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29 January 2026, Volume 22 Issue 1 Previous Issue   

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Guidelines for diagnosis and treatment of congenital non-syndromic craniosynostosis 2026, 22 (1):  1.  Abstract ( 0 )   PDF (1272KB) ( 55 )   Related Articles | Metrics

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Establishment of a three-dimensional statistical shape model of the mandible and its clinical applications CHEN Zhewei, HOU Tianru, YANG Bin 2026, 22 (1):  16.  Abstract ( 0 )   PDF (5469KB) ( 10 )   Objective To establish a  high-precision three-dimensional statistical shape model （SSM） of the mandible based on cranial CT data from a Chinese population， and to explore its clinical applications in morphological analysis， automated reconstruction of mandibular defects， and prediction of mandibular morphology based on facial shape. Methods Cranial CT data from 130 healthy Han Chinese adults were collected， of which 100 cases were used for model training and 30 for validation. Three-dimensional reconstruction， standardization， and non-rigid registration were performed using Mimics and Meshmixer to ensure topological consistency across models， followed by singular value decomposition （SVD） to construct the SSM. Principal component analysis （PCA） was employed to extract morphological features and compare differences between sexes. A posterior shape model （PSM） algorithm was integrated to achieve automated reconstruction of mandibular defects. In addition， leveraging the correlation between a three-dimensional facial SSM and the mandibular SSM， a support vector regression （SVR） model was developed to predict mandibular morphology based on facial shape. Results The first 15 principal components of the mandibular SSM explained 95.18% of shape variance. The average fitting error on the test set was  （0.55±0.08） mm， indicating strong generalization. Sex-related differences were primarily observed in overall volume and gonial angle characteristics. PSM-based automated reconstruction achieved higher accuracy than manual reconstruction in angle and body defects （RMSE of 0.77 mm and 0.67 mm； Dice coefficients of 0.87 and 0.94， respectively）. The mean error for predicting mandibular morphology from three-dimensional facial shape was （1.50±0.34） mm， significantly lower than inter-individual differences in a random population of （2.58±0.98） mm （P<0.001）. Conclusion This study presents the first high-precision， strongly generalizable three-dimensional mandibular SSM tailored to a Chinese population， and demonstrates its clinical feasibility for morphological analysis， automated defect reconstruction， and facial-shape-based prediction of mandibular morphology. The model provides new technical support and a research foundation for personalized maxillofacial surgical planning， radiation-free assessment， and telemedicine. Related Articles | Metrics

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Dense correspondence analysis（DeCA）of 3D mandibular geometry in isolated Pierre Robin sequence CHEN Yiyang, LIU Yijie, LIU Jiayu, et al 2026, 22 (1):  27.  Abstract ( 0 )   PDF (2722KB) ( 21 )   Objective Isolated Pierre Robin sequence （Ⅰ-PRS） is caused by abnormal mandibular development， and traditional sparse landmark-based methods are insufficient to capture its complete 3D morphology. This study aimed to use dense correspondence-based 3D geometric morphometrics to precisely quantify mandibular features in Ⅰ-PRS and establish a morphological classification system. Methods This retrospective case-control study included CT data from 200 infants with Ⅰ -PRS and 31 normal infants. Mandibular models were generated through 3D reconstruction， and point-to-point registration was performed using dense correspondence analysis. Principal component analysis （PCA） was used to explore morphological variation within the Ⅰ-PRS group， followed by K-means clustering and canonical variate analysis （CVA） for subtype classification and validation. Results The Ⅰ-PRS mandible showed significant dysmorphology compared to normal controls， with the greatest variations found at the symphysis and mandibular angle. PCA and cluster analysis identified three stable morphotypes： Type I （short body， flat arch）； Type Ⅱ（short ramus， V-shaped narrow arch， with posterior ramus rotation）； and Type ⅡI （high-angle， flat arch）. CVA confirmed the high statistical validity of this subtyping. Conclusion This study successfully quantified the morphological features of the Ⅰ-PRS mandible using dense correspondence analysis and， for the first time， identified and defined three objective morphological subtypes. This classification system provides an important morphological basis for understanding the clinical heterogeneity of Ⅰ-PRS and for guiding precision diagnosis and personalized surgical treatment. Related Articles | Metrics

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Three-dimensional finite element study of the mechanical properties of external fixation device for mandibular angle fracture in a miniature pig ZHANG Ruijuan, WU Jiang, GAO Quanwen 2026, 22 (1):  34.  Abstract ( 0 )   PDF (5431KB) ( 18 )   Objective To construct a finite element model of a miniature pig’s mandibular angle fracture with simulated installation of a self-developed external fixation device at the fracture site， and to analyze the device’s biomechanical performance by three-dimensional finite element technology， thereby laying a foundation for clinical application. Methods A healthy Bama miniature pig weighing 20 kg was selected for cranial CT scanning. The scanned DICOM data were imported into Mimics for cranial three-dimensional reconstruction. The STL file was then imported into Geomagic Studio software to complete geometric reverse modeling. The resulting IGES file， a universal surface geometry file， was imported into Solidworks software to set up a virtual fracture at the mandibular angle. At the same time， the data of the self-developed mandibular external fixation device was imported into the Solidworks software for three-dimensional reconstruction， and a simulation installation was carried out at the fracture site of the mandibular angle. The IGES data of the mandible and the data of the external fixation device were imported into ICEM software for meshing to generate an UNS mesh file， which was then imported  into Workbench software to analyze the stress and strain changes of the mandible and the external fixation device under a certain load. Results Three-dimensional finite element analysis revealed that after applying a vertically downward 196 N load at the first molar fossa of the right mandible， the maximum principal stress generated on both sides of the mandibular angle fracture ends was less than the ultimate strength of the mandible，103 MPa. The location of maximum Von-Mises stress of the screw was above the posterior end of the fracture， approximately 244.24 MPa. The location of maximum Von-Mises stress of the nut was also above the posterior end of the fracture， approximately 107.38 MPa. The location of maximum VonMises stress of the plate was at the screw hole below the anterior fracture end， approximately 138.54 MPa. The screw material  was medical stainless steel 00Cr18ni14mo3， with an ultimate strength of 860 MPa. The nut and plate material was titanium alloy Tc4， with an ultimate strength of 895 MPa. The stresses produced by the three structures of the external fixation device were all below the ultimate strength of its material. The overall deformation of the external fixation device was 0.861 mm， and the strain was small. Conclusion The models of the mandibular angle fracture and the external fixation device of the miniature pig established using medical digital imaging software and three-dimensional finite element software have high simulation accuracy and can provide multiple simulation experiments. According to the results of the three-dimensional finite element analysis， the selfdeveloped external fixation device for the mandible can achieve rigid fixation of the miniature pig’s mandibular angle fracture. Related Articles | Metrics

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Modified open cranial vault reconstruction technique combined with orthopedic helmet for treatment of infant lambdoid craniosynostosis ZHANG Di, GE Ming, LI Dapeng 2026, 22 (1):  42.  Abstract ( 0 )   PDF (11410KB) ( 17 )   Objective To investigate the therapeutic effect of an improved type of cranial vault reconstruction surgery combined with helmet correction after surgery for unilateral lambdoid craniosynostosis in infants. Methods Clinical data of patients with unilateral lambdoid craniosynostosis from July 2021 to September 2025 were retrospectively analyzed. An improved type of skull reconstruction was used for surgical treatment. The patient was placed in a prone position， and the affected parietal bone at 1.5 cm beside the midline was removed and subjected to an “X” osteotomy， which was remodeled to make it bulge. On the contralateral side， a “C”-shaped osteotomy was performed along 1.5 cm posterior to the coronal suture and beside the midline to 0.5 cm anterior to the lambdoid suture. A transverse osteotomy about 1.5-2 cm wide posterior to the sagittal suture was performed to completely disconnect the midline bone strip from the occipital bone. After the plastic reconstruction， the affected side of the parietal bone was reduced and fixed， and the contralateral “C”-shaped osteotomy bone flap was fixed on the remaining midline bone strip to make the compensatory side of the parietal bone contract. Orthotic helmets were worn from 2 to 4 weeks postoperatively for 6 to 12 months，20 to 22 hours per day. The patients were followed up regularly to observe the head shape， measure the cranial vault asymmetry index （CVAI） and the volume of left and right  posterior cranial cavity. The results were satisfactory if CVAI<3.5. Results A total of 7 patients with unilateral lambdoid craniosynostosis were enrolled， including 3 males and 4 females， aged from 5 to 18 months， with preoperative CVAI 6.15± 2.82. The hospital stay was （11.57±1.62） days， and the intraoperative blood loss was （105.71±23.0） mL. The operation was safe， only scalp swelling and fever occurred after operation， and no serious complications occurred. All patients were followed up for 6 to 12 months， and the head asymmetry was significantly corrected. At 6 months after surgery， the CVAI of helmet correction was 1.45±1.19， all less than 3.5， which reached the satisfactory standard. The preoperative CVAI， postoperative CVAI and postoperative helmet correction CVAI at 6 months were statistically different （P<0.05）. There was a significant difference in the volume difference between the left and right posterior cranial cavity before operation and 6 months after operation （P<0.05）. Conclusion Modified type of cranial vault reconstruction surgery combined with helmet correction for the treatment of unilateral lambdoid craniosynostosis in infants is safe and has few complications. This surgical method can effectively correct the head asymmetry of such patients， and after the helmet correction for 6 months， the head asymmetry was further corrected. The correction effect of unilateral lambdrage synostosis is satisfactory. Related Articles | Metrics

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The impact of continuous positive airway pressure（CPAP）on midfacial development in children with syndromic craniosynostosis ZHONG Yehong, LI Yashu, CHEN Zhewei, et al 2026, 22 (1):  49.  Abstract ( 0 )   PDF (3120KB) ( 18 )   Objective To investigate the impact of continuous positive airway pressure （CPAP） therapy on midfacial growth in children with syndromic craniosynostosis （SCS） using three-dimensional cephalometric analysis， and to provide evidence for optimizing airway management and treatment strategies. Methods A retrospective cohort of 28 children with SCS was reviewed. Fifteen patients who received CPAP therapy were included in the mask group，13 patients without CPAP treatment were included in the no mask group， and 15 healthy children were served as healthy controls. Computed tomography （CT） scans obtained before CPAP initiation and prior to midfacial advancement surgery were reconstructed into three dimensional models. Quantitative cephalometric measurements were performed to assess dynamic changes in midfacial morphology， and intergroup as well as intragroup comparisons were conducted. Results Compared with healthy controls， children with SCS consistently demonstrated maxillary retrusion. After CPAP therapy， the mask group showed significantly reduced PNS_Vertical， ANS_Horizon， and SNA values compared with the no mask group （P<0.05）. Within-group analysis revealed a significant reduction in PNS_Horizon （P<0.05）. Furthermore， the ANB angle was significantly greater in the mask  group than in the no mask group （P<0.05）， indicating an exacerbated tendency toward a concave facial profile. Conclusion CPAP therapy may further aggravate midfacial retrusion in children with syndromic craniosynostosis， characterized by clockwise maxillary rotation. Clinicians should carefully balance the benefits of airway improvement against potential adverse craniofacial effects. Future multi-center， large-sample， prospective studies are warranted to validate these findings and to explore optimized mask designs or adjunctive orthodontic interventions that may mitigate unfavorable craniofacial outcomes while preserving airway function. Related Articles | Metrics

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Recent progress of AI technology in diagnoses and treatment of craniosynostoses CHEN Qian, YANG Bin 2026, 22 (1):  57.  Abstract ( 0 )   PDF (1400KB) ( 20 )   Craniosynostoses are a sort of congenital craniofacial malformations characterized by premature fusion of one or more cranial sutures during childhood development， leading to abnormal calvarial morphology and restricted intracranial growth. In severe cases， it may result in neurodevelopmental disorders. Traditionally， management has depended on imaging assessment and clinician expertise. With the rise of artificial intelligence （AI）， however， AI has gradually been applied to various aspects of diagnosis， preoperative planning， intraoperative navigation， and postoperative rehabilitation of craniosynostosis， thus promoting a fully digital， end-to-end workflow from diagnosis to recovery. Related Articles | Metrics

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T cell-osteoclast interactions regulating the orderly regeneration of critical-sized bone defects by single-cell sequencing WU Qifeng, YAN Yangxuanyu, FENG Xinyi, et al 2026, 22 (1):  62.  Abstract ( 0 )   PDF (7586KB) ( 21 )   Objective To investigate the dynamic changes of the immune microenvironment during critical-sized bone defect repair and elucidate the regulatory role of T cells in bone regeneration. Methods A critical-sized bone defect model was established in pigs and mice. Regenerating tissues from steady state and multiple postoperative time points were collected for single-cell RNA sequencing （scRNA-seq）. After data preprocessing， dimension reduction， clustering， and cell-type annotation， T cells and myeloid populations were further extracted for subcluster identification， differential gene expression analysis， pathway enrichment， and intercellular communication analysis. Functional validation was performed in T celldeficient mice， and bone regeneration outcomes were assessed using Micro-CT. Results scRNA-seq analysis identified 10 major cell types， with T cells and myeloid cells rapidly recruited during the early regenerative phase and exhibiting timedependent functional reprogramming. T cells were classified into 7 subclusters， among which CD8 ⁺ T cell subclusters expanded markedly during bone repair and showed elevated expression of the chemokine CCL5. Myeloid cells were subdivided into 5 subpopulations， and osteoclasts were prominently increased and activated during the bone reconstruction phase. Intercellular interaction analysis indicated that CD8⁺ T cells promoted osteoclast migration and functional activation through the CCL5-CCR5 signaling axis. In T cell-deficient mice， excessive bone formation and ectopic ossification were observed， accompanied by a reduced osteoclast population and hyperactivation of osteogenic pathways. Conclusion During  critical-sized bone defect repair， T cells and myeloid cells undergo temporally coordinated recruitment and functional transitions. CD8⁺ T cells regulate osteoclast recruitment and activation via the CCL5-CCR5 signaling axis， maintaining the balance between bone formation and resorption， thereby ensuring orderly bone regeneration and structural reconstruction. Related Articles | Metrics

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Application of keystone perforator island flap in repairing medium and small-sized wounds at the distal extremities SUN Xinyang, DAI Jiangping, WANG Haifeng, et al 2026, 22 (1):  73.  Abstract ( 0 )   Related Articles | Metrics

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Research on the comprehensive treatment and efficacy evaluation of venous leg ulcers ZHONG Haiyan, YANG Yijie, WU Zishan, et al 2026, 22 (1):  78.  Abstract ( 0 )   PDF (6598KB) ( 30 )   fect. Methods The clinical data of 15 patients with C5-C6 VLU from January 2023 to September 2024 were retrospectively reviewed. The size of ulcers ranged from 1.5 cm×1.5 cm to 10 cm×20 cm， of which 13 cases were deep to the dermis-fat layer， and 2 cases had exposed bone and muscle tendon. Lower extremity Doppler ultrasound and antegrade lower extremity venography angiography were used to evaluate the vascular condition of the lower extremity before determining treatment scheme. The comprehensive treatment scheme includes the management of venous hypertension， debridement， platelet-rich plasma （PRP） injection， wound repair （free skin grafting or skin flap grafting）， postoperative wearing vein pressure stockings for varicose， and regular PRP injection for lesion site. The patients were followed up for 6 months to 1 year after discharge. Healing rate of ulcer， CIVIQ-10 score and clinical severity score of venous lesions were recorded at multiple points during treatment and follow up. Results The ulcers in this group healed completely within 4-6 weeks after surgery （healing rate was 100%）. At the end of follow-up period，14 patients had no ulcer recurrence and 1 patient had recurrence. All patients had elevated scores of CIVIQ-10 and reduced scores of VCSS. Conclusion A comprehensive treatment scheme combining accurate preoperative evaluation of lower limb vascular and wound， management of venous hypertension， repairing wound by debridement， PRP injection and surgery， postoperative wearing pressure stockings and regular PRP injections after being discharged from the hospital can effectively increase the healing rate of VLU， reduce the rate of recurrence， and significantly improve the patient's quality of life. Related Articles | Metrics

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Perioperative nursing care of hair follicle unit extraction for the treatment of androgenic alopecia patients ZHU Siyuan, DI Meihua, LIU Qian, et al 2026, 22 (1):  85.  Abstract ( 0 )   PDF (4165KB) ( 21 )   Objective To explore the effect of perioperative nursing care of hair follicle unit extraction （FUE） in the treatment of androgenetic alopecia （AGA） patients. Methods A retrospective analysis of the perioperative nursing care of 150 AGA patients undergoing hair transplantation from October 2020 to October 2021 was retrospectively analyzed， including preoperative lifestyle guidance， medication guidance， psychological counseling， and scalp care； Intraoperative surgical area preparation， position care， pain management， psychological care， and preparation of transplanted hair follicles； Postoperative dressing care， prevention and treatment of complications， medication guidance， dietary guidance， and postoperative follow-up. Results After 1 week to 12 months of follow-up， the survival rate of transplanted hair follicles was more than 95%， and the postoperative hair was beautiful and natural. The patient satisfaction rate reached 96.7%. Conclusion Perioperative care of FUE surgery for AGA is an important guarantee for the success of hair transplantation. Related Articles | Metrics

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Research progress on the dual regulation of cellular senescence by YAP in the pathogenesis of osteoarthritis YANG Lin, NIE Ping 2026, 22 (1):  89.  Abstract ( 0 )   PDF (1089KB) ( 24 )   In recent years， the regulatory role of YAP signaling in cell growth， proliferation， apoptosis， and senescence has become a research hotspot. Existing evidence suggests that YAP plays an important role in the development of various degenerative diseases， including osteoarthritis. YAP has a bidirectional regulatory effect on the proliferation， differentiation， and senescence of chondrocytes， mesenchymal stem cells， and macrophages in normal growth and development and pathological microenvironments. This bidirectional regulation depends on factors such as cell type and cell differentiation status. This article focuses on the biological structure and function of YAP， and reviews and prospects its regulatory mechanisms in cellular senescence in osteoarthritis Related Articles | Metrics

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Progress and mechanism of lysine lactylation in vascular malformations WANG Junbin, MA Ruoyan, LI Mengjie, et al 2026, 22 (1):  95.  Abstract ( 0 )   PDF (1064KB) ( 22 )   Vascular malformations are a group of congenital disorders caused by abnormal vascular development， with complex clinical phenotypes， slow progression， and a lack of effective molecularly targeted therapies. In recent years， with the in-depth research on the intersection of metabolic reprogramming and epigenetic regulation， a novel form of epigenetic modification， lysine lactylation （Kla）， has attracted widespread attention for its potential role in regulating gene expression and cell fate. However， the role of Kla in the pathogenesis of Vascular malformations has not been systematically explored. This paper focuses on the regulatory mechanism of Kla and the biological function of Kla， and systematically sort out the role of Kla in the regulation of angiogenesis and functional remodeling of endothelial cells， taking into account the recent domestic and international research advances in histone lactylation， endothelial cell metabolism shaping， and vascular developmental abnormalities. Then this paper further proposes that the pathological basis of PIK3CA mutation， enhanced glycolysis and microenvironmental hypoxia， which are common in vascular malformations， may be involved in lesion development by inducing lactate accumulation and Kla upregulation， which affects transcriptional regulation and endothelial behavior. Finally， this paper combines the existing data to deduce the possible regulatory mechanism of Kla in vascular malformations， and suggests that in the future， the role and application prospect of Kla in vascular malformations should be deeply explored from the directions of spatial genomics， metabolome-epigenome joint analysis， and in vivo functional validation model construction. This review is expected to provide a new perspective for exploring the function of metabolic-epigenetic regulatory axis in vascular developmental abnormalities， and provide a theoretical basis for molecular mechanism studies and development of targeted therapeutic strategies for vascular malformations. Related Articles | Metrics

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Pathogenesis and treatment strategies in sunken upper eyelid ZHENG Tengyue, LI Jie, MA Jiguang 2026, 22 (1):  101.  Abstract ( 0 )   PDF (1028KB) ( 21 )   Sunken upper eyelid is frequently associated with blepharoptosis and multiple eyelid folds， presenting an aged and fatigued appearance that affects periorbital aesthetics. This article reviews the domestic and international studies on the correction of sunken upper eyelid and classifies its etiologies into true volume deficiency of the upper eyelid and pseudovolume deficiency caused by the abnormal structure and malposition of fat tissue in the upper eyelid. This article also summarizes the treatment strategies of the sunken upper eyelid， as well as the indications， advantages， disadvantages， and complications of different treatment modalities. An etiology-driven， patient-specific approach is advocated to optimize aesthetic and functional outcomes in the correction of sunken upper eyelid deformity. Related Articles | Metrics

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Practical exploration and application of the diagnostic teaching course for congenital external ear malformations in#br# reconstructive surgery CHEN Xia, ZHANG Ruhong 2026, 22 (1):  105.  Abstract ( 0 )   PDF (1015KB) ( 21 )   Sunken upper eyelid is frequently associated with blepharoptosis and multiple eyelid folds， presenting an aged and fatigued appearance that affects periorbital aesthetics. This article reviews the domestic and international studies on the correction of sunken upper eyelid and classifies its etiologies into true volume deficiency of the upper eyelid and pseudovolume deficiency caused by the abnormal structure and malposition of fat tissue in the upper eyelid. This article also summarizes the treatment strategies of the sunken upper eyelid， as well as the indications， advantages， disadvantages， and complications of different treatment modalities. An etiology-driven， patient-specific approach is advocated to optimize aesthetic and functional outcomes in the correction of sunken upper eyelid deformity. Related Articles | Metrics