The main shortcomings of using electrocortical stimulation (ECS) in identifying the motor functional area around the focus in neurosurgery are certainly time-consuming, possibly cerebral cortex injuring and perhaps triggering epilepsy. To solve these problems, we in our research presented an intraoperative motor cortex functional mapping based on electrocorticography (ECoG). At first, using power spectrum estimation, we analyzed the characteristic of ECoG which was related to move task, and selected Mu rhythm as the move-related feature. Then we extracted the feature from original ECoG by multi-resolution wavelet analysis. By calculating the sum value of feature in every channel and observing the distribution of these sum values, we obtained the correlation between the cortex area under the electrode and motor cortex functional area. The results showed that the distribution of the relationship between the cortex under the electrode and motor cortex functional area was almost consistent with those identified by ECS which was called as the gold-standard. It indicated that this method was basically feasible, and it just needed five minutes totally. In conclusion, ECoG-based and passive identification of motor cortical function may serve as a useful adjunct to ECS in the intraoperative mapping.
Brain Mapping ; Electric Stimulation ; Electrocorticography ; Electrodes, Implanted ; Electroencephalography ; Epilepsy ; Humans ; Motor Cortex ; physiology ; Wavelet Analysis

AIM: To compare the difference in serum prolactin levels and the concentrations of anti-infective factors of human colostrums between normal labor and cesarean section. METHODS: The serum prolactin levels were measured at 48 h, 96 h after parturition in 100 cases of normal labor and cesarean using radioimmunoassay. Furthermore, the levels of SIgA, IgG, IgM, C3, C4 were tested in 100 cases at the same time using the technique of immuno-turbidimetry. RESULTS: The serum prolactin levels in normal labor tested at 48 h after parturition were significantly different with that of the cesarean section group. But there was no significant difference in serum prolatin levels 96 h after parturition between the two groups. The levels of SIgA,IgG,IgM,C3 and C4 of the colostrum in the cesarean group were higher significantly than those of the normal group at 48 h after parturition. (P＜0.05 or P＜0.01). At 96 h after parturition, there was no significant difference in SIgA, IgG, IgM and C3 between the two groups except C4. CONCLUSION: At 48 h after paturition, the serum prolactin levels of normal labor group are higher than that of the cesarean section group. The concentrations of anti-infective factors (SIgA, IgG, IgM, C3 and C4) of human colostrums at 48 h after paturition in cesarean section group are higher than those of normal labor group.

Objective To study the application value of direct digital X‐ray radiography system in the degenerative lumbar insta‐bility .Methods 100 patients with degenerative lumbar instability disease were collected in our hospital ,in which there were L4 ,L5 (80 cases) and L5 ,S1 (20 cases) with degenerative lumbar instability disease .Carestream DRX‐Evolution system was used ,which included conventional horizontal lumbar function photography (control group) and physiological load of lumbar function photography (observation group) .Changes of the displacement or the angle of the lumbar segment on two groups were measured ,and the statisti‐cal software was used to carry on the comparative analysis .Results In 100 patients ,the position and the physiological load position were showed on the sagittal position which were as following :For the lumbar segment of L4 and L5 ,flexion [position (4 .50 ± 0 .25) mm , load position (4 .78 ± 0 .30) mm] ,extension [position (4 .87 ± 0 .22) mm ,load position (5 .18 ± 0 .30) mm] ,and for the lumbar segment of L5 and S1 ,flexion [position (4 .64 ± 0 .24) mm ,load position (4 .91 ± 0 .24) mm] ,extension [position (4 .95 ± 0 .30) mm , load position (5 .30 ± 0 .29) mm];For the intervertebral angle degree of L4 and L5 ,flexion (position 10 .64° ± 0 .29° ,load position 12 .12°± 0 .57°) ,extension (position 11 .57°± 0 .24° ,load position 12 .61°± 0 .28°);For the intervertebral angle degree of L5 and S1 , flexion (position 11 .63° ± 0 .26° ,load position 12 .72° ± 0 .27°) ,extension (position 13 .55° ± 0 .30° ,load position 14 .58° ± 0 .33°) , respectively .The difference between two groups was statistically significant (P< 0 .05) .Conclusion Compared with traditional method ,DR lumbar physiological weight‐bearing functional can more accurately understand the lumbar instability degree ,grading and lumbar positive rate ,which provides the basis for clinical diagnosis and treatment plan .

BACKGROUND:Artificial knee joint replacement in older patients often combines with basic diseases, such as hypertension and diabetes. Perioperative blood loss is an important factor affecting the safety of replacement. OBJECTIVE: To explore the effect of the early closure of drainage tube on blood loss after primary total knee arthroplasty. METHODS: We randomly selected 90 patients with osteoarthritis of the knee who underwent primary total knee arthroplasty in the Affiliated Hospital of Qingdao University from January 2014 to July 2015. The patients were randomly divided into three groups (n=30). In the 4-hour occlusion group, the drainage tube was closed for 4 hours in early stage of replacement. In the 2-hour occlusion group, the drainage tube was closed for 2 hours in early stage of replacement. In the control group, the drainage tube was not closed. Because of the use of tourniquet during surgery, the amount of intraoperative blood loss was considered as 0 mL. Drainage blood loss after surgery was recorded. Total blood loss was calculated according to Gross formula through patient height, weight and preoperative and postoperative hematocrit. Hidden blood loss was gotten by subtracting the visible blood loss from total loss. Under the observation of postoperative joint sweling and subcutaneous ecchymosis, knee Hospital for Special Surgery score was recorded at 6 weeks after replacement, and compared among groups. RESULTS AND CONCLUSION:Statistical analysis indicated that significant differences in total blood loss and dominant blood loss were detected among the three groups (P < 0.05), indicating that both occlusion for 2 hours and 4 hours could reduce total blood loss and dominant blood loss, but the range of reduction was greater in occlusion for 4 hours. At 6 months after replacement, no significant difference in knee Hospital for Special Surgery score and hidden blood loss was detectable among three groups (P > 0.05). The incidence of joint sweling and subcutaneous ecchymosis was increased in the 4-hour occlusion group (P < 0.05). Above results confirmed that drainage tube occlusion can decrease total blood loss and dominant blood loss after total knee arthroplasty, but cannot reduce hidden blood loss. 2-hour occlusion after total knee arthroplasty is an ideal choice, but the amount of hidden blood loss should be carefuly considered.

Objective: To analyze the electrocardiographic (ECG) characteristics in patients with primary hyperparathyroidism (PHPT) and meanwhile, to explore the relationship between ECG abnormality and serum calcium level in relevant patients. Methods: Our study included 2 groups: Observation group,n=84 PHPT patients treated in our hospital from 2010-01 to 2014-04 and Control group,n=80 normal subjects from regular physical examination at the same period. The ECG manifestation was compared between 2 groups. Meanwhile, according to tertile levels of serum calcium, PHPT patients were further divided into 3 subgroups:①Ca2+ level (2.0-2.8) mmol/L,②Ca2+ level (2.8-3.1) mmol/L,③Ca2+ level >3.1 mmol/L andn=28 in each subgroup. The ECG abnormalities were compared among 3 subgroups and the relationship between ECG changes and serum calcium levels were studied. Results: The ECG abnormality rates in Observation group and Control group were as 83.3% vs 18.8%, P<0.001. Compared with Control group, Observation group presented more frequent ST-T changes, QRS duration widening, high left ventricular pressure and QT interval shortening,P<0.001 orP<0.05. In observation group, with the rising of serum calcium, the incidences of ST-T changes and high left ventricular pressure were increased accordingly, the ST-T changes among 3 subgroups were significant,P<0.05; while with the rising of serum calcium, the QT interval was shortened and QRS duration was widened accordingly, the differences were obvious among 3 subgroups, allP<0.05.Conclusion: PHPT patients have the higher incidence with abnormal ECG, while ECG abnormality has beenrelated to serum calcium level in relevant patients.

As a summary of the research progress of chemical modification of lead compounds by saccharides and their derivatives, this article studies the linkage style of saccharides with lead compounds and bioactivity changes of the modified lead compounds. The result shows that the modified lead compounds can decrease the toxicity and side effect efficiently, and enhance the pharmacal effect. Therefore, it is a promising research project to modify lead compounds by saccharides.

Objective To analyze the relationship between the expression of MHC class I chain-related gene A/B(MICA/B) on different human cancer cells and their sensitivity to NK cell cytotoxicity.Methods Hie expression MICA/B in K562,Bcap37,769P and A549 cells was measured by FACS.Isolation of NK cells were obtained by the modified RosetteSep~((R)) procedure.Cytotoxicity of NK cells at different ef0.50)%,(90.72±0.64)%,(55.59±0.55)%,and(3.84±0.10)% respectively.The purity of NK cells obtained by the modified RosetteSep~((R)) procedure was(96.52±2.42)%,whereas the cytotoxicity of NK cells against K562,Bcap39 and 769P was much higher than that of A549(P<0.01).The expression of MICA/B was significantly correlated with the cytotoxicity of NK cells at E:T ratios of 5:1,10:1 and 20:1 respectively(P<0.01).Conclusion The MICA/B expression on cancer cell lines was correlated with NK cell-mediated cytolysis and influenced the cytotoxicity of NK cells.

Objective To extract exosomes from dendritic cell (DC)and investigate antitumor effect of the special cytotoxic T lymphocytes activated by exosomes against 769-P.Methods Monocytes from peripheral blood of healthy donors were cultured to induce DC in intro and their phenotypes were analyzed by FACS.The exosomes were extracted from DC by ultrafiltration and ultracentrifugation and observed under electric microscope.Proliferation of T cells and the cytotoxicities of CTL against 769-P induced by exosome were measured by MTT.Results The exosomes could be separated from culture supernatant of DC by ultrafiltration and ultracentrifugation.The combination of the exosomes from DC and the 769-P antigen could effectively stimulate T cell proliferation and enhance their cytotoxicity, the absorption value of T cell proliferation(1.68±0.22), the cytotoxicity of CTL(38.23±2.16)%.Conclusion The exosomes extracted by ultrafiltration and ultracentrifugation can present tumor antigen to T cells and induce the cytotoxicity of CTL.

Objective To investigate a new surgical method by using pectoralis minor muscle for its partial transplantation to reconstruct the function of the opposite thumb anastomosed vessels and nerves. Methods The proposed method was evaluated by taking 20 cases of adult cadaveric thoraxes and hands,then compared with the morphology and dimension of both pectoralis minor muscle and palmer muscle to study the feasibility of the new method.Based on the observed data.We selected five suitable cases,in which the opposi- tion function was lost,and then applied the new operation on them with partial transplantation of pectoralis mi- nor muscle anastomosed vessels and nerves according to the results of anatomic study.The follow-up study was conducted to observe the functional recovery of opposition of the thumb.Results The main results can be summarized as follows.First,the anatomical position of pectoralis minor muscle was stable,and every peetoralis minor muscle was provided with self-sustaining artery,vein and nerve.The oppostition process of cadaveric hand succeeded after similar transplantation to clinic operation.Second,follow-up studies conducted 6 - 12 months after the operation showed that all five patients recovered fully.The muscle strength in all five cases re- covered to level four or higher.The shape of palm eminence was satisfactory.Conclusion The surgical method of pectoralis minor muscle transplantation for reconstructing the opposition function of the thumb was based on the clinical and anatomical application.The function of opposition of the thumb reached the satisfacto- ry requirement after the operation.So,the new surgical method can achieve better results than other existing operation methods.

ObjectiveTo explore sensitivities and specificities of Nutritional Risk Screening 2002 ( NRS 2002),Subjective Global Assessment (SGA),and Mini Nutritional Assessment (MNA) in the detection of blood prealbumin level.MethodsTotal 126 patients were consecutively enrolled from the oncology departments of three hospitals from November,2010 to March,2011.Nutritional screenings or assessments were performed on the next morning of hospital admission by nutritionists and medical oncologists using NRS 2002,SGA,and MNA.Prealbumin ( ＜ 180 g/L) was used as the reference standard of malnutrition (undernutrition) for assessing the sensitivities/specificities of these tools.ResultsAll 126 patients completed nutritional screening or assessment using the above three tools.The prevalence of malnutrition (undernutrition) determined by NRS 2002,SGA and MNA was 67.0％,46.2％,and 64.8％,respectively.With prealbumin in relation to clinical outcome as the reference standard,the sensitivities ofNRS 2002,SGA,and MNA were 78.2％,58.2％ and 89.1％,and the specificities were 50.0％,72.2％,and 27.8％,respectively.ConclusionsAmong these three tolls,NRS 2002 detects the nutrition risks,whereas SGA and MNA detect malnutrition.Since prealbumin is not an appropriate reference standard,it can not be used for the comparison among the three tools.Nevertheless,NRS 2002 reflects the clinical outcomes,and therefore is suitable for inpatients.