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.
Subjects with brain diseases are the major conditions of neurorehabilitation. It has brought new hopes to those with neurologic problems with the development of researches in the brain and other neurology. Strategies in the neurorehabilitation are now changing. It has progressed from focusing the improvement of the limbs of patients such as neurodevelopment approaches, functional electrical stimulation, robotic training, and so on, to the brain-orientated such as non-invasive brain stimulation, virtue reality, etc. A new model of neurorehabilitation is now being developed which integrates the methods stimulating the brain with those stimulating the limbs together either simultaneously or combination to modulate the effectiveness of different modalities. The final goals are to further enhance the outcome of 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.
ObjectiveTo evaluate the safety and efficacy of non-invasive positive pressure ventilation (NIPPV) combined with fiberoptic bronchoscopy(FB) on acute exacerbation of chronic obstructive puhmonary disease (AECOPD) patients with acute respiratory failure. MethodsA prospective study was conducted on the AECOPD patients with respiratory failure in respiratory intensive care unit of Tangdu Hospital of Fourth Military Medicine University from February 2010 to February 2011.They were randomly divided into a case group and a control group.The case group was administrated FB and lavage after one hour of NIPPV treatment.The control group was administrated NIPPV without FB and lavage.Other treatment regimen was the same in two groups. ResultsThere were 51 subjects recruited in the study, 25 subjects in the case group and 26 subjects in the control group.All variables at baseline were matched (P > 0.05).All variables improved after one hour of NIPPV before FB, without significant difference between two groups (P > 0.05).During the period of FB, heart rate in the case group was faster than that in the control group (P < 0.05), and other variables were not significantly different between two groups (P > 0.05).Both groups received NIPPV for one hour after FB, the variables including heart rate, respiratory rate, pH, PaO2, PaCO2 were statistically significant between two groups(P < 0.05).At the time of 24 hours after FB, the variables including mean arterial pressure, heart rate, respiratory rate, pH, PaO2 and PaCO2 in the case group were nearly recovered, and differences between two groups were significant (P < 0.05).The positive rate of sputum culture was significantly higher in the case group than that in the control group[88.0%(22/25) vs.58.6%(14/26)].Success rate in the case group were obviously superior to that in control group.The cases of failure, death and refusing in the case group were lower than those in the control group.Complications in two groups had no significant difference (P > 0.05).There was not serious complication such as hear arrest, hemoptysis and apnea during the process of NIPPV combined with early FB. Conclusion It deserves to be used in clinic because of the safety, efficacy and feasible for most of AECOPD patients through NIPPV combined with early FB.
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.
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.