Xingnao Kaiqiao acupuncture on promoting wake-up of consciousness disorder in children with early severe traumatic brain injury / 中国针灸

OBJECTIVE@#To observe the awakening effect and safety of Xingnao Kaiqiao (regaining consciousness and opening orifices) acupuncture on consciousness disorder in children with early severe traumatic brain injury (STBI) based on western medicine treatment.@*METHODS@#A total of 62 children with STBI were randomly divided into an observation group (31 cases,1 case dropped off) and a control group (31 cases, 1 case dropped off). The control group was treated with routine rehabilitation therapy (6 times a week for 30 days), and intravenous drip of cattle encephalon glycoside and ignotin injection (once a day for 28 days). On the basis of the treatment in the control group, the observation group was treated with Xingnao Kaiqiao acupuncture at Neiguan (PC 6), Shuigou (GV 26), Yintang (GV 24+), Baihui (GV 20), Sanyinjiao (SP 6), Zusanli (ST 36), etc., and supplementary acupoints according to clinical symptoms, once a day, 6 times a week for 30 days. The scores of Glasgow coma scale (GCS), coma recovery scale-revised (CRS-R) and modified Barthel index (MBI) were observed before treatment and 10, 20 and 30 d into treatment. Electroencephalogram (EEG) grading before and after treatment was observed in the two groups, and safety was evaluated.@*RESULTS@#After 10, 20 and 30 days of treatment, the scores of GCS, CRS-R and MBI in the two groups were increased compared before treatment (P<0.05), and those in the observation group were higher than the control group (P<0.05). After treatment, EEG grading of both groups was improved compared with that before treatment (P<0.05), and the observation group was better than the control group (P<0.05). There were no adverse events or adverse reactions in the two groups during treatment.@*CONCLUSION@#On the basis of western medicine treatment, Xingnao Kaiqiao acupuncture plays a remarkable role in wakening the early STBI children, can improve the level of consciousness disorder and daily living ability, and it is safe and effective.

Effects of Electroacupuncture on Consciousness Disorders Based on Transcranial Magnetic Stimulation: Study with Mismatch Negativity / 中国康复理论与实践

Objective:To observe the effect of electroacupuncture based on transcranial magnetic stimulation (TMS) on wakefulness for consciousness disorder. Methods:From January, 2015 to October, 2019, 30 inpatients with consciousness disorder from the General Hospital of Western Theater Command were randomly divided into control group (n = 15) and observetion group (n = 15), Both groups received TMS, and the observetion group received electroacupuncture at Baihui (GV20), Shenting (GV24), bilateral Neiguan (PC6) bilateral Hegu (LI4) and bilateral Yongquan (KI1) in addition, for three months. They were tested the latency of the mismatch negativity (MMN), and assessed with Glasgow Coma Scale (GCS) and persistent vegetative state (PVS) score before, and one month and three months after treatment. Results:The latency of MMN decreased more in the observetion group than in the control group three months after treatment (t = 2.159, P < 0.05). Conclusion:Combination of electroacupuncture on TMS is more effective on wakefulness for consciousness disorder.

Application of Blink Reflex and Brainstem Auditory Evoked Potential in Brain Stem Function Evaluation of Patients with Consciousness Disorder / 中国康复理论与实践

@#Objective To explore the characteristics of blink reflex (BR) and brainstem auditory evoked potential (BAEP) in patients with consciousness disorder and the role of BR and BAEP in the evaluation of brain stem function. Methods From January to December, 2015, 31 patients with consciousness disorder were examined with BAEP, BR and Glasgow Coma Scale (GCS), and the outcome was record-ed one month after examination. Results BAEP and BR were positively related with GCS score (r≥0.562, P<0.05) and outcome (χ2=9.644, P<0.01). Conclusion Both BR and BAEP can reflect the brain stem function and respective pathway. Their combination could provide ob-jective basis for prognosis evaluation.

Application of Blink Reflex and Brainstem Auditory Evoked Potential in Brain Stem Function Evaluation of Patients with Consciousness Disorder / 中国康复理论与实践

@#Objective To explore the characteristics of blink reflex (BR) and brainstem auditory evoked potential (BAEP) in patients with consciousness disorder and the role of BR and BAEP in the evaluation of brain stem function. Methods From January to December, 2015, 31 patients with consciousness disorder were examined with BAEP, BR and Glasgow Coma Scale (GCS), and the outcome was record-ed one month after examination. Results BAEP and BR were positively related with GCS score (r≥0.562, P<0.05) and outcome (χ2=9.644, P<0.01). Conclusion Both BR and BAEP can reflect the brain stem function and respective pathway. Their combination could provide ob-jective basis for prognosis evaluation.

Effect of restriction decision wheel and grade on ICU patients with critical consciousness disorder / 现代临床护理

Objective To investigate the effect of restriction decision wheel and grade ICU patients with critical consciousness disorder. Methods Two hundred and fifty four patients in ICU with critical consciousness disorder from July to December 2012, who were intubated and constrained with their limbs due to the risk of unexpected extubation, were divided into the control group (n=125) and the experiment group (n=129), according to registration sequence. The former were constrained to their limbs after evaluation referring to the constraint nursing form and the latter was constrained by using the constraint decision-making wheel and grade. The two groups were compared in terms of restraint rate, unplanned extubation rate, and incidence of skin abnormality. Results The restraint rate of the observation group was significantly lower than that of the control group (P0.05). Conclusion Constraints decision making wheel and grade is effective in ensuring patients'safety and improving the quality of nursing safety management by reducing unnecessary constraints or the incidence of delayed constraints.

Cerebral hemorrhage presenting as alteration of consciousness during the anesthesia recovery period: A case report

Catastrophic neurological events can occur rarely in anesthetic recovery period and they must be quickly diagnosed. We report here on a spontaneous intracerebral hemorrhage (SICH) that developed during the anesthesia recovery period in a 52-year-old man who had undergone uneventful orthopedic surgery. He had predisposing factors including 25 year history of heavy alcohol consumption and smoking. The risk of spontaneous intracerebral hemorrhage following non-cardiovascular and non-neurovascular surgery is exceedingly small during the anesthesia recovery period, especially for a patient with no history of hypertension and coagulopathy. We also describe the differential diagnosis of an altered mental status that occurs during anesthetic recovery period.

Title Assessment of 76 Cases of Bathing Accidents with Consciousness Disorder on Arrival at the Hospital / 日本温泉気候物理医学会雑誌

  Content We investigated 76 cases during the 6-year period from 1999 to 2005 in which a patient who developed a consciousness disorder while bathing was brought to the Emergency and Critical Care Center of Tokyo Women's Medical University Medical Center East. In. 86% of the cases the patient was in cardiopulmonary arrest, and they had a group of diseases with a poor prognosis in which the outcome was death, even the 6% of the patients who were resuscitated.<BR>The most common age group was the 70-to 79-year group, which contained 46% of the patients, and those 70 years of age and older accounted for 70% of the total.<BR>  Examination was possible in 16 cases, and the most common category, in 10 of them, was “drowning/suspicion of transient ischemic attack”. Adequate examinations were not performed on the patients who died in the outpatient department. Moreover, because the autopsy rate was low, it was impossible to make a definitive etiological diagnosis. However, the fact that “many were elderly persons whose autonomic nervous system's regulatory function is reduced” and that “the incidence was highest during the winter (53% during the 3 months from December to February)” suggests involvement of cardiovascular and cerebrovascular diseases secondary to changes in blood pressure. Many preventive measures have been described in the literature, and improvement in the resuscitation rate is expected as a result of becoming familiar with. and thoroughly implementing them. All 10 cases that occurred in public baths, where the time before discovery should have been short, were cases of cardiopulmonary arrest, and it is impossible to clearly explain why resuseitation attempts failed in all 10 of them. In order to identify the causative diseases we think it would be worthwhile to consider 1) performing a whole-body CT examination after confirming death, and 2) perforrning open-chest cardiac massage (only in patients brought to the hospital within a short time).