Objective:To investigate the feasibility of blue velvet arena test (BVAT) in evaluating spatial memory function in patients with chronic insomnia disorder (CID).Methods:From June 1, 2021 to May 31, 2022, 62 CID outpatients or inpatients were enrolled continuously in the Department of Sleep Disorders, the Affiliated Chaohu Hospital of Anhui Medical University, and 56 good sleepers in the same period were enrolled to serve as controls. Pittsburgh Sleep Quality Index (PSQI) was used to assess their sleep quality. Montreal Cognitive Assessment Scale (MoCA), nine box maze test (NBMT), and BVAT were used to assess general cognition and memories.Results:Compared to the controls, the CID patients had increased PSQI score [15.0 (12.8, 16.0) vs 0 (0, 1.0); Z=-9.47, P<0.001], and decreased MoCA score [24.5 (21.5, 27.0) vs 27.0 (26.0, 28.0); Z=-4.18, P<0.001]; increased numbers of errors in the spatial working [1.0 (0.8, 2.0) vs 1.0 (0, 1.0); Z=-2.24, P<0.05], object working [1.5 (0.8, 3.0) vs 0 (0, 1.0); Z=-4.36, P<0.001] and object recognition [0 (0, 0) vs 0 (0, 0); Z=-2.10, P<0.05] memories in NBMT; and increased average erroring distance in BVAT [23.0 (16.4, 27.2) cm vs 18.7 (16.6, 20.7) cm; Z=-3.30, P<0.01]. Partial correlation analysis showed that in the CID patients, the average erroring distance in BVAT was positively correlated with erroneous numbers in spatial working memory in NBMT ( r=0.54, P<0.001). Principal components analysis showed that the average erroring distance of BVAT (load=0.844) and the errors of spatial working memory in NBMT (load=0.801) were jointly attributed to the first factor. Receiver operating characteristic curve analysis showed that the sensitivity of BVAT was higher than that of NBMT (0.575 vs 0.250, P<0.05) for spatial memory detection in total sample. Conclusion:The BVAT has a higher reliability in the functional assessment of spatial memory in CID patients.

Chronic refractory wound (CRW) is one of the most challengeable issues in clinic due to complex pathogenesis, long course of disease and poor prognosis. Experts need to conduct systematic summary for the diagnosis and treatment of CRW due to complex pathogenesis and poor prognosis, and standard guidelines for the diagnosis and treatment of CRW should be created. The Guideline forthe diagnosis and treatment of chronic refractory wounds in orthopedic trauma patients ( version 2023) was created by the expert group organized by the Chinese Association of Orthopedic Surgeons, Chinese Orthopedic Association, Chinese Society of Traumatology, and Trauma Orthopedics and Multiple Traumatology Group of Emergency Resuscitation Committee of Chinese Medical Doctor Association after the clinical problems were chosen based on demand-driven principles and principles of evidence-based medicine. The guideline systematically elaborated CRW from aspects of the epidemiology, diagnosis, treatment, postoperative management, complication prevention and comorbidity management, and rehabilitation and health education, and 9 recommendations were finally proposed to provide a reliable clinical reference for the diagnosis and treatment of CRW.