Abstract:Objective To explore the biological factors influencing the prolonged length of stay in first-episode schizophrenia patients， construct a predictive model， and validate it. Methods A total of 203 schizophrenia patients in Shanghai Baoshan Mental Health Center from January 2022 to December 2023 were retrospectively selected for the study. Variables such as demographic and biological indicators， primary medications during hospitalization， blood concentrations， and length of stay were collected from patients before treatment and within one week before discharge. Pearson or Spearman correlation was used to analyze the correlation between length of stay and 25 hydroxyvitamin D［ （25（OH）D）］ in patients on different medications. The patients included in the prediction model were divided into a training set and a test set. LASSO regression was used to screen variables for the multifactor Logistic regression model. A predictive model was constructed by applying a nomogram to the independent risk factors for prolonged length of stay. Receiver operator characteristic （ROC） curve， calibration curve， and decision curve analysis were used to evaluate the predictive model. Results A total of 155 cases of first-episode schizophrenia were included in prediction model analysis and randomly assigned to training set（ 108 cases） and test set（ 47 cases） in a 7∶3 ratio. Follow up on indicators of the patient before treatment and within one week before discharge showed that， the levels of glycated hemoglobin， triglycerides， lipoproteins， cystatin C， prolactin， thyroid stimulating hormone， and 25（OH）D increased， levels of fasting blood glucose， total cholesterol， high-density lipoprotein， low-density lipoprotein， blood calcium， total triiodothyronine， total thyroxine， free triiodothyronine， free thyroxine， and cortisol decreased， levels of procalcitonin decreased and levels of immunoglobulin A increased in immune and inflammatory indicators within one week before discharge compared with those before treatment， and the differences were statistically significant（ all P＜0.05）. Multifactorial Logistic regression analysis showed that age［ OR=1.04， 95%CI（ 1.01， 1.07），P=0.002］ and 25（OH）D level［ OR=1.09，95%CI（ 1.02，1.16），P=0.002］ were risk factors for prolonged length of stay， and the difference was statistically significant. The area under the ROC curve of the training set and test set of the nomogram prediction model for prolonged length of stay was 0.698 and 0.716， respectively. For patients who applied aripiprazole， aripiprazole blood concentrations at one month post-treatment were negatively correlated with pre-treatment 25（OH）D levels with a statistical difference（ r=-0.40，P=0.027）. Conclusions This study constructs and validates a prediction model for prolonged length of stay in firstepisode schizophrenia， and the nomogram prediction model performs well. Older， higher 25（OH）D levels may result in patients having longer hospital stays， and high 25（OH）D levels may prolong hospital stays by affecting blood concentrations.

Abstract:Objective To analyze the impact of frailty， sarcopenia， and other factors on the prognosis of elderly patients with acute ischemic stroke（ AIS）. Methods A total of 305 elderly AIS patients hospitalized in the Department of Neurology of the First Affiliated Hospital of Shantou University Medical College from July 2023 to February 2024 were prospectively selected for the study using convenience sampling method. General Information Questionnaire and Strength， Assistance in Walking， Rise from a Chair， Climb Stairs and Falls（ SARC-F）， FRAIL Scale（ FRAIL）， and Barthel Index（ BI） were used to obtain information. Patients were followed up with modified Rankin Scale（ mRS） scores at 3 months after onset， and those with mRS ＞ 2 were included in poor prognosis group， and those with mRS ≤ 2 were included in good prognosis group. Risk factors of poor prognosis in elderly patients with AIS were screened by univariate and multivariate binary Logistic regression. Results There were 89 cases of poor prognosis in 305 elderly patients with AIS， and the incidence of poor prognosis was 29.18%. Univariate analysis showed statistically significant differences between poor prognosis group and good prognosis group in terms of gender， body mass index， indwelling gastric tube， National Institute of Health Stroke Scale（ NIHSS） score， speech impairment， venous thromboembolism assessment， nutritional risk assessment， frailty assessment， sarcopenia， swallowing test assessment， BI score， and total psychological resilience score（ all P＜0.05）. Multifactorial binary Logistic regression analysis showed that prefrailty［ OR=10.321， 95%CI（ 1.909， 55.799）］， frailty［ OR=14.304， 95%CI（ 2.313， 88.455）］， sarcopenia［ OR=2.997， 95%CI（ 1.172， 7.669）］， NIHSS score［ OR=1.188， 95%CI（ 1.045， 1.351）］ and NRS2002 assessment［ OR=5.097， 95%CI（ 1.675， 15.514）］ and BI score［ OR=0.942， 95%CI（ 0.923， 0.961）］ were the influencing factors for poor prognosis in elderly AIS patients. Conclusions Elderly patients with AIS have a high incidence of poor prognosis. Clinical attention should be focused on the patient's prefrailty， frailty， management of sarcopenia， recovery of neurological deficits， nutritional status and activities of daily living.

Abstract:Objective To explore the moderating effect of psychological resilience on the relationship between coping styles and depressive symptom scores in patients with acute ischemic stroke（ AIS）. Methods Convenience sampling was used to select 252 patients with AIS from January 2022 to June 2023 in the Affiliated Brain Hospital of Nanjing Medical University as study subjects. Connor-Davidson Resilience Scale （CD-RISC）， Simple Coping Style Questionnaire（ SCSQ）， and Self-Rating Depression Scale（ SDS） were used to assess the psychological resilience， coping styles， and depressive disorder of AIS patients. Pearson correlation was used to analyze the correlation between psychological resilience， coping styles， and depressive disorder. Stratified regression was used to analyze the moderating effect of psychological resilience on the relationship between coping styles and depressive symptom in patients with AIS. Results The CD-RISC score of AIS patients was（ 62.23±10.25）， with the highest mean score of（ 2.60±0.48） for the toughness dimension items. The SCSQ score was（ 28.04±5.23）， with the highest mean score of（ 1.45±0.28） for the negative coping dimension items. The SDS score was（ 52.27±10.93）. Pearson correlation analysis showed that CD-RISC scores， strength dimension scores， optimism dimension scores， and toughness dimension scores were all negatively correlated with negative coping dimension scores and SDS scores， and positively correlated with positive coping dimension scores（ r=-0.681， -0.665， -0.597， -0.504， -0.625， -0.547， -0.662， -0.612， 0.736， 0.642， 0.681， 0.709； all P ＜ 0.05）， negative coping dimension scores were negatively correlated with positive coping dimension scores and positively correlated with SDS scores（ r=-0.342， 0.517； all P ＜ 0.05）， and positive coping dimension scores were negatively correlated with SDS scores（ r=-0.552， P＜0.05）， and all of these differences were statistically significant. Stratified regression showed that the product of positive coping and toughness in model 3 was correlated with depressive disorder in AIS patients（ t=-3.587， P＜0.001）. Conclusions Coping styles are associated with depressive disorder in AIS patients， and psychological resilience plays a moderating effect between coping styles and depressive symptom scores. Positive coping styles are beneficial in reducing depressive symptom scores， and improved psychological resilience reduces the risk of depressive disorder due to coping styles in patients with AIS.

Abstract:Objective To explore the changes in serum insulin-like growth factor-1（ IGF-1） and cyclic glycine proline（ cGP） levels in patients with acute ischemic stroke（ AIS）， and their value in assessing the prognosis of neurological function in patients with AIS within three months. Methods A total of 132 patients with AIS admitted to the Department of Neurology of the First Affiliated Hospital of Xinxiang Medical University from June 2022 to March 2023 were selected for the study. Modified Rankin Scale（ mRS）， National Institute of Health Stroke Scale（ NIHSS）， and Barthel Index（ BI） were used to assess the severity of the patient's condition and prognosis. Patients were categorized into 80 cases in good prognosis group（ mRS≤2） and 52 cases in poor prognosis group（ mRS≥3） based on the mRS score at three months after the onset of the disease. Serum IGF-1 and cGP levels were measured using enzyme-linked immunosorbent assay（ ELISA） at the time of admission and 7 days after admission in both groups. Spearman correlation was used to analyze the correlation of serum IGF-1，cGP levels and cGP/IGF-1 molar ratio with clinical outcomes（ NIHSS score， mRS score and BI score）. Factors influencing poor prognosis were analyzed by binomial Logistic regression with 3-month poor prognosis（ yes/ no=1/0） as the dependent variable and serum levels of IGF-1 and cGP as the independent variables， and the strength of correlation of the 3-month prognostic factors in patients with AIS was determined using the receiver operating characteristic（ ROC） curve. Results At the time of admission and at 7 days of admission， the cGP levels in poor prognosis group were 9.49（ 6.48， 10.91） ng/ml， 8.10（ 6.93， 12.00） ng/ml， and the cGP/IGF-1 molar ratios were 1.67（ 0.94， 2.40） and 1.50（ 1.11， 2.26）， which were higher than those in good prognosis group of 4.45（ 2.78， 6.42） ng/ml， 4.62（ 3.66， 5.20） ng/ml and 1.03（ 0.31， 1.76），0.72（ 0.51， 0.79）， and the differences were statistically significant（ Z=-3.189，-3.777，-3.023，-3.952；all P＜ 0.01）. Serum cGP levels and cGP/ IGF-1 molar ratios were positively correlated with mRS scores after three months， with statistically significant differences（ r=0.400， P=0.005； r=0.597， P ＜ 0.001； r=0.348， P=0.015； r=0.603， P ＜ 0.001）. Binomial Logistic regression analysis showed elevated serum cGP levels at admission［ adjusted OR=1.467， 95%CI （1.099，1.957）， P=0.009］ and cGP levels at 7 days of admission［ adjusted OR=1.723， 95%CI（ 1.194，2.485）， P=0.004］， and increased cGP/IGF-1 molar ratio at admission［ adjusted OR=4.198， 95%CI（ 1.392，12.655）， P=0.011］ and cGP/IGF-1 molar ratio at 7 days of admission［ adjusted OR=15.892， 95%CI（ 2.536，99.576）， P=0.003］ were all risk factors for 3-month poor prognosis of AIS patients. The area under the ROC（ AUC） for serum cGP and cGP/IGF-1 molar ratio at 7 days of admission was 0.818 and 0.833， respectively. The cGP/IGF-1 molar ratio AUC was maximal with a critical value of 0.829. Conclusions Elevated serum cGP levels and cGP/ IGF-1 molar ratios in AIS patients are independently associated with poor functional outcomes. Serum cGP levels and cGP/IGF-1 molar ratios can be used as important biomarkers to assess AIS prognosis.

Abstract:Objective To assess the predictive value of triglyceride-glucose index（ TyG） combined with C-reactive protein（ CRP） in the prognosis of patients with ischemic stroke. Methods This was a retrospective cohort study that included 1 125 patients with ischemic stroke in Cangzhou People's Hospital from 2018 to 2021. Clinical and follow-up data were collected from patients， and TyG and CRP were determined and calculated. Patients were divided into recurrent group（ 79 cases） and non-recurrent group（ 1 046 cases） according to whether the follow-up outcome was recurrent ischemic stroke or not， and the clinical data of the two groups were compared. The relationship between TyG and CRP and ischemic stroke recurrence was explored using Cox proportional risk regression， and the value of these two markers individually and in combination in predicting stroke recurrence was assessed using receiver operating characteristic（ ROC） curve， and the covariance between the markers was analyzed using variance inflation factor（ VIF）. Results The proportion of diabetes， proportion of hypertension， proportion of atrial fibrillation， proportion of heart failure， serum uric acid（SUA），serum creatinine（SCr），homocgsteme（HCY），fasting blood glucose（ FBG），hemoglobinalc（HbA1c），total cholesterol （TC），triglyceride（TG），low-density lipoprotein cholesterol（LDL-C）， CRP， and TyG were higher in recurrent group compared with non-recurrent group， and the differences were statistically significant（ all P＜0.05）. After adjusting for all confounding factors， multifactorial Cox proportional risk regression model analysis showed that elevated CRP［ HR=1.028， 95%CI（ 1.017，1.039）， P＜0.001］ and TyG［ HR=2.450， 95%CI（ 1.487，4.039）， P ＜ 0.001］ were independent risk factors for recurrent ischemic stroke， and the difference was statistically significant. The area under the ROC curve（ AUC） was 0.689［ 95%CI（ 0.662，0.716）］ for CRP， 0.756［ 95%CI （0.730，0.781）］ for TyG， and 0.838［ 95%CI（ 0.815，0.859）］ for CRP combined with TyG. The combined predictive value of the two was statistically higher than the predictive value of CRP and TyG alone（ all P＜0.05）. CRP and TyG were analyzed for covariance in the univariate analysis， and the results showed that there was no covariance between them（ VIF=1.133）. Conclusions TyG and CRP have a certain independent predictive value for the prognosis of ischemic stroke patients， and the combined assessment of the two can further improve the accuracy of prediction.

Abstract:Objective To explore the relationship between poliovirus receptor-related protein 2 （PVRL2） gene expression and prognosis， immune infiltration， and molecular characteristics of gliomas. Methods University of California Santa Cruz（ UCSC） dataset was used to analyze the differences in PVRL2 gene expression， and the genomic and clinical data of 656 glioma（ GBMLGG） patients from The Cancer Genome Atlas（ TCGA） database were integrated to study the relationship between PVRL2 expression and clinical grade. The optimal cutoff value was determined by R package maxstat， and the samples were divided into high- expression group and low-expression group， and survival differences were assessed using Kaplan- Meier survival curves and log-rank tests and analyzed by Cox one-way regression. The correlation between PVRL2 expression and tumor stemness score was analyzed using Pearson correlation. Co-expressed genes， gene ontology（ GO）function and Kyoto encyclopedia of genes and genomes（ KEGG） pathway enrichment were analyzed to construct PPI networks. Correlation with immune cell infiltration and immunomodulatory genes was analyzed. Results PVRL2 was up-regulated in 25 types of tumors， down-regulated in 5 types of tumors， and significantly up-regulated in GBMLGG， with statistically significant differences（ P ＜0.05）. The expression value of PVRL2 was higher in high-grade gliomas（ 4.78±0.72） than in low-grade gliomas （4.41±0.51）， and the difference was statistically significant（ P ＜ 0.001）. The optimal cutoff value was calculated to be 5.190 7， and the patients were divided into high and low expression groups according to the cutoff value. Kaplan-Meier survival analysis showed that the survival of high expression group was shorter than that of low expression group in patients with total gliomas， low-grade， and high-grade gliomas， and the hazard ratios were all greater than 1， and that the PVRL2 expression was positively correlated with the risk of death and disease progression， and the differences were all statistical（ P ＜ 0.05）. PVRL2 was positively correlated with stemness scores based on DNA methylation， differential methylation， epigenetic regulation of DNA methylation and enhancer DNA methylation， with statistically significant differences（ all P ＜ 0.001）. PVRL2 was co-expressed with 20 118 genes， and enrichment analysis showed that it was associated with extracellular matrix， viral infection， immune regulation， angiogenesis， and other functions and pathways， and was highly correlated with immunomodulatory molecules（ FDR＜0.05）. PVRL2 expression was associated with multiple immune cell infiltrates and most immunomodulatory genes with a statistical difference（ P＜0.05）. Conclusions High PVRL2 expression correlates with clinical grade and poor prognosis of gliomas and is strongly associated with immune regulation.

Abstract:Autism spectrum disorders（ ASD） are a group of severe neurodevelopmental disorders that result from a combination of genetic and complex environmental factors， with unclear pathological mechanisms. The hypothesis of "excitatory and inhibitory neuronal dysfunction" has attracted a lot of attention from scholars， and it has been suggested that a critical period of neurodevelopment may be involved in the pathogenesis of ASD， or at least one subtype， and may be an important pathological basis of ASD. This paper reviews the animal tests， clinical studies and biochemicals， aiming to provide new targets for future ASD research.

Abstract:Translocator protein 18 kDa（ TSPO） is widely expressed in the mammalian nervous system and is commonly associated with processes such as neuroinflammation， neurodegeneration and neuroprotection. There is growing evidence suggests that the inflammatory response regulated by TSPO is closely related to depressive disorder. This paper summarizes the studies on TSPO and depressive disorder at home and abroad in recent years， with a view to providing clues and ideas for further research on the relationship between TSPO and depressive disorder and clinical application.

Abstract:Childhood trauma may have an impact on the microstructure of an individual's brain. Diffusion tensor imaging（ DTI） is one of the powerful means to study the changes in white matter microstructure. This article summarizes current DTI-related studies on white matter abnormalities in patients with childhood trauma experiences， focusing on the main structures and functions of white matter， as well as different types of childhood trauma. It provides a theoretical foundation and research basis for further exploration of the relationship between white matter microstructure changes and the neuropathological mechanisms of mental illness in childhood trauma patients.

Abstract:Diabetes mellitus is a metabolic disease characterized by chronic hyperglycemia， which can cause central nervous system dysfunction， mainly in the form of multidimensional cognitive dysfunction， such as decreased attention， memory and executive function. Cognitive dysfunction has an insidious onset， and early recognition and intervention are critical to improving prognosis. In recent years， resting-state functional magnetic resonance imaging （rs-fMRI）- based studies have confirmed severe cognitive dysfunction in patients with type 2 diabetes mellitus（ T2DM）， the mechanism of which is closely related to altered topological properties of wholebrain networks（ such as reduced functional connectivity of default-mode networks and decreased efficiency of small-world networks）， although the specific neuroimaging mechanism has not been fully elucidated. There is growing evidence that microangiopathy is an important mechanism for T2DM-related cognitive dysfunction. Microvascular complications such as diabetic peripheral neuropathy， diabetic retinopathy， and diabetic nephropathy not only independently damage target organs， but also synergistically drive remodeling of the functional brain network through blood-brain barrier disruption， cerebral perfusion abnormalities， and dysfunctional neurovascular coupling. This article focuses on the rs-fMRI features of T2DM microangiopathy and its impact on cognitive function networks， and systematically reviews the potential pathological associations between the two， aiming to provide new imaging biomarkers and intervention targets for clinical prevention and treatment of cognitive impairment.

Abstract:Low-grade inflammation is recognized as one of the important pathophysiological mechanisms of bipolar disorder. Inflammatory factors are not only involved in the etiologic process of the disease， but also provide direction for the development of new therapies. The potential of inflammatory factors as predictive markers and adjunctive therapy with anti-inflammatory drugs（ such as nonsteroidal anti-inflammatory drugs， N-acetylcysteine， and tumor necrosis factor antagonists） has been explored in clinical studies. Studies have shown that abnormal immune signaling occurs throughout all stages of bipolar disorder， suggesting the importance of inflammation as a potential therapeutic target. This article reviews the inflammatory factor alterations， inflammatory mechanisms， and adjunctive anti-inflammatory therapies associated with bipolar disorder， with the aim of providing a reference for clinical diagnosis and treatment

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