Microglia,the resident immune cells of the central nervous system,exhibit a wide array of functional states,even in their so-called“homeostatic”condition,when they are not actively responding to overt pathological s...Microglia,the resident immune cells of the central nervous system,exhibit a wide array of functional states,even in their so-called“homeostatic”condition,when they are not actively responding to overt pathological stimuli.These functional states can be visualized using a combination of multi-omics techniques(e.g.,gene and protein expression,posttranslational modifications,mRNA profiling,and metabolomics),and,in the case of homeostatic microglia,are largely defined by the global(e.g.,genetic variations,organism’s age,sex,circadian rhythms,and gut microbiota)as well as local(specific area of the brain,immediate microglial surrounding,neuron-glia interactions and synaptic density/activity)signals(Paolicelli et al.,2022).While phenomics(i.e.,ultrastructural microglial morphology and motility)is also one of the key microglial state-defining parameters,it is known that cells with similar morphology can belong to different functional states.展开更多
Spinal cord injury represents a severe form of central nervous system trauma for which effective treatments remain limited.Microglia is the resident immune cells of the central nervous system,play a critical role in s...Spinal cord injury represents a severe form of central nervous system trauma for which effective treatments remain limited.Microglia is the resident immune cells of the central nervous system,play a critical role in spinal cord injury.Previous studies have shown that microglia can promote neuronal survival by phagocytosing dead cells and debris and by releasing neuroprotective and anti-inflammatory factors.However,excessive activation of microglia can lead to persistent inflammation and contribute to the formation of glial scars,which hinder axonal regeneration.Despite this,the precise role and mechanisms of microglia during the acute phase of spinal cord injury remain controversial and poorly understood.To elucidate the role of microglia in spinal cord injury,we employed the colony-stimulating factor 1 receptor inhibitor PLX5622 to deplete microglia.We observed that sustained depletion of microglia resulted in an expansion of the lesion area,downregulation of brain-derived neurotrophic factor,and impaired functional recovery after spinal cord injury.Next,we generated a transgenic mouse line with conditional overexpression of brain-derived neurotrophic factor specifically in microglia.We found that brain-derived neurotrophic factor overexpression in microglia increased angiogenesis and blood flow following spinal cord injury and facilitated the recovery of hindlimb motor function.Additionally,brain-derived neurotrophic factor overexpression in microglia reduced inflammation and neuronal apoptosis during the acute phase of spinal cord injury.Furthermore,through using specific transgenic mouse lines,TMEM119,and the colony-stimulating factor 1 receptor inhibitor PLX73086,we demonstrated that the neuroprotective effects were predominantly due to brain-derived neurotrophic factor overexpression in microglia rather than macrophages.In conclusion,our findings suggest the critical role of microglia in the formation of protective glial scars.Depleting microglia is detrimental to recovery of spinal cord injury,whereas targeting brain-derived neurotrophic factor overexpression in microglia represents a promising and novel therapeutic strategy to enhance motor function recovery in patients with spinal cord injury.展开更多
Functional gastrointestinal disorders(FGIDs),including irritable bowel syndrome(IBS),functional dyspepsia(FD),and gastroesophageal reflux disease(GERD),present persistent diagnostic and therapeutic challenges due to s...Functional gastrointestinal disorders(FGIDs),including irritable bowel syndrome(IBS),functional dyspepsia(FD),and gastroesophageal reflux disease(GERD),present persistent diagnostic and therapeutic challenges due to symptom heterogeneity and the absence of reliable biomarkers.Artificial intelligence(AI)enables the integration of multimodal data to enhance FGID management through precision diagnostics and preventive healthcare.This minireview summarizes recent advancements in AI applications for FGIDs,highlighting progress in diagnostic accuracy,subtype classification,personalized interventions,and preventive strategies inspired by the traditional Chinese medicine concept of“treating the undiseased”.Machine learning and deep learning algorithms have demonstrated value in improving IBS diagnosis,refining FD neuro-gastrointestinal subtyping,and screening for GERD-related complications.Moreover,AI supports dietary,psychological,and integrative medicine-based interventions to improve patient adherence and quality of life.Nonetheless,key challenges remain,including data heterogeneity,limited model interpretability,and the need for robust clinical validation.Future directions emphasize interdisciplinary collaboration,the development of multimodal and explainable AI models,and the creation of patientcentered platforms to facilitate a shift from reactive treatment to proactive prevention.This review provides a systematic framework to guide the clinical application and theoretical innovation of AI in FGIDs.展开更多
The M1/M2 phenotypic shift of microglia after spinal cord injury plays an important role in the regulation of neuroinflammation during the secondary injury phase of spinal cord injury.Regulation of shifting microglia ...The M1/M2 phenotypic shift of microglia after spinal cord injury plays an important role in the regulation of neuroinflammation during the secondary injury phase of spinal cord injury.Regulation of shifting microglia polarization from M1(neurotoxic and proinflammatory type)to M2(neuroprotective and anti-inflammatory type)after spinal cord injury appears to be crucial.Tryptanthrin possesses an anti-inflammatory biological function.However,its roles and the underlying molecular mechanisms in spinal cord injury remain unknown.In this study,we found that tryptanthrin inhibited microglia-derived inflammation by promoting polarization to the M2 phenotype in vitro.Tryptanthrin promoted M2 polarization through inactivating the cGAS/STING/NF-κB pathway.Additionally,we found that targeting the cGAS/STING/NF-κB pathway with tryptanthrin shifted microglia from the M1 to M2 phenotype after spinal cord injury,inhibited neuronal loss,and promoted tissue repair and functional recovery in a mouse model of spinal cord injury.Finally,using a conditional co-culture system,we found that microglia treated with tryptanthrin suppressed endoplasmic reticulum stress-related neuronal apoptosis.Taken together,these results suggest that by targeting the cGAS/STING/NF-κB axis,tryptanthrin attenuates microglia-derived neuroinflammation and promotes functional recovery after spinal cord injury through shifting microglia polarization to the M2 phenotype.展开更多
BACKGROUND Suicide constitutes the second leading cause of death among adolescents globally and represents a critical public health concern.The neural mechanisms underlying suicidal behavior in adolescents with major ...BACKGROUND Suicide constitutes the second leading cause of death among adolescents globally and represents a critical public health concern.The neural mechanisms underlying suicidal behavior in adolescents with major depressive disorder(MDD)remain poorly understood.Aberrant resting-state functional connectivity(rsFC)in the amygdala,a key region implicated in emotional regulation and threat detection,is strongly implicated in depression and suicidal behavior.AIM To investigate rsFC alterations between amygdala subregions and whole-brain networks in adolescent patients with depression and suicide attempts.METHODS Resting-state functional magnetic resonance imaging data were acquired from 32 adolescents with MDD and suicide attempts(sMDD)group,33 adolescents with MDD but without suicide attempts(nsMDD)group,and 34 demographically matched healthy control(HC)group,with the lateral and medial amygdala(MeA)defined as regions of interest.The rsFC patterns of amygdala subregions were compared across the three groups,and associations between aberrant rsFC values and clinical symptom severity scores were examined.RESULTS Compared with the nsMDD group,the sMDD group exhibited reduced rsFC between the right lateral amygdala(LA)and the right inferior occipital gyrus as well as the left middle occipital gyrus.Compared with the HC group,the abnormal brain regions of rsFC in the sMDD group and nsMDD group involve the parahippocampal gyrus(PHG)and fusiform gyrus.In the sMDD group,right MeA and right temporal pole:Superior temporal gyrus rsFC value negatively correlated with the Rosenberg Self-Esteem Scale scores(r=-0.409,P=0.025),while left LA and right PHG rsFC value positively correlated with the Adolescent Self-Rating Life Events Checklist interpersonal relationship scores(r=0.372,P=0.043).CONCLUSION Aberrant rsFC changes between amygdala subregions and these brain regions provide novel insights into the underlying neural mechanisms of suicide attempts in adolescents with MDD.展开更多
Spinal cord injury(SCI) often results in permanent dysfunction of locomotion,sensation,and autonomic regulation,imposing a substantial burden on both individuals and society(Anjum et al.,2020).SCI has a complex pathop...Spinal cord injury(SCI) often results in permanent dysfunction of locomotion,sensation,and autonomic regulation,imposing a substantial burden on both individuals and society(Anjum et al.,2020).SCI has a complex pathophysiology:an initial primary injury(mechanical trauma,axonal disruption,and hemorrhage) is followed by a progressive secondary injury cascade that involves ischemia,neuronal loss,and inflammation.Given the challenges in achieving regeneration of the injured spinal cord,neuroprotection has been at the forefront of clinical research.展开更多
Exogenous neural stem cell transplantation has become one of the most promising treatment methods for chronic stroke.Recent studies have shown that most ischemia-reperfusion model rats recover spontaneously after inju...Exogenous neural stem cell transplantation has become one of the most promising treatment methods for chronic stroke.Recent studies have shown that most ischemia-reperfusion model rats recover spontaneously after injury,which limits the ability to observe long-term behavioral recovery.Here,we used a severe stroke rat model with 150 minutes of ischemia,which produced severe behavioral deficiencies that persisted at 12 weeks,to study the therapeutic effect of neural stem cells on neural restoration in chronic stroke.Our study showed that stroke model rats treated with human neural stem cells had long-term sustained recovery of motor function,reduced infarction volume,long-term human neural stem cell survival,and improved local inflammatory environment and angiogenesis.We also demonstrated that transplanted human neural stem cells differentiated into mature neurons in vivo,formed stable functional synaptic connections with host neurons,and exhibited the electrophysiological properties of functional mature neurons,indicating that they replaced the damaged host neurons.The findings showed that human fetal-derived neural stem cells had long-term effects for neurological recovery in a model of severe stroke,which suggests that human neural stem cells-based therapy may be effective for repairing damaged neural circuits in stroke patients.展开更多
BACKGROUND Functional gastrointestinal disorders(FGIDs)in children present with chronic symptoms like abdominal pain,diarrhea,and constipation without identifiable structural abnormalities.These disorders are closely ...BACKGROUND Functional gastrointestinal disorders(FGIDs)in children present with chronic symptoms like abdominal pain,diarrhea,and constipation without identifiable structural abnormalities.These disorders are closely linked to gut-brain axis dysfunction,altered gut microbiota,and psychosocial stress,leading to psychia-tric comorbidities such as anxiety,depression,and behavioral issues.Under-standing this bidirectional relationship is crucial for developing effective,holistic management strategies that address physical and mental health.AIM To examine the psychiatric impacts of FGIDs in children,focusing on anxiety and depression and their association with other neurodevelopmental disorders of childhood,such as attention-deficit/hyperactivity disorder,emphasizing the role of the gut-brain axis,emotional dysregulation,and psychosocial stress.Key mechanisms explored include neurotransmitter dysregulation,microbiota imbalance,central sensitization,heightening stress reactivity,emotional dysregulation,and symptom perception.The review also evaluates the role of family dynamics and coping strategies in exacerbating FGID symptoms and contributing to psychiatric conditions.METHODS A narrative review was conducted using 328 studies sourced from PubMed,Scopus,and Google Scholar,covering research published over the past 20 years.Inclusion criteria focused on studies examining FGID diagnosis,gut-brain mechanisms,psychiatric comorbidities,and psychosocial factors in pediatric populations.FGIDs commonly affecting children,including functional constipation,abdominal pain,irritable bowel syndrome,gastroesophageal reflux,and cyclic vomiting syndrome,were analyzed concerning their psychological impacts.RESULTS The review highlights a strong connection between FGIDs and psychiatric symptoms,mediated by gut-brain axis dysfunction,dysregulated microbiota,and central sensitization.These physiological disruptions increase children’s vulnerability to anxiety and depression,while psychosocial factors-such as chronic stress,early-life trauma,maladaptive family dynamics,and ineffective coping strategies-intensify the cycle of gastrointestinal and emotional distress.CONCLUSION Effective management of FGIDs requires a biopsychosocial approach integrating medical,psychological,and dietary interventions.Parental education,early intervention,and multidisciplinary care coordination are critical in mitigating long-term psychological impacts and improving both gastrointestinal and mental health outcomes in children with FGIDs.展开更多
Invasive as well as non-invasive neurotechnologies conceptualized to interface the central and peripheral nervous system have been probed for the past decades,which refer to electroencephalography,electrocorticography...Invasive as well as non-invasive neurotechnologies conceptualized to interface the central and peripheral nervous system have been probed for the past decades,which refer to electroencephalography,electrocorticography and microelectrode arrays.The challenges of these mentioned approaches are characterized by the bandwidth of the spatiotemporal resolution,which in turn is essential for large-area neuron recordings(Abiri et al.,2019).展开更多
In the words of the late Sir Colin Blakemore,neurologists have historically sought to infer brain functions in a manner akin to to king a hammer to a computeranalyzing localized anatomical lesions caused by trauma,tum...In the words of the late Sir Colin Blakemore,neurologists have historically sought to infer brain functions in a manner akin to to king a hammer to a computeranalyzing localized anatomical lesions caused by trauma,tumors,or strokes,noting deficits,and inferring what functions certain brain regions may be responsible for.This approach exemplifies a deletion heuristic,where the absence of a specific function reveals insights about the underlying structures or mechanisms responsible for it.By observing what is lost when a particular brain region is damaged,throughout the history of the field,neurologists have pieced together the intricate relationship between anatomy and function.展开更多
The mature central nervous system(CNS,composed of the brain,spinal cord,olfactory and optic nerves)is unable to regenerate spontaneously after an insult,both in the cases of neurodegenerative diseases(for example Alzh...The mature central nervous system(CNS,composed of the brain,spinal cord,olfactory and optic nerves)is unable to regenerate spontaneously after an insult,both in the cases of neurodegenerative diseases(for example Alzheimer's or Parkinson's disease)or traumatic injuries(such as spinal cord lesions).In the last 20 years,the field has made significant progress in unlocking axon regrowth.展开更多
Spontaneous recovery frequently proves maladaptive or insufficient because the plasticity of the injured adult mammalian central nervous system is limited.This limited plasticity serves as a primary barrier to functio...Spontaneous recovery frequently proves maladaptive or insufficient because the plasticity of the injured adult mammalian central nervous system is limited.This limited plasticity serves as a primary barrier to functional recovery after brain injury.Neuromodulation technologies represent one of the fastest-growing fields in medicine.These techniques utilize electricity,magnetism,sound,and light to restore or optimize brain functions by promoting reorganization or long-term changes that support functional recovery in patients with brain injury.Therefore,this review aims to provide a comprehensive overview of the effects and underlying mechanisms of neuromodulation technologies in supporting motor function recovery after brain injury.Many of these technologies are widely used in clinical practice and show significant improvements in motor function across various types of brain injury.However,studies report negative findings,potentially due to variations in stimulation protocols,differences in observation periods,and the severity of functional impairments among participants across different clinical trials.Additionally,we observed that different neuromodulation techniques share remarkably similar mechanisms,including promoting neuroplasticity,enhancing neurotrophic factor release,improving cerebral blood flow,suppressing neuroinflammation,and providing neuroprotection.Finally,considering the advantages and disadvantages of various neuromodulation techniques,we propose that future development should focus on closed-loop neural circuit stimulation,personalized treatment,interdisciplinary collaboration,and precision stimulation.展开更多
Freezing of gait is a significant and debilitating motor symptom often observed in individuals with Parkinson's disease.Resting-state functional magnetic resonance imaging,along with its multi-level feature indice...Freezing of gait is a significant and debilitating motor symptom often observed in individuals with Parkinson's disease.Resting-state functional magnetic resonance imaging,along with its multi-level feature indices,has provided a fresh perspective and valuable insight into the study of freezing of gait in Parkinson's disease.It has been revealed that Parkinson's disease is accompanied by widespread irregularities in inherent brain network activity.However,the effective integration of the multi-level indices of resting-state functional magnetic resonance imaging into clinical settings for the diagnosis of freezing of gait in Parkinson's disease remains a challenge.Although previous studies have demonstrated that radiomics can extract optimal features as biomarkers to identify or predict diseases,a knowledge gap still exists in the field of freezing of gait in Parkinson's disease.This cross-sectional study aimed to evaluate the ability of radiomics features based on multi-level indices of resting-state functional magnetic resonance imaging,along with clinical features,to distinguish between Parkinson's disease patients with and without freezing of gait.We recruited 28 patients with Parkinson's disease who had freezing of gait(15 men and 13 women,average age 63 years)and 30 patients with Parkinson's disease who had no freezing of gait(16 men and 14 women,average age 64 years).Magnetic resonance imaging scans were obtained using a 3.0T scanner to extract the mean amplitude of low-frequency fluctuations,mean regional homogeneity,and degree centrality.Neurological and clinical characteristics were also evaluated.We used the least absolute shrinkage and selection operator algorithm to extract features and established feedforward neural network models based solely on resting-state functional magnetic resonance imaging indicators.We then performed predictive analysis of three distinct groups based on resting-state functional magnetic resonance imaging indicators indicators combined with clinical features.Subsequently,we conducted 100 additional five-fold cross-validations to determine the most effective model for each classification task and evaluated the performance of the model using the area under the receiver operating characteristic curve.The results showed that when differentiating patients with Parkinson's disease who had freezing of gait from those who did not have freezing of gait,or from healthy controls,the models using only the mean regional homogeneity values achieved the highest area under the receiver operating characteristic curve values of 0.750(with an accuracy of 70.9%)and 0.759(with an accuracy of 65.3%),respectively.When classifying patients with Parkinson's disease who had freezing of gait from those who had no freezing of gait,the model using the mean amplitude of low-frequency fluctuation values combined with two clinical features achieved the highest area under the receiver operating characteristic curve of 0.847(with an accuracy of 74.3%).The most significant features for patients with Parkinson's disease who had freezing of gait were amplitude of low-frequency fluctuation alterations in the left parahippocampal gyrus and two clinical characteristics:Montreal Cognitive Assessment and Hamilton Depression Scale scores.Our findings suggest that radiomics features derived from resting-state functional magnetic resonance imaging indices and clinical information can serve as valuable indices for the identification of freezing of gait in Parkinson's disease.展开更多
The enhancement of mobility has always been a research focus in the field of thin-film transistors(TFTs).In this paper,we report a method using ultra-thin HfO2to improve the electrical performance of indium gallium zi...The enhancement of mobility has always been a research focus in the field of thin-film transistors(TFTs).In this paper,we report a method using ultra-thin HfO2to improve the electrical performance of indium gallium zinc oxide(IGZO)TFTs.HfO2not only repairs the surface morphology of the active layer,but also increases the carrier concentration.When the thickness of the HfO_(2) film was 3 nm,the mobility of the device was doubled(14.9 cm^(2)·V^(-1)·s^(-1)→29.6 cm^(2)·V^(-1)·s^(-1)),and the device exhibited excellent logic device performance.This paper provides a simple and effective method to enhance the electrical performance of IGZO TFTs,offering new ideas and experimental foundation for research into high-performance metal oxide(MO)TFTs.展开更多
As a key mode of transportation, urban metro networks have significantly enhanced urban traffic environments and travel efficiency, making the identification of critical stations within these networks increasingly ess...As a key mode of transportation, urban metro networks have significantly enhanced urban traffic environments and travel efficiency, making the identification of critical stations within these networks increasingly essential. This study presents a novel integrated topological-functional(ITF) algorithm for identifying critical nodes, combining topological metrics such as K-shell decomposition, node information entropy, and neighbor overlapping interaction with the functional attributes of passenger flow operations, while also considering the coupling effects between metro and bus networks. Using the Chengdu metro network as a case study, the effectiveness of the algorithm under different conditions is validated.The results indicate significant differences in passenger flow patterns between working and non-working days, leading to varying sets of critical nodes across these scenarios. Moreover, the ITF algorithm demonstrates a marked improvement in the accuracy of critical node identification compared to existing methods. This conclusion is supported by the analysis of changes in the overall network structure and relative global operational efficiency following targeted attacks on the identified critical nodes. The findings provide valuable insight into urban transportation planning, offering theoretical and practical guidance for improving metro network safety and resilience.展开更多
Land use change is a fundamental factor affecting ecosystem’s structures and functions.However,few studies have explored the ecological disturbance caused by land use change from a combined structural and functional ...Land use change is a fundamental factor affecting ecosystem’s structures and functions.However,few studies have explored the ecological disturbance caused by land use change from a combined structural and functional perspective.In this study,the ecological structural disturbance index(SDI)and functional disturbance index(FDI)were introduced to quantitatively evaluate ecological disturbance caused by land use change in a typical karst area—Huangping County,Guizhou Province,China during 2009–2019.Results show that although the area of ecological land increased during past 10 yr,there had been a fragmentation trend of ecological land.Agricultural occupation was more severe than construction encroachment on ecological land.The grids with negative structural disturbance were consistent with areas of obvious dynamic loss and gain of ecological land.Ecological fragmentation had a greater impact than habitat gain in grids with negative structural disturbance.The ecosystem service functions of supply,adjustment,support,and culture were obviously affected by land use change,and the total FDI reflects the trade-off among them.Negative FDI values were easily observed in the rocky desertification area or water and soil loss area.The combination analysis of the SDI and FDI indicated the characteristic of codirectional ecologically structural and functional disturbance in the majority of grids.The findings improve our understanding of multiple relationships among ecological disturbances and provide valuable information for guiding land use activities.展开更多
AIM:To assess the visual electrophysiological outcomes in children with functional amblyopia who exhibited poor response to conventional treatment.METHODS:Twenty-one children with functional amblyopia,aged 5.7±2....AIM:To assess the visual electrophysiological outcomes in children with functional amblyopia who exhibited poor response to conventional treatment.METHODS:Twenty-one children with functional amblyopia,aged 5.7±2.1y(range:4-10y),underwent comprehensive ophthalmic and refractive evaluations.Spectral domain-optical coherence tomography(SD-OCT)and multifocal electroretinography(mfERG)were conducted to analyze the macular retinal thickness and the first-order response P1 ring of the mfERG in the amblyopic eye(AE)compared to the fellow good eye(GE).RESULTS:Initially,visual acuity in the AE ranged from 20/800 to 20/40,while the GE exhibited a range of 20/25 to 20/20(P<0.01).After 6mo of treatment,17 patients demonstrated improved visual acuity in the AE to 20/50 or better,while 4 children showed no improvement.SD-OCT revealed comparable macular and optic disc structures between the AE and GE.Prior to treatment,the mfERG P1 ring amplitude was significantly reduced in the AE compared to GE(P<0.05).The AE/GE ratio of P1 ring amplitude showed significant improvement post-treatment.However,a smaller AE/GE ratio before treatment was associated with poorer improvement post-treatment.CONCLUSION:In the management of functional amblyopia,a thorough assessment of amblyopic eye examinations is crucial.Approximately 20%of amblyopic eyes may not achieve significant improvement in visual acuity,despite the absence of detectable organic retinal abnormalities.mfERG may reveal underlying abnormalities.Integrating mfERG into initial assessments or treatment follow-ups can aid in identifying potential hidden retinal defects and predicting the prognosis of the amblyopic eye.展开更多
The survival strategy of plants is to adjust their functional traits to adapt to the environment.However,these traits and survival strategies of evergreen broad-leaved forest species are not well understood.This study...The survival strategy of plants is to adjust their functional traits to adapt to the environment.However,these traits and survival strategies of evergreen broad-leaved forest species are not well understood.This study examined 10 leaf functional traits(LFTs)of 70 common plant species in an evergreen broad-leaved forest in Huangshan Mountain to decipher their adaptive strategies.The phylogenetic signals of these LFTs were assessed and phylogenetically independent contrasts(PIC)and correlation analyses were carried out.LFTs were analyzed to determine their CSR(C:competitor,S:stress-tolerator,R:ruderal)strategies.The results show that plant species exhibit different leaf functional traits and ecological strategies(nine strategies were identified;the most abundant were S/CS and S/CSR strategies).Some traits showed significant phylogenetic signals,indicating the effect of phylogeny on LFTs to an extent.Trait variations among species suggest distinct adaptation strategies to environmental changes.The study species were mainly clustered on the C-S strategy axis,with a high S component.Species leaning toward the C-strategy end(e.g.,deciduous species),favored a resource acquisition strategy characterized by higher specific leaf area(SLA),greater nutrient contents(N and P),lower leaf dry matter content(LDMC),and reduced nutrient utilization efficiency(C:N and C:P).Conversely,species closer to the S-strategy end(e.g.,evergreen species)usually adopted a resource conservative strategy with trait combinations contrary to those of C-strategy species.Overall,this study corroborated the applicability of the CSR strategy at a local scale and provides insights into the varied trait combinations and ecological strategies employed by plant species to adapt to their environment.These findings contribute to a better understanding of the mechanisms involved in biodiversity maintenance.展开更多
BACKGROUND Functional neurological disorder(FND)in children is a complex and multifaceted condition characterized by neurological symptoms that cannot be explained by organic pathology.Despite its prevalence,FND in pe...BACKGROUND Functional neurological disorder(FND)in children is a complex and multifaceted condition characterized by neurological symptoms that cannot be explained by organic pathology.Despite its prevalence,FND in pediatric populations remains under-researched,with challenges in diagnosis and management AIM To synthesize the current literature on FND in children,focusing on clinical presentation,diagnostic approaches,treatment strategies,and outcomes.METHODS A comprehensive literature search was conducted across multiple databases,including PubMed,Scopus,and Web of Science,for articles published up to August 2024.Studies were included if they addressed FND in pediatric populations,specifically focusing on review articles,research articles,systematic reviews,meta-analyses,case reports,guidelines,expert opinions,and editorials.Data extraction and quality assessment were performed according to PRISMA guidelines.A total of 308 articles were included in the final analysis.RESULTS The analysis included 189 review articles,57 research articles,3 systematic reviews and meta-analyses,5 case reports,2 guidelines,5 expert opinions,and 2 editorials.Key findings revealed a broad spectrum of symptoms,including motor and sensory disturbances and psychological factors contributing to the onset and persistence of FND.Diagnostic challenges were frequently highlighted,emphasizing the need for interdisciplinary approaches.Treatment strategies varied,with cognitive-behavioral therapy(CBT)and multidisciplinary care emerging as the most effective approaches.The outcomes varied,with early intervention being critical for a better prognosis.CONCLUSION Early diagnosis and multidisciplinary care,including CBT,are critical for improving outcomes in pediatric FND.Standardized diagnostic criteria and treatment protocols are needed to enhance clinical management.展开更多
Schwann cell transplantation is considered one of the most promising cell-based therapy to repair injured spinal cord due to its unique growth-promoting and myelin-forming properties.A the Food and Drug Administration...Schwann cell transplantation is considered one of the most promising cell-based therapy to repair injured spinal cord due to its unique growth-promoting and myelin-forming properties.A the Food and Drug Administration-approved Phase I clinical trial has been conducted to evaluate the safety of transplanted human autologous Schwann cells to treat patients with spinal cord injury.A major challenge for Schwann cell transplantation is that grafted Schwann cells are confined within the lesion cavity,and they do not migrate into the host environment due to the inhibitory barrier formed by injury-induced glial scar,thus limiting axonal reentry into the host spinal cord.Here we introduce a combinatorial strategy by suppressing the inhibitory extracellular environment with injection of lentivirus-mediated transfection of chondroitinase ABC gene at the rostral and caudal borders of the lesion site and simultaneously leveraging the repair capacity of transplanted Schwann cells in adult rats following a mid-thoracic contusive spinal cord injury.We report that when the glial scar was degraded by chondroitinase ABC at the rostral and caudal lesion borders,Schwann cells migrated for considerable distances in both rostral and caudal directions.Such Schwann cell migration led to enhanced axonal regrowth,including the serotonergic and dopaminergic axons originating from supraspinal regions,and promoted recovery of locomotor and urinary bladder functions.Importantly,the Schwann cell survival and axonal regrowth persisted up to 6 months after the injury,even when treatment was delayed for 3 months to mimic chronic spinal cord injury.These findings collectively show promising evidence for a combinatorial strategy with chondroitinase ABC and Schwann cells in promoting remodeling and recovery of function following spinal cord injury.展开更多
基金supported by Deutsche Forschungsgemeinschaft,German Research Foundation grant GA 654/13-2 to OG.
文摘Microglia,the resident immune cells of the central nervous system,exhibit a wide array of functional states,even in their so-called“homeostatic”condition,when they are not actively responding to overt pathological stimuli.These functional states can be visualized using a combination of multi-omics techniques(e.g.,gene and protein expression,posttranslational modifications,mRNA profiling,and metabolomics),and,in the case of homeostatic microglia,are largely defined by the global(e.g.,genetic variations,organism’s age,sex,circadian rhythms,and gut microbiota)as well as local(specific area of the brain,immediate microglial surrounding,neuron-glia interactions and synaptic density/activity)signals(Paolicelli et al.,2022).While phenomics(i.e.,ultrastructural microglial morphology and motility)is also one of the key microglial state-defining parameters,it is known that cells with similar morphology can belong to different functional states.
基金supported by the National Natural Science Foundation of China,Nos.82072165 and 82272256(both to XM)the Key Project of Xiangyang Central Hospital,No.2023YZ03(to RM)。
文摘Spinal cord injury represents a severe form of central nervous system trauma for which effective treatments remain limited.Microglia is the resident immune cells of the central nervous system,play a critical role in spinal cord injury.Previous studies have shown that microglia can promote neuronal survival by phagocytosing dead cells and debris and by releasing neuroprotective and anti-inflammatory factors.However,excessive activation of microglia can lead to persistent inflammation and contribute to the formation of glial scars,which hinder axonal regeneration.Despite this,the precise role and mechanisms of microglia during the acute phase of spinal cord injury remain controversial and poorly understood.To elucidate the role of microglia in spinal cord injury,we employed the colony-stimulating factor 1 receptor inhibitor PLX5622 to deplete microglia.We observed that sustained depletion of microglia resulted in an expansion of the lesion area,downregulation of brain-derived neurotrophic factor,and impaired functional recovery after spinal cord injury.Next,we generated a transgenic mouse line with conditional overexpression of brain-derived neurotrophic factor specifically in microglia.We found that brain-derived neurotrophic factor overexpression in microglia increased angiogenesis and blood flow following spinal cord injury and facilitated the recovery of hindlimb motor function.Additionally,brain-derived neurotrophic factor overexpression in microglia reduced inflammation and neuronal apoptosis during the acute phase of spinal cord injury.Furthermore,through using specific transgenic mouse lines,TMEM119,and the colony-stimulating factor 1 receptor inhibitor PLX73086,we demonstrated that the neuroprotective effects were predominantly due to brain-derived neurotrophic factor overexpression in microglia rather than macrophages.In conclusion,our findings suggest the critical role of microglia in the formation of protective glial scars.Depleting microglia is detrimental to recovery of spinal cord injury,whereas targeting brain-derived neurotrophic factor overexpression in microglia represents a promising and novel therapeutic strategy to enhance motor function recovery in patients with spinal cord injury.
基金Supported by The Natural Science Foundation of China,No.82374292the Plans for Major Provincial Science and Technology Projects of Anhui Province,No.202303a07020003the Innovation Team and Talents Cultivation Program of the National Administration of Traditional Chinese Medicine,No.ZYYCXTD-C-202401.
文摘Functional gastrointestinal disorders(FGIDs),including irritable bowel syndrome(IBS),functional dyspepsia(FD),and gastroesophageal reflux disease(GERD),present persistent diagnostic and therapeutic challenges due to symptom heterogeneity and the absence of reliable biomarkers.Artificial intelligence(AI)enables the integration of multimodal data to enhance FGID management through precision diagnostics and preventive healthcare.This minireview summarizes recent advancements in AI applications for FGIDs,highlighting progress in diagnostic accuracy,subtype classification,personalized interventions,and preventive strategies inspired by the traditional Chinese medicine concept of“treating the undiseased”.Machine learning and deep learning algorithms have demonstrated value in improving IBS diagnosis,refining FD neuro-gastrointestinal subtyping,and screening for GERD-related complications.Moreover,AI supports dietary,psychological,and integrative medicine-based interventions to improve patient adherence and quality of life.Nonetheless,key challenges remain,including data heterogeneity,limited model interpretability,and the need for robust clinical validation.Future directions emphasize interdisciplinary collaboration,the development of multimodal and explainable AI models,and the creation of patientcentered platforms to facilitate a shift from reactive treatment to proactive prevention.This review provides a systematic framework to guide the clinical application and theoretical innovation of AI in FGIDs.
基金supported by the National Natural Science Foundation of China,Nos.82071387(to HT),81971172(to YW)the Natural Science Foundation of Zhejiang Province,China,No.LY22H090012(to HT)the Basic Research Project of Wenzhou City,China,No.Y20220923(to MZ)。
文摘The M1/M2 phenotypic shift of microglia after spinal cord injury plays an important role in the regulation of neuroinflammation during the secondary injury phase of spinal cord injury.Regulation of shifting microglia polarization from M1(neurotoxic and proinflammatory type)to M2(neuroprotective and anti-inflammatory type)after spinal cord injury appears to be crucial.Tryptanthrin possesses an anti-inflammatory biological function.However,its roles and the underlying molecular mechanisms in spinal cord injury remain unknown.In this study,we found that tryptanthrin inhibited microglia-derived inflammation by promoting polarization to the M2 phenotype in vitro.Tryptanthrin promoted M2 polarization through inactivating the cGAS/STING/NF-κB pathway.Additionally,we found that targeting the cGAS/STING/NF-κB pathway with tryptanthrin shifted microglia from the M1 to M2 phenotype after spinal cord injury,inhibited neuronal loss,and promoted tissue repair and functional recovery in a mouse model of spinal cord injury.Finally,using a conditional co-culture system,we found that microglia treated with tryptanthrin suppressed endoplasmic reticulum stress-related neuronal apoptosis.Taken together,these results suggest that by targeting the cGAS/STING/NF-κB axis,tryptanthrin attenuates microglia-derived neuroinflammation and promotes functional recovery after spinal cord injury through shifting microglia polarization to the M2 phenotype.
基金Supported by Suzhou Clinical Medical Center for Mood Disorders,No.Szlcyxzx202109Suzhou Key Laboratory,No.SZS2024016Multicenter Clinical Research on Major Diseases in Suzhou,No.DZXYJ202413.
文摘BACKGROUND Suicide constitutes the second leading cause of death among adolescents globally and represents a critical public health concern.The neural mechanisms underlying suicidal behavior in adolescents with major depressive disorder(MDD)remain poorly understood.Aberrant resting-state functional connectivity(rsFC)in the amygdala,a key region implicated in emotional regulation and threat detection,is strongly implicated in depression and suicidal behavior.AIM To investigate rsFC alterations between amygdala subregions and whole-brain networks in adolescent patients with depression and suicide attempts.METHODS Resting-state functional magnetic resonance imaging data were acquired from 32 adolescents with MDD and suicide attempts(sMDD)group,33 adolescents with MDD but without suicide attempts(nsMDD)group,and 34 demographically matched healthy control(HC)group,with the lateral and medial amygdala(MeA)defined as regions of interest.The rsFC patterns of amygdala subregions were compared across the three groups,and associations between aberrant rsFC values and clinical symptom severity scores were examined.RESULTS Compared with the nsMDD group,the sMDD group exhibited reduced rsFC between the right lateral amygdala(LA)and the right inferior occipital gyrus as well as the left middle occipital gyrus.Compared with the HC group,the abnormal brain regions of rsFC in the sMDD group and nsMDD group involve the parahippocampal gyrus(PHG)and fusiform gyrus.In the sMDD group,right MeA and right temporal pole:Superior temporal gyrus rsFC value negatively correlated with the Rosenberg Self-Esteem Scale scores(r=-0.409,P=0.025),while left LA and right PHG rsFC value positively correlated with the Adolescent Self-Rating Life Events Checklist interpersonal relationship scores(r=0.372,P=0.043).CONCLUSION Aberrant rsFC changes between amygdala subregions and these brain regions provide novel insights into the underlying neural mechanisms of suicide attempts in adolescents with MDD.
文摘Spinal cord injury(SCI) often results in permanent dysfunction of locomotion,sensation,and autonomic regulation,imposing a substantial burden on both individuals and society(Anjum et al.,2020).SCI has a complex pathophysiology:an initial primary injury(mechanical trauma,axonal disruption,and hemorrhage) is followed by a progressive secondary injury cascade that involves ischemia,neuronal loss,and inflammation.Given the challenges in achieving regeneration of the injured spinal cord,neuroprotection has been at the forefront of clinical research.
文摘Exogenous neural stem cell transplantation has become one of the most promising treatment methods for chronic stroke.Recent studies have shown that most ischemia-reperfusion model rats recover spontaneously after injury,which limits the ability to observe long-term behavioral recovery.Here,we used a severe stroke rat model with 150 minutes of ischemia,which produced severe behavioral deficiencies that persisted at 12 weeks,to study the therapeutic effect of neural stem cells on neural restoration in chronic stroke.Our study showed that stroke model rats treated with human neural stem cells had long-term sustained recovery of motor function,reduced infarction volume,long-term human neural stem cell survival,and improved local inflammatory environment and angiogenesis.We also demonstrated that transplanted human neural stem cells differentiated into mature neurons in vivo,formed stable functional synaptic connections with host neurons,and exhibited the electrophysiological properties of functional mature neurons,indicating that they replaced the damaged host neurons.The findings showed that human fetal-derived neural stem cells had long-term effects for neurological recovery in a model of severe stroke,which suggests that human neural stem cells-based therapy may be effective for repairing damaged neural circuits in stroke patients.
文摘BACKGROUND Functional gastrointestinal disorders(FGIDs)in children present with chronic symptoms like abdominal pain,diarrhea,and constipation without identifiable structural abnormalities.These disorders are closely linked to gut-brain axis dysfunction,altered gut microbiota,and psychosocial stress,leading to psychia-tric comorbidities such as anxiety,depression,and behavioral issues.Under-standing this bidirectional relationship is crucial for developing effective,holistic management strategies that address physical and mental health.AIM To examine the psychiatric impacts of FGIDs in children,focusing on anxiety and depression and their association with other neurodevelopmental disorders of childhood,such as attention-deficit/hyperactivity disorder,emphasizing the role of the gut-brain axis,emotional dysregulation,and psychosocial stress.Key mechanisms explored include neurotransmitter dysregulation,microbiota imbalance,central sensitization,heightening stress reactivity,emotional dysregulation,and symptom perception.The review also evaluates the role of family dynamics and coping strategies in exacerbating FGID symptoms and contributing to psychiatric conditions.METHODS A narrative review was conducted using 328 studies sourced from PubMed,Scopus,and Google Scholar,covering research published over the past 20 years.Inclusion criteria focused on studies examining FGID diagnosis,gut-brain mechanisms,psychiatric comorbidities,and psychosocial factors in pediatric populations.FGIDs commonly affecting children,including functional constipation,abdominal pain,irritable bowel syndrome,gastroesophageal reflux,and cyclic vomiting syndrome,were analyzed concerning their psychological impacts.RESULTS The review highlights a strong connection between FGIDs and psychiatric symptoms,mediated by gut-brain axis dysfunction,dysregulated microbiota,and central sensitization.These physiological disruptions increase children’s vulnerability to anxiety and depression,while psychosocial factors-such as chronic stress,early-life trauma,maladaptive family dynamics,and ineffective coping strategies-intensify the cycle of gastrointestinal and emotional distress.CONCLUSION Effective management of FGIDs requires a biopsychosocial approach integrating medical,psychological,and dietary interventions.Parental education,early intervention,and multidisciplinary care coordination are critical in mitigating long-term psychological impacts and improving both gastrointestinal and mental health outcomes in children with FGIDs.
文摘Invasive as well as non-invasive neurotechnologies conceptualized to interface the central and peripheral nervous system have been probed for the past decades,which refer to electroencephalography,electrocorticography and microelectrode arrays.The challenges of these mentioned approaches are characterized by the bandwidth of the spatiotemporal resolution,which in turn is essential for large-area neuron recordings(Abiri et al.,2019).
文摘In the words of the late Sir Colin Blakemore,neurologists have historically sought to infer brain functions in a manner akin to to king a hammer to a computeranalyzing localized anatomical lesions caused by trauma,tumors,or strokes,noting deficits,and inferring what functions certain brain regions may be responsible for.This approach exemplifies a deletion heuristic,where the absence of a specific function reveals insights about the underlying structures or mechanisms responsible for it.By observing what is lost when a particular brain region is damaged,throughout the history of the field,neurologists have pieced together the intricate relationship between anatomy and function.
基金supported by ANR(ANR-21CE16-0008-01)ANR(ANR-21-CE16-0008-02 and ANR-23CE52-0007)+1 种基金UNADEV(A22018CS)(to HN)UNADEV(A22020CS)(to SB)。
文摘The mature central nervous system(CNS,composed of the brain,spinal cord,olfactory and optic nerves)is unable to regenerate spontaneously after an insult,both in the cases of neurodegenerative diseases(for example Alzheimer's or Parkinson's disease)or traumatic injuries(such as spinal cord lesions).In the last 20 years,the field has made significant progress in unlocking axon regrowth.
基金supported by the National Natural Science Foundation of China,No.82371399(to YY)the Natural Science Foundation of Jiangsu Province,No.BK20221206(to YY)+1 种基金the Young Elite Scientists Sponsorship Program of Jiangsu Province,No.TJ-2022-028(to YY)the Scientific Research Program of Wuxi Health Commission,No.Z202302(to LY)。
文摘Spontaneous recovery frequently proves maladaptive or insufficient because the plasticity of the injured adult mammalian central nervous system is limited.This limited plasticity serves as a primary barrier to functional recovery after brain injury.Neuromodulation technologies represent one of the fastest-growing fields in medicine.These techniques utilize electricity,magnetism,sound,and light to restore or optimize brain functions by promoting reorganization or long-term changes that support functional recovery in patients with brain injury.Therefore,this review aims to provide a comprehensive overview of the effects and underlying mechanisms of neuromodulation technologies in supporting motor function recovery after brain injury.Many of these technologies are widely used in clinical practice and show significant improvements in motor function across various types of brain injury.However,studies report negative findings,potentially due to variations in stimulation protocols,differences in observation periods,and the severity of functional impairments among participants across different clinical trials.Additionally,we observed that different neuromodulation techniques share remarkably similar mechanisms,including promoting neuroplasticity,enhancing neurotrophic factor release,improving cerebral blood flow,suppressing neuroinflammation,and providing neuroprotection.Finally,considering the advantages and disadvantages of various neuromodulation techniques,we propose that future development should focus on closed-loop neural circuit stimulation,personalized treatment,interdisciplinary collaboration,and precision stimulation.
基金supported by the National Natural Science Foundation of China,No.82071909(to GF)the Natural Science Foundation of Liaoning Province,No.2023-MS-07(to HL)。
文摘Freezing of gait is a significant and debilitating motor symptom often observed in individuals with Parkinson's disease.Resting-state functional magnetic resonance imaging,along with its multi-level feature indices,has provided a fresh perspective and valuable insight into the study of freezing of gait in Parkinson's disease.It has been revealed that Parkinson's disease is accompanied by widespread irregularities in inherent brain network activity.However,the effective integration of the multi-level indices of resting-state functional magnetic resonance imaging into clinical settings for the diagnosis of freezing of gait in Parkinson's disease remains a challenge.Although previous studies have demonstrated that radiomics can extract optimal features as biomarkers to identify or predict diseases,a knowledge gap still exists in the field of freezing of gait in Parkinson's disease.This cross-sectional study aimed to evaluate the ability of radiomics features based on multi-level indices of resting-state functional magnetic resonance imaging,along with clinical features,to distinguish between Parkinson's disease patients with and without freezing of gait.We recruited 28 patients with Parkinson's disease who had freezing of gait(15 men and 13 women,average age 63 years)and 30 patients with Parkinson's disease who had no freezing of gait(16 men and 14 women,average age 64 years).Magnetic resonance imaging scans were obtained using a 3.0T scanner to extract the mean amplitude of low-frequency fluctuations,mean regional homogeneity,and degree centrality.Neurological and clinical characteristics were also evaluated.We used the least absolute shrinkage and selection operator algorithm to extract features and established feedforward neural network models based solely on resting-state functional magnetic resonance imaging indicators.We then performed predictive analysis of three distinct groups based on resting-state functional magnetic resonance imaging indicators indicators combined with clinical features.Subsequently,we conducted 100 additional five-fold cross-validations to determine the most effective model for each classification task and evaluated the performance of the model using the area under the receiver operating characteristic curve.The results showed that when differentiating patients with Parkinson's disease who had freezing of gait from those who did not have freezing of gait,or from healthy controls,the models using only the mean regional homogeneity values achieved the highest area under the receiver operating characteristic curve values of 0.750(with an accuracy of 70.9%)and 0.759(with an accuracy of 65.3%),respectively.When classifying patients with Parkinson's disease who had freezing of gait from those who had no freezing of gait,the model using the mean amplitude of low-frequency fluctuation values combined with two clinical features achieved the highest area under the receiver operating characteristic curve of 0.847(with an accuracy of 74.3%).The most significant features for patients with Parkinson's disease who had freezing of gait were amplitude of low-frequency fluctuation alterations in the left parahippocampal gyrus and two clinical characteristics:Montreal Cognitive Assessment and Hamilton Depression Scale scores.Our findings suggest that radiomics features derived from resting-state functional magnetic resonance imaging indices and clinical information can serve as valuable indices for the identification of freezing of gait in Parkinson's disease.
基金Project supported by the National Natural Science Foundation of China(Grant No.62441407)the Natural Science Basic Research Program of Shaanxi(Grant No.2024JCYBQN-0631)+1 种基金the Natural Science Foundation of Shaanxi Provincial Department of Education(Grant No.23JK0482)the Shaanxi Province Key R&D Program General Project-Industrial Field(Grant No.2024GX-YBXM-085)。
文摘The enhancement of mobility has always been a research focus in the field of thin-film transistors(TFTs).In this paper,we report a method using ultra-thin HfO2to improve the electrical performance of indium gallium zinc oxide(IGZO)TFTs.HfO2not only repairs the surface morphology of the active layer,but also increases the carrier concentration.When the thickness of the HfO_(2) film was 3 nm,the mobility of the device was doubled(14.9 cm^(2)·V^(-1)·s^(-1)→29.6 cm^(2)·V^(-1)·s^(-1)),and the device exhibited excellent logic device performance.This paper provides a simple and effective method to enhance the electrical performance of IGZO TFTs,offering new ideas and experimental foundation for research into high-performance metal oxide(MO)TFTs.
基金Project supported by the National Natural Science Foundation of China (Grant No. 71971150)the Project of Research Center for System Sciences and Enterprise Development (Grant No. Xq16B05)the Fundamental Research Funds for the Central Universities of China (Grant No. SXYPY202313)。
文摘As a key mode of transportation, urban metro networks have significantly enhanced urban traffic environments and travel efficiency, making the identification of critical stations within these networks increasingly essential. This study presents a novel integrated topological-functional(ITF) algorithm for identifying critical nodes, combining topological metrics such as K-shell decomposition, node information entropy, and neighbor overlapping interaction with the functional attributes of passenger flow operations, while also considering the coupling effects between metro and bus networks. Using the Chengdu metro network as a case study, the effectiveness of the algorithm under different conditions is validated.The results indicate significant differences in passenger flow patterns between working and non-working days, leading to varying sets of critical nodes across these scenarios. Moreover, the ITF algorithm demonstrates a marked improvement in the accuracy of critical node identification compared to existing methods. This conclusion is supported by the analysis of changes in the overall network structure and relative global operational efficiency following targeted attacks on the identified critical nodes. The findings provide valuable insight into urban transportation planning, offering theoretical and practical guidance for improving metro network safety and resilience.
基金Under the auspices of the National Natural Science Foundation of China(No.41661088,32101593,42361028)Science and Technology Program of Guizhou Province(No.Qiankehe Zhongyindi[2023]005)+1 种基金2024 Humanities and Social Science Research Project of Guizhou Provincial Department of Education(No.24RWZX007)Graduate Research Fund Project of Guizhou Province(No.2024YJSKYJJ153)。
文摘Land use change is a fundamental factor affecting ecosystem’s structures and functions.However,few studies have explored the ecological disturbance caused by land use change from a combined structural and functional perspective.In this study,the ecological structural disturbance index(SDI)and functional disturbance index(FDI)were introduced to quantitatively evaluate ecological disturbance caused by land use change in a typical karst area—Huangping County,Guizhou Province,China during 2009–2019.Results show that although the area of ecological land increased during past 10 yr,there had been a fragmentation trend of ecological land.Agricultural occupation was more severe than construction encroachment on ecological land.The grids with negative structural disturbance were consistent with areas of obvious dynamic loss and gain of ecological land.Ecological fragmentation had a greater impact than habitat gain in grids with negative structural disturbance.The ecosystem service functions of supply,adjustment,support,and culture were obviously affected by land use change,and the total FDI reflects the trade-off among them.Negative FDI values were easily observed in the rocky desertification area or water and soil loss area.The combination analysis of the SDI and FDI indicated the characteristic of codirectional ecologically structural and functional disturbance in the majority of grids.The findings improve our understanding of multiple relationships among ecological disturbances and provide valuable information for guiding land use activities.
基金Supported by the National Natural Science Foundation of China(No.82271100)the Jiangsu Science and Technology Support Program(No.BE2022805)the Clinical Skills Enhancement Program of Jiangsu Province Hospital(No.JSPH-MC-2022-24).
文摘AIM:To assess the visual electrophysiological outcomes in children with functional amblyopia who exhibited poor response to conventional treatment.METHODS:Twenty-one children with functional amblyopia,aged 5.7±2.1y(range:4-10y),underwent comprehensive ophthalmic and refractive evaluations.Spectral domain-optical coherence tomography(SD-OCT)and multifocal electroretinography(mfERG)were conducted to analyze the macular retinal thickness and the first-order response P1 ring of the mfERG in the amblyopic eye(AE)compared to the fellow good eye(GE).RESULTS:Initially,visual acuity in the AE ranged from 20/800 to 20/40,while the GE exhibited a range of 20/25 to 20/20(P<0.01).After 6mo of treatment,17 patients demonstrated improved visual acuity in the AE to 20/50 or better,while 4 children showed no improvement.SD-OCT revealed comparable macular and optic disc structures between the AE and GE.Prior to treatment,the mfERG P1 ring amplitude was significantly reduced in the AE compared to GE(P<0.05).The AE/GE ratio of P1 ring amplitude showed significant improvement post-treatment.However,a smaller AE/GE ratio before treatment was associated with poorer improvement post-treatment.CONCLUSION:In the management of functional amblyopia,a thorough assessment of amblyopic eye examinations is crucial.Approximately 20%of amblyopic eyes may not achieve significant improvement in visual acuity,despite the absence of detectable organic retinal abnormalities.mfERG may reveal underlying abnormalities.Integrating mfERG into initial assessments or treatment follow-ups can aid in identifying potential hidden retinal defects and predicting the prognosis of the amblyopic eye.
基金supported by the Special Foundation for National Science and Technology Basic Resources Investigation of China(2019FY202300)the Biodiversity Survey,Observation and Assessment Project of the Ministry of Ecology and Environment(2110404).
文摘The survival strategy of plants is to adjust their functional traits to adapt to the environment.However,these traits and survival strategies of evergreen broad-leaved forest species are not well understood.This study examined 10 leaf functional traits(LFTs)of 70 common plant species in an evergreen broad-leaved forest in Huangshan Mountain to decipher their adaptive strategies.The phylogenetic signals of these LFTs were assessed and phylogenetically independent contrasts(PIC)and correlation analyses were carried out.LFTs were analyzed to determine their CSR(C:competitor,S:stress-tolerator,R:ruderal)strategies.The results show that plant species exhibit different leaf functional traits and ecological strategies(nine strategies were identified;the most abundant were S/CS and S/CSR strategies).Some traits showed significant phylogenetic signals,indicating the effect of phylogeny on LFTs to an extent.Trait variations among species suggest distinct adaptation strategies to environmental changes.The study species were mainly clustered on the C-S strategy axis,with a high S component.Species leaning toward the C-strategy end(e.g.,deciduous species),favored a resource acquisition strategy characterized by higher specific leaf area(SLA),greater nutrient contents(N and P),lower leaf dry matter content(LDMC),and reduced nutrient utilization efficiency(C:N and C:P).Conversely,species closer to the S-strategy end(e.g.,evergreen species)usually adopted a resource conservative strategy with trait combinations contrary to those of C-strategy species.Overall,this study corroborated the applicability of the CSR strategy at a local scale and provides insights into the varied trait combinations and ecological strategies employed by plant species to adapt to their environment.These findings contribute to a better understanding of the mechanisms involved in biodiversity maintenance.
文摘BACKGROUND Functional neurological disorder(FND)in children is a complex and multifaceted condition characterized by neurological symptoms that cannot be explained by organic pathology.Despite its prevalence,FND in pediatric populations remains under-researched,with challenges in diagnosis and management AIM To synthesize the current literature on FND in children,focusing on clinical presentation,diagnostic approaches,treatment strategies,and outcomes.METHODS A comprehensive literature search was conducted across multiple databases,including PubMed,Scopus,and Web of Science,for articles published up to August 2024.Studies were included if they addressed FND in pediatric populations,specifically focusing on review articles,research articles,systematic reviews,meta-analyses,case reports,guidelines,expert opinions,and editorials.Data extraction and quality assessment were performed according to PRISMA guidelines.A total of 308 articles were included in the final analysis.RESULTS The analysis included 189 review articles,57 research articles,3 systematic reviews and meta-analyses,5 case reports,2 guidelines,5 expert opinions,and 2 editorials.Key findings revealed a broad spectrum of symptoms,including motor and sensory disturbances and psychological factors contributing to the onset and persistence of FND.Diagnostic challenges were frequently highlighted,emphasizing the need for interdisciplinary approaches.Treatment strategies varied,with cognitive-behavioral therapy(CBT)and multidisciplinary care emerging as the most effective approaches.The outcomes varied,with early intervention being critical for a better prognosis.CONCLUSION Early diagnosis and multidisciplinary care,including CBT,are critical for improving outcomes in pediatric FND.Standardized diagnostic criteria and treatment protocols are needed to enhance clinical management.
基金supported in part by NIH R01 NS100531,R01 NS103481NIH R21NS130241(to LD)+3 种基金Merit Review Award I01 BX002356,I01 BX003705 from the U.S.Department of Veterans AffairsIndiana Spinal Cord and Brain Injury Research Foundation(No.19919)Mari Hulman George Endowment Funds(to XMX)Indiana Spinal Cord&Brain Injury Research Fund from ISDH(to NKL and LD)。
文摘Schwann cell transplantation is considered one of the most promising cell-based therapy to repair injured spinal cord due to its unique growth-promoting and myelin-forming properties.A the Food and Drug Administration-approved Phase I clinical trial has been conducted to evaluate the safety of transplanted human autologous Schwann cells to treat patients with spinal cord injury.A major challenge for Schwann cell transplantation is that grafted Schwann cells are confined within the lesion cavity,and they do not migrate into the host environment due to the inhibitory barrier formed by injury-induced glial scar,thus limiting axonal reentry into the host spinal cord.Here we introduce a combinatorial strategy by suppressing the inhibitory extracellular environment with injection of lentivirus-mediated transfection of chondroitinase ABC gene at the rostral and caudal borders of the lesion site and simultaneously leveraging the repair capacity of transplanted Schwann cells in adult rats following a mid-thoracic contusive spinal cord injury.We report that when the glial scar was degraded by chondroitinase ABC at the rostral and caudal lesion borders,Schwann cells migrated for considerable distances in both rostral and caudal directions.Such Schwann cell migration led to enhanced axonal regrowth,including the serotonergic and dopaminergic axons originating from supraspinal regions,and promoted recovery of locomotor and urinary bladder functions.Importantly,the Schwann cell survival and axonal regrowth persisted up to 6 months after the injury,even when treatment was delayed for 3 months to mimic chronic spinal cord injury.These findings collectively show promising evidence for a combinatorial strategy with chondroitinase ABC and Schwann cells in promoting remodeling and recovery of function following spinal cord injury.