Homotopic Connectivity in Early Pontine Infarction Predicts Late Motor Recovery.

Connectivity-based methods are essential to explore brain reorganization after a stroke and to provide meaningful predictors for late motor recovery. We aim to investigate the homotopic connectivity alterations during a 180-day follow-up of patients with pontine infarction to find an early biomarker for late motor recovery prediction. In our study, resting-state functional MRI was performed in 15 patients (11 males, 4 females, age: 57.87 ± 6.50) with unilateral pontine infarction and impaired motor function during a period of 6 months (7, 14, 30, 90, and 180 days after stroke onset). Clinical neurological assessments were performed using the Fugl-Meyer scale (FM).15 matched healthy volunteers were also recruited. Whole-brain functional homotopy in each individual scan was measured by voxel-mirrored homotopic connectivity (VMHC) values. Group-level analysis was performed between stroke patients and normal controls. A Pearson correlation was performed to evaluate correlations between early VMHC and the subsequent 4 visits for behavioral measures during day 14 to day 180. We found in early stroke (within 7 days after onset), decreased VMHC was detected in the bilateral precentral and postcentral gyrus and precuneus/posterior cingulate cortex (PCC), while increased VMHC was found in the hippocampus/amygdala and frontal pole (P < 0.01). During follow-up, VMHC in the precentral and postcentral gyrus increased to the normal level from day 90, while VMHC in the precuneus/PCC presented decreased intensity during all time points (P < 0.05). The hippocampus/amygdala and frontal pole presented a higher level of VMHC during all time points (P < 0.05). Negative correlation was found between early VMHC in the hippocampus/amygdala with FM on day 14 (r = -0.59, p = 0.021), day 30 (r = -0.643, p = 0.01), day 90 (r = -0.693, p = 0.004), and day 180 (r = -0.668, p = 0.007). Furthermore, early VMHC in the frontal pole was negatively correlated with FM scores on day 30 (r = -0.662, p = 0.013), day 90 (r = -0.606, p = 0.017), and day 180 (r = -0.552, p = 0.033). Our study demonstrated the potential utility of early homotopic connectivity for prediction of late motor recovery in pontine infarction.

Effect of femtosecond and microkeratome flaps creation on the cornea biomechanics during laser in situ keratomileusis: one year follow-up.

AIM: To compare the corneal biomechanical outcomes at one year after laser in situ keratomileusis (LASIK) with the flaps created by Ziemer and Moria M2 microkeratome with 110 head and -20 blade. METHODS: Totally 100 eyes of 50 consecutive patients were enrolled in this prospective study and divided into two groups for corneal flaps created by ZiemerFemto LDV and Moria M2 microkeratome with 110 head and -20 blade. Corneal biomechanical properties including cornea resistance factor (CRF) and cornea hysteresis (CH) were measured before and 1, 3, 6, 12mo after surgery by ocular response analyzer. Central cornea thickness and corneal flap thickness were measured by optical coherence tomography. RESULTS: The ablation depth (P=0.693), residual corneal thickness (P=0.453), and postoperative corneal curvature (P=0.264) were not significant different between Ziemer group and Moria 110-20 group after surgery. The residual stromal bed thickness, corneal flap thickness, CH and CRF at 12mo after surgery were significant different between Ziemer group and Moria 110-20 group (P<0.01);Ziemer group gained better corneal biomechanical results. The CRF and CH increased gradually from 1 to 12mo after surgery in Ziemer group, increased from 1 to 6mo but decreased from 6 to 12mo in Moria 110-20 group. Both CRF and CH at one year after surgery increased with the increasing of residual cornea thickness; pre-LASIK CRF, CRF also increased with residual stromal bed thickness, while CH decreased with the increasing of pre-LASIK intraocular pressure and cornea flap thickness (P<0.01). CONCLUSION: In one year follow-up, femtosecond laser can provide better cornea flaps with stable cornea biomechanics than mechanical microkeratome.

Comparison of Visual Outcomes After Femtosecond LASIK, Wave Front-Guided Femtosecond LASIK, and Femtosecond Lenticule Extraction.

PURPOSE: To compare the mesopic contrast sensitivity (CS) and higher order aberrations (HOAs) at 3 months after femtosecond-laser in situ keratomileusis (LASIK) (FS-LASIK), wave front-guided femtosecond LASIK (WF-LASIK), and femtosecond lenticule extraction (FLEx) for the correction of myopia and myopic astigmatism. METHODS: In this prospective nonrandomized study, 332 right eyes of 332 patients were treated with FS-LASIK, WF-LASIK, or FLEx. The HOAs and mesopic CS were evaluated preoperatively and at 3 months postoperatively. RESULTS: At 3 months of follow-up, 98 eyes (96.1%) of the FS-LASIK group, 92 eyes (98.9%) of the WF-LASIK group, and 133 eyes (96.4%) of the FLEx group had an uncorrected distance visual acuity of 20/20 or better. The HOAs improved from 0.34 µm during preoperative examination to 0.56 µm of the end of the follow-up in the FS-LASIK group, from 0.31 to 0.41 µm in the WF-LASIK group, and from 0.32 to 0.54 µm in the FLEx group (all P < 0.01). At a spatial frequency of 12 cycles per degree, a better mesopic CS was observed in the WF-LASIK group (1.47) than in the FS-LASIK (1.36) and FLEx (1.33) groups (P < 0.01); a better mesopic CS with glare was also noted in the WF-LASIK group (1.37) than in the FS-LASIK (1.25) and FLEx (1.29) groups (P < 0.01). CONCLUSIONS: The FS-LASIK, WF-LASIK, and FLEx procedures result in comparable refractive results at 3 months postoperatively. However, there is improvement in the mesopic CS and HOAs after WF-LASIK.

[Treatment of vocal cord submucosal bleeding with pricking therapy].

OBJECTIVE: To observe the clinical efficacy of pricking bleeding of 3 points of the thumb tip, and 3 points of the auricular helix for treatment of vocal cord submucosal bleeding (VCSB), so as to provide a better therapy for it. METHODS: Sixty VCSB patients were equally randomized into pricking bleeding group and ultrasonic atomizing inhalation (UAI) group. Pricking bleeding was applied to Shaoshang (LU 11, 0. 1 cun to the nail on the radial side), Zhongshang (the center of the thumb back, 0. 1 cun to the nail), Laoshang (0. 1 cun to the nail on the ulnar side), Lun 1, 3 and 5 (MA-H) of the helix, once daily for 7 days. Ultrasonic atomizing inhalation treatment was given to patients of the UAI group for 15 min every time, once daily for 7 days. The scores of symptoms and signs and their difference values were calculated before and after the treatment. The acoustical parameters maximum phonation time (MPT), frequency perturbation quotient (FPQ), amplitude perturbation quotient (APQ), ratio of harmonic to noise (H/N) were detected by using a USSA Computer Language Phonetic Spectrum Analysis System. RESULTS: Of the two 30 cases of VCSB patients in the pricking bleeding and UAI groups, 20 (66.67%) and 12(40.00%)were cured, 7 (23.33%) and 6 (20.00%) were improved remarkably, 3 (10.00%) and 8 (26.67%) improved, and 0 and 4 (13.33%) failed, with the cure plus markedly effective rates being 90% and 60%, respectively. The cure plus markedly effective rate of the pricking bleeding group was significantly superior to that of the UAI group (P<0. 01). The difference values between pre-treatment and post-treatment in hoarseness, laryngalgia, throat dryness, throat burning sensation, throat clearing, vocal bleeding, glottis dysraphism, and total score were significantly higher in the pricking bleeding group than those in the UAI group (P<0.05). In comparison with the pre-treatment, MPT and H/N values were increased obviously (P<0. 05), and FPQ and APQ decreased clearly in the two groups after the treatment (P<0.05), suggesting an improvement of the acoustical parameters after the treatment. But, no significant differences were found between the two groups (P>0. 05). CONCLUSION: Pricking bleeding therapy is effective in relieving submucosal bleeding of the vocal cord and can improve its clinical symptoms and signs.