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Approximately two-thirds of stroke survivors experience chronic upper-limb paresis; however, treatment options are limited. Repetitive transcranial magnetic stimulation (rTMS) can enhance motor function recovery in stroke survivors, but its efficacy is controversial. We compared the efficacy of stimulating different targets in 10 chronic stroke patients with severe upper-limb motor impairment. Motor imagery-based brain–computer interface training augmented with virtual reality was used to induce neural activity in the brain region during an imagery task. Participants were then randomly assigned to two groups: an experimental group (received high-frequency rTMS delivered to the brain region activated earlier) and a comparison group (received low-frequency rTMS delivered to the contralesional primary motor cortex). Behavioural metrics and diffusion tensor imaging were compared pre- and post rTMS. After the intervention, participants in both groups improved somewhat. This preliminary study indicates that in chronic stroke patients with severe upper-limb motor impairment, inducing activation in specific brain regions during motor imagery tasks and selecting these regions as a target is feasible. Further studies are needed to explore the efficacy of this intervention. [ABSTRACT FROM AUTHOR]

Abstract: Previous studies have found that anxiety disorders may increase the incidence of atrial fibrillation (AF). More and more studies have shown that α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors (AMPARs) are involved in the occurrence and development of cardiovascular diseases. However, the role of AMPARs in AF associated with anxiety disorder remains unclear. The aim of this study was to investigate the effect of AMPARs on AF susceptibility in rats with anxiety disorder and its possible mechanism. The anxiety disorder rat model was established by unpredictable empty bottle stimulation and was treated with AMPARs agonist and antagonist. Our results showed that AMPARs antagonist treatment significantly reduced sympathetic activity, improved heart rate variability, shortened action potential duration, prolonged effective refractory period, reduced AF induction rate, and improved cardiac electrical remodeling and the expression of inflammatory factors. In addition, inhibition of AMPARs reduced the phosphorylation of IκBα and p65. Our experimental results suggest that inhibition of AMPARs can reduce autonomic remodeling, improve atrial electrical remodeling, and suppress myocardial inflammation, which provides a potential therapeutic strategy for the treatment of AF associated with anxiety disorder., Competing Interests: The authors report no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: Individuals with chronic obstructive pulmonary disease (COPD) are more likely to develop heart failure (HF) compared with the general population, and the presence of HF may contribute to reduced quality of life (QoL), increased hospitalizations and worse survival rates in patients with COPD. Our study examined the exercise capacity, QoL, mental health, family burden and rehospitalization rate of patients with comorbid COPD and chronic heart failure (CHF) after individualized inpatient and outpatient nursing care., Methods: A total of 100 patients with comorbid COPD and CHF admitted to Affiliated Hospital of Jiangnan University January 2021 to July 2022 were enrolled in our study and then randomly assigned to one of two groups of 50 patients: patients receiving traditional nursing care and patients receiving individualized nursing care. Exercise capacity, mental health, QoL and family burden were assessed by means of the 6-minute walk test (6MWT), Zung's Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS), the short-form health survey (SF-36) and the Perceived Family Burden Scale (PFBS)., Results: The patients receiving individualized nursing care had notable differences regarding distance walked in the 6MWT, the scores in all domains of both the physical and mental composites, SAS and SDS scores and PFBS scores of patients at on admission (T0), at discharge (T1) and at 2 months after discharge (T2) (P < .05). The patients receiving individualized nursing care walked longer distances on the 6MWT, more scores reflecting improved QoL and reduced SAS and SDS scores at both T1 and T2 compared with patients receiving traditional nursing care (P < .05). The patients receiving individualized nursing care exhibited decreased PFBS scores at T2 compared with patients receiving traditional nursing care (P < .05). None of the patients receiving individualized nursing care were rehospitalized, but 2 patients receiving traditional nursing care were rehospitalized due to acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and acute HF, respectively., Conclusion: Our study demonstrates that individualized inpatient and outpatient nursing care can enhance exercise capacity and improve QoL and mental health in patients with comorbid COPD and CHF.

Purpose: To elucidate the morphological alterations of the conjunctiva in atopic keratoconjunctivitis (AKC) using the new generation Heidelberg Retina Tomograph II (HRT II)/Rostock Cornea Module confocal microscope in a prospective controlled study., Methods: Sixteen eyes from AKC patients (eight males, mean age: 20.3+/-5.9 years) were treated with 0.05% topical cyclosporine A (CsA) in addition to topical steroid and anti-allergic eye drops and 12 eyes from patients with AKC were treated using topical steroids and anti-allergic drops (six males, mean age: 22.2+/-10.0 year). These two groups, as well as 14 eyes from normal subjects (six males, one female, average age 30.4+/-6.8 years) were studied. All subjects underwent corneal sensitivity measurements, the Schirmer test, tear film break-up time (BUT), fluorescein, Rose Bengal staining of the ocular surface, and confocal laser scanning microscopy of the tarsal palpebral conjunctiva. The density of conjunctival inflammatory infiltrates was calculated. Morphological characteristics of the papillary lesions were also studied., Results: Corneal sensitivity, tear stability, and vital staining scores were significantly worse in patients with AKC compared to control subjects (p<0.01). Eyes of AKC patients using CsA showed a significantly lower density of inflammatory infiltrates compared to eyes on topical steroid and anti-allergic drops. Conjunctival inflammatory cell density showed a negative correlation with tear stability and corneal sensitivity and a positive correlation with the vital staining scores. Papillary lesions revealed remarkable fibrosis in patients using CsA., Conclusions: Confocal scanning laser microscopy was an efficient and a noninvasive tool for the quantitative assessment of the conjunctival inflammation and evaluation of pathological alterations in the papillary lesions and their relation to the ocular surface disease in patients with AKC.