Epilepsy is a prevalent neurological disorder characterized by recurrent, transient episodes of central nervous system dysfunction resulting from abnormal neuronal discharges in the brain. Diagnosis of epilepsy integrates clinical manifestations, electroencephalogram (EEG) findings, and imaging studies. Clinical presentations are diverse and variable, with abnormal EEG serving as a critical diagnostic indicator; however, some patients exhibit normal EEG results. Moreover, there are still many patients who were underdiagnosed because of atypical epilepsy symptoms. With advancements in EEG and multimodal imaging technologies, diagnostic strategies based on biorhythm theory have emerged. This paper reviewed the diagnostic approaches for epilepsy grounded in biorhythm theory, in order to provide more effective support for the clinical management of epilepsy.
ObjectiveTo analyze the current the sense of shame and its influencing factors in patients with epilepsy. Methods The research subjects selected information from 103 epilepsy patients who were hospitalized at the Affiliated Brain Hospital of Guangzhou Medical University from January 1, 2023 to December 31, 2023. The self-made General Information Questionnaire, social impact scale (SIS), social avoidance and distress scale, self-concealment scale and self-esteem scale were used to collect information. Pearson method was used to analyze the correlation between the score of SIS and the scores of social avoidance and distress scale, self-concealment scale and self-esteem scale Multiple linear regression model was used to analyze the factors affecting SIS score.Statistically, P<0.05 was considered statistically significant. Results The score of SIS was (58.40±12.649) .According to statistical analysis of Pearson’s results, the SIS score of patients with epilepsy was found to be positively correlated with the scores in the three tables above (all P<0.05). Multiple Regression analysis analysis showed that family income, social avoidance and distress scale, self-concealment scale and self-esteem scale were the influential factors of SIS score in epilepsy patients (all P<0.05). ConclusionClinical workers should pay close attention to the psychological changes of patients with epilepsy and do a good job in psychological nursing, so as to improve the quality of life of patients.
Objective To investigate the association of serum albumin and relevant composite indicators with malignant brain edema after acute ischemic stroke. Methods We screened patients with acute ischemic stroke admitted to the Department of Neurology, West China Hospital of Sichuan University between January and December 2022. The case group consisted of patients who developed malignant brain edema within 7 days of admission, while the control group consisted of patients who did not develop malignant brain edema within 7 days of admission. Multivariate logistic regression analysis was used to explore the association of serum albumin and relevant composite indicators with malignant brain edema after acute ischemic stroke. Results Finally, 428 patients were included, aged 70.00 (58.00, 82.00) years, with females accounting for 40.9% (n=175). The time from onset to admission was 10.00 (4.00, 24.00) hours. Forty-three patients (10.0%) developed malignant brain edema and were classified as the case group, and their onset time of malignant brain edema was 34.00 (22.50, 56.50) hours after the onset of the disease. Multivariate logistic regression analysis showed that the increase in the score of the baseline National Institutes of Health Stroke Scale scores [odds ratio (OR)=1.167], the combination of diabetes (OR=5.525), the treatment of thrombectomy (OR=23.875), and the neutrophil percentage-to-albumin ratio higher than the median (OR=3.806) were associated with the increased risk of malignant brain edema (P<0.05), and the successful reperfusion after thrombectomy (OR=0.120) was associated with the reduced risk of malignant brain edema (P<0.05). Conclusion A higher percentage of serum neutrophil percentage-to-albumin ratio within 24 hours of onset in patients with acute ischemic stroke is associated with an increased risk of malignant brain edema within 7 days of admission.
Stroke is a severe disease with high incidence, high recurrence, high disability, and high mortality rates. China has the highest prevalence of stroke in the world, where it is a leading cause of death and disability for adults. There is a struggling way to prevent and control stroke to reduce the disease burden. This review summarizes the temporal trends and characteristics of stroke in China, with an aim to provide baseline reference for stroke prevention and treatment in China. There was an increase in the incidence and prevalence of stroke in China in the past 15 years. The incidence, prevalence, mortality, and disability-adjusted life years of stroke in China were higher than those in developed countries such as the United Kingdom, the United States, and Japan. High-quality studies and standardized diagnosis and treatment are needed to overcome challenges in stroke prevention and treatment in China.
Artificial intelligence (AI) is reshaping evidence-based clinical decision-making. From the perspective of clinical decision-making, this paper explores the collaborative value of AI in life-cycle health management. While AI can enhance early disease screening efficiency (e.g., medical image analysis) and assist clinical decision-making through personalized health recommendations, its reliance on non-specialized data necessitates the development of dedicated AI systems grounded in high-quality, specialty-specific evidence. AI should serve as an auxiliary tool to evidence-based clinical decision-making, with physicians’ comprehensive judgment and humanistic care remaining central to medical decision-making. Clinicians must improve the reliability of decision making through refining prompt design and cross-validating AI outputs, while actively participate in AI tool optimization and ethical standard development. Future efforts should focus on creating specialty-specific AI tools based on high-quality evidence, establishing dynamic guideline update systems, and formulating medical ethical standards to position AI as a collaborative partner for physicians in implementing life-cycle health management.
ObjectiveTo explore the best nursing regimen for patients with severe Tardive dyskinesia (TD) after deep brain stimulation (DBS). MethodsTo analyze the clinical nursing data of 7 patients with TD treated by DBS in our department from January 2018 to August 2019, preoperative assessment of the patient's condition, dyskinesia care, psychological care, preoperative preparation, preoperative guidance, etc. General nursing, observation and nursing of complications, psychological nursing, safety management and rehabilitation training of limb function were carried out after operation discharge to discharge guidance, daily life guidance, DBS device-related education and other post-discharge continuous care to help patients improve quality of life. The changes of TD symptoms were assessed with the abnormal involuntary movement scale -LRB-AIMS, the nursing effect was assessed with the psychiatric nursing observation sc-Nosiee (NOSIE) , and the self-care ability was assessed with the ability of daily livin-ADL- scale (ADL). ResultsAll of the 7 TD patients recovered well after operation, without complications caused by improper nursing, and the TD symptoms were relieved. The AIMS and NOSIE scores were significantly lower at 1 month, 3 months and 1 year after operation than those before operation (P<0.05). The ADL scores were significantly higher than those before operation (P<0.05). ConclusionIn order to treat TD patients with DBS operation, we should pay attention to the pertinent nursing in perioperative period and the continuous nursing after discharge, it is of great significance to relieve the symptoms of involuntary movement, improve the mental state and improve the self-care ability of patients with TD.
Stroke prevention and treatment in China have achieved significant progress in reducing the disease burden and controlling major risk factors. However, important challenges remain, including a growing number of stroke cases and the need to establish a comprehensive and efficient patient management system spanning the pre-hospital, in-hospital, and post-hospital phases. This article systematically reviews the current status and key issues in stroke prevention and control and proposes that greater emphasis should be placed on accelerating the transition from a “treatment-oriented” to a “prevention-oriented” approach in stroke management. It highlights the importance of building a full lifecycle health-care system for stroke prevention and care, enhancing the effectiveness of interventions through a tiered and coordinated care model, and promoting the deep integration of digital and intelligent technologies. These efforts may provide valuable guidance for clinical practice and support the achievement of the “Healthy China” goals.
Objective To explore the effect of foot spacing on multi-directional reach test in the normal elderly and elderly patients with hemiplegia. Methods From October 2019 to December 2020, 50 eligible elderly hemiplegic cases and 50 normal elderly cases were randomly collected. The multi-directional reach tests with foot spacings of 1.0A, 1.5A and 2.0A (A=horizontal distance between bilateral anterior superior iliac spines) were carried out, and the differences and correlations of the maximum horizontal extension distances in the same direction with the three foot spacings were analyzed. Results The statistical results of the normal elderly group (n=50), the left hemiplegic elderly group (n=28), and the right hemiplegic elderly group (n=22) could be described as follows: the maximum horizontal stretching distances in the same direction of left or right were significantly different among the tests with three foot spacings (P<0.05), and the horizontal stretching distance was the largest when the foot spacing was 1.5A; there was no statistically significant difference in the maximum horizontal extension distances in the same direction of forward or backward among the tests with three foot spacings (P>0.05). In the normal elderly, the Pearson correlation coefficients between the maximum horizontal extension distances with the three foot spacings in the left direction were 0.64-0.71 (P<0.05), and those in the right direction were 0.68-0.75 (P<0.05). In the left hemiplegic elderly, the Pearson correlation coefficients between the maximum horizontal extension distances with the three foot spacings in the left direction were 0.72-0.77 (P<0.05), and those in the right direction were 0.78-0.82 (P<0.05). In the right hemiplegic elderly, the Pearson correlation coefficients between the maximum horizontal extension distances with the three foot spacings in the left direction were 0.62-0.77 (P<0.05), and those in the right direction were 0.72-0.88 (P<0.05). Conclusions The results of the study on the normal elderly, left hemiplegic elderly and right hemiplegic elderly are the same. When the normal elderly and hemiplegic elderly are tested in the community and clinic, the fixed foot spacing should be chosen, and the maximal horizontal extension distance on the coronal plane is significantly affected by different foot spacings.
Large language models (LLMs), a key component of artificial intelligence (AI), represent a significant breakthrough in natural language processing. As the capabilities of LLMs continue to evolve, their potential applications and future implications in clinical medical education warrant considerable attention. This study systematically reviews the development of LLMs, explores their innovative applications within the context of current challenges in clinical medical education, and critically assesses both the advantages and limitations of their implementation. The objective is to provide a comprehensive reference for the continued integration of AI-driven LLMs into clinical medical education.
Ischemic stroke is a major cause of death and disability in adult Chinese people. Proinflammatory cytokines may exacerbate ischemic brain injury after stroke. However, preclinical studies have shown that targeted inhibition of interleukin (IL)-1β, IL-6, and/or tumor necrosis factor-α (TNF-α) alleviated ischemic brain injury. But the efficacy of these strategies has not yet been confirmed in clinical trials. Further studies are needed to investigate the effect of anti-inflammatory therapy for stroke in clinical settings. Therefore, this article focuses on classical proinflammatory cytokines including IL-1β, IL-6, and TNF-α, and summarizes their roles and mechanisms in ischemic brain injury and progress in clinical translational research.