Intracranial pressure (ICP) monitoring is an important way to observe the condition of patients with severe neurological diseases; at present, ICP detection mainly relies on mean ICP, but with the progress of scientific and technological means and deepened research in related fields, ICP waveforms and their related derivative indicators have attracted more and more attention from clinicians. Based on the types and morphologies of ICP waveforms and their related derivative indexes, such as pressure response index and pressure amplitude index, relationships of ICP waveforms with brain tissue compliance and brain tissue lesions, and their clinical application are reviewed to provide some references for application of ICP waveforms in patients with severe neurological diseases.

Objective:To investigate the predictive value of Glasgow coma scale-pupil (GCS-P) score combined with arterial lactate level on 30-day mortality in patients with spontaneous intracerebral hemorrhage (sICH).Methods:Patients with sICH attended to the emergency department of the Affiliated Hospital of North China University of Science and Technology from January 2021 to September 2023 were respectively collected. The patients were divided into survival group and death group according to survival outcome at 30 d after the onset of the disease. The data of the patients between the two groups were compared, including basic data, vital signs on admission to the hospital, pupils status, laboratory indexes, emergency Glasgow coma scale (GCS) scores, and other clinical data. The binary logistic regression analysis was used to analyze the risk factors affecting the poor prognosis of sICH patients, and LASSO regression analysis was used for further validation. The receiver operating characteristic (ROC) curves were plotted to analyze the predictive value of the emergency GCS-P score combined with the lactate level score on the mortality rates of sICH patients.Results:A total of 512 patients were included, 235 in the survival group and 277 in the death group. The admission heart rate, blood glucose, arterial lactate level, and the proportion of patients with hypertension and stroke were significantly higher in the death group than in the survival group, and the GCS score and emergency GCS-P score were significantly lower than those in the survival group (all P<0.05). For the mortality analysis of sICH patients at different levels, the mortality rate of patients with very severe GCS-P was significantly higher than that of patients with severe disease ( P<0.05), However, there was no significant difference in GCS between the two groups ( P>0.05). Binary logistic regression analysis showed that emergency GCS-P score ( OR=1.400, 95% CI: 1.297-1.512, P<0.001) and arterial lactate level ( OR=0.674, 95% CI: 0.567-0.800, P<0.001) were predicted factors for the prognosis of patients with sICH. ROC curve analysis showed that the area under the curve of GCS, GCS-P, arterial lactate, and GCS-P combined with arterial lactate to predict the prognosis of patients was 0.748, 0.783, 0.718, and 0.819, respectively. Among them, GCS-P score combined with arterial lactate had the best prediction effect. Conclusion:GCS-P combined with arterial lactate levels could be used to predict the prognosis of sICH patients

Objective:To explore the effect of laryngeal massage combined with feeding training on swallowing function and quality of life in patients with poststroke swallowing disorders.Methods:From November 2021 to October 2022, convenience sampling was used to select 148 patients with poststroke swallowing disorders in the Department of Neurosurgery and Rehabilitation at the North China University of Science and Technology Affiliated Hospital. The patients were divided into a control group, a laryngeal massage group, a feeding training group, and a combination group using the random number table method, with 37 cases in each group. The control group was given routine nursing, while the laryngeal massage group and feeding training group respectively received laryngeal massage and feeding training on the basis of routine nursing. The combination group underwent laryngeal massage combined with feeding training on the basis of routine nursing. Before and after 2, 4, and 8 weeks of intervention, the Water Swallowing Test, Standardized Swallowing Assessment (SSA), and Chinese version Swallowing Quality of Life Questionnaire (SWAL-QOL) were used to compare the swallowing function and quality of life of four groups of patients with poststroke swallowing disorders.Results:After 2, 4, and 8 weeks of intervention, the Water Swallowing Test rating and efficacy evaluation of the 4 groups of patients with poststroke swallowing disorders were better than those before intervention ( P<0.05). Moreover, the SSA scores decreased compared to before intervention ( P<0.05), and the SWAL-QOL scores increased compared to before intervention ( P<0.05). The Water Swallowing Test efficacy evaluation and SWAL-QOL scores in the combined group were higher than those of the other groups ( P<0.05), while the SSA scores were lower than those of the other groups ( P<0.05) . Conclusions:Laryngeal massage and feeding training can improve the swallowing function and quality of life of patients with poststroke swallowing disorders, and the combination of the 2 interventions has a significant effect.

Objective To investigate the predictive value of Glasgow coma scale(GCS)-Full Out-line of UnResponsiveness(FOUR)scale(GCS-F)score and arterial lactate level for prognosis of intracerebral hemorrhage(ICH)in elderly patients.Methods A total of 278 elderly ICH patients admitted to Neurosurgical Intensive Care Unit of the Affiliated Hospital of North China Universi-ty of Science and Technology from January 2022 to January 2024 were retrospectively recruited.According score at 90 d after onset,95 of them were assigned into good prognosis group and 183 into poor prognosis group.Basic information,vital signs at admission,pupils,laboratory indica-tors,GCS score and other clinical data were compared between the two groups.Binary logistic re-gression analysis was used to analyze the risk factors of poor prognosis in elderly ICH patients.ROC curve was drawn to analyze the prognostic value of GCS-F score(including eye opening re-sponse and limb movement in GCS,and brainstem response in FOUR scale)combined with lac-tate level in elderly ICH patients.Results Significantly higher blood pressure,elevated levels of blood glucose,creatinine and arterial lactic acid,increased percentages of supratentorial and sub-tentorial bleeding,and larger blood loss,while obviously lower GCS score and GCS-F score were observed in the poor prognosis group than the good prognosis group(P＜0.05,P＜0.01).In the analyses for poor prognosis rate of ICH patients at different levels,the poor prognosis rate of se-vere GCS-F patients was significantly higher than that of patients with same level of GCS score(P＜0.05).Binary logistic regression analysis showed that GPS-F score(OR=1.762,95％CI:1.507-2.061,P=0.000)and arterial lactate level(OR=0.536,95％CI:0.385-0.746,P=0.000)were risk factors for 90-day poor prognosis in elderly ICH patients.ROC curve analysis indicated that the AUC value of arterial lactate,GCS score and GCS-F score in predicting 90-day poor prog-nosis in elderly ICH patients was 0.713(95％CI:0.650-0.775),0.827(95％CI:0.774-0.880)and 0.876(95％CI:0.828-0.925),respectively,and the AUC value of GCS-F score combined with arterial lactic acid was 0.919(95％CI:0.886-0.953),which was significantly higher than that of GCS score,GCS-F score and arterial lactic acid alone(P＜0.01).Conclusion GCS-F score has better performance than GCS score in predicting 90-day poor prognosis in elderly ICH pa-tients,especially for severe patients.The GPS-F score combined with arterial lactate level shows the best predictive effectiveness for elderly ICH patients.