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 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.

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.

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.

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 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.

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.

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.

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。

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.

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。

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.

Vestibular migraine (VM) is a common neurological disorder characterized by recurrent vertigo and migraine symptoms, which are usually associated with dysfunction of the vestibular system. Although there are certain clinical diagnostic criteria for VM, its specific pathogenesis is still not fully clarified. Recent studies have found that the pathogenesis of VM is closely related to the changes in brain functional networks. It not only involves abnormalities in the vestibular system but is also closely related to the dysfunction of multiple brain networks such as pain processing, sensory integration, and attention regulation. Functional magnetic resonance imaging (fMRI), as a non-invasive brain functional imaging technique, has become an important tool for revealing the neural mechanism of VM. This review will retrospectively analyze the application progress of fMRI in revealing the neural mechanism of VM, and also look forward to the future research directions.

The incidence of stroke is high, and post-stroke aphasia (PSA) is one of the common sequelae. Patients with PSA mainly have different degrees of impairment in speech comprehension and expression, resulting in significant decline in communication ability, which seriously affects their daily interactions and quality of life, and may even hinder the recovery of other functions. Aphasia screening is the first step in treatment. A comprehensive screening system is conducive to timely and accurate screening and intervention for patients, promoting their rehabilitation. This article summarizes and reviews the screening scales for PSA, with the aim of promoting the standardization and clinical application of aphasia screening scales in China.

Respiratory muscle dysfunction is a common complication of stroke, which can lead to decreased strength and atrophy of the respiratory muscles, increased incidence of pulmonary infection, and increased risk of non-vascular death in patients. This paper reviews the mechanisms, main assessment methods, and rehabilitation approaches for respiratory muscle dysfunction in stroke patients, in order to provide references for clinical rehabilitation and research on respiratory muscle dysfunction in stroke patients. The analysis shows that stroke can cause respiratory muscle dysfunction due to primary lesions in the central nervous system, secondary neuromuscular injury, and iatrogenic injury; commonly used clinical assessment methods include ultrasound, peak cough flow, pulmonary ventilation function tests, respiratory mechanics indexes measurement, electrophysiological examination, etc. Acoustic analysis can be used as one of the future visualization assessment and guidance for respiratory rehabilitation. Commonly used clinical rehabilitation approaches include external diaphragm pacing, neuromuscular electrical stimulation, proprioceptive neuromuscular facilitation, airway management, respiratory muscle training, etc. The electric standing bed can be used as one of the means to prevent infection and improve respiratory muscle function in critically ill patients.

Autophagy is a self-degradation process of cells that plays an important role in clearing misfolded or aggregated proteins, removing damaged organelles (such as mitochondria, endoplasmic reticulum, and peroxisomes), and eliminating intracellular pathogens. This article reviews and analyzes the relationship between autophagy and neurodegenerative diseases (Alzheimer’s disease, Parkinson’s disease, Huntington’s disease, and amyotrophic lateral sclerosis) by reviewing relevant literature, aiming to summarize the role of autophagy in the pathogenesis and treatment of neurodegenerative diseases, providing new ideas for the treatment of neurodegenerative disorders.

The discovery of meningeal lymphatic vessels has reshaped our understanding of fluid exchange, waste clearance, and immune privilege in the central nervous system. Currently, a large number of studies have elucidated the anatomical structure and function of meningeal lymphatic vessels, focusing on their potential roles in the pathophysiology of various neurological diseases. This paper reviews the anatomical structure, physiological function, relationship with the glymphatic system, and research progress in multiple neurological diseases such as Alzheimer's disease, multiple sclerosis, and brain tumors. This review aims to enhance the understanding of meningeal lymphatic vessels and provide a theoretical basis for the development of preventive and targeted therapies for central nervous system diseases through this pathway.

To investigate whether behavioral differences exist between female and male wild-type C57 mice in conditioned fear extinction experiments, providing a reference for the equal use of both sexes in fear conditioning and extinction-related studies. Methods: Fear levels, freezing episodes, freezing level per episode, and locomotor activity during conditioned stimulus presentation were measured through auditory-cued fear conditioning, extinction, and retrieval experiments. Behavioral differences between sexes were compared. Results: In fear conditioning and extinction experiments, no significant differences were observed between female and male mice across the four behavioral metrics. During the fear extinction retrieval test, female mice exhibited a higher freezing level per episode upon the first conditioned stimulus presentation, while no significant differences were found in other metrics. Conclusion: Wild-type C57 mice of both sexes show no behavioral differences in fear conditioning and extinction experiments, supporting their equal use in such studies. However, potential sex-based differences in the ability to maintain extinction memory suggest caution when investigating fear memory retention.

Schizophrenia is a common and severe mental disorder with unknown mechanisms. In recent years, a large number of studies on the correlation between autophagy and schizophrenia have suggested that autophagy may be part of the pathophysiological process of schizophrenia. Moreover, treatments such as medication, physics, and psychotherapy may alleviate psychotic symptoms by regulating autophagy, making autophagy regulation a new direction for the treatment of schizophrenia. This paper reviews the relationship between autophagy and the pathogenesis of schizophrenia, as well as advancements in autophagy-related treatments, providing new ideas for the diagnosis and treatment exploration of schizophrenia.

To propose a convenient and highly reproducible method for repeat collection of rat cerebrospinal fluid (CSF) samples. Methods: Twenty-five SD rats were randomly divided into control group and experimental group. After anesthesia, the rats in the experimental group were positioned with their heads at an angle of 45° to 90° relative to their bodies. A needle was inserted at the center point between the occipital protuberance and the first cervical vertebra, with the needle tip directed toward the head and inserted slowly parallel to the curve of the rat's head, reaching a depth of approximately 5 mm. CSF was then slowly aspirated, and the sample volume was recorded. Comprehensive assessments were conducted by observing changes in rat body weight and Bederson scores, as well as through Evans blue staining and hematoxylin and eosin (HE) staining, and by measuring interleukin-6 (IL-6) levels in the CSF. Results: In the experimental group, successful first-time sampling was achieved in 14 rats (70.0% ) with a sample volume of (93.30±13.33) μL. Successful consecutive second-time sampling was achieved in 10 rats (50.0%) with a sample volume of (93.00± 19.86) μL. Successful consecutive third-time sampling was achieved in 8 rats (40.0%) with a sample volume of (89.75±7.72) μL. Rats in the group with successful consecutive three-time sampling showed an increase in body weight of (47.6±1.51) g, which was not statistically significant compared to the control group (P>0.05). The Bederson scores of the rats in the experimental group were all 0, indicating no significant neurological deficits. No obvious Evans blue staining or morphological changes in brain tissue were observed. The IL-6 levels in the CSF samples collected during the three samplings were (28.98±4.70) pg/mL, (29.37±6.06) pg/mL, and (30.06± 5.47) pg/mL, respectively, with no statistically significant differences among the three collections (P>0.05). However, an increase in IL-6 levels was observed in CSF samples successfully collected after an initial failed attempt (P<0.05). Conclusion: The method of percutaneous cerebellomedullary cistern puncture for CSF collection requires simple equipment, has a short operating time, can be performed by a single individual, and causes minimal trauma to the animals.

Vascular dementia (VD) is the second leading cause of dementia after Alzheimer's disease, accounting for 15% of dementia cases in China. Currently, clinical treatment for VD is merely symptomatic drug therapy, which cannot effectively prevent and treat VD. The endoplasmic reticulum (ER) and mitochondria are important organelles within cells, and their interaction plays a crucial role in maintaining cellular homeostasis. Recent studies have shown that ER-mitochondrial interaction is one of the significant pathophysiological factors in the development of VD, but the specific mechanisms remain unclear. Studying the pathogenic mechanisms of VD and exploring potential strategies targeting ER-mitochondrial interaction for VD treatment has important clinical significance. This article will review the molecular mechanisms of ER-mitochondrial interaction, the possible pathogenesis of VD, and the association between the two.

To explore the clinical characteristics of cerebral infarction caused by paramedian pontine arteries (PPA) branch atheromatous disease (BAD) - PPA-BAD. Methods: A retrospective analysis was conducted on 221 patients diagnosed with PPA-BAD in the Department of Neurology, Civil Aviation General Hospital from 2018 to 2024. According to the presence or absence of progressive motor deficits, patients were divided into a progressive group (140 cases) and a control group (81 cases); based on prognosis, they were classified into a good prognosis group (163 cases) and a poor prognosis group (58 cases); depending on whether they received recombinant tissue plasminogen activator (rt-PA) thrombolytic therapy, they were divided into a treatment group (14 cases) and a control group (207 cases); for patients in the progressive group, based on whether tirofiban was used, they were divided into a tirofiban treatment group (42 cases) and a control group (98 cases). Demographic, clinical, and imaging data of each group were compared, and the effects of rt-PA intravenous thrombolysis and tirofiban treatment were explored. Results: (1) 140 cases (63.3% ) progressed after 6 hours of onset, indicating that PPA-BAD tends to easily progress and worsen; the proportion of patients with hyperlipidemia and those presenting with hemiplegia symptoms was higher in the progressive group, and the NIHSS scores at onset, peak, and discharge were higher (all P<0.05); the prognosis of the progressive group was worse than that of the control group (P<0.05). (2) Logistic multivariate analysis indicated that advanced age, history of old cerebral infarction, occurrence of progressive motor deficits, and large infarct size suggested a poor prognosis (all P<0.05); clinical manifestations accompanied by dizziness and ataxia tended to show a trend of good prognosis (P<0.05). (3) rt-PA intravenous thrombolysis and tirofiban were safe; there was no statistically significant difference in prognosis between the medication group and the control group (P>0.05). Conclusion: Patients with PPA-BAD are prone to developing progressive motor deficits; factors such as advanced age, history of old cerebral infarction, occurrence of progressive motor deficits, and large infarct size can lead to poor prognosis; currently, there is a lack of effective clinical predictive indicators, necessitating comprehensive individualized treatment; the application of rt-PA intravenous thrombolysis and tirofiban is recommended to improve therapeutic efficacy.

Acute unilateral peripheral vestibular dysfunction (AUPVD) has a high incidence among dizziness disorders, and can cause symptoms such as spontaneous nystagmus and postural imbalance, severely affecting the life quality of patients. Researches have shown that the vestibular compensation mechanism based on the neural circuits established between the vestibular nuclear complex and the cerebellum, cerebral cortex, and other brainstem nuclei provides a theoretical basis for vestibular rehabilitation therapy. Further exploration of the role and related technologies of different neural circuits in vestibular compensation is of great significance. Based on this, this article reviews the recent advances in the vestibular compensation-related circuits and technologies of AUPVD, in order to provide ideas for the research on vestibular compensation mechanisms.

Aphasia refers to the impairment of brain tissues related to language functions, leading to a decline in patients’ability to understand and express communicative symbol systems, as well as a reduction in the cognitive processes and functions that underlie language. Aphasia has been recognized as one of the functional disorders that severely affect patients’daily communication. Consequently, the assessment and treatment of aphasia have garnered increasing attention. Although there are numerous types of aphasia assessment scales, there remains a significant gap in tools specifically designed for minority languages, particularly for Tibetan aphasia. This article reviews the existing aphasia assessment scales applicable to Chinese and other minority languages, with the aim of developing an assessment scale suitable for the Tibetan population.

To investigate whether general anesthesia exposure during infancy (0～2 years old) affects attention in school-aged children. Methods: School-aged children who underwent general anesthesia during infancy (0～2 years old) between June 2009 and December 2013 at Nanjing Children's Hospital and were currently in primary school were selected as the exposed group (n=203). Healthy school-aged children without general anesthesia exposure were matched as the control group (n=208). The children underwent standardized attention tests and parent questionnaires. The exposed group was further subdivided into different subgroups based on the age of first exposure, duration of exposure, and number of exposures. The primary assessment tools were the Integrated Visual and Auditory Continuous Performance Test (IVA-CPT) and the Chinese version of Sw anson Nolan and Pelham, Version Scale-parent form（SNAP- Ⅳ）rating scale. Results: Auditory attention quotient was significantly correlated with gestational age at birth, singleton birth, number of exposures, age at first exposure, and duration of first anesthesia. Attention deficit and visual persistence quotient were significantly correlated with gestational age at birth, number of exposures, age at first exposure, and duration of first anesthesia. Visual sensory/motor quotient was significantly correlated with singleton birth, number of exposures, age at first exposure, and duration of first anesthesia. Auditory attention quotient was also significantly correlated with gestational age at birth, singleton birth, number of exposures, age at first exposure, and duration of first anesthesia. Conclusion: General anesthesia exposure during infancy (0～2 years old) has a certain impact on the development of attention in school-aged children, with multiple exposures being a prominent factor.

Alzheimer's disease (AD), commonly observed in the elderly, manifests clinically with symptoms such as memory decline and neuropsychiatric abnormalities. The pathogenesis of AD remains unclear to date, as the various existing hypotheses fail to fully account for all the disease characteristics of AD. Microglia, specialized macrophages in brain tissue, monitor the health of surrounding neurons and glial cells, exhibiting both neuroprotective and neurotoxic effects. Recent in-depth research on AD has revealed that microglia participate in the pathogenesis of AD through the triggering receptor expressed on myeloid cells 2 (TREM2). Loss of TREM2 function exacerbates the progression of AD. This article reviews the role of TREM2 and its mutants in mediating microglial functional alterations during the occurrence and development of AD.

The importance of the cholinergic system in the central nervous system lies in its regulatory role in cognitive functions, particularly in higher cognitive processes such as attention, memory, and learning. Cholinergic projection neurons from the basal forebrain regulate the activity of brain regions such as the hippocampus and prefrontal cortex through the release of acetylcholine. Research has shown that dysfunction of the cholinergic system is closely associated with various neurodegenerative diseases. In these diseases, degeneration of basal forebrain cholinergic neurons and the dysregulation of acetylcholine synthesis and transport are considered key contributors to cognitive impairments. Recent therapeutic strategies based on the cholinergic system for neurodegenerative diseases have shown certain therapeutic effects. Therefore, this paper primarily explores the impact of cholinergic system dysfunction on the development and progression of neurodegenerative diseases, aiming to deepen the understanding of the mechanisms underlying cholinergic system function and to provide more precise therapeutic approaches for neurodegenerative disorders.

Acute ischemic stroke (AIS) ranks as the leading cause of disability and mortality among Chinese residents, posing severe challenges to societal economic development and public health. Mechanical thrombectomy, as a rapidly evolving treatment method in recent years, has gained global recognition for its efficacy. This article summarizes three major aspects: recent research on select indications within mechanical thrombectomy, comparisons of effectiveness and safety between direct thrombectomy and bridging therapy, and failures in mechanical thrombectomy due to anatomical access challenges.

The vestibular system is an important sensory system within the human body, primarily responsible for maintaining balance and posture control. When vestibular function is impaired, a phenomenon called vestibular compensation occurs immediately, which is a process in which the central nervous system maintains the body's balance through adaptive regulation and compensatory mechanisms. This article reviews the process, mechanism, intervention strategies, evaluation, and measurement of vestibular compensation, in order to provide reference for future clinical treatment methods and research.

The vestibular system not only plays a role in maintaining body balance and orientation but may also affect sleep quality and duration. Sleep, in turn, may be related to the effective repair of vestibular nerves, and vestibular-related structures or functions can change in cases of sleep disorders. The interaction between the vestibular system and sleep has increasingly attracted attention. In recent years, scholars at home and abroad have conducted research on the mutual influence and related mechanisms between the vestibular system and sleep, achieving certain progress. This article reviews the recent research progress on the interaction and mechanisms between vestibular disorders and sleep disorders, aiming to provide better guidance for the diagnosis, treatment, and effectiveness evaluation when vestibular system diseases coexist with sleep disorders.

Microglia are very important immune cells, which are widely distributed in the central nervous system. They continuously monitor and sense the surrounding microenvironment, balancing the body's immune response by releasing various cellular inflammatory factors on the one hand, and regulating neural network function through phagocytosis of synapses and cells on the other. Dysfunction of microglia is a primary mechanism involved in the onset or exacerbation of neurodegenerative diseases, thus restoring microglial function may represent a potential therapeutic modality. CD22, an important member of the sialic acid-binding immunoglobulin-like lectin family, is typically expressed on the surface of B cells and serves an immunoinhibitory role. Recently, CD22 has been shown to improve cognitive function in aged mice through microglia, a discovery that holds promise for CD22 to become a novel target in the treatment of neurodegenerative diseases.

To investigate the impact of oral antiplatelet medication administration prior to onset on the efficacy and safety of rt-PA intravenous thrombolysis in patients with acute ischemic stroke (AIS). Methods: A retrospective analysis was conducted on 209 AIS patients who underwent rt-PA intravenous thrombolysis at Puren Hospital Affiliated to Wuhan University of Science and Technology between January 2020 and January 2023. Based on whether the patients had taken oral antiplatelet medication within 24 hours before onset, they were divided into two groups: the antiplatelet group (53 patients who were taking antiplatelet medication before thrombolysis) and the non-antiplatelet group (156 patients who did not take antiplatelet medication). The National Institutes of Health Stroke Scale (NIHSS) was used to assess the short-term efficacy before thrombolysis, at 24 hours post-thrombolysis, and at 7 days post-thrombolysis. The modified Rankin Scale (mRS) at 90 days post-thrombolysis was used to evaluate long-term prognosis. The incidence of bleeding at various sites and mortality rates were recorded to assess treatment safety. Results: There were no statistically significant differences in baseline characteristics between the two groups (P>0.05). In the antiplatelet group, the good prognosis rates at 24 hours and 7 days post-thrombolysis were 49.1% (26/53) and 75.5% (40/53), respectively. In the non-antiplatelet group, the corresponding rates were 41.7% (65/156) and 72.4% (113/156). The excellent prognosis rate at 90 days was 54.7% (29/53) and the good prognosis rate was 75.5% (40/53) in the antiplatelet group, compared to 59.0% (92/156) and 80.8% (126/156) in the non-antiplatelet group. There were no statistically significant differences in short-term efficacy and long-term prognosis between the two groups after thrombolysis (P>0.05). The incidence of bleeding was 15.1% in the antiplatelet group and 11.5% in the non-antiplatelet group, while the mortality rates were 5.7% and 1.9%, respectively. There were no statistically significant differences in bleeding incidence and mortality between the two groups (P>0.05). Multivariate Logistic regression analysis showed that the NIHSS score before thrombolysis was a risk factor for long-term prognosis in AIS patients (OR=1.293, 95% CI 1.181～1.415, P<0.001). History of antiplatelet medication use was not associated with long-term prognosis or bleeding in AIS patients (OR=1.182, 95% CI 0.505～2.765, P=0.700). Conclusion: The history of oral antiplatelet medication has no significant impact on the clinical efficacy of intravenous thrombolysis in AIS patients and does not increase the risk of bleeding or mortality after thrombolysis.

Spinal cord injury (SCI) is a common neurotraumatic damage, which may lead to paralysis or even death in patients and impose a significant medical burden on society. Various forms of regulated cell deaths (RCD), such as apoptosis, autophagy, pyroptosis, ferroptosis and so on, occur during the process of SCI. Reactive oxygen species (ROS), molecules or free radicals produced during incomplete reduction of oxygen in cellular metabolism, regulate RCD through various mechanisms in SCI, thereby influencing its prognosis. This paper reviews the mechanisms by which ROS regulate RCD in SCI in recent years.

目的：探讨莫旺综合征的临床特点、治疗及预后。方法：报道我院2例莫旺综合征并结合文献进行回 顾性分析。结果：2例中年男性患者均表现为全身发麻、烧灼感、肉跳，多汗，失眠、焦虑；肌电图可见较多束 颤电位、F波可见M波后放电位，血清电压门控钾离子通道(VGKC)复合物抗体阳性。搜索既往的莫旺综合 征 89 例，男多于女，平均年龄 53 岁，最主要临床表现肌束颤动、肌颤搐、肌痉挛和肌强直（100%），多汗 （92.1%）；90.6%患者被肌电图证实有异常自发活动、束颤电位、纤颤电位、F波后M波后放电位；25.8%患者 脑电图 REM期异常；血清抗体CASPR2抗体阳性多于 LGI1抗体阳性，有12.4%患者两种抗体同时存在。 结论：莫旺综合征是一种极少见的自身免疫性疾病，患者周围神经、自主神经、中枢神经系统过度兴奋症状 结合肌电图和血清抗体的检测可以尽早进行诊断和鉴别。

To investigate the risk factors for recurrence of intracranial aneurysms (IAs) after stent-assisted coiling (SAC). Methods: Total 446 patients with a total of 486 aneurysms who underwent SAC treatment and completed digital subtraction angiography (DSA) follow-up at our institution between January 2014 and December 2023 were enrolled. Based on imaging follow-up results, the aneurysms were categorized into a recurrence group (n=38) and a stable group (n=448). Demographic, clinical, surgical, and morphological characteristics were analyzed using Logistic regression. Variables with significance in univariate analysis were included in a multivariate Logistic regression using a stepwise forward method to identify independent risk factors. The area under the curve (AUC) of the receiver operating characteristic (ROC) curve was calculated to assess the predictive performance of the independent risk factors. Results: Independent risk factors for recurrence after SAC included neck (P<0.001, OR=1.287), size ratio (P<0.001, OR=1.877), Raymond scale II or III (P=0.034, OR=2.304), and Ruptured aneurysms (P=0.010, OR=3.058). The AUC values for neck size, size ratio, Raymond Class II or III, and ruptured aneurysms were 0.807, 0.797, 0.636, and 0.567, respectively. Conclusion: Neck, size ratio, Raymond grade II or III, and ruptured aneurysms are significant risk factors for recurrence following SAC of IAs.

To analyze the influencing factors of ineffective treatment with lamotrigine combined with sodium valproate in patients with post-stroke epilepsy. Methods: The clinical data were collected from 269 patients with post-stroke epilepsy in the Zhongnan Hospital of Wuhan University between March 2020 and April 2023. According to curative effect of lamotrigine combined with sodium valproate, patients were divided into effective group (n=215) and ineffective group (n=54). Among them, 219 cases were randomly selected as the training set and the other 50 cases were selected as the verification set. The patients in effective group and ineffective group were matched by propensity score matching method. In data set of balanced covariates, influencing factors of the curative effect were analyzed by Logistic regression model. The prediction model for the curative effect was constructed, and its predictive efficiency was evaluated by receiver operating characteristic (ROC) curves. Results: In the 219 patients with post-stroke epilepsy after 1 ∶ 1 propensity score matching method, there were 42 pairs of patients with successful matching, and the data such as age, gender, underlying diseases, smoking history and drinking history were basically balanced. The proportions of NIHSS score >14 points and monthly onset frequency ≥4 times, levels of homocysteine and uric acid in effective group were lower than those in ineffective group (P<0.05). The results of Logistic regression analysis showed that NIHSS score >14 points, monthly onset frequency ≥4 times and high level of homocysteine were independent influencing factors of ineffective treatment (P<0.05). The prediction model was as follow: P=e X /(1+e X ), X=－8.423+0.532×NIHSS score +0.575× monthly onset frequency +0.436× homocysteine. Hsomer-Lemeshow goodness-fit test showed that there was no significant difference between predicted value of the model and the actual observed value (P>0.05). Internal verification of the prediction model showed that AUC, sensitivity and specificity were 0.818, 78.57% and 73.81%, respectively (P<0.05). External verification of the prediction model with validation set data showed that AUC, sensitivity and specificity were 0.815, 62.50% and 88.10%, respectively. Conclusion: NIHSS score >14 points, monthly onset frequency ≥4 times and high level of homocysteine are independent influencing factors of ineffective treatment with lamotrigine combined with sodium valproate. The prediction model has good predictive efficiency for the curative effect.