Objective To investigate the impact of intergenerational caregiving on the brain structure and function of grandparents,and to analyze its correlation with caregiving factors.Methods Healthy adults(66 with grandchildren,24 without grandchildren)were recruited as study subjects,and clinical and MRI data were collected.Resting-state brain functional degree centrality(DC)and surface-based morphometry(SBM)methods were used to compare the differences in brain structure and function between the groups with and without grandchildren.The correlation between the differences in brain regions and △ values with grandchild's age,number,and time spent in childcare were assessed,respectively.Results Compared to the group without grandchildren,the group with grandchildren showed reduced surface area and cortical volume in the left middle temporal gyrus,as well as decreased DC values in the left medial superior frontal gyrus,bilateral orbital superior frontal gyrus,and left anterior cingulate and paracingulate gyrus(P＜0.05),respectively.In the grandchildren group,DC values and △ values in the left orbital superior frontal gyrus,left anterior cingulate and paracingulate gyrus were significantly positively correlated with time spent in childcare.Conclusion The brain structures and functions of grandparents related to empathy and motivation are changed in intergenerational caregiving,which may reveal the neuroplasticity after caring for their grandchildren.

Standardised emergency management protocols for hand injury in microsurgery is critical, as it directly determines ultimate clinical outcomes. This consensus consolidates expert insights regarding diagnostic and treatment procedure for hand injury in microsurgery, emergency support protocols and key points of emergency workflow optimisation. It summarises the opinions of experts and puts forward standardised recommendations to guide clinical practice in microsurgical treatment process, so as to further improve the quality of treatment for hand injury in microsurgery and maximise the protection of limb function and quality of life of patients.

The long-term functional impairment of survivors of ischemic stroke has emerged as an increasingly pressing concern, and most stroke patients are afflicted with cognitive impairment and functional deficits. Compared with the general population, stroke patients exhibit significantly greater magnetic resonance imaging burden of cerebral small vessel disease (CSVD), which is associated with substantially elevated risks of post-stroke dementia, aggravated disability severity, and increased stroke recurrence rates. This article reviews existing researches, delving deep into the role and significance of the CSVD magnetic resonance imaging burden in the assessment of cognitive impairment and functional prognosis in patients with ischemic stroke. The results demonstrate that CSVD magnetic resonance imaging burden, whether assessed through a grading scoring method or quantitative analysis, shows significant correlations with cognitive function in patients with ischemic stroke, and the total CSVD magnetic resonance imaging burden exhibits high sensitivity in predicting functional prognosis of patients with ischemic stroke. Therefore, this indicator holds great promise in providing pivotal support for aspects such as monitoring disease progression and formulating personalized treatment strategies.In the future, it will be imperative to establish multicenter prospective cohorts to further elucidate the relationship between the CSVD magnetic resonance imaging burden and the long-term prognosis of patients with ischemic stroke.

Objective:To investigate the predictive value of multimodal magnetic resonance imaging (MRI) techniques in assessing symptom remission of post-traumatic stress disorder (PTSD) of bereaved parents who lost their only child.Methods:In this prospective study, 34 parents with PTSD resulting from the loss of the only child were followed-up for 2 years. Based on the PTSD diagnostic status at the end of the follow-up, participants were divided into the remission group and the persistent group.R 3.6.1 and SPSS 20.0 software were used for statistical analysis.Baseline clinical data and neuroimaging findings were compared between the two groups. Logistic regression and LASSO regression analyses were used to identify independent predictors of PTSD symptom remission. The predictive performance of these factors was evaluated by receiver operating characteristic (ROC) curve analysis.Results:Initial screening with univariate Logistic regression and LASSO regression revealed that regional homogeneity (ReHo) in the left middle temporal gyrus, the combined predictive value based on ReHo, and the integrated predictive value combining gray matter volume (GMV) and ReHo (GMV-ReHo predictor) were significant factors influencing symptom remission (all P<0.05). Multivariate Logistic regression further demonstrated that the GMV-ReHo predictor retained independent predictive significance ( P<0.05), with ROC curve analysis showing an area under the curve (AUC) of 0.979 (95% CI=0.935-0.996, P<0.001) for its ability to predict PTSD remission. Notably, a combined model incorporating both the scores of the clinician administered PTSD scale (CAPS) and the GMV-ReHo predictor achieved an enhanced predictive performance, yielding an AUC of 0.984 (95% CI=0.952-0.998, P<0.001). Conclusion:The GMV-ReHo predictor effectively identifies symptom remission in PTSD resulting from the loss of the only child.

The long-term functional impairment of survivors of ischemic stroke has emerged as an increasingly pressing concern, and most stroke patients are afflicted with cognitive impairment and functional deficits. Compared with the general population, stroke patients exhibit significantly greater magnetic resonance imaging burden of cerebral small vessel disease (CSVD), which is associated with substantially elevated risks of post-stroke dementia, aggravated disability severity, and increased stroke recurrence rates. This article reviews existing researches, delving deep into the role and significance of the CSVD magnetic resonance imaging burden in the assessment of cognitive impairment and functional prognosis in patients with ischemic stroke. The results demonstrate that CSVD magnetic resonance imaging burden, whether assessed through a grading scoring method or quantitative analysis, shows significant correlations with cognitive function in patients with ischemic stroke, and the total CSVD magnetic resonance imaging burden exhibits high sensitivity in predicting functional prognosis of patients with ischemic stroke. Therefore, this indicator holds great promise in providing pivotal support for aspects such as monitoring disease progression and formulating personalized treatment strategies.In the future, it will be imperative to establish multicenter prospective cohorts to further elucidate the relationship between the CSVD magnetic resonance imaging burden and the long-term prognosis of patients with ischemic stroke.

Objective:To investigate the predictive value of multimodal magnetic resonance imaging (MRI) techniques in assessing symptom remission of post-traumatic stress disorder (PTSD) of bereaved parents who lost their only child.Methods:In this prospective study, 34 parents with PTSD resulting from the loss of the only child were followed-up for 2 years. Based on the PTSD diagnostic status at the end of the follow-up, participants were divided into the remission group and the persistent group.R 3.6.1 and SPSS 20.0 software were used for statistical analysis.Baseline clinical data and neuroimaging findings were compared between the two groups. Logistic regression and LASSO regression analyses were used to identify independent predictors of PTSD symptom remission. The predictive performance of these factors was evaluated by receiver operating characteristic (ROC) curve analysis.Results:Initial screening with univariate Logistic regression and LASSO regression revealed that regional homogeneity (ReHo) in the left middle temporal gyrus, the combined predictive value based on ReHo, and the integrated predictive value combining gray matter volume (GMV) and ReHo (GMV-ReHo predictor) were significant factors influencing symptom remission (all P<0.05). Multivariate Logistic regression further demonstrated that the GMV-ReHo predictor retained independent predictive significance ( P<0.05), with ROC curve analysis showing an area under the curve (AUC) of 0.979 (95% CI=0.935-0.996, P<0.001) for its ability to predict PTSD remission. Notably, a combined model incorporating both the scores of the clinician administered PTSD scale (CAPS) and the GMV-ReHo predictor achieved an enhanced predictive performance, yielding an AUC of 0.984 (95% CI=0.952-0.998, P<0.001). Conclusion:The GMV-ReHo predictor effectively identifies symptom remission in PTSD resulting from the loss of the only child.

Standardised emergency management protocols for hand injury in microsurgery is critical, as it directly determines ultimate clinical outcomes. This consensus consolidates expert insights regarding diagnostic and treatment procedure for hand injury in microsurgery, emergency support protocols and key points of emergency workflow optimisation. It summarises the opinions of experts and puts forward standardised recommendations to guide clinical practice in microsurgical treatment process, so as to further improve the quality of treatment for hand injury in microsurgery and maximise the protection of limb function and quality of life of patients.

Objective To investigate the impact of intergenerational caregiving on the brain structure and function of grandparents,and to analyze its correlation with caregiving factors.Methods Healthy adults(66 with grandchildren,24 without grandchildren)were recruited as study subjects,and clinical and MRI data were collected.Resting-state brain functional degree centrality(DC)and surface-based morphometry(SBM)methods were used to compare the differences in brain structure and function between the groups with and without grandchildren.The correlation between the differences in brain regions and △ values with grandchild's age,number,and time spent in childcare were assessed,respectively.Results Compared to the group without grandchildren,the group with grandchildren showed reduced surface area and cortical volume in the left middle temporal gyrus,as well as decreased DC values in the left medial superior frontal gyrus,bilateral orbital superior frontal gyrus,and left anterior cingulate and paracingulate gyrus(P＜0.05),respectively.In the grandchildren group,DC values and △ values in the left orbital superior frontal gyrus,left anterior cingulate and paracingulate gyrus were significantly positively correlated with time spent in childcare.Conclusion The brain structures and functions of grandparents related to empathy and motivation are changed in intergenerational caregiving,which may reveal the neuroplasticity after caring for their grandchildren.

Objective To investigate the clinicopathological parameters and risk factors of the patients with connective tissue disease-associated interstitial lung disease(CTD-ILD)complicated with Epstein-Barr virus(EBV)viraemia.Methods The CTD-ILD pa-tients admitted to Department of Respiratory and Critical Care Medicine,Nanjing Drum Tower Hospital from January 2023 to April 2024 were collected.Based on the detection results of EBV DNA,the patients were divided into the EBV DNA(+)group and EBV DNA(-)group.The clinicopathological parameters of the two groups were analyzed.Results Out of 162 CTD-ILD patients who underwent EBV DNA testing,a total of 28 were found to have EBV viraemia.The levels of serum albumin([32.7±4.1]g/L vs[34.8±3.8]g/L,t=2.559,P＜0.05),oxygenation index([268.5±94.0]mmHg vs[323.2±120.9]mmHg,t=2.062,P＜0.05),and percentages of predicted diffusing capacity for carbon monoxide([30.9±15.3]% vs[44.9±18.8]%,t=2.127,P＜0.05])in the EBV DNA(+)group were significantly lower than those in the EBV DNA(-)group,while the levels of lactate dehydrogenase(LDH,[369.1±206.2]U/L vs[298.8±128.7]U/L,t=2.335,P＜0.05)were significantly higher than that in the EBV DNA(-)group.The acute exacerbation of ILD in the EBV DNA(+)group was more common than that in the EBV DNA(-)group(P＜0.05).Multivariate Lo-gistic analysis showed that honeycombing and low oxygenation index were independent risk factors of CTD-ILD patients complicated with EBV viraemia.Conclusion The CTD-ILD patients complicated with EBV viraemia have poorer oxygenation and are more prone to suf-fer from acute exacerbation of ILD.Honeycombing in chest HRCT and low oxygenation index are independent risk factors of CTD-ILD patients complicated with EBV viraemia.

Objective To investigate the clinicopathological parameters and risk factors of the patients with connective tissue disease-associated interstitial lung disease(CTD-ILD)complicated with Epstein-Barr virus(EBV)viraemia.Methods The CTD-ILD pa-tients admitted to Department of Respiratory and Critical Care Medicine,Nanjing Drum Tower Hospital from January 2023 to April 2024 were collected.Based on the detection results of EBV DNA,the patients were divided into the EBV DNA(+)group and EBV DNA(-)group.The clinicopathological parameters of the two groups were analyzed.Results Out of 162 CTD-ILD patients who underwent EBV DNA testing,a total of 28 were found to have EBV viraemia.The levels of serum albumin([32.7±4.1]g/L vs[34.8±3.8]g/L,t=2.559,P＜0.05),oxygenation index([268.5±94.0]mmHg vs[323.2±120.9]mmHg,t=2.062,P＜0.05),and percentages of predicted diffusing capacity for carbon monoxide([30.9±15.3]% vs[44.9±18.8]%,t=2.127,P＜0.05])in the EBV DNA(+)group were significantly lower than those in the EBV DNA(-)group,while the levels of lactate dehydrogenase(LDH,[369.1±206.2]U/L vs[298.8±128.7]U/L,t=2.335,P＜0.05)were significantly higher than that in the EBV DNA(-)group.The acute exacerbation of ILD in the EBV DNA(+)group was more common than that in the EBV DNA(-)group(P＜0.05).Multivariate Lo-gistic analysis showed that honeycombing and low oxygenation index were independent risk factors of CTD-ILD patients complicated with EBV viraemia.Conclusion The CTD-ILD patients complicated with EBV viraemia have poorer oxygenation and are more prone to suf-fer from acute exacerbation of ILD.Honeycombing in chest HRCT and low oxygenation index are independent risk factors of CTD-ILD patients complicated with EBV viraemia.