BACKGROUND Although en bloc dissection of hepatic hilum lymph nodes has many advantages in radical tumor treatment,the feasibility and safety of this approach for laparo-scopic pancreaticoduodenectomy(LPD)require furt...BACKGROUND Although en bloc dissection of hepatic hilum lymph nodes has many advantages in radical tumor treatment,the feasibility and safety of this approach for laparo-scopic pancreaticoduodenectomy(LPD)require further clinical evaluation and investigation.AIM To explore the application value of the"five steps four quadrants"modularized en bloc dissection technique for accessing hepatic hilum lymph nodes in LPD patients.METHODS A total of 52 patients who underwent LPD via the"five steps four quadrants"modularized en bloc dissection technique for hepatic hilum lymph nodes from April 2021 to July 2023 in our department were analyzed retrospectively.The patients'body mass index(BMI),preoperative laboratory indices,intraoperative variables and postoperative complications were recorded.The relationships between preoperative data and intraoperative lymph node dissection time and blood loss were also analyzed.RESULTS Among the 52 patients,36 were males and 16 were females,and the average age was 62.2±11.0 years.There were 26 patients with pancreatic head cancer,16 patients with periampullary cancer,and 10 patients with distal bile duct cancer.The BMI was 22.3±3.3 kg/m²,and the median total bilirubin(TBIL)concentration was 57.7(16.0-155.7)µmol/L.All patients successfully underwent the"five steps four quadrants"modularized en bloc dissection technique without lymph node clearance-related complications such as postoperative bleeding or lymphatic leakage.Correlation analysis revealed significant associations between preoperative BMI(r=0.3581,P=0.0091),TBIL level(r=0.2988,P=0.0341),prothrombin time(r=0.3018,P=0.0297)and lymph node dissection time.Moreover,dissection time was significantly correlated with intraoperative blood loss(r=0.7744,P<0.0001).Further stratified analysis demonstrated that patients with a preoperative BMI≥21.9 kg/m²and a TIBL concentration≥57.7μmol/L had significantly longer lymph node dissection times(both P<0.05).CONCLUSION The"five steps four quadrants"modularized en bloc dissection technique for accessing the hepatic hilum lymph node is safe and feasible for LPD.This technique is expected to improve the efficiency of hepatic hilum lymph node dissection and shorten the learning curve;thus,it is worthy of further clinical promotion and application.展开更多
Objective: To explore the value of percutaneous ultrasonography combined with transvenous ultrasonography for accurate localization of sentinel lymph nodes and diagnosis of metastatic lymph nodes in patients with brea...Objective: To explore the value of percutaneous ultrasonography combined with transvenous ultrasonography for accurate localization of sentinel lymph nodes and diagnosis of metastatic lymph nodes in patients with breast cancer. Methods: 18 cases of patients with breast cancer attending the Hainan General Hospital from May 2022 to June 2024 who were proposed to undergo axillary lymph node dissection were selected, and the ultrasonographic agent was injected subcutaneously through the areola on the 1st day before the operation, and the marker localization of the manifestation of the Sentinel lymph nodes and draw the lymphatic vessel alignment for drainage on the body surface, and record the manifestation of SLN by conventional ultrasound and dual ultrasonography. At the time of surgery, intraoperative melphalan localization was used to identify the SLN, the difference between the number of ultrasound and melphalan localization was observed, and resection was performed for pathological examination to determine whether they were metastatic or not. Results: There were 8 metastatic lymph nodes and 18 non-metastatic lymph nodes among 31 SLN. A total of 62 SLN were localized by intraoperative melphalan, of which 31 were consistent with ultrasound localization and 31 were not identified by ultrasound. The diagnostic sensitivity of SLN metastasis diagnosed by transcutaneous ultrasonography was 62.50%, specificity was 91.30%, positive predictive value was 71.43%, negative predictive value 87.50%, accuracy was 83.87%, and the AUC was 0.769;the diagnostic sensitivityof transvenous ultrasonography diagnosed was 75.00%, specificity was 75.00%, and the accuracy was 83.87%, 75.00%, specificity 91.30%, positive predictive value 75.00%, negative predictive value 91.30%, accuracy 87.10%, AUC 0.832;dual ultrasonography diagnostic sensitivity 87.50%, specificity 91.30%, positive predictive value 77.78%, negative predictive value 95.45%, accuracy 90.32%. The AUC was 0.894. Conclusion: Transcutaneous ultrasonography combined with transvenous ultrasonography can accurately localize sentinel lymph nodes and improve the sensitivity and accuracy of the diagnosis of metastatic SLN.展开更多
This paper studies the target controllability of multilayer complex networked systems,in which the nodes are highdimensional linear time invariant(LTI)dynamical systems,and the network topology is directed and weighte...This paper studies the target controllability of multilayer complex networked systems,in which the nodes are highdimensional linear time invariant(LTI)dynamical systems,and the network topology is directed and weighted.The influence of inter-layer couplings on the target controllability of multi-layer networks is discussed.It is found that even if there exists a layer which is not target controllable,the entire multi-layer network can still be target controllable due to the inter-layer couplings.For the multi-layer networks with general structure,a necessary and sufficient condition for target controllability is given by establishing the relationship between uncontrollable subspace and output matrix.By the derived condition,it can be found that the system may be target controllable even if it is not state controllable.On this basis,two corollaries are derived,which clarify the relationship between target controllability,state controllability and output controllability.For the multi-layer networks where the inter-layer couplings are directed chains and directed stars,sufficient conditions for target controllability of networked systems are given,respectively.These conditions are easier to verify than the classic criterion.展开更多
As industrialization and informatization becomemore deeply intertwined,industrial control networks have entered an era of intelligence.The connection between industrial control networks and the external internet is be...As industrialization and informatization becomemore deeply intertwined,industrial control networks have entered an era of intelligence.The connection between industrial control networks and the external internet is becoming increasingly close,which leads to frequent security accidents.This paper proposes a model for the industrial control network.It includes a malware containment strategy that integrates intrusion detection,quarantine,and monitoring.Basedonthismodel,the role of keynodes in the spreadofmalware is studied,a comparisonexperiment is conducted to validate the impact of the containment strategy.In addition,the dynamic behavior of the model is analyzed,the basic reproduction number is computed,and the disease-free and endemic equilibrium of the model is also obtained by the basic reproduction number.Moreover,through simulation experiments,the effectiveness of the containment strategy is validated,the influence of the relevant parameters is analyzed,and the containment strategy is optimized.In otherwords,selective immunity to key nodes can effectively suppress the spread ofmalware andmaintain the stability of industrial control systems.The earlier the immunization of key nodes,the better.Once the time exceeds the threshold,immunizing key nodes is almost ineffective.The analysis provides a better way to contain the malware in the industrial control network.展开更多
In this editorial,we proceed to comment on the article by Chua et al,addressing the management of metastatic lateral pelvic lymph nodes(mLLN)in stage II/III rectal cancer patients below the peritoneal reflection.The t...In this editorial,we proceed to comment on the article by Chua et al,addressing the management of metastatic lateral pelvic lymph nodes(mLLN)in stage II/III rectal cancer patients below the peritoneal reflection.The treatment of this nodal area sparks significant controversy due to the strategic differences followed by Eastern and Western physicians,albeit with a higher degree of convergence in recent years.The dissection of lateral pelvic lymph nodes without neoadjuvant therapy is a standard practice in Eastern countries.In contrast,in the West,preference leans towards opting for neoadjuvant therapy with chemoradiotherapy or radiotherapy,that would cover the treatment of this area without the need to add the dissection of these nodes to the total mesorectal excision.In the presence of high-risk nodal characteristics for mLLN related to radiological imaging and lack of response to neoadjuvant therapy,the risk of lateral local recurrence increases,suggesting the appropriate selection of strategies to reduce the risk of recurrence in each patient profile.Despite the heterogeneous and retrospective nature of studies addressing this area,an international consensus is necessary to approach this clinical scenario uniformly.展开更多
BACKGROUND Para-aortic lymph nodes(PALNs)are common sites for the regional spread of cervical squamous cell carcinoma(SCC).CASE SUMMARY We report the case of a 36-year-old woman who presented with cervical SCC with mu...BACKGROUND Para-aortic lymph nodes(PALNs)are common sites for the regional spread of cervical squamous cell carcinoma(SCC).CASE SUMMARY We report the case of a 36-year-old woman who presented with cervical SCC with multiple bulky PALNs,largest measured 4.5 cm×5 cm×10 cm.The patient was treated with radical intent with definitive chemoradiation using sequential doseescalated adaptive radiotherapy,followed by maintenance chemotherapy.The patient achieved a complete response;she has been doing well since the completion of treatment with no evidence of the disease for 2 years.CONCLUSION Regardless of the size of PALN metastases of cervical carcinoma origin,it is still treatable(with radical intent)via concurrent chemoradiation.Adaptive radiotherapy allows dose escalation with minimal toxicity.展开更多
Enhancing the security of Wireless Sensor Networks(WSNs)improves the usability of their applications.Therefore,finding solutions to various attacks,such as the blackhole attack,is crucial for the success of WSN applic...Enhancing the security of Wireless Sensor Networks(WSNs)improves the usability of their applications.Therefore,finding solutions to various attacks,such as the blackhole attack,is crucial for the success of WSN applications.This paper proposes an enhanced version of the AODV(Ad Hoc On-Demand Distance Vector)protocol capable of detecting blackholes and malfunctioning benign nodes in WSNs,thereby avoiding them when delivering packets.The proposed version employs a network-based reputation system to select the best and most secure path to a destination.To achieve this goal,the proposed version utilizes the Watchdogs/Pathrater mechanisms in AODV to gather and broadcast reputations to all network nodes to build the network-based reputation system.To minimize the network overhead of the proposed approach,the paper uses reputation aggregator nodes only for forwarding reputation tables.Moreover,to reduce the overhead of updating reputation tables,the paper proposes three mechanisms,which are the prompt broadcast,the regular broadcast,and the light broadcast approaches.The proposed enhanced version has been designed to perform effectively in dynamic environments such as mobile WSNs where nodes,including blackholes,move continuously,which is considered a challenge for other protocols.Using the proposed enhanced protocol,a node evaluates the security of different routes to a destination and can select the most secure routing path.The paper provides an algorithm that explains the proposed protocol in detail and demonstrates a case study that shows the operations of calculating and updating reputation values when nodes move across different zones.Furthermore,the paper discusses the proposed approach’s overhead analysis to prove the proposed enhancement’s correctness and applicability.展开更多
BACKGROUND Lymph node(LN)staging in rectal cancer(RC)affects treatment decisions and patient prognosis.For radiologists,the traditional preoperative assessment of LN metastasis(LNM)using magnetic resonance imaging(MRI...BACKGROUND Lymph node(LN)staging in rectal cancer(RC)affects treatment decisions and patient prognosis.For radiologists,the traditional preoperative assessment of LN metastasis(LNM)using magnetic resonance imaging(MRI)poses a challenge.AIM To explore the value of a nomogram model that combines Conventional MRI and radiomics features from the LNs of RC in assessing the preoperative metastasis of evaluable LNs.METHODS In this retrospective study,270 LNs(158 nonmetastatic,112 metastatic)were randomly split into training(n=189)and validation sets(n=81).LNs were classified based on pathology-MRI matching.Conventional MRI features[size,shape,margin,T2-weighted imaging(T2WI)appearance,and CE-T1-weighted imaging(T1WI)enhancement]were evaluated.Three radiomics models used 3D features from T1WI and T2WI images.Additionally,a nomogram model combining conventional MRI and radiomics features was developed.The model used univariate analysis and multivariable logistic regression.Evaluation employed the receiver operating characteristic curve,with DeLong test for comparing diagnostic performance.Nomogram performance was assessed using calibration and decision curve analysis.RESULTS The nomogram model outperformed conventional MRI and single radiomics models in evaluating LNM.In the training set,the nomogram model achieved an area under the curve(AUC)of 0.92,which was significantly higher than the AUCs of 0.82(P<0.001)and 0.89(P<0.001)of the conventional MRI and radiomics models,respectively.In the validation set,the nomogram model achieved an AUC of 0.91,significantly surpassing 0.80(P<0.001)and 0.86(P<0.001),respectively.CONCLUSION The nomogram model showed the best performance in predicting metastasis of evaluable LNs.展开更多
BACKGROUND Owing to the advancement in bacterial identification techniques,the detection rate of non-tuberculous mycobacterium(NTM)has been on the rise.Different from Mycobacterium tuberculosis,the clinical symptoms o...BACKGROUND Owing to the advancement in bacterial identification techniques,the detection rate of non-tuberculous mycobacterium(NTM)has been on the rise.Different from Mycobacterium tuberculosis,the clinical symptoms of NTM are not easily detected,and the clinical efficacy and prognosis are somewhat heterogeneous.To report a case of Mycobacterium gordoniasis of cervical lymph node diagnosed in Anhui Chest Hospital in July 2022.CASE SUMMARY Upon examination,the patient who weighed 67.5 kg,was human immunodeficiency virus negative,healthy,without hypertension,diabetes,heart disease and other basic diseases microscopic analysis revealed granulomatous inflammation with coagulation necrosis in the lymphocyte,and tuberculosis was not ruled out.Plain computed tomography scans of the neck and chest indicated the presence of a single grayish-yellow and grayish-brown tissue,the dimensions of which was top of form 10.5 cm×3.0 cm×1.5 cm.After pathological consultation in our hospital,the diagnosis was confirmed as NTM infection.CONCLUSION This case report and the clinical epidemiological research on improving NTM have important guiding significance for improving decision-making in clinical treatments.展开更多
Significant controversies exist with regards to the optimal management of lateral pelvic lymph nodes metastases(mLLN)in patients with low rectal cancer.The differing views held by Japanese and Western clinicians on th...Significant controversies exist with regards to the optimal management of lateral pelvic lymph nodes metastases(mLLN)in patients with low rectal cancer.The differing views held by Japanese and Western clinicians on the management of mLLN have been well documented.However,the adequacy of pelvic lymph node dissection(PLND)or neoadjuvant chemoradiation(NACRT)alone in addition to total mesorectal excision(TME)have recently come into question,due to the relatively high incidence of lateral local recurrences following PLND and TME,or NACRT and TME alone.Recently,a more selective approach to PLND has been suggested,involving a combination of neoadjuvant therapy,followed by PLND only to patients in whom the oncological benefit is likely to outweigh the risk of potential adverse events.A number of studies have attempted to retrospectively identify certain nodal characteristics on preoperative imaging,such as nodal size,appearance,and size reduction following neoadjuvant therapy.However,no consensus has been reached regarding the optimal criteria for a selective approach to PLND,partly due to the heterogeneity and retrospective nature of most of these studies.This review aims to provide an overview of recent evidence with regards to the diagnostic challenges,considerations for,and outcomes of the current management strategies for mLLN in rectal cancer patients.展开更多
Immunotherapy has become a promising research“hotspot”in cancer treatment.“Soldier”immune cells are not uniform throughout the body;they accumulate mostly in the immune organs such as the spleen and lymph nodes(LN...Immunotherapy has become a promising research“hotspot”in cancer treatment.“Soldier”immune cells are not uniform throughout the body;they accumulate mostly in the immune organs such as the spleen and lymph nodes(LNs),etc.The unique structure of LNs provides the microenvironment suitable for the survival,activation,and proliferation of multiple types of immune cells.LNs play an important role in both the initiation of adaptive immunity and the generation of durable anti-tumor responses.Antigens taken up by antigen-presenting cells in peripheral tissues need to migrate with lymphatic fluid to LNs to activate the lymphocytes therein.Meanwhile,the accumulation and retaining of many immune functional compounds in LNs enhance their efficacy significantly.Therefore,LNs have become a key target for tumor immunotherapy.Unfortunately,the nonspecific distribution of the immune drugs in vivo greatly limits the activation and proliferation of immune cells,which leads to unsatisfactory anti-tumor effects.The efficient nano-delivery system to LNs is an effective strategy to maximize the efficacy of immune drugs.Nano-delivery systems have shown beneficial in improving biodistribution and enhancing accumulation in lymphoid tissues,exhibiting powerful and promising prospects for achieving effective delivery to LNs.Herein,the physiological structure and the delivery barriers of LNs were summarized and the factors affecting LNs accumulation were discussed thoroughly.Moreover,developments in nano-delivery systems were reviewed and the transformation prospects of LNs targeting nanocarriers were summarized and discussed.展开更多
BACKGROUND Colon cancer(CC)is one of the most common cancers of the digestive tract,the third most common cancer worldwide,and the second most common cause of cancer-related deaths.Previous studies have demonstrated a...BACKGROUND Colon cancer(CC)is one of the most common cancers of the digestive tract,the third most common cancer worldwide,and the second most common cause of cancer-related deaths.Previous studies have demonstrated a higher risk of lymph node metastasis(LNM)in young patients with CC.It might be reasonable to treat patients with early-onset locally advanced CC with extended lymph node dissection.However,few studies have focused on early-onset CC(ECC)patients with LNM.At present,the methods of predicting and evaluating the prognosis of ECC patients with LNM are controversial.From the data of patients with CC obtained from the Surveillance,Epidemiology,and End Results(SEER)database,data of young patients with ECC(≤50 years old)was screened.Patients with unknown data were excluded from the study,while the remaining patients were included.The patients were randomly divided into a training group(train)and a testing group(test)in the ratio of 7:3,while building the model.The model was constructed by the training group and verified by the testing group.Using multiple Cox regression models to compare the prediction efficiency of LNM indicators,nomograms were built based on the best model selected for overall survival(OS)and cause-specific survival(CSS).In the two groups,the performance of the nomogram was evaluated by constructing a calibration plot,time-dependent area under the curve(AUC),and decision curve analysis.Finally,the patients were grouped based on the risk score predicted by the prognosis model,and the survival curve was constructed after comparing the survival status of the high and low-risk groups.RESULTS Records of 26922 ECC patients were screened from the SEER database.N classification,positive lymph nodes(PLN),lymph node ratio(LNR)and log odds of PLN(LODDS)were considered to be independent predictors of OS and CSS.In addition,independent risk factors for OS included gender,race,marital status,primary site,histology,grade,T,and M classification,while the independent prognostic factors for CSS included race,marital status,primary site,grade,T,and M classification.The prediction model including LODDS is composed of minimal Akaike information criterion,maximal concordance indexes,and AUCs.Factors including gender,race,marital status,primary site,histology,grade,T,M classification,and LODDS were integrated into the OS nomogram,while race,marital status,primary site,grade,T,M classification,and LODDS were included into the CSS nomogram.The nomogram representing both cohorts had been successfully verified in terms of prediction accuracy and clinical practicability.CONCLUSION LODDS is superior to N-stage,PLN,and LNR of ECC.The nomogram containing LODDS might be helpful in tumor evaluation and clinical decision-making,since it provides an appropriate prediction of ECC.展开更多
The foundation of ad hoc networks lies in the guarantee of continuous connectivity.However,critical nodes,whose failure can easily destroy network connectivity,will influence the ad hoc network connectivity significan...The foundation of ad hoc networks lies in the guarantee of continuous connectivity.However,critical nodes,whose failure can easily destroy network connectivity,will influence the ad hoc network connectivity significantly.To protect the network efficiently,critical nodes should be identified accurately and rapidly.Unlike existing critical node identification methods for unknown topology that identify critical nodes according to historical information,this paper develops a critical node identification method to relax the prior topology information condition about critical nodes.Specifically,we first deduce a theorem about the minimum communication range for a node through the number of nodes and deployment ranges,and prove the universality of the theorem in a realistic two-dimensional scenario.After that,we analyze the relationship between communication range and degree value for each node and prove that the greater number of nodes within the communication range of a node,the greater degree value of nodes with high probability.Moreover,we develop a novel strategy to improve the accuracy of critical node identification without topology information.Finally,simulation results indicate the proposed strategy can achieve high accuracy and low redundancy while ensuring low time consumption in the scenarios with unknown topology information in ad hoc networks.展开更多
Mobile Ad hoc Network(MANET)is decentralized wireless network and can communicate without existing infrastructure in many areas.MANET is vulnerable to various attacks that affect its performance such as blackhole atta...Mobile Ad hoc Network(MANET)is decentralized wireless network and can communicate without existing infrastructure in many areas.MANET is vulnerable to various attacks that affect its performance such as blackhole attack.Blackhole attacker,inject fault routing information to persuade the source node to select the path with malicious node as the shortest path.To eliminate malicious nodes from launching any collaborative attack.A cooperative Trapping Approach(CTA)was proposed based on modifying Ad-hoc On-demand Distance Vector(AODV)routing protocol and trapping the malicious nodes by responding to the trap request message.The approach aims to eliminate and rule out both single and collaborative malicious blackhole nodes from any attack.The approach realizes a backward tracking mechanism to perform the elimination process.The proposed algorithm(CTA)was executed using NS-2 network simulator.The performance metrics that has been considered to evaluate the performance of the proposed algorithm such as throughput,end to end delay,packet delivery ratio,and consuming energy.The experimental results have shown the performance metrics of the proposed approach outperformed other state of at algorithms.展开更多
Identifying influential nodes in complex networks and ranking their importance plays an important role in many fields such as public opinion analysis, marketing, epidemic prevention and control. To solve the issue of ...Identifying influential nodes in complex networks and ranking their importance plays an important role in many fields such as public opinion analysis, marketing, epidemic prevention and control. To solve the issue of the existing node centrality measure only considering the specific statistical feature of a single dimension, a SLGC model is proposed that combines a node’s self-influence, its local neighborhood influence, and global influence to identify influential nodes in the network. The exponential function of e is introduced to measure the node’s self-influence;in the local neighborhood,the node’s one-hop neighboring nodes and two-hop neighboring nodes are considered, while the information entropy is introduced to measure the node’s local influence;the topological position of the node in the network and the shortest path between nodes are considered to measure the node’s global influence. To demonstrate the effectiveness of the proposed model, extensive comparison experiments are conducted with eight existing node centrality measures on six real network data sets using node differentiation ability experiments, susceptible–infected–recovered(SIR) model and network efficiency as evaluation criteria. The experimental results show that the method can identify influential nodes in complex networks more accurately.展开更多
BACKGROUND Total gastrectomy with splenectomy is the standard treatment for advanced proximal gastric cancer with greater-curvature invasion.As an alternative to splenectomy,laparoscopic spleen-preserving splenic hila...BACKGROUND Total gastrectomy with splenectomy is the standard treatment for advanced proximal gastric cancer with greater-curvature invasion.As an alternative to splenectomy,laparoscopic spleen-preserving splenic hilar lymph node(LN)dissection(SPSHLD)has been developed.With SPSHLD,the posterior splenic hilar LNs are left behind.AIM To clarify the distribution of splenic hilar(No.10)and splenic artery(No.11p and 11d)LNs and to verify the possibility of omitting posterior LN dissection in laparoscopic SPSHLD from an anatomical standpoint.METHODS Hematoxylin&eosin-stained specimens were prepared from six cadavers,and the distribution of LN No.10,11p,and 11d was evaluated.In addition,heatmaps were constructed and three-dimensional reconstructions were created to visualize the LN distribution for qualitative evaluation.RESULTS There was little difference in the number of No.10 LNs between the anterior and posterior sides.For LN No.11p and 11d,the anterior LNs were more numerous than the posterior LNs in all cases.The number of posterior LNs increased toward the hilar side.Heatmaps and three-dimensional reconstructions showed that LN No.11p was more abundant in the superficial area,while LN No.11d and 10 were more abundant in the deep intervascular area.CONCLUSION The number of posterior LNs increased toward the hilum and was not neglectable.Thus,surgeons should consider that some posterior No.10 and No.11d LNs may remain after SPSHLD.展开更多
The extreme ultraviolet(XUV)light beam carrying orbital angular momentum(OAM)can be produced via high-order harmonic generation(HHG)due to the interaction of an intense vortex infrared laser and a gas medium.Here we s...The extreme ultraviolet(XUV)light beam carrying orbital angular momentum(OAM)can be produced via high-order harmonic generation(HHG)due to the interaction of an intense vortex infrared laser and a gas medium.Here we show that the OAM spectrum of vortex HHG can be readily tailored by varying the radial node(from 0 to 2)in the driving laser consisting of two mixed Laguerre-Gaussian(LG)beams.We find that due to the change in spatial profile of HHG,the distribution range of the OAM spectrum can be broadened and its shape can be modified by increasing the radial node.We also show that the OAM mode range becomes much wider and its distribution shape becomes more symmetric when the harmonic order is increased from the plateau to the cutoff when the driving laser has the nonzero radial nodes.Through the map of coherence length and the evolution of harmonic field in the medium,we reveal that the favorable off-axis phase-matching conditions are greatly modified due to the change of intensity and phase distributions of driving laser with the radial node.We anticipate this work to stimulate some interests in generating the XUV vortex beam with tunable OAM spectrum through the gaseous HHG process achieved by manipulating the mode properties of the driving laser beam.展开更多
Network approaches have been widely accepted to guide surgical strategy and predict outcome for epilepsy treatment.This study starts with a single oscillator to explore brain activity,using a phenomenological model ca...Network approaches have been widely accepted to guide surgical strategy and predict outcome for epilepsy treatment.This study starts with a single oscillator to explore brain activity,using a phenomenological model capable of describing healthy and epileptic states.The ictal number of seizures decreases or remains unchanged with increasing the speed of oscillator excitability and in each seizure,there is an increasing tendency for ictal duration with respect to the speed.The underlying reason is that the strong excitability speed is conducive to reduce transition behaviors between two attractor basins.Moreover,the selection of the optimal removal node is estimated by an indicator proposed in this study.Results show that when the indicator is less than the threshold,removing the driving node is more possible to reduce seizures significantly,while the indicator exceeds the threshold,the epileptic node could be the removal one.Furthermore,the driving node is such a potential target that stimulating it is obviously effective in suppressing seizure-like activity compared to other nodes,and the propensity of seizures can be reduced 60%with the increased stimulus strength.Our results could provide new therapeutic ideas for epilepsy surgery and neuromodulation.展开更多
基金Supported by Health Research Program of Anhui,No.AHWJ2022b032。
文摘BACKGROUND Although en bloc dissection of hepatic hilum lymph nodes has many advantages in radical tumor treatment,the feasibility and safety of this approach for laparo-scopic pancreaticoduodenectomy(LPD)require further clinical evaluation and investigation.AIM To explore the application value of the"five steps four quadrants"modularized en bloc dissection technique for accessing hepatic hilum lymph nodes in LPD patients.METHODS A total of 52 patients who underwent LPD via the"five steps four quadrants"modularized en bloc dissection technique for hepatic hilum lymph nodes from April 2021 to July 2023 in our department were analyzed retrospectively.The patients'body mass index(BMI),preoperative laboratory indices,intraoperative variables and postoperative complications were recorded.The relationships between preoperative data and intraoperative lymph node dissection time and blood loss were also analyzed.RESULTS Among the 52 patients,36 were males and 16 were females,and the average age was 62.2±11.0 years.There were 26 patients with pancreatic head cancer,16 patients with periampullary cancer,and 10 patients with distal bile duct cancer.The BMI was 22.3±3.3 kg/m²,and the median total bilirubin(TBIL)concentration was 57.7(16.0-155.7)µmol/L.All patients successfully underwent the"five steps four quadrants"modularized en bloc dissection technique without lymph node clearance-related complications such as postoperative bleeding or lymphatic leakage.Correlation analysis revealed significant associations between preoperative BMI(r=0.3581,P=0.0091),TBIL level(r=0.2988,P=0.0341),prothrombin time(r=0.3018,P=0.0297)and lymph node dissection time.Moreover,dissection time was significantly correlated with intraoperative blood loss(r=0.7744,P<0.0001).Further stratified analysis demonstrated that patients with a preoperative BMI≥21.9 kg/m²and a TIBL concentration≥57.7μmol/L had significantly longer lymph node dissection times(both P<0.05).CONCLUSION The"five steps four quadrants"modularized en bloc dissection technique for accessing the hepatic hilum lymph node is safe and feasible for LPD.This technique is expected to improve the efficiency of hepatic hilum lymph node dissection and shorten the learning curve;thus,it is worthy of further clinical promotion and application.
文摘Objective: To explore the value of percutaneous ultrasonography combined with transvenous ultrasonography for accurate localization of sentinel lymph nodes and diagnosis of metastatic lymph nodes in patients with breast cancer. Methods: 18 cases of patients with breast cancer attending the Hainan General Hospital from May 2022 to June 2024 who were proposed to undergo axillary lymph node dissection were selected, and the ultrasonographic agent was injected subcutaneously through the areola on the 1st day before the operation, and the marker localization of the manifestation of the Sentinel lymph nodes and draw the lymphatic vessel alignment for drainage on the body surface, and record the manifestation of SLN by conventional ultrasound and dual ultrasonography. At the time of surgery, intraoperative melphalan localization was used to identify the SLN, the difference between the number of ultrasound and melphalan localization was observed, and resection was performed for pathological examination to determine whether they were metastatic or not. Results: There were 8 metastatic lymph nodes and 18 non-metastatic lymph nodes among 31 SLN. A total of 62 SLN were localized by intraoperative melphalan, of which 31 were consistent with ultrasound localization and 31 were not identified by ultrasound. The diagnostic sensitivity of SLN metastasis diagnosed by transcutaneous ultrasonography was 62.50%, specificity was 91.30%, positive predictive value was 71.43%, negative predictive value 87.50%, accuracy was 83.87%, and the AUC was 0.769;the diagnostic sensitivityof transvenous ultrasonography diagnosed was 75.00%, specificity was 75.00%, and the accuracy was 83.87%, 75.00%, specificity 91.30%, positive predictive value 75.00%, negative predictive value 91.30%, accuracy 87.10%, AUC 0.832;dual ultrasonography diagnostic sensitivity 87.50%, specificity 91.30%, positive predictive value 77.78%, negative predictive value 95.45%, accuracy 90.32%. The AUC was 0.894. Conclusion: Transcutaneous ultrasonography combined with transvenous ultrasonography can accurately localize sentinel lymph nodes and improve the sensitivity and accuracy of the diagnosis of metastatic SLN.
基金supported by the National Natural Science Foundation of China (U1808205)Hebei Natural Science Foundation (F2000501005)。
文摘This paper studies the target controllability of multilayer complex networked systems,in which the nodes are highdimensional linear time invariant(LTI)dynamical systems,and the network topology is directed and weighted.The influence of inter-layer couplings on the target controllability of multi-layer networks is discussed.It is found that even if there exists a layer which is not target controllable,the entire multi-layer network can still be target controllable due to the inter-layer couplings.For the multi-layer networks with general structure,a necessary and sufficient condition for target controllability is given by establishing the relationship between uncontrollable subspace and output matrix.By the derived condition,it can be found that the system may be target controllable even if it is not state controllable.On this basis,two corollaries are derived,which clarify the relationship between target controllability,state controllability and output controllability.For the multi-layer networks where the inter-layer couplings are directed chains and directed stars,sufficient conditions for target controllability of networked systems are given,respectively.These conditions are easier to verify than the classic criterion.
基金Scientific Research Project of Liaoning Province Education Department,Code:LJKQZ20222457&LJKMZ20220781Liaoning Province Nature Fund Project,Code:No.2022-MS-291.
文摘As industrialization and informatization becomemore deeply intertwined,industrial control networks have entered an era of intelligence.The connection between industrial control networks and the external internet is becoming increasingly close,which leads to frequent security accidents.This paper proposes a model for the industrial control network.It includes a malware containment strategy that integrates intrusion detection,quarantine,and monitoring.Basedonthismodel,the role of keynodes in the spreadofmalware is studied,a comparisonexperiment is conducted to validate the impact of the containment strategy.In addition,the dynamic behavior of the model is analyzed,the basic reproduction number is computed,and the disease-free and endemic equilibrium of the model is also obtained by the basic reproduction number.Moreover,through simulation experiments,the effectiveness of the containment strategy is validated,the influence of the relevant parameters is analyzed,and the containment strategy is optimized.In otherwords,selective immunity to key nodes can effectively suppress the spread ofmalware andmaintain the stability of industrial control systems.The earlier the immunization of key nodes,the better.Once the time exceeds the threshold,immunizing key nodes is almost ineffective.The analysis provides a better way to contain the malware in the industrial control network.
文摘In this editorial,we proceed to comment on the article by Chua et al,addressing the management of metastatic lateral pelvic lymph nodes(mLLN)in stage II/III rectal cancer patients below the peritoneal reflection.The treatment of this nodal area sparks significant controversy due to the strategic differences followed by Eastern and Western physicians,albeit with a higher degree of convergence in recent years.The dissection of lateral pelvic lymph nodes without neoadjuvant therapy is a standard practice in Eastern countries.In contrast,in the West,preference leans towards opting for neoadjuvant therapy with chemoradiotherapy or radiotherapy,that would cover the treatment of this area without the need to add the dissection of these nodes to the total mesorectal excision.In the presence of high-risk nodal characteristics for mLLN related to radiological imaging and lack of response to neoadjuvant therapy,the risk of lateral local recurrence increases,suggesting the appropriate selection of strategies to reduce the risk of recurrence in each patient profile.Despite the heterogeneous and retrospective nature of studies addressing this area,an international consensus is necessary to approach this clinical scenario uniformly.
文摘BACKGROUND Para-aortic lymph nodes(PALNs)are common sites for the regional spread of cervical squamous cell carcinoma(SCC).CASE SUMMARY We report the case of a 36-year-old woman who presented with cervical SCC with multiple bulky PALNs,largest measured 4.5 cm×5 cm×10 cm.The patient was treated with radical intent with definitive chemoradiation using sequential doseescalated adaptive radiotherapy,followed by maintenance chemotherapy.The patient achieved a complete response;she has been doing well since the completion of treatment with no evidence of the disease for 2 years.CONCLUSION Regardless of the size of PALN metastases of cervical carcinoma origin,it is still treatable(with radical intent)via concurrent chemoradiation.Adaptive radiotherapy allows dose escalation with minimal toxicity.
文摘Enhancing the security of Wireless Sensor Networks(WSNs)improves the usability of their applications.Therefore,finding solutions to various attacks,such as the blackhole attack,is crucial for the success of WSN applications.This paper proposes an enhanced version of the AODV(Ad Hoc On-Demand Distance Vector)protocol capable of detecting blackholes and malfunctioning benign nodes in WSNs,thereby avoiding them when delivering packets.The proposed version employs a network-based reputation system to select the best and most secure path to a destination.To achieve this goal,the proposed version utilizes the Watchdogs/Pathrater mechanisms in AODV to gather and broadcast reputations to all network nodes to build the network-based reputation system.To minimize the network overhead of the proposed approach,the paper uses reputation aggregator nodes only for forwarding reputation tables.Moreover,to reduce the overhead of updating reputation tables,the paper proposes three mechanisms,which are the prompt broadcast,the regular broadcast,and the light broadcast approaches.The proposed enhanced version has been designed to perform effectively in dynamic environments such as mobile WSNs where nodes,including blackholes,move continuously,which is considered a challenge for other protocols.Using the proposed enhanced protocol,a node evaluates the security of different routes to a destination and can select the most secure routing path.The paper provides an algorithm that explains the proposed protocol in detail and demonstrates a case study that shows the operations of calculating and updating reputation values when nodes move across different zones.Furthermore,the paper discusses the proposed approach’s overhead analysis to prove the proposed enhancement’s correctness and applicability.
基金Supported by the National Natural Science Foundation of China,No.81602145 and No.82072704Jiangsu Province TCM Science and Technology Development Plan Monographic Project,No.ZT202118+6 种基金Jiangsu Provincial Natural Science Foundation,No.BK20171509China Postdoctoral Science Foundation,No.2018M632265The“333 Talents”Program of Jiangsu Province,No.BRA2020390Key R&D Plan of Jiangsu Provincial Department of Science and Technology,No.BE2020723Nanjing Medical University Project,No.NMUC2020046Nanjing Science and Technology Project,No.202110027Elderly Health Research Project of Jiangsu Provincial Health Commission,No.LR2022006.
文摘BACKGROUND Lymph node(LN)staging in rectal cancer(RC)affects treatment decisions and patient prognosis.For radiologists,the traditional preoperative assessment of LN metastasis(LNM)using magnetic resonance imaging(MRI)poses a challenge.AIM To explore the value of a nomogram model that combines Conventional MRI and radiomics features from the LNs of RC in assessing the preoperative metastasis of evaluable LNs.METHODS In this retrospective study,270 LNs(158 nonmetastatic,112 metastatic)were randomly split into training(n=189)and validation sets(n=81).LNs were classified based on pathology-MRI matching.Conventional MRI features[size,shape,margin,T2-weighted imaging(T2WI)appearance,and CE-T1-weighted imaging(T1WI)enhancement]were evaluated.Three radiomics models used 3D features from T1WI and T2WI images.Additionally,a nomogram model combining conventional MRI and radiomics features was developed.The model used univariate analysis and multivariable logistic regression.Evaluation employed the receiver operating characteristic curve,with DeLong test for comparing diagnostic performance.Nomogram performance was assessed using calibration and decision curve analysis.RESULTS The nomogram model outperformed conventional MRI and single radiomics models in evaluating LNM.In the training set,the nomogram model achieved an area under the curve(AUC)of 0.92,which was significantly higher than the AUCs of 0.82(P<0.001)and 0.89(P<0.001)of the conventional MRI and radiomics models,respectively.In the validation set,the nomogram model achieved an AUC of 0.91,significantly surpassing 0.80(P<0.001)and 0.86(P<0.001),respectively.CONCLUSION The nomogram model showed the best performance in predicting metastasis of evaluable LNs.
文摘BACKGROUND Owing to the advancement in bacterial identification techniques,the detection rate of non-tuberculous mycobacterium(NTM)has been on the rise.Different from Mycobacterium tuberculosis,the clinical symptoms of NTM are not easily detected,and the clinical efficacy and prognosis are somewhat heterogeneous.To report a case of Mycobacterium gordoniasis of cervical lymph node diagnosed in Anhui Chest Hospital in July 2022.CASE SUMMARY Upon examination,the patient who weighed 67.5 kg,was human immunodeficiency virus negative,healthy,without hypertension,diabetes,heart disease and other basic diseases microscopic analysis revealed granulomatous inflammation with coagulation necrosis in the lymphocyte,and tuberculosis was not ruled out.Plain computed tomography scans of the neck and chest indicated the presence of a single grayish-yellow and grayish-brown tissue,the dimensions of which was top of form 10.5 cm×3.0 cm×1.5 cm.After pathological consultation in our hospital,the diagnosis was confirmed as NTM infection.CONCLUSION This case report and the clinical epidemiological research on improving NTM have important guiding significance for improving decision-making in clinical treatments.
文摘Significant controversies exist with regards to the optimal management of lateral pelvic lymph nodes metastases(mLLN)in patients with low rectal cancer.The differing views held by Japanese and Western clinicians on the management of mLLN have been well documented.However,the adequacy of pelvic lymph node dissection(PLND)or neoadjuvant chemoradiation(NACRT)alone in addition to total mesorectal excision(TME)have recently come into question,due to the relatively high incidence of lateral local recurrences following PLND and TME,or NACRT and TME alone.Recently,a more selective approach to PLND has been suggested,involving a combination of neoadjuvant therapy,followed by PLND only to patients in whom the oncological benefit is likely to outweigh the risk of potential adverse events.A number of studies have attempted to retrospectively identify certain nodal characteristics on preoperative imaging,such as nodal size,appearance,and size reduction following neoadjuvant therapy.However,no consensus has been reached regarding the optimal criteria for a selective approach to PLND,partly due to the heterogeneity and retrospective nature of most of these studies.This review aims to provide an overview of recent evidence with regards to the diagnostic challenges,considerations for,and outcomes of the current management strategies for mLLN in rectal cancer patients.
基金supported by National Natural Science Foundation of China(No.82173757,No.82173756)Scientists Fund of National Natural Science Foundation of China(82003682)+1 种基金Medical Science and Technolpgy Program of Henan Province(Joint construction project,LHGJ20200026)Shandong Excellent Youth Fund(ZR2022YQ76).
文摘Immunotherapy has become a promising research“hotspot”in cancer treatment.“Soldier”immune cells are not uniform throughout the body;they accumulate mostly in the immune organs such as the spleen and lymph nodes(LNs),etc.The unique structure of LNs provides the microenvironment suitable for the survival,activation,and proliferation of multiple types of immune cells.LNs play an important role in both the initiation of adaptive immunity and the generation of durable anti-tumor responses.Antigens taken up by antigen-presenting cells in peripheral tissues need to migrate with lymphatic fluid to LNs to activate the lymphocytes therein.Meanwhile,the accumulation and retaining of many immune functional compounds in LNs enhance their efficacy significantly.Therefore,LNs have become a key target for tumor immunotherapy.Unfortunately,the nonspecific distribution of the immune drugs in vivo greatly limits the activation and proliferation of immune cells,which leads to unsatisfactory anti-tumor effects.The efficient nano-delivery system to LNs is an effective strategy to maximize the efficacy of immune drugs.Nano-delivery systems have shown beneficial in improving biodistribution and enhancing accumulation in lymphoid tissues,exhibiting powerful and promising prospects for achieving effective delivery to LNs.Herein,the physiological structure and the delivery barriers of LNs were summarized and the factors affecting LNs accumulation were discussed thoroughly.Moreover,developments in nano-delivery systems were reviewed and the transformation prospects of LNs targeting nanocarriers were summarized and discussed.
文摘BACKGROUND Colon cancer(CC)is one of the most common cancers of the digestive tract,the third most common cancer worldwide,and the second most common cause of cancer-related deaths.Previous studies have demonstrated a higher risk of lymph node metastasis(LNM)in young patients with CC.It might be reasonable to treat patients with early-onset locally advanced CC with extended lymph node dissection.However,few studies have focused on early-onset CC(ECC)patients with LNM.At present,the methods of predicting and evaluating the prognosis of ECC patients with LNM are controversial.From the data of patients with CC obtained from the Surveillance,Epidemiology,and End Results(SEER)database,data of young patients with ECC(≤50 years old)was screened.Patients with unknown data were excluded from the study,while the remaining patients were included.The patients were randomly divided into a training group(train)and a testing group(test)in the ratio of 7:3,while building the model.The model was constructed by the training group and verified by the testing group.Using multiple Cox regression models to compare the prediction efficiency of LNM indicators,nomograms were built based on the best model selected for overall survival(OS)and cause-specific survival(CSS).In the two groups,the performance of the nomogram was evaluated by constructing a calibration plot,time-dependent area under the curve(AUC),and decision curve analysis.Finally,the patients were grouped based on the risk score predicted by the prognosis model,and the survival curve was constructed after comparing the survival status of the high and low-risk groups.RESULTS Records of 26922 ECC patients were screened from the SEER database.N classification,positive lymph nodes(PLN),lymph node ratio(LNR)and log odds of PLN(LODDS)were considered to be independent predictors of OS and CSS.In addition,independent risk factors for OS included gender,race,marital status,primary site,histology,grade,T,and M classification,while the independent prognostic factors for CSS included race,marital status,primary site,grade,T,and M classification.The prediction model including LODDS is composed of minimal Akaike information criterion,maximal concordance indexes,and AUCs.Factors including gender,race,marital status,primary site,histology,grade,T,M classification,and LODDS were integrated into the OS nomogram,while race,marital status,primary site,grade,T,M classification,and LODDS were included into the CSS nomogram.The nomogram representing both cohorts had been successfully verified in terms of prediction accuracy and clinical practicability.CONCLUSION LODDS is superior to N-stage,PLN,and LNR of ECC.The nomogram containing LODDS might be helpful in tumor evaluation and clinical decision-making,since it provides an appropriate prediction of ECC.
基金supported by the National Natural Science Foundation of China(62231020)the Youth Innovation Team of Shaanxi Universities。
文摘The foundation of ad hoc networks lies in the guarantee of continuous connectivity.However,critical nodes,whose failure can easily destroy network connectivity,will influence the ad hoc network connectivity significantly.To protect the network efficiently,critical nodes should be identified accurately and rapidly.Unlike existing critical node identification methods for unknown topology that identify critical nodes according to historical information,this paper develops a critical node identification method to relax the prior topology information condition about critical nodes.Specifically,we first deduce a theorem about the minimum communication range for a node through the number of nodes and deployment ranges,and prove the universality of the theorem in a realistic two-dimensional scenario.After that,we analyze the relationship between communication range and degree value for each node and prove that the greater number of nodes within the communication range of a node,the greater degree value of nodes with high probability.Moreover,we develop a novel strategy to improve the accuracy of critical node identification without topology information.Finally,simulation results indicate the proposed strategy can achieve high accuracy and low redundancy while ensuring low time consumption in the scenarios with unknown topology information in ad hoc networks.
文摘Mobile Ad hoc Network(MANET)is decentralized wireless network and can communicate without existing infrastructure in many areas.MANET is vulnerable to various attacks that affect its performance such as blackhole attack.Blackhole attacker,inject fault routing information to persuade the source node to select the path with malicious node as the shortest path.To eliminate malicious nodes from launching any collaborative attack.A cooperative Trapping Approach(CTA)was proposed based on modifying Ad-hoc On-demand Distance Vector(AODV)routing protocol and trapping the malicious nodes by responding to the trap request message.The approach aims to eliminate and rule out both single and collaborative malicious blackhole nodes from any attack.The approach realizes a backward tracking mechanism to perform the elimination process.The proposed algorithm(CTA)was executed using NS-2 network simulator.The performance metrics that has been considered to evaluate the performance of the proposed algorithm such as throughput,end to end delay,packet delivery ratio,and consuming energy.The experimental results have shown the performance metrics of the proposed approach outperformed other state of at algorithms.
基金Project supported by the Natural Science Basic Research Program of Shaanxi Province of China (Grant No. 2022JQ675)the Youth Innovation Team of Shaanxi Universities。
文摘Identifying influential nodes in complex networks and ranking their importance plays an important role in many fields such as public opinion analysis, marketing, epidemic prevention and control. To solve the issue of the existing node centrality measure only considering the specific statistical feature of a single dimension, a SLGC model is proposed that combines a node’s self-influence, its local neighborhood influence, and global influence to identify influential nodes in the network. The exponential function of e is introduced to measure the node’s self-influence;in the local neighborhood,the node’s one-hop neighboring nodes and two-hop neighboring nodes are considered, while the information entropy is introduced to measure the node’s local influence;the topological position of the node in the network and the shortest path between nodes are considered to measure the node’s global influence. To demonstrate the effectiveness of the proposed model, extensive comparison experiments are conducted with eight existing node centrality measures on six real network data sets using node differentiation ability experiments, susceptible–infected–recovered(SIR) model and network efficiency as evaluation criteria. The experimental results show that the method can identify influential nodes in complex networks more accurately.
文摘BACKGROUND Total gastrectomy with splenectomy is the standard treatment for advanced proximal gastric cancer with greater-curvature invasion.As an alternative to splenectomy,laparoscopic spleen-preserving splenic hilar lymph node(LN)dissection(SPSHLD)has been developed.With SPSHLD,the posterior splenic hilar LNs are left behind.AIM To clarify the distribution of splenic hilar(No.10)and splenic artery(No.11p and 11d)LNs and to verify the possibility of omitting posterior LN dissection in laparoscopic SPSHLD from an anatomical standpoint.METHODS Hematoxylin&eosin-stained specimens were prepared from six cadavers,and the distribution of LN No.10,11p,and 11d was evaluated.In addition,heatmaps were constructed and three-dimensional reconstructions were created to visualize the LN distribution for qualitative evaluation.RESULTS There was little difference in the number of No.10 LNs between the anterior and posterior sides.For LN No.11p and 11d,the anterior LNs were more numerous than the posterior LNs in all cases.The number of posterior LNs increased toward the hilar side.Heatmaps and three-dimensional reconstructions showed that LN No.11p was more abundant in the superficial area,while LN No.11d and 10 were more abundant in the deep intervascular area.CONCLUSION The number of posterior LNs increased toward the hilum and was not neglectable.Thus,surgeons should consider that some posterior No.10 and No.11d LNs may remain after SPSHLD.
基金Project supported by the National Natural Science Foundation of China (Grant Nos.12274230,91950102,and 11834004)the Funding of Nanjing University of Science and Technology (Grant No.TSXK2022D005)。
文摘The extreme ultraviolet(XUV)light beam carrying orbital angular momentum(OAM)can be produced via high-order harmonic generation(HHG)due to the interaction of an intense vortex infrared laser and a gas medium.Here we show that the OAM spectrum of vortex HHG can be readily tailored by varying the radial node(from 0 to 2)in the driving laser consisting of two mixed Laguerre-Gaussian(LG)beams.We find that due to the change in spatial profile of HHG,the distribution range of the OAM spectrum can be broadened and its shape can be modified by increasing the radial node.We also show that the OAM mode range becomes much wider and its distribution shape becomes more symmetric when the harmonic order is increased from the plateau to the cutoff when the driving laser has the nonzero radial nodes.Through the map of coherence length and the evolution of harmonic field in the medium,we reveal that the favorable off-axis phase-matching conditions are greatly modified due to the change of intensity and phase distributions of driving laser with the radial node.We anticipate this work to stimulate some interests in generating the XUV vortex beam with tunable OAM spectrum through the gaseous HHG process achieved by manipulating the mode properties of the driving laser beam.
基金Project supported by the National Natural Science Foundation of China(Grant Nos.12072265,12272295,and 11972288)。
文摘Network approaches have been widely accepted to guide surgical strategy and predict outcome for epilepsy treatment.This study starts with a single oscillator to explore brain activity,using a phenomenological model capable of describing healthy and epileptic states.The ictal number of seizures decreases or remains unchanged with increasing the speed of oscillator excitability and in each seizure,there is an increasing tendency for ictal duration with respect to the speed.The underlying reason is that the strong excitability speed is conducive to reduce transition behaviors between two attractor basins.Moreover,the selection of the optimal removal node is estimated by an indicator proposed in this study.Results show that when the indicator is less than the threshold,removing the driving node is more possible to reduce seizures significantly,while the indicator exceeds the threshold,the epileptic node could be the removal one.Furthermore,the driving node is such a potential target that stimulating it is obviously effective in suppressing seizure-like activity compared to other nodes,and the propensity of seizures can be reduced 60%with the increased stimulus strength.Our results could provide new therapeutic ideas for epilepsy surgery and neuromodulation.