Objective:To investigate the relationship between the severity of pharyngolaryngeal sensory impairment and swallowing biomechanics as well as the risk of penetration-aspiration in patients with dysphagia following infratentorial stroke.Methods:This retrospective cross-sectional study enrolled 51 patients with dysphagia following infratentorial stroke hospitalized in the Department of Rehabilitation Medicine of The Third Affiliated Hospital of Sun Yat-sen University between January 2022 and December 2023. Participants were categorized into three groups: normal sensation group [15 males, 2 females; age range 29-76 (56.0±13.3)years], diminished sensation group[16 males, 3 females; age range 38-80(62.0±11.8)years], and absent sensation group [14 males, 1 female; age range 44-75 (60.0±9.7)years]. All patients underwent laryngoscopy and videofluoroscopic swallowing study, which included pharyngolaryngeal sensory testing and Penetration-Aspiration Scale assessment. Swallowing temporal parameters were quantitatively analyzed. Group comparisons for different variable types were conducted using the Chi-square test, one-way ANOVA, and the Kruskal-Wallis test. The correlation between sensory groups and Penetration-Aspiration Scale scores was assessed using Spearman′s correlation analysis. Logistic regression was employed to analyze the impact of pharyngolaryngeal sensory function on penetration-aspiration events.Results:Among the 51 patients, 33.33% (17/51) had normal pharyngolaryngeal sensation, while, 66.67% (34/51) exhibited sensory impairment. The normal sensation group exhibited a significantly longer laryngeal vestibule closure (LVC) time [792 (643, 1 205) ms] compared to the diminished [528 (380, 776) ms] and absent sensation groups [380 (322, 404) ms] ( H=6.502, P=0.039). Additionally, the upper esophageal sphincter opening time was longer in the normal sensation group than in the absent sensation group [528 (371, 710) ms vs 182 (0, 710) ms, H=6.003, P=0.049]. Correlation analysis indicated a significant negative correlation between the severity of sensory impairment and Penetration-Aspiration Scale scores ( r=-0.366, P=0.008). Logistic regression analysis demonstrated that greater sensory impairment was an independent risk factor for penetration-aspiration ( OR=9.29, 95%CI=1.57-54.77, P=0.014). Conclusion:Pharyngolaryngeal sensory deficits are common after infratentorial stroke dysphagia and are significantly associated with impaired swallowing biomechanics and increased aspiration risk. The severity of sensory deficit is a key determinant of penetration-aspiration risk, highlighting its value in risk stratification and therapeutic decision-making for dysphagia.

With the increasing aging population, the number of elderly patients suffering from fractures is also on the rise.Fractures not only cause significant suffering for patients but also impose a considerable economic and social burden on society.The primary causes of fractures in the elderly include osteoporosis, muscle weakness, impaired balance and proprioception, and cognitive frailty.Exercise interventions have been shown to increase bone mineral density, reduce the incidence of osteoporosis, enhance muscle strength, improve balance, and delay cognitive decline, thereby mitigating the risk of fractures among older adults.This article aims to explore the risk factors associated with fractures in the elderly and the mechanisms through which exercise interventions influence these risks, thereby offering a novel strategy for the prevention of fractures in older adults from the perspective of exercise interventions.

Objective:To elucidate the temporal characteristics of dysphagia following infratentorial stroke and its associa-tion with penetration/aspiration.Method:A total of 51 patients with infratentorial stroke and 26 healthy controls were recruited.All partici-pants underwent videofluoroscopic swallowing studies(VFSS),during which they swallowed 5ml of thin liquid in two separate trials.Swallowing parameters analyzed included oral transit time(OTT),velopharyngeal clo-sure duration(VCD),hyoid movement duration(HMD),laryngeal vestibule closure duration(LCD),upper esophageal sphincter(UES)opening duration(UOD),and stage transition duration(STD).The temporal coor-dination and sequential order of four swallowing actions and the intervals namely T1-T4 were also assessed.Inter-rater variability was evaluated using intraclass correlation coefficients(ICCs)for 20％of the results.Result:In the patient group,40.2％exhibited failed opening in UES,39.3％had penetration,and 20.5％ex-perienced aspiration.Compared to the control group,patients showed significantly prolonged OTT,VCD,and STD(P＜0.01),while UOD was significantly shorter(P＜0.01).The conformity rates of temporal sequences 3 and 4 were significantly lower in the patient group compared to controls(P＜0.001),and intervals Tl,T2,and T3 were significantly longer(P＜0.01).Significant negative correlations were found between VCD and PAS,UOD and PAS,and T2(P＜0.01).All measured parameters demonstrated good reliability.Conclusion:Patients with infratentorial stroke experience abnormal swallowing sequence,which is associated with the severity of penetration and aspiration.These findings may help in developing more targeted interven-tions to prevent aspiration.

Objective:To elucidate the temporal characteristics of dysphagia following infratentorial stroke and its associa-tion with penetration/aspiration.Method:A total of 51 patients with infratentorial stroke and 26 healthy controls were recruited.All partici-pants underwent videofluoroscopic swallowing studies(VFSS),during which they swallowed 5ml of thin liquid in two separate trials.Swallowing parameters analyzed included oral transit time(OTT),velopharyngeal clo-sure duration(VCD),hyoid movement duration(HMD),laryngeal vestibule closure duration(LCD),upper esophageal sphincter(UES)opening duration(UOD),and stage transition duration(STD).The temporal coor-dination and sequential order of four swallowing actions and the intervals namely T1-T4 were also assessed.Inter-rater variability was evaluated using intraclass correlation coefficients(ICCs)for 20％of the results.Result:In the patient group,40.2％exhibited failed opening in UES,39.3％had penetration,and 20.5％ex-perienced aspiration.Compared to the control group,patients showed significantly prolonged OTT,VCD,and STD(P＜0.01),while UOD was significantly shorter(P＜0.01).The conformity rates of temporal sequences 3 and 4 were significantly lower in the patient group compared to controls(P＜0.001),and intervals Tl,T2,and T3 were significantly longer(P＜0.01).Significant negative correlations were found between VCD and PAS,UOD and PAS,and T2(P＜0.01).All measured parameters demonstrated good reliability.Conclusion:Patients with infratentorial stroke experience abnormal swallowing sequence,which is associated with the severity of penetration and aspiration.These findings may help in developing more targeted interven-tions to prevent aspiration.

Objective:To investigate the relationship between the severity of pharyngolaryngeal sensory impairment and swallowing biomechanics as well as the risk of penetration-aspiration in patients with dysphagia following infratentorial stroke.Methods:This retrospective cross-sectional study enrolled 51 patients with dysphagia following infratentorial stroke hospitalized in the Department of Rehabilitation Medicine of The Third Affiliated Hospital of Sun Yat-sen University between January 2022 and December 2023. Participants were categorized into three groups: normal sensation group [15 males, 2 females; age range 29-76 (56.0±13.3)years], diminished sensation group[16 males, 3 females; age range 38-80(62.0±11.8)years], and absent sensation group [14 males, 1 female; age range 44-75 (60.0±9.7)years]. All patients underwent laryngoscopy and videofluoroscopic swallowing study, which included pharyngolaryngeal sensory testing and Penetration-Aspiration Scale assessment. Swallowing temporal parameters were quantitatively analyzed. Group comparisons for different variable types were conducted using the Chi-square test, one-way ANOVA, and the Kruskal-Wallis test. The correlation between sensory groups and Penetration-Aspiration Scale scores was assessed using Spearman′s correlation analysis. Logistic regression was employed to analyze the impact of pharyngolaryngeal sensory function on penetration-aspiration events.Results:Among the 51 patients, 33.33% (17/51) had normal pharyngolaryngeal sensation, while, 66.67% (34/51) exhibited sensory impairment. The normal sensation group exhibited a significantly longer laryngeal vestibule closure (LVC) time [792 (643, 1 205) ms] compared to the diminished [528 (380, 776) ms] and absent sensation groups [380 (322, 404) ms] ( H=6.502, P=0.039). Additionally, the upper esophageal sphincter opening time was longer in the normal sensation group than in the absent sensation group [528 (371, 710) ms vs 182 (0, 710) ms, H=6.003, P=0.049]. Correlation analysis indicated a significant negative correlation between the severity of sensory impairment and Penetration-Aspiration Scale scores ( r=-0.366, P=0.008). Logistic regression analysis demonstrated that greater sensory impairment was an independent risk factor for penetration-aspiration ( OR=9.29, 95%CI=1.57-54.77, P=0.014). Conclusion:Pharyngolaryngeal sensory deficits are common after infratentorial stroke dysphagia and are significantly associated with impaired swallowing biomechanics and increased aspiration risk. The severity of sensory deficit is a key determinant of penetration-aspiration risk, highlighting its value in risk stratification and therapeutic decision-making for dysphagia.

With the increasing aging population, the number of elderly patients suffering from fractures is also on the rise.Fractures not only cause significant suffering for patients but also impose a considerable economic and social burden on society.The primary causes of fractures in the elderly include osteoporosis, muscle weakness, impaired balance and proprioception, and cognitive frailty.Exercise interventions have been shown to increase bone mineral density, reduce the incidence of osteoporosis, enhance muscle strength, improve balance, and delay cognitive decline, thereby mitigating the risk of fractures among older adults.This article aims to explore the risk factors associated with fractures in the elderly and the mechanisms through which exercise interventions influence these risks, thereby offering a novel strategy for the prevention of fractures in older adults from the perspective of exercise interventions.

Epigenomic imbalance drives abnormal transcriptional processes,promoting the onset and progression of cancer.Although defective gene regulation generally affects carcinogenesis and tumor suppression networks,tumor immunogenicity and immune cells involved in antitumor responses may also be affected by epigenomic changes,which may have significant implications for the development and application of epigenetic therapy,cancer immunotherapy,and their combinations.Herein,we focus on the impact of epigenetic regulation on tumor immune cell function and the role of key abnormal epigenetic processes,DNA methylation,histone post-translational modification,and chromatin structure in tumor immunogenicity,and introduce these epigenetic research methods.We emphasize the value of small-molecule inhibitors of epigenetic modulators in enhancing antitumor immune responses and discuss the challenges of developing treatment plans that combine epigenetic therapy and immuno-therapy through the complex interaction between cancer epigenetics and cancer immunology.

Objective:The results of syphilis antibody screening in Peking University Third Hospital from 2016 to 2020 were analyzed,to explore the characteristics of sex, age and distribution of patients with positive syphilis antibody.Methods:A retrospective study was conducted to collect the results of syphilis antibody in outpatients and inpatients of Peking University Third Hospital from 2016 to 2020. Syphilis antibodies were screened in 626 528 patients aged 1-98 years, 4 232 were retested positive by TPPA test, including 2 132 males (50.4%) and 2 100 females (49.6%). Chemiluminescence immunoassay (CMIA) was used for syphilis antibody screening, and Treponema pallidum particle agglutination (TPPA) test was used for reexamination. SPSS20.0 data statistical analysis software was used to analyze the detection rate, age, sex, department and clinical diagnosis of patients with positive syphilis antibody by χ2 test.Results:Among 626 528 patients who were positive for treponema pallidum antibody screening, 4 232 were retested positive by TPPA test, accounting for 0.68% of the total number of patients tested. The number of syphilis tests increased year by year, however the positive detection rate decreased. The positive detection rate of syphilis antibody in 2020 decreased by 18.9% compared with 2016. The positive rate of syphilis antibody in male patients was higher than that in female patients, accounting for 0.80% and 0.59% of the total number of patients tested respectively. The positive rate of syphilis antibody of different genders increased with age, the total positive rate of 0-20, 21-40, 41-60, 61-80,>80 years old were 0.15%, 0.45%, 0.95%, 1.07% and 1.41%, respectively. While the increase rate of males was higher than that of females. The positive rate of male over 80 years old was 18.13 times of the group of 0-20 years old, and 5.54 times in women. The top 6 departments with positive syphilis antibody detection rate were emergency department, oncology department, respiratory department, geriatrics department, endocrinology department and neurology department, and the positive rates were 1.79% (104/5 810),1.46% (55/3 767),1.20% (74/6 167),1.20% (22/1 833),1.10% (32/2 909),1.09% (94/8 624), respectively. From the analysis of clinical diagnosis, the proportion of positive syphilis antibody in infertile patients (0.64%, 672/104 911) was higher than that in naturally conceived patients (0.10%, 24/23 969).Conclusions:From 2016 to 2020, the positive detection rate of syphilis antibody in Peking University Third Hospital decreased year by year. However, the positive detection rate increased with the age of patients. The positive rate of syphilis antibody in male was higher than that in female. The positive rate of syphilis antibody in pregnant women was lower than that in infertile patients.

Objective:The results of syphilis antibody screening in Peking University Third Hospital from 2016 to 2020 were analyzed,to explore the characteristics of sex, age and distribution of patients with positive syphilis antibody.Methods:A retrospective study was conducted to collect the results of syphilis antibody in outpatients and inpatients of Peking University Third Hospital from 2016 to 2020. Syphilis antibodies were screened in 626 528 patients aged 1-98 years, 4 232 were retested positive by TPPA test, including 2 132 males (50.4%) and 2 100 females (49.6%). Chemiluminescence immunoassay (CMIA) was used for syphilis antibody screening, and Treponema pallidum particle agglutination (TPPA) test was used for reexamination. SPSS20.0 data statistical analysis software was used to analyze the detection rate, age, sex, department and clinical diagnosis of patients with positive syphilis antibody by χ2 test.Results:Among 626 528 patients who were positive for treponema pallidum antibody screening, 4 232 were retested positive by TPPA test, accounting for 0.68% of the total number of patients tested. The number of syphilis tests increased year by year, however the positive detection rate decreased. The positive detection rate of syphilis antibody in 2020 decreased by 18.9% compared with 2016. The positive rate of syphilis antibody in male patients was higher than that in female patients, accounting for 0.80% and 0.59% of the total number of patients tested respectively. The positive rate of syphilis antibody of different genders increased with age, the total positive rate of 0-20, 21-40, 41-60, 61-80,>80 years old were 0.15%, 0.45%, 0.95%, 1.07% and 1.41%, respectively. While the increase rate of males was higher than that of females. The positive rate of male over 80 years old was 18.13 times of the group of 0-20 years old, and 5.54 times in women. The top 6 departments with positive syphilis antibody detection rate were emergency department, oncology department, respiratory department, geriatrics department, endocrinology department and neurology department, and the positive rates were 1.79% (104/5 810),1.46% (55/3 767),1.20% (74/6 167),1.20% (22/1 833),1.10% (32/2 909),1.09% (94/8 624), respectively. From the analysis of clinical diagnosis, the proportion of positive syphilis antibody in infertile patients (0.64%, 672/104 911) was higher than that in naturally conceived patients (0.10%, 24/23 969).Conclusions:From 2016 to 2020, the positive detection rate of syphilis antibody in Peking University Third Hospital decreased year by year. However, the positive detection rate increased with the age of patients. The positive rate of syphilis antibody in male was higher than that in female. The positive rate of syphilis antibody in pregnant women was lower than that in infertile patients.