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Background Labor epidural analgesia has been suggested to be associated with intrapartum fever. We designed this study to investigate the effects of epidural analgesia and combined spinal-epidural analgesia on maternal intrapartum temperature. Methods Four hundred healthy nullipara patients were randomly assigned to receive either epidural analgesia (EA group) or combined spinal-epidural analgesia (CSEA group). Maternal temperature was measured hourly after analgesia administration. The primary outcome was the incidence of maternal fever, and the secondary outcomes were the duration of analgesia, analgesia to full cervical dilation and analgesia to delivery. Neonatal outcomes and other basic labor events were also recorded. Results Maternal temperature gradually increased with time in both analgesia groups during labor. However, the CSEA group had a lower incidence of maternal fever, and a lower mean maternal temperature at 5 h, 6 h, and 9 h after analgesia. In addtion, the CSEA group also had a shorter time of analgesia duration, analgesia to full cervical dilation, analgesia to delivery, and less dose of epidural local anesthetic than the EA group. Conclusion Our findings suggest that combined spinal-epidural analgesia is associated with a lower risk of intrapartum fever than epidural analgesia. Trial registration ChiCTR1900026606. Registered on 16/10/2019.

r Abstract: The basal ganglia, a brain structure related to motor control, is implicated in the modulation of epileptic discharges generalization in patients with idiopathic generalized epilepsy (IGE). Using group independent component analysis (ICA) on resting-state fMRI data, this study identified a resting state functional network that predominantly consisted of the basal ganglia in both healthy controls and patients with IGE. In order to gain a better understanding of the basal ganglia network(BGN) in IGE patients, we compared the BGN functional connectivity of controls with that of epilepsy patients, ei- ther with interictal epileptic discharges (with-discharge period, WDP) or without epileptic discharge (nondischarge period, NDP) while scanning. Compared with controls, functional connectivity of BGN in IGE patients demonstrated significantly more integration within BGN except cerebellum and supple- mentary motor area (SMA) during both periods. Compared with the NDP group, the increased func- tional connectivity was found in bilateral caudate nucleus and the putamen, and decreases were observed in the bilateral cerebellum and SMA in WDP group. In accord with the proposal that the ba- sal ganglia modulates epileptic discharge activity, the results showed that the modulation enhanced the integration in BGN of patients, and modulation during WDP was stronger than that during NDP. Furthermore, reduction of functional connectivity in cerebellum and SMA, the abnormality might be further aggravated during WDP, was consistent with the behavioral manifestations with disturbed motor function in IGE. These resting-state fMRI findings in the current study provided evidence confirming the role of the BGN as an important modulator in IGE. Hum Brain Mapp 33:1279-1294, 2012. V C 2011 Wiley Periodicals, Inc.

Background and Purpose— There have not been any new epidemiological studies related to stroke in Tibet for 20 years. This study aimed to collect stroke data from The City Staff Medical Insurance Registry in Lhasa, Tibet, to describe the incidence, clinical subtypes, and associated risk factors of stroke. Methods— We used retrospective, population-based descriptive analysis of all urban and rural workers in the City Staff Medical Insurance Registry who were admitted to designated hospitals from October 2006 to October 2008. Stroke was defined by the International Classification of Disease (ICD)-10 coded from hospital records. Results— Workers (81 298) were listed in the City Staff Medical Insurance Registry. Stroke patients (165) were included in the study, with 133 being first-ever patients. The age-standardized incidence rate was 88.725/100 000 per year (95% CI, 72.228–105.221), and mortality rate was 25.941/100 000 per year (95% CI, 16.416–35.466). The case fatality rate was 21.82%. Seventeen of the 133 patients (12.8%) were Conclusion— Since the last study 20 years ago in Lhasa, stroke remains the primary fatal disease for the elderly, and its occurrence at younger ages is higher in Lhasa than in other areas of China. However, the annual incidence rate and mortality rate have decreased. The annual incidence rate is at a similar level to that in other parts of China. The primary subtype of stroke in Lhasa is cerebral ischemia.

Summary Purpose Simultaneous electroencephalography and functional magnetic resonance imaging (EEG–fMRI) is considered as a powerful and non-invasive method that allows definition of the irritative zone. However, the complex interictal epileptic discharge (IED) may be present in some patients, and sometimes no active foci can be localized using General Linear Model (GLM) which is a widely adopted tool in EEG–fMRI study. The purpose of this study is to develop a new scheme to improve the detectability and localize the canonical HRF localizable foci. Method Various IEDs are classified using a combination of an independent component analysis (ICA) and a temporal correlation analysis between the independent components and the raw EEG channel; and the classified IEDs are then separately used for foci localization. This scheme is tested by ten patients with variable IEDs, including two patients whose activity could not be identified by common method. Result Applying this scheme to the two patients, some foci consistent with electroclinical data were localized. When it was applied to the remaining eight patients with positive results using common method, 2–4 types of IEDs were classified, and the activity could be identified from at least one type of IED. The results were similar to that received from common method. Conclusion These results indicate that the proposed scheme could enhance the imaging of the localizable foci by isolating its IEDs. This scheme is potentially a useful tool for epilepsy clinic.

Summary Background Absence epilepsy is characterized clinically by the impairment of consciousness and 3 Hz generalized spike-wave discharges (GSWDs) on EEG. Clinical absence can be observed with ictal GSWDs, but interictal GSWD bursts are usually clinically silent. Simultaneous EEG and blood-oxygen-level-dependent (BOLD) functional MRI (EEG–fMRI) has been successfully used to link the changes in regional neuronal activity to the occurrence of GSWDs. Methods We used EEG–fMRI to investigate and compare the BOLD signal changes during interictal and ictal GSWDs in patients with childhood absence epilepsy (CAE). Results Fifteen drug-naive children with newly diagnosed CAE were studied using continuous EEG–fMRI. BOLD signal changes associated with interictal (nine sessions with six patients) and ictal (eight sessions with six patients) GSWDs were analyzed at the individual and group levels. GSWDs were associated with widespread and symmetrical deactivation in the cortex and caudate nucleus with a frontal maximum, and predominant activation in the thalamus bilaterally during ictal GSWDs and in the cortex during interictal GSWDs. The BOLD response was characterized by a higher statistical significance and a more widespread extent at the time of the ictal GSWDs as compared to the time of interictal GSWDs. Conclusions Both interictal and ictal GSWDs in patients with CAE are associated with BOLD signal changes in the basal ganglia–thalamocortical loop. Ictal GSWDs showing predominant thalamic activation and widespread cortical deactivation might cause a complete suspension of the normal brain's default state and manifest clinically as abrupt loss of consciousness (absence seizures).

Affinity selection-mass spectrometry (AS-MS) is a sensitive technology for identifying small molecules that bind to target proteins, and assays enabled by AS-MS can be used to delineate relative binding affinities of ligands for proteins. 'Indirect' AS-MS assays employ size-exclusion techniques to separate target-ligand complexes from unbound ligands, and target-associated ligands are then specifically detected by liquid chromatography mass spectrometry. We report how indirect AS-MS binding assays with known reference control compounds were used as guideposts for development of an optimized purification method for CXCR4, a G-protein coupled chemokine receptor, for which we sought novel antagonists. The CXCR4 purification method that was developed was amenable to scale-up and enabled the screening of purified recombinant human CXCR4 against a large combinatorial library of small molecules by high throughput indirect AS-MS. The screen resulted in the discovery of new ligands that competed off binding of reference compounds to CXCR4 in AS-MS binding assays and that antagonized SDF1α-triggered responses and CXCR4-mediated HIV1 viral uptake in cell-based assays. This report provides a methodological paradigm whereby indirect AS-MS-based ligand binding assays may be used to guide optimal integral membrane protein purification methods that enable downstream affinity selection-based applications such as high throughput AS-MS screens.

We report the first case of a pilomotor seizure detected by electroencephalography /functional magnetic resonance imaging (EEG/fMRI). An adult woman presented with history of bouts of gooseflesh feeling and poilomotor activity in the left leg following viral encephalitis. 24-hour video-EEG and simultaneous EEG during fMRI revealed ictal discharges in the right parietal and temporal lobes. Associated blood oxygen level- dependent (BOLD) activations were found mainly in the right parietal region. The result represents a different generator of pilomotor seizure compared to prior reports. We suggests that the feeling of gooseflesh could be the core ictal symptom and a direct pathway from the sensory cortex to the lower autonomic system may exist bypassing the classic cerebral autonomic center.

The hemodynamic response function (HRF) describes the dynamic process of the blood oxygen level dependent (BOLD) signal evoked by a very short stimulus of unit intensity. Understanding HRF is a key issue for exploring the underlying dynamics of nervous system activation. Some researches suggested that the shape of HRF varied with different brain regions and different subjects, even at different time point in the same brain region of a subject. In this work, epilepsy discharges were adopted as markers of short stimuli, and then we use EEG-fMRI method to investigate HRF in temporal lobe epilepsy with interictal regional slow wave. Five patients with idiopathic temporal lobe epilepsy were enrolled in this study, the peak delay and amplitude of the estimated HRF was compared with Gamma, Glover and the SPM canonical HRF, and the results show that the delay of the estimated HRF is different from either one of the three theoretical model, thus further study on both theoretical model and real data estimation is needed.

Objective To establish an operational model of a network for managing patients with convulsive epilepsy in rural areas of West China. Methods The network is under unified leadership of the public health administration departments, who liaised with medical institutions and disease control and prevention organizations to foster local communities to participate. Patients with convulsive epilepsy were treated with phenobarbital. Trained local primary health care physicians carried out screening, treatment, and follow-up. Political, financial, and technological support was incrementally provided through the network. Efficacy was assessed as the percentage reduction in seizure frequency and the retention of patients on treatment. Results Two thousand five hundred fourteen patients with active convulsive epilepsy were enrolled. After more than 1 year of treatment, 78.4% of the patients had a 50% or greater reduction in seizure frequency and 43.3% remained seizure free. Probability of retention was 85.8% at 750 days. Nearly 20% patients withdrew from the project, and most of them migrated out of the study areas. Some regular training and educational programs were also carried out. Conclusion This pragmatic procedure suggests that the network could be suitable for managing convulsive epilepsy in resource-poor regions. Such a network could depend on existing primary health services to ensure its sustainability.

Different to conventional water-proton MRI, the signal source of optical pumping hyperpolarized noble gas (HPNG) MRI is hyperpolarized noble gas. A set of phantom was designed to evaluate the performance of HPNG MRI system. In order to keep the polarizations of HPNG, all of sections of phantom were manufactured by nonmetal materials such as methacrylic resin or glass. All interfaces of phantom which contact with hyperpolarized noble gas were coated with paraffin to reduce the spin-lattice relaxation of HPNG caused by collisions between HPNG and phantom walls. The phantom was used to establish absolutely performance standards. The magnetic resonance imaging of phantom provides information of HPNG MRI system including: image uniformity, slice position, spatial linearity, slice thickness, spatial resolution, phase related image artifacts. The phantom system includes resolution section, slice thickness section, uniformity and linearity section. All of these sections were placed inside of a rectangular box with vacuum valve.

Screening assays using target-based affinity selection coupled with high-sensitivity detection technologies to identify small-molecule hits from chemical libraries can provide a useful discovery approach that complements traditional assay systems. Affinity selection-mass spectrometry (AS-MS) is one such methodology that holds promise for providing selective and sensitive high-throughput screening platforms. Although AS-MS screening platforms have been used to discover small-molecule ligands of proteins from many target families, they have not yet been used routinely to screen integral membrane proteins. The authors present a proof-of-concept study using size exclusion chromatography coupled to AS-MS to perform a primary screen for small-molecule ligands of the purified muscarinic M2 acetylcholine receptor, a G-protein-coupled receptor. AS-MS is used to characterize the binding mechanisms of 2 newly discovered ligands. NGD-3350 is a novel M2-specific orthosteric antagonist of M2 function. NGD-3366 is an allosteric ligand with binding properties similar to the allosteric antagonist W-84, which decreases the dissociation rate of N-methyl-scopolamine from the M2 receptor. Binding properties of the ligands discerned from AS-MS assays agree with those from in vitro biochemical assays. The authors conclude that when used with appropriate small-molecule libraries, AS-MS may provide a useful high-throughput assay system for the discovery and characterization of all classes of integral membrane protein ligands, including allosteric modulators.

Plasmon-waveguide resonance (PWR) spectroscopy is an optical technique that can be used to probe the molecular interactions occurring within anisotropic proteolipid membranes in real time without requiring molecular labeling. This method directly monitors mass density, conformation, and molecular orientation changes occurring in such systems and allows determination of protein-ligand binding constants and binding kinetics. In the present study, PWR has been used to monitor the incorporation of the human beta(2)-adrenergic receptor into a solid-supported egg phosphatidylcholine lipid bilayer and to follow the binding of full agonists (isoproterenol, epinephrine), a partial agonist (dobutamine), an antagonist (alprenolol), and an inverse agonist (ICI-118,551) to the receptor. The combination of differences in binding kinetics and the PWR spectral changes point to the occurrence of multiple conformations that are characteristic of the type of ligand, reflecting differences in the receptor structural states produced by the binding process. These results provide new evidence for the conformational heterogeneity of the liganded states formed by the beta(2)-adrenergic receptor.

Based on our study of synergetics and dissipative structure theory, by means of mathematics, in terms of the viewpoint of system dynamics, this paper concentrates on the study of chaos in system dynamics: we analyze the nature of chaos phenomenon and the characteristics of system dynamics, put forward the viewpoint that chaos testing should be included in model testing of S.D. ; we investgate several necessary conditions of chaos; we creat a model to question a famous sufficient condition of chaos; then, we shed some light on the way toward which chaos will occur. At last, we successfully apply our theoretic study to a standard nuclear spin generator model.