Traumatic spinal cord injury is often accompanied by irreversible damage to neurons and deterioration and remodeling of the cellular microenvironment， causing long-term loss of movement，sensory dyfunction and autonomic dysfunction. Although rodent and non-human primate models have contributed significantly to modelling the pathological mechanisms of spinal cord damage and to screening treatments， animal experimental results often differ from clinical practice due to differences between species. Recent studies shown that functional neural organoids formed from pluripotent stem cells in a three-dimensional culture system contain many key features of the human brain or spinal cord.Compared with the neural stem cells/neural progenitor cells cultured in two dimensions， the neural organoids have more stable cell architecture， tissue morphology and more mature neural differentiation，and，play a significant role in the simulation of diseases such as Parkinson's disease，Alzheimer's disease，traumatic brain injury， and stroke. Meanwhile， in nerve injury repair， neural organoids have a high survival rate after transplantation， and can promote vascular regeneration in the injured area and form functional connections with the host. This review summarizes the application of neural organoids in Parkinson's disease， Alzheimer's disease， traumatic brain injury， stroke， and discusses the application value of spinal cord injury repairment.
Cardiovascular and cerebrovascular diseases are the leading causes of harm to human health and life， with the Jiangxi region located in a central area characterized by high incidence and mortality rates. Cardiogenic stroke （CES） accounts for 65% to 70% of all types of stroke. The prevention and treatment of CES are hindered by barriers between cardiology and neurology， and the diagnostic and treatment processes are not well standardized. This highlights the urgent need to optimize the current diagnosis and treatment procedures and improve specialized techniques， with a multidisciplinary and close cooperation system of“heart-brain treatment”. This consensus has been developed through the exploration of a series of scientific issues to guide clinical practice， promote the prevention and treatment of CES， and explore multidisciplinary collaborative diagnostic and treatment models. By leveraging a multidisciplinary， comprehensive diagnostic and treatment network， the aim is to establish a joint“screening-prevention-treatment”model across provincial，municipal，and county-level hospitals.
To investigate the effects of multi-target neuroregulation technology on upper limb motor function recovery in stroke patients.
Methods
A total of 78 patients with upper limb motor dysfunction after stroke admitted to Rehabilitation Medicine Department of the Third Hospital of Mianyang and Mianyang Traditional Chinese Medicine Hospital from June 2021 to August 2022 were selected for this prospective study. Patients were randomly assigned to the experimental group and the control group using a random number table， with 39 patients in each group. The experimental group received high-precision transcranial direct current stimulation multi-target neuroregulation technology combined with conventional rehabilitation training， while the control group received the same rehabilitation training but with sham stimulation. The treatment period was one month. Before and after treatment，upper limb function was assessed using the Fugl-Meyer assessment upper extremity （FMA-UE），and functional near-infrared spectroscopy data were collected during the resting state.
Results
After training， significant improvements in FMA-UE scores were observed in both groups （P＜0.001）， with a significantly greater improvement in the experimental group compared to the control group （P＜0.05）.Before and after training， both groups showed increased brain network connectivity strength， with significantly greater improvement in the experimental group compared to the control group （P＜0.05）.
Conclusion
Multi-target neuroregulation technology and conventional rehabilitation training can both enhance upper limb motor function and brain network connectivity in stroke patients.However，compared to traditional rehabilitation methods， multi-target neuroregulation technology has a more significant effect on improving upper limb motor function and resting-state brain functional network connectivity.
To investigate influencing factors of short-term mortality risk in patients with severe traumatic brain injury （sTBI） after decompressive craniectomy.
Methods
Clinical data of 154 sTBI patients after decompressive craniectomy admitted to Neurosurgery Department of the Second Affiliated Hospital of Fuyang Normal University （Fuyang Fifth People's Hospital） from January 2018 to October 2023 were retrospectively analyzed. The sTBI patients were divided into the death group and the survival group based on whether they died within 14 d after operation. Independent influencing factors for short-term mortality risk in sTBI patients after decompressive craniectomy were revealed by univariate and multivariate Logistic regression analysis. Receiver operating characteristic （ROC） curve and area under curve （AUC） were used to evaluate the ability of different influencing factors to predict the short-term mortality risk.
Results
Among 154 sTBI patients， 51 cases died within 14 d after operation and were included in the death group， and the incidence of short-term mortality risk was 33.1%， the remaining 103 surviving patients were included in the survival group. There were statistically significant differences in admission time， GCS score on admission， cerebral hernia， posttraumatic cerebral infarction （PTCI）， platelet count， serum total calcium concentration， blood glucose level， level of creatine kinase MB isoenzyme （CK-MB）， level of fibrinogen （FIB）， prothrombin time （PT），activated partial thromboplastin time （APTT） and thrombin time （TT） between the two groups （P＜0.05）.Multivariate Logistic regression analysis showed that GCS score on admission， PTCI， TT were independent influencing factors for short-term mortality risk （P＜0.05）. The ROC curve analysis results showed that the AUC values of admission GCS score， PTCI， TT alone and in combination for predicting short-term mortality risk were 0.806， 0.697， 0.715， 0.896， respectively. Among them， the AUC and specificity predicted by the combination of three indicators were higher than those predicted separately.
Conclusion
The combination of admission GCS score， PTCI， and TT can improve the predictive value of short-term mortality risk in sTBI patients. In clinical practice， effective intervention measures should be taken in time to improve the prognosis of patients.
To analyze the effects of action observation therapy （AOT） combined with trunk control training （TCT） on lower limb motor function， balance and walking function， and activities of daily living （ADL） ability in post-stroke hemiplegic patients.
Methods
Eighty cases of hemiplegic stroke patients admitted to Rehabilitation Medicine Department of the Second People's Hospital of Hefei from January 2022 to April 2024 were selected and divided into four groups of 20 cases each by using the stratified randomized grouping method. In the control group， traditional rehabilitation training and the same duration of training of the healthy lower limb were carried out； in the AOT group， the training of lower limb AOT was added on the basis of traditional rehabilitation training； in the TCT group， the TCT was added on the basis of traditional rehabilitation training； and in the combined group， received AOT and TCT combined therapy on the basis of traditional rehabilitation training was given. Before the treatment， after 2 weeks and after 4 weeks of the treatment， the lower extremity motor ability of patients was evaluated using the Fugl-Meyer assessment scale lower extremity portion （FMA-LE）， the patients'balance ability was evaluated using the Berg balance scale （BBS） and Fugl-Meyer assessment scale balance portion （FMA-LB）， the patients' ADL was evaluated using the modified Barthel index （MBI）. The patients' walking ability was assessed using the functional walking classification （FAC） after treatment.
Results
After 2 and 4 weeks of treatment， the BBS， FMA-LE， FMA-LB and MBI scores of the four groups improved compared with those of the same group before treatment， and the difference was statistically significant（P＜0.05）.After 2 weeks of treatment，the FMA-LE，FMA-LB and MBI scores of the combined group were better than those of the control group，and the difference was statistically significant（P＜0.05）.After 4 weeks of treatment，the BBS，FMA-LE，FMA-LB and MBI scores of the combined group were better than those of the remaining three groups， and the differences were statistically significant （P＜0.05）. The difference between the BBS， FMA-LE， FMA-LB and MBI scores of the AOT group， the TCT group and the combined group after 4 weeks of treatment and those before treatment was better than that of the control group， and the differences were all statistically significant （P＜0.05）， the difference between the AOT group and the TCT group was not statistically significant （P＞0.05）； After 4 weeks of treatment，the FAC grading of the combined group was better than that of the control group， and the proportion of FAC grading in grades Ⅲ-Ⅴin the combined group was better than that of the control group， with a statistically significant difference （P＜0.05）.
Conclusion
Based on the closed-loop rehabilitation theory of“central-peripheral-central”， AOT combined with TCT helps hemiplegic patients to recover lower limb locomotor ability，balance and walking function，and further improves the ability of ADL.
About 50% of patients with traumatic brain injury （TBI） are admitted to the intensive care unit，of which 10% may develop acute kidney injury （AKI）.Reducing intracranial pressure （ICP）and maintaining cerebral perfusion pressure （CPP） are important measures for preventing and treating secondary brain injury in TBI patients. Optimizing the management of ICP and CPP in TBI treatment is a feasible strategy for clinical prevention and control of AKI risk. By more accurate blood flow dynamic monitoring and the use of more beneficial vasoactive drugs， while maintaining intracranial and renal perfusion pressure， it is expected to reduce the occurrence or progression of AKI. This article provides a review of the research progress on AKI after TBI， exploring the potential pathophysiological mechanisms of AKI induction after TBI，the potential mechanisms between AKI and TBI progression，and summarizing the prevention and treatment strategies for TBl patients with AKI or at risk of AKI.The aim is to enhance clinical physicians' diagnosis and understanding of AKI， and provide reference for early diagnosis，prevention，and improvement of patient prognosis.
Aphasia is considered to be a language network disorder caused by organic brain lesions， which seriously affect the daily communication of patients， and relying only on routine rehabilitation training has limited efficacy. Currently， repetitive transcranial magnetic stimulation （rTMS）is extensively utilized in the clinical treatment of aphasia to facilitate functional recovery by inducing persistent cortical circuit plasticity alterations. Theta burst stimulation （TBS）， a novel treatment modality of rTMS，has a fundamental principle largely similar to that of traditional rTMS.However，it can stimulate cortical plasticity within a shorter period and is gradually being employed in the treatment of aphasia.This article reviews the research advancement of TBS in the treatment of aphasia and its related aspects，the aim is to offer a new idea and reference for the clinical selection of TBS stimulation.
Stroke can lead to permanent disability and a decline in quality of life，with the recovery of upper limb function being an important goal and challenge in stroke rehabilitation. Exoskeleton rehabilitation robots are similar in structure to the human limbs and can be worn on the patient's limbs to precisely move each joint and perform movements， effectively increasing upper limb strength and promoting separate movements of the upper limbs， thereby promoting the recovery of upper limb function after stroke. However， there is still controversy over the effectiveness of upper limb exoskeleton robots in reducing upper limb muscle tension and improving daily living ability， and there is no consensus on the training intensity， duration， and frequency for patients at different stages of recovery. This article reviews the application and research progress of upper limb exoskeleton robots in stroke rehabilitation， aiming to provide reference for the upper limb functional rehabilitation of stroke patients in the future.
The disability and mortality rates of posterior circulation aneurysms are higher than those of aneurysms in other areas. The incidence rate of fatal rebleeding in the acute phase of the first ruptured aneurysm of the posterior inferior cerebellar artery （PICA） is extremely high. Microsurgical craniotomy and clipping of the aneurysm is an effective surgical treatment for PICA aneurysms. Early surgical treatment is of great significance for improving the prognosis of patients.
