Neurological Function In Patients Research Articles

Value of Chuanjin Qinggan decoction in improving the depressive state of patients with herpes zoster combined with depression.

Western medicine is beneficial for the recovery of neurological function in patients with depression, but some patients experience side effects such as headaches, dizziness, nausea, gastrointestinal symptoms, insomnia, and cardiac dysfunction. In recent years, integrative medicine has achieved positive results in the treatment of various diseases. To study Chuanjin Qinggan decoction combined with selective serotonin reuptake inhibitors (SSRIs) in patients with herpes zoster complicated by depression. Patients with herpes zoster complicated by depression who were treated at the Yantai Hospital of Traditional Chinese Medicine from January 2021 to December 2022 were retrospectively selected as research participants. Among them, 43 patients with herpes zoster complicated by depression who received SSRI treatment between January and December 2021 were assigned to the Western medicine group, while those who received combined treatment of traditional Chinese and Western medicine between January and December 2022 were assigned to the combined group. Both groups were treated for eight weeks. The degree of pain, effect of herpes zoster treatment, degree of improvement in depressive symptoms, serum neurotransmitter levels, sleep quality, and occurrence of adverse reactions were compared between the two groups. We found that after eight weeks of drug treatment, the two treatment schemes achieved differing efficacy. In further comparison, we found that, compared with patients treated with SSRIs alone, patients treated with Chuanjin Qinggan decoction combined with SSRIs showed more significant improvement in depression and a greater increase in dopamine and 5-hydroxytryptamine levels after treatment (P < 0.05). Patients treated with Chuanjin Qinggan decoction combined with SSRIs also experienced lower pain, better treatment efficacy for herpes zoster, better sleep quality, and a lower incidence of adverse reactions compared to those treated with SSRIs alone (P < 0.05). All minor adverse reactions occurring during treatment were resolved after symptomatic treatment. The treatment scheme of Chuanjin Qinggan decoction combined with SSRIs can improve the psychological state of patients with herpes zoster complicated by depression and alleviate adverse reactions.

Extracorporeal cardiopulmonary resuscitation versus conventional cardiopulmonary resuscitation for patients with refractory out-of-hospital cardiac arrest: A retrospective propensity matching analysis.

The incidence of out-of-hospital cardiac arrest (OHCA) is high. Though extracorporeal cardiopulmonary resuscitation (ECPR) has been considered a potential treatment for refractory cardiac arrest after failure of conventional cardiopulmonary resuscitation (CCPR), the benefit of ECPR in refractory OHCA remains uncertain. In this retrospective cohort study, we included patients with refractory OHCA who visited the Emergency Department of the Aerospace Center Hospital between January 2018 and April 2023. We divided the patients into the ECPR Group and the CCPR Group. The primary endpoint of the study was the neurological function of the patients in both groups 3months after the cardiac arrest. We used propensity score matching to reduce selection bias and identified factors associated with good neurological function when OHCA was treated with ECPR by performing univariate and multivariate correlation analyses on surviving patients with good neurological function in the ECPR group. During the study period, we enrolled 133 patients, consisting of 33 in the ECPR group and 100 in the CCPR group. The survival rate of patients with good neurological function at discharge was 18.2% (6/33 cases) in the ECPR group and 9% (9/100 cases) in the CCPR group, p = .20. Three months after discharge, the survival rate of patients with good neurological function was 15.2% (5/33 cases) in the ECPR group and 8% (8/100 cases) in the CCPR group, p = .31. Using propensity score matching, we identified 22 pairs of patients for further analysis. Among these, 3months after discharge, the survival rate of patients with good neurological function was 13.6% (3/22 cases) in the ECPR group and 4.5% (1/22 cases) in the CCPR group, p = .61, and the survival rate at discharge was 18.2% (4/22 cases) in the ECPR group and 4.5% (1/22 cases) in the CCPR group, p = .34. The univariate analysis of patients with good neurological function in the ECPR group showed that time without perfusion, hypoperfusion time, and PCI treatment were associated factors affecting the prognosis of neurological function in patients, while multivariate analysis showed that hypoperfusion time was independently associated with good neurological function, with an OR (95% CI) of 1.06 (1.00-1.14) and p = .05. Our findings suggested that ECPR failed to significantly improve neurological outcome in patients with refractory OHCA; however, the small sample size in this study may be insufficient to detect clinically relevant differences. In addition, hypoperfusion time may be a key predictive factor in identifying candidates for ECPR.

The advantages of multi-level omics research on stem cell-based therapies for ischemic stroke.

Stem cell transplantation is a potential therapeutic strategy for ischemic stroke. However, despite many years of preclinical research, the application of stem cells is still limited to the clinical trial stage. Although stem cell therapy can be highly beneficial in promoting functional recovery, the precise mechanisms of action that are responsible for this effect have yet to be fully elucidated. Omics analysis provides us with a new perspective to investigate the physiological mechanisms and multiple functions of stem cells in ischemic stroke. Transcriptomic, proteomic, and metabolomic analyses have become important tools for discovering biomarkers and analyzing molecular changes under pathological conditions. Omics analysis could help us to identify new pathways mediated by stem cells for the treatment of ischemic stroke via stem cell therapy, thereby facilitating the translation of stem cell therapies into clinical use. In this review, we summarize the pathophysiology of ischemic stroke and discuss recent progress in the development of stem cell therapies for the treatment of ischemic stroke by applying multi-level omics. We also discuss changes in RNAs, proteins, and metabolites in the cerebral tissues and body fluids under stroke conditions and following stem cell treatment, and summarize the regulatory factors that play a key role in stem cell therapy. The exploration of stem cell therapy at the molecular level will facilitate the clinical application of stem cells and provide new treatment possibilities for the complete recovery of neurological function in patients with ischemic stroke.

10162-STMO-8 A SINGLE CENTER RETROSPECTIVE ANALYSIS OF AWAKE CRANIOTOMY FOR BRAIN METASTASIS.

Abstract BACKGROUND/AIM Awake surgery is often used for resecting glioma, but it is controversial whether it should be performed for brain metastasis, because brain tumor is rather demarcated than glioma. However, a small number of hospitals can perform awake craniotomy by limitation of hospital capacity. Here we show a single center retrospective analysis of awake craniotomy for brain metastasis to examine the safety and efficacy of awake craniotomy. MATERIAL/METHOD We analyzed consecutive 50 cases from January 2016 to May 2023 in our hospital. Rehabilitation staff evaluated their neurological status within a week before and after surgery. RESULT Patients characteristics were as follow. Median age was 62 (16-81). Left side tumor were 43 (86.0%). Frontal lobe was 36 (72.0%),temporal lobe 8 (16.0%), parietal lobe 5 (10.0%), occipital lobe 1 (2.0%). Primary cancer was lung 26 (52.0%), gastrointestinal lesion 7 (14.0%), breast 6 (12.0%), soft tissues 4 (8.0%), uterus 1 and malignant melanoma 1, respectively. Radiation necrosis after stereotactic radiosurgery for brain metastases was 5 (10.0%). Preoperative KPS 100-90 was 25 (50.0%), KPS 80 was 10 (20.0%) and less than or equal to KPS 70 was 15 (30.0%). Gross total removal was 43, partial removal was 7. MMSE of before and after surgery was mean 27.1 and median 29. Median OS was 18.8 months (95%CI: 11.2-526). DISCUSSION/CONCLUSION We selected most awake craniotomy for a tumor on left frontal lobe and each evaluationg scales showed no deterioration. Awake craniotomy for brain metastasis is probed to be performed without deteriorating patient's neurological function.

Influence of ganglioside combined with methylprednisolone sodium succinate on efficacy and neurological function in patients with acute myelitis

Influence of ganglioside combined with methylprednisolone sodium succinate on efficacy and neurological function in patients with acute myelitis

Synergistic effect of continuous care and cephalosporin antimicrobials in managing pulmonary infections in acute stroke patients: A comprehensive study

Purpose: To investigate potential benefits of continuous nursing combined with cephalosporin antibiotics in patients with acute cerebral infarction complicated by pulmonary infection.&#x0D; Methods: A total of 106 patients diagnosed with acute cerebral infarction complicated by pulmonary infection were selected for this study, and admitted to The Second Affiliated Hospital of Hainan Medical University, Haikou, China from June 2020 to June 2022. Patients were randomly divided into a control group (which received conventional care and cephalosporin antibiotics, n =53), and a study group managed with sustained nursing and cephalosporin antibiotics (n = 53). The study compared various clinical parameters between two groups before and after intervention, including time of symptom relief for fever, cough, and wet rales, as well as the National Institutes of Health Stroke Scale (NIHSS), FuglMeyer Assessment (FMA), Barthel Index (BI), Self-Perceived Burden Scale (SPBS), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Acute Physiology and Chronic Health Evaluation II (APACHE II) score, and severity of pulmonary infection which was assessed by CURB 65 score.&#x0D; Results: Compared with control group, study group had a significantly shorter clinical symptom relief time after intervention (p &lt; 0.05). After intervention, NIHSS, SPBS, SAS, SDS, APACHE II, and CURB 65 scores in study group were significantly lower, whereas FMA and BI scores were significantly higher before intervention (p &lt; 0.05). &#x0D; Conclusion: Administration of nursing care and cephalosporin antibiotics reduces the time required for symptom relief, and improves neurological function in patients with acute cerebral infarction and pulmonary infections.

High-Dose Methotrexate Containing Induction Chemotherapy Followed By Nivolumab Consolidation in Older (≥ 65) Patients with Previously Untreated Primary CNS Lymphoma

Introduction: High-dose methotrexate (HD-MTX)-containing chemotherapy followed by either autologous stem cell transplant (ASCT) or whole-brain irradiation (WBI) is widely considered the standard for primary CNS lymphoma (PCNSL) treatment. However, many older frail patients with PCNSL are unable to undergo ASCT or WBI due to increased risk of treatment-related toxicity, such as infections and neurotoxicity. Without consolidation, survival outcomes are significantly worse, with a 3-year progression free survival (PFS) rate of ~ 30%. Therefore, novel therapeutic approaches are urgently needed for older PCNSL patients. Recently, nivolumab, an anti-PD1 antibody, showed promising clinical activities in relapsed/refractory PCNSL, and we hypothesized that addition of nivolumab in the frontline setting would be safe and improve survival outcomes of older PCNSL patients who are deemed poor candidates for ASCT or WBI. Methods: In this phase 1/1B single-arm multicenter study, patients ≥ 65, who were deemed poor candidates for ASCT and WBI, with previously untreated PCNSL received at least 3 cycles of HD-MTX-containing chemotherapy followed by nivolumab consolidation for 6 cycles (NCT 04022980). Patients with systemic lymphoma or known ocular involvement were excluded from the study. Stage 1 was designed to evaluate the safety of nivolumab consolidation after HD-MTX-containing induction chemotherapy. A 3+3 design was used as safety run-in, initiating 6 patients on nivolumab at the FDA-approved single-agent dose and monitoring for dose-limiting toxicities (DLTs) during Cycle 1. If less than 2 out of 6 subjects experienced a DLT, then the stage 2 part of study would initiate to evaluate the efficacy of nivolumab consolidation in terms of the 2-year PFS. The patient's neurological function was assessed at baseline and throughout the study follow-up using the Neurologic Assessment in Neuro-Oncology (NANO) scale. Results: A total of 14 patients enrolled in the study between April 2020 and December 2022 at 4 US sites. In 14 evaluable patients who underwent the study treatment, the median age was 72 years (range, 65-79), 71% patients were female, and 35% patients had ECOG score of 2 or 3. Variations of the following regimens were used for induction: 43% R-MPV (rituximab, methotrexate, procarbazine, and vincristine) (43%), 29% MRT (methotrexate, rituximab, and temozolomide), 21% MR (methotrexate and rituximab), and 7% MATRix (methotrexate, cytarabine, thiotepa, and rituximab). After induction, 58% achieved a complete response (CR), 33% achieved a partial response (PR), and 8% had a stable disease (SD). Patients received a median of 6 cycles of nivolumab consolidation. Patients who received at least 1 cycle of nivolumab consolidation achieved an overall response rate of 83% with a CR rate of 75%. With a median follow-up duration of 18 months, the 1-year overall survival (OS) and PFS rates were 91.7% and 66.1%, respectively. No DLTs were observed during Cycle 1 of nivolumab consolidation in Stage 1. The most common grade ≥ 3 Adverse Events (AEs) associated with nivolumab consolidation included neutropenia (14%) and fatigue (7%). One patient (7%) developed a grade 4 Stevens-Johnson syndrome associated with sepsis and acute kidney injury, requiring discontinuation of nivolumab after Cycle 1. Conclusion: The current study demonstrates encouraging safety and clinical outcomes of nivolumab consolidation in older PCNSL patients who are deemed poor candidates for ASCT or WBI. No DLT was observed during the safety run-in phase, and there was no unexpected toxicity associated with nivolumab although 1 patient discontinued the study treatment due to Stevens-Johnson syndrome, a rare but known AE associated with nivolumab, after Cycle 1. Overall, nivolumab consolidation was associated with favorable survival rates in a group of patients with poor-risk PCNSL. We are in the process of identifying various clinical and biological factors, including 9p24.1 copy number alteration, in association with the response to nivolumab consolidation. Furthermore, changes in the neurological function based on the NANO scale assessed before and after the nivolumab consolidation are being analyzed.

Impact of comorbid primary headache on neurological function of patients with multiple sclerosis

Multiple Sclerosis (MS) is a progressive disease affecting the working population. Due to the demyelination process, patients have motor, sensory and cognitive impairments. Often patients with MS complain of headaches. Comorbid primary headache accompanies more than half of patients with MS. The aim of our study was to reveal the relationship between the presence of primary comorbid headache and the progression of MS. For this purpose, the Expanded Disability Status Scale (EDSS), motor testing for 25-Foot Walk Test (25FWT), 9-Hole Peg Test (9HPT) were used. International Classification of Headache - 3 (ICHD-3) scale was used for differential diagnosis of headache types. The obtained data were compared among patients with different types of MS: Relapsing-Remitting (RRMS); primary and secondary progressive, which was combined into Progressive forms of MS (PMS). 130 patients with MS were studied, among whom patients with RRMS prevailed (n=98), primary comorbid headache was found in 56.2% (n=73). Among patients with MS, migraine prevailed (p=0.015), in particular, the most cases were found in patients with RRMS. Among patients with PMS, tension headache prevailed (p&lt;0.05). The 9HPT and 25FWT scores did not differ significantly between the groups with and without primary comorbid headache, however, according to the confidence intervals, the EDSS score exceeded the score in the group of patients with comorbid headache. It was found that patients with comorbid migraine performed the motor test faster than patients with tension type headache. Therefore, it can be concluded that comorbid primary headache may have an impact on motor function indicators among MS patients and requires further investigation to determine the role of comorbid headache in the patterns of initial MS symptoms. Keywords: central nervous system, demyelination, migraine, tension type headache, motor function, comorbidity.

Effect of Tirofiban Combined with Neurointerventional Therapy on Neurological Function of Patients with Acute Cerebral Infarction

Objective: To analyze the effect of tirofiban combined with neurointerventional therapy on neurological function of patients with acute cerebral infarction. Methods: 70 patients with acute cerebral infarction admitted between January 2022 and January 2023 were selected as research objects, and patients were divided into control group (neurological interventional therapy) and experimental group (tirofiban combined with neurointerventional therapy) according to the computerized grouping method. The treatment outcomes of both groups were compared. Results: The efficacy of the treatment in the experimental group was 94.9%, which was significantly higher that of the control group control group at 77.14% (P &lt; 0.05). Before treatment, there was no difference in the National Institutes of Health Stroke Scale and Barthel Index between the control group and the experimental group (P &lt; 0.05); after treatment, the NIHSS score of the experimental group was lower than that of the control group, and the BI score was higher than that of the control group (P &lt; 0.05). Before treatment, there was no difference in the levels of high-sensitivity C-reactive protein (hs-CRP) and neuron-specific enolase (NSE) between the control group and the experimental group (P &lt; 0.05); after treatment, the levels of hs-CRP and NSE in the experimental group were lower than those in the control group (P &lt; 0.05). Before treatment, there was no difference in the levels of carbon monoxide (CO), endothelin (ET), nerve growth factor (NGF), and myelin basic protein (MBP) between the control group and the experimental group (P &lt; 0.05); after treatment, the levels of CO and NGF in the experimental group were higher than those in the control group, and the levels of ET and MBP were lower than those in the control group, with statistical significance (P &lt; 0.05). Conclusion: Tirofiban combined with neurointervention is effective in treating acute cerebral infarction. It can not only control the development of the disease, but also improve the patients’ neurological function and the quality of life.

Analysis of the Efficacy of Neuroendoscopic Hematoma Evacuation in the Treatment of Chronic Subdural Hematoma and its Influence on the Neurological Function of Patients

Objective: To analyze the effect of neuroendoscopic hematoma evacuation on neurological function in patients with chronic subdural hematoma (CSDH). Methods: From September 2019 to September 2022, 113 patients with CSDH were selected and randomly divided into group A for neuroendoscopic hematoma evacuation and group B for soft channel drainage. The differences in neurological function of these two groups were compared. Results: Except for intraoperative blood loss and duration of surgery, all surgical indicators in group A were better than those in group B , P &lt; 0.05. One month after operation, the neurological deficit (CSS) score in group A was lower than that in group B, and the quality of life (SF-36), activities of daily living (ADL) scores were higher than those in group B, with P &lt; 0.05. 7 days after operation, the scores of superoxide dismutase (SOD), malondialdehyde (MDA), glutathione peroxidase (GSH-Px) and other oxidative stress indicators were better than those in group B, P &lt; 0.05; the complication rate in group A was lower than that in group B, with P &lt; 0.05. Conclusion: Neuroendoscopic hematoma evacuation therapy can regulate oxidative stress indicators, improve nerve defects, and improve the outcome of CSDH patients.

Comparison of the clinical efficacy of unilateral and bilateral pedicle screw short-segment fixation and fusion in the treatment of atlantoaxial fracture-dislocation.

Few studies have compared the clinical efficacy of unilateral and bilateral pedicle screw fixation and fusion in treating atlantoaxial fracture-dislocation. To compare the efficacy of unilateral and bilateral fixation and fusion for atlantoaxial fracture-dislocation and to explore the feasibility of the unilateral surgical procedure. Twenty-eight consecutive patients with atlantoaxial fracture-dislocation were included in the study from June 2013 to May 2018. They were divided into a unilateral fixation group and a bilateral fixation group (14 patients in each group with an average age of 43.6 ± 16.3 years and 51.8 ± 15.4 years, respectively). The unilateral group had a unilateral anatomical variation of the pedicle or vertebral artery, or traumatic pedicle destruction. All patients underwent atlantoaxial unilateral or bilateral pedicle screw fixation and fusion. Intraoperative blood loss and operation time were recorded. The visual analog scale (VAS) and Japanese Orthopedic Association (JOA) scoring systems were used to evaluate pre- and postoperative occipital-neck pain and neurological function. X-ray and computerized tomography (CT) were used to assess atlantoaxial stability, the implants' position, and bone graft fusion. All patients were followed up for 39-71 months postoperatively. Intraoperatively, no spinal cord or vertebral artery injury was observed. At the last follow-up, occipital-neck pain and neurological function in the two groups were significantly improved (P< 0.05). The X-ray films and CT showed satisfactory atlantoaxial stability, implant position, and osseous fusion in all the patients at 6 months postoperatively. Unilateral and bilateral pedicle screw fixation and fusion can restore atlantoaxial stability and improve occipital-neck pain and neurological function in patients with atlantoaxial fracture-dislocation. The unilateral surgical procedure can be a supplementary option for patients with unilateral abnormal atlantoaxial lesions.

Prospective, Longitudinal Study of Clinical Outcome and Morphometric Posterior Fossa Changes after Craniocervical Decompression for Symptomatic Chiari I Malformation.

The time course of changes in posterior fossa morphology, quality of life, and neurologic function of patients with Chiari I malformation after craniocervical decompression requires further elaboration. To better understand the pace of these changes, we longitudinally studied patients with Chiari I malformation, with or without syringomyelia, before and after the operation for up to 5 years. Thirty-eight symptomatic adult patients (35 women, 3 men) diagnosed with Chiari I malformation only (n = 15) or Chiari I malformation and syringomyelia (n = 23) and without previous Chiari I malformation surgery were enrolled in a clinical study. Patients underwent outpatient study visits and MR imaging at 7 time points (ie, initial [before the operation], 3 months, 1 year, 2 years, 3 years, 4 years, and 5 years) during 5 years. The surgical procedure for all patients was suboccipital craniectomy, C1 laminectomy, and autologous duraplasty. Morphometric measurements demonstrated an enlargement of the CSF areas posterior to the cerebellar tonsils after the operation, which remained largely stable through the following years. There was a decrease in pain and improved quality of life after the operation, which remained steady during the following years. Reduction in pain and improved quality of life correlated with CSF area morphometrics. Most changes in MR imaging morphometrics and quality of life measures occurred within the first year after the operation. A 1-year follow-up period after Chiari I malformation surgery is usually sufficient for evaluating surgical efficacy and postoperative MR imaging changes.

P11.63.B VALIDATING THE NEUROLOGIC ASSESSMENT IN NEURO-ONCOLOGY (NANO) SCALE IN CLINICAL PRACTICE: A MULTI-CENTER PROSPECTIVE STUDY IN PATIENTS WITH GLIOBLASTOMA

Abstract BACKGROUND The neurologic assessment in neuro-oncology (NANO) scale was developed as a standardized metric to objectively measure neurologic function in patients with brain tumors and complement radiographic assessment in defining overall outcomes. The scale has been incorporated in clinical trials, however, real-world use of the NANO scale to drive clinical decision-making and the predictive value of the NANO scale to determine overall survival remains unclear in glioblastoma. MATERIAL AND METHODS We report on an ongoing multi-center study of prospective NANO score collection to evaluate neurologic function in patients with glioblastoma, seen at Dana-Farber Cancer Institute (DFCI) and Sunnybrook Health Sciences Center (SHSC). Patient demographics, tumor histology, molecular status, treatment history, and progression dates are being captured. NANO score, Karnofsky performance status (KPS) and corticosteroid dose are collected at prespecified time points (prior to start of therapy, and during each subsequent MRI visit). Changes in the NANO score will be correlated to overall survival and subgroup analyses will be performed for specific domains of the NANO scale. Statistical analyses including descriptive data analysis and generalized linear models will be performed using R (version 3.4.3). RESULTS Since June 2020, 145 patients have been enrolled in this study across the two sites including 90 (62%) with ≥2 follow-up visits. 129 patients had baseline post-operative NANOs captured, with 45 (35%) patients having no deficits in any NANO domain at baseline. All patients with intact baseline NANO had a KPS of 80 or above. Adaptation to a virtual platform for NANO (vNANO) allowed for improved recruitment and follow-up of patients. Validation of vNANO is being performed in a subset of this population. Our interim analysis will be presented at the 2023 EANO meeting. CONCLUSION Evaluation of neurologic function by NANO is feasible in both an in-person and virtual framework in a prospective multi-center study in patients with glioblastoma. NANO is able to objectively track neurologic function throughout disease course in glioblastoma. Integration of vNANO may allow for reduced clinical visits and improve access to specialized care for patients in geographically remote locations.

Effects of Remote Ischemic Preconditioning on Delirium and Neurological Function in Patients Undergoing Cardiac Surgery: A Multicenter Randomized Controlled Trial.

Postoperative delirium (POD) and neurological dysfunction are very common following cardiac surgery and deteriorate the patient's prognosis and the outcome of surgical procedures. A clinically effective management strategy or drug is not yet available for POD. Additionally, it is unknown whether remote ischemic preconditioning (RIPC) has neuroprotective and anti-delirium benefits in patients who undergo cardiac surgery. This study examined whether RIPC can improve POD and neurological function in cardiac surgery patients. We screened 510 consecutive adult patients aged 18 and older who underwent cardiac surgery between January 2018 and December 2022. Then, 448 of these patients were recruited in the trial as the intention to treat (ITT) group, who were then randomly assigned to receive either a control (n = 223) or RIPC treatment (n = 225). The primary outcome measures were hospitalization postoperative delirium, six-month modified Rankins scale (mRS), hospital cerebral infarction, 30-day overall mortality, neuron-specific enolase (NSE) and S-100b levels, related adverse effects, hospital costs, and hospital stay. A statistically significant variation was not observed between the two groups in terms of the baseline clinical data. In contrast to the control group, the POD in the RIPC group was considerably alleviated. RIPC treatment also decreased the levels of NSE and S-100b, which alleviated nerve injury. The adverse impacts of RIPC-induced objective indicators of tissue or neurovascular damage were similar in both groups, showing no significant variations between the two. The hospital stays and hospitalization costs also decreased significantly in the RIPC-treated patients. The study findings suggested that RIPC may benefit cardiac surgery patients by reducing POD, alleviating injury, and lowering hospital expenditures and length of stay. Cardiac surgery patients can be treated with RIPC, which is an effective and safe technique.

The effect of butylphthalide on improving the neurological function of patients with acute anterior circulation cerebral infarction after mechanical thrombectomy.

Butylphthalide can improve blood circulation in patients with acute cerebral infarction. Complement 3a receptor 1 (C3aR1) is involved in the regulation of innate immune response and pathogen monitoring, which is closely related to the pathophysiological processes of breast cancer, neurogenesis and lipid catabolism. Our study explored the therapeutic effect of butylphthalide on improving the neurological function of patients with acute anterior circulation cerebral infarction after mechanical thrombectomy, and evaluated the correlation between serum C3aR1 and butylphthalide on improving the neurological function after mechanical thrombectomy. 288 patients with acute anterior circulation cerebral infarction who were admitted to our hospital from January 2019 to November 2022 and were treated with mechanical thrombectomy for the first time were included in this retrospective study and divided into the butylphthalide group and control group that they received treatment methods. The National Institutes of Health Stroke Scale (NIHSS) scale was used to evaluate the patient neurological function treatment efficacy, and the modified Rankin Scale (mRS) scale was used to measure the patient neurological function status 3 months after surgery. Enzyme-linked immunosorbent assay method was used to determine the content of C3aR1 in serum. Two weeks after thrombus removal, the NIHSS efficacy of the butylphthalide group and the control group were 94.44% and 72.22%, respectively. The butylphthalide group was significantly higher than the control group (P < .001). Three months after the operation, the mRS score of the butylphthalide group was significantly lower than that of the control group (P = .001), and the excellent and good rate was significantly higher than that of the control group (P < .001). The serum C3aR1 level of the butylphthalide group was significantly lower than that of the control group 2 weeks after operation and 3 months after operation (P < .001). The serum C3aR1 was positively correlated with the efficacy of NIHSS (R = 0.815, P = .004), which was positively correlated with mRS score (R = 0.774, P = .007). Butylphthalide can improve the therapeutic effect of neurological function in patients with acute anterior circulation cerebral infarction after mechanical thrombus removal. The patient serum C3aR1 is related to the patient neurotherapy efficacy and neurological function status, and its level can reflect the patient neurological function recovery to a certain extent.

The Objective Dementia Severity Scale Based on MRI with Contrastive Learning: A Whole Brain Neuroimaging Perspective.

In the clinical treatment of Alzheimer's disease, one of the most important tasks is evaluating its severity for diagnosis and therapy. However, traditional testing methods are deficient, such as their susceptibility to subjective factors, incomplete evaluation, low accuracy, or insufficient granularity, resulting in unreliable evaluation scores. To address these issues, we propose an objective dementia severity scale based on MRI (ODSS-MRI) using contrastive learning to automatically evaluate the neurological function of patients. The approach utilizes a deep learning framework and a contrastive learning strategy to mine relevant information from structural magnetic resonance images to obtain the patient's neurological function level score. Given that the model is driven by the patient's whole brain imaging data, but without any possible biased manual intervention or instruction from the physician or patient, it provides a comprehensive and objective evaluation of the patient's neurological function. We conducted experiments on the Alzheimer's disease Neuroimaging Initiative (ADNI) dataset, and the results showed that the proposed ODSS-MRI was correlated with the stages of AD 88.55% better than all existing methods. This demonstrates its efficacy to describe the neurological function changes of patients during AD progression. It also outperformed traditional psychiatric rating scales in discriminating different stages of AD, which is indicative of its superiority for neurological function evaluation.

MLC901 in hypoxic-ischemic brain injury patients: A double-blind, randomized placebo-controlled pilot study.

Hypoxic-ischemic brain injury (HIBI) is a disabling consequence of cardiopulmonary resuscitation, which has no direct treatment except supportive care. Many studies have used pharmacological agents to reduce or stop this disability. MLC901 is a traditional Chinese medicine showing neuroprotective and regenerative effects on focal and global ischemia in previous animal and human studies. We designed an experimental, randomized, double-blind, placebo-controlled study to analyze MLC901 efficacy in HIBI patients. In a randomized, placebo-controlled trial, 35 patients with HIBI were randomly designated to receive either MLC901 or placebo capsules 3 times per day over 6 months. We assessed the 2 groups by modified Rankin Scale and Glasgow Outcome Scale at baseline, and follow-up visits in 3rd month, and 6th-month after injury. Thirty-one patients completed this study. There was no significant difference in baseline characteristics between the 2 groups as regards age, gender, time of resuscitation, the interval between injury and start of the intervention, and the length of intensive care unit stay. Both the placebo and intervention groups improved during the investigation. However, the Glasgow Outcome Scale and modified Rankin Scale scales were significantly improved in the MLC901 group compared to the placebo after 6 months (P < .05) with close to no adverse effects. No major side effect was reported. MLC901 has shown, compared to placebo, a statistically better improvement at 6 months in neurological functions of patients with HIBI.

ID: 218088 10 kHz Spinal Cord Stimulation Durably Improves Foot Sensation in Patients With Painful Diabetic Neuropathy

Approximately 20% of persons with diabetes will develop neuropathic or neurological symptoms, including loss of protective sensation. In a large prospective, randomized controlled trial, we assessed neurological function in patients with painful diabetic neuropathy (PDN) in response to 10 kHz spinal cord stimulation (SCS) [1,2]. In that study, we demonstrated that 10kHzSCS significantly improves innocuous and noxious sensory responses after 3 months. Here, we assessed the long-term durability of these improvements over 24 months of continuous 10kHzSCS.

ID: 218017 10kHz Spinal Cord Stimulation Significantly Improves Foot Sensory Function in Patients With Painful Diabetic Neuropathy

Approximately 20% of persons with diabetes will develop neuropathic or neurological symptoms, including loss of protective sensation. In a large prospective randomized controlled trial, we assessed neurological function in patients with painful diabetic neuropathy (PDN) in response to 10 kHz spinal cord stimulation (SCS) [1,2].

Nurses' Knowledge Regarding Glasgow Coma Scale at Tertiary Care Hospital Karachi, Pakistan

The "Glasgow Coma Scale" (GCS) is a neurological scale used to assess the level of consciousness in patients with brain injuries. GCS measures three aspects of a patient's neurological function: eye-opening, verbal response, and motor response. Each category is assigned a score from 1 to 4 or 1 to 5, depending on the response observed, with a total possible score of 15. Objective: To assess the nurses' knowledge regarding Glasgow Coma Scale at tertiary care hospital in Karachi, Pakistan. Methods: This Quantitative, descriptive Cross-Sectional study was conducted at the tertiary care Hospital of Karachi, Pakistan, from September to December 2022. A total of 50 nurses were recruited through purposive sampling from the hospital's different departments, emergency departments, Neurology, and ICUs. Moreover, those nurses who had three months of experience were included in the study. The data were collected through a valid and reliable tool that was self-administered. Results: This study's findings revealed that Male participants were 64% and females 36%. Furthermore, findings show that 06% of participants had a low level of knowledge,72% had a moderate level of knowledge, and 22% had a high level of knowledge regarding GCS. Conclusions: Overall, these findings highlight the importance of continued education and training on GCS for healthcare professionals and the general public to ensure better outcomes for individuals who experience traumatic brain injuries.