Background: and Purpose Essential tremor with a midline distribution (Mid-ET) may represent a distinct subtype of essential tremor (ET) that primarily affects midline structures, often indicating advanced disease stage and increased severity. Recent studies have highlighted the complexity of Mid-ET, but research on neurological soft signs (NSS) in Mid-ET remains insufficient. Methods: The patients with ET included in this cross-sectional study were divided into two subgroups based on whether or not the ET had a midline distribution: Mid-ET and No-MidET. Comparative analyses were performed to assess clinical features and NSS prevalence in these subgroups. Results: Among 1,160 patients, 567 (48.9%) were Mid-ET and 593 (51.1%) were No-Mid-ET.The prevalence rates of head, face (including the jaw), and voice tremors were 31.9%, 23.0%, and 25.8%, respectively. In Mid-ET, tremor often affects multiple midline structures simultaneously. In the entire cohort, 24.7%, 16.6%, and 7.6% of patients exhibited tremors in one, two, and three midline structures, respectively. The prevalence of common NSS, including mild cognitive impairment, impaired tandem gait, and questionable dystonic posturing, was significantly higher in the Mid-ET than the No-Mid-ET subgroup (all p<0.001). Furthermore, we found that female sex (p<0.001), olfactory dysfunction (p=0.003), and questionable dystonic posturing (p=0.004) were associated with Mid-ET. Conclusions Mid-ET and No-Mid-ET presented significant clinical differences. The presence of questionable dystonic posturing may contribute to the distinct characteristics of Mid-ET, suggesting the presence of pathophysiological differences between the subgroups. Further investigations are warranted to determine the potential pathophysiological link between NSS and Mid-ET.

Background: and Purpose Essential tremor with a midline distribution (Mid-ET) may represent a distinct subtype of essential tremor (ET) that primarily affects midline structures, often indicating advanced disease stage and increased severity. Recent studies have highlighted the complexity of Mid-ET, but research on neurological soft signs (NSS) in Mid-ET remains insufficient. Methods: The patients with ET included in this cross-sectional study were divided into two subgroups based on whether or not the ET had a midline distribution: Mid-ET and No-MidET. Comparative analyses were performed to assess clinical features and NSS prevalence in these subgroups. Results: Among 1,160 patients, 567 (48.9%) were Mid-ET and 593 (51.1%) were No-Mid-ET.The prevalence rates of head, face (including the jaw), and voice tremors were 31.9%, 23.0%, and 25.8%, respectively. In Mid-ET, tremor often affects multiple midline structures simultaneously. In the entire cohort, 24.7%, 16.6%, and 7.6% of patients exhibited tremors in one, two, and three midline structures, respectively. The prevalence of common NSS, including mild cognitive impairment, impaired tandem gait, and questionable dystonic posturing, was significantly higher in the Mid-ET than the No-Mid-ET subgroup (all p<0.001). Furthermore, we found that female sex (p<0.001), olfactory dysfunction (p=0.003), and questionable dystonic posturing (p=0.004) were associated with Mid-ET. Conclusions Mid-ET and No-Mid-ET presented significant clinical differences. The presence of questionable dystonic posturing may contribute to the distinct characteristics of Mid-ET, suggesting the presence of pathophysiological differences between the subgroups. Further investigations are warranted to determine the potential pathophysiological link between NSS and Mid-ET.

Background: and Purpose Essential tremor with a midline distribution (Mid-ET) may represent a distinct subtype of essential tremor (ET) that primarily affects midline structures, often indicating advanced disease stage and increased severity. Recent studies have highlighted the complexity of Mid-ET, but research on neurological soft signs (NSS) in Mid-ET remains insufficient. Methods: The patients with ET included in this cross-sectional study were divided into two subgroups based on whether or not the ET had a midline distribution: Mid-ET and No-MidET. Comparative analyses were performed to assess clinical features and NSS prevalence in these subgroups. Results: Among 1,160 patients, 567 (48.9%) were Mid-ET and 593 (51.1%) were No-Mid-ET.The prevalence rates of head, face (including the jaw), and voice tremors were 31.9%, 23.0%, and 25.8%, respectively. In Mid-ET, tremor often affects multiple midline structures simultaneously. In the entire cohort, 24.7%, 16.6%, and 7.6% of patients exhibited tremors in one, two, and three midline structures, respectively. The prevalence of common NSS, including mild cognitive impairment, impaired tandem gait, and questionable dystonic posturing, was significantly higher in the Mid-ET than the No-Mid-ET subgroup (all p<0.001). Furthermore, we found that female sex (p<0.001), olfactory dysfunction (p=0.003), and questionable dystonic posturing (p=0.004) were associated with Mid-ET. Conclusions Mid-ET and No-Mid-ET presented significant clinical differences. The presence of questionable dystonic posturing may contribute to the distinct characteristics of Mid-ET, suggesting the presence of pathophysiological differences between the subgroups. Further investigations are warranted to determine the potential pathophysiological link between NSS and Mid-ET.

Essential tremor (ET) is one of the most common movement disorders, and its main clinical feature is action tremor at 4-12 Hz in both upper limbs. With the development and progress of disease, the cognition of ET has changed from benign, single-symptomatic and age-related disease to the disease with heterogeneity in etiology, pathology and clinical manifestation. At present, the etiology and pathogenesis of ET have not been fully defined. With the development of technology, magnetic resonance imaging has been widely used in the research of ET due to its advantages of high temporal and spatial resolution, multi-angle, multi-parameter imaging, and no ionizing radiation, and many new discoveries have been made in the neuropathophysiological mechanism. In this regard, this paper summarizes the latest progress of magnetic resonance imaging in ET, including structural magnetic resonance imaging, functional magnetic resonance imaging, etc., for the purpose of exploring the pathophysiology of ET and looking forward to clinical application prospects of magnetic resonance imaging.

Essential tremor (ET) is one of the most common movement disorders, and its main clinical feature is action tremor at 4-12 Hz in both upper limbs. With the development and progress of disease, the cognition of ET has changed from benign, single-symptomatic and age-related disease to the disease with heterogeneity in etiology, pathology and clinical manifestation. At present, the etiology and pathogenesis of ET have not been fully defined. With the development of technology, magnetic resonance imaging has been widely used in the research of ET due to its advantages of high temporal and spatial resolution, multi-angle, multi-parameter imaging, and no ionizing radiation, and many new discoveries have been made in the neuropathophysiological mechanism. In this regard, this paper summarizes the latest progress of magnetic resonance imaging in ET, including structural magnetic resonance imaging, functional magnetic resonance imaging, etc., for the purpose of exploring the pathophysiology of ET and looking forward to clinical application prospects of magnetic resonance imaging.

Objective:To explore the effects of maternal exposure to Morinda officinalis oligosaccharides (MOO) during lactation on the Sprague-Dawley (SD) maternal rats and their offspring's growth and development. Methods:Seventy-two female rats with a surviving litter size of ≥ 6 were divided into the excipients control group, MOO low-dose group (50 mg/kg), MOO medium-dose group (160 mg/kg), and MOO high-dose group (500 mg/kg) using a snake-shaped grouping based on body weight, with 18 rats per group. The rats were gavage fed once daily until 20 days of delivery. The response of maternal rats after MOO exposure during lactation, as well as the appearance, response, gross anatomical abnormalities of their F1 and F2 offspring were observed. The body weight and food intake of maternal rats during lactation and those of their offspring before and after weaning were measured. The behavior (central nervous system function) of the F1 and F2 offspring was evaluated using functional observation battery (FOB). The learning and memory function of the F1 offspring was evaluated using Y-maze test. The male and female F1 offspring in the same dose group were mated when they were raised to 10-12 weeks in order to observe the reproductive function of F1 female rats.Results:Compared with the excipients control group, no abnormality was found in the clinical observation of maternal rats in the 3 MOO exposure groups during lactation, and there was no significant differences in their body weight and daily food intake during lactation (all P>0.05). No significant effects were found on the appearance, clinical symptoms, gross anatomy, body weight, and food intake of the F1 and F2 offspring after maternal rats receiving MOO exposure during lactation. In the FOB of the F1 and F2 offspring and the Y-maze test of F1 offspring, few differences in MOO exposure groups were observed and lack of significant dose-response relationship. After pregnancy, there were no statistically significant differences in the number of corpus luteum, implantation number, birth index, delivery index, survival index, and weaning index in F1 female offspring of maternal rats exposed to MOO at different doses during lactation compared with those of the excipients control group (all P>0.05). Conclusions:There were no obvious toxic reactions in maternal rats after exposure to different doses of MOO during lactation, nor in the growth and development, nervous system, learning and memory, and reproductive function of their offspring.

Objective:To explore the effects of maternal exposure to Morinda officinalis oligosaccharides (MOO) during lactation on the Sprague-Dawley (SD) maternal rats and their offspring's growth and development. Methods:Seventy-two female rats with a surviving litter size of ≥ 6 were divided into the excipients control group, MOO low-dose group (50 mg/kg), MOO medium-dose group (160 mg/kg), and MOO high-dose group (500 mg/kg) using a snake-shaped grouping based on body weight, with 18 rats per group. The rats were gavage fed once daily until 20 days of delivery. The response of maternal rats after MOO exposure during lactation, as well as the appearance, response, gross anatomical abnormalities of their F1 and F2 offspring were observed. The body weight and food intake of maternal rats during lactation and those of their offspring before and after weaning were measured. The behavior (central nervous system function) of the F1 and F2 offspring was evaluated using functional observation battery (FOB). The learning and memory function of the F1 offspring was evaluated using Y-maze test. The male and female F1 offspring in the same dose group were mated when they were raised to 10-12 weeks in order to observe the reproductive function of F1 female rats.Results:Compared with the excipients control group, no abnormality was found in the clinical observation of maternal rats in the 3 MOO exposure groups during lactation, and there was no significant differences in their body weight and daily food intake during lactation (all P>0.05). No significant effects were found on the appearance, clinical symptoms, gross anatomy, body weight, and food intake of the F1 and F2 offspring after maternal rats receiving MOO exposure during lactation. In the FOB of the F1 and F2 offspring and the Y-maze test of F1 offspring, few differences in MOO exposure groups were observed and lack of significant dose-response relationship. After pregnancy, there were no statistically significant differences in the number of corpus luteum, implantation number, birth index, delivery index, survival index, and weaning index in F1 female offspring of maternal rats exposed to MOO at different doses during lactation compared with those of the excipients control group (all P>0.05). Conclusions:There were no obvious toxic reactions in maternal rats after exposure to different doses of MOO during lactation, nor in the growth and development, nervous system, learning and memory, and reproductive function of their offspring.

Objective:To evaluate the effects of opioid-sparing analgesia on the incidence of sepsis in severely burned patients in the retrospective cohort study.Methods:The clinical data from patients with severe burns admitted to three teaching hospitals in Guangdong from 2011 to 2020 were retrospectively extracted and analyzed. The patients were divided into 2 groups based on the analgesic regimen within 30 days after injury: continuous opioids analgesia group (continuous opioid infusion at a relative constant rate for more than 72 h) and opioid-sparing analgesia group (patient-controlled intravenous analgesia/intermittent administration/opioid-free analgesia). Patient′s age, severity of burn, inhalation injury and basal pain score at rest were matched by the propensity score at a 1∶1 ratio. The primary outcome measure was the occurrence of sepsis within 90 days of admission. Secondary outcome measures included 30-day and 90-day all-cause mortality, clinical diagnosis of multiple organ dysfunction syndrome, and prevalence of burn wound infection. The amount of opioid used was also recorded.Results:A total of 328 severely burned patients were finally enrolled, with 145 patients in continuous opioid analgesia group and 183 patients in opioid-sparing analgesia group, and 110 pairs of patients (220 cases) were finally matched by the propensity score.Compared with continuous opioid analgesia group, the total consumption of opioid, daily consumption per analgesia, and consumption per burn area were significantly decreased, and the incidence of sepsis and wound infection was decreased( P<0.05), and no significant change was found in the incidence of multiple organ dysfunction syndrome, 30-day and 90-day all-cause mortality in opioid-sparing analgesia group( P>0.05). Conclusions:Compared with the continuous opioid analgesia regimen, opioid-sparing analgesia can reduce the risk of sepsis in severely burned patients.

Essential tremor (ET) is a common movement disorder. It is characterized by a distinctive 4-12 Hz action tremor typically affecting bilateral upper limbs. Existing drugs for ET mainly include β-blockers, anticonvulsants, benzodiazepines, etc. However, the efficacy of existing drugs is limited. With the development of the medical research, some progress has been made in the treatment of ET. The review will explore the recent advances in the treatment of ET,such as new drugs, surgical treatment, repetitive transcranial magnetic stimulation, rehabilitation treatment, etc., in order to provide clinical application prospects.