Abstract:Lung cancer is one of the malignant tumors with the highest morbidity and mortality worldwide， in which brain metastases are a common complication of advanced lung cancer， significantly affecting the quality of life and survival of patients. With the development of genomics technologies such as genomics， transcriptomics， proteomics and metabolomics， research on lung cancer brain metastases has gradually deepened. The trans-omics approach systematically resolves tumor molecular features by integrating genome sequencing， single-cell transcriptome analysis， high-throughput mass spectrometry proteomics， and metabolite profiling analysis， and reveals the molecular mechanisms of brain metastases of lung cancer in a multidimensional way， which provides a significant advantage in early diagnosis. Radiomics combined with multi-omics data allows early identification of patients with asymptomatic brain metastases and dynamic monitoring of treatment response by metabolic markers（ e.g. GSH， AKR1B10）. Genomic analysis of circulating tumor DNA in blood or cerebrospinal fluid can detect genetic mutations associated with lung cancer brain metastases for early warning. Transcriptome combined with proteomics analysis can identify specific gene expression profile changes and provide molecular markers for early diagnosis. Based on trans-omics diagnosis， this paper reviews the data from multi-omics studies by integrating them and explore their potential application and clinical translation in precision medicine， with a view to providing new ideas and references for trans-omics diagnosis of brain metastases in lung cancer.

Abstract:Objective To explore the overall expression of mRNA in peripheral blood mononuclear cell（ PBMC） of patients with bipolar disorder（ BD） and analyze the immune infiltration. Methods From October 2022 to July 2023， 24 patients with BD and 12 healthy controls（ HC） attending the Mental Health Center of the First Hospital of Hebei Medical University were selected for the study. Genome-wide gene expression profiles in PBMC of 36 enrollees were analyzed using microarrays for Gene Ontology（ GO） and Kyoto Encyclopedia of Genes and Genomes（ KEGG） pathway enrichment analysis. Protein-protein interaction（ PPI） analysis was performed and immune cell infiltration and its interrelationships were assessed using gene set variation analysis（ GSVA）. Results A total of 304 differentially expressed genes（ DEGs） were identified in BD versus HC comparisons， of which 217 genes were upregulated and 87 genes were downregulated. Enrichment analysis suggested that biological processes and signaling pathways related to extracellular matrix， stress response， heparin binding， and immune inflammation were upregulated in BD group. In the IL-17 pathway， Jun， Fosb， Fosl1， TNFAIP3， NFKBIA， CXCL2， CXCL8， IL6， and IL17C gene expression was upregulated in BD patients compared to HC. Real-time quantitative reverse transcription PCR（ qRT-PCR） analysis showed that Jun， Fosb， Fosl1， NFKBIA， TNFAIP3， CXCL2 and CXCL8 gene expression were upregulated in BD， but only Jun， Fosl1， NFKBIA， CXCL2 and CXCL8 changes were statistically significant（ all P＜0.05）. Immune infiltration analysis showed that central memory CD4+ T cells（ P=0.010）， eosinophils（ P=0.038） and mast cells（ P=0.029） were infiltrated increased in BD group， and there were positive correlations between effector memory CD8+ T cells and activated CD8+ T cells and T follicular helper cells， and the differences were statistically significant（ r=0.56，0.58， both P ＜ 0.05）. Conclusions This study integrates transcriptomics and immune microenvironment analysis to reveal characteristic changes in the peripheral immune system of BD patients， suggesting that the peripheral immune system may be involved in the pathogenesis of BD through chemokine-induced inflammatory responses. Immune infiltration analysis reveals the presence of a chronic immune activation state in patients with BD.

Abstract:Objective To investigate the effects of urine dry chemical indexes on the detection level of Alzheimer-associated neuronal thread protein（ AD7c-NTP） in the elderly population. Methods A total of 455 health examination subjects from the Affiliated Hospital of Guilin Medical University from July 2021 to March 2022 were selected as participants. Urine samples were collected， the concentration of AD7c-NTP were detected by enzyme-linked immunosorbent assay（ ELISA）， the urine dry chemical indicators were detected by dry chemical analyzer. Non-parametric test was used to analyze the effects of urine dry chemical indexes on AD7c-NTP levels， partial correlation test was used to analyze the correlation between urine dry chemical indexes and AD7c-NTP. Results The urine AD7c-NTP level in men was lower than that in women， and the difference was statistically significant（ P＜0.05）. There was significant difference in the level of AD7c-NTP among different age groups（ P＜0.01）. There were no significant differences in the levels of AD7c-NTP in different subgroups of pH， specific gravity， nitrite and glucose in male urine dry chemistry indexes（ all P ＞ 0.05）； There were significant differences in AD7c-NTP levels among different subgroups of people with turbidity， occult blood， granulocyte esterase and urinary protein（ all P＜0.05）. There was no correlation between AD7c-NTP level and urine turbidity， pH value， specific gravity， nitrite， glucose in male urine dry chemical indicators（ all P＞0.05）； The level of AD7c-NTP was correlated with the degree of occult blood in urine， granulocyte esterase and urinary protein（ all P＜0.05）. There were no significant differences in the levels of AD7c-NTP in different subgroups of female urine dry chemical indicators， such as pH value， specific gravity， glucose and occult blood（ all P＞0.05）； The levels of AD7c-NTP in different subgroups of turbidity， nitrite， granulocyte esterase and urinary protein were significantly different（ all P＜0.05）. There was no correlation between urine pH， specific gravity， glucose and AD7c-NTP levels in female（ all P ＞0.05）； Urine turbidity， nitrite， occult blood， granulocyte esterase and urine protein were correlated with AD7c-NTP levels（ all P＜0.05）. Conclusions The urine nitrite， occult blood， granulocytic esterase and protein of dry chemical indexes were correlated with AD7c-NTP， the interpretation of AD7c-NTP detection results in clinical application should refer to urine dry chemical indexes.

Abstract:Objective To explore the correlation between triglyceride-glucose（ TyG） index and cognitive impairment in patients with Parkinson's disease（ PD）. Methods The clinical data of 268 PD patients in the Parkinson's Group of the Department of Neurology， Xuanwu Hospital of Capital Medical University from August 2019 to December 2022 were selected for retrospective analysis. Montreal Cognitive Assessment（ MoCA） was applied to assess the subjects' cognitive function. Patients with MoCA ＜ 26（ plus 1 point for illiteracy） were categorized into cognitive impairment group（ 169 cases）， and those with MoCA ≥ 26 were categorized into non-cognitive impairment group（ 99 cases）. General information and laboratory parameters such as triglycerides（ TG）， glycosylated hemoglobin（ HBA1c）， and fasting plasma glucose（ FPG） were collected from the subjects and the TyG index was calculated. The motor symptoms of PD patients were evaluated by the Unified Parkinson's Disease Rating Scale Part Ⅲ（ UPDRS Ⅲ） of the Movement Disorders Society， and their severity was evaluated by using the modified Hoehn-Yahr stage. Quality of life of PD patients was evaluated using the 39-item Parkinson's Disease Questionnaire（ PDQ-39）. Multifactorial Logistic regression was used to analyze the risk factors of cognitive impairment in PD and to construct a Logistic regression prediction model for cognitive impairment. Area under the receiver operating characteristic（ ROC） curve was plotted and the optimal model best cut-off values and sensitivities and specificities were calculated. Results Univariate analysis showed that the differences in age， education， UPDRS Ⅲ score， PDQ-39 score， HBA1c， TyG index， urinary frequency， and diabetes mellitus were statistically significant between the two groups（ all P＜0.05）. Multifactorial Logistic regression analysis showed that age［ OR=1.06， 95%CI（ 1.02， 1.09）］， TyG index［ OR=5.67， 95%CI（ 2.80， 11.46）］， and diabetes mellitus［ OR=2.99， 95%CI（ 1.07， 8.36）］ were independent influencing factors of cognitive impairment in patients with PD. The results of the ROC curve showed that the best cutoff value of the prediction model constructed from the three indicators of age， TyG index， and diabetes mellitus was 0.635， with a sensitivity of 0.692， a specificity of 0.768， and an area under the ROC curve of 0.777. Conclusions Age， TyG index， and diabetes mellitus are independent influencing factors of cognitive impairment in PD. A prediction model consisting of age， TyG index and diabetes mellitus has a good predictive performance for cognitive impairment in patients with PD.

Abstract:Objective To explore the neuroprotective effect of APP5-mer Peptide Memantine （RERMS-MEM） on glutamate-induced injury of SY5Y cells. Methods SY5Y cells were cultured aseptically， and the injury model was established with high concentration of L-glutamic acid（ 10 mM）. RERMS-MEM was self-designed and synthesized. After screening the effective concentration of drugs by MTT method， SY5Y cells were divided into control group， L-glu injury group， L+RM group（ L-glu+RERMS-MEM） and L+M group（ L-glu+MEM）. MTT assay was used to detect the survival rate of cells， LDH kit was used to detect the leakage rate of LDH in supernatant， Western blot was used to detect the expression of nerve growth factor （NGF） and BDNF protein， real-time fluorescence quantitative PCR was used to detect the expression of NGF and BDNF mRNA， DCFH-DA kit was used to detect the expression of reactive oxygen species（ ROS） in each group. Results MTT assay was used to detect the effect of RERMS-MEM on the survival rate of SY5Y cells damaged by L-glu. Compared with control group［ cell survival rate was（ 100.00±5.01） %］， the cell survival rate decreased to（ 74.89±4.94） % in L-glu group， the difference was statistically significant（ P ＜ 0.05）. Compared with L-glu group， the survival rate of cells treated with RERMS-MEM at 1， 5， 10 and 20 μM was （86.40±14.81）%，（ 90.24±5.87） %，（ 90.47±8.10） % and（ 91.84±11.60） %， respectively， showing a dosedependent increase in cell survival rate with RERMS-MEM， and the difference was statistically significant at 5，10， and 20μM intervention（ all P＜0.05）. Compared with L-glu group， the cell survival rate of L+M group at low concentration（ 1， 5， 10 μ m） was improved， but the difference was not statistically significant（ all P＞ 0.05）. After 20 μM intervention， the cell survival rate was significantly reduced to（ 61.37±10.32）%， and the difference was statistically significant（ P ＜ 0.05）. Finally， 5μM was selected as the intervention dose of RERMS-MEM and MEM. The results of Muse cell analyzer showed that the number of living cells in the L-glu group was significantly lower than that in the control group（ P ＜ 0.01）. Compared with the L-glu group， the number of living cells in the L+RM group was significantly increased after RERMS-MEM intervention， and the difference was statistically significant（ P ＜ 0.01）. After MEM intervention in L+M group， the number of living cells increased less than that in L+RM group， and the difference was not statistically significant（ P ＞ 0.05）. LDH test results showed that compared with the control group， the LDH leakage rate of the L-glu group was significantly increased， and the difference was statistically significant（ P＜0.01）. Compared with the L-glu group， the LDH leakage rate of the L+RM group was significantly reduced， and the difference was statistically significant（ P＜ 0.01）. The LDH leakage rate of the L+M group was also reduced， but the difference was not statistically significant（ P ＞ 0.05）. The results of Western Blot and RT-qPCR showed that compared with the control group， the relative expression of NGF protein and mRNA in the L-glu group was significantly decreased， and the difference was statistically significant（ all P ＜ 0.05）. Compared with the L-glu group， the expression levels of L+RM group and L+M group were significantly increased， and the differences were statistically significant（all P ＜ 0.05）. And the L+RM group showed higher NGF protein and mRNA expression levels compared to the L+M group. BDNF detection results indicated a statistically significant difference between the L+M group and the L-glu group（P ＜ 0.05）. The relative mRNA expression level was not significantly increased， but the difference between the L+M group and the L-glu group was statistically significant（ P ＜ 0.05）. Compared with the control group， ROS expression levels in the L-glu group were significantly elevated by two detection methods， and the difference was statistically significant（ P＜0.05）. Compared with the L-glu group， ROS expression in both the L+RM group and the L+M group was reduced， and the difference was statistically significant（ both P＜0.05）， and the reduction was more pronounced in the L+RM group. Compared with the control group， the total cell apoptosis rate in the L-glu group was increased， and the difference was statistically significant（ P ＜ 0.01）. Compared with the L-glu group， the total cell apoptosis rates in both the L+RM group and the L+M group were reduced， and the difference was statistically significant（ both P＜0.01）. Conclusions APP5-mer Peptide memantine has better neuroprotective effect and lower cytotoxicity in vitro than memantine. The neuroprotective effect of RERMS-MEM may be realized by inhibiting apoptosis， oxidative stress injury and increasing the expression of neurotrophic factors.

Abstract:Cognitive impairment is a varying degree of impairment of cognitive functioning from a variety of causes， and it is strongly associated with the occurrence of dysphagia. Dysphagia can occur in any one or more stages of the mouth， pharynx， or esophagus. Dysphagia presenting in cognitively impaired patients often goes unnoticed， leading to lung infections， malnutrition， dehydration， and reduced quality of life， resulting in increased morbidity and mortality and prolonged hospital stay. Swallowing function can be assessed in multiple dimensions， and early recognition of dysphagia and timely prevention and treatment can improve patients' quality of life. This article reviews studies related to cognitive impairment and dysphagia with the aim of increasing awareness and attention among healthcare professionals so that early interventions can be implemented to delay and prevent the onset of adverse disease outcomes and improve the quality of life of patients with cognitive impairment.

Abstract:Objective To investigate the correlation between self-rating and other-rating scales for symptom assessment and overall state assessment in depressive disorder patients treated with esketamine nasal spray. Methods Data were collected from 32 patients with depressive disorder who participated in a clinical trial of esketamine nasal spray treatment from June 2018 to February 2021 at Beijing Anding Hospital， Capital Medical University. All patients were randomly divided into the experimental group（ 18 cases） and the control group（ 14 cases） treated with esketamine nasal spray for 4 weeks and twice a week after the clinical trial of esketamine. Patients were assessed using the Montgomery-Asberg Depression Rating Scale（ MADRS）， Generalized Anxiety Disorder（ GAD-7）， Clinical Global Impression-Severity of Illness Scale（ CGI-S）， and the European Quality of Life-5 Dimensions 5 Levels（ EQ-5D-5L） on days 15（ D15） and 28（ D28） of the treatment period， and weeks 2（ W2）， 5（ W5）， and 8（ W8） of the follow-up period. The correlation of the amount of change was analyzed using Pearson's correlation and linear regression with repeated measures. Results In all subjects， the self-rating GAD-7 correlated moderately with the other-rating MADRS during the treatment and follow-up periods（ D28： r=0.420， P=0.017； W5： r=0.417， P=0.022； W8： r=0.568， P=0.001）. The amount of change in the self-rating EQ-5D-5L during the treatment period did not correlate statistically with the amount of change in the other-rating CGI-S（ D15： P=0.393， D28： P=0.187）， but showed a moderate correlation during the follow-up period（ W5： r=0.402， P=0.028； W8： r=0.473， P=0.008）. In the experimental group of ketamine administration， there was no correlation between the CGI-S reduction score of all scoring points and the EQ-5D- 5L addition rate（ P＞0.05）. In the placebo control group， there was a significant positive correlation between CGI-S score reduction and EQ-5D-5L score increase rate on the 15 th day of treatment， the 2 nd week， the 5 th week and the 8 th week of follow-up（ D15：r=0.740，P=0.003；W2：r=0.594，P=0.025；W5：r=0.675，P=0.016； W8：r=0.599，P=0.031）. Conclusions During treatment with esketamine nasal spray， self-rating of overall state in depressive disorder patients do not correlate significantly with other-rating， whereas there is a moderate correlation in the assessment of symptoms， and the combination of self-rating and other-rating contributes to a comprehensive assessment.

Abstract:Objective To explore the correlation of thrombus pathologic components with clinical features and prognosis of endovascular treatment（ EVT） in patients with acute ischemic stroke（ AIS）. Methods A total of 120 AIS patients admitted to Chongqing University Fuling Hospital for EVT from January 2021 to January 2024 were selected to analyze their postoperative histology of thrombus pathology. Three months after surgery， the patients were categorized into good prognosis group（ 94 cases，mRS≤2） and poor prognosis group（ 26 cases，mRS＞2） according to the modified Rankin Scale（ mRS） score. Logistic regression was used to analyze the correlation between the thrombus pathological components and clinical features and prognosis of EVT. Results There was no significant difference in gender， history of diabetes mellitus， smoking and drinking， interval from onset to admission， scores of NIHSS and Alberta Stroke Program Early CT（ ASPECT） at admission， occlusion sites， thrombectomy frequency or interval from puncture to reflow between the two groups（ all P＞0.05）. The proportions of age ≥65 years， hypertension history and fibrin-rich thrombus in poor prognosis group were higher than those in good prognosis group（ χ2=5.701，10.343，16.094，all P ＜ 0.05）. Logistic regression analysis with prognosis as the dependent variable revealed that age ≥ 65 years， history of hypertension， and fibrin-rich thrombus were risk factors for poor prognosis in patients with AIS， and the difference was statistically significant（ OR=1.168， 1.155， 1.256， all P ＜ 0.05）. Conclusions Age， blood pressure， and thrombus pathologic composition are influencing factors of the prognosis of EVT in patients with AIS.

Abstract:Parkinson's disease（ PD） is a chronic neurodegenerative disorder characterized by symptoms such as tremor， rigidity， bradykinesia， and balance impairment， in which the importance of the insulin signaling pathway in PD has received increasing attention. Patients with PD often have insulin resistance， which is closely related to the pathologic process of PD and the worsening of its symptoms. Antidiabetic drugs show potential neuroprotective effects in the treatment of PD due to their modulatory effects on insulin sensitivity. This paper describes the mechanism of insulin signaling pathway in PD， aiming to assess the prospect of antidiabetic drugs for PD.

Abstract:As medicine and technology continue to evolve， the diagnosis rate of adult attention deficit hyperactivity disorder（ ADHD） has been rising year by year， and the attention is growing. Currently， the concept of smart healthcare is widely spread and applied in various fields of medical health. This paper focuses on the current development of smart medicine and the diagnostic challenges of adult ADHD， explores the prospects for the application of smart medical devices in adult ADHD， discusses the feasibility of smart medical devices to assist in the diagnosis of adult ADHD， and proposes ethical and safety issues that may be involved in the process of the research， as well as the possible risks and challenges.

Abstract:Multiple sclerosis（ MS） is an immune-mediated inflammatory demyelinating disease of the central nervous system and a leading cause of non-traumatic disability in young adults. Fatigue， characterized by its persistence and complexity， is a common and debilitating symptom among MS patients， significantly impacting rehabilitation outcomes and quality of life. Numerous fatigue assessment tools have been developed internationally for screening and evaluating fatigue in MS. This article reviews and analyzes the characteristics and clinical applications of these tools， aiming to raise awareness among healthcare professionals regarding fatigue management in MS patients and to provide evidence-based references for optimizing fatigue assessment and intervention strategies in clinical practice.