Neuroimaging correlates of language network impairment and reorganization in temporal lobe epilepsy

Advanced, noninvasive imaging has revolutionized our understanding of language networks in the brain and is reshaping our approach to the presurgical evaluation of patients with epilepsy. Functional magnetic resonance imaging (fMRI) has had the greatest impact, unveiling the complexity of language organization and reorganization in patients with epilepsy both pre- and postoperatively, while volumetric MRI and diffusion tensor imaging have led to a greater appreciation of structural and microstructural correlates of language dysfunction in different epilepsy syndromes. In this article, we review recent literature describing how unimodal and multimodal imaging has advanced our knowledge of language networks and their plasticity in epilepsy, with a focus on the most frequently studied epilepsy syndrome in adults, temporal lobe epilepsy (TLE). We also describe how new analytic techniques (i.e., graph theory) are leading to a refined characterization of abnormal brain connectivity, and how subject-specific imaging profiles combined with clinical data may enhance the prediction of both seizure and language outcomes following surgical interventions.

[A mini-incision on the anterior hip for pediatric femur neck fractures of type Delbet Ⅱ]

Objective: To investigate the early clinical outcomes of hip anterior short incision and open reduction and internal fixation for the treatment of children with Delbet Ⅱ femoral neck fracture. Methods: A retrospective analysis of 12 children with DelbetⅡ femoral neck fractures was performed with the anterior short incision approach at Department of Pediatric Orthopaedic, Children's Hospital, Nanjing Medical University from January 2014 to August 2016. There were 7 males and 5 females including 8 cases at left side and 4 cases at right side,aged (11.5±0.8) years (range: 8-14 years).Patients underwent surgery in (12.0±0.9) hours (range: 6-20 hours) after the injury. Displaced fractures were treated by open reduction if closed reduction failed.The surgical incision was performed with the anterior inferior iliac spine centered on, extending along the groin crease, and the length was 3 to 4 cm. The interval between the sartorius and the tensor fascia latae was applied, and the direct and indirect head of rectus femoris were resected to visualize the hip joint capsule. T-shaped incision was made in the capsule. After the reduction was obtained, two or three compression canulated screws were used to fix the fracture site. The healing time, complications and corresponding record outcome by X-ray and clinical examination were recorded. At the latest follow-up,the results were analyzed using the Ratliff criteria and clinical outcomes were assessed by pain, restrictive hip movement, normal activity or the avoidance of games, and the femoral neck in the radiograph. Results: Twelve patients had been followed-up for (30.0±4.1)months(range: 24-36 months). X-ray showed the fractures' healing time was (8.0±0.4) weeks(range: 7-9 weeks). Ten of the 12 fractures healed after one operation and were associated with no evidence of osteonecrosis of the femoral head. One case occurred premature physeal closure. There were no cases with fracture relocation, coaxvara, delayed union and nonunion or any significant postoperative complications. There was no infection, flexible internal fixation or ruptures. According to Ratliff grade, 9 cases of 12 patients were fine and 3 cases was acceptable. Conclusions: Satisfactory short-term effects can be achieved by a mini-incision on the anterior hip for Delbet Ⅱ pediatric femur neck fractures. The anterior incision has the advantage of less trauma, smaller incision scar, better fracture reduction and fixation, and less wound complications.

Laparoscopic vs open resection of pT4 colon cancer: a propensity score analysis of 94 patients

AIM

Our aim was to compare short- and long-term oncological outcomes between laparoscopic and open colectomy in T4 colon cancer.

METHODS

We retrospectively analysed oncological outcomes of 94 patients who underwent surgery between December 2010 and December 2016 for pT4 colon cancer, with propensity score matching. All patients were treated with curative intent, by either laparoscopic or open en bloc resection.

RESULTS

The conversion rate in the laparoscopic group was 17.0%. Blood loss, time to flatus and postoperative hospitalization were significantly less in the laparoscopic group. Postoperative morbidity and mortality within 30 days did not significantly differ between the two groups. R0 resection rates and lymph node harvests were similar between the two groups. At 5 years, laparoscopic outcomes were not inferior to open outcomes (overall survival 56.8% vs 50.2%, P = 0.250; disease-free survival 59.7% vs 41.7%, P = 0.06).

CONCLUSION

The laparoscopic approach is safe and feasible for pathologically confirmed T4 colon cancer. It results in a faster postoperative recovery.

Turbulence generation from a stochastic wavelet model

This research presents a new turbulence generation method based on stochastic wavelets and tests various properties of the generated turbulence field in both the homogeneous and inhomogeneous cases. Numerical results indicate that turbulence fields can be generated with much smaller bases in comparison to synthetic Fourier methods while maintaining comparable accuracy. Adaptive generation of inhomogeneous turbulence is achieved by a scale reduction algorithm, which greatly reduces the computation cost and practically introduces no error. The generating formula issued in this research could be adjusted to generate fully inhomogeneous and anisotropic turbulence with given RANS data under divergence-free constraint, which was not achieved previously in similar research. Numerical examples shows that the generated homogeneous and inhomogeneous turbulence are in good agreement with the input data and theoretical results.

[Complications of 2 133 cases of pediatric long bone fracture undergoing elastic stable intramedullary nailing in a single medical center]

Objective: To summarize the clinical data of elastic stable intramedullary nailing(ESIN) in the treatment of long bone fracture of children in a single medical center, and to analyze the problems occurred after the ESIN surgery and corresponding solutions. Methods: A retrospective analysis was conducted regarding the clinical data of 2 133 pediatric long bone fractures conforming to inclusion and exclusion criteria from June, 2005 to December, 2017 in Department of Orthopedics, Children's Hospital of Nanjing Medical University.There were 1 191 boys and 942 girls, aged from 23 months to 14 years with mean age of (5.7 ± 3.1)years.There were 1 866 cases treated with closed reduction with ESIN, while 267 cases were treated with small incision assisted reduction with ESIN.Postoperative problems have been statistically analyzed. Results: There were altogether 2 133 children, including 603 cases of femur, 311 cases of tibia, 8 cases of fibula, 219 cases of humerus, and 992 cases of ulna/radius.The postoperative complications mainly consist of 62 cases of needle tail irritation reaction, 21 cases of misalignments of fracture alignment, 11 cases of intramedullary nail deformity or angular deformity, 7 cases of limb shortening, 14 cases of limited joint activity, 4 cases of nerve injury, 2 cases of tendon injury, 14 cases of difficult nail removal, 4 cases of cortical cleavage, 8 cases of delayed union, 1 case of nonunion, 6 cases of varus/valgus deformity, 5 cases of epiphyseal injury, 6 cases of ESIN exposure, and 2 cases of metal debris of ESIN' end. Conclusions: The complications of treatment for children with long bone fractures by ESIN cannot be ignored.To master the important biomechanical properties, to get familiar with the local anatomy and to avoid obvious technical errors can reduce the occurrence of postoperative complications.

High performance composites of spinel LiMn2O4/3DG for lithium ion batteries

A highly crystalline nanosized spinel LiMn₂O₄/3DG composite cathode material for high rate lithium ion batteries was successfully prepared by mixing spinel LiMn₂O₄ particles with reduced graphene oxide (3DG). Spinel LiMn₂O₄ and reduced three-dimensional graphene oxide were synthesized using a hydrothermal method and freeze-drying technology, respectively. The structure, morphology and electrochemical performance of the synthesized materials were characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM), cyclic voltammetry (CV), electrochemical impedance spectroscopy (EIS) and galvanostatic charge–discharge techniques. The results showed that the LiMn₂O₄/3DG composites exhibited excellent rate capability and stable cycling performance. The discharge capacity was 131 mA h g⁻¹ and the capacity remains at 89.3% after 100 cycles at a 0.5 C rate, while the discharge capacity was 90 mA h g⁻¹ at 10 C. Compared with spinel LiMn₂O₄ materials, the LiMn₂O₄/3DG composites showed obvious improvement in electrochemical performance.

3DG/LiMn₂O₄ composites exhibit a high specific capacity and excellent rate performance.

External Quality Assessment for Rubella Virus RNA Detection Using Armored RNA in China

BACKGROUND

Although tremendous efforts have been made to reduce rubella incidence, there are still 300 new cases of congenital rubella syndrome daily; thus, rubella infections remain one of the leading causes of preventable congenital birth defects. An effective surveillance system, which could be achieved and maintained by using an external quality assessment program, is critical for prevention and control of this disease.

METHODS

Armored RNAs, which are noninfectious and RNase-resistant, were used for encapsulation of the E1 gene of rubella virus and for preparation of a 10-specimen panel for external quality assessment. Thirty-two laboratories across mainland China that used nucleic acid tests for rubella virus RNA detection were included in the external quality assessment program organized by the National Center for Clinical Laboratories of China.

RESULTS

Different kinds of commercial kits were used by the laboratories for nucleic acid extraction and TaqMan real-time reverse-transcription PCR for rubella virus RNA detection; 99.2% sensitivity and 100% specificity were achieved in this external quality assessment program.

CONCLUSIONS

Most of the participating laboratories obtained accurate results for rubella nucleic acid tests, thereby achieving the quality required for regional rubella and congenital rubella syndrome elimination.

The immunoproteasome: An old player with a novel and emerging role in alloimmunity

Modern treatment strategies for the maintenance of allograft acceptance frequently target ubiquitously-expressed pathways, leading to significant side-effects and poor long-term allograft outcomes. Constitutive proteasome inhibitors, which have recently been introduced for the treatment of antibody-mediated rejection, target the ubiquitously-expressed proteasome. To limit off-target effects and serious mechanism-based toxicity, however, these inhibitors are administered intermittently and suboptimally. Immunoproteasomes, which are an inducible subset of proteasomes enriched in immune cells, replace constitutive proteasomes after cell exposure to proinflammatory cytokines such as interferon-γ. While immunoproteasomes were first described as processors of antigen for presentation by major histocompatibility complex molecules, recent findings point to its broader biological roles. These vary from activating different subsets of the immune system, by controlling transcriptional activators and downstream cytokines, to affecting their differentiation and survival. These emerging roles of the immunoproteasome in activated immune cells have made it a rational candidate for the targeted treatment of immune-mediated diseases. Preclinical studies have established its role in maintaining allograft acceptance without significant short- or long-term toxicity. This review provides a brief background of the immunoproteasome and outlines its role in immunological pathways and its potential in alloimmunity.