AIMS:To investigate the association between a standardized ankle fascial manipulation protocol and improvements in symptoms and quality of life for patients with urinary incontinence (UI). METHODS:This retrospective study reviewed the clinical records of 81 patients (aged 30-75) with stress, urgency, or mixed UI who completed a standardized intervention. The protocol consisted of 16 sessions of ankle fascial manipulation over 8 weeks. Primary outcomes included the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF) score and 24-h pad test volume. Secondary outcomes included the King's Health Questionnaire (KHQ). Assessments were performed at baseline, 8 weeks, and a 3-month follow-up. RESULTS:Significant improvements were observed. The mean ICIQ-SF score decreased from 14.3 ± 3.2 to 6.8 ± 2.9 (p < 0.001), and the 24-h pad test volume reduced by 63.7% (p < 0.001). Patients with stress UI demonstrated the greatest reduction in leakage (72.4%), compared to urgency (54.8%) and mixed (61.3%) UI (p = 0.023). Quality of life improved significantly, with the mean total KHQ score decreasing from 65.3 to 31.8 (p < 0.001). Improvements were largely maintained at the 3-month follow-up. CONCLUSIONS:Ankle fascial manipulation was associated with significant improvements in urinary incontinence symptoms and quality of life, particularly for stress UI. These findings suggest it may be a promising complementary therapy. Rigorous randomized controlled trials are needed to confirm efficacy and investigate underlying mechanisms.

Background and Objective:Cough is an essential defensive reflex that plays a critical role in airway protection. Dysfunction of this reflex, often manifesting as chronic cough or cough hypersensitivity, involves complex alterations in both peripheral and central nervous systems. While previous studies primarily focused on brainstem-mediated reflexes, recent neuroimaging highlights the pivotal role of higher cortical areas in regulating both voluntary and involuntary cough. This review aims to comprehensively summarize the application of multimodal magnetic resonance imaging (MRI) in delineating these central mechanisms and identifying therapeutic targets. Methods:For this narrative review, we conducted a structured literature search using PubMed, Embase, and Web of Science to identify relevant studies published up to January 2026. Search terms included "cough", "chronic cough", "multimodal MRI", "structural MRI (sMRI)", "functional MRI (fMRI)", and "diffusion MRI (dMRI)". Relevant articles focusing on neural substrates of cough and neuroimaging-guided interventions were selected and synthesized. Key Content and Findings:By integrating sMRI, fMRI, and dMRI, current research has delineated a dynamic cough-related neural network. Key hubs identified include the dorsolateral prefrontal cortex (DLPFC), anterior cingulate cortex (ACC), and nucleus tractus solitarius (NTS). The review further describes mechanisms of central sensitization and neuroplasticity that may characterize refractory cough. Additionally, we explore how these imaging biomarkers can guide pharmacological and non-invasive interventions, such as transcranial direct current stimulation (tDCS). Conclusions:Multimodal MRI facilitates a deeper understanding of the central functional alterations associated with cough dysfunction. Identification of specific imaging biomarkers provides reliable neuroimaging targets for novel diagnostic and therapeutic strategies, ultimately facilitating the development of precision medicine for patients with cough-related neurological disorders.

Background/Aims: Epidemiological associations between metabolic dysfunction-associated fatty liver disease (MAFLD) and sleep disturbances point to shared mechanisms, yet the underlying central pathways remain unexplored. We hypothesized that high-fat diet (HFD)-induced MAFLD disrupts sleep architecture via hippocampal neuroinflammation and dysregulation of the IRS-1/Akt/mTOR signaling axis. Methods Male BALB/c mice were fed a control diet (CD) or a 60% HFD for 16 weeks to induce MAFLD. Sleep–wake architecture was assessed by 24-h EEG/EMG recordings. We evaluated hepatic steatosis, serum cytokines, hippocampal histology, and pro-inflammatory cytokines. Hippocampal expression and phosphorylation of IRS-1 (Ser307), Akt (Ser473), and mTOR (Ser2448) were analyzed by Western blot. Results HFD-fed mice developed hepatic steatosis, elevated liver enzymes, and increased serum TNF-α and IL-1β. These mice exhibited reduced non‑rapid eye movement (NREM) and rapid eye movement (REM) sleep duration, severe sleep fragmentation (reflected by increased bout numbers and shorter mean bout durations), and diminished NREM sleep delta power. Cosinor analysis revealed a dampened circadian rhythm of NREM sleep delta power. In the hippocampus, HFD induced neuronal injury, elevated TNF-α and IL-1β levels, and a bifurcated signaling profile: increased p-IRS-1 (Ser307), decreased p-Akt (Ser473), yet paradoxically elevated p-mTOR (Ser2448). Conclusion Our findings establish a novel liver–hippocampus–sleep axis in which MAFLD-driven systemic inflammation and hippocampal IRS-1/Akt/mTOR dysregulation are associated with profound sleep disruption. Targeting this axis may offer new therapeutic strategies for sleep disorders in MAFLD.

This cross-sectional study examines the association between coffee and caffeine consumption and depressive symptoms in postpartum women. In total, 821 postpartum women who met the study's inclusion criteria were interviewed. Data were extracted from the 2007-2018 National Health and Nutrition Examination Survey. Coffee consumption and 11 confounding variables were considered and analyzed as baseline data. Weighted logistic regression models were constructed by adjusting the variables, and the odds ratios of total coffee, caffeinated coffee, and decaffeinated coffee were assessed for their impact on depression status. In addition, subgroup analyses were conducted according to race, breastfeeding status, and postpartum period. The results show that generic coffee and caffeinated coffee intake have a potentially protective effect in postpartum women. Drinking more than three cups of caffeinated coffee may lower the risk of postpartum depression, particularly in the 1-2 year postpartum period and in non-breastfeeding women. The association between decaffeinated coffee consumption and postpartum depression remains unclear.

腹直肌分离(diastasis rectus abdominis,DRA)是产后最常见疾病之一,其发病率在产后6周可达60％[1],二胎及以上产妇产后腹直肌分离的发病率较一胎更高[2].腹直肌分离若不及时治疗,不仅可导致产后体态不良,亦可导致腰骶骨盆区长期慢性疼痛,甚至脐疝等更为严重后果[3-5].随着国家政策的引导及妇女对产后生活质量的要求,产后腹直肌分离的有效治疗将成为产后康复的重要任务.

Firefighters' high-intensity training often leads to injuries in the musculoskeletal system. Studies have found that these injuries in the musculoskeletal system may contribute to poor psychological issues. At the same time, low psychological well-being increases the risk of injuries, illness, and mortality. According to research reports, firefighters generally have a good psychological state. So this study aims to survey and analyze the training-related injuries and psychological states of firefighting and rescue personnel in Beijing. This cross-sectional study employed a questionnaire survey to gather data from a total of 214 firefighters in a certain city. The participants were required to complete a questionnaire about musculoskeletal injuries and psychological status, and then these data were statistically analyzed. The incidence of training-related injuries is relatively high among firefighting and rescue teams, with the highest proportions observed in the lower back, knees, and ankles. Overweight and obese firefighters are more prone to ankle injuries. In the group with injuries, the subjective well-being index is lower compared to the group without injuries. Firefighters experiencing moderate to severe pain due to injuries exhibit lower subjective well-being indices compared to those with mild pain. Psychological resilience and the impact of pain on training and sleep can predict the subjective well-being index of firefighters. It is recommended that firefighting and rescue teams enhance preventive measures for musculoskeletal injuries during training to elevate the subjective well-being of firefighters.

近年来,血流限制训练(blood flow restriction train-ing,BFRT)作为一种新兴的训练方式被广泛应用,其特点是配合低强度运动,能够达到和高强度运动相似的效果.血流限制训练不仅能够促进肌肉肥大、增加肌肉力量和激素分泌,而且联合低强度有氧运动能有效提升心肺耐力.

Background The cough reflex is a protective reflex of the human body. Increases or decreases in cough reflex sensitivity may be related to chronic cough, aspiration pneumonia and other diseases. The right primary somatosensory cortex (RS1) is the main activation centre for the urge to cough. Here, we discuss the effects of transcranial direct current stimulation (tDCS) of RS1 on the cough reflex and urge to cough. In addition, we explored the role of the left dorsolateral prefrontal cortex (lDLPFC) in cough using tDCS. Methods 24 healthy young adults completed this pilot randomised controlled crossover experiment. Each person was tested three times, receiving, in random order, anodal tDCS of RS1 or lDLPFC or sham stimulation. The current intensity was set to 2 mA, the stimulation time was 30 min and the interval between any two stimuli was ≥1 week. After each intervention, the citric acid cough challenge test was used immediately to assess the urge to cough and cough reflex sensitivity. Results The cough reflex thresholds, expressed as LogC2 and LogC5, were significantly reduced after RS1 anodal stimulation compared to sham stimulation, accompanied by increased urge-to-cough sensitivity (urge-to-cough log–log slope 1.19±0.40 point·L·g−1 versus 0.92±0.33 point·L·g−1, p=0.001), but the threshold for the urge to cough did not change significantly. There were no significant changes in the urge to cough and cough reflex sensitivity after tDCS anodal lDLPFC stimulation. Conclusion Anodal tDCS stimulation of the RS1 can increase urge-to-cough sensitivity and reduce cough reflex threshold. The effects of tDCS on cough reflex, as well as the underlying mechanisms driving those effects, should be explored further.

BackgroundRandomized controlled trials (RCTs) have shown conflicting results regarding the effects of perioperative cognitive training (CT) on the incidence of postoperative cognitive dysfunction (POCD) and postoperative delirium (POD). We, therefore, performed a meta-analysis to assess the overall effects of studies on this topic.MethodsWe searched PubMed, Embase, the Cochrane Library, and Web of Science for all RCTs and cohort studies that investigated the effects of perioperative CT on the incidence of POCD and POD. Data extraction and quality assessment were conducted independently by two researchers.ResultsThis study included nine clinical trials with a total of 975 patients. The results showed that perioperative CT significantly reduced the incidence of POCD compared with the control group [risk ratio (RR) = 0.5, 95% CI (confidence interval): 0.28–0.89, P = 0.02]. Nevertheless, for the incidence of POD, the difference between the two groups was not statistically significant (RR = 0.64; 95% CI: 0.29–1.43, P = 0.28). In addition, the CT group had less postoperative decline in the cognitive function scores compared with the control group [mean differences (MD): 1.58, 95% CI: 0.57–2.59, P = 0.002]. In addition, there were no statistically differences in length of hospital stay between the two groups (MD: −0.18, 95% CI: −0.93–0.57, P = 0.64). Regarding CT adherence, the proportion of patients in the cognitive training group who completed the planned duration of CT was 10% (95% CI: 0.05–0.14, P = 0.258).ConclusionOur meta-analysis revealed that perioperative cognitive training is possibly an effective measure to reduce the incidence of POCD, but not for the incidence of POD.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022371306, identifier: CRD42022371306.

目的:探索古籍中多寐的病因病机特点及用药规律.方法:搜索历代古籍中对多寐的相关论述及治疗方剂,采用Excel及SPSS 21.0统计软件对多寐的病因病机及中药性、味、归经等进行频数和聚类分析.结果:1)古籍条文中多寐的病因病机主要有热邪伤阴、卫气滞阴、脾病湿困、胆热肝实、心虚神乱、阴病阳虚等;2)中药药性以温、寒为主,药味以辛、甘、苦为主,归经以脾、胃、肝、肺、肾为主,使用频率较高的核心药物有人参、甘草、茯苓、白术、陈皮等24味;3)共得到4组药物聚类分析组合,C1:丁香、肉豆蔻、干姜、木香、肉桂、附子;C2:神曲、麦芽、陈皮、苍术、白术、厚朴;C3:当归、黄芪、五味子、升麻、白芍、麦冬;C4:人参、茯苓、半夏、酸枣仁.结论:古代医家治疗多寐多以脾胃为病机核心,涉及气、血、阴、阳及湿邪等多种病理证素.

Feng spinal mobilization (FSM) is one of the most widely practiced techniques in traditional Chinese osteopathy, especially in China. However, whether this FSM technique is more effective than the Maitland posteroanterior mobilization (MM), which is widely used all over the world, is still unknown. The purpose of this study was to retrospectively analyze and compare the efficacy of these 2 treatments in patients with chronic nonspecific low back pain (CNLBP) as to provide a basis for the clinical treatment of chronic low back pain. A total of 83 patients, including 43 patients in the FSM group and 40 in the MM group, were enrolled in this cohort study. FSM or MM was performed on patients 3 times during a period of 2 weeks. Changes in the subjective and objective measurements were measured before and after the third treatment. The subjective symptoms recorded included the visual analogue scale (VAS), Oswestry disability index, and Patient Health Questionnaire-9. The objective symptoms, including the lumbar range of motion (ROM), and straight leg raise (SLR) height were also checked for any changes. The VAS scores were reassessed at the 1-year follow-up visit. The results showed that 2 weeks of FSM treatment significantly improved CNLBP patients modified Schober test (P < .05), extension ROM (P < .01), and SLR height (P < .05) while MM treatment did not. Both treatments significantly decreased the values of VAS, Oswestry disability index, and Patient Health Questionnaire-9 (P < .01). Compared to the MM treatment, the FSM treatment showed a much more significant improvement in VAS score (P < .01), range of motion of extension (P < .01), and SLR of both sides (P < .05). At the 1-year follow-up, VAS scores in both groups decreased significantly compared to pretreatments; however, there was no significant difference between the 2 groups. Our data suggested that the FSM treatment can provide better efficacy than MM in CNLBP patients, improving the VAS scores, lumbar extension ROM, and SLR height in a shorter time.

目的 探讨盐酸氨基葡萄糖与塞来昔布结合体外冲击波治疗对膝关节骨性关节炎患者关节活动功能的影响.方法 94例膝关节骨性关节炎患者均分为观察组(给予盐酸氨基葡萄糖、塞来昔布结合体外冲击波治疗)和对照组(给予盐酸氨基葡萄糖联合塞来昔布治疗),于治疗前和治疗3个月时检测2组患者关节液中白细胞介素-13(IL-13)、可溶性细胞间黏附分子1(sICAM-1)、IL-1β、Diekkopf-1(DKK-1)、骨保护素(OPG)、β连环素(β-catenin)、β内啡肽(β-EP)、神经肽Y(NPY)及6-酮前列腺素E1α(6-keto-PGE1α)水平,比较2组患者治疗前和治疗3个月时的视觉模拟评分(VAS)、膝关节运动功能Lysholm量表(LKSS)评分及健康状况调查表(SF-36)评分.结果 治疗前,2组患者关节液中IL-13、sICAM-1、IL-1β、DKK-1、OPG、β-catenin、β-EP、NPY、6-keto-PGE1α水平及VAS、LKSS、SF-36评分比较,差异无统计学意义(P>0.05);2组患者治疗3个月时的关节液IL-13、sICAM-1、IL-1β、β-catenin、NPY、6-keto-PGE1α水平及VAS评分水平低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05),2组患者治疗3个月时的关节液中DKK-1、OPG、β-EP水平及LKSS、SF-36评分高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05).结论 给予膝关节骨性关节炎患者盐酸氨基葡萄糖、塞来昔布结合体外冲击波治疗,可改善患者关节活动功能,其机制可能与联合治疗调节关节液中β-catenin、DKK-1、OPG等介质的水平有关.

目的 探讨急性心肌梗死(AMI)患者急诊经皮冠状动脉介入治疗(PCI)后行早期心脏康复的安全性.方法 在首都医科大学附属北京友谊医院心血管中心CBD-Bank数据库选取2017年5月至2019年12月住院的AMI患者1364例,根据纳入与排除标准最终纳入379例行急诊PCI的AMI患者.根据患者是否接受早期心脏康复将其分为心脏康复组(接受早期心脏康复患者,n=79)和对照组(未接受早期心脏康复患者,n=300).对两组患者基线资料进行1:1倾向性评分匹配.比较两组患者住院期间主要不良心血管事件(MACE)发生率及随访1年全因死亡率、心源性死亡率、因急性冠脉综合征(ACS)再住院率.结果 匹配后,两组心源性死亡率及靶血管重建、恶性心律失常发生率比较,差异无统计学意义(P>0.05).匹配后,两组随访1年全因死亡率、心源性死亡率比较,差异无统计学意义(P>0.05);心脏康复组随访1年因ACS再住院率低于对照组(P<0.05).结论 AMI患者急诊PCI后开展早期心脏康复相对安全,且早期心脏康复可有效降低AMI患者因ACS再住院率.

1肥胖的流行病学 肥胖已逐渐成为全球关注的公共卫生问题.WHO规定,对于成年人,超重是指体质指数(body mass index,BMI)≥25,BMI≥30即为肥胖.从1975-2014年,在全球200多个国家中,男性肥胖者的比例从3.2％增长到10.8％,女性肥胖者的比例从6.4％增长到14.9％,并且仍然呈上升趋势.

目的 分析急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)后急性期心脏康复干预时机及其影响因素.方法 于首都医科大学附属北京友谊医院心血管中心CBD-Bank数据库选取2017年5月至2019年12月PCI后接受心脏康复的AMI患者409例.以PCI后即刻至急性期心脏康复开始时间为3 d作为截点,将所有患者分为早期心脏康复组(PCI后即刻至心脏康复开始时间≤3 d,n=252)和延迟心脏康复组(PCI后即刻至心脏康复开始时间>3 d,n=157).比较两组患者临床资料、住院期间主要不良心血管事件(MACE)发生情况、出院前6 min步行试验情况(完成情况及6 min步行距离)、恢复期心脏康复干预情况及出院后1年因急性冠脉综合征(ACS)再住院率、戒烟率.AMI患者PCI后急性期心脏康复干预时机的影响因素分析采用多因素Logistic回归分析.结果 本组患者PCI后即刻距心脏康复开始时间≤3 d者252例,占61.61％.早期心脏康复组患者腹型肥胖者占比高于延迟心脏康复组,ST段抬高型心肌梗死、行急诊PCI者占比低于延迟心脏康复组(P<0.05).多因素Logistic回归分析结果显示,腹型肥胖〔OR=1.783,95％CI(1.123,2.832)〕、心肌梗死类型〔OR=0.490,95％CI(0.269,0.891)〕及PCI类型〔OR=0.240,95％CI(0.137,0.421)〕是AMI患者PCI后急性期心脏康复干预时机的独立影响因素(P<0.05).早期心脏康复组患者心源性死亡率及恶性心律失常发生率低于延迟心脏康复组,出院前6 min步行距离长于延迟心脏康复组(P<0.05);早期心脏康复组ST段抬高型心肌梗死患者出院前6 min步行距离长于延迟康复组ST段抬高型心肌梗死患者(P<0.05).结论 AMI患者PCI后行早期心脏康复者占61.61％.早期心脏康复能有效改善AMI患者PCI后心肺耐量,尤其是ST段抬高型心肌梗死患者.腹型肥胖、心肌梗死类型及PCI类型是AMI患者PCI后急性期心脏康复干预时机的独立影响因素,其中腹型肥胖、行择期PCI的AMI患者及非ST段抬高型心肌梗死患者更有可能参与早期心脏康复.

目的 探讨不同时机追加反馈对老年脑卒中患者运动学习的影响.方法 选取2020年6—12月在首都医科大学附属北京友谊医院康复医学科就诊的脑卒中患者40例,按随机数字表法分为追加反馈延迟间隔0 s组、追加反馈延迟间隔2 s组、追加反馈延迟间隔4 s组和追加反馈延迟间隔6 s组(以下简称0 s组、2 s组、4 s组和6 s组),每组10例.记录各组追加反馈后即刻、1 d、1周实际握力与目标握力差值的绝对值.结果 不同时机追加反馈与时间在实际握力与目标握力差值的绝对值上不存在交互作用(P>0.05);不同时机追加反馈、时间在实际握力与目标握力差值的绝对值上主效应显著(P<0.05).2 s组、4 s组、6 s组追加反馈后即刻、1 d、1周实际握力与目标握力差值的绝对值低于0 s组(P<0.05);0 s组、2 s组、4 s组、6 s组追加反馈后1周实际握力与目标握力差值的绝对值分别高于本组追加反馈后即刻、1 d(P<0.05).结论 老年脑卒中患者进行简单运动学习任务时,延迟追加反馈对运动学习效果优于即刻追加反馈.

目的 分析急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)后急性期心脏康复参与现状及其影响因素.方法 在首都医科大学附属北京友谊医院心血管中心CBD-Bank数据库选取2017年5月至2019年12月行PCI的AMI患者1365例,根据是否参与急性期心脏康复将其分为康复组(n=409)和非康复组(n=956).收集两组患者临床资料,AMI患者PCI后参与急性期心脏康复的影响因素分析采用单因素、多因素Logistic回归分析.结果 AMI患者PCI后急性期心脏康复参与率为29.96％(409/1365).随着年龄增长,AMI患者PCI后急性期心脏康复参与率呈下降趋势(P<0.05).AMI患者PCI后即刻至心脏康复开始时间平均为3.5 d.多因素Logistic回归分析结果显示,腹型肥胖〔OR=1.508,95％CI(1.163,1.956)〕、手术类型〔OR=1.804,95％CI(1.398,2.328)〕、冠心病史〔OR=0.737,95％CI(0.548,0.991)〕、心律失常史〔OR=0.540,95％CI(0.332,0.878)〕、脑卒中史〔OR=0.655,95％CI(0.450,0.954)〕、冠心病家族史〔OR=1.325,95％CI(1.020,1.721)〕、左心室射血分数(LVEF)降低〔OR=0.692,95％CI(0.489,0.979)〕是AMI患者PCI后参与急性期心脏康复的独立影响因素(P<0.05).结论 AMI患者PCI后急性期心脏康复参与率为29.96％,且随着年龄增长,其急性期心脏康复参与率呈下降趋势,其中腹型肥胖、行急诊PCI及无LVEF降低、冠心病史、心律失常史、脑卒中史、冠心病家族史的AMI患者PCI后参与急性期心脏康复的概率更高.

目的:探讨虚拟情景互动训练对注意障碍脑卒中患者上肢运动功能的影响.方法:选取有注意障碍的60例脑卒中患者,随机分为对照组和观察组各30例.对照组予常规上肢康复训练;观察组在常规康复训练的基础上,增加虚拟情景互动训练训练.以上训练每天1次,每周5次,持续4周.训练前后分别采用蒙特利尔认知评估量表(MoCA)、Fugl-Meyer评定量表上肢部分(FMA-UE)、运动评定量表(MAS)、试听整合持续作业注意测试(IVA-CPT)、改良Barthel指数(MBI)对2组进行评定.结果:经过4周治疗,2组患者MoCA、FMA-UE、MAS、MBI、综合反应控制商及综合注意力商评分均较治疗前明显提高(P＜0.05),且观察组各项评分均较对照组提高(P＜0.01),结论:结合虚拟情景互动训练的康复训练较常规康复训练更有助于改善有注意障碍脑卒中患者的上肢运动功能,以及促进日常生活能力的恢复,对注意功能的改善也有明显促进作用,值得临床应用.

目的 探讨经颅微电流刺激(CES)对老年轻度认知功能障碍患者认知功能的疗效.方法 选择2018年至2019年在本院住院的老年轻度认知障碍患者40例,随机分为对照组(n=20)和治疗组(n=20).两组均接受常规药物治疗(无促认知药物);治疗组增加CES治疗,共8周.治疗前,治疗后4周、8周,由两人采用改良Barthel指数(MBI)和蒙特利尔认知评估量表(MoCA)进行单盲评定.对照组于8周后予免费CES治疗.结果 MoCA评分时间主效应显著(F=5.603,P=0.007),组间主效应不显著(F=2.160,P=0.150),交互效应显著(F=9.160,P<0.001),治疗组高于对照组.MBI时间主效应(F=0.322,P=0.726)、组间主效应(F=0.009,P=0.925)和交互效应(F=0.322,P=0.726)均不显著.CES干预过程中未见不良反应.结论 CES对老年轻度认知功能障碍的干预可能有效.