Background: The number of patients with prolonged disorders of consciousness (pDOC) is increasing. However, its clinical treatment remains challenging. To date, no studies have reported the effect of vagus nerve modulation (VNM) using repetitive transcranial magnetic stimulation (rTMS) in patients with pDOC. We aimed to evaluate the effect of vagus nerve magnetic modulation (VNMM) on pDOC patients. Methods: We performed VNMM in 17 pDOC patients. The Revised Coma Recovery Scale (CRS-R), Glasgow scale (GCS), somatosensory evoked potentials (SEP) and brainstem auditory evoked potentials (BAEP) were assessed before and after treatment. Results: Both CRS-R and GCS results showed significant improvement in p DOC patients after VNMM treatment. The CRS-R improved from 7.88 ± 2.93 to 11.53 ± 4.94. The GCS score also improved from 7.65 ± 1.9 to 9.18 ± 2.65. The number of BAEP grades I increased from 3 to 5 after treatment. The number of BAEP grades I increased from 3 to 5, grade II increased by 1, and grade III decreased from 4 to 1. Conclusion: This study provides a preliminary indication of the potential of VNMM in the rehabilitation of pDOC patients. It provides the basis for a Phase 2 or Phase 3 study of VNMM in patients with pDOC.

Background: Studies have shown that platelet-rich plasma (PRP) can enhance the effect of meniscus repair, but some studies have suggested different views on the role of PRP. Therefore, a meta-analysis was conducted to determine whether PRP can enhance the effect of meniscus repair with respect to pain reduction and improved functionality and cure rate in patients with meniscus injury. Methods: PubMed, EMBASE, Cochrane Library Databases, clinicaltrials.gov, and the CNKI Database were searched from their inception till December 1, 2020. The RCTs reporting the outcomes of the Pain Visual Analog Scale (VAS), Lysholm score, healing rate, and adverse events were included. The risk of bias was assessed using Cochrane collaborative tools. The simulated results were expressed with effect size and 95% confidence interval, and sensitivity and subgroup analysis were performed. Results: The meta-analysis included 8 RCTs and 431 participants. Compared with the control group, use of PRP during meniscus surgery significantly improved the VAS (SMD: –0.40, P = .002, 95%CI: –0.66 to –0.15) and Lysholm score (MD: 3.06, P < .0001, 95%CI: 1.70–4.42) of meniscus injury, but the PRP showed no benefit in improving the healing rate of meniscus repair (RR: 1.22, P = .06, 95%CI: 0.99–1.51). No serious adverse events were reported in any study. Conclusions: PRP is safe and effective in improving the effect of meniscus repair as augment. High quality RCTs with long follow-up and definitive results are needed in the future to confirm the use and efficacy of PRP in meniscus tears.

Background: Studies have shown that platelet-rich plasma (PRP) can enhance the effect of meniscus repair, but some studies have suggested different views on the role of PRP. Purpose: To determine whether PRP can enhance the effect of meniscus repair with respect to pain reduction and improved functionality and cure rate in patients with meniscus injury. Methods: By searching PubMed, EMBASE, Cochrane Library databases, clinicaltrials.gov , and the CNKI database from their inception till December 1, 2020, we performed a meta-analysis of RCTs reporting the results of the Pain Visual Analog Scale (VAS), the pain of Knee injury and Osteoarthritis Outcome Score (KOOS), Lysholm score, the International Knee Documentation Committee (IKDC), healing rate, and adverse events. The risk of bias is assessed using Cochrane’s collaborative tools. The summary results are expressed with effect size and 95% confidence interval, and sensitivity were performed. Results: The meta-analysis included 9 RCTs and 345 patients. In general, compared with the control group, used of PRP during meniscus surgery significantly improved the pain (SMD: -0.95, p < 0.00001,95% CI: -1.22 to -0.69, I2 = 42%) and knee joint function (SMD: 1.00, p = 0.01.95% CI: 0.22 to 1.79, I2 = 89%) of patients with meniscus injury at 6 months after treatment. However, both PRP and non-PRP showed improvements in the pain and knee joint function, with no significant difference between the groups at 1 months and beyond 12 months. The PRP enhancement technique showed benefit in improving the cure rate of meniscus repair (RR:1.44; p < 0.0001, 95% CI: 1.20–1.73). No serious adverse events were reported in any study. Conclusion: As an enhancement program for meniscus repair, PRP is worthy of further consideration in improving the function and pain of patients during the mid-term follow-up after surgery, and PRP can further improve the healing rate of meniscus repair. However, the evidence still needs to be interpreted carefully because of the quantity and quality of the included studies.

In this study, we investigated the effects of transcranial direct current stimulation (tDCS) combined with acupuncture therapy on pain, dysfunction and functional connectivity in patients with knee osteoarthritis (KOA), and to evaluate its potential therapeutic value. In this single-center, randomized controlled trial, patients were recruited from May 2023 to August 2024 from the Departments of Rehabilitation, Orthopedics, and Pain Management at the Affiliated Hospital of North Sichuan Medical College. The patients were randomly assigned to three groups, including the acupuncture group, the tDCS group, and the combined acupuncture and tDCS group. All treatments were administered five times a week for two weeks. The condition of the patients was evaluated by the visual analog scale (VAS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Lequesne index, and functional near-infrared spectroscopy (fNIRS) before treatment and after two weeks of treatment, respectively. In total, 63 patients were enrolled and randomly assigned to three groups. Three patients were excluded for work-related reasons, fear of acupuncture, or time conflicts repectively, which prevented further follow-up. The VAS score, WOMAC score, and Lequesne indexes of all patients were significantly lower after treatment than before treatment (P < 0.01). Compared to the tDCS group and the acupuncture group, the combined group showed greater improvements in the VAS score, WOMAC score, and Lequesne indexes (P < 0.05). The fNIRS results indicated a significant reduction in the mean cerebral functional connectivity strength based on oxyhemoglobin (HbO2) and deoxyhemoglobin (HbR) across all three groups following treatment (P < 0.05). The functional connectivity strengths of the HbO2-based LPFC ~ LPFC, RPFC ~ RPFC, LMC ~ LMC, RMC ~ RMC, LPFC ~ RPFC, LPFC ~ LMC, LPFC ~ RMC, RPFC ~ LMC, RPFC ~ RMC, LMC ~ RMC; HbR-based LPFC ~ LPFC, RPFC ~ RPFC, LMC ~ LMC, RMC ~ RMC, LPFC ~ LMC, LPFC ~ RMC and LMC ~ RMC in the combined group were significantly lower than those in the acupuncture group (P < 0.05).The HbO2-based LPFC ~ LPFC, RPFC ~ RPFC, LMC ~ LMC, and RMC ~ RMC in the combined group were significantly lower than those in the tDCS group (P < 0.01). Compared to those in the acupuncture group, the HbR-based LPFC ~ LPFC and LMC ~ LMC of the patients in the tDCS group were lower (P < 0.05). The combination therapy of tDCS and acupuncture is better than monotherapy in relieving pain and dysfunction in patients with KOA. The improvement in efficacy may be related to the reduction in brain functional connectivity and may become a new treatment method for treating KOA. ChiCTR2300073819.

Background: There is no diagnostic assessment procedure with moderate or strong evidence of use, and evidence for current means of treating prolonged disorders of consciousness (pDOC) is sparse. This may be related to the fact that the mechanisms of pDOC have not been studied deeply enough and are not clear enough. Therefore, the aim of this study was to explore the mechanism of pDOC using functional near‐infrared spectroscopy (fNIRS) to provide a basis for the treatment of pDOC, as well as to explore preclinical markers for determining the arousal of pDOC patients.Methods: Five minutes resting‐state data were collected from 10 pDOC patients and 13healthy adults using fNIRS. Based on the concentrations of oxyhemoglobin (HbO) and deoxyhemoglobin (HbR) in the time series, the resting‐state cortical brain functional connectivity strengths of the two groups were calculated, and the functional connectivity strengths of homologous and heterologous brain networks were compared at the sensorimotor network (SEN), dorsal attention network (DAN), ventral attention network (VAN), default mode network (DMN), frontoparietal network (FPN), and visual network (VIS) levels. Univariate binary logistic regression analyses were performed on brain networks with statistically significant differences to identify brain networks associated with arousal in pDOC patients. The receiver operating characteristic (ROC) curves were further analyzed to determine the cut‐off value of the relevant brain networks to provide clinical biomarkers for the prediction of arousal in pDOC patients.Results: The results showed that the functional connectivity strengths of oxyhemoglobin (HbO)‐based SEN∼SEN, VIS∼VIS, DAN∼DAN, DMN∼DMN, SEN∼VIS, SEN∼FPN, SEN∼DAN, SEN∼DMN, VIS∼FPN, VIS∼DAN, VIS∼DMN, HbR‐based SEN∼SEN, and SEN∼DAN were significantly reduced in the pDOC group and were factors that could reflect the participants' state of consciousness. The cut‐off value of resting‐state functional connectivity strength calculated by ROC curve analysis can be used as a potential preclinical marker for predicting the arousal state of subjects.Conclusion: Resting‐state functional connectivity strength of cortical networks is significantly reduced in pDOC patients. The cut‐off values of resting‐state functional connectivity strength are potential preclinical markers for predicting arousal in pDOC patients.

This systematic review and meta‐analysis of 23 randomized controlled trials (RCTs) encompassed an overall sample size of 2061 patients diagnosed with coronary heart disease. The objective was to assess the impact of omega‐3 fatty acids intake on lipid profiles and arterial plaque volume. Omega‐3 fatty acids supplementation significantly reduced circulating levels of triglycerides (TGs) (standardized mean difference [SMD] = −0.25, 95% confidence interval [CI] = −0.38 to −0.11) and total cholesterol (TC) (SMD = −0.12, 95% CI = −0.23 to −0.02), with no significant impact on the levels of high‐density lipoprotein cholesterol (HDL‐C), low‐density lipoprotein cholesterol (LDL‐C), or arterial plaque volume. Our omega‐3 fatty acids dose–response analysis revealed a linear relationship with TG and a “J” shaped curve for TC and LDL‐C levels. Our findings suggest that omega‐3 fatty acids intake had a positive impact on the circulating levels of TG and TC. Our findings underscore the importance of tailoring omega‐3 fatty acids dosage to individual patient needs in clinical practice. Trial Registration: PROSPERO:CRD42023486434