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Spontaneous intracerebral hemorrhage (ICH) is a commonly occurring disease in neurosurgery, yet its surgical treatment is controversial. This paper pertains to the study of the effects of different treatment regimens on the outcome of ICH population. Based on a globally shared third-party MIMIC-III database, the researchers firstly described the dissimilarities in survival probability, mortality, and neurological recovery among mainstream treatments for ICH; secondly, patient classification was determined by important clinical features; and outcome variations among treatment groups were compared. The 28-day, 90-day, and in-hospital mortality in the craniotomy group were significantly lower than minimally invasive surgery (MIS) and non-surgical group patients; and, the medium/long-term mortality in MIS group was significantly lower than the non-surgical group. The craniotomy group positively correlated with short-term GCS recovery compared with the MIS group; no difference existed between the non-surgical and MIS groups. The craniotomy group 90-day survival probability and short-term GCS recovery were superior to the other two treatments in the subgroups of first GCS 3-12; this tendency also presented in the MIS group over non-surgical group. For milder patients (first GCS 12), the three treatment regimens had a minimal effect on patient survival, but the non-surgical group showed an advantage in short-term GCS recovery. Craniotomy patients have a lower mortality and a better short-term neurological recovery in an ICH population, especially in short-to-medium term mortality and short-term neurological recovery over MIS patients. In addition, surgical treatment is recommendable for patients with a GCS ≤ 12.

Reed is a common species in China's estuarine wetlands, contains high carbon and low nitrogen, and its litters have potential to be reused as external carbon source to achieve denitrification efficiency enhancement in estuarine wetlands. In this study, leaching experiments of reed leaf and stem under estuarine wetland salinity were conducted, and a certain amount of reed litters was then added into simulated estuarine wetlands under 0‰ and 7‰ salinity respectively. It was observed that reed litters had a higher release of total organic carbon (TOC) under 7‰ salinity than 0‰ salinity, and reed leaf litters released more TOC than stem litters did. Meantime, it was found that salinity had a more significant effect on TOC leached from stems than from leaves. In simulated estuarine wetlands, NO3--N removal rates were found to be improved about 20% under 7‰ salinity and 25% under 0‰ salinity in average after the addition of mixed litters, and almost no additional improvement in NO3--N removal was found after leaf-only litter addition compared with mixed litter addition. Besides, mixed litter addition could work two weeks longer than leaf-only litter addition. Moreover, the microbial community change was analyzed by high-throughput sequencing and found that litter addition could increase the denitrification-related genera and then increased the NO3--N removal efficiency. For simulated estuarine wetland, reed litter addition could achieve better nitrogen removal efficiency.

Background Evidence regarding the relationship between preoperative platelet and 30-day postoperative mortality of intracranial tumor patients undergoing craniotomy is still limited. Therefore, the present research was conducted to explore the link of the platelet and 30-day postoperative mortality. Methods Electronic medical records of 18,642 adult patients undergoing craniotomy for brain tumors from 2012 to 2015 in the American College of Surgeons National Surgical Quality Improvement Program, were subject to secondary retrospective analysis. A binary logistic regression model evaluated the independent association between preoperative platelet and 30-day postoperative mortality. A generalized additive model and smooth curve fitting was conducted to explore the exact shape of the curve between them. Additionally, We also conducted sensitivity analyses to test the robustness of the results, and performed subgroup analyses. Results Eighteen thousand sixty-three patients were included in this study analysis. Of these, 47.49% were male. The mean preoperative platelet value was (244.12 ± 76.77) × 109/L. The 30-day postoperative mortality of included participants was 2.5% (452/18,063). After adjusting covariates, the results showed that preoperative platelet was positively associated with 30-day postoperative mortality (OR = 0.999, 95%CI: 0.997, 1.000). There was also a nonlinear relationship between preoperative platelet and 30-day postoperative mortality, and the inflection point of the platelet was 236. The effect sizes (OR) on the right and left sides of the inflection point were 1.002 (1.000, 1.004) and 0.993 (0.990, 0.995), respectively. And sensitive analysis demonstrated the robustness of the results. Subgroup analysis showed a stronger association between preoperative platelet and 30-day postoperative mortality in non-emergency surgery patients when preoperative platelet value is less than 235 × 109/L. Conclusions This research demonstrates a positive and non-linear relationship between preoperative platelet and 30-day postoperative mortality in U.S. adult brain tumor patients undergoing craniotomy. Preoperative platelet is strongly related to 30-day postoperative mortality when the platelet is less than 235 × 109/L. Proper preoperative management of platelet and maintenance of platelet near inflection point (235) could reduce risk of 30-day postoperative mortality in these cases.

Première traduction anglaise d’une collection de mythes spécifiques aux tribus aborigènes de l’île de Taïwan (Atayal, Saisiyat, Bunun, Tsou, Paiwan, Rukai, Amis, Yami, Pingpu) : mythe du déluge ainsi que divers mythes étiologiques (origine du vent, de l’arc-en-ciel, de l’immortalité).

Probing proton transport is of vital importance for understanding cellular transport, surface catalysis and fuel cells. Conventional proton transport measurements rely on the use of electrochemical conductivity and do not allow for the direct visualization of proton transport pathways. The development of novel experimental techniques to spatiotemporally resolve proton transport is in high demand. Here, building upon the general conversion of aqueous proton flux into spatially resolved fluorescence signals, we optically visualize proton transport through nanopores and along hydrophilic interfaces. We observed that the fluorescence intensity increased at negative voltage due to lateral transport. Thanks to the temporal resolution of optical imaging, our technique further empowers the analysis of proton transport dynamics.

Background. Large scalp defects, especially those complicated by calvarial defects, titanium mesh exposure, or cerebrospinal fluid (CSF) leak, pose a challenge for the neurosurgeon and plastic surgeon. Here, we describe our experience of reconstructing the complex scalp defect with free flap transfer. Methods. From October 2012 to September 2017, 8 patients underwent free flap transfer for the reconstruction of the scalp or complicated scalp and calvarial defects. Five patients presented with scalp tumor and the other 3 patients with scalp necrosis or ulceration (2 patients with titanium plate exposure). Seven anterolateral thigh flaps and one radial forearm flap were harvested and employed. The clinical data, including defect characteristics, flap type, complications, and outcomes, were recorded and analyzed. Results. Five patients were pathologically diagnosed with malignant tumor, and 3 of them were given further radiotherapy. For the 2 patients with exposure of titanium plate, no titanium plate was removed. For the patient with scalp necrosis after decompressive craniectomy accompanied by CSF leakage, the CSF leak was stopped after reconstruction. The size of the flaps ranged from 3 to 14 cm in width and 4 to 18 cm in length. No flap failure occurred in these cases. From follow-up to the present, no ulceration or necrosis occurred. Conclusions. Free flap transfer is an ideal method for the reconstruction of large, complicated scalp defects with a one-stage operation. The anterolateral thigh flap is favored because of its durability, adjustability, water tightness, and infection prevention.

We prove the existence and multiplicity of subharmonic solutions for bounded coupled Hamiltonian systems. The nonlinearities are assumed to satisfy Landesman-Lazer conditions at the zero eigenvalue, and to have some kind of sublinear behavior at infinity. The proof is based on phase plane analysis and a higher dimensional version of the Poincaré-Birkhoff twist theorem by Fonda and Ureña. The results obtained generalize the previous works for scalar second-order differential equations or relativistic equations to higher dimensional systems.

Background Central nervous system (CNS) tuberculoma is a rare disease with severe neurological deficits. This retrospective research is to review the data of patients diagnosed as CNS tuberculoma. Surgeries were performed in all patients. The clinical features especially the neurological image and the anatomical characters of the tuberculomas were concerned. Methods Totally 11 patients diagnosed as CNS tuberculoma were admitted in Guangzhou First People’s Hospital (7cases) and Changzheng Hospital (4 cases) during 2006–2015. The data including preoperative condition, neurological imaging, and surgical findings was collected and analyzed. Results The lesions of nine patients (9/11) were totally or subtotally excised and two (2/11) were partially excised. Neurological functions of all patients were improved after surgery without secondary infection. Lesions of nine (9/11) patients preoperatively progressed as a result of paradoxical reaction. Of the 9 patients demonstrated paradoxical progression, all lesions were partially or totally located at the cisterns or the subarachnoid space. Preoperative ATTs lasted 2 to 12 months and tuberculomas were not eliminated. The arachnoid was found thickened and tightly adhered to the lesions during surgeries. Of the 2 cases that paradoxical reaction were excluded, both patients (case 6, intramedullary tuberculoma; case 11, intradural extramedullary tuberculoma) were admitted at onset of the disease. ATTs were preoperatively given for 1 week as neurological deficits aggravated. The tuberculous lesions of CNS or other system showed no obvious change and paradoxical reaction could not be established in both cases. Conclusions Exudates of tuberculosis is usually accumulated in the cisterns and frequently results in the paradoxical formation of tuberculoma. Intracisternal tuberculoma is closely related to paradoxical reaction and refractory to anti-tuberculosis therapy. Micro-surgical excision is safe and effective. Early surgical intervention may be considered in the diagnosis of intracisternal tuberculoma especially when paradoxical reaction participates in the development of tuberculoma.

The effect of Polygonum multiflorum against hair loss has been widely recognized. 2,3,5,4′-Tetrahydroxystilbene-2-O-β-D-glucoside (TSG) is the main component of Polygonum multiflorum; however, its role in hair regeneration has not been established. To evaluate the hair growth-promoting activity of TSG, depilated C57BL/6J mice were topically treated with normal saline, TSG, Pifithrin-α, Minoxidil for 2 weeks. In this study, we identified that p53, Caspase-3, Active Caspase-3, and Caspase-9 were obviously upregulated in the skin of human and mice with hair loss by western blot analysis. Depilated mice treated with TSG showed markedly hair regrowth. TUNEL+ cells were also reduced in mice with TSG. These changes were accompanied with inhibition of Fas, p53, Bax, Active Caspase-3, and Procaspase-9 activities. These results demonstrated that TSG exerts great hair regrowth effect on hair loss, which was probably mediated by inhibition of p53, Fas, and Bax induced apoptosis.

This essay explores the Chinese imagination and “logic” that construct both literal and figurative ways of ascending to heaven from the mythic or imaginary facts to the pragmatic and spiritual practice. Many Taoist philosophers and alchemists draw on figurative language and allegories to demonstrate abstract notions and wisdom. This figurative mediation is reminiscent of Plato’s approach in staging Socrates as a “teller of myth”. The present study thus resorts to the theory of the imaginary to better illuminate the underlying symbolism and the universal imaginary in Chinese texts and thought. The Taoist imagination of celestial ascension evolves from the mythic figures, to the rhetorical figures of metaphysics, through to theoretical and literary alchemy. This imaginary actualization is possible through the spatial and temporal passages offered by mountain caves and animal rides.

Glioma stem cells (GSCs) are thought to be critical for resistance to radiotherapy and chemotherapy and for tumor recurrence after surgery in glioma patients. Identification of new therapeutic strategies that can target GSCs may thus be critical for improving patient survival. MicroRNAs (miRNAs) are small non-coding RNAs that function as tumor suppressors or oncogenes. In this study, we confirmed that miR-107 was down-regulated in GSCs. To investigate the role of miR-107 in tumorigenesis of GSCs, a lentiviral vector over-expressing miR-107 in U87GSCs was constructed. We found that over-expression of miR-107 suppressed proliferation and down-regulated Notch2 protein and stem cell marker (CD133 and Nestin) expression in U87GSCs. Furthermore, enhanced miR-107 expression significantly inhibited U87GSC invasion and reduced matrix metalloproteinase-12 expression. miR-107 also suppressed U87GSCs xenograft growth in vivo. These findings suggest that miR-107 is involved in U87GSCs growth and invasion and may provide a potential therapeutic target for glioma treatment.

Parmi les thèmes récurrents du récit fantastique chinois, la création artistique occupe une place considérable. « L’animation » et le pouvoir magique de l’art servent non seulement à créer l’effet fantastique mais fonctionnent aussi comme médium permettant de concrétiser l’idéal esthétique. Dans cet article nous présenterons d’abord la peinture comme motif consacrant un seuil entre réel et irréel, puis nous analyserons la représentation de la peinture dans son lien avec l’esthétique chinoise. Artistic creation features as an important theme in Chinese fantastic narratives. The animation and the magic power of art function not only to create the fantastic effect but also to embody the ideal aesthetic. This article brings to light how painting is used as the threshold striding across the real and the unreal in the text and studies the representation of painting as grounded in Chinese aesthetic. Entre los temas recurrentes del relato fantástico chino, la labor artística ocupa un lugar relevante. La “animación” y el poder mágico del arte no sólo crean el efecto fantástico, también funcionan como un médium que permite concretizar un ideal estético. En un principio presentaremos en este artículo la pintura como un motivo que consagra un umbral entre lo real y lo irreal, para analizar posteriormente la representación de la pintura en y sus lazos con la estética china.

Background Type 2 trigeminal neuralgia (TN) is an intractable neuropathic pain syndrome compared with type 1 TN because of the difficulty of diagnosis as well as the unsatisfactory prognosis. Neurovascular compression (NVC) is considered the major pathology of TN. Routine magnetic resonance imaging (MRI) sequences are inadequate for revealing the effect of NVC which is related to the surgical decision and outcome. The decreasing of fractional anisotropy (FA), one of the MRI diffusion tensor imaging (DTI) metrics, is correlated with the demyelination of trigeminal nerve (TGN) that reveal the severity of NVC. Methods A retrospective review of patients treated with micro-vascular decompression (MVD) surgery was undertaken. All the patients were diagnosed as type 2 TN. FA of TGN of both sides were measured. The FA declining proportion = ((the mean FA value of healthy lateral)-(the mean FA value of the symptomatic lateral))/(the mean FA value of healthy lateral). Declining proportion of FA value, discovery of surgery and outcome of MVD were recorded and analyzed. Logistic regression analysis and linear regression analysis were employed to analyze the risk factors of declining proportion of FA value and MVD outcome. Results Nineteen patients were assessed in our study. The average declining proportion of FA value for all patients was 0.25 ± 0.12. The average declining proportion of FA value of “success” and “failure” group was 0.32 ± 0.09 to 0.14 ± 0.10 (P = 0.002