Intracranial atherosclerotic stenosis (ICAS) is one of the most common causes of ischemic stroke. Stenting is a treatment option for symptomatic ICAS, but it also has problems such as procedure-related complications and in-stent restenosis. This article reviews the application of stenting, particularly different stent systems, in patients with symptomatic ICAS.

Neurodegenerative diseases are a class of nervous system disorders characterized by delayed onset and selective neuronal dysfunction, which are closely associated with aging.Given the challenges associated with early detection and the irreversible nature of the condition, the pursuit of specific biomarkers has emerged as a critical component of disease prevention strategies.Optical coherence tomography angiography (OCTA) generates images which exhibit near-histological resolution without the requirement for contrast agent injection, demonstrating superior sensitivity compared to fundus photography. OCTA has the ability to identify and evaluate neurodegenerative diseases via the quantitative analysis of retinal parameters. The OCTA of the retina and choroid has been verified as a highly sensitive instrument for detecting microvascular abnormalities in both ocular and systemic retinal disorders. This review focuses on the application of OCTA in various neurodegenerative diseases, such as Alzheimer′s disease, Parkinson disease, Huntington′s disease, amyotrophic lateral sclerosis and Wolfram syndrome, with the aim of providing a reference for the early diagnosis and prevention of neurodegenerative diseases.

Neurodegenerative diseases are a class of nervous system disorders characterized by delayed onset and selective neuronal dysfunction, which are closely associated with aging.Given the challenges associated with early detection and the irreversible nature of the condition, the pursuit of specific biomarkers has emerged as a critical component of disease prevention strategies.Optical coherence tomography angiography (OCTA) generates images which exhibit near-histological resolution without the requirement for contrast agent injection, demonstrating superior sensitivity compared to fundus photography. OCTA has the ability to identify and evaluate neurodegenerative diseases via the quantitative analysis of retinal parameters. The OCTA of the retina and choroid has been verified as a highly sensitive instrument for detecting microvascular abnormalities in both ocular and systemic retinal disorders. This review focuses on the application of OCTA in various neurodegenerative diseases, such as Alzheimer′s disease, Parkinson disease, Huntington′s disease, amyotrophic lateral sclerosis and Wolfram syndrome, with the aim of providing a reference for the early diagnosis and prevention of neurodegenerative diseases.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

A 41-year-old male was presented with rapidly progression memory impairment for 2 months and episodic limb shaking for 2 weeks as the main manifestations.Physical examination showed verbal disadvantage with decreased memory,attention,comprehension,and orientation.Serum vitamin B12 levels decreased,serum anti gastric parietal cell antibodies and anti-intrinsic factor antibodies were positive.Blood analysis showed macrocytic anemia,neuropsychological scale showed functional impairment in multiple cognitive domains,electrophysiological examination showed peripheral nerve damage,cerebrospinal fluid and imaging examination showed no abnormalities.The patient was diagnosed as having vitamin B12 deficiency dementia,vitamin B12 deficiency related involuntary movement and pernicious anemia.Supplementing with B vitamins and folic acid significantly improved cognitive impairment and eliminated symptoms of limb shaking.The purpose of this case report is to enhance the understanding of clinical doctors about dementia and involunting movement caused by vitamin B12 deficiency,in order to diagnose and treat it early.

Objective To investigate the correlation between red blood cell distribution width(RDW),systemic immune-inflammation index(SII)and major depressive disorder(MDD).Methods The clinical data of 176 MDD patients hospitalized in the clinical psychology department of our hospital from 2020 to 2022 and 209 non-MDD comparators who were routinely examined in Hebei General Hospital were retrospectively analyzed.Blood analysis was conducted to obtain values of RDW,SII,and red blood cell distribution width/platelet ratio(RPR).The data was used to plot the receiver operator characteristic(ROC)curve to determine the optimal threshold and the area under the curve(AUC)for RDW to discriminate between patients and controls.Result Patients in the MDD group had significantly higher RDW[median and quartiles:13.20(12.70,13.98)vs.12.80(12.40,13.35)],and SII levels[median and quartiles 510.87(350.95,878.12)vs.405.33(313.74,539.92)]compared with those in non-MDD group(P<0.05).There was no significant difference in RPR between the two groups(P>0.05).Multifactorial logistic regression analysis showed that RDW was positively correlated with MDD after adjusting for confounders(OR=3.086,95% CI:1.926-4.944).ROC curve showed that the optimal threshold for RDW to differentiate the risk of developing MDD was 12.85,with an AUC of 0.647(95% CI:0.592-0.702;P<0.001).Conclusion Present study shows that high RDW is a risk factor for the occurrence of MDD and an important parameter for the risk of developing depression.

Adenosine monophosphate-activated protein kinase(AMPK) is a highly conserved serine/ threonine protein kinase which plays an important role in regulating energy metabolism of the systemic cells. Under stress conditions, such as ischemia and hypoxia, AMPK can be activated.Then it plays a neuroprotective role in regulating mechanisms such as oxidative stress, autophagy, apoptosis and neuroinflammation and so on. Researches have found that chronic cerebral hypoperfusion may be a major cause of vascular cognitive impairment(VCI).AMPK can exert neuroprotective effects on VCI by regulating the aforementioned pathological processes.Therefore, this article reviews the molecular biological characteristics of AMPK and its role and mechanism in VCI, with the aim of promoting further research on AMPK and making it a new target for VCI treatment.

Objective:To observe the projections from tyrosine hydroxylase(TH)positive neurons in locus coerule-us(LC)to tachykinin-1(TAC1)neurons in paraventricular nucleus of the thalamus(PVT),and morphologically determine whether they are involved in transmission and modulation of nociceptive information.Methods:TAC1-ires-Cre mice were hybridized with Rosa26:CAG-LSL-tdTomato(Ai9)mice.And spared nerve injury(SNI)induced neu-ropathic pain model was established with TAC1-ires-Cre::Ai9 mice to observe the colocalization of TAC1 and Fos and the close appositions between TAC1/FOS double-labeled neurons and TH positive axonal terminals.The distribution of the TH positive neurons and FG retrogradely labeled neurons were observed in the LC after Fluorogold(FG)was injec-ted into the PVT.Finally,the coexistences of TH positive neurons and RV labeled neurons in the LC were observed after injection of RV-mediated retrograde tracing system.Results:TAC1 positive neurons were shown with red fluores-cence in TAC1-ires-Cre::Ai9 mice.TAC1/FOS double-labeled neurons were found in the PVT of the SNI model.Some TAC1/FOS double labeled neurons made close appositions with TH positive axonal terminals.FG retrogradely labeled neurons were observed in the LC after FG injected into the PVT,and some of the FG labeled neurons coexisted with TH positive neurons.Using RV retrograde transsynaptic tracing virus,the results showed that presynaptic neurons of TAC1 positive neurons in the PVT were found in the LC,and most of the presynaptic neurons were TH positive neu-rons.Conclusion:TH positive neurons in the LC project to TAC1 positive neurons of the PVT,forming LCTH+-PVTTAC1+neural circuit,which were activated by nociceptive information.It demonstrates that this pathway plays a role in pain transmission or regulation.

The detection rate of cerebral small vessel disease (CSVD) is constantly increasing, and identifying early CSVD lesions is of great significance for its prevention and treatment. Based on the similarities in physiological characteristics and embryonic origin between the retina and the central nervous system, optical coherence tomography angiography can quickly and non-invasively evaluate brain microcirculation through deep analysis of retinal blood vessels. This article reviews the application of this technology in CSVD and vascular cognitive impairment, aiming to provide reference for the early diagnosis and prevention of CSVD.

Objective:To investigate the effect of triglyceride-glucose index (TyG) on the severity of depression in patients with depression.Methods:The clinical data of 653 patients with depression admitted to Hebei General Hospital from January to December 2021 were retrospectively analyzed. The patients were categorized into mild-moderate depression group ( n=324) and severe depression group ( n=329) according to the 17-item Hamilton depression scale (HAMD-17) score. Patients' demographics and data on fasting plasma glucose (FPG), triglyceride (TG), total cholesterol, high-density lipoprotein, and low-density lipoprotein were extracted from the electronic medical records, and TyG was calculated. Statistical analyses were performed by SPSS 25.0 software.The Mann-Whitney U test was used to compare the differences between the two groups. Spearman correlation analysis and binary Logistic regression analysis were used to investigate the relationship between TyG level and depression severity. Results:(1) In the severe depression group, FPG( 956.9 (118.9) mg/L vs 865.0 (1 44.2) mg/L), TG(1 275.8 (1 027.8) mg/L vs 983.5 (766.4) mg/L), total cholesterol (2 007.0 (477.6) mg/L vs 1 730.5 (547.2) mg/L), high-density lipoprotein (514.3 (168.2) mg/L vs 464.0 (138.2) mg/L), low-density lipoprotein (1 264.5 (326.8) mg/L vs 1 088.6 (412.8) mg/L), and TyG (8.72 (0.77) vs 8.37 (0.78)) were higher than those in the mild-moderate depression group, and the differences were statistically significant (all P<0.05).(2) Both TyG level and HAMA score were positively correlated with HAMD-17 score ( r=0.231, 0.586, both P<0.05); (3) The results of binary logistic regression analysis showed that TyG ( B=1.116, OR=3.054, 95% CI=2.058-4.531, P<0.05) was a risk factor for the severity of depression in patients with depression. Conclusion:The higher the TyG, the more severe the severity of depression in patients. Insulin resistance may affect the severity of depression in patients with depression.