Loss of visual function imposes a substantial burden on daily life and socioeconomic well-being. Sensory substitution (e.g., tactile or auditory channels) represents a commonly employed non-invasive approach with low surgical risk; however, its capacity for information transfer is limited. Recent advancements in materials science, artificial intelligence, and microelectronic fabrication have positioned implantable visual brain-computer interfaces (BCIs) as a more direct method for eliciting visual perceptions. This article focuses on elaborating the technical approaches and latest research progress of implantable visual BCIs from the perspectives of retinal implants and cortical implants, further analyzes critical technical challenges and potential breakthroughs, and looks ahead to the future development of related technologies, aiming to provide a reference for the scientific research and clinical practice of implantable BCIs applied to visual restoration, and bring new hope for the visual recovery of the blind.

Approximately 70%-80% of stroke survivors experience residual hemiplegic motor dysfunction, significantly impairing their capacity for activities of daily life. Current therapeutic modalities for post-stroke hemiplegia primarily include pharmacological interventions, rehabilitation therapies, and orthopedic surgical procedures; however, these conventional approaches exhibit notable limitations. Spinal cord stimulation (SCS), which involves precise epidural electrode implantation to modulate spinal and cerebral neural network activity, has demonstrated preliminary safety and efficacy in improving motor function. This consensus document systematizes and summarizes key aspects of SCS implementation for post-stroke hemiplegia, including surgical indications, optimal timing, preoperative assessment, surgical techniques, parameter configuration, postoperative management, and rehabilitation protocols. The objective is to establish standardized protocols to facilitate the widespread adoption of this therapeutic technology.

To investigate the impact of changes in T helper 17 (Th17) cell/interleukin-17A (IL-17A) levels in serum and cerebrospinal fluid (CSF) on the clinical outcomes of patients with anti-N-methyl-D-aspartate receptor (NMDAR) antibody-associated autoimmune encephalitis (AE).

Patients with anti-NMDAR antibody-positive AE admitted to the Neurology Department of the Affiliated Nanjing Brain Hospital of Nanjing Medical University, from October 2013 to January 2020 were enrolled. Clinical data including prodromal symptoms, initial symptoms, main clinical manifestations, electroencephalography (EEG) findings, brain imaging features and treatment methods were collected. Meanwhile, the levels of Th17 cells and IL-17A in serum and CSF were detected at the early stage of disease onset. All enrolled patients were followed up for at least 2 years after disease onset. Clinical sequelae and modified Rankin scale (mRS) scores were assessed. Patients with an mRS score≥2 were defined as the poor prognosis group, while those with a score≤1 were assigned to the good prognosis group. Further analysis was conducted to explore the effect of Th17 cell/IL-17A level changes on patients' clinical outcomes.

A total of 54 patients were included in the study, with 20 cases in the poor prognosis group and 34 cases in the good prognosis group. The levels of IL-17A [72.15 (32.60, 102.15) pg/mL] and anti-NMDAR antibody titer [100.0 (32.0, 1000.0)] in CSF, as well as the levels of IL-17A [190.05 (91.9, 381.20) pg/mL] and anti-NMDAR antibody titer [32.0 (10.0, 1000.0)] in serum of the poor prognosis group were significantly higher than those in the good prognosis group [20.15 (11.93, 61.43) pg/mL, 10.0 (3.2, 32.0), 47.55 (33.88, 101.83) pg/mL, 10.0 (3.2, 32.0)], with statistically significant differences (P<0.05). Among patients in the poor prognosis group, 50% (10/20) had presented with mental and behavioral abnormalities, which was significantly lower than that in the good prognosis group (76.74%, 26/34), the difference was statistically significant (P<0.05). The results of the multivariate Logistic regression analysis showed that elevated serum levels of IL-17A and anti-NMDAR antibody titers at the time of onset were independent risk factors associated with poor clinical prognosis in patients with this type of AE (P<0.05).

Elevated levels of IL-17A in early CSF and serum, as well as increased Th17 cell levels in CSF, may indicate a potential poor prognosis of the anti-NMDAR antibody-associated AE patients. Moreover, higher serum IL-17A levels and anti-NMDAR antibody titers at disease onset are independent predictors of poor prognosis. These indicators are expected to serve as biomarkers for early identification of clinical outcomes in AE.

To perform multidimensional rehabilitation functional assessment in patients of different ages with moderate-to-severe traumatic brain injury (TBI), analyze differences in motor function, muscle tone, range of motion (ROM), balance, and language/cognitive function, and provide a reference for age-stratified rehabilitation interventions.

A total of 1 200 patients with moderate-to-severe TBI admitted to the Neurosurgery Department of Shifang People's Hospital and the Neurosurgery Department of West China Hospital, Sichuan University, from January 2014 to December 2023 were retrospectively enrolled. According to age, patients were divided into an elderly group (60-80 years, n=160), a middle-aged group (45-59 years, n=680), and a young group (<45 years, n=360). Multidimensional rehabilitation functional assessments were performed at the beginning and at the end of the rehabilitation program, including Brunnstrom motor assessment, Ashworth scale, ROM evaluation, Bobath assessment, and language/cognitive impairment assessment. Based on the degree of change in each scale at the end of rehabilitation, functional assessment results and differences across various dimensions were compared among the different age groups.

Brunnstrom motor assessment showed that motor function improved significantly from baseline in all three groups after rehabilitation, with higher rates of good recovery in the young and middle-aged groups than in the elderly group, while the proportion of poor recovery was highest in the elderly group (P<0.05). Ashworth evaluation showed the favorable recovery rate for muscle spasticity in the elderly group was lower than that in both the middle-aged and young groups, with statistically significant differences (P<0.05). ROM assessment: All three groups achieved ROM recovery; the favorable recovery rate was significantly lower in the elderly group than in the middle-aged and young groups (P<0.05). Bobath evaluation showed all three groups demonstrated significant improvements in sitting and standing balance functions compared to initial assessments. However, no statistically significant differences were observed in the favorable balance status rates among the groups at the end of rehabilitation (P>0.05). In terms of language and cognition, the proportions of patients whose language-cognitive function scores improved from the 7-17 range to the 18-28 range were 87.5% in the elderly group, 95.5% in the middle-aged group, and 97.2% in the young group. Pairwise comparisons among these three age groups all demonstrated statistically significant differences (P<0.05).

Multidimensional rehabilitation functional assessment comprehensively reflects the rehabilitation status of moderate-to-severe TBI patients, revealing significant differences across age groups. Specifically, elderly patients show relatively insufficient recovery in spasticity relief and joint ROM restoration, while middle-aged and young patients demonstrate more prominent advantages in motor function and language-cognitive recovery. Clinical practice should emphasize the role of differential analysis in multidimensional assessments across age groups, enabling the development of age-stratified, individualized rehabilitation strategies based on assessment outcomes.

To explore the effect of motor imagery training (MIT) combined with task-oriented training (TOT) on lower limb function in patients with hemiplegia after stroke.

A total of 93 stroke patients with hemiplegia admitted to the Rehabilitation Department of Hefei Second People's Hospital from January 2024 to January 2025 were selected as the study subjects. They were randomly divided into a control group (31 cases), an MIT group (31 cases), and a combined group (31 cases) using a random number table method.All three groups received conventional rehabilitation treatment. The control group received 30 min of healthy lower limb training on this basis, while the MIT group received additional MIT, the combination group received a combination of MIT and TOT. All interventions lasted for 4 weeks. Lower limb motor function, balance function, gait function, and activities of daily living were assessed using the Fugl-Meyer assessment scale lower extremity portion (FMA-LE), Berg balance scale (BBS), Tinetti gait assessment scale (TGA), and modified Barthel index (MBI) before treatment and after 4 weeks of intervention.

After 4 weeks of intervention, the FMA-LE, BBS, TGA, and MBI scores of patients in all three groups were significantly improved compared to those before treatment within the same group. Furthermore, the FMA-LE score (23.45±3.11), BBS score (44.13±5.28), TGA score (9.29±1.53), and MBI score (73.61±9.27) in the combined group were significantly better than those in both the control group and the MIT group, with all differences being statistically significant (P<0.05).

MIT combined with TOT can effectively improve the lower limb function of patients with hemiplegia after stroke.

To analyse the relationship between the peripheral blood phosphatidylinositol-3-kinase (PI3K)/serine-threonine-specific protein kinase (Akt)/mammalian target of rapamycin (mTOR) signalling pathway and hemorrhagic transformation (HT) following intravenous thrombolysis in acute ischemic stroke (AIS).

Two hundred and sixty AIS patients at our hospital were chosen from June 2022 to May 2024, and given intravenous thrombolysis as a treatment. patients were divided into HT group (55 cases) and non-HT group (205 cases) according to the head CT results 48 h after thrombolysis. The peripheral blood PI3K, Akt, mTOR mRNA relative expression levels, clinical data, and laboratory indicators were compared between the two groups. the influencing factors of HT after AIS intravenous thrombolysis were analyzed by multivariate Logistic regression analysis, the peripheral blood PI3K, Akt, mTOR mRNA relative expression levels and the value of their combined prediction of HT after AIS intravenous thrombolysis were analyzed by receiver operating characteristic (ROC) curve.

The relative expression levels of PI3K mRNA, Akt mRNA, and mTOR mRNA in peripheral blood of patients in the HT group were lower than those in the non-HT group, the time from onset to thrombolysis and the National Institutes of Health stroke scale (NIHSS) score in the HT group were higher than those in the non-HT group, with statistically significant differences (P<0.05). Multivariate Logistic regression analysis revealed that the time from symptom onset to thrombolysis, NIHSS score, and the relative expression levels of PI3K, Akt, and mTOR mRNA were independent risk factors for the occurrence of HT after intravenous thrombolysis in AIS patients (P<0.05). The areas under the ROC curve (95%CI) of PI3K, Akt, mTOR, and their combined prediction of HT following intravenous thrombolysis in AIS were 0.772 (0.582-0.952), 0.728(0.498-0.937), 0.680(0.395-0.957) and 0.849(0.725-0.957), respectively, with the combination of the three having the highest predictive value.

The peripheral blood PI3K/Akt/mTOR signalling pathway relative expression levels reduce of HT following intravenous thrombolysis in AIS, and inhibition of this pathway increases the risk of HT, the combined detection of peripheral blood PI3K/Akt/mTOR signaling pathway relative has good predictive value for intravenous thrombolysis in AIS.

To explore the effectiveness of severe case-based discussions and problem-based learning (PBL) methods in cultivating clinical abilities of medical treatment teams.

A total of 120 visiting trainees (including both physicians and therapists) from the spring and autumn intakes of 2023-2024 at West China Hospital of Sichuan University were enrolled and randomly assigned to either an experimental group or a control group, with 60 participants in each group. Each group consisted of 30 visiting physicians and 30 visiting therapists. The experimental group received a teaching intervention combining complex case discussions in critical care rehabilitation with PBL, while the control group participated only in routine clinical activities. Both groups underwent theoretical examinations before and after the training period. Following the training, all participants completed a survey questionnaire covering five domains: teaching content, teaching quality, instructional innovativeness, perceived effectiveness in developing clinical competencies, and overall teaching effectiveness. Responses were collected using a 5-point Likert scale. Subgroup analyses were performed separately for visiting physicians and therapists across these five dimensions.

The theoretical assessment scores of the trainees in the experimental group were higher one week before the end of the refresher course compared to before the course, and those in the experimental group were also higher than those in the control group, with statistically significant differences (P<0.05). There were statistically significant differences between the two groups in the survey evaluations across all measured domains: teaching content, teaching quality, instructional innovativeness, perceived enhancement of clinical competencies, and overall teaching effectiveness (P<0.05). In the subgroup analysis, there were statistically significant differences between the two groups of rehabilitation physicians and therapists in terms of teaching content, teaching quality, teaching novelty, and the effect on clinical ability development and teaching effectiveness after participation in the learning (P<0.05).

The integration of complex case discussions with PBL in critical care rehabilitation training enhances the clinical competencies of the rehabilitation team, effectively motivates the active engagement of trainees, improves instructional outcomes, and strengthens interprofessional collaboration.

Lumbar drainage (LD) serves as a vital diagnostic and therapeutic intervention in neurosurgery. Its key role involves the gradual, sustained, and effective removal of pathological cerebrospinal fluid, such as hemorrhagic or inflammatory cerebrospinal fluid, from the intracranial compartment. By facilitating the generation of fresh cerebrospinal fluid and reestablishing physiological cerebrospinal fluid circulation, this procedure accelerates cerebrospinal fluid normalization. This process not only optimizes short-term treatment outcomes but also helps reduce the long-term risk of hydrocephalus. Furthermore, the external lumbar drain enables continuous intracranial pressure monitoring and permits intrathecal medication delivery, extending its utility to both diagnostic and therapeutic domains. The technique is extensively employed in managing common neurosurgical conditions including subarachnoid hemorrhage, intraventricular hemorrhage, and intracranial infections, where it has demonstrated considerable clinical effectiveness. Despite its evident clinical value, post-procedural complications such as cerebrospinal fluid leakage and intracranial infection remain significant challenges, often discouraging broader adoption of this method. In response, the tunneled lumbar drainage (TLD) has been introduced to mitigate these risks. This review examines the clinical applications of TLD in neurosurgical practice, with the objective of offering evidence-based insights to enhance clinical management. The aim is to promote efficient drainage of abnormal cerebrospinal fluid while minimizing associated complications, ultimately contributing to improved patient outcomes in both the immediate and extended postoperative periods.