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Background: Insulin resistance (IR) is linked to an increased risk of neurological impairment following a stroke and may contribute to poor neurological prognosis in affected patients. The metabolic score for the insulin resistance index, shortened as the METS-IR, generally serves as a surrogate index for IR. However, its association with the severity of neurological impairment in patients with severe cerebral infarction (CI) in neurological intensive care units (ICU) has not been fully established. Methods: Patients with a diagnosis of CI, admitted to the neurological ICUs of Yangzhou University's Affiliated Hospital and Xuzhou Medical University's Affiliated Hospital, were included in the study. A multivariate logistic regression model and restricted cubic splines (RCS) were employed to explore the relationship between the METS-IR index and the severity of neurological impairment in these patients. The predictive capabilities of the METS-IR index and the triglyceride-glucose (TyG) index for outcome measures were compared through the ROC curve. Furthermore, a decision curve analysis was executed, and the integrated discrimination improvement (IDI) index was computed to evaluate the enhancements in predictive performance and clinical utility of various scoring systems with the inclusion of the METS-IR index. Subgroup analysis was conducted regarding age, BMI, and smoking status. Results: The study ultimately included 504 participants. Adjusted logistic regression and RCS results showed that as the METS-IR index increases, the risk of neurological impairment in patients with severe CI consistently grows (P for overall = 0.0146, P-nonlinear: 0.0689). The METS-IR index's predictive capability for neurological impairment (AUC = 0.669) was superior to that of the TyG index (AUC = 0.519). Conclusion: From the study results, the METS-IR index can serve as an important predictor for neurological impairment in ICU patients with severe CI. It can aid in the identification and early intervention of neurological impairment in these patients. [ABSTRACT FROM AUTHOR]

Objective To explore the application effect of neuromuscular electrical stimulation combined with early swallowing function training in patients with swallowing disorders after craniocerebral injury. Methods A total of 184 patients with swallowing disorders caused by craniocerebral injury admitted to the hospital from April 2021 to April 2023 were selected and randomly divided into the control group and the observation group by the random number table method, with 92 cases in each group. Patients in the control group were given routine rehabilitation intervention, while the patients in the observation group were given neuromuscular electrical stimulation combined with early swallowing function training on the basis of routine rehabilitation intervention. The intervention time of both groups was two months. The rehabilitation effects of the two groups were compared. Results The scores of standard swallowing function scale, the national institutes of health stroke scale and swallowing quality of life scale in the observation group were higher than those in the control group, and the differences were statistically significant（P＜0. 05). The incidence of complications such as aspiration pneumonia, aspiration and malnutrition in the observation group was lower than that in the control group, and the differences were statistically significant（P＜0. 05). Conclusion The combination of neuromuscular electrical stimulation and early swallowing function training intervention in patients with swallowing disorders after craniocerebral injury can improve swallowing and neurological function in the patients, reduce the risk of complications, and further enhance their quality of life. [ABSTRACT FROM AUTHOR]

Background: The systemic immune-inflammation index (SII) is a novel inflammatory marker used to assess the immune-inflammatory status of the human body. The systemic immune inflammation has an interplay and mutual relationship with neurological disorders. Serum neurofilament light chain (sNfL) is widely regarded as a potential biomarker for various neurological diseases. The study aimed to examine the association between SII and sNfL. Methods: This cross-sectional investigation was conducted in a population with complete data on SII and sNfL from the 2013-2014 National Health and Nutrition Examination Survey (NHANES). The SII was calculated by dividing the product of platelet count and neutrophil count by the lymphocyte count. Multivariate linear regression models and smooth curves were used to explore the linear connection between SII and sNfL. Sensitivity analyses, interaction tests, and diabetes subgroup smoothing curve fitting were also performed. Results: A total of 2,025 participants were included in our present research. SII showed a significant positive association with the natural logarithm-transformed sNfL (ln-sNfL) in crude model [0.17 (0.07, 0.28)], partially adjusted model [0.13 (0.03, 0.22)], and fully adjusted model [0.12 (0.02, 0.22)]. In all participants, the positive association between SII and ln-sNfL served as a linear relationship, as indicated by a smooth curve. Interaction tests showed that age, gender, BMI, hypertension, and diabetes did not have a significant impact on this positive association (p for interaction >0.05). The subgroup analysis of diabetes was conducted using smooth curve fitting. It was found that compared to the group without diabetes and the group in a pre-diabetic state, the effect was more pronounced in the group with diabetes. Conclusion: Our findings suggest that there is a positive association between SII and sNfL. Furthermore, in comparison to individuals without diabetes and those in a pre-diabetic state, the positive association between SII and sNfL was more pronounced in individuals with diabetes. Further large-scale prospective studies are needed to confirm the association between SII and sNfL. [ABSTRACT FROM AUTHOR]

Introduction: This research seeks to investigate how early rehabilitation nursing, guided by Orem's self-care theory, affects cognitive function, neurological function, and daily living skills in individuals who have suffered a traumatic brain injury (TBI). Methods: A study was conducted with 108 patients with traumatic brain injury who were hospitalized at our facility from January 2021 to March 2023. Based on their admission dates, the participants were separated into a control group (n = 56) and an observation group (n = 52). The control group received standard nursing care, while the observation group received a combination of conventional treatment and nursing interventions based on Orem's self-care model. The research assessed alterations in the ability to perform daily tasks (Activities of Daily Living, ADL), neurological health (National Institutes of Health Stroke Scale, NIHSS; Glasgow Coma Scale, GCS), and cognitive abilities (Montreal Cognitive Assessment Scale, MoCA; Mini-Mental State Examination, MMSE) in both sets of participants prior to and following 4 and 8weeks of nursing assistance. Results: Following the intervention, the group being observed showed notably increased ADL scores at 4 weeks (p < 0.001) and 8 weeks (p < 0.001) in comparison to the control group. At 4 weeks and 8 weeks after nursing, the observation group had significantly lower NIHSS scores compared to the control group (4 weeks after nursing, p = 0.03; 4 weeks after nursing, p < 0.001). GCS score comparison showed the similar results (4 weeks after nursing, p = 0.013; 4 weeks after nursing, p = 0.003). Moreover, the participants in the observation group had notably higher MoCA and MMSE scores in comparison with the control group 4 and 8 weeks after nursing (all p < 0.001). Conclusion: Orem's self-care theory improves patients' cognitive, neurological, and daily living functions of TBI patients during early rehabilitation nursing. This method helps enhance the level of care given by healthcare professionals, leading to more thorough and compassionate nursing care for patients. [ABSTRACT FROM AUTHOR]

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This study examined the effectiveness of the ketogenic diet as a therapeutic intervention for cerebral hemorrhage recovery. This randomized controlled trial consisted of 108 patients, recruited for the study, 54 patients were assigned to the intervention group, which followed a ketogenic diet and 54 patients were assigned to the control group, which followed a regular diet. The intervention group followed a ketogenic diet while the control group followed a regular diet. We evaluated the effects of the ketogenic diet on neurological function, metabolic profile, cognitive function, depression levels, physical activity levels, and the occurrence of adverse events over a 6-month period. The results demonstrated significant improvements in the intervention group compared to the control group, with notable reductions in National Institutes of Health Stroke Scale scores and enhancements in Modified Rankin Scale scores at both 3 and 6 months, indicating improved neurological function and faster functional recovery. Ketogenic diet intervention also resulted in significant enhancements in cognitive performance and depression scores, indicating further advantages for mental health, and increased the level of physical activity compared to the control group. Overall, our results demonstrate that the ketogenic diet shows potential as an additional treatment for cerebral hemorrhage recovery. It provides notable advantages in terms of neurological and functional recovery, metabolic health, cognitive performance, and emotional well-being. [ABSTRACT FROM AUTHOR]

Compared with acute cerebral infarction alone, the nutritional status of patients with acute cerebral infarction and dysphagia is significantly worse, which not only negatively impacts clinical treatment, but also contributes to the poor prognosis of patients. In traditional clinical treatment, more focus is placed on improving the neurological function of patients with acute cerebral infarction combined with dysphagia, often neglecting their nutritional status, leading to unsatisfactory prognosis. In this study, we explored the influence of enhanced recovery after surgery care on the neurological function and nutritional status of patients with acute cerebral infarction combined with dysphagia after thrombolytic therapy. It was found that the use of enhanced recovery after surgery care improved neurological function and nutritional status and reduced blood pressure and stress responses, while promoting the recovery of patients' muscle strength. Therefore, enhanced recovery after surgery care has high application value in the future clinical treatment of acute cerebral infarction combined with dysphagia. [ABSTRACT FROM AUTHOR]

This study aimed to explore the effects of the cluster nursing strategy applied to traumatic brain injury (TBI) patients. Ninety-eight TBI patients admitted to the hospital were selected as the study subjects. They were randomized into two groups, the control group and the cluster group, with 49 cases in each group. The control group received routine nursing methods, while the cluster group received cluster nursing strategy. The intervention effects were compared between the two groups. After 3 months, the total occurrence of complications in the cluster group was significantly lower than that in the control group. Postintervention, the cluster group had a significantly lower National Institutes of Health Stroke Scale score and significantly higher Fugl–Meyer score and Loewenstein Occupational Therapy Cognitive Assessment score compared with the control group. The serum level of glial fibrillary acidic protein in the control group was significantly higher than that in the cluster group, while the serum level of brain-derived neurotrophic factor was significantly lower. The application of the cluster nursing strategy in the care of patients with TBI could effectively reduce the risk of complications and improve neurological, motor, and cognitive functions. [ABSTRACT FROM AUTHOR]

BACKGROUND: Traumatic brain injury is a condition in which the normal function of the brain is disrupted by a bump or impact to the head. It is necessary to find effective treatments and objective targets that can help doctors diagnose the injury status and restore the brain function of patients. OBJECTIVE: To explore the effect of electroacupuncture combined with low-frequency transcranial ultrasound stimulation on the electroencephalographic signals of rats with traumatic brain injury. METHODS: Forty 6-week-old SPF male Sprague-Dawley rats were randomly divided into five groups: sham group, model group, electroacupuncture group, lowfrequency transcranial ultrasound stimulation group and combined group (electroacupuncture+low-frequency transcranial ultrasound stimulation), with eight rats in each group. Feeney weight-drop method was used to establish the animal model of traumatic brain injury. In the sham group, the bone window was only opened without impact. Interventions were started at 1 day after modeling. Electroacupuncture in the electroacupuncture group, low-frequency transcranial ultrasound stimulation in the low-frequency transcranial ultrasound stimulation group, and electroacupuncture+low-frequency transcranial ultrasound stimulation in the combined group were performed for days in total. The modified neurological severity scale score for assessing rats’ neurological deficits was performed at 8 hours after modeling. The percentage of spontaneous alternation behavior in the Y-maze was measured at 7 days after modeling. Then, the electroencephalographic signals were collected and electroencephalographic data of α, β, θ, and δ waves were extracted by fast Fourier transform, and the value of oscillation amplitude and energy ratio were calculated in α, β, θ, and δ waves, as well as the Lempel-Ziv complexity and sample entropy. RESULTS AND CONCLUSION: Compared with the sham group, the modified neurological severity scale scores in the model group, electroacupuncture group, low-frequency transcranial ultrasound stimulation group and combined group were significantly increased at 8 hours after modeling (P < 0.05). Compared with the sham group, the value of oscillation amplitude in δ wave and the value of δ energy ratio were significantly increased in the model group at 7 days after modeling, meanwhile the percentage of spontaneous alternation behavior in Y-maze, and the value of α/β energy ratio, Lempel-Ziv complexity, and sample entropy were significantly decreased (P < 0.05). Compared with the model group, the value of oscillation amplitude in α and δ waves was significantly decreased in the combined group (P < 0.05), while the value of α/β energy ratio was significantly increased (P < 0.05) and the value of δ energy ratio was significantly decreased (P < 0.05) in the electroacupuncture group, low-frequency transcranial ultrasound stimulation group and combined group. Compared with the electroacupuncture group and low-frequency transcranial ultrasound stimulation group, the value of δ energy ratio was significantly decreased in the combined group (P < 0.05), while the percentage of spontaneous alternation behavior, the value of α/β energy ratio, the Lempel-Ziv complexity, and the sample entropy were significantly increased (P < 0.05). To conclude, abnormal electroencephalographic signals can appear in rats with traumatic brain injury, while the electroacupuncture combined with low-frequency transcranial ultrasound stimulation can alleviate the abnormal electroencephalographic signals in rats, which suggests the electroencephalographic frequency domain value and nonlinear features can be used to assess the severity of traumatic brain injury. [ABSTRACT FROM AUTHOR]

Objective To explore the impacts of health empowerment model combined with binary coping intervention on neurological function,coping style,and hope level in elderly stroke patients. Methods A total of 144 elderly stroke patients admitted to Handan Central Hospital from October 2020 to October 2022 were selected as the research subjects,they were randomly separated into a reference group and an observation group,with 72 cases in each group.The reference group received routine nursing intervention,while observation group received health empowerment combined with binary coping intervention,The neurological function [National Institutes of Health Stroke Scale(NIHSS)] ,coping style [Simplified coping style questionnaire(SCSQ)] ,and hope level [Herth hope index(HHI)] of both groups were evaluated before and after intervention. Results There was no statistically significant difference in NIHSS scores,SCSQ scores,and HHI scores between the two groups before intervention(P>0.05).After intervention,the NIHSS scores of the observation group were lower than those in the control group(P

Objective: To determine the efficacy of mechanical thrombectomy combined with prolonged mild hypothermia compared with conventional treatment in managing acute middle cerebral artery occlusion, and to explore whether extending the duration of hypothermia can improve neurological function. Method: From 2018 to June 2023, a retrospective analysis was conducted on 45 patients with acute middle cerebral artery occlusion treated at the NICU of Suzhou Kowloon Hospital, affiliated with Shanghai Jiao Tong University School of Medicine. After thrombectomy, patients were admitted to the neurological intensive care unit (NICU) for targeted temperature management. Patients were divided into two groups: the mild hypothermia group (34.5-35.9°C) receiving 5-7 days of treatment, and the normothermia group (control group) whose body temperature was kept between 36 and 37.5°C using pharmacological and physical cooling methods. Baseline characteristics and temperature changes were compared between the two groups of patients. The primary outcome was the modified Rankin Scale (mRS) score at 3 month after surgery, and the secondary outcomes were related complications and mortality rate. Prognostic risk factors were investigated using both univariate and multivariate logistic regression analyses. Results: Among 45 patients, 21 underwent prolonged mild hypothermia, and 24 received normothermia, with no significant differences in baseline characteristics between the two groups. The duration of mild hypothermia ranged from 5 to 7 days. The incidence of chills (33.3% vs. 8.3%, p = 0.031) and constipation (57.1% vs. 20.8%, p = 0.028) was significantly higher in the mild hypothermia group compared with the control group. There was no significant difference in mortality rates between the mild hypothermia and the control group (4.76% vs. 8.33%, p = 1.000, OR = 1.75, 95% CI, 0.171-17.949). At 3 month, there was no significant difference in the modified mRS (0-3) score between the mild hypothermia and control groups (52.4% vs. 25%, p = 0.114, OR = 0.477, 95% CI, 0.214-1.066). Infarct core volume was an independent risk factor for adverse neurological outcomes. Conclusion: Prolonged mild hypothermia following mechanical thrombectomy had no severe complications and shows a trend to improve the prognosis of neurological function. The Infarct core volume on CTP was an independent risk factor for predicting neurological function. [ABSTRACT FROM AUTHOR]

BACKGROUND: There are differentially expressed genes in acute intracerebral hemorrhage, which are related to the occurrence and development of intracerebral hemorrhage OBJECTIVE: To screen differentially expressed genes and key genes in brain tissue of a rat model with acute intracerebral hemorrhage, to validate them through qPCR, and to analyze the relationships between key genes and the neurological function and brain tissue water content after intracerebral hemorrhage. METHODS: Seventy-eight Sprague-Dawley rats were randomly divided into two groups: in intracerebral hemorrhage group, a rat model of acute intracerebral hemorrhage was made using collagenase injection at the right caudate nucleus; and in sham-operated group, rats were injected with equal amount of saline at the same site. RNA was extracted from rat brain tissues of both groups using the TRIzol method and transcriptome sequencing technology was used to identify differentially expressed genes in brain tissues of acute intracerebral hemorrhage, which were then verified by qPCR and analyzed for the relationships between the genes and neurological function and brain tissue water content after intracerebral hemorrhage. And the key genes were analyzed by GO and KEGG functional enrichment analysis in combination with bioinformatics. RESULTS AND CONCLUSION: Ten key genes were identified, including CXCL8, SERPINE1, TFPI2, CXCR4, GDA, KCNQ5, ERICH3, SCN3B, CACNA1E, and CCL20. The contents of GDA, KCNQ5, ERICH3, SCN3B, and CACNA1E in the intracerebral hemorrhage group were lower than those in the sham-operated group (P < 0.05). The contents of CXCL8, SERPINE1, TFPI2, CXCR4 and CCL20 in the intracerebral hemorrhage group were higher than those in the sham-operated group (P < 0.05). The contents of GDA, KCNQ5, ERICH3, SCN3B, and CACNA1E were positively correlated with brain tissue water content and neurologic deficit score (P < 0.05), while the contents of CXCL8, SERPINE1, TFPI2, CXCR4 and CCL20 were negatively correlated with brain tissue water content and neurologic deficit score (P < 0.05). GO analysis indicated that differentially expressed genes were mainly enriched in two biological processes (leukocyte chemotaxis and chemokine-mediated signaling pathways), two cell components (cation channel complexes and ion channel complexes), and two molecular functions (gated channel activity and ion channel activity). KEGG analysis indicated that differentially expressed genes were concentrated in tumor necrosis factor signaling pathway, glutamatergic synapses and GABAergic synapses. To conclude, the differentially expressed genes in intracerebral hemorrhage include CXCL8, SERPINE1, TFPI2, CXCR4, GDA, KCNQ5, ERICH3, SCN3B, CACNA1E, and CCL20, and these genes are related to brain tissue water content and neurological function after intracerebral hemorrhage. These genes are mainly enriched in cell components, binding functions, cellular protrusions, and other related biological functions. [ABSTRACT FROM AUTHOR]

BACKGROUND: Stage III Kümmell’s disease is characterized by a high degree of vertebral compression and posterior wall defects. Most of the patients are elderly people with severe osteoporosis and various medical diseases. Clinically, some surgical methods are often at high risk and are controversial. OBJECTIVE: To investigate the clinical efficacy of screw placement combined with transpedicular impaction bone grafting in the treatment of stage III Kümmell’s disease. METHODS: The clinical data of injured vertebral screw placement combined with transpedicular impaction bone grafting in treatment of stage III Kummell’s disease from May 2016 to August 2021 were retrospectively analyzed. Visual analog scale score, Oswestry disability index, anterior vertebral heights, kyphotic Cobb angle and American Spinal Injury Association (ASIA) impairment scale were used to evaluate the effects of surgery. The operation time, intraoperative blood loss and complications were recorded. CT scans were used to evaluate the healing of injured vertebrae at the final follow-up visit. RESULTS AND CONCLUSION: (1) A total of 26 patients were included, with 7 males and 19 females, at the age range of 62-81 years [mean (69.7±4.8) years]. The follow-up time was 18-60 months [mean (35.1±8.9) months]. The average operative duration was 133.5 minutes (100-165 minutes), and the average intraoperative blood loss was 285.3 mL (210-350 mL). (2) Visual analog scale and Oswestry disability index scores 1 week after surgery were significantly lower than those before surgery. (3) At 1 week after surgery, the anterior vertebral height corrections and the Cobb angle were (9.0±0.7) mm and (16.2±1.0)°, respectively. During the follow-up period, the loss of vertebral height and kyphosis correction were (5.1±0.3) mm and (8.0±0.4)°, respectively. (4) 14 patients (54%) had ASIA grade D before operation, which recovered to grade E at the last follow-up. CT scan showed that all patients achieved good osseous union. (5) Complications occurred in seven patients (27%), including hypostatic pneumonia in two cases, postoperative superficial wound tissue liquefaction in two cases, and adjacent vertebral compression fractures in three cases. (6) It is concluded that screw placement of the injured vertebra combined with transpedicular impaction bone grafting can rapidly rebuild spinal stability, effectively relieve pain and improve neurological function in the treatment of stage III Kümmell’s disease. This technique is an effective and relatively minimally invasive surgical option. [ABSTRACT FROM AUTHOR]

Ischemic stroke is a leading cause of mortality and disability. The relationships of heart rate variability (HRV) and stroke-related factors with mortality and functional outcome are complex and not fully understood. Understanding these relationships is crucial for providing better insights regarding ischemic stroke prognosis. The objective of this study is to examine the relationship between HRV, neurological function, and clinical factors with mortality and 3-month behavioral functional outcome in ischemic stroke. We prospectively collected the HRV data and monitored the behavioral functional outcome of patients with ischemic stroke. The behavioral functional outcome was represented by a modified Rankin Scale (mRS) score. This study population consisted of 58 ischemic stroke patients (56.9% male; mean age 70) with favorable (mRS score ≤ 2) and unfavorable (mRS score ≥ 3) outcome. The analysis indicated that the median of the mean RR interval (RR mean) showed no statistical difference between mortality groups. Conversely, the median of the RR mean had significant association with unfavorable outcome (OR = 0.989, p = 0.007). Lower hemoglobin levels had significant association with unfavorable outcome (OR = 0.411, p = 0.010). Higher National Institute of Health Stroke Scale (NIHSS) score at admission had significant association with unfavorable outcome (OR = 1.396, p = 0.002). In contrast, age, stroke history, NIHSS score at admission, and hemoglobin showed no significant association with mortality in ischemic stroke. These results imply that HRV, as indicated by the median of RR mean, alongside specific clinical factors and neurological function at admission (measured by NIHSS score), may serve as potential prognostic indicators for 3-month behavioral functional outcome in ischemic stroke. [ABSTRACT FROM AUTHOR]

Background: Dl-3-n-Butylphthalide (NBP) has emerged as a potential therapeutic agent for cerebral hemorrhage, despite not being included in current guideline recommendations. Investigating the underlying physiological and pathological mechanisms of Dl-3-n-Butylphthalide in cerebral hemorrhage treatment remains a critical area of research. Objective: This review aims to evaluate the efficacy of Dl-3-n-Butylphthalide in cerebral hemorrhage treatment and elucidate its potential biological mechanisms, thereby providing evidence to support treatment optimization. Methods: A comprehensive search of seven electronic databases (PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, VIP, and Wanfang Database) was conducted for studies published up to September 2023. Screening and data extraction were performed by a team of researchers. The Cochrane collaboration tool was utilized for risk bias assessment, and Revman 5.3 along with Stata 17.0 were employed for statistical analysis. Outcomes: We searched 254 literature, and 19 were included in this metaanalysis. The results showed that Dl-3-n-Butylphthalide improved the clinical efficacy rate (RR = 1.25, 95% CI 1.19-1.31; p = 0.00), quality of life (MD = 13.93, 95% CI: 11.88-15.98; p = 0.000), increased cerebral blood flow and velocity, reduced cerebral edema volume, Hcy concentration, and did not have obvious adverse reactions (RR = 0.68, 95% CI: 0.39-1.18; p = 0.10). Conclusion: This meta-analysis is the first to demonstrate the potential of Dl-3-n-Butylphthalide in treating cerebral hemorrhage. It suggests that Dl-3-n-Butylphthalide may alleviate clinical symptoms by modulating neurological function and improving hemodynamics. Our findings provide robust evidence for incorporating Dl-3-n-Butylphthalide into cerebral hemorrhage treatment strategies, potentially guiding future clinical practice and research. [ABSTRACT FROM AUTHOR]

Increasing evidence shows that the administration of mesenchymal stem cells (MSCs) is a promising option for various brain diseases, including ischemic stroke. Studies have demonstrated that MSC transplantation after ischemic stroke provides beneficial effects, such as neural regeneration, partially by activating endogenous neural stem/progenitor cells (NSPCs) in conventional neurogenic zones, such as the subventricular and subgranular zones. However, whether MSC transplantation regulates the fate of injury-induced NSPCs (iNSPCs) regionally activated at injured regions after ischemic stroke remains unclear. Therefore, mice were subjected to ischemic stroke, and mCherry-labeled human MSCs (h-MSCs) were transplanted around the injured sites of nestin–GFP transgenic mice. Immunohistochemistry of brain sections revealed that many GFP+ cells were observed around the grafted sites rather than in the regions in the subventricular zone, suggesting that transplanted mCherry+ h-MSCs stimulated GFP+ locally activated endogenous iNSPCs. In support of these findings, coculture studies have shown that h-MSCs promoted the proliferation and neural differentiation of iNSPCs extracted from ischemic areas. Furthermore, pathway analysis and gene ontology analysis using microarray data showed that the expression patterns of various genes related to self-renewal, neural differentiation, and synapse formation were changed in iNSPCs cocultured with h-MSCs. We also transplanted h-MSCs (5.0 × 104 cells/µL) transcranially into post-stroke mouse brains 6 weeks after middle cerebral artery occlusion. Compared with phosphate-buffered saline-injected controls, h-MSC transplantation displayed significantly improved neurological functions. These results suggest that h-MSC transplantation improves neurological function after ischemic stroke in part by regulating the fate of iNSPCs. [ABSTRACT FROM AUTHOR]

Objective To analyze the joint efficacy of butylphthalide （NBP) and limb ischemic postconditioning （LIPost C） in the treatment of elderly patients with atherosclerotic cerebral infarction. Methods A total of 160 patients with large atherosclerotic cerebral infarction hospitalized in Bijie Hospital from October 2020 to October 2022 were divided into four groups: NBP， LIPost C, NBP + sham LIPost C, and NBP + LIPost C by the random number table method， with 40 cases in each group. Before and after one-month treatment, the four groups were compared in terms of collateral circulation evaluated by the leptomeningeal scoring （rLMC), neurological function evaluated by the National Institutes of Health Stroke Scale （NIHSS）， limb function disability evaluated by the Modified Rankin Scale （MRS), cognitive function evaluated by the Mini Mental State Scale （MMSE）， daily living ability evaluated by the Barthel Index, as well as the occurrence of bleeding adverse events. Results After one-month treatment, the four groups all showed an increase in the rLMC score, with the NBP + LIPost C group significantly higher than the other three groups （P < 0.05), and a decrease in the scores of NIHSS and MRS at each time point， with the NBP + LIPost C group significantly lower than the other three groups （P < 0.05）. Additionally， the four groups demonstrated an increase in the MMSE score and Barthel index at each time point （P < 0.05），with the NBP + LIPost C group higher than the other three groups （P < 0.05）. Moreover, all the four groups showed no statistically significant difference in the incidence of bleeding adverse events （P > 0.05）. Conclusion NBP combined with LIPost C can effectively promote the establishment of collateral circulation and the recovery of neurological function in elderly patients with atherosclerotic cerebral infarction. Meanwhile, it can improve their motor function, daily living ability, and cognitive function. Moreover, it has high safety. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodsResultsConclusionTo observe the clinical efficacy of calcipotriol combined with AYJ(An Yi Jia) sodium alginate repair dressing in the treatment of psoriasis vulgaris (PV) and its effect on patients’ neurological function.A retrospective analysis was conducted on the clinical data of 103 patients with PV admitted to our hospital from January 2022 to January 2024. All patients met the inclusion and exclusion criteria. According to the treatment interventions received by the patients, they were divided into control group (n = 51, receiving calcipotriol monotherapy) and observation group (n = 52, receiving calcipotriol combined with AYJ sodium alginate repair dressing). The clinical treatment effects, severity of the disease (PSSI score), levels of T lymphocyte subsets (CD4+, CD8+), serum nerve growth factor (NGF), inflammatory factors [interferon-gamma (IFN-γ), interleukin-8 (IL-8), tumor necrosis factor-alpha (TNF-α)], and adverse reactions were compared between the two groups.① Clinical treatment effects: The total effective rate in the observation group was higher than that in the control group (p < 0.05). ② Severity of the disease: The PASI scores of both groups gradually decreased with prolonged treatment time, and the observation group showed a greater magnitude of change (p < 0.05). ③ T lymphocyte subset cells and serum nerve growth factor: The levels of CD4+ were increased after treatment in both groups, while CD8+ and NGF levels were decreased compared to before treatment, with a greater magnitude of change in the observation group (p < 0.05). ④ Inflammatory factors: The levels of IFN-γ, IL-8, and TNF-α were decreased after treatment in both groups, with a greater magnitude of change in the observation group (p < 0.05). ⑤ Adverse reactions: There was no significant difference in the incidence of adverse reactions between the two groups (p > 0.05).Calcipotriol combined with AYJ sodium alginate repair dressing has ideal therapeutic effects in the treatment of PV. Compared with calcipotriol alone, the combined application of AYJ sodium alginate repair dressing can further improve patient efficacy, improve immune and neurological function, alleviate patient inflammatory responses, and does not increase the risk of adverse reactions in patients. [ABSTRACT FROM AUTHOR]

BACKGROUND: Comprehensive geriatric assessment (CGA) has been used in inpatient, outpatient, and emergency patients in Western countries and is an important evaluation tool in medicine. In China, the application of CGA to multiple single diseases has achieved satisfactory intervention effects. OBJECTIVE: To explore the effect of CGA on postoperative quality of life (QoL), psychological state, neurological recovery, and self-efficacy in patients with cerebral hemorrhage. METHODS: In this randomized controlled trial, a total of 133 postoperative patients with cerebral hemorrhage who were treated and nursed in our hospital between March 2019 and March 2021 were randomly assigned to a control group (68 patients) and an observation group (65 patients). The control group was given a general comprehensive care intervention. The observation group was evaluated using an electronic medical record-based CGA system that assessed patient prognosis and was given individualized interventions based on the CGA findings. The postoperative QoL, psychological state, neurological recovery, and self-efficacy of the two groups were compared. RESULTS: After the intervention, self-decompression, self-decision-making, and positive attitudes of the observation group were higher than those of the control group. However, the National Institute of Health Stroke Scale score of the observation group was lower than that of the control group, the Self-rating anxiety scale and self-rating depression scale scores of the observation group were lower than those of the control group, and the social support score was significantly higher in the observation group than in the control group. After the intervention, the mental vitality, social interaction, emotional restriction, and mental status scores of the observation group were significantly higher than those of the control group. CONCLUSION: Comprehensive evaluation of patients with cerebral hemorrhage based on a CGA, targeting the individual factors that affect the prognosis of patients, and formulating and implementing individualized nursing intervention programs based on the CGA results can effectively relieve the symptoms of cerebral hemorrhage, reduce anxiety and depression, and improve the QoL of patients with cerebral hemorrhage. [ABSTRACT FROM AUTHOR]

For patients monitored in intensive care units in the aftermath of a cardiac arrest, one of the well-established difficulties of care after resuscitation is the ability to perform the necessary prognostic assessments as accurately and early as possible. Although current guidelines include algorithms to determine prognosis, there are still missing links and uncertainties. Biomarkers obtained from peripheral blood are generally non-invasive and easy to obtain. Although the potential to use microRNA as a prognostic biomarker after cardiac arrest has received less interest recently, its popularity has increased in the last few years. By identifying prognostic biomarkers within 24 h of cardiac arrest, clinicians in intensive care could gain valuable insights to guide patient outcomes and predict both mortality and survival rates.

Swallowing dysfunction in elderly stroke patients is a common and significant clinical problem that has a considerable impact on their health and quality of life. Studies have indicated that impaired swallowing function in elderly stroke patients is associated with multiple factors, including the location and extent of the stroke, the degree of damage to the neural pathways, and related inflammatory responses. Interventions for swallowing dysfunction in elderly stroke patients have gradually become more diverse and individualized. This paper reviewed the studies on dysphagia in elderly stroke patients, summarized etiologic and pathophysiologic mechanisms, assessment tools, and treatment of dysphagia, and provided reference for diversifying clinical research and treatment. (吞咽功能障碍是老年脑卒中患者常见并发症, 严重影响患者预后和生活质量。老年脑卒中患者的吞咽功能受损与中风部位和范围、神经通路的受损程度以及相关的炎症反应等因素有关。随着脑卒中相关研究的深入开展, 老年脑卒中患者吞咽功能障碍的干预措施逐渐多样化和个体化。本研究主要回顾和总结老年脑卒中后吞咽功能障碍的研究进展, 包括病因和病理生理机制、评估工具以及治疗方法等方面, 以期为临床研究以及治疗的多元化提供参考。)

Abstract Traumatic brain injury (TBI) is the main cause of disability, mental health disorder, and even death, with its incidence and social costs rising steadily. Although different treatment strategies have been developed and tested to mitigate neurological decline, a definitive cure for these conditions remains elusive. Studies have revealed that various neurotrophins represented by the brain‐derived neurotrophic factor are the key regulators of neuroinflammation, apoptosis, blood–brain barrier permeability, neurite regeneration, and memory function. These factors are instrumental in alleviating neuroinflammation and promoting neuroregeneration. In addition, neural stem cells (NSC) contribute to nerve repair through inherent neuroprotective and immunomodulatory properties, the release of neurotrophins, the activation of endogenous NSCs, and intercellular signaling. Notably, innovative research proposals are emerging to combine BDNF and NSCs, enabling them to synergistically complement and promote each other in facilitating injury repair and improving neuron differentiation after TBI. In this review, we summarize the mechanism of neurotrophins in promoting neurogenesis and restoring neural function after TBI, comprehensively explore the potential therapeutic effects of various neurotrophins in basic research on TBI, and investigate their interaction with NSCs. This endeavor aims to provide a valuable insight into the clinical treatment and transformation of neurotrophins in TBI, thereby promoting the progress of TBI therapeutics.

Abstract Background Smoke exposure is a prevalent and well-documented risk factor for various diseases across different organ systems. Serum neurofilament light chain (sNfL) has emerged as a promising biomarker for a multitude of nervous system disorders. However, there is a notable paucity of research exploring the associations between smoke exposure and sNfL levels. Methods We conducted a comprehensive analysis of the National Health and Nutrition Examination Survey (NHANES) cross-sectional data spanning the years 2013 to 2014. Serum cotinine levels were classified into the following three groups: < 0.05, 0.05–2.99, and ≥ 3 ng/ml. Multiple linear regression models were employed to assess the relationships between serum cotinine levels and sNfL levels. Additionally, we utilized restricted cubic spline analyses to elucidate the potential nonlinear relationship between serum cotinine and sNfL levels. Results A total of 2053 participants were included in our present research. Among these individuals, the mean age was 47.04 ± 15.32 years, and males accounted for 48.2% of the total study population. After adjusting the full model, serum cotinine was positively correlated with sNfl in the second group (β = 0.08, 95%CI 0.01–0.15) and in the highest concentration of serum cotinine (β = 0.10, 95%CI 0.01–0.19) compared to the group with the lowest serum cotinine concentrations. Current smokers, in comparison to non-smokers, exhibited a trend toward elevated sNfL levels (β = 0.07, 95%CI 0.01–0.13). Furthermore, subgroup analyses revealed interactions between serum cotinine levels and different age groups (P for interaction = 0.001) and gender stratification (P for interaction = 0.015) on sNfL levels. Conclusion The study suggested that serum cotinine was significantly and positively associated with sNfl levels in adult participants. Furthermore, current smokers tend to exhibit elevated sNfL levels. This research sheds light on the potential implications of smoke exposure on neurological function impairment and underscores the importance of further exploration in this area.

Background: It is well established that traumatic brain injury (TBI) causes acute and chronic alterations in systemic immune function and that systemic immune changes contribute to posttraumatic neuroinflammation and neurodegeneration. However, how TBI affects bone marrow (BM) hematopoietic stem/progenitor cells chronically and to what extent such changes may negatively impact innate immunity and neurological function has not been examined. Methods: To further understand the role of BM cell derivatives on TBI outcome, we generated BM chimeric mice by transplanting BM from chronically injured or sham (i.e., 90 days post-surgery) congenic donor mice into otherwise healthy, age-matched, irradiated CD45.2 C57BL/6 (WT) hosts. Immune changes were evaluated by flow cytometry, multiplex ELISA, and NanoString technology. Moderate-to-severe TBI was induced by controlled cortical impact injury and neurological function was measured using a battery of behavioral tests. Results: TBI induced chronic alterations in the transcriptome of BM lineage−c-Kit+Sca1+ (LSK+) cells in C57BL/6 mice, including modified epigenetic and senescence pathways. After 8 weeks of reconstitution, peripheral myeloid cells from TBI→WT mice showed significantly higher oxidative stress levels and reduced phagocytic activity. At eight months after reconstitution, TBI→WT chimeric mice were leukopenic, with continued alterations in phagocytosis and oxidative stress responses, as well as persistent neurological deficits. Gene expression analysis revealed BM-driven changes in neuroinflammation and neuropathology after 8 weeks and 8 months of reconstitution, respectively. Chimeric mice subjected to TBI at 8 weeks and 8 months post-reconstitution showed that longer reconstitution periods (i.e., time post-injury) were associated with increased microgliosis and leukocyte infiltration. Pre-treatment with a senolytic agent, ABT-263, significantly improved behavioral performance of aged C57BL/6 mice at baseline, although it did not attenuate neuroinflammation in the acutely injured brain. Conclusions: TBI causes chronic activation and progressive dysfunction of the BM stem/progenitor cell pool, which drives long-term deficits in hematopoiesis, innate immunity, and neurological function, as well as altered sensitivity to subsequent brain injury. [ABSTRACT FROM AUTHOR]

Objective: To observe the therapeutic effect of Xuantong Tang combined with hyperbaric oxygen on post stroke depression and its impact on patients' neurological function and psychological state. Methods: 82 patients with post-stroke depression who were diagnosed and treated in our hospital between February 2021 to February 2023 were enrolled prospectively and divided into a control group and an observation group, with 41 patients in each group. The control group received hyperbaric oxygen treatment, while the observation group received Xuantong Tang treatment in addition to the control group. Compare the National Institutes of Health Stroke Scale (NIHSS) and Hamilton Depression Scale (HAMD) scores, as well as transcranial Doppler ultrasound parameters, serum C-reaction protein (CRP), before and after treatment between two groups of patients homocysteine (Hcy) and low density lipoprotein cholesterol (LDL-C) levels. Results: After treatment, the NIHSS score, HAMD score, and serum CRP, Hcy, and LDL-C levels of the two groups of patients were lower than before treatment. The blood flow velocity at the lesion side of the vertebral artery (VA) and basilar artery (BA) was lower than before treatment(P<0.05). After treatment, the NIHSS score, HAMD score, and serum CRP, Hcy, and LDL-C levels in the observation group were lower than those in the control group (P<0.05). After treatment, the blood flow velocity at the VA and BA positions on the lesion side of the observation group was higher than that of the control group (P<0.05). Conclusions: Xuantong Tang combined with hyperbaric oxygen can significantly improve the neurological function damage and alleviate the degree of depression in patients with post-stroke depression, which may be related to the recovery of cerebral blood flow velocity and the decrease of vascular endothelial injury factor levels. [ABSTRACT FROM AUTHOR]

For patients monitored in intensive care units in the aftermath of a cardiac arrest, one of the well-established difficulties of care after resuscitation is the ability to perform the necessary prognostic assessments as accurately and early as possible. Although current guidelines include algorithms to determine prognosis, there are still missing links and uncertainties. Biomarkers obtained from peripheral blood are generally non-invasive and easy to obtain. Although the potential to use microRNA as a prognostic biomarker after cardiac arrest has received less interest recently, its popularity has increased in the last few years. By identifying prognostic biomarkers within 24 h of cardiac arrest, clinicians in intensive care could gain valuable insights to guide patient outcomes and predict both mortality and survival rates. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodsResultsConclusionThis study aims to explore the application of refined nursing intervention in patients undergoing unruptured intracranial aneurysm intervention, evaluating its impact on neurological function recovery and prognosis improvement.Patients diagnosed with intracranial aneurysms and undergoing treatment at our hospital from February 2022 to June 2023 were included in this study. After applying complete inclusion and exclusion criteria to ensure sample representativeness, a total of 92 patients were enrolled. Using a randomization method, patients were divided into an observation group and a control group. The control group received routine nursing care, while the observation group received refined nursing intervention. Nursing effects were compared between the two groups, and statistical analysis was conducted using appropriate methods, with content analysis summarizing the results.The observation group, post-intervention, exhibited significantly improved Neurological Function Deficit (NFD) scores compared to the control group (p = 0.023). Additionally, the observation group showed higher proportions of Grade V patients in the Glasgow Outcome Scale (GOS) post-intervention (p = 0.031). Moreover, Fugl Meyer Assessment (FMA) scores for motor function were notably higher in the observation group than the control group (p = 0.003). The observation group also reported lower headache intensity and fewer adverse outcomes than the control group (p = 0.018, 0.038).Refined nursing intervention in patients undergoing intracranial aneurysm intervention demonstrates better outcomes in terms of neurological function recovery and prognosis improvement. It reduces uncertainty in nursing practices, effectively enhancing nursing outcomes, and warrants clinical application and promotion. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of naomaili granules combined with edaravone dextrorphan injection concentrate solution on neurological function, hemorheology and oxidative stress in patients with acute cerebral infarction (ACI) . Methods: 140 ACI patients admitted to Nanjing Central Hospital and Changzhou First People’s Hospital from July 2022 to July 2023 were selected, and patients were divided into control group (n=70, conventional treatment combined with edaravone dextrorphan injection concentrate solution treatment) and observation group (n=70, received naomaili granules treatment on the basis of control group) according to random number table method. The efficacy, neurological function, activities of daily living, hemorheology and oxidative stress were compared in two groups. Results: The total clinical effective rate in observation group was higher than that in control group (P＜0.05) . The National Institutes of Health Stroke Scale (NIHSS), plasma viscosity, whole blood low shear viscosity, whole blood high shear viscosity, packet cell volume and malondialdehyde (MDA) in observation group were lower than those in control group after treatment, and daily living ability scale score (Barthel index) score and superoxide dismutase (SOD) in observation group were higher than those in control group (P＜0.05) .Conclusion: The combination of naomaili granules and edaravone dextroborneol injection concentrate solution in the treatment of ACI patients, which is helpful to regulate hemorheology, improve neurological function, reduce oxidative stress and improve their activities of daily living. [ABSTRACT FROM AUTHOR]

Objective: To investigate the correlation of serum osteopontin levels with disease severity and prognosis in patients with acute cerebral infarction. Methods: This retrospective analysis included forty patients with acute cerebral infarction (ACI) admitted to the Department of Neurology of Baoding Children's Hospital from May, 2019 to May, 2022 within 24 hours of onset were selected as the observation group, while 40 healthy subjects in our hospital during the same period were selected as the control group. The correlation between serum Osteopontin (OPN) levels and risk factors on one day, seven days and 14 days was analyzed. Patients in the observation group were subdivided into the good prognosis group and the poor prognosis group according to mRS score, and the serum OPN levels of the two groups were compared. The correlation between serum OPN and disease severity and prognosis of patients with ACI was analyzed. Results: The serum OPN levels in the observation group were significantly higher than those in control group (P< 0.05), and its level was positively correlated with NIHSS score and infarct size. The proportion of patients with hyperlipidemia, smoking, drinking, hypertension and OPN level on seven day in the poor prognosis group were higher than those in the good prognosis group (P<0.05). The OPN level > 8.720 ng/ml on seven days was an independent risk factor for poor prognosis of cerebral infarction. Conclusion: OPN is involved in the entire pathophysiological process of ACI, and its level can predict the severity of the disease in patients with ACI, and can be used as an important indicator for evaluating their clinical prognosis. [ABSTRACT FROM AUTHOR]

Background & Objective: Spontaneous intracerebral hemorrhage (SICH) is one of the stroke forms with the highest disability and mortality rates and significant differences in prognosis among patients with different locations of SICH. Angong Niuhuang Pill (ANP) ... is one of the most well-known traditional Chinese patent medicines used in the clinical emergency treatment of cardio-cerebrovascular diseases. This prospective study was performed to determine the therapeutic effect of ANP in different locations of SICH. Methods: Patients with basal ganglia(n=81) and cerebral lobe (n=67) hemorrhage were randomly assigned into two groups: the standard medical management (SMM) group and the combined ANP as well as medical management group (ANP group). Fisher exact test and Mann- Whitney U test were used for comparing the differences between two groups. Primary and secondary outcomes were the 6-month modified Rankin Scale (mRS) scores and the 2-week Brunnstrom stage ratings. Results: For patients with basal ganglia hemorrhage and cerebral lobe hemorrhage, there were no significant differences observed between the ANP group and the SMM group in terms of patient age (53.1±5.3 vs 52.7±6.4; 54.7±4.8 vs 52.7±5.9), sex (male:64.3% vs 53.8%; 63.6% vs 58.8%), body mass index (25.1±2.1 vs 24.2±2.6; 25.6±2.0 vs 25.0±2.4), mean hematoma volume (17.1±6.6 vs 18.6±5.7; 18.4±7.4 vs 18.9±6.0), as well as the proportions of hypertension (88.1%vs71.8%; 90.9% vs 76.5%), alcoholism (40.5% vs 51.3%; 54.6% vs 41.2%), smoking (40.5% vs 38.5%; 36.4% vs 38.2%), and diabetes mellitus (21.4% vs 18%; 12.1% vs 17.7%). The proportion of basal ganglia hemorrhage patients with a 6-month mRS score of 0-2 in the ANP group was significantly higher than that in the SMM group (26.2% vs. 2.6%, P=0.004), but it was not significantly improved in patients with cerebral lobe hemorrhage (57.6% vs 38.2%, P=0.145). The 2-week Brunnstrom stage ratings of patients with basal ganglia hemorrhage were significant difference (P=0.048). But for patients with cerebral lobe hemorrhage, there was no significant difference (P=0.164). The incidence of liver dysfunction, renal dysfunction, gastrointestinal dysfunction, hypothermia and allergy in the two groups of patients was not significantly different. Conclusions: ANP has different therapeutic effects on different locations of SICH, and has the most obvious effect on improving the long-term neurological function of patients with basal ganglia hemorrhage. [ABSTRACT FROM AUTHOR]

Objective To analyze the clinical effect of somatosensory games combined with Baduanjin intervention on stroke patients with dyskinesia. Methods A total of 82 stroke patients with dyskinesia admitted to the hospital from March 2022 to March 2023 were divided into a study group and a control group, with 41 cases in each group. The control group was given routine intervention, and the study group was given somatosensory games combined with Baduanjin intervention to compare the rehabilitation of patients. Results Compared with the control group, the National Institutes of Health Stroke Scale（NIHSS） score of the study group was lower, the level of motor function was higher, the negative emotion score was lower, the clinical symptom score was lower, and the level of daily living ability was higher after intervention, and the differences were statistical significance（P＜0. 05）. Conclusion Somatosensory games combined with Baduanjin intervention for stroke patients with movement disorders can help them get rid of the disease and have a good promoting effect on the recovery of patients′ prognosis and health, which is worthy of promotion and application. [ABSTRACT FROM AUTHOR]

To investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on neurological function indexes and peripheral blood nod-like receptor protein 3 (NLRP3) inflammasome in patients with post-stroke cognitive impairment(PSCI). 98 PSCI patients who were admitted to Guangdong Sanjiu Brain Hospital from April 2020 to May 2022 were selected, patients were divided into control group (conventional drug therapy and rehabilitation training, n=49) and experimental group (rTMS on the basis of control group, n=49) according to the random number table method. The scale scores, neurological function indexes and peripheral blood NLRP3 inflammasome were compared between two groups. 4 weeks after treatment, the scores of mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA) and modified Barthel index (MBI) in experimental group were higher than those in control group (P<0.05). The levels of glial fibrillary acidic protein (GFAP), neuron-specific enolase (NSE) and S100β in experimental group were lower than those in control group(P<0.05). The peripheral blood NLRP3 mRNA, interleukin-18 (IL-18) andinterleukin-1β (IL-1β) in experimental group were lower than those in control group (P<0.05). The treatment of PSCI with rTMS can effectively reduce the cognitive dysfunction of patients, improve the ability of self-care, and regulate the neurological function index and peripheral blood NLRP3 inflammasome. [ABSTRACT FROM AUTHOR]

Background: Smoke exposure is a prevalent and well-documented risk factor for various diseases across different organ systems. Serum neurofilament light chain (sNfL) has emerged as a promising biomarker for a multitude of nervous system disorders. However, there is a notable paucity of research exploring the associations between smoke exposure and sNfL levels. Methods: We conducted a comprehensive analysis of the National Health and Nutrition Examination Survey (NHANES) cross-sectional data spanning the years 2013 to 2014. Serum cotinine levels were classified into the following three groups: < 0.05, 0.05–2.99, and ≥ 3 ng/ml. Multiple linear regression models were employed to assess the relationships between serum cotinine levels and sNfL levels. Additionally, we utilized restricted cubic spline analyses to elucidate the potential nonlinear relationship between serum cotinine and sNfL levels. Results: A total of 2053 participants were included in our present research. Among these individuals, the mean age was 47.04 ± 15.32 years, and males accounted for 48.2% of the total study population. After adjusting the full model, serum cotinine was positively correlated with sNfl in the second group (β = 0.08, 95%CI 0.01–0.15) and in the highest concentration of serum cotinine (β = 0.10, 95%CI 0.01–0.19) compared to the group with the lowest serum cotinine concentrations. Current smokers, in comparison to non-smokers, exhibited a trend toward elevated sNfL levels (β = 0.07, 95%CI 0.01–0.13). Furthermore, subgroup analyses revealed interactions between serum cotinine levels and different age groups (P for interaction = 0.001) and gender stratification (P for interaction = 0.015) on sNfL levels. Conclusion: The study suggested that serum cotinine was significantly and positively associated with sNfl levels in adult participants. Furthermore, current smokers tend to exhibit elevated sNfL levels. This research sheds light on the potential implications of smoke exposure on neurological function impairment and underscores the importance of further exploration in this area. [ABSTRACT FROM AUTHOR]

AbstractBackgroundMethodsResultsConclusionAcute cerebral infarction profoundly affects patients’ neurological function and quality of life. This study explores the impact of Solitaire AB stent thrombectomy, combined with tirofiban and butylphthalide, on neurological function and inflammatory factors in patients with acute cerebral infarction.Seventy-three eligible patients treated between 2021 and 2023 were divided into a control group (Solitaire AB stent thrombectomy) and a treatment group (Solitaire AB stent thrombectomy with tirofiban and butylphthalide). Postoperative neurological function scores and inflammatory factor levels were analyzed.The treatment group demonstrated a higher clinical effective rate, lower National Institutes of Health Stroke Scale scores at one day and seven days and higher Mini-Mental State Examination and Montreal Cognitive Assessment scores post-treatment. Inflammatory factor levels (Neuron Specific Enolase (NSE), S100-β, TNF-α and IL-6) were lower in the treatment group. No significant differences in adverse outcomes were observed.Solitaire AB stent thrombectomy with tirofiban and butylphthalide shows superior efficacy, improving neurological function and inflammatory factors without increasing adverse outcomes. This offers valuable insights for clinical treatment of acute cerebral infarction. [ABSTRACT FROM AUTHOR]

This article discusses a study on the use of endovascular thrombectomy (EVT) as a treatment for acute ischemic stroke (AIS) within different time windows. The study analyzed data from the National Stroke Registry in China and found that EVT within 24 hours of stroke onset was associated with early neurological improvement. However, the proportion of functional improvement was lower compared to EVT within 6 hours. The study suggests the importance of shortening prehospital delay time and considering EVT beyond the recommended time window for better neurological outcomes. The document is a data availability statement for the study, indicating that the data can be obtained from the corresponding author upon request. [Extracted from the article]

Aims: The aim of this study was to evaluate the effect of epicatechin, on neurological recovery and neuroinflammation after traumatic brain injury (TBI) to investigate its potential value in clinical practice. Methods: TBI model was established in adult rats by CCI method. The effect of epicatechin was evaluated after intraperitoneal injection. Neurological recovery after TBI was assessed by Morris Water Maze, mNSS score, Rotarod test and Adhesive removal test. Protein and gene expression was assessed by Western blot, ELISA, PCR and immunofluorescence. Furthermore, the use of AKT pathway inhibitors blocked the therapeutic effects of epicatechin clarifying AKT‐P53/CREB as a potential pathway for the effects of epicatechin. Results: Administering epicatechin after TBI prevented neuronal death, reduced neuroinflammation, and promoted neurological function restoration in TBI rats. Network pharmacology study suggested that epicatechin may exert its therapeutic benefits through the AKT‐P53/CREB pathway Conclusion: These results indicate that epicatechin, a monomeric compound derived from tea polyphenols, possesses potent antioxidant and anti‐inflammatory properties after TBI. The mechanism may be related to the regulation of the AKT‐P53/CREB signal pathway. [ABSTRACT FROM AUTHOR]

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Background and purpose: Acupuncture exerts an anti-inflammatory effect and is recommended by the World Health Organization as a complementary therapy for stroke. This study investigated the improvement in neurological function outcome in acute-stage intervention of acute ischemic stroke (AIS), and the anti-inflammatory effect of early acupuncture. Methods: Fifty patients with AIS were randomly assigned to either a control group (CG, 25 patients, received sham acupuncture) or treatment group (TG, 25 patients, received acupuncture treatment). Acupuncture intervention was administered twice a week for a total of 8 sessions over 4 consecutive weeks. The primary outcome was the changes in the National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), and Barthel Index (BI) scores. The secondary outcome was the changes in serum inflammation-related biomarker levels.(ANAIS trial) Results: A total of 35 patients (18 patients in the CG and 17 patients in the TG) completed the trial. The reduction in NIHSS scores was greater in the TG than in the CG between V2 (second assessment administered after acupuncture intervention) and V1 (first assessment administered before acupuncture intervention; 4.33 ± 1.91 vs. 2.68 ± 1.42, p = 0.005) and between V3 (third assessment administered 28 days after last acupuncture intervention) and V1 (6.00 ± 2.53 vs. 3.83 ± 2.31, p = 0.012). The increase in BI scores was greater in the TG than in the CG between V2 and V1 (28.89 ± 15.39 vs. 14.21 ± 19.38, p = 0.016) and between V3 and V1 (39.41 ± 20.98 vs. 25.00 ± 18.47, p = 0.038). Among participants with high inflammation, the increase in serum IL-12p70 level between V2 and V1 was greater in the TG than in the CG (0.20 ± 0.19 vs. −0.14 ± 0.30, pg/mL p = 0.006). Conclusions: Acupuncture improved the neurological function of patients with AIS, and the relationship between acupuncture improving neurological function and anti-inflammatory effect needs further study. In addition, studies with larger sample sizes and longer follow-ups as well as multicenter clinical trials are expected in the future.

Abstract Background Corpus callosum glioblastoma (ccGBM) is a specific type of GBM and has worse outcomes than other non-ccGBMs. We sought to identify whether en-bloc resection of ccGBMs based on T2-FLAIR imaging contributes to clinical outcomes and can achieve a satisfactory balance between maximal resection and preservation of neurological function. Methods A total of 106 adult ccGBM patients (including astrocytoma, WHO grade 4, IDH mutation, and glioblastoma) were obtained from the Department of Neurosurgery in Nanfang Hospital between January 2008 and December 2018. The clinical data, including gender, age, symptoms, location of tumor, involvement of eloquent areas, extent of resection (EOR), pre- and postoperative Karnofsky Performance Status (KPS) scales, and National Institute of Health stroke scale (NIHSS) scores were collected. Propensity score matching (PSM) analysis was applied to control the confounders for analyzing the relationship between the en-bloc technique and EOR, and the change in the postoperative KPS scales and NIHSS scores. Results Applying the en-bloc technique did not negatively affect the postoperative KPS scales compared to no-en-bloc resection (P = 0.851 for PSM analysis) but had a positive effect on preserving or improving the postoperative NIHSS scores (P = 0.004 for PSM analysis). A positive correlation between EOR and the en-bloc technique was identified (r = 0.483, P

AbstractThis retrospective study analyzed the efficacy of combined antiplatelet therapy with Argatroban in treating acute ischemic stroke (AIS) and its impact on patients’ coagulation and neurological functions. Clinical data of 113 AIS patients admitted between January 2021 and January 2023 were retrospectively analyzed. Patients were divided into control (n = 56) and observation (n = 57) groups based on treatment interventions. The control group patients were treated with antiplatelet drugs, while the observation group patients received combination therapy with apatinib on the basis of the control group treatment. Compared to the control group, the observation group demonstrated higher clinical efficacy, improved coagulation parameters, reduced stroke severity (measured by NIHSS), enhanced daily living abilities (BI scores), and lowered inflammatory and neural injury markers post-treatment. Adverse reaction incidence was similar between groups. Combining Argatroban with antiplatelet drugs in AIS management showed superior efficacy without increasing adverse effects, suggesting its potential for clinical application. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodsResultsConclusionTo analyze the effects of Butylphthalide on cerebral vascular circulation, coagulation function, and neurological function in patients with acute severe ischemic stroke following intravenous thrombolysis.Clinical efficacy, cerebral vascular circulation indicators [anterior cerebral artery (ACA), middle cerebral artery (MCA), vertebral artery (VA) blood flow velocity], coagulation function indicators [prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen (FIB)], neurological function indicators [Activities of Daily Living (ADL) score.The total effective rate of treatment in the control group was 76.47%, while in the observation group, it was 96.08%, with the observation group showing a significantly higher total effective rate than the control group (p < 0.05). Before treatment, there was no significant difference in ACA, MCA, and VA blood flow velocity between the two groups (p > 0.05). However, after treatment, the ACA, MCA, and VA blood flow velocity in the observation group were significantly higher than those in the control group (p < 0.05). Before treatment, there was no significant difference in PT, APTT, TT, and FIB levels between the two groups (p > 0.05).In patients with acute severe ischemic stroke undergoing intravenous thrombolysis, the addition of Butylphthalide to the treatment regimen yields favorable clinical outcomes. Compared to Alteplase alone, the addition of Butylphthalide further improves cerebral vascular circulation and coagulation function, promoting the recovery and reconstruction of neurological function in patients. Importantly, the addition of Butylphthalide does not increase the risk of adverse reactions, making it a safe and ideal option for clinical application. [ABSTRACT FROM AUTHOR]

Background: Corpus callosum glioblastoma (ccGBM) is a specific type of GBM and has worse outcomes than other non-ccGBMs. We sought to identify whether en-bloc resection of ccGBMs based on T2-FLAIR imaging contributes to clinical outcomes and can achieve a satisfactory balance between maximal resection and preservation of neurological function. Methods: A total of 106 adult ccGBM patients (including astrocytoma, WHO grade 4, IDH mutation, and glioblastoma) were obtained from the Department of Neurosurgery in Nanfang Hospital between January 2008 and December 2018. The clinical data, including gender, age, symptoms, location of tumor, involvement of eloquent areas, extent of resection (EOR), pre- and postoperative Karnofsky Performance Status (KPS) scales, and National Institute of Health stroke scale (NIHSS) scores were collected. Propensity score matching (PSM) analysis was applied to control the confounders for analyzing the relationship between the en-bloc technique and EOR, and the change in the postoperative KPS scales and NIHSS scores. Results: Applying the en-bloc technique did not negatively affect the postoperative KPS scales compared to no-en-bloc resection (P = 0.851 for PSM analysis) but had a positive effect on preserving or improving the postoperative NIHSS scores (P = 0.004 for PSM analysis). A positive correlation between EOR and the en-bloc technique was identified (r = 0.483, P < 0.001; r = 0.720, P < 0.001 for PSM analysis), indicating that applying the en-bloc technique could contribute to enlarged maximal resection. Further survival analysis confirmed that applying the en-bloc technique and achieving supramaximal resection could significantly prolong OS and PFS, and multivariate analysis suggested that tumor location, pathology, EOR and the en-bloc technique could be regarded as independent prognostic indicators for OS in patients with ccGBMs, and pathology, EOR and the en-bloc technique were independently correlated with patient's PFS. Interestingly, the en-bloc technique also provided a marked reduction in the risk of tumor recurrence compared with the no-en-bloc technique in tumors undergoing TR, indicating that the essential role of the en-bloc technique in ccGBM surgery (HR: 0.712; 95% CI: 0.535–0.947; P = 0.02). Conclusions: The en-bloc technique could contribute to achieving an enlarged maximal resection and could significantly prolong overall survival and progression-free survival in patients with ccGBMs. [ABSTRACT FROM AUTHOR]

The present study aimed to clarify the practical implications of implementing a risk pre-warning nursing model combined with early nasojejunal enteral nutrition in patients with severe stroke. One hundred patients with severe stroke treated at the Affiliated Hospital of Nantong University, Nantong City, China between January 2022 and June 2023 were recruited. The control group received early enteral nutrition support and conventional nursing, whereas the experimental group was subjected to a risk pre-warning nursing model. After the intervention, the serum albumin, prealbumin, and total protein levels were higher in the experimental group than in the control group. However, the experimental group demonstrated shorter bowel sound recovery, anal exhaust, and anal defecation times. The incidence of complications was lower in the experimental group (4.0%) than in the control group (18.0%). The experimental group exhibited a reduction in intensive care unit hospitalization time, total hospitalization time, and expenses than the control group. The National Institute of Health stroke scale, self-rating depression scale, and self-rating anxiety scale scores were lower in the experimental group than in the control group. In conclusion, early nasojejunal nutrition with risk pre-warning nursing model can improve nutritional status and gastrointestinal function, regulate neurological function, alleviate negative emotions, reduce complications, and shorten the hospital stay of patients with severe stroke. [ABSTRACT FROM AUTHOR]

Background: Depressive disorder is a chronic mental illness characterized by persistent low mood as its primary clinical symptom. Currently, psychotherapy and drug therapy stand as the primary treatment modalities in clinical practice, offering a certain degree of relief from negative emotions for patients. Nevertheless, sole reliance on drug therapy exhibits a delayed impact on neurotransmitters, and long-term usage often results in adverse side effects such as nausea, drowsiness, and constipation, significantly impeding medication adherence. This study aims to investigate the impact of combining transcranial magnetic stimulation with sertraline on the cognitive level, inflammatory response, and neurological function in patients with depressive disorder who engage in non-suicidal self-injury (NSSI) behavior. Methods: A total of 130 depressive patients NSSI behavior, who were admitted to our hospital from December 2020 to February 2023, were selected as the subjects for this research. The single-group (65 cases) received treatment with oral sertraline hydrochloride tablets, while the combination group (65 cases) underwent repetitive transcranial magnetic stimulation (rTMS) in conjunction with sertraline. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was utilized to assess the depression status and cognitive function levels of both groups. Additionally, the enzyme-linked immunosorbent assay (ELISA) was employed to measure serum levels of inflammatory factors, including tumor necrosis factor- α (TNF-α), interleukin-1β (IL-1β), and interleukin-6 (IL- 6). Furthermore, serum levels of neurotransmitters (norepinephrine (NE), dopamine (DA), 5-hydroxytryptamine (5- HT)) and neuro-cytokines (brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), glial fibrillary acidic protein (GFAP)) were assessed. The clinical effects of the interventions on both groups were then evaluated. Results: Following the treatment, the combination group exhibited significantly higher levels of immediate memory, delayed memory, attention, visual function, and language function compared to the single group, with statistically significant differences (p < 0.05). Additionally, the serum levels of TNF-α, IL-1β, IL-6, and GFAP in the combination group were lower than those in the single group, while the levels of BDNF and NGF were higher in the combination group compared to the single group. These differences were also statistically significant (p < 0.05). Simultaneously, the total clinical effective rate in the combination group reached 95.38%, surpassing the 84.61% observed in the single group, and the disparity between the two groups was statistically significant (p < 0.05). Conclusions: The combined use of rTMS and sertraline in treating patients with depressive disorder exhibiting NSSI behavior has proven to be effective in enhancing cognitive function, mitigating inflammatory responses, and elevating levels of neurotransmitters and nerve cytokines in the patients. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To probe into the clinical effect of conventional Western medicine combined with Qizhi Tongluo capsules on patients’ recovery after acute ischemic stroke intervention. METHODS: A total of 86 patients with acute ischemic stroke underwent interventional operation in the interventional medicine department of Xuzhou Cancer Hospital from Jun. 2019 to Dec. 2021 were selected and divided via the random number table method, 43 cases in the control group were given aspirin and conventional rehabilitation treatment; 43 cases in the observation group received Qizhi Tongluo capsules on the basis of the control group. After continuous treatment for 3 months, the clinical efficacy, degree of neurological impairment [National Institutes of Health Stroke Neurologic Deficit Scale (NIHSS) scores], hemorheological indicators (whole blood high shear viscosity, whole blood low shear viscosity and plasma viscosity level), quality of life score [activities of daily living (ADL) scores] and incidences of adverse drug reactions were compared between two groups. RESULTS: After 3 months of treatment, the total effective rate of the observation group was 93. 0% (40 / 43), which was higher than that of the control group (76. 7%, 33 / 43), with statistically significant difference (P<0. 05). The NIHSS scores of both groups decreased significantly after treatment compared with those before treatment, and the NIHSS scores in the observation group was lower than that in the control group, with statistically significant differences (P<0. 05). The whole blood high shear viscosity, whole blood low shear viscosity and plasma viscosity levels of both groups decreased compared with those before treatment, and the above indicators in the observation group were lower than those in the control group, with statistically significant differences (P<0. 05); the ADL scores of both groups increased compared with those before treatment, and the ADL scores in the observation group was higher than that in the control group, with statistically significant differences (P<0. 05). The incidences of adverse drug reactions of the observation group was 7. 0% (3 / 43), lower than that of the control group (18. 6%, 8 / 43), the difference was not statistically significant ( P > 0. 05). CONCLUSIONS: The efficacy of conventional Western medicine combined with Qizhi Tongluo capsules in the treatment of patients with acute ischemic stroke after interventional surgery is remarkable, which can improve neurological function damage, regulate hemorheology, promote the quality of life, with high safety. [ABSTRACT FROM AUTHOR]

This study investigated the effects of subchronic arsenic exposure on behavior, neurological function, and hippocampal damage in rats. Thirty-two male Wistar rats were divided into four groups and exposed to different concentrations of arsenic in their drinking water for 12 weeks, while weekly water intake and body weight were recorded. Various neurobehavioral tests were conducted, evaluating overall activity levels, exploratory behavior, short-term memory, spatial learning and memory, anxiety-like behavior, and depressive-like states. Arsenic levels in urine, serum, and brain tissue were measured, and histopathological analysis assessed hippocampal damage using hematoxylin and eosin staining. The results demonstrated that arsenic exposure did not significantly affect overall activity or exploratory behavior. However, it impaired short-term memory and spatial learning and memory functions. Arsenic-exposed rats exhibited increased anxiety-like behavior and a depressive-like state. Arsenic levels increased dose-dependently in urine, serum, and brain tissue. The histopathological examinations revealed significant hippocampal damage, including neuronal shrinkage, cell proliferation, irregular structure, disordered arrangement, and vacuolation. These findings emphasize the importance of understanding the impact of arsenic exposure on behavior and brain health, highlighting its potential neurological consequences. [ABSTRACT FROM AUTHOR]

Introduction: In-hospital CA (IHCA) is associated with rates of high incidence, low return of spontaneous circulation (ROSC), low survival to discharge, and poor neurological outcomes. We aimed to construct and evaluate prediction models for non-return of spontaneous circulation (non-ROSC) and poor neurological outcomes 12 months after ROSC (PNO-12). Methods: We retrospectively analyzed baseline and clinical data from patients experiencing cardiac arrest (CA) in a big academic hospital of Jilin University in China. Patients experiencing CA between September 1, 2019 and December 31, 2020 were categorized into the ROSC and non-ROSC groups. Patients maintaining ROSC >20min were divided into the good and PNO-12 subgroups. Results: Univariate and multivariate logistic regression identified independent factors associated with non-ROSC and PNO-12. Two nomogram prediction models were constructed and evaluated. Of 2,129 patients with IHCA, 851 were included in the study. Multivariate logistic regression analysis revealed that male sex, age >80 years, CPR duration >23min, and total dose of adrenaline >3mg were significant risk factors for non-ROSC. Before CA, combined arrhythmia, initial defibrillation rhythm, and advanced airway management (mainly as endotracheal intubation) also influenced outcomes. The area under the receiver operating characteristic curve in the prediction model was 0.904 (C-index: 0.901). Respiratory failure, shock, CA in the monitoring area, advanced airway management, and noradrenaline administration were independent risk factors for PNO-12. The AUC was 0.912 (C-index: 0.918). Conclusions: Prediction models based on IHCA data could be helpful to reduce mortality rates and improve prognosis. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effects of oral positioning therapy (OPT) combined with hyperbaric oxygen rehabilitation training on cerebral oxygen metabolism, swallowing function, and serum neurological damage indicators in children with severe viral encephalitis complicated with swallowing disorders. Methods: 80 children with severe viral encephalitis and swallowing disorders who were admitted to Southern Theater Command General Hospital from January 2015 to August 2022 were selected. The children were divided into control group (conventional symptomatic treatment, oral swallowing rehabilitation training combined with OPT rehabilitation training) and study group (control group combined with hyperbaric oxygen treatment) using envelope drawing method, with 40 cases each. The efficacy, swallowing function, cerebral oxygen metabolism, and serum neurological damage indicators between the two groups were compared. Result: The total clinical effective rate of the study group after intervention was higher than that of the control group（P＜0.05) .After intervention, the swallowing disorders questionnaire (DDS) scores of the study group in Oral stage, esophageal stage and pharyngeal stage were lower than those of the control group (P＜0.05) .After the intervention, the oxygen saturation (Sjv O2) and cerebral oxygen uptake rate (CERO2) in the study group were higher than those in the control group, and the cerebral arteriovenous oxygen content difference (Da-jv O2) was lower than that in the control group (P＜0.05) .After the intervention, brain derived neurotrophin (BDNF) in the study group was higher than that in the control group, myelin basic protein (MBP), central nervous system specific protein (S100β), neuron specific enolase (NSE), β-Endorphin（β-EP) were lower than those in the control group (P＜0.05) .Conclusion: The combination of OPT rehabilitation training and hyperbaric oxygen therapy can significantly improve swallowing function, cerebral oxygen metabolism, and serum neurological damage indicator levels in children with severe viral encephalitis complicated with swallowing disorders. [ABSTRACT FROM AUTHOR]