Research of Sleep Disorders in Patients with Acute Cerebral Infarction.

BACKGROUND: The purpose of this study is to investigate the incidence of sleep disorders (SD), characteristic of cerebral infarction patients with different parts affected. METHODS: The research selected 101 patients with a first occurrence of acute cerebral infarction as the experimental group, and 86 patients without cerebral infarction as controls. Polysomnography, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and US National Stroke Scale were assessed. RESULTS: Compared with control group, the incidence of SD was higher in experimental group (P < .05), and the incidence of SD in women was more frequent in experimental group (P < .05). There was no significant difference in the types of SD patients with acute cerebral infarction. In addition, the sleep quality of cerebral infarction patients with different parts affected was different: the sleep quality of left hemisphere infarction patients was poor compared with the right one, and the sleep quality of anterior circulation patients was poor compared with posterior circulation patients. Patients with thalamus infarction had a longer sleep time and a shorter sleep latency and stage 2 of non-rapid eye movement sleep compared with non-thalamus infarction group. CONCLUSIONS: The prevalence of SD was relatively high in acute cerebral infarction patients, and the detailed classification of acute cerebral infarction may provide a more effective therapeutic method and therefore relieve patients' pain and supply a better quality of sleep.

Extrinsic factors associated with the response to immunotherapy in glioblastoma.

Glioblastoma (GBM) is a heterogeneous and lethal brain tumor. Despite the success of immune checkpoint inhibitors against various malignancies, GBM remains largely refractory to treatment. The immune microenvironment of GBM is highly immunosuppressive, which poses a major hurdle for the success of immunotherapy. Obviously, except for the GBM cells itself, there are also extrinsic reasons for the lack of efficacy of immunotherapy. Accumulated evidence indicates that factors other than GBM cells determine the efficacy of immunotherapy. In this review, we first described the unique immune microenvironment of the brain, which must be considered when using immunotherapy in patients with GBM. Second, we also described the mechanisms by which different immune and non-immune cells in the GBM microenvironment affect the efficacy of immunotherapy. Furthermore, the impact of standard therapies on the response to immunotherapy was delineated. Finally, we briefly discussed strategies for resolving these problems and improving the efficacy of immunotherapy.

Glioblastoma precision therapy: From the bench to the clinic.

Glioblastoma (GBM) is the most common malignancy of the central nervous system, and most patients with GBM die of the disease despite standard treatment. By clarifying the molecular abnormalities that drive the malignant phenotype of GBM, various drugs that specifically target tumor cells and the tumor microenvironment have been developed. These drugs, including drugs targeting growth factor receptors and their downstream signaling pathways, angiogenesis, aberrant metabolism, epigenetic deregulation, and aberrant immune microenvironments, have been investigated in preclinical or clinical trials. However, these drugs that significantly inhibited the growth of GBM in the preclinical stage have not produced survival benefits in patients with GBM. One reason for their failure is the lack of a definite driver gene to select patients most likely to benefit. Another reason is the inadequate pharmacokinetic properties of the drugs owing of the blood-brain barrier. In the present review, we discuss progress in the development of target therapeutic strategies. Furthermore, we discuss the development of nanomaterials that act as local drug delivery systems to penetrate the blood-brain barrier for managing GBM.