To observe the effect of acupuncture on the AMPK/SIRT1/PGC- 1α signaling pathway in skeletal muscle of aging rats, and to explore the possible mechanism of acupuncture in delaying aging skeletal muscle atrophy in lumbar skeletal muscle.

Forty male SD rats were randomly divided into blank group, model group, acupuncture group and non-acupoint group. The blank group received daily subcutaneous injections of normal saline in the dorsal neck region. The other three groups received daily subcutaneous injections of D-galactose (D-gal) in the same region for 12 weeks to induce aging. Starting from week 9, acupuncture intervention was performed for 4 weeks. The acupuncture group took bilateral L3—L5 Jiaji points, and the non-acupoint group took bilateral non-meridian and non-acupoint points. Body weight and growth rates were measured, and muscle strength was evaluated using a grip strength test. Lumbar skeletal muscle atrophy was assessed using hematoxylin and eosin staining. Serum levels of superoxide dismutase (SOD), malondialdehyde (MDA), and glutathione peroxidase (GSH-PX) were analyzed biochemically. Relative expression levels of AMPKα, SIRT1, PGC-1α, P21 and P53 mRNA were detected by real-time quantitative PCR.

Compared with the blank group, the body weight of the model group, the acupuncture group and the non-acupoint group was reduced (P<0.01, P<0.05, P<0.01), and the difference in terminal body weight growth rate was significant (P<0.001 for all). Before intervention, grip strength was significantly reduced in all experimental groups compared to the blank group (P<0.01 for all), with no significant differences among the experimental groups (P>0.05). After the intervention, the model group showed significantly lower grip strength compared to the blank group (P<0.001), accompanied by evident lumbar skeletal muscle atrophy, as reflected by reduced muscle fiber area and diameter (P<0.001, P<0.01). Additionally, serum SOD and GSH-PX activities decreased (P<0.001, P<0.001), while MDA increased significantly (P<0.01). The mRNA expression levels of AMPKα, SIRT1, and PGC-1α decreased significantly (P<0.001, P<0.001, P<0.01), while the relative mRNA expression levels of P21 and P53 were higher than those in the blank group (P<0.05, P<0.01). Compared with the model group, the acupuncture group demonstrated increased grip strength (P<0.001), improved skeletal muscle fiber area and diameter (P<0.01, P<0.05), enhanced serum SOD and GSH-PX activities (P<0.001, P<0.01), reduced serum MDA levels (P<0.05), and elevated AMPKα, SIRT1, and PGC-1α mRNA expression (P<0.001, P<0.01, P<0.05). Moreover, P21 and P53 mRNA expression levels were significantly reduced in the acupuncture group (P<0.05, P<0.01), while there was no significant difference in the non-acupoint group (P>0.05).

Acupuncture at Jiaji points alleviated the atrophy of lumbar skeletal muscles, improved muscle strength and inhibited oxidative stress in aging rats. These effects may be mediated through the AMPK/SIRT1/PGC-1α signaling pathway.

To investigate the protective effects of treadmill exercise training on lung injury following spinal cord injury (SCI) and its potential underlying mechanisms.

A rat model of SCI was established and randomly divided into different intervention groups. The experimental group underwent treadmill exercise training, while the control group received no exercise intervention. Lung tissue was analyzed for the expression of inflammatory factors TNF-α and IL-6, the activity of the phosphatidylinositol 3-kinase/protein kinase B/mammalian target of rapamycin (PI3K/AKT/mTOR) signaling pathway, and the level of autophagy. These measures were used to assess the impact of exercise training on lung injury post-SCI.

Compared to the control group, treadmill exercise training significantly reduced the expression of inflammatory factors in the lungs post-SCI, activated the PI3K/AKT/mTOR signaling pathway, and promoted lung autophagy in lung tissue.

Treadmill exercise training can mitigate lung injury after SCI by activating the PI3K/AKT/mTOR signaling pathway and promoting autophagy in lung tissue.

To facilitate remote home- based intelligent assessment and rehabilitation guidance for upper limb motor dysfunction in stroke patients, this study aimed to explore the reliability and accuracy of a machine-learning-based intelligent assessment system for evaluating Brunnstrom stages of upper limb and hand motor function in stroke patients.

A total of 220 patients with stroke who were admitted to the Department of Rehabilitation Medicine of the First Affiliated Hospital of Sun Yat-sen University from August 1, 2024 to June 30, 2025 were enrolled. Data from 160 stroke patients were used to train and optimize the machine-learning model of the intelligent assessment system for upper-limb motor function in stroke patients. Patients completed standardized movements under video guidance and were recorded by trained therapists. Brunnstrom stages of upper limb and hand motor function were independently evaluated by therapists and the intelligent assessment system. The remaining 60 stroke patients were used to validate the system by comparing automated assessments with therapist ratings.

The machine learning-based intelligent assessment system demonstrated excellent test-retest reliability, with intraclass correlation coefficients (ICCs) of 0.989 for upper limb staging and 0.969 for hand staging. The inter-rater reliability for the intelligent assessment system was also high (upper limb ICC was 0.896; hand ICC was 0.959). Agreement between the intelligent assessment system and therapist ratings was excellent, with a Kappa coefficient of 0.900 (P<0.001) for upper limb staging and 0.816 (P<0.001) for hand staging.

The machine-learning-based intelligent assessment system demonstrated good reliability and accuracy in assessing upper limb motor function after stroke and may serve as a practical assessment tool for remote upper limb function evaluation and monitoring in patients with stroke.

To elucidate the therapeutic effects and neural mechanisms of a neuromodulatory priming strategy using intermittent theta burst stimulation (iTBS) combined with lower-limb exoskeleton robot training on functional recovery in stroke patients.

Eighty post-stroke patients with lower limb motor dysfunction were randomized into four groups (n=20 in each) :conventional rehabilitation (CR), iTBS, lower limb robot (LLR), and iTBS+LLR. All groups received conventional rehabilitation therapy. In addition, the iTBS and LLR groups received their respective interventions, while the combined group received both iTBS and robotic training. Outcome measures, including the Fugl-Meyer Assessment for Lower Extremity (FMA-LE), Modified Barthel Index (MBI), Berg Balance Scale (BBS), 3D gait analysis, and fNIRS, were assessed before and after treatment.

There were no significant differences in baseline characteristics or outcome measures among the four groups (P>0.05). Compared to baseline, all four groups exhibited statistically significant improvements in FMA-LE, MBI, and BBS scores following the intervention (P<0.001). The iTBS+LLR group demonstrated superior outcomes in FMA-LE, MBI, and BBS scores compared to other groups (P<0.05). Gait analysis indicated that all groups showed significant improvements in various gait parameters after treatment compared to pretreatment values (P<0.05). The iTBS+LLR group displayed more pronounced enhancements in temporal, spatial, and kinematic gait metrics than other groups (P<0.05). At the neurophysiological level, functional connectivity (FC) within and between regions of interest (ROIs) significantly increased in all groups after treatment (P<0.05). The iTBS+LLR group showed greater FC augmentation compared to other groups (P<0.05). The iT-BS+LLR group demonstrated broadened activation involving left and right primary motor cortex (LM1/RM1), left and right supplementary motor area (LSMA/RSMA), left and right prefrontal cortex (LPFC/RPFC), and left occipital lobe (LOL) (P<0.01). Intergroup comparisons confirmed that activation in LM1, LSMA, RS-MA, LPFC, and LOL was significantly stronger in the combined group than in the other groups (P<0.05).

Priming iTBS combined with a lower limb exoskeleton robot results in greater improvements in motor function and gait in stroke patients than either intervention alone. These benefits may be associated with enhanced motor cortical excitability, strengthened functional connectivity, and facilitation of synergistic neuroplasticity within gait-control networks.

To investigate the value of the predict recovery potential (PREP) 2 algorithm for prognostic stratification in the acute phase of stroke and to longitudinally analyze functional recovery trajectories across different prognostic subgroups in a Chinese stroke population.

In this prospective longitudinal study, 65 stroke patients admitted to the First Affiliated Hospital of Wenzhou Medical University within 3 days of onset between March 2023 and January 2024 were enrolled. The Shoulder Abduction and Finger Extension (SAFE) score was assessed within 3 days post-stroke, and transcranial magnetic stimulation-motor evoked potential (TMS-MEP) assessment was performed within 10 days (T1) for prognostic stratification. Prognostic stratification was subsequently conducted using the PREP2 algorithm. Functional assessments, including the upper limb Fugl-Meyer assessment (UE-FMA), national institutes of health stroke scale (NIHSS), and modified Barthel index (MBI), were conducted at T1, 1 month (T2), and 3 months (T3) post-stroke. All patients received standardized comprehensive rehabilitation therapy.

The PREP2-predicted stratification showed agreement with the 3-month outcome levels defined by UE-FMA recovery rate (weighted Kappa=0.785, P<0.001). Repeated-measures ANOVA revealed significant main effects of time and significant time-by-stratification interaction effects for both UE-FMA and MBI scores (P<0.001), indicating distinct functional recovery trajectories among the prognostic subgroups. Multiple linear regression identified the SAFE score (β=0.407, P<0.001) and MEP status (β=0.304, P<0.001) as independent positive predictors of UE-FMA scores at T3, whereas age (β=-0.181, P<0.001) and NIHSS score at T1 (β=-0.205, P<0.001) were negative predictors.

Under real-world clinical conditions in China, the application of the PREP2 algorithm in the early post-stroke phase (within 10 days) enables effective stratification to distinguish patient subgroups with different recovery trends.

To observe the effects of robot-assisted training on postural control and cognitive ability in stroke patients with hemiplegia by evaluating changes of lower limb function and proprioception, balance, cognition, and activities of daily living.

Forty-eight stroke patients with hemiplegia were recruited and randomly divided into experimental group and control group. The control group received conventional physical therapy, while the experimental group received robot-assisted training in addition to the conventional physical therapy. After 4 weeks of training, the Fugl-Meyer motor function (FMA-LE), joint position sense (JPS), Berg balance scale (BBS), Montreal cognitive assessment (MoCA) and modified Barthel index (MBI) were evaluated. Pearson correlation coefficient was used to analyze the correlation between FMA-LE, MoCA and robot-assisted training scores.

After treatment, the FMA-LE, JPS, BBS, MoCA and MBI of the two groups were significantly better than those before treatment (P<0.05). After 4 weeks of treatment, the improvement of FMA-LE, JPS, BBS and MoCA in the treatment group was significantly better than that in the control group (P<0.05), but there was no significant difference in MBI (P>0.05). The training scores of the experimental group were improved after treatment, and were correlated with the FMA-LE and MoCA score.

Both conventional rehabilitation and robot-assisted training can improve balance, walking, and cognition in hemiplegic stroke patients. Robot-assisted training is more effective in improving postural control ability, but not in activities of daily living.

To evaluate the effect of telerehabilitation system in ward extension training of stroke patients using the international classification of functioning, disability and health (ICF) core sets for stroke.

Eighty stroke patients were randomly divided into an experimental group (n=40) and a control group (n=40). Both groups received routine rehabilitation treatment. Professional therapists assigned ward extension training content and guidance videos to patients in the experimental group through telerehabilitation system, while patients in the control group were only provided with oral task assignments. The patients were assessed using the Fugl-Meyer assessment (FMA), Montreal cognitive assessment (MoCA), and the Short Form 36 Health Survey Questionnaire (SF-36) before and after treatment (20 days) through single-blind design.

After 20 days of treatment, FMA, MoCA, and SF-36 of the experimental group were significantly improved, and the differences were statistically significant (P<0.05). Bodily pain (BP), vitality (VT), social functioning (SF), role emotional (RE), and mental health (MH) dimensions of SF-36 in the control group were not significantly improved (P>0.05), while other scores were significantly improved, and the differences were statistically significant (P<0.05). The scores of FMA, physical functioning (PF), and role physical (RP) in SF-36 of the experimental group were significantly higher than those in the control group (P<0.05).

The telerehabilitation system can improve physical motor function, cognitive function and quality of life in ward extension training of stroke patients.

To investigate the effects of blood flow restriction combined with low intensity resistance training on upper limb function and activities of daily living (ADL) in patients with high-level spinal cord injury.

Thirty- four patients with cervical spinal cord injury admitted to Beijing Boai hospital from March 2023 to October 2023 were randomly divided into an experimental group and a control group, with 17 patients in each group. The control group received low intensity resistance training for both upper limbs, while the experimental group added blood flow restriction conditions on top of the control group. Comparing five aspects of muscle thickness, muscle strength, capabolities of upper extremity questionnaire (CUE-Q), spinal cord independence measure- Ⅲ (SCIM- Ⅲ) and spinal cord injury of dysfunction quality of life rating scale (SCIDOLRS) between the two groups before and after intervention.

①Upper limb function:After 6 weeks of treatment, the muscle thickness of each muscle in the experimental group significantly increased compared to before treatment (P<0.05), while the control group only partially improved (P<0.05). The difference in muscle thickness between the experimental group and the control group was significantly different (P<0.05); After treatment, the muscle strength of most muscle groups in the experimental and control groups increased compared to before treatment. In addition, the muscle strength of bilateral elbow flexion and extension muscle groups in the experimental group were better than that in the control group (P<0.05); After 6 weeks of treatment, the CUE-Q scores of both groups significantly increased (P<0.05), and the scores of the experimental group were higher than control group (P<0.05).②Changes in daily activity ability:After 6 weeks of treatment, both groups of patients showed improvements in SCIM- Ⅲ and SCIDOLRS scores (P<0.05), and the experimental group scored better than the control group (P<0.05).

Compared to low intensity resistance training, blood flow restriction combined with low intensity resistance training can more effectively improve upper limb function and daily activity ability in patients with high level spinal cord injury.

Combining multiple bioinformatics analyses to screen for hub genes between multiple sclerosis (MS) and amyotrophic lateral sclerosis (ALS) and to explore the potential relationship between the two diseases from a genetic perspective.

Gene expression datasets were downloaded from the GEO database, differentially expressed genes (DEGs) were screened using the Limma package in the R software, and GO terminology analysis, KEGG pathway analysis, protein-protein interaction (PPI), ROC analysis, and qRT-PCR analysis were performed on the differentially expressed genes.

A total of 2 GEO datasets (GSE108000 and GSE68605) were included, 681 DEGs were present in MS and 1365 DEGs were available in ALS compared to the normal group, and 66 common DEGs were observed both in MS and ALS, among which the top 10 hub genes were identified to be significantly associated with MS and ALS. In addition, in order to better supplement clinical diagnosis and treatment, the Enrichr platform was used to detect signature drug molecules for the top 10 hub genes. The diagnostic efficacy of the first four hub genes was also determined based on ROC analysis as well as qRT-PCR analysis.

A bioinformatics approach was applied to effectively screen out the hub genes between MS and ALS, which provided new thoughts for the clinical diagnostic and therapeutic target development.

To develop a combined program of Tai Chi and exercise rehabilitation for total hip arthroplasty and evaluate its effect on functional rehabilitation.

A total of 80 patients undergoing primary total hip arthroplasty (posterior lateral approach) were randomly divided into a control group (n=40) and an experimental group (n=40). The control group received a routine rehabilitation training program, while the experimental group received the combined program of Tai Chi and exercise rehabilitation for total hip arthroplasty, constructed by the research group based on the Delphi method, for a total of 24 weeks. Before and after treatment, the BIODEX balance test system, timed up and go test (TUGT), Harris hip joint function assessment scale, modified fall efficacy energy scale (MFES), and SF-36 quality of life comprehensive scale were used for evaluation.

A total of 7 cases dropped off, 3 in the control group and 4 in the experimental group. Thus, data from 73 patients (control group: n=37; experimental group: n=36) were analyzed. After treatment, both groups showed significant improvement in BIODEX balance function score, TUGT score, Harris hip function score, MFES score, and SF-36 comprehensive quality of life score (P<0.05), with the experimental group showing significantly better results than the control group (P<0.05).

The combined program of Tai Chi and exercise rehabilitation after total hip arthroplasty based on Delphi method is scientific and feasible. This program can effectively improve the hip joint function, balance function and walking ability in patients undergoing total hip arthroplasty, reduce fear of falling, and improve the quality of life.

To study the correlation and difference between epilepsy and simple epileptiform discharge and risk factors in children with cerebral palsy (CP).

Total 375 children with cerebral palsy who were hospitalized in the Third Affiliated Hospital of Jiamusi University from January 2015 to June 2023 were selected as subjects. The clinical data of the children were collected and analyzed retrospectively. According to whether the EEG showed epileptiform discharges and whether the clinical manifestations were epileptic seizures, the patients were divided into the simple cerebral palsy group (278 cases), simple epileptiform discharge group (58 cases), and epilepsy group (39 cases). The χ² test was used to compare the differences between groups, and statistically significant factors were screened and included in multivariate logistic regression analysis to explore the independent risk factors affecting epilepsy and epileptiform discharges in children with cerebral palsy.

Univariate analysis found that there were significant differences in the history of neonatal seizures [14 (5%), 5 (8.6%), 13 (33.3%), χ²=35.089, P<0.001], spastic quadriplegia[25 (9.0%), 11 (19.0%), 15 (38.5%), χ²=26.958, P<0.001] between the three groups. There were significant differences in head circumference [50 (18.0%), 22 (37.9%), 18 (46.2%), χ²=22.178, P<0.001] and GMFCS grade Ⅳ and Ⅴ [91 (32.7%), 27 (46.6%), 20 (51.3%), χ²=7.865, P=0.020] between the three groups. Multivariate ordinal logistic regression analysis showed that small head circumference [OR=2.312, 95% CI:1.372—3.896, P=0.002], neonatal seizures [OR=5.048, 95% CI:2.457—10.360, P<0.001] and spastic quadriplegia [OR=3.212, 95% CI:1.680—6.141, P<0.001] were risk factors for epileptiform discharges and seizures in children with cerebral palsy.

Small head circumference, neonatal seizures, and spastic quadriplegia are risk factors for epileptiform discharges and seizures in children with cerebral palsy.

To evaluate the efficacy of vestibular rehabilitation therapy (VRT) on patients with chronic dizziness, and to provide a clinical evidence for the application of VRT in chronic dizziness rehabilitation.

Sixty patients with chronic dizziness were randomly divided into experimental group (n=30) and control group (n=30). The control group was treated with betahistine mesylate tablet and Xuanyunning tablet, while the experimental group received vestibular rehabilitation therapy on the basis of the control group. The assessment measures included the visual analogue scale of dizziness, the dizziness handicap inventory (DHI), the activities-specific balance confidence scale (ABC), the modified Barthel index (MBI), the hospital anxiety and depression scale (HADS) and the Pittsburgh sleep quality index (PSQI). Patients were evaluated before treatment, after 4 weeks of treatment, and at 3 months of follow-up.

Before treatment, there was no significant difference in general information and dizziness related evaluation indexes between the two groups (P>0.05). After 4 weeks of treatment and at the 3-month follow-up, the experimental group showed significantly lower Visual analogue scale of dizziness, DHI score and HADS score (P<0.05). After 4 weeks of treatment, the experimental group showed significantly higher ABC score and MBI score than those of control group (P<0.05). There were no adverse reactions in either group.

VRT is an effective and safe intervention for improving dizziness symptoms and balance function, daily living ability, psychological well-being in patients with chronic dizziness. It holds significant clinical value and warrants further application in rehabilitation settings.