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Ischemic stroke (IS), a common cerebrovascular disease, results from a sudden blockage of a blood vessel in the brain, thereby restricting blood supply to the area in question, and making a significantly negative impact on human health. read more Unfortunately, current treatments, that are mainly based on a recanalization of occluded blood vessels, are insufficient or inaccessible to many stroke patients. Recently, the profound influence of the neurovascular unit (NVU) on recanalization and the prognosis of IS have become better understood; in-depth studies of the NVU have also provided novel approaches for IS treatment. In this article, we review the intimate connections between the changes in the NVU and IS outcomes, and discuss possible new management strategies having practical significance to IS. We discuss the concept of the NVU, as well as its roles in IS blood-brain barrier regulation, cell preservation, inflammatory immune response, and neurovascular repair. Besides, we also summarize the influence of noncoding RNAs in NVU, and IS therapies targeting the NVU. We conclude that both the pathophysiological and neurovascular repair processes of IS are strongly associated with the homeostatic state of the NVU and that further research into therapies directed at the NVU could expand the range of treatments available for IS.

Subthalamic deep brain stimulation (DBS) is an established therapy for Parkinson's disease. Connectomic DBS modeling is a burgeoning subfield of research aimed at characterizing the axonal connections activated by DBS. This article describes our approach and methods for evolving the StimVision software platform to meet the technical demands of connectomic DBS modeling in the subthalamic region.

StimVision v2 was developed with Visualization Toolkit (VTK) libraries and integrates four major components 1) medical image visualization, 2) axonal pathway visualization, 3) electrode positioning, and 4) stimulation calculation.

StimVision v2 implemented two key technological advances for connectomic DBS analyses in the subthalamic region. First was the application of anatomical axonal pathway models to patient-specific DBS models. Second was the application of a novel driving-force method to estimate the response of those axonal pathways to DBS. Example simulations with directional DBS electrodes and clinically defined therapeutic DBS settings are presented to demonstrate the general outputs of StimVision v2 models.

StimVision v2 provides the opportunity to evaluate patient-specific axonal pathway activation from subthalamic DBS using anatomically detailed pathway models and electrically detailed electric field distributions with interactive adjustment of the DBS electrode position and stimulation parameter settings.

StimVision v2 provides the opportunity to evaluate patient-specific axonal pathway activation from subthalamic DBS using anatomically detailed pathway models and electrically detailed electric field distributions with interactive adjustment of the DBS electrode position and stimulation parameter settings.We present hybrid reconstruction of distal lateral "through-and-through" nasal defects (skin, cartilage, and mucosa) due to resection of tumor and/or infection. Retrospective descriptive study. The study was performed in multicenter clinics between July 2011 and September 2016. 13 patients with full thickness distal nasal defects secondary to tumor and/or infection were included. Defects included dorsal and/or caudal septum, upper lateral cartilage, or inner/outer nasal valve. Caudal-based turn-in flaps were planned and used to repair inner lining of nasal cavity. Conchal and septal cartilages were used as cartilage grafts. Skin defects were reconstructed with lateral nasal artery perforator flaps. All flaps healed uneventfully, without flap loss. Nasal passage collapse, adhesion, or difficulty in breathing were not seen. No hematoma, infection, and deformity at cartilage graft donor areas was observed. During nasal reconstruction, it is mandatory to consider 3D complex and functional structure of nose. The repair of skin defects may not be enough for functional restoration. We believe that single step reconstruction of full thickness nasal defects through hybrid reconstruction may lead to anticipated successful results.

Patients diagnosed with the novel coronavirus disease (COVID-19) who develop severe symptoms need to be determined in advance so that appropriate treatment strategies are in place.

To determine the clinic features of patients diagnosed definitely with COVID-19 and evaluate risk factors for severe outcome, the medical records of hospitalized patients were reviewed retrospectively by us and data were compiled. Laboratory data from 90 cases were analyzed, and COVID-19 patients were classified into two groups (severe and non-severe) based on the severity.

Severe COVID-19 cases on admission had higher leukocyte and neutrophil counts, neutrophil-to-lymphocyte ratio (NLR), D-dimer, fibrinogen, C-reactive protein levels, and lower lymphocyte counts compared with those of non-severe cases (p<0.05). The area under the curve (AUC) for leukocyte counts, neutrophil counts, and levels of C-reactive protein was 0.778, 0.831, and 0.800, respectively. The thresholds were 7.70×10

/L for leukocyte counts, 5.93×10⁹/L for neutrophil counts, and 75.07mg/L for C-reactive protein, respectively. Logistic regression analyses indicated that higher white blood cell (WBC) counts (OR, 1.34; 95% CI, 1.05-1.71), neutrophil counts (OR, 1.35; 95% CI, 1.06-1.73), and C-reactive protein levels (OR, 1.02; 95% CI, 1.0-1.04) were several predictive factors for severe outcome. Severe COVID-19 patients had a reduction in WBC counts, D-dimer, C-reactive protein, and fibrinogen upon discharge from hospital, while lymphocyte counts increased (p<0.05).

Counts of WBC, neutrophil, and lymphocyte, NLR, and levels of C-reactive protein, D-dimer, and fibrinogen are helpful for prediction of the deterioration trend in patients diagnosed with COVID-19.

Counts of WBC, neutrophil, and lymphocyte, NLR, and levels of C-reactive protein, D-dimer, and fibrinogen are helpful for prediction of the deterioration trend in patients diagnosed with COVID-19.