UNASSIGNED: Currently, the use of spinal cord electrical stimulations for patients with severe disorders of consciousness after traumatic brain injury remains limited, and long-term follow-up studies are even scarcer. To date, there have been few reports using near-infrared spectroscopy to evaluate the clinical effects and optimal parameters of spinal cord electrical stimulation for severe consciousness disorders. This report describes a case of a patient with severe disturbance of consciousness after traumatic brain injury who underwent spinal cord electrical stimulation implantation. Advanced near-infrared spectroscopy was employed to monitor and evaluate postoperative efficacy. The findings of this case report will provide a reference for the clinical treatment of severe consciousness disturbances.
UNASSIGNED: A patient diagnosed with a severe disturbance of consciousness following traumatic brain injury presented symptoms of coma and lack of voluntary activity. The treatment regimen included conventional approaches (medication combined with rehabilitation training) and adjustments to the spinal cord electrical stimulation parameters. Advanced functional near-infrared spectroscopy (fNIRS) was used to explore changes in brain functional connectivity strength and assess clinical efficacy.
UNASSIGNED: The integration of conventional treatment and continuous modification of spinal cord electrical stimulation parameters, combined with fNIRS monitoring, demonstrated that conventional treatment and spinal cord electrical stimulation displayed a positive effect on increasing brain functional strength connection. The Glasgow Coma Scale(GCS) score significantly improved from the baseline. Optimal results were observed with spinal cord stimulation settings at 4.5 V amplitude, 210 μs pulse width, and 70 Hz frequency, operating from 8:00-20:00 in a cycling mode of 15 min on and 15 min off, where improvements in consciousness were markedly evident.
UNASSIGNED: Patients with severe disturbances of consciousness after traumatic brain injury recover slowly. Conventional treatment combined with spinal cord electrical stimulation can improve the degree of disturbance of consciousness and promote recovery from the condition.

BACKGROUND: Dyclonine hydrochloride mucilage is a topical anaesthetic formulated for mucosal surfaces. It is employed frequently for topical anaesthesia of the pharynx prior to endoscopic examinations such as electronic gastroscopy, and few adverse reactions have been reported. This article describes a patient who experienced a transient but severe disturbance of consciousness following oral dyclonine hydrochloride mucilage administration.
METHODS: A 75-year-old female presenting with gastrointestinal bleeding was examined by electronic gastroscopy. Six minutes after oral dyclonine hydrochloride mucilage administration, the patient entered a comatose-like state accompanied by loss of limb muscle tone and profuse perspiration. This response was not accompanied by changes in cardiac rhythm, blood pressure, or respiration rate, suggesting an effect on higher brain centres. After ten minutes, the patient\'s symptoms were alleviated.
CONCLUSIONS: We suggest that sites of dyclonine hydrochloride mucilage use be equipped with appropriate rescue devices for these rare events.

Nasal myiasis is a rare parasitic disease. The growth of myiasis in the nasal cavity causes damage to the nasal cavity and paranasal sinuses. Once the dipeterous larvae are migrated, it causes damage to the surrounding structures such as eyes and skull cavity. Proper treatment and active prevention and control can reduce and avoid the occurrence of serious complications. On May 14, 2020, a patient with cerebral infarction and coma was admitted to Xiangya Hospital of Central South University and developed nasal myiasis. During the treatment of the primary disease, the patient was found to be infected with rhinomyiasis. The patient was treated with dehydration, cranial pressure reduction, brain protection, blood glucose control, blood pressure control, and anti-infection. Nasal endoscopy and nasal irrigation were carried out to treat nasal myiasis. The patient was properly placed and isolated for prevention and control so as to prevent the spread of myiasis in the ward. After 16 days, the patient regained consciousness, no worm was found in the nasal cavity, and was discharged from the hospital. The patient was followed-up for 6 months, no maggots were found in the nasal cavity of the patients, no complaints of nasal discomfort was occurred, and no other patients and medical staff were infected with myiasis. The prevention of myiasis is very important, and proper measures should be taken to reduce the risk of community and hospital infection.
鼻蝇蛆病是一种较为罕见的寄生虫病，蝇蛆在鼻腔内生长对鼻腔、鼻窦造成损伤，一旦移行，会导致眼、颅腔等周围结构受损，妥善治疗和积极防控才能减少和避免严重并发症的出现。2020年5月14日中南大学湘雅医院收治的1例脑梗死昏迷患者发生了鼻蝇蛆病。该患者在治疗原发病的过程中，发现感染了蝇蛆。给予脱水降颅压、护脑、控制血糖和血压、抗感染等，积极治疗原发疾病，对鼻腔进行了鼻内镜检查/取虫、鼻腔冲洗等以治疗鼻蝇蛆病，然后对患者进行了妥善安置和隔离防控，以防止蝇蛆病在病区内播散。入院第16天后，患者神志恢复，鼻腔内未再发现虫体，病情好转出院。随访6个月，患者鼻腔未再发现蝇蛆，未诉鼻腔不适，收治病区无患者及医务人员感染蝇蛆。蝇蛆病重在预防，应当积极采取措施以降低社区及医院感染的风险。.

Salivary duct carcinoma (SDC) is a rare and highly aggressive salivary gland tumor with rapid growth, distant metastasis, and a high recurrence rate. Moreover, the parotid gland is the most common site with a poor prognosis. A lower frequency of distance metastasis to the liver, skin, and brain has also been reported, although the lungs, bones, and lymph nodes are the most common sites of SDC metastasis. We report a case of nonconvulsive status epilepticus (NCSE) in a 73-year-old male comatose patient having SDC of the parotid gland with an unusual metastasis to the skin and brain diagnosed by frequent cerebrospinal fluid examinations. Meningeal carcinomatosis usually has a poor prognosis, and NCSE is a reversible cause of altered mentation. Clinicians should know the unique set of epilepsy etiologies in patients with malignant tumors.

A 46-year-old female patient was diagnosed as mixed phenotype acute leukemia with chief complaints of intermittent gingival swelling and bleeding for 1 week. The induction chemotherapy was not effective. During the second course chemotherapy, the patient had sudden convulsion and coma. She was transferred to the intensive care unit with worsened condition after transient improvement. Her final diagnosis was secondary adrenocortical insufficiency, adrenal crisis, intractable hyponatremia and cerebral edema.
患者女性，46岁。因\"间断牙龈肿痛伴出血1周\"入院，诊断急性混合细胞白血病。给予诱导化疗效果不佳，第2次化疗过程中突发抽搐、意识不清，转入重症监护病房经积极治疗控制后又不断反复。最终诊断：继发性肾上腺皮质功能不全，肾上腺危象，顽固性低钠血症，脑水肿。.

Cortical blindness induced by hepatic encephalopathy is an extremely rare complication and its epidemiology has not been studied in great detail. We report a 63-year-old man with liver cirrhosis who developed sudden bilateral visual impairment.
On arrival at hospital, the patient had orientation disturbance, slurred speech, and mild disturbance of consciousness with impaired vision (light sense). He had no focal neurological deficits except for bilateral blindness. Cerebral stroke was suspected, but imaging and ophthalmological examination did not reveal major abnormalities. An increased concentration of ammonia in blood suggested hepatic encephalopathy; a diagnosis of cortical blindness was proposed. His vision returned gradually with relief of hepatic encephalopathy.
Cortical blindness can be an initial symptom of hepatic encephalopathy without severe disturbance of consciousness, and can be misdiagnosed as cerebral stroke. Cortical blindness induced by hepatic encephalopathy has been reported in only 10 cases, including our patient, and merits further evaluation.