Drug-refractory epilepsy (DRE) may be treated by surgical intervention. Intracranial EEG has been widely used to localize the epileptogenic zone (EZ). Most studies of epileptic network focus on the features of EZ nodes, such as centrality and degrees. It is difficult to apply those features to the treatment of individual patients. In this study, we proposed a spatial neighbor expansion approach for EZ localization based on a neural computational model and epileptic network reconstruction. The virtual resection method was also used to validate the effectiveness of our approach. The electrocorticography (ECoG) data from 11 patients with DRE were analyzed in this study. Both interictal data and surgical resection regions were used. The results showed that the rate of consistency between the localized regions and the surgical resections in patients with good outcomes was higher than that in patients with poor outcomes. The average deviation distance of the localized region for patients with good outcomes and poor outcomes were 15 mm and 36 mm, respectively. Outcome prediction showed that the patients with poor outcomes could be improved when the brain regions localized by the proposed approach were treated. This study provides a quantitative analysis tool for patient-specific measures for potential surgical treatment of epilepsy.
Humans ; Epilepsy/surgery* ; Brain/surgery* ; Electrocorticography/methods* ; Drug Resistant Epilepsy/surgery* ; Brain Mapping/methods* ; Electroencephalography/methods*

Objective:To compare and analyze the clinical appplication and therapeutic effect of applying three methods for correction of moderate and severe upper eyelid skin laxity.Methods:From January 2017 to March 2019, retrospective analysis was performed to evaluate the therapeutic effect of applying three methods by Department of Plastic Surgery at Xijing Hospital of Air Force Medical University to correct moderate and severe upper eyelid skin laxity, such as subbrow blepharoplasty(SBB), double eyelid surgery(DES) and combination of subbrow blepharoplasty and double eyelid surgery(CSD). Patients were divided into the SBB group, DES group, and CSD group according to the different surgical methods, inclusion and exclusion criteria. The 6 month postoperative improvement of upper eyelid skin laxity, including marginal reflex distance 1(MRD1), medial corneal margin-fold distance (MCMFD), middle pupil margin-fold distance (MPMFD), lateral canthus margin-fold distance (LCMFD), the improvement of upper eyelid wrinkles and patient and surgeon visual analog scores (VAS) were compared. Measurement data were expressed as mean ± standard deviation, comparison between groups was performed by ANOVA, pairwise comparison between groups was performed by LSD- t test, P<0.05 was considered statistically significant. Results:Ninety female patients were included in this study. Thirty patients in each group, patients were between 35 and 62 years old. There was no significant difference in gender, age, and degree of upper eyelid skin laxity among the three groups ( P>0.05). All patients were followed up for 6 to 24 months. Upper eyelid skin laxity and upper eyelid wrinkles were obviously improved in all cases after operation. With the exception of 2 cases of vomiting and 1 case of scalp numbness of CSD group. The improvement of MRD1 in SBB group, DES group and CSD group was (0.14±0.09) mm, (0.34±0.11) mm, (0.43±0.15) mm, showing significant difference between three groups ( F=34.537, P <0.001). The differences between the SBB group and the DES group, the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=6.418, 2.824, 9.236, P <0.001, 0.008, <0.001). The improvement of MCMFD in SBB group, DES group and CSD group was (0.32±0.15) mm, (0.92±0.21) mm, (0.97±0.24) mm, showing significant difference between three groups ( F=94.082, P <0.001). The differences between the SBB group and the DES group, the SBB group and the CSD group were statistically significant ( t=11.273, 12.404, P <0.001), and there was no significant difference between the DES group and the CSD group ( t=1.132, P=0.261). The improvement of MPMFD in SBB group, DES group and CSD group was (0.34±0.13) mm, (1.07±0.24) mm, (1.37±0.23) mm, showing significant difference between three groups ( F=193.935, P<0.001). The differences between the SBB group and the DES group, the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=13.531, 5.628, 19.159, P <0.001). The improvement of LCMFD in SBB group, DES group and CSD group was (0.54±0.17) mm, (1.58±0.37) mm, (1.97±0.48) mm, showing significant difference between three groups ( F=121.405, P <0.001). The differences between the SBB group and the DES group, the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=10.971, 4.097, 15.068, P <0.001). The improvement of upper eyelid wrinkles in SBB group, DES group and CSD group was 0.70±0.47, 0.50±0.51, 1.20±0.48, showing significant difference between three groups ( F=16.471, P <0.001). There was no significant difference between the SBB group and the DES group ( t=1.592, P=0.115), while the differences between the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=5.571, 3.979, P <0.001). The VAS patients score in SBB group, DES group and CSD group was 2.77±0.57, 2.17±0.38, 3.90±0.31, showing significant difference between three groups ( F=124.575, P<0.001). The differences between the SBB group and the DES group, the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=5.379, 15.541, 10.161, P <0.001). The VAS surgeons score was 2.80±0.61, 2.27±0.58, 4.07±0.45, showing significant difference between three groups ( F=84.085, P<0.001). The differences between the SBB group and the DES group, the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=3.740, 12.624, 8.883, P <0.001). Conclusions:Compared with subbrow blepharoplasty and double eyelid surgery, the combination of subbrow blepharoplasty and double eyelid surgery is an effective way to excise upper eyelid skin and reduce wrinkles, which has the best results in promoting upper eyelid rejuvenation. It should be considered as optimal method for correction of moderate and severe upper eyelid skin laxity.

Objective:To compare and analyze the clinical appplication and therapeutic effect of applying three methods for correction of moderate and severe upper eyelid skin laxity.Methods:From January 2017 to March 2019, retrospective analysis was performed to evaluate the therapeutic effect of applying three methods by Department of Plastic Surgery at Xijing Hospital of Air Force Medical University to correct moderate and severe upper eyelid skin laxity, such as subbrow blepharoplasty(SBB), double eyelid surgery(DES) and combination of subbrow blepharoplasty and double eyelid surgery(CSD). Patients were divided into the SBB group, DES group, and CSD group according to the different surgical methods, inclusion and exclusion criteria. The 6 month postoperative improvement of upper eyelid skin laxity, including marginal reflex distance 1(MRD1), medial corneal margin-fold distance (MCMFD), middle pupil margin-fold distance (MPMFD), lateral canthus margin-fold distance (LCMFD), the improvement of upper eyelid wrinkles and patient and surgeon visual analog scores (VAS) were compared. Measurement data were expressed as mean ± standard deviation, comparison between groups was performed by ANOVA, pairwise comparison between groups was performed by LSD- t test, P<0.05 was considered statistically significant. Results:Ninety female patients were included in this study. Thirty patients in each group, patients were between 35 and 62 years old. There was no significant difference in gender, age, and degree of upper eyelid skin laxity among the three groups ( P>0.05). All patients were followed up for 6 to 24 months. Upper eyelid skin laxity and upper eyelid wrinkles were obviously improved in all cases after operation. With the exception of 2 cases of vomiting and 1 case of scalp numbness of CSD group. The improvement of MRD1 in SBB group, DES group and CSD group was (0.14±0.09) mm, (0.34±0.11) mm, (0.43±0.15) mm, showing significant difference between three groups ( F=34.537, P <0.001). The differences between the SBB group and the DES group, the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=6.418, 2.824, 9.236, P <0.001, 0.008, <0.001). The improvement of MCMFD in SBB group, DES group and CSD group was (0.32±0.15) mm, (0.92±0.21) mm, (0.97±0.24) mm, showing significant difference between three groups ( F=94.082, P <0.001). The differences between the SBB group and the DES group, the SBB group and the CSD group were statistically significant ( t=11.273, 12.404, P <0.001), and there was no significant difference between the DES group and the CSD group ( t=1.132, P=0.261). The improvement of MPMFD in SBB group, DES group and CSD group was (0.34±0.13) mm, (1.07±0.24) mm, (1.37±0.23) mm, showing significant difference between three groups ( F=193.935, P<0.001). The differences between the SBB group and the DES group, the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=13.531, 5.628, 19.159, P <0.001). The improvement of LCMFD in SBB group, DES group and CSD group was (0.54±0.17) mm, (1.58±0.37) mm, (1.97±0.48) mm, showing significant difference between three groups ( F=121.405, P <0.001). The differences between the SBB group and the DES group, the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=10.971, 4.097, 15.068, P <0.001). The improvement of upper eyelid wrinkles in SBB group, DES group and CSD group was 0.70±0.47, 0.50±0.51, 1.20±0.48, showing significant difference between three groups ( F=16.471, P <0.001). There was no significant difference between the SBB group and the DES group ( t=1.592, P=0.115), while the differences between the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=5.571, 3.979, P <0.001). The VAS patients score in SBB group, DES group and CSD group was 2.77±0.57, 2.17±0.38, 3.90±0.31, showing significant difference between three groups ( F=124.575, P<0.001). The differences between the SBB group and the DES group, the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=5.379, 15.541, 10.161, P <0.001). The VAS surgeons score was 2.80±0.61, 2.27±0.58, 4.07±0.45, showing significant difference between three groups ( F=84.085, P<0.001). The differences between the SBB group and the DES group, the DES group and the CSD group, and the SBB group and the CSD group were statistically significant ( t=3.740, 12.624, 8.883, P <0.001). Conclusions:Compared with subbrow blepharoplasty and double eyelid surgery, the combination of subbrow blepharoplasty and double eyelid surgery is an effective way to excise upper eyelid skin and reduce wrinkles, which has the best results in promoting upper eyelid rejuvenation. It should be considered as optimal method for correction of moderate and severe upper eyelid skin laxity.

Gradual distraction with an external fixator is a widely used treatment for severe postburn ankle contracture (SPAC). However, application of external fixators is complex, and conventional two-dimensional (2D) imaging-based surgical planning is not particularly helpful due to a lack of spatial geometry. The purpose of this study was to evaluate the surgical planning process for this procedure with patient-specific three-dimension-printed models (3DPMs). In this study, patients coming from two centers were divided into two cohorts (3DPM group vs. control group) depending on whether a 3DPM was used for preoperative surgical planning. Operation duration, improvement in metatarsal-tibial angle (MTA), range of motion (ROM), the American Orthopedic Foot and Ankle Society (AOFAS) scores, complications, and patient-reported satisfaction were compared between two groups. The 3DPM group had significantly shorter operation duration than the control group ((2.0±0.3) h vs. (3.2±0.3) h,