AIM:To investigate whether casein kinase 2(CK2)/calmodulin(CaM)/small-conductance Ca2+-activated K+channel type 2(SK2)signaling pathway mediates autophagy-induced sympathoexcitation in the paraventricu-lar nucleus(PVN)of rats with chronic heart failure(CHF).METHODS:We randomly divided 180 Wistar rats,aged 6 to 8 weeks,into 10 groups:sham+dimethyl sulfoxide(DMSO),sham+artificial cerebrospinal(aCSF),CHF+DMSO,CHF+aCSF,CHF+rapamycin(RAPA),CHF+3-methyladenine(3-MA),CHF+5,6-dichlorobenzimidazole riboside(DRB),CHF+calmidazolium chloride(CMDZ),CHF+N-cyclohexyl-N-[2-(3,5-dimethyl-1H-pyrazol-1-yl)-6-methyl-pyrimidin-4-yl]-amine(CyPPA),and CHF+apamin groups.We measured cardiac function,hemodynamic parameters,anatomic indicators,and sympathetic drive indicators(n=18).Western blot was used to examine the protein levels of mi-crotubule-associated protein 1 light chain 3-II(LC3-II)/LC3-I,beclin-1,P62,CK2α,SK2,and phosphorylated CaM.The number of SK2-positive neurons was measured using immunofluorescence staining.The NG108 cells were randomly divided into 6 groups:DMSO,aCSF,RAPA,3-MA,RAPA+DRB,and RAPA+CMDZ groups.Radioisotope 32P-ATP pro-tein kinase activity assays were used to detect CK2 activity in cultured NG108 cells.We used Western blot to examine the protein levels of CK2α,SK2,and phosphorylated CaM.RESULTS:Compared with CHF rats treated with vehicle,CHF rats treated with RAPA or apamin exhibited increased sympathetic drive indicators,but decreased left ventricular ejection fraction and fractional shortening(P<0.01).However,CHF symptoms,including sympathoexcitation,were attenuated by 3-MA,DRB,CMDZ or CyPPA infusion into the PVN(P<0.01).In CHF rats,RAPA infusion into the PVN induced CK2 activity,up-regulated LC3-II/LC3-I,beclin-1,CK2α,and phosphorylated CaM levels,but down-regulated P62 and SK2 expression,as well as the number of SK2-positive neurons(P<0.05 or P<0.01).In CHF rats,infusion of 3-MA or DRB into the PVN decreased CK2 activity,and down-regulated phosphorylated CaM level(P<0.01).Infusion of 3-MA,DRB or CMDZ into the PVN up-regulated SK2 expression and the number of SK2-positive neurons(P<0.01).In cultured NG108 cells,RAPA induced CK2 activation and up-regulated the expression of CK2α and the phosphorylation of CaM,but down-regulated SK2 expression(P<0.01).Treatment with RAPA increased the level of phosphorylated CaM and down-regulated SK2 expression in cultured NG108 cells(P<0.01),which was inhibited by DRB and CMDZ(P<0.05 or P<0.01).CONCLUSION:In rats with CHF,the CK2/CaM/SK2 signaling pathway in the PVN contributes to autophagy-induced sympathoexcitation.

Objective To explore the effect of repetitive transcranial magnetic stimulation(rTMS)on the sleep disorder and examination results of recruits.Methods At a training base,the Pittsburgh Sleep Quality Index(PSQI)was used to screen the recruits with sleep disorders(total score of PSQI>7).The recruits were randomly assigned to rTMS group or sham rTMS group.Both groups received cognitive and behavioral intervention therapy,including sleep health education and relaxation training.Moreover,the rTMS group was treated with rTMS at the right posterior parietal lobe by continuous theta burst stimulation(cTBS)twice a day at an interval of at least 50 min for 5 consecutive days as a course of treatment with an interval of 2 days for a total of 2 courses of treatment.The coil position and stimulus intensity of sham rTMS group were consistent with the rTMS group,but the head of subjects was perpendicular to the coil plane and there was no effective stimulation.Before and after treatment,PSQI,self-rating depression scale,generalized anxiety disorder-7 and health questionnaire-15 were used to evaluate the sleep,mood and physical state of the recruits.The training result was assessed one month after treatment.The total effective rate of PSQI improvement and examination results were compared between the two groups.The independent influencing factors of excellent examination result were analyzed.Results Among 351 recruits,83 with sleep disorders completed treatment and follow-up.There were 40 patients in the rTMS group and 43 patients in the sham rTMS group.There was no significant difference between the two groups at baseline.After treatment,the total effective rate of PSQI improvement in the rTMS group was higher than that in the sham rTMS group(77.50%vs 53.49%,P=0.022).The average examination score and excellent rate of the rTMS group were higher than those of the sham rTMS group(91.58±3.19 vs 89.47±4.67,P=0.020;85%vs 65.12%,P=0.037).Logistic regression analysis showed that the treatment mode(rTMS group)was the independent influencing factor of excellent examination results(P=0.032).Conclusion rTMS can effectively and safely improve the sleep disorders and examination results of recruits.rTMS may play a positive role in improving the learning and training effect of recruits,which needs to be further proved.

Objective To explore the immediate impact of acute vision changes in hemiplegic patients on their gait.Methods Thirty visually normal hemiplegic patients were recruited.Plane mirrors(0°),concave lenses(+150°,+450°)were selected to simulate normal vision,moderate myopia,and high myopia scenarios for straight line walking tests.The Qualisys three-dimensional(3D)motion capture system and Kistler 3D force platform were employed to collect kinematic and dynamic parameters of the patients,and the differences in related indicators before and after visual intervention were compared.Results Visual intervention affected the step length,walking speed,and joint angles of hemiplegic patients.Especially after acute vision changes,there was a significant difference in the stride length and ankle joint angles on the patient's affected side.Under high myopia,the step length and step length symmetry were better than those under moderate myopia,but at the expense of gait speed.Visual intervention led to asymmetric trends in step the length symmetry and joint angle symmetry.There were very significant differences in center of pressure(COP)and COP symmetry between normal vision and high myopia.Conclusions Acute vision changes can affect the gait of hemiplegic patients,especially in individuals with high myopia presenting both a notable decrease in walking speed and an increased ankle range of motion,and an increase in walking speed with moderate myopia.Meanwhile,the symmetry of the COP decreases,indicating that acute vision changes lead to a higher risk of falls for patients.Reasonable vision assessment and corresponding intervention measures are expected to improve walking ability and life quality of the patients.

Objective To explore the impact of vision impairment(VI)on the gait of hemiplegic patients,assess their walking ability and fall risks,and provide a basis for developing effective rehabilitation strategies.Methods Thirty hemiplegic patients were enrolled and stratified by the severity of visual acuity impairment into three groups(unimpaired,mildly impaired,and severely impaired).The gait data of patients under uncorrected vision were collected using the Qualisys motion capture system and the Kistler three-dimensional force platform,and the balance ability of patients was assessed simultaneously.Subsequently,the gait and assessment data were statistically analyzed to compare inter-group differences.Results Compared with the visually unimpaired group,significant differences in step length,symmetry,and walking speed were observed in hemiplegic patients of the mild visual impairment group and severe visual impairment group.As VI increased,gait abnormalities became more pronounced,with a longer double-limb support phase,a longer swing phase of the affected limb,and a shorter single-limb support phase of the affected limb in the gait cycle.Compared with the visually unimpaired group,significant differences in center of pressure(COP)and COP symmetry were found between the mild visual impairment group and severe visual impairment group,with gait abnormalities intensifying.The Berg balance scale(BBS)scores showed that there was a significant difference between the visually unimpaired group and severe visual impairment group,indicating that the group with visual impairment had poorer balance ability.Conclusions VI has a significant negative impact on the gait and walking ability of hemiplegic patients.This study emphasizes the importance of focusing on the impact of VI in the rehabilitation of hemiplegic patients,with regular vision assessments and personalized interventions being conducted,which are of great significance in enhancing patients' walking quality.

Objective To explore the impact of vision impairment(VI)on the gait of hemiplegic patients,assess their walking ability and fall risks,and provide a basis for developing effective rehabilitation strategies.Methods Thirty hemiplegic patients were enrolled and stratified by the severity of visual acuity impairment into three groups(unimpaired,mildly impaired,and severely impaired).The gait data of patients under uncorrected vision were collected using the Qualisys motion capture system and the Kistler three-dimensional force platform,and the balance ability of patients was assessed simultaneously.Subsequently,the gait and assessment data were statistically analyzed to compare inter-group differences.Results Compared with the visually unimpaired group,significant differences in step length,symmetry,and walking speed were observed in hemiplegic patients of the mild visual impairment group and severe visual impairment group.As VI increased,gait abnormalities became more pronounced,with a longer double-limb support phase,a longer swing phase of the affected limb,and a shorter single-limb support phase of the affected limb in the gait cycle.Compared with the visually unimpaired group,significant differences in center of pressure(COP)and COP symmetry were found between the mild visual impairment group and severe visual impairment group,with gait abnormalities intensifying.The Berg balance scale(BBS)scores showed that there was a significant difference between the visually unimpaired group and severe visual impairment group,indicating that the group with visual impairment had poorer balance ability.Conclusions VI has a significant negative impact on the gait and walking ability of hemiplegic patients.This study emphasizes the importance of focusing on the impact of VI in the rehabilitation of hemiplegic patients,with regular vision assessments and personalized interventions being conducted,which are of great significance in enhancing patients' walking quality.

AIM:To investigate whether casein kinase 2(CK2)/calmodulin(CaM)/small-conductance Ca2+-activated K+channel type 2(SK2)signaling pathway mediates autophagy-induced sympathoexcitation in the paraventricu-lar nucleus(PVN)of rats with chronic heart failure(CHF).METHODS:We randomly divided 180 Wistar rats,aged 6 to 8 weeks,into 10 groups:sham+dimethyl sulfoxide(DMSO),sham+artificial cerebrospinal(aCSF),CHF+DMSO,CHF+aCSF,CHF+rapamycin(RAPA),CHF+3-methyladenine(3-MA),CHF+5,6-dichlorobenzimidazole riboside(DRB),CHF+calmidazolium chloride(CMDZ),CHF+N-cyclohexyl-N-[2-(3,5-dimethyl-1H-pyrazol-1-yl)-6-methyl-pyrimidin-4-yl]-amine(CyPPA),and CHF+apamin groups.We measured cardiac function,hemodynamic parameters,anatomic indicators,and sympathetic drive indicators(n=18).Western blot was used to examine the protein levels of mi-crotubule-associated protein 1 light chain 3-II(LC3-II)/LC3-I,beclin-1,P62,CK2α,SK2,and phosphorylated CaM.The number of SK2-positive neurons was measured using immunofluorescence staining.The NG108 cells were randomly divided into 6 groups:DMSO,aCSF,RAPA,3-MA,RAPA+DRB,and RAPA+CMDZ groups.Radioisotope 32P-ATP pro-tein kinase activity assays were used to detect CK2 activity in cultured NG108 cells.We used Western blot to examine the protein levels of CK2α,SK2,and phosphorylated CaM.RESULTS:Compared with CHF rats treated with vehicle,CHF rats treated with RAPA or apamin exhibited increased sympathetic drive indicators,but decreased left ventricular ejection fraction and fractional shortening(P<0.01).However,CHF symptoms,including sympathoexcitation,were attenuated by 3-MA,DRB,CMDZ or CyPPA infusion into the PVN(P<0.01).In CHF rats,RAPA infusion into the PVN induced CK2 activity,up-regulated LC3-II/LC3-I,beclin-1,CK2α,and phosphorylated CaM levels,but down-regulated P62 and SK2 expression,as well as the number of SK2-positive neurons(P<0.05 or P<0.01).In CHF rats,infusion of 3-MA or DRB into the PVN decreased CK2 activity,and down-regulated phosphorylated CaM level(P<0.01).Infusion of 3-MA,DRB or CMDZ into the PVN up-regulated SK2 expression and the number of SK2-positive neurons(P<0.01).In cultured NG108 cells,RAPA induced CK2 activation and up-regulated the expression of CK2α and the phosphorylation of CaM,but down-regulated SK2 expression(P<0.01).Treatment with RAPA increased the level of phosphorylated CaM and down-regulated SK2 expression in cultured NG108 cells(P<0.01),which was inhibited by DRB and CMDZ(P<0.05 or P<0.01).CONCLUSION:In rats with CHF,the CK2/CaM/SK2 signaling pathway in the PVN contributes to autophagy-induced sympathoexcitation.

Objective To explore the immediate impact of acute vision changes in hemiplegic patients on their gait.Methods Thirty visually normal hemiplegic patients were recruited.Plane mirrors(0°),concave lenses(+150°,+450°)were selected to simulate normal vision,moderate myopia,and high myopia scenarios for straight line walking tests.The Qualisys three-dimensional(3D)motion capture system and Kistler 3D force platform were employed to collect kinematic and dynamic parameters of the patients,and the differences in related indicators before and after visual intervention were compared.Results Visual intervention affected the step length,walking speed,and joint angles of hemiplegic patients.Especially after acute vision changes,there was a significant difference in the stride length and ankle joint angles on the patient's affected side.Under high myopia,the step length and step length symmetry were better than those under moderate myopia,but at the expense of gait speed.Visual intervention led to asymmetric trends in step the length symmetry and joint angle symmetry.There were very significant differences in center of pressure(COP)and COP symmetry between normal vision and high myopia.Conclusions Acute vision changes can affect the gait of hemiplegic patients,especially in individuals with high myopia presenting both a notable decrease in walking speed and an increased ankle range of motion,and an increase in walking speed with moderate myopia.Meanwhile,the symmetry of the COP decreases,indicating that acute vision changes lead to a higher risk of falls for patients.Reasonable vision assessment and corresponding intervention measures are expected to improve walking ability and life quality of the patients.

Clinicians need to focus on various points in the diagnosis and treatment of insomnia.This article prescribed the treatment protocol based on the unique features,such as insomnia in the elderly,women experiencing specific physiologi-cal periods,children insomnia,insomnia in sleep-breathing disorder patients,insomnia in patients with chronic liver and kidney dysfunction.It pro-vides some reference for clinicians while they make decision on diagnosis,differentiation and treat-ment methods.

ObjectiveTo investigate the effect of Danggui Shaoyaosan （DSS） on the morphology and function of mitochondria in rats model of Alzheimer's disease （AD） and its possible mechanism. MethodRats model of AD was established by injection of streptozocin （STZ） into bilateral ventricles of SD rats. The 40 rats were randomly divided into sham group， model group， low， medium and high dosages of Danggui Shaoyaosan （12，24，36 g·kg^-1·d^-1） groups，observed the morphological changes of mitochondria in hippocampus of rats by electron microscopy after 14 days of continuous gavage. In situ end labeling（TUNEL） staining used to detect apoptosis and immunofluorescencereactive used to observe the expression of reactive oxygen species （ROS） and peroxisome proliferators-activated receptor γ coactivator lalpha （PGC-1α），quantitative Real-time polymerase chain reaction（Real-time PCR）detected the mRNA expression of dynamin-related protein 1 （Drp1），mitochondrial fusion protein 2 （MFN2） ，cytochrome C oxidase subunit Ⅳ （COX Ⅳ） and PGC-1α. Western blot detected the protein expression of adenosine 5'-monophosphate （AMP）-activated protein kinase （AMPK），phosphorylation（p）-AMPK，recombinant Sirtuin 1 （SIRT1） and PGC-1α. ResultCompared with the sham group，the results of model group showed that the damage of mitochondria in hippocampus was more obvious，accelerated the ROS production and apoptosis rate （P<0.01），decreased the mRNA level of MFN2，COX Ⅳ，PGC-1α，increased the mRNA level of Drp1，and descended the protein of p-AMPK/AMPK，SIRT1，PGC-1α （P<0.05，P<0.01）.Compared with the model group，the medium and high dose of DSS group notably improved the damage of mitochondria，reduced the production of ROS and apoptosis rate （P<0.01），promoted the mRNA expression of MFN2，COX Ⅳ，PGC-1α，inhibited the mRNA expression of Drp1，and up-regulated the protein of p-AMPK/AMPK，SIRT1，PGC-1α （P<0.01）. ResultDSS can significantly ameliorate the mitochondrial homeostasis imbalance in AD rats.

Objective:To evaluate the efficacy of combining modified manipulative reduction with functional training for the treatment of acute anterior disc displacement without reduction.Methods:Sixty anterior disc displacement patients aged from 19 to 55 years were randomly divided into an experimental group and a control group, each of 30. The experimental group was given modified manipulative reduction, while the control group was provided with traditional manipulative reduction. After the manipulative reduction, both groups received 3 months of functional training. Visual analog scale (VAS) ratings, maximum active mouth opening, a mandibular movement index and magnetic resonance imaging (MRI) were employed before and immediately after the reduction and after the functional training to evaluate their effectiveness. An oral health-related quality of life scale was also used. The number of attempts needed to achieve successful reduction and the overall success rate were compared between the two groups.Results:There was significant improvement in the average VAS ratings, maximum active mouth opening, mandibular movement index and oral health-related life quality of both groups after the experiment. Immediately after reduction, the maximum active mouth opening and mandible movement in the experimental group were significantly higher than in the control group, on average. Further improvement was observed after the treatment such that there was no significant difference between the two groups. After the functional training, however, the experimental group′s average VAS and oral health-related life quality scores were significantly better than the control group′s averages. According to MRI right after reduction, the success rate of the experimental group (96.7%) was significantly better than among the control group (80%). After the functional training the corresponding values were 86.7% and 73.3%. That difference was no longer significant. There was also no significant difference in the number of attempts needed to achieve successful reduction.Conclusion:The modified manipulative reduction not only has a higher success rate, but also can immediately improve mouth opening and mandible mobility. Combined with functional training, it can effectively reduce pain and improve life quality.