Topographical reorganization of brain functional connectivity during an early period of epileptogenesis.

OBJECTIVE: The current study aims to investigate functional brain network representations during the early period of epileptogenesis. METHODS: Eighteen rats with the intrahippocampal kainate model of mesial temporal lobe epilepsy were used for this experiment. Functional magnetic resonance imaging (fMRI) measurements were made 1 week after status epilepticus, followed by 2-4-month electrophysiological and video monitoring. Animals were identified as having (1) developed epilepsy (E+, n = 9) or (2) not developed epilepsy (E-, n = 6). Nine additional animals served as controls. Graph theory analysis was performed on the fMRI data to quantify the functional brain networks in all animals prior to the development of epilepsy. Spectrum clustering with the network features was performed to estimate their predictability in epileptogenesis. RESULTS: Our data indicated that E+ animals showed an overall increase in functional connectivity strength compared to E- and control animals. Global network features and small-worldness of E- rats were similar to controls, whereas E+ rats demonstrated increased small-worldness, including increased reorganization degree, clustering coefficient, and global efficiency, with reduced shortest pathlength. A notable classification of the combined brain network parameters was found in E+ and E- animals. For the local network parameters, the E- rats showed increased hubs in sensorimotor cortex, and decreased hubness in hippocampus. The E+ rats showed a complete loss of hippocampal hubs, and the appearance of new hubs in the prefrontal cortex. We also observed that lesion severity was not related to epileptogenesis. SIGNIFICANCE: Our data provide a view of the reorganization of topographical functional brain networks in the early period of epileptogenesis and how it can significantly predict the development of epilepsy. The differences from E- animals offer a potential means for applying noninvasive neuroimaging tools for the early prediction of epilepsy.

Design of a microchannel-nanochannel-microchannel array based nanoelectroporation system for precise gene transfection.

A micro/nano-fabrication process of a nanochannel electroporation (NEP) array and its application for precise delivery of plasmid for non-viral gene transfection is described. A dip-combing device is optimized to produce DNA nanowires across a microridge array patterned on the polydimethylsiloxane (PDMS) surface with a yield up to 95%. Molecular imprinting based on a low viscosity resin, 1,4-butanediol diacrylate (1,4-BDDA), adopted to convert the microridge-nanowire-microridge array into a microchannel-nanochannel-microchannel (MNM) array. Secondary machining by femtosecond laser ablation is applied to shorten one side of microchannels from 3000 to 50 µm to facilitate cell loading and unloading. The biochip is then sealed in a packaging case with reservoirs and microfluidic channels to enable cell and plasmid loading, and to protect the biochip from leakage and contamination. The package case can be opened for cell unloading after NEP to allow for the follow-up cell culture and analysis. These NEP cases can be placed in a spinning disc and up to ten discs can be piled together for spinning. The resulting centrifugal force can simultaneously manipulate hundreds or thousands of cells into microchannels of NEP arrays within 3 minutes. To demonstrate its application, a 13 kbp OSKM plasmid of induced pluripotent stem cell (iPSC) is injected into mouse embryonic fibroblasts cells (MEFCs). Fluorescence detection of transfected cells within the NEP biochips shows that the delivered dosage is high and much more uniform compared with similar gene transfection carried out by the conventional bulk electroporation (BEP) method.

Plasma gelsolin levels and outcomes after aneurysmal subarachnoid hemorrhage.

INTRODUCTION: Lower gelsolin levels have been associated with the severity and poor outcome of critical illness. Nevertheless, their link with clinical outcomes of aneurysmal subarachnoid hemorrhage is unknown. Therefore, we aimed to investigate the relationship between plasma gelsolin levels and clinical outcomes in patients with aneurysmal subarachnoid hemorrhage. METHODS: A total of 262 consecutive patients and 150 healthy subjects were included. Plasma gelsolin levels were measured by enzyme-linked immunosorbent assay. Mortality and poor long-term outcome (Glasgow Outcome Scale score of 1-3) at 6 months were recorded. RESULTS: Plasma gelsolin levels on admission were substantially lower in patients than in healthy controls (66.9 (26.4) mg/L vs. 126.4 (35.4) mg/L, P < 0.001), and negatively associated with World Federation of Neurological Surgeons score (r = -0.554, P < 0.001) and Fisher score (r = -0.538, P < 0.001), and identified as an independent predictor of poor functional outcome (odds ratio, 0.957; 95% confidence interval (CI), 0.933-0.983; P = 0.001) and death (odds ratio, 0.953; 95% CI, 0.917-0.990; P = 0.003) after 6 months. The areas under the ROC curve of gelsolin for functional outcome and mortality were similar to those of World Federation of Neurological Surgeons score and Fisher score (all P > 0.05). Gelsolin improved the predictive values of World Federation of Neurological Surgeons score and Fisher score for functional outcome (both P < 0.05), but not for mortality (both P > 0.05). CONCLUSIONS: Gelsolin levels are a useful, complementary tool to predict functional outcome and mortality 6 months after aneurysmal subarachnoid hemorrhage.

[Moving cupping at Hechelu combined with rubbing method for depression of diabetes mellitus].

OBJECTIVE: To compare the efficacy between moving cupping at Hechelu combined with rubbing method and western medication for depression of diabetes mellitus (DM). METHODS: Two hundred and sixteen patients were randomly divided into an observation group and a control group, 108 cases in each group. Patients in the observation group were treated with moving cupping at Hechelu combined with rubbing method, once every: other day; six treatments were considered as one course, and totally two courses were given with an interval of: 4 days between courses. Patients in the control group were treated with oral administration of fluoxetine hydrochloride capsules, once a day for consecutive 4 weeks. The Hamilton depression scale (HAMD), self-rating depression scale (SDS) and TCM symptom score were measured before treatment, after the treatment and in follow-up visit one and a half months after treatment. The fasting blood glucose was tested before and after treatment. The glycosylated hemoglobin (HbA1c) was tested in the follow-up visit. RESULTS: The total effective rate was 90.9% (90/99) in the observation group, which was superior to 73.7% (70/95) in the control group (P < 0.05). After the treatment, HAMD, SDS and TCM symptom scores were all reduced apparently in the observation group and the control group (all P < 0.05). After the treatment and the follow-up visit, the TCM symptom score in the observation group was lower than that in the control group (P < 0.05). The levels of HbA1c and GLU were stable in the observation group, and were decreased compared with those before treatment; but the difference between the, two groups was not significant (P > 0.05). CONCLUSION: The Hechelu theory-based TCM treatment has better: efficacy for depression of diabetes mellitus than fluoxetine hydrochloride capsule, which has less adverse effects.

Stent, balloon-assisted coiling and double microcatheter for treating wide-neck aneurysms in anterior cerebral circulation.

OBJECTIVE: To investigate the clinical application of adjuvant coiling techniques in treating anterior-circulation wide-necked aneurysms. METHODS: Over 4·5 years, 93 anterior-circulation wide-neck aneurysms in 81 patients were treated with different endovascular techniques: balloon-assisted, stent-assisted, and double-microcatheter coiling. Demographic, clinical, and angiographic data were reviewed retrospectively. RESULTS: Of the 93 aneurysms, 45 were treated using stent, 28 using balloon, and 20 using double microcatheter. The proportion of ruptured aneurysms was significantly lower in the stent group (53·3%) than in the balloon (71·4%) or the double-microcatheter group (75%). Stent embolization was used for 61·1% of aneurysms located in the internal carotid artery, whereas aneurysms in the anterior communicating and middle cerebral arteries were mainly treated with balloon remodeling (42·9%) and double microcatheter (52·4%). The majority of aneurysms with neck ≧ 7 mm (87·5%) and all aneurysms with a dome/neck ratio < 1·0 (100%) were treated by stent-assisted coiling. For aneurysms with neck < 4 mm, the mean dome/neck ratio was 0·93 in the stent group, 1·08 in the balloon group, and 1·16 in the double-microcatheter group. Total occlusion was achieved in 21 cases (46·7%), with the rates for stent being significantly lower than for balloon (78·6%) or double microcatheter (75·0%). Clinical outcome was favorable in 73 cases (Glasgow Outcome Scale (GOS) 4-5) and fair in 4 (GOS 3), while 2 were severely disabled (GOS 2) and 2 others died (GOS 1). CONCLUSION: Double microcatheter was better for distal aneurysms with dome/neck ratio of 1·1-1·2, while stent was better for proximal aneurysms with an extremely wide neck (≥ 7 mm) and for loudspeaker-shaped aneurysms (dome/neck ratio < 1·0) with poor vessel condition. For emergency cases, both balloon remodeling and double microcatheter are better choices than stent.

[Combination of acupuncture, cupping and medicine for treatment of fibromyalgia syndrome: a multi-central randomized controlled trial].

OBJECTIVE: To evaluate the clinical effect of combination of acupuncture, cupping and medicine for treatment of fibromyalgia syndrome. METHODS: By using multi-central randomized controlled method, 186 cases were randomly divided into an acupuncture combined with cupping and western medicine group (group A), an acupuncture combined with cupping group (group B) and a western medicine group (group C) and treated continuously for 4 weeks. The treatment of acupuncture combined with cupping was produced by acupuncture at five mental points and moving cupping on the Hechelu of the back, once evrey other day, thrice each week, and the western medicine therapy by oral administration of Amitriptyline, once each day. The scores of McGill Pain Questionnaire (MPQ), the amount of tenderness point and the time of producing effect were compared and the therapeutic effects were assessed with the Hamilton Depression Scale (HAMD). RESULTS: The cured and markedly effective rate was 65.0% (39/60) in the group A, which was superior to 15.9% (10/63) in the group B and 16.1% (9/56) in the group C (both P < 0.001). After treatment, the scores of MPQ and HAMD and the amount of tenderness point all decreased in the three groups, group A being significantly better than group B and group C, and the time of producing effect in the group A was more earlier than those in the group B and the group C. CONCLUSION: The therapeutic effect of combination of acupuncture, cupping and medicine on fibromyalgia syndrome is superior to that of the simple acupuncture combined with cupping or the simple medicine.