Craniocervical Manual Lymphatic Drainage Increases the Efficiency of Atorvastatin-Based Treatment of Chronic Subdural Hematoma.

The objective of this study is to explore whether craniocervical manual lymphatic drainage (cMLD) can promote hematoma absorption and increase the efficiency of atorvastatin-based conservative treatment in chronic subdural hematoma (CSDH) patients. All CSDH patients treated with atorvastatin-based therapy between October 2020 and February 2022 in our department were retrospectively screened for enrollment. The patients were divided into the control and cMLD groups according to whether cMLD was performed. Head CT or MR images in both groups were obtained before the treatment and 2 weeks and 4 weeks after the treatment. MR images of the deep cervical lymphatic nodes (dCLNs) in 23 patients were obtained in the cMLD group before and approximately 2 weeks after treatment. The volumes of the dCLNs and hematoma were calculated. The primary outcomes are the differences in hematoma volume reduction after 4 weeks of treatment. The secondary outcomes were (1) the differences in hematoma volume reduction between the patients in these two groups in the 2nd week, (2) the dCLN volume change in the cMLD group before and after 2 weeks of treatment, and (3) the percentage of patients who transitioned to surgery because of failure to the conservative treatment. A total of 106 consecutive patients were enrolled in this study for analysis; 54 patients received atorvastatin-based treatment (control group), and 52 were treated with both atorvastatin-based treatment and cMLD (cMLD group). At baseline, the mean hematoma volume was 76.53 ± 42.97 ml in the control group and 88.57 ± 49.01 ml in the cMLD group (p = 0.181). In the 4th week, the absolute number of hematoma reductions (20.79 ± 34.73 ml vs. 37.28 ± 28.24 ml, p = 0.009) and percentage of hematoma reductions (22.58% ± 60.01% vs. 46.43% ± 30.12%, p = 0.012) in the cMLD group were greater than those in the control group. After 2 weeks of treatment, the absolute number of hematoma reductions showed no difference in the two groups, while the percentage of hematoma reduction was higher in the cMLD group (18.18% ± 24.61% vs. 2.08% ± 25.72%, p = 0.001). One patient in cMLD and 8 patients in the control group were transitioned to receive surgical treatment. The dCLN volumes in 23 experimental patients increased significantly after 2 weeks of treatment in the cMLD group (p = 0.032). There were no severe side effects that needed to be reported. Combined with atorvastatin-based therapy, cMLD can promote hematoma absorption and decrease the surgery rate, which provides a new therapeutic strategy for CSDH.

Possible mechanism and Atorvastatin-based treatment in cupping therapy-related subdural hematoma: A case report and literature review.

Subdural hematoma (SDH) is one of the most lethal types of traumatic brain injury. SDH caused by Intracranial Pressure Reduction (ICPR) is rare, and the mechanism remains unclear. Here, we report three cases of SDH that occurred after substandard cupping therapy and are conjected to be associated with ICPR. All of them had undergone cupping treatments. On the last cupping procedure, they experienced a severe headache after the cup placed on the occipital-neck junction (ONJ) was suddenly removed and were diagnosed with SDH the next day. In standard cupping therapy, the cups are not usually placed on the ONJ. We speculate that removing these cups on the soft tissue over the cisterna magna repeatedly created localized negative pressure, caused temporary but repeated ICPR, and eventually led to SDH development. The Monro-Kellie Doctrine can explain the mechanism behind this - it states that the intracranial pressure is regulated by a fixed system, with any change in one component causing a compensatory change in the other. The repeated ICPR promoted brain displacement, tearing of the bridging veins, and development of SDH. The literature was reviewed to illustrate the common etiologies and therapies of secondary ICPR-associated SDH. Despite the popularity of cupping therapy, its side effects are rarely mentioned. This case is reported to remind professional technicians to fully assess a patient's condition before cupping therapy and ensure that the cups are not placed at the ONJ.

Conjugated Polythiophene for Rapid, Simple, and High-Throughput Screening of Antimicrobial Photosensitizers.

The cationic conjugated poly[3-(3'-N,N,N-triethylamino-1'-propyloxy)-4-methyl-2,5-thiophene hydrochloride] (PMNT) has been developed for high-throughput screening of photodynamic antimicrobial chemotherapy photosensitizers (PSs). The bacterial number can be detected quantitatively by PMNT via various fluorescence quenching efficiencies. The photosensitized inactivation of bacteria is not efficient with ineffective PSs, and thus the bacteria grow exponentially and can be coated tightly by PMNT through electrostatic and hydrophobic interactions, resulting in aggregates and fluorescence quenching of PMNT, whereas, conversely, effective PSs lead to original and strong fluorescence of PMNT. This new platform of high-throughput screening is promising for discovering new PSs.

Is the current iodine content in edible salt appropriate for eliminating iodine deficiency in China.

OBJECTIVE: This study was designed to measure the urinary iodine excretion of volunteers who daily consumed iodized salt and to evaluate whether the current iodine content in salt is appropriate. A field trial study was then conducted to determine how the salt iodization content should be adjusted, either to prevent iodine deficiency or to avoid excess consumption. METHODS: A total of 1,099 volunteers from 399 households from urban and rural regions were selected. The levels of salt iodine and urinary iodine were measured prior to the field trial. All the households were randomly divided into four groups according to different salt iodine concentrations: group A, 6+/-2 mg/kg; group B, 15+/-2 mg/kg, group C, 24+/-2 mg/kg; and group D, 34+/-2 mg/kg. The urinary iodine levels of households were determined over five consecutive days, starting on the 27th day after the intervention. RESULTS: Before the intervention, the median urinary iodine excretions for urban and rural residents are 294 microg/L and 509 microg/L, respectively. By contrast, urinary iodine excretion in all groups significantly declined after the intervention. The median excretions of urinary iodine on the 28th day after the intervention for all groups were 97.2 microg/L, 199 microg/L, 249 microg/L and 331 microg/L for urban residents, and 101 microg/L, 193 microg/L, 246 microg/L and 308 microg/L for their rural counterparts, respectively. CONCLUSIONS: The trial exhibits a tendency of slightly excessive iodine intake among the households under the currently recommended standard.