Brain-Computer Interface (BCI) controlled Functional Electrical Stimulation (FES) is an emerging rehabilitation technology in recent years. This technology primarily works by monitoring the motor intention signals emitted from the patient’s brain via BCI and converting these signals into control commands to drive the FES device, thereby helping the patient achieve intended movements through corresponding electrical stimulation. Compared to traditional rehabilitation techniques, it can more effectively promote limb function recovery in patients with central nervous system injuries. This article reviews the technology of BCI-FES, its mechanisms of action, and the current state of its application in clinical rehabilitation, aiming to provide theoretical foundations for the rehabilitation of central nervous system diseases and the promotion and use of BCI-FES.

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.

Survivors of stroke often have varying degrees of upper limb motor dysfunction, which limits their independence in daily life. Restoring upper limb motor function is crucial for regaining the ability to perform activities of daily living. Transcranial magnetic stimulation (TMS) is a non-invasive neuromodulation technique that has become an important tool in stroke rehabilitation in recent years. This article reviews the progress in the application of different modes of TMS in the treatment of upper limb motor dysfunction after stroke, including the mechanism of action and therapeutic effects. There is substantial evidence supporting the efficacy of repetitive TMS (rTMS) in improving upper limb motor function, while there is limited research on theta burst stimulation (TBS) and paired associative stimulation (PAS), and their mechanisms are still unclear with controversies regarding their effectiveness. Future research should focus on exploring new targets and optimal treatment parameters for TMS in treating upper limb motor dysfunction after stroke, in order to develop personalized TMS treatment plans for stroke patients.

Cerebral small vessel disease (CSVD) is a common cause of stroke and dementia. Advanced magnetic resonance imaging (MRI) techniques can provide more sensitive assessments of the extent of CSVD damage, thereby facilitating disease monitoring and providing more insights into the underlying pathophysiological mechanisms. This review first summarizes the latest applications of structural MRI in CSVD, including diffusion MRI and quantitative MRI techniques. Subsequently, the review introduces the application of advanced MRI techniques for assessing cerebrovascular function and abnormalities associated with the small cerebral arteries in CSVD patients.

Autism Spectrum Disorders (ASDs) encompass a set of neurodevelopmental conditions marked by challenges in social interaction, communication, and by restricted or repetitive behaviors, with their etiology linked to atypical brain network patterns. Non-Invasive Brain Stimulation (NIBS) has been shown to influence cerebral cortex activation and reorganize brain networks in individuals with ASDs, leading to improvements in behavioral symptoms. This review explores the impact of two brain stimulation methods, Transcranial Magnetic Stimulation (TMS) and Transcranial Direct Current Stimulation (tDCS), on behavior, cognitive functions, and speech in patients with ASDs, and assesses the potential for clinical applications of NIBS.

Alzheimer's disease (AD) has become the fourth leading cause of death among people aged 65 and above in China. PET/CT plays a significant role in the clinical diagnosis and research on the pathogenesis of AD. The combined use of PET/CT and digital technology within the Alzheimer's Disease Neuroimaging Initiative (ADNI) provides important scientific support for tracking the trajectory of cognitive changes in patients and improving the accuracy of clinical diagnosis. This article focuses on reviewing the research progress in exploring the pathological progression patterns and early diagnosis of AD using PET/CT within ADNI over the past three years.

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.

To explore the relationship between thyroid hormone levels and suicide attempts, suicidal ideation, and clinical characteristics of patients with depression, providing a reference for clinical intervention. Methods: 1229 patients with depression who received treatment in Hefei Fourth People’s Hospital from January 2020 to July 2023 were recruited. Based on the medical history, 578 patients with suicidal thoughts and behaviors within the past month were included in the suicide attempt group (attempt group), 306 patients with suicidal thoughts without behaviors within the past month were included in the suicide ideation group (ideation group), and 345 patients without suicidal behaviors or thoughts within the past month were included in the no suicide behavior and ideation group (control group). We analyzed the baseline data of the three groups and the levels of thyroid hormones, as well as the correlations between the levels of thyroid hormones in the attempt group and ideation group and depressive clinical symptoms. Results: The HAMD cognitive impairment and hopelessness factor scores in the attempt group were significantly higher than those in the ideation group (both P<0.01), and the cognitive impairment factor score in the attempt group was higher than that in the control group (P<0.05). Among the three groups, the serum levels of T3, FT3, and FT4 were lower in the attempt group＜ideation group＜control group (all P<0.05), with serum T3, FT3, and FT4 levels in the attempt group being significantly lower than those in the control group (all P<0.05) serum FT3 level in the ideation group was significantly lower than that in the control group (P<0.05). Serum FT4 levels in both attempt and ideation groups correlated positively with the total scores on the HAMD and HAMA scales (P<0.05), while serum T3 and FT3 levels in the attempt group also correlated positively with the total scores on the HAMD scale (P<0.05). Logistic regression showed that FT3 levels and cognitive impairment factors in HAMD were independent risk factors for suicidal attempts among depressive patients (P<0.01), and FT3 levels and hopelessness factors in HAMD were independent risk factors for suicide ideation among depressive patients (P<0.01). Conclusion: There are significant differences in serum T3, FT3 and FT4 levels between patients with suicide attempts and ideation and those without. Serum FT4 levels in both the attempt and ideation groups correlated positively with the total scores on the HAMD and HAMA scales. Among depressive patients, serum FT3 level is an independent biological risk factor for suicide attempts and ideation, while cognitive impairment factor in HAMD score is an independent risk factor for suicide attempts, and hopelessness factor is an independent risk factor for suicidal ideation.

In recent years, research on non-invasive brain stimulation targeting motor-related brain areas to enhance motor learning memory performance has increased. Transcranial alternating current stimulation (tACS), as one of the non-invasive brain stimulation techniques, has garnered widespread attention for its ability to modulate neuronal communication signals through induced brain oscillatory activities via externally applied alternating currents. This review summarizes the studies on tACS in enhancing motor learning memory and motor performance across different populations, aiming to provide new strategies for improving motor learning memory and enhancing motor performance in healthy individuals and those with movement disorders.

To investigate the effects of intermittent theta burst stimulation (iTBS) of the cerebellum combined with conventional physical therapy on motor and balance functions in patients with hemiplegia following stroke. Methods: Forty stroke patients admitted to Beijing Fengtai You'anmen Hospital from May 2021 to December 2023 were selected and randomly divided into a control group and an experimental group, with 20 cases in each. Both groups received conventional pharmacological and rehabilitation treatments, while the experimental group received cerebellar iTBS prior to rehabilitation therapy, and the control group received sham stimulation. Motor and balance functions were assessed using the Berg Balance Scale (BBS), Fugl-Meyer Assessment (FMA), and the Modified Barthel Index (mBI) before treatment and two weeks after treatment. Diffusion Tensor Imaging (DTI) was performed to measure Fractional Anisotropy (FA) and Apparent Diffusion Coefficient (ADC) values of three pairs of cerebellar peduncles. Results: There was no statistically significant difference in BBS, FMA, and mBI scores between the two groups before treatment (P>0.05). After treatment, BBS, FMA, and mBI scores increased significantly in both groups (P<0.01), and the experimental group scored higher than the control group (P<0.05). Before treatment, there was no statistically significant difference in FA values of the cerebellar peduncles between the two groups (P>0.05). After treatment, there was no statistically significant difference in FA values of the affected-side cerebellar peduncles between the two groups (P>0.05), but the non-affected-side superior cerebellar peduncle FA value was higher in the experimental group than in the control group (P<0.05). Within the experimental group, the FA value of the non-affected-side superior cerebellar peduncle increased after treatment compared to before treatment (P<0.05). Within the control group, there was no statistically significant difference in FA values of the affected-side and non-affected-side cerebellar peduncles before and after treatment (P>0.05). After treatment, there was no statistically significant difference in ADC values of the cerebellar peduncles between the groups or between the affected-side and non-affected-side within groups (P>0.05). Conclusion: Cerebellar iTBS treatment can promote the recovery of motor and balance functions in patients with hemiplegia following stroke. The mechanism may be related to iTBS-induced cortical reorganization through the cerebellum, improving neural conduction ability and plasticity.

Most of the clinical treatment of neurodegenerative diseases (ND) can only relieve the symptoms. In recent years, with the continuous development of cellular reprogramming technology, the regenerative transformation of degenerate and lost neurons has become a possibility. Astrocytes (ASs), widely present in the central nervous system (CNS), participate in maintaining the functional stability of the CNS under physiological conditions. AS transdifferentiation, characterized by low rejection rates and minimal microenvironment toxicity, has been applied in ND treatment research. This article focuses on various studies in recent years on AS transdifferentiation for the treatment of various NDs, including animal models, vector tools, target molecules, types of induced neurons, and treatment effects. Among them, the most significant progress has been made in Parkinson's disease (PD), where multiple different induction methods have successfully reprogrammed ASs into dopaminergic neurons, resulting in some improvement in symptoms in model mice. However, there are still disagreements regarding the origin of differentiated cells and treatment effects. The newly developed lineage-targeting tracing technology can more accurately confirm the origin of induced cells. Additionally, issues such as the survival rate and long-term effects of induced cells, as well as the age dependence of reprogramming ASs, require further investigation.

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.

目的：探讨文拉法辛缓释胶囊联合劳拉西泮片治疗帕金森病（PD）伴焦虑抑郁症状患者的临床疗 效。方法：选择PD伴焦虑抑郁患者120例，随机分为文拉法辛组、劳拉西泮组和联合治疗组，每组40例。 文拉法辛组在常规抗PD治疗基础上使用文拉法辛缓释胶囊治疗；劳拉西泮组在常规抗PD治疗基础上使 用劳拉西泮片治疗；联合治疗组则常规抗PD治疗基础上加用文拉法辛缓释胶囊及劳拉西泮片治疗。治疗 前及治疗后使用帕金森病综合评分量表（UPDRS）、汉密尔顿焦虑量表（HAMA）和汉密尔顿抑郁量表 （HAMD）作为患者PD和焦虑抑郁症状评定指标。结果：3组治疗前UPDRS、HAMA、HAMD评分差异无统 计学意义，3组治疗后各项评分均较治疗前降低，且联合治疗组均低于文拉法辛组和劳拉西泮组，差异有统 计学意义（P＜0.05）。3组不良反应发生率比较，差异无统计学意义（P＞0.05）。结论：使用文拉法辛缓释胶 囊联合劳拉西泮片治疗PD伴焦虑抑郁有效改善PD患者的运动症状和焦虑抑郁症状。

To systematically evaluate the impact of repeated transcranial magnetic stimulation (rTMS) on the rehabilitation outcomes of patients with spinal cord injury (SCI). Methods: Computerized searches were conducted in electronic databases including PubMed, Web of Science, Embase, Cochrane Library, CNKI, Wanfang, VIP, and China Biology Medicine for randomized controlled trials (RCTs) on rTMS treatment for SCI. The search period covered from the inception of each database to September 21, 2023. Outcome indicators included the Spinal Cord Independence Measure (SCIM), Functional Independence Measure (FIM), Barthel Index (BI), Resting Motor Threshold (RMT), Motor Evoked Potential (MEP) amplitude, Lower Extremity Motor Score (LEMS), Walking Index for Spinal Cord Injury II (WISCI-II), Modified Ashworth Scale (MAS), and Visual Analog Scale (VAS) for pain. Risk of bias was assessed using tools recommended by the Cochrane Handbook for Systematic Reviews of Interventions, and Meta-analysis was performed using RevMan 5.4 software. Results: A total of 23 RCTs involving 1 478 patients were enrolled. Meta-analysis results showed significant improvements in the rTMS treatment group compared to the control group in SCIM score [MD=6.93, 95% CI (5.48, 8.37), P< 0.00001], FIM [MD=16.17, 95%CI (11.66, 20.69), P<0.00001], BI score [MD=10.43, 95%CI (5.17, 15.69), P< 0.00001], RMT [MD=－3.99, 95%CI (－4.88, －3.09), P<0.00001], MEP amplitude [MD=0.33, 95%CI (0.23, 0.43), P<0.00001], LEMS [MD=5.47, 95%CI (3.80, 7.14), P<0.00001], WISCI-II [MD=1.79, 95%CI (1.41, 2.18), P<0.00001], MAS score [MD=－0.15, 95%CI (－0.20, －0.10), P<0.00001], and VAS pain score [MD=－1.37, 95%CI (－1.66, －1.08), P<0.00001]. Conclusion: rTMS treatment is beneficial for SCI patients in improving functional independence and activities of daily living, ameliorating lower extremity motor dysfunction, and alleviating neuropathic pain and spasms.

Post-Traumatic Stress Disorder (PTSD) refers to a mental illness that develops after an individual experiences a significant trauma or life-threatening event. In recent years, repetitive transcranial magnetic stimulation (rTMS) has gradually been applied to the treatment of PTSD. This article aims to review the research on rTMS treatment for PTSD, clarifying its therapeutic parameters, mechanisms of action, safety, and adverse reactions, with the hope of providing guidance for clinical practice.

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.

Respiratory dysfunction is a crucial factor influencing morbidity, rehospitalization, and mortality following spinal cord injury (SCI), posing significant challenges in rehabilitation treatment. Traditional therapeutic methods have shown limited efficacy in promoting the recovery of respiratory function after SCI. Neuromodulation, an emerging biomedical technology, is increasingly being utilized in respiratory rehabilitation post-SCI. This technique can regulate the damaged respiratory neural networks in SCI patients, exerting a positive effect on improving respiratory function and long-term prognosis. Therefore, neuromodulation techniques based on respiratory neural plasticity have the potential to become a promising treatment for respiratory rehabilitation after SCI.

目的：观察醒脑开窍针刺法联合补阳还五汤对自发性基底节区脑出血患者的疗效及其对患者神经功 能的影响。方法：将石家庄市人民医院2020年10月～2023年2月收治的100例自发性基底节区脑出血患 者采用随机分组、平行对照的方法分为西医组和中西医联合组各50例。西医组给予西医常规治疗，中西医 联合组给予西医常规治疗联合醒脑开窍针刺法和补阳还五汤治疗，均连续治疗4周。统计治疗后2组患者 临床疗效和并发症发生率，评定治疗前后2组患者美国国立卫生研究院卒中量表（NIHSS）评分、巴塞尔指 数（BI）评分及斯堪的那维亚卒中量表（SSS）评分、格拉斯哥昏迷量表（GCS）评分、中医症候评分，检测治疗 前后2组患者水肿相关因子水通道蛋白-1（AQP-1）、水通道蛋白-4（AQP-4）水平，并且进行组间比较。结 果：中西医联合组患者治疗4周后治愈+显效+有效共47例，总有效率明显高于西医组（94.00%，78.00%，P＜ 0.05）。治疗前，2组患者NIHSS评分、BI评分、SSS评分、GCS评分、中医症候评分比较差异均无统计学意 义（均P＞0.05）；治疗后，2组患者NIHSS评分、SSS评分、中医症候评分均较治疗前明显降低（均P＜0.05）， BI评分、GCS评分均较治疗前明显升高（均P＜0.05），并且中西医联合组患者NIHSS评分、SSS评分、中医 症候评分均明显低于西医组（均P＜0.05），BI评分、GCS评分均明显高于西医组（均P＜0.05）。治疗前，2组 患者AQP-1、AQP-4水平比较差异均无统计学意义（均P＞0.05）；治疗后，2组患者AQP-1、AQP-4水平均较 治疗前明显降低（均 P＜0.05），并且中西医联合组患者 AQP-1、AQP-4 水平均明显低于西医组（均 P＜ 0.05）。治疗4周后中西医联合组总并发症发生率明显低于西医组（P＜0.05）。结论：醒脑开窍针刺法联合 补阳还五汤治疗自发性基底节区脑出血可提高患者的治疗效果，降低脑水肿相关因子的表达，改善神经功 能，降低并发症发生率，为自发性基底节区脑出血的治疗提供新的方案。

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.

This study aims to explore the efficacy of a new repetitive transcranial magnetic stimulation (rTMS) treatment protocol for primary trigeminal neuralgia (PTN). Methods: Sixty-four patients with PTN were randomly divided into a control group and a treatment group, each consisting of 32 patients. The control group received standard carbamazepine treatment, while the treatment group was given a progressive decremental rTMS therapy (5 sessions per week for weeks 1-2; 2 sessions per week for weeks 3-4; 1 session per week for weeks 5-8) in addition to carbamazepine treatment. Both groups underwent an 8-week treatment period. The enrollment time point was designated as T0, and at the end of each week (T1-T8), assessments were recorded. Visual Analogue Scale (VAS) and Brief Pain Inventory (BPI) were used to evaluate pain-related indicators at T0-T8. Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality at T0, T4, and T8, and the BPI item assessing the impact of pain on daily life was used to evaluate quality of life. Results: Two patients dropped out from each group, resulting in a final inclusion of 30 patients per group. There were no statistically significant differences in VAS and BPI pain severity scores between the two groups at T0 and T1 (P> 0.05). From T2 to T8, the VAS and BPI pain severity scores decreased significantly more in the treatment group compared to the control group (P<0.05). Before treatment, there were no statistically significant differences in the scores of the impact of pain on daily life and PSQI between the two groups (P>0.05). At T4 and T8, the treatment group showed a significantly greater reduction in the impact of pain on daily life and PSQI scores compared to the control group (P<0.05). Conclusion: The rTMS treatment protocol adopted in this study can effectively alleviate pain in PTN patients, reduce the impact of pain on daily living functions, and improve sleep quality.

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.

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 whether there is a causal relation between serum uric acid (SUA) levels and cerebral small vessel disease(CSVD). Methods: Data of SUA, lacunar infarction (LI), white matter hyperintensitie (WMH), fractional anisotropy (FA) and mean diffusivity (MD) were obtained from published genome-wide association study. Single nucleotide polymorphisms (SNPs) strongly associated with SUA (F-statistic>10) were selected as instrumental variables, and causal analysis is carried out by inverse variance weighted, MR-Egger, and Weighted median method. Meanwhile, the heterogeneity and horizontal pleiotropic tests were performed using MR-Egger intercept test and Cochran's Q test. Results: Inverse variance weighted showed that SUA was not associated with LI (OR=1.086, 95%CI 0.959～1.230, P=0.193), WMH (OR=1.010, 95%CI 0.956～1.066, P=0.725), FA (OR=1.058, 95%CI 0.848～1.320, P=0.617) and MD (OR=1.009, 95%CI 0.790～1.288, P=0.943). Moreover, sensitivity analysis showed no heterogeneity and horizontal pleiotropy. Conclusion: Current MR Studies had shown no causal relationship between SUA and CSVD, but standardized, large-sample clinical studies and large-scale GWAS-based MR Studies are needed to more fully evaluate the association.

To systematically evaluate the effect of tizanidine hydrochloride combined with rehabilitation training in the treatment of muscle spasm after stroke. Methods: Randomized controlled trials of tizanidine hydrochloride in the treatment of muscle spasm after stroke were searched from China National Knowledge Intemet(CNKI), Wanfang Data medicalinformation system(WF), VIP database, Pubmed, Web of Science, Embase and Cochrane Library databases from the establishment to September 2022. Meta-analysis of the studies that met the inclusion criteria was performed using RevMan 5.4. Results: Nine studies involving 683 patients were included. The results of Meta-analysis showed that the modified Ashworth Scale(MAS) score (WMD=－0.22, 95% CI －0.29～－0.14, P<0.00001) and modified Barthel Index(MBI) score (WMD=2.68, 95%CI 0.10～5.27, P=0.04) in the treatment group were better than those in the control group, but there was no difference in the Fugl-Meyer assessment(FMA) score [WMD=2.14, 95% CI － 0.33～4.61, P=0.09]. In subgroup analysis of different control interventions, compared with rehabilitation training alone, tizanidine can effectively relieve muscle spasm (MAS score: WMD=－0.38, 95%CI －0.48～－0.27, P<0.00001；CSI score: WMD=－2.61, 95%CI －3.30～－1.92, P<0.00001) after stroke and improve the activies of daily living(ADL) (MBI score：WMD=10.48, 95% CI 8.20～12.75, P<0.00001), but has no obvious advantage in improving movement disorders (FMA score：WMD=4.55，95% CI －1.03～10.13, P=0.11). There was no difference in MAS score[WMD=－0.06，95%CI －0.16～0.05, P=0.31), FMA score[WMD=0.82，95%CI (－0.31, 1.96), P= 0.16], MBI score[WMD=0.27，95%CI －0.77～1.32, P=0.61) and clinical effective rate[WMD=2.07, 95%CI 0.97～4.43, P=0.06) between the treatment group(Tizanidine) and the control drug group(Baclofen and Eperisone).The incidence of adverse reactions of tizanidine was lower than that of Baclofen(WMD=0.51，95% CI 0.30～0.88, P=0.02), but not different from eperisone (WMD=1.37, 95% CI 0.52～3.57, P=0.53). Conclusion: Compared with rehabilitation training alone, tizanidine combined with rehabilitation training can effectively reduce muscle tone and improve daily living ability of patients after stroke, while the efficacy is comparable to other oral antispasticity drugs, and the safety is better.

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 systematically evaluate the key driving factors of health-promoting behaviors in stroke patients. Methods: Qualitative studies related to health-promoting behaviors in stroke patients were retrieved from databases such as CNKI, Wanfang, VIP, PubMed, Scopus, Web of Science, Cochrane, CINAHL, EMBase, PsycINFO, and Sinomed, up to December 2023. The quality of the included studies was evaluated using the JBI's quality appraisal tools for qualitative research in evidence-based healthcare, and a meta-synthesis was conducted on the themes extracted from the included studies. Results: A total of 9 studies were included in this study, yielding 52 themes. These themes were ultimately summarized into 2 synthetic findings and 10 categories. Conclusion: The transition to health-promoting behaviors in stroke patients is the result of the combined effects of multiple factors.

To investigate the efficacy of a wearable vibratory training system on the rehabilitation of upper limb dysfunction in patients during the post-stroke sequelae stage and its neural imaging mechanisms. Methods: Seventy-six patients with post-stroke sequelae who were hospitalized at Sichuan Bayi Rehabilitation Hospital from January to August 2022 were randomly divided into an experimental group and a control group, with 38 patients in each. Both groups received conventional rehabilitation treatments, while the experimental group additionally used the wearable vibratory training system for rehabilitation. The Modified Ashworth Scale (MAS) was used to assess muscle tone, the Modified Barthel Index (MBI) to evaluate activities of daily living, and the Fugl-Meyer Upper Extremity Scale (FMA-UE) to assess upper limb motor function before rehabilitation and after 1 and 2 months of treatment. Ten patients with post-stroke sequelae recruited from Weihai Municipal Hospital between July 2023 and April 2024 were given rehabilitation treatment using the wearable vibratory training system for 2 months. Diffusion Tensor Imaging (DTI) scans were performed before rehabilitation and 3 months after the start of treatment. Results: After one month of rehabilitation, both groups showed lower MAS scores (P<0.05) and higher MBI and FMA-UE scores (P<0.05) compared to their pre-treatment levels, but there were no significant differences between the groups (P>0.05). After two months of rehabilitation, the MAS scores continued to decrease, with the experimental group showing lower scores than the control group (P<0.05); the MBI and FMA-UE scores also increased, with the experimental group scoring higher than the control group (P< 0.05). DTI images indicated that the fractional anisotropy (FA) values in the affected hemisphere were significantly lower than those in the normal hemisphere (P<0.05), and after two months of treatment with the wearable vibratory training system, FA values in the affected side increased significantly (P<0.05). Conclusion: Treatment with the wearable vibratory training system can effectively improve upper limb dysfunction in patients during the post-stroke sequelae stage. The mechanism may be related to the repair of damaged neural fiber tracts following stroke.

Vascular dementia (VD) refers to the dementia caused by cerebral hypoperfusion injuries, such as memory, cognition, and behavior, due to ischemic or hemorrhagic changes in cerebral blood vessels. Repetitive transcranial magnetic stimulation (rTMS) is a non-invasive, painless neuromodulation technique that not only benefits the cognitive function of VD patients but also plays a certain role in preventing and reversing VD. As a non-pharmacological treatment, rTMS has become one of the common alternative therapies for VD. This article systematically outlines the latest research progress on the treatment of VD by rTMS through regulating related signaling pathways in recent years and discusses its potential mechanism of action.

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.

To analyze the correlation between serum insulin-like growth factor-1 (IGF-1) levels and carotid unstable plaques in patients with type 2 diabetes mellitus (T2DM). Methods: A total of 213 T2DM patients admitted to the Department of Endocrinology at Xiaogan Central Hospital from February 2022 to February 2023 were selected. Bilateral common carotid arteries, bifurcations, and internal and external carotid arteries were examined using color Doppler ultrasound. Based on the characteristics of the ultrasound images, the subjects were divided into three groups: no plaque group (73 cases), stable plaque group (51 cases), and unstable plaque group (89 cases). Clinical data, laboratory indicators, and serum IGF-1 levels were detected and compared among the groups. Spearman correlation analysis was used to investigate the relationship between serum IGF-1 levels and various indicators in T2DM patients with carotid unstable plaques. Multivariate logistic regression analysis was used to identify the influencing factors of carotid plaque instability in T2DM patients. Results: Compared with the no plaque group, the stable plaque group had higher levels of age, systolic blood pressure, glycosylated hemoglobin (HbA1c), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C), but lower levels of IGF-1; the unstable plaque group also had higher levels of age, HbA1c, TG, and LDL-C, but lower levels of IGF-1, with statistically significant differences (P<0.05). Compared with the stable plaque group, the unstable plaque group had higher levels of HbA1c, TG, and LDL-C, but lower levels of systolic blood pressure and IGF-1, with statistically significant differences (P<0.05). Spearman correlation analysis showed that serum IGF-1 levels in T2DM patients with carotid unstable plaques were negatively correlated with age, systolic blood pressure, HbA1c, and LDL-C (P<0.05). Logistic regression analysis indicated that serum HbA1c, LDL-C, TG, and IGF-1 were influencing factors for carotid plaque instability in T2DM patients (P<0.05). Conclusion: Low levels of IGF-1 may be a contributing factor to the instability of carotid artery plaques in patients with type 2 diabetes and can aid in the assessment of plaque formation and progression.

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 observe the clinical efficacy of acupuncture combined with hyperbaric oxygen therapy in the treatment of idiopathic sudden deafness. Methods: Total 80 patients with idiopathic sudden deafness were randomly divided into a control group and a treatment group, with 40 patients in each group. Both groups received integrated traditional Chinese and Western medicine drug treatment, while the treatment group also received acupuncture and hyperbaric oxygen therapy. The average hearing threshold, clinical efficacy, Tinnitus Handicap Inventory (THI), and Tinnitus Evaluation Questionnaire (TEQ) scores before and after treatment were compared between the two groups. Results: The average hearing thresholds of both groups were improved compared to before treatment (P<0.05), and the degree of improvement in the treatment group was superior to that in the control group, with a statistically significant difference (P=0.010). The effective rate was 55.0% in the control group and 77.5% in the treatment group, with the clinical effective rate in the treatment group being higher than that in the control group, and the difference was statistically significant (χ2 =4.530, P= 0.030). There was no statistically significant difference in TEQ and THI scores before and after treatment in the control group, while there was a statistically significant improvement in TEQ and THI scores after treatment in the treatment group (P<0.05). Conclusion: Acupuncture combined with hyperbaric oxygen therapy in the integrated treatment of idiopathic sudden deafness can effectively alleviate tinnitus symptoms, improve hearing levels, and increase the clinical effective rate.

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.

目的：探讨叙事护理干预联合功能锻炼在儿童肱骨髁上骨折恐动症患儿中的应用效果。方法：将某三 甲医院儿外科2022年1月至2022年12月收治的学龄期肱骨髁上骨折患儿78例随机分为对照组和观察组，各 39例。对照组实施常规功能锻炼方案；观察组在对照组的基础上实施叙事护理干预联合功能锻炼方案。于 入院时、术后24 h及出院时，采用恐动症评估量表（Tampa Scale of Kinesiophobia，TSK）评估患儿的恐动症水 平；于术后3个月，采用关节功能评价标准评估患儿的肘关节活动度。结果：入院时，2组患儿的TSK评分差 异无统计学意义（P＞0.05）；术后24 h及出院时，观察组患儿的TSK评分均显著低于对照组（P＜0.01）。术后3 个月，观察组患儿肘关节活动度为“优”“良”的比例显著高于对照组（P＜0.01）。结论：对骨髁上骨折患儿实施 叙事护理干预联合功能锻炼方案，有助于患儿降低恐动症水平，提高患儿功能锻炼依从性，改善关节功能。

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 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.

目的：加深对叉头框P2基因（FOXP2）基因变异与儿童言语失用症（Childhood Apraxia of Speech，CAS） 关系的理解。方法：全外显子组测序（Whole exome sequencing，WES）用于鉴定与CAS相关的基因变异。使用 生物信息学工具预测可能的致病突变，并进行多物种序列比对。通过美国医学遗传学和基因组学学会 （American Society for Medical Genetics and Genomics，ACMG）评分进一步评估了该变异的致病性，并进行相 关文献复习。结果：5月龄患儿于4月前开始无明显诱因出现呼吸急促，伴有呛奶症状，体格检查发现患儿营养 不良、生长迟缓，WES检测结果显示FOXP2基因存在杂合变异c.1604delC (p. A535Efs*4)。它是一种移码 突变，此变异可导致蛋白合成过程中提前终止。该变异被分类为“1类-致病突变”。结论：在1个CAS病例中展 示了一种新的FOXP2移码突变c.1604delC (p. A535Efs*4)，这扩展了对FOXP2基因突变表型特征的理解。

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.