vertex fault and one edge fault, we prove that the maximum cycle length is n2n − 2 if n is even and n2n − 1 if n is odd. When there are two faulty vertices, the maximum cycle length is n2n − 2 for odd n. All these results are optimal because the wrapped butterfly graph is bipartite if and only if n is even. © 2003 Wiley Periodicals, Inc.

Previous works on edge-fault tolerance with respect to hypercubes Q/sub n/ are mainly focused on 1-edge fault and 2- or 3-edge fault with limited size of n. We give a construction scheme for 2-EFT(Q/sub n/) graphs and 3-EFT(Q/sub n/) graphs, where n is arbitrarily large. In our constructions, approximately log n extra degree is added to the vertices of Q/sub n/ for 2-edge-fault tolerance, and one more degree for 3-edge-fault tolerance.

A most vital edge of a graph (w.r.t. the spanning trees) is an edge whose deletion most drastically decreases the number of spanning trees. We present an algorithm for determining the most vital edges based on Kirchoff's matrix-tree theorem whose asymptotic time-complexity can be reduced to that of the fastest matrix multiplication routine, currently O(n/sup 2.376/). The foundation for this approach is a more general algorithm for directed graphs for counting the rooted spanning arborescences containing each of the arcs of a digraph. A network can be modeled as a probabilistic graph. Under one such model proposed by Kel'mans, the all-terminal network reliability, maximizing the number of spanning trees is critical to maximizing reliability when edges are very unreliable. For this model, the most vital edges characterize the locations where an improvement of the reliability of the link most improves the reliability of the network. >