Deep Learning for Feynman's Path Integral in Strong-Field Time-Dependent Dynamics.

Feynman's path integral approach is to sum over all possible spatiotemporal paths to reproduce the quantum wave function and the corresponding time evolution, which has enormous potential to reveal quantum processes in the classical view. However, the complete characterization of the quantum wave function with infinite paths is a formidable challenge, which greatly limits the application potential, especially in the strong-field physics and attosecond science. Instead of brute-force tracking every path one by one, here we propose a deep-learning-performed strong-field Feynman's formulation with a preclassification scheme that can predict directly the final results only with data of initial conditions, so as to attack unsurmountable tasks by existing strong-field methods and explore new physics. Our results build a bridge between deep learning and strong-field physics through Feynman's path integral, which would boost applications of deep learning to study the ultrafast time-dependent dynamics in strong-field physics and attosecond science and shed new light on the quantum-classical correspondence.

Mitochondrial Fusion and Fission in Neuronal Death Induced by Cerebral Ischemia-Reperfusion and Its Clinical Application: A Mini-Review.

Mitochondria are highly dynamic organelles which are joined by mitochondrial fusion and divided by mitochondrial fission. The balance of mitochondrial fusion and fission plays a critical role in maintaining the normal function of neurons, of which the processes are both mediated by several proteins activated by external stimulation. Cerebral ischemia-reperfusion (I/R) injury can disrupt the balance of mitochondrial fusion and fission through regulating the expression and post-translation modification of fusion- and fission-related proteins, thereby destroying homeostasis of the intracellular environment and causing neuronal death. Furthermore, human intervention in fusion- and fission-related proteins can influence the function of neurons and change the outcomes of cerebral I/R injury. In recent years, researchers have found that mitochondrial dysfunction was one of the main factors involved in I/R, and mitochondria is an attractive target in I/R neuroprotection. Therefore, mitochondrial-targeted therapy of the nervous system for I/R gradually started from basic study to clinical application. In the present review, we highlight recent progress in mitochondria fusion and fission in neuronal death induced by cerebral I/R to help understanding the regulatory factors and signaling networks of aberrant mitochondrial fusion and fission contributing to neuronal death during I/R, as well as the potential neuroprotective therapeutics targeting mitochondrial dynamics, which may help clinical treatment and development of relevant dugs.

Utilizing real-time contrast medium to detect the fistula of giant spinal arachnoid cyst and treat with minimal invasive surgery.

BACKGROUND: Spinal arachnoid cysts are rare and have varied clinical manifestations depending on the affected spinal region and nerve roots. A complete cyst excision with fistula closure is the first choice of treatment. However, it might be difficult to localize the specific position of the fistula because previous images have no enhancements or the fistula is too tiny to be detected. CASE PRESENTATION: This case is a giant lumbar extradural arachnoid cyst. We administered a lumbar injection with contrast medium into subarachnoid space under digital subtraction angiography (DSA) and disclosed the fistula. Confirming the location of fistula enabled us to perform minimally invasive surgery to ligate the fistula. Surgical intervention for a spinal arachnoid cyst might encounter the problem of the formation of a postoperative cerebrospinal fluid (CSF) fistula. We propose the option of detecting the fistula preoperatively for minimal invasive surgery. Recurrence depends on the long-term follow-up, and more cases are needed to further evaluate our technique. CONCLUSIONS: The real-time contrast medium technique for spinal arachnoid cysts contributes to the complete ligation with minimally invasive surgery.

Stability, Antioxidant Capacity and Degradation Kinetics of Pelargonidin-3-glucoside Exposed to Ultrasound Power at Low Temperature.

As an alternative preservation method to thermal treatment, ultrasound is a novel non-thermal processing technology that can significantly avoid undesirable nutritional changes. However, recently literature indicated that anthocyanin degradation occurred when high amplitude ultrasound was applied to juice. This work mainly studied the effect of ultrasound on the stability and antioxidant capacity of pelargonidin-3-glucoside (Pg-3-glu) and the correlation between anthocyanin degradation and •OH generation in a simulated system. Results indicated that the spectral intensities of Pg-3-glu decreased with increasing ultrasound power (200-500 W) and treatment time (0-60 min). The degradation trend was consistent with first-order reaction kinetics (R² > 0.9100). Further study showed that there was a good linear correlation between Pg-3-glu degradation and •OH production (R² = 0.8790), which indicated the important role of •OH in the degradation of anthocyanin during ultrasound exposure. Moreover, a decrease in the antioxidant activity of solution(s) containing Pg-3-glu as evaluated by the DPPH and FRAP methods was observed after ultrasound treatment.

Zinc finger A20 and NF-κB correlate with high-risk human papillomavirus of squamous cell carcinoma patients.

Genital human papillomavirus (HPV) is associated with the development of cutaneous malignant tumors, and differences in HPV subtypes are found in several cancers by histology. NF-κB is persistently activated in most cancers and confers a survival advantage to cancer cells, while A20 is a critical negative regulator of NF-κB and is an important tumor suppressor inactivated in B cell lymphomas. This study was undertaken to identify HPV types in cutaneous squamous cell carcinoma (SCC) as well as to determine whether the crosstalk of A20/NF-κB was involved in HPV-induced SCC. Overall, HPV positivity was observed to be 66.2 %, with HPV16 being most common followed by infection with HPV18. Out of 43 HPV-positive samples, 35 samples were positive for one or more high-risk HPV (HR-HPV) types, suggesting a high association of SCC with HR-HPV infection, while only five HPV infections were detected in 21 normal skin samples and low-risk HPV (LR-HPV) infection was the most common. Both A20 and NF-κB were overexpressed in HPV-positive SCC samples (56 vs 87.4 %) and were closely correlated with TNM stage and lymph node transfer, respectively. More interestingly, the expression of A20 and NF-κB was much higher in HR-HPV samples than in LR-HPV samples. These results suggest that the crosstalk of A20 and NF-κB may contribute to HR-HPV-associated tumor growth and metastasis of SCC and may be a novel therapeutic target for SCC in the future.

Synthesis and antimicrobial activity of polyhalo isophthalonitrile derivatives.

A series of polyhalo isophthalonitrile derivatives (3 and 4) that incorporate a variety of substituents at the 2-, 4-, 5- and/or 6-positions of the isophthalonitrile moieties have been designed and synthesized. These derivatives were evaluated for their antimicrobial activity against Staphylococcus aureus, Bacillus cereus (Gram-positive bacteria), Escherichia coli, Pseudomonas aeruginosa (Gram-negative bacteria); and Candida albicans (Fungi). Compounds 3 and 4 showed stronger inhibition of Gram-positive bacteria and fungi growth, and the antimicrobial ability of compound 3j (a 4-(benzylamino)-5-chloro-2,6-difluoro analog, MIC[SA] = 0.5 µg/mL; MIC[BC] = 0.4 µg/mL; MIC[CA] = 0.5 µg/mL) were close to nofloxacin and fluconazole and identified as the most potent antimicrobial agents in the series. The preliminary analysis of structure-activity relationships is also discussed.

The incidence of cerebral amyloid angiopathy in surgically treated intracranial hemorrhage in the Chinese population.

Despite being widely accepted as an important cause of spontaneous intracranial hemorrhage (ICH), cerebral amyloid angiopathy (CAA) has seldom been studied in the Chinese population. The current study aims to investigate the incidence and features of CAA in surgically treated ICH patients in China. From May 2006 to April 2011, 974 patients admitted to 71 hospitals throughout China for acute spontaneous ICH were studied. Craniotomy for hematoma evacuation was performed. Brain tissue from the superficial side of the suspected residual hematoma cavity, as well as from the cortex and subcortex, was obtained. Congo Red stain and ß-amyloid immunohistochemistry were used for the diagnosis. Each case was assigned a pathological severity score. Of the 974 involved patients, 37.7% were identified with CAA of different degrees. CAA had positive correlation with age and was independent of sex. Most patients had mild CAA with only the superficial vessels involved in lobes instead of the basal ganglia; the patients ≥65 years had more severe pathological score of CAA than those <65 years and had more lobes and cerebellum involved than the latter. More than one third of the surgically treated Chinese ICH patients may have CAA of different degrees.

[Di-(2-ethylhexyl) phthalate activates the apoptosis Caspase pathway in rat Leydig cells in vitro].

OBJECTIVE: To investigate the effects of di-(2-ethylhexyl) phthalate (DEHP) on the expressions of Caspase-3 and Caspase-9 genes in rat Leydig cells and the apoptosis of the cells in vitro. METHODS: Leydig cells were isolated from male SD rats, primarily cultured and treated with DEHP at a low (10 nmol/L), a medium (50 nmol/L) and a high dose (100 nmol/L) for 24 hours. Then the mRNA expressions of Caspase-3 and Caspase-9 genes in the Leydig cells were detected by real time PCR, their protein expressions determined by Western blot, and the apoptosis of the Leydig cells measured by flow cytometry. RESULTS: Compared with the DMSO control group, the low-, medium- and high-dose DEHP groups showed significantly upregulated expressions of Caspase-3 mRNA (1.69 +/- 0.38 vs 3.82 +/- 0.39, 6.91 +/- 0.40 and 15.47 +/- 0.40, P < 0.05), Caspase-3 protein (0.18 +/- 0.0.09 vs 0.32 +/- 0.10, 0.61 +/- 0.08 and 0.89 +/- 0.09, P < 0.05), Caspase-9 mRNA (2.24 +/- 0.41 vs 5.16 +/- 0.43, 9.61 +/- 0.45 and 19.22 +/- 0.43, P < 0.05) and Caspase-9 protein (0.26 +/- 0.07 vs 0.40 +/- 0.08, 0.68 +/- 0.09 and 0.96 +/- 0.08, P < 0.05), as well as increased apoptosis rate of Leydig cells (4.36 +/- 1.11 vs 7.52 +/- 1.09, 12.72 +/- 1.10 and 24.59 +/- 1.11, P < 0.05), all in a dose-dependent manner. CONCLUSION: DEHP can induce the apoptosis of rat Leydig cells by activating the apoptosis Caspase pathway, and consequently affect the function of Leydig cells.

[Retracted] MicroRNA­199a­3p inhibits ovarian cancer cell viability by targeting the oncogene YAP1.

Following the publication of the above article, the authors have submitted a request that it be retracted on account of the fact that, when requested to do so, the first author was unable to provide the original data for this article. The Editor of Molecular Medicine Reports has agreed with the request that this article be retracted. Note that all the authors agree with the decision to retract this article. The Editor and the authors regret any inconvenience that this retraction will cause to the readership of the Journal. [Molecular Medicine Reports 23: 237, 2021; DOI: 10.3892/mmr.2021.11876].

Global Trends and Hotspots in Trigeminal Neuralgia Research From 2001 to 2021: A Bibliometric Analysis.

Background: In recent years, there have been an increasing number of studies on trigeminal neuralgia (TN). However, a scientific and comprehensive study of the current situation and trends in the field of TN research is lacking. The purpose of this study is to summarize and visualize the development, research hotspots, and future trends in TN based on a bibliometric approach. Methods: Studies on TN published from 2001 to 2021 were obtained from the Web of Science Core Collection (WoSCC). Bibliometrics, CiteSpace, and VOSviewer tools were used for bibliometric analysis and visualization. Results: In total, 4,112 documents were searched. The number of research articles in the field is generally on an upward trend, with the fastest growth in the number of articles from 2017 to 2020. Shanghai Jiao Tong University, Pittsburgh University, and Mayo Clinic are the three institutions with the most publications. Shiting Li and Zakrzewska JM are the most prolific author and top co-cited authors, respectively. The Journal of Neurosurgery is the most influential journal. The top 5 keywords in that time frame are TN, microvascular decompression, facial pain, stereotactic radiosurgery, and neuropathic pain. Conclusion: This is the first comprehensive scientific bibliometric analysis of the global research field on TN over the past 21 years, providing a meaningful reference for further exploration of topical issues and research trends in the field.

Sirtuin2 correlates with lymph node metastasis, increased FIGO stage, worse overall survival, and reduced chemosensitivity to cisplatin and paclitaxel in endometrial cancer.

BACKGROUND: This study aimed to investigate the correlation of sirtuin2 (SIRT2) with clinical characteristics, prognosis in endometrial cancer (EC) patients, and its effect on chemosensitivity in EC cell lines. METHODS: A total of 137 EC patients who underwent surgical resection were retrospectively enrolled. SIRT2 expression in tumor tissues (n = 137) and adjacent tissues (n = 61) was detected by immunohistochemistry (IHC) staining and evaluated by a semiquantitative scoring method. EC patients' clinical characteristics and survival data were collected. Besides, SIRT2 was modulated by plasmid transfection in EC cells, then their chemosensitivity to cisplatin and paclitaxel was evaluated. RESULTS: SIRT2 was increased in tumor tissues compared with adjacent tissues (reflected by both IHC score and high-expression ratio, both P < 0.001). Meanwhile, tumor SIRT2 was positively correlated with lymph node metastasis (P = 0.037) and the International Federation of Gynecology and Obstetrics (FIGO) stage (P = 0.044), but not other clinical characteristics. Moreover, tumor SIRT2 high expression was correlated with worse overall survival (OS) (P = 0.023), while it could not independently predict OS (P = 0.090, hazard ratio = 2.782). Besides, both mRNA and protein levels of SIRT2 were increased in Ishikawa (P = 0.035) and KLE (P < 0.001) cells compared with human endometrial epithelial cells. SIRT2 overexpression decreased chemosensitivity to cisplatin and paclitaxel in Ishikawa cells, while SIRT2 knockdown increased chemosensitivity to cisplatin and paclitaxel in KLE cells (all P < 0.05). CONCLUSION: SIRT2 correlates with lymph node metastasis, increased FIGO stage, worse OS, and reduced chemosensitivity to cisplatin and paclitaxel in EC.

Retraction Note: MicroRNA-199a-5p suppresses the cell growth of colorectal cancer by targeting oncogene Caprin1.

[This retracts the article DOI: 10.1007/s13205-020-02433-9.].

Intradural osteomas: Report of two cases.

BACKGROUND: Intradural osteoma is very rarely located in the subdural or subarachnoid space. Unfortunately, intradural osteoma lacks specificity in clinical manifestations and imaging features and there is currently no consensus on its diagnosis method or treatment strategy. Moreover, the pathogenesis of osteoma without skull structure involvement remains unclear. CASE SUMMARY: We describe two cases of intradural osteomas located in the subdural and subarachnoid spaces, respectively. The first case involved a 47-year-old woman who presented with a 3-year history of intermittent headache and dizziness. Intraoperatively, a bony hard mass was found in the left frontal area, attached to the inner surface of the dura mater and compressing the underlying arachnoid membrane and brain. The second case involved a 56-year-old woman who had an intracranial high-density lesion isolated under the right greater wing of the sphenoid. Intraoperatively, an arachnoid-covered bony tumor was found in the sylvian fissure. The pathological diagnosis for both patients was osteoma. CONCLUSION: Surgery and pathological examination are required for diagnosis of intradural osteomas, and craniotomy is a safe and effective treatment.

MicroRNA­199a­3p inhibits ovarian cancer cell viability by targeting the oncogene YAP1.

MicroRNA­199a­3p (miR­199a­3p) is aberrantly expressed in various types of cancer where it exhibits a tumor suppressive role. However, the biological role of miR­199a­3p in ovarian cancer (OC) remains unclear. The present study aimed to investigate whether miR­199a­3p was a tumor suppressor in OC and to identify the possible mechanisms. It was found that miR­199a­3p expression was significantly downregulated in the tumor tissues and blood samples of patients with OC, as well as in three OC cell lines. In addition, its low expression was closely associated with International Federation of Gynecology and Obstetrics disease stage, histological grade and lymph node metastasis. It was demonstrated that overexpression of miR­199a­3p inhibited the viability and promoted apoptosis of OV90 and SKOV­3 cells. In addition, Yes­associated protein 1 (YAP1), a well­known oncogene, was identified as a direct target of miR­199a­3p in OC cells. Additionally, it was observed that YAP1 was significantly increased and inversely correlated with miR­199a­3p expression in OC tissues. Notably, YAP1 overexpression abrogated the tumor suppressive effects of miR­199a­3p in vitro. Collectively, the present results indicated that miR­199a­3p suppressed viability in OC cells, at least partly via inhibiting the YAP1 oncogene, suggesting that miR­199a­3p may act as a biomarker and therapeutic target for patients with OC.

Fasting Glucose of 6.1 mmol/L as a Possible Optimal Target for Type 2 Diabetic Patients with Insulin Glargine: A Randomized Clinical Trial.

To observe whether different insulin glargine titration algorithms based on fasting blood glucose (FBG) levels lead to different glycaemic variations (GVs) in type 2 diabetes (T2D) patients, a prospective, randomized, single-centre, comparative, three-arm parallel-group, open-label, treat-to-target, 24-week study was performed. A total of 71 uncontrolled T2D patients were recruited and randomized 1 : 3 : 3 into Groups 1, 2, and 3 (insulin titration goals of FBG ≤ 5.6, ≤6.1, and ≤7.0) for this study. The initiated insulin glargine dose was recommended at 0.2 U/kg/day and was then titrated following the FBG target. Patients were subjected to two 3-day continuous glucose monitoring (CGM) at baseline and the endpoint, wherein the CGM data were analysed, and the study's primary endpoint was the difference in 24 hrs mean amplitude of glycaemic excursion (MAGE) among the three groups. We observed that patients in the three groups had similar MAGE levels at the endpoint; however, Group 2 achieved a significant decrease in the MAGE level from baseline to the endpoint as compared to Groups 1 and 3 (all p < 0.05). We also observed that these patients had significant glycated haemoglobin A1c (HbA1c) value improvements as compared to the other two groups (all p < 0.05). Therefore, choosing an FBG level of 6.1 mmol/L as an insulin titration target provided significant GVs and HbA1c value improvements in T2D patients. Moreover, our data indicated that an FBG of 6.1 mmol/L could possibly be an insulin glargine titration target in T2D patients.

Analysis of Related Factors of Tumor Recurrence or Progression After Transnasal Sphenoidal Surgical Treatment of Large and Giant Pituitary Adenomas and Establish a Nomogram to Predict Tumor Prognosis.

Background: Pituitary adenoma (PA) is a benign neuroendocrine tumor caused by adenohypophysial cells, and accounts for 10%-20% of all primary intracranial tumors. The surgical outcomes and prognosis of giant pituitary adenomas measuring ≥3 cm in diameter differ significantly due to the influence of multiple factors such as tumor morphology, invasion site, pathological characteristics and so on. The aim of this study was to explore the risk factors related to the recurrence or progression of giant and large PAs after transnasal sphenoidal surgery, and develop a predictive model for tumor prognosis. Methods: The clinical and follow-up data of 172 patients with large or giant PA who underwent sphenoidal surgery at the Second Affiliated Hospital of Zhejiang University School of Medicine from January 2011 to December 2017 were retrospectively analyzed. The basic clinical information (age, gender, past medical history etc.), imaging features (tumor size, invasion characteristics, extent of resection etc.), and histopathological characteristics (pathological results, Ki-67, P53 etc.) were retrieved. SPSS 21.0 software was used for statistical analysis, and the R software was used to establish the predictive nomogram. Results: Seventy out of the 172 examined cases (40.7%) had tumor recurrence or progression. The overall progress free survival (PFS) rates of the patients at 1, 3 and 5 years after surgery were 90.70%, 79.65% and 59.30% respectively. Log-rank test indicated that BMI (P < 0.001), Knosp classification (P < 0.001), extent of resection (P < 0.001), Ki-67 (P < 0.001), sphenoidal sinus invasion (P = 0.001), Hardy classification (P = 0.003) and smoking history (P = 0.018) were significantly associated with post-surgery recurrence or progression. Cox regression analysis further indicated that smoking history, BMI ≥25 kg/m2, Knosp classification grade 4, partial resection and ≥3% Ki-67 positive rate were independent risk factors of tumor recurrence or progression (P < 0.05). In addition, the nomogram and ROC curve based on the above results indicated significant clinical value. Conclusion: The postoperative recurrence or progression of large and giant PAs is related to multiple factors and a prognostic nomogram based on BMI (≥25 kg/m2), Knosp classification (grade 4), extent of resection (partial resection) and Ki-67 (≥3%) can predict the recurrence or progression of large and giant PAs after transnasal sphenoidal surgery.

Synergistic effects of FGF-2 and PDGF-BB on angiogenesis and muscle regeneration in rabbit hindlimb ischemia model.

Combinatorial strategy has been used in therapeutic angiogenesis in animal models of peripheral arterial disease (PAD) and coronary artery disease for decades. Previous studies have shown that basic fibroblast growth factor (FGF-2) and platelet-derived growth factor BB (PDGF-BB) proteins together establish functional and stable vascular networks on mouse corneal and also in animal model of hindlimb ischemia. However, the short half life of protein by single injection is not sufficient to achieve effective dosage, repeated and prolonged injection causes systemic toxicity. Here we study the synergistic effects of FGF-2 and PDGF-BB by intramuscular injection of naked plasmid DNA on therapeutic angiogenesis in rabbit model of hindlimb ischemia. We found that transient delivery of FGF-2 and PDGF-BB naked DNA together resulted in greater increases in capillary growth, collateral formation and popliteal blood flow compared with control and single gene delivery. Our data provided novel evidence of beneficial effects of DNA-based FGF-2 and PDFG-BB on muscle repair after ischemic injury. These findings reveal an alternative therapeutic approach in the treatment of ischemic diseases and even in muscular disorders.

[The study of association between spontaneous intracranial hemorrhage and cerebral amyloid angiopathy].

OBJECTIVE: To get the general situation of the cerebral amyloid angiopathy (CAA) incidence in spontaneous intracranial hemorrhage (SICH) patients receiving surgical treatment in Chinese people. METHODS: During the period May 2008 and March 2009, 105 patients admitted to 30 hospitals throughout China for acute SICH were studied, including 68 male and 37 female mean aged (55 +/- 13). The patients were suffered from SICH proved by computed tomography scan (CT). Emergent craniotomies for hemorrhage evacuation were performed for these patients within 72 h after hemorrhage onset and brain tissue of the cortex was also obtained meanwhile. A further histological study, Congo red stained and Abeta immunochemistry included was followed to verify the existence of CAA. RESULT: Fifteen out of the 105 cases is identified as CAA positive, and the total ratio is 14.29%. As to age groups, about 20.83% (5/24) of the cases of the 40-49 years old group have been diagnosed as CAA, 17.14% (6/35) of the 50-59 years old group, 4.17% (1/24) of the 60-69 group, and for those older than 70 years, the ratio is 8.00% (2/25). CONCLUSION: We come to the conclusion that 14.29% of the surgically treated SICH events might be closely related to CAA.

MicroRNA-199a-5p suppresses the cell growth of colorectal cancer by targeting oncogene Caprin1.

MicroRNAs-199a-5p (miR-199a-5p) plays critical regulatory roles in various types of human cancers. However, the biological function and regulatory mechanisms of miR-199a-5p in colorectal cancer (CRC) remain unclear. The aim of this study was to investigate the role of miR-199a-5p in CRC and possible mechanisms of its action. The expression of miR-199a-5p in CRC tumor tissues was validated using quantitative real-time PCR (qRT-PCR). The effects of miR-199a-5p on cell proliferation and apoptosis were evaluated in vitro. Then, the association of miR-199a-5p and its downstream target was investigated in both cell line and clinical specimens. Furthermore, gain- and loss-of-function studies of cytoplasmic activation/proliferation-associated protein-1 (Caprin1) were performed to assess whether the suppressive effect of on CRC cells were via targeting Caprin1. Using a microarray platform, we focused on miR-199a-5p for further research, which was one of the most markedly downregulated miRNAs in CRC tumor tissues. Functionally, the overexpression of miR-199a-5p inhibited proliferation and induced apoptosis in both HTC116 and SW480 cells. Furthermore, cytoplasmic activation/proliferation-associated protein-1 (Caprin1), a well-known oncogene, was directly targeted by miR-199a-5p. It was also observed that Caprin1 was upregulated, and inversely correlated with miR-199a-5p levels in CRC tissues. Further investigations revealed that knockdown of Caprin1 by siRNA has similar role with miR-199a-5p overexpression in CRC cells, suggesting the oncogenic role of Caprin1 in CRC. In the contrast, we found that overexpression of Caprin1 reversed the suppressive effects of miR-199a-5p on CRC cells. Collectively, our study suggests that miR-199a-5p/Caprin1 axis may serve as potential therapeutic targets for the treatment of CRC.

[Application of individually designed trans-fissure approach in brain surgery: analysis of 90 cases].

OBJECTIVE: To explore the feasibility and value of trans-fissure approaches in brain surgery through individually designed craniotomy. METHODS: Ninety patients with intracranial space-occupying lesions, 47 males and 58 females, aged (43 +/- 14) (1 - 68), were treated by individualized trans-fissure approach surgeries. Linear scalp incision or "horseshoe shape" scalp incision were designed to perform the operation, with a bone flap 3 - 4 cm in diameter. The shortest approach to reach the lesion was decided under the guidance of neuro-navigation and real-time B-mode ultrasonography. Then the lesions were removed through natural cortical fissures. Another 79 patients with intracranial space-occupying lesions, 53 males and 51 females, aged (42 +/- 11) (15 -73), undergoing classical surgeries in the same period were used as control group. The average operation time, size of bone flap, amount of blood loss, hospitalization time, and hospitalization cost were compared between these 2 groups. RESULTS: The operation time of the individually designed trans-fissure approach group was (3.1 +/- 1.6) hours (1.33 - 10.83 hours), significantly shorter than that of the control group [(4.8 +/- 1.9) hrs, P < 0.05]. The amount of blood loss of the individually designed trans-fissure approach group was (173 +/- 168) ml (20 m - 500 ml), significantly less than that of the control group [(410 +/- 61) ml, P < 0.01]. The size of bone flap of the individually designed trans-fissure approach group was (12 +/- 5) cm2 [(1 - 25) cm2], significantly smaller than that of the control group [(20. +/- 9) cm2, P < 0.01]. Four of the 90 patients of the individually designed trans-fissure approach group received retransfusion, compared to 15 in the control group, during operation. No infection or other significant complications occurred after operation in the individually designed trans-fissure approach group. The hospitalization time of the individually designed trans-fissure approach group was (20 +/- 6) days (9 - 39 days), significantly shorter than that of the control group [(24 +/- 7) days, P < 0.01]. The average hospitalization cost of the individually designed trans-fissure approach group was (23171 +/- 7280) yuan RMB; significantly lower than that of the control group [(28096 +/- 10822) yuan, P < 0.01]. CONCLUSIONS: One of the land markers of minimally invasive neurosurgery, individualized trans-fissure approach has been proved to be an effective minimally invasive approach that leads to better outcome and fewer complications after operation.