Analysis of Chinese Medical Syndrome Features of Ischemic Stroke Based on Similarity of Symptoms Subgroup.

OBJECTIVE: To derive the Chinese medicine (CM) syndrome classification and subgroup syndrome characteristics of ischemic stroke patients. METHODS: By extracting the CM clinical electronic medical records (EMRs) of 7,170 hospitalized patients with ischemic stroke from 2016 to 2018 at Weifang Hospital of Traditional Chinese Medicine, Shandong Province, China, a patient similarity network (PSN) was constructed based on the symptomatic phenotype of the patients. Thereafter the efficient community detection method BGLL was used to identify subgroups of patients. Finally, subgroups with a large number of cases were selected to analyze the specific manifestations of clinical symptoms and CM syndromes in each subgroup. RESULTS: Seven main subgroups of patients with specific symptom characteristics were identified, including M3, M2, M1, M5, M0, M29 and M4. M3 and M0 subgroups had prominent posterior circulatory symptoms, while M3 was associated with autonomic disorders, and M4 manifested as anxiety; M2 and M4 had motor and motor coordination disorders; M1 had sensory disorders; M5 had more obvious lung infections; M29 had a disorder of consciousness. The specificity of CM syndromes of each subgroup was as follows. M3, M2, M1, M0, M29 and M4 all had the same syndrome as wind phlegm pattern; M3 and M0 both showed hyperactivity of Gan (Liver) yang pattern; M2 and M29 had similar syndromes, which corresponded to intertwined phlegm and blood stasis pattern and phlegm-stasis obstructing meridians pattern, respectively. The manifestations of CM syndromes often appeared in a combination of 2 or more syndrome elements. The most common combination of these 7 subgroups was wind-phlegm. The 7 subgroups of CM syndrome elements were specifically manifested as pathogenic wind, pathogenic phlegm, and deficiency pathogens. CONCLUSIONS: There were 7 main symptom similarity-based subgroups in ischemic stroke patients, and their specific characteristics were obvious. The main syndromes were wind phlegm pattern and hyperactivity of Gan yang pattern.

Efficacy of median nerve electrical stimulation on the recovery of patients with consciousness disorders: a systematic review and meta-analysis.

OBJECTIVE: To identify whether median nerve stimulation (MNS) may be a potential candidate for the treatment of consciousness disorders via a systematic review and meta-analysis. METHODS: PubMed, Cochrane Library, China National Knowledge Infrastructure, Chinese VIP Information, Wanfang, and SinoMed databases were searched. Risk of bias was assessed using the Cochrane Collaboration's tool. The Glasgow Coma Scale (GCS), Disability Rating Scale (DRS), electroencephalogram (EEG), days in the Intensive Care Unit (ICU), and cerebral blood flow measures were compared between the median nerve stimulation and control groups. The meta-analysis was conducted using Review Manager software. RESULTS: We identified 2244 studies, of which 23 (with data from 1856 patients) qualified for the analysis. MNS improved GCS scores (mean difference [MD] = 2.15), EEG scores (MD = 1.61), cerebral mean blood flow velocity (MD = 4.23), and cerebral systolic blood flow velocity (MD = 10.51). Furthermore, it decreased DRS scores (MD = -1.77) and days in the ICU (MD = -2.02). The effects of MNS on GCS scores increased with longer treatments (1 week, MD = 1.03; 1 month, MD = 2.35) and were better with right MNS (right, MD = 2.36; bilateral, MD = 1.72). CONCLUSIONS: MNS may promote recovery from consciousness disorders.

The neuroprotective effect of dexmedetomidine and its mechanism.

Dexmedetomidine (DEX) is a highly selective α2 receptor agonist that is routinely used in the clinic for sedation and anesthesia. Recently, an increasing number of studies have shown that DEX has a protective effect against brain injury caused by traumatic brain injury (TBI), subarachnoid hemorrhage (SAH), cerebral ischemia and ischemia-reperfusion (I/R), suggesting its potential as a neuroprotective agent. Here, we summarized the neuroprotective effects of DEX in several models of neurological damage and examined its mechanism based on the current literature. Ultimately, we found that the neuroprotective effect of DEX mainly involved inhibition of inflammatory reactions, reduction of apoptosis and autophagy, and protection of the blood-brain barrier and enhancement of stable cell structures in five way. Therefore, DEX can provide a crucial advantage in neurological recovery for patients with brain injury. The purpose of this study was to further clarify the neuroprotective mechanisms of DEX therefore suggesting its potential in the clinical management of the neurological injuries.

Application of Multimodal Neuroimaging in the Treatment of Neurological Patients.

Objective: In order to study the application of multimodal neuroimaging in the treatment of neurological patients, the brain of patients was scanned and identified through multimodal neuroimaging, so as to provide basis for doctors to judge their diseases and give treatment plans. Method: Understand the principle of multimodal neural scene currently used through literature analysis, analyze the current level of neurological diseases in the medical field and the application of multimodal neural image in diseases, recalculate the imaging examination data through neurofuzzy algorithm, and obtain a more optimized identification method than the previous visual judgment method. Result: The image inspection data is dimensioned through computer spatial convolution. At this time, the output two-dimensional array is not accurate enough. It needs to be processed again through fuzzy spatial convolution to obtain relatively accurate data output, generate a small two-dimensional array, and use the convolution core for the spatial convolution process of two-dimensional array. The algorithm uses neural network machine learning algorithm to identify and judge the inspection data. Conclusion: Through this algorithm to identify the examination data, the early diagnosis sensitivity of intracranial space occupying lesions and intracranial hematogenous lesions are more than 20% higher than the previous traditional recognition methods, which provides a medical imaging basis for the early diagnosis and treatment of acoustic diseases, and improves the treatment probability and prognosis quality of life of neurological patients.

Using the Symptom Patient Similarity Network to Explore the Difference between the Chinese and Western Medicine Pathways of Ischemic Stroke and its Comorbidities.

METHODS: Individualized treatment of traditional Chinese medicine (TCM) provides a theoretical basis for the study of the personalized classification of complex diseases. Utilizing the TCM clinical electronic medical records (EMRs) of 7170 in patients with IS, a patient similarity network (PSN) with shared symptoms was constructed. Next, patient subgroups were identified using community detection methods and enrichment analyses were performed. Finally, genetic data of symptoms, herbs, and drugs were used for pathway and GO analysis to explore the characteristics of pathways of subgroups and to compare the similarities and differences in genetic pathways of herbs and drugs from the perspective of molecular pathways of symptoms. RESULTS: We identified 34 patient modules from the PSN, of which 7 modules include 98.48% of the whole cases. The 7 patient subgroups have their own characteristics of risk factors, complications, and comorbidities and the underlying genetic pathways of symptoms, drugs, and herbs. Each subgroup has the largest number of herb pathways. For specific symptom pathways, the number of herb pathways is more than that of drugs. CONCLUSION: The research of disease classification based on community detection of symptom-shared patient networks is practical; the common molecular pathway of symptoms and herbs reflects the rationality of TCM herbs on symptoms and the wide range of therapeutic targets.

Dynamic analysis of blood pressure changes in progressive cerebral infarction.

BACKGROUND: Progressive cerebral infarction is one of the leading causes of high disability and lethality for stroke patients. However, the association between progression of BP changes and cerebral infarction is not currently well understood. METHODS: We analyzed the dynamic changes in the BP of patients with acute ischemic stroke and explored the correlation between BP change and cerebral infarction progression. RESULTS: 30.9% (30/97) of the patients investigated developed to progressive cerebral infarction 17-141 h after admission. The percentage of patients with a long history of hypertension was significantly higher in the progressive group than in the non-progressive group. The mean systolic BP of the patients 16 h to 5 d after admission was also much higher in the progressive group. A greater abnormality of circadian blood pressure was also observed among patients in the progressive group. CONCLUSIONS: Hypertension history of more than 5 years is an important risk factor for progressive cerebral infarction. Both the elevation of systolic blood pressure 16 h to 5 d after admission and abnormal circadian blood pressure are associated with the disease progression.