ObjectiveTo analyze the application trends and research hotspots of action observation therapy (AOT) in the field of stroke rehabilitation over the past decade. MethodsLiteratures on AOT in stroke rehabilitation published from January, 2016 to December, 2025 were retrieved from the Web of Science Core Collection database. CiteSpace 6.4.R1 was used for visual analysis. ResultsA total of 463 articles were included. The annual publication volume showed a fluctuating upward trend. The country with the highest number of publications was China, the most productive institution was Chang Gung University and Consiglio Nazionale delle Ricerche, and the most prolific author was Avanzini Pietro. Mirror neuron system, motor imagery, upper limb and facilitation were identified as high-frequency keywords and bursting words. ConclusionIn the past decade, the number of publications on AOT in stroke rehabilitation has generally increased. Researches are focusing on the synergy of sensory-closed-loop multimodal technologies, reconstruction of fine upper limb function and neural facilitation mechanisms.

Objective To analyze the current situation of accidental injuries among the population in Garze Tibetan are-a,clarify the main causes and risk factors,and develop prevention and control strategies based on crisis management and system management theory to reduce the incidence and disability rate.Methods Collect data from 78 166 outpatient patients from 2018 to 2024 and 15 015 hospitalized patients from 2021 to 2024,and analyze the distribution characteristics and causes of injuries.Results The incidence rate of Han ethnicity is higher than that of Tibetan ethnicity,higher in males than females,and higher in adults than minors;The incidence rate of elderly Han people aged 60 and above is expected to reach nearly 9％in 2024,while the working age population of Tibetan people is expected to sharply increase in 2021.The incidence rate in southern and eastern counties is significantly higher than in other regions,and higher in rural areas than in urban areas.Falls account for 49.64％of the total,followed by labor injuries,falls from heights,and traffic accidents.There are differences in the causes and locations of injuries among different age groups.Conclusion Accidental injuries are closely related to ethnicity,age,gender,and regional distribution.Falls,falls,labor injuries,and car accidents are the four main causes.It is recommended to construct a full cycle emergency response mechanism based on crisis management theory,and integrate multidimensional resources such as medical,transportation,and community through system management theory to strengthen the construction of orthopedic sub specialties and targeted prevention and treatment.

Objective:To explore the correlation between triglyceride-glucose (TyG) index-body mass index (BMI) product (TyG-BMI) and hypertension.Methods:Based on the cross-sectional survey data of adult hypertension prevalence in Hunan Province from June 2013 to May 2014, 4 012 subjects aged ≥18 years with complete key data were included. Binary logistic regression analysis was used to analyze the correlation between TyG-BMI and hypertension, and receiver operating characteristic (ROC) curve was used to compare the ability of TyG index and TyG-BMI to identify hypertension.Results:A total of 4 012 subjects were included in this study, with an average age of (54.6±12.6)years, and males accounted for 40.98%(1 644/4 012). The prevalence of hypertension was 38.33%(1 538/4 012). Logistic regression analysis showed that elevated TyG-BMI was an independent risk factor for hypertension ( P<0.05). In the fully adjusted model, each 1/4 increase in TyG-BMI was associated with a 1.017-fold increase in the risk of hypertension ( OR=1.017, 95% CI: 1.014-1.019). Compared with the lowest quartile group (Q 1), the higher quartile groups (Q 2, Q 3, Q 4) of TyG-BMI had a higher risk of hypertension, with OR values of 1.841, 2.265, and 4.386, respectively. Restricted cubic spline plot showed a linear dose-response relationship between TyG-BMI and the risk of hypertension (overall trend P<0.001). In subgroup analyses stratified by age, gender, smoking and drinking status, TyG-BMI was positively correlated with hypertension. In addition, ROC curve analysis showed that TyG-BMI had better diagnostic value for hypertension compared with TyG index. Conclusions:TyG-BMI is an independent risk factor for hypertension. Excessively high TyG-BMI or gradual increase of TyG-BMI will increase the risk of hypertension, and TyG-BMI has higher value in identifying hypertension compared with TyG index.

Objective To analyze the current situation of accidental injuries among the population in Garze Tibetan are-a,clarify the main causes and risk factors,and develop prevention and control strategies based on crisis management and system management theory to reduce the incidence and disability rate.Methods Collect data from 78 166 outpatient patients from 2018 to 2024 and 15 015 hospitalized patients from 2021 to 2024,and analyze the distribution characteristics and causes of injuries.Results The incidence rate of Han ethnicity is higher than that of Tibetan ethnicity,higher in males than females,and higher in adults than minors;The incidence rate of elderly Han people aged 60 and above is expected to reach nearly 9％in 2024,while the working age population of Tibetan people is expected to sharply increase in 2021.The incidence rate in southern and eastern counties is significantly higher than in other regions,and higher in rural areas than in urban areas.Falls account for 49.64％of the total,followed by labor injuries,falls from heights,and traffic accidents.There are differences in the causes and locations of injuries among different age groups.Conclusion Accidental injuries are closely related to ethnicity,age,gender,and regional distribution.Falls,falls,labor injuries,and car accidents are the four main causes.It is recommended to construct a full cycle emergency response mechanism based on crisis management theory,and integrate multidimensional resources such as medical,transportation,and community through system management theory to strengthen the construction of orthopedic sub specialties and targeted prevention and treatment.

Objective:To explore the correlation between triglyceride-glucose (TyG) index-body mass index (BMI) product (TyG-BMI) and hypertension.Methods:Based on the cross-sectional survey data of adult hypertension prevalence in Hunan Province from June 2013 to May 2014, 4 012 subjects aged ≥18 years with complete key data were included. Binary logistic regression analysis was used to analyze the correlation between TyG-BMI and hypertension, and receiver operating characteristic (ROC) curve was used to compare the ability of TyG index and TyG-BMI to identify hypertension.Results:A total of 4 012 subjects were included in this study, with an average age of (54.6±12.6)years, and males accounted for 40.98%(1 644/4 012). The prevalence of hypertension was 38.33%(1 538/4 012). Logistic regression analysis showed that elevated TyG-BMI was an independent risk factor for hypertension ( P<0.05). In the fully adjusted model, each 1/4 increase in TyG-BMI was associated with a 1.017-fold increase in the risk of hypertension ( OR=1.017, 95% CI: 1.014-1.019). Compared with the lowest quartile group (Q 1), the higher quartile groups (Q 2, Q 3, Q 4) of TyG-BMI had a higher risk of hypertension, with OR values of 1.841, 2.265, and 4.386, respectively. Restricted cubic spline plot showed a linear dose-response relationship between TyG-BMI and the risk of hypertension (overall trend P<0.001). In subgroup analyses stratified by age, gender, smoking and drinking status, TyG-BMI was positively correlated with hypertension. In addition, ROC curve analysis showed that TyG-BMI had better diagnostic value for hypertension compared with TyG index. Conclusions:TyG-BMI is an independent risk factor for hypertension. Excessively high TyG-BMI or gradual increase of TyG-BMI will increase the risk of hypertension, and TyG-BMI has higher value in identifying hypertension compared with TyG index.

Objective:To investigate the correlation between serum hypoxia inducible factor 1 alpha (HIF-1α), vascular endothelial growth factor (VEGF), soluble triggering receptor expressed on myeloid cells-1 (sTREM-1), and inflammatory factors and incision infection after anal fistula surgery.Methods:A retrospective analysis was conducted on the clinical data of 120 patients who underwent anal fistula thread hanging surgery at the First People′s Hospital of Shuangliu District, Chengdu from June 2022 to April 2023. The patients were divided into an infected group (36 cases) and a non infected group (84 cases) based on their postoperative incision infection status. The differences in serum HIF-1 α, VEGF, sTREM-1 and inflammatory factors [C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor α (TNF-α)] between the infected and non infected groups were compared, and the correlation between CRP, IL-6, TNF-α, HIF-1 α, VEGF, sTREM-1 and postoperative infection of anal fistula was analyzed by Pearson correlation coefficient; The correlation between CRP, IL-6, TNF-α and HIF-1 α, VEGF, sTREM-1. And the efficacy of serum HIF-1 α, VEGF, sTREM-1, inflammatory factors and their individual and combined diagnosis of incision infection after anal fistula surgery was analyzed by receiver operating characteristic (ROC) curve analysis.Results:The levels of serum HIF-1 α, sTREM-1, CRP, IL-6, and TNF-α in the infected group were higher than those before surgery and higher than those in the uninfected group 3 days after surgery; VEGF levels were lower than preoperative levels and lower than those in the non infected group (all P<0.05). Pearson correlation analysis showed that HIF-1α, sTREM-1, CRP, IL-6, TNF-α were positively correlated with postoperative infection in anal fistula ( r=0.456, 0.494, 0.455, 0.510, 0.363, all P<0.05), while VEGF was negatively correlated with postoperative infection in anal fistula ( r=-0.462, P<0.05). CRP, IL-6, TNF-α were positively correlated with HIF-1 α and sTREM-1 ( r=0.574/0.611/0.653, 0.661/0.608/0.610, all P<0.05), while CRP, IL-6, TNF-α were negatively correlated with VEGF ( r=-0.200, -0.207, -0.254, all P<0.05). The area under the curve (AUC) of HIF-1 α, VEGF, sTREM-1, CRP, IL-6, and TNF-α for diagnosing incision infection after anal fistula surgery were 0.716, 0.787, 0.741, 0.678, 0.792, and 0.688, respectively. The AUC of the combined diagnosis of inflammatory factors and 6 data points for postoperative incision infection in anal fistula surgery were 0.836 and 0.921, respectively. Conclusions:Serum levels of HIF-1 α, sTREM-1, CRP, IL-6, and TNF-α are abnormally high in patients with incision infection after anal fistula surgery, while VEGF is abnormally low in expression. HIF-1 α, VEGF, sTREM-1, and inflammatory factors can be used as effective indicators for clinical diagnosis of incision infection after anal fistula surgery, and their combined diagnostic value is better. HIF-1 α and sTREM-1 are positively correlated with inflammatory factors, while VEGF is negatively correlated with inflammatory factors.

Objective:This study aims to investigate the determinants influencing the efficacy of microsurgical sperm retrieval in individuals diagnosed with idiopathic non-obstructive azoospermia (iNOA).Methods:A retrospective analysis was performed on the clinical data of 757 patients diagnosed with iNOA who underwent microsurgical sperm extraction at Peking University Third Hospital between January 2019 and December 2021. The median age of patients was 31(29, 33)years, and the duration of infertility was 3(2, 5)years. A total of 169 patients (22.3%) received preoperative pharmacological treatment with agents such as follicle-stimulating hormone, human chorionic gonadotropin, or aromatase inhibitors. Additionally, 327 patients (43.2%) underwent testicular biopsy (TESA) prior to surgery. Among these, 51 cases (15.9%) exhibited sperm presence on smear microscopy, while 57 cases (17.8%) demonstrated sperm presence on pathological examination. The pathological classifications of the biopsies included 102 cases (31.9%) of reduced spermatogenic function, 66 cases (20.6%) of delayed sperm maturation, and 63 cases (19.7%) of sertoli cell-only syndrome.Preoperative median pituitary prolactin(PRL)was 9.1(6.5, 12.5)ng/ml, follicle-stimulating hormone (FSH)20.1(14.2, 28.5)U/L, luteinizing hormone (LH)7.9(5.5, 11.3)U/L, testosterone(T)117 .0(81.3, 154.0)nmol/L, estradiol(E2)8.7(6.3, 11.8)pmol/L. Under general anesthesia, patients underwent microsurgical testicular incision for sperm retrieval.The surgical testicular volume was measured at a median of 6(5, 10) ml. Among the cases studied, 59 patients (7.7%) underwent left testicular surgery, 213 patients (28.1%) underwent right testicular surgery, and 485 patients (64.0%) underwent bilateral testicular surgery. Furthermore, 44 patients (5.8%) underwent a second microsurgical sperm retrieval procedure, while 4 patients (0.5%) underwent a third procedure.Based on the presence of sperm identified during the surgical procedure, participants were categorized into a sperm retrieval group and a non-sperm retrieval group. Clinical data of these two groups were analyzed. A subgroup analysis was performed on the observed indicators. Both univariate and multivariate logistic regression analyses were employed to examine the factors influencing the micro sperm retrieval rate.Results:Among the 757 iNOA patients, 255(33.7%) obtained sperm through micro sperm retrieval, while 502(66.3%) did not obtain sperm through micro sperm retrieval. The age of sperm-receiving group was higher than that of the non-sperm-receiving group [32(30, 35)years vs. 30(28, 33)years, P<0.01], and the course of infertility was longer than that of the non-sperm-receiving group [3.0(2.0, 5.5)years vs. 3.0(2.0, 4.0)years, P=0.004]. There was no significant difference in the sperm acquisition rate in the subgroup with or without preoperative drug treatment [38.5%(65/169)vs. 32.7%(185/566), P=0.164]. There was statistical significance in the sperm collection rate of different TESA results in subgroups [85.7%(24/28)of sperm were detected by microscopic smear and pathological examination and 75.9%(22/29)of sperm were detected by pathological examination and no sperm were detected by microscopic smear and 17% of sperm were not detected by microscopic smear and pathological examination (42/247), P<0.01). The rate of spermatogenesis in the subgroup with low spermatogenic function was significantly higher than that in the subgroup with spermatogenic maturation retardation and sercell-only syndrome [47.1%(48/112), 12.1%(8/66)vs. 11.1%(7/63), P<0.01]. There was no significant difference in testicular volume between the seminal and non-seminal groups [6.0(5.0, 10.0)ml vs. 6.0(5.0, 9.5)ml, P=0.862]. Pituitary prolactin [8.3(5.8, 12.0)ng/ml vs. 9.3(7.5, 13.0)ng/ml, P=0.001] and FSH[18.3(11.8, 27.4)U/L vs. 20.7(15.2, 28.7)U/L, P=0.005] in spermated group were lower than those in non-spermated group. Luteinizing hormone [7.6(5.1, 11.0)U/L vs. 8.0(5.6, 11.5)U/L, P=0.126], testosterone [8.8(6.0, 11.8)nmol/L vs. 8.7(6.4, 11.7)nmol/L, P=0.607], estradiol [124.0(87.8, 156.0)nmol/L vs. 114.5(79.9, 151.3)nmol/L, P=0.105] had no significant difference. The recovery rate of the first operation was higher than that of the second operation [97.7%(43/44)vs. 81.8%(36/42), P=0.032]. The sperm retrieval rate of bilateral operation was significantly lower than that of unilateral operation [6.0% bilateral (29/485)vs. 86.4% left (51/59)vs. 82.2% right (175/213), P<0.01]. The proportion of no sperm on one side of bilateral operation and only 4.7%(23/485)on the opposite side were obtained. The results of multivariate analysis showed that >30 and ≤40 years old subgroup ( OR=2.226, 95% CI 1.364-3.632, P=0.001), >40 and ≤50 years old subgroup ( OR=4.282, 95% CI 1.457-12.588, P=0.008)was higher than that of >20 and ≤30 years old subgroup. The sperm acquisition rate of the sperm subgroup was significantly increased by smear microscopy and pathological examination ( OR=6.486, 95% Cl 1.444-29.127, P=0.015), while the sperm acquisition rate of the sperm subgroup was not significantly decreased by smear microscopy and pathological examination ( OR=0.420, 95% Cl 0.200-0.881, P=0.022). The pathological type of puncture was associated with lower spermatogenesis maturation block ( OR=0.099, 95% CI 0.019-0.509, P=0.006). Higher FSH (>7.6 U/L)was associated with lower sperm yield ( OR=0.324, 95% CI 0.122-0.856, P=0.023). Conclusions:Age, FSH level, results of testicular biopsy and pathologic type of biopsy are independent factors affecting the sperm retrieval rate of iNOA patients undergoing micro-TESE. The success rate of sperm retrieval diminished following multiple surgical procedures. Furthermore, for patients who did not have sperm successfully retrieved from one side, that the likelihood of sperm retrieval from contralateral surgery would also be low.

Objective:This study aims to investigate the determinants influencing the efficacy of microsurgical sperm retrieval in individuals diagnosed with idiopathic non-obstructive azoospermia (iNOA).Methods:A retrospective analysis was performed on the clinical data of 757 patients diagnosed with iNOA who underwent microsurgical sperm extraction at Peking University Third Hospital between January 2019 and December 2021. The median age of patients was 31(29, 33)years, and the duration of infertility was 3(2, 5)years. A total of 169 patients (22.3%) received preoperative pharmacological treatment with agents such as follicle-stimulating hormone, human chorionic gonadotropin, or aromatase inhibitors. Additionally, 327 patients (43.2%) underwent testicular biopsy (TESA) prior to surgery. Among these, 51 cases (15.9%) exhibited sperm presence on smear microscopy, while 57 cases (17.8%) demonstrated sperm presence on pathological examination. The pathological classifications of the biopsies included 102 cases (31.9%) of reduced spermatogenic function, 66 cases (20.6%) of delayed sperm maturation, and 63 cases (19.7%) of sertoli cell-only syndrome.Preoperative median pituitary prolactin(PRL)was 9.1(6.5, 12.5)ng/ml, follicle-stimulating hormone (FSH)20.1(14.2, 28.5)U/L, luteinizing hormone (LH)7.9(5.5, 11.3)U/L, testosterone(T)117 .0(81.3, 154.0)nmol/L, estradiol(E2)8.7(6.3, 11.8)pmol/L. Under general anesthesia, patients underwent microsurgical testicular incision for sperm retrieval.The surgical testicular volume was measured at a median of 6(5, 10) ml. Among the cases studied, 59 patients (7.7%) underwent left testicular surgery, 213 patients (28.1%) underwent right testicular surgery, and 485 patients (64.0%) underwent bilateral testicular surgery. Furthermore, 44 patients (5.8%) underwent a second microsurgical sperm retrieval procedure, while 4 patients (0.5%) underwent a third procedure.Based on the presence of sperm identified during the surgical procedure, participants were categorized into a sperm retrieval group and a non-sperm retrieval group. Clinical data of these two groups were analyzed. A subgroup analysis was performed on the observed indicators. Both univariate and multivariate logistic regression analyses were employed to examine the factors influencing the micro sperm retrieval rate.Results:Among the 757 iNOA patients, 255(33.7%) obtained sperm through micro sperm retrieval, while 502(66.3%) did not obtain sperm through micro sperm retrieval. The age of sperm-receiving group was higher than that of the non-sperm-receiving group [32(30, 35)years vs. 30(28, 33)years, P<0.01], and the course of infertility was longer than that of the non-sperm-receiving group [3.0(2.0, 5.5)years vs. 3.0(2.0, 4.0)years, P=0.004]. There was no significant difference in the sperm acquisition rate in the subgroup with or without preoperative drug treatment [38.5%(65/169)vs. 32.7%(185/566), P=0.164]. There was statistical significance in the sperm collection rate of different TESA results in subgroups [85.7%(24/28)of sperm were detected by microscopic smear and pathological examination and 75.9%(22/29)of sperm were detected by pathological examination and no sperm were detected by microscopic smear and 17% of sperm were not detected by microscopic smear and pathological examination (42/247), P<0.01). The rate of spermatogenesis in the subgroup with low spermatogenic function was significantly higher than that in the subgroup with spermatogenic maturation retardation and sercell-only syndrome [47.1%(48/112), 12.1%(8/66)vs. 11.1%(7/63), P<0.01]. There was no significant difference in testicular volume between the seminal and non-seminal groups [6.0(5.0, 10.0)ml vs. 6.0(5.0, 9.5)ml, P=0.862]. Pituitary prolactin [8.3(5.8, 12.0)ng/ml vs. 9.3(7.5, 13.0)ng/ml, P=0.001] and FSH[18.3(11.8, 27.4)U/L vs. 20.7(15.2, 28.7)U/L, P=0.005] in spermated group were lower than those in non-spermated group. Luteinizing hormone [7.6(5.1, 11.0)U/L vs. 8.0(5.6, 11.5)U/L, P=0.126], testosterone [8.8(6.0, 11.8)nmol/L vs. 8.7(6.4, 11.7)nmol/L, P=0.607], estradiol [124.0(87.8, 156.0)nmol/L vs. 114.5(79.9, 151.3)nmol/L, P=0.105] had no significant difference. The recovery rate of the first operation was higher than that of the second operation [97.7%(43/44)vs. 81.8%(36/42), P=0.032]. The sperm retrieval rate of bilateral operation was significantly lower than that of unilateral operation [6.0% bilateral (29/485)vs. 86.4% left (51/59)vs. 82.2% right (175/213), P<0.01]. The proportion of no sperm on one side of bilateral operation and only 4.7%(23/485)on the opposite side were obtained. The results of multivariate analysis showed that >30 and ≤40 years old subgroup ( OR=2.226, 95% CI 1.364-3.632, P=0.001), >40 and ≤50 years old subgroup ( OR=4.282, 95% CI 1.457-12.588, P=0.008)was higher than that of >20 and ≤30 years old subgroup. The sperm acquisition rate of the sperm subgroup was significantly increased by smear microscopy and pathological examination ( OR=6.486, 95% Cl 1.444-29.127, P=0.015), while the sperm acquisition rate of the sperm subgroup was not significantly decreased by smear microscopy and pathological examination ( OR=0.420, 95% Cl 0.200-0.881, P=0.022). The pathological type of puncture was associated with lower spermatogenesis maturation block ( OR=0.099, 95% CI 0.019-0.509, P=0.006). Higher FSH (>7.6 U/L)was associated with lower sperm yield ( OR=0.324, 95% CI 0.122-0.856, P=0.023). Conclusions:Age, FSH level, results of testicular biopsy and pathologic type of biopsy are independent factors affecting the sperm retrieval rate of iNOA patients undergoing micro-TESE. The success rate of sperm retrieval diminished following multiple surgical procedures. Furthermore, for patients who did not have sperm successfully retrieved from one side, that the likelihood of sperm retrieval from contralateral surgery would also be low.

Objective To evaluate the efficacy and safety of a domestic arterial thrombus aspiration catheter in treating acute arterial ischemic events in the experimental dogs,and to compare this catheter with Penumbra suction catheter.Methods Acute ischemic embolism model was established in the external carotid and renal arteries of experimental dogs,and the experimental dogs were randomly assigned to the study group and control group.The embolized blood vessels were treated with thrombectomy.Results A total of 12 experimental dogs were enrolled in this study,with 6 dogs in each group.All of the 12 experimental dogs were successfully modeled.In the study group and the control group,the cumulative success rates of thrombectomy were 92.9％and 66.7％respectively(P＞0.05),the incidences of intraoperative vascular dissection were 0％and 8.3％respectively(P＞0.05),and the incidences of vasospasm were 35.7％and 0.75％respectively(P＞0.05).Conclusion In treating thrombus-embolized blood vessels with mechanical thrombectomy in experimental dogs,no statistically significant differences in the efficacy and safety exist between using domestic arterial thrombus aspiration catheter and using Penumbra suction catheter.(J Intervent Radiol,2023,32:1207-1210)

Based on single-cell sequencing of the hippocampi of 5x familiar Alzheimer's disease(5x FAD)and wild type mice at 2-,12-,and 24-month of age,we found an increased percentage of microglia in aging and Alzheimer's disease(AD)mice.Blood brain barrier injury may also have contributed to this increase.Immune regulation by microglia plays a major role in the progression of aging and AD,according to the functions of 41 intersecting differentially expressed genes in microglia.Signaling crosstalk between C-C motif chemokine ligand(CCL)and major histocompatibility complex-1 bridges intercellular communi-cation in the hippocampus during aging and AD.The amyloid precursor protein(APP)and colony stimulating factor(CSF)signals drive 5x FAD to deviate from aging track to AD occurrence among intercellular communication in hippocampus.Microglia are involved in the progression of aging and AD can be divided into 10 functional types.The strength of the interaction among microglial subtypes weakened with aging,and the CCL and CSF signaling pathways were the fundamental bridge of communication among microglial subtypes.