Background: Malnutrition is commonly observed after stroke and is closely associated with poor clinical outcomes. So, early nutrition support is particularly crucial for severe stroke patients. However, a significant number of critically ill patients are intolerant to enteral nutrition (EN). Probiotics have been widely used in malnutrition by various diseases and have a low incidence of enteral intolerance. So, we aim to elucidate the efficacy of probiotics in EN in improving the nutritional status and clinical prognosis of severe stroke patients with nasal feeding. Method: Embase, PubMed, Sinomed, Web of Science, Cochrane Library, China National Knowledge Infrastructure, Wanfang database, and Vip Journal Integration Platform were searched from inception to March 31, 2021. Randomized controlled trials that applied probiotics in patients with severe stroke were included. The data were extracted and the risk of bias was assessed independently by 2 evaluators. Results: Twenty-four studies comprising 2003 participants of randomized controlled trials were included. The result of pooled analyses showed that probiotics in EN were associated with better outcomes than EN alone on Glasgow Coma Scale score (mean difference [MD] = 1.03, 95% confidence intervals [CI]: 0.78–1.27; P < .00001), infection events (odds ratio [OR] = 0.25, 95% CI: 0.15–0.43; P < .00001), rate of intestinal flora dysbiosis (OR = 0.24, 95% CI: 0.12–0.48; P < .0001), gastrointestinal complications (OR = 0.25, 95% CI: 0.16–0.37, P < .00001), time to reach target nutrition (MD = −1.80, 95% CI: −2.42 to 1.18, P < .00001), prealbumin content (MD = 25.83, 95% CI: 13.68–37.99, P < .0001). Conclusion: Our results demonstrated that probiotics supplementation might be an effective intervention for improving the clinical prognosis in severe stroke patients with nasal feeding, but no significant effect on increasing muscle circumference.

Exosomes have received great attention for their diagnostic, therapeutic, and prognostic roles in the field of neuroscience over the past decade. This scientometric study aimed to quantitatively and qualitatively evaluate knowledge structure, hot topics, and research trends of studies about exosomes in the field of neuroscience using visualization tools. Web of Science Core collection databases were searched for relevant publications between 2005 and 2021. The Carrot2 online system, BICOMB, gCLUTO, and Ucinet software were utilized for key word analysis, and co-citations analyses were conducted in Citespace and VOSviewer. Altogether, 21 high-frequency key words were collected from 856 included articles, and 5 clusters were identified through biclustering analyses. The strategic diagram and social network analysis further determined research hotspots and trends. Co-citation analysis results revealed a few crucial works that contributed to the development of research on exosomes in the field of neuroscience. Moreover, the important sources that had contributed to the development of this field were identified. Our findings suggested that Alzheimer's disease-related research remained a hot topic in this field till now, and recent researchers had extended their scopes to more cognitive impairments. Importantly, researches related to exosomes in multiple sclerosis and Parkinson's disease were promising. While exosomes in acute central nervous system injury had not been sufficiently investigated, with continuous improvement in exosome-based delivery technology, this subject might make a breakthrough in terms of therapeutic innovations in the immediate future.

Background and Purpose. Angong Niuhuang Wan (ANW) is a traditional Chinese herbal formula that has been widely used for the treatment of ischemic stroke, whereas its underlying therapeutic mechanism remains unclear. The objective of the study is to explore the main bioactive ingredients and interaction mechanism of ANW on ischemic stroke based on the network pharmacology method. Methods. The chemical ingredients of ANW were retrieved from TCMSP, TCMID, and literature. We predicted the potential targets of active ingredients by PubChem, Swiss Target Prediction, and STITCH databases. The targets related to ischemic stroke were retrieved using GeneCards, DisGeNET, DrugBank, TTD, and GEO databases. Subsequently, Venn diagrams were used to identify common targets of active ingredients and ischemic stroke. Protein-protein interaction (PPI) network was structured with STRING platform and Cytoscape 3.8.2. Gene ontology (GO) enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses of key targets were performed in the Metascape database. Finally, molecular docking was conducted by AutoDock Tools and PyMOL software. Results. A total of 2391 targets were identified for 230 active ingredients of ANW, and 1386 of them overlapped with ischemic stroke targets. The key active ingredients were mainly quercetin, β-estradiol, berberine, wogonin, and β-sitosterol, and the key targets were also identified, including IL-6, AKT1, MAPK3, PIK3CA, and TNF. The biological process (BP) results indicated that ANW may have therapeutic effects through response oxidative stress, inflammatory response, cellular response to lipid, and response to nutrient levels. Furthermore, the ingredients of ANW were predicted to have therapeutic effects on ischemic stroke via the HIF-1 signaling pathway, FoxO signaling pathway, chemokine signaling pathway, fluid shear stress and atherosclerosis, and neurotrophin signaling pathway. The molecular docking results all showed that the core ingredients were strong binding activity with the core targets. Conclusion. In conclusion, the bioinformatics and pharmacological results reveal that counteracting oxidative stress, suppressing inflammation, inhibiting the development of AS, and even protecting neurological function are critical pathways for ANW in the treatment of ischemic stroke. These results may help to elucidate the mechanism of ANW on ischemic stroke for experimental studies and clinical applications.

No abstract

Backgroud Ischemic stroke (IS) is an acute cerebrovascular incident that threatens public health. Zhengan Xifeng Decoction (ZXD), as a common herbal formula, has been widely applied in clinical practice for IS. The purpose of this study was to investigate the bioactive ingredients and potential pharmacological mechanisms of ZXD for IS based on network pharmacology and molecular docking.Methods Chemical ingredients of ZXD were screened from TCMSP, BATMAN-TCM and the literature. Then, the targets of the chemical ingredients were predicted through STITCH and SwissTargetPrediction databases. IS-related targets were selected from DisGeNET, DrugBank, MalaCards and GeneCards databases. And, the String database and Cytoscape 3.8.2 software were used to construct the protein-protein interaction (PPI) network. Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) enrichment analysis were analyzed in Metascape. At last, Molecular docking was carried out using Open Babel GUI, AutoDock 1.5.6 and Pymol.Results 284 active ingredients involving 2353 putative targets were identified in ZXD, of which 1098 targets were linked to IS. A total of 20 core targets including MAPK3, MAPK1, and AKT1 were identified by analyzing PPI network. The biological process associated with IS were related to response to growth factor, apoptotic signaling pathway, MAPK cascade and neuron death. And KEGG enrichment included that Prolactin signaling pathway, VEGF signaling pathway and ErbB signaling pathway were closely correlated with neurogenesis, neurotransmission, synaptic plasticity vascular growth factor regulation, in IS. Finally, molecular docking revealed that core ingredients of Quercetin, Carvone and Asparamide had well-binding ability to core targets.Conclusion The study suggested that ZXD treated IS by modulating multiple targets and pathways. And, the results demonstrated that the mechanism of ZXD anti-IS may be related to the regulation of neuroprotection and angiogenesis through Prolactin signaling pathway, VEGF signaling pathway and the ErbB signaling pathway.