ObjectiveTo evaluate the impact of stroke on diaphragmatic function by ultrasound. MethodsFrom April, 2024 to June, 2025, 40 stroke patients (stroke group) were recruited in Xuanwu Hospital Capital Medical University. Additionally, 40 sex- and age-matched healthy subjects (control group) were recruited without directional selection. Diaphragmatic excursion and diaphragmatic thickness during quiet breathing and deep breathing were assessed using ultrasound in both groups, and the diaphragmatic thickening fraction was calculated. The stroke group was further divided into two subgroups according to disease course: ≤ 30 days group and > 30 days group, for subgroup analysis. ResultsDuring both quiet and deep breathing, diaphragmatic excursion on the affected side in the stroke group was smaller than that on the unaffected side and in the control group (P < 0.05). During quiet breathing, diaphragmatic thickening fraction on the affected side in the stroke group was smaller than that on the unaffected side and in the control group (P < 0.05), while the diaphragmatic thickening fraction on the unaffected side was significantly smaller than that in the control group (P < 0.01). During deep breathing, the bilateral diaphragmatic thickening fraction in the stroke group was significantly smaller than that in the control group (P < 0.001), and the bilateral end-inspiratory diaphragmatic thickness was significantly smaller than that in the control group (P < 0.001). During quiet breathing, diaphragmatic excursion in both the ≤ 30 d group and the > 30 d group was smaller than that in the control group (P < 0.05); during deep breathing, diaphragmatic excursion in the ≤ 30 d group was smaller than that in the control group (P < 0.05). In both quiet breathing and deep breathing, the diaphragmatic thickening fraction in the ≤ 30 d group and the >30 d group were lower than those in the control group (P < 0.05). During deep breathing, end-inspiratory diaphragmatic thickness in both the ≤ 30 d group and the > 30 d group was significantly smaller than that in the control group (P < 0.01). ConclusionUltrasound can effectively identify the impact of stroke on patients' diaphragmatic function. In stroke patients, both diaphragmatic excursion and contractile performance are reduced on the affected side, while contractile performance is also reduced on the unaffected side.

The plant F-box protein more axillary growth 2 (MAX2) is a key factor in the signal transduction of strigolactones (SLs) and karrinkins (KARs). As the main component of the SKP1-CUL1-FBX (SCF) complex ubiquitin ligase E3, MAX2 is responsible for specifically recognizing the target proteins, suppressor of MAX2 1/SMAX1-like proteins (SMAX1/SMXLs), which would be degraded after ubiquitination. It can thereby regulate plant morphogenesis and stress responses. There exist homologous genes of MAX2 in the important grain and oil crop soybean (Glycine max). However, its role in plant defense responses has not been investigated yet. Here, GmMAX2b, a homologous gene of MAX2, was successfully cloned from stressed soybean. Bioinformatics analysis revealed that there were two MAX2 homologous genes, GmMAX2a and GmMAX2b, with a similarity of 96.2% in soybean. Their F-box regions were highly conserved. The sequence alignment and cluster analysis of plant MAX2 homologous proteins basically reflected the evolutionary relationship of plants and also suggested that soybean MAX2 might be a multifunctional protein. Expression analysis showed that plant pathogen infection and salicylic acid treatment induced the expression of GmMAX2b in soybean, which is consistent with that of MAX2 in Arabidopsis. Ectopic expression of GmMAX2b compensated for the susceptibility of Arabidopsis max2-2 mutant to pathogen, indicating that GmMAX2b positively regulated plant disease resistance. In addition, yeast two hybrid technology was used to explore the potential target proteins of GmMAX2b. The results showed that GmMAX2b interacted with SMXL6 and weakly interacted with SMXL2. In summary, GmMAX2b is a positive regulator in plant defense responses, and its expression is induced by pathogen infection and salicylic acid treatment. GmMAX2b might exert its effect through interaction with SMXL6 and SMXL2. This study expands the theoretical exploration of soybean disease resistant F-box and provides a scientific basis for future soybean disease resistant breeding.
Glycine max/metabolism* ; Disease Resistance/genetics* ; Plant Diseases/immunology* ; Plant Proteins/genetics* ; Cloning, Molecular ; Gene Expression Regulation, Plant ; F-Box Proteins/genetics* ; Arabidopsis/genetics* ; Phylogeny

Objective To investigate cortical morphological changes and structural covariance network(SCN)topological features in patients with visuospatial neglect(VSN)after stroke.Methods A retrospective analysis was conducted on acute stroke patients admitted consecutively to the Department of Rehabilitation Medicine,Xuanwu Hospital,Capital Medical University,from December 2023 to February 2025.General and clinical data were collected and compared,including age,sex,stroke type(hemorrhagic or ischemic),and time from stroke onset to first brain MRI.All patients were assessed for VSN using the line bisection task,line cancellation test,and star cancellation test.Patients with VSN were assigned to the VSN group,and those without VSN to the non-VSN group.Brain MRI was used to collect patients' brain structural images.T1-weighted MRI data were processed using Freesurfer for whole-brain segmentation.Based on the Desikan-Killiany atlas,the cortex was parcellated into 68 regions per hemisphere,total intracranial volume and cortical parameters were extracted,including cortical area(CA),mean cortical curvature(CC),cortical thickness(CT),and cortical volume(CV).A region-specific asymmetry index(AI)was calculated for cortical parameters of each brain regions using(left-right)/(left+right)to assess cortical lateralization.Analyze the SCN of each cortical parameters through covariance matrix to reflect covariation pattern of each brain region's structural morphological alternations.SCN were constructed separately for each cortical parameter based on inter-regional Pearson correlation coefficients(absolute values),with intracranial volume,age,and sex controlled via linear regression.The resulting 68×68 SCN matrices were transformed into binary networks across a sparsity range of 0.1 to 0.4(in 0.01 steps),and graph theoretical analysis were performed.Permutation tests were used to compare the global and local graph theoretical metrics of cortical SCN under each cortical parameters with different sparsity.Global metrics included clustering coefficient,path length,small-worldness parameters(normalized clustering coefficient[Gamma],normalized path length[Lambda],and small-world index[Sigma]),global efficiency,and average local efficiency.Local metrics included nodal degree,betweenness centrality,and nodal efficiency.Results(1)A total of 109 acute stroke patients were included(81 males,28 females,aged 30-80 years,mean[64±9]years),with 54 in the VSN group and 55 in the non-VSN group.No significant differences were found in age,sex,stroke type,or time from stroke onset to MRI between two groups(all P＞0.05).(2)Comparison of cortical features(of different brain regions)between two groups showed significantly larger CA in the right insular surface area in the VSN group(2 466.50[2 143.75,2 662.50]mm2 vs.2 128.00[1 961.00,2 479.00)]mm2,P=0.037).No significant differences were observed in other regions or metrics(all P＞0.05).The VSN group has significantly lower AI values for CT in the right isthmus cingulate gyrus(-0.01[-0.05,0.03]vs.0.02[-0.01,0.06],P=0.028)and postcentral gyrus(-0.02[-0.04,0.00]vs.0.00[-0.02,0.02],P=0.026).No significant AI differences were observed in other regions or metrics(all P＞0.05).(3)For global network metrics:in the CA-based VSN,compared with the non-VSN group,Sigma values were significantly higher in the VSN group across multiple sparsity thresholds and at the average sparsity level(P＜0.01).In the CT-based SCN,Lambda values were significantly higher in the VSN group at most sparsity thresholds and at the average level(P=0.004).In the CC-based SCN,clustering coefficient and average local efficiency were significantly lower in the VSN group across most sparsity thresholds and average sparsity(P＜0.01).No significant differences were found in global metrics within the CV-based SCN.(4)For local metrics:in the CV-based SCN,compared with the non-VSN group,the VSN group showed significantly lower nodal efficiency in the left inferior temporal gyrus at most sparsity thresholds and at the average level(0.35[0.29,0.50]vs.0.65[0.51,0.72],P＜0.01).No significant differences in local metrics were observed in other SCN between the two groups.Conclusions Patients with VSN exhibit abnormal cortical morphology and SCN topology,characterized by reduced overall integration efficiency and weakened local connectivity,alongside enhanced small-worldness and possible compensatory reorganization.The conclusions of this study require further validation in multicenter,large-scale,prospective studies.

Objective To investigate cortical morphological changes and structural covariance network(SCN)topological features in patients with visuospatial neglect(VSN)after stroke.Methods A retrospective analysis was conducted on acute stroke patients admitted consecutively to the Department of Rehabilitation Medicine,Xuanwu Hospital,Capital Medical University,from December 2023 to February 2025.General and clinical data were collected and compared,including age,sex,stroke type(hemorrhagic or ischemic),and time from stroke onset to first brain MRI.All patients were assessed for VSN using the line bisection task,line cancellation test,and star cancellation test.Patients with VSN were assigned to the VSN group,and those without VSN to the non-VSN group.Brain MRI was used to collect patients' brain structural images.T1-weighted MRI data were processed using Freesurfer for whole-brain segmentation.Based on the Desikan-Killiany atlas,the cortex was parcellated into 68 regions per hemisphere,total intracranial volume and cortical parameters were extracted,including cortical area(CA),mean cortical curvature(CC),cortical thickness(CT),and cortical volume(CV).A region-specific asymmetry index(AI)was calculated for cortical parameters of each brain regions using(left-right)/(left+right)to assess cortical lateralization.Analyze the SCN of each cortical parameters through covariance matrix to reflect covariation pattern of each brain region's structural morphological alternations.SCN were constructed separately for each cortical parameter based on inter-regional Pearson correlation coefficients(absolute values),with intracranial volume,age,and sex controlled via linear regression.The resulting 68×68 SCN matrices were transformed into binary networks across a sparsity range of 0.1 to 0.4(in 0.01 steps),and graph theoretical analysis were performed.Permutation tests were used to compare the global and local graph theoretical metrics of cortical SCN under each cortical parameters with different sparsity.Global metrics included clustering coefficient,path length,small-worldness parameters(normalized clustering coefficient[Gamma],normalized path length[Lambda],and small-world index[Sigma]),global efficiency,and average local efficiency.Local metrics included nodal degree,betweenness centrality,and nodal efficiency.Results(1)A total of 109 acute stroke patients were included(81 males,28 females,aged 30-80 years,mean[64±9]years),with 54 in the VSN group and 55 in the non-VSN group.No significant differences were found in age,sex,stroke type,or time from stroke onset to MRI between two groups(all P＞0.05).(2)Comparison of cortical features(of different brain regions)between two groups showed significantly larger CA in the right insular surface area in the VSN group(2 466.50[2 143.75,2 662.50]mm2 vs.2 128.00[1 961.00,2 479.00)]mm2,P=0.037).No significant differences were observed in other regions or metrics(all P＞0.05).The VSN group has significantly lower AI values for CT in the right isthmus cingulate gyrus(-0.01[-0.05,0.03]vs.0.02[-0.01,0.06],P=0.028)and postcentral gyrus(-0.02[-0.04,0.00]vs.0.00[-0.02,0.02],P=0.026).No significant AI differences were observed in other regions or metrics(all P＞0.05).(3)For global network metrics:in the CA-based VSN,compared with the non-VSN group,Sigma values were significantly higher in the VSN group across multiple sparsity thresholds and at the average sparsity level(P＜0.01).In the CT-based SCN,Lambda values were significantly higher in the VSN group at most sparsity thresholds and at the average level(P=0.004).In the CC-based SCN,clustering coefficient and average local efficiency were significantly lower in the VSN group across most sparsity thresholds and average sparsity(P＜0.01).No significant differences were found in global metrics within the CV-based SCN.(4)For local metrics:in the CV-based SCN,compared with the non-VSN group,the VSN group showed significantly lower nodal efficiency in the left inferior temporal gyrus at most sparsity thresholds and at the average level(0.35[0.29,0.50]vs.0.65[0.51,0.72],P＜0.01).No significant differences in local metrics were observed in other SCN between the two groups.Conclusions Patients with VSN exhibit abnormal cortical morphology and SCN topology,characterized by reduced overall integration efficiency and weakened local connectivity,alongside enhanced small-worldness and possible compensatory reorganization.The conclusions of this study require further validation in multicenter,large-scale,prospective studies.

Objective To investigate the effect of transcranial direct current stimulation(tDCS)in the left posterior sylvia temporal-parietal association area on language function in patients with post-stroke conductive aphasia.Methods The post-stroke aphasia patients admitted to the Department of Rehabilitation Medicine,Xuanwu Hospital,Capital Medical University were prospectively included from June 2021 to April 2024.A self-cross randomized controlled trial was performed in this study.The patients enrolled were assessed as conductive aphasia by Western aphasia test kit diagnostic criteria.Twelve patients with post-stroke conductive aphasia were completely randomly divided into group A(treatment sequence:stage A—washout period—stage B)and group B(treatment sequence:stage B—washout period—stage A),with 6 cases in each group.Stage A performed true tDCS therapy combined with speech and language training,and stage B performed sham tDCS therapy combined with speech and language training.During washout period,only speech and language training was performed,and each stage was trained for 5 days.The tDCS anode is the stimulation electrode and is placed at the stimulation target.The cathode is the reference electrode and is placed on the right shoulder.The intensity of tDCS was 1.4 mA,the true stimulation was 20 min/time,and the sham stimulation stopped automatically after only 30 s/time,both twice/d,and a total of 10 times treatment were performed.Speech and language training was performed 30 min/time,2 times/d,a total of 10 times treatment.The function of rehearsal and picture naming(training item and non-training item)were examined before and after treatment of stage A and B immediately,and the difference of function scores of rehearsal and picture naming(training item and non-training item)before and after treatment of stage A and B were compared.Results(1)There were no significant differences in gender,age,course of disease and educational level between group A and group B(all P＞0.05).(2)Before and after washout period,there were no statistical significance in functional scores of rehearsal and picture naming(training items and non-training items)in both group A and group B(all P＞0.05).(3)There were no significant differences in functional scores of rehearsal and picture naming(training items and non-training items)between group A and group B before and after washout treatment(all P＞0.05).(4)Compared with the difference before and after treatment of stage B,the function scores difference before and after treatment of stage A in rehearsal function,picture naming(training item)and picture naming(non-training item)were higher([6.9±1.4]scores vs.[2.2±1.0]scores,t=9.604;[6.2±1.2]scores vs.[1.8±1.1]scores,t=9.277;[6.5±1.0]scores vs.[1.5±1.0]scores,t=12.247;all P＜0.01).Conclusions Preliminary analysis suggested that tDCS intervention in the brain tissue of the temporoparietal association area of the left posterior lateral cleft may help improve the rehearsal and picture naming(training and non-training items)ability in conductive aphasia patients after stroke.The sample size of this study is small,and the results need to be further explored.

ObjectiveTo explore the effect of motor imagery (MI) on knee function after unicompartmental knee arthroplasty (UKA). MethodsFrom January to September, 2022, 32 patients underwent UKA for the first time in Xuanwu Hospital were randomly divided into control group (n = 16) and experimental group (n = 16). All the patients accepted routine rehabilitation, and the experimental group accepted MI in addition, until four weeks after discharge. They were assessed with Oxford Knee Score (OKS), Visual Analogue Scale for pain (VAS), range of motion (ROM) of knee, and Timed Up and Go Test (TUGT) before and after treatment. ResultsAll the indexes improved after treatment (|t| > 2.517, P < 0.05), except ROM in the control group; and they improved more in the experimental group than in the control group (F > 7.999, P < 0.01), except the VAS score. ConclusionMI can further improve the knee function after UKA, but do less for pain.

ObjectiveTo observe the effect of transcranial direct current stimulation (tDCS) combined with task-oriented rehabilitation training single pellet reaching and grasping (SPG) on the motor function of forelimb in rats with unilateral contusion of C₅ spinal cord. MethodsA total of 60 adult male Sprague-Dawley rats were randomly divided into sham operation group (sham group), spinal cord injury (SCI) group, tDCS group, SPG group, false group and tDCS+SPG group, with ten rats in each group. Only C₅ lamina was removed in the sham group, and the C₅ spinal cord contusion model was established by IH spinal cord impactor in the other five groups. The rats received tDCS in tDCS group, SPG in SPG group, tDCS without current in false group, tDCS combined with SPG in tDCS+SPG group, and no treatment in the SCI and the sham groups. The rats were evaluated with Rearing and Grooming tests, and motor-evoked potential (MEP). ResultsFour weeks after operation, compared with SCI group, the scores of Rearing and Grooming increased in tDCS group and tDCS+SPG group (P < 0.05), and they were more in the tDCS+SPG group than in tDCS group and SPG group (P < 0.05); the score of Grooming increased in SPG group (P < 0.05); while the amplitude of MEP increased in tDCS group, SPG group and tDCS+SPG group (P < 0.05), and the latency shortened in tDCS group and tDCS+SPG group (P < 0.05); and the amplitude increased more in tDCS+SPG group than in tDCS group and SPG group (P < 0.01). ConclusiontDCS could promote the recovery of motor function in rats with SCI, and the combination therapy of tDCS and task-oriented rehabilitation training is more effective.

ObjectiveTo study the effect of anodal transcranial direct current stimulation (atDCS) combined with mirror therapy (MT) on upper limb function for stroke patients. MethodsFrom July, 2018 to June, 2019, 54 stroke patients from the Department of Rehabilitation Medicine, Xuanwu Hospital, Capital Medical University, were randomly divided into groups A, B and C, with 18 cases in each group. All the patients received routine medication and rehabilitation training, while group A accepted 60 minutes of MT, group B accepted 20 minuts of atDCS first and then 40 minuts of MT, and group C accepted 40 minutes of MT first and then 20 minuts of atDCS in addittion; for four weeks. They were assessed with Fugl-Meyer Assessment-Upper Extremities (FMA-UE), Action Research Arm Test (ARAT), Motor Assessment Scale (MAS) and modified Barthel Index (MBI) before and after treatment. ResultsThe main effect of time was significant in scores of FMA-UE (F = 159.811, P < 0.001), ARAT (F = 353.227, P < 0.001), MAS (F = 513.494, P < 0.001) and MBI (F = 85.982, P < 0.001), and all of them improved after treatment. The main effect of groups was significant in scores of FMA-UE (F = 12.502, P < 0.001), ARAT (F = 20.095, P < 0.001), MAS (F = 16.371, P < 0.001) and MBI (F = 11.882, P < 0.001). The interacted-effect between time and groups was significant in scores of FMA-UE (F = 37.659, P < 0.001), ARAT (F = 78.681, P < 0.001), MAS (F = 97.997, P < 0.001) and MBI (F = 48.015, P < 0.001); while all the scores were the best in group B (P < 0.01), and there was no significant difference between groups A and C (P > 0.05). ConclusionThe combination of atDCS first and then MT can promote the recovery of motor function of the affected limbs for stroke patients.

Objective:To investigate any effect of combining mirror visual feedback (MVF) training with robot-assisted gait training (RGT) in promoting the recovery of lower limb motor function among stroke survivors.Methods:Sixty stroke survivors were randomly divided into a combined treatment group, an RGT group and a control group, each of 20. In addition to traditional rehabilitation, the RGT group received 30min of RGT 5 days a week for 4 weeks, while the combined treatment group underwent 30min of RGT and also 20min of MVF training with the same frequency and duration. Before and after the treatment, the lower extremities motor functioning and walking ability of all of the patients were assessed using the Fugl-Meyer Assessment for the lower extremities (FMA-LE), the Berg Balance Scale (BBS) and Functional Ambulation Categories (FAC).Results:There were no systematic differences in any of the measurements before the treatment. After the 4 weeks, however, the average FMA-LE, BBS and FAC scores of the combined treatment and RGT groups were significantly better than the control group′s averages, and those of the combined treatment group were significantly superior to the RGT group′s. All of the groups had, however, improved significantly compared with before the treatment.Conclusions:Robot-assisted gait training is more effective in enhancing the motor functioning of the lower extremities and walking ability when it is combined with MVF.

ObjectiveTo study the conceptual framework and methodological system of the International Classification of Functioning, Disability and Health (ICF) in occupational therapy and its systematic implementation in clinical practice. MethodsBased on the ICF theory and the policy documents of the World Federation of Occupational Therapists, the conceptual framework of occupational therapy and the systematic implementation in clinical settings based on the ICF framework were analyzed. ResultsThis study constructed a conceptual framework and approach for occupational therapy based on ICF, and clarified the goals, principles, and implementation methods of integrated occupational therapy interventions in rehabilitation services. The goal of occupational therapy interventions was to improve the individual activity and participation through multidisciplinary and cross-cutting implementation of integrated occupational therapy programs to optimize functioning. Occupational therapy was based on the bio-psycho-social model, adhered to the principles of person-centeredness and functioning orientation, and implemented individualized intervention programs in different context. In clinical practice, it was recommended to follow ICF-based standardized process and systematically use World Health Organization Family International Classifications: functioning and unmet needs analysis using ICHI; functional classification, assessment and coding using ICF; disease classification, diagnosis and coding using ICD; intervention of occupational therapies using ICHI to build a systematic occupational therapy service system. ConclusionAn ICF-based occupational therapy concept and methodological system has been built, a comprehensive clinical occupational therapy implementation model has been established, the goal of activity and participation oriented occupational therapy interventions has been clarified, and the systematic, structured, standardized and refined level of occupational therapy has been enhanced.