Epilepsy centers in China: Current status and ways forward.

OBJECTIVE: China has the largest population of patients with epilepsy worldwide, which imposes a heavy burden on the public and health care systems. Several epidemiological surveys on epilepsy have been performed in China. Although these surveys grossly describe the prevalence and gap in treatment of epilepsy, the status of epilepsy centers is unclear. The number of epilepsy centers has increased substantially in recent decades. Therefore, a nationwide investigation of the scale and distribution, personnel, equipment, and epilepsy care capacity of each epilepsy center is of great value. METHODS: In 2017-2018, a multicenter cross-sectional survey was performed by the Commission on Standardized Development of Epilepsy Centers, China Association Against Epilepsy in 31 provinces, autonomous regions, and municipalities. The survey consisted of 74 questions divided into four sections: (1) overview, (2) personnel, (3) essential equipment and facilities, and (4) epilepsy care service capacity. The questions ranged from January 1, 2016 to December 31, 2016. The data were analyzed using descriptive statistics. RESULTS: There were 358 epilepsy centers for the 1.38 billion national population in 2016. Three quarters were in the eastern and western regions, and >90% were in tertiary hospitals. There were 9688 doctors engaged in epilepsy care, and 4.8% of doctors and electrophysiological physicians/technicians passed the national test for electroencephalography technical accreditation. A total of 9667 patients underwent resective surgeries in 2016. There were 888 vagus nerve stimulation procedures and 275 deep brain stimulation procedures. SIGNIFICANCE: This study is the first unique survey of epilepsy centers in China. Despite their rapid development, epilepsy centers cannot meet patients' needs at this stage. The results provide data-based evidence for the formulation of policies related to epilepsy service planning.

Antistricture Ureteral Stents with a Braided Composite Structure and Surface Modification with Antistenosis Drugs.

The present work describes the development of a drug-loaded ureteral stent with antistricture function based on a trilayer design in which the middle layer was braided from biodegradable poly(p-dioxanone) (PDO) monofilament. Antistenosis drugs rapamycin and paclitaxel were loaded into a silk fibroin (SF) solution and coated on the inner and outer layers of the braided PDO stent. The cumulative release of rapamycin and paclitaxel was sustained over 30 days, with a total release above 80%. The drug-loaded ureteral stents inhibited the proliferation of fibroblasts and smooth muscle cells in vitro. Subcutaneous implantation in rats showed that the drug-loaded ureteral stents were biocompatible with durable mechanical properties in vivo, revealing the inhibition of an excessive growth of fibroblasts and excessive deposition of collagen fibers. In conclusion, the dual-drug-loaded biodegradable ureteral stents show the possibility for treatment of ureteral strictures and avoid the occurrence of complications such as inflammation and restricture.

Silk Fibroin/Wool Keratin Composite Scaffold with Hierarchical Fibrous and Porous Structure.

The present study describes a silk microfiber reinforced meniscus scaffold (SMRMS) with hierarchical fibrous and porous structure made from silk fibroin (SF) and wool keratin (WK) using electrospinning and freeze-drying technology. This study focuses on the morphology, secondary structure, mechanical properties, and water absorption properties of the scaffold. The cytotoxicity and biocompatibility of SMRMS are assessed in vivo and in vitro. The scaffold shows hierarchical fibrous and porous structure, hierarchical pore size distribution (ranges from 50 to 650 µm), robust mechanical properties (compression strength can reach at 2.8 MPa), and stable biodegradability. A positive growth condition revealed by in vitro cytotoxicity testing indicates that the scaffold is not hazardous to cells. In vivo assessments of biocompatibility reveal that only a mild inflammatory reaction is present in implanted rat tissue. Meniscal scaffold made of SF/WK composite shows a potential application prospect in the meniscal repair engineering field with its development.

Preparation and mechanical optimization of a two-layer silk/magnesium wires braided porous artificial nerve guidance conduit.

Peripheral nerve injures have long been a tricky problem in surgery and a feasible treatment is the transplantation of nerve guidance conduits (NGCs). This study presents a two-layer composite NGC with fair mechanical properties and good biocompatibility. The inner layer was made of degummed silk yarns/magnesium wires using braiding technology, and the outer layer was made from mixed solution of silk fibroin/chitosan (SF/CS) using freeze-drying treatment. Orthogonal experimental design was applied to rationally design the braided structural layer and obtain the optimal combination of technical process parameters. Meanwhile, the SF/CS porous outer layer was optimized from three concentrations of SF/CS solution. In vitro and in vivo study suggested that the textile-forming scaffold exhibited good biocompatibility and no toxicity. During 4 weeks' degradation, the skeleton of conduits retained its shape, and magnesium ions released from degraded magnesium wires contributed to sustainable release and uniform dispersion, proliferation and adhesion of Schwann cells, indicating potential approach in the development of NGCs.

The National Comprehensive Governance for epilepsy prevention and control in China.

This article describes "the national comprehensive governance for epilepsy prevention and control in China" as an example of a strategic working program for the prevention and control of epilepsy at a national level. The comprehensive governance includes 10 key elements: epilepsy centers' consortium and three tier diagnosis/treatment network; rural and urban community projects on epilepsy care; awareness, publicity, and education; big data platform; development of telemedicine; team and capacity building; strengthening epilepsy research; developing and strengthening partnership; coordination with government; and international collaboration.

Implantable nerve guidance conduits: Material combinations, multi-functional strategies and advanced engineering innovations.

Nerve guidance conduits (NGCs) have attracted much attention due to their great necessity and applicability in clinical use for the peripheral nerve repair. Great efforts in recent years have been devoted to the development of high-performance NGCs using various materials and strategies. The present review provides a comprehensive overview of progress in the material innovation, structural design, advanced engineering technologies and multi functionalization of state-of-the-art nerve guidance conduits NGCs. Abundant advanced engineering technologies including extrusion-based system, laser-based system, and novel textile forming techniques in terms of weaving, knitting, braiding, and electrospinning techniques were also analyzed in detail. Findings arising from this review indicate that the structural mimetic NGCs combined with natural and synthetic materials using advanced manufacturing technologies can make full use of their complementary advantages, acquiring better biomechanical properties, chemical stability and biocompatibility. Finally, the existing challenges and future opportunities of NGCs were put forward aiming for further research and applications of NGCs.

[Effect of static magnetic field on development toxicity of rat embryonic midbrain neurons cells].

OBJECTIVE: To explore the effect of static magnetic field (SMF) on the differentiation and proliferation of rat embryonic midbrain neurons cells. METHODS: The micromass culture of rat embryonic midbrain neurons cell was applied to study the effect of varieties of SMF (1.0, 10.0, 50.0, 100.0, 200.0 mT) and FACS. RESULTS: SMF inhibited the differentiation of the cell without affecting cell proliferation. The concentration of 50% inhibition of cell differentiation (ICD(50)) was 25 mT. The concentration of 50% inhibition of cell differentiation (IVD(50)) was 45 mT. CONCLUSIONS: The inhibition of SMF on embryonic midbrain neurons cells may be associated with impact of protein syntheses, and lipid peroxidation.

Dexamethasone attenuates bleomycin-induced lung fibrosis in mice through TGF-ß, Smad3 and JAK-STAT pathway.

In order to find the possible mechanism of Dexamethasone (Dex) during curing fibrosis, the bleomycin (BLM)-induced mice model was used. After fibrosis were induced by BLM, histopathological evaluation and RT-PCR were employed to detect the expression of TGF-ß1, Smad3 and STAT1. It was found that BLM promoted the development of inflammation, leading to severe pulmonary fibrosis with the increasing of TGF-ß1, Smad3 and STAT1. After Dex treatment, the expression of TGF-ß1, Smad3 and STAT1 showed a little higher with alleviation of the fibrosis. Thus it is concluded that there is a possible pathway of mouse pulmonary fibrosis model through TGF-ß, Smad3 and JAK-STAT pathway.

Pathogenesis pathways of idiopathic pulmonary fibrosis in bleomycin-induced lung injury model in mice.

Our objective was to investigate the pathogenesis pathways of idiopathic pulmonary fibrosis (IPF). Bleomycin (BLM) induced animal models of experimental lung fibrosis were used. CHIP assay was executed to find the link between Smad3 and IL-31, and the expressions of TGF-ß1, Smad3, IL-31 and STAT1 were detected to find whether they were similar with each other. We found that in the early injury or inflammation of the animal model, BLM promoted the development of inflammation, leading to severe pulmonary fibrosis. Then the expression of TGF-ß1 and Smad3 increased. Activated Smad3 bound to the IL-31 promoter region, followed by the activation of JAK-STAT pathways. The inhibitor of TGF-ß1 receptor decreased the IL-31 expression and knocking-down of IL-31 also decreased the STAT1 expression. We conclude that there is a pathway of pathogenesis in BLM-induced mouse model that involves the TGF-ß, IL-31 and JAKs/STATs pathway.

Effects of matrine on JAK-STAT signaling transduction pathways in bleomycin-induced pulmonary fibrosis.

The current study aims to investigate the effects of matrine on the JAK-STAT signaling transduction pathways in bleomycin (BLM)-induced pulmonary fibrosis (PF) and to explore its action mechanism. A total of 72 male C57BL/6 mice were randomized into the control, model, and treatment groups. PF models were established by instilling BLM intratracheally. The treatment group was given daily matrine through gastric lavage. Six mice were sacrificed in each group at 3, 7, 14, and 28 days. The lung tissues were observed using hematoxylin-eosin staining. The expression of JAK, STAT1, and STAT3 was observed using immunohistochemistry and then determined using real-time polymerase chain reaction. Alveolitis and PF significantly improved in the treatment group compared with the model group (P < 0.05). The expression of JAK, STAT1, and STAT3 in the model group increased at day 7, peaked at day 14 and then decreased, but the expression was still higher than that in the control group at day 28 (P < 0.05). The three indices in the treatment group were significantly lower than those in the model group at any detection time point (P < 0.05). PF causes high expression of JAK, STAT1, and STAT3. Matrine exerts an anti-PF effect by inhibiting the JAK-STAT signaling transduction pathways.

Neuronal progenitor cells seeded in fibrin gel differentiate into ChAT-positive neuron.

Previous studies indicate that neural progenitor cells seeded in fibrin can differentiate into the glia cells and neurons. However, whether fibrin gel can induce differentiation of neural progenitor cells of spinal cord into motoneurons remains to be elucidated. In this study, we prepared a fibrin-based hybrid gel incorporated with laminin and fibronectin using rat fresh plasma as a crosslinking agent. The physical properties of this hybrid gel were examined with electron microscope, as well as its degradation and vascularization after subcutaneous transplantation with histological methods. Immunofluorescence stainings were used to study the proliferation and differentiation of the neural progenitor cells seeded in this 3D hybrid gel. The results indicate that such a hybrid gel possesses the unique physical characteristics, and the ability to promote both the proliferation and differentiation of the neural progenitor cells into neuron, including ChAT-positive motoneuron. Thus, it is suggested that this hybrid gel might be suitable for a mimetic tissue transplant for central nerve system injury, such as injured spinal cord repair.