BackgroundNitrous oxide (N2O), a long-standing anesthetic, is also neurotoxic by interfering with the bioavailability of vitamin B12 if abused. A few case studies have reported the neurological and psychiatric complications of N2O.Case presentationHere, we reported a patient of N2O induced subacute combined degeneration (SCD) with longitudinally extensive myelopathy with inverted V-sign exhibiting progressive limb paresthesia and unsteady gait.ConclusionsThis case raises the awareness of an important mechanism of neural toxicity of N2O, and clinical physicians should be well recognized this in the field of substance-related disorders.

BackgroundInfarcts of the corpus callosum are rare and have not been well documented previously. As for a variety of signs and symptoms presented, alien hand syndrome (AHS) can be easily overlooked.Case presentationIn this report, we present a patient with a mixed types of AHS coexistence secondary to the corpus callosum infarction, including a motor type of AHS by intermanual conflict (callosal type AHS) and a sensory type of AHS by alien hand and left hemianesthesia (posterior AHS).ConclusionsOur case may contribute to the early recognition of AHS and to explore the abnormal neural mechanism of AHS. To our knowledge, rare reports have ever documented such mixed AHS coexisting secondary to the callosal lesion, based on advanced neuroimaging methods as in our case.

Background: Recently, a simplified modified Rankin Scale (mRS) questionnaire (smRSq) showed good reliability but has not been tested for its validity by its original creators. Our study aimed to test its reliability and validity in Chinese stroke patients. Methods: Randomly chosen paired raters scored the smRSq, the conventional mRS, and the NIH Stroke Scale (NIHSS) face-to-face in 150 hospitalized stroke patients. Inter-rater reliability and concurrent validity were assessed for this translated questionnaire. Results: For inter-rater reliability of the smRSq, the overall agreement among the raters was 84%, the ĸ was 0.79 (95% CI 0.72–0.87), and the ĸw was 0.91 (95% CI 0.88–0.94). For inter-rater reliability of the mRS, the overall agreement among the raters was 81%, the ĸ was 0.75 (95% CI 0.67–0.83), and the ĸw was 0.88 (95% CI 0.84–0.92). The agreement between the mRS and smRSq was 71%, ĸ = 0.63 (95% CI 0.54–0.71), and ĸw = 0.83 (95% CI 0.79–0.88). The correlation between the NIHSS and the smRSq (concurrent validity) was moderate (Spearman’s correlation coefficient 0.70, p < 0.0001). Conclusions: Our results confirm the value of the smRSq in the assessment of stroke functional outcome in China. As this is a novel stroke tool, further validations are needed.

BACKGROUND Urological calculi often cause renal colic, which is characterized by paroxysmal or persistent severe pain in the upper abdomen or lumbar region. Development of methods to quickly relieve these pain symptoms has garnered clinical attention. Wrist-ankle acupuncture is a type of floating acupuncture therapy administered at selected points in the carpal and ankle areas, and it has good pain-relieving effects. We used wrist-ankle acupuncture combined with pain nursing for pain intervention in patients with renal calculi to confirm its application and safety. AIM To study the effect of wrist-ankle acupuncture combined with pain nursing in the treatment of urinary calculi with acute pain. METHODS Eighty-two patients with urinary calculi with acute pain as the first symptom followed at our hospital from November 2019 to June 2021 were enrolled in the study and classified into two groups according to the odd and even numbers of the visit sequences, each with 41 cases. The control group received a routine nursing intervention and intramuscular injection of nonsteroidal anti-inflammatory drugs, whereas the observation group received pain management nursing and wrist-ankle acupuncture. Subsequently, the pain-relieving effect was compared between the two groups. RESULTS The score on the visual analog scale (VAS) at 24, 48, and 72 h postintervention was decreased in both groups compared with the baseline data; moreover, the observation group scored significantly lower than the control group on the VAS at each time point after the intervention ( P < 0.05). The clinical efficacy at 24 h postintervention was not significantly different between the two groups ( P > 0.05). In turn, the pain recurrence rate at 72 h postintervention was lower in the observation group compared with the control group ( P < 0.05). Finally, the nursing satisfaction rate in the observation group was significantly higher than that observed in the control group ( P < 0.05). No serious adverse reactions occurred during the treatment and the safety of treatment was high in both groups. CONCLUSION Wrist-ankle acupuncture combined with pain nursing for treating urolithiasis with acute pain effectively alleviated the degree of pain and reduced the recurrence rate, which was worthy of clinical application.