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In Lepidoptera (butterflies and moths), the genomic region around the gene cortex is a 'hotspot' locus, repeatedly used to generate intraspecific melanic wing color polymorphisms across 100-million-years of evolution. However, the identity of the effector gene regulating melanic wing color within this locus remains unknown. Here, we show that none of the four candidate protein-coding genes within this locus, including cortex, serve as major effectors. Instead, a micro-RNA (miRNA), mir-193, serves as the major effector across three deeply diverged lineages of butterflies, and its function is conserved in Drosophila. In Lepidoptera, mir-193 is derived from a gigantic long non-coding RNA, ivory, and it functions by directly repressing multiple pigmentation genes. We show that a miRNA can drive repeated instances of adaptive evolution in animals.
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We introduce the concept of polarized vortex Smith-Purcell radiation by the interaction of an electron beam and cascaded metasurfaces. The spin and orbital angular momenta of Smith-Purcell radiation are determined by the cascaded metasurface that consists of a grating and a phase gradient metasurface. The grating converts the electron beam radiation into the desired polarized light, while the phase gradient metasurface generates the vortex light. Furthermore, the vortex Smith-Purcell radiation with linear and circular polarizations can be achieved by the various cascaded metasurfaces. In particular, the conversion of chirality in the Smith-Purcell radiation carrying circular polarization is accompanied by the alteration of positive and negative topological charges. This work paves the way for generating polarized vortex electron radiation and is beneficial to promote the development of free-electron-driven devices.
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BACKGROUND: To review the treatment and the causes of postoperative epidural hematoma (PEDH) after intracranial tumor resection. METHOD: A retrospective case study was conducted to examine a series of patients who developed PEDH as a complication following intracranial tumor resection between January 2016 and June 2021. The study collected data from hospital charts, including clinical status at admission, imaging results, histopathologic findings, surgical management, complications, and outcomes. Causes of PEDH were evaluated through a review of operative notes and discussions with the surgical team. RESULTS: Twenty-five patients (10 males, 15 females; median age 42 years, range 11-61 years; median medical history 27 months, range 1-96 months) were enrolled in the study. Regarding tumor location, 16 cases exhibited supratentorial brain tumors, 4 cases had infratentorial brain tumors, 2 cases of tumors occurred in the petroclival region, 2 cases in the peritorcular region, and 1 case in the pineal region. Four of these cases were complicated with supratentorial hydrocephalus. The 25 cases in this study were classified into four types based on location. Type 1 refers to EDHs that occur at the adjacent site of the operative field without involvement of the surgical area. Type 2 includes hematomas that occur at the adjacent site of the surgical area and the surgical area. Type 3 includes EDHs that occur in distant areas, and type 4 involves EDHs in the surgical field. The numbers of cases of types 1, 2, 3, and 4 PEDHs were 16, 2, 3, and 4 cases, respectively. Most PEDHs were associated with reduced ICP after craniotomy due to intracranial tumor resection and substantial loss of CSF. All patients achieved satisfactory outcomes after hematoma evacuation. CONCLUSION: The decrease in ICP resulting from intracranial tumor resection and CSF loss might lead to PEDHs. By employing optimized surgical techniques and meticulous patient management to prevent rapid decreases in ICP and dural detachment, we can potentially lower the incidence of PEDHs. Additionally, prompt evacuation of hematomas can contribute to positive outcomes.
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Transverse scattering is a special directional scattering perpendicular to the propagation direction, which has attracted great interest due to its potential applications from directional antennas, optical metrology to optical sensing. Here we reveal annular transverse scattering and unidirectional transverse scattering by magnetoelectric coupling of Omega particle. The annular transverse scattering can be achieved by the longitudinal dipole mode of the Omega particle. Furthermore, we demonstrate the highly asymmetric unidirectional transverse scattering by adjusting the transverse electric dipole (ED) and longitudinal magnetic dipole (MD) modes. Meanwhile, the forward scattering and backward scattering are suppressed by the interference of transverse ED and longitudinal MD modes. In particular, the lateral force exerted on the particle is accompanied by the transverse scattering. Our results provide a useful toolset for manipulating light scattered by the particle and broaden the application range of the particle with magnetoelectric coupling.
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Electronic medical records (EMRs) contain a wealth of knowledge that can be used to assist doctors in making clinical decisions like disease diagnosis. Constructing a medical knowledge network (MKN) to link medical concepts in EMRs is an effective way to manage this knowledge. The quality of the diagnostic result made by MKN-based clinical decision support system depends on the accuracy of medical knowledge and the completeness of the network. However, collecting knowledge is a long-lasting and cumulative process, which means it's hard to construct a complete MKN with limited data. This study was conducted with the objective of developing an expandable EMR-based MKN to enhance capabilities in making an initial clinical diagnosis. A network of symptom-indicate-disease knowledge in 992 Chinese EMRs (CEMRs) was manually constructed as Original-MKN, and an incremental expansion framework was applied to it to obtain an expandable MKN based on new CEMRs. The framework was composed by: (1) integrating external knowledge extracted from the medical information websites and (2) mining potential knowledge with new EMRs. The framework also adopts a diagnosis-driven learning method to estimate the effectiveness of each knowledge in clinical practice. Experimental results indicate that our expanded MKN achieves a precision of 0.837 for a recall of 0.719 in clinical diagnosis, which outperforms Original-MKN and four classical machine learning methods. Furthermore, both external medical knowledge and potential medical knowledge benefit MKN expansion and disease diagnosis. The proposed incremental expansion framework sustains the MKN learning new knowledge.
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Sistemas de Apoio a Decisões Clínicas , Registros Eletrônicos de Saúde , Humanos , Bases de Conhecimento , Aprendizado de MáquinaRESUMO
BACKGROUND AND PURPOSE: Epilepsy is one of the most common diseases of the nervous system. Approximately one-third of epilepsy cases are drug-resistant, among which generalized-onset seizures are very common. The present study aimed to analyze abnormalities of the thalamocortical fiber pathways in each hemisphere of the brains of patients with drug-resistant generalized epilepsy. MATERIALS AND METHODS: The thalamocortical structural pathways were identified by diffusion tensor imaging (DTI) in 15 patients with drug-resistant generalized epilepsy and 16 gender/age-matched controls. The thalami of both groups were parcellated into subregions according to the local thalamocortical connectivity pattern. DTI measures of thalamocortical connections were compared between the two groups. RESULTS: Probabilistic tractography analyses showed that fractional anisotropy of thalamocortical pathways in patients with epilepsy decreased significantly, and the radial diffusivity of the left thalamus pathways with homolateral motor and parietal-occipital cortical regions in the drug-resistant epilepsy group increased significantly. In addition to the right thalamus pathway and prefrontal cortical region, fractional anisotropy of all other pathways was inversely correlated with disease duration. CONCLUSION: The results provide evidence indicating widespread bilateral abnormalities in the thalamocortical pathways in epilepsy patients and imply that the degree of abnormality in the pathway increases with the disease duration.
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Córtex Cerebral/patologia , Epilepsia Resistente a Medicamentos/patologia , Epilepsia Generalizada/patologia , Tálamo/patologia , Adulto , Anisotropia , Imagem de Tensor de Difusão , Feminino , Humanos , Masculino , Vias Neurais/patologiaRESUMO
PURPOSE: Epilepsy is considered a disorder of neural networks. Patients diagnosed with refractory epilepsy frequently experience attention impairments. Seizure activity in epilepsy may disturb brain networks and damage the brain function of attention. The aims of this study were to assess functional and causal connectivities of the attention networks and default mode network using resting-state functional magnetic resonance imaging (fMRI). METHOD: Resting-state fMRI data were gathered from 19 patients with refractory epilepsy (mixed localization and aetiologies) and 21 healthy people. The fMRI data were analyzed by group independent component analysis (ICA) fMRI toolbox to extract dorsal attention network (DAN), ventral attention network (VAN), and default mode network (DMN). The components of the selected networks were compared between patients and healthy controls to explore the change in functional connectivity (FC). Granger causality analysis was performed by taking the aforementioned significant brain areas as regions of interest (ROIs) to calculate autoregression coefficients of each pair of ROIs. Comparisons were done to find the significantly different causal connectivity when FC was changed between patients and healthy controls. RESULTS: In DAN, the FC values of the bilateral frontal eye field (FEF) and left intraparietal sulcus (IPS) were decreased. In VAN, the FC values of the double-side ventral prefrontal cortex (vPFC) and the temporoparietal junction (TPJ) were reduced. As for DMN, the FC values of the bilateral medial prefrontal cortices (mPFC) were decreased whereas those for the bilateral precuneus (PCUN) were increased. Granger causal connectivity values were correlated: causal influence was decreased significantly from the left IPS (in DAN) to the double side of the vPFC but remained the same for the right FEF (in DAN) to the right TPJ. The value was decreased from the left PCUN (in DMN) to the right TPJ and FEF, and the causal flow from the right PCUN to the right TPJ and bilateral vPFC was also significantly inhibited (pâ¯<â¯0.05). CONCLUSION: Frequent seizures in patients with refractory epilepsy may damage the cortex and disturb DAN, VAN, and DMN, leading to functional and causal connectivity alteration. In addition, epileptic activity may disrupt network interactions and further influence information communication.
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Atenção/fisiologia , Mapeamento Encefálico , Córtex Cerebral/fisiopatologia , Epilepsia Resistente a Medicamentos/fisiopatologia , Imageamento por Ressonância Magnética , Rede Nervosa/fisiopatologia , Adulto , Estudos de Casos e Controles , Córtex Cerebral/diagnóstico por imagem , Epilepsia Resistente a Medicamentos/diagnóstico por imagem , Epilepsia Resistente a Medicamentos/psicologia , Feminino , Humanos , Masculino , Rede Nervosa/diagnóstico por imagemRESUMO
BACKGROUND: Microvascular decompression of the trigeminal nerve is the most effective treatment for trigeminal neuralgia. However, when encountering classical trigeminal neuralgia caused by venous compression, the procedure becomes much more difficult, and failure or recurrence because of incomplete decompression may become frequent. This study aimed to investigate the anatomic variation of the culprit veins and discuss the surgical strategy for different types. METHODS: We performed a retrospective analysis of 64 consecutive cases in whom veins were considered as responsible vessels alone or combined with other adjacent arteries. The study classified culprit veins according to operative anatomy and designed personalized approaches and decompression management according to different forms of compressive veins. Curative effects were assessed by the Barrow Neurological Institute (BNI) pain intensity score and BNI facial numbness score. RESULTS: The most commonly encountered veins were the superior petrosal venous complex (SPVC), which was artificially divided into 4 types according to both venous tributary distribution and empty point site. We synthetically considered these factors and selected an approach to expose the trigeminal root entry zone, including the suprafloccular transhorizontal fissure approach and infratentorial supracerebellar approach. The methods of decompression consist of interposing and transposing by using Teflon, and sometimes with the aid of medical adhesive. Nerve combing (NC) of the trigeminal root was conducted in situations of extremely difficult neurovascular compression, instead of sacrificing veins. Pain completely disappeared in 51 patients, and the excellent outcome rate was 79.7%. There were 13 patients with pain relief treated with reoperation. Postoperative complications included 10 cases of facial numbness, 1 case of intracranial infection, and 1 case of high-frequency hearing loss. CONCLUSIONS: The accuracy recognition of anatomic variation of the SPVC is crucial for the management of classical trigeminal neuralgia caused by venous compression. Selecting an appropriate approach and using reasonable decompression methods can bring complete postoperative pain relief for most cases. NC can be an alternative choice for extremely difficult cases, but it could lead to facial numbness more frequently.
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Veias Cerebrais/diagnóstico por imagem , Veias Cerebrais/cirurgia , Cirurgia de Descompressão Microvascular/métodos , Neuralgia do Trigêmeo/diagnóstico por imagem , Neuralgia do Trigêmeo/cirurgia , Adulto , Idoso , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Manejo da Dor/métodos , Estudos Retrospectivos , Neuralgia do Trigêmeo/etiologiaRESUMO
OBJECTIVE: To discuss the alterations of brain network efficiency in patients with post-concussion syndrome. METHODS: A total of 23 patients from Anhui Provincial Hospital in the period from 2013/6 to 2014/3 who have had the concussion for 3 months were enrolled and 23 volunteers paired in sex, age and education were also enrolled as healthy controls. Comparisons of selective attention of both groups were conducted using Stroop Word-Color Test. The data of resting-state functional magnetic resonance imaging (fMRI) in both groups were collected and the data were dealt with Network Construction which is a part of GRETNA software to obtain the Matrix of brain network. Network analysis was used to obtain Global and Nodal efficiency, then independent t-test was used for statistical analyses of the value of Global and Nodal efficiency. RESULTS: The difference in Global efficiency of two groups in every threshold value had no statistical significance. Compared with healthy controls, the Nodal efficiencies in patients with post-concussion syndrome were significantly different in the brain regions as below: left orbital middle frontal gyrus, left posterior cingulate, left lingual, left thalamus, left superior temporal gyrus, right anterior cingulate, right posterior cingulate, right supramarginalgyrus. CONCLUSIONS: Compared with healthy controls, there is no significant changes of Globe efficiency in patients with post-concussion syndrome, and the brain function deficits in these patients may be caused by changes of Nodal efficiency in their brain network.
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Encéfalo , Síndrome Pós-Concussão , Atenção , Humanos , Imageamento por Ressonância MagnéticaRESUMO
Local field potentials (LFPs) and spikes (SPKs) sampled at the thalamocortical recipient layers represent the inputs from the thalamus and outputs to other layers. Previous studies have shown that SPK-constructed receptive fields (RFSPK) of cortical neurons are much smaller than LFP-constructed RFs (RFLFP). The difference in cortical RFLFP and RFSPK is therefore a plausible indication of local networking. The presence of a boarder RFLFP appears due to contamination, to some degree, from remote sites. Our studies of the mouse primary auditory cortex show that the best frequencies and minimum thresholds of RFSPK and RFLFP were similar. We also observed that the RFLFP area was only slightly larger than the RFSPK area, a very different finding from previous reports. The bandwidth of RFLFP was slightly broader than that of RFSPK at all levels. These data do not support the explanation that bioelectrical signals from distant sites impact on cortical LFP through volume conduction. That the cortical LFP represents a local event is further supported by comparisons of RFSPK and RFLFP after cortical inhibition by muscimol and cortical disinhibition by bicuculine. We conclude that the difference between RFSPK (output of cortical neurons) and RFLFP (input of cortical neurons) results from intracortical processing, including cortical lateral inhibition and excitation.
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Córtex Auditivo/fisiologia , Percepção Auditiva/fisiologia , Ondas Encefálicas , Neurônios/fisiologia , Estimulação Acústica , Potenciais de Ação , Animais , Feminino , Camundongos , Camundongos Endogâmicos C57BL , Inibição NeuralRESUMO
OBJECTIVE: To explore the functions of amygdala functional connectivity in the pathogenesis of refractory epilepsy with resting-state functional magnetic resonance imaging (RS-fMRI). METHODS: A total of 19 patients with refractory epilepsy were recruited from August 2013 to June 2014. And 19 healthy persons were selected as the controls.No obvious epileptogenic lesions of intracranial structures were found on multi-modal neuroimaging.Ictal and interictal epileptic activities on long-term video electroencephalogram (EEG) showed spine spread spike and wave in bilateral cerebral hemispheres. All fMRI data were preprocessed after RS-fMRI scanning. Then left and right amygdalas were selected as regions of interest (ROIs) for calculating the linear correlation between amygdala and whole brain. As relative to the control group, the changes of brain areas in functional connectivity were examined for the intractable epilepsy group. RESULTS: Compared with the controls, left amygdala in refractory epilepsy group showed increased functional connectivity with bilateral fusiform gyrus, bilateral calcarine gyrus and right lingual, on the contrary decreased functional connectivity with bilateral cuneus, bilateral precuneus, bilateral caudatas and left thalamus.However, right amygdala demonstrated increased functional connectivity with bilateral calcarine gyrus and bilateral linguals, but decreased functional connectivity with bilateral caudatas and left putamen (P < 0.05). CONCLUSION: Altered functional connectivity of amygdala reflects its dysfunction in refractory epilepsy patients. It suggested that amygdala is an important component of "epileptic network" participating in the occurrence and development of refractory epilepsy.
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Tonsila do Cerebelo , Epilepsia , Imageamento por Ressonância Magnética , Encéfalo , Mapeamento Encefálico , Eletroencefalografia , HumanosRESUMO
OBJECTIVE: To explore the neuroimaging diagnosis and therapeutic efficacy of different surgical methods of gliomatosis cerebri. METHODS: 26 cases of gliomatosis cerebri at our department between September 2008 and September 2013 were retrospectively analyzed. Preoperative cranial computed tomography (CT), magnetic resonance imaging (MRI) and other multimodal imaging scans were performed. The procedures included stereotactic brain biopsy (n = 11) and large craniotomy lobotomy (n = 15). Whole brain radiotherapy and/or temozolomide therapy was performed postoperatively according to the malignancy of tumors. Follow-ups were conducted to analyze the survival differences between stereotactic brain biopsy and large craniotomy lobotomy groups. RESULTS: According to the different features of multimodal imaging, gliomatosis cerebri could be divided into two types: (1) type I(n = 19) showed a diffuse infiltrating lesion infringing multiple brain lobes or regions with central corpus callosum but without obvious enhancement; (2) type II (n = 7) appeared as sporadic or tuberous enhancement in addition to the features of type I. Pathological diagnosis: pilocytic astrocytoma (n = 2), diffuse astrocytoma (n = 13), oligodendroglial tumors (n = 3), oligoastrocytoma (n = 1), anaplastic astrocytoma (n = 5) and glioblastoma (n = 2). The degree of malignancy was a prognostic factor for postoperative survival in patients with gliomatosis cerebri. The mean survival time (MST) of large craniotomy lobotomy group (23 ± 7) was significantly longer than that of stereotactic brain biopsy group (13 ± 3) (P < 0.05). CONCLUSION: Gliomatosis cerebri is a primary brain glial tumor with diffuse infiltrative growth but retaining the general structure of central nervous system. Multimodal imaging studies plus pathological examination yield a definitive diagnosis. Comprehensive treatment of operation plus chemo- or radio-therapy can prolong postoperative MST.
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Neoplasias Encefálicas/diagnóstico , Glioma/diagnóstico , Biópsia , Humanos , Imageamento por Ressonância Magnética , Neuroimagem , Estudos Retrospectivos , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVE: To explore the functions of temporal parietal junction (TPJ) as parts of attention networks in the pathogenesis of online game addiction using resting-state functional magnetic resonance imaging (fMRI). METHODS: A total of 17 online game addicts (OGA) were recruited as OGA group and 17 healthy controls during the same period were recruited as CON group. The neuropsychological tests were performed for all of them to compare the inter-group differences in the results of Internet Addiction Test (IAT) and attention functions. All fMRI data were preprocessed after resting-state fMRI scanning. Then left and right TPJ were selected as regions of interest (ROIs) to calculate the linear correlation between TPJ and entire brain to compare the inter-group differences. RESULTS: Obvious differences existed between OGA group (71 ± 5 scores) and CON group (19 ± 7 scores) in the IAT results and attention function (P < 0.05). Compared with the controls, right TPJ in online game addicts showed decreased functional connectivity with bilateral ventromedial prefrontal cortex (VMPFC), bilateral hippocampal gyrus and bilateral amygdaloid nucleus, but increased functional connectivity with right cuneus.However, left TPJ demonstrated decreased functional connectivity with bilateral superior frontal gyrus and bilateral middle frontal gyrus, but increased functional connectivity with bilateral cuneus (P < 0.05). CONCLUSION: Altered functional connectivity of TPJ reflected its dysfunction in online game addicts.It suggests that TPJ is an important component of attention networks participating in the generation of online game addiction.
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Comportamento Aditivo/fisiopatologia , Imageamento por Ressonância Magnética/métodos , Córtex Pré-Frontal/fisiopatologia , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Adulto JovemRESUMO
Online game addiction (OGA) has attracted greater attention as a serious public mental health issue. However, there are only a few brain magnetic resonance imaging studies on brain structure about OGA. In the current study, we used voxel-based morphometry (VBM) analysis and tract-based spatial statistics (TBSS) to investigate the microstructural changes in OGA and assessed the relationship between these morphology changes and the Young's Internet Addiction Scale (YIAS) scores within the OGA group. Compared with healthy subjects, OGA individuals showed significant gray matter atrophy in the right orbitofrontal cortex, bilateral insula, and right supplementary motor area. According to TBSS analysis, OGA subjects had significantly reduced FA in the right genu of corpus callosum, bilateral frontal lobe white matter, and right external capsule. Gray matter volumes (GMV) of the right orbitofrontal cortex, bilateral insula and FA values of the right external capsule were significantly positively correlated with the YIAS scores in the OGA subjects. Our findings suggested that microstructure abnormalities of gray and white matter were present in OGA subjects. This finding may provide more insights into the understanding of the underlying neural mechanisms of OGA.
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Encéfalo/patologia , Imagem de Tensor de Difusão/métodos , Jogo de Azar/etiologia , Jogo de Azar/patologia , Fibras Nervosas Mielinizadas/patologia , Neurônios/patologia , Jogos de Vídeo/efeitos adversos , Adolescente , Comportamento Aditivo/etiologia , Comportamento Aditivo/patologia , Feminino , Humanos , Masculino , Sistemas On-Line , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
OBJECTIVE: To explore the brain regions associated with impulsive decision-making behaviors and interpret the nervous mechanism for addiction and relapse in heroin abusers. METHODS: Using the paradigms of psychological experiment, the subjects in both heroin addiction group (HA group) and normal control group (HC group) performed Iowa gambling task (IGT) and simultaneously underwent functional magnetic resonance imaging (fMRI) scan. All the above data were gathered and then analyzed by SPM5 software to explore both the brain regions and their functional changes correlated with impulsive decision-making. RESULTS: Evidence by IGT behavioral consequences demonstrated that the net scores in HC group increased with numbers of decision-making whereas no increment (fluctuating between-1 and 0) was observed in HA group. Based on the results of fMRI analysis, right orbitofrontal cortex (OFC), dorsolateral prefrontal cortex (DLPFC), left ventromedial prefrontal cortex (MPFC) and anterior cingulate cortex (ACC) were activated in both groups. But the right OFC was more active while the right DLPFC and left MPFC were weaker in HA group versus the HC group. Meanwhile, activation of right lenticular nucleus, right thalamus, right insula, hippocampus and left caudate nucleus were observed in HA group. CONCLUSION: Heroin abusers are incapable of impulsive decision-making in behavioral studies. Such a brain region as prefrontal cortex participates in the decision-making performance and control of impulsiveness. Functionally abnormal brain regions correlated with impulsive decision-making may be one cause of genesis, maintenance and relapse of heroin addiction.
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Tomada de Decisões/efeitos dos fármacos , Dependência de Heroína/fisiopatologia , Dependência de Heroína/psicologia , Comportamento Impulsivo , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Córtex Pré-Frontal/fisiopatologia , Adulto JovemRESUMO
OBJECTIVE: To explore the possible brain mechanism of online game addiction (OGA) in terms of brain morphology through voxel-based morphometric (VBM) analysis. METHODS: Seventeen subjects with OGA and 17 age- and gender-matched healthy controls (HC group) were recruited from Department of Psychology at our hospital during February-December 2011. The internet addiction scale (IAS) was used to measure the degree of OGA tendency. Magnetic resonance imaging (MRI) scans were performed to acquire 3-dimensional T1-weighted images. And FSL 4.1 software was employed to confirm regional gray matter volume changes. For the regions where OGA subjects showed significantly different gray matter volumes from the controls, the gray matter volumes of these areas were extracted, averaged and regressed against the scores of IAS. RESULTS: The OGA group had lower gray matter volume in left orbitofrontal cortex (OFC), left medial prefrontal cortex (mPFC), bilateral insula (INS), left posterior cingulate cortex (PCC) and left supplementary motor area (SMA). Gray matter volumes of left OFC and bilateral INS showed a negative correlation with the scores of IAS (r = -0.65, r = -0.78, P < 0.05). CONCLUSION: Gray matter volume changes are present in online game addicts and they may be correlated with the occurrence and maintenance of OGA.
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Comportamento Aditivo/patologia , Córtex Cerebral/patologia , Internet , Jogos de Vídeo/psicologia , Adolescente , Biometria , Feminino , Lobo Frontal/patologia , Giro do Cíngulo/patologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Córtex Pré-Frontal/patologia , Adulto JovemRESUMO
BACKGROUND: Traumatic brain injury (TBI) is the leading cause of death for traumatic injury, which is the fifth highest killer in China and the highest killer in adults under 40 years of age. But, there is a lack of epidemiologic data of TBI in China during the past decade. This study aimed to investigate the epidemiologic data of TBI in eastern China, based on a prospective multicenter trial. METHODS: Data were collected from the 77 hospitals by standardized structured questionnaires in this region during the 1-year period (2004). RESULTS: A total of 14,948 of cases of traumatic brain injury were identified from 77 hospitals in eastern China. There were 11,446 men (76.6%) and 3,502 women (25.4%). Male adolescents and young adults were affected more often by brain injury. Traffic accidents (60.9%), knock on head (13.4%), and falls (13.1%) were the leading causes of patients with TBI. Approximately one-thirds of the traffic-related TBI were motorcyclists, 31% were pedestrians, and 21.9% were cyclists, whereas motor vehicle occupants only counted for 14% of the cases. The distribution of head injury severity, on the basis of Glasgow Coma Scale scores, was mild in 62%, moderate in 18.1%, and severe in 20% for all cases. The traffic accidents caused the most of severe injuries, which accounted for about 70.4%. Based on Glasgow Outcome Scale assessment, 10.8% of the patients died, 2.6% were in vegetation status, 2.2% had severe disability, 7.2% had moderate disability, and 77.3% had good recovery. And, the outcome depended on age, injury mechanism and initial Glasgow Coma Scale score. CONCLUSIONS: The prospective cohort study shows an alteration of TBI during the past decade in eastern China. It is essential to establish a standardized surveillance system of TBI incidence, risk factors, causes, and outcomes for development of new, more effective, targeted strategies to prevent TBI.
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Acidentes de Trânsito/estatística & dados numéricos , Lesões Encefálicas/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Lesões Encefálicas/classificação , Lesões Encefálicas/etiologia , Criança , Pré-Escolar , China/epidemiologia , Feminino , Escala de Resultado de Glasgow/estatística & dados numéricos , Humanos , Incidência , Lactente , Escala de Gravidade do Ferimento , Masculino , Pessoa de Meia-Idade , Estudos Multicêntricos como Assunto , Estudos Prospectivos , Sistema de Registros , Distribuição por Sexo , Inquéritos e QuestionáriosRESUMO
Patients with personality disorders such as the histrionic type exaggerate their responses when receiving external social or environmental stimuli. We speculated that they might also show an augmenting pattern of the auditory evoked potential N1-P2 component in response to stimuli with increasing levels of intensity, a response pattern that is thought to be inversely correlated with cerebral serotonin (5-HT) activity. To test this hypothesis, we collected auditory evoked potentials in 191 patients with personality disorders (19 patients with the paranoid type, 12 schizoid, 14 schizotypal, 18 antisocial, 15 borderline, 13 histrionic, 17 narcissistic, 25 avoidant, 30 dependent and 28 obsessive-compulsive) and 26 healthy volunteers. Their personality traits were measured using the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ). Compared with healthy subjects and other patient groups, the histrionic group scored higher on the basic traits Affective Instability, Stimulus Seeking, Rejection and Narcissism, and on the higher traits Emotional Dysregulation and Dissocial, than the other groups, and the schizoid group scored lower on most of the DAPP-BQ basic and higher traits. In addition, the histrionic group showed steeper amplitude/stimulus intensity function (ASF) slopes at three midline scalp electrodes than the healthy controls or the other patient groups. The ASF slopes were not correlated with any DAPP-BQ traits in the total sample of 217 subjects. However, the DAPP-BQ basic trait Rejection was positively correlated with the ASF slopes at all three electrode sites in the histrionic group. The increased intensity dependence of the auditory N1-P2 component might indicate that cerebral 5-HT neuronal activity is, on average, weak in the histrionic patients.
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Transtornos Cognitivos/epidemiologia , Transtornos Cognitivos/fisiopatologia , Potenciais Evocados Auditivos/fisiologia , Transtornos da Personalidade/epidemiologia , Transtornos da Personalidade/fisiopatologia , Adulto , Encéfalo/metabolismo , Feminino , Humanos , Masculino , Transtornos da Personalidade/diagnóstico , Serotonina/metabolismo , Inquéritos e QuestionáriosRESUMO
As a brief reflection on the development of stereotactic neurosurgery, this article reviews its founding and early history in China.
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Neurocirurgia/tendências , Técnicas Estereotáxicas/tendências , China , HumanosRESUMO
INTRODUCTION: Normal line bisection deviation to the left of the true centre has been interpreted as resulting from relative right hemisphere activation. Right hemisphere involvement has also been associated with the problems in dependency and attachment from infancy to adulthood. This hemispheric association predicts that patients diagnosed with dependent personality disorder will deviate significantly to the left on the line bisection task. METHODS: This hypothesis was tested by comparing the results of the line bisection task obtained respectively from 30 right-handed healthy volunteers and 14, 16, 18, and 26 outpatients with schizotypal, antisocial, borderline, and dependent personality disorders. Subjects completed eight horizontal line bisection tasks and the Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ), a self-report measure of 18 traits delineating personality disorder. RESULTS: Patients with dependent personality disorder bisected significantly leftward compared to healthy controls. Dependent personality disorder patients scored significantly higher on DAPP-BQ Insecure Attachment, and lower on DAPP Stimulus Seeking, Callousness, Intimacy Problems, and Conduct Problems compared to the healthy controls and all other patient groups. CONCLUSIONS: Line bisection differentiates dependent personality disorder from other personality disorder diagnoses and healthy controls. This study thus suggests that line bisection can be used to enhance diagnostic specificity of dependent personality disorder and localises the brain areas implicated in the disorder.