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BACKGROUND Implant vagus nerve stimulation is an adjunctive treatment for intractable epilepsy when patients are not suitable for resective surgery. AIM To identify the safety and efficacy of vagus nerve stimulation in children with intractable epilepsy and analyze the effects on different epilepsy syndromes. METHODS Eligible children with intractable epilepsy were admitted to the study. We collected data from preoperative assessments as the baseline. During the follow-up time, we recorded the process of seizures (frequency, duration, and seizure type), the changes of drugs or parameters, the complications, etc. The mean reduction rate of seizures, response rate, and McHugh scale were chosen as the outcomes. RESULTS A total of 213 patients were implanted with Tsinghua Pins vagus nerve stimulators, and the average age was 6.6 years. In the follow-up time of postoperative 3 mo, 6 mo, 12 mo, 18 mo, and 24 mo, the average reduction rate was 30.2%, 49.5%, 56.3%, 59.4%, and 63.2%, while the response rate was 21.8%, 62.5%, 57.1%, 69.2%, and 70.7%. In addition, implanted vagus nerve stimulation had different effects on epilepsy syndromes. The reduction rate of West syndrome increased from 36.4% (postoperative 6 m) to 74.3% (postoperative 24 m). The reduction rate of Lennox-Gastaut syndrome improved from 25.4% to 73.1% in 24 mo. The chi-square test of the five efficacy grades showed P < 0.05. The comparison between the 3-mo follow-up and the 6-mo follow-up showed P < 0.05, and the comparison between the 6-mo follow-up and the 24-mo follow-up showed P > 0.05. CONCLUSION Vagus nerve stimulation is safe and effective in children with intractable epilepsy, and the seizure reduction occurred in a time-dependent manner. Moreover, patients with West syndrome may get the most benefits.

Background KMT2B-related dystonia is a recently discovered hereditary dystonia that mostly occurs in childhood. This dystonia usually progresses to generalized dystonia with cervical, cranial, pharynx and larynx involvement. Our study summarizes genotype-phenotype features and deep brain stimulation (DBS) efficacy observed with KMT2B-related dystonia patients in China. Methods We identified 20 patients with KMT2B variations from dystonia samples with a gene panel and whole exome sequencing. Genetic, clinical and treatment analyses of these patients with KMT2B mutations were further conducted. Results We summarized the genotype and phenotypic characteristics of KMT2B-related patients in China, including 16 sporadic patients and 3 pedigrees (including 4 patients). Thirty-five percent (7/20) of patients had been published previously. The age of onset was between 1 month and 24 years (average 6.90 ± 5.72 years). Sixty-five percent (13/20) of patients had onset from lower limbs. Upper limbs or larynx accounted for 15% (3/20) and 20% (4/20) of patients, respectively. In the same family, male patients tended to have more severe symptoms than female patients. Carriers of KMT2B variants may present with nonmotor symptoms without dystonia. Abnormal endocrine metabolism could also be seen in our patients, including advanced bone age that had never been reported previously. Nine of our patients underwent DBS surgery. The mean follow-up time was 4.9 (range 1.3–16) months after DBS, and perceptible improvement of clinical symptoms were observed. Conclusions The genotypic and phenotypic spectra of Chinese KMT2B-related dystonia patients were further expanded. DBS surgery might be the preferred option for severe KMT2B-related dystonia patients till now.

Objective To investigate the role of dual-layer detector energy spectral CT in resting myocardial perfusion imaging for patients with normal coronary artery. Methods One hundred and fifty-six patients with suspected coronary heart disease underwent dual-layer detector energy spectral CT coronary angiography,and resting myocardial perfusion imaging was performed for 28 patients with normal coronary artery.According to American Heart Association's 17-segmentmodel,the iodine density and effective atomic number(Z

Shenmai injection (SMI) is increasingly used in tumor combination therapy, devoting to enhancing anti-tumor effects and reducing the toxicity of chemotherapy drugs. This study aimed to explore the role of SMI in papillary thyroid carcinoma (PTC) treatment. Flow cytometry was used to examine Treg cells percentage in CD4 + T cells. The expression of RNA and protein was analyzed by quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot, respectively. Inducers were used to stimulate CD4 + T cells to differentiate into Treg cells. The interaction between miR-103 and G protein-coupled estrogen receptor 1 (GPER1) was confirmed with the dual luciferase assays. Cell transfection and recombinant plasmids were used to achieve endogenous expression. Compared with patients not treated with 131 I, the Treg cells percentage and Foxp3 expression were clearly increased in patients with 131 I radiotherapy, just the opposite in SMI combination therapy. SMI inhibited the differentiation of CD4 + T cells into Treg cells. Aberrant expression of miR-103 and GPER1 induced by 131 I was reversed by SMI and 131 I combination therapy. GPER1 was negatively regulated by miR-103 and SMI inhibits the differentiation of CD4 + T cells into Treg cells via miR-103/GPER1 axis, which improves the postoperative immunological function of PTC patients with 131 I radiotherapy.

Mild cognitive impairment (MCI) is commonly observed in Parkinson’s disease (PD), even in the early stages. However, the neural substrates of cognitive impairment in PD remain unclear. The aim of the current study was to investigate the change of local brain function in PD patients with MCI. Fifty patients with PD, including 25 PD patients with MCI (PD-MCI) and 25 PD patients with normal cognition (PD-NC), and 25 age- and sex-matched healthy controls (HC) were enrolled. Conventional magnetic resonance imaging (MRI), 3D structural images, and resting state-functional MRI (rs-fMRI) were performed in all subjects. Regional homogeneity (ReHo) was measured based on the rs-fMRI images to investigate the altered local brain functions. Brain regions with decreased ReHo were located in the left posterior cerebellar lobe in PD sub-groups compared to the HC group, and the brain regions with increased ReHo were located in the limbic lobe (right precuneus/bilateral middle cingulate cortex) in PD-MCI compared with HC group. PD-MCI presented with increased ReHo in the bilateral precuneus/left superior parietal lobe and decreased ReHo in the left insula compared to PD-NC. ReHo values for the left precuneus were negatively related to neuropsychological scores, and ReHo values for the left insula were positively related to neuropsychological scores in PD subjects. The present study demonstrated abnormal spontaneous synchrony in the left insula and left precuneus in patients with PD-MCI compared to PD-NC, which might provide a novel insight into the diagnosis and clinical treatment of cognitive impairment in PD.

The authors describe the case of a spontaneous out-of-body experience (OBE) in a 15-year-old right-handed boy with intractable epilepsy in whom psychosis had been misdiagnosed. After successful resection of a right temporoparietal focal cortical dysplasia, the OBE and seizures resolved. The authors analyzed the underlying causes of the OBE and discussed the mechanism of the OBE caused by an epileptic lesion.

To investigate the conventional magnetic resonance (MR) findings of cervical spinal cord, to explore the possible changes on diffusion tensor imaging (DTI) in patients with amyotrophic lateral sclerosis (ALS), and to assess the correlations between the changes on DTI and clinical parameters in patients with ALS.Conventional MR imaging (MRI) and DTI in 24 patients with ALS and 16 age-matched control subjects were obtained. On axial planes, regions of interest (ROIs) were marked in bilateral spinothalamic tracts (STs), posterior funiculus, and bilateral lateral corticospinal tracts (LCTs), respectively, at the levels of cervical 2-4 vertebral bodies. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of these ROIs were estimated. Independent sample t test and Pearson correlation analysis were used.In patients with ALS, no abnormal findings were noted in the cervical spinal cord on conventional MRI. FA values of bilateral LCTs decreased significantly compared to those of the control group (P.05), and ADC values of bilateral LCTs were significantly greater than those of the control group (P.05). FA and ADC values of bilateral LCTs showed no significant difference between patients with definite and probable ALS (P.05). No significant correlation existed between abnormal DTI parameters (FA and ADC values of bilateral LCTs) and clinical parameters (P.05).Subtle abnormalities in bilateral LCTs in the "normal-appearing" cervical spinal cord can be detected using quantitative DTI technique in patients with ALS.

Functional connectivity is altered in several mental disorders. We used resting-state functional MRI to examine the alterations in functional connectivity that occur in patients with absence epilepsy. We found an altered functional connectivity within and between functional modules in patients with absence epilepsy. Some brain regions had a greater number of altered connections. The functional connectivity within and between modules in absence epilepsy patients showed an increase in the number of positive connections and a decrease in the number of the negative connections. In particular, the superior frontal gyrus demonstrated both an increased number of connections with other nodes of the frontal default mode network and a decreased number of connections with the limbic system. These findings provide a new perspective and shed light on how the balance of connections within and between modules may contribute to the development of absence epilepsy.

Functional connectivity has been correlated with a patient’s level of consciousness and has been found to be altered in several neuropsychiatric disorders. Absence epilepsy patients, who experience a loss of consciousness, are assumed to suffer from alterations in thalamocortical networks; however, previous studies have not explored the changes at a functional module level. We used resting-state functional magnetic resonance imaging to examine the alteration in functional connectivity that occurs in absence epilepsy patients. By parcellating the brain into 90 brain regions/nodes, we uncovered an altered functional connectivity within and between functional modules. Some brain regions had a greater number of altered connections and therefore behaved as key nodes in the changed network pattern; these regions included the superior frontal gyrus, the amygdala, and the putamen. In particular, the superior frontal gyrus demonstrated both an increased value of connections with other nodes of the frontal default mode network and a decreased value of connections with the limbic system. This divergence is positively correlated with epilepsy duration. These findings provide a new perspective and shed light on how functional connectivity and the balance of within/between module connections may contribute to both the state of consciousness and the development of absence epilepsy.

In hydrogen-cooled generator, the quality of hydrogen environment directly affects generator’s operating especially the retaining ring. In order to research the relationship between the hydrogen environment and stress corrosion of material, the metallographic analysis is held for retired retaining ring of a power plant. There were intergranular and transcrystalline cracks, similar with hydrogen embrittlement. Designed generating system of occurrence for wet hydrogen, hydrogen charging is operated to retaining ring material used in tensile test, and then observed fracture by scanning electron microscope. The results showed that fracture was including cleavage, dimple and secondary crack caused by hydrogen-induced lagging plastic deformation.

Positron emission tomography (PET) scan with tracer [18F]-fluorodeoxy-glucose (18F-FDG) is widely used to measure the glucose metabolism in neurodegenerative disease such as Idiopathic Parkinson’s disease (IPD). Previous studies using 18F-FDG PET mainly focused on the motor or non-motor symptoms but not the severity of IPD. In this study, we aimed to determine the metabolic patterns of 18F-FDG in different stages of IPD defined by Hoehn and Yahr rating scale (H-Y rating scale) and to identify regions in the brain that play critical roles in disease progression. Fifty IPD patients were included in this study. They were 29 men and 21 women (mean±SD, age 57.7±11.1 years, disease duration 4.0±3.8 years, H-Y 2.2±1.1). Twenty healthy individuals were included as normal controls. Following 18F-FDG PET scan, image analysis was performed using Statistical Parametric Mapping (SPM) and Resting-State fMRI Data Analysis Toolkit (REST). The metabolic feature of IPD and regions-of-interests (ROIs) were determined. Correlation analysis between ROIs and H-Y stage was performed. SPM analysis demonstrated a significant hypometabolic activity in bilateral putamen, caudate and anterior cingulate as well as left parietal lobe, prefrontal cortex in IPD patients. In contrast, hypermetabolism was observed in the cerebellum and vermis. There was a negative correlation (p=0.007, r=-0.412) between H-Y stage and caudate metabolic activity. Moreover, the prefrontal area also showed a negative correlation with H-Y (P=0.033, r=-0.334). Thus, the uptake of FDG in caudate and prefrontal cortex can potentially be used as a surrogate marker to evaluate the severity of IPD.

Object The goal in this study was to investigate early diagnostic evidence, optimal therapeutic strategies, and prophylactic methods for slit ventricle syndrome (SVS) in patients with temporal lobe arachnoid cysts who received cyst-peritoneal (CP) shunts. Methods Six cases of SVS in patients with temporal lobe arachnoid cysts who received CP shunts were treated by the senior authors in 2 institutions between January 2005 and January 2009. The radiological data, treatment process, and therapeutic results were reviewed retrospectively. Results There were 4 boys and 2 girls, whose mean age at presentation was 4 years and 1 month. The main clinical symptoms were severe headache, nausea, vomiting, and decreasing eyesight. Radiological studies showed normal or slightly smaller than normal ventricles, and arachnoid cysts that had shrunk dramatically. The most effective treatment for SVS was to replace the original shunts with devices that had a programmable valve, or if this was unsuccessful, to replace the original shunts with ventriculoperitoneal (VP) shunts. All symptoms in these patients disappeared, and the mean follow-up duration was 24 months. Conclusions The SVS presents more often in patients with hydrocephalus who undergo VP shunting. However, it is also a serious complication in patients with arachnoid cysts who receive a CP shunt. The SVS is not a single condition; rather, different pathophysiological conditions can underlie this complicated syndrome. Because there are no striking morphological changes on radiological studies of the SVS in the patients with CP shunts, it is not easy for this syndrome to be diagnosed in time and treated rationally. Misdiagnosis and delayed treatment usually occur. The use of programmable shunts or VP shunts to replace the original shunt is an optimal therapeutic choice. The use of low-pressure shunts to treat arachnoid cysts should be abandoned unless dictated by specific indications.

This paper describes the development and main operational capabilities of Voyager, a PC-based, geospatially-enabled piece of software that can fuse and visualize large, multi-variable data sets that change in space (XYZ) and time (T). The new software has the ability to simultaneously visualize imagery, bathymetry/terrain, true volumetric (voxel), and flow field data in a fully interactive geo-referenced mode. In addition to providing global coverage, a key feature of this software is the capability to interactively visualize large data sets while operating on a desktop PC. This is achieved by using tiling and level-of-detail (LOD) technology for terrain, imagery, and volumetric data, as well as compression techniques and the multi-threading capabilities of modern PCs.

In order to overcome the uncertain throw distance problem in vehicle-pedestrian accident reconstruction, the relationship between the flight-phase distance and the impact velocity was studied. A useful equation was given, which can be used for evaluating the minimum value of the impact velocity when the accident happened on a flat road. The equation was validated through comparison with other scholars’ research and simulation results obtained from the Pc-Crash. The study on the relationship between the flight-phase distance and the impact velocity will be a good supplement to existing vehicle-pedestrian accident reconstruction methods.

Despite advances in microsurgery and the development of new endovascular techniques, the treatment of complex intracranial aneurysms remains a daunting challenge for neurosurgeons. In the present study, we retrospectively reviewed our experience of bypass surgery in the treatment of 93 cases of complex intracranial aneurysms. A series of 93 consecutive cases of complex intracranial aneurysms were treated with bypass surgery between April 2004 and July 2013. Radial artery (RA) grafts were used in 58 cases, saphenous vein (SV) grafts in 16 cases, and occipital artery (OA) grafts in 6 cases, while the remaining 13 cases were managed with superficial temporal artery (STA) grafts. In this series, the aneurysms were excised after trapping in 32 cases with mass effect and neural compression. Proximal occlusion of the parent artery was performed in 22 cases of fusiform or giant dissecting aneurysms with subsequent retrograde flow to avoid compromise of the perforators nearby. Trapping was performed after bypass surgery in the remaining 39 cases. Postoperative angiographies were performed in 91 patients and patency of the bypass graft and obliteration of the aneurysms were confirmed in 89 patients. Patency of the bypass could not be confirmed in the remaining two patients, of which one presented with cerebral infarction due to graft occlusion, and the other remained asymptomatic. Within 1 month after surgery, 88 patients had good outcome, four patients needed assistance for daily living, and one death occurred due to brainstem infarction. In 77 patients with a mean follow-up of 3.0 years, 72 patients had good outcome, 4 patients needed assistance for daily living, and 1 death occurred unrelated to surgery. Complex intracranial aneurysms present unique therapeutic challenges that require thorough surgical planning, individualized treatment strategies, and refined neurovascular techniques for successful outcome. Proper use of bypass surgery is imperative in preserving the parent artery and its major perforators. The internal maxillary artery, used as a donor in a bypass, is an effective method due to its shorter distance from the recipient vessels and relatively large diameter with resulting higher flow rate.

The braking situation is important information in vehicle-pedestrian accident responsibility identification. In order to distinguish the braking situation, the relation between the post-braking distance and the throw distance on slope roads were studier firstly, and then the Pc-Crash and those existing research results were used for validating the proposed relation, finally a method used for analyzing the probability that a vehicle is fully braked or not was proposed based on the obtained relation. According to the method, the probability curve of two special cases were given, results showed that the method proposed in the paper is meaningful in practice.

Vehicle will cross the pole when using the Pc-Crash to reconstruct a side pole impact accident. In order to overcome this problem, a fractional step method based on Pc-Crash was proposed. In this method, the motion of the vehicle before impact is reconstructed firstly, and then the impact between the vehicle and the pole will be reconstructed, these two steps will be repeated to obtain a reasonable simulation results. Finally, a side pole impact accident was given, the steps of the fractional step method were demonstrated, and results showed that this new method is feasible in practice. The practical step method will reduce the difficulty of accident reconstruction and make the reconstruction results more credible.

This paper describes recent efforts to create a fully interactive visualization system that operates within a standard desktop web browser. We present the client-server architecture of the new system, in which a visualization server is able to stream rendered images to a lightweight client operating within a user's web browser. We show that this system is practical in various usage scenarios, including a marine environmental display and collaborative visualization of massive LIDAR point clouds, and that it is an effective means to bring scientific visualization to low-powered desktops computers and tablets.

The subtemporal transtentoral approach has been reported for nearly two decades; however it was not well used due to some limitations in dealing with large and giant petroclival meningiomas. The clinical outcome and merit of the modified subtemporal transpetrosal apex approach in large and giant petroclival meningiomas, as well as the choices, the improvements and the therapy strategies of the microsurgical approach in such patients were evaluated in this study.Totally 25 cases of large and giant petroclival meningiomas undergone the modified subtemporal transpetrosal apex approach between April 2004 and January 2010 were enrolled in this study. The choice and improvement of the approach, the basis of anatomy and related research, the effect of accessory equipment, the exposure of tumor and the changes of neurofunction pre- and post-operation were all reviewed retrospectively. The operation outcomes and complications in this approach were also compared with those in the transpetrous presigmoid approach done in 14 cases in the same period.All 25 cases underwent the modified subtemporal transpetrosal apex approach under electrophysiologic monitoring of cranial nerves and brain stem function. Trochlear nerve was partly wrapped in 14 cases, totally wrapped but can be explored in the initial segment of the cerebellum tentorium in 8 cases, totally wrapped and could not be seen until tumor was partly removed in 3 cases. The cerebellum tentorium was cut along the temporal bone from the anterior part of the apex to the mastoid part of superior petrous sinus in 6 cases, from the posterior part of the apex to the mastoid part of superior petrous sinus in 19 cases. Gross tumor resection was accomplished in 17 (68%) patients, subtotal resection in 7 (28%) patients, and partial resection in 1 (4%) patient. The most common postoperative complication was new neurological deficits or aggravations of preexisting deficit (64%). Follow-up ranged from 3 to 69 months. Compared with the transpetrous presigmoid approach done in 14 cases in the same period, the modified subtemporal transpetrosal apex approach showed obvious advantages such as simplicity in manipulating, microinvasiveness, less time-consuming, less complication, higher rate of tumor resection though the rates of gross tumor resection might be of no significant difference.Modified subtemporal transpetrosal apex approach has obvious advantages compared with the transpetrous presigmoid approach. Some complications need to be solved by practice and modification of the approach as well as the accumulation of the experiences.

To evaluate patients' clinical outcome, survival and performance status at the mild-term follow-up evaluation after optimal microsurgical resection of large and giant petroclival meningiomas (PCMs).During a 4-year period (2004-2008), 41 patients underwent operative procedures for resection of PCMs. The tumour size was large or giant in 100% of the patients, with a mean tumour diameter of 4.4 cm. Tumours extended into adjoining regions in 26 of the patients. Six previously underwent operation or irradiation. Gross tumour resection (GTR) was accomplished in 25 (61.0%) patients, subtotal resection (STR) in 15 (36.6%) patients and partial resection in 1 (2.4%) patient. There were no operative deaths. Postoperative complications (cerebrospinal fluid leakage, quadriparesis, infections, cranial nerve palsies, etc.) were observed in 27 (65.9%) patients. Postoperative radiation or radiosurgery was administered to 6 of the 41 patients who had residual tumours.At the conclusion of the study, 27 (65.9%) patients were alive with radiological evidence of the residual disease, and 14 (34.1%) patients were alive without radiological evidence of the residual disease. The mean follow-up period was 35 months (range, 15-45 months). Six (14.6%; five of the STR and partially resected patients and one of the total resection patients) had recurrence; of these patients, four underwent repeat resection and two were treated with gamma knife radiosurgery. The Karnofsky Performance Scale score was 78 ± 14 preoperatively, 80 ± 10 at 1 year postoperatively and 81 ± 10 at the time of the latest follow-up evaluation. Common disabilities at the time of the follow-up evaluation included diplopia, facial numbness and swallowing difficulty. Most patients developed coping mechanisms.The surgical strategy of large and giant PCMs should be focused on the survival and postoperative quality of life. The good surgical approach should be based on the tumour location, the growth direction, the invasion of adjacent structure, the age of the patients and the experience of neurosurgeons. Selectively pursuing an STR without radiotherapy rather than a GTR is a reasonable strategy. Moreover, microneurosurgical technique plays a key role in the level of tumour resection and preservation of nerve function. Intraoperative electrophysiological monitoring also contributes dramatically to the preservation of the nerve function.

Beijing Functional Neurosurgery Institute, Xuanwu Hospital, The Capital University of Medical Sciences, Changchun Street Number 45, Xicheng District, Beijing 100053, China Department of Neurosurgery, Sanbo Neurosurgical Hospital, No. 50, Xiangshan Yikesong Road, Haidian District, Beijing 100093, China The Department of Neurosurgery, The Armed Police General Hospital of China, Yongding Road Number 69, Haidian District, Beijing 100039, China

This paper describes the development and main operational capabilities of a PC-based, geospatially enabled software that can fuse and visualize large, multi-variable data sets that change in space (x, y, z) and time (t). The new software has the ability to simultaneously visualize imagery, bathymetry/terrain, and true volumetric (voxel) data in a fully interactive geo-referenced mode. In addition to providing global coverage, a key feature of this software is the capability to interactively visualize large data sets while operating on a desktop PC. This is achieved by using tiling and Level Of Detail (LOD) technology for terrain, imagery, and volumetric data as well as compression techniques and the multithreading capabilities of modern PCs.

To observe the mechanical properties of the prefabricated connective tissue tube as blood vessel substitute and its changes after implantation at the femoral artery.The acellular matrix tube of 8-12 cm in length with a silicone rod inside it was implanted into dog peritoneal cavity. 3 weeks later, a new formed tube around the silicone rod was transferred to the femoral artery as blood vessel substitute. The mechanical properties and histological examination of the blood vessel substitute were assessed and compared to those of the carotid artery and vein. 6 months after transfer, the patency of the blood vessels substitute was observed. The histological change was studied by light microscopy, scanning and transmitting electron microscopy.(1) The mechanical properties of blood vessel substitute was not as strong as artery, but better than the vein. (2) There were elastic and collagen fibers with many fibroblasts around the tube wall, but few mesothelial cells around the inner wall. All of the blood vessel substitutes (n = 6) were found to keep patency and the structure of the blood vessels substitutes became similar to femoral artery 6 months after they had been grafted to the femoral artery.These results suggest that tissue engineering in vivo is a good approach to construct vessels substitute. The tissue tubes made in dog's peritoneal cavity have good condition when it is used as a blood vessel substitutes.

Link Analysis plays an important role in Web Information Retrieval. Most of the existing link analysis algorithms use link as the main factor to determine the importance of a Web page, which can not reflect complicated relationships among Web pages. In this paper, we propose G-HITS (Gravitation-Based HITS), which condenses useful information associate to a Web as its "mass ", and reflects relationship between two Web pages as "attractive force" inspired by Newton's theory of gravitation, thus giving a physical interpretation for link analysis. Experimental results show that G-HITS is more reasonable to interpret link analysis problems and it can identify higher quality authorities on given topics.

Denial of Service (DoS) attack is one of the most common network attacks on network in the present. Usually DoS attack is often executed in fraudulent way, so they have the characteristic of fraudulence and danger. A new method of DoS intrusion detection based on the immune danger theory is presented in the paper, according to the characteristic of DoS intrusion. In the method, a definition of danger signal with a formula of computing it quantificationally is presented. And the method is tested by experiment in which DoS intrusion is detected in the real-time way. The results of the experiment show that the method can not only detect DoS intrusion in the real-time way, but also have the advantage of working with less false positive rate and with faster response. It is an effective method for DoS intrusion detection.

OBJECTIVE Crosslink decellularized canine carotid artery allograft by EDC [1-3-(dimethylamino)propyl-3-ethylcarbodiimide methiodide] and evaluate the biocompatibility of it.Use the multi-step detergent-enzyme method to construct decellularized canine carotid artery allograft and cross-link it by EDC with the weight ratio of decellularized artery to EDC 1:1 and 1:2. Evaluate the biocompatibility of it by the cytotoxical MTT test and the rat subdermal bury test.Decellularized canine carotid artery cross-linked by EDC has a lower degradation rate treated by collagenase type II, the result of MTT test show that the EDC cross-linked decellularized artery has no cytotoxity and the rat subdermal bury test show that crosslinking greatly enhance the ability of decellularize artery to resist the enzyme degradation and lower the immune reaction. The more the artery was cross-linked , the more effects it has.Decellularized canine carotid artery cross-linked by EDC has fairly good biocompatibility and ability to resist the collagenase degradation.

Collapsin response mediator proteins (CRMPs) are important molecules in neurite outgrowth and axonal guidance. Within the CRMP family, CRMP-2 has been implicated in several neurological diseases (Alzheimer's, epilepsy, and ischemia). Here, we investigated the integrity of CRMPs (CRMP-1, -2, -4, -5) after in vitro neurotoxin treatment and in vivo traumatic brain injury (TBI). After maitotoxin (MTX) and NMDA treatment of primary cortical neurons, a dramatic decrease of intact CRMP-1, -2 and -4 proteins were observed, accompanied by the appearance of distinct 55-kDa and 58-kDa breakdown products (BDP) for CRMP-2 and -4, respectively. Inhibition of calpain activation prevented NMDA-induced CRMP-2 proteolysis and redistribution of CRMP-2 from the neurites to the cell body, while attenuating neurite damage and neuronal cell injury. Similarly, CRMP-1, -2, and -4 were also found degraded in rat cortex and hippocampus following controlled cortical impact (CCI), an in vivo model of TBI. The appearance of the 55-kDa CRMP-2 BDP was observed to increase, in a time-dependent manner, between 24 and 48 h in the ipsilateral cortex, and by 48 hours in the hippocampus. The observed 55-kDa CRMP-2 BDP following TBI was reproduced by in vitro incubation of naive brain lysate with activated calpain-2, but not activated caspase-3. Sequence analysis revealed several possible cleavage sites near the C-terminus of CRMP-2. Collectively, this study demonstrated that CRMP-1, -2, and -4 are degraded following both acute traumatic and neurotoxic injury. Furthermore, calpain-2 was identified as the possible proteolytic mediator of CRMP-2 following excitotoxic injury and TBI, which appears to correlate well with neuronal cell injury and neurite damage. It is possible that the calpain-mediated truncation of CRMPs following TBI may be an inhibiting factor for post-injury neurite regeneration.

To construct tissue engineered cartilage using cartilage microparticle acellular tissue matrix (CMACTM) as scaffold.To determine the content of hydroxyproline, glycosaminoglycan and DNA of CMACTM prepared from sheep's articular cartilage with multistep enzymic method, and to analyze CMACTM with gross observation, histology and scanning electron microscopy. Allogenic chondrocytes were mixed with CMACTM and cultured in vitro from 0 to 35 days. Observations through inverted microscope, scanning and transmission electron microscope, quantifications of hydroxyproline, glycosaminoglycan and DNA in the composite, cells adhesion rate were applied to analyze the results.The diameter of CMACTM was 0.100-0.154 mm, which contain extracellular matrix only. Hydroxyproline, glycosaminoglycan and DNA quantifications in CMACTM were 204.374 +/- 3.120 microg/mg, 18.302 +/- 2.037 microg/mg and 0.042 +/- 0.013 microg/mg respectively. Allogenic chondrocytes enclosed CMACTM tightly, hydroxyproline, glycosaminoglycan and DNA quantifications in the composite of the two formers increased with difference on 7th day compared with that on 0 day, reached to the peaks on 14th day (hydroxyproline, DNA) and on 21st day (glycosaminoglycan), and retained at a high level on the following days. Cells adhesion rate was 92%.Allogenic CMACTM possessed satisfactory biocompatibility for chondrocytes and provided a new scaffold for cartilage tissue engineering.

To document the vascular anatomy of the distally based superficial sural artery flap and to study the vascular anastomoses between the superficial sural artery and the septocutaneous perforators of the peroneal artery.Ten fresh human cadavers were injected with lead oxide, gelatin and water. Twenty lags were then dissected and an overall map of the cutaneous vasculature was constructed. Vascular communications between the superficial sural artery and the lowest septocutaneous perforator of the peroneal artery was evaluated to determine the cutaneous vascular territory of the superficial sural flap. The distally based superficial sural artery island flap was used in 26 cases.There is constant vascular anastomosis between the superficial sural artery and the lowest septocutaneous perforator of the peroneal artery. The 26 flaps survived uneventfully except for two of partial fat necrosis.The anatomic information enhances our understanding of flap design.

To investigate a new technique for functional treatment of chronic facial paralysis.Based on anatomy of intramuscular neurovascular structure in the rectus femoris muscle, 7 consecutive patients with facial paralysis were treated by using a technique of microsurgically free-transferring neurovascular rectus femoris muscle segment to the face in one-stage. Follow-ups were 10 to 24 months.All of the 7 patients showed significantly improvement in the appearance of the oral commissure and oral competence. No complications occurred in the donor site.The above mentioned technique may have the advantages of preventing the intramuscular nerve and vessel from the surgical injury during splitting the muscle. It could also maintain the transferred muscular segment in a proper tension in the recipient site.

The objective of this anatomic study was to investigate the intramuscular neurovascular configuration and to evaluate whether the muscle could be split into two functional units in transplantation.Ten fresh cadavers and ten preserved cadavers were used in the study. A mixture of lead oxide, gelatin and water was injected to the femoral artery of the fresh cadaver. The rectus femoris muscle with its neurovascular pedicles was dissected and radiographed.Three vascular patterns of the rectus femoris muscle were found in the 40 cadaver legs. The muscle received its blood supply through a single vascular pedicle (12.5%), or a dominant pedicle with 1-2 ramified (80%), or two dominant vascular pedicles (7.5%).The study provided a detailed description on the intramuscular neurovascular territories of the rectus femoris muscle. Based on the neurovascular supply of the muscle, it is possible to subdivide the muscle into two functional units for segmental muscle transfer.

During a 10-year period, 41 patients underwent surgery for resection of large or giant petroclival meningiomas. Gross total resection (GTR) was accomplished in 25 patients (61.0%), subtotal resection (STR) in 15 patients (36.6%), and partial resection in one patient (2.4%). Postoperative complications were observed in 27 patients (65.9%). Postoperative radiosurgery was administered in six patients who had residual tumors. Survival and postoperative quality of life are the goals of successful surgery on large or giant petroclival meningiomas, and the strategic surgical approach is based on the tumor location, the direction of growth, the invasion of adjacent structures, patient age and neurosurgeon expertise. Selectively pursuing STR with radiotherapy rather than GTR is a reasonable strategy.