Objective To compare the effect of transcranial direct current stimulation(tDCS),functional electrical stimulation(FES)of the forearm flexors,and their combined intervention on grip strength and cerebral cortical activation in healthy young adults.Methods From December,2024 to March,2025,twelve healthy right-handed young volunteers aged 20 to 23 years were recruited from the Fifth Hospital of Xiamen.They were randomly assigned to receive tDCS alone(tDCS group),FES alone(FES group),or simultaneous tDCS-FES(Sim group)in a crossover design.For tDCS,synchronous bihemispheric stimulation of the primary motor cortex(M1)was applied(anode on the left/cathode on the right).FES was delivered to the right flexor carpi radialis and flexor digitorum superficialis muscles.Isometric maximal grip strength was measured before and after each intervention,and functional near-infrared spectroscopy(fNIRS)was used to synchronously monitor oxyhemoglobin(HbO2)during grip strength tasks.Results A case dropped down.The effect of time on grip strength was significant(F=3.964,P=0.048);Post-hoc tests revealed that grip strength significantly increased after intervention in both FES group and Sim group(P<0.05).The effect of groups was significant on HbO2 of the left prefrontal cortex(PFC)and left premotor and supplemen-tary motor cortex(PMC)(F>3.613,P<0.05);Post-hoc tests revealed that the HbO2 of the left PFC and left pri-mary sensory cortex was higher in FES group than in Sim group,while the HbO2 of the left PMC and right PMC was higher in tDCS group than in Sim group(all P<0.05).Correlation analysis indicated that the grip strength was positively correlated with the HbO2 of the bilateral M1 only in Sim group(r>0.694,P<0.05).Conclusion For healthy young adults,tDCS alone mainly activates motor-related brain regions such as PFC and PMC,while FES alone directly enhances peripheral muscle force output and activates the left PFC to participate in mo-tor regulation.The combined intervention achieves the maximum gain in grip strength through a brain-limb inte-grated regulation mechanism,which may be associated with optimization of neural resource and M1 activity.

Objective To compare the effect of transcranial direct current stimulation(tDCS),functional electrical stimulation(FES)of the forearm flexors,and their combined intervention on grip strength and cerebral cortical activation in healthy young adults.Methods From December,2024 to March,2025,twelve healthy right-handed young volunteers aged 20 to 23 years were recruited from the Fifth Hospital of Xiamen.They were randomly assigned to receive tDCS alone(tDCS group),FES alone(FES group),or simultaneous tDCS-FES(Sim group)in a crossover design.For tDCS,synchronous bihemispheric stimulation of the primary motor cortex(M1)was applied(anode on the left/cathode on the right).FES was delivered to the right flexor carpi radialis and flexor digitorum superficialis muscles.Isometric maximal grip strength was measured before and after each intervention,and functional near-infrared spectroscopy(fNIRS)was used to synchronously monitor oxyhemoglobin(HbO2)during grip strength tasks.Results A case dropped down.The effect of time on grip strength was significant(F=3.964,P=0.048);Post-hoc tests revealed that grip strength significantly increased after intervention in both FES group and Sim group(P<0.05).The effect of groups was significant on HbO2 of the left prefrontal cortex(PFC)and left premotor and supplemen-tary motor cortex(PMC)(F>3.613,P<0.05);Post-hoc tests revealed that the HbO2 of the left PFC and left pri-mary sensory cortex was higher in FES group than in Sim group,while the HbO2 of the left PMC and right PMC was higher in tDCS group than in Sim group(all P<0.05).Correlation analysis indicated that the grip strength was positively correlated with the HbO2 of the bilateral M1 only in Sim group(r>0.694,P<0.05).Conclusion For healthy young adults,tDCS alone mainly activates motor-related brain regions such as PFC and PMC,while FES alone directly enhances peripheral muscle force output and activates the left PFC to participate in mo-tor regulation.The combined intervention achieves the maximum gain in grip strength through a brain-limb inte-grated regulation mechanism,which may be associated with optimization of neural resource and M1 activity.

Objective: To investigate the effect and mechanism of RNA binding protein Lin28 on the 5-fluorouracil (5-Fu) sensitivity of HepG2 cells. Methods: HepG2 cells were transfected with plasmid pcDNA3.1-Lin28 or si-Lin28 (small interfering RNA of Lin28). qPCR and Western blotting were used to detect the expression of Lin28 in HepG2 cells after transfection. Changes of cell proliferation in transfected cells after 5-Fu treatment was detected by CCK8 assay and the 50% inhibitory concentration (IC50) was calculated. Flow cytometry was used to detect apoptotic rate after 5-Fu treatment and the expression of apoptosis-related protein was assayed by Western blotting. The mRNA expressions of drug-resistant miRNAs (let-7a and let-7b), as well as cancer stem cell markers (Oct4, Nanog and Sox2) after transfection were detected by qPCR. Results: As compared to the HepG2/Vector cells, the mRNA and protein expressions of Lin28 were significantly up-regulated in HepG2/Lin28 cells (P<0.05 or P<0.01). Over-expression of Lin28 significantly suppressed the sensitivity of HepG2 cells to 5-Fu (IC50elevated obviously, P<0.05) and significantly increased cell proliferation while decreased apoptotic rate and expression of apoptotic-related protein caspase-3 (all P<0.01). As compared to si-control group, expression of Lin28 in HepG2/si-Lin28 cells was significantly down-regulated (P<0.01). Lin28 knockdown significantly reduced cell proliferation and IC50 of 5-Fu (all P<0.01) but increased apoptotic rate and expression of apoptosis-related protein (P<0.01). Compared with HepG2/Vector group, expressions of let-7a and let-7b, as well as cancer stem cell markers (Oct4, Nanog and Sox2) were significantly increased in HepG2/Lin28 cells (all P<0.01); while these molecules were significantly decreased in HepG2/si-Lin28 cells as comparing to si-control group (all P<0.01). Conclusion: Lin28 can modulate the chemosensitivity of HepG2 cells by regulating the expression of miRNAs and the formation of cancer stem cells. Targeting Lin28 might be a promising approach to improve the chemotherapy efficacy in HCC.

Objective: To discuss the surgical method and clinical effect of applying the facial artery perforator-based nasolabial para-nasal advanced flap to repair the medial canthus and inner lower eyelid skin defects. Methods: The advance nasolabial para-nasal perforator flap supplied by facial artery, was used to repair the medial canthus and inner lower eyelid skin defects, caused by dermatoma excision. Results: All 18 flaps completely survived. The detects in the medial canthus andinner lower eyelid, and the donor sites in the nasolabial fold were primary healed.The medial canthus and inner lower eyelid were recovery satisfactorily.The flaps were not bloated, and the contour and texture of flaps were similar to adjacent tissue, with no need of secondary repair.The donor site was successfully hidden in the nasolabial dermatoglyph. Conclusions Nasolabial para-nasal perforator flap is easily obtained, reliable in blood supply, and flexible in transfer. It has a wide range of movement and is easy to advance, so as to repair medial canthus andinner lower eyelid defect. With above advantages, this flap is worthy towidely popularize.

Background:Gross target volume of primary tumor (GTV?P) is very important for the prognosis prediction of patients with nasopharyngeal carcinoma (NPC), but it is unknown whether the same is true for locally advanced NPC patients treated with intensity?modulated radiotherapy (IMRT). This study aimed to clarify the prognostic value of tumor volume for patient with locally advanced NPC receiving IMRT and to ifnd a suitable cut?off value of GTV?P for prognosis prediction. Methods:Clinical data of 358 patients with locally advanced NPC who received IMRT were reviewed. Receiver oper?ating characteristic (ROC) curves were used to identify the cut?off values of GTV?P for the prediction of different end?points [overall survival (OS), local relapse?free survival (LRFS), distant metastasis?free survival (DMFS), and disease?free survival (DFS)] and to test the prognostic value of GTV?P when compared with that of the American Joint Committee on Cancer T staging system. Results:The 358 patients with locally advanced NPC were divided into two groups by the cut?off value of GTV?P as determined using ROC curves: 219 (61.2%) patients with GTV?P≤46.4mL and 139 (38.8%) with GTV?P>46.4mL. The 3?year OS, LRFS, DMFS, and DFS rates were all higher in patients with GTV?P≤46.4mL than in those with GTV?P>46.4mL (allP<0.05). Multivariate analysis indicated that GTV?P>46.4mL was an independent unfavorable prognostic factor for patient survival. The ROC curve veriifed that the predictive ability of GTV?P was superior to that of T category (P<0.001). The cut?off values of GTV?P for the prediction of OS, LRFS, DMFS, and DFS were 46.4, 57.9, 75.4 and 46.4mL, respectively. Conclusion:In patients with locally advanced NPC, GTV?P>46.4mL is an independent unfavorable prognostic indi?cator for survival after IMRT, with a prognostic value superior to that of T category.

Objective To study the effect of early enteral nutrition on stress ulcer in patients with severe craniocerebral injury.Methods 134 patients with severe craniocerebral injury were randomly divided into two groups,the early enteral nutrition group (the EEN group,69 cases) was given nasogastric intubation feeding after hospitalization or within 24 hours postoperation,the delayed enteral nutrition group (the DEN group,65 cases) was given nasogastric intubation feeding 24 hours postoperation.The incidence of upper gastrointestinal bleeding in two groups were compared.Results The incidence of upper gastrointestinal bleeding in the EEN group was significantly lower than that of the DEN group.Conclusions Patients with severe brain injury should be given enteral nutrition as soon as possible to reduce the occurrence of stress ulcer and prevent upper gastrointestinal bleeding.

Objective:To observe the therapeutic effect ofexternal application ofChinese herbal medicine film plus acupoint-injection on breast hyperplasia.Methods:The 120 cases ofbreast hyperplasia with syndrome ofthe liver failing to maintain the normal flow ofqi were randomly divided into treatment group(40cases) which was treated by external application ofChinese herbal medicine film plus acupoint-injection, acupoint-injection group(40 cases) and control group(40cases).The changes ofsymptoms and signs, level ofserum sexual hormone and color doppler ultrasound analysis ofthree group were observed for comparison.Results:After 1 course oftreatment, the total effective rate oftreatment group was obviously higher than that ofcontrol group(P0.05).After 2 courses oftreatment, the total effective rate oftreatment group and acupoint-injection group was obviously higher than that ofcontrol group(P