Abstract:Post-stroke depression （PSD） is one of the common complications of stroke， but its pathophysiological mechanism has not been fully elucidated. In recent years， it has become a research hotspot to find serological markers related to PSD and the targets of new antidepressants. Interleukin-6 （IL-6） has a wide range of biological functions and a clear pro-inflammatory effect in vivo， which is closely related to the occurrence of PSD. This article aims to review the relationship between IL-6 and the pathogenesis of PSD， and to explore the possibility of IL-6 as a potential therapeutic target.

Abstract:Objective To evaluate the consistency between the intelligent interpretation of antidepressant therapeutic drug monitoring （TDM） results using blood drug concentration data processing software and reference standards， and assess its clinical utility in assisting junior psychiatrists in identifying abnormal TDM results. Methods From March 1 to 31， 2024， 226 patients with depressive disorder hospitalized at Beijing Anding Hospital affiliated with Capital Medical University were selected as research subjects. Firstly， the consistency between the TDM results interpreted by the software and the reference standards was verified. Subsequently， 10 junior physicians who passed the assessment and had good consistency were recruited from three clinical centers for TDM result interpretation. All TDM results were randomly and evenly distributed， and each physician interpreted the TDM results of the same case twice in sequence， once by an independent physician and once by software assisted physician （software + physician）. Paired χ2 test was used to analyze the differences between two interpretation methods and reference standards， as well as the differences in sensitivity， specificity， and accuracy. The area under the receiver operating characteristic （ROC） curve （AUC） was used to compare the efficiency of two interpretation methods. Results Among the TDM results of which of 226 patients， 109 （48.23%） were abnormal. The consistency rate between the abnormal TDM results identified by the software and the reference standard was 100%. The accuracy of individual physician interpretation was 65.93% （95%CI=59.35%-72.08%）， lower than the assistance of "software"， of which the accuracy was 99.12% （95%CI=96.84%-99.89%）， and the difference was statistically significant （χ2 =75.00， P ＜ 0.001）. Paired χ2 test showed that the sensitivity （χ2 =64.00， P ＜ 0.001） and specificity （χ2 =6.23， P＜ 0.05） of the software + physician combined interpretation of abnormal TDM results were superior to those of independent physician interpretation， and the differences were statistically significant. The comparison of AUC between the two interpretation methods showed that the accuracy of software + physician combined interpretation was better than that of independent physician interpretation （0.991 vs 0.647）， and the difference was statistically significant （Z=12.51， P＜ 0.001）. Conclusions The serum concentration data processing software shows high consistency between the TDM results and the reference standards， which helps to improve the identification and cause analysis of abnormal TDM results by junior psychiatrists.

Abstract:Objective To explore the impact of obesity on poor prognosis of recombinant tissue plasminogen activator （rt-PA） intravenous thrombolysis in patients with first-episode acute ischemic stroke. Methods From December 2017 to December 2023， 297 patients with first-episode stroke who underwent rt-PA intravenous thrombolysis in the Department of Neurology of Suzhou Ninth Hospital affiliated to Soochow University were selected as participants. According to the 90 days Modified Rankin Scale （mRS） score， patients were divided into a poor prognosis group （mRS score of 3 to 6） and a good prognosis group （mRS score of 0 to 2）. Multivariate Logistic regression was used to analyze the risk factors for poor 90-day prognosis in patients with acute ischemic stroke undergoing intravenous thrombolysis. Results Among 297 patients with first-episode acute ischemic stroke， 212 had good prognosis and 85 had poor prognosis， with a poor prognosis rate of 28.62%. In the poor prognosis group， obese patients （BMI ≥ 28.0 kg/m2 ） accounted for 27.06% （23/85）， smoking patients accounted for 31.76% （27/85）， and the National Institute of Health Stroke Scale （NIHSS） score before thrombolysis was 13.00 （9.50， 18.00）， which were higher than the good prognosis group's 16.98% （36/212）， 20.28% （43/212）， and 7.00 （5.00， 11.00）， respectively， and the differences were statistically significant （χ2 /Z=3.871， 4.440， -8.013； P ＜ 0.05）. Multivariate Logistic regression analysis showed that obesity （OR=2.918， 95%CI=1.364-6.242）， smoking （OR=3.648， 95%CI=1.678-7.931）， and high pre-thrombolysis NIHSS score （OR=1.269， 95%CI=1.184-1.361） were risk factors for poor prognosis in patients with acute ischemic stroke undergoing intravenous thrombolysis， with statistically significant differences （P＜ 0.05）. Conclusions Obesity is a risk factor for poor prognosis after 90 days of intravenous thrombolysis in patients with first-episode ischemic stroke.

Abstract:Objective To explore the clinical therapeutic value of repetitive transcranial magnetic stimulation with intermittent Theta burst stimulation （iTBS） combined with neuromuscular electrical stimulation （NMES） in post-stroke dysphagia （PSD）. Methods From November 2022 to October 2023， 60 PSD patients admitted to the rehabilitation department of Xuzhou Central Hospital were selected as research subjects. Patients were randomly divided into NMES group and NMES + iTBS group using a random number table method， with 30 cases in each group. Both groups of patients were treated with routine swallowing rehabilitation training. NMES group received NMES on this basis， while NMES + iTBS group received repetitive transcranial magnetic stimulation with iTBS in the cortical representative area of the superior hyoid muscle group on the healthy side of the patient's brain on the basis of NMES group. Both groups carried out continuous treatment for two weeks. Before and after treatment， swallowing disorder imaging was performed on the patient， and the Videofluoroscopic Dysphagia Scale （VDS） score and Rosenbek Penetration-Aspiration Scale （PAS） grading were evaluated based on the examination results. The swallowing function was assessed using the Standardized Swallowing Assessment Scale （SSA） and Water Swallow Test （WST） grading. Results Before treatment， there was no statistically significant difference in VDS score， PAS grading， SSA score， and WST grading between the two groups of patients （Z=-0.371、-0.718、-0.507、-1.104；all P＞ 0.05）. After treatment， the VDS score， PAS grading， SSA score， and WST grading of the two groups of patients were lower than before treatment， and the score and grading of patients in the NMES + iTBS group were better than those in NMES group， and the differences were statistically significant （Z=-5.412 - -3.884；all P ＜ 0.05）. Conclusions The combination of repetitive transcranial magnetic stimulation with iTBS and NMES can effectively promote the recovery of swallowing function in PSD patients.

Abstract:Stroke can damage sensory and motor nerve transmission pathways， causing limb dysfunction in patients. Short latency somatosensory evoked potentials （SLSEP） can objectively assess the sensory and motor dysfunction caused by stroke from a neurophysiological perspective in the early stage， supplementing the deficiency of imaging and rating scales， and has important clinical significance for predicting patient functional outcomes. This paper reviews the evaluation of limb function and prognosis in stroke patients using SLSEP， providing a basis for clinical practice.

Abstract:Ischemic stroke （IS） complicated with cardiac injury is common and can lead to poor prognosis for patients. Currently， the diagnosis and treatment of IS is gradually shifting towards a multidisciplinary collaboration model of simultaneous treatment of brain and heart. Recently， cardiac magnetic resonance （CMR） imaging has become the gold standard for non-invasive evaluation of cardiac structure and function， and its role in IS is increasingly valued. This paper reviews the manifestations，features， injury mechanisms and clinical managementof IS complicated with cardiac injury， and the application of CMR imaging in IS， so as to provide theoretical basis for early identification and clinical management of IS patients with cardiac injury， along with the utilization of CMR in IS cases.

Abstract:Objective To explore the differences in intestinal microbiota species between patients with depression and healthy controls， providing reference for the diagnosis and treatment of depression. Methods A total of 53 patients with depression who visited the psychiatric department of Zhuzhou Third Hospital from November 2020 to November 2022 were selected as the depression group. At the same time， 55 healthy volunteers matched in gender and age were publicly recruited as the health control group in Zhuzhou City. General data were collected. The fresh feces from subjects were collected. 16S rDNA metagene sequencing was applied to analyze the differences in intestinal microbiota diversity， abundance， structure and correlation with clinical symptoms. Results A total of 27 237 978 16s rDNA were collected. The α diversity analysis of the overall abundance of intestinal microbiota showed that there was no significant difference between the two groups （P ＞ 0.05）. In terms of species and structure， the β diversity analysis of four distances （Jaccard distance， Bray-Curtis distance， unweighted UniFrac distance， and weighted UniFrac distance） showed that the differences between the two groups were statistically significant （all P ＜ 0.05）. Compared with the healthy control group， the proportion of Bacteroidetes in the depression group increased （12.4% vs. 44.1%）， and the ratio of Firmicutes to Bacteroidetes （F/B） decreased （6.35 vs. 1.04）. Linear discriminant analysis effect size （LEfSe） analysis showed that， as many as 30 species of gut microbiota were statistically different between the two groups （P＜ 0.05， LDA＞ 2）. Conclusions There are differences in intestinal microbiota between patients with depression and healthy controls， and the different gut microbiota species may be used as potential objective markers and intervention targets.

Abstract:Objective To construct and validate the prediction model of early neurological deterioration （END） in patients with branch atheromatous disease （BAD）. Methods From January 2017 to December 2022， 246 END patients with BAD who were admitted to the Department of Neurology of Yellow River Sanmenxia Hospital were selected as participants. All patients were randomly divided into a modeling group （n=172） and a validation group （n=74） according to a 7∶3 ratio. General and clinical information of patients were collected. Multivariate Logistic regression was used to analyze the influencing factors of END in patients with BAD. Consistency index and receiver operating characteristic （ROC） curve were used to analyze the discriminative power of the predictive model in the modeling and validation groups， and a calibration curve was drawn to evaluate the accuracy of the predictive model in two groups. Results Among the patients in the modeling group， there were 109 males （63.37%） and 63 females （36.63%）， with an age of （65.47±13.00） years and a median onset time of 4.00 （2.00， 7.00） hours. Among the patients in the validation group， there were 39 males （52.70%） and 35 females （47.30%）， with an age of （66.09±12.14） years and a median onset time of 2.50 （1.90， 6.00） hours. Multivariate Logistic regression showed that smoking， degree of white matter lesions， neutrophil count， low-density lipoprotein cholesterol， and intravenous thrombolysis was the influencing factors for END in patients with BAD， and the differences were statistically significant （P＜ 0.05）. The sensitivity and specificity of the prediction model were 82.29% and 72.37%， respectively. The sensitivity and specificity of the validation model were 73.17% and 72.73%， respectively. The calibration curves were close to the curve with a straight line of 1. Conclusions Based on smoking， white matter lesion degree， neutrophil count， low-density lipoprotein cholesterol， intravenous thrombolysis， the prediction model of END in patients with BAD established by nomogram can assist in predicting the short-term prognosis of patients.

Abstract:Panic disorder is an acute anxiety disorder characterized by recurrent panic attacks， which seriously affects the social functioning and quality of life of patients. Currently， the pathogenesis of panic disorder is not clear. Studies show that anxiety sensitivity is a susceptibility factor for panic attacks， and high levels of anxiety sensitivity are positively correlated with the severity of panic disorder， leading to poor prognosis for patients. This paper reviews the characteristics of anxiety sensitivity in patients with panic disorder and the role of anxiety sensitivity in the occurrence， progression， and intervention of panic disorder， so as to provide a perspective for clinical diagnosis and treatment of panic disorder.

Abstract:Schizophrenia is a serious mental disorder characterized by cognitive impairment as one of its core symptoms. Metabolic complications such as abdominal obesity are widespread in patients with schizophrenia. This not only elevates the risk of cardiovascular disease in patients， but is also associated with cognitive deficits， particularly impairments in attention， memory， and executive function. Studies have shown that combined abdominal obesity in schizophrenia may affect cognitive function through multiple mechanisms， such as triggering chronic inflammatory responses， insulin resistance， and influencing the composition of the gut flora， which may further exacerbate cognitive impairment. This article describes the risk factors for combined abdominal obesity in schizophrenia， as well as the potential mechanisms and treatment strategies affecting cognitive impairment， and looks forward to future research directions， with a view to providing a theoretical basis for improving abdominal obesity and cognitive impairment in schizophrenia.

Abstract:Parkinson disease is a common neurodegenerative disease， characterized by movement disorders， and the etiology and pathogenesis of Parkinson disease are still not fully understood. Exosomes are small vesicles widely present in biological body fluids that carry various biological molecules， including RNA， and are involved in various physiological activities and pathological processes of cells. An increasing number of studies have shown that exosome non-coding RNAs play an important role in Parkinson disease. This paper reviews the research progress of exosome non-coding RNAs in the diagnosis and treatment of Parkinson disease. Although it is still in the research stage， with the deepening of scientific research， therapies based on exosome non-coding RNAs will bring new hope to Parkinson disease patients.

Abstract:

Abstract: