On February 25, 2023, a major academic symposium led by Nanjing Zijin Hospital was successfully held on the banks of Baijia Lake in Nanjing. Experts and leaders from Shanghai Huashan Hospital, the First Affiliated Hospital of Zhejiang University, Jiangsu Provincial People’s Hospital, Beijing Tiantan Hospital, Beijing Chaoyang Hospital, Shenzhen People’s Hospital, and other institutions gathered to offer valuable guidance for the sixth revision of the Chinese Neurological Outcome Scale for Persistent Vegetative State (CNPVSS).

Scene from the Revision Meeting of the Chinese Nanjing Scale for Persistent Vegetative State

China News Service’s health client, Yangtze Evening News, Jiangsu Public Channel, Nanjing News Comprehensive Channel, Zijinshan News, Jiaohuidian News, Nanjing Daily Online, and other major domestic newspapers and television stations have all provided extensive coverage of this event.

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The third edition of the Consciousness Disorder Rating Scale is set to be released, supporting the assessment and treatment of functional impairments — People’s Daily Health Client

Following “The Dormant Ones” helps reduce the rate of misdiagnosis: Revision of the Persistent Vegetative State Scale — Litchi News

A new clinical guideline for the “vegetative state” is set to be released in Nanjing, helping clinicians provide more precise treatment for patients with disorders of consciousness—Zijinshan News.

More precise assessment across the entire spectrum from coma to wakefulness: Nanjing is set to introduce new diagnostic and treatment standards for the “vegetative state” — Jiaohuidian News

To more accurately assess the entire spectrum from coma to consciousness, Nanjing is set to introduce new clinical guidelines for the diagnosis and treatment of “vegetative state” — Xinhua Daily Health.

Global Highlight! A New Standard for the Diagnosis and Treatment of “Vegetative State” Will Be Released in Nanjing — Nanjing Daily Online

Recovery is not “flipping a switch”: China’s Nanjing has revised the Persistent Vegetative State Scale for the sixth time—Yangtze Evening News

Revised “Vegetative State” Scoring Scale: Treatment to Become More Precise — Niuka Video

The Chinese Nanjing Scale for the Assessment of Persistent Vegetative State, developed by pioneering experts in the field of brain resuscitation in China, has been in clinical use for 26 years and has undergone five revisions. The most recent version was published 12 years ago. Over this period, significant advances have been made in the definitions, classifications, and assessment methods of disorders of consciousness, and numerous new findings have emerged from both clinical and basic research. Consequently, some of the original definitions and scoring criteria in the scale no longer align with the concepts outlined in the latest international and national guidelines, creating an urgent need to revise the instrument for contemporary clinical practice. With strong support from organizations including the Hyperbaric Oxygen Therapy Branch of the Chinese Medical Association and the Journal of Naval Medicine and Hyperbaric Medicine, and under the guidance of the attending experts, Nanjing Zijin Hospital—China’s first tertiary rehabilitation hospital with more than two decades of experience in the clinical application of the CNPVSS—has undertaken the responsibility of hosting this revision conference.

Group photo from the first revision meeting

Sixth Revision Meeting of the CNPVSS

Ge Jiangping, head of the CNPVSS Scale Revision Working Group and President of Nanjing Zijin Hospital, delivered a welcoming address, expressing his heartfelt admiration and gratitude to the distinguished experts for accepting the invitation to join in guiding the sixth revision of the CNPVSS scale, despite their busy schedules and unwavering sense of responsibility and mission.

Leader of the Scale Revision Working Group, Ge Jiangping

“The transition from coma to consciousness is not an instantaneous ‘switch’; rather, it unfolds through a series of intermediate states, such as the vegetative state and the minimally conscious state…” Prior to the start of the conference, Gao Zhiqiang—deputy head of the CNPVSS scale revision working group, leader of the Brain Resuscitation Group of the Hyperbaric Oxygen Medicine Branch of the Jiangsu Medical Association, and executive vice president of Nanjing Zijin Hospital—provided a vivid explanation in interviews with Jiangsu Television, Xinhua Daily, Yangtze Evening News, Nanjing Daily, and other media outlets, detailing the varying degrees of transitional states that lie between the two extreme conditions of coma and wakefulness.

Gao Zhiqiang, Deputy Leader of the Scale Revision Working Group

As the conference chair, Ding Xinsheng, a member of the Board of Directors of the Jiangsu Medical Association and former Director of the Department of Neurology and the Department of General Medicine at Jiangsu Provincial People’s Hospital, declared the meeting open and extended his best wishes for its successful convening.

Expert Advisor for Scale Revision: Ding Xinsheng

Li Jinsheng, current Chairman of the Hyperbaric Oxygen Medicine Branch of the Chinese Medical Association and Director of the Hyperbaric Oxygen Medicine Research Institute at Shenzhen People’s Hospital, delivered a keynote address, fully commending Nanjing Zijin Hospital for its 35-year contributions to the field of disorders of consciousness. He also underscored the necessity and urgency of convening this meeting to revise the CNPVSS scale.

Expert Advisor for Scale Revision: Li Jinsheng

Deputy Team Leader Gao Zhiqiang provided a detailed report on the proposed revisions, including the scale’s name, the names of its sub-items, the order of these sub-items, the content of the sub-items “Visual Response (formerly Ocular Movements)” and “Auditory Response (formerly Auditory Function),” the interpretation of the scale’s scoring, and the addition of an English translation of the scale.

Gao Zhiqiang, Deputy Leader of the Scale Revision Working Group

Following the conclusion of the proposal presentation, experts from across the country in relevant fields commended and endorsed the key elements that align with the clinical research needs in the field of modern consciousness disorders, while also engaging in in-depth discussions and analyses of certain details.

Scale Revision Advisory Expert: Wang Peidong

Expert Advisor for Scale Revision: Chu Xinqi

Expert Advisor for Scale Revision: Gao Li

Following the conclusion of the proposal presentation, experts from across the country in relevant fields commended and endorsed the key elements that align with the clinical research needs in the field of modern consciousness disorders, while also engaging in in-depth discussions and analyses of certain details.

Academician Li Jian’an’s concluding remarks

Li Jian’an, President of Jiangsu Zhongshan Geriatric Rehabilitation Hospital and an International Fellow of the U.S. National Academy of Medicine, delivered a concluding address at this scale‑revision conference. In an interview with the media, he stated, “Without an assessment of functional impairment, there can be no evaluation of treatment efficacy. The more scientific and precise the assessment of functional impairment, the more targeted the treatment and the better the outcomes; therefore, functional assessment is the foundation and prerequisite of all rehabilitation medicine. With this revision of the scale, our understanding will reach a new level.”

Academician Li Jian’an granted a media interview.

The sixth revision meeting of the China Nanjing Persistent Vegetative State Scale (CNPVSS) concluded after a 40-minute delay. The participating experts expressed their satisfaction and, while reaching a consensus, look forward to issuing a formal public statement once a unified resolution is adopted in the future. We are confident that the continually refined CNPVSS will become even more scientific and effective, thereby benefiting a broad population of patients with disorders of consciousness.

Group photo of the organizing members of the Sixth Revision Meeting of the Chinese Nanking Scale for Persistent Vegetative State.