ObjectiveTo investigate the effect of repetitive peripheral magnetic stimulation (rPMS) combined with upper limb intelligent robotic training on muscle tension, motor function and cortical excitability in children with unilateral spastic cerebral palsy (USCP). MethodsFrom March, 2023 to December, 2024, 90 children with USCP admitted to Children's Hospital of Soochow University were selected and randomly divided into control group (n = 30), rPMS group (n = 30) and combined group (n = 30). The control group received conventional occupational therapy. The rPMS group received rPMS intervention followed by conventional occupational therapy. The combined group received rPMS followed by upper limb intelligent robot training, for four weeks. Before and after treatment, muscle tension of biceps brachii was assessed using the modified Ashworth Scale (MAS); upper limb motor function was evaluated using the Fugl-Meyer Assessment-Upper Extremity (FMA-UE) and upper limb intelligent parameters; and cortical excitability was measured using transcranial magnetic stimulation (TMS), including resting motor threshold (RMT) and motor-evoked potential (MEP) amplitude of the affected hemisphere. ResultsAfter treatment, MAS grades improved in all groups (|Z| > 3.523, P < 0.001), and the improvement in the combined group was superior to that in the control group (P < 0.05). Significant intra-group (F > 65.21, P < 0.001), inter-group (F > 17.94, P < 0.001) and interaction effects (F > 5.36, P < 0.01) were observed in FMA-UE scores, upper limb intelligent parameters and TMS parameters. Post Hoc analysis showed that the combined group demonstrated significantly greater improvements in FMA-UE scores, upper limb intelligent parameters, and TMS parameters compared with both the control and rPMS groups (all P < 0.01). Except for FMA-UE scores, the rPMS group showed significantly greater improvements than the control group in upper limb intelligent parameters (mechanical feedback, trajectory, and range of motion) and TMS parameters (RMT and MEP amplitude) (P < 0.05). ConclusionrPMS combined with upper limb intelligent robotic training can reduce upper limb muscle tension, improve motor function, and enhance cortical excitability in children with USCP.

ObjectiveTo investigate the effect of different visual inputs and task conditions on balance function and lower limb biomechanical characteristics in children with spastic hemiplegia. MethodsFrom March to July, 2025, 30 children aged six to nine years old with spastic hemiplegia (hemiplegia group) and 30 healthy children (control group) were selected. A 2×2×2 mixed experimental design was employed, involving groups (hemiplegia vs. healthy), tasks (single-task vs. dual-task), and vision (eyes open vs. eyes closed). One week before test, they were evaluated with Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Wee Function Independent Measurement (WeeFIM) and Wechsler Intelligence Scale for Children, Fourth Edition (WISC-Ⅳ). A 3D gait analysis system and a plantar pressure testing system were used to collect spatio-temporal parameters of walking speed, stride length, cadence and step width, kinematic parameters of hip/knee/ankle joint angles, kinetic parameters of forefoot loading ratio, center of pressure (CoP) displacement, while dual-task cost (DTC) was caculated. ResultsSpatio-temporal parameters showed that under dual-task and eyes-closed conditions, walking speed and stride length decreased while step width increased in the hemiplegia group. Significant interaction effects among group, task, and vision were observed for speed, stride length, and step width (F > 4.886, P < 0.05). Kinematic parameters indicated that during dual-tasks, the hemiplegia group exhibited increased hip flexion and decreased ankle dorsiflexion; under eyes-closed conditions, knee flexion increased. The interaction of the three factors significantly affected all joint angles (F > 4.876, P < 0.05). Kinetic parameters showed that under dual-task and eyes-closed conditions, the forefoot loading ratio and anteroposterior CoP displacement decreased, while mediolateral CoP displacement increased. The interaction of the three factors significantly affected CoP displacement (F > 4.355, P < 0.05). All the DTC was significantly higher in the hemiplegia group than in the control group, except DTC of the cadence (|t| > 14.393, P < 0.001). Correlation analysis revealed that the score of FMA-LE was strongly negatively correlated with DTC (|r| > 0.731, P < 0.01). The Functional Independence Measure for Children and Working Memory Index showed moderate negative correlations with the DTC of walking speed and cadence (|r| > 0.462, P < 0.05). ConclusionThe gait and balance of children with spastic hemiplegia are concurrently influenced by dual-tasking and visual input. The superposition of visual deprivation and dual-tasks significantly exacerbates gait abnormalities. Furthermore, is strongly correlated with motor function and working memory.

ObjectiveTo investigate the effect of different visual inputs and task conditions on balance function and lower limb biomechanical characteristics in children with spastic hemiplegia. MethodsFrom March to July, 2025, 30 children aged six to nine years old with spastic hemiplegia (hemiplegia group) and 30 healthy children (control group) were selected. A 2×2×2 mixed experimental design was employed, involving groups (hemiplegia vs. healthy), tasks (single-task vs. dual-task), and vision (eyes open vs. eyes closed). One week before test, they were evaluated with Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Wee Function Independent Measurement (WeeFIM) and Wechsler Intelligence Scale for Children, Fourth Edition (WISC-Ⅳ). A 3D gait analysis system and a plantar pressure testing system were used to collect spatio-temporal parameters of walking speed, stride length, cadence and step width, kinematic parameters of hip/knee/ankle joint angles, kinetic parameters of forefoot loading ratio, center of pressure (CoP) displacement, while dual-task cost (DTC) was caculated. ResultsSpatio-temporal parameters showed that under dual-task and eyes-closed conditions, walking speed and stride length decreased while step width increased in the hemiplegia group. Significant interaction effects among group, task, and vision were observed for speed, stride length, and step width (F > 4.886, P < 0.05). Kinematic parameters indicated that during dual-tasks, the hemiplegia group exhibited increased hip flexion and decreased ankle dorsiflexion; under eyes-closed conditions, knee flexion increased. The interaction of the three factors significantly affected all joint angles (F > 4.876, P < 0.05). Kinetic parameters showed that under dual-task and eyes-closed conditions, the forefoot loading ratio and anteroposterior CoP displacement decreased, while mediolateral CoP displacement increased. The interaction of the three factors significantly affected CoP displacement (F > 4.355, P < 0.05). All the DTC was significantly higher in the hemiplegia group than in the control group, except DTC of the cadence (|t| > 14.393, P < 0.001). Correlation analysis revealed that the score of FMA-LE was strongly negatively correlated with DTC (|r| > 0.731, P < 0.01). The Functional Independence Measure for Children and Working Memory Index showed moderate negative correlations with the DTC of walking speed and cadence (|r| > 0.462, P < 0.05). ConclusionThe gait and balance of children with spastic hemiplegia are concurrently influenced by dual-tasking and visual input. The superposition of visual deprivation and dual-tasks significantly exacerbates gait abnormalities. Furthermore, is strongly correlated with motor function and working memory.

ObjectiveTo investigate the effect of different visual inputs and task conditions on balance function and lower limb biomechanical characteristics in children with spastic hemiplegia. MethodsFrom March to July, 2025, 30 children aged six to nine years old with spastic hemiplegia (hemiplegia group) and 30 healthy children (control group) were selected. A 2×2×2 mixed experimental design was employed, involving groups (hemiplegia vs. healthy), tasks (single-task vs. dual-task), and vision (eyes open vs. eyes closed). One week before test, they were evaluated with Fugl-Meyer Assessment-Lower Extremities (FMA-LE), Wee Function Independent Measurement (WeeFIM) and Wechsler Intelligence Scale for Children, Fourth Edition (WISC-Ⅳ). A 3D gait analysis system and a plantar pressure testing system were used to collect spatio-temporal parameters of walking speed, stride length, cadence and step width, kinematic parameters of hip/knee/ankle joint angles, kinetic parameters of forefoot loading ratio, center of pressure (CoP) displacement, while dual-task cost (DTC) was caculated. ResultsSpatio-temporal parameters showed that under dual-task and eyes-closed conditions, walking speed and stride length decreased while step width increased in the hemiplegia group. Significant interaction effects among group, task, and vision were observed for speed, stride length, and step width (F > 4.886, P < 0.05). Kinematic parameters indicated that during dual-tasks, the hemiplegia group exhibited increased hip flexion and decreased ankle dorsiflexion; under eyes-closed conditions, knee flexion increased. The interaction of the three factors significantly affected all joint angles (F > 4.876, P < 0.05). Kinetic parameters showed that under dual-task and eyes-closed conditions, the forefoot loading ratio and anteroposterior CoP displacement decreased, while mediolateral CoP displacement increased. The interaction of the three factors significantly affected CoP displacement (F > 4.355, P < 0.05). All the DTC was significantly higher in the hemiplegia group than in the control group, except DTC of the cadence (|t| > 14.393, P < 0.001). Correlation analysis revealed that the score of FMA-LE was strongly negatively correlated with DTC (|r| > 0.731, P < 0.01). The Functional Independence Measure for Children and Working Memory Index showed moderate negative correlations with the DTC of walking speed and cadence (|r| > 0.462, P < 0.05). ConclusionThe gait and balance of children with spastic hemiplegia are concurrently influenced by dual-tasking and visual input. The superposition of visual deprivation and dual-tasks significantly exacerbates gait abnormalities. Furthermore, is strongly correlated with motor function and working memory.

Objective:To compare the aneuploidy rate of embryos between poor ovarian response (POR) patients and women with normal ovarian reserve stratified by age, and to eliminate the influence of ovarian reserve on embryo quality.Methods:This was a retrospective case-control study of patients who underwent preimplantation genetic testing for aneuploidies (PGT-A) at the Department of Reproduction and Genetics in Hospital for Reproductive Medicine, Shandong University from January 2017 to December 2020. According to the POSEIDON criteria, POR patients were divided into group 1 [age<35 years, anti-Müllerian hormone (AMH)≥1.2 μg/L, number of oocytes retrieved≤9, 258 cycles], group 2 (age≥35 years, AMH≥1.2 μg/L, number of oocytes retrieved≤9, 397 cycles), group 3 (age<35 years, AMH<1.2 μg/L, number of oocytes retrieved≤9, 99 cycles) and group 4 (age≥35 years, AMH<1.2 μg/L, number of oocytes retrieved≤9, 377 cycles). The aneuploidy rate of the blastocysts in each group was compared with age-matched control women with normal ovarian reserve and normal ovarian response (non-POR 1 group, non-POR 2 group, non-POR 3 group and non-POR 4 group, AMH≥1.2 μg/L, number of oocytes retrieved>9). Based on the difference in sample size of POR groups and control groups, a 1∶2 propensity score matching (PSM) analysis was performed between the <35 years old POR groups and age-matched control groups (POR 1 group vs. non-POR 1 group, POR 3 group vs. non-POR 3 group) and a 1∶1 PSM analysis was performed between the ≥35 years old POR groups and age-matched control groups (POR 2 group vs. non-POR 2 group, POR 4 group vs. non-POR 4 group). The main outcomes were the rates of euploid and aneuploid embryo, the secondary outcomes were the numbers of oocytes retrieved, metaphaseⅡ oocytes, two pronuclei, embryos biopsied, euploid embryos, aneuploid embryos and mosaic embryos per cycle. Results:The number of oocytes retrieved and embryos biopsied embryos in POR 1-4 groups was significantly decreased compared with non-POR 1-4 groups [No. of oocytes retrieved: 7.0 (6.0, 9.0) vs. 16.0 (13.0, 20.0), 7.0 (5.0, 8.0) vs. 14.0 (11.0, 17.0), 6.0 (4.0, 9.0) vs. 16.0 (13.0, 20.0), 5.0 (3.0, 7.0) vs. 13.0 (11.0, 17.0), all P<0.001; No. of embryos biopsied: 3.0 (2.0, 4.0) vs. 4.0 (3.0, 6.0), 2.0 (1.0,3.0) vs. 3.0 (2.0, 5), 3.0 (2.0, 4.0) vs. 4.0 (3.0, 6.0), 2.0 (1.0, 3.0) vs. 3.0 (2.0, 5.0), all P<0.001]. After adjusting for repeated egg retrieval, PGT-A indications, ovarian stimulation protocol and total dosage of gonadotrophin, the embryo aneuploidy rate in group 4 POR patients was significantly higher than controls ( OR=1.252, 95% CI:1.053-1.488, P=0.011). However, no differences were identified in embryo aneuploidy rate between POR patients in groups 1, 2, 3 and corresponding controls, respectively (all P>0.05). Conclusion:The ovarian reserve adversely affects the quantity and quality of oocytes in advanced age POR women (≥35 years old). Decreased ovarian reserve in young women (<35 years old) mainly affects the number of oocytes retrieved.

Diabetic peripheral neuropathy (DPN) is the common chronic complication of diabetes, which can lead to foot ulcers, gangrene, and amputation in severe cases, seriously affecting their quality of life. DPN belongs to the category of "arthralgia", "hemorrhoids" and other categories of TCM, and the main pathogenesis is the deficiency of qi and blood, yin and yang, and the obstruction of the meridians by phlegm and stasis. Clinically, DPN is more common with qi deficiency and blood stasis syndrome. Based on the theory of "qi meridian constant communication" in the Huang Di Nei Jing, this article proposed that for patients with DPN with qi deficiency and blood stasis syndrome, the treatment should be based on the principle of "invigorating qi and activating blood circulation, dissolving stasis and arthralgia", so that the patients' qi meridian can be accessible, delay the disease progression, and provide reference for the TCM treatment of DPN.

Objective To investigate the effect of dexmedetomidine on renal function in patients with septic-associated acute kidney injury(SAKI).Methods A prospective cohort study was conducted in 180 patients with sepsis admitted to ICU in the Second Affiliated Hospital of Guangdong Medical University from October 2021 to April 2023.According to the principle of randomized controlled trials,60 non-acute kidney injury(AKI)patients were divided into S-D group(n = 30,dexmedetomidine + conventional treatment)and S group(n = 30,conventional treatment),and the occurrence and disease score of AKI after treatment were compared between the two groups.A total of 120 AKI patients were divided into SA-D-RT group(n = 30,dexmedetomidine + blood purification + conven-tional treatment),SA-D group(n = 30,dexmedetomidine + conventional treatment),SA-RT group(n = 30,blood purification + conventional treatment)and SA group(n = 30,conventional treatment).Renal function,inflammatory factor level and disease change of the four groups were compared after treatment.Results After treatment,the inci-dence of AKI in S-D group was lower than that in S group,and the APACHEII score and SOFA score in S-D group were lower than those in S group on the 7th day after treatment(P<0.05).After 7 days of treatment,the level of Scr,BUN and CysC in the 4 groups was significantly lower than that on the 1st and 3rd day,and those in the SA-D-RT group were lower than those in the SA-D group,SA-RT group and SA group(P<0.05).After 7 days of treatment,the level of CRP,PCT,TNF-α,IL-6 and IL-1β in four groups was significantly decreased compared with on the 1st and 3rd day,and the level of CRP,PCT,TNF-α,IL-6 and IL-1β in SA-D-RT group was lower than that in SA-D group,SA-RT group and SA group(P<0.05).After 7 days of treatment,the APACHEII score and SOFA score of the four groups were significantly lower than on the 1st and 3rd day,and the scores of the SA-D group were lower than those of the SA-D group,the SA-RT group and the SA group(P<0.05).Conclusion Dexmedetomidine can effectively reduce the incidence of AKI,affect the expression level of renal function markers and inflammatory factors in serum of SAKI patients,and improve the condition of patients.

Objective To study the efficacy of speech training combined with Montessori education on speech problems in children after velopharyngeal insufficiency surgery.Methods A retrospective analysis of 63 cases of children who underwent velopharyngeal repair at Children's Hospital of Soochow University between January 2019 and December 2021 was conducted.Subjects were divided into three groups.A total of 21 patients who received family rehabilitation training after the operation were divided into control group A,42 patients who received regular hospital rehabilitation training after the operation were divided into group B and group C,of which 21 patients in group B received routine speech training,and 21 patients in group C received Montessori education and routine speech training.Nasal resonance status,assessment of dysarthric intelligibility,and cranially positioned lateral radi-ographs when pronouncing/i/sounds were evaluated individually before treatment and 6 months after treatment.The improvement of velopharyngeal function,nasal resonance status,and dysarthric articulation were evaluated.Results After the six-month intervention,the dysarthric speech intelligibility were significantly improved in three groups with improvement of 35.45％in group A,43.66％in group B,and 49.33％in group C,respectively(P＜0.05).The improvement rate of nasality reached 100％in the B and C group with nasality elimination rate of 70％in group B and 95.24％nasality elimination in group C,and the efficacy of the two groups was statistically signifi-cant(P＜0.05).During phonation of the/i/tone,velopharyngeal insufficiency was observed in seven patients in group B and in only one patient in group C,and the efficacy was statistically significant in both groups(P＜0.05).Conclusion Postoperative targeted speech training is necessary in patients with velopharyngeal insufficiency,and speech training combined with Montessori education can significantly improve the function of velopharyngeal clo-sure,thus achieving a good state of nasal resonance and correct articulation as early as possible.

Objective:To compare the aneuploidy rate of embryos between poor ovarian response (POR) patients and women with normal ovarian reserve stratified by age, and to eliminate the influence of ovarian reserve on embryo quality.Methods:This was a retrospective case-control study of patients who underwent preimplantation genetic testing for aneuploidies (PGT-A) at the Department of Reproduction and Genetics in Hospital for Reproductive Medicine, Shandong University from January 2017 to December 2020. According to the POSEIDON criteria, POR patients were divided into group 1 [age<35 years, anti-Müllerian hormone (AMH)≥1.2 μg/L, number of oocytes retrieved≤9, 258 cycles], group 2 (age≥35 years, AMH≥1.2 μg/L, number of oocytes retrieved≤9, 397 cycles), group 3 (age<35 years, AMH<1.2 μg/L, number of oocytes retrieved≤9, 99 cycles) and group 4 (age≥35 years, AMH<1.2 μg/L, number of oocytes retrieved≤9, 377 cycles). The aneuploidy rate of the blastocysts in each group was compared with age-matched control women with normal ovarian reserve and normal ovarian response (non-POR 1 group, non-POR 2 group, non-POR 3 group and non-POR 4 group, AMH≥1.2 μg/L, number of oocytes retrieved>9). Based on the difference in sample size of POR groups and control groups, a 1∶2 propensity score matching (PSM) analysis was performed between the <35 years old POR groups and age-matched control groups (POR 1 group vs. non-POR 1 group, POR 3 group vs. non-POR 3 group) and a 1∶1 PSM analysis was performed between the ≥35 years old POR groups and age-matched control groups (POR 2 group vs. non-POR 2 group, POR 4 group vs. non-POR 4 group). The main outcomes were the rates of euploid and aneuploid embryo, the secondary outcomes were the numbers of oocytes retrieved, metaphaseⅡ oocytes, two pronuclei, embryos biopsied, euploid embryos, aneuploid embryos and mosaic embryos per cycle. Results:The number of oocytes retrieved and embryos biopsied embryos in POR 1-4 groups was significantly decreased compared with non-POR 1-4 groups [No. of oocytes retrieved: 7.0 (6.0, 9.0) vs. 16.0 (13.0, 20.0), 7.0 (5.0, 8.0) vs. 14.0 (11.0, 17.0), 6.0 (4.0, 9.0) vs. 16.0 (13.0, 20.0), 5.0 (3.0, 7.0) vs. 13.0 (11.0, 17.0), all P<0.001; No. of embryos biopsied: 3.0 (2.0, 4.0) vs. 4.0 (3.0, 6.0), 2.0 (1.0,3.0) vs. 3.0 (2.0, 5), 3.0 (2.0, 4.0) vs. 4.0 (3.0, 6.0), 2.0 (1.0, 3.0) vs. 3.0 (2.0, 5.0), all P<0.001]. After adjusting for repeated egg retrieval, PGT-A indications, ovarian stimulation protocol and total dosage of gonadotrophin, the embryo aneuploidy rate in group 4 POR patients was significantly higher than controls ( OR=1.252, 95% CI:1.053-1.488, P=0.011). However, no differences were identified in embryo aneuploidy rate between POR patients in groups 1, 2, 3 and corresponding controls, respectively (all P>0.05). Conclusion:The ovarian reserve adversely affects the quantity and quality of oocytes in advanced age POR women (≥35 years old). Decreased ovarian reserve in young women (<35 years old) mainly affects the number of oocytes retrieved.

Objective:To investigate the dynamic changes of mitochondrial fission and fusion in the heart of cardiac arrest (CA) rats after return of spontaneous circulation (ROSC), and to explore the role of mitochondrial fission and fusion in the myocardial injury after ROSC.Methods:Healthy male SD rats were randomly random number assigned into the post-resuscitation (PR) 4 h ( n=12), PR 24 h ( n=12), PR 72 h ( n=12), and sham groups ( n=6). The rat CA model was induced by asphyxia, and cardiopulmonary resuscitation (CPR) was performed 6 min after CA. The protein expressions of mitochondrial Drp1, Fis1, Mfn1, and Opa1 were determined by Western blot in each group at 4, 24 and 72 h after ROSC. The mRNA expressions of Drp1, Fis1, Mfn1, and Opa1 were determined by RT-PCR. Myocardial ATP content and mitochondrial respiratory function were measured. The histopathologic changes of myocardial tissue were observed under light microscope. One-way analysis of variance (ANOVA) was use to compare quantitative data, and LSD- t test was used for comparison between groups. Results:Compared with the sham group, the protein and mRNA expressions of Drp1 and Fis1 were increased (all P<0.05) and the protein and mRNA expressions of Mfn1 and Opa1 were decreased (all P<0.05) in the PR 4 h and PR 24 h groups. However, there were no statistical differences in the protein and mRNA expressions of Drp1, Fis1, Mfn1, and Opa1 in the PR 72 h group compared with the sham group (all P>0.05). Compared with the sham group, the levels of ATP content [(4.53±0.76) nmol/g protein vs. (8.57±0.44) nmol/g protein and (5.58±0.58) nmol/g protein vs. (8.57±0.44) nmol/g protein] and mitochondrial respiratory control rate [(2.47±0.38) vs. (3.45±0.32) and (2.97±0.24) vs. (3.45±0.32)] were obviously decreased in the PR 4 h and PR 24 h groups (all P<0.05). There were no statistically significant differences in the ATP content [(7.73±0.95) nmol/g protein vs. (8.57±0.44) nmol/g protein] and mitochondrial respiratory control ratio [(3.39±0.34) vs. (3.45±0.32)] between the PR 72 h group and the sham group (all P>0.05). The pathological damage of myocardial tissue was obvious in the PR 4 h group, and was improved significantly in the PR 72 h group. Conclusions:The imbalance of mitochondrial fission and fusion is probably involved in the pathological process of myocardial injury after ROSC, which may be related to mitochondrial dysfunction.