Efficacy and safety of short-term edaravone or nerve growth factor add-on therapy for alcohol-related brain damage: A multi-centre randomised control trial.

AIMS: To measure the therapeutic effect of an anti-oxidant, edaravone (EDV), or neurotrophic treatment with nerve growth factor (NGF) as an add-on treatment for alcohol-related brain damage (ARBD). DESIGN: Multi-centre, randomised, single-blinded, comparative clinical trial. SETTING AND PARTICIPANTS: One hundred and twenty-two inpatients recruited from seven hospitals in different regions of China, all diagnosed with ARBD and aged 18 to 65 years old; among them, only two were female. INTERVENTION AND COMPARATOR: Patients were randomly assigned to receive one of three treatments for 2 weeks: 40 patients, treatment as usual (TAU: a combination of intramuscular injections of thiamine, intravenous infusions of other B vitamins with vitamin C and oral medication with vitamin E per day); 40, EDV add-on treatment to TAU (intravenous infusion with 30 mg of EDV twice per day); and 42, NGF add-on treatment to TAU (intramuscular injection of 20 µg of NGF per day). The patients underwent follow-up for 24 weeks. MEASUREMENTS: The primary outcome was the composite score of executive cognitive function in the 2nd week after treatment, which was measured as the mean of the Z scores of the assessments, including the digit symbol substitute test (DSST), digit span memory test-forward (DST-F), digit span memory test-reverse (DST-R) and space span memory test (SSMT). The secondary outcomes were the composite scores at later follow-ups, the score for each component of cognitive function, global cognitive function measured by the Montreal Cognitive Assessment (MoCA), craving for alcohol and the safety of the therapies. FINDINGS: EDV add-on treatment improved the composite score of executive cognitive function better than TAU in the 2nd week (adjusted mean difference: 0.24, 95% confidence interval 0.06 to 0.41; P = 0.008), but NGF add-on treatment did not (adjusted mean difference: 0.07, 95% confidence interval -0.09 to 0.24; P = 0.502). During the follow-up to 24 weeks, EDV add-on treatment improved the composite score of executive cognitive function and DST-R score better than TAU (both P < 0.01). Craving for alcohol was relieved in all three groups. No severe adverse events were observed. CONCLUSION: The short-term addition of edaravone to supplementary therapy treatment for alcohol-related brain damage (ARBD) improved executive cognitive function in patients with ARBD.

Fasudil may alleviate alcohol-induced astrocyte damage by modifying lipid metabolism, as determined by metabonomics analysis.

Alcohol dependence is a chronic, relapsing encephalopathy characterized by compulsive craving for alcohol, loss of control over alcohol use, and the presence of negative emotions and physical discomfort when alcohol is unavailable. Harmful use of alcohol is one of the greatest risk factors for death, illness, and disability. Rho kinase inhibitors have neuroprotective effects. This study used metabonomics analysis to assess untreated astrocytes, astrocytes exposed to 75 mmol/L of alcohol, and astrocytes exposed to 75 mmol/L of alcohol and treated with 15 µg/mL fasudil for 24 h. One of the clearest differences between the alcohol-exposed and fasudil-treated alcohol-exposed groups was the abundance of lipids and lipid-like molecules, although glycerophospholipid metabolism was comparable in both groups. Our findings show that fasudil may alleviate alcohol-induced astrocyte damage by modifying lipid metabolism, providing a new approach for preventing and treating alcohol dependence.

Association between leg motor restlessness and depression among Chinese males living at high-altitude: the mediating role of insomnia.

OBJECTIVE: Previous research has documented an association between insomnia and depression among patients with restless legs syndrome (RLS)/Willis-Ekbom disease. Given that leg motor restlessness (LMR) is closely related to RLS, the purpose of this study was to investigate the prevalence of insomnia and depression among individuals with LMR. In addition, we examined the associations among LMR, insomnia, and depression in a sample of young Chinese men living in high-altitude areas. METHODS: Chinese military personnel working on the Qinghai Tibet Plateau (Lhasa, an altitude of 3600 m) were recruited in 2019 to complete a series of questionnaires. Participants having the urge to move their legs but not meeting the diagnostic criteria for RLS were classified as having LMR. Hierarchical linear regressions and mediational analyses using the SPSS PROCESS macro in SPSS were conducted to examine the associations among LMR, insomnia, and depression. RESULTS: Of 196 participants, 36 (18%) had LMR. Only 1 participant was diagnosed with RLS. The proportions of participants suffering from insomnia who had LMR and did not have LMR were 44% and 22%, respectively. For depression, the proportions were 47% and 28%, respectively. Results of the hierarchical linear regressions showed that both LMR and depression were associated with increased insomnia symptoms. In addition, results from the mediational analyses indicated that the indirect effect of LMR on depression was significant and accounted for 52% of the total effect. CONCLUSIONS: Participants with LMR had a higher prevalence of insomnia and depression compared with those without LMR. In addition, LMR was correlated with depression, and insomnia played a significant role in this co-occurrence.

Effectiveness of rehabilitation training combined with acupuncture on aphasia after cerebral hemorrhage: A systematic review protocol of randomized controlled trial.

BACKGROUND: This study aims to systematically evaluate the effectiveness of rehabilitation training (RT) combined with acupuncture on aphasia after cerebral hemorrhage (CH). METHODS: PUBMED, Cochrane Central Register of Controlled Trials, EMBASE, Web of Science, Ovid, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure will be searched to identify any potential studies from inception to March 1, 2019, without language restrictions. All randomized controlled trials and case-controlled studies assessing the effectiveness of RT combined with acupuncture for the treatment of aphasia following CH will be included in this study. Cochrane risk of bias tool will be used to determine the methodological quality for included studies. RevMan 5.3 software (Cochrane Community, London, UK) will be utilized to perform statistical analysis. RESULTS: This study will systematically evaluate the effectiveness of RT and acupuncture for aphasia post CH. Primary outcome includes aphasia, which can be measured by Aachener Aphasia Test or Communicative Activity Log or other related scales. Secondary outcomes consist of speech performance, as assessed by Western Aphasia Battery-Revised; measure of skill in Supported Conversation scales; measure of Participation in Conversation scales; types of strategies used in conversation; occurrence and repair of conversation breakdowns; as well as any adverse events. CONCLUSION: The results of this study will provide present evidence on assessing effectiveness of RT and acupuncture after CH. DISSEMINATION AND ETHICS: The findings of this study are expected to be published in peer-reviewed journals. It does not require ethical approval, because no individual data will be utilized in this study. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019131587.

Rehabilitation training combined acupuncture for limb hemiplegia caused by cerebral hemorrhage: A protocol for a systematic review of randomized controlled trial.

BACKGROUND: Previous studies have reported that rehabilitation training combined acupuncture (RTA) can be used for the treatment of limb hemiplegia (LH) caused by cerebral hemorrhage (CH). However, its effectiveness is still unclear. In this systematic review study, we aim to evaluate the effectiveness and safety of RTA for LH following CH. METHODS: We will retrieve the databases of CENTRAL, EMBASE, MEDILINE, CINAHL, AMED, CBM, and CNKI from inception to March 1, 2019 with no language restrictions. The randomized controlled trials of RTA for evaluating effectiveness and safety in patients with LH following CH will be included. Cochrane risk of bias tool will be used to measure the methodological quality for all included studies. Two authors will independently select the studies, extract the data, and assess the methodological quality of included studies. A third author will be invited to discuss if any disagreements exist between 2 authors. If more than 2 eligible studies will be included, the outcome data will be pooled, and meta-analysis will be conducted if it is possible. RESULTS: This systematic review will assess the effectiveness and safety of RTA for LH caused by CH. The primary outcome includes limbs function. The secondary outcomes consist of muscle strength, muscle tone, quality of life, and any adverse events. CONCLUSION: The findings of this study will summarize the current evidence of RTA for LH caused by CH, and may provide helpful evidence for the clinical treatment. DISSEMINATION AND ETHICS: The results of this study will be published in peer-reviewed journals or will be presented on conference meeting. This work does not require ethic approval, because it will be conducted based on the published studies. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019120034.

A retrospective study of transcutaneous vagus nerve stimulation for poststroke epilepsy.

BACKGROUND: This study assessed the effect transcutaneous vagus nerve stimulation (TVNS) for poststroke epilepsy (PSE). METHODS: Fifty-two patients with PSE were included in this study. Twenty-seven patients received TVNS, 30 minutes each session, once daily, twice weekly for a total of 4 weeks; and were assigned to the treatment group. Twenty-five patients were at waiting list and were assigned to the control group. The primary outcome included weekly seizure frequency. The secondary outcomes consisted of each seizure episode, and quality of life, measured by the Quality of Life in Epilepsy Inventory-31 (QOLIE-31), as well as the adverse events. All outcomes were measured before and after 4-week treatment. RESULTS: After treatment, TVNS failed to show better outcomes in weekly seizure frequency (treatment group, P = .12; control group, P = .56), seizure episode (treatment group, P = .65; control group, P = .92), and QOLIE-31 (treatment group, P = .73; control group, P = .84) compared with these before the treatment. Furthermore, TVNS also did not elaborate the promising effect in seizure frequency (P = .81), seizure episode (P = .75), and QOLIE-31 (P = .33), compared with these in the control group. In addition, minor and acceptable adverse events were recorded in this study. CONCLUSION: The results of this study showed that TVNS may be not effective for Chinese patients PSE after 4-week treatment.

Risk factors of outcomes in elderly patients with acute ischemic stroke in China.

BACKGROUND: Stroke results in poor outcomes among elderly patients. However, the factors associated with outcome over different follow-up periods in this population are unknown. AIMS: To evaluate the outcomes and risk factors of outcomes in elderly patients after stroke. MATERIALS AND METHODS: Outcomes, including mortality, dependency (defined as a mRS >2), and recurrence rates, and associated risk factors were assessed at 3 and 12 months after stroke in patients aged ≥80 years. RESULTS: There were 419 acute ischemic stroke patients aged ≥80 years at 3 months, and 309 patients at 12 months; outcomes and relevant risk factors were assessed in these patients. Hypertension was more prevalent in women than in men. At 3 months, the mortality, dependency, and recurrence rates were 13.8, 54.2, and 18.1 %, respectively; the corresponding rates at 12 months were 26.9, 58.0, and 32.6 %, respectively. In the multivariate analysis, after adjusting by confounding factors, TOAST classification and stroke severity were associated with mortality and recurrence, while stroke severity was associated with dependency at 3 months. The mortality and dependency rates at 12 months were significantly associated with moderate and severe stroke, but severe stroke was an independent factor associated with recurrence. CONCLUSION: Stroke subtype and severity were associated with stroke outcomes among elderly patients in northern China. These findings suggest that it is crucial to highlight the affected factors of stroke outcome among elderly patients for reduce the burden of stroke in China.

[Effects of algicidal bacterium BS03 (Microbulbifer sp.) on the growth and antioxidant systems of Alexandrium tamarense].

OBJECTIVE: We studied the algicidal mechanism of extracellular substances of algicidal bacteria strain BS03 (Microbulbifer sp.) on photosynthetic characteristics, antioxident enzyme system and cysteine-dependent aspartate specific protease-3 (Caspase-3) of Alexandrium tamarense. METHODS: We tested photosynthetic pigments, chlorophyll fluorescence efficiency, antioxidant systems and caspase-3 activity in the algae cells treated with 0.5%, 1.0% , 1.5% and 2.0% BS03 cell-free filtrate after 12, 24, 36 and 48 h. RESULTS: (1) The chlorophyll-a and chlorophyll fluorescence efficiency Fv/Fm decreased with the increase of BS03 cell-free filtrate and treatment time. Carotenoids contents of A. tamarense cells treated with low BS03 (0.5% and 1.0%) cell-free filtrate were higher than the control. (2) Antioxident enzyme activities varied as treatment time and concentration. Malodialdehyde (MDA) contents increased significantly with BS03 cell-free filtrate treatment. (3) Caspase-3 protease activities of algal cells increased by BS03 cell-free filtrate. CONCLUSION: BS03 inhibited the photosynthesis whereas enhanced the lipid peroxidation of the cellular membrane of Alexandrium tamarense, indicating its algicidal activity.