Objective:To observe any effect of dual-task training on abnormal gait and fall risk among hemiplegic stroke survivors.Methods:A total of 90 stroke survivors were randomly divided into a control group, a cognitive dual-task group, and a motor dual-task group, each of 30. All 3 groups received conventional post-stroke medication and rehabilitation training, but the cognitive and motor dual-task groups received cognitive or motor dual-task training as well. Before and after 4 weeks of the training, everyone′s balance, walking and lower limb motor functioning were assessed using the Berg Balance Scale (BBS), the Timed Up and Go test (TUGT) and the Fugl-Meyer lower extremity assessment (FMA-LE). Additionally, three-dimensional gait analysis was performed to document gait speed, bilateral spatial asymmetry, bilateral temporal asymmetry, and the dual-task cost (DTC) of gait speed.Results:Significant improvement was observed in the average BBS scores, TUGT times, FMA-LE scores, gait speed, DTC of gait speed, bilateral spatial asymmetry ratios, and bilateral temporal asymmetry ratios of all 3 groups after the experiment. The averages of the cognitive dual-task group were then significantly better than the control group′s averages. The motor dual-task group′s average BBS score (42.67±7.87), TUGT time [(22.30±8.53)s], gait speed (0.58±0.2m/s), DTC of gait speed (19.02±5.99%), and bilateral spatial asymmetry ratio (19.79±10.41%) were then significantly better than the control group′s averages but not significantly different from those of the cognitive dual-task group.Conclusions:Dual-task training can significantly improve the balance, walking and lower limb motor function of stroke survivors, correcting their abnormal gait patterns and consequently reducing their fall risks.

Objective:To observe the clinical efficacy of different treatment methods in treating older patients with oral papilloma.Methods:A randomized controlled study was conducted on 40 older patients with oral papilloma who visited the Department of Stomatology of Beijing Hospital from August 2022 to November 2024.They were randomly divided into a surgical resection group and a 5-aminolevulinic acid (ALA) application group.There were 15 males and 25 females, with ages ranging from 60 to 82 (70.20 ± 6.53) years old.The ALA application group received ALA photodynamic therapy (PDT), while the surgical resection group underwent surgical resection of the papilloma.Visual analog scale (VAS) and self-assessment anxiety and depression scale were used to evaluate the two groups of patients at different periods.Results:All lesions in both groups achieved complete healing, with no recurrence observed during the 6-month follow-up period.Although the ALA application group received more treatment sessions than the surgical resection group, postoperative VAS scores and the duration of postoperative pain were both significantly lower [VAS score: (2.95±0.83) vs. (4.95±1.32) points; pain duration: (4.65±0.67) vs.(6.20±1.06) days]( t=5.755 and 5.540, respectively; both P<0.001). Before treatment, there was no statistically significant difference in either self- assessed anxiety or self- assessed depression scores between the two groups (both P>0.05). Six months after treatment, the self- assessed anxiety score in the ALA application group was significantly higher than that in the surgical resection group ( P<0.05), whereas no significant difference was observed in the self- assessed depression score ( P>0.05). Conclusions:Both ALA-PDT and surgical resection can effectively treat oral papilloma in older patients.However, ALA-PDT has lighter and shorter duration of postoperative pain, making it more suitable for treating lesions in special anatomical areas such as the corners of the mouth and the duct openings of the parotid glands.

Objective:Summarize the clinical characteristics, treatment methods, and prognosis of paraneoplastic pemphigus with oral lesions, and identify commonalities and features to provide better references for the clinical diagnosis and treatment of this disease.Methods:A retrospective analysis was conducted on the case data and clinical photos of 9 patients with paraneoplastic pemphigus accompanied by oral lesions treated in the Internal Medicine Ward and Department of Stomatology of Beijing Hospital from September 2017 to December 2023, and the clinical characteristics were summarized and analyzed.Results:All 9 patients had oral mucosal and skin lesions simultaneously, in whom visceral tumors were found upon systemic examinations, including 4 cases of Castleman′s disease, 4 cases of thymoma, and 1 case of lung cancer. All patients had received glucocorticoid therapy before a clear diagnosis, but the effect was not significant. After removing the primary tumor, corticosteroid intravenous or oral therapies were usually continued, supplemented with immunoglobulin and immunosuppressants for treatment, which could achieve significant therapeutic effects. With primary tumor resection, 6 patients continued to receive corticosteroid intravenous or oral treatment for 6 to 12 months, supplemented with immunoglobulin and immunosuppressants. Oral mucosal erosion improved significantly and skin lesions were relieved. Three patients who were unable to remove their primary tumor continued with the previous glucocorticoid treatment regimen and died within one year. However, local treatment of their oral cavity during the treatment process still helped alleviate oral mucosal pain, promote erosion healing, and improve nutritional status.Conclusions:Multiple erosions of the oral mucosa and polymorphic skin damages are common clinical manifestations of paraneoplastic pemphigus. Castleman′s disease and thymoma are common coexisting tumors. Early diagnosis and timely surgical resection of tumors are crucial for treatment and prognosis. The application of glucocorticoids and local oral treatment after resection is effective.

Objective:To propose a deep learning（DL）-based ultrasound imaging auxiliary tool for automatic segmentation and recognition of the brachial plexus（BP），and to enhance the accuracy and safety of clinical procedures.Methods:It was a multicenter study that collected 773 healthy subjects from Peking University Third Hospital and its branch campuses，the Third Medical Center of the Chinese PLA General Hospital，and Shanghai Eighth People's Hospital between August 2024 and February 2025. Brachial plexus（BP）images in the interscalene groove were captured used high-frequency ultrasound by senior sonographers，a dataset comprising 1 289 standardized images were constructed and the improved model（CHA-TransUNet）was trained. The test set was input into 6 different models（CHA-TransUNet，R50-Unet，TransUnet，SegFormer，SwinUnet，MISSFormer）for segmentation. Segmentation accuracy was evaluated using metrics including the Dice similarity coefficient（DSC），95% Hausdorff distance（HD95）and mean intersection over union（mIoU），and was compared with the segmentation results of 3 ultrasound physicians with varying experience levels（junior physicians and senior physicians）to validate the model's segmentation efficacy.Results:The CHA-TransUNet model established based on a dataset of 1 289 standardized images achieved segmentation results for the BP with a DSC of 90.15%，mIoU of 91.02%，and HD95 of 8.08. Its accuracy was higher than other mainstream models（DSC：90.15% vs. 87.60%，87.77%，81.35%，84.78%，84.55%），significantly better than junior physicians（DSC：90.15% vs. 68.73%， Z=-127.76， P<0.001），and approached the level of senior physician（DSC：90.15% vs. 86.15%， Z=-31.33， P=0.549）. The model demonstrated superior boundary recognition in complex anatomical structures（e.g.，C6/C7 nerve roots）compared to ultrasound physicians（junior and senior）（HD95：8.08 vs. 26.34，17.44，56.80）. Conclusions:This study proposes an analysis model for BP ultrasound images，CHA-TransUNet. This model achieves segmentation and recognition of the BP with relatively complex pathways and structures. The model exhibits high accuracy and stability，outperforming current mainstream network models and junior physicians while approaching the performance level of senior physicians. It assists junior physicians or trainees in more accurately identifying and localizing the BP.

Objective:Summarize the clinical characteristics, treatment methods, and prognosis of paraneoplastic pemphigus with oral lesions, and identify commonalities and features to provide better references for the clinical diagnosis and treatment of this disease.Methods:A retrospective analysis was conducted on the case data and clinical photos of 9 patients with paraneoplastic pemphigus accompanied by oral lesions treated in the Internal Medicine Ward and Department of Stomatology of Beijing Hospital from September 2017 to December 2023, and the clinical characteristics were summarized and analyzed.Results:All 9 patients had oral mucosal and skin lesions simultaneously, in whom visceral tumors were found upon systemic examinations, including 4 cases of Castleman′s disease, 4 cases of thymoma, and 1 case of lung cancer. All patients had received glucocorticoid therapy before a clear diagnosis, but the effect was not significant. After removing the primary tumor, corticosteroid intravenous or oral therapies were usually continued, supplemented with immunoglobulin and immunosuppressants for treatment, which could achieve significant therapeutic effects. With primary tumor resection, 6 patients continued to receive corticosteroid intravenous or oral treatment for 6 to 12 months, supplemented with immunoglobulin and immunosuppressants. Oral mucosal erosion improved significantly and skin lesions were relieved. Three patients who were unable to remove their primary tumor continued with the previous glucocorticoid treatment regimen and died within one year. However, local treatment of their oral cavity during the treatment process still helped alleviate oral mucosal pain, promote erosion healing, and improve nutritional status.Conclusions:Multiple erosions of the oral mucosa and polymorphic skin damages are common clinical manifestations of paraneoplastic pemphigus. Castleman′s disease and thymoma are common coexisting tumors. Early diagnosis and timely surgical resection of tumors are crucial for treatment and prognosis. The application of glucocorticoids and local oral treatment after resection is effective.

Objective:To observe any effect of dual-task training on abnormal gait and fall risk among hemiplegic stroke survivors.Methods:A total of 90 stroke survivors were randomly divided into a control group, a cognitive dual-task group, and a motor dual-task group, each of 30. All 3 groups received conventional post-stroke medication and rehabilitation training, but the cognitive and motor dual-task groups received cognitive or motor dual-task training as well. Before and after 4 weeks of the training, everyone′s balance, walking and lower limb motor functioning were assessed using the Berg Balance Scale (BBS), the Timed Up and Go test (TUGT) and the Fugl-Meyer lower extremity assessment (FMA-LE). Additionally, three-dimensional gait analysis was performed to document gait speed, bilateral spatial asymmetry, bilateral temporal asymmetry, and the dual-task cost (DTC) of gait speed.Results:Significant improvement was observed in the average BBS scores, TUGT times, FMA-LE scores, gait speed, DTC of gait speed, bilateral spatial asymmetry ratios, and bilateral temporal asymmetry ratios of all 3 groups after the experiment. The averages of the cognitive dual-task group were then significantly better than the control group′s averages. The motor dual-task group′s average BBS score (42.67±7.87), TUGT time [(22.30±8.53)s], gait speed (0.58±0.2m/s), DTC of gait speed (19.02±5.99%), and bilateral spatial asymmetry ratio (19.79±10.41%) were then significantly better than the control group′s averages but not significantly different from those of the cognitive dual-task group.Conclusions:Dual-task training can significantly improve the balance, walking and lower limb motor function of stroke survivors, correcting their abnormal gait patterns and consequently reducing their fall risks.

Objective:To observe the clinical efficacy of different treatment methods in treating older patients with oral papilloma.Methods:A randomized controlled study was conducted on 40 older patients with oral papilloma who visited the Department of Stomatology of Beijing Hospital from August 2022 to November 2024.They were randomly divided into a surgical resection group and a 5-aminolevulinic acid (ALA) application group.There were 15 males and 25 females, with ages ranging from 60 to 82 (70.20 ± 6.53) years old.The ALA application group received ALA photodynamic therapy (PDT), while the surgical resection group underwent surgical resection of the papilloma.Visual analog scale (VAS) and self-assessment anxiety and depression scale were used to evaluate the two groups of patients at different periods.Results:All lesions in both groups achieved complete healing, with no recurrence observed during the 6-month follow-up period.Although the ALA application group received more treatment sessions than the surgical resection group, postoperative VAS scores and the duration of postoperative pain were both significantly lower [VAS score: (2.95±0.83) vs. (4.95±1.32) points; pain duration: (4.65±0.67) vs.(6.20±1.06) days]( t=5.755 and 5.540, respectively; both P<0.001). Before treatment, there was no statistically significant difference in either self- assessed anxiety or self- assessed depression scores between the two groups (both P>0.05). Six months after treatment, the self- assessed anxiety score in the ALA application group was significantly higher than that in the surgical resection group ( P<0.05), whereas no significant difference was observed in the self- assessed depression score ( P>0.05). Conclusions:Both ALA-PDT and surgical resection can effectively treat oral papilloma in older patients.However, ALA-PDT has lighter and shorter duration of postoperative pain, making it more suitable for treating lesions in special anatomical areas such as the corners of the mouth and the duct openings of the parotid glands.

Objective:To propose a deep learning（DL）-based ultrasound imaging auxiliary tool for automatic segmentation and recognition of the brachial plexus（BP），and to enhance the accuracy and safety of clinical procedures.Methods:It was a multicenter study that collected 773 healthy subjects from Peking University Third Hospital and its branch campuses，the Third Medical Center of the Chinese PLA General Hospital，and Shanghai Eighth People's Hospital between August 2024 and February 2025. Brachial plexus（BP）images in the interscalene groove were captured used high-frequency ultrasound by senior sonographers，a dataset comprising 1 289 standardized images were constructed and the improved model（CHA-TransUNet）was trained. The test set was input into 6 different models（CHA-TransUNet，R50-Unet，TransUnet，SegFormer，SwinUnet，MISSFormer）for segmentation. Segmentation accuracy was evaluated using metrics including the Dice similarity coefficient（DSC），95% Hausdorff distance（HD95）and mean intersection over union（mIoU），and was compared with the segmentation results of 3 ultrasound physicians with varying experience levels（junior physicians and senior physicians）to validate the model's segmentation efficacy.Results:The CHA-TransUNet model established based on a dataset of 1 289 standardized images achieved segmentation results for the BP with a DSC of 90.15%，mIoU of 91.02%，and HD95 of 8.08. Its accuracy was higher than other mainstream models（DSC：90.15% vs. 87.60%，87.77%，81.35%，84.78%，84.55%），significantly better than junior physicians（DSC：90.15% vs. 68.73%， Z=-127.76， P<0.001），and approached the level of senior physician（DSC：90.15% vs. 86.15%， Z=-31.33， P=0.549）. The model demonstrated superior boundary recognition in complex anatomical structures（e.g.，C6/C7 nerve roots）compared to ultrasound physicians（junior and senior）（HD95：8.08 vs. 26.34，17.44，56.80）. Conclusions:This study proposes an analysis model for BP ultrasound images，CHA-TransUNet. This model achieves segmentation and recognition of the BP with relatively complex pathways and structures. The model exhibits high accuracy and stability，outperforming current mainstream network models and junior physicians while approaching the performance level of senior physicians. It assists junior physicians or trainees in more accurately identifying and localizing the BP.

Objective To observe the clinical efficacy and safety of external application of Piyan Formula in treating epidermal growth factor receptor tyrosine kinase inhibitor(EGFR-TKIs)-related rashes.Methods Sixty cases of EGFR-TKIs-related rash patients were randomly allocated into either a treatment group or a control group.The treatment group received external application of Piyan Formula to the rash area twice daily for 14 days.The control group received external application of fucidic acid cream to the rash area twice daily for 14 days.Changes in rash grading,itching grading,quality of life scores and adverse event were observed and recorded in both groups.At the same time,levels of hypersensitive C-reactive protein,interleukin(IL)-6,and IL-1β were measured before treatment and 24 hours after treatment.Results After treatment,the rash severity,itching severity,and quality of life scores were notably lower in the treatment group compared to the control group(P<0.05).The levels of hypersensitive C-reactive protein,IL-6,and IL-1β exhibited a significant decrease compared to their pre-treatment values.(P<0.05).Compared with the control group,the levels of hypersensitive C-reactive protein,IL-6,and IL-1β decreased in the treatment group,with statistically significant differences(P<0.05).No adverse events related to Piyan Formula or fucidic acid cream occurred during the treatment process.Conclusion External application of Piyan Formula in treating EGFR-TKIs-related rashes shows significant clinical efficacy,can effectively reduce the levels of inflammatory factors,and has high safety,thus warranting clinical promotion.

Objective To compare the safety and clinical value of warm-water infusion or carbon dioxide(CO2)insufflation in difficult colonoscopy.Methods A collection of 150 patients from May 2021 to October 2023 who underwent unsedated and difficult colonoscopy were randomly divided into warm-water insufflation group(W group,n=50),CO2 insufflation group(C group,n=50)and air insufflation group(A group,n=50).Record the cecal insertion time,the abdominal pain score during the examination and 20 min and 1 h after the examination,the success rate of intubation,the polyps detection rate,the willingness to re-examine and the need for assistance in the three groups.Some patients were randomly selected to record partial pressure of end-tidal carbon dioxide(PetCO2)of pre-examination,the ileocecal and 20 min after the examination to understand CO2 retention in the body.Results The cecal insertion time of group A was longer than that of group W and group C,and group W was shorter than group C.The abdominal pain score of group A was higher than that of group W and group C at each time point,and the abdominal pain score during the examination was lower in the group W compared with group C.The success rate of intubation and the willingness to re-examination in the group A were lower than those in group W and group C,The above differences were statistically significant(P<0.05).However,there was no statistical difference between the the group W and group C in terms of success rate of intubation,willingness to re-examine,and abdominal pain score at 20 minutes and 1 hour after the examination(P>0.05).In the group W,significantly fewer patients required abdominal compression compared with the other two groups,and the rate of position conversion was significantly lower than that in group A(P<0.05).There was no significant difference in the detection rate of polyps among the three groups(P>0.05).In addition,PetCO2 of group C was within the normal range at all time points,and there was no statistical difference compared with the group A(P>0.05).Conclusion Compared with the air group,water or CO2 insufflation colonoscopy is safe and has a high success rate in difficult colonoscopy.It can reduce the patient's abdominal discomfort,especially water insufflation colonoscopy is more suitable for promotion in primary hospitals.