Chiari malformation type Ⅲ (CM-Ⅲ) is a rare subtype, accounting for less than 1% of all Chiari malformation subtypes. CM-Ⅲ is frequently complicated by occipitocervical encephalocele, brainstem or lower cranial nerve dysfunction, hydrocephalus and complex venous sinus variations. Perioperative decisions therefore need to address the difficult airway, protection of the encephalocele, restoration of cerebrospinal fluid circulation, and long-term neurodevelopment. At present, there are no unified standardized diagnostic and therapeutic protocols for CM-Ⅲ. Individualized precise therapeutic strategies should be formulated according to the contents of the herniated sac, venous anatomical features, status of hydrocephalus and systemic associated malformations. Based on recent imaging classifications, case series, and multidisciplinary management evidence, this review proposes a practical framework centered on prenatal recognition and delivery planning, imaging-based risk stratification, conditional surgical timing, stratified hydrocephalus management, watertight dural closure, and early continuous rehabilitation, aiming to provide practical references for standardized treatment of CM-Ⅲ. Emergency intervention should accompany resuscitation and stabilization in patients with sac rupture or cerebrospinal fluid leakage, progressive respiratory failure, or acute intracranial hypertension. For stable patients, surgery should be conducted in the early neonatal period after completing multidisciplinary evaluation.

To investigate the prognostic value of fatty acid metabolism-related genes in glioma, construct a comprehensive model based on these genes, and analyze its associations with the immune microenvironment and drug sensitivity.

This study integrated transcriptomic and clinical data from The Cancer Genome Atlas (TCGA) and the Genotype Tissue Expression (GTEx) databases. Differentially expressed genes and Cox proportional hazards model regression were first used to screen for core prognostic fatty acid metabolism-related genes. Glioma patients were then randomly divided into a training set and a validation set at a 7:3 ratio. A risk score model was constructed using the random forest algorithm. Survival analysis was performed on age, gender, and race to identify survival-related factors, which were then combined with methylation site levels to develop a comprehensive nomogram. Consensus clustering was subsequently applied to classify glioma samples into two fatty acid metabolism subtypes (subtype 1/low-metabolism group and subtype 2/high-metabolism group). Immune infiltration characteristics and drug sensitivity were evaluated using the CIBERSORT algorithm and the Genomics of Drug Sensitivity in Cancer database. Finally, expression levels of the core genes were validated in glioma cells by real-time quantitative polymerase chain reaction (RT-qPCR).

Four core fatty acid metabolism-related genes were identified: ACOT2, ACOT4, ACLS5, and ADH6. Based on these four genes, a random-forest risk model was constructed, and glioma patients were randomly split into a training set (422 patients) and a validation set (182 patients) in a 7:3 ratio. The model exhibited robust performance in both datasets, with areas under the curve (AUCs) for predicting 1-, 3-, and 5-year survival all greater than 0.75 in the training set and all greater than 0.6 in the validation set. The combined nomogram also exhibited excellent predictive accuracy (calibration curve R²=0.92). Immune infiltration analysis revealed significant enrichment of M2 macrophages in glioma tissues. Drug sensitivity analysis indicated that subtype 2 (high-metabolism group) was more sensitive to agents such as Fluorouracil (with half-maximal inhibitory concentration reduced by 30%-50%). Cell experiments confirmed that the above core genes were significantly overexpressed in glioma (P<0.001).

The comprehensive model based on fatty acid metabolism-related genes (ACOT2, ACOT4, ACSL5, ADH6), MGMT methylation status, and patient age can effectively stratify the prognosis of glioma, providing a new theoretical basis for individualized treatment strategies.

To assess the therapeutic effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) on motor dysfunction in patients with ischemic stroke using diffusion tensor imaging (DTI), and to explore the underlying neural mechanism of high-frequency rTMS for motor dysfunction.

Forty patients with ischemic stroke admitted to Neurology Department, Brain Center and Neurorehabilitation Center of Baotou Central Hospital from October 2023 to December 2024 were collected, and divided into treatment group and control group by the random number table method, with 20 cases in each group. Both groups received basic pharmacotherapy and conventional rehabilitation. On this basis, the treatment group underwent high-frequency (10 Hz) rTMS for 4 weeks, 5 times a week, 15 min each time. The control group received 10 Hz sham stimulation. DTI examinations and functional assessments using the National Institutes of Health stroke scale (NIHSS), Fugl-Meyer assessment (FMA), and modified Barthel index (MBI) were performed on the day of the first and last treatment sessions to evaluate neurological deficit severity, limb motor impairment, and activities of daily living. Regions of interest (ROIs) for DTI were placed in the corona radiata and posterior limb of the internal capsule. Fractional anisotropy (FA) values in each ROI were recorded, and relative FA (rFA) was calculated. Rehabilitation scale scores and DTI metrics before and after treatment were compared between the two groups.

After 4 weeks of treatment, the NIHSS scores of both groups decreased compared to those before treatment, with a more significant decrease in the treatment group, and the differences were statistically significant (P<0.05). Both FMA and MBI scores increased compared to those before treatment, with a more significant increase in the treatment group, and the differences were statistically significant (P<0.05). The FA and rFA values of the radiating coronary region and posterior limb of the internal capsule in the treatment group increased compared to those before treatment, and the differences were statistically significant (P<0.05). However, there was no statistically significant difference in the FA and rFA values between the control group before and after treatment (P>0.05).

High-frequency rTMS combined with conventional rehabilitation therapy can significantly improve motor dysfunction in patients with ischemic stroke and improve the integrity of the corticospinal tract on the affected side, which may represent the neural mechanism underlying the therapeutic effect of high-frequency rTMS on post-stroke motor dysfunction.

To explore the characteristics of swallowing disorders and their influencing factors in Parkinson disease (PD) patients, aiming to provide a reference for the early detection, diagnosis, and intervention of swallowing disorders in this population.

Thirty-four PD patients admitted to The Eighth People's Hospital of Longgang District in Shenzhen from June 2023 to April 2025 were consecutively enrolled. Their general data, characteristics of swallowing disorders, and the relationship with disease duration and cognitive function were analyzed. The characteristics of swallowing disorders were analyzed using the incidence rates of various manifestations, and influencing factors were analyzed using binary Logistic regression.

Among the 34 PD patients, swallowing delay had the highest incidence (88.2%), followed by premature spillage and residue (both 55.9%). As the intake volume increased, the incidence rates of all three swallowing disorder manifestations showed a significant upward trend (P<0.05). Binary Logistic regression analysis revealed that disease duration was not an independent influencing factor for swallowing delay, premature spillage or residue (P>0.05). The MoCA score was an independent protective factor for premature spillage with 10 mL low-thickened and 5 mL high-thickened boluses, and an independent risk factor for residue with 5 mL high-thickened boluses (all P<0.05).

Swallowing delay was a common feature of dysphagia in PD patients, with the risk of swallowing impairments rising as bolus volume increased. MoCA-evaluated cognitive function was associated with premature spillage and residue, whereas disease duration had no significant impact on these three swallowing outcomes.

To evaluate the timeliness and safety of domestically produced 16-slice mobile CT systems in neurosurgical intensive care units (ICUs).

Head CT examination data were collected from hospitalized patients in the Neurosurgery ICU of Sichuan Provincial People's Hospital from January 2023 to October 2024. Patients underwent single or multiple head CT scans according to clinical indications (e.g., disease progression monitoring or routine follow-up). Examination data were categorized into mobile CT group and fixed large-scale CT group according to device type. Comparison was conducted regarding scanning procedures, examination duration, incidence of adverse events, and the substitution rate of mobile CT.

A total of 2274 patients underwent 8661 scans, including 5214 fixed large-scale CT scans and 3447 mobile CT scans, yielding a substitution rate of 39.8% (3447/8661). The mobile CT group required fewer procedural steps than the fixed large-scale CT group; its examination duration [7.4 (6.0, 9.2) min] was significantly shorter than that of the fixed large-scale CT group [18.3 (16.6, 21.1) min] (P<0.05). No severe adverse events such as bed falls, catheter dislodgement, or shock occurred in the mobile CT group.

The 16-slice mobile CT system revolutionizes head imaging examinations in critical care settings, demonstrating significant timeliness advantages in ICU monitoring.

To analyze the core demands of stroke patients for home-based rehabilitation and to construct a design scheme of a rehabilitation mobile platform with traditional Chinese medicine characteristics.

Stroke patients and their family members admitted to the Rehabilitation Medicine Center of West China Hospital and Chongqing Rongchang District Hospital of Traditional Chinese Medicine from February to March 2025 were investigated, and a questionnaire survey on demands for the mobile traditional Chinese medicine rehabilitation platform was conducted. Information on platform functions, operational convenience, traditional Chinese medicine-featured content and information security was collected, and the demand characteristics were analyzed; the core modules of the platform were constructed using the Delphi expert consultation method.

A total of 273 valid questionnaires were collected. The importance scores of all demand items ranged from 4.01 to 4.62, with coefficients of variation all<0.30: 94.88% of the respondents expected the platform to improve their activities of daily living, 93.4% emphasized a clear interface and simple operation, 95.24% recognized the effectiveness of traditional Chinese medicine methods (e.g., acupuncture and Tuina) in stroke rehabilitation, and 79.48% were concerned about health information leakage. Twenty experts completed three rounds of consultation; all items scored >4 points, and scientific validity of rehabilitation programs (85%), completeness of risk warning mechanisms (90%), simplicity of operation (95%) and community scalability (80%) were the most valued indicators.

The design of the traditional Chinese medicine rehabilitation mobile platform incorporating Fugl-Meyer-assessment-based personalized training, traditional Chinese medicine interventions including Baduanjin/acupoint massage, and a nutritional management system can achieve an "assessment-training-monitoring" closed loop using mobile-application development technologies, constructing a new model of remote rehabilitation for integrated Chinese-Western medicine.

Cerebral hemorrhage has a high incidence, disability, and mortality rate, making it a common and critical neurological disease. Surgical treatment is the primary method for treating cerebral hemorrhage and can significantly improve patient prognosis. Neuroelectrophysiological monitoring technology provides precise functional assessment for cerebral hemorrhage surgery by monitoring neuroelectrical activity in real time, reducing surgery-related nerve injury, and improving surgical safety and effectiveness. This article reviews the monitoring methods, clinical value, and existing challenges of neuroelectrophysiological monitoring in cerebral hemorrhage surgery, summarizes the current application status of the technology and looks ahead to future development directions, aiming to provide clinicians with theoretical reference for related surgical diagnosis and treatment and promote further application and development of this technology in cerebral hemorrhage surgery.