Background and Objective Electromagnetic navigation technology has demonstrated significant potential in enhancing the accuracy and safety of neurosurgical procedures.However,traditional electromagnetic navigation sys...Background and Objective Electromagnetic navigation technology has demonstrated significant potential in enhancing the accuracy and safety of neurosurgical procedures.However,traditional electromagnetic navigation systems face challenges such as high equipment costs,complex operation,bulky size,and insufficient anti-interference performance.To address these limitations,our study developed and validated a novel portable electromagnetic neuronavigation system designed to improve the precision,accessibility,and clinical applicability of electromagnetic navigation technology in cranial surgery.Methods The software and hardware architecture of a portable neural magnetic navigation system was designed.The key technologies of the system were analysed,including electromagnetic positioning algorithms,miniaturized sensor design,optimization of electromagnetic positioning and navigation algorithms,anti-interference signal processing methods,and fast three-dimensional reconstruction algorithms.A prototype was developed,and its accuracy was tested.Finally,a preliminary clinical application evaluation was conducted.Results This study successfully developed a comprehensive portable electromagnetic neuronavigation system capable of achieving preoperative planning,intraoperative real-time positioning and navigation,and postoperative evaluation of navigation outcomes.Through rigorous collaborative testing of the system’s software and hardware,the accuracy of electromagnetic neuronavigation has been validated to meet clinical requirements.Conclusions This study developed a portable neuroelectromagnetic navigation system and validated its effectiveness and safety through rigorous model testing and preliminary clinical applications.The system is characterized by its compact size,high precision,excellent portability,and user-friendly operation,making it highly valuable for promoting navigation technology and advancing the precision and minimally invasive nature of neurosurgical procedures.展开更多
The cranial base synchondroses,comprised of opposite-facing bidirectional chondrocyte layers,drive anteroposterior cranial base growth.In humans,RUNX2 haploinsufficiency causes cleidocranial dysplasia associated with ...The cranial base synchondroses,comprised of opposite-facing bidirectional chondrocyte layers,drive anteroposterior cranial base growth.In humans,RUNX2 haploinsufficiency causes cleidocranial dysplasia associated with deficient midfacial growth.However,how RUNX2 regulates chondrocytes in the cranial base synchondroses remains unknown.To address this,we inactivated Runx2 in postnatal synchondrosis chondrocytes using a tamoxifen-inducible Fgfr3-creER(Fgfr3-Runx2cKO)mouse model.Fgfr3-Runx2cKO mice displayed skeletal dwarfism and reduced anteroposterior cranial base growth associated with premature synchondrosis ossification due to impaired chondrocyte proliferation,accelerated hypertrophy,apoptosis,and osteoclast-mediated cartilage resorption.Lineage tracing reveals that Runx2-deficient Fgfr3+cells failed to differentiate into osteoblasts.Notably,Runx2-deficient chondrocytes showed an elevated level of FGFR3 and its downstream signaling components,pERK1/2 and SOX9,suggesting that RUNX2 downregulates FGFR3 in the synchondrosis.This study unveils a new role of Runx2 in cranial base chondrocytes,identifying a possible RUNX2-FGFR3-MAPK-SOX9 signaling axis that may control cranial base growth.展开更多
This narrative review examines the use of imaging biomarkers for diagnosing and monitoring hydrocephalus from birth through childhood.Early detection and longitudinal follow-up are essential for guiding timely interve...This narrative review examines the use of imaging biomarkers for diagnosing and monitoring hydrocephalus from birth through childhood.Early detection and longitudinal follow-up are essential for guiding timely interventions and asse-ssing treatment outcomes.Cranial ultrasound and magnetic resonance imaging(MRI)are the primary imaging modalities,providing critical insights into ventri-cular size,cerebrospinal fluid dynamics,and neurodevelopmental implications.Key parameters,including Evans’index,Levene’s index,and the Cella Media index,as well as volumetric and diffusion-based MRI techniques,have been explored for their diagnostic and prognostic value.Advances in automated image analysis and artificial intelligence have further improved measurement precision and reproducibility.Despite these developments,challenges remain in standar-dizing imaging protocols and establishing normative reference values across different pediatric populations.This review highlights the strengths and limita-tions of current imaging approaches,emphasizing the need for consistent metho-dologies to enhance diagnostic accuracy and optimize patient management in hydrocephalus.展开更多
Traumatic brain injury (TBI) represents a major global health challenge due to its complex pathophysiology and long-term neurological sequelae.Current treatments are insufficient to promote neural repair and functiona...Traumatic brain injury (TBI) represents a major global health challenge due to its complex pathophysiology and long-term neurological sequelae.Current treatments are insufficient to promote neural repair and functional recovery,highlighting the urgent need for innovative strategies.Biomaterial-based approaches have emerged as transformative solutions,offering new possibilities for TBI treatment and cranial repair.This review explores the role of extracellular matrix (ECM) simulation in TBI repair,emphasizing ECM-inspired biomaterials that replicate natural microenvironments to support cell adhesion,migration,and differentiation.Advanced biomaterials regulate cell behavior through biophysical and biochemicalcues,enhancing neural regeneration.Strategies for activating key signaling pathways,such as PI3K/Akt and Nrf2/HO-1,are discussed,showing how biomaterials promote neuroprotection,reduce inflammation,and support tissue repair.The review also highlights the potential of 3D printing technology to design personalized scaffolds to address TBI repair's structural and functional complexities.Finally,neural interfaces are presented as cutting-edge bioelectronic systems that integrate with neural tissues,reducing mechanical mismatch and promoting functional recovery.These interfaces provide a platform for precise neural stimulation and real-time monitoring.By integrating ECM simulation,advanced biomaterials,3D printing,and neural interfaces,this review provides a comprehensive framework for addressing the challenges of TBI repair.These innovations hold promise for developing personalized,next-generation therapies to improve patient outcomes and advance regenerative medicine.Future researchshould focus on developing dynamic,intelligent biomaterials,advancing 3D printing for precise tissue reconstruction,and integrating biomaterials with gene and drug therapies to create personalized,multi-faceted treatment approaches for traumatic brain injury repair.展开更多
Objective:To analyze the value of bedside cranial ultrasonography in the early diagnosis of neonatal brain tissue injury in intrauterine distress.Methods:128 neonates with suspected intrauterine distress admitted to t...Objective:To analyze the value of bedside cranial ultrasonography in the early diagnosis of neonatal brain tissue injury in intrauterine distress.Methods:128 neonates with suspected intrauterine distress admitted to the Yichang Central People’s Hospital from January 2023 to December 2024 were selected as study subjects based on the inclusion and exclusion criteria,and all subjects underwent bedside craniocerebral ultrasonography and MRI,and the results of MRI were used as the gold standard to divide the infants into the brain-injury group(n=31)and the no-brain-injury The children were divided into brain injury group(n=31)and no brain injury group(n=97),and the value of bedside cranial ultrasonography for early diagnosis of brain tissue injury in neonates with intrauterine distress was analyzed.Results:(1)Among the 128 cases of intrauterine distress neonates,31 cases were examined for abnormal signs,including 22 cases(70.97%)examined by bedside craniocerebral ultrasonography and 28 cases(90.32%)examined by MRI.(2)Bedside cranial ultrasound detected hypoxic-ischemic encephalopathy in 6 cases,accounting for 4.69%,ventricular widening in 2 cases,accounting for 1.56%,intracranial hemorrhage in 8 cases,accounting for 6.25%,periventricular softening of white matter in 5 cases,accounting for 3.91%,and cerebral edema in 1 case,accounting for 0.78%,while MRI detected hypoxic-ischemic encephalopathy in 9 cases,accounting for 7.03%.3 cases of ventricular widening,accounting for 2.34%,4 cases of intracranial hemorrhage,accounting for 3.13%,9 cases of periventricular-intraventricular white matter softening,accounting for 7.03%,and 3 cases of cerebral edema,accounting for 2.34%were examined.Among them,the detection rate of periventricular-intraventricular hemorrhage by bedside cranial ultrasound was significantly higher than that of MRI(P<0.05).Conclusion:The diagnostic value of bedside cranial ultrasound in periventricular-intraventricular hemorrhage is high,but the diagnostic value is not as good as that of MRI in other brain tissue injuries,and clinically appropriate examination protocols can be selected according to the specific types of craniocerebral injuries.展开更多
Understanding frictional anisotropy,which refers to the variation in frictional resistance based on the shear direction,is crucial for optimizing the friction angle between a bio-inspired structure and the surrounding...Understanding frictional anisotropy,which refers to the variation in frictional resistance based on the shear direction,is crucial for optimizing the friction angle between a bio-inspired structure and the surrounding soil.Previous studies focused on estimating the interface frictional anisotropy mobilized by snakeskin-inspired textured surfaces and sand under monotonic shear loading conditions.However,there is a need to estimate interface frictional anisotropy under repetitive shear loads.In this study,a series of repetitive direct shear(DS)tests are performed with snakeskin-inspired textured surfaces under a constant vertical stress and two shear directions(cranial first half→caudal second half or caudal first half→cranial second half).The results show that(1)mobilized shear stress increases with the number of shearing cycles,(2)cranial shearing(shearing against the scales)consistently produces a higher shear resistance and less contractive behavior than caudal shearing(shearing along the scales),and(3)a higher scale height or smaller scale length of the surface yields a higher interface friction angle across all shearing cycles.Further analysis reveals that the gap between the cranial and caudal shear zones of the interface friction angle as a function of L/H(i.e.the ratio of scale length L to scale height H)continues to decrease as the number of shearing cycles approaches asymptotic values.The directional frictional resistance(DFR)decreases as the number of shearing cycles increases.Furthermore,the discussion covers the impact of initial relative density,vertical stress,and the number of shearing cycles on interface frictional anisotropy.展开更多
The present study revisited the controversial taxonomic status ofPetaurista yunanensis, P. philippensis, P. hainana, and P. petaurista by using a considerably extended set of morphometrical characters （26 cranial var...The present study revisited the controversial taxonomic status ofPetaurista yunanensis, P. philippensis, P. hainana, and P. petaurista by using a considerably extended set of morphometrical characters （26 cranial variables from 60 adult specimen skulls）. The results revealed no sexual dimorphism in any of the four species but confirmed significant craniometric differences among the four species in both the principal components analysis （PCA） and discriminant function analysis （DFA）, with the greatest distinction observed between P. petaurista and other Petaurista species. Both univariate and multivariate analysis indicated that the morphological differences between P. yunanensis and P. philippensis were less than that between P. philippensis and P. hainana. The morphometric results were concordant in geographic patterns with mtDNA data from previous studies and indicated that P. petaurista, P. hainana, P. philippensis, and P. yunanensis could be recognized as valid species.展开更多
Objective To investigate the clinical efficacy of acupuncture combined with medicine for AIzheimer＇s disease. Methods Fifty-five patients of Alzheimer＇s disease were randomly divided into two groups in accordance wi...Objective To investigate the clinical efficacy of acupuncture combined with medicine for AIzheimer＇s disease. Methods Fifty-five patients of Alzheimer＇s disease were randomly divided into two groups in accordance with random number table： the drug group （n=28） was treated with oral donepezil hydrochloride tablets, once a day for 5-10 mg with 10 days as a course of treatment; the combined acupuncture and drug group （n=27） was treated with cranial suture acupuncture combined with donepezil hydrochloride tablets in the above-mentioned way. The cranial suture acupuncture was given once a day for 30 min with 10 days as a course of treatment. Both groups were given treatment for two courses. Mini-mental state examination （MMSE）, Alzheimer＇s disease assessment scale （ADAS-Cog）, activities of daily living scale （Barthel） and electroencephalogram （EEG） were checked before and after treatment, to evaluate the efficacy of each group via integral changes of Barthel. Results MMSE score increased, Barthel index score increased, and ADAS-Cog score decreased in the two groups after treatment （P〈0.05, P〈0.01）, and the efficacy of the combined acupuncture and drug group was more significant （P〈0.01）. The α wave frequency and amplitude and θ wave frequency of EEG increased after treatment in both groups （P〈0.05）, θ wave amplitude decreased （P〈0.01）, and the efficacy of the combined acupuncture and drug group was superior to that of the drug group in terms of EEG improvement （P〈0.05）. The total effective rate of the combined acupuncture and drug group （88.9%, 24/27） was superior to that of drug group （67.9%, 18/28, P〈0.05）. Conclusion The effect of cranial suture acupuncture combined with donepezil hydrochloride tablets for Alzheimer＇s disease is more significant than only medicine therapy.展开更多
Objective: To study the imaging features of extra-axial tumors and tumor-likelesions involving both middle and posterior cranial fossae and to make a classification. Methods:Sixty cases of pathologically confirmed ext...Objective: To study the imaging features of extra-axial tumors and tumor-likelesions involving both middle and posterior cranial fossae and to make a classification. Methods:Sixty cases of pathologically confirmed extra-axil tumors and tumor-like lesions involving bothmiddle and posterior cranial fossae were analyzed. They were divided into central and lateral types,the latter of which were subdivided into three types: middle cranial fossae type, posterior cranialfossae type and the over-riding type. The constitution and imaging features of each type wereanalyzed. Results: There were 12 cases of central type, including chordoma (n=5), pituitary adenoma(n=3), nasopharyngeal carcinoma (n=2), craniopharyn-gioma (n=1) and meningioma (n=l). 48 cases oflateral type including trigeminal nerve tumors (n=14), meningioma (n=12), epidermoid cyst (n=11),dural cavernous hemangioma (n=4), dermoid cyst (n=2), metastasis (n=2), hemangiopericytoma (n=1),paraganglioma of glonius jugular (n=1) and nasopharyngeal carcinoma (n=1). Each type of the lesionshad its own shape features, some of which were characteristic for some specific tumors. Most of thetumors and tumor-like lesions could be qualitatively diagnosed according to their imagingcharacteristics and the extent of the lesions could be defined definitely. Conclusion: It is helpfulto categorize extra-axial tumors and tumor-like lesions involving both middle and posterior cranialfossae according to their location for qualitative diagnosis and description of the extent of theselesions. It is of great clinical value in providing more precise and thorough imaging informationfor planning therapeutic methods and route of operation.展开更多
Intracranial complications of sinusitis are rare. However, they have an important morbidity and mortality rate, and can be a source of disabling neurological sequelae in the absence of a rapid diagnosis and adequate t...Intracranial complications of sinusitis are rare. However, they have an important morbidity and mortality rate, and can be a source of disabling neurological sequelae in the absence of a rapid diagnosis and adequate treatment. We carry a retrospective study of 23 patients having sinusitis with intracranial complications, treated between 1996 and 2011. All patients underwent complete ENT and neurological examination, biological investigations and sinonasal and cerebral CT. An intraveinous large-spectrum antibiotherapy was administered to all patients. Twenty patients underwent surgery. It included evacuation of the intracranial collection, sinus drainage, with or without cranialization of the frontal sinus. Evolution was assessed on clinical biological and radiological criteria. Mean age was 25 years and sex-ratio was 3.6. Neurological signs were the most frequent symptoms. Rhinological signs were essentially purulent rhinorrhea (14 cases) and nasal obstruction (12 cases). Nasal endoscopy showed pus in the middle meatus in 10 cases. On CT, intracranial complications included subdural empyema (11 cases), extradural empyema (7 cases) and brain abscess (5 cases). Associated cerebral thrombophlebitis was noted in 4 cases. Three patients with extradural empyema had had an exclusive medical treatment. All other patients (20 cases) were operated. Clinical and radiological evolution was favorable after initial treatment in 14 cases (60.8%). Six patients required secondary surgery. Two patients have died despite intensive care. The intracranial complications of sinusitis are serious and source of important morbidity and mortality. Management should rapid and adequate, combining effective antibiotic therapy and eventually neurosurgical treatment.展开更多
Abducens nerve palsy（ANP） is commonly seen in patients with diabetes mellitus. The validity of acupuncture as a traditional Chinese medicine method in peripheral nerve repair is well established. However, its effica...Abducens nerve palsy（ANP） is commonly seen in patients with diabetes mellitus. The validity of acupuncture as a traditional Chinese medicine method in peripheral nerve repair is well established. However, its efficacy in randomized controlled trials remains unclear. Herein, we designed a protocol for a prospective, single-center, randomized controlled trial to investigate the effect of intraorbital electroacupuncture on diabetic ANP. We plan to recruit 60 patients with diabetic ANP, and randomly divide them into treatment and control groups. Patients in both groups will continue their glucose-lowering therapy. A neural nutrition drug will be given to both groups for six weeks. The treatment group will also receive intraorbital electroacupuncture therapy. We will assess efficacy of treatment, eyeball movement, diplopia deviation and the levels of fasting blood-glucose and glycosylated hemoglobin before treatment at 2, 4, and 6 weeks after treatment. The efficacy and recurrence will be investigated during follow-up（1 month after intervention）. This protocol was registered at Chinese Clinical Trial Registry on 16 January 2015（Chi CTR-IPR-15005836）. This study was approved by the Ethics Committee of First Affiliated Hospital of Harbin Medical University of China（approval number： 201452）. All protocols will be in accordance with Declaration of Helsinki, formulated by the World Medical Association. Written informed consent will be provided by participants. We envisage that the results of this clinical trial will provide evidence for promoting clinical use of this new therapy for management of ANP.展开更多
We present a case of a 25-year-old female with diagnosed familial adenomatous polyposis and elevated carcinoembryonic antigen with negative family history. The suspicion of Gardner's syndrome was raised because ex...We present a case of a 25-year-old female with diagnosed familial adenomatous polyposis and elevated carcinoembryonic antigen with negative family history. The suspicion of Gardner's syndrome was raised because extirpation of an osteoma of the left temporo-occipital region was made 10 years ago. Restorative procto-colectomy and ileal pouch anal anastomosis was made but histology delineated adenocarcinoma of the rectum (Dukes C stage). We conclude that cranial osteomas often precede gastrointestinal manifestations of familial adenomatous polyposis or Gardner's syndrome and such patients should be evaluated with genetic testing followed by colonoscopy if results are positive to prevent the development of colorectal carcinoma. If the diagnosis is positive all family members should be evaluated for familial adenomatous polyposis.展开更多
Rheumatoid arthritis is a chronic systemic inflammatory disease that often affects the cervical spine.While it was initially thought that cervical involvement was innocuous,natural history studies have substantiated t...Rheumatoid arthritis is a chronic systemic inflammatory disease that often affects the cervical spine.While it was initially thought that cervical involvement was innocuous,natural history studies have substantiated the progressive nature of untreated disease.Over the past 50 years,there has been further elucidation in the pathophysiology of the disease,as well as significant advancements in medical and surgical therapy.The introduction of disease modifying drugs and biologic agents has reduced the amount of patients with advanced stages of the disease needing surgery.Advancement in instrumentation techniques has improved patient outcomes and fusion rates.The introduction of endoscopic approaches for ventral decompression may further lower surgical morbidity.In this review,we give a brief overview of the pertinent positives of the disease.A discussion of historical techniques and the evolution of surgical therapy into the modern era is provided.With improved medical therapies and lessinvasive approaches,we will likely continue to see less advanced cases of disease and less surgical morbidity.Nonetheless,a thorough understanding of the disease is crucial,as its systemic involvement and need for continued medical therapy have tremendous impact on overall complications and outcomes even in patients being seen for standard degenerative disease with comorbid rheumatoid.展开更多
Allactaginae is a subfamily of dipodids consisting of four-and five-toed jerboas(Allactaga, Allactodipus,Orientallactaga, Pygeretmus, Scarturus) found in open habitats of Asia and North Africa. Recent molecular phylog...Allactaginae is a subfamily of dipodids consisting of four-and five-toed jerboas(Allactaga, Allactodipus,Orientallactaga, Pygeretmus, Scarturus) found in open habitats of Asia and North Africa. Recent molecular phylogenies have upended our understanding of this group's systematics across taxonomic scales. Here, I used cranial geometric morphometrics to examine variation across 219 specimens of 14 allactagine species(Allactaga major, A. severtzovi, Orientallactaga balikunica, O.bullata, O. sibirica, Pygeretmus platyurus, P. pumilio,P. shitkovi, Scarturus aralychensis, S. euphraticus,S. hotsoni, S. indicus, S. tetradactylus, S. williamsi)in light of their revised taxonomy. Results showed no significant sexual size or shape dimorphism. Species significantly differed in cranial size and shape both overall and as species pairs. Species identity had a strong effect on both cranial size and shape. Only a small part of cranial shape variation was allometric,with no evidence of unique species allometries, and most specimens fit closely to the common allometric regression vector. Allactaga was the largest,followed by Orientallactaga, Scarturus, and finally Pygeretmus. Principal component 1(PC1) separated O. bullata+O. balikunica+S. hotsoni(with inflated bullae along with reduced zygomatic arches and rostra) from A. major+A. severtzovi+O. sibirica(with converse patterns), while PC2 differentiated Orientallactaga(with enlarged cranial bases and rostra along with reduced zygomatic arches and foramina magna) from Scarturus+Pygeretmus(with the opposite patterns). Clustering based on the unweighted pair group method with arithmetic mean(UPGMA) contained the four genera, but S. hotsoni clustered with O. bullata+O. balikunica and O.sibirica clustered with A. major+A. severtzovi, likely due to convergence and allometry, respectively.展开更多
The intricate anatomy and physiology of cranial nerves have inspired clinicians and scientists to study their roles in the nervous system. Damage to motor cranial nerves may result from a variety of organic or iatroge...The intricate anatomy and physiology of cranial nerves have inspired clinicians and scientists to study their roles in the nervous system. Damage to motor cranial nerves may result from a variety of organic or iatrogenic insults and causes devastating functional impairment and disfigurement. Surgical innovations directed towards restoring function to injured motor cranial nerves and their associated organs have evolved to include nerve repair, grafting, substitution, and muscle transposition. In parallel with this progress, research on tissue-engineered constructs, development of bioelectrical interfaces, and modulation of the regenerative milieu through cellular, immunomodulatory, or neurotrophic mechanisms has proliferated to enhance the available repertoire of clinically applicable reconstructive options. Despite these advances, patients continue to suffer from functional limitations relating to inadequate cranial nerve regeneration, aberrant reinnervation, or incomplete recovery of neuromuscular function. These shortfalls have profound quality of life ramifications and provide an impetus to further elucidate mechanisms underlying cranial nerve denervation and to improve repair. In this review, we summarize the literature on reconstruction and regeneration of motor cranial nerves following various injury patterns. We focus on seven cranial nerves with predominantly efferent functions and highlight shared patterns of injuries and clinical manifestations. We also present an overview of the existing reconstructive approaches, from facial reanimation, laryngeal reinnervation, to variations of interposition nerve grafts for reconstruction. We discuss ongoing endeavors to promote nerve regeneration and to suppress aberrant reinnervation and the development of synkinesis. Insights from these studies will shed light on recent progress and new horizons in understanding the biomechanics of peripheral nerve neurobiology, with emphasis on promising strategies for optimizing neural regeneration and identifying future directions in the field of motor cranial neuron research.展开更多
基金funded by National Natural Science Foundation of China(No.82272134)Innovative Research Group Project of the National Natural Science Foundation of China(No.82272134,Xiao-lei Chen).
文摘Background and Objective Electromagnetic navigation technology has demonstrated significant potential in enhancing the accuracy and safety of neurosurgical procedures.However,traditional electromagnetic navigation systems face challenges such as high equipment costs,complex operation,bulky size,and insufficient anti-interference performance.To address these limitations,our study developed and validated a novel portable electromagnetic neuronavigation system designed to improve the precision,accessibility,and clinical applicability of electromagnetic navigation technology in cranial surgery.Methods The software and hardware architecture of a portable neural magnetic navigation system was designed.The key technologies of the system were analysed,including electromagnetic positioning algorithms,miniaturized sensor design,optimization of electromagnetic positioning and navigation algorithms,anti-interference signal processing methods,and fast three-dimensional reconstruction algorithms.A prototype was developed,and its accuracy was tested.Finally,a preliminary clinical application evaluation was conducted.Results This study successfully developed a comprehensive portable electromagnetic neuronavigation system capable of achieving preoperative planning,intraoperative real-time positioning and navigation,and postoperative evaluation of navigation outcomes.Through rigorous collaborative testing of the system’s software and hardware,the accuracy of electromagnetic neuronavigation has been validated to meet clinical requirements.Conclusions This study developed a portable neuroelectromagnetic navigation system and validated its effectiveness and safety through rigorous model testing and preliminary clinical applications.The system is characterized by its compact size,high precision,excellent portability,and user-friendly operation,making it highly valuable for promoting navigation technology and advancing the precision and minimally invasive nature of neurosurgical procedures.
基金National Institutes of Health grant F30DE030675(S.A.H.)National Institutes of Health grant T32DE007057(S.A.H.)+7 种基金University of Michigan Rackham Graduate School Pre-Candidate Research Grant(S.A.H.)University of Michigan Rackham Graduate School Candidate Research Grant(S.A.H.)National Institutes of Health grant R35DE034348(N.O.)National Institutes of Health grant R01DE026666(N.O.)National Institutes of Health grant R01DE030630(N.O.)National Institutes of Health grant R01DE029465(R.T.F.)Department of Defense grant W81XWH2010571(R.T.F.)National Institutes of Health grant P30 AR069620(The Michigan Integrative Musculoskeletal.Health Core Center).
文摘The cranial base synchondroses,comprised of opposite-facing bidirectional chondrocyte layers,drive anteroposterior cranial base growth.In humans,RUNX2 haploinsufficiency causes cleidocranial dysplasia associated with deficient midfacial growth.However,how RUNX2 regulates chondrocytes in the cranial base synchondroses remains unknown.To address this,we inactivated Runx2 in postnatal synchondrosis chondrocytes using a tamoxifen-inducible Fgfr3-creER(Fgfr3-Runx2cKO)mouse model.Fgfr3-Runx2cKO mice displayed skeletal dwarfism and reduced anteroposterior cranial base growth associated with premature synchondrosis ossification due to impaired chondrocyte proliferation,accelerated hypertrophy,apoptosis,and osteoclast-mediated cartilage resorption.Lineage tracing reveals that Runx2-deficient Fgfr3+cells failed to differentiate into osteoblasts.Notably,Runx2-deficient chondrocytes showed an elevated level of FGFR3 and its downstream signaling components,pERK1/2 and SOX9,suggesting that RUNX2 downregulates FGFR3 in the synchondrosis.This study unveils a new role of Runx2 in cranial base chondrocytes,identifying a possible RUNX2-FGFR3-MAPK-SOX9 signaling axis that may control cranial base growth.
文摘This narrative review examines the use of imaging biomarkers for diagnosing and monitoring hydrocephalus from birth through childhood.Early detection and longitudinal follow-up are essential for guiding timely interventions and asse-ssing treatment outcomes.Cranial ultrasound and magnetic resonance imaging(MRI)are the primary imaging modalities,providing critical insights into ventri-cular size,cerebrospinal fluid dynamics,and neurodevelopmental implications.Key parameters,including Evans’index,Levene’s index,and the Cella Media index,as well as volumetric and diffusion-based MRI techniques,have been explored for their diagnostic and prognostic value.Advances in automated image analysis and artificial intelligence have further improved measurement precision and reproducibility.Despite these developments,challenges remain in standar-dizing imaging protocols and establishing normative reference values across different pediatric populations.This review highlights the strengths and limita-tions of current imaging approaches,emphasizing the need for consistent metho-dologies to enhance diagnostic accuracy and optimize patient management in hydrocephalus.
基金financially supported by the Natural Science Foundation of Sichuan(No.2022NSFSC1474)Sichuan Administration of Traditional Chinese Medicine Research Special Foundation(No.2024zd034)
文摘Traumatic brain injury (TBI) represents a major global health challenge due to its complex pathophysiology and long-term neurological sequelae.Current treatments are insufficient to promote neural repair and functional recovery,highlighting the urgent need for innovative strategies.Biomaterial-based approaches have emerged as transformative solutions,offering new possibilities for TBI treatment and cranial repair.This review explores the role of extracellular matrix (ECM) simulation in TBI repair,emphasizing ECM-inspired biomaterials that replicate natural microenvironments to support cell adhesion,migration,and differentiation.Advanced biomaterials regulate cell behavior through biophysical and biochemicalcues,enhancing neural regeneration.Strategies for activating key signaling pathways,such as PI3K/Akt and Nrf2/HO-1,are discussed,showing how biomaterials promote neuroprotection,reduce inflammation,and support tissue repair.The review also highlights the potential of 3D printing technology to design personalized scaffolds to address TBI repair's structural and functional complexities.Finally,neural interfaces are presented as cutting-edge bioelectronic systems that integrate with neural tissues,reducing mechanical mismatch and promoting functional recovery.These interfaces provide a platform for precise neural stimulation and real-time monitoring.By integrating ECM simulation,advanced biomaterials,3D printing,and neural interfaces,this review provides a comprehensive framework for addressing the challenges of TBI repair.These innovations hold promise for developing personalized,next-generation therapies to improve patient outcomes and advance regenerative medicine.Future researchshould focus on developing dynamic,intelligent biomaterials,advancing 3D printing for precise tissue reconstruction,and integrating biomaterials with gene and drug therapies to create personalized,multi-faceted treatment approaches for traumatic brain injury repair.
文摘Objective:To analyze the value of bedside cranial ultrasonography in the early diagnosis of neonatal brain tissue injury in intrauterine distress.Methods:128 neonates with suspected intrauterine distress admitted to the Yichang Central People’s Hospital from January 2023 to December 2024 were selected as study subjects based on the inclusion and exclusion criteria,and all subjects underwent bedside craniocerebral ultrasonography and MRI,and the results of MRI were used as the gold standard to divide the infants into the brain-injury group(n=31)and the no-brain-injury The children were divided into brain injury group(n=31)and no brain injury group(n=97),and the value of bedside cranial ultrasonography for early diagnosis of brain tissue injury in neonates with intrauterine distress was analyzed.Results:(1)Among the 128 cases of intrauterine distress neonates,31 cases were examined for abnormal signs,including 22 cases(70.97%)examined by bedside craniocerebral ultrasonography and 28 cases(90.32%)examined by MRI.(2)Bedside cranial ultrasound detected hypoxic-ischemic encephalopathy in 6 cases,accounting for 4.69%,ventricular widening in 2 cases,accounting for 1.56%,intracranial hemorrhage in 8 cases,accounting for 6.25%,periventricular softening of white matter in 5 cases,accounting for 3.91%,and cerebral edema in 1 case,accounting for 0.78%,while MRI detected hypoxic-ischemic encephalopathy in 9 cases,accounting for 7.03%.3 cases of ventricular widening,accounting for 2.34%,4 cases of intracranial hemorrhage,accounting for 3.13%,9 cases of periventricular-intraventricular white matter softening,accounting for 7.03%,and 3 cases of cerebral edema,accounting for 2.34%were examined.Among them,the detection rate of periventricular-intraventricular hemorrhage by bedside cranial ultrasound was significantly higher than that of MRI(P<0.05).Conclusion:The diagnostic value of bedside cranial ultrasound in periventricular-intraventricular hemorrhage is high,but the diagnostic value is not as good as that of MRI in other brain tissue injuries,and clinically appropriate examination protocols can be selected according to the specific types of craniocerebral injuries.
基金the funding supported from the National Research Foundation of Korea(NRF)grant funded by the Korea Government MSIT(No.2021R1C1C1006003).
文摘Understanding frictional anisotropy,which refers to the variation in frictional resistance based on the shear direction,is crucial for optimizing the friction angle between a bio-inspired structure and the surrounding soil.Previous studies focused on estimating the interface frictional anisotropy mobilized by snakeskin-inspired textured surfaces and sand under monotonic shear loading conditions.However,there is a need to estimate interface frictional anisotropy under repetitive shear loads.In this study,a series of repetitive direct shear(DS)tests are performed with snakeskin-inspired textured surfaces under a constant vertical stress and two shear directions(cranial first half→caudal second half or caudal first half→cranial second half).The results show that(1)mobilized shear stress increases with the number of shearing cycles,(2)cranial shearing(shearing against the scales)consistently produces a higher shear resistance and less contractive behavior than caudal shearing(shearing along the scales),and(3)a higher scale height or smaller scale length of the surface yields a higher interface friction angle across all shearing cycles.Further analysis reveals that the gap between the cranial and caudal shear zones of the interface friction angle as a function of L/H(i.e.the ratio of scale length L to scale height H)continues to decrease as the number of shearing cycles approaches asymptotic values.The directional frictional resistance(DFR)decreases as the number of shearing cycles increases.Furthermore,the discussion covers the impact of initial relative density,vertical stress,and the number of shearing cycles on interface frictional anisotropy.
基金National Natural Science Fund of China (30970332)National Basic Research Program of China (973 Program) (2007CB411600)+1 种基金Natural Science Found of Yunnan Province (2007C099M)Special Subjects Funds of National Natural Science Fund of China (J0930004)
文摘The present study revisited the controversial taxonomic status ofPetaurista yunanensis, P. philippensis, P. hainana, and P. petaurista by using a considerably extended set of morphometrical characters （26 cranial variables from 60 adult specimen skulls）. The results revealed no sexual dimorphism in any of the four species but confirmed significant craniometric differences among the four species in both the principal components analysis （PCA） and discriminant function analysis （DFA）, with the greatest distinction observed between P. petaurista and other Petaurista species. Both univariate and multivariate analysis indicated that the morphological differences between P. yunanensis and P. philippensis were less than that between P. philippensis and P. hainana. The morphometric results were concordant in geographic patterns with mtDNA data from previous studies and indicated that P. petaurista, P. hainana, P. philippensis, and P. yunanensis could be recognized as valid species.
文摘Objective To investigate the clinical efficacy of acupuncture combined with medicine for AIzheimer＇s disease. Methods Fifty-five patients of Alzheimer＇s disease were randomly divided into two groups in accordance with random number table： the drug group （n=28） was treated with oral donepezil hydrochloride tablets, once a day for 5-10 mg with 10 days as a course of treatment; the combined acupuncture and drug group （n=27） was treated with cranial suture acupuncture combined with donepezil hydrochloride tablets in the above-mentioned way. The cranial suture acupuncture was given once a day for 30 min with 10 days as a course of treatment. Both groups were given treatment for two courses. Mini-mental state examination （MMSE）, Alzheimer＇s disease assessment scale （ADAS-Cog）, activities of daily living scale （Barthel） and electroencephalogram （EEG） were checked before and after treatment, to evaluate the efficacy of each group via integral changes of Barthel. Results MMSE score increased, Barthel index score increased, and ADAS-Cog score decreased in the two groups after treatment （P〈0.05, P〈0.01）, and the efficacy of the combined acupuncture and drug group was more significant （P〈0.01）. The α wave frequency and amplitude and θ wave frequency of EEG increased after treatment in both groups （P〈0.05）, θ wave amplitude decreased （P〈0.01）, and the efficacy of the combined acupuncture and drug group was superior to that of the drug group in terms of EEG improvement （P〈0.05）. The total effective rate of the combined acupuncture and drug group （88.9%, 24/27） was superior to that of drug group （67.9%, 18/28, P〈0.05）. Conclusion The effect of cranial suture acupuncture combined with donepezil hydrochloride tablets for Alzheimer＇s disease is more significant than only medicine therapy.
文摘Objective: To study the imaging features of extra-axial tumors and tumor-likelesions involving both middle and posterior cranial fossae and to make a classification. Methods:Sixty cases of pathologically confirmed extra-axil tumors and tumor-like lesions involving bothmiddle and posterior cranial fossae were analyzed. They were divided into central and lateral types,the latter of which were subdivided into three types: middle cranial fossae type, posterior cranialfossae type and the over-riding type. The constitution and imaging features of each type wereanalyzed. Results: There were 12 cases of central type, including chordoma (n=5), pituitary adenoma(n=3), nasopharyngeal carcinoma (n=2), craniopharyn-gioma (n=1) and meningioma (n=l). 48 cases oflateral type including trigeminal nerve tumors (n=14), meningioma (n=12), epidermoid cyst (n=11),dural cavernous hemangioma (n=4), dermoid cyst (n=2), metastasis (n=2), hemangiopericytoma (n=1),paraganglioma of glonius jugular (n=1) and nasopharyngeal carcinoma (n=1). Each type of the lesionshad its own shape features, some of which were characteristic for some specific tumors. Most of thetumors and tumor-like lesions could be qualitatively diagnosed according to their imagingcharacteristics and the extent of the lesions could be defined definitely. Conclusion: It is helpfulto categorize extra-axial tumors and tumor-like lesions involving both middle and posterior cranialfossae according to their location for qualitative diagnosis and description of the extent of theselesions. It is of great clinical value in providing more precise and thorough imaging informationfor planning therapeutic methods and route of operation.
文摘Intracranial complications of sinusitis are rare. However, they have an important morbidity and mortality rate, and can be a source of disabling neurological sequelae in the absence of a rapid diagnosis and adequate treatment. We carry a retrospective study of 23 patients having sinusitis with intracranial complications, treated between 1996 and 2011. All patients underwent complete ENT and neurological examination, biological investigations and sinonasal and cerebral CT. An intraveinous large-spectrum antibiotherapy was administered to all patients. Twenty patients underwent surgery. It included evacuation of the intracranial collection, sinus drainage, with or without cranialization of the frontal sinus. Evolution was assessed on clinical biological and radiological criteria. Mean age was 25 years and sex-ratio was 3.6. Neurological signs were the most frequent symptoms. Rhinological signs were essentially purulent rhinorrhea (14 cases) and nasal obstruction (12 cases). Nasal endoscopy showed pus in the middle meatus in 10 cases. On CT, intracranial complications included subdural empyema (11 cases), extradural empyema (7 cases) and brain abscess (5 cases). Associated cerebral thrombophlebitis was noted in 4 cases. Three patients with extradural empyema had had an exclusive medical treatment. All other patients (20 cases) were operated. Clinical and radiological evolution was favorable after initial treatment in 14 cases (60.8%). Six patients required secondary surgery. Two patients have died despite intensive care. The intracranial complications of sinusitis are serious and source of important morbidity and mortality. Management should rapid and adequate, combining effective antibiotic therapy and eventually neurosurgical treatment.
基金supported by the National Natural Science Foundation of China,No.81674052the Key Project of Natural Science Foundation of Heilongjiang Province of China,No.ZD201211a grant from the Project of Innovational Scientific Research of Harbin Medical University of China,No.2016LCZX49
文摘Abducens nerve palsy（ANP） is commonly seen in patients with diabetes mellitus. The validity of acupuncture as a traditional Chinese medicine method in peripheral nerve repair is well established. However, its efficacy in randomized controlled trials remains unclear. Herein, we designed a protocol for a prospective, single-center, randomized controlled trial to investigate the effect of intraorbital electroacupuncture on diabetic ANP. We plan to recruit 60 patients with diabetic ANP, and randomly divide them into treatment and control groups. Patients in both groups will continue their glucose-lowering therapy. A neural nutrition drug will be given to both groups for six weeks. The treatment group will also receive intraorbital electroacupuncture therapy. We will assess efficacy of treatment, eyeball movement, diplopia deviation and the levels of fasting blood-glucose and glycosylated hemoglobin before treatment at 2, 4, and 6 weeks after treatment. The efficacy and recurrence will be investigated during follow-up（1 month after intervention）. This protocol was registered at Chinese Clinical Trial Registry on 16 January 2015（Chi CTR-IPR-15005836）. This study was approved by the Ethics Committee of First Affiliated Hospital of Harbin Medical University of China（approval number： 201452）. All protocols will be in accordance with Declaration of Helsinki, formulated by the World Medical Association. Written informed consent will be provided by participants. We envisage that the results of this clinical trial will provide evidence for promoting clinical use of this new therapy for management of ANP.
文摘We present a case of a 25-year-old female with diagnosed familial adenomatous polyposis and elevated carcinoembryonic antigen with negative family history. The suspicion of Gardner's syndrome was raised because extirpation of an osteoma of the left temporo-occipital region was made 10 years ago. Restorative procto-colectomy and ileal pouch anal anastomosis was made but histology delineated adenocarcinoma of the rectum (Dukes C stage). We conclude that cranial osteomas often precede gastrointestinal manifestations of familial adenomatous polyposis or Gardner's syndrome and such patients should be evaluated with genetic testing followed by colonoscopy if results are positive to prevent the development of colorectal carcinoma. If the diagnosis is positive all family members should be evaluated for familial adenomatous polyposis.
文摘Rheumatoid arthritis is a chronic systemic inflammatory disease that often affects the cervical spine.While it was initially thought that cervical involvement was innocuous,natural history studies have substantiated the progressive nature of untreated disease.Over the past 50 years,there has been further elucidation in the pathophysiology of the disease,as well as significant advancements in medical and surgical therapy.The introduction of disease modifying drugs and biologic agents has reduced the amount of patients with advanced stages of the disease needing surgery.Advancement in instrumentation techniques has improved patient outcomes and fusion rates.The introduction of endoscopic approaches for ventral decompression may further lower surgical morbidity.In this review,we give a brief overview of the pertinent positives of the disease.A discussion of historical techniques and the evolution of surgical therapy into the modern era is provided.With improved medical therapies and lessinvasive approaches,we will likely continue to see less advanced cases of disease and less surgical morbidity.Nonetheless,a thorough understanding of the disease is crucial,as its systemic involvement and need for continued medical therapy have tremendous impact on overall complications and outcomes even in patients being seen for standard degenerative disease with comorbid rheumatoid.
文摘Allactaginae is a subfamily of dipodids consisting of four-and five-toed jerboas(Allactaga, Allactodipus,Orientallactaga, Pygeretmus, Scarturus) found in open habitats of Asia and North Africa. Recent molecular phylogenies have upended our understanding of this group's systematics across taxonomic scales. Here, I used cranial geometric morphometrics to examine variation across 219 specimens of 14 allactagine species(Allactaga major, A. severtzovi, Orientallactaga balikunica, O.bullata, O. sibirica, Pygeretmus platyurus, P. pumilio,P. shitkovi, Scarturus aralychensis, S. euphraticus,S. hotsoni, S. indicus, S. tetradactylus, S. williamsi)in light of their revised taxonomy. Results showed no significant sexual size or shape dimorphism. Species significantly differed in cranial size and shape both overall and as species pairs. Species identity had a strong effect on both cranial size and shape. Only a small part of cranial shape variation was allometric,with no evidence of unique species allometries, and most specimens fit closely to the common allometric regression vector. Allactaga was the largest,followed by Orientallactaga, Scarturus, and finally Pygeretmus. Principal component 1(PC1) separated O. bullata+O. balikunica+S. hotsoni(with inflated bullae along with reduced zygomatic arches and rostra) from A. major+A. severtzovi+O. sibirica(with converse patterns), while PC2 differentiated Orientallactaga(with enlarged cranial bases and rostra along with reduced zygomatic arches and foramina magna) from Scarturus+Pygeretmus(with the opposite patterns). Clustering based on the unweighted pair group method with arithmetic mean(UPGMA) contained the four genera, but S. hotsoni clustered with O. bullata+O. balikunica and O.sibirica clustered with A. major+A. severtzovi, likely due to convergence and allometry, respectively.
基金supported by the United States National Institute of Health grant 1K08DC012535(to MJB)Program for Neurology Research and Discoverythe Sinai Medical Staff Foundation Neuroscience Scholar Fund(to ELF)
文摘The intricate anatomy and physiology of cranial nerves have inspired clinicians and scientists to study their roles in the nervous system. Damage to motor cranial nerves may result from a variety of organic or iatrogenic insults and causes devastating functional impairment and disfigurement. Surgical innovations directed towards restoring function to injured motor cranial nerves and their associated organs have evolved to include nerve repair, grafting, substitution, and muscle transposition. In parallel with this progress, research on tissue-engineered constructs, development of bioelectrical interfaces, and modulation of the regenerative milieu through cellular, immunomodulatory, or neurotrophic mechanisms has proliferated to enhance the available repertoire of clinically applicable reconstructive options. Despite these advances, patients continue to suffer from functional limitations relating to inadequate cranial nerve regeneration, aberrant reinnervation, or incomplete recovery of neuromuscular function. These shortfalls have profound quality of life ramifications and provide an impetus to further elucidate mechanisms underlying cranial nerve denervation and to improve repair. In this review, we summarize the literature on reconstruction and regeneration of motor cranial nerves following various injury patterns. We focus on seven cranial nerves with predominantly efferent functions and highlight shared patterns of injuries and clinical manifestations. We also present an overview of the existing reconstructive approaches, from facial reanimation, laryngeal reinnervation, to variations of interposition nerve grafts for reconstruction. We discuss ongoing endeavors to promote nerve regeneration and to suppress aberrant reinnervation and the development of synkinesis. Insights from these studies will shed light on recent progress and new horizons in understanding the biomechanics of peripheral nerve neurobiology, with emphasis on promising strategies for optimizing neural regeneration and identifying future directions in the field of motor cranial neuron research.
