Objective To investigate the effect of unilateral or bilateral transcranial direct current stimulation(tDCS)on post-stroke dysphagia.Methods From February,2023 to March,2025,27 stroke patients with dysphagia and nasal feeding in Beijing Bo'ai Hos-pital were randomly divided into healthy side stimulation group,bilateral stimulation group and sham stimulation group,with nine cases in each group.All the groups received conventional swallowing training and tDCS,while the healthy side stimulation group stimulated on the healthy side of oropharyngeal cortex;and the bilateral stimu-lation group alternatively stimulated bilateral oropharyngeal cortex,with one hour interval between bilateral stim-ulation;the sham stimulation group stimulated the healthy side of oropharyngeal cortex for 30 seconds and then stop.The course lasted two weeks.The scores of Standard Swallowing Function Assessment Scale(SSA),Modi-fied Mann Assessment of Swallowing Ability(MMASA)and Rosenbek Penetration-Aspiration Scale(PAS)were compared before and after treatment.Results The intra-group effect(F=16.185,P<0.01)was significant in the scores of SSA,the intra-group effect(F=28.650,P<0.01)and interaction effect(F=3.453,P<0.01)were significant in the scores of MMASA,and there was no significant difference in the inter-group effect,intra-group effect and interaction effect in the scores of PAS(P>0.05).Post hoc test showed that there was no significant difference in the scores of SSA,MMASA and PAS among three groups(P>0.05).There was significant difference in the score difference of MMASA be-fore and after treatment among three groups(F=4.698,P<0.05).Post hoc test showed that the score difference of MMAS was more in the healthy side stimulation group than in the bilateral stimulation group and the sham stimulation group(P<0.05),with no significant difference between the bilateral stimulation group and the sham stimulation group(P>0.05).Conclusion tDCS can partly improve post-stroke dysphagia.The healthy side anode stimulation is superior to the alter-nating bilateral hemisphere anode stimulation.

Objective:To observe the effect of exercise-regulated miR-344g-5p on the fibrosis-related SMAD genes and transforming growth factor beta (TGF-β) in the myocardia of mice modeling diabetes.Methods:Twenty-four male C57BL/6 mice (6-8 weeks old) were randomly divided into a control group ( n=12) and a type 2 diabetes group ( n=12). Each group was further divided into two subgroups based on exercise status to form a sedentary control group, an exercise control, a sedentary type 2 diabetes group and an exercise type 2 diabetes group with six mice in each subgroup. The control groups were fed a normal diet, while the type 2 diabetes groups were on a high-fat diet for 12 weeks. Type 2 diabetes was then induced by intraperitoneal injection of streptozotocin. Two weeks later, the exercise groups began 40 minutes of daily swimming training, five days a week for eight consecutive weeks. Right after that, their cardiac function was measured using a small animal ultrasound system and the derived ejection fraction (EF) and the maximal early (E) and late (A) transmitral velocities ratio (E/A ratio) in diastole. They were then sacrificed and myocardial tissue was resected and stained with Sirius red. The expression of miR-344g-5p in the myocardium was detected using quantitative polymerase chain reactions. The expression of phosphorylated SMAD3 (p-SMAD3) and TGF-β were assessed using western blotting. The Target Scan database was exploited to analyze whether there were predicted targets of miR-344g-5p and pro-fibrotic genes such as SMAD3, TGFBR2, COL1A2 and COL12A1, and to determine any correlations in the gene regulation. Results:After 22 weeks, the EF and E/A ratio in the sedentary type 2 diabetes group were (57.5±4.1)% and (1.4±0.3), respectively, both significantly lower than in the other groups. Myocardial collagen fibers in the sedentary type 2 diabetes group were significantly more abundant than in the sedentary control and exercise type 2 diabetes groups. And miR-344g-5p expression in the myocardia of the exercise type 2 diabetes group was significantly greater than that in the sedentary type 2 diabetes group. The expression of p-SMAD3 and TGF-β in the myocardia of the sedentary type 2 diabetes group was significantly higher than in the sedentary control and exercise type 2 diabetes groups. Target Scan analysis revealed that miR-344g-5p had potential binding sites with several fibrosis-related genes such as SMAD3, TGFBR2, COL1A2, and COL12A1. Based on the reduction in TGF-β and p-SMAD protein expression in the exercise type 2 diabetes group, it was hypothesized that miR-344g-5p may inhibit the post-transcriptional processes of those genes.Conclusions:Exercise promotes the recovery of diabetic cardiomyopathy by upregulating myocardial miR-344g-5p expression, which subsequently targets and suppresses p-SMAD3 and TGF-β protein expression, thereby reducing diabetic myocardial fibrosis.

Epileptic seizure classification serves as an essential tool for evaluating seizures in clinical practice. In 2025, the International League Against Epilepsy updated the classification framework for epileptic seizures. An interpretation of the key updates is provided, with detailed content presented below: "onset" is removed from the names of the main seizure classes; consciousness is used as a classifier instead of awareness; the dichotomy of motor and non-motor is replaced by observable vs nonobservable manifestations; epileptic negative myocionus is recognized as a seizure type, to clarify the key updates to facilitate better application of the consensus in clinical practice.

Objective:To analyze the incidence of surgical site infection (SSI) in patients undergoing colorectal cancer (CRC) surgery and to identify risk factors associated with SSI in an attempt to provide a reference for clinical prevention strategies.Methods:A retrospective cohort study was conducted. Clinical data were retrospectively collected from a total of 2,248 patients who underwent surgery for pathologically confirmed CRC between 2017 and 2022 at two centers: Huangshan Shoukang Hospital ( n=649) and Northern Jiangsu People's Hospital ( n=1 599). Inclusion criteria consisted of the following: (1) age >18 years; (2) pathologically confirmed CRC treated with curative resection, including extended resections (e.g. pelvic exenteration); (3) no surgical incisions other than abdominal or perineal; and (4) no use of prosthetic implants. The incidence of SSI was analyzed, and multivariate logistic regression was used to identify independent its risk factors. Results:A total of 121 patients (5.4%) developed SSI. Among them, 68 cases (56.2%) were organ/space infections, 35 cases (28.9%) were deep incisional infections, and 18 cases (14.9%) were superficial incisional infections. The median postoperative hospital stay was significantly longer in patients with SSI compared to those without (21.0 days vs. 13.0 days, U=65,754, P<0.001). The median hospitalization cost was also significantly higher in the SSI group (56,550 yuan vs. 43,645 yuan, U=72,008, P<0.001). Multivariate logistic regression analysis identified body mass index (BMI) ≤ 20 kg/m 2 (OR=4.25, 95%CI: 3.38-5.34, P<0.001), diabetes mellitus (OR=3.44, 95%CI: 1.89-6.24, P<0.001), open surgery (OR=4.23, 95%CI: 2.37-7.56, P<0.001), and colostomy or ileostomy (OR=1.67, 95% CI: 1.04-2.69, P=0.034) as independent risk factors for SSI. Conclusion:To prevent SSI following CRC surgery, attention should be given to optimizing body weight and glycemic control, promoting minimally invasive surgical approaches when feasible, and cautiously considering the necessity of colostomy or ileostomy.

Objective:To investigate the clinical manifestation, therapy, and prognosis of Susac syndrome and enhance the understanding of this disease.Methods:A case summary was made.The clinical data of two siblings with Susac syndrome treated at Children′s Medical Center, Peking University First Hospital in January 2024 were summarized.Reported cases of pediatric Susac syndrome were reviewed.Results:The onset of the disease in the two siblings was at the age of 3.00 and 6.75 years, with recurrent headaches, tinnitus, hearing loss and encephalopathy symptoms.Cranial magnetic resonance imaging showed multiple cerebral microbleeding and microinfarction lesions, " snowball like" in the corpus callosum and diffuse white matter edema in the brain.Audiometry revealed sensorineural hearing loss.In one case, ophthalmic fluorescein angiography revealed ischemic changes due to branch retinal artery occlusions.No pathogenic variants were detected in gene testing.This child was diagnosed with Susac syndrome, and the symptoms were improved after treatment with Corticosteroids and Rituximab.No relapse was observed during the 9-month follow-up.A total of 20 pediatric cases of Susac syndrome were retrieved, including 18 reported previously and 2 cases from this study.There were 2 boys and 18 girls, with the age of onset ranging from 2.5 to 17.0 years.The common initial symptoms included headache (19 cases), vertigo and tinnitus or hearing loss (9 cases), and vision impairment or visual field defect (4 cases). The symptoms were improved after immunotherapy.Conclusions:With a low incidence, Susac syndrome is rare in children and difficult to diagnose.There may be a genetic predisposition in such disease.Early diagnosis and immunotherapy can low the relapse and improve the prognosis.

Objective To report the individualized rehabilitation protocol administered to a patient suffering from corpus callosum injury subsequent to cerebral infarction,manifesting clinically as alien hand syndrome,attention deficits,spatial neglect and gait apraxia;and to emphasize the application of functional near infrared spectroscopy(fNIRS)in the assessment of cerebral activation.Methods A 54-year-old male with corpus callosum damage following cerebral infarction was assessed by a comprehen-sive array of neuropsychological assessments,such as Mini-Mental State Examination,Montreal Cognitive As-sessment,Loewenstein Occupational Therapy Cognitive Assessment and Wisconsin Card Sorting Test,etc.Based on these assessments,a personalized rehabilitation program was devised,incorporating physical therapy,occupa-tional therapy,task-oriented training,mirror therapy,computer-assisted cognitive training,as well as Schulte's square attention training,bilateral limb coordination training and transcranial magnetic stimulation(TMS).fNIRS was used to evaluate changes in brain activation before and after rehabilitation.Results After more than a month of comprehensive rehabilitation,the patient experienced significant improvements in Alien hand syndrome,attention deficit and spatial neglect.Gait was normalized,and enhancements were ob-served in motor function,cognition and activity of daily living.fNIRS analysis revealed favorable alterations in cerebral activation patterns.Conclusion For the intricate symptoms associated with corpus callosum injury,a multidisciplinary rehabilitation ap-proach,particularly the incorporation of Schulte's square attention training,bilateral coordination exercises and TMS,alongside fNIRS for monitoring cerebral activation,showed significant rehabilitation effects.

Objective:To investigate the clinical manifestation, therapy, and prognosis of Susac syndrome and enhance the understanding of this disease.Methods:A case summary was made.The clinical data of two siblings with Susac syndrome treated at Children′s Medical Center, Peking University First Hospital in January 2024 were summarized.Reported cases of pediatric Susac syndrome were reviewed.Results:The onset of the disease in the two siblings was at the age of 3.00 and 6.75 years, with recurrent headaches, tinnitus, hearing loss and encephalopathy symptoms.Cranial magnetic resonance imaging showed multiple cerebral microbleeding and microinfarction lesions, " snowball like" in the corpus callosum and diffuse white matter edema in the brain.Audiometry revealed sensorineural hearing loss.In one case, ophthalmic fluorescein angiography revealed ischemic changes due to branch retinal artery occlusions.No pathogenic variants were detected in gene testing.This child was diagnosed with Susac syndrome, and the symptoms were improved after treatment with Corticosteroids and Rituximab.No relapse was observed during the 9-month follow-up.A total of 20 pediatric cases of Susac syndrome were retrieved, including 18 reported previously and 2 cases from this study.There were 2 boys and 18 girls, with the age of onset ranging from 2.5 to 17.0 years.The common initial symptoms included headache (19 cases), vertigo and tinnitus or hearing loss (9 cases), and vision impairment or visual field defect (4 cases). The symptoms were improved after immunotherapy.Conclusions:With a low incidence, Susac syndrome is rare in children and difficult to diagnose.There may be a genetic predisposition in such disease.Early diagnosis and immunotherapy can low the relapse and improve the prognosis.

Objective:To analyze the incidence of surgical site infection (SSI) in patients undergoing colorectal cancer (CRC) surgery and to identify risk factors associated with SSI in an attempt to provide a reference for clinical prevention strategies.Methods:A retrospective cohort study was conducted. Clinical data were retrospectively collected from a total of 2,248 patients who underwent surgery for pathologically confirmed CRC between 2017 and 2022 at two centers: Huangshan Shoukang Hospital ( n=649) and Northern Jiangsu People's Hospital ( n=1 599). Inclusion criteria consisted of the following: (1) age >18 years; (2) pathologically confirmed CRC treated with curative resection, including extended resections (e.g. pelvic exenteration); (3) no surgical incisions other than abdominal or perineal; and (4) no use of prosthetic implants. The incidence of SSI was analyzed, and multivariate logistic regression was used to identify independent its risk factors. Results:A total of 121 patients (5.4%) developed SSI. Among them, 68 cases (56.2%) were organ/space infections, 35 cases (28.9%) were deep incisional infections, and 18 cases (14.9%) were superficial incisional infections. The median postoperative hospital stay was significantly longer in patients with SSI compared to those without (21.0 days vs. 13.0 days, U=65,754, P<0.001). The median hospitalization cost was also significantly higher in the SSI group (56,550 yuan vs. 43,645 yuan, U=72,008, P<0.001). Multivariate logistic regression analysis identified body mass index (BMI) ≤ 20 kg/m 2 (OR=4.25, 95%CI: 3.38-5.34, P<0.001), diabetes mellitus (OR=3.44, 95%CI: 1.89-6.24, P<0.001), open surgery (OR=4.23, 95%CI: 2.37-7.56, P<0.001), and colostomy or ileostomy (OR=1.67, 95% CI: 1.04-2.69, P=0.034) as independent risk factors for SSI. Conclusion:To prevent SSI following CRC surgery, attention should be given to optimizing body weight and glycemic control, promoting minimally invasive surgical approaches when feasible, and cautiously considering the necessity of colostomy or ileostomy.

Objective:To observe the effect of exercise-regulated miR-344g-5p on the fibrosis-related SMAD genes and transforming growth factor beta (TGF-β) in the myocardia of mice modeling diabetes.Methods:Twenty-four male C57BL/6 mice (6-8 weeks old) were randomly divided into a control group ( n=12) and a type 2 diabetes group ( n=12). Each group was further divided into two subgroups based on exercise status to form a sedentary control group, an exercise control, a sedentary type 2 diabetes group and an exercise type 2 diabetes group with six mice in each subgroup. The control groups were fed a normal diet, while the type 2 diabetes groups were on a high-fat diet for 12 weeks. Type 2 diabetes was then induced by intraperitoneal injection of streptozotocin. Two weeks later, the exercise groups began 40 minutes of daily swimming training, five days a week for eight consecutive weeks. Right after that, their cardiac function was measured using a small animal ultrasound system and the derived ejection fraction (EF) and the maximal early (E) and late (A) transmitral velocities ratio (E/A ratio) in diastole. They were then sacrificed and myocardial tissue was resected and stained with Sirius red. The expression of miR-344g-5p in the myocardium was detected using quantitative polymerase chain reactions. The expression of phosphorylated SMAD3 (p-SMAD3) and TGF-β were assessed using western blotting. The Target Scan database was exploited to analyze whether there were predicted targets of miR-344g-5p and pro-fibrotic genes such as SMAD3, TGFBR2, COL1A2 and COL12A1, and to determine any correlations in the gene regulation. Results:After 22 weeks, the EF and E/A ratio in the sedentary type 2 diabetes group were (57.5±4.1)% and (1.4±0.3), respectively, both significantly lower than in the other groups. Myocardial collagen fibers in the sedentary type 2 diabetes group were significantly more abundant than in the sedentary control and exercise type 2 diabetes groups. And miR-344g-5p expression in the myocardia of the exercise type 2 diabetes group was significantly greater than that in the sedentary type 2 diabetes group. The expression of p-SMAD3 and TGF-β in the myocardia of the sedentary type 2 diabetes group was significantly higher than in the sedentary control and exercise type 2 diabetes groups. Target Scan analysis revealed that miR-344g-5p had potential binding sites with several fibrosis-related genes such as SMAD3, TGFBR2, COL1A2, and COL12A1. Based on the reduction in TGF-β and p-SMAD protein expression in the exercise type 2 diabetes group, it was hypothesized that miR-344g-5p may inhibit the post-transcriptional processes of those genes.Conclusions:Exercise promotes the recovery of diabetic cardiomyopathy by upregulating myocardial miR-344g-5p expression, which subsequently targets and suppresses p-SMAD3 and TGF-β protein expression, thereby reducing diabetic myocardial fibrosis.

Epileptic seizure classification serves as an essential tool for evaluating seizures in clinical practice. In 2025, the International League Against Epilepsy updated the classification framework for epileptic seizures. An interpretation of the key updates is provided, with detailed content presented below: "onset" is removed from the names of the main seizure classes; consciousness is used as a classifier instead of awareness; the dichotomy of motor and non-motor is replaced by observable vs nonobservable manifestations; epileptic negative myocionus is recognized as a seizure type, to clarify the key updates to facilitate better application of the consensus in clinical practice.