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.
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.
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.
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.
