The goal of the current study is to describe the transnasal endoscopic anatomy of the cavernous sinus and to provide the surgical approaches to this area.Six silicon-injected adult cadaveric heads (12 sides) were dissected through endoscopic endonasal approach. The cavernous sinus and adjacent structures were exposed; detailed anatomies were demonstrated. High-quality pictures were produced.The cavernous sinus had four walls, namely medial, lateral, posterior and superior walls. Five venous spaces within the sinus were identified by their relation to the carotid artery; those were the medial, lateral, posterosuperior, posteroinferior and anterolateral compartments. Three branches arising from the cavernous segment of internal carotid artery from proximal to distal were meningohypophyseal trunk, inferolateral trunk and McConnell capsular artery. Cavernous sinuses communicated each other by intercavernous sinuses, as well as basilar sinus in middle line, and connected with superior and inferior petrosal sinuses. The third and fourth nerves coursed in superior part of the lateral wall of the cavernous sinus; Meckel's cave located in the posteroinferior part of the lateral wall of the cavernous sinus; V1 sloped to the superior orbital fissure along the lateral wall; the sixth nerve entered the posteroinferior compartment then passed through the internal carotid artery and reached to superior orbital fissure. The approaches to the cavernous sinus included trans-sphenoid-sellar-medial cavernous sinus (medial to the internal carotid artery) and trans-ethmoid-pterygoid-sphenoid-lateral cavernous sinus (lateral to the internal carotid artery). Trans-sphenoid-sellar-medial cavernous sinus approach was able to expose medial compartment and posterosuperior compartment and part of posteroinferior compartment. Trans-ethmoid-pterygoid-sphenoid-lateral cavernous sinus approach was able to expose anteroinferior compartment, lateral cavernous sinus and cranial nerves in lateral wall.An understanding of the complex relationships of the cavernous segment of internal carotid artery and cranial nerves in cavernous sinus is paramount for surgically dealing with the disease involved cavernous sinus and adjacent region.
The extraction of vegetation cover information has significance for watershed resource and environmental quality assessment, management and development, and sustainable development. This paper extracts the vegetation fraction using the 2009 TM image data of the Yiluo River Basin, based on the dimidiate pixel model. Vegetation fraction is divided into five categories from low to high in order to study the spatial variation of vegetation cover situation. The results show that the basin's vegetation cover is good overall, with an average 60%. High value region of vegetation cover is located in Luanchuan, and near Bear Ear Mountain, and the southern of Luonan County. The low value region is located in Song County and the River part of Luoning County. The area of vegetation's fraction is greater than 80%, and accounts for 57% of the entire study area, mainly concentrated in the Luhun reservoir to Luoning County. Less than 20% accounts for less than 5%, and mainly along both sides of the rivers, Luonan County and Luoyang City. The results will provide the basis for regional development and controlling.
Objective To retrospectively investigate the hemodynamic stresses in initiating aneurysm formation on major cerebral arterial bifurcations with computational fluid dynamics (CFD) analysis. Methods The cerebral 3D angiographic data of major cerebral arterial bifurcations of the internal carotid, middle cerebral, anterior cerebral, and basilar arteries in 80 patients harboring bifurcation aneurysms and 80 control subjects with no aneurysms were retrospectively collected for the CFD analysis of hemodynamic stresses associated with aneurysm formation. Results Bifurcation angles at major bifurcations in all patients were significantly positively ( P < 0.001) correlated with the age. At the center of direct flow impingement (CDFI) on the bifurcation wall, total pressure was the highest but dropped rapidly toward the branches. Wall shear stress, dynamic pressure, strain rate, and vorticity were lowest at the CDFI but they increased quickly toward the branches. The bifurcation angle was significantly ( P < 0.001) enlarged in patients with bifurcation aneurysms than those without them, for all major arterial bifurcations. Most aneurysms leaned toward the smaller arterial branch or the arterial branch that formed a smaller angle with the parent artery, where the hemodynamic stresses increased significantly ( P < 0.05), compared with those on the contralateral arterial branch forming a larger angle with the parent artery. Following the aneurysm development, all the hemodynamic stresses on the aneurysm dome decreased significantly ( P < 0.001) compared with those at the initiation site on the bifurcation wall after virtual aneurysm removal. With the decrease of bifurcation angles, all the hemodynamic stresses decreased. Conclusion The formation of intracranial aneurysms on major intracranial arterial bifurcations is significantly associated with locally abnormally augmented hemodynamic stresses, which must be reduced.
Abstract Background The niche of tissue development in vivo involves the growth matrix, biophysical cues and cell-cell interactions. Although natural extracellular matrixes may provide good supporting for seeding cells in vitro, it is evitable to destroy biophysical cues during decellularization. Reconstructing the bioactivities of extracellular matrix-based scaffolds is essential for their usage in tissue repair. Results In the study, a hybrid hydrogel was developed by incorporating single-wall carbon nanotubes (SWCNTs) into heart-derived extracellular matrixes. Interestingly, insoluble SWCNTs were well dispersed in hybrid hydrogel solution via the interaction with extracellular matrix proteins. Importantly, an augmented integrin-dependent niche was reconstructed in the hybrid hydrogel, which could work like biophysical cues to activate integrin-related pathway of seeding cells. As supporting scaffolds in vitro, the hybrid hydrogels were observed to significantly promote seeding cell adhesion, differentiation, as well as structural and functional development towards mature cardiac tissues. As injectable carrier scaffolds in vivo, the hybrid hydrogels were then used to delivery stem cells for myocardial repair in rats. Similarly, significantly enhanced cardiac differentiation and maturation(12.5 ± 2.3% VS 32.8 ± 5%) of stem cells were detected in vivo, resulting in improved myocardial regeneration and repair. Conclusions The study represented a simple and powerful approach for exploring bioactive scaffold to promote stem cell-based tissue repair. Graphic abstract
Reactive oxygen species (ROS), which were largely generated after myocardial ischemia, severely impaired the adhesion and survival of transplanted stem cells. In this study, we aimed to determine whether Exendin-4 pretreatment could improve the adhesion and therapeutic efficacy of transplanted adipose derived stem cells (ADSCs) in ischemic myocardium. In vitro, H2O2 was used to provide ROS environments, in which ADSCs pretreated with Exendin-4 were incubated. ADSCs without pretreatment were used as control. Then, cell adhesion and viability were analyzed with time. Compared with control ADSCs, Exendin-4 treatment significantly increased the adhesion of ADSCs in ROS environment, while reduced intracellular ROS and cell injury as determined by dihydroethidium (DHE) staining live/Dead staining, lactate dehydrogenase-release assay and MTT assay. Western Blotting demonstrated that ROS significantly decreased the expression of adhesion-related integrins and integrin-related focal adhesion proteins, which were significantly reversed by Exendin-4 pretreatment and followed by decreases in caspase-3, indicating that Exendin-4 may facilitate cell survival through enhanced adhesion. In vivo, myocardial infarction (MI) was induced by the left anterior descending artery ligation in SD rats. Autologous ADSCs with or without Exendin-4 pretreatment were injected into the border area of infarcted hearts, respectively. Multi-techniques were used to assess the beneficial effects after transplantation. Longitudinal bioluminescence imaging and histological staining revealed that Exendin-4 pretreatment enhanced the survival and differentiation of engrafted ADSCs in ischemic myocardium, accompanied with significant benefits in cardiac function, matrix remodeling, and angiogenesis compared with non-pretreated ADSCs 4 weeks post-transplantation. In conclusion, transplantation of Exendin-4 pretreated ADSCs significantly improved cardiac performance and can be an innovative approach in the clinical perspective.
Omentin is a novel adipokine, which is expressed in and released from omental adipose tissue. In the present study, the effect of omentin on neural stem cells (NSCs) was investigated. NSCs are a subtype of stem cell in the nervous system, which are able to self‑renew and generate neurons and glia for repairing neural lesions. Mouse NSCs were isolated and cultured in vitro. Treatment with recombinant omentin for 3 and 5 days significantly increased the size of NSC neurospheres (P<0.01) and enhanced NSC cell viability in normal conditions. In addition, omentin protected against the decrease in cell viability induced by the pro‑inflammatory cytokine tumor necrosis factor‑α. In the NSCs, incubation of omentin for 2, 4, 6, 8 and 16 h enhanced the phosphorylation of Akt at the Thr308 site and of AS160 at the Ser318 site, peaking 6 h after treatment. Additionally, treatment with LY294002 (10 µM), a specific inhibitor of phosphatidylinositol 3‑kinase/Akt signaling, eliminated the omentin‑induced increase in neurosphere size and cell viability. Overall, the present study provided the first evidence, to the best of our knowledge, that omentin promotes the growth and survival of NSCs in vitro through activation of the Akt signaling pathway. These results may contribute to the understanding of the role of omentin in the nervous system.
To investigate the surgical therapy of midline skull defect accompanied with frontal sinus injury.11 cases with midline skull defect accompanied with frontal sinus injury were treated. Free temporal fascia was transplanted to close the top of frontal sinus after curettage of the frontal sinus wall. Then titanium prostheses were used to repair the skull defects at the same stage in 10 patients. 1 patient received skull defect repair at the second stage operation.Good results were achieved in 10 cases. The titanium prosthesis had to be taken out in one case due to frontal sinusitis and the anastomosis of frontal sinus and nasal cavity was performed.In patients with midline skull defect accompanied with frontal sinus injury, free temporal fascia could be used to close the top of frontal sinus after curettage of frontal sinus wall. If there is no infection or mild infection in frontal sinus, the skull defect repair could be performed in the same stage. If there is severe frontal sinusitis, the defect repair should be done at the second stage.
Rationale: Adolescent wrist trauma can cause epiphyseal dysplasia and even distal radius deformity malunion. At present, there is no uniform treatment standard for the malunion of the distal radius of adolescents. Osteotomy and autologous bone grafting are currently one of the effective ways to treat the disease. We treated an adolescent patient with distal radius deformity malunion, and used this surgical method to treat the patient and achieved satisfactory results. Patient concerns: A 16-year-old boy suffered from a serious distal radius deformity after trauma of the left wrist 8 years ago. Diagnoses: Physical examination, X-rays examination, high-resolution computed tomography scan, and 3-dimensional reconstruction images of the affected limb helped us diagnose the distal radius fracture malunion. Interventions: The fracture malunion was treated by osteotomy and autologous iliac bone grafting. Outcomes: At the 2-year follow-up, wrist flexion returned to 68°, wrist dorsiflexion to 55°, radial deviation to 14°, ulnar deviation to 12°, forearm pronation to 75°, supination to 67°. Grip strength increased to 35.1 kg after 2 years of operation, recovered to 87% of the uninjured side. Quick DASH score at 2-year follow-up was 9. No complication, such as nonunion or infection, was observed. Lessons: This rare case provides valuable insights for hand surgeons. High-resolution computed tomography scan and 3-dimensional reconstruction can help us effectively diagnose wrist diseases. Small lesions on the articular surface of the distal radius will change the position and function of the wrist joint, and cause traumatic arthritis of the wrist joint. Therefore, it is very important to reconstruct the normal structure of the distal radius articular surface. Osteotomy and autologous iliac bone grafting are effective treatments for serious distal radius fracture malunion in the adolescent patient. During the operation, care should be taken to protect the osteoepiphysis to avoid bone dysplasia.
Polychloro-para-xylylene (parylene-C) is a flexible and transparent polymer material which has excellent chemical stability and high biocompatibility. Here we demonstrate a polymer device based on single-component parylene-C with memory and temperature sensing functionalities. The device shows stable bipolar resistive switching behavior, remarkable storage window (>10⁴), and low operation voltages, exhibiting great potential for flexible resistive random-access memory (RRAM) applications. The I-V curves and conductive atomic force microscopy (CAFM) results verify the metallic filamentary-type switching mechanism based on the formation and dissolution of a metal bridge related to the redox reaction of the active metal electrode. In addition, due to the metallic properties of the low-resistance state (LRS) in the polymer device, the resistance in the LRS exhibits a nearly linear relationship at the temperature regime between 25 °C and 100 °C. With a temperature coefficient of resistance (TCR) of 2.136 × 10-3/°C, the device is also promising for the flexible temperature sensor applications.
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