In recent years,significant breakthroughs have been achieved in the immunotherapy for Alzheimer's disease.In line with global advancements,two anti-amyloid-β monoclonal antibodies have been approved and successfully launched in China for clinical use.Lecanemab and Donanemab were officially used in June 2024 and April 2025 in China,respectively.In order to standardize the rational and safe application of anti-amyloid-β monoclonal antibodies for Alzheimer's disease in China,this article integrates recom-mendations from the clinical trials and real-world experience from the author's team and domestic peers to further update the recom-mendations for the clinical use of anti-amyloid-β monoclonal antibody based on the 2024 version.It includes indications for therapy,pre-treatment evaluation and preparation,administration protocols and safety measures during treatment,and post-treatment monitor-ing strategies.

Objective:To investigate the variation of reference ranges of hemodynamic parameters in normal pregnancy and their relation to maternal basic characteristics.Methods:A total of 598 healthy pregnant women who underwent regular prenatal examination at the Third Affiliated Hospital of Guangzhou Medical University from January to December 2023 were prospectively enrolled, and noninvasive hemodynamic monitors were used to detect changes in hemodynamic parameters of the pregnant women with the week of gestation, including cardiac output (CO), stroke volume (SV), thoracic fluid content (TFC), systemic vascular resistance (SVR), mean arterial pressure (MAP), and heart rate (HR). Relationships between hemodynamic parameters and maternal basic characteristics, including age, height, and weight, were analyzed using restricted cubic spline.Results:(1) CO ( r=0.155, P<0.001), TFC ( r=0.338, P<0.001), MAP ( r=0.204, P<0.001), and HR ( r=0.352, P<0.001) were positively correlated with the week of gestation, and SV was negatively correlated with the week of gestation ( r=-0.158, P<0.001). There was no significant correlation between SVR and gestational age ( r=-0.051, P=0.258). (2) CO exhibited a positive correlation with maternal height and weight (all P<0.001). The taller and heavier of pregnant women, the higher their CO. A linear relationship was observed between maternal weight and SV, MAP and HR (all P<0.01). As maternal weight increased, SV, MAP and HR showed an upward trend. Furthermore, there was an inverse association between maternal age and SVR ( P<0.001). (3) There was a significant nonlinear association observed between TFC and body mass index during pregnancy ( P<0.05). Additionally, a nonlinear relationship was found between SVR and MAP in relation to maternal age (all P<0.05). Notably, when the age exceeded 31 years old, there was an evident upward trend observed in both SVR and MAP. Conclusions:The hemodynamic parameters of normal pregnant women are influenced by their height, body weight, and age. It is advisable to maintain a reasonable weight during pregnancy and give birth at an appropriate age.

To explore the influence of common chronic diseases on cognitive function, the potential pathological mechanism and related treatments.This article summarizes the research progress on a relationship between a variety of common elderly chronic diseases and cognitive dysfunction at home and abroad in recent years, in order to improve the awareness of prevention and treatment of cognitive dysfunction in elderly patients.

Huntington's disease (HD) is a deadly neurodegenerative disease with abnormal expansion of CAG repeats in the huntingtin gene. Mutant Huntingtin protein (mHTT) forms abnormal aggregates and intranuclear inclusions in specific neurons, resulting in cell death. Here, we tested the ability of a natural heat-shock protein 90 inhibitor, Gedunin, to degrade transfected mHTT in Neuro-2a cells and endogenous mHTT aggregates and intranuclear inclusions in both fibroblasts from HD patients and neurons derived from induced pluripotent stem cells from patients. Our data showed that Gedunin treatment degraded transfected mHTT in Neuro-2a cells, endogenous mHTT aggregates and intranuclear inclusions in fibroblasts from HD patients, and in neurons derived from induced pluripotent stem cells from patients in a dose- and time-dependent manner, and its activity depended on the proteasomal pathway rather than the autophagy route. These findings also showed that although Gedunin degraded abnormal mHTT aggregates and intranuclear inclusions in cells from HD patient, it did not affect normal cells, thus providing a new perspective for using Gedunin to treat HD.

Objective To study the relationship between regional cerebral blood flow (rCBF) in matter lesion (WML) and cognitive impairment by arterial spin labeling (ASL).Methods Fourteen WML patients served as a WML group and 9 WML-free subjects served as a control group.Their neuropsychology was assessed and their rCBF was measured by ASL.Results The MoCA score,positive rate of symbol digit modalities test (SDMT),verbal fluency test (VFT) and digital span test forward and backward (DST F and B) were significantly lower while the trail making test-A (TMT-A) score and positive rate of Stroop B test and psychomotion speed test were significantly higher in WML group than in control group (P＜0.05,P＜0.01).The rCBF in regional WML was significantly slower in right and left semioval center,anterior and posterior horn of right and left lateral ventricle than that in normal white matter region (P＜0.01).The rCBF in WML was positively related with DST F and B (P＜0.05).The rCBF in NAWM was positively related with VFT (P＜0.01).Conclusion ASL can show the relationship between rCBF and cognitive impairment,especially executive function,attention and memory in elderly WML patients and decreased rCBF can thus increase their risk of cognitive impairment and dementia.

Acute paraplegia is a rare presentation for a spinal cord ependymoma. Subarachnoid hemorrhage (SAH) due to spinal ependymoma is also very rare. We report a 32-year-old woman who presented with acute paraplegia and typical clinical signs of SAH with normal cerebral angiography, and further diagnostic work-up revealed an spinal cord ependymoma as the source of the hemorrhage. There is evidence that some spinal cord ependymomas have intratumoral hemorrhage, but most of these bleedings occur without symptoms. We discuss the clinical and neuroradiological findings of this rare case and review the literature related to this unusual presentation.431

Objective To evaluate the roles of proton magnetic resonance spectroscopy(1H-MRS) and the volume of the hippocampus(HCV) measured by MRI in the diagnosis and the differential diagnosis of mild cognitive impairment (MCI) and mild Alzheimer disease (AD).Methods HCV and 1H-MRS were performed in the bilateral hippocampus and the bilateral medial temporal lobes(MTLS) in 30 cases with MCI,30 cases mild with AD and 30 healthy persons in age and sex-matched with controls by using volume analysis software and stimulates echo acquisition mode(STEAM). The ratios of NAA/Cr,Cho/Cr,MI/Cr,NAA/MI and HCV were compared among these groups.The contributions of HCV and 1H-MRS in diagnosis of MCI and AD was compared.Correlation coefficients were calculated for Mini Mental State Examination (MMSE) scores and HCV or the ratios of NAA/Cr,Cho/Cr,MI/Cr and NAA/MI in the MCI group and the mild AD group.Results Patients with mild AD showed significant reduction of HCV and NAA/Cr and NAA/MI ratios in the bilateral HCVand MTLS,and significant MI/Cr increase in the bilateral MTLS relative to control subjects. Patients with MCI demonstrates significant reduction of NAA/Cr in the left MTL , significant reduction of the bilateral HCV and NAA/MI ratio and significant MI/Cr increase in the bilateral HCV and MTLS relative to control subjects. Patients with mild AD showed statistical differences of MI/Cr and NAA/MI ratios in the left MTL relative to patients with MCI . Patients with mild AD showed no significant differences of HCV and NAA/Cr relative to patients with MCI .The Cho/Cr ratios among three groups showed no significant differences. HCV yielded the volume with the sensitivity 50% and specificity 83.33% in the diagnosis of MCI . 1H-MRS yielded the ratios with 43.33% in sensitivity and 81.25% in specificity in the di- agnosis of MCI.The combination of HCV and 1H-MRS yielded the volume and ratios with sensitivity of 73.33% and specificity of 84.62% in the diagnosis of MCI. HCV yielded the volume with sensitivity of 73.33% and specificity of 88% in the diagnosis of mild AD.1H-MRS yielded the ratios with sensitivity of 70% and specificity of 87.5% in the diagnosis of mild AD.The combination of HCV and 1H-MRS yielded the volume and ratios with sensitivity of 83.33% and specificity of 86.21% in the diagnosis of mild AD. HCV yielded the volume with the sensitivity of 50% and specificity of 62.5% in the differential diagnosis of MCI and mild AD.1H-MRS yielded the ratios with sensitivity of 56.67% and specificity of 65.38% in the differential diagnosis of MCI and mild AD.The combination of HCV and 1H-MRS yielded the volume and ratios with sensitivity of 66.67% and specificity of 64.52% in the differential diagnosis of MCI and mild AD. Patients with mild AD and MCI showed significant correlation between MMSE and the bilateral HCV ,NAA/Cr ratio. Patients with mild AD showed significant correlation between MMSE and right NAA/MI ratio .Patients with mild AD and MCI showed significant correlation between HCV and NAA/Cr ratio. Conclusion The combination of HCV and 1H-MRS are the best choice in the diagnosis and the differential diagnosis of MCI and mild AD.

Objective To verify the variation of mitogen-activated protein kinase kinase kinase 5 (MAPKKK5) gene expression in patients with cryptogenic refractory temporal lobe epilepsy (TLE) and to evaluate the possible molecular pathogenesis of intractable TLE. Methods Reverse transcription polymerase chain reaction (RT-PCR) and Western-blot analysis were used to measure the expression alterations of MAPKKK5 mRNA as well as its protein product MAPKKK5 in temporal cortex samples from patients who had undergone temporal lobectomy for intractable epilepsy (n=10). Tissues from 10 subjects who did not have epilepsy served as controls. Results The expression of MAPKKK5 mRNA (1.001?0.321) and its protein MAPKKK5 (0.359?0.299) were significantly increased in epileptic brain compared with the controls (0.648?0.157, 0.137?0.084, respectively) (all P