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.

Femoral neck fracture (FNF) in the elderly patients is currently a major health challenge worldwide, with excessive consumption of medical resources, high incidence of complications as well as suboptimal outcome and prognosis. Hip joint arthroplasty (HJA) has been the mainstream treatment for FNF in the elderly, but the conventional surgical approaches and techniques are still confronted with a series of bottlenecks such as dislocation, limp and limb length discrepancy. In recent years, direct anterior approach (DAA) for HJA (DAA-HJA) has been a major new choice in the field of joint replacement, which achieves improved clinical effectiveness of HJA in the treatment of elderly FNF, due to the fact that DAA approach involves the neuromuscular interface and accords with the idea of soft tissue retention and enhanced recovery after surgery. However, there is still a lack of unified understanding of standard technique and procedure of DAA-HJA in the treatment of elderly FNF. Therefore, relevant experts from the Hip Joint Group of Chinese Orthopedics Association of Chinese Medical Association, Youth Arthrology Group of Orthopedic Committee of PLA, Orthopedic Committee of Chongqing Medical Association, Branch of Orthopedic Surgeons of Chongqing Medical Doctor Association and Sport Medicine Committee of Chongqing Medical Association were organized to formulate the " Chinese expert consensus on the technical standard of direct anterior hip arthroplasty for elderly femoral neck fracture ( version 2023)" based on evidence-based medicine. This consensus mainly proposed 13 recommendations covering indications, surgical plans, prosthesis selections, surgical techniques and processes, and postoperative management of DAA-HJA in elderly patients with FNF, aiming to promote standardized, systematic and patient-specific diagnosis and treatment to improve the functional prognosis of the patients.

Intracranial arterial dolichoectasia (IADE), also known as dilated cerebral artery disease, is manifested as an increase in the length and diameter of one or more intracranial arteries, the affected arteries being enlarged and dilated significantly, or even with winding and tortuosity. The diagnosis and prognostic evaluation of IADE are mainly based on the diameter and curvature of the intracranial artery. IADE can be manifested as ischemic stroke, transient ischemic attack, hydrocephalus, and hemorrhagic stroke. The review focuses on IADE, including the concept, diagnostic criteria, etiology, pathogenesis, pathology, clinical manifestations, treatment, and prognosis.

Background: Cardiopulmonary resuscitation (CPR) strategies in COVID-19 patients differ from those in patients suffering from cardiogenic cardiac arrest. During CPR, both healthcare and non-healthcare workers who provide resuscitation are at risk of infection. The Working Group for Expert Consensus on Prevention and Cardiopulmonary Resuscitation for Cardiac Arrest in COVID-19 has developed this Chinese Expert Consensus to guide clinical practice of CPR in COVID-19 patients. Main recommendations: 1) A medical team should be assigned to evaluate severe and critical COVID-19 for early monitoring of cardiac-arrest warning signs. 2) Psychological counseling and treatment are highly recommended, since sympathetic and vagal abnormalities induced by psychological stress from the COVID-19 pandemic can induce cardiac arrest. 3) Healthcare workers should wear personal protective equipment (PPE). 4) Mouth-to-mouth ventilation should be avoided on patients suspected of having or diagnosed with COVID-19. 5) Hands-only chest compression and mechanical chest compression are recommended. 6) Tracheal-intubation procedures should be optimized and tracheal-intubation strategies should be implemented early. 7) CPR should be provided for 20-30 min. 8) Various factors should be taken into consideration such as the interests of patients and family members, ethics, transmission risks, and laws and regulations governing infectious disease control. Changes in management: The following changes or modifications to CPR strategy in COVID-19 patients are proposed: 1) Healthcare workers should wear PPE. 2) Hands-only chest compression and mechanical chest compression can be implemented to reduce or avoid the spread of viruses by aerosols. 3) Both the benefits to patients and the risk of infection should be considered. 4) Hhealthcare workers should be fully aware of and trained in CPR strategies and procedures specifically for patients with COVID-19.

Objective:To investigate the effects of of anti tumor necrosis factor-α (TNF-α) in adjuvant treatment of strangulated intestinal obstruction combined with ischemic intestinal necrosis.Methods:From February 2011 to August 2016 in Huadu District People′s Hospital Affiliated with Southern Medical University, 122 patients with strangulated intestinal obstruction combined with ischemic intestinal necrosis were selected and were equally divided into the experimental group and control group with 61 cases in each group according to the random draw envelope principle. Conventional surgical resection and anastomosis was used in control group, the postoperative anti TNF-α therapy was given for 2 weeks based on the treatment in control group.Results:All patients completed surgery and there were no serious complications during operation.The postoperative anal exhaust time and symptom remission time in experimental group were significantly lower than those in control group: (2.14 ± 0.41) d vs. (6.24 ± 1.28) d and (3.54 ± 0.77) d vs. (6.99 ± 0.91) d ( P<0.05). The incidence of postoperative 14 d complications such as anastomotic leakage, wound infection, anastomotic stenosis and pulmonary infection in the experimental group was 4.9%(3/61), and that of the control group was 18%(11/61), and the incidence of postoperative complications in the experimental group was significantly lower than that in the control group ( P<0.05). The postoperative 1d and 7 d serum TNF-α content in the experimental group was significantly lower than that in the control group ( P<0.05). The postoperative 14 d anal function in the experimental group was significantly better than that in the control group ( P<0.05). MRASP and MSP of postoperative 14 d in experimental group were all significantly higher than those in the control group: (80.24 ± 11.39) mmHg (1 mmHg=0.133 kPa) vs. (76.24 ± 12.11) mmHg, (231.98 ± 45.29) mmHg vs. (226.39 ± 41.87) mmHg ( P<0.05). Conclusions:The anti TNF-α in adjuvant treatment of strangulated intestinal obstruction combined with ischemic intestinal necrosis can promote the recovery of clinical symptoms and inhibit the release of TNF-α. It also can reduce the incidence of postoperative complications and improve gastrointestinal motility of patients.

Objective To investigate the effect of repeated application of low-frequency transcranial magne-tic stimulation ( rTMS) when combined with hyperbaric oxygen ( HBO) in the treatment non-fluent aphasia after a stroke. Methods Forty-eight stroke survivors with non-fluent aphasia were randomly assigned to a control group, an HBO group or an observation group, each of 16. All received conventional rehabilitation therapy consisting of drug therapy, speech training and conventional physical exercises, while the HBO and observation groups were additionally given HBO and rTMS combined with HBO respectively. The 1 Hz rTMS was applied over the Broca's homologues of the unaffected hemisphere. Before and after 4 weeks of treatment, the Western Aphasia Battery ( WAB) was used to evaluate the subjects' language function and the Modified Barthel Index ( MBI) was used to assess their ability in the activities of daily living. Results There was no significant difference in the average WAB scores among the three groups before the treatment. After 4 weeks of treatment the average WAB and MBI scores of the HBO group and the observation group had improved significantly, and there was then a significant difference among the three groups. The observation group was performing significantly better than the HBO group and the control group in spontaneous speech, auditory comprehension, repetition, naming, AQ score and MBI score. Pairwise comparisons showed that the observation group's average WAB score, spontaneous speech, auditory comprehension, repetition, naming, AQ score and MBI score were the best, followed by those of the HBO group and then those of the control group. All of the differences were statistically significant. Conclusions Low-frequency rTMS combined with HBO can significantly improve the language function and the quality of life of patients with non-fluent aphasia. Such combined therapy is worthy of clinical promotion and application.

Objective To investigate the influence of estimated glomerular filtration rate (eGFR) in rehabilitation of motor function and short-term prognoses in patients with acute middle cerebral artery (MCA) infarction. MethodsSeventy-four patients with acute MCA infarction, admitted to Department of Neurology from March 2016 to September 2018, and then, accepted rehabilitation training for 4 weeks in Department of Rehabilitation medicine, were recruited. Modification of Diet in Renal Disease was used to evaluate the eGFR instead of renal function; according to the results, these patients were divided into normal renal function group and mild-moderate renal dysfunction group. National Institute of Health Stroke Scale (NIHSS) was used to assess the neurologic function. Fazekas scale was used to assess degrees of leukoaraiosis. Fugl-Meyer Motor Function Assessment (FMA) was used to assess motor functions before rehabilitation treatment and 90 d after onset. Modified Barthel Index (MBI) was used to assess activity of daily living 90 d after onset. According to MBI scores, the patients were divided into good prognosis group (MBI scores>60) and poor prognosis group (MBI scores≤60); multivariate Logistic regression analysis was used to confirm the risk factors affecting prognoses 90 d after onset.ResultsAmong 74 enrolled patients, 40 were classified as normal renal function group and 34 as mild-moderate renal dysfunction group; patients in the mild-moderate renal dysfunction group had significantly higher level of blood urea nitrogen, proportion of silent lacunar cerebral infarction and Fazekas scale scores, and had statistically lower FMA scores and MBI 90 d after onset than normal renal function group (P<0.05). Among the 74 patients, good prognosis was found in 32 patients and poor prognosis in 42 patients; multivariate Logistic regression analysis found that age, eGFR (OR=0.944,P= 0.011, 95％CI: 0.903-0.987), baseline NIHSS scores, and Fazekas scale scores were risk factors affecting prognoses 90 d after onset.ConclusionIn acute MCA infarction patients, eGFR can influence the rehabilitation of motor function and short-term prognoses.

Objective To evaluate the effect on salvage treatment of sudden deafness with comprehensive Chinese medicine therapy. Methods Fifty-three sudden deafness patients failing in conventional western medicine treatment were given comprehensive Chinese medicine therapy, and the salvage treatment followed by oral use of Chinese medicine, intravenous injection of Chinese patent medicine, acupoint injection, ear acupoint plastering, acupoint application, acupuncture, sound healing, and massage. The therapeutic effect and the relief of major accompanying symptoms were evaluated after treatment, and the relationship of disease course with clinical efficacy was also investigated. Results (1) After treatment, 4 cases were cured, 9 were markedly effective, 13 were effective, 27 were ineffective, and the total effective rate was 49.06%. (2) Except for the 2 excluded cases, the major accompanying symptoms such as tinnitus, auricular distress, and vertigo were relieved to various degrees in other cases. ( 3) Twenty-two patients had a course of disease within 14 days, and the total effective rate for them was 72.73%. A total effective rate of 32.26% was achieved in 31 cases with disease course over 14 days. It is indicated that the therapeutic effect for patients with a disease course less than 14 days was superior to that with a disease course over 14 days (P<0.01). Conclusion Comprehensive Chinese medicine therapy exerts inspiring therapeutic effect on salvage treatment of sudden deafness, and earlier intervention results into better effect.

Objective:To study the qualitative and quantitative methods of Shenbai concentrated pills. Methods:Danshen root and lightyellow sophora root in Shenbai concentrated pills were identified with the method of TLC. The contents of astragaloside Ⅳ and paeoniflorin were determined with the method of HPLC. Results: For TLC, the spots of the two herbal drugs were well separated and without interference. Quantitative analysis of HPLC showed that the average recovery of astragaloside 1V was 100.82% (RSD1.73%) with the RSD values of precision, repeatability and stability tests were 2.79%, 1.48% and 1.44%, respectively; and the average recovery of paeoniflorin was 99.83% (RSD2.34%) with the RSD values of precision, repeataibility and stability tests were 2.25%, 2.16% and 1.60%, respectively. Conclusions: The methods set up by this study are accurate and easy to perform with the merits of good resolution, specificity and reproducibility. It could effectively control the quality of Shenbai concentrated pills.

Objectives: To observe the effects and the mechanisms of exogenous fatty acids on colorectal cancer cells(LoVo). Methods:The effect of exogenous fatty acids on LoVo cells was determined by 5 diphenyl tetrazolium bromide(MTT) assay.The content of MDA was examined to evaluate the extent of lipid peroxidation. Results:The growth of LoVo cells was inhibited by polyunsaturated fatty acids(PUFAs).The inhibitory effect of saturated fatty acids and monounsaturated fatty acids on LoVo cells was not showed.None of the fatty acids was found to fibroblast cells(HLF).PUFAs caused the significant rising of intracellular MDA content. Conclusions:PUFAs could inhibit the growth of colorectal cancer cells.The strengthening of lipid peroxidation may be one of the mechanisms.