The nervous system processes a vast amount of information,performing computations that underlie perception,cognition,and behavior.During development,neuronal guidance genes,which encode extracellular cues,their recept...The nervous system processes a vast amount of information,performing computations that underlie perception,cognition,and behavior.During development,neuronal guidance genes,which encode extracellular cues,their receptors,and downstream signal transducers,organize neural wiring to generate the complex architecture of the nervous system.It is now evident that many of these neuroguidance cues and their receptors are active during development and are also expressed in the adult nervous system.This suggests that neuronal guidance pathways are critical not only for neural wiring but also for ongoing function and maintenance of the mature nervous system.Supporting this view,these pathways continue to regulate synaptic connectivity,plasticity,and remodeling,and overall brain homeostasis throughout adulthood.Genetic and transcriptomic analyses have further revealed many neuronal guidance genes to be associated with a wide range of neurodegenerative and neuropsychiatric disorders.Although the precise mechanisms by which aberrant neuronal guidance signaling drives the pathogenesis of these diseases remain to be clarified,emerging evidence points to several common themes,including dysfunction in neurons,microglia,astrocytes,and endothelial cells,along with dysregulation of neuron-microglia-astrocyte,neuroimmune,and neurovascular interactions.In this review,we explore recent advances in understanding the molecular and cellular mechanisms by which aberrant neuronal guidance signaling contributes to disease pathogenesis through altered cell-cell interactions.For instance,recent studies have unveiled two distinct semaphorin-plexin signaling pathways that affect microglial activation and neuroinflammation.We discuss the challenges ahead,along with the therapeutic potentials of targeting neuronal guidance pathways for treating neurodegenerative diseases.Particular focus is placed on how neuronal guidance mechanisms control neuron-glia and neuroimmune interactions and modulate microglial function under physiological and pathological conditions.Specifically,we examine the crosstalk between neuronal guidance signaling and TREM2,a master regulator of microglial function,in the context of pathogenic protein aggregates.It is well-established that age is a major risk factor for neurodegeneration.Future research should address how aging and neuronal guidance signaling interact to influence an individual’s susceptibility to various late-onset neurological diseases and how the progression of these diseases could be therapeutically blocked by targeting neuronal guidance pathways.展开更多
Acute central nervous system injuries,including ischemic stro ke,intracerebral hemorrhage,subarachnoid hemorrhage,traumatic brain injury,and spinal co rd injury,are a major global health challenge.Identifying optimal ...Acute central nervous system injuries,including ischemic stro ke,intracerebral hemorrhage,subarachnoid hemorrhage,traumatic brain injury,and spinal co rd injury,are a major global health challenge.Identifying optimal therapies and improving the long-term neurological functions of patients with acute central nervous system injuries are urgent priorities.Mitochondria are susceptible to damage after acute central nervous system injury,and this leads to the release of toxic levels of reactive oxygen species,which induce cell death.Mitophagy,a selective form of autophagy,is crucial in eliminating redundant or damaged mitochondria during these events.Recent evidence has highlighted the significant role of mitophagy in acute central nervous system injuries.In this review,we provide a comprehensive overview of the process,classification,and related mechanisms of mitophagy.We also highlight the recent developments in research into the role of mitophagy in various acute central nervous system injuries and drug therapies that regulate mitophagy.In the final section of this review,we emphasize the potential for treating these disorders by focusing on mitophagy and suggest future research paths in this area.展开更多
Objective:This study aims to explore the facilitating and hindering factors faced by rehabilitation professionals in providing cognitive rehabilitation services for patients with Post-Stroke Cognitive Impairment(PSCI)...Objective:This study aims to explore the facilitating and hindering factors faced by rehabilitation professionals in providing cognitive rehabilitation services for patients with Post-Stroke Cognitive Impairment(PSCI)in China,offering empirical evidence for optimizing service models.Methods:Using purposive sampling,semi-structured interviews were conducted with 15 rehabilitation professionals from three tertiary hospitals and two community health service centers in Hubei Province from September to November 2023.Audio recordings were transcribed to obtain textual data,which were analyzed using Nvivo 12 software for coding.An inductive thematic analysis approach was employed to distill key themes.Results:The study identified multiple facilitating and hindering factors related to cognitive rehabilitation,summarizing them into four core themes and eight sub-themes:(1)Cognitive Screening:Presence of practical barriers and inadequate professional knowledge,which limited early detection and effective intervention for cognitive impairments;(2)Individualized Rehabilitation:Lack of patient-directed personalized interventions and multidisciplinary team collaboration,affecting patient engagement and rehabilitation outcomes;(3)Lack of Psychological Rehabilitation:The necessity of psychological interventions was emphasized,yet there is a significant scarcity of neuropsychological resources,limiting the implementation of psychological support;(4)Challenges of Community Continuity in Rehabilitation:Severe service discontinuity,with community healthcare institutions facing shortages of professional knowledge and equipment,resulting in patients being unable to receive continuous and effective rehabilitation support after discharge.Conclusion:Current PSCI rehabilitation services face issues such as insufficient staffing,ineffective multidisciplinary team collaboration,and a lack of community resources.Enhancing neuropsychological resources,establishing standardized MDT collaboration processes,and creating a referral system linking hospitals,communities,and families are essential to improve primary care capacity and enhance rehabilitation outcomes for patients.展开更多
This paper summarizes the systematic rehabilitation nursing experience for a patient with acute respiratory failure combined with heart failure and obesity(BMI=39.1).Key nursing interventions included implementing a s...This paper summarizes the systematic rehabilitation nursing experience for a patient with acute respiratory failure combined with heart failure and obesity(BMI=39.1).Key nursing interventions included implementing a sequential respiratory support strategy(high-flow oxygen therapy→non-invasive ventilation→transition to home ventilator),conducting phased exercise rehabilitation training,delivering precise nutritional management(total daily calorie intake controlled at 1500-1800 kcal),enhancing interdisciplinary risk prevention and control,and employing SMART goal setting for behavioral intervention.Following systematic intervention,after 4 days of hospitalization,the patient’s SpO2 increased from 80%to 92%while off mechanical ventilator support,and the self-care ability score rose to 85 points.One week after discharge,the patient’s body weight had decreased by 2 kg,pulmonary function indices showed improvement,and the patient successfully returned to work.展开更多
BACKGROUND Restless legs syndrome(RLS)is a neurological disorder characterized by an uncontrollable urge to move the legs during rest.Standard treatments may provide short-term relief but are limited by long-term adve...BACKGROUND Restless legs syndrome(RLS)is a neurological disorder characterized by an uncontrollable urge to move the legs during rest.Standard treatments may provide short-term relief but are limited by long-term adverse effects.Herbal medicine containing Paeoniae Radix(HCP)has traditionally been used in Korean medicine to treat RLS symptoms.AIM To investigate the clinical effectiveness and safety of HCP in treating RLS.METHODS This retrospective chart review study included 15 patients with RLS who were treated with HCP between September 2017 and August 2022 at the Kyung Hee University Korean Medicine Hospital.The demographic,disease-related,and treatment-related characteristics,as well as the impressions of each patient,were analyzed.The study also evaluated the changes in the subjective complaints of RLS symptoms,the Korean version of the International Restless Legs Scale(KIRLS)scores before and after treatment,and the adverse events after HCP administration.RESULTS Following HCP administration,14 patients(93.3%)experienced a decrease in the degree of discomfort associated with their symptoms,with an average reduction to 44.7±35.1%compared to their discomfort levels before taking the drug.After treatment,the mean total K-IRLS score decreased significantly from 23.00±9.75 to 13.93±10.9(P=0.005).Among the HCP,a significant reduction in the K-IRLS score was observed in the Gyejibokryeonghwan(26.0±9.7 to 10.0±9.4,P=0.028)and Jakyakgamchotang(23.2±12.6 to 6.6±4.2,P=0.042)groups.Additionally,no adverse events were reported.CONCLUSION HCP improved symptoms in RLS patients.These results suggest that HCP may be an effective and safe alternative for RLS.A randomized controlled trial is required to confirm these findings.展开更多
Previous studies have found associations between color discrimination deficits and cognitive impairments besides aging.However,investigations into the microstructural pathology of brain white matter(WM)associated with...Previous studies have found associations between color discrimination deficits and cognitive impairments besides aging.However,investigations into the microstructural pathology of brain white matter(WM)associated with these deficits remain limited.This study aimed to examine the microstructural characteristics of WM in the non-demented population with abnormal color discrimination,utilizing Neurite Orientation Dispersion and Density Imaging(NODDI),and to explore their correlations with cognitive functions and cognition-related plasma biomarkers.The tract-based spatial statistic analysis revealed significant differences in specific brain regions between the abnormal color discrimination group and the healthy controls,characterized by increased isotropic volume fraction and decreased neurite density index and orientation dispersion index.Further analysis of region-of-interest parameters revealed that the isotropic volume fraction in the bilateral anterior thalamic radiation,superior longitudinal fasciculus,cingulum,and forceps minor was significantly correlated with poorer performance on neuropsychological assessments and to varying degrees various cognition-related plasma biomarkers.These findings provide neuroimaging evidence that WM microstructural abnormalities in non-demented individuals with abnormal color discrimination are associated with cognitive dysfunction,potentially serving as early markers for cognitive decline.展开更多
Genetic factors may be learnt from families with gene mutations that render nerve-injury sus- ceptibility even to ordinary physical activities. A typical example is hereditary neuropathy with liability to pressure pal...Genetic factors may be learnt from families with gene mutations that render nerve-injury sus- ceptibility even to ordinary physical activities. A typical example is hereditary neuropathy with liability to pressure palsies （HNPP）. HNPP is caused by a heterozygous deletion of PMP22 gene. PMP22 deficiency disrupts myelin junctions （such as tight junction and adherens junctions）, leading to abnormally increased myelin permeability that explains the nerve susceptibility to injury. This finding should motivate investigators to identify additional genetic factors contribut- ing to nerve vulnerability of injury.展开更多
In 1906,Dr.Alois Alzheimer reported a case of dementia and thought it was a new type of disease.Later,Dr.Emil Kraepelin named it Alzheimer’s disease(AD).One hundred years later,AD has become the most common type of d...In 1906,Dr.Alois Alzheimer reported a case of dementia and thought it was a new type of disease.Later,Dr.Emil Kraepelin named it Alzheimer’s disease(AD).One hundred years later,AD has become the most common type of dementia affecting the elderly population and a heavy health burden.However,the pathogenesis of the disease remains unclear,and no disease-modifying therapies are available to prevent,halt,or even slow the progression of the disease[1].展开更多
Migraine is a common and debilitating headache disorder. Although its pathogenesis remains elusive,abnormal trigeminal and central nervous system activity is likely to play an important role. Transient receptor potent...Migraine is a common and debilitating headache disorder. Although its pathogenesis remains elusive,abnormal trigeminal and central nervous system activity is likely to play an important role. Transient receptor potential(TRP) channels, which transduce noxious stimuli into pain signals, are expressed in trigeminal ganglion neurons and brain regions closely associated with the pathophysiology of migraine. In the trigeminal ganglion,TRP channels co-localize with calcitonin gene-related peptide, a neuropeptide crucially implicated in migraine pathophysiology. Many preclinical and clinical data support the roles of TRP channels in migraine. In particular,activation of TRP cation channel V1 has been shown to regulate calcitonin gene-related peptide release from trigeminal nerves. Intriguingly, several effective antimigraine therapies, including botulinum neurotoxin type A, affect the functions of TRP cation channels. Here, we discuss currently available data regarding the roles of major TRP cation channels in the pathophysiology of migraine and the therapeutic applicability thereof.展开更多
Amyotrophic lateral sclerosis is a fatal multisystemic neurodegenerative disease with motor neurons being a primary target.Although progressive weakness is a hallmark feature of amyotrophic lateral sclerosis,there is ...Amyotrophic lateral sclerosis is a fatal multisystemic neurodegenerative disease with motor neurons being a primary target.Although progressive weakness is a hallmark feature of amyotrophic lateral sclerosis,there is considerable heterogeneity,including clinical presentation,progression,and the underlying triggers for disease initiation.Based on longitudinal studies with families harboring amyotrophic lateral sclerosis-associated gene mutations,it has become apparent that overt disease is preceded by a prodromal phase,possibly in years,where compensatory mechanisms delay symptom onset.Since 85-90%of amyotrophic lateral sclerosis is sporadic,there is a strong need for identifying biomarkers that can detect this prodromal phase as motor neurons have limited capacity for regeneration.Current Food and Drug Administration-approved therapies work by slowing the degenerative process and are most effective early in the disease.Skeletal muscle,including the neuromuscular junction,manifests abnormalities at the earliest stages of the disease,before motor neuron loss,making it a promising source for identifying biomarkers of the prodromal phase.The accessibility of muscle through biopsy provides a lens into the distal motor system at earlier stages and in real time.The advent of“omics”technology has led to the identification of numerous dysregulated molecules in amyotrophic lateral sclerosis muscle,ranging from coding and non-coding RNAs to proteins and metabolites.This technology has opened the door for identifying biomarkers of disease activity and providing insight into disease mechanisms.A major challenge is correlating the myriad of dysregulated molecules with clinical or histological progression and understanding their relevance to presymptomatic phases of disease.There are two major goals of this review.The first is to summarize some of the biomarkers identified in human amyotrophic lateral sclerosis muscle that have a clinicopathological correlation with disease activity,evidence of a similar dysregulation in the SOD1G93A mouse during presymptomatic stages,and evidence of progressive change during disease progression.The second goal is to review the molecular pathways these biomarkers reflect and their potential role in mitigating or promoting disease progression,and as such,their potential as therapeutic targets in amyotrophic lateral sclerosis.展开更多
The central nervous system has a very high energy requirement. Accord- ingly, despite representing only 2% of the body＇s mass, the brain uses 20% of the total oxygen consumption. Importantly, because most of this ene...The central nervous system has a very high energy requirement. Accord- ingly, despite representing only 2% of the body＇s mass, the brain uses 20% of the total oxygen consumption. Importantly, because most of this energy is used to maintain synaptic activity, even a mild decrease in its supply to the brain has deleterious implications for synaptic function.展开更多
Insomnia is one of the most frequently observed sleep disorders, affecting nearly 10% of the general population. It has multiple etiological factors. Recently, it has been reported that EEG abnormalities are associate...Insomnia is one of the most frequently observed sleep disorders, affecting nearly 10% of the general population. It has multiple etiological factors. Recently, it has been reported that EEG abnormalities are associated with insomnia in patients previously diagnosed as idiopathic insomniacs. In addition, transcranial magnetic stimulation (TMS) has shown to be effective in the treatment of disorders characterized by neural hyper-excitability. Method: In the present study, patients with insomnia and EEG abnormalities were submitted to slow repetitive trans-cranial magnetic stimulation, for 15 minutes daily during 10 days. Polysomnographic recordings were performed before and after TMS. Results: The results indicate that the presence of EEG abnormalities significantly decreased after TMS. In addition, most of the sleep parameters showed significant improvement. Conclusions: These data support the notion that TMS is a reliable therapeutic tool for patients affected with abnormalities linked to neuronal hyper-excitability.展开更多
More than 2 million new ischemic stroke patients are diagnosed every year in China,with a prevalence of about11 million.Stroke is the leading cause of death in the country[1,2].The therapeutic effect on ischemic strok...More than 2 million new ischemic stroke patients are diagnosed every year in China,with a prevalence of about11 million.Stroke is the leading cause of death in the country[1,2].The therapeutic effect on ischemic stroke in the ultra-early period depends on the timely restoration of the blood supply to rescue brain tissue.展开更多
Multiple cellular components,including neuronal,glial and endothelial ceils,are involved in the sophis-ticated pathological processes following central nervous system injury.The pathological process cannot reduce dama...Multiple cellular components,including neuronal,glial and endothelial ceils,are involved in the sophis-ticated pathological processes following central nervous system injury.The pathological process cannot reduce damage or improve functional recovery by merely targeting the molecular mechanisms of neuronal cell death after central nerve system injuries.Eph receptors and ephrin ligands have drawn wide attention since the discovery of their extensive distribution and unique bidirectional signaling between astrocytes and neurons.The roles of Eph/ephrin bidirectional signaling in the developmental processes have been re-ported in previous research.Recent observations suggest that Eph/ephrin bidirectional signaling continues to be expressed in most regions and cell types in the adult central nervous system,playing diverse roles.The Eph/ephrin complex mediates neurogenesis and angiogenesis,promotes glial scar formation,regulates endocrine levels,inhibits myelin formation and aggravates inflammation and nerve pain caused by injury.~lhe interaction between Eph and ephrin is also considered to be the key to angiogenesis.This review focus-es on the roles of Eph/ephrin bidirectional signaling in the repair of central nervous system injuries.展开更多
Neurodegenerative diseases include several kinds of neurological disorder that are caused by the progressive death of neurons in different regions of the brain.Such diseases affect millions of people worldwide and imp...Neurodegenerative diseases include several kinds of neurological disorder that are caused by the progressive death of neurons in different regions of the brain.Such diseases affect millions of people worldwide and impose a heavy health burden on modern societies.However,their pathogenesis remains elusive,and disease-modifying methods are not currently available to prevent,halt,or reverse them[1].展开更多
With the progress of society, there is an increasing need to tackle disorders of the central nervous system. Human brain tissue, unlike animal tissues, is an irreplaceable resource for the study of neurological diseas...With the progress of society, there is an increasing need to tackle disorders of the central nervous system. Human brain tissue, unlike animal tissues, is an irreplaceable resource for the study of neurological diseases (1)Aimed at scientific research and education, the roles of human brain tissue repositories are to acquire brain tissue from donors, prepare, process, and preserve collected samples,provide tissue to specific eligible facilities, and determine the characteristics of each tissue sample.展开更多
Unipolar depressive disorder(UDD)affects more than 264 million people worldwide and was projected well before the severe acute respiratory syndrome coronavirus 2 pandemic to be the leading cause of disability-adjusted...Unipolar depressive disorder(UDD)affects more than 264 million people worldwide and was projected well before the severe acute respiratory syndrome coronavirus 2 pandemic to be the leading cause of disability-adjusted life years lost in 2030.It is imperative for leading economies to implement preventive strategies targeted towards UDD,given consistent policies are currently lacking.Recently established similarities between the aetiological hypotheses of depression and cardiometabolic diseases are shifting paradigms within this field.It is believed that dietary practices could potentially reduce the incidence of depression;similar to their effects on metabolism.Thus,the aim of this review was to compile current evidence on healthy dietary patterns as suitable contributors towards primary prevention strategies against UDD.Most of the well-known biological mechanisms behind depression have been positively associated with healthful diets and dietary patterns to varying degrees.Interestingly,a common factor of UDD is the production and overall effects of inflammatory cytokines,such as interleukin-6,tumor necrosis factor-α,and Creactive protein.These compounds have been associated with depressive symptoms,disturbances in neuroendocrine function,leaky gut,monoamine activity and brain function,while also being key factors in the development of cardiometabolic diseases.The Mediterranean diet(MD)in particular,is well supported by first-level evidence regarding its preventive qualities against metabolic and cardiovascular diseases and thus considered a model for healthy eating by various organizations.In one of the few clinical trials investigating these associations,the PREDIMED trial,individuals with diabetes assigned to a MD supplemented with mixed tree nuts experienced a 41%relative risk reduction for developing depression.Lastly,there is a need to include health related quality of life as an indicator of physical and mental well-being,considering its putative associations with depression and suicide risk.Going forward,focusing on clinical trials,using precise nutritional assessments,and identifying nutritional biomarkers which may be related to depression are needed to fully support the implementation of dietary recommendations in the field of psychiatry.展开更多
BACKGROUND Research on physiopathology of obesity may receive new hints from studies on skinny people(SP). These are individuals who show a poor or null gaining of body weight, in spite of high-calorie intake, by far ...BACKGROUND Research on physiopathology of obesity may receive new hints from studies on skinny people(SP). These are individuals who show a poor or null gaining of body weight, in spite of high-calorie intake, by far exceeding the body requirements.AIM To evaluate how circulating factors present in the SP sera may affect adipogenesis of mesenchymal stromal cells(MSCs).METHODS We isolated MSCs from bone marrow of healthy donors with both normal body mass index(BMI) and caloric consumption. MSC cultures were primed with sera collected from SP or normal people(NP). Then biomolecular assays were performed to evaluate effect on proliferation, apoptosis, senescence, cell commitment, and differentiation.RESULTS SP priming affected adipocyte cell commitment and reduced spontaneous adipogenesis. Moreover, an in-depth analysis of exogenous-induced adipocyte differentiation showed striking differences between differentiation in SP-primed samples compared with NP ones. In adipocytes from SP cultures we observed a reduced size of lipid droplets, an increased expression of adipose triglyceride lipase, along with high mitochondria content and ability to produce ATP in starvation condition. These data and the expression of UCP1 protein, indicated that SP pretreatment produced a bias toward brown adipocyte differentiation.CONCLUSION Our data suggest that sera from SP may promote brown adipogenesis rather that white adipocyte differentiation. This finding could explain why SP present normal body composition in spite of an excess of caloric intake. We hypothesize that some circulating components present in the blood of these individuals may favor brown adipogenesis at expense of white adipocyte production.展开更多
基金supported by JSPS(KAKENHI:21K06205,23K06937,24K23419)AMED(to JYK,SaY,TM,SiY,YT,and NH)JYW had long been supported by the NIH.
文摘The nervous system processes a vast amount of information,performing computations that underlie perception,cognition,and behavior.During development,neuronal guidance genes,which encode extracellular cues,their receptors,and downstream signal transducers,organize neural wiring to generate the complex architecture of the nervous system.It is now evident that many of these neuroguidance cues and their receptors are active during development and are also expressed in the adult nervous system.This suggests that neuronal guidance pathways are critical not only for neural wiring but also for ongoing function and maintenance of the mature nervous system.Supporting this view,these pathways continue to regulate synaptic connectivity,plasticity,and remodeling,and overall brain homeostasis throughout adulthood.Genetic and transcriptomic analyses have further revealed many neuronal guidance genes to be associated with a wide range of neurodegenerative and neuropsychiatric disorders.Although the precise mechanisms by which aberrant neuronal guidance signaling drives the pathogenesis of these diseases remain to be clarified,emerging evidence points to several common themes,including dysfunction in neurons,microglia,astrocytes,and endothelial cells,along with dysregulation of neuron-microglia-astrocyte,neuroimmune,and neurovascular interactions.In this review,we explore recent advances in understanding the molecular and cellular mechanisms by which aberrant neuronal guidance signaling contributes to disease pathogenesis through altered cell-cell interactions.For instance,recent studies have unveiled two distinct semaphorin-plexin signaling pathways that affect microglial activation and neuroinflammation.We discuss the challenges ahead,along with the therapeutic potentials of targeting neuronal guidance pathways for treating neurodegenerative diseases.Particular focus is placed on how neuronal guidance mechanisms control neuron-glia and neuroimmune interactions and modulate microglial function under physiological and pathological conditions.Specifically,we examine the crosstalk between neuronal guidance signaling and TREM2,a master regulator of microglial function,in the context of pathogenic protein aggregates.It is well-established that age is a major risk factor for neurodegeneration.Future research should address how aging and neuronal guidance signaling interact to influence an individual’s susceptibility to various late-onset neurological diseases and how the progression of these diseases could be therapeutically blocked by targeting neuronal guidance pathways.
基金supported by the National Natural Science Foundation of China,Nos.81920108017(to YX),82130036(to YX),82371326(to XC),82171310(to XC)the STI2030-Major Projects,No.2022ZD0211800(to YX)Jiangsu Province Key Medical Discipline,No.ZDXK202216(to YX)。
文摘Acute central nervous system injuries,including ischemic stro ke,intracerebral hemorrhage,subarachnoid hemorrhage,traumatic brain injury,and spinal co rd injury,are a major global health challenge.Identifying optimal therapies and improving the long-term neurological functions of patients with acute central nervous system injuries are urgent priorities.Mitochondria are susceptible to damage after acute central nervous system injury,and this leads to the release of toxic levels of reactive oxygen species,which induce cell death.Mitophagy,a selective form of autophagy,is crucial in eliminating redundant or damaged mitochondria during these events.Recent evidence has highlighted the significant role of mitophagy in acute central nervous system injuries.In this review,we provide a comprehensive overview of the process,classification,and related mechanisms of mitophagy.We also highlight the recent developments in research into the role of mitophagy in various acute central nervous system injuries and drug therapies that regulate mitophagy.In the final section of this review,we emphasize the potential for treating these disorders by focusing on mitophagy and suggest future research paths in this area.
基金Ethics Committee of Taihe Hospital in Shiyan City(Project No.:2023XM008)。
文摘Objective:This study aims to explore the facilitating and hindering factors faced by rehabilitation professionals in providing cognitive rehabilitation services for patients with Post-Stroke Cognitive Impairment(PSCI)in China,offering empirical evidence for optimizing service models.Methods:Using purposive sampling,semi-structured interviews were conducted with 15 rehabilitation professionals from three tertiary hospitals and two community health service centers in Hubei Province from September to November 2023.Audio recordings were transcribed to obtain textual data,which were analyzed using Nvivo 12 software for coding.An inductive thematic analysis approach was employed to distill key themes.Results:The study identified multiple facilitating and hindering factors related to cognitive rehabilitation,summarizing them into four core themes and eight sub-themes:(1)Cognitive Screening:Presence of practical barriers and inadequate professional knowledge,which limited early detection and effective intervention for cognitive impairments;(2)Individualized Rehabilitation:Lack of patient-directed personalized interventions and multidisciplinary team collaboration,affecting patient engagement and rehabilitation outcomes;(3)Lack of Psychological Rehabilitation:The necessity of psychological interventions was emphasized,yet there is a significant scarcity of neuropsychological resources,limiting the implementation of psychological support;(4)Challenges of Community Continuity in Rehabilitation:Severe service discontinuity,with community healthcare institutions facing shortages of professional knowledge and equipment,resulting in patients being unable to receive continuous and effective rehabilitation support after discharge.Conclusion:Current PSCI rehabilitation services face issues such as insufficient staffing,ineffective multidisciplinary team collaboration,and a lack of community resources.Enhancing neuropsychological resources,establishing standardized MDT collaboration processes,and creating a referral system linking hospitals,communities,and families are essential to improve primary care capacity and enhance rehabilitation outcomes for patients.
文摘This paper summarizes the systematic rehabilitation nursing experience for a patient with acute respiratory failure combined with heart failure and obesity(BMI=39.1).Key nursing interventions included implementing a sequential respiratory support strategy(high-flow oxygen therapy→non-invasive ventilation→transition to home ventilator),conducting phased exercise rehabilitation training,delivering precise nutritional management(total daily calorie intake controlled at 1500-1800 kcal),enhancing interdisciplinary risk prevention and control,and employing SMART goal setting for behavioral intervention.Following systematic intervention,after 4 days of hospitalization,the patient’s SpO2 increased from 80%to 92%while off mechanical ventilator support,and the self-care ability score rose to 85 points.One week after discharge,the patient’s body weight had decreased by 2 kg,pulmonary function indices showed improvement,and the patient successfully returned to work.
基金Supported by Korea Health Technology R&D Project through the Korea Health Industry Development Institute(KHIDI),the Ministry of Health and Welfare,Republic of Korea,No.RS-2023-KH142002.
文摘BACKGROUND Restless legs syndrome(RLS)is a neurological disorder characterized by an uncontrollable urge to move the legs during rest.Standard treatments may provide short-term relief but are limited by long-term adverse effects.Herbal medicine containing Paeoniae Radix(HCP)has traditionally been used in Korean medicine to treat RLS symptoms.AIM To investigate the clinical effectiveness and safety of HCP in treating RLS.METHODS This retrospective chart review study included 15 patients with RLS who were treated with HCP between September 2017 and August 2022 at the Kyung Hee University Korean Medicine Hospital.The demographic,disease-related,and treatment-related characteristics,as well as the impressions of each patient,were analyzed.The study also evaluated the changes in the subjective complaints of RLS symptoms,the Korean version of the International Restless Legs Scale(KIRLS)scores before and after treatment,and the adverse events after HCP administration.RESULTS Following HCP administration,14 patients(93.3%)experienced a decrease in the degree of discomfort associated with their symptoms,with an average reduction to 44.7±35.1%compared to their discomfort levels before taking the drug.After treatment,the mean total K-IRLS score decreased significantly from 23.00±9.75 to 13.93±10.9(P=0.005).Among the HCP,a significant reduction in the K-IRLS score was observed in the Gyejibokryeonghwan(26.0±9.7 to 10.0±9.4,P=0.028)and Jakyakgamchotang(23.2±12.6 to 6.6±4.2,P=0.042)groups.Additionally,no adverse events were reported.CONCLUSION HCP improved symptoms in RLS patients.These results suggest that HCP may be an effective and safe alternative for RLS.A randomized controlled trial is required to confirm these findings.
基金supported by the Joint Funds for Innovation of Science and Technology,Fujian Province(2021Y9037)a National Clinical Key Special Subject of China(21281003).
文摘Previous studies have found associations between color discrimination deficits and cognitive impairments besides aging.However,investigations into the microstructural pathology of brain white matter(WM)associated with these deficits remain limited.This study aimed to examine the microstructural characteristics of WM in the non-demented population with abnormal color discrimination,utilizing Neurite Orientation Dispersion and Density Imaging(NODDI),and to explore their correlations with cognitive functions and cognition-related plasma biomarkers.The tract-based spatial statistic analysis revealed significant differences in specific brain regions between the abnormal color discrimination group and the healthy controls,characterized by increased isotropic volume fraction and decreased neurite density index and orientation dispersion index.Further analysis of region-of-interest parameters revealed that the isotropic volume fraction in the bilateral anterior thalamic radiation,superior longitudinal fasciculus,cingulum,and forceps minor was significantly correlated with poorer performance on neuropsychological assessments and to varying degrees various cognition-related plasma biomarkers.These findings provide neuroimaging evidence that WM microstructural abnormalities in non-demented individuals with abnormal color discrimination are associated with cognitive dysfunction,potentially serving as early markers for cognitive decline.
基金supported by grants from NINDS R01NS066927Department of Veterans Affairs R&D funds
文摘Genetic factors may be learnt from families with gene mutations that render nerve-injury sus- ceptibility even to ordinary physical activities. A typical example is hereditary neuropathy with liability to pressure palsies （HNPP）. HNPP is caused by a heterozygous deletion of PMP22 gene. PMP22 deficiency disrupts myelin junctions （such as tight junction and adherens junctions）, leading to abnormally increased myelin permeability that explains the nerve susceptibility to injury. This finding should motivate investigators to identify additional genetic factors contribut- ing to nerve vulnerability of injury.
基金supported by the National Natural Science Foundation of China(91749206 and 81625007).
文摘In 1906,Dr.Alois Alzheimer reported a case of dementia and thought it was a new type of disease.Later,Dr.Emil Kraepelin named it Alzheimer’s disease(AD).One hundred years later,AD has become the most common type of dementia affecting the elderly population and a heavy health burden.However,the pathogenesis of the disease remains unclear,and no disease-modifying therapies are available to prevent,halt,or even slow the progression of the disease[1].
基金supported by the Japan Society for the Promotion of Science KAKENHI(26460706 and 19K07849)a Japan-China Sasakawa Medical Fellowship(2017816)a State Scholarship Fund of the China Scholarship Council(201908500072)。
文摘Migraine is a common and debilitating headache disorder. Although its pathogenesis remains elusive,abnormal trigeminal and central nervous system activity is likely to play an important role. Transient receptor potential(TRP) channels, which transduce noxious stimuli into pain signals, are expressed in trigeminal ganglion neurons and brain regions closely associated with the pathophysiology of migraine. In the trigeminal ganglion,TRP channels co-localize with calcitonin gene-related peptide, a neuropeptide crucially implicated in migraine pathophysiology. Many preclinical and clinical data support the roles of TRP channels in migraine. In particular,activation of TRP cation channel V1 has been shown to regulate calcitonin gene-related peptide release from trigeminal nerves. Intriguingly, several effective antimigraine therapies, including botulinum neurotoxin type A, affect the functions of TRP cation channels. Here, we discuss currently available data regarding the roles of major TRP cation channels in the pathophysiology of migraine and the therapeutic applicability thereof.
基金supported by NIH Grants R01NS092651 and R21NS111275-01the Department of Veterans Affairs,BX001148 and BX005899(to PHK)。
文摘Amyotrophic lateral sclerosis is a fatal multisystemic neurodegenerative disease with motor neurons being a primary target.Although progressive weakness is a hallmark feature of amyotrophic lateral sclerosis,there is considerable heterogeneity,including clinical presentation,progression,and the underlying triggers for disease initiation.Based on longitudinal studies with families harboring amyotrophic lateral sclerosis-associated gene mutations,it has become apparent that overt disease is preceded by a prodromal phase,possibly in years,where compensatory mechanisms delay symptom onset.Since 85-90%of amyotrophic lateral sclerosis is sporadic,there is a strong need for identifying biomarkers that can detect this prodromal phase as motor neurons have limited capacity for regeneration.Current Food and Drug Administration-approved therapies work by slowing the degenerative process and are most effective early in the disease.Skeletal muscle,including the neuromuscular junction,manifests abnormalities at the earliest stages of the disease,before motor neuron loss,making it a promising source for identifying biomarkers of the prodromal phase.The accessibility of muscle through biopsy provides a lens into the distal motor system at earlier stages and in real time.The advent of“omics”technology has led to the identification of numerous dysregulated molecules in amyotrophic lateral sclerosis muscle,ranging from coding and non-coding RNAs to proteins and metabolites.This technology has opened the door for identifying biomarkers of disease activity and providing insight into disease mechanisms.A major challenge is correlating the myriad of dysregulated molecules with clinical or histological progression and understanding their relevance to presymptomatic phases of disease.There are two major goals of this review.The first is to summarize some of the biomarkers identified in human amyotrophic lateral sclerosis muscle that have a clinicopathological correlation with disease activity,evidence of a similar dysregulation in the SOD1G93A mouse during presymptomatic stages,and evidence of progressive change during disease progression.The second goal is to review the molecular pathways these biomarkers reflect and their potential role in mitigating or promoting disease progression,and as such,their potential as therapeutic targets in amyotrophic lateral sclerosis.
基金supported in part by National Institutes of Health Grants NS-091201(to MY)and NS-079331(to MY)VA MERIT Award IO1BX003441(to MY)
文摘The central nervous system has a very high energy requirement. Accord- ingly, despite representing only 2% of the body＇s mass, the brain uses 20% of the total oxygen consumption. Importantly, because most of this energy is used to maintain synaptic activity, even a mild decrease in its supply to the brain has deleterious implications for synaptic function.
文摘Insomnia is one of the most frequently observed sleep disorders, affecting nearly 10% of the general population. It has multiple etiological factors. Recently, it has been reported that EEG abnormalities are associated with insomnia in patients previously diagnosed as idiopathic insomniacs. In addition, transcranial magnetic stimulation (TMS) has shown to be effective in the treatment of disorders characterized by neural hyper-excitability. Method: In the present study, patients with insomnia and EEG abnormalities were submitted to slow repetitive trans-cranial magnetic stimulation, for 15 minutes daily during 10 days. Polysomnographic recordings were performed before and after TMS. Results: The results indicate that the presence of EEG abnormalities significantly decreased after TMS. In addition, most of the sleep parameters showed significant improvement. Conclusions: These data support the notion that TMS is a reliable therapeutic tool for patients affected with abnormalities linked to neuronal hyper-excitability.
基金the Clinical Medical Research Expert Training Program of Daping Hospital,China(2018XLC2022)。
文摘More than 2 million new ischemic stroke patients are diagnosed every year in China,with a prevalence of about11 million.Stroke is the leading cause of death in the country[1,2].The therapeutic effect on ischemic stroke in the ultra-early period depends on the timely restoration of the blood supply to rescue brain tissue.
基金supported by the National Natural Science Foundation of China,No.81371312,81030021the National Basic Research Development Program of China(973 Program),No.2011CB504403
文摘Multiple cellular components,including neuronal,glial and endothelial ceils,are involved in the sophis-ticated pathological processes following central nervous system injury.The pathological process cannot reduce damage or improve functional recovery by merely targeting the molecular mechanisms of neuronal cell death after central nerve system injuries.Eph receptors and ephrin ligands have drawn wide attention since the discovery of their extensive distribution and unique bidirectional signaling between astrocytes and neurons.The roles of Eph/ephrin bidirectional signaling in the developmental processes have been re-ported in previous research.Recent observations suggest that Eph/ephrin bidirectional signaling continues to be expressed in most regions and cell types in the adult central nervous system,playing diverse roles.The Eph/ephrin complex mediates neurogenesis and angiogenesis,promotes glial scar formation,regulates endocrine levels,inhibits myelin formation and aggravates inflammation and nerve pain caused by injury.~lhe interaction between Eph and ephrin is also considered to be the key to angiogenesis.This review focus-es on the roles of Eph/ephrin bidirectional signaling in the repair of central nervous system injuries.
基金supported by the National Natural Science Foundation of China(91749206)。
文摘Neurodegenerative diseases include several kinds of neurological disorder that are caused by the progressive death of neurons in different regions of the brain.Such diseases affect millions of people worldwide and impose a heavy health burden on modern societies.However,their pathogenesis remains elusive,and disease-modifying methods are not currently available to prevent,halt,or reverse them[1].
文摘With the progress of society, there is an increasing need to tackle disorders of the central nervous system. Human brain tissue, unlike animal tissues, is an irreplaceable resource for the study of neurological diseases (1)Aimed at scientific research and education, the roles of human brain tissue repositories are to acquire brain tissue from donors, prepare, process, and preserve collected samples,provide tissue to specific eligible facilities, and determine the characteristics of each tissue sample.
文摘Unipolar depressive disorder(UDD)affects more than 264 million people worldwide and was projected well before the severe acute respiratory syndrome coronavirus 2 pandemic to be the leading cause of disability-adjusted life years lost in 2030.It is imperative for leading economies to implement preventive strategies targeted towards UDD,given consistent policies are currently lacking.Recently established similarities between the aetiological hypotheses of depression and cardiometabolic diseases are shifting paradigms within this field.It is believed that dietary practices could potentially reduce the incidence of depression;similar to their effects on metabolism.Thus,the aim of this review was to compile current evidence on healthy dietary patterns as suitable contributors towards primary prevention strategies against UDD.Most of the well-known biological mechanisms behind depression have been positively associated with healthful diets and dietary patterns to varying degrees.Interestingly,a common factor of UDD is the production and overall effects of inflammatory cytokines,such as interleukin-6,tumor necrosis factor-α,and Creactive protein.These compounds have been associated with depressive symptoms,disturbances in neuroendocrine function,leaky gut,monoamine activity and brain function,while also being key factors in the development of cardiometabolic diseases.The Mediterranean diet(MD)in particular,is well supported by first-level evidence regarding its preventive qualities against metabolic and cardiovascular diseases and thus considered a model for healthy eating by various organizations.In one of the few clinical trials investigating these associations,the PREDIMED trial,individuals with diabetes assigned to a MD supplemented with mixed tree nuts experienced a 41%relative risk reduction for developing depression.Lastly,there is a need to include health related quality of life as an indicator of physical and mental well-being,considering its putative associations with depression and suicide risk.Going forward,focusing on clinical trials,using precise nutritional assessments,and identifying nutritional biomarkers which may be related to depression are needed to fully support the implementation of dietary recommendations in the field of psychiatry.
基金a 2018 Grant of Experimental Medicine Department(Luigi Vanvitelli Campania University)to Umberto Galderisi and Marcellino Monda(partially)
文摘BACKGROUND Research on physiopathology of obesity may receive new hints from studies on skinny people(SP). These are individuals who show a poor or null gaining of body weight, in spite of high-calorie intake, by far exceeding the body requirements.AIM To evaluate how circulating factors present in the SP sera may affect adipogenesis of mesenchymal stromal cells(MSCs).METHODS We isolated MSCs from bone marrow of healthy donors with both normal body mass index(BMI) and caloric consumption. MSC cultures were primed with sera collected from SP or normal people(NP). Then biomolecular assays were performed to evaluate effect on proliferation, apoptosis, senescence, cell commitment, and differentiation.RESULTS SP priming affected adipocyte cell commitment and reduced spontaneous adipogenesis. Moreover, an in-depth analysis of exogenous-induced adipocyte differentiation showed striking differences between differentiation in SP-primed samples compared with NP ones. In adipocytes from SP cultures we observed a reduced size of lipid droplets, an increased expression of adipose triglyceride lipase, along with high mitochondria content and ability to produce ATP in starvation condition. These data and the expression of UCP1 protein, indicated that SP pretreatment produced a bias toward brown adipocyte differentiation.CONCLUSION Our data suggest that sera from SP may promote brown adipogenesis rather that white adipocyte differentiation. This finding could explain why SP present normal body composition in spite of an excess of caloric intake. We hypothesize that some circulating components present in the blood of these individuals may favor brown adipogenesis at expense of white adipocyte production.
