Spinal cord injury (SCI) elicits sensory, motor, and autonomic dysfunctions caudal to the lesion site, resulting in enduring functional deficits. Successful recovery hinges upon compensatory axonal sprouting from intact neurons or regeneration of damaged axons, a process constrained by transcriptional regulatory dynamics. Epigenetics emerges as a pivotal determinant in instigating and sustaining regenerative transcriptional cascades. Specifically, histone covalent modifications intricately modulate post-injury chromatin restructuring, consequently influencing transcriptional dynamics. This review delineates the epigenetic regulatory framework governing post-SCI axonal regeneration, emphasizing the role of histone covalent modifications as potential therapeutic targets to enhance clinical interventions for SCI repair.

This study aimed to explore the correlation between multiple attachment relationships and metacognitive function in clinically stable patients with schizophrenia and its sex differences. Methods: Eighty stable schizophrenia patients (45 males and 35 females) treated in Hefei Fourth People's Hospital were enrolled and divided into male and female groups. The Indiana Psychiatric Illness Interview (IPII) and the abbreviated Metacognition Assessment Scale (MAS-A) were used to assess the metacognitive function of all participants. The Experiences in Close Relationships-Relationship Structures Scale (ECR-RS) was adopted to evaluate multiple attachment relationships. Independent samples t-test or Mann-Whitney U test was used to compare the differences in metacognitive function and ECR-RS scores between the male and female groups. Partial correlation analysis was conducted to explore the association between multiple attachment relationships and metacognitive function in clinically stable patients with schizophrenia. Results: The female group had significantly higher total metacognitive scores (t=－1.989, P<0.05) and decentration scores (D scores) (Z=－3.775, P<0.001) than the male group. There were no statistically significant differences in the total scores and factor scores of the ECR-RS scale between the two groups (P>0.05). Partial correlation analysis showed that attachment anxiety in the partner attachment domain (ECR-RS-3) was significantly negatively correlated with decentration scores (D scores) (r=－0.250, P<0.05), mastery scores (M scores) (r=－0.292, P<0.05), and total scores (r=－0.266, P<0.05) of metacognition when the age, course and other factors were statistically controlled. Subgroup analysis revealed that in the male group, partner attachment anxiety was related to decentration scores (D scores); while in the female group, partner attachment anxiety was associated with mastery scores (M scores). Conclusion: The better partner relationship in clinically stable patients results better cognitive understanding of self and others and the ability to cope with social dilemmas, and there are significant sex differences.

To explore the correlation between suicidal attitudes and parental rearing styles in adolescents with depression who have engaged in suicidal behaviors, and to analyze related risk factors. Methods: A cross-sectional survey was conducted on 197 adolescent patients with depression hospitalized in the Department of Clinical Psychology at Jingmen People's Hospital from June 2020 to May 2023, who voluntarily participated in the study. Patients were divided into a suicidal group (115 cases) and a non-suicidal group (82 cases) based on whether they had engaged in suicidal behaviors in the past 6 months. Both groups were assessed using a general information questionnaire, the Patient Health Questionnaire-9 (PHQ-9), the Questionnaire on Suicide Atitude (QSA), and the Egna Minnen av Barndoms Uppfostran (EMBU). Group comparisons were made, and all variables were included in a multivariate Logistic regression model for analysis. Results: (1) The suicidal group was younger in age and had a higher rate of alcohol use than the non-suicidal group (both P<0.05). (2) QSA results showed that the suicidal group had lower scores than the non-suicidal group in attitudes toward suicidal behavior and toward suicide victims (P<0.01 and P<0.05, respectively), but higher scores in attitudes toward the families of suicide victims (P<0.01). There was no significant difference in attitudes toward euthanasia between the two groups (P>0.05). (3) EMBU results revealed that the total score of the suicidal group was significantly higher than that of the non-suicidal group (P<0.01). Specifically, the suicidal group scored lower on maternal emotional warmth (P<0.05) and higher on paternal and maternal overprotection, rejecting denial, and harsh punishment (P<0.01). Additionally, the suicidal group had higher scores on paternal overinterference (P<0.01). (4) Logistic regression analysis identified paternal harsh punishment and excessive interference as risk factors for suicidal behavior in adolescents with depression (P<0.05). Conclusion: Adolescents with depression have a high incidence of suicidal behaviors. Those who engage in suicidal behaviors tend to show understanding or approval of suicide and ambivalence toward the families of individuals who have attempted suicide. Their family education models often lack emotional support and involve excessive interference, punishment, and denial. Adolescents raised by fathers with overinterference, harshness, and punitive parenting styles are at greater risk of suicidal behavior.

To explore the efficacy and safety of right-sided low-frequency repetitive transcranial magnetic stimulation (rTMS) in treating depression comorbid with anxiety in elderly patients. Methods: A total of 72 elderly patients with depression comorbid with anxiety, hospitalized in the Department of Psychiatry of Liyuan Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from January 2021 to June 2021, were selected and randomly divided into a control group (35 cases) and a low-frequency group (37 cases) using a random number table. Both groups received antidepressant medication. Additionally, the low-frequency group was treated with rTMS (1.0 Hz) on the right dorsolateral prefrontal cortex, 20 minutes per session, once daily, five times per week, for a total of 20 sessions over 4 weeks. The control group received sham stimulation with the same duration and frequency. The Hamilton Depression Rating Scale-24 (HAMD-24) and the Hamilton Anxiety Rating Scale-14 (HAMA-14) were used to evaluate anxiety and depression symptoms and treatment efficacy at baseline and at the end of weeks 1, 2, 3, 4, 6, and 8. Adverse reactions were recorded, and repeated measures ANOVA was used to compare the scores of anxiety and depression between the two groups at different time points. Results: The main effects of time, group, and time-group interaction for HAMD-24 and HAMA-14 scores were statistically significant (P<0.05). Further analysis showed that HAMD-24 scores in both groups were significantly lower than baseline at weeks 1, 2, 3, 4, 6, and 8 (P<0.01). There was no significant difference in HAMD-24 scores between the two groups at weeks 1, 2, 3, and 4 (P>0.05), but the low-frequency group had significantly lower HAMD-24 scores than the control group at week 6 (P<0.01) and week 8 (P<0.05). For HAMA-14 scores, both groups showed significant reductions compared to baseline at weeks 1, 2, 3, 4, 6, and week 8 (P<0.01). The low-frequency group had significantly lower HAMA-14 scores than the control group at weeks 1 and 2 (P<0.05) and at weeks 3, 4, 6, and 8 (P<0.01). After 4 weeks of treatment, the overall response rate in the low-frequency group was higher than that in the control group (P<0.05). After 6 weeks, the marked improvement rate in the low-frequency group was significantly higher (P<0.05), but there was no significant difference in marked improvement rates between the two groups after 8 weeks (P>0.05). No severe adverse reactions were observed in either group. Conclusion: Combined antidepressant and right-sided rTMS therapy effectively alleviates both depressive and anxiety symptoms in elderly patients with comorbid depression and anxiety, demonstrating superiority to antidepressant medication alone while maintaining a favorable safety profile.

To evaluate the proportion of intraplaque hemorrhage (IPH) and its clinical correlation in patients with atherosclerotic stenosis of the middle cerebral artery (MCA) using high-resolution magnetic resonance vessel wall imaging (HRMR-VWI). Methods: We collected clinical and imaging data from patients with moderate to severe stenosis (50%～99%) of the MCA-M1 or M2 segments treated in our hospital from July 2019 to August 2023. IPH was defined as T1 hyperintensity on fat-saturated HRMR-VWI images, with signal intensity>150% of the surrounding muscle tissue. Patients were divided into symptomatic stenosis and asymptomatic stenosis groups based on the presence of ischemic symptoms within the MCA territory within 3 months. The symptomatic stenosis group was further subdivided into artery-to-artery embolism and non-artery-to-artery embolism subgroups according to DWI characteristics. Clinical and imaging data were compared among groups and subgroups. Results: A total of 59 patients were included in the analysis, of whom 14(23.7% ) had IPH in the MCA stenosis lesions. The symptomatic stenosis group comprised 30 patients (50.8%), and the incidence of IPH in symptomatic stenosis patients was 11/30(36.7%), significantly higher than that in asymptomatic stenosis patients [3/29(10.3%)], with a statistically significant difference (P=0.018). Among symptomatic stenosis patients, 11(36.7% ) had artery-to-artery embolism, of whom 7/11(63.6% ) had IPH, a significantly higher incidence than in non-artery-to-artery embolism patients (4/19, 21.1% ), with a statistically significant difference (P=0.047). No significant differences were observed for other factors between the two groups and two subgroups (all P>0.05). Conclusion: The proportion of IPH is higher in symptomatic MCA moderate to severe stenosis patients compared to asymptomatic patients. Moreover, within the symptomatic group, patients with embolic infarction have a higher incidence of IPH. This finding is significant for evaluating the infarction mechanism and stroke risk in MCA stenosis patients.

To explore the clinical features of spinocerebellar ataxia type 3 (SCA3) characterized by tremor as the main feature, and to analyze a family with extrapyramidal signs such as tremor and peripheral neuropathy, providing a basis for clinical diagnosis. Methods: Ten SCA3 patients characterized by tremor were collected, including 4 from the same family. The clinical features, imaging, genetic testing, and drug responsiveness of 6 non-family patients, 4 familial patients, and their family members (5 cases) were summarized, along with a review of related literature. Results: Among the 9 patients in the family, 4 were diagnosed through genetic testing (ATXN3 gene CAG repeats 57～58 times, Sanger validation 60～62 times), and 5 were suspected patients. Among the 4 confirmed cases, 2 presented with tremor as the main symptom (postural/action tremor, exacerbated by activity), 1 was accompanied by bradykinesia and a history of epilepsy, and 1 had peripheral neuropathy. No significant atrophy was observed on brain MRI. Compared with typical SCA3 patients with CAG repeats 66～73 times (mainly ataxia), tremor symptoms were significant in this family, partially relieved by Madopar treatment. Conclusion: The clinical phenotype of SCA3 may be related to the number of CAG repeats (60～62 repeats mainly presenting as tremor/bradykinesia, 66～73 repeats mainly as ataxia). It is necessary to pay attention to the identification of atypical symptoms, with genetic testing being crucial for diagnosis.

To investigate the effect of adipose-derived mesenchymal stem cells (ADSCs) combined with arginine-glycine-aspartic acid (Arg-Gly-Asp, RGD) peptide modified hydrogel on regenerative repair after spinal cord injury (SCI) in rats. Methods: Fifty SD rats were randomly divided into five groups: sham operation group (Sham group), model group (SCI group), adipose-derived mesenchymal stem cell group (ADSCs group), RGD peptide-modified hydrogel group (p-Gel group), and adipose-derived mesenchymal stem cell combined with hydrogel group (ADSCs-pGel group), with 10 rats in each group. The SCI model was established using a transection method, and each group was injected with 100 μL of normal saline, ADSCs, RGD peptide-modified hydrogel, or a mixture of ADSCs and RGD peptide-modified hydrogel at the site of spinal cord injury. The Basso Beattie Bresnahan (BBB) scale was used to score the motor function of the rats' hindlimbs on days 1, 3, 7, 14, 21, and 28 after modeling. On day 7 after modeling, immunofluorescence staining was used to detect the expression levels of CD68 (clone ED-1), glial fibrillary acidic protein (GFAP), and neurofilament-200 (NF-200). Results: Starting from day 7, the BBB scores of the ADSCs-pGel group were higher than those of the SCI group (P<0.05). From day 14 onwards, the BBB scores of the ADSCs-pGel group were higher than those of the ADSCs group (P<0.05), and the BBB scores of the p-Gel group and ADSCs group were higher than those of the SCI group (P<0.05). The fluorescence expression levels of ED-1 and GFAP in all groups were significantly higher than those in the Sham group (P<0.001), but the fluorescence expression levels of ED-1 and GFAP in the ADSCs-pGel group were significantly lower than those in the p-Gel group and ADSCs group (P<0.01). The fluorescence expression level of NF-200 in all groups was significantly lower than that in the Sham group (P<0.001), but the fluorescence expression level of NF-200 in the ADSCs-pGel group was significantly higher than that in the p-Gel group and ADSCs group (P<0.001). Conclusion: Transplantation of ADSCs combined with RGD peptide-modified hydrogel to the SCI site can promote the recovery of motor function in the hindlimbs of rats, and the effect is more significant than the single application of ADSCs or RGD peptide-modified hydrogel.

Spinal cord injury (SCI) is a severe traumatic disease that has a profound impact on society, families, and patients. After SCI, neuronal axons exhibit limited spontaneous regenerative capacity, and effective clinical treatments remain lacking. Previous studies have demonstrated that various growth factors play crucial roles in protecting neural tissue, stimulating axonal regeneration and remyelination, and reducing scar formation after SCI. Hydrogels are currently considered ideal biomaterial scaffolds, as they can protect growth factors from degradation, enable localized delivery and sustained release of growth factors, and play significant roles in both the early phase and subsequent tissue regeneration stages after SCI. This article focuses on reviewing the research progress on hydrogel-delivered growth factor therapies for SCI during different stages of secondary damage and tissue regeneration.

The gut microbiota (GM), as a complex ecosystem, exerts influences on human body structure, endocrine levels, metabolic capacity, nervous system, and immune function. It has been discovered that the diversity of GM decreases dramatically with ageing, and even undergoes harmful transformations in functional structure, jeopardizing the health of elderly individuals. Since GM is modifiable, this review systematically analyzes research progress on the role of GM in elderly endocrinology, skeletal muscle systems, cognitive-psychological functions, neurological disorders, and viral infections, while exploring underlying mechanisms. The objective is to investigate novel therapeutic approaches and potential targets for age-related diseases, and to provide references for future GM-omics studies.

Ischemic stroke is characterized by high morbidity and disability rates. Recent studies have revealed that trimethylamine N-oxide (TMAO), a metabolite derived from gut microbiota, promotes the initiation and progression of atherosclerosis, enhances platelet reactivity, and increases thrombotic risk. This review summarizes the current research progress on the role of TMAO in ischemic stroke.

Migraine is a neurological disorder with high prevalence, often coexisting with various diseases to form comorbidities. These comorbid conditions are bidirectionally interconnected with migraine through shared genetic, environmental, and pathophysiological mechanisms. This review summarizes the comorbidity relationships between migraine and cardiovascular/cerebrovascular diseases, endocrine disorders, epilepsy, psychiatric disorders, sleep-related diseases, gastrointestinal conditions, and immune-mediated diseases. Identifying comorbidities aids in elucidating the etiology of migraine, guiding research on its pathophysiology, and facilitating individualized comprehensive management for migraine patients.

Stroke is the leading cause of mortality and disability in China. Post-stroke anxiety (PSA) and post-stroke depression (PSD) are common psychiatric sequelae after stroke, significantly reducing patients’quality of life, impairing physical and mental health, and hindering functional recovery. Current research suggests that the pathophysiology primarily involves biological mechanisms and psychosocial factors. Treatment strategies predominantly rely on pharmacotherapy, complemented by physical therapies and psychological interventions. This review summarizes recent advances in the mechanisms and treatment of PSA and PSD, aiming to provide a reference for future research.

To improve clinicians' diagnostic and therapeutic skills for neurobrucellosis (NB) and enhance patient outcomes. Methods: Clinical data of 4 patients with NB diagnosed at Beijing Ditan Hospital, Capital Medical University, from January 2024 to September 2024 were retrospectively analyzed. Results: All 4 patients had a clear epidemiological history. Clinical manifestations included meningitis, myelitis, and other neurological symptoms. Lumbar puncture was performed in all cases. Cerebrospinal fluid (CSF) analysis revealed elevated pressure in 3 patients, increased white blood cell counts in all 4, elevated protein levels in all 4, and reduced glucose levels in 3. Serum Brucella agglutination tests were positive in all patients, and CSF Brucella agglutination tests were positive in 3. All patients received triple or quadruple anti-Brucella therapy based on rifampicin and doxycycline. Conclusion: Neurobrucellosis presents with complex and diverse clinical features. Early detection and diagnosis are critical for improving prognosis, while delayed diagnosis leads to poor outcomes and potential long-term sequelae.