Cognitive deficits can impact functional outcomes as well as the efficacy of rehabilitation therapy after stroke, but these must be understood in the context of the specific cognitive impairments. We describe here functional improvement during admission to an inpatient rehabilitation facility (IRF) in a patient with an uncommon form of cognitive abnormality, Alice in Wonderland Syndrome (AIWS), which is characterized by visual and other perceptual distortions. The course of this syndrome in the context of inpatient rehabilitation therapy has not been previously described. A 52-year-old male with an acute ischemic infarct involving the left (dominant) occipital, posterior parietal, and posterior temporal lobes received intensive rehabilitation therapy in an IRF setting. The patient reported complete resolution of his AIWS symptoms by day 14 of his IRF admission (day 22 after stroke onset), with daily assessments showing steady gains in his self-care score. Current results suggest that intensive rehabilitation therapy can be provided in the setting of AIWS, and that functional recovery can occur in the presence of AIWS symptoms.

Aim : Diabetic kidney disease (DKD) is a critical microvascular complication of diabetes and the main cause of in end-stage renal disease (ESRD). Conventional clinical treatments for blood glucose, blood pressure, and blood lipid control include ACEI/ARB drugs and other symptomatic treatments, which do not control disease progression. Therefore, in the present study, we assessed the effectiveness of a Chinese medicinal therapy for the treatment of DKD, ameliorating patients’ clinical symptoms, controlling proteinuria, delaying the progression of DKD, and protecting renal function.

Methods : From July 2007 to January 2018, we assessed five DKD patients. We collected data on these patients’ symptoms, physical examination findings, and physicochemical examination findings at multiple visits. Patient medical records were reviewed retrospectively. also improved.

Results : In the five cases reported, clinical symptoms such as edema and urine foam were obviously relieved or even resolved completely. Serum creatinine (Scr) decreased or was maintained, and the 24-hour urinary protein tended to decrease. In the course of treatment, not only were no adverse reactions observed, but patient renal functioning improved or remained stable. Patient quality of life  also improved.

Conclusion : Shenzhuo formula is a promising and safe method for the treatment of DKD and is thus worthy of further controlled clinical and mechanistic studies.

Introduction: Retroperitoneal fibrosis (RPF) is a rare fibroinflammatory disorder characterized by progressive deposition of dense collagenous tissue within the retroperitoneal space, encasing vascular and visceral structures. Although most cases are idiopathic, certain pharmacological agents have been implicated in symptom exacerbation. This case report describes an acute deterioration of gastrointestinal function following initiation of a non-selective beta-adrenergic blocker in a patient with otherwise stable disease.

Case Presentation: A 45-year-old Caucasian woman with dyslipidemia and chronic sinus tachycardia underwent exploratory laparotomy for suspected peritoneal malignancy. Histopathological examination confirmed extensive fibrotic deposition with chronic inflammatory infiltrates and excluded neoplasia, establishing a diagnosis of RPF. During three years of surveillance with serial laboratory testing and magnetic resonance imaging, the disease remained quiescent. To optimize heart rate control, therapy with a beta-1-selective antagonist was replaced by propranolol 40 mg twice daily, a non-selective beta-adrenergic blocker. Within days, she developed severe crampy abdominal pain, marked distension, and altered bowel habits, despite stable imaging findings. The close temporal relationship, together with the established role of beta-2 receptors in intestinal smooth muscle relaxation, implicated non-selective blockade in aggravating colonic dysmotility against a background of fibrotic compression. Dietary modifications and low-dose antispasmodics provided only marginal relief.

Conclusion: This case highlights that non-selective beta-blockers may exacerbate gastrointestinal symptoms in RPF by impairing smooth muscle relaxation. In patients with colonic involvement, beta-1-selective agents should be preferred, with careful consideration of cardiovascular benefits versus gastrointestinal risks.