Botulinum toxin poisoning can lead to severe health crises, and multidisciplinary collaboration is crucial for rapid diagnosis and emergency treatment. This article reported a case of a 21-year-old female patient who developed symptoms of botulinum toxin poisoning 4 days after receiving botulinum toxin type A through an unofficial route. Significant symptomatic improvement was observed 9 days after the onset of poisoning following botulinum antitoxin treatment. Through a case report and a review of neurophysiological literature, the role of neurophysiological examinations in aiding diagnosis was analyzed, providing a scientific basis for clinical treatment..

Objective To investigate the clinical efficacy of the"dynamic and static combination"approach in the treatment of Hepple Ⅰ-Ⅲ type osteochondral lesions of the talus(OLT),utilizing external ankle shaking,pulling,and poking manipulations in conjunction with ankle brace fixation.Methods A total of 82 patients diagnosed with OLT,who sought treatment at four hospitals between June 2022 and December 2023,were included in the study.Both the experimental and control groups received ankle immobilization using braces through-out the treatment period.The control group was administered Voltaren Emulgel topically twice daily(morning and evening),with each treatment course lasting 30 days,for a total of one course.The experimental group received additional therapeutic intervention involving shaking,pulling,and poking manipulations,conducted twice weekly,with the same duration and number of treatment courses as the control group.Follow-up assessments were scheduled at 2 weeks,4 weeks,and 2 months post-treatment.Outcome measures included the pain rating index(PRI),visual analogue scale(VAS)for pain intensity,current pain intensity(PPI),American Orthopaedic Foot & Ankle Society(AOFAS)ankle and hindfoot scores,proprioceptive function,and the size of OLT.Results During the longitudinal assessment conducted at 2-week,4-week,and follow-up intervals,the experimental group exhibited superior clinical outcomes compared to the control group,with statistically significant decreases in PRI,PPI,and AOFAS scores(all P＜0.05).VAS scores showed progressive improvement over time,with significant intergroup differences observed at both the 4-week and follow-up assessments(P＜0.05).Biomechanical analysis performed post-intervention indicated improved kinematic repositioning accuracy in the experimental group,as reflected by significantly reduced active-passive error angles(P＜0.05).Importantly,measurements of OLT area revealed notable therapeutic effects in the experimental group(P＜0.05),whereas no statistically significant changes were observed in the control group throughout the study period(all P＞0.05).Conclusions Under the guidance of the"dynamic and static combination"concept,the integration of shaking,pulling,and poking manipu-lation with conventional Western medicine-based conservative treatment for OLT demonstrates more pronounced advantages in alleviating pain,improving ankle joint function,restoring proprioception,facilitating lesion recovery,and enhancing overall quality of life.

Objective To investigate the clinical efficacy of the"dynamic and static combination"approach in the treatment of Hepple Ⅰ-Ⅲ type osteochondral lesions of the talus(OLT),utilizing external ankle shaking,pulling,and poking manipulations in conjunction with ankle brace fixation.Methods A total of 82 patients diagnosed with OLT,who sought treatment at four hospitals between June 2022 and December 2023,were included in the study.Both the experimental and control groups received ankle immobilization using braces through-out the treatment period.The control group was administered Voltaren Emulgel topically twice daily(morning and evening),with each treatment course lasting 30 days,for a total of one course.The experimental group received additional therapeutic intervention involving shaking,pulling,and poking manipulations,conducted twice weekly,with the same duration and number of treatment courses as the control group.Follow-up assessments were scheduled at 2 weeks,4 weeks,and 2 months post-treatment.Outcome measures included the pain rating index(PRI),visual analogue scale(VAS)for pain intensity,current pain intensity(PPI),American Orthopaedic Foot & Ankle Society(AOFAS)ankle and hindfoot scores,proprioceptive function,and the size of OLT.Results During the longitudinal assessment conducted at 2-week,4-week,and follow-up intervals,the experimental group exhibited superior clinical outcomes compared to the control group,with statistically significant decreases in PRI,PPI,and AOFAS scores(all P＜0.05).VAS scores showed progressive improvement over time,with significant intergroup differences observed at both the 4-week and follow-up assessments(P＜0.05).Biomechanical analysis performed post-intervention indicated improved kinematic repositioning accuracy in the experimental group,as reflected by significantly reduced active-passive error angles(P＜0.05).Importantly,measurements of OLT area revealed notable therapeutic effects in the experimental group(P＜0.05),whereas no statistically significant changes were observed in the control group throughout the study period(all P＞0.05).Conclusions Under the guidance of the"dynamic and static combination"concept,the integration of shaking,pulling,and poking manipu-lation with conventional Western medicine-based conservative treatment for OLT demonstrates more pronounced advantages in alleviating pain,improving ankle joint function,restoring proprioception,facilitating lesion recovery,and enhancing overall quality of life.

Botulinum toxin poisoning can lead to severe health crises, and multidisciplinary collaboration is crucial for rapid diagnosis and emergency treatment. This article reported a case of a 21-year-old female patient who developed symptoms of botulinum toxin poisoning 4 days after receiving botulinum toxin type A through an unofficial route. Significant symptomatic improvement was observed 9 days after the onset of poisoning following botulinum antitoxin treatment. Through a case report and a review of neurophysiological literature, the role of neurophysiological examinations in aiding diagnosis was analyzed, providing a scientific basis for clinical treatment..

Deep brain stimulation(DBS)has become an established technique for the treatment of neurodegenerative diseases such as Parkinson disease(PD).This technique significantly improves the clinical symptoms of PD patients by directly stimulating specific basal ganglia nuclei with implanted electrodes,but its physiological mechanism of action remains unclear.The control mechanisms of eye movement involve the cerebral cortex and basal ganglia,which are extensively overlapped with the targeted network of DBS,but there are relatively few studies on the combined analysis of DBS and eye movement.This article explores the interaction mechanism between DBS and eye movement control to deeply understand the influence of DBS on eye movement function,which is of great significance for optimizing stimulation parameters and improving therapeutic effect.In addition,these studies provide new perspectives for revealing the mechanism of action of DBS and the pathophysiology of PD.

Objective To explore the MRI characteristics of anatomy and injuries of the tendons and ligaments in the midfoot.Methods Twenty healthy volunteers and 46 patients with midfoot trauma were selected for retrospective analysis.All subjects underwent examination on MR T1WI and proton density-fat suppression(PD FS)scans on three planes,respectively.Then the MRI features of tendon and ligaments injury were compared.Results The tendons and ligaments of 20 healthy volunteers(40 lateral feet)showed homogeneous low signal intensity with varing thickness.The anterior tibialis tendons showed a thin linear shape,and the posterior tibialis tendons showed a slightly thick band with uniform low signal intensity,and the calcaneonavicular ligament showed thin linelike low signal in different directions.In the 46 patients with midfoot injuries,there were 16 cases of anterior tibialis tendons injuries,18 cases of posterior tibialis tendons injuries,and 12 cases of calcaneonavicular ligament injuries.According to the MRI findings,the degree of injuries of tendons and ligaments was divided into injury,partial tear,and complete rupture.Conclusion MRI can clearly show the anatomy and injury features of ligaments and tendons in midfoot,which is of important value for the early diagnosis and accurate treatment of the ligaments and tendons injuries.

OBJECTIVE To establish an analytical method for the simultaneous determination of multiple anesthetics and their metabolites in aquatic products by ultra performance liquid chromatography-tandem mass spectrometry with pass-through solid phase extraction purification. METHODS After homogenization, the samples were extracted by 80% acetonitrile aqueous solution, and purified by ProElt PLS-A pass-through solid phase extraction column. The extract was determined by positive ion mode with mobile phase of 0.1% formic acid water and 0.1% formic acid acetonitrile in the separation by programmed gradient. Multiple reaction monitoring mode was used to draw standard curves with the matrix-matched method. RESULTS The calibration curves of the 14 anesthetics showed good linearity in the concentration range of 1-50 µg·L-1 and their metabolites showed good linearity in the concentration range of 10-500 μg·L-1, with the correlation coefficients >0.99. The limits of detection were 0.5 μg·kg-1 in anesthetics and 5 µg·kg-1 in their metabolites. The lower limits of quantification were 1 μg·kg-1 in anesthetics and 10 μg·kg-1 in their metabolites. The recoveries at high, medium and low concentrations ranged from 62.48% to 116.5% with RSDs<10%. CONCLUSION The method is simple and can be used for the accurate detection of anesthetics and their metabolites in aquatic products with high reliabilities.

Rapid eye movement sleep behavior disorder(RBD) is one of the most typical concomitant symptoms of Parkinson disease(PD). Studies have shown that RBD is related to the deterioration of motor and non-motor symptoms,which seriously affects the prognosis and quality of life of patients with PD. However,the pathogenesis of PD with RBD(PD-RBD+) remains unclear. With the development of neuroimaging techniques in recent years,more and more studies have focused on the neuroimaging changes of PD-RBD+ to identify specific imaging markers for the diagnosis and treatment of the disease. This article reviews the research on neuroimaging related to PD-RBD+.

Parkinson disease (PD) is a common neurodegenerative disease with motor and non-motor symptoms that seriously affect the quality of life and social function of patients. The current non-invasive techniques in PD brain function studies mainly include functional magnetic resonance imaging and electroencephalography, which made it difficult to assess brain function under motor state or magnetoelectric treatment. As an emerging functional neuroimaging technique, functional near-infrared spectroscopy (fNIRS) can monitor the real movement-related cortical responses of PD patients in real time, providing a safe and non-invasive method with high ecological validity for direct monitoring of brain activity. This article presented a review of recent advances in the application of fNIRS technology in PD research, intending to provide new ideas for functional neuroimaging studies in PD. The results suggested that PD gait and balance deficits were closely associated with abnormal activation of the cerebral cortex, particularly the prefrontal cortex, involving a compensatory strategy of cortical cognitive resources for basal ganglia dysfunction. Drugs, deep brain stimulation, and other interventions could be applied to fNIRS techniques to evaluate neurorehabilitation effects and reveal the neural basis of intervention effects. This area of research is currently in its infancy, but the evidence provided supports for the translation of fNIRS into clinical practice. Future research should develop multimodal imaging techniques and in-depth studies of broad areas of the cerebral cortex to obtain more valuable findings for clinical practice.

Objective:To investigate the relationship between mental resilience and quality of life in patients with Parkinson ′s disease and provide basis for paying attention to the mental health of this group. Methods:A total of 190 in patients with Parkinson ′s disease (PD) were selected from April to July 2017 in the First Affiliated Hospital of Dalian Medical University. The general data questionnaire, Mental Resilience Scale and 39-Item Quality of Life (QOL) Questionnaires were used to investigate among the patients. Results:The mental resilience score of PD patients was 48.0 (29.8, 62.2) points and the quality of life score was 56.0 (27.8, 82.0) points. There was a significant negative correlation between mental resilience and quality of life score ( r value was -0.538, P<0.01). Multivariate linear regression analysis showed that with the increase of psychological elasticity score, the score of quality of life decreased ( b value was -0.002, P<0.001). Conclusions:The mental resilience and quality of life of PD patients are both at a low level, the improvement of mental resilience is beneficial to improve their quality of life.