Cerebrovascular diseases, characterized by high incidence, disability, and mortality rates, have emerged as a leading global cause of death and long-term disability. Organoid technology, a three-dimensional in vitro culture system derived from stem cells or tissue cells, enables the simulation of organ development, physiological processes, and pathological mechanisms, demonstrating significant potential in cerebrovascular disease research and therapeutic development. This review summarizes recent advances in organoid applications for cerebrovascular diseases, with a focus on strategies for constructing vascularized cerebral organoids, including in vivo transplantation, in vitro culture systems, and bioengineering approaches. Studies reveal that these models not only recapitulate neurovascular unit interactions but also serve as powerful platforms for drug screening and mechanistic investigations, offering novel therapeutic strategies for cerebrovascular disorders. Current challenges include insufficient vascularization efficiency and limited integration capacity with host tissues. Future integration of gene editing, microfluidic chips, and high-throughput 3D bioprinting technologies is expected to enhance the functionality and clinical translatability of vascularized cerebral organoids, thereby advancing personalized medicine and precision healthcare.

Cerebral ischemia-reperfusion injury(CIRI)is a serious complication caused by the recovery of blood flow in the affected brain tissue of patients with ischemic stroke.CIRI patients are often accompanied by neurological dysfunction,cognitive impairment,emotional disorders and other symptoms,which have a serious impact on daily life.At present,CIRI is easy to be diagnosed early,but there are relatively few related specific treatments.In this paper,the correlation between cyclic adenylate-activated exchange protein 1/RAS-related protein 1(Epac1/Rap1)signaling pathway and CIRI is reviewed,in order to provide new ideas for clinical treatment of CIRI patients.

Objective To investigate the effects of electrical stimulation combined with muscle strength training on knee joint biomechanical characteristics in patients with patellofemoral pain(PFP).Methods Forty-six patients with PFP were recruited and randomly assigned to the muscle strength training(MST)and electrical muscle stimulation with strength training(EMS)groups.The intervention was performed three times a week for six weeks.The anterior knee pain scale(AKPS)was used to measure the knee pain degree.Knee kinematics,dynamics,and surface electromyography(sEMG)data were collected using an infrared motion capture system,force platform,and sEMG system during drop jumps before and after the intervention.Two-way analysis of variance with repeated measures was applied to determine the differences between the dependent variables of the two groups before and after the intervention.Results Compared with pre-intervention,the AKPS score,vastus medialis oblique(VMO)activation,VMO/vastus lateralis(VMO/VL)activation,maximum knee flexion angle,and peak knee extension moment increased significantly in the EMS group;the maximum knee abduction,external rotation angle,and peak knee external rotation moment decreased significantly in the EMS group after intervention.Compared with pre-intervention,the AKPS score,maximum knee flexion angle,and peak knee extension moment increased significantly in the MST group after intervention,the peak knee abduction and external rotation moment significantly decreased in the MST group after intervention.Post-hoc comparisons indicated that compared with the MST group,the AKPS score,VMO activation,VMO/VL activation were significantly higher and the maximum knee abduction angle was significantly lower in the EMS group.Conclusions EMS contributes to the better balance muscle activation of the VMO and VL and corrects the excessive knee abduction angle during jump landing,which may be helpful in relieving pain and improving lower limb function in patients with PFP.

BACKGROUND:Lower limb peri-knee muscle strength training and neuromuscular electrical stimulation are generally safe and effective rehabilitation methods for patellofemoral joint pain,but the mechanism of their intervention is still unclear. OBJECTIVE:To determine the effect of muscle strength training combined with neuromuscular electrical stimulation on pain,lower extremity function and biomechanical characteristics in patients with patellofemoral pain. METHODS:Thirty-seven patients with patellofemoral pain were randomly divided into muscle strength training combined with electrical stimulation group(trial group,n=19)and muscle strength training group(control group,n=18).Both groups underwent intervention training for 6 weeks,three times a week.The visual analog scale and anterior knee pain scale were used to evaluate the pain level and functional level of the knee.Kinematic and kinetics data during running were collected by using an infrared motion capture system and a three-dimensional force platform simultaneously.A two-way analysis of variance with repeated measures(group*time)was applied to analyze the data. RESULTS AND CONCLUSION:(1)After the intervention,the visual analog scale scores of the trial group and the control group were significantly decreased(P<0.001),and the anterior knee pain scale scores were significantly increased(Ptrial group<0.001,Pcontrol group=0.001)in the trial group and control group.The anterior knee pain scale scores of the trial group were significantly higher compared to the control group after the intervention(P=0.001).(2)The peak knee flexion angle(P=0.011),peak knee extension moment(P<0.001),the peak knee internal rotation moment(P=0.008),the peak patellofemoral stress(P<0.001)and the peak patellofemoral contact force(P<0.001)were significantly decreased in the trial and control groups during running after the intervention compared with those before the intervention.(3)In conclusion,both muscle strength training and muscle strength training combined with electrical stimulation training are helpful to improve the subjective pain and lower limb function of patellofemoral pain patients,enhance the movement pattern during running and reduce the stress of the patellofemoral joint.Compared with muscle strength training alone,muscle strength training combined with electrical stimulation can improve lower limb function more significantly.

BACKGROUND:Studies have shown that poor dynamic postural control may lead to abnormal movement patterns during exercise,which may increase the risk of lower limb joint and anterior cruciate ligament injury.The stability of the body core is the basis of good dynamic postural control. OBJECTIVE:To investigate the effects of core stability training on dynamic postural control and risk of injury in landing movements,and to compare the differences in training effects between genders. METHODS:Thirty-five college students(male=19,female=16)were recruited for 6 weeks of core stability training.The results of the Y balance test,trunk extensor endurance test,trunk flexor endurance test,lateral bridge endurance test,and landing error scoring system were analyzed before and after training. RESULTS AND CONCLUSION:The 6-week core stability training could improve trunk extensor endurance(P＜0.001),flexor endurance(P＜0.001),and lateral abdominal muscle endurance(P＜0.001).Core stability training could improve forward distance(P=0.026),backward inward distance(P＜0.001),backward outward distance(P=0.005)and comprehensive score(P＜0.001)of Y balance test for male and female college students.Landing error scoring system scores of both male and female college students significantly decreased after 6 weeks of core stability training(P＜0.001)while increasing knee(P＜0.001)and hip flexion angles(P＜0.001),decreasing knee valgus angle(P＜0.001)at the moment of touchdown,and could increase the maximum knee flexion angle(P＜0.001)and decrease the maximum knee valgus angle(P＜0.001).It is concluded that core stability training improves dynamic postural control and improves landing movement patterns,suggesting that it may help reduce the risk of anterior cruciate ligament injury.There are no sex differences in core stability training in terms of increased trunk flexor endurance,lateral bridge muscle group endurance,improved dynamic postural control,and reduced risk of anterior cruciate ligament injury.

BACKGROUND:Distal tibial tuberosity-high tibial osteotomy is a surgical treatment for knee osteoarthritis,but there is still a lack of clinical studies on its effect on ankle joints. OBJECTIVE:To observe the effects of distal tibial tuberosity-high tibial osteotomy on ankle angle on coronal plane of the radiography of the full length of lower limb in weight loading. METHODS:Data of 40 patients(41 knees)with distal tibial tuberosity-high tibial osteotomy from March 2021 to March 2022 were retrospectively analyzed,including 31 females and 9 males,20 left knees and 21 right knees,aged 49-75 years,mean(63.44±6.57)years.The radiographic data of the full length of the lower limb in weight loading were collected before,week 2 and week 48 postoperatively.Hip-knee-ankle angle,talar tilt angle,tilt angle of the ankle,tibiocrural angle,and tibial articular surface angle were measured before and after surgery. RESULTS AND CONCLUSION:(1)Hip-knee-ankle angle improved from(-6.24±3.69)° before operation to(2.59±3.49)° week 2 postoperatively and(2.15±3.49)° week 48 postoperatively.The tilt angle of the ankle changed from(-7.90±3.11)° before operation to(-2.51±2.59)° week 2 postoperatively and(-2.46±2.42)° week 48 postoperatively,with statistically significant difference(P<0.001).(2)There was no significant difference in talar tilt angle,tibiocrural angle,and tibial articular surface angle before and week 2 postoperatively.(3)No significant difference in the angle changes was detected between week 2 and week 48 postoperatively.(4)It is indicated that distal tibial tuberosity-high tibial osteotomy can not only correct genu varus but also improve ankle angle.This result remains stable after 48 weeks of weight-bearing activities.

Objective To explore the effect of muscle energy technique(MET)on dynamic posture control and lumbar neuromuscu-lar function in patients with non-specific low back pain. Methods From March to June,2022,30 college students with non-specific low back pain from Shandong Sport Universi-ty were randomly divided into control group(n=15)and intervention group(n=15).The control group received health education,and the intervention group received MET,for four weeks.They were assessed with Visual Ana-logue Scale(VAS)of pain,Oswestry Disability Index(ODI),Y-balance test and trunk flexion-relaxation test be-fore and after intervention. Results VAS scores decreased in both groups after intervention(|t|>2.449,P<0.05),and it was less in the intervention group than in the control group(t=-5.068,P<0.001);while ODI score decreased in the intervention group(t=4.785,P<0.001),and it was less in the intervention group than in the control group(t=-2.895,P=0.007);the performance of Y-balance test increased(t=-3.662,P=0.003)in the intervention group,as well as flexion-re-laxation ratio of multifidus(t=-2.460,P=0.029). Conclusion MET is effective on alleviating pain and lumbar dysfunction,improving dynamic posture control and en-hancing the function of the multifidus during flexion in patients with non-specific low back pain.

Methods: This retrospective study analyzed patients who underwent chest CT and DXA at our hospital between August 2021 and August 2022. Thoracic thoracolumbar segment HU values, lumbar T-scores, and hip T-scores were computed for comparison, and thoracic thoracolumbar segment HU thresholds suggestive of potential bone density abnormalities were established using receiver operating characteristic curves. Results: In total, 470 patients (72.4% women; mean age, 65.5±12.3 years) were included in this study. DXA revealed that of the 470 patients, 90 (19%) had osteoporosis, 180 (38%) had reduced osteopenia, and 200 (43%) had normal bone mineral density (BMD). To differentiate osteoporosis from osteopenia, the HU threshold was established as 105.1 (sensitivity, 54.4%; specificity, 72.2%) for T11 and 85.7 (sensitivity, 69.4%; specificity, 61.1%) for T12. To differentiate between osteopenia and normal BMD, the HU threshold was 146.7 for T11 (sensitivity, 57.5%; specificity, 84.4%) and 135.7 for T12 (sensitivity, 59.5%; specificity, 80%). Conclusions This study supports the significance of HU values from chest CT for BMD assessment. Chest CT provides a new method for clinical opportunistic screening of osteoporosis. When the T11 HU is >146.7 or the T12 HU is >135.7, additional osteoporosis testing is not needed unless a vertebral fracture is detected. If the T11 HU is <105.1 or the T12 HU is <85.7, further DXA testing is strongly advised. In addition, vertebral HU values that fall faster than those of the T11 and L1 vertebrae may explain the high incidence of T12 vertebral fractures.

Objective:To evaluate the effect of the improved team-based learning (TBL) teaching method in the undergraduate probation course of ophthalmology based on the goal of cultivating excellent doctors.Methods:The undergraduates of clinical medicine were randomly divided into experimental group and control group. The control group ( n=50) was given conventional ophthalmology probation teaching, while the experimental group ( n=50) was given ophthalmology probation teaching of improved TBL teaching method. The theoretical examination performance and skill assessment results of students in the two groups were compared, and the subjective evaluation of the students on the teaching was also compared. SPSS 23.0 was used to conduct t-test and Wilcoxon's rank sum test. Results:The theoretical examination performance of experimental group (29.68±4.52) was better than that of control group (27.84±4.33), with significant differences ( P<0.05); the skill assessment results of experimental group (32.88±5.05) were also better than those of the control group (30.88±6.99), with significant differences ( P<0.05); the subjective evaluation of teaching effect in each item of experimental group was better than that of control group ( P<0.05). Conclusion:The improved TBL teaching method can not only improve students' theoretical knowledge and experimental skills, but also improve students' self-study and teamwork ability, which will provide a feasible educational reform plan for achieving the goal of cultivating excellent doctors.

Objective To reveal the mechanism of action of AS-Ⅳ on HepG2 cells based on molecular dynamics simulation and experimental evaluation. Methods We constructed a "drug-disease" network pharmacological map, analyzed the core genes of astragaloside Ⅳ (AS-Ⅳ) in HCC, screened key signaling pathways, and established a "drug-target" molecular dynamics model. In vitro assay was used to detect migration, proliferation and invasion abilities. Flow cytometry and qRT-PCR were used to detect the effect of AS-Ⅳ on the cell cycle and apoptosis, and the expression of core gene of HepG2. Results The core target of AS-Ⅳ acting on HCC was VEGFA. Compared with the control group, the high concentration of AS-Ⅳ significantly inhibited the migration, invasion and proliferation of HepG2 cells, blocked the metastasis of HepG2 cells from G₁ to G₂ phase, promoted their apoptosis, down-regulated VEGFA expression and up-regulated TGF-β1 expression. Conclusion AS-Ⅳ may inhibit the proliferation of hepatocellular carcinoma cells through multi-target and multi-pathway.