Background Blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI) plays an important role in identifying functional cortical areas of the brain, especially in patients with gliomas. This ...Background Blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI) plays an important role in identifying functional cortical areas of the brain, especially in patients with gliomas. This study aimed to assess the value of fMRI in presurgical planning and functional outcome of patients with gliomas in the motor cortical areas. Methods Twenty-six patients with gliomas in the motor cortex were recruited in the study. Before operation, fMRI was performed in each patient to obtain the mapping of bilateral hands area on the primary sensorimotor cortex. This examination was performed on a 3.0T scanner with a bilateral hands movement paradigm. During microsurgery under awake anesthesia, the motor area was identified using direct electrical stimulation and compared with preoperative mapping. Finally the tumor was resected as much as possible with the motor cortex preserved in each patient. Karnofsky performance status (KPS) was evaluated in all patients before and after operation. Results Twenty-three patients showed a successful fMRI mapping. Among them, 19 were calssified to be grade Ⅲ; 4, grade Ⅱ; 3, grade Ⅰ. The operation time was about 7 hours in the 23 patients, 8.5 hours in the other 3. The pre-and postoperative KPS score was 82.3±8.6 and 94.2±8.1, respectively. Conclusions Preoperative fMRI of the hand motor area shows a high consistency with intraoperative cortical electronic stimulation. Combined use of the two methods shows a maximum benefit in surgical treatment.展开更多
Background Localization of sensory cortical areas during the operation is essential to preserve the sensory function. Intraoperative direct electrostimulation under awake anesthesia is the golden standard but time-con...Background Localization of sensory cortical areas during the operation is essential to preserve the sensory function. Intraoperative direct electrostimulation under awake anesthesia is the golden standard but time-consuming. We applied 3T high field blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI) to identify the relationship between glioma and cortical sensory areas preoperatively and to guide intraoperative direct electrostimulation for quick and precise localization. Methods Five glioma patients with sensory cortex involvement by or next to the lesion had preoperative BOLD fMRI to determine the spatial relationship of cortical sensory areas to the tumours. Bilateral hand opposite movement was performed by these patients for fMRI. Precentral and postcentral gyri were identified by electrical stimulation during the operation. Karnofsky Performance Status scores of the patients' pre- and postoperative and the role of BOLD fMRI were evaluated. Results The cortical sensory areas were all activated in five glioma patients involving postcentral gyrus areas by BOLD fMRI with bilateral hand opposite movement. The detected activation areas corresponded with the results from cortical electrical stimulation. Conclusions The relationship between cortical sensory areas and tumour can be accurately shown by BOLD fMRI before operation. And the information used to make the tumour resection could obtain good clinical results.展开更多
Background The mechanism of acupuncture analgesia in craniotomy has been widely studied. However, the theoretical basis for selection of acupoints has not been examined. In this study, we used the regional homogeneit...Background The mechanism of acupuncture analgesia in craniotomy has been widely studied. However, the theoretical basis for selection of acupoints has not been examined. In this study, we used the regional homogeneity method blood oxygen level-dependent (BOLD) signals to determine changes in brain activity in response to transcutaneous electrical stimulation on acupoints and non-acupoints in resting state functional magnetic resonance imaging (fMRI).Methods Twelve healthy volunteers were enrolled in this study. BOLD fMRI scanning of the brain was performed for 306 seconds before and 30 minutes after transcutaneous electrical stimulation on acupoints UB63 (Jinmen), LV3 (Tai chong), ST36 (Zusanli), and GB40 (Qiuxu). The procedure was repeated after one week with stimulation on non-acupoints (one was 9 above BL67, the second was 12 above BL67 (Kunlun), the third was 7 above KI3, and the fourth was 10 above KI3 (Taixi)).Results The regional homogeneity in the acupoint group was increased in the left thalamus, caudate, putamen, lentiform nucleus (BA19, 30, 39), postcentral gyrus, precentral gyrus (BA3, 4, 30, 32), calcarine fissure, middle temporal gyrus (BA30), right superior temporal gyrus, inferior temporal gyrus (BA38), cuneus, and precuneus (BA7, 19) when compared to the non-acupoint group. The regional homogeneity of the acupoint group was decreased in the left cerebellum posterior lobe, middle frontal gyrus (BA10), double-side precuneus (BA7), and the postcentral gyrus (BA40).Conclusions The brain region activated following acupoint stimulation is the ipsilateral pain-related brain region, which may relate to the therapeutic effect of acupuncture on pain relief. Further acupoint stimulation causes different central nervous responses compared to non-acupoint stimulation.展开更多
RF deflectors can be used for bunch length measurement with high resolution. This paper describes a completed S-band traveling wave RF deflector and the bunch length measurement of the electron beam produced by the ph...RF deflectors can be used for bunch length measurement with high resolution. This paper describes a completed S-band traveling wave RF deflector and the bunch length measurement of the electron beam produced by the photocathode RF gun of the Shanghai DUV-FEL facility. This is the first time that such a transverse RF deflector has been developed and used to measure the bunch length of picosecond order in China. The deflector's VSWR is 1.06, the whole attenuation 0.5 dB, and the bandwidth 4.77 MHz for VSWR less than 1.1. With a laser pulse width of 8.5 ps, beam energy of 4.2 MeV, and bunch charge of 0.64 nC, the bunch lengths for different RF input power into the deflector were measured, and an averaged rms bunch length of 5.25 ps was obtained. A YAG crystal is used as a screen downstream of the deflector, with the calibrated value of 1 pix = 136 μm.展开更多
Background Reliable early prediction response to therapy and time-to-progression (TTP) remain an important goal of high-grade gliomas (HGGs) research. Proton magnetic resonance spectroscopy (1H-MRS) has been app...Background Reliable early prediction response to therapy and time-to-progression (TTP) remain an important goal of high-grade gliomas (HGGs) research. Proton magnetic resonance spectroscopy (1H-MRS) has been applied with variable success in clinical application, and we hypothesize that 1H-MRS in predictive value should perform well as a marker of TTP in patients treated with radiotherapy (RT) after surgery. Methods 1H-MRS was performed before surgery on 25 patients who had undergone resection of HGGs; then the ratios of lipid/creatine (Lip/Cr) and myo-inositol/creatine (ml/Cr) were determined in the solid tumor. RT response was classified as follows: complete resolution (CR), partial response (PR), stable disease (SD), and progressive disease (PD) by comparison of pre-treatment and post-radiotherapy scans. TTP was defined at the time to radiographic progression by MacDonald criteria. Correlation was evaluated between the ratios of Lip/Cr, ml/Cr and treatment response, TTP. The chi-square test and Pearson correlation test were used for data analyses. Results Multivariate analysis revealed that the prognostic value of spectroscopic variables was independent of age, sex, WHO histologic grade, extent of surgery, and Karnofsky score (KPS). The correlation between the ratios of lipid/Cr and TTP was significant (r=0.894, P=0.000), and between the ratios of ml/Cr and TTP was also significant (r=0.891, P=-0.000). As predicted, RT response correlated significantly with TTP (r=0.59, P=0.002): median TTP was 49.9 days for patients with PD compared with 202.7 days for SD, 208.0 days for PR, and 234.5 days for CR. Conclusion The ratios of Lip/Cr and ml/Cr of the solid tumor region before surgery could provide important information in predicting RT response and TTP in patients with HGGs treated by radiation alone after surgery.展开更多
Background Appropriate planning and staffing for medical services at large-scale athletic events is essential to provide for a safe and successful competition. There are few well-documented accounts describing the dem...Background Appropriate planning and staffing for medical services at large-scale athletic events is essential to provide for a safe and successful competition. There are few well-documented accounts describing the demand for such services. The present study provided the data from the Beijing 2008 Olympics and Paralympics, with a view to provide the guidance for planning future events.展开更多
Background The paralimbic system, which is composed of three parts, is an important functional unit. Gliomas located in the region remain a challenge for clinical treatment. However, the dynamic change of gliomas in t...Background The paralimbic system, which is composed of three parts, is an important functional unit. Gliomas located in the region remain a challenge for clinical treatment. However, the dynamic change of gliomas in the area has not been well documented. The purpose of this study was to identify the growth tendency of gliomas located in the paralimbic system and to obtain some suggestions for clinical treatment. Methods Eleven cases of gliomas located in the paralimbic system were recruited in the study. All of them were proven by pathology. Analysis of the serial radiological examinations in each patient was performed from the initial to the final examination, taking into consideration the following items: initial tumor location, final location and the growth tendency. Results In the initial and final examinations the ratios of insula involvement were 64% and 100%, respectively. On the other hand, the ratios of gliomas located in two or more parts of paralimbic system increased from 64% to 100% during the dynamic examination. Conclusions Even though the paralimbic system is composed of three independent anatomical parts, gliomas tend to involve all three parts, especially the insula. Therapeutic plans should aim at the whole region of the system, even during the early stages of gliomas.展开更多
文摘Background Blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI) plays an important role in identifying functional cortical areas of the brain, especially in patients with gliomas. This study aimed to assess the value of fMRI in presurgical planning and functional outcome of patients with gliomas in the motor cortical areas. Methods Twenty-six patients with gliomas in the motor cortex were recruited in the study. Before operation, fMRI was performed in each patient to obtain the mapping of bilateral hands area on the primary sensorimotor cortex. This examination was performed on a 3.0T scanner with a bilateral hands movement paradigm. During microsurgery under awake anesthesia, the motor area was identified using direct electrical stimulation and compared with preoperative mapping. Finally the tumor was resected as much as possible with the motor cortex preserved in each patient. Karnofsky performance status (KPS) was evaluated in all patients before and after operation. Results Twenty-three patients showed a successful fMRI mapping. Among them, 19 were calssified to be grade Ⅲ; 4, grade Ⅱ; 3, grade Ⅰ. The operation time was about 7 hours in the 23 patients, 8.5 hours in the other 3. The pre-and postoperative KPS score was 82.3±8.6 and 94.2±8.1, respectively. Conclusions Preoperative fMRI of the hand motor area shows a high consistency with intraoperative cortical electronic stimulation. Combined use of the two methods shows a maximum benefit in surgical treatment.
基金This work was supported by a grant from the country "11th Five-Year Plan" (No. 2007BAI05B08), Major Program of the National Natural Science Foundation of China (No. 30730035) and Key Project of Chinese National Programs for Fundamental Research and Development (973 Program, No. 2007CB512500).
文摘Background Localization of sensory cortical areas during the operation is essential to preserve the sensory function. Intraoperative direct electrostimulation under awake anesthesia is the golden standard but time-consuming. We applied 3T high field blood oxygen level-dependent (BOLD) functional magnetic resonance imaging (fMRI) to identify the relationship between glioma and cortical sensory areas preoperatively and to guide intraoperative direct electrostimulation for quick and precise localization. Methods Five glioma patients with sensory cortex involvement by or next to the lesion had preoperative BOLD fMRI to determine the spatial relationship of cortical sensory areas to the tumours. Bilateral hand opposite movement was performed by these patients for fMRI. Precentral and postcentral gyri were identified by electrical stimulation during the operation. Karnofsky Performance Status scores of the patients' pre- and postoperative and the role of BOLD fMRI were evaluated. Results The cortical sensory areas were all activated in five glioma patients involving postcentral gyrus areas by BOLD fMRI with bilateral hand opposite movement. The detected activation areas corresponded with the results from cortical electrical stimulation. Conclusions The relationship between cortical sensory areas and tumour can be accurately shown by BOLD fMRI before operation. And the information used to make the tumour resection could obtain good clinical results.
基金This work was supported by the grants from the National Key Basic Research and Development Program "973" Project (No. 2007CB512503), and the China Postdoctoral Science Foundation (No. 20070420403).Acknowledgements: The authors are highly grateful to Professor ZANG Yu-feng (State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University) for software support.
文摘Background The mechanism of acupuncture analgesia in craniotomy has been widely studied. However, the theoretical basis for selection of acupoints has not been examined. In this study, we used the regional homogeneity method blood oxygen level-dependent (BOLD) signals to determine changes in brain activity in response to transcutaneous electrical stimulation on acupoints and non-acupoints in resting state functional magnetic resonance imaging (fMRI).Methods Twelve healthy volunteers were enrolled in this study. BOLD fMRI scanning of the brain was performed for 306 seconds before and 30 minutes after transcutaneous electrical stimulation on acupoints UB63 (Jinmen), LV3 (Tai chong), ST36 (Zusanli), and GB40 (Qiuxu). The procedure was repeated after one week with stimulation on non-acupoints (one was 9 above BL67, the second was 12 above BL67 (Kunlun), the third was 7 above KI3, and the fourth was 10 above KI3 (Taixi)).Results The regional homogeneity in the acupoint group was increased in the left thalamus, caudate, putamen, lentiform nucleus (BA19, 30, 39), postcentral gyrus, precentral gyrus (BA3, 4, 30, 32), calcarine fissure, middle temporal gyrus (BA30), right superior temporal gyrus, inferior temporal gyrus (BA38), cuneus, and precuneus (BA7, 19) when compared to the non-acupoint group. The regional homogeneity of the acupoint group was decreased in the left cerebellum posterior lobe, middle frontal gyrus (BA10), double-side precuneus (BA7), and the postcentral gyrus (BA40).Conclusions The brain region activated following acupoint stimulation is the ipsilateral pain-related brain region, which may relate to the therapeutic effect of acupuncture on pain relief. Further acupoint stimulation causes different central nervous responses compared to non-acupoint stimulation.
基金Supported by Major State Research Development Program (2002CB713606)
文摘RF deflectors can be used for bunch length measurement with high resolution. This paper describes a completed S-band traveling wave RF deflector and the bunch length measurement of the electron beam produced by the photocathode RF gun of the Shanghai DUV-FEL facility. This is the first time that such a transverse RF deflector has been developed and used to measure the bunch length of picosecond order in China. The deflector's VSWR is 1.06, the whole attenuation 0.5 dB, and the bandwidth 4.77 MHz for VSWR less than 1.1. With a laser pulse width of 8.5 ps, beam energy of 4.2 MeV, and bunch charge of 0.64 nC, the bunch lengths for different RF input power into the deflector were measured, and an averaged rms bunch length of 5.25 ps was obtained. A YAG crystal is used as a screen downstream of the deflector, with the calibrated value of 1 pix = 136 μm.
基金This study was supported by grants of the National Key Project of Science and Technology Supporting Programs of China (No. 2007BAI05B08), the National Natural Science Foundation of China (No. 30770617, 30730035), the International Cooperation Project of Henan Science and Technology Supporting Programs of China (No. 114300510016), and special funding of the Henan Health Science and Technology Innovation Talent Project (No. 201004057).
文摘Background Reliable early prediction response to therapy and time-to-progression (TTP) remain an important goal of high-grade gliomas (HGGs) research. Proton magnetic resonance spectroscopy (1H-MRS) has been applied with variable success in clinical application, and we hypothesize that 1H-MRS in predictive value should perform well as a marker of TTP in patients treated with radiotherapy (RT) after surgery. Methods 1H-MRS was performed before surgery on 25 patients who had undergone resection of HGGs; then the ratios of lipid/creatine (Lip/Cr) and myo-inositol/creatine (ml/Cr) were determined in the solid tumor. RT response was classified as follows: complete resolution (CR), partial response (PR), stable disease (SD), and progressive disease (PD) by comparison of pre-treatment and post-radiotherapy scans. TTP was defined at the time to radiographic progression by MacDonald criteria. Correlation was evaluated between the ratios of Lip/Cr, ml/Cr and treatment response, TTP. The chi-square test and Pearson correlation test were used for data analyses. Results Multivariate analysis revealed that the prognostic value of spectroscopic variables was independent of age, sex, WHO histologic grade, extent of surgery, and Karnofsky score (KPS). The correlation between the ratios of lipid/Cr and TTP was significant (r=0.894, P=0.000), and between the ratios of ml/Cr and TTP was also significant (r=0.891, P=-0.000). As predicted, RT response correlated significantly with TTP (r=0.59, P=0.002): median TTP was 49.9 days for patients with PD compared with 202.7 days for SD, 208.0 days for PR, and 234.5 days for CR. Conclusion The ratios of Lip/Cr and ml/Cr of the solid tumor region before surgery could provide important information in predicting RT response and TTP in patients with HGGs treated by radiation alone after surgery.
文摘Background Appropriate planning and staffing for medical services at large-scale athletic events is essential to provide for a safe and successful competition. There are few well-documented accounts describing the demand for such services. The present study provided the data from the Beijing 2008 Olympics and Paralympics, with a view to provide the guidance for planning future events.
基金This study was supported by the funds from the National Key Project of Science and Technology Supporting Programs of China (No. 2007BAI05B08) and the National Natural Science Foundation of China (No. 30770617)
文摘Background The paralimbic system, which is composed of three parts, is an important functional unit. Gliomas located in the region remain a challenge for clinical treatment. However, the dynamic change of gliomas in the area has not been well documented. The purpose of this study was to identify the growth tendency of gliomas located in the paralimbic system and to obtain some suggestions for clinical treatment. Methods Eleven cases of gliomas located in the paralimbic system were recruited in the study. All of them were proven by pathology. Analysis of the serial radiological examinations in each patient was performed from the initial to the final examination, taking into consideration the following items: initial tumor location, final location and the growth tendency. Results In the initial and final examinations the ratios of insula involvement were 64% and 100%, respectively. On the other hand, the ratios of gliomas located in two or more parts of paralimbic system increased from 64% to 100% during the dynamic examination. Conclusions Even though the paralimbic system is composed of three independent anatomical parts, gliomas tend to involve all three parts, especially the insula. Therapeutic plans should aim at the whole region of the system, even during the early stages of gliomas.