Alzheimer's disease (AD) is a common neurodegenerative disease. With the aging of the global population, the number of patients with AD is constantly increasing, bringing heavy burdens to the patients, families and society. The early and accurate diagnosis of AD has always been a hot and difficult issue. In recent years, with the advancement of scientific research, there have been significant achievements in the study of imaging and biofluid biomarkers of AD, such as the new breakthroughs in PET imaging technology in detecting amyloid and Tau protein deposition in the brain, and the discovery and application of blood biomarkers among biofluid biomarkers. In 2024, The National Institute on Aging and Alzheimer's Association (NIA-AA) updated the diagnostic and staging guidelines for AD, namely the Revised Criteria for Diagnosis and Staging of Alzheimer's Disease (2024). This paper aims to interpret the guidelines and review the progress in the diagnosis and staging of AD, providing more accurate diagnostic basis for clinicians and helping researchers to further explore the pathogenesis of AD.

Amyloid-related imaging abnormalities (ARIA) are abnormal appearances on the image. In a narrow sense, the default refers specifically to abnormalities on MRI, not CT or PET. MRI findings are characteristic, including ARIA-E (edema/effusion) and ARIA-H (hemorrhage). These abnormalities occur only in patients with Alzheimer's disease (AD) and in specific disease scenarios, and are associated with β-amyloid (Aβ), which has diagnostic specificity. This article introduces the history and definition of ARIA, imaging manifestations and detection methods, severity grading of ARIA-E and ARIA-H, and clinical issues related to ARIA, in order to provide references for clinical identification and treatment of ARIA.

The diagnosis of mental disorders relies predominantly on a symptom-based descriptive diagnostic system currently, lacking reliable biomarkers and golden standards. The diagnostic method restricts the accuracy of disease diagnosis to a large extent. Traditional psychiatric diagnosis is based on medical history and mental examination. The difficulties in diagnosis include subjective judgment on disorders, lacking of multi-dimensional perspectives, and deficits in the diagnostic holism. During the psychiatric diagnosis, we should integrate syndrome clusters features, functional impairment, and illness background; We can utilize the auxiliary examinations to enhance diagnostic accuracy. Based on the efforts above, it can promote comprehensive advancements in psychiatric diagnosis, treatment, and clinical research.

Epilepsy is a recurrent chronic brain disease with a variety of different pathological mechanisms and clinical manifestations. Epilepsy is one of the most common brain diseases which has the characteristics of repeatability, complexity, suddenness and long course. The incidence rate of epilepsy is relatively high in infant stage and elderly stage. The traditional Chinese medicine characteristic therapy has significant advantages in the treatment of epilepsy by adjusting the function of viscera and the operation of qi and blood in meridians, based on the holistic concept, the principle of syndrome differentiation and treatment, the theory of viscera and the theory of meridians. This article summarizes and analyzes the research progress of traditional Chinese medicine characteristic therapies for epilepsy, such as acupuncture, bloodletting, massage, auricular point pressing, and acupoint catgut embedding. We show the effect of traditional Chinese medicine characteristic therapy on patients.We aim to provide patients with better treatment and rehabilitation protection.

There is a lot of confusion and misunderstanding in the terms for functional neurological disorders, functional neurosurgery and functional neurology (similar to chiropractic neurology) in daily academic and clinical situations. Functional neurological disorders represent a specific type of disease, where "functional" refers to the nature of the disease; functional neurosurgery is an emerging branch of neurosurgery, where "functional" refers to the restoration of function as a result of neurosurgical intervention; functional neurology is a branch of alternative medicine that integrates the theories of chiropractic neurology, rehabilitation, neurology, acupuncture and other disciplines.

Objective: To design and produce a type of medical restraint gloves with rehabilitation function for use in patients with post-stroke hemiplegia and catheterization, and evaluate its limb restraint protection effect and assisted rehabilitation ability.

Methods: 70 stroke patients with hemiplegia and catheterization who were admitted to the department of neurology in the Second Affiliated Hospital of Fujian Medical University from April 1, 2023 to January 12, 2024 and met the inclusion and exclusion criteria were selected as the study subjects. They were randomly divided into an observation group and a control group, with 35 patients in each group. The observation group used medical restraint gloves with rehabilitation function for protective restraint, while the control group used traditional restraint belts. Both groups of patients underwent 14 days of early limb exercise and observation. The neurology physical restraint checklist and Brunnstrom recovery stage were used to evaluate the skin integrity, fingertip blood flow, paralyzed upper limb movement ability, and unplanned extubation of the patient's restraint site.

Results: There was no statistically significant difference in stroke type, age, gender, educat on level, marital status, medical insurance payment method, number of strokes, catheterization status, and paralyzed limb condition between the 2 groups of patients. During the 14 day intervention and observation period, the proportion of skin integrity at the constraint site in the observation group was higher than that in the control group (P＝0.032), the proportion of patients with good fingertip blood flow at the constraint site in the observation group was higher than that in the control group (P＝0.003), and the improvement of upper limb motor ability on the paralyzed side in the observation group was higher than that in the control group (P<0.001), with statistically significant differences. There was no statistically significant difference in the unplanned extubation rate between the observation group and the control group (P＝0.112).

Conclusion: Medical restraint gloves with rehabilitation function can better protect and restrain patients with limb hemiplegia and catheterization after stroke, and have a certain improvement effect on the motor function of the paralyzed upper limb, promoting early limb rehabilitation of stroke patients.

Objective: To report the clinical features, diagnostic process, and treatment strategy of a patient with posterior cortical atrophy (PCA), and to enhance the awareness of peers on this subject through a literature review.

Methods: We analyzed the clinical data of a PCA patient and summaried the literature on the clinical characteristics, diagnostic methods, differential diagnosis, and treatment strategies of the disease.

Results: A 67-year-old male patient presented with a chief complaint of memory decline for over 3 years. The clinical manifestations included progressive visuospatial deficits, visual perceptual impairments, and Gerstmanns syndrome. The neuropsychological assessment of the patient revealed there's a global fluctuating cognitive decline accompanied by relatively preserved early memory. Brain MRI of the patient showed the atrophy in the parietal, occipital, and temporal lobes, among which the parietal lobe being most prominently affected. The analysis of cerebrospinal fluid(CSF) demonstrated the Aβ1-42/Aβ1-40 ratio decreased and the phosphorylated Tau protein (181) increased in the patient's CSF. Overall, the patient was diagnosed with Alzheimer's disease-related posterior cortical atrophy. Treatment strategies of this patient included applying acetylcholinesterase inhibitors and Nmethyl-D-aspartate receptor antagonists.

Conclusion: PCA is a neurodegenerative disorder primarily characterized by visual and spatial cognitive impairments. Its unique clinical presentation makes it prone to misdiagnosis or underdiagnosis. Improving awareness of PCA and combining clinical manifestations, neuropsychological assessments, imaging studies, and biomarker detection can facilitate early diagnosis and intervention.

Objective: To explore the characteristics of P300 event-related potential in children with autism spectrum disorders (ASD) of different severity levels and to analyze the correlation between its latency or amplitude and the severity of ASD.

Methods: The study included 100 children with ASD who visited the Shenzhen Luohu District Maternal and Child Health Hospital from October 2022 to October 2023. Children with ASD were divided into 2 groups (mild to moderate group and severe group) according to the scoring results of the Childhood Autism Rating Scale (CARS). We compared the characteristics of P300 event-related potential latency and amplitude at midline sites (Fz, Cz and Pz) between the two groups. We explored the relationship between latency or amplitude and the severity of ASD in children.

Results: The study included a total of 100 children with ASD, including 59 in the mild to moderate group and 41 in the severe group. There was no statistically significant difference in age, gender, family history, and medication treatment history between the two groups. (P>0.05). Factors such as the latency of P300 at the Fz, Cz, and Pz midline loci (P values of <0.001, 0.008, and 0.004, respectively) and the amplitude of P300 at the Cz and Pz midline loci (P values of <0.001 and 0.004, respectively) were statistically significant between the two groups according to the univariate logistic analysis. The latency value of Fz locus P300 might be a risk factor for the severity of ASD [OR＝1.018 (95% CI: 1.008-1.028), P<0.001], while the amplitude value of Cz locus P300 might be a protective factor for the severity of ASD [OR＝0.505 (95% CI: 0.352-0.726), P<0.001] based on the multiple logistic regression analysis. The P300 latency values of various midline loci in ASD children were positively correlated with CARS scores (all P<0.01), and the P300 amplitude values of Cz and Pz midline loci in ASD children were negatively correlated with CARS scores (all P<0.001) according to the correlation analysis of CARS scores of enrolled ASD children.

Conclusion: There are significant differences in the expression of P300 event-related potential in children with ASD of different severity levels. Children with ASD of higher severity have lower P300 latency at each midline locus, and lower P300 amplitude at Cz and Pz midline loci; The latency value of Fz locus P300 may be a risk factor for the severity of ASD, while the amplitude value of Cz locus P300 may be a protective factor for the severity of ASD. The latency and amplitude detection of P300 event-related potential can provide an objective neurophysiological basis for evaluating the severity of ASD in children.

Current technological advances in clinical and research fields have enabled people to have a deeper and comprehensive understanding of Alzheimer's disease (AD). β -Amyloid (Aβ) is the core biomarker of AD. Aβ-PET can objectively detect the abnormal Aβ deposition and distribution in the brain, and can be widely used in the early accurate diagnosis and therapeutic evaluation of AD. This article elaborates on the detection methods and advantages and disadvantages of AD biomarkers, with a focus on the application and value of Aβ-PET in the diagnosis and treatment of AD.

Elderly patients with cognitive impairment face a series of safety incidents, which not only affect their quality of life, but also pose potential risks to their families and society. Current research primarily focuses on safety issues in medical settings, such as falls, choking,wandering, medication safety, and violent behaviors, while there is relatively less attention given to risks associated with household fires, abuse, property safety, and driving safety. The assessment of safety incidents mainly relies on subjective evaluation tools, while objective assessment tools still need further development. There is insufficient evidence for nursing interventions targeting different degrees or settings of cognitive impairment. This paper reviews the research progress on the incidence rate, influencing factors, subjective and objective evaluation tools, and evidence-based nursing measures of the safety incidents, in order to provide guidance for medical providers to carry out safety management of elderly patients with cognitive impairment and continuously improve the management of safety care.

Amyotrophic lateral sclerosis (ALS) is a chronic progressive neurodegenerative disease with no effective treatment. The etiology of ALS is unknown but it is related to many factors such as genetics, diet, environment, and lifestyle habits. The pathogenesis of ALS includes glutamate excitatory toxicity, oxidative stress, mitochondrial dysfunction, and axon transport disruption. Currently, the approved ALS treatment drugs include Riluzole, Edaravone, Dextromethorphan/Quinidine and Tofersen injection. There are many drugs in clinical trails, but effective treatment options are still limited. This review summarizes the etiology and pathogenesis of ALS, and summarizes in detail the traditional Chinese and Western medicine treatment methods for ALS, which has great practicability in clinical practice.

Objective:Enhance understanding of neuroautoimmune disorders associated with glutamic acid decarboxylase(GAD) antibodies to prevent misdiagnoses.

Methods:The clinical data of a patient primarily exhibiting stiff person syndrome was reported, reviewing symptomatology, pathogenesis,diagnostic processes, and treatment modalities based on existing literature.

Results:Symptoms in patients with GAD antibody-associated neurological syndrome vary and imaging results are often non-specific. The presence of GAD antibodies is crucial for accurate diagnosis. In this reported case, the patient showed improvement following plasma exchange therapy and maintained symptom stability with ongoing immunotherapy.

Conclusion:Stiff person syndrome frequently manifests in anti-GADantibody associated neurological syndromes. The intrathecal synthesis of GAD antibodies strongly supports diagnosis. Immunomodulatory therapy has proven effective in treating this condition.

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease with noeffective treatment and a serious threat to human health. Traditional Chinese Medicine(TCM)has a good curative effect on ALS, and some basic studies have verified thecurative mechanism of TcM on ALS. At present, there is still no clear theoreticalmechanism of TCM on ALS. This article started from the foundation of TcM, based on thetheory of priori and the posterior, and explained the TcM of treating ALS with spleenand kidney as the core. Combined with modern medical scientific research, it discussed the feasibility and effectiveness of treating ALs both internally and externally, provided agood theoretical basis for the future treatment of ALS with TCM.

This article briefly described the theoretical origin of the treatment of post-stroke epilepsy (PSE) from the perspective of phlegm, and discussed the treatment principles of PSE. Through literature review, it was found that treating PSE with phlegm therapy could significantly improve various clinical indicators of patients, with good clinical efficacy and fewer adverse reactions. Some formulas with expectorant effects were used to treat PSE, such as Ditan Tang, Dingxian Wan, Huatan Tongluo Tang, and Antiepileptic Decoction. The treatment of PSE based on phlegm might be a research direction in the future.

Objective: To collect randomized controlled trial (RCT) literature on the treatment of epilepsy with Ditan Decoction with modifications in recent years, and to use Meta-analysis method based on objective data to demonstrate the fficacy and safety of the treatment.

Methods: Chinese and English databases such as CNKI, VIP, Wanfang data were searched for randomized clinical trials on the treatment of epilepsy with Ditan Decoction. After strict screening the quality was evaluated using the Cochrane evaluation tool, Meta-analysis was conducted using RevMan 5.4 software, and conclusions were drawn.

Results: A preliminary search yielded 115 articles, of which 16 were finally included, totaling 1510 patients with epilepsy enrolled. Meta-analysis results showed that the overall clinical ficacy of Ditan Decoction combined with anti-epileptic drugs [AEDs) in the treatment of epilepsy: RR = 1.23,95% CI; 116-131,Z=7.10,P<0.000 01; seizure frequency: SMD=-2.07,95%CI:- 2.87~- 1.27,Z=5.10,P<0.000 01; quality of life: SMD=1.00, 95%CI; 0.75-1.26,Z=7.66, P<0.00001; lL-6:SMD=-2.28, 95%CI:-2.66~-1.91,Z=11.92,P< 0.000 01; hs-CRP: MD= -0.94,95%CI: -1.29~-0.59,Z= 5.32,P<000 01; MDA: MD= -1.71, 95%CI:-2.59~-0.83,Z= 3.80,P=0.000 1; SOD: MD=23.72,95% Cl:22.86-24.57,Z = 54.32, P<0.000 01; adverse reactions after medication: RR= 0.45, 95%CI 0.30-0.68,Z- 3.87,P= 0.000 1. The above indicators of the research group were superior to those of the control group, and the differences were statistically significant.

Conclusion: Ditan Decoction with modifications combined with AEDs is superior t conventional AEDs treatment for epilepsy, with fewer adverse reactions and high safety. However, due to limitations in the quality and quantity of the included RCT, the relevant conclusions serve only as a reference for the clinical diagnosis and treatment of epilepsy, and more high-quality research is needed to further confirm its efficacy.

Misfolding and clumping of proteins in the brain has been linked to various neurodegenerative diseases, these include Alzheimer' s disease (AD), Parkinson' s disease (PD) and amyotrophic lateral sclerosis (ALS). In pathological, these neurodegenerative diseases are related to protein misfolding and aggregation. AD is pathologically characterized by abnormal aggregation of ß -amyloid protein and tau protein neurofibrillary tangles in the brain, and PD is pathologically related to abnormal aggregation of a-synuclein in dopaminergic neurons in the brain. The misfolding of specific protein, such as transactive response element DNA binding protein-43 (TDP-43) and inclusion body formation, is one of the markers of ALS. Sleep disorder is not only a concomitant symptom of patients with these diseases, but also a precursor symptom of the onset of these diseases. This review elaborates on the abnormal protein aggregation characteristics and sleep disorder features of AD, PD, and ALS, and summarizes the potential of sleep disorder in early diagnosis and treatment of these diseases. Sleep disorder may become early diagnostic clues and treatment entry point for neurodegenerative diseases.

Objective: To investigate the therapeutic effect of clozapine combined with agomelatine onnegative symptoms and cognitive fiunction in patients with chronic schizophrenia, as wellas its impact on serum melatonin expression levels.

Methods: 98 patients with chronic schizophrenia from Shanghai Huangpu District MentalHealth Center were included and randomly divided into research group and control groupusing a random number table, with 49 patients in each group. The control group wastreated with clozapine combined with placebo, while the research group was treated withclozapine combined with agomelatine for 12 weeks. Two groups were evaluated forcognitive function, negative symptoms, and depressive symptoms at the time of enrollmentand at the end of the 4th, 8th, and 12th week of treatment, Serum melatonin levels weremeasured by mass spectrometry analysis at the same time point. Statistical analysis wasperformed on the relevant indicators of the two groups.

Results: Excluding dropouts, the study group and control group ultimately included 42 patients each. During the baseline period, there was no statistically significant difference incognitive function dimensions, negative symptoms, depressive symptoms, and serummelatonin levels between the two groups. After 12 weeks of treatment, there werestatistically significant differences in N3 (emotional communication disorder)(P=0.027)vocabulary recall (P=0.016), story recall (P=0.002), graphic recognition(P=0.017)Repeatable Battery for the Assessment ofNeuropsychological Status(RBANS) conversion score P=0.007), Calgary Depression Scale for Schizophrenia (CDss)(P=0.000) score, and serummelatonin levels (P=0.002) between the two groups. Within the group comparison, therewere statistically significant differences in cognitive function, negative symptom anddepression symptom scores, and serum melatonin levels between the treatment group atthe 4th, 8th, and 12th weekends and the baseline period (P<0.01 for all). There was asignificant correlation between changes in serum melatonin levels and improvements instory recall (r²=0.25,P=0.02).

Conclusion: Clozapine combined with agomelatine has significant therapeutic effects onsome dimensions of cognitive function, negative symptoms, and depressive symptoms inpatients with chronic schizophrenia, and the improvement of some cognitive functions issignificantly correlated with changes in serum melatonin levels.

Alzheimer's disease (AD)is a neurodegenerative disorder characterized by memoryimpairment, cognitive decline and neuronal loss. Its pathogenesis involves a variety offactors, among which amyloid-β (Aβ) is critical in neurons and the body. Aβ is thedecomposition product of human amyloid precursor protein(APP) through various amyloidprocessing routes and non-amyloid processing routes, and is cleared through various wayssuch as cerebrospinal fuid and inter-tissue fluid lymphatic drainage, cell clearance, bloodand brain barrier transport and enzymatic hydrolysis. The generation and clearance of Aβ is a dyamic and balanced process, and the imbalance of its balance will accumulate Aβ in the brain, leading to neuronal cell death, impaired synaptic function and neuronalnetwork changes, inducing and exacerbate AD symptoms. This review expounded themechanisms of Aβ generation, clearance and metabolism in AD, summarized theinteraction mechanisms of Aβ with neurons, astrocytes, urea cycle, etc, and provided newideas for further discovery of new therapeutic and diagnostic targets for AD.

This article systematically summarized the understanding of the etiology, pathogenesis, andtreatment principles of Traditional Chinese Medicine (TcM) in the treatment of epilepsycombined with cognitive impairment, as well as the research progress of TCM therapy in thetreatment of epilepsy combined with cognitive impairment, including experimental andclinical research on single herbs, compound formulas, and other TCM therapies. The aim isto provide more practical basis for the clinical treatment of epilepsy combined with cognitiveimpairment and to provide ideas for subsequent experimental and clinical research.

Objective: To analyse a case report of "central- peripheral- central" rehabilitation modefor cognitive impairment in a patient with delayed encephalopathy after carbon monoxide poisoning (DEACMP), and to provide ideas for clinical cognitive impairment rehabilitation.

Methods:The clinical data, rehabilitation diagnosis, treatment process, and the changes ofcognitive function, language function and daily living ability of an adult patient withDEACMP were reported, and the efficacy was analyzed in conjunction with the relevantliterature.

Results: A 42 -year -old male patient was admitted to the hospital with“55 days ofcognitive impairment after carbon monoxide poisoning", and physical examinationrevealed that he was unable to speak, unresponsive, and uncooperative. MRl of the headshowed symmetrical patchy abnormal signals in the basal ganglia area and radiativecrown area, which was clinically diagnosed as DEACMP. The patient was given "hyperbaricoxygen therapy+transcranial magnetic stimulation+transcranial direct current+Schuelllanguage training+ognitive training"for central regulation, and "Lee Silverman VoiceTreatment (LSVT) training+daily living ability training" for peripheral intervention, withhis cognitive function had significantly improved. The score of modified Barthel index was15 points at admission and 60 points at discharge. The result showed that the patientcould achieve basic self- care in daily living.

Conclusion: DEACMP often leads to severe cognitive impairment, poor prognosis and highdisability rate. The application of"central-peripheral-central"rehabilitation mode tocognitive impairment of DEACMP can effectively promote the recovery of cognitivefunction in patients.

Objective: To observe the efficacy of speech and language therapy in one case ofhereditary spastic paraplegia (HSP).

Methods: A patient with HSP who participated in this study from November 2023 toDecember 2023 was treated with repetitive transcranial magnetic therapy (rTMS) combined with speech and language therapy. The pantient's improvement of dysarthriawas assessed by Frenchay dysarthria assessment scale,maximal phonation time (MPT)、speech intelligibility and Oral- diadochokinesis (DDk).

Results: The total score of Frenchay dysarthria assessment scale was 95 before treatmentand 113 after treatment. MPT was 4 seconds before treatment and 10 seconds aftertreatment. Speech intelligibility score was 86 points before treatment and 100 points aftertreatment,The sequential motion rates (SMR) in DDK before treatment were 4, and aftertreatment, the SMR was 9.

Conclusion: Patients with HSP who received rTMS and speech and language therapypromoted improvements in oral motor function, as well as a significant increase in theclarity of their consonants, suggesting that this protocol may improve dysarthria.

Objective: To systematically review evaluate the association between the expression levelsof NLR family, pyrin domain-containing 3 protein (NLRP3)in serum and Alzheimer'sdisease ( AD ).

Methods:We searched databases including the Cochrane Library, PubMed, Embase,CBM, VIP, Wan Fang Data and CNKl databases committed to case control studies on therelationship between serum NLRP3 level and AD. The retrieval time limit was from theestablishment of the database to August 2024. Two reviewers independently screenedliterature, extracted data and assessed the risk of bias of included studies. Meta analysiswas performed by Stata 15.1 SE and Review Manager 5.0 software.

Results: Nine articles were included in total. The results of meta analysis showed that serum NLRP3 expression level was associated with AD(SMD=1.66,95%CI=1.28-2.04,P<0.01)Subgroup analysis was conducted based on different  NLRP3 measurement methods, and both the enzyme-linked immunosorbent assay group(SMD=1.48,95%CI=15-1.80,P<0.01 and the PCR group(SMD=2.12,95%CI=0.78-3.45,P-0.002)showed an association between NLRP3 levels and AD. Sensitivity analysis showed that the results were stable.

Conclusion: The meta analysis suggested that high level of serum NLRP3 expression maybe associated with the development of AD. Limited by the quality and quantity of includedstudies, the above conclusions needed to be verified by more clinical studies.

Objective: To screen the risk factors of white matter lesion (WML) and explore therelationship between WML with stroke and dementia.

Methods: In this study, a total of 260 patients with WML and 60 without WML underwentMRl were collected. The patients with WML were divided into 3 grades according toFazekas scale. Gender, age,education level, hypertension,diabetes, hyperlipemia,hyperhomocysteinemia, overweight, smoking and drinking history, and stroke history ofall enrolled patients were collected. Multiple ordered logistic regression analysis was usedto identify the risk factors of WML. Compare whether the degree of WMl in strokepatients is more severe than in non-stroke patients. MMSE scale was used to score theenrolled patients, analyzed the relationship between WML and cognition.

Results: Age, history of hypertension, hyperhomocysteinemia and smoking were correlatedwith the severity of WML, The Fazekas classification of stroke patients was statisticallydifferent from that of non-stroke patients(2=-10.305,P=0.000). With the increase ofFazekas grading, the MMSE score ofpatients decreased(r_s-0.511,P=0.000).

Conclusion: Age, hypertension, hyperhomocysteinemia and smoking are independent riskfactors for WML. WM may be a predictive signal of stroke. The more severe the degree ofWML, the higher the risk of dementia in patients.

Epilepsy, as a difficult-to-treat disease in the clinic, is characterized by seizuresrecurrence, and stereotype. Without pharmacologic intervention,the physical and mentalhealth of patients will be seriously affected. After searching through the literature ofTraditional Chinese Medicine (TCM) treatment of epilepsy at home and abroad, it wasfound that anti-epileptic drugs were used to rapidly control the symptoms during theseizure period, and in the remission period of epilepsy, it was supplemented with TCMevidence-based treatment. Based on the identification of phlegm, blood stasis, anddeficiency, the treatment principles included soothing the liver, resolving phlegmdispelling blood stasis, and tonifying deficiency. The treatment methods mainly includedacupuncture, acupoint embedding,moxibustion, and TCM decoctions. Multiple studiessuggested that TCM can effectively reduce the frequency of epileptic seizures, alleviateseizure symptoms, and alleviate adverse reactions, with good clinical treatment effects.The aim of this study was to summarize the latest advances in the treatment of epilepsy with TCM, and to provided guidance for future clinical practice.

Schizophrenia is a chronic and severe mental disorder that often occurs in adolescence or early adulthood, with a lifetime prevalence of 1%. More than half of patients experience mental disabilities, which have varying degrees of impact on themselves, their families, and society. Cognitive impairment is one of the core symptoms of schizophrenia and an important cause of mental disability, which has adverse effects on the daily functioning and overall clinical outcomes of schizophrenia patients. In recent years, cognitive impairment has become a research hot spot in the field of schizophrenia. More and more evidences suggest that cognitive impairment already exists in patients' childhood and continues to affect their condition and social functioning. Most treatment interventions for cognitive impairment in schizophrenia, including the use of medication and non-medication therapies, have varying effects and lack precise and effective intervention methods. In this article, we provide a descriptive review of the treatment measures for cognitive impairment in schizophrenia and offer some suggestions on how future work can improve cognitive dysfunction in schizophrenia.

Objective: To systematically evaluate the value of different aspiration risk assessment tools for assessing aspiration risk in stroke patients with dysphagia.

Methods: The literatures to evaluate the risk of aspiration in stroke patients with swallowing disorders using different tools were searched from databases including CNKI, Wanfang Database, VIP, PubMed, Cochrane Library, and Web of Science from databases establishment until April 2024. The combined sensitivity, combined specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio (DOR), and area under the curve (AUC) of different tools for diagnosing aspiration were calculated comparing with the gold standard.

Results: A total of 17 eligible studies were included, mainly including four risk assessment tools for aspiration, namely Kubota water swallowing test (WST), standardized swallowing assessment (SSA), Toronto bedside swallowing screening test (TOR-BSST), and Gussing swallowing screen (GUSS). The Meta-analysis results showed that the combined sensitivity of WST was 0.57 (95% CI: 0.51-0.62, P＝0.006), combined specificity was 0.80 (95% CI: 0.74-0.85, P＝0.014), DOR was 5.94 (95% CI: 3.42-10.31, P＝0.153), and AUC was 0.75. The combined sensitivity of SSA was 0.87 (95% CI: 0.82-0.90, P＝0.124), combined specificity was 0.65 (95% CI: 0.59-0.71, P＝0.031), DOR was 11.88 (95% CI: 5.63-25.07, P=0.214), and AUC was 0.73. The combined sensitivity of TOR-BSST was 0.65 (95% CI: 0.56-0.74, P＝ 0.004), combined specificity was 0.70 (95% CI: 0.62-0.77, P＝0.000), DOR was 3.40 (95% CI: 2.06-5.62, P＝0.000), and AUC was 0.69. The combined sensitivity of GUSS was 0.96 (95% CI: 0.91-0.99, P＝0.425), combined specificity was 0.62 (95% CI: 0.52-0.71, P＝0.729), DOR was 34.71 (95% CI: 12.39-97.24, P＝0.893), and AUC was 0.92.

Conclusion: For the risk assessment of aspiration in stroke patients with swallowing disorders, WST, SSA, TOR-BSST and GUSS all have good diagnostic values, and GUSS has a higher comprehensive diagnostic efficiency.

With the intensification of population aging in China, neurodegenerative diseases have significantly impacted the health of the elderly population. Parkinson's disease (PD) is the second most common neurodegenerative disorder. In recent years, the incidence and prevalence of PD in China have shown an upward trend, imposing a substantial burden on patients, their families and sciety. To optimize the PD prevention and treatment system, Renji Hospital, Shanghai Jiao Tong University School of Medicine has led an initiative involving experts from various authoritative institutions (School of Public Health, Shanghai Jiao Tong University School of Medicine; School of Public Health, Fudan University; Ruijin Hospital, Shanghai Jiao Tong University School of Medicine; West China Hospital, Sichuan University; Department of Neurology, First Affiliated Hospital of Anhui Medical University) to jointly compile the China Parkinson's Disease Report, 2025. This report presents epidemiological data on PD in China, provides an in-depth analysis of the latest economic burden of PD, and comprehensively assesses the current state of PD diagnosis and treatment services as well as the allocation of public health resources in China. The report aims to offer scientific technical guidance and robust data support for PD diagnosis and treatment, while providing professional insights to support government and relevant departments in formulating targeted health policies and interventions. It also seeks to establish a platform for academic exchange and collaboration in this field both domestically and internationally. Through the dissemination and application of this report, it is expected to not only provide a valuable reference for professionals, but also raise public awareness of PD.

Parkinson's disease (PD) is a common neurodegenerative disease that severely impacts patients' quality of life. The diagnostic and therapeutic techniques for PD are improving due to the continuous advancement in medicine. This review summaries recent clinical research achievements in both traditional Chinese medicine (TCM) and western medicine, as well as our team's clinical experiences, proposing that an integrated TCM and western medicine treatment approach is the optimal strategy for enhancing PD therapeutic outcomes and improving patients' quality of life. The integrated TCM and western medicine in the treatment of PD, including the Chinese herbal medicine, acupuncture and traditional physical therapy, has unique advantages in the management of the whole course of PD, especially TCM plays an important role in early intervention, reducing the amount of western medicine and adverse reactions, improving non-movement symptoms, delaying the progress of the disease, and improving the quality of patients' life.

This article reviews the discovery process and pathophysiological mechanisms of a distinctive neuroimaging feature known as the hot cross bun (HCB) sign, through reporting a patient with HCB sign in the pontine on MRI image and who was ultimately diagnosed as multiple system atrophy-cerebellar subtype (MSA-C). Then the association of HCB sign with various neurological diseases and its significance in differential diagnosis and treatment have been discussed.

Objective: To investigate the predictive value of neutrophil to lymphocyte ratio (NLR) combined with hematoma imaging features for delayed perihematoma edema (dPHE) after spontaneous basal ganglia hemorrhage.

Methods: Retrospective inclusion of patients with spontaneous basal ganglia hemorrhage admitted to the neurology department of Jinhua Hospital affiliated to Zhejiang University School of Medicine (Jinhua Municipal Central Hospital) from January 2017 to December 2023. We compared clinical data between the dPHE group and no-dPHE group based on the univariate analysis and multivariate binary logistic regression analysis. We identified the independent influencing factors of dPHE, and evaluated the predictive value of the model for dPHE using receiver operating characteristic (ROC).

Results: A total of 372 patients were included in this study, including 115 in the dPHE group and 257 in the no-dPHE group. Univariate analysis showed that the baseline National Institutes of Health Stroke Scale (NIHSS) score, baseline hematoma volume, high-sensitivity Creactive protein, lymphocyte count, NLR, blend sign, lateral hematoma, and high-dose mannitol proportion in the dPHE group were significantly higher than those in the non-dPHE group (P<0.05). Moreover, the NIHSS score and hospitalization expenses in the dPHE group were higher than those in the no-dPHE group (P<0.05), and their hospitalization time was also longer in the dPHE group (P<0.05). Furthermore, the multivariate logistic regression analysis revealed that NLR [odds ratio (OR) ＝1.138 (95% CI: 1.056-1.227); P＝0.001], baseline hematoma volume [OR＝1.187 (95% CI: 1.132-1.246); P<0.001] and lateral hematoma [OR＝3.067 (95% CI: 1.611-5.838); P＝0.001] were independent predictive factors of dPHE. ROC analysis showed that the area under the curve of the model was 0.810 (95% CI: 0.765-0.856).

Conclusion: The higher the baseline NLR, the larger the hematoma volume, and patients with lateral basal ganglia hemorrhage are more susceptible to dPHE.

Object: To improve the understanding of osmotic demyelination syndrome (ODS) after coronavirus disease 2019 (COVID-19) infection.

Method: The clinical manifestations and imaging features of 4 patients with ODS after COVID-19 infection were retrospectively described, and the related literatures were reviewed and analyzed.

Results: All 4 patients suffered from severe hyponatremia and overcorrection after COVID19 infection, with clinical manifestations including fever, vomiting, disturbance of consciousness, convulsions and movement disorders. No abnormalities were found in head MRI examination the early stage of the disease, and extrapontine lesions with or without pontine involvement appeared after 2-3 weeks. The patients were treated with gammaglobulin, steroids and plasmapheresis. Two patients achieved favorable outcomes, while the other two had poor prognoses.

Conclusion: Patients with COVID-19 infection are at high risk of ODS, which may be related to overly rapid sodium supplementation within 24 hours in the context of pre-existing hyponatremia. Other contributing factors include hypertension and hypovolemia induced by diuretic use. Close monitoring of serum sodium levels is essential during sodium supplementation. If the patient exhibits symptoms such as altered consciousness or head MRI suggests lesions involving the cortex, more aggressive immunotherapy and appropriate nursing measures should be taken.

Exasomes are smaller vesidles secreted by cells, enriched with cell-derived proteins, nudeic acids, lipids and other signaling substances, which have physiological functions such as removing waste materials, mediating intercellular information transfer and generating immune tolerance. Traditional Chinese Medicine(TCM) and its main active ingredients can be used to treat cerebral diseases by regulating exosumes, but the mechanism of action is still unclear. In this paper, we reviewed the characteristics of exosomes in cerebral disesses(ischemic stroke, cerebral bemorrhage, vascular dementia, Alzheimer's disease, multiple sderosis) and the mechanism of action of the main active ingredients of traditional Chinese medicines on exosomal proteins, so as to provide a new strategy and a new way of thinking for the treatnent of cerebral diseases.