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Accurate source localization of the epileptogenic zone (EZ) is the primary condition of surgical removal of EZ. The traditional localization results based on three-dimensional ball model or standard head model may cause errors. This study intended to localize the EZ by using the patient-specific head model and multi-dipole algorithms using spikes during sleep. Then the current density distribution on the cortex was computed and used to construct the phase transfer entropy functional connectivity network between different brain areas to obtain the localization of EZ. The experiment result showed that our improved methods could reach the accuracy of 89.27% and the number of implanted electrodes could be reduced by (19.34 ± 7.15)%. This work can not only improve the accuracy of EZ localization, but also reduce the additional injury and potential risk caused by preoperative examination and surgical operation, and provide a more intuitive and effective reference for neurosurgeons to make surgical plans.
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Humans , Scalp , Brain Mapping/methods , Epilepsy/diagnosis , Electroencephalography/methods , BrainABSTRACT
Objective To explore the relationship among aggression of patients,doctor-patient trust and perceived social support,and to provide a new prospective of improving doctor-patient relationship.Methods Data of Chinese buss-perry aggression scale,wake forest physician trust scale and perceived social support were collected from a sample of 338 patients in Guangzhou and analyzed with structural equation modeling.Results ①Median (interquartile range) of aggression,doctor-patient trust and perceived social support were 54(18),32(8) and 62(15) respectively.②Total score of aggression(Z=-2.37,P=0.02) and the dimension score of physical-aggression(Z=-4.07,P＜0.01) between different gender were statistically significant,and the scores of male were higher than female.③According to relevant result,aggression of patients was significantly negatively correlated with both doctor-patient trust (r=-0.13,P＜0.05)and perceived social support(r=-0.14,P＜0.01).Doctor-patient trust was significantly positively correlated with perceived social support(r=0.36,P＜0.01) ④Perceived social support fully mediate the relationship between aggression of patients and doctor-patient trust(GFI =0.989,NFI =0.989,IFI =0.998,CFI =0.998,RMSEA =0.026,x2/df=1.229).Conclusion Perceived social support is a protective factor of aggression of patients.Improving the perceived social support of patients can promote the doctor-patient trust.
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Objective To explore the relationship among clinicians' work pressure,perceived social support and compassion fatigue,and to provide a new prospective for the localization studying of intervention and treatment to compassion fatigue.Methods Data of scale for occupational stressors on clinician,perceived social support scale and professional quality of life scale were collected from a sample of 533 clinicians and analyzed with structural equation modeling to study the relationship among clinicians' work pressure,perceived social support and compassion fatigue.Results (1)Work pressure(2.40±0.45),burnout (2.14±0.54) and secondary traumatic stress(1.93±0.60) scores of the clinicians with high perceived social support were significantly lower than that of the clinicians with low perceived social support (2.78±3.67,2.73± 0.59,2.32±0.71;t=7.68,-9.44,8.77,5.07;P＜0.01).Compassion satisfaction scores (4.15±0.63) of the clinicians with high perceived social support were significantly higher than that of the clinicians with low perceived social support (3.40±0.71,t =-9.44,P＜0.01).(2) According to relevant results,work pressure was significantly negative correlation with both perceived social support (r=-0.34,P＜0.01) and compassion satisfaction (r=-0.44,P＜0.01),and significantly positive correlation with both burnout (r=0.69,P＜0.01) and secondary traumatic stress(r=0.53,P＜0.01);while perceived social support was significantly positive correlation with compassion satisfaction (r=0.42,P＜0.01),and significantly negative correlation with burnout (r=-0.40,P＜0.01) and secondary traumatic stress(r=-0.26,P＜0.01).(3) According to the results of structural equation modeling,perceived social support played a partly mediating role in the effect of work pressure toward compassion satisfaction and fatigue with the intermediary effect of 55.4％ and 12.5％.Conclusion Perceived social support plays a mediation role between work pressure and compassion fatigue for clinicians,and better social support of the clinician is beneficial to clinicians mental health level.
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95%) was performed in 62 cases, a subtotal resection (76%~95%) was performed in 6 cases, and a partial resection (≤75%), 2 cases. No peri-operative deaths occurred. Transient diabetes insipidus was noted in 24 cases and was cured within 3 weeks after operation. Nasal cerebrospinal fluid leakage was observed in 8 cases, 5 of which spontaneously recovered after 2 weeks of bed rest, and 3 of which were cured by lumbar cistern drainage. Follow-up observations for 3 months ~ 2 years (mean, 7 months) in 48 cases found 2 cases of recurrence. Conclusions Transnasal transseptal transsphenoidal approach adenomectomy is an effective and minimally invasive procedure, with simplicity to performance, short operative time and fewer complications.