Epilepsy is one of the major clinical features of tuberous sclerosis complex, and it is drug-resistant in the majority of cases.Surgical resection is an effective way to resolve the seizures.Precise preoperative evaluation is critical to the surgical outcome.Preoperative evaluation mainly aims to determine the range of the epileptogenic zone and the functional areas that should be preserved.Because of the complexity of the epileptogenic mechanism and brain network, there isn′t a single and specific measure that can accurately position the epileptogenic zone, so it is necessary to comprehensively evaluate and localize the epileptogenic zone by using multiple methods, including collection of a detailed medical history, symptomatic analysis during the attack of seizures, magnetic resonance imaging, positronemission tomography, electroencephalogram, neuropsychological evaluation, etc.In this paper, the rational use of above-mentioned approaches and comprehensive analysis of their results were summarized, which play an essential role in contro-lling seizures in children with tuberous sclerosis complex and refractory seizures.

According to the definition of professional morality in the employed and profession, the employed,service objects varied professions, three aspects must be grasped: the importance of medical technology must be understood fully, the study of evidence based laboratory medicine must be developed for patients; the responsibility for post must be enhanced to afford clinic correct directions. If these were carried out, the good respect and fondness for the medical technology profession should be trained.

Infants suffering from angiostrongylus eosinophilic meningitis (AEM) is rare, while AEM can cause severe consequences.The diagnostic value of high-throughput sequencing for AEM was studied by analyzing 2 AEM children (< 2 years old) in the Department of Neurology, Shenzhen Children′s Hospital in 2019.Case 1 mainly pre-sented intermittent fever, vomiting, mental fatigue and bregma bulge.Case 2 mainly manifested intermittent fever, cough, vomiting and convulsion.Due to hypereosinophils in patients′ peripheral blood and cerebrospinal fluid (CSF), and abundant DNA sequences from a cantonensis in CSF and positive antibody test, the patients were diagnosed with AEM.The patients were treated with albendazole to deworm, and small doses of methylprednisolone to reduce inflammation.The clinical characteristics of AEM infant are not typical, and high-throughput sequencing technology can assist the diagnosis of AEM.

Objective:To explore the effects of smoking on lung function and physical fitness of college students.Method:168 college students on September 30, 2020 were selected as the research subjects by convenient sampling. According to whether they had been smoking for more than 3 years in the past or (and) now, they were divided into smoking group (66 cases, 39.3%) and non-smoking group (102 cases, 60.7%). The general demographic data, body composition, health fitness and lung function of all the included subjects were collected, and the health status of the two groups were compared, the relationship between lung function and healthy physical fitness in the smoking group was analyzed, and the influencing factors of forced vital capacity (FVC), forced expiratory volume in the first second (FEV 1) and expiratory vital capacity (EVC) were also analyzed. Results:The peak expiratory flow rate (PEF) of male college students in smoking group was lower than that of non-smoking group [(9.37±1.72) vs (10.04±1.69) L/s] ( F=5.051, P=0.026). The standing time with eyes closed and one foot of smoking group was longer than that of non-smoking group [(87.2±49.1) vs (63.6±39.7) s] ( F=9.327, P=0.003). The number of sit ups per minute of female college students in smoking group was less than that in non-smoking group [(39.5±7.5) vs (49.2±12.5) times/min] ( F=5.189, P=0.029). The peak inspiratory flow rate (PIF), FVC, FEV 1, EVC and PEF in the smoking group were positively correlated with grip strength, back muscle strength, number of sit ups, push ups, standing high jump and standing long jump ( P<0.001); through the analysis of relevant data, the estimation formula of lung function and health fitness items was obtained. Conclusion:Smoking is harmful to college students′ lung function and physical fitness.

Objective To investigate clinical manifestations,morphological characteristics of skin lesions,and histopathological features of cutaneous Rosai-Dorfman disease (CRDD).Methods Basic information and clinical data were collected from 20 patients with CRDD.According to the morphological characteristics,the skin lesions were classified into different types,and then subjected to histopathological examination and immunohistochemical staining.Results Of the 20 patients with CRDD,11 had multiple lesions,and 9 had solitary lesions.Skin lesions involved single anatomical site in 16 patients,multiple anatomical sites in 4 patients,and there were a total of 24 involved anatomical sites.Skin lesions on the 24 sites were divided into 3 main types,including papulonodular type (10/24,41.67％),infiltrating plaque type (12/24,50.00％) and tumor-like type (2/24,8.33％).Of the 20 patients,6 had mixed-type skin lesions,including 5 with papulonodular-type lesions complicated by infiltrating plaque-type lesions,and 1 with infiltrating plaque-type lesions complicated by tumor-like lesions.There were similar histopathological manifestations of skin lesions among the 24 involved anatomical sites.Concretely speaking,varying numbers of large histiocytes were scattered or distributed in sheets in the dermis and/or subcutaneous adipose tissue,with infiltration of plenty of inflammatory cells,mainly lymphocytes and plasma cells.Moreover,varying numbers of lymphocytes and neutrophils were observed in the cytoplasm of histiocytes.Immunohistochemically,these histiocytes were stained positive for S100 and CD68,but negative for CD1a.At 17 anatomical sites,lesions affected the full-thickness dermis,and the subcutaneous adipose tissues were involved at 13 of 17 sites.Of the 24 involved anatomical sites,lesions only affected the superficial to middle dermis at 6 sites,and affected the deep dermis and subcutaneous adipose tissue at 1 site.There were no obvious differences in the extent of lesion involvement and pattern of inflammatory infiltration among different morphological types of skin lesions.Conclusions CRDD mainly manifests as papulonodular-type and infiltrating plaque-type lesions,and tumor-like lesions are rare.Histopathologically,varying numbers of emperipoletic histiocytes can be observed in lesions of different types.

Deep brain stimulation (DBS) is an effective method to treat motor disorders and a powerful tool to study brain function.With the spread of DBS in clinical practice and the development of electrical stimulation and electrical recording in brain function,it's clear that implanting electrodes at different targets in the brain or allowing different contacts of implanted electrodes reaching multiple target nuclei and functional areas can improve the clinical efficacy of DBS;and more useful information than single neuronal electrophysiological records will also be obtained by the combination of multiple neuronal electrophysiological records.In this paper,the application of multitarget DBS and electrophysiological records is briefly reviewed.

Objective To explore the related factors affecting postoperative pneumonia in patients with cavernous cerebrovascular malformation (CCM).MethodsClinical data of 151 CCM patients admitted to our hospital from January 2010 to January 2017 were retrospectively collected. Patients were divided into postoperative pneumonia group (n=11) and postoperative non-pneumonia group (n=140) according to the occurrence of postoperative pneumonia. Univariate Logistic regression analysis, multivariate Logistic regression analysis and receiver operating characteristic (ROC) curve were used to screen the relevant factors influencing the occurrence of postoperative pneumonia in CCM patients and evaluate the predictive value of relevant factors in postoperative pneumonia.ResultsAs compared with patients from postoperative non-pneumonia group, patients from postoperative pneumonia group had significantly increased modified Rankin scale (mRS) scores and significantly higher percentage of CCM combined with hemorrhage, and significantly decreased Glasgow coma scale (GCS) scores (P<0.05). Multivariate Logistic regression analysis showed that preoperative GCS scores (OR=4.75, 95％CI: 1.14-19.80,P=0.032) and mRS scores (OR=15.61, 95％CI: 3.22-75.58,P=0.001) were independent factors influencing the occurrence of postoperative pneumonia. ROC curve showed that the sensitivity and specificity of mRS scores≥4 to predict postoperative pneumonia were 45.5％ and 95.7％, respectively, and the sensitivity and specificity of GCS scores≤13 to predict postoperative pneumonia were 54.5％ and 85.7％, respectively.ConclusionFor CCM patients with preoperative GCS scores≤13 or mRS scores≥4, more attention should be paid to perioperative lung management and occurrence of postoperative pneumonia should be vigilant.

Objective The aim of our study was to establish an endoscopic endonasal transsphenoidal surgical training model, and to examine its application value. Methods The endoscopic endonasal transsphenoidal surgical training models were made.After assessments,the models was used for endoscopic operation training for 8 neurosurgeons with no experiences of endoscopic operation. Results The available operating space of this model is similar to the actual operating space in endoscopic endonasal transsphenoidal surgery. The egg fixed on the model has many layers of structure, such as eggshell, shell membrane, egg white and egg yolk, which constituted a good practice object. All students indicated that they could benefit from the training using this model. The skill in grinding the eggshell [(1.07 ± 0.221)cm2/min vs.(1.45±0.27)cm2/min, P<0.001]was significantly improved and the chance for shell membrane rupture (8 vs. 2, P=0.007) was significantly reduced in the last-time practice compared with the first-time practice (P<0.001). Conclusion The endoscopic endonasal transsphenoidal surgical training model is helpful for neurosurgeons to practice the basic operation of endoscopic surgery and to improve their surgical skills,and can be used repeatedly.It can be used in basic operation training before the training using cadaver cranium.

Objective To investigate the distance change of bilateral internal carotid artery in acromegalic patients. Methods Twenty patients with acromegaly were included in this study from August 2016 to March 2018 in Department of Neurosurgery of the First Affiliated Hospital of Fujian Medical University. There were 7 males and 13 females with an average age of 40.2±12.6 years (range from 21 to 62 years old). Forty sex and age matched patients with non-functional pituitary adenoma were selected as controls. The 3D printing software was used for reconstructing the internal carotid artery. Distances of the bilateral internal carotid arteries were measured on the reconstructed images. Results The maximum distance between bilateral siphon carotid ectasias (25.1±3.9 mm vs. 23.2±2.9 mm, P=0.041) and distance between bilateral lacerum segments (26.2 ±3.1 mm vs. 23.8 ±4.1 mm, P=0.022) were significantly longer in patients with acromegaly than in those without. Although the distance between bilateral cavernous segments (20.7 ±4.3 mm vs. 22.4 ±3.1 mm, P=0.076) tended to be shorter, the difference was not statistically significant. The distance between bilateral ophthalmic segments was not significantly different between the two groups (15.7±5.1 mm vs. 16.0±2.5 mm, P=0.783). Conclusion The distance of bilateral internal carotid artery of acromegalic patients is different from that of patients with non-functional pituitary adenomas. Patients with acromegaly have significantly longer distance between bilateral siphon carotid ectasias and distance between bilateral lacerum segments compared with the patients with non- functional pituitary adenomas.

We reported a case of microcephaly-capillary malformation(MIC-CAP)caused by STAMBP gene variant,in order to improve the clinical diagnosis and treatment.The patient is a 3-month-old male with recurrent convulsions and the main clinical manifestations are multiple forms of seizures,microcephaly,multiple small capillary malformations in the skin,and generalized hypotonia.The genetic test showed that a heterozygous variant in the STAMBP gene was present in the child.Both parents were heterozygous carriers.He was administrated various anti-seizure medications and ketogenic diet,but still had frequent seizures.He then underwent corpus callosotomy,and was followed up until he was 4 years and 10 months old.The post operational outcome was grade IV on Engel's classification.Based on the clinical data of 22 patients in literature,in addition to severe psychomotor retardation,microcephaly,and cutaneous capillary malformations,early-onset drug-refractory epilepsy is also a major feature of MIC-CAP syndrome,which is clinically rare and has a poor prognosis;Callosotomy may help to reduce seizures in the short term.However,the long-term outcome is poor.STAMBP gene is the main responsible gene for this syndrome.