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.

Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

Objective To explore the prognostic value of serum glutathione reductase(GR),superoxide dismutase(SOD),cystatin C(Cys-C),homocysteine(Hcy)and lipoprotein a[Lp(a)]levels in patients with cerebral ischemic stroke(CIS),and to provide a reference for improving the prognosis of CIS patients.Methods 126 patients with CIS admitted to the 980th Hospital of Joint Logistics Support Force from June 2022 to April 2023 were selected as the observation group,another 126 healthy individuals were selected as the control group at a ratio of 1:1.The expression levels of GR,SOD,Cys-C,Hcy and Lp(a)in the two groups were detected and compared after admission and during physical examination.The degree of neurological deficit in patients with CIS was classified into mild(NIHSS:2～4 points,n=35),moderate(NIHSS:5～15 points,n=47),moderate-severe(NIHSS:16～20 points,n=26)and severe(NIHSS:21～42 points,n=18)according to the National Institutes of Health Stroke Scale(NIHSS).The expression of serum GR,SOD,Cys-C,Hcy and Lp(a)in patients with different degrees of neurological deficit was compared,and the correlation between each indicator and the degree of neurological deficit was analyzed.The observation group received intravenous thrombolytic therapy after admission and was re-examined one day after thrombolysis.After treatment,follow-up visits were conducted for 28 days.According to the patient's condition(modified Rankin scale),patients were divided into good prognosis(n=94)and poor prognosis groups(n=32).The levels of each indicator in patients with different prognoses were compared,and the predictive value of GR,SOD,Cys-C,Hcy and Lp(a)expression for poor prognosis and early warning were analyzed.Results The expression levels of serum GR(48.54±3.07U/L)and SOD(157.17±25.47U/ml)in the observation group were lower than those in the control group(61.68±3.15U/L,203.63±18.31U/ml),while the expression levels of Cys-C(1.24±0.28mg/L),Hcy(15.21±1.62μmol/L)and Lp(a)(386.53±52.16mg/L)were higher than those in the control group(0.82±0.23mg/L,9.58±0.60μmol/L,257.83±45.34mg/L),with statistically significant differences(t=13.011～36.582,all P<0.05).As the disease progressed,the expression levels of GR and SOD gradually decreased,while the expression levels of Cys-C,Hcy and Lp(a)gradually increased,with statistically significant differences(F=14.685～197.041,all P<0.05).Spearman analysis,GR and SOD were negatively correlated with the degree of neurological deficit in patients with CIS(r=-0.814,-0.753,all P<0.05),while Cys-C,Hcy and Lp(a)were positively correlated with the degree of neurological deficit in patients with CIS(r=0.647,0.782,0.724,all P<0.05).The expression of GR and SOD in patients with good prognosis at admission and 1 day after thrombolysis was higher than that in patients with poor prognosis(t=9.109,6.338;2.934,4.358,all P<0.05),while the expression of Cys-C,Hcy and Lp(a)was lower than that in patients with poor prognosis(t=5.246,5.118,8.561;4.636,5.298,7.461,all P<0.05).The AUC(95%CI)of combined prediction of GR,SOD,Cys-C,Hcy and Lp(a)at admission was 0.898(0.832～0.945),and the AUC(95%CI)of combined prediction of GR,SOD,Cys-C,Hcy and Lp(a)at 1 day after thrombolysis was 0.931(0.871～0.968).The RR(95%CI)values caused by the expression of GR,SOD,Cys-C,Hcy and Lp(a)at 1 day after thrombolysis were 2.868(1.594～5.161),3.194(1.807～5.645),0.155(0.082～0.291),0.150(0.071～0.319)and 0.227(0.119～0.435).Conclusion Abnormal changes in the levels of GR,SOD,Cys-C,Hcy and Lp(a)are closely related to the degree of neurological deficit and prognosis in patients with CIS.Early combined detection of GR,SOD,Cys-C,Hcy and Lp(a)levels has high predictive value and early warning for evaluating the poor prognosis of patients with CIS.

Objective:To evaluate the efficacy and safety of high-frequency repetitive transcranial magnetic stimulation (hrTMS) in postherpetic neuralgia (PHN).Methods:A prospective randomized controlled trial was performed; 63 PHN patients treated in Department of Neurology and Department of Dermatology and Venereology of Anqing Municipal Hospital from June 2024 to March 2025 were enrolled; they were randomly assigned to 2 groups: an hrTMS group ( n=32) received hrTMS (frequency: 10 Hz; total pulses: 2,400; intensity: 90% of resting motor threshold) to the contralateral primary motor cortex (M1), and a sham stimulation group ( n=31) received sham stimulation using a sham figure-of-eight coil generating no actual magnetic field. Scores of short-form McGill pain questionnaires (pain rating index [PRI] total score, PRI sensory subscore, PRI affective subscore, visual analogue scale [VAS] score, present pain intensity [PPI] score) and N100 amplitude were collected before treatment and at 1, 2, 3, and 4 weeks after treatment. Adverse events during treatment were recorded. Results:At 2 weeks after treatment, significant difference was observed between the hrTMS group and sham stimulation group in PRI total score, VAS score, and N100 amplitude ( P<0.05). At 3 and 4 weeks after treatment, significant differences were found between the two groups in PRI total score, PRI sensory subscore, PRI affective subscore, VAS score, PPI score and N100 amplitude (3 weeks after treatment: 8.59±1.13 vs. 9.61±1.20, 5.34±0.79 vs. 5.90±0.94, 3.25±0.57 vs. 3.71±0.46, 5.78±0.66 vs. 6.42±0.92, 2.16±0.37 vs. 2.55±0.51, and [2.53±0.51] μV vs. [2.13±0.34] μV; 4 weeks after treatment: 7.53±0.92 vs. 9.68±1.35, 4.94±0.62 vs. 6.00±1.07, 2.59±0.56 vs. 3.68±0.60, 5.06±0.67 vs. 6.23±1.06, 1.97±0.17 vs. 2.52±0.51, and [2.81±0.40] μV vs. [2.16±0.52] μV, P<0.05). In the hrTMS group, PRI total score, PRI sensory subscore, PRI affective subscore, VAS score, PPI score and N100 amplitude were significantly different at 2, 3, and 4 weeks after treatment compared with those before treatment ( P<0.05). Incidence of adverse events (headache, dizziness or tinnitus) did not differ significantly between the two groups ( P>0.05). Conclusion:The hrTMS applied to the M1 region in PHN patients is effective by obviously reducing pain intensity and improving negative emotional states, with favorable safety profile.

Objective To explore the prognostic value of serum glutathione reductase(GR),superoxide dismutase(SOD),cystatin C(Cys-C),homocysteine(Hcy)and lipoprotein a[Lp(a)]levels in patients with cerebral ischemic stroke(CIS),and to provide a reference for improving the prognosis of CIS patients.Methods 126 patients with CIS admitted to the 980th Hospital of Joint Logistics Support Force from June 2022 to April 2023 were selected as the observation group,another 126 healthy individuals were selected as the control group at a ratio of 1:1.The expression levels of GR,SOD,Cys-C,Hcy and Lp(a)in the two groups were detected and compared after admission and during physical examination.The degree of neurological deficit in patients with CIS was classified into mild(NIHSS:2～4 points,n=35),moderate(NIHSS:5～15 points,n=47),moderate-severe(NIHSS:16～20 points,n=26)and severe(NIHSS:21～42 points,n=18)according to the National Institutes of Health Stroke Scale(NIHSS).The expression of serum GR,SOD,Cys-C,Hcy and Lp(a)in patients with different degrees of neurological deficit was compared,and the correlation between each indicator and the degree of neurological deficit was analyzed.The observation group received intravenous thrombolytic therapy after admission and was re-examined one day after thrombolysis.After treatment,follow-up visits were conducted for 28 days.According to the patient's condition(modified Rankin scale),patients were divided into good prognosis(n=94)and poor prognosis groups(n=32).The levels of each indicator in patients with different prognoses were compared,and the predictive value of GR,SOD,Cys-C,Hcy and Lp(a)expression for poor prognosis and early warning were analyzed.Results The expression levels of serum GR(48.54±3.07U/L)and SOD(157.17±25.47U/ml)in the observation group were lower than those in the control group(61.68±3.15U/L,203.63±18.31U/ml),while the expression levels of Cys-C(1.24±0.28mg/L),Hcy(15.21±1.62μmol/L)and Lp(a)(386.53±52.16mg/L)were higher than those in the control group(0.82±0.23mg/L,9.58±0.60μmol/L,257.83±45.34mg/L),with statistically significant differences(t=13.011～36.582,all P<0.05).As the disease progressed,the expression levels of GR and SOD gradually decreased,while the expression levels of Cys-C,Hcy and Lp(a)gradually increased,with statistically significant differences(F=14.685～197.041,all P<0.05).Spearman analysis,GR and SOD were negatively correlated with the degree of neurological deficit in patients with CIS(r=-0.814,-0.753,all P<0.05),while Cys-C,Hcy and Lp(a)were positively correlated with the degree of neurological deficit in patients with CIS(r=0.647,0.782,0.724,all P<0.05).The expression of GR and SOD in patients with good prognosis at admission and 1 day after thrombolysis was higher than that in patients with poor prognosis(t=9.109,6.338;2.934,4.358,all P<0.05),while the expression of Cys-C,Hcy and Lp(a)was lower than that in patients with poor prognosis(t=5.246,5.118,8.561;4.636,5.298,7.461,all P<0.05).The AUC(95%CI)of combined prediction of GR,SOD,Cys-C,Hcy and Lp(a)at admission was 0.898(0.832～0.945),and the AUC(95%CI)of combined prediction of GR,SOD,Cys-C,Hcy and Lp(a)at 1 day after thrombolysis was 0.931(0.871～0.968).The RR(95%CI)values caused by the expression of GR,SOD,Cys-C,Hcy and Lp(a)at 1 day after thrombolysis were 2.868(1.594～5.161),3.194(1.807～5.645),0.155(0.082～0.291),0.150(0.071～0.319)and 0.227(0.119～0.435).Conclusion Abnormal changes in the levels of GR,SOD,Cys-C,Hcy and Lp(a)are closely related to the degree of neurological deficit and prognosis in patients with CIS.Early combined detection of GR,SOD,Cys-C,Hcy and Lp(a)levels has high predictive value and early warning for evaluating the poor prognosis of patients with CIS.

Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.

Objective:To evaluate the efficacy and safety of high-frequency repetitive transcranial magnetic stimulation (hrTMS) in postherpetic neuralgia (PHN).Methods:A prospective randomized controlled trial was performed; 63 PHN patients treated in Department of Neurology and Department of Dermatology and Venereology of Anqing Municipal Hospital from June 2024 to March 2025 were enrolled; they were randomly assigned to 2 groups: an hrTMS group ( n=32) received hrTMS (frequency: 10 Hz; total pulses: 2,400; intensity: 90% of resting motor threshold) to the contralateral primary motor cortex (M1), and a sham stimulation group ( n=31) received sham stimulation using a sham figure-of-eight coil generating no actual magnetic field. Scores of short-form McGill pain questionnaires (pain rating index [PRI] total score, PRI sensory subscore, PRI affective subscore, visual analogue scale [VAS] score, present pain intensity [PPI] score) and N100 amplitude were collected before treatment and at 1, 2, 3, and 4 weeks after treatment. Adverse events during treatment were recorded. Results:At 2 weeks after treatment, significant difference was observed between the hrTMS group and sham stimulation group in PRI total score, VAS score, and N100 amplitude ( P<0.05). At 3 and 4 weeks after treatment, significant differences were found between the two groups in PRI total score, PRI sensory subscore, PRI affective subscore, VAS score, PPI score and N100 amplitude (3 weeks after treatment: 8.59±1.13 vs. 9.61±1.20, 5.34±0.79 vs. 5.90±0.94, 3.25±0.57 vs. 3.71±0.46, 5.78±0.66 vs. 6.42±0.92, 2.16±0.37 vs. 2.55±0.51, and [2.53±0.51] μV vs. [2.13±0.34] μV; 4 weeks after treatment: 7.53±0.92 vs. 9.68±1.35, 4.94±0.62 vs. 6.00±1.07, 2.59±0.56 vs. 3.68±0.60, 5.06±0.67 vs. 6.23±1.06, 1.97±0.17 vs. 2.52±0.51, and [2.81±0.40] μV vs. [2.16±0.52] μV, P<0.05). In the hrTMS group, PRI total score, PRI sensory subscore, PRI affective subscore, VAS score, PPI score and N100 amplitude were significantly different at 2, 3, and 4 weeks after treatment compared with those before treatment ( P<0.05). Incidence of adverse events (headache, dizziness or tinnitus) did not differ significantly between the two groups ( P>0.05). Conclusion:The hrTMS applied to the M1 region in PHN patients is effective by obviously reducing pain intensity and improving negative emotional states, with favorable safety profile.

Since 1986, the WHO has held ten global health promotion conferences covering various health promotion issues and sustainable development worldwide. These sessions have formed a series of consensus and actions that guide promoting health globally. This study analyzed the declarations, reports, and news materials from the ten conferences that studied health promotion action areas, focal topics, actor networks, partnership relationships, and other significant outcomes. It also explored how these conferences contributed to the construction and advancement of global health promotion consensus and actions. The first Global Conference on Health Promotion identified the concept of health promotion and five key action areas, laying the foundation for subsequent conferences and health promotion actions. Over the years, the ten conferences continuously expanded the essence of health promotion, developed partnership relationships, formulated public health promotion policies, and called for health promotion actions. This process culminated in the formation of global consensus and collective actions. The latter conferences have gained significant attention and influence. The conferences offer valuable insights for future global health promotion endeavors and provide global perspectives and pathways for the development of Healthy China.

Objective To construct secretory IgA(sIgA)based on the previously screened IgG neutralizing antibody ZW2G10 against SARS-CoV-2,evaluate its activity and find out about the biodistribution of sIgA in ICR mice after nasal administration.Methods After expression,purification,and identification,sIgA was evaluated for its binding and neutralizing activity through ELISA and pseudovirus-based neutralization assays.SIgA was coupled with Alexa Fluor 750 dye and administered to mice via nasal administration.In vivo imaging was used to observe the biodistribution of sIgA.After dissection of the mice,the biodistribution of sIgA in various tissues and organs was observed.Results Compared with IgG,sIgA retained the binding ability to SARS-CoV-2 S proteins,and its neutralizing ability was enhanced.After nasal administration of a single dose of 1 mg/kg,sIgA could be retained in the lungs of mice for more than 72 hours.SIgA could be detected only in the nasal cavity and gastrointestinal tract within 8 h of administration,but not in the heart,liver,kidney,spleen,brain,bladder or blood.Conclusion In this study,a universal and efficient sIgA expression system has been established.sIgA can effectively target the respiratory tract and lungs after nasal administration.SIgA is expected to become a potential drug that provides immediate passive immune protection.

BACKGROUND: This study aimed to explore the effect of a nanomaterial-based miR-320a inhibitor sustained release system in trauma-induced osteonecrosis of the femoral head (TIONFH). METHODS: The miR-320a inhibitor-loaded polyethylene glycol (PEG)- Poly(lactic-co-glycolic acid) (PLGA)- Poly-L-lysine (PLL) nanoparticles were constructed using the double emulsion method. The TIONFH rabbit model was established to observe the effects of miR-320a inhibitor nanoparticles in vivo. Hematoxylin–eosin staining and microcomputed tomography scanning were used for bone morphology analysis. Bone marrow mesenchymal stem cells (BMSCs), derived from TIONFH rabbits, were used for in vitro experiments. Cell viability was determined using the MTT assay. RESULTS: High expression of miR-320a inhibited the osteogenic differentiation capacity of BMSCs in vitro by inhibiting the expression of the osteoblastic differentiation markers ALP and RUNX2. MiR-320a inhibitor-loaded PEG-PLGA-PLL nanoparticles were constructed with a mean loading efficiency of 1.414 ± 0.160%, and a mean encapsulation efficiency of 93.45 ± 1.24%, which released 50% of the loaded miR-320a inhibitor at day 12 and 80% on day 18. Then, inhibitor release entered the plateau. After treatment with the miR-320a inhibitor nanoparticle, the empty lacunae were decreased in the femoral head tissue of TIONFH rabbits, and the osteoblast surface/bone surface (Ob.S/BS), osteoblast number/bone perimeter (Ob.N/B.Pm), bone volume fraction, and bone mineral density increased. Additionally, the expression of osteogenic markers RUNX2 and ALP was significantly elevated in the TIONFH rabbit model. CONCLUSION The miR-320a inhibitor-loaded PEG-PLGA-PLL nanoparticle sustained drug release system significantly contributed to bone regeneration in the TIONFH rabbit model, which might be a promising strategy for the treatment of TIONFH.