ABSTRACT
Objective:To investigate the effect of conventional treatment plus long-term transcranial direct current stimulation (tDCS) on consciousness recovery in patients with minimally conscious state (MCS) after traumatic brain injury (TBI).Methods:A retrospective cohort study was conducted to analyze the clinical data of 60 patients with MCS after TBI admitted to Zhejiang Armed Police Corps Hospital from January 2019 to December 2020, including 38 males and 22 females, aged 19-60 years [(45.7±11.4)years]. Course of disease was 3-6 months [(4.6±0.9)months]. Of all, 30 patients received internal medicine, hyperbaric oxygen, rehabilitation and other conventional treatment (conventional treatment group), and 30 patients received tDCS stimulation on the basis of conventional treatment (tDCS treatment group). The tDCS stimulation contained 4 cycles for 28 days with each cycle lasting for 7 days (stimulation for 5 days, rest for 2 days). Coma recovery scale-revised (CRS-R) total score, brainstem auditory evoked potential (BAEP) score and clinical effictive rate (significantly effective+effective) were compared between the two groups before treatment, during 4 cycles of treatment and at 6 months and 12 months after treatment. Complications induced by tDCS were also evaluated.Results:There was no significant difference in CRS-R total score and BAEP score between the two groups before treatment (all P>0.05). CRS-R total score and BAEP score in tDCS treatment group were significantly higher than those in conventional treatment group during 4 cycles of treatment and at 6 months and 12 months after treatment (all P<0.05). CRS-R total score and BAEP score in both groups gradually increased during 4 cycles of treatment and at 6 months and 12 months after treatment (all P<0.05). The clinical effective rate in tDCS treatment group was 73% (22/30) when compared to 57% (17/30) in conventional treatment group ( P<0.05). In tDCS treatment group, 10 patients had local reversible slight redness at the cathodal position, while no other serious adverse effects, such as local burns, ulceration, exudation or epilepsy. Conclusion:Compared with conventional treatment, conventional treatment plus long-term tDCS can be more effective in improving the state of consciousness without serious adverse effects for MCS patients after TBI.
ABSTRACT
Background:It was demonstrated that vitamin D has extensive biological effects,and evidence exists on association between vitamin D and a variety of immune mediated diseases such as inflammatory bowel disease. Aims:To investigate the relationship between serum level of 25-hydroxyvitamin D(25OHD)and disease activity and quality of life in patients with ulcerative colitis( UC). Methods:Serum level of 25OHD was detected by electrochemiluminescence in 50 outpatients/inpatients with UC from Oct. 2015 to Mar. 2016 at the Anhui Provincial Hospital;35 healthy subjects were served as normal controls. CRP,ESR and PLT were determined by routine laboratory tests in UC patients. Disease activity of UC was assessed by improved Mayo score,and Chinese version IBD questionnaire( IBDQ)was employed to assess quality of life. Results:Vitamin D deficiency defined as serum 25OHD ﹤20 ng/mL was detected in 68. 0% of the UC patients. The mean value of serum 25OHD was significantly lower in UC group than in normal control group[(16. 73 ± 8. 83)ng/mL vs.(19. 84 ± 4. 56)ng/mL,P﹤0. 05]. When patients were stratified with disease activity,serum level of 25OHD decreased in the order of remission,mild,moderate and severe active stage(P ﹤0. 05). In UC patients with vitamin D deficiency,the value of CRP,ESR and PLT were significantly increased(P all ﹤0. 05)and the overall score of IBDQ and scores of four dimensions of IBDQ referring to bowel symptom,systemic symptom,emotional function and social function were significantly decreased(P all ﹤0. 05). Spearman and Pearson correlation coefficients analyses showed that serum level of 25OHD was negatively correlated with Mayo score,CRP,ESR and PLT(P all ﹤0. 05),and positively correlated with scores of IBDQ,including overall score and four dimensional scores in UC group( P all ﹤0. 05 ). Conclusions:Vitamin D deficiency occurs frequently in patients with UC and might have a negative impact on disease activity and quality of life.