In recent years, a rapid development in non-invasive brain stimulation (NIBS) techniques have been witnessed in the field of rehabilitation. These techniques have gained significant attention from researchers in the field of brain dysfunction rehabilitation, holding great promise as a therapeutic modality to alleviate impairments in brain function. However, the efficacy of most NIBS treatment protocols often falls short of patients’ expectations in clinical practice. To address this gap, further research and practical efforts are necessary to delve into the mechanisms underlying NIBS effectiveness, devise strategies for enhancing efficacy, and address safety concerns associated with its application. This article provides a comprehensive review of recent research advancements of NIBS in the context of brain dysfunction. Moreover, it offers insights into future development trends, intending to serve as a valuable reference for studies investigating the effectiveness and safety of NIBS, while guiding appropriate clinical practices in rehabilitation.
Non-invasive brain stimulation is a technology that uses magnetic field or electric field to act on the brain to adjust the activity of cerebral cortex neurons. It mainly includes transcranial magnetic stimulation and transcranial direct current stimulation. The principle is to accelerate the induction of neuroplasticity by changing the excitability of the cerebral cortex. The characteristics are noninvasive, safe and that the patient can tolerate it. This article mainly introduces the theoretical foundation and mechanisms of non-invasive brain stimulation, and its application and safety in stroke complications, neuropathic pain and epilepsy, and discusses the commonly used treatment regimens of non-invasive brain stimulation in different neurological diseases, in order to provide possible treatment reference for the rehabilitation of neurological diseases.
Blood glucose monitoring has become the weakest point in the overall management of diabetes in China. Long-term monitoring of blood glucose levels in diabetic patients has become an important means of controlling the development of diabetes and its complications, so that technological innovations in blood glucose testing methods have far-reaching implications for accurate blood glucose testing. This article discusses the basic principles of minimally invasive and non-invasive blood glucose testing assays, including urine glucose assays, tear assays, methods of extravasation of tissue fluid, and optical detection methods, etc., focuses on the advantages of minimally invasive and non-invasive blood glucose testing methods and the latest relevant results, and summarizes the current problems of various testing methods and prospects for future development trends.
The non-invasive brain-computer interface (BCI) has gradually become a hot spot of current research, and it has been applied in many fields such as mental disorder detection and physiological monitoring. However, the electroencephalography (EEG) signals required by the non-invasive BCI can be easily contaminated by electrooculographic (EOG) artifacts, which seriously affects the analysis of EEG signals. Therefore, this paper proposed an improved independent component analysis method combined with a frequency filter, which automatically recognizes artifact components based on the correlation coefficient and kurtosis dual threshold. In this method, the frequency difference between EOG and EEG was used to remove the EOG information in the artifact component through frequency filter, so as to retain more EEG information. The experimental results on the public datasets and our laboratory data showed that the method in this paper could effectively improve the effect of EOG artifact removal and improve the loss of EEG information, which is helpful for the promotion of non-invasive BCI.
Brain-computer interface (BCI) can establish a direct communications pathway between the human brain and the external devices, which is independent of peripheral nerves and muscles. Compared with invasive BCI, non-invasive BCI has the advantages of low cost, low risk, and ease of operation. In recent years, using non-invasive BCI technology to control devices has gradually evolved into a new type of human-computer interaction manner. Moreover, the control strategy for BCI is an essential component of this manner. First, this study introduced how the brain control techniques were developed and classified. Second, the basic characteristics of direct and shared control strategies were thoroughly explained. And then the benefits and drawbacks of these two strategies were compared and further analyzed. Finally, the development direction and application prospects for non-invasive brain control strategies were suggested.
Objective To evaluate the clinical efficacy of integrated treatment ( sequential noninvasive following invasive mechanical ventilation, bronchoscope suction, combined inhalation) in patients with acute respiratory failure induced by chronic obstructive pulmonary disease ( COPD) . Methods 59 elderly patients with COPD and acute respiratory failure in ICU fromJuly 2006 to July 2009 were enrolled in the study. The patients were randomized into three groups, ie. a non-invasive mechanical ventilation group ( NIV group) , a sequential non-invasive following invasive mechanical ventilation group ( SV group) , a integrated treatment group ( IT group) . APACHEⅡ score, clinical pulmonary infection score ( CPIS) ,arterial blood gas analysis, respiratory rate ( RR) , heart rate ( HR) , and mean artery blood pressure ( MAP)at 0 h, 3 h, 3 d, 12 d after treatment were recorded. Results With the extension of treatment time,APACHEⅡ score, CPIS score, RR, HR, PaCO2 , and white blood cells gradually reduced, while pH and PaO2 gradually increased in the three groups ( P lt;0. 05) . The differences in RR, HR, PaCO2 , and PaO2 at the time of 3 d and 12 d were significant between the three groups( P lt;0. 05) . The occurrence of pulmonary infection control ( PIC) window and ventilation associated pneumonia ( VAP) had no difference among the three groups( P gt;0. 05) . The duration of total mechanical ventilation, durations of ICU stay and hospital stay were shorter in SV group than those in NIV group( P lt;0. 05) . The duration of total mechanical ventilation,duration of invasive mechanical ventilation, durations of ICU stay and hospital stay were shorter in IT group than those in SV group( P lt;0. 05) . The incidence of VAP was higher in SV group than NIV group, but lower in IT group than SV group( P lt;0. 05) . Hospital mortality was lower in SV group than NIV group, and higher in IT group than SV group( P lt; 0. 05) . Conclusion In elderly COPD patients with acute respiratory failure, integrated treatment given early can reduce the duration of mechanical ventilation, the length of ICU and hospital stay, and decrease the morbidity of VAP and mortality.
ObjectiveTo evaluate the effects of home mechanical ventilation (HMV) for stable chronic obstructive pulmonary disease (COPD) patients with respiratory failure in Tongzhou district of Beijing city. MethodsTwenty stable COPD patients with respiratory failure were included in the study.During the one-year follow-up period,4 patients died and 1 withdrew and 15 patients finished the follow-up.The patients was followed up by telephone each month and guided in drug administration,HMV,and rehabilitation therapy.At the beginning of the study and one year later,the patients were interviewed and accessed on the general data,nutritional status,COPD assessment test (CAT),Borg dyspnea and respiratory fatigue score,Hamilton depression scale,Hamilton anxiety scale,and arterial blood gas analysis. ResultsAt the end of one-year follow-up,nutrition index,CAT,Borg dyspnea and respiratory fatigue score,Hamilton depression scale,Hamilton anxiety scale,pH,and PaO2 did not change significantly (P>0.05),while PaCO2 decreased significantly compared with those at the beginning of the study (P<0.05).Compared with the past year,the times of hospitalization due to acute exacerbation of COPD was significantly reduced during the follow-up year (P<0.05). ConclusionHMV can ameliorate carbon dioxide retention and reduce times of hospitalization due to acute exacerbation of COPD for COPD patients with respiratory failure.
ObjectiveTo compare the therapeutic effects of invasive-high-flow oxygen therapy (HFNC) and invasive-non-invasive ventilation (NIV) sequential strategies on severe respiratory failure caused by chronic obstructive pulmonary disease (COPD), and explore the feasibility of HFNC after extubation from invasive ventilation for COPD patients with severe respiratory failure.MethodsFrom October 2017 to October 2019, COPD patients with type Ⅱ respiratory failure who received invasive ventilation were randomly assigned to a HFNC group and a NIV group at 1: 1 in intensive care unit (ICU), when pulmonary infection control window appeared after treatments. The patients in the HFNC group received HFNC, while the patients in the NIV group received NIV after extubation. The primary endpoint was treatment failure rate. The secondary endpoints were blood gas analysis and vital signs at 1 hour, 24 hours, and 48 hours after extubation, total respiratory support time after extubation, daily airway care interventions, comfort scores, and incidence of nasal and facial skin lesions, ICU length of stay, total length of stay and 28-day mortality after extubation.ResultsOne hundred and twelve patients were randomly assigned to the HFNC group and the NIV group. After secondary exclusion, 53 patients and 52 patients in the HFNC group and the NIV group were included in the analysis respectively. The treatment failure rate in the HFNC group was 22.6%, which was lower than the 28.8% in the NIV group. The risk difference of the failure rate between the two groups was –6.2% (95%CI –22.47 - 10.43, P=0.509), which was significantly lower than the non-inferior effect of 9%. Analysis of the causes of treatment failure showed that treatment intolerance in the HFNC group was significantly lower than that in the NIV group, with a risk difference of –38.4% (95%CI –62.5 - –3.6, P=0.043). One hour after extubation, the respiratory rate of both groups increased higher than the baseline level before extubation (P<0.05). 24 hours after extubation, the respiratory rate in the HFNC group decreased to the baseline level, but the respiratory rate in the NIV group was still higher than the baseline level, and the respiratory rate in the HFNC group was lower than that in the NIV group [(19.1±3.8) vs. (21.7±4.5) times per minute, P<0.05]. 48 hours after extubation, the respiratory rates in the two groups were not significantly different from their baseline levels. The average daily airway care intervention in the NIV group was 9 (5 - 12) times, which was significantly higher than the 5 (4 - 7) times in the HFNC group (P=0.006). The comfort score of the HFNC group was significantly higher than that of the NIV group (8.6±3.2 vs. 5.7±2.8, P= 0.022), while the incidence of nasal and facial skin lesions in the HFNC group was significantly lower than that in the NIV group (0 vs. 9.6%, P=0.027). There was no significant difference in dyspnea score, length of stay and 28-day mortality between the two groups.ConclusionsThe efficacy of invasive-HFNC sequential treatment on COPD with severe respiratory failure is not inferior to that of invasive-NIV sequential strategy. The two groups have similar treatment failure rates, and HFNC has better comfort and treatment tolerance.
ObjectiveTo summarize the significance of laboratory examinations in diagnosis of ulcerative colitis (UC). MethodsLiteratures at home and abroad were searched to review the clinical significance of laboratory examinations indexes in diagnosis of UC. ResultsAnti-neutrophilcytoplasmicantibodies (ANCA) had some value in diagnosis of UC, but it was limited in evaluation of UC in active patients. The positive rate of anti-intestinal goblet cell antibody (GAB) in patients with UC was higher than that of patients with Crohn's disease (CD), so it could be used as identification indexes of the two diseases, but it could not reflect the severity of the disease. Anti-saccharomyces cerevisiae antibodies (ASCA) and anti-pancreatic antibody (PAB) were mainly used in the differential diagnosis of UC and CD, but they had no significant advantages in diagnosis of UC. Fecal calprotectin (FCP) played a positive role in evaluation of recurrence and activity in UC. Although lactoferrin, M2-pyruvate kinase (M2-PK), and S100A12 were not as effective as FCP, but if combined with related indicators, they were also important. ConclusionsOf the relevant indexes of laboratory examination in the diagnosis of UC, FCP plays an importent role in the evaluation of recurrence and activity of UC.
ObjectiveTo compare the effect of three different wetting liquid supply modes for noninvasive ventilation. MethodsNinety patients who accepted noninvasive ventilation between February and October 2014 were randomly divided into three groups with 30 in each. Patients in group A underwent humidification with traditional kettle water; those in group B received humidification by one-time automatic water supplying; and patients in group C received continuous infusion to add water for humidification. The wetting effect and humidification related situations among the three groups of patients were compared and analyzed. ResultsThere were statistically significant differences among the three groups in terms of wetting effect, comfort degree, water renewal cycle, working time and economic cost (P<0.05). Good wetting rate of group C was superior to group A and B (P<0.05), but there was no statistically significant difference between group A and B (P>0.05). Humidification comfort degree of group C was obviously higher than that in group A and B (P<0.05), while there was no statistically significant difference between group A and B (P>0.05). Water renewal cycle and working time of group C were significantly shorter than those in group A and B (P<0.05). At the same time, economic cost of group A and C was significantly less than that of group B (P<0.05), while there was no statistically significant difference between group A and C (P>0.05). ConclusionThe kind of continuous infusion for humidification in noninvasive ventilation has a good therapeutic effect for patients receiving airway wetting therapy, which is worthy of clinical popularization and application.