Objective To investigate the clinical efficacy of stellate ganglion block(SGB)combined with nicergoline in patients with dysphagia after stroke.Methods A total of 104 patients with dysphagia after stroke were randomly divided into the observation group and the control group.The observation group was treated with niergoline and SGB,while the control group received functional electrical stimulation.The total effective rate,swallowing condition,inflammatory factor level and adverse events were compared between the two groups.Results After treatment,the total effective rate was significantly higher in the observation group(92.31%)than that of the control group(73.08%,P＜0.05).The level of interleukin-6(IL-6),the standardized swallowing assessment(SSA)score and the level of tumor necrosis factor alpha(TNF-α)were significantly lower in the observation group than those in the control group(P＜0.05).The Mann swallowing ability assessment scale(MASA)score was significantly higher in the observation group than that of the control group(P＜0.05).There were no significant differences in adverse reactions such as glottis closure and laryngeal spasm between the two groups(P＞0.05).Conclusion The combined treatment of SGB and nicergoline can effectively improve swallowing function in patients with dysphagia after stroke,with good safety,ideal results and high clinical application value.

Objective:To evaluate the efficacy and safety of therapeutic temperature control in patients with severe traumatic brain injury (sTBI).Methods:The full-text databases of Chinese Medical Journal, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, VIP Database, China Biomedical Database, PubMed, Embase, and Cochrane Library were searched for randomized controlled trials (RCTs) of hypothermia treatment and conventional treatment in patients with sTBI. The search period was from January 2016 to June 2025. Meta-analysis was performed using RevMan 5.3 software. The evaluation indicators included intracranial pressure before treatment, at 3 and 5 days after treatment, favorable prognosis rate and mortality rate within 6 months after treatment, and incidence of pulmonary infection, intracranial infection, epilepsy, acute gastrointestinal dysfunction, deep vein thrombosis, abnormal coagulation function, and arrhythmia during treatment; publication bias.Results:A total of 33 studies involving 3 322 patients were included, with 1 696 patients in the temperature treatment group and 1 626 in the conventional treatment group. There was no statistically significant difference in intracranial pressure between the two groups before treatment ( SMD=0, 95% CI -0.13, 0.14, P>0.05). However, at 3 and 5 days after treatment, the intracranial pressure was lower in the temperature treatment group than that in the conventional treatment group ( SMD=-2.29, 95% CI -2.76, -1.82, P<0.01; SMD=-2.66, 95% CI -3.43, -1.89, P<0.01). Within 6 months after treatment, the favorable prognosis rate was higher in the temperature treatment group than that in the conventional treatment group ( RR=1.41, 95% CI 1.32, 1.50, P<0.01), and mortality rate was lower than that in the conventional treatment group ( RR=0.64, 95% CI 0.55, 0.75, P<0.01). Compared with the conventional treatment group, the incidences of epilepsy and acute gastrointestinal dysfunction in the temperature treatment group were statistically reduced ( RR=0.33, 95% CI 0.13, 0.83, P<0.05; RR=0.43, 95% CI 0.25, 0.74, P<0.05). There were no statistically significant differences in the incidence of pulmonary infection ( RR=0.96, 95% CI 0.85, 1.08, P>0.05), intracranial infection ( RR=0.56, 95% CI 0.20, 1.56, P>0.05), deep vein thrombosis ( RR=0.93, 95% CI 0.69, 1.25, P>0.05), abnormal coagulation function ( RR=1.19, 95% CI 0.43, 3.31, P>0.05) or arrhythmia ( RR=0.51, 95% CI 0.23, 1.12, P>0.05) between the two groups. Egger′s test indicated the presence of publication bias and the results remained robust after trim and fill analysis. Conclusions:For patients with sTBI, temperature control therapy shows lowered intracranial pressure and mortality rate as well as improved favorable prognosis rate at 6 months posttreatment, and decreased incidence of epilepsy and acute gastrointestinal dysfunction during treatment, while reveals similar incidence of pulmonary infection, intracranial infection, deep vein thrombosis, abnormal coagulation function, and arrhythmia when compared with conventional treatment.

Objective:To evaluate the efficacy and safety of therapeutic temperature control in patients with severe traumatic brain injury (sTBI).Methods:The full-text databases of Chinese Medical Journal, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, VIP Database, China Biomedical Database, PubMed, Embase, and Cochrane Library were searched for randomized controlled trials (RCTs) of hypothermia treatment and conventional treatment in patients with sTBI. The search period was from January 2016 to June 2025. Meta-analysis was performed using RevMan 5.3 software. The evaluation indicators included intracranial pressure before treatment, at 3 and 5 days after treatment, favorable prognosis rate and mortality rate within 6 months after treatment, and incidence of pulmonary infection, intracranial infection, epilepsy, acute gastrointestinal dysfunction, deep vein thrombosis, abnormal coagulation function, and arrhythmia during treatment; publication bias.Results:A total of 33 studies involving 3 322 patients were included, with 1 696 patients in the temperature treatment group and 1 626 in the conventional treatment group. There was no statistically significant difference in intracranial pressure between the two groups before treatment ( SMD=0, 95% CI -0.13, 0.14, P>0.05). However, at 3 and 5 days after treatment, the intracranial pressure was lower in the temperature treatment group than that in the conventional treatment group ( SMD=-2.29, 95% CI -2.76, -1.82, P<0.01; SMD=-2.66, 95% CI -3.43, -1.89, P<0.01). Within 6 months after treatment, the favorable prognosis rate was higher in the temperature treatment group than that in the conventional treatment group ( RR=1.41, 95% CI 1.32, 1.50, P<0.01), and mortality rate was lower than that in the conventional treatment group ( RR=0.64, 95% CI 0.55, 0.75, P<0.01). Compared with the conventional treatment group, the incidences of epilepsy and acute gastrointestinal dysfunction in the temperature treatment group were statistically reduced ( RR=0.33, 95% CI 0.13, 0.83, P<0.05; RR=0.43, 95% CI 0.25, 0.74, P<0.05). There were no statistically significant differences in the incidence of pulmonary infection ( RR=0.96, 95% CI 0.85, 1.08, P>0.05), intracranial infection ( RR=0.56, 95% CI 0.20, 1.56, P>0.05), deep vein thrombosis ( RR=0.93, 95% CI 0.69, 1.25, P>0.05), abnormal coagulation function ( RR=1.19, 95% CI 0.43, 3.31, P>0.05) or arrhythmia ( RR=0.51, 95% CI 0.23, 1.12, P>0.05) between the two groups. Egger′s test indicated the presence of publication bias and the results remained robust after trim and fill analysis. Conclusions:For patients with sTBI, temperature control therapy shows lowered intracranial pressure and mortality rate as well as improved favorable prognosis rate at 6 months posttreatment, and decreased incidence of epilepsy and acute gastrointestinal dysfunction during treatment, while reveals similar incidence of pulmonary infection, intracranial infection, deep vein thrombosis, abnormal coagulation function, and arrhythmia when compared with conventional treatment.

Objective To investigate the clinical efficacy of stellate ganglion block(SGB)combined with nicergoline in patients with dysphagia after stroke.Methods A total of 104 patients with dysphagia after stroke were randomly divided into the observation group and the control group.The observation group was treated with niergoline and SGB,while the control group received functional electrical stimulation.The total effective rate,swallowing condition,inflammatory factor level and adverse events were compared between the two groups.Results After treatment,the total effective rate was significantly higher in the observation group(92.31%)than that of the control group(73.08%,P＜0.05).The level of interleukin-6(IL-6),the standardized swallowing assessment(SSA)score and the level of tumor necrosis factor alpha(TNF-α)were significantly lower in the observation group than those in the control group(P＜0.05).The Mann swallowing ability assessment scale(MASA)score was significantly higher in the observation group than that of the control group(P＜0.05).There were no significant differences in adverse reactions such as glottis closure and laryngeal spasm between the two groups(P＞0.05).Conclusion The combined treatment of SGB and nicergoline can effectively improve swallowing function in patients with dysphagia after stroke,with good safety,ideal results and high clinical application value.

Objective To investigate the relationship between serum histone deacetylase 4(HDAC4)and myeloid differentiation protein 88(MYD88)levels and hemorrhagic transformation after intravenous throm-bolysis with recombinant tissue plasminogen activator(rt-PA)in patients with acute cerebral infarction(ACI).Methods A total of 169 patients with ACI who were treated with rt-PA intravenous thrombolysis in this hospital from May 2020 to May 2022 were selected as the research objects,and they were divided into transformation group(46 cases)and non-transformation group(123 cases)according to whether hemorrhagic transformation occurred after rt-PA intravenous thrombolysis.In addition,156 healthy people who underwent physical examination in the hospital during the same period were selected as the control group.Enzyme-linked immunosorbent assay was used to detect the serum levels of HDAC4 and MYD88 in each group,and the gen-eral data of transformation group and non-transformation group were compared.Pearson correlation was used to analyze the correlation between serum HDAC4 and MYD88 levels in ACI patients.Multivariate Logistic re-gression analysis was used to analyze the related factors of hemorrhagic transformation in ACI patients after intravenous thrombolysis with rt-PA.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic value of HDAC4,MYD88 levels and their combination for hemorrhagic transformation in ACI patients after rt-PA intravenous thrombolysis.Results The serum level of HDAC4 in ACI group was signifi-cantly lower than that in control group,and the serum level of MYD88 in ACI group was significantly higher than that in control group(P＜0.05).There were no significant differences in gender,age,body mass index,fasting blood glucose,hyperlipidemia,and coronary heart disease between the non-transformation group and the transformation group(P＞0.05),while there were significant differences in atrial fibrillation,National In-stitute of Health Stroke Scale(NIHSS)score,and the time from onset to thrombolysis between the two groups(P＜0.05).The level of serum HDAC4 in transformation group was lower than that in non-transfor-mation group,and the level of serum MYD88 in transformation group was higher than that in non-transforma-tion group,and the difference was statistically significant(P＜0.05).Pearson correlation analysis showed that serum HDAC4 level was negatively correlated with MYD88 in ACI patients(r=-0.401,P＜0.001).Multi-variate Logistic regression analysis showed that atrial fibrillation,time from onset to thrombolysis,NIHSS score and MYD88 level were the risk factors for hemorrhagic transformation in ACI patients after rt-PA intra-venous thrombolysis,HDAC4 level was a protective factor for hemorrhagic transformation in ACI patients af-ter intravenous thrombolysis with rt-PA(P＜0.05).The area under the curve(AUC)of combined HDAC4 and MYD88 was 0.876,and the sensitivity and specificity were 65.22％and 98.37％,respectively,which was better than that of HDAC4 and MYD88 alone(Zcombined-HDAC4=2.298,P=0.022;Zcombined-MYD88=2.5 4 5,P=0.011).Conclusion The serum levels of HDAC4 and MYD88 in ACI patients are closely related to hemor-rhagic transformation after intravenous thrombolysis with rt-PA.

Objective: The study aims to explore the neural mechanism of cognitive differences in college students with posttraumatic stress disorder under verbal fluency task based on functional near infrared spectroscopy (fNIRS), so as to provide neuroimaging support for the evaluation, diagnosis and treatment of posttraumatic stress disorder(PTSD). Methods: Posttaumatic Stress Disorder Checklist Combat(PCL-C) was used to screen the subjects, including 21 students in PTSD group (PCL-C≥38) and 30 students in control group from September to Novenber in 2020. A 53 channel near infrared spectroscopy device was used to collect cerebral blood oxygen signals under the verbal fluency task, and correlation analysis, Mann Whitney U test and independent sample t test were performed on the results. Results: The difference in the total average score of PCL-C Scale between PTSD group and the control group(46.38±6.96，25.57±6.09) was statistically significant ( t=11.33, P <0.05). Correlation analysis showed that Avg-HbO in left dorsolateral prefrontal lobe was negatively correlated with PCL-C Score ( r=-0.37, P <0.05). Mann Whitney U test showed that in the left dorsolateral prefrontal lobe (Ch6), the Avg-HbO change in PTSD group [0.19(-0.09, 0.86)mmol/(L〖KG*7〗·mm)] was significantly lower than the control group [0.79( 0.37 , 1.47)mmol/(L ·mm)] ( Z=2.16, P <0.05), which was statistically significant. Conclusions The degree of PTSD was negatively correlated with the index of oxygenated hemoglobin in the left dorsolateral prefrontal lobe, and the oxygenated hemoglobin content in the PTSD group was lower than that in the normal group. In the future, fNIRS may be used to collect blood oxygen signals from the left dorsolateral prefrontal lobe in cognitive tasks to provide imaging evidence for the identification of PTSD.

BACKGROUND: Forest frog is a rare medicinal animal in China, but the skin of forest frog is waste after Oviductus Ranae production. The forest frog skin is rich of collagen, and is large in quantity without pollution and disease risk. So the forest frog skin has potential to be developed into collagen sponge; however, there is no research on collagen sponge preparation as yet.OBJECTIVE: To optimize the preparation of collagen sponge from forest frog skin, and to investigate the physical properties and in vitro cell compatibility.METHODS: Chitosan and glutaraldehyde were used to modify collagen sponge from forest frog skin. Chitosan/collagen (w/w) (1:1, 1:2, 1:4) and glutaraldehyde concentration (1%, 1.5% and 2%) were selected as the experimental factors.The significant water absorbency, mechanical properties and thermal denaturation temperature were chosen as the indexes. Using the orthogonal experimental design, we optimized collagen sponge preparation process. We also investigated the in vitro cell compatibility and surface morphology of the collagen sponge. The nine kinds of collagen sponges from forest frog skins were co-cultured with human foreskin fibroblasts to detect cell proliferation.RESULTS AND CONCLUSION: When the chitosan/collagen was 1:1 and the glutaraldehyde concentration was 1%, we could get the collagen sponge with ideal water absorbency (water absorption capacity=5.22), mechanical properties (elongation at break=10.96%) and thermal denaturation temperature (81.24 ℃). The aperture of the forest frog skin collagen sponge was 200-400 μm, and the pores were consistent in the size and arranged regularly. Except the chitosan/collagen of 1:4 and the glutaraldehyde concentration of 1% or 5%, all kinds of forest frog skin collagen sponges could promote the viability of human foreskin fibroblasts and exerted benefits to cell viability and growth. To conclude,the forest frog skin collagen sponge has good biocompatibility and apparent morphology, in aggreement with the requirements of biological materials.