Traumatic brain injury (TBI) is often secondary to brain dysfunctions such as cognitive, motor, emotional and consciousness disorders, which are characterized by high disability rate, long rehabilitation cycle and limited efficacy of traditional rehabilitation, and have become an urgent problem to be solved in the fields of neurosurgery and rehabilitation medicine. With the rapid iteration of artificial intelligence and neuroengineering technology, brain-computer interface (BCI) can realize real-time decoding and closed-loop interaction of brain functional signals, and neuromodulation technology can accurately target and regulate the excitability of abnormal neural circuits. The combined application of the two breaks the limitations of passive training in traditional rehabilitation and constructs a new rehabilitation system of "neural signal monitoring-precise regulation-active functional remodeling". Based on the recent domestic and foreign research progress, this paper systematically expounds the neural mechanism of the synergistic effect of BCI and neuromodulation technology, summarizes the clinical application value of their combination in the rehabilitation of post-traumatic consciousness disturbance, motor function defect, cognitive and emotional disorders, analyzes the current bottlenecks in technology integration, clinical implementation and standardized system construction, and prospects for the future development direction of intelligent, precise and individualized neural rehabilitation, aiming to provide new ideas and theoretical references for precise diagnosis, treatment, and rehabilitation of functional disorders after TBI.

Acute spine and spinal cord injury is one of the serious types of injuries with a high disability rate in trauma patients, typically caused by high-energy injury mechanisms such as falls from height, traffic collisions, and violent impacts. It is characterized by rapid onset, severe illness, and complex treatment. Due to the involvement of multifaceted pathological alterations such as spinal fracture-dislocation, spinal cord compression, and neurological dysfunction, the entire treatment process includes important milestones such as early assessment and grading, rapid transport and imaging diagnosis, timely decompression and fixation, prevention and control of complications, and rehabilitation management. This consensus is developed based on the latest international and domestic guidelines and literature evidence, combined with clinical practice in China, through multidisciplinary collaboration among experts in orthopedics, neurosurgery, critical care medicine, emergency medicine, and rehabilitation medicine. It aims to standardize the early identification and grading, imaging evaluation and surgical treatment, perioperative management, and rehabilitation intervention for adult acute spine and spinal cord injury in China, so as to improve the overall rescue level and functional prognosis. This consensus has been registered on the Practice guidelines REgistration for transPAREncy (PREPARE) platform, with the registration number PREPARE-2025CN1399.

To develop nitrogen-doped carbon quantum dots (NCQDs) with antioxidant and immunomodulatory functions and evaluate their effects on peripheral nerve injury repair using a sciatic nerve injury model.

(1) In vitro experiment: NCQDs were synthesized using diallyldimethylammonium chloride and anhydrous citric acid. NCQDs were set to 4 concentration groups of 0, 10, 20, and 30 μg/mL, named CON group, NCQDs-10 group, NCQDs-20 group, and NCQDs-30 group. Mouse monocyte macrophage leukemia cell line (RAW 264.7) was inoculated into a culture plate according to the experimental design. After the cells adhered to the wall and the cell status was confirmed to be good, corresponding concentrations of NCQDs were added and cultured for 1 and 4 d, respectively, to detect cytotoxicity. After 24 h of culture, the antioxidant performance was detected. Five dorsal root ganglia (DRG) neurons from C57 mice were taken, and DAPI/NF-200 immunofluorescence staining was used to observe the effect of NCQDs on neuronal growth. NCQDs were used to treat DRG neurons for 12 and 24 h to verify their cytotoxicity and immunomodulatory properties on neurons. (2) In vivo experiment: A sciatic nerve injury model was established in 6-week-old C57 mice, which were randomly divided into a control group and a NCQDs group. Normal saline and NCQDs were locally injected into the injury site, respectively. At 7 d post-injury, nerve regeneration was assessed via nerve histology and spinal cord pathological sections. At 28 d post-injury, functional recovery of the sciatic nerve and ipsilateral hindlimb muscles were further evaluated using electrophysiology, footprint analysis, and gastrocnemius muscle histological staining. Serum biochemical parameters and H&E staining of major organs were performed to assess the in vivo biosafety of NCQDs.

(1) In vitro experiment: NCQDs exhibited excellent biocompatibility and can significantly reduce RAW264.7 cell activity, decrease ROS expression levels, and maintain a stable ROS clearance rate within 30 d. Zeta potential detection showed that the Zeta potential of NCQDs was +6.98 mV. Enzyme-linked immunosorbent assay detection showed that compared with the CON group, the expression levels of tumor necrosis factor-α, interleukin (IL)-6, IL-8, and IL-1β in the NCQDs-10 group, NCQDs-20 group, and NCQDs-30 group were all reduced, and the differences were statistically significant (P<0.05). (2) In vivo experiment: Compared with the control group, the NCQDs group showed a significant increase in the number of positive neurons, an increase in the number and distance of regenerated axons at the injury site, a significant reduction in action potential latency, and an increase in conduction velocity, with statistically significant differences (P<0.05); Behavioral analysis showed significant improvements in footprint area, contact density, and plantar pressure, while the average diameter of gastrocnemius muscle fibers increased significantly, with statistically significant differences (P<0.05). Hematological and serum biochemical indicators, as well as histological examinations of major organs such as heart, liver, spleen, lungs, and kidneys in two groups of mice, showed no significant abnormalities.

NCQDs possess favorable biosafety both in vitro and in vivo, they significantly enhance sciatic nerve repair through combined anti-inflammatory and antioxidant mechanisms.

To construct a predictive model based on the Delta radiomics and clinical baseline data of preoperative contrast-enhanced MRI imaging, and evaluate its predictive value for recurrence and survival in patients with brain glioma (BG).

A retrospective analysis was conducted on clinical data of 220 BG patients admitted to Oncology Department of Xiangyang No.1 People’s Hospital, Hubei University of Medicine from August 2015 to April 2023. Patients were divided into a normal group (n=125) and a recurrence group (n=95) according to their survival status. The cohort was split into a training set (155 cases, 88 normal cases and 67 recurrence cases) and a testing set (65 cases, 37 normal cases and 28 recurrence cases) at a ratio of 7∶3. Delta radiomics features were extracted from the peritumoral edema area (3-12 mm) and within the tumor, respectively, and the least absolute shrinkage and selection operator (LASSO) algorithm combined with ten-fold cross-validation was used to generate the peritumoral radiomics score (Radscore1) and intratumoral radiomics score (Radscore2). The clinical baseline data and imaging characteristics of normal and recurrent patients in the training and testing sets were compared. Based on the training set data, 3 postoperative recurrence prediction models were constructed using multiple Logistic regression: clinical model, imaging model, and combination model. DeLong test was used to compare the differences in area under the ROC curve (AUC) between the models, and decision curve analysis was used to evaluate the clinical net benefit of each model. XGboost machine learning algorithm was used to verify the prediction results of each model, and the predictive performance of the models was further validated in the testing set. Kaplan-Meier method was used to plot the overall survival (OS) curve after surgery, and the Log-rank test was used for inter group comparison. The median OS and 95%CI were calculated, and a survival column chart was constructed to evaluate its predictive value for postoperative survival of BG patients.

In the training set, there were statistically significant differences in gender, isocitrate dehydrogenase-1 (IDH1) mutation, 1p19q heterozygous deletion, MRI enhancement mode, and Radscore1 and Radscore2 between the two groups of patients (P<0.05). The comparison results of the above data in the testing set are consistent with those in the training set. Multivariate Logistic regression analysis showed that gender, IDH1 mutation status, 1p19q heterozygous deletion, Radscore1 and Radscore2 were independent influencing factors for BG recurrence (P<0.05). Based on the above factors, three prediction models were constructed: clinical model, imaging model, and combination model. ROC curve analysis showed that the predictive performance of the combination model (AUC=0.890, 95%CI: 0.830-0.935) was significantly better than that of the clinical model (AUC=0.748, 95%CI: 0.672-0.814) and the imaging model (AUC=0.832, 95%CI: 0.763-0.887), and the differences were statistically significant (P<0.05). The XGboost algorithm validated the prediction results of the combination model, and the decision curve showed that the clinical net benefit of the combination model was higher. This result was validated in the testing set, and ultimately the column chart based on the combination model simplified the prediction process of BG recurrence, with a sensitivity of 0.857 and a specificity of 0.756 in the testing set. Kaplan-Meier survival curve analysis showed that there were statistically significant differences in OS between subgroups based on gender, 1p19q heterozygous deletion, Radscore1, and Radscore2 (P<0.05). The AUC for predicting BG survival based on the survival column chart established based on these factors is 0.859 (95%CI: 0.802-0.933), with sensitivity and specificity of 0.872 and 0.705, respectively.

The predictive model based on Delta radiomics from preoperative contrast-enhanced MRI can improve the prediction of postoperative recurrence and survival in BG patients, providing a basis for individualized management and clinical decision-making after surgery.

To investigate the diagonstic value of oxo-modified low-density lipoprotein (ox-LDL), caveolin-1, and serum axon growth inhibitory factor (Nogo-A) and postoperative cerebral edema in patients with acute cerebral hemorrhage before minimally invasive interventional hematoma removal.

A total of 105 patients with acute cerebral hemorrhage who received minimally invasive interventional hematoma removal at Suining Hospital of Traditional Chinese Medicine from January 2023 to January 2024 were selected and divided into cerebral edema group and non-cerebral edema group according to whether postoperative cerebral edema 48 h after the operation was complicated, and the general data, preoperative ox-LDL, caveolin-1 positive and Nogo-A levels of patients in the two groups were compared. Multivariate Logistic regression analysis was used to analyze the influencing factors of cerebral edema after minimally invasive interventional hematoma removal in patients with acute cerebral hemorrhage. The receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic efficacy of preoperative ox-LDL, caveolin-1, and Nogo-A levels for cerebral edema after minimally invasive interventional hematoma removal in patients with acute cerebral hemorrhage.

Among the 105 patients included in the study, 35 cases developed cerebral edema after surgery (cerebral edema group), with an incidence of 33.33%, the remaining 70 cases were in non-cerebral edema group. The levels of ox-LDL, Nogo-A and the positive rate of caveolin-1 in cerebral edema group were higher than those in non-cerebral edema group, and the differences were statistically significant (P<0.05). Multivariate Logistic regression analysis showed that preoperative ox-LDL, caveolin-1 positivity, and Nogo-A were independent influencing factors for cerebral edema after minimally invasive interventional hematoma removal in patients with acute cerebral hemorrhage (P<0.05). ROC curve analysis showed that the cutoff values of ox-LDL and Nogo-A were 0.66 mg/L and 138.93 ng/mL, respectively. The AUC values for diagnosing cerebral edema after minimally invasive hematoma clearance in patients with acute cerebral hemorrhage were 0.893 (95%CI: 0.817-0.945) and 0.852 (95%CI: 0.770-0.914), respectively; the AUC of caveolin-1 positive diagnosis for cerebral edema after minimally invasive hematoma clearance in patients with acute cerebral hemorrhage was 0.657 (95%CI: 0.558-0.747); the AUC of the combined diagnosis of the three indicators was 0.950 (95%CI: 0.889-0.983), which was higher than the detection of each indicator separately, and the difference was statistically significant (P<0.05).

The levels of preoperative ox-LDL, caveolin-1 and Nogo-A are independent influencing factors for cerebral edema after minimally invasive interventional hematoma removal in patients with acute cerebral hemorrhage. The combined detection of the three indicators has better predictive efficacy for postoperative cerebral edema than the individual application of each indicator.

Traumatic brain injury (TBI) is a disease type with high mortality and disability rates, and effective treatments to prevent long-term neurological dysfunction remain lacking. Recent animal studies have shown that the ketogenic diet (KD) can exert neuroprotective effects and promote neurological recovery by regulating energy metabolism, enhancing mitochondrial function, and alleviating neuroinflammation, thereby providing a novel strategic direction for the treatment of TBI. This review explores the physiological and metabolic effects of KD, its potential neuroprotective mechanisms in TBI, and its clinical applications, aiming to provide a theoretical basis for further basic research and clinical translation of KD in TBI.