We study afresh how the glucose control system anomalies impact the organicity of the glucose homeostasis and build up events of persistent hyperglycemia and diabetes mellitus. We have used critically the state of art...We study afresh how the glucose control system anomalies impact the organicity of the glucose homeostasis and build up events of persistent hyperglycemia and diabetes mellitus. We have used critically the state of art literature related to the subject, in order to cross, to compare, and to organize the relevant contents to create a logical and consistent support to the finds. We show that it is consistent to assume that persistent hyperglycemia and diabetes mellitus can have precursors not only in pancreas, but also in brain, mainly induced by noxious dysfunctions of hypothalamus sensor neurons circuits and external noxious elements, causing pancreas overload, and the consequent exhaustion—overburden.展开更多
Objective To investigate the role of decompressive craniectomy (DC) to decrease intractable intracranial hypertension(ICH) due to diffuse brain swelling and / or cerebral edema after severe traumatic brain injury and ...Objective To investigate the role of decompressive craniectomy (DC) to decrease intractable intracranial hypertension(ICH) due to diffuse brain swelling and / or cerebral edema after severe traumatic brain injury and the time window of DC to affect on prognosis. Methods The clinical record of 132 patients who underwent DC for posttraumatic intractable ICH in our hospital from July 2003 to展开更多
Concussion,or mild traumatic brain injury,incidence rates have reached epidemic levels and impaired postural control is a cardinal symptom.The purpose of this review is to provide an overview of the linear and non-lin...Concussion,or mild traumatic brain injury,incidence rates have reached epidemic levels and impaired postural control is a cardinal symptom.The purpose of this review is to provide an overview of the linear and non-linear assessments of post-concussion postural control.The current acute evaluation for concussion utilizes the subjective balance error scoring system(BESS) to assess postural control.While the sensitivity of the overall test battery is high,the sensitivity of the BESS is unacceptably low and,with repeat administration,is unable to accurately identify recovery.Sophisticated measures of postural control,utilizing traditional linear assessments,have identified impairments in postural control well beyond BESS recovery.Both assessments of quiet stance and gait have identified lingering impairments for at least 1 month post-concussion.Recently,the application of non-linear metrics to concussion recovery have begun to receive limited attention with the most commonly utilized metric being approximate entropy(Ap En).Ap En,most commonly in the medial-lateral plane,has successfully identified impaired postural control in the acute post-concussion timeframe even when linear assessments of instrumented measures are equivalent to healthy pre-injury values;unfortunately these studies have not gone beyond the acute phase of recovery.One study has identified lingering deficits in postural control,utilizing Shannon and Renyi entropy metrics,which persist at least through clinical recovery and return to participation.Finally,limited evidence from two studies suggest that individuals with a previous history of a single concussion,even months or years prior,may display altered Ap En metrics.Overall,non-linear metrics provide a fertile area for future study to further the understanding of postural control impairments acutely post-concussion and address the current challenge of sensitive identification of recovery.展开更多
Objective:To systematically evaluate the intervention effect of virtual reality technology on patients recovering from traumatic brain injury.Methods:The computer retrieved CNKI,VIP,Wan Fang,Embase,The Cochrane Librar...Objective:To systematically evaluate the intervention effect of virtual reality technology on patients recovering from traumatic brain injury.Methods:The computer retrieved CNKI,VIP,Wan Fang,Embase,The Cochrane Library and PubMed database,and collected randomized controlled trials of virtual reality technology combined with routine rehabilitation training and simple routine rehabilitation training on patients recovering from traumatic brain injury.The retrieval period was from the establishment of the database to July 2019.Two researchers independently screened the literature,extracted the data and evaluated the risk of bias in the included studies.RevMan 5.3 software was used for analysis.Results:A total of 7 articles were included.Meta-analysis results showed that virtual reality technology could significantly improve balance function(mean difference(MD)=3.72,95%confidence interval(CI)(2.61,4.83),P<0.001),daily living ability(MD=11.87,95%CI(10.42,13.32),P<0.001),and exercise ability(MD=3.83,95%CI(2.30,5.36),P<0.001).In the aspect of posture control ability,the trajectory motion length,trajectory velocity and peripheral area were improved(standardised mean difference(SMD)=0.80,95%CI(1.19,0.41),P<0.0001),(SMD=0.95,95%CI(1.45,0.45),P=0.0002),(SMD=0.69,95%CI(1.11,0.26),P=0.001).Conclusion:Virtual reality technology can significantly improve the balance function,daily living ability,motor function and postural control ability of patients recovering from cerebral trauma.Limited by the quantity and quality of the included studies,the above conclusions need to be verified by more high-quality studies.展开更多
Many newly emerging and re-emerging viruses have neuroinvasive potential,underscoring viral encephalitis as a global research priority.Upon entry of the virus into the CNS,severe neurological life-threatening conditio...Many newly emerging and re-emerging viruses have neuroinvasive potential,underscoring viral encephalitis as a global research priority.Upon entry of the virus into the CNS,severe neurological life-threatening conditions may manifest that are associated with high morbidity and mortality.The currently available therapeutic arsenal against viral encephalitis is rather limited,emphasizing the need to better understand the conditions of local antiviral immunity within the infected CNS.In this review,we discuss new insights into the pathophysiology of viral encephalitis,with a focus on myeloid cells and CD8^(+)T cells,which critically contribute to protection against viral CNS infection.By illuminating the prerequisites of myeloid and T cell activation,discussing new discoveries regarding their transcriptional signatures,and dissecting the mechanisms of their recruitment to sites of viral replication within the CNS,we aim to further delineate the complexity of antiviral responses within the infected CNS.Moreover,we summarize the current knowledge in the field of virus infection and neurodegeneration and discuss the potential links of some neurotropic viruses with certain pathological hallmarks observed in neurodegeneration.展开更多
目的:以脑功能磁共振成像(functional magnetic resonance imaging,fMRI)为观察指标,系统评价针灸治疗缺血性脑卒中(ischemic stroke,IS)的疗效。方法:计算机全面检索国内外期刊数据库,查找以fMRI成像为观察指标的针灸治疗IS随机对照实...目的:以脑功能磁共振成像(functional magnetic resonance imaging,fMRI)为观察指标,系统评价针灸治疗缺血性脑卒中(ischemic stroke,IS)的疗效。方法:计算机全面检索国内外期刊数据库,查找以fMRI成像为观察指标的针灸治疗IS随机对照实验(RCT),并追索纳入文献的参考文献,时间范围为建库日至2020年1月31日。由2名研究者根据纳入和排除标准分别独立筛选文献、提取资料,并通过Cochrane系统的偏移风险评估工具对纳入的研究进行方法学质量评价,再通过RevMan 5.2软件进行Meta分析。结果:最终纳入18篇RCT,共631例患者。18项研究均以fMRI成像作为观察指标,但因临床异质性过大,仅作描述性评价,结果显示针灸可引起缺血性脑卒中患者脑灰质结构改变、脑区局部一致性(ReHo)增高、脑区激活及脑区功能连接强度变化。次要结局指标Meta分析结果显示,针灸治疗IS临床疗效优于非针灸组,并可有效提高IS患者的Barthel指数及Fugl-Meyer肢体运动功能评分,可降低患者神经功能缺损评分。结论:目前证据显示,针灸治疗IS疗效显著,且可刺激脑区神经细胞生物活性,从而发生神经元活动改变,引起脑网络结构重组或脑区功能连接强度变化,使得受损神经功能可逆性恢复,或为针灸改善机体运动和认知功能的潜在治疗靶点和作用机制。展开更多
文摘We study afresh how the glucose control system anomalies impact the organicity of the glucose homeostasis and build up events of persistent hyperglycemia and diabetes mellitus. We have used critically the state of art literature related to the subject, in order to cross, to compare, and to organize the relevant contents to create a logical and consistent support to the finds. We show that it is consistent to assume that persistent hyperglycemia and diabetes mellitus can have precursors not only in pancreas, but also in brain, mainly induced by noxious dysfunctions of hypothalamus sensor neurons circuits and external noxious elements, causing pancreas overload, and the consequent exhaustion—overburden.
文摘Objective To investigate the role of decompressive craniectomy (DC) to decrease intractable intracranial hypertension(ICH) due to diffuse brain swelling and / or cerebral edema after severe traumatic brain injury and the time window of DC to affect on prognosis. Methods The clinical record of 132 patients who underwent DC for posttraumatic intractable ICH in our hospital from July 2003 to
文摘Concussion,or mild traumatic brain injury,incidence rates have reached epidemic levels and impaired postural control is a cardinal symptom.The purpose of this review is to provide an overview of the linear and non-linear assessments of post-concussion postural control.The current acute evaluation for concussion utilizes the subjective balance error scoring system(BESS) to assess postural control.While the sensitivity of the overall test battery is high,the sensitivity of the BESS is unacceptably low and,with repeat administration,is unable to accurately identify recovery.Sophisticated measures of postural control,utilizing traditional linear assessments,have identified impairments in postural control well beyond BESS recovery.Both assessments of quiet stance and gait have identified lingering impairments for at least 1 month post-concussion.Recently,the application of non-linear metrics to concussion recovery have begun to receive limited attention with the most commonly utilized metric being approximate entropy(Ap En).Ap En,most commonly in the medial-lateral plane,has successfully identified impaired postural control in the acute post-concussion timeframe even when linear assessments of instrumented measures are equivalent to healthy pre-injury values;unfortunately these studies have not gone beyond the acute phase of recovery.One study has identified lingering deficits in postural control,utilizing Shannon and Renyi entropy metrics,which persist at least through clinical recovery and return to participation.Finally,limited evidence from two studies suggest that individuals with a previous history of a single concussion,even months or years prior,may display altered Ap En metrics.Overall,non-linear metrics provide a fertile area for future study to further the understanding of postural control impairments acutely post-concussion and address the current challenge of sensitive identification of recovery.
文摘Objective:To systematically evaluate the intervention effect of virtual reality technology on patients recovering from traumatic brain injury.Methods:The computer retrieved CNKI,VIP,Wan Fang,Embase,The Cochrane Library and PubMed database,and collected randomized controlled trials of virtual reality technology combined with routine rehabilitation training and simple routine rehabilitation training on patients recovering from traumatic brain injury.The retrieval period was from the establishment of the database to July 2019.Two researchers independently screened the literature,extracted the data and evaluated the risk of bias in the included studies.RevMan 5.3 software was used for analysis.Results:A total of 7 articles were included.Meta-analysis results showed that virtual reality technology could significantly improve balance function(mean difference(MD)=3.72,95%confidence interval(CI)(2.61,4.83),P<0.001),daily living ability(MD=11.87,95%CI(10.42,13.32),P<0.001),and exercise ability(MD=3.83,95%CI(2.30,5.36),P<0.001).In the aspect of posture control ability,the trajectory motion length,trajectory velocity and peripheral area were improved(standardised mean difference(SMD)=0.80,95%CI(1.19,0.41),P<0.0001),(SMD=0.95,95%CI(1.45,0.45),P=0.0002),(SMD=0.69,95%CI(1.11,0.26),P=0.001).Conclusion:Virtual reality technology can significantly improve the balance function,daily living ability,motor function and postural control ability of patients recovering from cerebral trauma.Limited by the quantity and quality of the included studies,the above conclusions need to be verified by more high-quality studies.
基金supported by funding from the Deutsche Forschungsgemeinschaft(DFGGerman Research Foundation)—398066876/GRK 2485/1 to UK,the DFG under Germany’s Excellence Strategy—EXC 2155“RESIST”—Project ID 39087428 to UKby the Helmholtz Association(Zukunftsthema“Immunology&Inflammation”(ZT-0027))to UK.Figures were created using Biorender.com.We thank Elisabeth Janecek-Erfurth for her help with the submission of the manuscript.
文摘Many newly emerging and re-emerging viruses have neuroinvasive potential,underscoring viral encephalitis as a global research priority.Upon entry of the virus into the CNS,severe neurological life-threatening conditions may manifest that are associated with high morbidity and mortality.The currently available therapeutic arsenal against viral encephalitis is rather limited,emphasizing the need to better understand the conditions of local antiviral immunity within the infected CNS.In this review,we discuss new insights into the pathophysiology of viral encephalitis,with a focus on myeloid cells and CD8^(+)T cells,which critically contribute to protection against viral CNS infection.By illuminating the prerequisites of myeloid and T cell activation,discussing new discoveries regarding their transcriptional signatures,and dissecting the mechanisms of their recruitment to sites of viral replication within the CNS,we aim to further delineate the complexity of antiviral responses within the infected CNS.Moreover,we summarize the current knowledge in the field of virus infection and neurodegeneration and discuss the potential links of some neurotropic viruses with certain pathological hallmarks observed in neurodegeneration.
