Background: and Purpose This study aimed to investigate the association between residual inflammatory risk (RIR) and vulnerable plaques using high-resolution magnetic resonance imaging (HRMRI) in symptomatic intracranial atherosclerotic stenosis (ICAS). Methods: This retrospective study included 70%–99% symptomatic ICAS patients hospitalized from January 2016 to December 2022. Patients were classified into four groups based on high-sensitivity C-reactive protein (hs-CRP) and low-density lipoprotein cholesterol (LDL-C): residual cholesterol inflammatory risk (RCIR, hs-CRP ≥3 mg/L and LDL-C ≥2.6 mmol/L), RIR (hs-CRP ≥3 mg/L and LDL-C <2.6 mmol/L), residual cholesterol risk (RCR, hs-CRP <3 mg/L and LDL-C ≥2.6 mmol/L), and no residual risk (NRR, hs-CRP <3 mg/L and LDL-C <2.6 mmol/L). Vulnerable plaque features on HRMRI included positive remodeling, diffuse distribution, intraplaque hemorrhage, and strong enhancement. Results: Among 336 included patients, 21, 60, 58, and 197 were assigned to the RCIR, RIR, RCR, and NRR groups, respectively. Patients with RCIR (adjusted odds ratio [aOR], 3.606; 95% confidence interval [CI], 1.346–9.662; P=0.011) and RIR (aOR, 3.361; 95% CI, 1.774–6.368, P<0.001) had higher risks of strong enhancement than those with NRR. Additionally, patients with RCIR (aOR, 2.965; 95% CI, 1.060–8.297; P=0.038) were more likely to have intraplaque hemorrhage compared with those with NRR. In the sensitivity analysis, RCR (aOR, 2.595; 95% CI, 1.201–5.608; P=0.015) exhibited an additional correlation with an increased risk of intraplaque hemorrhage. Conclusion In patients with symptomatic ICAS, RIR is associated with a higher risk of intraplaque hemorrhage and strong enhancement, indicating an increased vulnerability to atherosclerotic plaques.

Hand degloving injury represents one of the most severe forms of hand trauma, characterised by challenging treatment and a complex prognostic outcome. It is crucial to effectively utilise the degloved tissues in emergency or primary repair of a hand degloving injury. This consensus provides a comprehensive review of the existing literature on definition, classification, emergency assessment, debridement, judgment of skin viability, in situ repair of the degloved skin, and adjunctive treatment for degloving injury of hand. Based on conclusion of both domestic and international experiences, this expert consensus on the classification of hand degloving injury and the emergency repair with the avulsed skin is established, aiming to provide a guidance to surgeons on standardised treatment strategy and improve the management of hand degloving injury.

Background: and Purpose This study aimed to investigate the association between residual inflammatory risk (RIR) and vulnerable plaques using high-resolution magnetic resonance imaging (HRMRI) in symptomatic intracranial atherosclerotic stenosis (ICAS). Methods: This retrospective study included 70%–99% symptomatic ICAS patients hospitalized from January 2016 to December 2022. Patients were classified into four groups based on high-sensitivity C-reactive protein (hs-CRP) and low-density lipoprotein cholesterol (LDL-C): residual cholesterol inflammatory risk (RCIR, hs-CRP ≥3 mg/L and LDL-C ≥2.6 mmol/L), RIR (hs-CRP ≥3 mg/L and LDL-C <2.6 mmol/L), residual cholesterol risk (RCR, hs-CRP <3 mg/L and LDL-C ≥2.6 mmol/L), and no residual risk (NRR, hs-CRP <3 mg/L and LDL-C <2.6 mmol/L). Vulnerable plaque features on HRMRI included positive remodeling, diffuse distribution, intraplaque hemorrhage, and strong enhancement. Results: Among 336 included patients, 21, 60, 58, and 197 were assigned to the RCIR, RIR, RCR, and NRR groups, respectively. Patients with RCIR (adjusted odds ratio [aOR], 3.606; 95% confidence interval [CI], 1.346–9.662; P=0.011) and RIR (aOR, 3.361; 95% CI, 1.774–6.368, P<0.001) had higher risks of strong enhancement than those with NRR. Additionally, patients with RCIR (aOR, 2.965; 95% CI, 1.060–8.297; P=0.038) were more likely to have intraplaque hemorrhage compared with those with NRR. In the sensitivity analysis, RCR (aOR, 2.595; 95% CI, 1.201–5.608; P=0.015) exhibited an additional correlation with an increased risk of intraplaque hemorrhage. Conclusion In patients with symptomatic ICAS, RIR is associated with a higher risk of intraplaque hemorrhage and strong enhancement, indicating an increased vulnerability to atherosclerotic plaques.

Background: and Purpose This study aimed to investigate the association between residual inflammatory risk (RIR) and vulnerable plaques using high-resolution magnetic resonance imaging (HRMRI) in symptomatic intracranial atherosclerotic stenosis (ICAS). Methods: This retrospective study included 70%–99% symptomatic ICAS patients hospitalized from January 2016 to December 2022. Patients were classified into four groups based on high-sensitivity C-reactive protein (hs-CRP) and low-density lipoprotein cholesterol (LDL-C): residual cholesterol inflammatory risk (RCIR, hs-CRP ≥3 mg/L and LDL-C ≥2.6 mmol/L), RIR (hs-CRP ≥3 mg/L and LDL-C <2.6 mmol/L), residual cholesterol risk (RCR, hs-CRP <3 mg/L and LDL-C ≥2.6 mmol/L), and no residual risk (NRR, hs-CRP <3 mg/L and LDL-C <2.6 mmol/L). Vulnerable plaque features on HRMRI included positive remodeling, diffuse distribution, intraplaque hemorrhage, and strong enhancement. Results: Among 336 included patients, 21, 60, 58, and 197 were assigned to the RCIR, RIR, RCR, and NRR groups, respectively. Patients with RCIR (adjusted odds ratio [aOR], 3.606; 95% confidence interval [CI], 1.346–9.662; P=0.011) and RIR (aOR, 3.361; 95% CI, 1.774–6.368, P<0.001) had higher risks of strong enhancement than those with NRR. Additionally, patients with RCIR (aOR, 2.965; 95% CI, 1.060–8.297; P=0.038) were more likely to have intraplaque hemorrhage compared with those with NRR. In the sensitivity analysis, RCR (aOR, 2.595; 95% CI, 1.201–5.608; P=0.015) exhibited an additional correlation with an increased risk of intraplaque hemorrhage. Conclusion In patients with symptomatic ICAS, RIR is associated with a higher risk of intraplaque hemorrhage and strong enhancement, indicating an increased vulnerability to atherosclerotic plaques.

Hand degloving injury represents one of the most severe forms of hand trauma, characterised by challenging treatment and a complex prognostic outcome. It is crucial to effectively utilise the degloved tissues in emergency or primary repair of a hand degloving injury. This consensus provides a comprehensive review of the existing literature on definition, classification, emergency assessment, debridement, judgment of skin viability, in situ repair of the degloved skin, and adjunctive treatment for degloving injury of hand. Based on conclusion of both domestic and international experiences, this expert consensus on the classification of hand degloving injury and the emergency repair with the avulsed skin is established, aiming to provide a guidance to surgeons on standardised treatment strategy and improve the management of hand degloving injury.

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.

Objective:To investigate the hemodynamic characteristics of frontal cortex and bilateral temporal lobes in patients with obsessive-compulsive disorder (OCD) during verbal fluency tasks using functional near-infrared spectroscopy (fNIRS), and assess the value of fNIRS in aiding OCD diagnosis.Methods:Clinical data of 30 OCD patients who visited the Psychology Department at Ruijin Hospital, affiliated with the Shanghai Jiaotong University School of Medicine between June 2022 and June 2023 were prospectively collected. There were 17 males and 13 females aged 16-41 years, and the education level was 9-19 years. Another 30 healthy control participants voluntarily participated in the study, including 12 males and 18 females aged 19-54 years with 9-19 years of education. Cerebral hemodynamic changes in the prefrontal and bilateral temporal lobes were detected using fNIRS during verbal fluency tasks. Specific parameters including integral values, centroid values, and slopes for both the prefrontal and bilateral temporal lobes were analyzed using independent two-sample t-tests and non-parametric Mann-Whitney U tests. Influencing indicators for OCD were analyzed using a binary logistic regression model. Receiver Operating Characteristic (ROC) curve analysis was plotted to evaluate the diagnostic performance of fNIRS indicators in distinguishing OCD patients from healthy controls, and the optimal cutoff value were calculated. Results:OCD patients generated significantly less words during the verbal fluency task compared to healthy controls ( M( Q1, Q3)) (Number of 9.0 (7.0, 12.0) vs 12.0 (10.0, 16.3), Z=2.80, P=0.005). The integral values and slopes of the frontal lobe, and the integral values of the bilateral temporal lobes, were significantly lower in OCD patient group (32.3 (-7.8, 62.2) vs 123.7 (96.2, 181.3), Z=5.76; 0.000 5±0.001 2 vs 0.001 5±0.001 6, t=-2.54; 87.0±71.4 vs 186.1±90.3, t=-4.71), while centroid values of both the frontal and bilateral temporal lobes were higher ((60.4±13.8) seconds vs (54.4±7.8) seconds, t=2.80; 60.3 (55.5, 65.0) seconds vs 56.2 (52.7, 59.2) seconds, Z=-2.42), with all the differences statistically significant (all P<0.05). No significant difference was observed in slope of bilateral temporal lobes between two groups ( t=-1.60, P=0.116). Binary logistic regression showed that integral value of frontal cortex significantly influenced OCD occurrence ( OR=0.958, 95% CI: 0.932-0.985, P=0.003). ROC analysis indicated ideal diagnostic performance of integral value of frontal lobe in distinguishing OCD patients from healthy controls with an optimal cut-off value of 68.2, sensitivity of 0.900, specificity of 0.833, and AUCs of 0.931 (95% CI: 0.869-0.993, P<0.001). AUCs of number of words generated, integral value of frontal cortex, slope of frontal cortex, integral value of bilateral temporal lobes, and centroid value of bilateral temporal lobes were 0.709 (95% CI: 0.580-0.839), 0.931 (95% CI: 0.869-0.993), 0.665 (95% CI: 0.527-0.803), 0.793 (95% CI: 0.683-0.904), and 0.682 (95% CI: 0.542-0.822), respectively (all P<0.05). Centroid value of frontal cortex showed poor diagnostic performance (AUC=0.637, 95% CI: 0.493-0.781, P=0.069). Conclusion:OCD patients generated less words and have decreased integrated values and increased centroid values of frontal cortex and bilateral temporal lobes during verbal fluency tasks. Integral values of frontal cortex significantly influence OCD occurrence and demonstrate high sensitivity and specificity in distinguishing OCD patients from healthy controls.

Objective:To investigate the hemodynamic characteristics of frontal cortex and bilateral temporal lobes in patients with obsessive-compulsive disorder (OCD) during verbal fluency tasks using functional near-infrared spectroscopy (fNIRS), and assess the value of fNIRS in aiding OCD diagnosis.Methods:Clinical data of 30 OCD patients who visited the Psychology Department at Ruijin Hospital, affiliated with the Shanghai Jiaotong University School of Medicine between June 2022 and June 2023 were prospectively collected. There were 17 males and 13 females aged 16-41 years, and the education level was 9-19 years. Another 30 healthy control participants voluntarily participated in the study, including 12 males and 18 females aged 19-54 years with 9-19 years of education. Cerebral hemodynamic changes in the prefrontal and bilateral temporal lobes were detected using fNIRS during verbal fluency tasks. Specific parameters including integral values, centroid values, and slopes for both the prefrontal and bilateral temporal lobes were analyzed using independent two-sample t-tests and non-parametric Mann-Whitney U tests. Influencing indicators for OCD were analyzed using a binary logistic regression model. Receiver Operating Characteristic (ROC) curve analysis was plotted to evaluate the diagnostic performance of fNIRS indicators in distinguishing OCD patients from healthy controls, and the optimal cutoff value were calculated. Results:OCD patients generated significantly less words during the verbal fluency task compared to healthy controls ( M( Q1, Q3)) (Number of 9.0 (7.0, 12.0) vs 12.0 (10.0, 16.3), Z=2.80, P=0.005). The integral values and slopes of the frontal lobe, and the integral values of the bilateral temporal lobes, were significantly lower in OCD patient group (32.3 (-7.8, 62.2) vs 123.7 (96.2, 181.3), Z=5.76; 0.000 5±0.001 2 vs 0.001 5±0.001 6, t=-2.54; 87.0±71.4 vs 186.1±90.3, t=-4.71), while centroid values of both the frontal and bilateral temporal lobes were higher ((60.4±13.8) seconds vs (54.4±7.8) seconds, t=2.80; 60.3 (55.5, 65.0) seconds vs 56.2 (52.7, 59.2) seconds, Z=-2.42), with all the differences statistically significant (all P<0.05). No significant difference was observed in slope of bilateral temporal lobes between two groups ( t=-1.60, P=0.116). Binary logistic regression showed that integral value of frontal cortex significantly influenced OCD occurrence ( OR=0.958, 95% CI: 0.932-0.985, P=0.003). ROC analysis indicated ideal diagnostic performance of integral value of frontal lobe in distinguishing OCD patients from healthy controls with an optimal cut-off value of 68.2, sensitivity of 0.900, specificity of 0.833, and AUCs of 0.931 (95% CI: 0.869-0.993, P<0.001). AUCs of number of words generated, integral value of frontal cortex, slope of frontal cortex, integral value of bilateral temporal lobes, and centroid value of bilateral temporal lobes were 0.709 (95% CI: 0.580-0.839), 0.931 (95% CI: 0.869-0.993), 0.665 (95% CI: 0.527-0.803), 0.793 (95% CI: 0.683-0.904), and 0.682 (95% CI: 0.542-0.822), respectively (all P<0.05). Centroid value of frontal cortex showed poor diagnostic performance (AUC=0.637, 95% CI: 0.493-0.781, P=0.069). Conclusion:OCD patients generated less words and have decreased integrated values and increased centroid values of frontal cortex and bilateral temporal lobes during verbal fluency tasks. Integral values of frontal cortex significantly influence OCD occurrence and demonstrate high sensitivity and specificity in distinguishing OCD patients from healthy controls.

The 24th National Conference of Neurology of Chinese Medical Association was held in Zhuhai City, Guangdong Province during September 23-26,2021.The conference adopted a combination of online and offline methods, with a total of 2 plenary meetings, 20 special seminars, 284 invited reports, 382 papers exchanged at the conference and 1 088 papers exchanged on the wall. The conference focused on cerebrovascular diseases, epilepsy, cognitive disorders, myopathy, peripheral neuropathy, neurodegenerative diseases, nerve infectious diseases, demyelinating diseases, neuroimmune diseases, genetic and metabolic nerve diseases, nerve rehabilitation, anxiety and depression, headache, sleep disorders, nerve nursing, nerve intervention, neuroimaging, neuroelectrophysiology, translational medicine, precision medicine and other related nervous system diseases. There were more than 7 000 participants who attended this conferece.

Background: and Purpose Intracranial vertebrobasilar atherosclerotic stenosis (IVBAS) is a major cause of posterior circulation stroke. Some patients suffer from stroke recurrence despite receiving medical treatment. This study aimed to determine the prognostic value of a new score for the posterior communicating artery and the P1 segment of the posterior cerebral artery (PCoA-P1) for predicting stroke recurrence in IVBAS. Methods: We retrospectively enrolled patients with severe IVBAS (70%–99%). According to the number of stroke recurrences, patients were divided into no-recurrence, single-recurrence, and multiple-recurrences groups. We developed a new 5-point grading scale, with the PCoA-P1 score ranging from 0 to 4 based on magnetic resonance angiography, in which primary collaterals were dichotomized into good (2–4 points) and poor (0 or 1 point). Stroke recurrences after the index stroke were recorded. Patients who did not experience stroke recurrence were compared with those who experienced single or multiple stroke recurrences. Results: From January 2012 to December 2019, 176 patients were enrolled, of which 116 (65.9%) had no stroke recurrence, 35 (19.9%) had a single stroke recurrence, and 25 (14.2%) had multiple stroke recurrences. Patients with single stroke recurrence (odds ratio [OR]= 4.134, 95% confidence interval [CI]=1.822–9.380, p=0.001) and multiple stroke recurrences (OR=6.894, 95% CI=2.489–19.092, p<0.001) were more likely to have poor primary collaterals than those with no stroke recurrence. Conclusions The new PCoA-P1 score appears to provide improve predictions of stroke recurrence in patients with IVBAS.