Objective To evaluate the efficacy of electrocorticographic (ECoG) monitoring and the application of different surgical approaches in the surgical treatment of solitary supretentorial cavernous malformations with secondary epilepsy.
Methods This study enrolled a consecutive series of 36 patients with solitary supratentorial cavernous malformations and secondary epilepsy who underwent surgery with intraoperative ECoG monitoring in the Department of Neurosurgery between January 2004 and January 2008. The patients were composed of 15 males and 21 females, aged between 8 and 52 years (mean age 27.3±2.8 years) at the time of surgery. Epilepsy history, the type of epilepsy at the presentation, lesion location, the incidence of residual epileptiform discharges, and postoperative outcomes were evaluated.
Results Histopathological examination indicated cavernous malformations and hippocampal sclerosis in 36 and 5 cases, respectively. Neuronal degeneration, glial cell proliferation, and neurofibrillary tangles were found in all the resected cerebral tissues of extended lesionectomy of residual epileptic foci. Lesionectomy, anterior temporal lobectomy, anterior temporal lobectomy plus cortical thermocoagulation, extended lesionectomy, extended lesionectomy plus cortical thermocoagulation were performed in 4, 4, 1, 14, and 13 cases, respectively. Residual epileptiform discharges were captured in 9 out of the 14 patients who had additional cortical thermocoagulation. According to Engle class for postoperative outcomes, 27 cases were class I (75.00%), 5 were class II (13.89%), 2 were class III (5.56%), and 2 were class IV (5.56%), thus the total effective rate (class I+class II) was 88.89%. Neither of epilepsy history, the type of epilepsy, and the location of cavernous malformation was significantly related to outcomes (P>0.05). A significant relationship was found between the incidence of residual epileptiform discharges and outcomes (P=0.041).
Conclusions Intraoperative ECoG monitoring, the application of different surgical approaches, and the resection of residual epileptic foci could produce good result in the surgical treatment of supratentorial cavernous malformation with secondary epilepsy. Postoperative residual epileptiform discharges could be a useful predictor for evaluating the outcomes.

Objective To study the surgical treatment and effects of the lesions in the third ventricle. Methods The data of 15 patients with third ventricular lesion, accepted surgical treatment were retrospectively analyzed. The lesions were removed through transcallosal approach in 11 patients, frontal trans-cortical approach in 2 and trans-terminalis approach in 2,respectively. Postoperative radiotherapy was performed in 5 and chemotherapy in 2. VP shunt was performed in 1. Results The lesions were total-resected in 8 (53.3%), subtotal-resected in 5 (33.3%) and partial-resected in 2 (13.3%) with 1 postoperative death. The hydrocephalus were resolved in all cases. With a follow-up of 3 to 12 months, all the 14 patients recovered without obvious neurological deficits. Conclusion Proper microsurgical approach and perfect surgical skills are the keys to high resection and good prognosis. And postoperative radiotherapy or chemotherapy may be helpful in improving the outcome

Objective To investigate the therapeutic effect of surgical management on patients with secondary epilepsy under the monitoring of cortical electrocorticography (ECoG). Methods Eighty-four patients with secondary epilepsy, admitted to our hospital from September 2004 to January 2008, were chosen; intraoperative ECoG monitoring was performed to locate the epileptic foci before the resection of the primary lesion. After the resection of primary lesion, resection of epileptic foci, enlarged resection of epileptic foci, cortical thermocoagulation, anterior temporal lobectomy,amygdalohippocampectomy and anterior callosotomy were performed, respectively, in different patients according to the clinical manifestations of seizures, and the locations of lesions and epileptic waveform discharges detected by intraoperative ECoG monitoring. Results The epileptic waveform discharges in 84 patients were noted before the resection of primary lesion. The epileptic waves were found in 80patients at the peripheral areas of the primary nidus under immediately postoperative ECoG monitoring,with a relevance ratio reaching 95.24%; after the resection of residual cortical zone with epileptic wave discharges, epileptic wave disappeared on immediately postoperative ECoG in 13 patients whose lesion located in nonfunctional area; normal signals were noted in 60 of the 67 patients performed cortical thermocoagulation whose cortical zone with epileptic wave discharges were located or neighbored in functional area, and good outcomes under the immediately postoperative ECoG monitoring were noted in the other 7 patients performed thermocoagulation combined with anterior callosotomy and/or amygdalohippocampectomy. The follow-up studies for 10 months to 4 years showed that grade Ⅰ in 56patients (66.67%), grade Ⅱ in 21 (25.00%), grade Ⅲ in 4 (4.76%) and grade Ⅳ in 3 (3.57%) according to the Engle standard of curative effect were achieved; the total effective rate was 96. 42%. Conclusion ECoG monitoring can significantly improve the efficiency of surgical management of secondary epilepsy.

Objective To explore the clinical efficacy of focused ultrasound for patients with white lesions of the vulva,as well as its safety and feasibility.Methods Clinical data of 941 patients with white lesions of the vulva treated with focused ultrasound from June 2003 to December 2005 were retrospectively reviewed.The mean age of the patients was 40.8 years(18-70 years)and the median course of the disease was 6.2 years(3 months-45 years).Meanwhile,pathological diagnosis was performed in all the patients before treatment,in which 498 cases were squamous hyperplasia,342 cases were lichen sclerosus and 101 cases were lichen sclerosus with squamous hyperplasia.Patients were followed up and therapeutic effects of focused ultrasound was evaluated at 6 and 12 months after the treatment,respectively.The symptoms of pruritus in the vulva and the changes in the color and elasticity of the vulvar lesions were observed.Results Of all the patients,900 were followed up after the treatment,and the ratio of effectiveness was 94.9%.Only 46 patients(5.1%)had no response to the therapy.Of the effective patients,434 cases were completely cured(48.2%),and 420 cases were improved(46.7%).Pruritus of vulva recurred in 101 patients (11.2%)one year after treatment;however,these patients still had a response to the second or third treatment.Conclusions Focused ultrasound therapy is a highly effective instrument in treatment of white lesions of the vulva.It can not only relieve the symptoms of itching,but is also helpful in recovering the color and elasticity of the vulva.

Objective To investigate the therapic efficiency of early one-stage ventriculo-peritoneal shunt and cranioplasty on patients with skull deficit,hydrocephalus and hernia in the cerebral tissue of deficited skull after large flap decompression.Methods Thirty-eight patients with skull deficit,hydrocephalus and hernia in the cerebral tissue of deficited skull after large flap decompression,admitted to our hospital from June 2009 to December 2010,were chosen in our study;early (within two months of onset) one-stage ventriculo-peritoneal shunt and cranioplasty were performed on these patients; follow up was performed for 6-24 months.Results Postoperative CT scan 10 days after the surgery showed that hydrocephlus disappeared in 31 patients and significantly alleviated in 7; the midline located on the middle of the brain,and the titanium structure in the skull deficit was good.The follow-up of 6-24 months (mean 13 months) indicated that hydrocephlus disappeared in 30 patients,significantly alleviated in 6,and recurred in 2 patients under CT scan; recurred hydrocephalus disappeared after a new re-operation of ventriculo-peritoneal shunt.Conslusion The early one-stage ventriculo-peritoneal shunt and cranioplasty could achieve favorable outcome for patients with skull deficit,hydrocephalus and hernia in the cerebral tissue of deficited skull after large flap decompression.

OBJECTIVETo establish a long-term culture system for mouse spermatogonial stem cells (SSCs) and to discuss the key factor that supports mouse SSC self-renewal and proliferation.

METHODSTestis cells from 4-6 days postpartum male transgenic BALB/c mce were collected by a modified two-step enzymatic digestion method and plated on 0. 2% elatin-coated tissue culture plates. The germ cells were enriched by differential adherence selections after respectively incubated for 1, 5 and 24 h and then plated on the mitomycin C-inactivated mouse embryonic fibroblast (MEF) feeder layer. The basal culture medium was StemPro-34 SFM supplemented with other 15 nutrient factors. The 20 ng/ml Glial cell line-derived neurotrophic factor (GDNF), 10 ng/ml basic fibroblast growth factor (bFGF) and 200 ng/ml GDNF-family receptor alpha 1 (GFRalpha1) were added to the serum-free medium to promote SSC proliferation. Several important surface markers and special genes were examined by immunocytochemical staining and RT-PCR analysis.

RESULTSAfter 3-4 days culture on the MEF feeder, SSCs proliferated continuously and formed typical colonies. SSCs from the BALB/c mice could be cultured in a steady state for 3 months. Immunocytochemical staining showed that Oct4 was specifically expressed in the cultured SSC nucleus and GFRalpha1 strongly expressed on the surface of the membrane. RT-PCR confirmed that the cultured SSCs expressed Oct-4, GFRalpha1, Sox2 and several other special genes resembling undifferentiated spermatogonia.

CONCLUSIONSSCs from BALB/c mice could be cultured in the improved culture system for 3 months. This culture system could help further understand the regulating mechanism of SSCs and might provide an opportunity for the treatment of male infertility by SSC transplantation.

Animals ; Cell Culture Techniques ; methods ; Male ; Mice ; Mice, Inbred BALB C ; Spermatogonia ; cytology ; Stem Cells ; cytology

Objective To investigate the prevalence and influencing factors related to abuse and negligence against the elderly in the rural areas. Methods 975 elderly over 60 years from 41counties in Anhui province were included. All participants completed an anonymous questionnaire including items as: educational background, marital condition, income, child-discipline, rude action to parents, daily activities, physical functions, having chronic illness, abuse and negligence against the elderly, etc. Results In the last year, rates of common physical abuse, serious physical abuse,emotional abuse, financial exploitation, negligence, overall abuse and negligence against the elderly were 4.5%, 1.5%, 26.9%, 4.9%, 7.2%, 29.9% respectively. Among the 281 victims, 80.4% reported that they were suffered more than 3 times of abuse and neglect episodes, and 34.9% reported that they were suffered more than 2 forms of abuse and negligence. The primary sadism was carried out by the daughter-in-law or son-in-law (43.2%) of the elderly. Low activity on daily life and having chronic illness were the risk factors causing common physical abuse while better education was the protective factor to it, Low ability in managing daily activity of living was the risk factor causing serions physical abuse. Less active on daily life and having rude action to parents were the risk factors to emotional abuse, but being strict with their children was the protective factor to emotional abuse. Less active on daily life, often beating their children and having rude action to parents were the risk factors related to financial exploitation. Less active on daily life, having rude action to parents and having bad physical functions were the risk factors causing negligence. Less active on daily life and having rude manner to parents were the risk factors of overall elderly abuse and negligence, but being strict with their children was protective factor to the abuse and negligence against the elderly. Conclusion High prevalence on abuse and negligence against the elderly was seen in the rural areas of China. Different forms on elderly abuse and negligence were affected by different factors that called for more attention to be paid to those elderly with lower ability in managing their daily life.

China ; epidemiology ; Cholera ; epidemiology ; Disease Outbreaks ; Humans

OBJECTIVETo explore the status of child neglect among rural areas children aged 0 - 6 years in China.

METHODSA total of 7411 rural children aged 0 - 6 years old who were composed of two age groups (3315 children aged 0 - 2 years old and 4096 children aged 3 - 6 years old) were multistage stratified randomly sampled from 84 villages which were representative of 10 provinces of China, in accordance with sex and age in November 2010. To identify the child neglect based on the Neglect Norms for Children Aged 0 to 2 and 3 to 6 Years Old in Rural Areas of China, SPSS 13.0 was employed for analyzing neglect frequency and degree for every group of different age, sex and neglect type (including physical, emotional, educational, medical, safety and social neglects). χ(2) test and analysis of variance were also used.

RESULTSThe degree of child neglect for the children aged 0 - 2 years old was 45.01 ± 7.56, the neglect frequency was 54.9% (1819/3315); the degree of child neglect for the children aged 3 - 6 years old was 44.42 ± 7.57, the neglect frequency was 53.8% (2203/4096). The neglect frequency of children aged 0, 1, 2 years old were 58.5% (654/1117), 52.2% (597/1144), 53.9% (568/1054) (P < 0.05). For children aged 3 - 6 years old, the degrees of emotional and safety neglect for males (44.60 ± 7.86, 36.82 ± 9.03) were higher than females (44.03 ± 7.72, 36.25 ± 9.05) (P < 0.05); and the frequencies of emotional and social neglect for males (16.8% (349/2072), 28.3% (586/2072)) were also higher than females (14.1% (286/2024), 24.8% (503/2024)) (P < 0.05). All children of two age groups suffered neglect mainly on one of the six neglect types (incidences were 20.6% (683/3315) and 22.7% (931/4096)). For 0-2 age groups, the higher neglect frequencies happened in the single-parent family and the remarried family (62.5% (15/24) and 63.2% (12/19)), but for children aged 3 - 6 years old groups, it happened in the single-parent family (60.0%, 27/45).

CONCLUSIONDegree and frequency of child neglect among children aged 0 to 6 years old in the rural areas of China are high, and we should find out risk factors and provide efficient prevention measures.

Child Abuse ; prevention & control ; statistics & numerical data ; Child, Preschool ; China ; Cross-Sectional Studies ; Female ; Humans ; Infant ; Male ; Rural Population ; Surveys and Questionnaires

Objective To develop the National Norms of Negligence (NNN) for rural children aged 0 to 35 months.Methods According to multi-stage stratified cluster sampling principle,10 provinces or municipalities (Jilin,Shaanxi,Shanxi,Beijing,Anhui,Jiangsu,Hunan,Hubei,Yunnan,Chongqing) in China were selected.A national research group was formed collaboratively.A questionnaire was designed by ourselves.According to several statistical analysis methods,such as item,factor and reliability analysis etc.we determined the norm.The evaluation criteria of the scale were determined by percentile method.Finally,the reliability and validity of the norm were evaluated.Results In total,2310 children were surveyed,in which the effective sample were 2227,with an effective rate as 96.4％.The scale consisted of 6 neglected dimensions and 65 items in total.The total Cronbach's α coefficient of the scale was 0.903,with the split-half reliability coefficient as 0.829,the parallel reliability as 0.720 and the re-test reliability as 0.678,respectively.The total neglect cut-off score of this scale was 139.Conclusion The scale seemed to have perfect stability and reliability and all the statistical indicators met the psychometric demands.