Research Progress on Brain-Derived Neurotrophic Factor (BDNF) in the Sequelae of Stroke

The research progress of brain-derived neurotrophic factor (BDNF) in the treatment of sequelae of stroke is an important topic. Stroke is among the diseases with the highest mortality and disability rates among the elderly in China. BDNF plays an important role in the development and functional maintenance of the nervous system. In recent years, the application value of BDNF in rehabilitation therapy has gradually received attention. This study has adopted a systematic literature review method, searched Chinese and English databases, screened relevant studies, and conducted data extraction and quality evaluation. This review systematically introduced the research progress of BDNF in the correlation with post-stroke sequelae, with special attention to its application in post-stroke depression, motor dysfunction, and cognitive dysfunction. The results showed that a decrease in BDNF levels is closely related to the exacerbation of depressive symptoms, limited recovery of motor dysfunction, and the occurrence of cognitive dysfunction. BDNF, as a key neurobiological factor, has shown significant potential in the rehabilitation treatment of stroke. By exploring the potential of BDNF as a therapeutic target to prevent and treat sequelae of ischemic stroke, the current research bottlenecks, and the development trends of future treatment strategies.

Application of Chinese Medicine Nursing Techniques in the Sequelae of Pelvic Inflammatory Diseases: A Review

Sequelae of Pelvic Inflammatory Diseases (SPID) is a common and frequent disease in gynecology, which adversely affects women’s reproductive health and quality of life due to its prolonged course. In recent years, traditional Chinese medicine (TCM) in China has gradually shown its clinical advantages in the treatment of SPID. Therefore, the present review summarizes the etiology and pathogenesis of SPID, the evidence typology, and the clinical application effects of moxibustion, herbal retention enema, acupoint compresses, external application of traditional Chinese medicine, auricular pressure beans, tuina massage, traditional Chinese medicine gongfu, and other commonly used Chinese medicine nursing techniques, with the aim of providing references and experiences for the subsequent related studies.

Total hip arthroplasty for sequelae of childhood hip disorders:Current review of management to achieve hip centre restoration

Adults requiring total hip arthroplasty(THA)for childhood disorder sequelae present with shortening,limp,pain,and altered gait.THA,which can be particularly challenging due to altered anatomy,requires careful planning,assessment,and computed tomography evaluation.Preoperative templating is essential to establish the appropriate acetabular and femoral size.Information regarding neck length and offset is needed to ensure the proper options are available at THA.Hip centre restoration must be planned preoperatively and achieved intraoperatively with appropriate exposure,identification,and stable fixation with optimum-size components.Identifying the actual acetabular floor is essential as changes include altered anatomy,distortion of the margins and version changes.Proximal femur changes include anatomical variation,decreased canal diameter,cortical thickness,changes in anteversion,and metaphyseal and diaphyseal mismatch.Preoperative assessment should consist of limb assessment for variations due to prior surgical procedures.Evaluation of the shortening pattern with the relationship of the lesser trochanter to the teardrop would help identify and plan for subtrochanteric shortening osteotomy,especially in high-riding hips.The surgical approach must ensure adequate exposure and soft tissue release to achieve restoration of the anatomical hip centre.The femoral components may require modularity to enable restoration of anteversion and optimum fixation.

Treatment and Sequelae of Panfacial Fractures in the Maxillofacial Surgery and Stomatology Department of the Hospital University of Treichville-Abidjan (Cote d’Ivoire)

Introduction: The treatment of panfacial fractures is complex and constitutes a challenge for the maxillofacial surgeon, who, despite therapeutic progress, frequently suffers functional and aesthetic sequelae. This study aimed to describe the treatment and evaluate the functional and aesthetic sequelae of panfacial fractures in the stomatology and maxillofacial surgery department of the Treichville University Hospital. Materials and Methods: We conducted a retrospective study over a 6 years in the stomatology and maxillofacial surgery department of Treichville University Hospital. Forty-two patients with panfacial fractures were included in the study. Results: Forty-two patients were registered. The average time to osteosynthesis was 12.4 days. Nasotracheal intubation was used most often (88%), and in the majority of cases, mixed osteosynthesis combining a screwed plate and steel wire was performed (64.29%). The “Bottom-up and Outside-in” surgical sequence was the most commonly used (64.29%). All patients had at least one functional and/or cosmetic sequela after treatment. Functional sequelae were dominated by occlusal problems and aesthetic sequelae by nasal deformities. Discussion: Panfacial fractures are characterised by their complexity, presenting maxillo-facial surgeons with a therapeutic and evolutionary challenge. The quality of the initial, often multidisciplinary, management of panfacial fractures is an essential factor in both functional and aesthetic prognosis. Conclusion: The treatment of panfacial fractures, even if well managed, is sometimes a source of sequelae, requiring often complex secondary management.

Perspectives on multidimensional assessment of post-stroke sequelae: fromclinimetrics to holism

In this work,we intended to connect clinimetrics with holism in traditional Chinese medicine towards multidimensional assessment of post-stroke sequelae in real-world setting,as a bridge between inheritance and innovation.Firstly,a systematic search of current evidence that supported integrated treatment of traditional Chinese and Western medicine for post-stroke sequelae sufferers was performed.Secondly,on the basis of available evidence,we presented couples of implications.Lastly,as psychosomatic perspective is one of the main academic paradigms of traditional Chinese medicine holism,we chiefly proposed comprehensive assessment for both motor and non-motor severities to probably match consonance with traditional Chinese medicine practice that treats psycho-/somatic-complains simultaneously.

Effect of Danzhi decoction on expression of angiogenesis factors in patients with sequelae of pelvic inflammatory disease

Objective:To investigate the efteets of traditional Chinese medicine.Danzhi decoction,on the expression angiogenesis factors in human endometrial cells during the sequelae of pelvic inflammatoty disease(SPID) and explore the role of Danzhi decction in improving the blood stasis microenvironment of SPID.Methods:A three-dimensional(3D) co—culture system including human vascular endothelial cells(VECs),endometrial stromal cells and glandular epithelial cells was established in vitro and treated with Danzhi decoction,sterilized water and aspirin respectively.A Milliplex multifunctional liquid chip technique was used to measure the expression levels of vascular endothelial growth factor(VEGF)—A/C/D,fibroblast growth factor-1/2.angiopoietin-2.epidermal growth factor(EGF) HB-EGF,bone morphogenetic protein-9.endoglin.endothehn-l.granulocyte colony stimulating factor,hepatocyte growth factor,interleukin-8,follistatin.placenta growth factor and leptin.The location of angiogenesis factors was monitored by immunofluorescence labeling and confocal laser scanning microscope3 D reconstruction.Results:Endometrial stromal cells and glandular epithelial cells were isolated and primary cultured for establishing a 3D co-culture system.The levels of VEGF—A/C/D in Danzhi decoction group and aspirin group were significantly lower than those in mock group(P<0.05).while there was no significant difference between Danzhi decoction group and aspirin group(P>0.05).Furthermore,the alterative location of VEGF—A/C/D was observed in the cytoplasm of endometrial glandular epithelial cells.Conclusions:Danzhi decoction mav inhibit the expression of VEGF in the blood stasis microenvironment of SPID by targeting the cytoplasm of endometrial glandular epithelial cell.

Risk factors causing structural sequelae after anastomotic leakage in mid to low rectal cancer

AIM: To investigate the risk factors causing structural sequelae after anastomotic leakage in patients with mid to low rectal cancer.METHODS: Prospectively collected data of consecutive subjects who had anastomotic leakage after surgical resection for rectal cancer from March 2006 to May 2013 at Korea University Anam Hospital were retrospectively analyzed. Two subgroup analyses were performed. The patients were initially divided into the sequelae(stricture, fistula, or sinus) and no sequelae groups and then divided into the permanent stoma(PS)and no PS groups. Univariate and multivariate analyses were performed to identify the risk factors of structural sequelae after anastomotic leakage.RESULTS: Structural sequelae after anastomotic leakage were identified in 29 patients(39.7%).Multivariate analysis revealed that diversion ileostomy at the first operation increases the risk of structural sequelae [odds ratio(OR) = 6.741; P = 0.017].Fourteen patients(17.7%) had permanent stoma during the follow-up period(median, 37 mo). Multivariate analysis showed that the tumor level from the dentate line was associated with the risk of permanent stoma(OR = 0.751; P = 0.045).CONCLUSION: Diversion ileostomy at the first operation increased the risk of structural sequelae of the anastomosis, while lower tumor location was associated with the risk of permanent stoma in the management of anastomotic leakage.

Acute carbon monoxide poisoning and delayed neurological sequelae: a potential neuroprotection bundle therapy

Currently, there is no known optimal therapy for carbon monoxide （CO） poisoning and CO-associated delayed neu- rological sequelae. Hyperbaric oxygen therapy （HBOT） is a well-known treatment method, but its use for CO poison- ing patients is controversial to use due to lack of evidences regarding its efficacy. Thus, it is unlikely that HBOT alone will be accepted as the standard treatment method. In this article, current and potential treatment methods of CO poi- soning are presented as well as the tentative multi-factorial pathophysiology. A series of treatments are suggested for use as a bundle therapy, with targeted temperature management as the base treatment method. Such a therapy holds a great potential, especially for the cases where HBOT is not readily available. We suggest further investigations for elucidating the effects of these suggested treatments and their roles in terms of the complex pathophysiology of CO poisoning. Future ac- ceptance of this therapy based on the improved scientific and clinical knowledge may result in injury prevention and mini- mization of the signs and the symptoms in CO poisoning.

Psychiatric sequelae in COVID-19 survivors:A narrative review

In December 2019,a novel coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)was initially reported in Wuhan,China.Previous epidemics including SARS and middle east respiratory syndrome raises concern that COVID-19 infection may pose a significant threat to the mental health of affected individuals.Studies and reviews have shown the acute psychiatric manifestations in COVID-19 patients,although long term psychiatric sequelae are predicted,there are only few review studies about the long term psychiatry outcome in COVID-19 survivors.Clinically significant posttraumatic stress disorder,anxiety,and/or depression among COVID-19 survivors during 14-90 d were observed following the diagnosis.Risk of anxiety or depression were higher in patients with more severe illness at 6 mo follow-up,early convalescence,and at 1 mo follow-up.Diagnosis of COVID-19 Led to more first diagnoses and relapses of psychiatric illness during the first 14-90 d after COVID-19 diagnosis.The possible underlying mechanisms of psychiatric sequelae in COVID-19 infection are neurotropism,immune response to SARS-CoV-2,hypothalamo-pituitary-adrenal axis hyperactivity,disrupted neuronal circuits in several brain regions,increased stress levels,neuroinflammation,and neuronal death.This study will review the psychiatric sequelae in previous coronavirus pandemics,current studies,risk factors,and thorough explanation on pathophysiology of the psychiatric sequalae in COVID-19 survivors.

COMBINED TREATMENT OF 54 CASES OF APOPLECTIC SEQUELAE WITH ACUPUNCTURE AND CHINESE MEDICINAL HERBS

In the present paper, 54 cases of apoplectic sequelae were treated with acupuncture plus Chinese medicinal herbs. Acupoints used were scalp point Motor Area (MS 6), points of body acupuncture: Jianyu(LI 15) and Shousanli(LI 10) for paralysis of the upper limb; Zusanli (ST 36)and Xuanzhong (GB 39) for paralysis of the lower limb, combined with other points based on syndromes. Chinese medicinal herbs for reinforcing qi, promoting blood circulation, relieving muscular spasm and dredging meridians were used. Patients of the control group were treated with Troxerutinum, enteric Aspirin, etc.. Findings showed that out of the 54 cases of the treatment group, 28 were cured basically, 16 had marked improvement, 8 had improvement and 2 were ineffective, with the total effective rate of 96. 3%; of the 28 cases in the control group, 3 were cured basically, 7 had striking improvement, 13 had improvement and 5 were ineffective, with the total effective rate of 82.2%.Both the total effective rate and the basic-cure rate of the treatment group were significantly higher than those of the control group (P<0. 01). Results of the present paper display that manipulating the needle to cause "qi reaching the affected area" and applying Chinese medicinal herbs can act on the locus by way of meridians which is the key point for achieving better therapeutic effect.

CLINICAL OBSERVATION ON 134 CASES OF SEQUELAE OF POLIOMYELITIS TREATED WITH ACUPUNCTURE PLUS ACUPOINT-INJECTION

We had treated 134 cases of sequelae of poliomyelitis with acupuncture and acu-point-injection from 1989 to 1991. The patients’ ages ranged from 3 months to 2 years, and thecourses of disease were 3 days to 2 years. For most of cases, we had got a satisfactory effect after 3curative courses. The total effective rate was 91%. It indicates that the acupuncture plus acupoint-in-jection is a good method for treating the sequela of poliomyelitis.

TREATMENT OF APOPLECTIC SEQUELAE—HEMIPLEGIA WITH BALANCE ACUPUNCTURE

The present paper reports a clinical study on treatment of apoplectic hemiplegia with balance-acupuncture therapy. Main (balance acupuncture) point used was Piantan (BP-HN 2), combined with Jiantong (BP-LE 6), Qitong (BP-UE 2), etc.. Of the 190 cases, 148 (77. 89% ) were cured, 24 (12.63 % ) had marked improvement, 12 (6. 32 % ) had improvement and 6 (3. 16 % ) had no effect, with a cure rate of 77. 89 % and an effective rate of 96. 84 %.

RESEARCH ON SEQUELAE OF CEREBROVASCULAR ACCIDENT TREATED BY THREE DIFFERENT NEEDLING TECHNIQUES

One hundred and sixty cases of sequelae of cerebrovascular accident (CVA) wererandomly divided into three groups: The temporal point group (TG), 58 cases; the scalp acupuncturegroup(SG), 52 cases; the body acupuncture group(BG), 50 cases. It was shown that after 30 treat-ments the curative effects were significantly different (P【0. 01) among the three groups. The effectin TG was better than those in SG and BG. There was no difference in curative effects between SGand BG. It is indicated that all the three needling techniques can improve encephalic blood flow in pa-tients. It seems that the effects of the three needling techniques are as follows: TG】SG】BG.

Use of the Tinetti Index to Assess Fall Risk in Patients with Sequelae of Stroke

Background and Objective: The knowledge about risk of falls in patients with sequelae of stroke by applying a scale constitutes an important factor fort nurses since it allows planning for quality care and consequently improves the quality of life of such patients. The present study aimed to assess the risk of falls of patients with sequelae of stroke using Tinetti Index. Methods: Transversal descriptive study with 61 hospitalized patients. The data were collected through the application of Tinetti Index, the total score of which is 28 points. Results: The index evaluation shows que 47.9% had 19 points under the ideal score, indicating a high risk of falls, 41.7% from 24 to 28, indicating moderate risk and 10.4% from 19 to 23 points, indicating low risk of falls. The final average was (15.23), the median (16.50) and standard deviation (±11.034). Conclusions: There is a high risk of falls in this population, a quantification of impaired balance and gait anticipate the future risk of falls. The use of assessment instruments has important implications for improving the quality of life in patients with symptomatic stroke.

Treatment of Sequelae of Wind Stroke by Acupuncture in Combination with Massage

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Acute and delayed psychiatric sequelae among patients hospitalised with COVID-19:a cohort study using LIFE study data

Background Characterising the psychiatric sequelae of coronavirus disease 2019(COVID-19)can inform the development of long-term treatment strategies.However,few studies have examined these sequelae at different time points after COVID-19 infection.Aims The study aimed to investigate the incidences and risks of acute and delayed psychiatric sequelae in patients hospitalised with COVID-19 in Japan.Methods This retrospective cohort study was conducted using a database comprising healthcare claims data from public health insurance enrollees residing in a Japanese city.We analysed a primary cohort comprising patients hospitalised with COVID-19 between March 2020 and July 2021 and two control cohorts comprising patients hospitalised with influenza or other respiratory tract infections(RTI)during the same period.We calculated the incidences of acute(1–3 months after infection)and delayed(4–6 months after infection)psychiatric sequelae.These sequelae were identified using diagnosis codes and categorised as mood/anxiety/psychotic disorder,mood disorder,anxiety disorder,psychotic disorder or insomnia.Multivariable logistic regression models were used to estimate the odds ratios(ORs)of psychiatric sequelae occurrence after COVID-19 infection compared with influenza and other RTI.Results The study population with acute psychiatric sequela consisted of 662 patients with COVID-19,644 patients with influenza,and 7369 patients with RTI who could be followed for 3 months;the study population with delayed psychiatric sequelae consisted of 371 patients with COVID-19,546 patients with influenza,and 5397 patients with RTI who could be followed for 6 months.In the analysis of acute psychiatric sequelae,COVID-19 had significantly higher odds of mood/anxiety/psychotic disorder(OR:1.39,p=0.026),psychotic disorder(OR:2.13,p<0.001),and insomnia(OR:2.59,p<0.001)than influenza,and significantly higher odds of insomnia(OR:1.44,p=0.002)and significantly lower odds of anxiety disorder(OR:0.56,p<0.001)than other RTI.In the analysis of delayed psychiatric sequelae,COVID-19 had significantly higher odds of psychotic disorder(OR:2.25,p=0.007)than influenza,but significantly lower odds of anxiety disorder(OR:0.55,p=0.011)than other RTI.Conclusions COVID-19 was generally associated with an increased risk of psychiatric sequelae occurring within 3 months after infection,but had a lower risk of new psychiatric sequelae developing 4–6 months after infection.

A rare neurological sequelae of chicken pox in an adult

Chicken pox is a disease of childhood caused by varicella zoster virus belonging to the α-herpesvirus-3 family. But the clinical presentation in adults is uncommon and is usually associated with complications. The complications are more commonly seen in immunocompromised individuals and in people who get infected at the later age group. Since the varicella zoster virus rarely causes cerebellar disease in adults, hence here we report a non-immunized, immune-competent adult patient presented to the emergency department with unsteadiness in gait, profuse sweating, exanthematous vesicular rash. We made a diagnosis of acute cerebellar ataxia due to varicella zoster virus and treated accordingly.

Clinical Observation on Treatment of Sequelae of Apoplexy With Eye and Body Acupuncture

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COVID-19 sequelae:Clinical features and research progress

With the increasing number of COVID-19 patients cured and discharged,the emergence of associated sequelae has become a new global health crisis following acute infection.The sequela of COVID-19 involves many systems such as respiration,circulation,nerve,digestion,psychological cognition,and so on,with varying duration and severity,seriously affecting people's physical and mental health,as well as the development of society.This paper summarizes the clinical characteristics and research progress of COVID-19 sequelae through extensive review of relevant domestic and foreign literature,in order to provide reference for the development of a comprehensive and systematic management system.

Effects of Electrical Stimulation in People with Post-Concussion Syndromes: A Pilot Study

Post-concussion syndrome (PCS) is a complex disorder with various symptoms. There is limited evidence to support that any intervention enhances recovery after a concussion. This pilot study aimed to examine the efficacy of neck paraspinal muscles electrical stimulation (ES) in conjunction with physical therapy (PT) on reducing the severity of post concussive symptoms. Twenty-four individuals with PCS were randomly assigned to the ES group (PT + ES) or the control group (PT only). Both groups received the intervention twice a week for eight weeks. Clinical measures including the Concussion Signs/Symptoms Checklist, balance error scoring system, King-Devick test, ImPACT, and the Standardized Assessment of Concussion were used to evaluate the symptoms. We investigated the recovery rate by calculating slopes of changes over time for each participant. A changing slope was derived by linearly fitting the symptoms severity over time with the initial severity score as the intercept. Significant overall improvement was observed in both groups after the interventions. There was no significant difference seen in total symptom recovery rate between two groups (-1.49 ± 1.59 versus -1.2 ± 1.56, p = 0.32). The cognitive symptoms recovery rate of the ES group was faster than the control group (-0.5 ± 0.49 and -0.13 ± 0.46 respectively, p = 0.04). Physical therapy targeting the cervical region is beneficial for persons with PCS. Moreover, peripheral electrical stimulation on the paraspinal muscles surrounding the neck region could potentially advance the cognitive function recovery of persons with PCS.