Ras-related C3 botulinum toxin substrate 1 (Rac1) is an important member of the Rho GTPase family. In physiological and pathological cases, Rac1 is closely associated with neuronal plasticity, apoptosis, reactive oxygen species (ROS) production, and inflammatory response. An increasing body of research indicates that Rac1 plays a significant role in diseases of the central nervous system (CNS). This article reviews the physiological role of Rac1 in regulating synaptic morphology and neuronal structural plasticity of neurons, as well as the pathological role of Rac1 in regulating CNS diseases, aiming to provide new insights for the early diagnosis and treatment of CNS diseases.

Anxiety disorders represent chronic mental health conditions characterized by high incidence rates and a propensity for recurrence. As a novel form of psychological intervention, mindfulness therapy has exhibited promising applications in the management of anxiety disorders. This paper reviews the primary origins and evolution of mindfulness therapy and its practical uses in treating anxiety disorders, delving into its underlying mechanisms. Mindfulness therapy has proven effective in reducing anxiety symptoms and enhancing life quality, with outcomes comparable to those of first-line medications or cognitive-behavioral therapies. Nevertheless, the sustained effectiveness of mindfulness therapy requires additional validation, ideal treatment plans need refinement, and its impact may differ across various anxiety disorder subtypes. Future research should focus on advancing our understanding of mindfulness therapy’s role in anxiety disorders, clarifying its mechanisms, perfecting therapeutic approaches, and facilitating its standardized use in clinical settings.

Cerebral angiogenesis is an important physiological process for the development of the cerebrovascular system and the primary mechanism of revascularization following cerebrovascular damage. Abnormal cerebral angiogenesis may lead to several diseases, such as brain tumor growth and arteriovenous malformations. Neurovascular unit, the smallest functional unit of the brain, consists of neurons, glial cells, pericytes, etc., and is involved in maintaining homeostasis of the brain microenvironment. The neurovascular unit has crucial roles in cerebral angiogenesis. In this paper, we review the regulatory roles and mechanisms of various cellular components of the neurovascular unit (neurons, astrocytes, microglia, pericytes, and smooth muscle cells) in cerebral angiogenesis, which will provide an important reference for the research and clinical treatment of cerebrovascular-related disorders.

To analyze the impact of lifestyle factors on frailty in middle-aged and older adults, providing a theoretical basis for the management of frailty in this population. Methods: Data from 6945 individuals aged ≥45 years were extracted from the China Health and Retirement Longitudinal Study (CHARLS) database. Frailty levels were assessed using the frailty index (FI). Social demographic information, lifestyle, and health status of the participants were also collected. The influence of lifestyle on frailty in middle-aged and older adults was statistically analyzed. Results: After adjusting for gender, age, education level, and marital status through binary logistic regression analysis, it was found that middle-aged and older adults with the highest frequency of alcohol consumption >2 times/day (OR=1.85, 95% CI 1.00-3.39, P<0.047), nap duration >30 minutes (OR=1.57, 95% CI 1.22-2.02, P<0.001), and self-reported health status below“good”(OR=1.53, 95% CI 1.25-1.85, P<0.001) had a higher risk of frailty; those with high-intensity physical activity (OR=0.69, 95% CI 0.55-0.84, P<0.001), alcohol consumption frequency ≤1 time/day (OR=0.79, 95% CI 0.65-0.96, P=0.018), and nighttime sleep duration ≥6 hours (OR=0.71, 95% CI 0.62-0.81, P<0.001) had a lower risk of frailty. Conclu? sion: Lifestyle factors such as alcohol consumption, sleep, and physical activity may be associated with frailty status; a healthy lifestyle may help reduce the incidence of frailty in middle-aged and older adults.

The technology of optical coherence tomography angiography (OCTA) has become a key tool in the non-invasive, high-resolution imaging for the diagnosis and treatment monitoring of neuromyelitis optica spectrum disorders (NMOSD). This review focuses on the application of OCTA in revealing retinal microvascular changes and its use in the management of NMOSD. The dynamic information on retinal blood flow provided by OCTA offers a scientific basis for formulating personalized treatment plans and complements traditional imaging techniques well. Further exploration of its necessity and potential value in the application within NMOSD is warranted.

Swallowing is a complex motor process that involves multiple brain regions and neural networks. Central nervous system diseases can lead to dysphagia. Functional magnetic resonance imaging(fMRI) displays the relationship between the structure and function of the central nervous system, while diffusion tensor imaging(DTI) provides clear observation of the integrity of brain white matter fibers. This article reviews the relevant literature on multimodal magnetic resonance imaging research on swallowing and dysphagia.

To investigate the mediating effect of blood inflammatory markers on the relationship between obesity and depression in individuals with ischemic stroke. Methods: A total of 317 patients with ischemic stroke were assessed using the General Information Survey method and the Hamilton Depression Scale Descriptive analysis, correlation analysis, and mediation analysis were performed using SPSS 25.0 and statistical software R package 4.2.2. The significance of the mediation effect was tested using the percentile Bootstrap method. Results: After adjusted for age, gender, education levels, smoking status, alcohol consumption, hypertension, diabetes, coronary heart disease, hyperlipidemia, use of antidepressants, use of anti-inflammatory drugs, TOAST classification, NIHSS score, obesity and higher body mass index were found to be positively correlated with increased white blood cell count (WBC) and lymphocyte count (LYM) (WBC: β=0.76, P=0.044; β =0.06, P=0.002; LYM: β =0.37, P=0.008; β =0.03, P<0.001). Furthermore, there was a positive correlation between obesity and depressive symptoms (WBC: OR=3.47, P=0.017; LYM: OR=1.10, P=0.001). After including the mediating variable of blood inflammatory markers, the direct effect of obesity on depressive symptoms remained statistically significant. Additionally, when controlling for obesity indicators, a positive correlation between blood inflammatory markers and depressive symptoms was observed (WBC: OR=1.23, P=0.019; LYM: OR=1.62, P=0.027; NAR: OR=3.36, P=0.034). Analysis of the mediating effect indicated that the association between body mass index and depression was partially mediated by WBC and LYM, with the proportion of mediating effect being 9.77% and 13.95%, respectively. Conclusion: Blood inflammatory markers such as WBC and LYM exhibit a partial mediating effect in the relationship between obesity and depression.

To identify potential mechanisms influencing the occurrence of diabetic peripheral neuropathy (DPN) in type 2 diabetes mellitus (T2DM) through bioinformatics techniques. Methods: The relevant dataset (GSE24290) was downloaded from the Gene Expression Omnibus (GEO) database. Differential expression analysis was conducted on the dataset using the R package 'limma'. GO and KEGG enrichment analyses of the target genes were performed using the 'org.Hs.eg.db' and 'clusterProfiler' packages. The protein-protein interaction network of the relevant genes was obtained from the STRING website (https://cn. string-db.org/). The molecular network was visualized using the 'Networkx' and 'Netwulf' libraries in Python. Clinical samples were referenced to determine whether the identified factors influencing disease occurrence were consistent with Chinese samples. Finally, Mendelian randomization (MR) analysis was employed to determine the gene-level causal effect relationship between the identified influencing factors and the risk of T2DM and T2DM DPN. Results: After differential analysis of the GEO database data, the GO and KEGG results showed that the biological pathways of differential genes were mainly concentrated in fat metabolism processes. The STRING results indicated that the commonality of genes related to lipid metabolism pathways was to promote the occurrence and development of hyperlipidemia. In Chinese clinical samples, the expression levels of total cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein, and apolipoprotein B were higher in the T2DM group and T2DM DPN group compared to the healthy control group (P<0.05). Compared to the T2DM group, the expression levels of blood lipid-related indicators were higher, but the difference was not statistically significant (P>0.05). The MR analysis results showed no causal effect relationship between blood lipids-T2DM and hyperlipidemia-T2DM DPN. MR-Egger, WME, Weighted mode, and Simple mode were used to determine the stability of the MR results, and scatter plots, leave-one-out analysis, and funnel plots confirmed the reliability of the results. Conclusion: Hyperlipidemia is a potential influencing factor for the occurrence of T2DM DPN, but no causal effect relationship was found at the gene level.

Alzheimer’s disease (AD) is the most common neurodegenerative disease, primarily characterized by detrimental and irreversible cognitive dysfunction. Sleep-wake rhythm disturban is a common symptom in AD patients, and extensive researches have shown that sleep-wake rhythm disturban predates the onset of behavioral symptoms of AD. The normal sleep-wake rhythm facilitates the metabolism of Amyloid-β-protein (A β) and tau protein. However, when the sleep-wake cycle is disturbed, the central nervous system’s ability to clear harmful metabolic waste diminishes. Moreover, sleep-wake rhythm disturban can also lead to neuroinflammation and oxidative stress in the central nervous system, accelerating cognitive impairment. Therefore, this review primarily explores the relationship between the disturban of the sleep-wake cycle and the development of AD.

To explore the relationships between different subtypes of adverse childhood experiences (ACEs), psychological resilience, and various depressive symptoms in adolescents. Methods: A total of 170 adolescent patients, including 132 adolescents with depression and 38 healthy adolescents, were selected from the psychiatry outpatient clinic of Wuhan University Renmin Hospital. The Adverse Childhood Experiences International Questionnaire (ACES-IQ) was used to assess the exposure to ACEs in adolescents, the Connor-Davidson Resilience Scale (CD-RISC) was employed to evaluate the level of psychological resilience, and the 17-item Hamilton Depression Rating Scale (HAMD-17) as well as the Snaith-Hamilton Exuberance Scale (SHAPS) were utilized to assess depressive symptoms and their severity in adolescents. Graph theory-based network analysis was conducted to explore the associations among ACEs, psychological resilience, and depressive symptoms within the adolescent population. Results: (1) The exposure levels of all three types of ACEs were positively correlated with the severity of all six types of depressive symptoms, while the scores of psychological resilience were negatively correlated with the exposure levels of the three types of ACEs and the severity of the six types of depressive symptoms. (2) In the ACEs-psychological resilience-depressive symptoms network,“psychomotor retardation”among the depressive symptoms showed the highest degree centrality and was the most important depressive symptom;“abuse and neglect”among the three types of ACEs patterns exhibited the highest degree centrality and was the most significant ACEs pattern;“psychological resilience” demonstrated the greatest bridge strength, acting as the“bridge”connecting different nodes. (3) The results of network stability and accuracy tests indicated that both degree centrality and bridge strength had sufficient stability. Conclusion: Psychological resilience is an important supportive factor for mental health, and efforts should be made to enhance the level of psychological resilience in order to prevent and treat the adverse consequences brought about by ACEs.

Multiple sclerosis (MS) pathogenesis is complex, and current clinical treatments cannot halt disease progression and have numerous side effects. There is an urgent need to develop new and effective clinical treatments to improve the clinical symptoms and prognosis of MS patients. Remyelination can provide benefits throughout the entire course of MS, making it a highly promising treatment approach for MS. Oligodendrocyte precursor cells, responsible for myelin regeneration in MS, have their regenerative capacity influenced by various microenvironmental factors. This article provides the first review of the impact and mechanisms of microenvironmental factors such as innate immune cells, myelin debris, extracellular matrix, astrocytes, neurons, pericytes and endothelial cells, adaptive immune cells, peripheral circulation, and aging on MS remyelination, aiming to offer references for the prevention and treatment of MS.

To develop a convenient and low-cost gait tracking system based on deep learning technology for detecting gait details in experimental mice, and to preliminarily test its application in wild-type mice and various central nervous system disease mouse models. Methods: A simple gait corridor was built, and mice were allowed to walk freely inside the corridor for 4 minutes while their walking videos were recorded from the ventral side. From the free movement videos of the mice, 120 frames were extracted and analyzed using DeepLabCut to label 36 body parts for neural network training. The system and network were applied to analyze the gait of wild-type mice at ages 1, 3, 6, and 18 months, APP/PS1 mice (6 months old, Alzheimer’s disease model), social isolation (SI) mice (3 months old, anxiety and depression model), bilateral carotid artery stenosis (BCAS) mice (3 months old, chronic cerebral ischemia model), and sepsis-associated encephalopathy (SAE) mice at postoperative days 1, 3, and 7 (2 months old). Results: DeepLabCut demonstrated high accuracy in all animal video tracking. Three-month-old wild-type mice had the fastest movement speed and increased stride length compared to other age groups. APP/PS1 mice showed significantly higher movement speed than age-matched controls, accompanied by increased stride length and decreased standing time. SI mice exhibited shortened stride length, reduced toe spread and toe angle of the left front paw, indicating foot posture changes. BCAS mice showed no significant change in stride length but had significantly increased hind limb toe spread and decreased toe angle. SAE mice showed reduced movement speed with shortened stride length and extended standing time on postoperative days 1 and 3. By day 7 post-operation, SAE mice had lower movement speed than control mice but without significant difference, and had smaller hind limb toe spread and toe angle compared to the control group. Conclusion: This study established a convenient, low-cost gait analysis device based on deep learning, requiring minimal effort to label body parts of interest, making it more cost-effective than previous gait analysis methods. Using this device, we described the gait characteristics of wild-type mice across different age groups and demonstrated that mice models of Alzheimer’s disease, anxiety and depression, chronic cerebral ischemia, and sepsis-associated encephalopathy exhibit gait deficits.

To explore the correlation and influencing factors of white matter hyperintensity (WMH) in patients with Parkinson's disease (PD) on clinical motor and cognitive impairment. Methods: A total of 125 patients with primary PD were enrolled. The clinical data of motor function and cognitive function were evaluated, and the imaging data (T1, T2 and FLAIR sequences) were collected. According to the score of Fazekas scale, the patients were divided into three groups, including 73 mild WMH group, 32 moderate WMH group and 20 severe WMH group. Spearman correlation analysis and ordered multiple Logistic regression analysis were used to determine the correlation between WMH and motor and cognitive impairment in PD patients, as well as the influencing factors of WMH. Results: Older PD patients with hypertension and diabetes had more severe WMH, and with the increase of WMH, the movement disorders and cognitive disorders of the patients gradually increased. WMH load is closely related to the severity of motor and cognitive impairment in PD patients, especially the impairment of specific cognitive domains (visuospatial, language and executive function). Hypertension, diabetes, and poor executive function are independent risk factors for WMH severity in PD patients. Conclusion: The increase of WMH severity is associated with motor and cognitive impairment in PD patients.

To understand the addictive characteristics of non-suicidal self-injury (NSSI) behavior and its related influencing factors in adolescent patients with depressive disorders. Methods: A total of 152 adolescent patients diagnosed with depressive disorders at our hospital’s psychiatric outpatient clinic were included, divided into an NSSI group (85 cases) and a non-NSSI group (67 cases) based on the presence or absence of NSSI behavior. The Hamilton Depression Rating Scale (HAMD), Adolescent Self-Harm Inventory (ASH), Ottawa Self-Injury Inventory (OSI), Adolescent Life Events Scale (ASLEC), Toronto Alexithymia Scale (TAS), Childhood Borderline Personality Features Scale (BPFS-C), and Family APGAR were administered to assess and analyze the patients. Results: The NSSI group scored higher on HAMD, ASLEC, TAS, and BPFS-C, while scoring lower on the Family APGAR compared to the non-NSSI group (P<0.05). In the NSSI group, 55.29% of patients exhibited addictive NSSI behavior, and the OSI addiction score was correlated with HAMD, severity of NSSI, ASLEC, BPFS-C, and Family APGAR scores (P<0.01); depression severity, NSSI severity, adverse life events, borderline personality traits, and family dysfunction were found to be influencing factors for NSSI behavior addiction (P<0.05). Conclusion: Adolescent patients with depressive disorders exhibit certain addictive tendencies in their NSSI behavior. Severe depression, severe NSSI, borderline personality traits, family dysfunction, and adverse life events may be risk factors leading to NSSI behavior addiction. Adolescent patients with depressive disorders accompanied by NSSI behavior are more likely to have borderline personality traits, experience adverse life events, family dysfunction, and alexithymia.

Multiple sclerosis (MS) is an inflammatory demyelinating disease of the central nervous system. The disability and cognitive impairment caused by MS cause a great economic burden on patients and society. Early prediction and understanding of the development direction of the disease are helpful to improve the treatment plan. With the development of imaging technology, the understanding of the changes of the central nervous system caused by MS is more comprehensive and detailed. More and more studies have focused on observing the atrophy of various parts of the brain through imaging technology, so as to explain its correlation with the accumulation of disability and cognitive impairment. This article reviews the relationship between brain atrophy and disability and cognitive impairment from five parts: cerebral cortex, thalamus, basal ganglia area, cerebellum, and brain stem.

To explore the efficacy and safety of Calculus Bovis Sativus (CBS) in treating neurological diseases through a Meta-analysis. Methods: Electronic databases such as PubMed, Web of science, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang, VIP, and China Biology Medicine disc (CBMdisc) were searched for studies on CBS treatment of neurological diseases. The search period covered from the establishment of each database until December 4th, 2024. Studies were screened according to inclusion and exclusion criteria, relevant data were extracted, risk assessment was conducted using the bias risk assessment tool recommended by the Cochrane Systematic Review Handbook, and Meta-analysis was performed using RevMan 5.4 statistical software. Results: A total of five randomized controlled trials involving 414 patients were included. The Meta-analysis results showed that compared to the control group, the combination of conventional therapy and CBS significantly reduced tumor necrosis factor-α (TNF-α) levels [SMD=－1.40, 95% CI (－1.78, －1.01), P<0.001], significantly reduced interleukin-6 (IL-6) levels [SMD=－1.82, 95% CI (－2.23, －1.41), P<0.001], improved Glasgow coma scale (GCS) scores [SMD= 0.44, 95% CI (0.21, 0.68), P=0.002], and decreased National Institutes of Health Stroke Scale (NIHSS) scores [SMD=－ 0.49, 95% CI (－ 0.92, － 0.07), P=0.02]. Conclusion: CBS is effective and safe in treating stroke-related neurological diseases, but more high-quality research is needed for further support.

To analyze the correlation between oxidative stress response and cognitive function in patients with vascular Parkinson's syndrome (VPS). Methods: A total of 64 patients with VPS were enrolled in the VPS group, 64 patients with Parkinson's disease (PD) admitted to the hospital during the same period were selected as the PD group, and 64 healthy individuals undergoing physical examinations during the same period were included as the healthy control group. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) scale. Oxidative stress indicators [superoxide dismutase (SOD) and malonaldehyde (MDA)] and MoCA scores were measured and compared among the three groups. The VPS group was further divided into an early subgroup (29 patients) and a middle-to-late subgroup (35 patients) based on Hoehn-Yahr (H-Y) staging, and into a cognitive impairment subgroup (44 patients) and a non-cognitive impairment subgroup (20 patients) based on MoCA scores. Pearson correlation analysis was conducted to assess the relationship between serum SOD, MDA, and MoCA scores. Receiver Operating Characteristic (ROC) curves were plotted to analyze the predictive value of SOD and MDA for cognitive impairment. Univariate and multivariate Logistic regression analyses were performed to identify risk factors for cognitive impairment in VPS patients. Results: The VPS group had higher serum MDA levels than the PD and healthy control groups (P<0.05), and lower serum SOD levels and MoCA scores than the PD and healthy control groups (P<0.05). The middle-to-late subgroup had higher serum MDA levels than the early subgroup (P<0.05) and lower serum SOD levels and MoCA scores than the early subgroup (P<0.05). The cognitive impairment subgroup had higher serum MDA levels than the non-cognitive impairment subgroup (P<0.05) and lower serum SOD levels than the non-cognitive impairment subgroup (P<0.05). Pearson correlation analysis showed a significant positive correlation between serum SOD levels and MoCA scores (r=0.398, P<0.001) and a significant negative correlation between serum MDA levels and MoCA scores (r=－0.432, P<0.001). The area under the ROC curve for combined detection of SOD and MDA in predicting cognitive impairment was 0.811 (95% CI: 0.727～0.954), with sensitivity (93.28%) and specificity (90.17%) higher than those of SOD (76.67%, 74.09%) and MDA (74.28%, 71.46%) alone (P<0.05). Age, hyperuricemia, serum homocysteine (Hcy) levels, cerebral infarction location, cerebral infarction size, microbleeds, SOD, and MDA were identified as risk factors for cognitive impairment in VPS patients (P<0.05). Conclusion: VPS patients exhibit abnormally high serum MDA levels and abnormally low serum SOD levels, which are associated with their cognitive function. Combined detection of MDA and SOD can improve the predictive accuracy for cognitive impairment in VPS patients.

Frailty is a clinical syndrome characterized by a decline in the body’s physiological system reserve capacity. Its incidence is rising exponentially, seriously affecting the quality of life and health of the elderly, and even elevating the risk of mortality. This paper reviews the latest research progress on the concept, risk factors, assessment tools, possible mechanisms, and prevention of frailty, and highlights the challenges and future directions in identifying, assessing, intervening, and monitoring frailty. This article aims to help clinicians initially understand the concept, assessment, and prevention of frailty, so that they can actively and comprehensively intervene in frailty from multiple aspects, delay its development as much as possible, avoid adverse outcomes, and improve the quality of life of the elderly.

To investigate the influencing factors of non-suicidal self-injury (NSSI) in patients with depressive disorder. Methods: Quantitative analysis and closed questionnaires were used to investigate outpatients and inpatients with depressive disorders. According to the evaluation results of the Patient Health Questionnaire-9 (PHQ-9), the 17-Item Hamilton Rating Scale for Depression (HAMD-17) and the 14-Item Hamilton Rating Scale for Anxiety (HAMD-14), the patients enrolled were divided into non-NSSI group and NSSI group, with 60 cases in each group. The general demographic information, depression and anxiety (HAMA score and HAMD score), presence or absence of suicidal idea, parental and peer attachment questionnaire (father-child trust, mother-child trust, father-child communication, mother-child communication, father-child alienation, and mother-child alienation) scores, and Experiences in Close Relationships Inventory (ECR) scores were compared between groups. The influencing factors of NSSI in patients with depressive disorder were analyzed based on the final results. Results: There were significant differences between the two groups in terms of HAMA score (t=20.256), HAMD score (t=16.854), suicidal idea (χ 2 =14.903), parental and peer attachment (t= 4.075, 6.542, 4.520, 6.941, 7.565, 8.593), and ECR attachment distribution (χ2 =5.546) (OR=4.875, 3.440, 2.508, 3.997, 2.374, 1.360, 3.445, P=0.001, 0.028, 0.035, 0.025, 0.031, 0.038, 0.029). Correlation analysis and Logistic regression analysis showed that HAMA score, HAMD score, suicidal idea, parent-child attachment, and adult attachment were main influencing factors of NSSI in patients with depressive disorder (P<0.05). Conclusion: Patients with depressive disorders have relatively severe NSSI. Depression and anxiety, suicidal idea, parent-child attachment and adult attachment are main influencing factors.

Isolated bilateral abducens nerve palsy is a condition characterized by simultaneous damage to both abducens nerves without involvement of other cranial nerves, with clinical manifestations primarily featuring double vision and limited outward movement of both eyes. Previous literature mainly consists of case reports, involving complex and varying etiologies and pathological mechanisms. This article focuses on isolated bilateral abducens nerve palsy, analyzing the causes, pathological mechanisms, and differential diagnosis based on domestic and international literature reports on bilateral abducens nerve palsy over the past decade. The etiologies are categorized into three major types: secondary, congenital, and idiopathic. Pathological mechanisms include excessive traction, direct compression, blood-neurotoxic substances, nutritional deficiencies, and vascular supply disorders. The aim is to provide insights for the etiological research and clinical diagnosis and treatment of bilateral abducens nerve palsy.

To systematically evaluate the effect of five different rehabilitation therapies-functional electrical stimulation, electromyographic biofeedback, ankle-foot orthosis, Kinesiotex and repetitive transcranial magnetic stimulation-on lower limb motor function in patients with post-stroke foot drop. Methods: A computerized search was conducted in EMbase, Web of Science, The Cochrane Library, CBM, PubMed, CNKI, WanFang Data and VIP databases for randomized controlled trials treating post-stroke foot drop with the five rehabilitation therapies, from inception to July 2022. Two researchers independently screened literature, extracted data, and assessed the risk of bias in the included studies. Network Meta-analysis was performed using STATA and ADDIS software. Results: A total of 40 randomized controlled trials involving 2749 patients were included. Meta-analysis results indicated that in terms of movement, balance and daily living ability, functional electrical stimulation, ankle-foot orthosis and electromyographic biofeedback were superior to conventional rehabilitation, and ankle-foot orthosis was the best. Conclusion: Ankle-foot orthosis have more advantages than the other four therapies in improving lower limb motor function, balance and daily living ability in stroke patients with foot drop. However, due to the limitations of the quantity and quality of the included literatures, the conclusions need to be further verified by more high-quality studies.

Alzheimer’s Disease (AD) is a neurodegenerative disorder of the central nervous system manifested by progressive cognitive decline and behavioral alterations. Research indicates that the overactivation of the complement system significantly contributes to the pathology of AD, and suppressing this overactivation offers novel clinical approaches for AD diagnosis and treatment. This paper will discuss the relationship and advancements in research between the complement system and AD progression, as well as outline the progress in complement-targeted treatments for AD.

To systematically evaluated the clinical efficacy of kinesio taping on swallowing function of patients with stroke. Methods: A computerized search was performed to identify the literature in English or Chinese published from 1973 to December 2021. The English databases included the Cochrane Library, Wiley, Web of Science, Embase, MEDLINE. The Chinese databases included CNKI, Chongqing VIP and Wanfang Data. After retrieving the studies that meet the criteria, we screened and included the literature, extracted data, evaluated quality, and assessed risks. The results of meta-analysis were conducted by Stata12.0 software. Results: A total of 9 studies (560 patients) were included. The results of meta-analysis showed that based on conventional rehabilitation program, kinesio taping led to superior increasement to stroke patients with dysphagia in cure rate (RR=2.27, 95% CI (1.57, 3.3), P<0.001], and helped to improve swallowing function [SMD=1.05, 95% CI (0.61, 1.49), P<0.001] and quality of life [SMD=1.2, 95% CI (0.85, 1.55), P<0.001] in stroke patients with dysphagia. Conclusion: Very low to low level evidence suggests that the use of kinesio tape on the basis of conventional rehabilitation therapy can improve swallowing function and quality of life in patients after stroke, with better clinical efficacy.

An ideal animal model of post-stroke dysphagia (PSD) can aid in deeply understanding its physiological and pathological processes, thus promoting the development of research on this disease. Different types of models exhibit diversity, allowing researchers to choose the appropriate animal model based on their research content and practical needs. Currently, common methods for creating animal models of PSD include photochemical induction, thread embolism, bilateral common carotid artery ligation, and type Ⅶ collagenase-induced right hemorrhage plus right hypoglossal nerve injury. This article provides an overview and comparison of the advantages and disadvantages of the above animal models in terms of experimental animal selection, theoretical basis, modeling methods, and model characteristics. Compared with the other three methods, the photochemical method has the characteristics of high survival rate and precise damage at specific sites, and it holds certain advantages in evaluating brain plasticity at the cellular and molecular levels.

目 的 ：观 察 和 探 讨 新 Bobath 治 疗 联 合 低 频 重 复 经 颅 磁 刺 激（repetitive transcranial magnetic stimulation，rTMS）对脑卒中偏瘫患者下肢运动功能的影响。方法：选取2019年9月至2020年6月西南医科 大学附属医院康复医学科收治的脑卒中患者40例，按随机表分成运动组和联合组各20例。运动组患者采 用新Bobath治疗进行训练，联合组患者在新Bobath治疗基础上加以低频rTMS治疗。在治疗前、治疗12周 后采用 Fugl-Meyer 评定法（Fugl-Meyer assessment，FMA）下肢运动功能量表、Berg 平衡量表（Berg balance scale，BBS）以及改良Barthel指数（modified Barthel index，MBI）评定2组患者偏瘫下肢运动功能，并且进行 组间比较。结果：治疗前2组患者FMA评分、BBS 评分和MBI评分比较差异均无统计学意义(均P＞0.05)； 治疗12周后2组患者FMA评分、BBS评分和MBI评分均较治疗前显著提高（均P＜0.01），并且联合组患者 FMA评分、BBS评分和MBI评分均高于运动组（均P＜0.05）。结论：与单纯新Bobath治疗比较，新Bobath治 疗联合低频rTMS能更有效改善脑卒中偏瘫患者下肢运动功能。

Frontotemporal dementia (FTD) is a common neurodegenerative disorder and an early-onset form of dementia, characterized by prominent psychiatric and behavioral abnormalities and cognitive impairment. Due to its unclear pathogenesis and marked heterogeneity, early diagnosis and treatment are currently challenging. In recent years, as technology has matured, research on FTD biofluid markers has become a hot topic, with many studies identifying potential marker molecules for application. This article summarizes recent related research in order to provide clinicians with an understanding of the progress in early diagnostic markers for FTD, to offer reference directions for subsequent basic research, and to present possible options for clinical application.

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.

To investigate the clinical features of newly-onset central nervous system (CNS) demyelinating disorders post-SARS-CoV-2 infection. Methods: A total of 57 patients with newly diagnosed CNS demyelinating diseases admitted to our department from May 2022 to May 2023 were studied. Among these, 37 individuals who contracted SARS-CoV-2 within a month preceding symptom onset constituted the infection group; meanwhile, 20 patients without prior SARS-CoV-2 exposure formed the control group. Clinical and radiological records of both groups were gathered for comparative assessment, followed by a year-long surveillance. Results: The median time span between SARS-CoV-2 infection and the manifestation of CNS demyelination in the infected group was 13 (7, 20) days. Disparities were observed in specific spinal manifestations and annual recurrence rates (ARR) between the groups; specifically, the infection group exhibited elevated frequencies of limb paralysis (22.1% vs 16.7%, P<0.05) and disturbances in bladder and bowel function (17.6% vs 5.6%, P<0.05) relative to controls (P<0.05), along with a reduced ARR [(0.00 ± 0.35) vs (0.00 ± 0.69), P<0.05]; conversely, no statistically significant disparities emerged in other clinical presentations, neurological evaluations, immunological markers, imaging characteristics, electrophysiological studies, ophthalmological tests, or short-term prognoses across the two groups (P>0.05). Conclusion: While an association exists between SARS-CoV-2 infection and the emergence of CNS demyelinating conditions, the causal link remains undetermined. Clinically, demyelinating patients with and without SARS-CoV-2 infection largely share similar profiles, save for select spinal symptoms and variations in ARR.

The pathological features of neurodegenerative diseases mainly include the accumulation and deposition of abnormally misfolded proteins or peptides. Autophagy can clear intracellular aggregated proteins and dysfunctional organelles, making it an important target for delaying the progression of neurodegenerative diseases. Impairments in the production or maturation process of autophagosomes can promote the development and progression of neurodegenerative diseases. A thorough understanding of the signal transduction pathways regulating autophagy is crucial for devising treatment strategies for related diseases. This paper mainly introduces the important role of autophagy in neurodegenerative diseases and its associated molecular mechanisms.

To explore the rehabilitation efficacy of Mirror Neuron System Based Therapy(MNST) instrument training combined with the Promotion of Communication Effectiveness Method (PACE) one-on-one speech rehabilitation model on post-acute phase stroke patients with non-fluent aphasia. Methods: Sixty patients with non-fluent aphasia after sub-acute phase stroke treated in our hospital’s department of rehabilitation medicine from March 2022 to June 2023 were randomly divided into PACE group, MNST group, and combined group, with 20 cases in each group. The MNST group received MNST treatment for 30 minutes, the PACE group received PACE treatment for 30 minutes, and the combined group received both MNST and PACE treatments for 15 minutes each; the treatment frequency and duration were once per day, five days per week, for four consecutive weeks. The Western Aphasia Battery (WAB) and Boston Diagnostic Aphasia Examination (BDAE) assessment results before and after four weeks of treatment were collected and compared among all patients. Results: One case dropped out from the PACE group. Before treatment, there were no significant differences in WAB scores or BDAE grading among the three groups (P>0.05). After four weeks of treatment, intra-group comparison showed that spontaneous speech, auditory comprehension, repetition, naming, and AQ in the WAB significantly improved in all three groups compared to pre-treatment (P<0.01); inter-group comparison revealed: (1) Compared to the PACE group, the combined group had better scores in spontaneous speech, repetition, naming, and AQ (all P<0.05); (2) Compared to the MNST group, the combined group had better scores in repetition, naming, and AQ (all P<0.05); (3) The MNST group had higher repetition scores than the PACE group (P<0.05); other inter-group scores showed no significant differences (P>0.05). After four weeks of treatment, the BDAE grading improved in all three groups compared to pre-treatment (P<0.05). The combined group had a better BDAE grading than both the PACE and MNST groups (P< 0.05), while there was no significant difference between the PACE and MNST groups (P>0.05). Conclusion: For patients with non-fluent aphasia after sub-acute phase stroke, MNST machine training is more effective than PACE-based one-on-one manual training in improving repetition ability. The combination of the two treatments has a better effect than either MNST alone or PACE alone.

About 15% to 20% of patients with myasthenia gravis (MG) develop a myasthenic crisis, which involves the respiratory muscles, leading to weakness in coughing, difficulty breathing, and an inability to maintain normal ventilation. Early assessment of respiratory muscle function in MG patients helps provide a basis for judging the risk of developing a myasthenic crisis. The diaphragm is the main respiratory muscle, and examining diaphragmatic function is beneficial for early evaluation of respiratory function in MG patients. However, previous literature on diaphragmatic function research lacks effective integration. This article will summarize and review factors affecting MG antibodies, clinical classifications, mechanisms of diaphragmatic dysfunction occurrence, manifestations, examinations, diagnostic methods, etc., providing references for in-depth research and clinical applications of respiratory function in MG patients.

To explore the central nervous control mechanism of voluntary respiratory movements by detecting the cortical activation patterns under different respiratory tasks. Methods: Seven healthy males and 16 females were recruited. Two motor tasks were set up: inhale-hold (isometric contraction of expiratory muscles) and pursed-lip expiratory (isotonic contraction of expiratory muscles). Functional near-infrared spectroscopy (fNIRS) was used to measure changes in oxyhemoglobin concentration (HbO2) over time and spatial distribution differences between the two tasks. Results: During the inhale-hold task, significant activation was observed in bilateral primary motor cortex (BA4), bilateral premotor/supplementary motor area (BA6), bilateral dorsolateral prefrontal cortex (BA46), bilateral frontal pole and orbitofrontal regions (BA10, BA11), bilateral primary visual cortex (BA17), right primary somatosensory cortex (BA1, BA2, BA3), right inferior frontal gyrus anterior part (BA47), and left visual association cortex (BA18). In the pursed-lip expiration task, significant cortical activation was seen in bilateral frontal pole (BA10) and orbitofrontal areas (BA11). Comparing the two tasks, holding breath resulted in stronger activation than pursed-lip expiration in the right premotor area/supplementary motor area (BA6). Conclusion: Voluntary inspiratory actions followed by holding breath or pursed-lip expiration are characterized by frontally dominant sensorimotor cortical activity. There are central control differences between isometric and concentric contractions of the expiratory muscles.

To evaluate the clinical efficacy of 3D printed guide plate navigation technology in the application of percutaneous radiofrequency thermocoagulation (PRT) for the treatment of trigeminal neuralgia. Methods: A total of 35 patients with primary trigeminal neuralgia and indications for PRT treated in our hospital were selected as research subjects and randomly divided into a control group (15 cases) and an observation group (20 cases). The control group underwent PRT guided by digital subtraction angiography (DSA), while the observation group used 3D printed guide plate navigation-assisted PRT. The two groups were compared in terms of the success rate of one-time puncture, the time required for percutaneous puncture to reach the target, operation duration, number of DSA scans, intraoperative discomfort in patients, Numerical Rating Scale (NRS) scores immediately after surgery, at 3 days, and at 30 days post-surgery, therapeutic effect evaluation at 1, 3, and 6 months after surgery, surgical satisfaction, adverse reactions, and the incidence of complications. Results: The success rate of one-time puncture in the observation group was higher than that in the control group (P<0.01); the observation group had lower times for puncture to reach the target, operation duration, number of DSA scans, intraoperative discomfort, adverse reactions after surgery, and NRS scores immediately after surgery and at 3 days post-surgery than the control group (P<0.01); the incidence of adverse reactions after surgery in the observation group was significantly lower than that in the control group (P<0.01). There was no statistically significant difference between the two groups in NRS scores at 1 month after surgery, therapeutic effect evaluation at 1, 3, and 6 months after surgery, satisfaction, and secondary surgeries (P>0.05). Conclusion: 3D printed guide plate navigation technology-assisted PRT helps increase the efficiency and safety of the surgery for trigeminal neuralgia, reduce pain and adverse reactions, and has a good prospect for clinical application.

目的：探讨经颅多普勒（TCD）在头臂动脉型大动脉炎中的诊断意义。方法：通过TCD对1例经DSA 确诊的头臂动脉型大动脉炎患者的脑血流动力学特点进行分析，结合既往文献回顾性分析。结果：头臂动 脉型大动脉炎主要累及主动脉弓及其主要分支，以头臂干、颈总动脉、锁骨下动脉为主。本例头臂动脉型 大动脉炎的TCD特点主要表现为：双侧颅外动脉及颅内动脉的血流搏动指数（PI值）明显减低，呈类似静脉 的频谱改变。而颅内动脉的血流速度受患者新生血管代偿供血的影响减低不明显。结论：TCD对于头臂 动脉型大动脉炎具有较高的筛查和诊断价值。

目的：探讨基于精准护理理念的时点匹配预防性镇痛在学龄期肱骨髁上骨折围手术期中的应用效 果。方法：纳入2023年1月至2023年11月我院收治的学龄期肱骨髁上骨折手术患儿108例，随机分为对照 组和观察组，各54例。对照组采用常规多模式疼痛管理方案，观察组在此基础上采用时点匹配的预防性镇 痛方案。于不同时间点（入院时、术后6 h、术后当天入睡前、术后次日9 am、2 pm和8 pm功能锻炼时），采用 Wong-Baker面部表情疼痛评估法评估患儿疼痛程度；于不同时间点（入院时、术后24 h、出院时）采用恐动症 量表评估患儿恐动症水平；于术后3个月，评价标准对患儿肘关节活动度。结果：不同时间点观察组的疼痛 评分和恐动症评分均显著低于对照组（P＜0.01）；术后3个月，肘关节活动度优于对照组（P＜0.01）。结论： 实施基于精准护理的时点匹配预防性镇痛，有助于缓解学龄期肱骨髁上骨折患儿的疼痛水平和恐动症水 平，提高患儿的功能锻炼依从性，从而改善关节功能。

To investigate the methodologies and focal points of standardized clinical training programs for brain death diagnosis in secondary general hospitals, ensuring the quality of such training. Methods: The Second Affiliated Hospital of Hainan Medical University served as a pilot site for this standardized training initiative, offering a four-phase course to 79 trainees from 33 secondary general hospitals spanning 17 counties and cities within the province. The training comprised three stages: pre-training baseline assessment, establishment of training goals and adaptation of key training elements, and post-training feedback collection. An analysis and summary of the training protocol, achievements, and satisfaction levels were conducted. Results: Post-training, all 79 trainees achieved the qualifying criteria for brain death diagnosis training (with a correct response rate exceeding 70%), yielding a 100% pass rate. Satisfaction rates with the training schedule and format stood at 88.7%, while the content and delivery of instruction received satisfaction ratings of 93.6% and 91.9% respectively; the overall evaluation of the training garnered a satisfaction rate of 93.6%. With ongoing refinement and optimization of the training scheme, there was a statistically significant incremental improvement in assessment scores across the phases (F=8.89, P<0.01). Pairwise comparisons revealed that scores in phases 2, 3, and 4 were significantly higher than in phase 1 (P<0.05), with phase 4 also surpassing phase 2 (P<0.05). Con? clusion: The pilot training program of Hainan Province for standardized clinical determination of brain death in secondary general hospitals exhibited superior training quality, thereby securing the proficient execution of brain death determinations. This model can inform the broad implementation of standardized clinical training for brain death diagnosis in secondary general hospitals across the nation.

To explore new targets for the prevention and treatment of painful diabetic peripheral neuropathy (DPNPAIN) by comparing and analyzing the clinical and gut microbiota characteristics of patients with DPNPAIN, non-painful diabetic peripheral neuropathy (DPN), and diabetes patients without peripheral nerve injury (NDPN). Methods: Diabetes patients who visited the Department of Neurology or Endocrinology at Beijing Friendship Hospital from January 2021 to December 2022 were screened according to the inclusion and exclusion criteria. They were divided into three groups through medical history inquiry, physical examination, and electrophysiological examination: DPNPAIN group, DPN group, and NDPN group. The basic clinical data of the enrolled patients were analyzed, and stool samples were collected for microbial analysis. Results: A total of 112 patients were enrolled in this study, with 37 cases in the NDPN group, 41 cases in the DPN group, and 34 cases in the DPNPAIN group. Clinical data analysis found that age, eosinophil count, platelet count, high-density lipoprotein, and glycosylated hemoglobin may be related to the occurrence of DPNPAIN. Gut microbiota analysis found that c_Negativicutes and its branching populations were dominant species in the feces of DPNPAIN group patients, which may be biological markers of this disease. Conclusion: This study observed the clinical and gut microbiota characteristics of DPNPAIN through group comparison, speculating that improving the gut microbiota and reducing the content of c_Negativicutes and its branching species could become a new target for the treatment of this disease.

To investigate the safety and effectiveness of mechanical thrombectomy in the treatment of distal medium posterior cerebral artery (PCA) occlusion. Methods: A total of 26 patients with occlusion in the P2 and P3 segments of the PCA who underwent endovascular interventional therapy at Wuhan First Hospital from September 2017 to January 2023 were included. A retrospective analysis was conducted on patients' general characteristics, vascular risk factors, National Institutes of Health Stroke Scale (NIHSS) scores at admission, posterior circulation ASPECTS scores at admission, preoperative intravenous thrombolysis, occlusion sites, time from onset to puncture, time from puncture to revascularization, postoperative modified Thrombolysis In Cerebral Infarction (mTICI) grades, NIHSS scores at discharge, modified Rankin Scale (mRS) scores at 90-day follow-up, and incidence of intracranial hemorrhage and mortality within 90 days postoperatively. Results: Among the 26 patients, 17 (65.4% ) achieved immediate complete revascularization (mTICI grade 3) postoperatively, and 23 (88.5% ) achieved successful revascularization (mTICI grade ≥ 2b) immediately after surgery. Four patients (15.4% ) died within 90 days postoperatively, one patient (3.9% ) experienced symptomatic cerebral hemorrhage postoperatively, and 16 patients (61.5%) had mRS scores ≤ 2 at the 90-day follow-up. Conclusion: Mechanical thrombectomy demonstrates acceptable safety and effectiveness in the treatment of acute PCA occlusion stroke.

To explore in vitro the effect and mechanism of dimethyl fumarate (DMF) on modulating microglial polarization under chronic hypoperfusion-induced white matter injury (WMI). Methods: An in vitro model of low perfusion white matter demyelination was established by glucose-oxygen deprivation and stimulation with exogenous myelin debris, combined with DMF intervention in microglial cells. Real-time quantitative PCR, transcriptome sequencing, and immunofluorescence staining were employed to investigate the inflammatory phenotype transformation of microglia. Results: (1) Compared to the control group, the expression of pro-inflammatory genes interleukin (IL)-6, IL-1β and tumor necrosis factor (TNF)-α significantly decreased after DMF administration (P<0.05); (2) Transcriptome analysis revealed downregulation of neuroinflammation-related pathways and upregulation of autophagy-related pathways in microglia after DMF treatment; (3) Compared to the control group, the expression of autophagy-related genes and proteins was significantly increased in the DMF intervention group (P<0.05). Conclusion: DMF may regulate the transformation of microglia from a pro-inflammatory to an anti-inflammatory phenotype by activating the autophagy pathway.