Nonpharmacological therapies for central poststroke pain: A systematic review.

BACKGROUND: Central poststroke pain (CPSP) is a neuropathic pain syndrome that can occur after a cerebrovascular accident. It has negative effects on mood, sleep, rehabilitation, and quality of life in stroke patients. This systematic review assessed the efficacy and safety of nonpharmacological therapies for treating CPSP. METHODS: The Cochrane, PubMed, Embase, and Web of Science databases were systematically searched for studies from inception to August 2020. Two authors worked independently and in duplicate to identify suitable studies. RESULTS: Eleven studies were identified. Pain related to CPSP was ameliorated by precentral gyrus stimulation (P = .01), caloric vestibular stimulation (P = 0.004), transcranial direct current stimulation (P < .05), and bee venom acupuncture point injection (P = .009). Acupuncture (P = .72) and electroacupuncture therapies (P > .05) were as effective for thalamic pain as oral carbamazepine treatment. Motor cortex stimulation, but not deep brain stimulation (DBS), was effective for treating refractory CPSP, and appeared to be more effective than thalamic stimulation for controlling bulbar pain secondary to Wallenberg syndrome. However, DBS in the ventral striatum or anterior limb of the internal capsule improved depression (P = .020) and anxiety in patients with refractory CPSP. Some serious adverse events were reported in response to invasive electrical brain stimulation, but most of these effects recovered with treatment. CONCLUSIONS: Nonpharmacological therapies appear to be effective in CPSP, but the evidence is relatively weak. Invasive electrical brain stimulation can be accompanied by serious adverse events, but most patients recover from these effects.

Management of delayed encephalopathy after CO poisoning: An evidence-based narrative review.

BACKGROUND: Approximately 10% to 30% patients develop delayed encephalopathy after acute CO poisoning (DEACMP). No specific treatment is available and poor prognosis is a characteristic of this disease. We aimed to evaluate the efficacy and safety of all therapies that have been tried in randomized controlled trial (RCT) for DEACMP. METHODS: We conducted a systematic search of the Cochrane, Embase, PubMed, and Web of Science databases. RESULTS: Overall, 4 RCTs were identified in our study. Both hyperbaric oxygen (HBO) and mesenchymal stem cell (MSC) transplantation were effective in DEACMP, and MSC seemed to be superior to HBO. The addition of dexamethasone, N-butylphthalide, or XingZhi-YiNao granules into HBO, or butylphthalide into MSC could achieve better neurological recovery in DEACMP patients but did not significantly increase the incidence of adverse events. CONCLUSION: Several therapies have shown positive results in treating DEACMP and need to be proven by further studies.

[Study on preparation and spectroscopy of silica-alumina hydrogel and silica from kaolin].

In our research, silica-alumina hydrogel was prepared by activation with NaOH and reaction with HCl from kaolin, and silica was obtained from the hydrogel by drying and acidifying with HCl. IR, XRD and XRF were used for testing the results, and better result was obtained. The optimal conditions of processing for kaolin 40 g were 15-20 g of sodium hydroxide and 4-5 mol x L(-1) of hydrochloric acid. Finally, preparation processing to get silica, as well as the structure and purity of the resulting silica were characterized by means of IR, XRD and XRF.