Cervical spinal cord injury without fracture-dislocation (CSCIWFD) is referred to as a special type of cervical spinal cord injury characterized by traumatic spinal cord dysfunction and no significant bony structural abnormalities on imagines. Duo to the high risk of missed diagnosis during the initial consultation, CSCIWFD may lead to progressive neurological deterioration or even complete paralysis, severely impacting patients′ prognosis. Currently, there are no established consensuses over the diagnosis and treatment of CSCIWFD, such as the lack of evidence-based standards for indications of non-surgical treatment and risk of secondary neurological injury, as well as debates over the optimal timing for surgical intervention and indications for different surgical approaches. To address these issues, the Spine Trauma Group of the Orthopedic Branch of the Chinese Medical Doctor Association organized experts in the relevant fields to formulate Diagnosis and treatment guideline for acute cervical spinal cord injury without fracture- dislocation in adults ( version 2025) . Based on evidence-based medicine and the principles of scientific rigor and clinical applicability, the guidelines proposed 11 recommendations covering terminology, diagnosis, evaluation treatment, and rehabilitation, etc., aiming to standardize the management of CSCIWFD.

Vertebral refracture following percutaneous vertebral augmentation (PVA) is commonly seen in elderly patients with osteoporotic thoracolumbar compression fractures (OTLCF). It can lead to recurrent pain, loss of vertebral height, progression of kyphosis, and even neurological dysfunction, significantly impairing patients′ quality of life. Current diagnosis and treatment face multiple challenges, including high misdiagnosis rate, difficulty in choosing between surgical and non-surgical treatment options, lack of standardized surgical protocols, interference from intralesional bone cement during procedures, inadequate stability of internal fixation in osteoporotic bone, and suboptimal compliance of anti-osteoporotic therapy. Establishing a standardized diagnostic and therapeutic framework is urgently needed. To standardize the management process and improve outcomes for vertebral refractures after PVA in elderly OTLCF patients, Spinal Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field to develop Guideline for the diagnosis and treatment of vertebral refracture after percutaneous vertebral augmentation in elderly patients with osteoporotic thoracolumbar compression fractures ( version 2025), based on current literature and clinical experience, and adhering to principles of scientific rigor and clinical applicability. A total of 11 recommendations were proposed, encompassing diagnosis, treatment, and rehabilitation of vertebral refracture after PVA in elderly patients with OTLCF, aiming to provide a foundation for a standardized management.

One of the important goals of assisted reproductive technology management is the safety of offspring. When the needs of patients conflict with the management of assisted reproductive technology, reproductive ethical problems arise. The storage and use of frozen embryos is a part of the management of assisted reproductive technology. When the patient has a conflict in the storage and use of frozen embryos, a small number of court decisions are consistent with the national management measures, but the vast majority of court decisions give the patient the right to ownership of frozen embryos, ruling that the patient has the right to custody and disposal, and the hospital will be difficult to implement embryo cryopreservation and management by national laws and regulations. In this paper, we review the ethical considerations in embryos, in order to provide beneficial references for embryo management in assisted reproductive technology.

One of the important goals of assisted reproductive technology management is the safety of offspring. When the needs of patients conflict with the management of assisted reproductive technology, reproductive ethical problems arise. The storage and use of frozen embryos is a part of the management of assisted reproductive technology. When the patient has a conflict in the storage and use of frozen embryos, a small number of court decisions are consistent with the national management measures, but the vast majority of court decisions give the patient the right to ownership of frozen embryos, ruling that the patient has the right to custody and disposal, and the hospital will be difficult to implement embryo cryopreservation and management by national laws and regulations. In this paper, we review the ethical considerations in embryos, in order to provide beneficial references for embryo management in assisted reproductive technology.

Cervical spinal cord injury without fracture-dislocation (CSCIWFD) is referred to as a special type of cervical spinal cord injury characterized by traumatic spinal cord dysfunction and no significant bony structural abnormalities on imagines. Duo to the high risk of missed diagnosis during the initial consultation, CSCIWFD may lead to progressive neurological deterioration or even complete paralysis, severely impacting patients′ prognosis. Currently, there are no established consensuses over the diagnosis and treatment of CSCIWFD, such as the lack of evidence-based standards for indications of non-surgical treatment and risk of secondary neurological injury, as well as debates over the optimal timing for surgical intervention and indications for different surgical approaches. To address these issues, the Spine Trauma Group of the Orthopedic Branch of the Chinese Medical Doctor Association organized experts in the relevant fields to formulate Diagnosis and treatment guideline for acute cervical spinal cord injury without fracture- dislocation in adults ( version 2025) . Based on evidence-based medicine and the principles of scientific rigor and clinical applicability, the guidelines proposed 11 recommendations covering terminology, diagnosis, evaluation treatment, and rehabilitation, etc., aiming to standardize the management of CSCIWFD.

Vertebral refracture following percutaneous vertebral augmentation (PVA) is commonly seen in elderly patients with osteoporotic thoracolumbar compression fractures (OTLCF). It can lead to recurrent pain, loss of vertebral height, progression of kyphosis, and even neurological dysfunction, significantly impairing patients′ quality of life. Current diagnosis and treatment face multiple challenges, including high misdiagnosis rate, difficulty in choosing between surgical and non-surgical treatment options, lack of standardized surgical protocols, interference from intralesional bone cement during procedures, inadequate stability of internal fixation in osteoporotic bone, and suboptimal compliance of anti-osteoporotic therapy. Establishing a standardized diagnostic and therapeutic framework is urgently needed. To standardize the management process and improve outcomes for vertebral refractures after PVA in elderly OTLCF patients, Spinal Trauma Group of the Orthopedic Branch of Chinese Medical Doctor Association organized experts in the field to develop Guideline for the diagnosis and treatment of vertebral refracture after percutaneous vertebral augmentation in elderly patients with osteoporotic thoracolumbar compression fractures ( version 2025), based on current literature and clinical experience, and adhering to principles of scientific rigor and clinical applicability. A total of 11 recommendations were proposed, encompassing diagnosis, treatment, and rehabilitation of vertebral refracture after PVA in elderly patients with OTLCF, aiming to provide a foundation for a standardized management.

Ankylosing spondylitis (AS) combined with lower cervical fracture is often categorized into unstable fracture, with a high incidence of neurological injury and a high rate of disability and morbidity. As factors such as shoulder occlusion may affect the accuracy of X-ray imaging diagnosis, it is often easily misdiagnosed at the primary diagnosis. Non-operative treatment has complications such as bone nonunion and the possibility of secondary neurological damage, while the timing, access and choice of surgical treatment are still controversial. Currently, there are no clinical practice guidelines for the treatment of AS combined with lower cervical fracture with or without dislocation. To this end, the Spinal Trauma Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate Clinical guidelines for the treatment of ankylosing spondylitis combined with lower cervical fracture in adults ( version 2024) in accordance with the principles of evidence-based medicine, scientificity and practicality, in which 11 recommendations were put forward in terms of the diagnosis, imaging evaluation, typing and treatment, etc, to provide guidance for the diagnosis and treatment of AS combined with lower cervical fracture.

Spinal surgical site infection (SSI), especially deep SSI after internal fixation is difficult in treatment, with long course of disease and poor prognosis. At present, there are many controversies in the diagnosis and treatment of spinal SSI, with unsatisfactory overall efficacy of its diagnosis and treatment. Besides, no diagnosis and treatment guideline based on evidence-based medicine has been in existence. To this end, the Spinal Infection Group of the Orthopedic Branch of the Chinese Medical Doctor Association and the Spinal Infection Group of the Spinal Surgery Branch of the Chinese Rehabilitation Medicine Association jointly organized relevant experts to formulate Evidence-based clinical guideline for the diagnosis and treatment of surgical site infection in spinal trauma ( version 2024) based on an evidence-based approach. A total of 10 recommendations were proposed on the diagnosis and treatment of spinal SSI, so as to provide a clinical reference for the diagnosis and treatment of spinal SSI.

Enlarged perivascular spaces（EPVSs）are one of the imaging biomarkers of cerebral small vessel disease（CSVD），and associated with other pathological changes of CSVD，worse cognitive function，and aging. This review describes the imaging characteristics and visual rating of EPVSs using magnetic resonance imaging and summarizes the research progress of EPVSs in Alzheimer disease in recent years in order to promote the understanding of this field.
Alzheimer Disease

Objective To investigate the relationship between cerebral small vessel disease （CSVD） burden scores and cognitive function in patients with CSVD with asymptomatic lacunes. Methods A total of 128 patients with CSVD with asymptomatic lacunes who visited the Department of Neurology of Weifang People′s Hospital from July 2021 to October 2023 were included. All the patients were scored using the Montreal Cognitive Assessment （MoCA） for cognitive function and using the total CSVD score and the modified CSVD score for CSVD burden. They were divided into cognitive impairment group （MoCA score<26） and non-cognitive impairment group （MoCA score≥26）. The demographic information， vascular disease risk factors， and the CSVD scores of the two groups were compared. A linear regression analysis was performed to assess the relationship between the MoCA score and the two CSVD scores. A trend analysis was conducted to analyze the trend of incidence of cognitive impairment in patients with CSVD with asymptomatic lacunes. Results Among the 128 patients with CSVD with asymptomatic lacunes， 68 （53.1%） were in the cognitive impairment group and 60 （46.9%） were in the non-cognitive impairment group. There were no significant differences in the demographic information and vascular disease risk factors between the two groups （P>0.05）. The total CSVD score and the modified CSVD score differed significantly between the two groups （P<0.05）. The Spearman correlation analysis showed that the total and modified CSVD scores were significantly negatively correlated with the MoCA score （P<0.001）. The chi-square test for linear trend revealed that the cognitive impairment risk increased significantly with the modified CSVD score in patients with CSVD with asymptomatic lacunes （Ptrend<0.05）， but with no significance for the total CSVD score （Ptrend=0.069）. Conclusion Both the total and modified CSVD scores are useful tools to detect cognitive impairment in patients with CSVD with asymptomatic lacunes， and the modified CSVD score may be superior in identifying patients at high risk of cognitive impairment.
Cognition