目的 横断面调查成人无功能性垂体腺瘤(non-functional pituitary adenoma,NFPA)术后垂体功能减退患者骨密度(bone mineral density,BMD)及身体成分的改变,进一步分析BMD与身体成分的关系.方法 收集2018年11月至2020年1月就诊于中南大学湘雅医院的成人NFPA术后垂体功能减退患者43例,并收集年龄、性别比、体质量指数(body mass index,BMI)匹配的健康对照组56例,测量所有研究对象BMI、腰围、腰臀比,采用双能X线骨密度仪(DEXA)评估腰椎及髋关节的BMD并分析骨骼肌质量及体脂含量.结果 (1)垂体功能减退组腰椎L1～4、股骨颈的BMD及Z值,全身总和骨矿含量均显著低于对照组(P<0.05).(2)在男性,垂体功能减退患者的腰臀比、腰围身高比、躯干及全身脂肪百分比、脂肪指数显著高于对照组;在女性,垂体功能减退患者的腰围、腰臀比、躯干及全身脂肪百分比、A/G比率、躯干脂肪比/腿部脂肪比均显著高于对照组(P<0.05).(3)Pearson相关性分析显示,四肢骨骼肌质量(ASM)、骨骼肌质量指数(SMI)与男性患者各部位的BMD呈显著正相关,躯干及全身脂肪百分比与女性患者髋部BMD呈显著负相关(P<0.05).多元线性回归分析示,SMI是男性患者腰椎L1～4 BMD、股骨颈BMD、全髋关节BMD、全身骨矿含量的独立保护因素(P<0.05).结论 (1)成人无功能性垂体腺瘤术后发生垂体功能减退的患者出现骨密度减低及腹部脂肪沉积的风险增加.(2)骨骼肌质量及体脂对骨密度有重要影响,SMI是男性垂体功能减退患者腰椎与髋部骨密度、全身骨矿含量的独立保护因素.

Objective To summarize the key points of neuroendoscopic transcranial resection for cerebellopontine angle (CPA) tumors. Methods Twenty⁃eight patients with CPA tumors diagnosed and treated in Xiangya Hospital Central South University from January 2019 to December 2020 were included, and all of them underwent neuroendoscopic transcranial surgery to remove CPA tumors. Results All the 28 patients were successfully treated with neuroendoscopic transcranial resection of tumors in CPA region, and the tumors were totally removed. After operation, 9 cases of acoustic neuroma, 8 cases of meningioma, 9 cases of cholesteatoma, one case of hemangioblastoma, and one case of trigeminal neurinoma were confirmed by postoperative pathology. Postoperative facial nerve function was grade Ⅲ in 3 cases, grade Ⅱ in 6 cases, and grade Ⅰ in 19 cases. One patient had no obvious recovery of auditory nerve function injury, and 2 patients had dizziness, vertigo and nausea after operation. No complications such as cerebrospinal fluid leakage, meningitis and incision infection occurred, and no death occurred. At 3 months of follow ⁃ up, no tumor recurrence was seen on MRI, and no new neurological symptoms occurred. Conclusions Neuroendoscopic transcranial resection of CPA tumors has many advantages, but also has some shortcomings, and has a good development in the future.

ObjectiveTo investigate whether enhanced recovery after surgery (ERAS) can promote rehabilitation of patients after neurosurgical craniotomy.MethodsThe clinical data of 100 patients with brain tumor undergoing craniotomy in the Department of Neurosurgery, Xiangya Hospital, Central South University, from January 2018 to August 2020 were collected, including 50 patients in the ERAS group and 50 patients in the control group. t-Test, Wilcoxon’s rank sum test, and chi-square analysis were used to compare the clinical characteristics, prognosis, and hospitalization time between the two groups.ResultsThere was no significant difference in gender, age, and other general clinical data between the two groups (p > 0.05). The days of antiemetic drugs applied in the ERAS group were less than those in the control group (1.00 vs. 2.00 days, p = 0.003), and the proportion of patients requiring analgesics was lower than that of the control group (30% vs. 52%, OR = 0.41, 95% CI 0.18–0.93, p = 0.031). The time of urinary catheter removal and that of patients starting ambulation in the ERAS group were shorter than those in the control group (16.00 vs. 24.00 h, and 1.00 vs. 2.00 days, p < 0.001, respectively); and the hospital length of stay (LOS) in the ERAS group was shorter than that in the control group (Total LOS, 13.00 vs. 15.50 days; Postoperative LOS, 7.00 vs. 10.00 days, p < 0.001). By analyzing the prognosis of patients in the ERAS group and control group, we found that there was no significant difference in postoperative complications and Karnofsky Performance Status (KPS) score 1 month after operation between the two groups.ConclusionThe application of ERAS in craniotomy can accelerate the postoperative recovery of patients without increasing the perioperative risk, which is worthy of wide application. However, whether the ERAS measures can reduce the postoperative complications and improve the prognosis of patients still needs more large-scale case validation and multicenter collaborative study.

目的 探究急性脑梗死患者重组组织型纤溶酶原激活剂(rt-PA)治疗后并发脑出血的高危因素.方法 急性脑梗塞并接受rt-PA治疗的患者56例,采用美国国立卫生研究院卒中量表(NIHSS)分析患者溶栓前、溶栓后早期(溶栓完成后24 h、72 h、5 d、7 d)、溶栓后远期(溶栓完成后1月、3月、6月)评分,用巴氏量表指数(Barthel Index)评价溶栓完成后远期的独立生活能力;根据脑出血分型判断标准,分析溶栓后36 h内脑出血发生情况,按照治疗后并发脑出血类型分为非症状出血组、症状性出血组和未并发脑出血组,分析患者临床资料;并采用Logistic回归分析法分析脑出血发生的危险因素.结果 溶栓24 h时NIHSS 2～4分患者比例明显高于溶栓前,溶栓72 h时NIHSS 2～4分患者比例明显高于溶栓24 h,溶栓7 d时NIHSS 0～1分患者比例明显高于溶栓5 d时NIHSS,差异有统计学意义(P<0.05);溶栓后36 h内共有13例患者并发脑出血,其中非症状性出血8例(14.29％)、症状性出血5例(8.23％);症状性脑出血患者起病至接受溶栓时间、溶栓前收缩压、溶栓前大梗死面积、溶栓后NIHSS评分大于未并发脑出血患者(P<0.05);平均年龄过大、溶栓后24 h收缩压高是发生非症状性出血的独立危险因素(P<0.05);平均年龄过大、起病至接受溶栓时间过长、溶栓前后大梗死面积、溶栓后24 h收缩压高、溶栓后24 h NIHSS评分>4分是发生症状性出血的独立危险因素(P<0.05).结论 急性脑梗死患者rt-PA治疗后并发脑出血的独立危险因素包括平均年龄过大、溶栓后24 h收缩压高,起病至接受溶栓时间过长、溶栓前大梗死面积及溶栓后24 h NIHSS评分>4分.

OBJECTIVES To evaluate the image quality of magnetic resonance 3D-sampling perfection with application-optimized contrasts by using different filp angle evolutions (3D-SPACE) sequence combined with different fusion methods in image fusion technology and the application value of fusion technology in preoperative evaluation of pituitary macroadenoma. METHODS We collected MRI data of 43 patients with pituitary macroadenoma confirmed by Xiangya Hospital of Central South University, including collecting conventional MRI scan+enhancement, 3D-SPACE T2WI, and 3D-SPACE T1WI+C image data. 3D-SPACE sequence fusion was used in 6 combinations of 3D-SPACE T2WI/3D-SPACE T1WI+C, which were normal phase+normal phase, reverse phase+normal phase, normal phase+reverse phase, reverse phase+reverse phase, and normal phase pseudo color+normal phase, normal phase+normal phase pseudo color. Two senior radiologists used semi-quantitative methods to evaluate and compare the image quality of different combinations to obtain the best fusion mode. According to the degree of tumor invasion of the optic chiasma, oculomotor nerve, and cavernous sinus vessels, the MRI enhancement, 3D-SPACE T2WI, 3D-SPACE T1WI+C, and 2 3D-SPACE sequence fusion images were performed according to a three-level score system. Taking the intraoperative observation as the gold standard, Fisher probability exact method was used to compare different sequences to show the difference between the degree of invasion of the pituitary macroadenoma to the surrounding tissue and the intraoperative results. RESULTS The Kruskal-Wallis H rank sum test showed that among the 6 image fusion modes, 3D-SPACE T1WI+C normal phase pseudo-color and 3D-SPACE T2WI normal phase fusion images had the best quality (P<0.05). No significance was observed among the 4 groups in the evaluation of consistency between the intraoperative findings and the graphically displayed extent of tumor invasion into oculomotor nerve (both level I, II, and III, P>0.05). The 3D-SPACE T2WI/3D-SPACE T1WI+C fusion images and the 3D-SPACE T2WI images showed better performance in the evaluation of consistency between the intraoperative findings and the graphically displayed extent of tumor invasion into optic chiasma (level II and III) than that in other two kinds of imaging data of the MRI enhancement group and 3D-SPACE T1WI+C group (P<0.01, P<0.05, respectively), with no significance being observed in level I. The 3D-SPACE T2WI/3D-SPACE T1WI+C fusion images and the 3D-SPACE T1WI+C images showed better performance in the evaluation of consistency between the intraoperative findings and the graphically displayed extent of tumor invasion into cavernous sinus vessels (level II) than that in other two kinds of imaging data of the MRI enhancement group and 3D-SPACE T2WI group (P<0.01, P<0.05, respectively), with no significance being observed in level I and III. CONCLUSIONS Magnetic resonance 3D-SPACE sequence combined with image fusion technology is better than conventional magnetic resonance sequence for showing pituitary macroadenoma invasion of skull base vascular nerves. The invasion is better than the 3D-SPACE sequence alone, showing that the relationship between tumor and cavernous sinus vascular grade II better than the 3D-SPACE sequence alone. It has good application prospects for preoperative risk assessment and surgical plan.

术前对颅内肿瘤质地的准确评估对于手术人路的选择以及预后的评估极为重要.目前,对颅内肿瘤质地的预测方法主要是通过磁共振成像.本文分别对磁共振常规序列、弥散序列、弹性序列及其他序列预测肿瘤质地研究相关的文献进行综述和分析.我们认为常规序列和弥散序列预测肿瘤质地的有效性尚存在争议;磁共振波谱、灌注加权成像及稳态进动平衡序列目前研究数据较少,不能得出有效的结论;弹性序列是目前预测肿瘤质地最有效的评价指标.

Objectives:To discuss the feasibility of joint service between medical social worker and volunteer in hospital,learn the willing and training requirement of young medical staff participating medical social work and to complete volunteer training mechanism.Methods:Young medical staff under 35 years old in 3 large public hospitals were randomly selected to have a self-designed questionnaire which involves the basic situation,the willing and training requirement on participating medical social work.The data were analyzed.Results:More than 90％ of the investigated willing to participate in medical social work.And there is no significant difference between volunteer and others.The priority sequence of training process in volunteer group are health and safety knowledge,professional knowledge and skill for medical social worker,policies and regulations,team building,the concept of medical social work,project development and management capacity respectively.The priority sequence of control group are health and safety knowledge,policies and regulations,the concept of medical social work,team building,professional knowledge and skill for medical social worker,project development and management capacity respectively.There are significant difference between volunteer group and control group(P＜0.01).The training requirement on volunteer group is more than that of control group.Conclusions:It is feasible to build a joint mode of medical social work in hospital between medical social worker and hospital volunteer.But the volunteer training mechanism,medical social work concept,professional knowledge and skill,policies and regulations and health and safety knowledge needs to be further completed.

The AT-rich interactive domain 1A gene (ARID1A) plays an important role in malignant tumorigenesis, but its role in gliomas remains unclear. This study aims to identify a possible biomarker that could be used in the diagnosis and tumour grade assessment of gliomas. Additionally, the biological role of ARID1A was further characterized in glioma cells. Data were collected from sporadic glioma specimens (n = 55) and normal brain tissues (n = 5), and ARID1A expression was examined by quantitative RT-PCR and Western blot. We verified the differential expression of ARID1A and evaluated the associations of ARID1A expression with the pathological characteristics of gliomas. An ARID1A overexpression plasmid was constructed and transfected into the human glioblastoma cell line U87, and cell proliferation and apoptosis were examined. Our results showed that the ARID1A mRNA in gliomas was significantly down-regulated compared with that in normal brain tissues. As the pathological grade (World Health Organization classification 2007) increased, the expression of ARID1A decreased. Overexpression of ARID1A was able to inhibit cell proliferation and arrest cell cycle progression in the G1/S phase as well as induce cell apoptosis in glioma cells. Furthermore, ARID1A overexpression was accompanied by the suppression of glioma cell proliferation via the phosphatidylinositol 3-kinase pathway and decreased expression of pAKT and pS6K. Therefore, ARID1A may be a useful target for the diagnosis and therapy of gliomas. Introduction Glioma is the most common primary central nervous system tumour and often results in the death of patients within 1–2 years1. The aggressive nature of glioma is characterized by intense cell proliferation, diffuse infiltration and high resistance to apoptosis2. With few advances in early detection, most patients are at advanced stages at the time of diagnosis, which decreases the chances for successful treatment3. To date, no tumour marker has been found to detect glioma at a potentially curative stage, and the factors that mediate glioma proliferation and recurrence are still poorly understood4. Consequently, there is a meaningful urgency to identify critical carcinogenic pathways and discover potential genes as diagnostic and therapeutic targets. The AT-rich interactive domain 1A gene (ARID1A), which encodes one of the subunits in the switch/sucrose non-fermentable (SWI/SNF) chromatin remodelling complex, has been shown to function as a tumour suppressor in various cancer types5,6. Recent studies found that ARID1A was mutated in 46% of ovarian clear cell carcinomas, 30% of endometrioid carcinomas, 13% of hepatitis B virusassociated hepatocellular carcinomas and 10% of gastrointestinal neoplasms. Mutations were also identified in 2%–8% of pancreatic, breast, brain (medulloblastomas), prostate and lung tumours6–8. These data suggest that the loss of ARID1A may play an important role in the process of carcinogenesis. Therefore, ARID1A is a candidate for targeted therapy for various cancers. Restoring ARID1A expression significantly inhibited cell proliferation and colony formation in gastric and ovarian cancer cells9,10. Moreover, it appears to be a good biomarker for the early diagnosis of cancer. Some researchers found ARID1A mutation or loss to be an early event in the carcinogenesis of endometrioid uterine carcinomas. Also, the loss of ARID1A was associated with an advanced invasion depth of endometrioid uterine carcinomas and gastric cancer10,11. Unfortunately, the expression of ARID1A and its role in gliomas remain largely unknown. In this current study, we used quantitative real-time polymerase chain reaction (RT-PCR) and Western blot analysis to investigate the correlation between ARID1A expression and glioma grade. To explore its associated molecular mechanisms in glioma cells, we examined the effect of ARID1A gene overexpression on cell proliferation and apoptosis in vitro. These findings will be useful in identifying potential candidates for the diagnosis and targeted therapy of glioma. Materials and methods Patients and tissue samples A total of 55 glioma specimens were collected in this study. These specimens were obtained from patients who underwent either explorative or radical surgery at the Xiangya Hospital of Central South University (Hunan, China) from February 2011 to May 2012 after informed consent was obtained. The gliomas were histopathologically and clinically diagnosed and classified according to World Health Organization (WHO) * Corresponding authors Email: xylancet@yahoo.com.cn; min.li@uth. tmc.edu 1 Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China 2 The Vivian L. Smith Department of Neurosurgery, The University of Texas Medical School at Houston, Houston, TX, USA

Peer-to-Peer (P2P) streaming provides an effective method to deploy large-scale internet protocol television (IPTV) application over today¿s Internet. A major challenge in designing such an application is how to deal with content delivery among heterogeneous clients. Especially, with the development of the mobile internet and smart phones, how to provide an effective multi-source heterogeneous P2P IPTV solution becomes of great importance. Due to the special requirement of supporting differentiated multiple video streaming for different users, already existing P2P live video streaming techniques are inappropriate to be adopted directly. Therefore, this paper proposes a source-aware mobile P2P IPTV solution (SAMP) to provide multi-source live streaming for heterogeneous clients. In detail, SAMP includes a source-aware P2P topology construction algorithm to deduce the bandwidth occupation and the control overhead among the P2P clients, and contains a source-aware P2P streaming scheduling algorithm to further enhance the delay performance of the P2P IPTV system. The evaluation results show that the proposed SAMP scheme can provide a differentiated multi-source live streaming for heterogeneous clients with reduced bandwidth consumption, control overhead, and delivery delay.

In this paper, an efficient content-based video copy detection method is proposed by using video signatures. Consecutive frame features are mapped into hashes with a time constraint. We employ a winnowing scheme to generate video signatures, which are a subset of the hashes of a video, resulting in notably reduced computing complexity. Experimental results on test videos show that the proposed method is promising.

This chapter presents a new and efficient method for shot boundary detection (SBD) and scene segmentation. Commonly the first step in content-based video analysis, SBD partitions video data into fundamental units of shots. Over the past decade, SBD has attracted a considerable amount of research attention. However, the detection accuracy achieved leaves much to be desired. In this chapter, a new SBD method based on sequential change detection is proposed to achieve improved detection accuracy. The method is then extended to segment videos into scenes. Compared with existing scene segmentation methods, the proposed method can also obtain more accurate results over a large set of test videos.

This paper presents an event detection framework using multimodal feature analysis. In this framework, multimodal features are extracted from video data and then analyzed to generate various mid-level concepts, such as video shot, face appearance and so on. Two schemes, the logistic regression and Bayesian belief network, are then employed to fuse the information obtained from multimodal feature analysis and detect the video events of interest. We aim to use this framework as a general template for event detection in different video domains. Experimental results on various test videos in different video domains suggest that the proposed event detection framework is promising.

In content-based video analysis, scene clustering is an important step toward automated understanding of video semantics, identification of video events, and indexing and retrieval of relevant video contents. Many methods have been proposed to cluster video shots into scenes by using conventional k-means clustering and hierarchical clustering methods. However, "noise" shots analysis has not been fully investigated and incorporated in the clustering procedure. In this paper, we propose a Gaussian mixture model based clustering method incorporating noise analysis. The proposed method can identify noise shots and predict the scene types of new coming shots with satisfactory results.

In content-based video analysis, commonly the first step is to segment a video into independent shots. However, it is rather inefficient to represent video using shot information, as one hour video may contain more than a hundred shots. To address this limitation, most recent work has focused on segmenting a video into scenes, each aggregated by consecutive shots that share similar visual properties or cover a same dramatic event. With the use of sequential change detection and the help of nonparametric density estimation, we propose a novel approach for video scene segmentation in this paper. Experimental results obtained from various test videos suggest that the proposed approach is promising.

In content-based video analysis, substantial research efforts have been focused on developing techniques to detect the boundaries between two successive shots, each comprising consecutive frames filmed with a single camera act. However, there is still room for further improvement in the detection performance. With the use of sequential change detection and the help of nonparametric density estimation principles, we propose A new shot boundary detection method that can maintain not only satisfactory detection accuracy, but also consistent detection performance based on the results of various test videos.

Sequential pretreatments of wheat straw Soda-AQ pulp with Aspergillus niger xylanase and Basidiomycete sp. laccase before sodium hypochloride bleaching were studied. The effect of different treatments by synergistic action of xylanase (X) and laccase (L) on pulp hardness (KMn04 number) and brightness was discussed, and the optimum conditions concerning laccase dosage, mediator dosage and reaction time were also investigated. Results showed that the optimum conditions were laccase charge 2.5 U/g, mediator charge 0.1% and retention time 120 min.The KMn04 number decreased rate of the pulp treated by LMS under 1 kg/cm2 oxygen pressure was 31.6%, 21 percent higher than that treated without oxygen. The hardness of the pulp pretreated by L-X sequence was lower than that by X-L one, their bleached pulps brightness was respectively 3.9%ISO and 3.0%ISO higher than the control pulp.

Two fungi, wich produced an acid and an alkaline-stable xylanase, were isolated from soil and identified as strains of Aspergillus niger. The basic characteristics of both xylanases were studied and the conditions of pretreating wheat straw pulps with xylanases were also optimized. The results showed that enzyme-pretreated pulps can obtain higher brightness, or 20%-30% of hypochlorine can be reduced at the same final brightness level. It can be predicted that xylanase has a great potential economic and environmental benefits in non-wood pulp bleaching in the near future.