ObjectiveTo explore the effectiveness and safety of vibration-kneading abdominal tuina as an adjunct treatment for insomnia of phlegm-heat harassing the interior syndrome with "stomach disharmony" symptom. MethodsSeventy-six insomnia patients of phlegm-heat harassing the interior syndrome with "stomach disharmony" symptom were recruited， and randomly divided into the treatment group and the control group with 38 cases in each group. The control group received eszopiclone 2mg once a night and sleep hygiene guidance， while the treatment group received vibration-kneading abdominal tuina additionally， 5 times a week， 30 min each time. Both groups were treated for 4 weeks. The Pittsburgh Sleep Quality Index （PSQI） （including sleep quality， time to fall asleep， sleep duration， sleep efficiency， sleep disorders， daytime functioning scores， and total scores） and traditional Chinese medicine （TCM） symptom scores of "stomach disharmony" was assessed before and after 4-week treatment and at follow-up （12 weeks after treatment）. Adverse events were also observed and recorded during the study. Pearson correlation analysis was used to assess the correlation between the pre-treatment PQSI total score and TCM symptom score of "stomach disharmony". ResultsThe PSQI scores of sleep quality， time to fall asleep， sleep duration， sleep efficiency， sleep disorders， daytime dysfunction scores， and total scores reduced in both groups decreased after treatment and at follow-up （P＜0.05 or P＜0.01）， as well as the TCM symptom score of "stomach disharmony" （P＜0.01）. After treatment， the PSQI scores of sleep quality， sleep duration， and TCM symptom score of "stomach disharmony" of the treatment group were lower than those of the control group （P＜0.05 or P＜0.01）. At follow-up， the PSQI scores of sleep quality， sleep duration， sleep efficiency， daytime dysfunction score， total score， and TCM symptom score of "stomach disharmony" of the treatment group were lower than those of the control group （P＜0.05 or P＜0.01）. No adverse reactions occurred in any participants during the study. There was a positive correlation between the patients' pre-treatment PQSI total scores and TCM symptom score of "stomach disharmony" （r=0.88， P＜0.01）. ConclusionVibration-kneading abdominal tuina as an adjunct treatment could significantly improve the symptoms of stomach and epigastric symptoms in insomnia patients of phlegm-heat harassing the interior syndrome with "stomach disharmony" symptom， and improve the quality of sleep， with good immediate and long-term therapeutic effects， and sound safety.

Objective To explore the research status and trends in the field of post-stroke foot drop. Methods The literature on post-stroke foot drop was retrieved from the Web of Science Core Collection database from inception to January,2024.The data were analyzed using VOSviewer and CiteSpace. Results A total of 490 articles were included.The annul articles were published more and more year by year since 1992,peaking in 2020.The main institutions were located in USA.The literature focused on the fields of medicine,healthcare and clinical studies.There were as many as 230 papers on rehabilitation.The most frequency key-words were rehabilitation,hemiplegic gait,electrical stimulation,foot drop,and stroke,and so on.Keyword co-occurrence analysis showed ten major clusters as motor rehabilitation,neurorehabilitation technology,gait analy-sis,functional recovery technology,and assessment of rehabilitation treatment effects,and so on. Conclusion Researches on the rehabilitation of post-stroke foot drop are moving towards the integration of technology and therapeutic methods,emphasizing the assessment of motor function and evidence of treatment effects,and exploring personalized rehabilitation plans.

Objective To explore the current research status and frontier hotspot of task-state functional magnetic resonance imaging(fMRI)based on language task in the field of neuropsychiatric diseases. Methods Literature about the application of task-state fMRI based on language task in neuropsychiatric disorders was re-trieved from CNKI,VIP and Web of Science Core Collection databases up to November 12nd,2023.The includ-ed literature was analyzed using CiteSpace and VOSviewer. Results A total of 91 literatures were included.The researches about application of task-state fMRI based on language task in the field of neuropsychiatric disorders were reported since 2002,and developed uniformly;particularly for the diagnosis and treatment of stroke,brain tumors,epilepsy,schizophrenia and other neuropsychiatric disorders,as well as in studies of brain functional connectivity.Research hotspots included mechanisms of aphasia recov-ery,brain functional changes,functional connectivity and language laterality.Journals of psychology,education and sociology played the core role,disciplines such as neurology also contributed to the advancement of this tech-nology. Conclusion Task-state fMRI based on language task demonstrates significant potential in elucidating the mechanisms of how the brain processes language in neuropsychiatric disorders.

ObjectiveTo visualize the research trends of verbal and nonverbal cognitive functions in patients with post-stroke aphasia (PSA). MethodsPapers about verbal and nonverbal cognitive functions after stroke were extracted from Web of Science Core Collection from establishment to August, 2022, and a bibliometric analysis was conducted on the distribution of articles published by year, author, journal, institution, and country. Author cooperation, author co-citation, journal co-citation, country/institution cooperation, dynamic evolution, keyword hotspots, and trends were visually analyzed by using VOSviewer software. ResultsA total of 1 630 publications were identified for final analysis. The first article related to the topic was retrieved in 2004. After that, the number of published papers showed an increasing trend year by year, with some fluctuations after 2019. Matthew A. Lambon Ralph and Elizabeth Jefferies were the authors who produced the most, were cited the most, and were the most influential. Neuropsychologia was a highly productive and well-cited publication. The University of Manchester in the United Kingdom and Johns Hopkins University in the United States were the nations/institutions with high yield and high centrality. Although China had a high yield and was in the top five, the centrality was insufficient. The dynamic emergence of keywords revealed that the research had gone through the following stages: evaluating the mechanism of language and nonverbal cognitive function impairment based on neuroimage, exploring the role of nonverbal cognitive dysfunction in pathology and recovery mechanisms of patients with PSA, examining the therapeutic mechanism of non-invasive brain stimulation and electronic tele-rehabilitation equipment, and revealing not only the frontal and temporal areas but also brain network supporting nonverbal cognition. ConclusionIn recent years, some achievements have been made in the researches on verbal and nonverbal cognitive function, particularly in the studies of the neuroimaging-based mechanisms of common damage and the intervention effects of synergistic therapy. In the future, academic cooperation between different regions and different teams needs to be strengthened. Further exploration should be focused on refining the cognitive neuropsychology and exploring new technologies to improve the therapeutic effect of PSA.

Objective:To explore the teaching effect and novel ideas of online teaching applied in skill operation course.Methods:One hundred and fifty-one students studying in Sichuan University taking the First Aid in the Life: Basic Knowledge and Skills as an elective course in the autumn semester of 2019 and spring semester of 2020 were included as the research subjects in this study. Among them, 77 students in the spring semester of 2020 were selected as the experimental group and 74 students in the autumn semester of 2019 were selected as the control group. The students in the experimental group studied the first aid course by online platform, and the others in the control group studied through traditional teaching mode. The teaching effect of the two groups was compared and the teaching satisfaction of the two groups weas analyzed. SPSS 23.0 was used for Chi-square test and t-test. Results:There was no significant difference between the control group and the experimental group in the assessment scores of cardiopulmonary resuscitation, hemostatic bandaging, and fracture fixation [(8.65±0.81 vs 8.69±0.90, P=0.750); (8.10±0.50 vs 8.12±0.61, P=0.880); (8.21±0.89 vs 8.16±0.78, P=0.710)]. Among the students participating in the questionnaire survey in the experimental group, 59 (95.16%) students thought that this course was helpful in dealing with first aid in daily life, and 38 (61.29%) students did not want to change the traditional teaching method to online teaching. Conclusion:The application of online teaching in first-aid skill operation course is feasible and can achieve the similar teaching effect, which provides a novel idea for exploring the online teaching of first aid skills.

ObjectiveTo explore the current status and frontier hotspots of functional near-infrared spectroscopy (fNIRS) in the field of stroke. MethodsRelevant literature on stroke and fNIRS from the Web of Science Core Collection (WoSCC) database was searched from its inception to July, 2023. VOSviewer, CiteSpace and Scimago were utilized for analysis of publication output, countries (regions) and institutions, international collaboration, co-cited references, co-occurring keywords and burst keywords. ResultsA total of 379 articles were included. The research activity in this field showed an overall upward trend with slight fluctuations in the early stage. Among the top five institutions by publication output, four were from China. Co-occurrence analysis revealed that Beihang University and Boston Children's Hospital were central in collaboration networks. This study involved 1 787 authors, with 120 core authors, in which the top five most cited authors were Li Zengyong, Li Wenhao, Huo Congcong, Dou Zulin and Song Ying. The publications in this field were primarily concentrated in disciplines such as neurology, psychiatry, ophthalmology and clinical medicine. Overlay visualization of journal co-citation networks demonstrated associations between medical, clinical, and neurology disciplines with psychology, education, and sociology. Co-occurrence and clustering analysis of keywords indicated research emphasis on stroke rehabilitation, integration of multiple technical modalities, and exploration of innovative training strategies and brain activation connectivity. The research evolution of fNIRS in the stroke domain revealed initial use of photodiode devices for cerebral ischemia reperfusion monitoring. Subsequent studies refined cortical activation through improved laser sources, avalanche photodiodes, single-task experimental designs and transcranial direct current stimulation. Later, research extended to whole-brain detection, multimodal stimulation and the combination of virtual reality technology with audiovisual stimulation, resulting in significantly enhanced brain activation. The application of brain-computer interface technology further facilitated direct restoration of motor function. ConclusionResearches in the field of stroke using fNIRS technology overall demonstrat a continuous upward trend. The researches focuse on post-stroke rehabilitation, integrating multimodal fusion, brain-computer interfaces, virtual reality, and sensory stimulation for real-time monitoring and personalized neurorehabilitation training strategies. It emphasizes interdisciplinary collaboration, expanding innovative research and the application of new technologies.

OBJECTIVE: To investigate the effect of working time on the prognosis of patients with ischemic stroke undergoing intravenous thrombolysis. METHODS: Clinical data of 3050 patients with ischemic stroke received intravenous thrombolysis from 71 hospitals in Zhejiang Province during June 2017 and September 2018 were retrospective analyzed. Whole day of Saturday and Sunday were defined as weekend; whole day of Monday to Friday were defined as weekdays; Monday to Friday 8:00-17:00 were defined as daytime of weekdays; Monday to Friday 17:01-07:59 on next day were defined as nights of weekdays; unconventional working time were defined as weekend and nights of weekdays. Good outcome was defined as mRS 0-2 at 3 months. Univariate analyses of baseline and prognostic variables in group of weekend and weekdays, nights of weekdays and daytime of weekdays, unconventional working time and daytime of weekdays were performed. Binary logistic regression was used to investigate whether weekend, nights of weekdays and unconventional working time were independent predicting factors of outcome after intravenous thrombolysis, respectively. RESULTS: There was no difference in 7-day mortality, 3-month mortality and good outcome at 3-month between weekend group and weekdays group, nights of weekdays group and daytime of weekdays group, unconventional working time group and daytime of weekdays group (all >0.05). Binary logistic regression results showed that weekends, nights of weekdays and unconventional working time were not independent predicting factors for outcome after intravenous thrombolysis (all >0.05). CONCLUSIONS The working time has not affected the outcomes of patients with ischemic stroke undergoing intravenous thrombolysis in studied hospitals of Zhejiang province.
Brain Ischemia ; drug therapy ; Humans ; Prognosis ; Retrospective Studies ; Stroke ; drug therapy ; Thrombolytic Therapy ; Time Factors

OBJECTIVE: To compare the time delay between in-hospital stroke and out-of-hospital stroke patients, and to explore the influence factors for the prognosis of in-hospital stroke patients treated by intravenous thrombolysis. METHODS: Clinical data of 3050 patients with ischemic stroke who received intravenous thrombolysis in 71 hospitals in Zhejiang province from June 2017 to September 2018 were analyzed. Differences of time delay including door to imaging time (DIT), imaging to needle time (INT) and door to needle time (DNT) between in-hospital stroke (=101) and out-of-hospital stroke (=2949) were observed. The influencing factors for the outcome at 3 month after intravenous thrombolysis in patients with in-hospital stroke were analyzed using binary logistic regression analysis. RESULTS: Patients with in-hospital stroke had longer DIT[53.5 (32.0-79.8) min vs. 20.0 (14.0-28.0) min, <0.01], longer IDT[47.5(27.3-64.0)min vs. 36.0(24.0-53.0)min, <0.01], and longer DNT[99.0 (70.5-140.5) min vs. 55.0 (41.0-74.0) min, <0.01], compared with patients with out-of-hospital stroke; patients in comprehensive stroke center had longer DIT[59.5(44.5-83.3) min vs. 37.5(16.5-63.5) min, <0.01], longer DNT[110.0(77.0-145.0) min vs. 88.0 (53.8-124.3) min, <0.05], but shorter INT[36.5(23.8-60.3)min vs. 53.5 (34.3-64.8) min, <0.05], compared with patients in primary stroke center. Age (=0.934, 95% 0.882-0.989, <0.05) and baseline National Institute of Health Stroke Scale score (=0.912, 95% 0.855-0.973, <0.01) were independent risk factors for prognosis of in-hospital stroke patients. CONCLUSIONS In-hospital stroke had longer DIT and DNT than out-of-hospital stroke, which suggests that a more smooth thrombolysis process of in-hospital stroke should be established.
Administration, Intravenous ; Brain Ischemia ; drug therapy ; Fibrinolytic Agents ; therapeutic use ; Hospitals ; statistics & numerical data ; Humans ; Prognosis ; Stroke ; drug therapy ; Thrombolytic Therapy ; statistics & numerical data ; Time Factors ; Treatment Outcome

OBJECTIVE: To investigate the association of atrial fibrillation (AF) with hemorrhagic transformation (HT) in patients with ischemic stroke treated by intravenous thrombolysis. METHODS: Clinical data of 3272 patients treated by intravenous thrombolysis from 71 hospitals in Zhejiang Province during June 2017 and December 2018 were retrospectively reviewed. Intracranial HT was defined as intracranial hemorrhage suggested by imaging examination 24 hours after intravenous thrombolysis. Patients were dichotomized into HT group (=533) and non-HT group (=2739). The association of AF and HT was analyzed by univariate analysis and binary logistic regression. RESULTS: Compared with the non-HT group, the HT group were older, had longer onset to needle time (ONT), higher baseline National Institute of Health Stroke Scale (NIHSS) score, higher baseline glucose level, and higher AF rate (<0.05 or <0.01). Binary logistic regression analysis revealed that AF was independently associated with HT (=2.527, 95%:2.030-3.146, <0.01). CONCLUSIONS AF is independently associated with the occurrence of HT in ischemic stroke patients treated with intravenous thrombolysis.
Antifibrinolytic Agents ; adverse effects ; pharmacology ; Atrial Fibrillation ; complications ; Brain Ischemia ; complications ; drug therapy ; Humans ; Retrospective Studies ; Stroke ; complications ; drug therapy ; Thrombolytic Therapy ; adverse effects ; Treatment Outcome

OBJECTIVE: To investigate the effect of treatment time on the outcome of patients with ischemic stroke undergoing reperfusion therapy. METHODS: The clinical data of 3229 ischemic stroke patients who received intravenous thrombolysis with or without arterial thrombolysis from 71 hospitals in Zhejiang province from June 2017 to September 2018 were retrospectively reviewed. The good outcome was defined as modified Rankin Scale (mRS) ≤ 2. Binary logistic regression analysis was used to investigate the association of door to needle time (DNT), or door to reperfusion time (DRT) with the outcomes in patients treated by intravenous thrombolysis or bridging arterial thrombolysis, respectively. RESULTS: Binary logistic regression showed that DNT (=0.994, 95%:0.991-0.997, <0.01) or DRT (=0.989, 95%:0.983-0.995, <0.01) were independently associated with good outcomes, respectively. Every hour decreases in DNT resulted in a 4.7%increased probability of functional independence (mRS 0-2) in patients treated by intravenous thrombolysis; Every hour decreases in DRT was associated with a 11.4%increased probability of functional independence in patients treated by intravenous thrombolysis with arterial thrombolysis. CONCLUSIONS Good outcomes are associated with lower DNT in ischemic stroke patients treated by intravenous thrombolysis or lower DRT in patients treated by intravenous thrombolysis bridging arterial thrombolysis.
Brain Ischemia ; drug therapy ; Fibrinolytic Agents ; therapeutic use ; Humans ; Reperfusion ; Retrospective Studies ; Stroke ; drug therapy ; Thrombolytic Therapy ; Time Factors ; Treatment Outcome