Optimized multi-scale entropy to localize epileptogenic hemisphere of temporal lobe epilepsy based on resting-state functional magnetic resonance imaging / 生物医学工程学杂志

Entropy model is widely used in epileptic electroencephalogram (EEG) analysis, but there are few reports on how to objectively select the parameters to compute the entropy model in the analysis of resting-state functional magnetic resonance imaging (rfMRI). Therefore, an optimization algorithm to confirm the parameters in multi-scale entropy (MSE) model was proposed, and the location of epileptogenic hemisphere was taken as an example to test the optimization effect by supervised machine learning. The rfMRI data of 20 temporal lobe epilepsy (TLE) patients with hippocampal sclerosis, positive on structural magnetic resonance imaging, were divided into left and right groups. Then, the parameters in MSE model were optimized by the receiver operating characteristic curves (ROC) and area under ROC curve (AUC) values in sensitivity analysis, and the entropy value of the brain regions with statistically significant difference between the groups were taken as sensitive features to epileptogenic hemisphere lateral. The optimized entropy values of these bio-marker brain areas were considered as feature vectors input into the support vector machine (SVM). Finally, combining optimized MSE model with SVM could accurately distinguish epileptogenic hemisphere in TLE at an average accuracy rate of 95%, which was higher than the current level. The results show that the MSE model parameter optimization algorithm can accurately extract the functional imaging markers sensitive to the epileptogenic hemisphere, and achieve the purpose of objectively selecting the parameters for MSE in rfMRI, which provides the basis for the application of entropy in advanced technology detection.

Effect of ultra-early stent-assisted coil embolization on ruptured intracranial aneurysms / 中国脑血管病杂志

Objective To investigate the therapeutic effect of the ultra-early stent-assisted coil embolization of the ruptured intracranial aneurysms. Methods The clinical data of 13 patients with ruptured intracranial aneurysm treated by ultra-early stent-assisted coil embolization were analyzed retrospectively. The preoperative Hunt-Hess gradeⅠ-Ⅱ was in 7 cases,gradeⅢ was in 4 cases,and grade Ⅳ was in 2 cases. The patients were treated with stent-assisted coil embolization under the general anesthesia with endotracheal intubation within 24 h of aneurysm rupture. The postoperative embolization was assessed according to the Raymond grading standard. The postoperative complications and the assessment of the follow-up results from 1 to 6 months after procedure according to the modified Rankin scale (mRS ) scores were observed. Results All 11 patients recovered well,1 case had postoperative hemiplegia,1 case had postoperative bleeding,and none of them died. During the follow-up period,no patients had rebleeding, 1 had recurrence,and DSA revealed that the patient was embolized completely at 2 months after reembolization. Conclusion The method of ultra-early stent-assisted coil embolization of ruptured intracranial aneurysms is feasible. It may improve the cure rate of the ruptured aneurysms and improve the prognosis of patients.

The treatment of delayed intracranial hematoma-based acute encephalocele during brain injury operation / 中国基层医药

ObjectiveTo investigate the experience in the treatment of acute encephalocele associated with delayed intracranial hematoma during severe brain injury operation.Methods42 patients suffered from acute encephalocele during brain injury operation were,retrospectively analyzed.ResultsAll patients with acute encephalocele were associated with delayed intracranial hematoma.The effective treatment of acute encephalocele was to remove the hematoma out of the brain timely and thoroughly.33 patients survived the disorder of acute encephalocele,of which,good recovery occurred in 20 patients,moderate disability in 6 patients,severe disability in 4 patients,and vegetative state in 3 patients according to Glasgow Outcome Score 3 months later.ConclusionHead-CT scanning should be timely performed when intracperative acute encephalocele occurred,whereas the measures of efficacy improvement on acute encephalocele were to timely.

Clinical analysis of the microsurgical treatment for intramedullary spinal cord tumors / 中国基层医药

ObjectiveTo explore the effect of the microsurgical treatment for intramedullary spinal cord tumors.Methods38 patients with intramedullary spinal cord tumors were retrospectively analyzed,and the removal of the tumor cases and functional changes in patients after surgery was summarized.Results38 cases of intramedullary spinal cord tumors,17 cases of ependymoma were all totally removed under the microscope;13 cases of astrocytoma resection achieved in 5 cases,near total resection in 4 cases,partial resection in 4 cases;5 patients most of the lipoma removed;3 cases of hemangioblastoma resection were done.32 patients before surgery in patients with different degrees of movement disorders at discharge in 29 patients with different degrees of improvement,no change in 1 case,2 cases decreased compared with preoperation ;29 patients with varying degrees of preoperative sensory disturbance,21patients at discharge with improvement,5 patients had no change,three cases aggravated; 14 patients had sphincter dysfunction,12 patients improveed than before surgery 2 patients had no change.ConclusionEarhy diagnosis and taking early microsurgical treatment was the preferred method in treatment of Intramedullary spinal cord tumors in clinical application.