Objective:To explore the drugs and clinical characteristics causing drug-induced liver injury (DILI) in recent years, as well as identify drug-induced liver failure, and chronic DILI risk factors, in order to better manage them timely.Methods:A retrospective investigation and analysis was conducted on 224 cases diagnosed with DILI and followed up for at least six months between January 2018 and December 2020. Univariate and multivariate logistic regression analyses were used to identify risk factors for drug-induced liver failure and chronic DILI.Results:Traditional Chinese medicine (accounting for 62.5%), herbal medicine (accounting for 84.3% of traditional Chinese medicine), and some Chinese patent medicines were the main causes of DILI found in this study. Severe and chronic DILI was associated with cholestatic type. Preexisting gallbladder disease, initial total bilirubin, initial prothrombin time, and initial antinuclear antibody titer were independent risk factors for DILI. Prolonged time interval between alkaline phosphatase (ALP) and alanine aminotransferase (ALT) falling from the peak to half of the peak (T 0.5ALP and T 0.5ALT) was an independent risk factor for chronic DILI [area under the receiver operating characteristic curve (AUC)?=?0.787, 95%CI: 0.697~0.878, P ?

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.

Post-stroke cognitive impairment (PSCI) seriously affects neurological recovery and quality of life of patients. Its mechanism, clinical evaluation, intervention have become research hotspot at home and abroad. Many studies have confirmed that secondary neurodegeneration in remote cognitive-related brain not affected by ischemia after stroke is one of the mechanisms of PSCI. It has been found in rodents that β-amyloid deposition and neuron loss in distant cognitive-related brain regions are involved in the occurrence of cognitive dysfunction and reducing these secondary damages can improve cognitive function. Experiments involving non-human primates have found neuronal loss but no β-amyloid deposition in distant brain regions after stroke. Clinical studies have found associations between secondary neurodegeneration in remote regions and cognitive function by using neuroimaging techniques, but the relationship between PSCI and β-amyloid deposition is not clear now. Due to its late occurrence time and wider therapeutic time window, its intervention treatment is expected to alleviate cognitive impairment, which has great clinical significance.

Cerebral venous thrombosis is a rare type of cerebrovascular diseases. Its etiology and risk factors are different from those of cerebral artery occlusive disease, which are mainly related to prethrombotic state caused by various reasons. The clinical symptoms are complex and diverse, lacking of characteristic manifestations. Neuroimaging examination is the main basis for the diagnosis. Magnetic resonance imaging/magnetic resonance venography is the best way to diagnose the disease and follow-up the patients′ condition. At present, the management of the disease is mainly aimed at etiology treatment and vascular recanalization treatment, of which anticoagulation is the most important means, and there is still a lack of recognized effective measures in prevention.

Based on the Chinese guidelines for diagnosis and treatment of cerebral venous sinus thrombosis 2015, combined with the relevant progress in China and abroad in recent years, the revised Chinese guidelines for diagnosis and treatment of cerebral venous thrombosis 2019 mainly updated the background information to December 2019, refined and supplemented the recommendations, including the etiology and risk factors, clinical manifestations and imaging diagnosis, treatment and prevention. It is a new basis for the diagnosis and treatment of cerebral venous thrombosis in China.

It was generally believed that muscular atrophy of paralyzed limbs after stroke was due to disuse. However, recent studies have found that secondary lesions of motor neurons in the contralateral anterior horn of the spinal cord and the decrease of motor units lead to denervation, which plays an essential role in muscular atrophy and muscle fiber type transition. This article reviews the phenomenon and mechanism of muscular atrophy and denervation of paralyzed limbs after stroke, to provide a reference for clinical evaluation and experimental research.

Objective: To retrospectively analyze the efficacy and prognostic factors of postoperative intensity modulated radiotherapy for grade Ⅱ gliomas. Methods: Retrospective analysis was conducted on patients with postoperative grade Ⅱ glioma in our hospital from Jan. 2010 to Dec. 2018. The primary endpoint was progression-free survival, and the secondary endpoint was overall survival. Correlative analyses of prognosis by age, gender, initial resection status, the maximum diameter of the lesions, bi-hemisphere, astrocytoma, chemoradiation, adjuvant chemotherapy were conducted. Results: A total of 109 cases with grade Ⅱ glioma were enrolled. The follow-up rate was 91.75%, including 10 cases dead and 27 relapsed. There were 24 cases (88.9%) of in-field failure, and 3 cases (11.1%) of out-field failure. 14 cases of recurrence occurred in 81 cases of total resection group, accounting for 17.3%, and 13 in 28 cases of subtotal resection group, accounting for 46.4%. The recurrence rate in the subtotal resection group was significantly higher than that in the total resection group (χ ²=9.484, P<0.05). The 1-, 2-, 3-, 4- and 5-year progression-free survival rates were 92.5%, 86.0%, 80.6%, 77.5% and 66.8%, respectively. The 2-, 3-, 4- and 5-year overall survival rates were 97.2%, 90.8%, 87.7% and 84.5%, respectively. Multivariate analysis showed that patients with subtotal resection(HR=3.608, P<0.05) and bi-hemisphere(HR=3.183, P<0.05)were significantly correlated with the progression free survival. Conclusions Postoperative intensity modulated radiotherapy for grade Ⅱ gliomas can achieve a better PFS. Recurrence in the radiation field is the main failure mode. Initial resection status and bi-hemisphere of tumor are important influential factors for PFS of grade Ⅱ gliomas patients.

Four versions of diagnostic criteria for cerebral vascular diseases have been published since 1978 in China. Based on the three previous versions, the 2019 version conformed the new published Chinese classification for cerebral vascular disease and International Classification of Diseases-11, integrated the symptoms, signs and imaging findings, and then formulated the diagnostic criteria for main types of cerebral vascular diseases. It emphasizes the clinical manifestation and neuro-imaging findings, specifies etiology on diagnosis and becomes the most concrete and comprehensive version of diagnostic criteria for cerebral vascular diseases in China.

Four versions of diagnostic criteria for cerebral vascular diseases have been published since 1978 in China. Based on the three previous versions, the 2019 version conformed the new published Chinese classification for cerebral vascular disease and International Classification of Diseases?11, integrated the symptoms, signs and imaging findings, and then formulated the diagnostic criteria for main types of cerebral vascular diseases. It emphasizes the clinical manifestation and neuro?imaging findings, specifies etiology on diagnosis and becomes the most concrete and comprehensive version of diagnostic criteria for cerebral vascular diseases in China.

Objective To analyze the clinical effects of thrombolytic therapy in patients with ischemic in-hos-pital stroke (IHS). Methods The clinical data were collected from patients with ischemic IHS in the last five years. The patients were divided into thrombolysis group and non-thrombolysis group, according to the use of recombinant tissue plasminogen activator (r-tPA) treatment. The clinical outcomes were measured by the modified Rankin scale (mRS) at discharge. Results There were a total of 121 patients in this study. There were 6 patients in thrombolysis group and 115 patients in the non-thrombolysis group, respectively. Six patients (100%) in the thrombolysis group achieved favor-able outcomes (mRS 0~2) at discharge whereas only 42 patients (36.5%) in the non-thrombolysis group achieved fa-vourable outcomes. The rate of favorable outcomes was significantly higher in the thrombolysis group than in the non-thrombolysis group (P<0.05). Conclusions R-tPA thrombolytic therapy can improve the prognosis of patients with ischemic IHS.