PURPOSE: Auditory nerve injury is one of the most common nerve injury complications of skull base fractures. However, there is currently a lack of auxiliary examination methods for its direct diagnosis. The purpose of this study was to find a more efficient and accurate means of diagnosis for auditory nerve injury. METHODS: Through retrospectively analyzing the results of brainstem auditory evoked potential (BAEP) and high-resolution CT (HRCT) in 37 patients with hearing impairment following trauma from January 1, 2018 to July 31, 2020, the role of the two inspection methods in the diagnosis of auditory nerve injury was studied. Inclusion criteria were patient had a clear history of trauma and unilateral hearing impairment after trauma; while exclusion criteria were: (1) severe patient with a Glasgow coma scale score ≤5 because these patients were classified as severe head injury and admitted to the intensive care unit, (2) patient in the subacute stage admitted 72 h after trauma, and (3) patient with prior hearing impairment before trauma. According to Goodman's classification of hearing impairment, the patients were divided into low/medium/severe injury groups. In addition, patients were divided into HRCT-positive and negative groups for further investigation with their BAEP results. The positive rates of BEAP for each group were observed, and the results were analyzed by Chi-square test (p < 0.05, regarded as statistical difference). RESULTS: A total of 37 patients were included, including 21 males and 16 females. All of them were hospitalized patients with GCS score of 6-15 at the time of admission. The BAEP positive rate in the medium and severe injury group was 100%, which was significantly higher than that in the low injury group (27.27%) (p < 0.01). The rate of BEAP positivity was significantly higher in the HRCT-positive group (20/30, 66.7%) than in the HRCT-negative group (1/7, 14.3%) (p < 0.05). Twenty patients (54.05%) were both positive for BEAP and HRCT test, and considered to have auditory nerve damage. Six patients (16.22%) were both negative for BEAP and HRCT test, and 10 patients (27.03%) were BAEP-negative but HRCT-positive: all the 16 patients were considered as non-neurological injury. The rest 1 case (2.70%) was BAEP-positive but HRCT-negative, which we speculate may have auditory nerve concussion. CONCLUSION By way of BAEP combining with skull base HRCT, we may improve the accuracy of the diagnosis of auditory nerve injury. Such a diagnostic strategy may be beneficial to guiding treatment plans and evaluating prognosis.
Cochlear Nerve ; Evoked Potentials, Auditory, Brain Stem/physiology* ; Female ; Hearing Loss ; Humans ; Male ; Retrospective Studies ; Skull Base/diagnostic imaging* ; Tomography, X-Ray Computed

OBJECTIVETo explore the functions of phospholipase C (PLC)-independent protein kinase C signaling pathway (PTH/nonPLC/PKC) of parathyroid hormone (PTH) and its role in bone metabolism.

METHODSOsteoblasts isolated from the calvaria of 2- or 3-day-old C57BL mice, identified by alkaline phosphatase staining and Alizarin red staining, were treated for 4 h with 100 nmol/L [Gly(1), Arg(19)]hPTH(1-28) plus 10 nmol/L RP-cAMP, 10 nmol/L [Gly(1), Arg(19)]hPTH(1-34) plus 10 nmol/L RP-cAMP , 10 nmol/L PTH(1-34), or and 0.1% trifluoroacetic acid (TFA). The total RNA was then isolated for screening differentially expressed genes related to PTH/nonPLC/PKC pathway using Affymetrix mouse 12x135K gene expression profile microarray, and the identified genes were confirmed by real-time quantitative PCR. MC3T3-E1 cells treated with [Gly(1), Arg(19)]hPTH(1-28)+RP-cAMP, [Gly(1), Arg(19)]hPTH(1-34)+RP-cAMP, [Gly(1), Arg(19)]hPTH(1-34)+ RP-cAMP +100 nmol/L Go6983, or 0.1% TFA were also examined for GR(1-28)- or GR(1-34)-mediated gene expression changes using real-time quantitative PCR.

RESULTSAlizarin red staining visualized red mineralized nodules in the osteoblasts at 28 days of culture. According to the genechip results, we selected 56 target genes related to PTH/nonPLC/PKC pathway, among which CITED1 showed higher expressions in [Gly(1), Arg(19)]hPTH(1-34)+ RP-cAMP group than in both the control group and [Gly(1), Arg(19)]hPTH(1-28)+RP-cAMP group (P<0.05), and its expression was the highest in PTH(1-34) group (P<0.05). RT-PCR of MC3T3-E1 cells yielded consist results with those in the primary osteoblasts, and the cells treated with Go6983 (a PKC inhibitor) did not show GR(1-28)- or GR(1-34)-mediated differential expression of CITED1.

CONCLUSIONThe activation of PLC-independent protein kinase C signaling pathway of PTH enhances the expression of CITED1 in mouse osteoblasts to mediate the effect of PTH on bone metabolism, and this pathway is not dependent on the activation of PLC or PKA signaling.

Animals ; Cells, Cultured ; Indoles ; Maleimides ; Mice ; Mice, Inbred C57BL ; Nuclear Proteins ; physiology ; Osteoblasts ; physiology ; Parathyroid Hormone ; physiology ; Protein Kinase C ; physiology ; Signal Transduction ; Skull ; Trans-Activators ; physiology ; Type C Phospholipases

BACKGROUND: Prenatal tongue development may affect oral-craniofacial structures, but this muscular organ has rarely been investigated. METHODS: In order to document the physiology of prenatal tongue growth, we histologically examined the facial and cranial base structures of 56 embryos and 106 fetuses. RESULTS: In Streeter's stages 13-14 (fertilization age [FA], 28 to 32 days), the tongue protruded into the stomodeal cavity from the retrohyoid space to the cartilaginous mesenchyme of the primitive cranial base, and in Streeter's stage 15 (FA, 33 to 36 days), the tongue rapidly swelled and compressed the cranial base to initiate spheno-occipital synchondrosis and continued to swell laterally to occupy most of the stomodeal cavity in Streeter's stage 16-17 (FA, 37 to 43 days). In Streeter's stage 18-20 (FA, 44 to 51 days), the tongue was vertically positioned and filled the posterior nasopharyngeal space. As the growth of the mandible and maxilla advanced, the tongue was pulled down and protruded anteriorly to form the linguomandibular complex. Angulation between the anterior cranial base (ACB) and the posterior cranial base (PCB) was formed by the emerging tongue at FA 4 weeks and became constant at approximately 124degrees-126degrees from FA 6 weeks until birth, which was consistent with angulations measured on adult cephalograms. CONCLUSIONS: The early clockwise growth of the ACB to the maxillary plane became harmonious with the counter-clockwise growth of the PCB to the tongue axis during the early prenatal period. These observations suggest that human embryonic tongue growth affects ACB and PCB angulation, stimulates maxillary growth, and induces mandibular movement to achieve the essential functions of oral and maxillofacial structures.
Adult ; Axis, Cervical Vertebra ; Embryonic Structures* ; Fetus* ; Humans ; Mandible ; Maxilla ; Mesoderm ; Parturition ; Physiology ; Skull Base ; Tongue*

Biomechanical Phenomena ; Bone Substitutes ; therapeutic use ; Child ; Facial Bones ; physiology ; Fracture Fixation, Internal ; Fracture Healing ; Humans ; Skull ; physiology ; Skull Fractures ; therapy ; Stress, Mechanical

This paper is focused on head modeling using the sophisticated realistic finite element method (FEM) with five-layer tissues based on segmented data. First, the location of every pixel of the FEM head model was fixed on according to the registration method based on the magnetic resonance imaging (MRI) and computer tomography (CT) images. Then the location information was rebuilt with the hexahedron pattern in the ANSYS FEM software. Finally, the forward problem numerical computation was performed on this FEM head model. The simulation results verified the rationality and reliability of the model applied on the electroencephalograph (EEG)/magnetoencephalograph (MEG) study. The hexahedron meshing realistic head model combined with the MRI scanner information has potential in the future research of EEG/MEG.
Brain ; diagnostic imaging ; physiology ; Electroencephalography ; methods ; Finite Element Analysis ; Humans ; Imaging, Three-Dimensional ; methods ; Magnetic Resonance Imaging ; methods ; Models, Biological ; Skull ; diagnostic imaging ; physiology ; Tomography, X-Ray Computed ; methods

OBJECTIVE: To establish a human 3D finite element skull model, and to explore its value in biomechanics analysis. METHODS: The cadaveric head was scanned and then 3D skull model was created using Mimics software based on 2D CT axial images. The 3D skull model was optimized by preprocessor along with creation of the surface and volume meshes. The stress changes, after the head was struck by an object or the head hit the ground directly, were analyzed using ANSYS software. RESULTS: The original 3D skull model showed a large number of triangles with a poor quality and high similarity with the real head, while the optimized model showed high quality surface and volume meshes with a small number of triangles comparatively. The model could show the local and global stress changes effectively. CONCLUSION The human 3D skull model can be established using MSCT and Mimics software and provides a good finite element model for biomechanics analysis. This model may also provide a base for the study of head stress changes following different forces.
Biomechanical Phenomena ; Cadaver ; Computer Simulation ; Finite Element Analysis ; Forensic Medicine/methods* ; Humans ; Imaging, Three-Dimensional/methods* ; Male ; Models, Anatomic ; Skull/physiology* ; Software ; Stress, Mechanical ; Tomography, Spiral Computed/methods*

The degradable performance and bio-mineralization function of PLA-PEG-PLA/PLA tissue engineering scaffolds in vitro and in vivo were systematically studied. The X-ray diffraction and Fourier transform infrared spectra showed that there was the deposition of bone-like carbonate hydroxyapatite on the surface of scaffolds. We found that the weight of scaffolds did not always decrease with the prolongation of time in vitro. At the same time, we found that after the PLA-PEG-PLA/PLA tissue engineering scaffolds were embedded in skulls of rhesus monkeys, the new bone area reached 75% at the 12th week. Histological observation showed that the new bones were rebuilt and knitted bones were formed at the 12th week. These findings meant that the PLA-PEG-PLA/PLA tissue engineering scaffolds were potential in clinical use.
Animals ; Biocompatible Materials ; chemistry ; Bone Regeneration ; Bone Substitutes ; chemistry ; Implants, Experimental ; Macaca mulatta ; Polyethylene Glycols ; chemistry ; Polymers ; chemistry ; Skull ; drug effects ; physiology ; Tissue Engineering ; methods ; Tissue Scaffolds ; chemistry

This is an experimental study in the realm of physiology inquiring about the effect of pulsatile fluid flow shear stress on the proliferation, differentiation and functions of osteoblasts;the objective is to validate the important effect of fluid flow shear stress on the mechanics adaptability of bone tissue. The osteoblasts derived from Wistar rat's calvaria were exposed to fluid shear stress 5, 10, 20 and 30 mN/cm2 for 3, 6, 9, 12, 24, 36h respectively in the flow chamber. The ability of proliferation, alkaline phosphatase (ALP) activity and extracellular calcium secretion of osteoblasts were assessed. The results showed that fluid flow shear stress at 5, and 10 mN/cm2 increased the proliferation, but at 20 and 30 N/cm2, the shear stress inhibited the proliferation. The shear stress at 5, 10, 20 mN/cm2 increased the ALP activity and extracellular calcium secretion of osteoblasts, and advanced the time of the peak value of ALP activity during the experiment period, but the shear stress at 30 mN/cm2 decreased ALP activity. So osteoblasts responded rapidly to shear stress; the proliferation, differentiation and mineralization of cells were regulated in the presence of some shear stress; and such regulation exhibited a pattern of dependence on the mN/cm2 level of shear stress.
Alkaline Phosphatase ; metabolism ; Animals ; Cell Proliferation ; Cells, Cultured ; Mechanotransduction, Cellular ; physiology ; Osteoblasts ; cytology ; enzymology ; Pulsatile Flow ; Rats ; Rats, Wistar ; Shear Strength ; Skull ; cytology ; Stress, Mechanical

This study was aimed to develop nano-hydroxyapatite/type I collagen artificial bone scaffold and investigate its structure, osteogenic ability and biocompatibility in vivo. According to biomimetic and self-organization mechanism, nano-hydroxyapatite/type I collagen artificial bone scaffold was developed with nano-hydroxyapatite and pure type I collagen. General observation, scanning electron microscope, porosity measurement and X-ray diffraction were used to analyze the scaffold. In vivo test, the model of rabbit skull with two defects was created, the scaffold was embedded in one defect, and another defect served as vacuity control. The in vivo study involved 12 rabbits. At 2, 4, 8 and 12 weeks, the rabbits were sacrificed in sequence and specimens were obtained for histological observation. Nano-hydroxyapatite/type I collagen artificial bone scaffold was similar to sponge under microscope, the pore size was 100-300 microm, the average ratio of porosity was 92.6%, and the inner structure was homothetic to the natural bone. No acute or chronic immunologic rejection was observed in vivo. The rabbit skull defect was repaired by nano-hydroxyapatite/type I collagen artificial bone scaffolds completely in 12 weeks. Nano-hydroxyapatite/type I collagen artificial bone scaffold structure was homothetic to natural bone structure, and had excellent osteogenic ability, biocompatibility, osteogenesis and suitable degradation.
Animals ; Bone Substitutes ; Collagen Type I ; chemistry ; Guided Tissue Regeneration ; Humans ; Hydroxyapatites ; chemistry ; Implants, Experimental ; Nanostructures ; chemistry ; Osteogenesis ; drug effects ; physiology ; Rabbits ; Skull ; injuries ; surgery ; Tissue Scaffolds

OBJECTIVEThis study was designed to investigate the optimal combination of known osteogenic biomaterials with shape conforming struts to achieve calvarial vault reconstruction, using a canine model.

METHODSEighteen adolescent beagles were divided equally into 6 groups. A critical size defect of 6 x 2 cm traversed the sagittal suture. The biomaterials used for calvarial reconstruction were demineralised perforated bone matrix (DBM), recombinant human bone morphogenetic protein-2 (rhBMP2) and autogenous platelet-rich plasma (PRP). The struts used were cobalt chrome (metal) or resorbable plate. The groupings were as follows: 1) DBM + metal, 2) DBM + PRP + metal, 3) DBM + PRP + resorbable plate, 4) DBM + rhBMP2 + metal, 5) DBM + rhBMP2 + PRP + metal, and 6) DBM + rhBMP2 + resorbable plate. Animals were euthanised at 3 months post-surgery. There was no mortality or major complications. Analysis was performed macroscopically, histologically, and with computed tomography (CT).

RESULTSThere was complete bony regeneration in the rhBMP2 groups only. Non-rhBMP2 groups had minimal bony ingrowth from the defect edges and on the dural surface, a finding confirmed by CT scan and histology. PRP did not enhance bone regeneration. Shape conformation was good with both metal and resorbable plate.

CONCLUSIONrhBMP2 but not PRP accelerated calvarial regeneration in 3 months. The DBM in the rhBMP2 groups were substituted by new trabecular bone. Shape molding was good with both metal and resorbable plate.

Animals ; Biocompatible Materials ; Bone Morphogenetic Protein 2 ; Bone Morphogenetic Proteins ; pharmacology ; Bone Regeneration ; physiology ; Dogs ; Models, Animal ; Postoperative Care ; Recombinant Proteins ; pharmacology ; Reconstructive Surgical Procedures ; Skull ; growth & development ; pathology ; surgery ; Transforming Growth Factor beta ; pharmacology