Effectiveness and Influencing Factors of Comprehensive Rehabilitation Therapy in Patients with Aneurysmal Subarachnoid Hemorrhage

This study aimed to determine the effectiveness of comprehensive rehabilitation for patients with aneurysmal subarachnoid hemorrhage (aSAH) and to explore the factors influencing the prognosis of rehabilitation. This was a retrospective study. Twenty-five patients with aSAH were treated with physical therapy, occupational therapy, speech therapy, cognitive therapy, music therapy, Chinese acupuncture, hyperbaric oxygen, and transcranial magnetic stimulation. The general data of all patients were collected, and the functional scores at admission were compared with those at discharge. The Mini Mental State Examination, Fugl-Meyer Assessment Scale (FMAS) for motor and balance assessment, Holden Functional Ambulation Classification (FAC), modified Rankin Scale, National Institute of Health Stroke Scale, Modified Barthel Index for activities of daily living (ADL), and Glasgow Outcome Scale were significantly improved among 25 patients with aSAH after 1 month of comprehensive rehabilitation training. Hydrocephalus was an independent factor of the ability to perform ADLs (odds ratio, 0.29;95% confidence interval, 2.03. 3.15;p = 0.000). The improvement of ADLs in aSAH patients was not related to sex, surgical method, aneurysm location, age, or smoking status. Comprehensive and professional rehabilitation is effective for the cognition, movement, walking, ADLs, and functional prognosis of patients with aSAH, while early hydrocephalus may be a risk factor for poor ADLs.

Effects of Comprehensive Rehabilitation on Patients with Progressive Multifocal Leukoencephalopathy Due to Systemic Lupus Erythematosus: A Case Report

Introduction: Little is known about the feasibility and effectiveness of rehabilitative treatment for systemic lupus erythematosus (SLE) in individuals with progressive multifocal leukoencephalopathy (PML). We describe a patient with SLE complicated by PML and ameliorated by comprehensive rehabilitation. We also review the epidemiology, pathology, imaging characteristics, and treatment of PML. Patient Concerns: We found a patient with SLE with PML improved by multidisciplinary rehabilitation techniques. Diagnoses, Interventions, and Outcomes: We diagnosed a PML with a 13-year history of SLE and lupus nephritis after longtime immunosuppressive therapy. The patient underwent a comprehensive, multifaceted rehabilitation program, including drug therapy, integrated physical therapy, occupational therapy, acupuncture, music therapy, computer-aided cognitive rehabilitation training, and behavioral management training. This rehabilitation program improved her motor function and activities of daily living. Conclusions: Her condition improved in the short term through comprehensive rehabilitation, including physical, speech, and cognitive therapy. Therefore, we recommend comprehensive rehabilitation to improve the function and activities of daily living in patients with PML.

Supersaturation-driven self-assembly formation of ceftriaxone sodium spherulites:From amorphous form to spherulites

Drug particles with spherical morphology possess amazing advantages in terms of particle flowability,mechanical properties,drug solubility,and bioavailability.The growth mechanism of drug spherulite is of great importance for the preparation and regulation of spherulites.Herein,ceftriaxone sodium spherulites were fabricated by the antisolvent crystallization method using dropwise addition of ceftriaxone sodium solution to acetone.Online observation of the whole crystallization process combined with electron microscopy technique revealed the spherical growth process from amorphous form to spherulites.As the supersaturation of the crystallization system was adjusted,the ceftriaxone sodium crystals transformed from amorphous form to spherulites.In the process of antisolvent crystallization with acetone as antisolvent,when the theoretical supersaturation degree S was higher than 2.62,the crystallization system tended to appear amorphous form;when S was between 2.57 and 2.62,the amorphous form transformed into clustered spherulites;when S was less than 2.57,the surface of spherulites will be covered with flaky crystal,which transformed into urchin-like type.With the understanding of the spherical growth mechanism,the ceftriaxone sodium spherulites prepared in this research with modified supersaturation control had a low residue of antisolvent acetone,and the flowability was significantly improved.

Glycyrrhetinic acid binds to the conserved P-loop region and interferes with the interaction of RAS-effector proteins

Members of the RAS proto-oncogene superfamily are indispensable molecular switches that play critical roles in cell proliferation, differentiation, and cell survival. Recent studies have attempted to prevent the interaction of RAS/GTP with RAS guanine nucleotide exchange factors(GEFs), impair RASeffector interactions, and suppress RAS localization to prevent oncogenic signalling. The present study aimed to investigate the effect of the natural triterpenoic acid inhibitor glycyrrhetinic acid, which is isolated from the roots of Glycyrrhiza plant species, on RAS stability. We found that glycyrrhetinic acid may bind to the P-loop of RAS and alter its stability. Based on our biochemical tests and structural analysis results, glycyrrhetinic acid induced a conformational change in RAS. Meanwhile, glycyrrhetinic acid abolishes the function of RAS by interfering with the effector protein RAF kinase activation and RAS/MAPK signalling.