Abstract:Alzheimer disease（ AD） is a serious threat to healthy aging. The difficulty lies in its complicated pathogenesis， unknown etiology and lack of effective intervention means. The use of multi-omics technology to explore the spatio-temporal variation rules in the occurrence and development of AD from the gene level to the metabolic level may provide evidence for identifying risk factors， discovering early biomarkers， targeting early intervention time windows， and formulating effective intervention targets. In this paper， we summarize the research progresses of multi-omics technology in AD， aiming to provide references for the related research.

Abstract:Objective To summarize the efficacy and safety of transcranial magnetic stimulation（ TMS） for anhedonia in patients with depressive disorder and schizophrenia and related influencing factors by metaanalysis. Methods The literature on TMS for anhedonia in patients with depressive disorder and schizophrenia was electronically searched in PubMed， Web of Science， Embase， PsycINFO， CINAHL， The Cochrane Library， China National Knowledge Infrastructure， China Biomedical Database， and WanFang Database. The search period was from database establishment to December 2024. Two researchers independently extracted data from the included literature and performed meta-analysis using RevMan 5.4.1 and Stata 16.0. Results A total of 18 papers with a total of 1 175 patients（ 782 with depressive disorder and 393 with schizophrenia） were included. Meta-analysis showed that TMS improved anhedonia in depressive disorder and schizophrenia with a statistically significant difference［ SMD=0.55， 95%CI（ 0.16，0.94），Z=2.74，P=0.006］. Subgroup analysis showed that the efficacy in anhedonia using TMS in the left dorsolateral prefrontal cortex（ DLPFC） was superior to that in other stimulation sites， and the difference was statistically significant［ SMD=0.67，95%CI（ 0.21，1.13）， Z=2.86，P=0.004］. The efficacy of using high-frequency TMS greater than 1 Hz to intervene in anhedonia was superior to other stimulation frequencies， and the difference was statistically significant［ SMD=0.53， 95%CI （0.15， 0.90）， Z=2.74， P=0.006］. The efficacy of the TMS intervention duration of ≥ 4 weeks was superior to the other intervention durations， and the difference met the statistical threshold criterion［ SMD=0.58， 95%CI（ 0.01， 1.16）， Z=1.98， P=0.05］. When assessed using the Negative Symptoms Scale， the improvement in anhedonia was better in intervention group than that in control group， and the difference was statistically significant［ SMD=0.53， 95%CI（ 0.24，0.83）， Z=3.54， P=0.000 4］. TMS had no significant adverse effects relative to other interventions［ RR=0.83， 95%CI（ 0.52， 1.33）， Z=0.78， P=0.44］. Conclusions Longduration， high-frequency and left DLPFC TMS can significantly improve anhedonia in patients with depressive disorder and schizophrenia without significant adverse effects.

Abstract:Objective To explore changes in peripheral biological clock rhythms in patients with ischemic stroke and to analyze the correlation between such changes and alterations in functional connectivity in specific brain regions. Methods Using a prospective case-control design， 17 ischemic stroke patients were recruited as the stroke patient group from January 2018 to July 2019 at the Department of Neurorehabilitation， China Rehabilitation Research Center， and 17 healthy controls were recruited from the community as the healthy control group. The oscillatory periods of peripheral brain and muscle ARNT-Like protein 1（ Bmal1） expression in U2OS cells after serum treatment were compared between the two groups. Resting-state functional magnetic resonance imaging（ rs-fMRI） was used to compare changes in brain functional connectivity between the two groups with bilateral hypothalamus as seed points. Spearman correlation was used to analyze the correlation between changes in biological clock rhythms and alterations in brain functional connectivity among stroke patients. Results The peripheral Bmal1 daily oscillation period was longer in stroke patient group［ （24.33±0.42） h］ than in healthy control group［ （23.81±0.48） h］， and the difference was statistically significant（ t=3.352， P=0.002）. In terms of brain functional connectivity， stroke patient group demonstrated enhanced brain functional connectivity from the hypothalamus to the right talar gyrus and from the hypothalamus to the right Roland's insula lid， and the extent of this enhanced brain functional connectivity was positively correlated with the length of the Bmal1 oscillatory period， with statistically significant differences（ r=0.369， P=0.032； r=0.393， P=0.022）. Conclusions Peripheral biological clock rhythms are altered in patients with ischemic stroke and may be associated with changes in functional connectivity in specific brain regions.

Abstract:Objective To investigate the risk of metabolic syndrome（ MS） in patients with schizophrenia， develop and validate its prediction model. Methods The data of 362 schizophrenia patients in Traditional Chinese Medicine Hospital of Meishan from January 2022 to April 2024 were selected for retrospective analysis. The patients were divided into 253 cases in model group and 109 cases in validation group using the "caret" package in the R language software in a ratio of 7∶3 to collect factors that may affect MS. In model group， patients were divided into MS group and non-MS group according to whether they were combined with MS or not， and the general information， disease and treatment-related indexes of patients in the two groups were compared. LASSO regression was used to screen potential variables and then multifactor Logistic regression was performed to screen potential predictors， which was used to establish the multifactor Logistic regression model. Model validation was performed after visualization in a nomogram. Results There were 62 patients（ 24.51%） with MS in model group. The differences in age， duration of disease， history of smoking， history of drinking， family history of MS， 21-item Three-Factor Eating Questionnaire（ TFEQ-21）scores， average daily exercise time， type of medication， and years of medication between patients in MS group and non-MS group were statistically significant（ all P＜0.05）. Multifactorial Logistic regression analysis showed that age［ OR=1.027， 95%CI（ 1.007，1.047）］， duration of disease［ OR=1.946， 95%CI（ 1.405，2.695）］， body mass index［ OR=1.066， 95%CI（ 1.004，1.132）］， family history of MS［ OR=2.514， 95%CI（ 1.197， 5.281）］， TFEQ-21 score［ OR=1.218， 95%CI（ 1.130， 1.312）］， and type of medication［ OR=2.802， 95%CI（ 1.126， 6.970）］ were independent predictors of MS in patients with schizophrenia（ P＜0.05）. In model group， the area under the receiver operating characteristic（ ROC） curve was 0.856［95%CI（ 0.803，0.908）］， with a sensitivity of 80.6% and a specificity of 73.3%. In validation group， the area under the ROC curve was 0.854［ 95%CI （0.799，0.908）］， with a sensitivity of 77.4% and a specificity of 78.5%. The model curves of model group and validation group were basically fitted diagonally to the ideal model curves. Clinical effectiveness analysis showed the highest net benefit in predicting MS in patients with schizophrenia using the model when the predictive probability threshold was 0.05 to 0.95. Conclusions MS in patients with schizophrenia is mainly influenced by age， disease duration， and body mass index， and a nomogram based on these factors can be used to predict the risk of MS in patients with schizophrenia.

Abstract:Objective To develop and validate a risk prediction model for poor prognosis in patients treated with acute cerebral infarction undergoing endovascular therapy. Methods From January 1， 2020 to December 31， 2022， 180 patients with acute cerebral infarction who underwent early endovascular therapy in the Department of Neurology， Suzhou Hospital of Anhui Medical University were selected for the study. Patient general information and treatment process were collected through the Hospital Management Information System （HMIS）. The National Institutes of Health Stroke Scale（ NIHSS） was used to assess the degree of neurological deficit， the Alberta Stroke Program Early CT Score（ ASPECTS） was used to evaluate the degree of cerebral tissue damage caused by early ischemic changes， and the Modified Rankin Scale（ mRS） was used to evaluate the neurological recovery of stroke patients. Patients were categorized into a good prognosis group（ mRS score ≤2） and a poor prognosis group（ mRS score ＞2） based on the mRS score at 3 months. Risk factors of prognosis were analyzed using multifactorial Logistic regression， and the model was constructed and presented in the form of a nomogram. Consistency of the model was assessed by plotting the calibration curve using the Bootstrap method with 1 000 self-sampling iterations， and decision curve analysis（ DCA） was performed to assess its clinical applicability. Results There were 98 patients in good prognosis group and 82 patients in poor prognosis group. Multifactorial Logistic regression analysis showed that pre-onset mRS score［ OR（ 95%CI）=2.383（ 1.372，4.105）］， ASPECTS［ OR（ 95%CI）=0.481（0.272，0.874）］， and hemorrhagic transformation［ OR（95%CI）=16.370（1.941， 138.220）］ were independent risk factors of patients' prognosis， and the differences were statistically significant （all P＜ 0.05）. The area under the curve（ AUC） of the prediction model was 0.88［ 95%CI（ 0.82，0.94）］. The sensitivity was 0.887， the specificity was 0.792， and the optimal cutoff value was 0.482. The P-value of the Hosmer-Lemeshow test was 1.000， indicating good predictive performance of the model. Conclusions The risk prediction model based on pre-onset mRS score， ASPECTS score， hemorrhagic transformation， and other risk factors of the prognosis of patients after treatment can assist in predicting the prognosis of patients treated with endovascular therapy for acute cerebral infarction.

Abstract:Objective To investigate the effects of apigenin（ Apg） on cognitive impairment in KKAy mice， a model of type 2 diabetes（ T2DM）， and explore its potential mechanisms. Methods Bioinformatics analysis was performed to identify overlapping target genes of Apg， T2DM， and cerebral small vessel disease （CSVD）. Protein-protein interaction（ PPI） analysis， Gene Ontology（ GO）， and Kyoto Encyclopedia of Genes and Genomes（ KEGG） pathway enrichment were conducted using the DAVID database. Ten-week-old SPF grade spontaneous type 2 diabetic KKAy mice weighing（ 36±3） g were selected. KKAy mice were randomly divided into four groups（ n=10 per group）： T2DM model group（ Model group）， and low-（ 3 mg/kg）， medium-（ 6 mg/kg）， and high-dose（ 12 mg/kg） Apg intervention groups（ intraperitoneal injection）. Additionally， 10 C57BL/J mice served as the blank control group（ Control group）. Cognitive function was assessed using the Morris water maze test. The Apg group， which showed the most significant cognitive improvement， was selected for further experiments， including RT-PCR， inflammatory factor detection， and Western blotting. Neuronal apoptosis， tumor protein 53（ TP53）， interleukin-6（ IL-6）， tumor necrosis factor-α（ TNF-α）， I L-1β， B-cell lymphoma-2 （Bcl-2）， Bcl -2-associated X protein（ Bax）， and caspase-3 expression levels were measured. Results TNF-α and TP53 were identified as key target genes， with downstream interactions mainly involving Caspase and Bid family proteins. The MWM test showed that mice in the high-dose Apg group exhibited significantly increased platform crossings［ （4.42±0.76） vs.（ 1.80±0.41） times， t=9.59， P＜ 0.05］ and longer residence time in the target quadrant［ （33.5±6.1） vs.（ 16.1±4.1）s， t=7.49，P＜ 0.05］ compared with the Model group， indicating improved cognitive function. Thus， the high-dose group was selected for subsequent studies（ named as Apg group）. Further experiments showed that compared with the Model group， Apg intervention significantly reduced the expression of TNF-α［ （50.4±9.6） vs（. 29.3±7.1） pg/ml， t=6.28， P＜0.01］， IL-1β［ （60.4±13.6） vs（. 28.7± 7.1） pg/ml， t=6.56， P＜0.01］， IL-6［ （3.4±0.5） vs（. 1.8±0.3），t=5.58，P＜0.01］ and TP53［ （4.4±0.9） vs（. 2.3±0.4）， t=6.18， P＜ 0.01］ in mouse hippocampus. It also decreased the expression of Bax［ （2.74±0.60） vs.（ 1.60±0.30）， t=5.18， P＜0.05］ and Caspase-3 proteins［ （3.14±0.60） vs（. 1.80±0.40）， t=5.58， P＜0.05］， increased Bcl-2 protein expression［ （0.61±0.10） vs.（ 0.78±0.10）， t=4.46， P ＜ 0.05］， and reduced neuronal apoptosis ［（30.4±5.6）% vs.（ 18.0±2.1）%， t=6.56， P ＜ 0.01］. Conclusions Apg may exert neuroprotective effects against T2DM-induced cognitive impairment through anti-inflammatory（ downregulating TNF-α， IL-1β， IL-6）， anti-apoptotic（ regulating Bax/Bcl-2/Caspase-3）， and TP53 signaling pathway modulation mechanisms.

Abstract:Objective To evaluate the impact of "Free Medication Policy" in Tianjin on medication adherence among impoverished patients with severe mental disorders in the community. Methods A total of 14 935 impoverished patients with severe mental disorders in the 2021 Tianjin Mental Health Information System were selected as research subjects. The differences in medication adherence between 3 722 impoverished patients with severe mental disorders who participated in the "Free Medication Policy" and 11 213 impoverished patients with severe mental disorders who did not participate in the "Free Medication Policy" were compared， and the relevant factors of medication adherence were analyzed. Logistic multiple regression was used to analyze the impact of "Free Medication Policy" on patients' medication adherence. Results Among 14 935 impoverished patients with severe mental disorders， 3 722（ 24.92%） participated in the "Free Medication Policy". The proportion of patients who participated in the "Free Medication Policy" taking medication regularly was 95.43%（3 552/3 722）， which was significantly higher than the 87.75%（ 9 839/11 213） of patients who did not participate， and the difference was statistically significant（ χ2=178.09， P＜ 0.01）. The probability of patients participating in the "Free Medication Policy" taking medication regularly was 2.72 times that of patients who did not participate in the policy［ OR=2.72， 95%CI（ 2.29，3.23）］. Previous risky behavior［ OR=1.36， 95%CI（ 1.01， 1.84）］ and hospitalization［ OR=1.16， 95%CI（ 1.02，1.32）］ were protective factors for patients taking medication regularly， and schizophrenia［ OR=0.80， 95%CI（ 0.69，0.92）］ and weak monitoring［ OR=0.73， 95%CI（ 0.61， 0.87）］ were risk factors for patients taking medication regularly. Conclusions The "Free Medication Policy" improves the medication adherence of impoverished patients with severe mental disorders in the community. In community prevention and control work， special attention should be paid to the medication situation of patients with schizophrenia and weak monitoring， and policy promotion and guidance should be increased.

Abstract:In recent years， with the technological development of several medical fields such as molecular genetics， pathology and imaging， neurodegenerative diseases have made significant breakthroughs in both basic research and clinical practice， and precise diagnosis and treatment have become possible. Therefore， it is crucial to train specialized postgraduates with a precision medicine mindset. This paper applies the concept of precision medicine to the training of postgraduates majoring in neurodegenerative diseases on the basis of the traditional training mode， improves and optimizes the teaching content and teaching methods， and builds a multidisciplinary joint teaching platform， which will improve the clinical diagnosis and treatment ability and research and innovation ability of postgraduates majoring in neurodegenerative diseases， and provide a new idea for the cultivation of compound talents in the field of neurodegenerative diseases.

Abstract:The etiology and pathogenesis of depressive disorder are complex， and different patients respond differently to treatment. Treatment outcomes for patients with depressive episodes associated with specific psychological stress are generally suboptimal， and the causes and mechanisms for this are still unclear. The research in neuroimmunology and inflammatory factors provides new ideas for the clinical diagnosis and treatment of patients with depressive episodes associated with specific psychological stress. This paper summarizes the association between psychological stress， depressive disorder and inflammatory factors with the aim of revealing the potential pathogenesis of depressive episodes associated with specific psychological stress.

Abstract:Recent studies have shown abnormalities in neurometabolism in brain regions such as prefrontal cortex， anterior cingulate gyrus， and striatum in a variety of mental disorders. Currently， magnetic resonance spectroscopy is an important tool for studying cerebral neurometabolism. This paper reviews the latest progress in the neurometabolism of three functional brain regions， prefrontal cortex， anterior cingulate gyrus， and striatum， in bipolar disorder and obsessive-compulsive disorder， with the aim of providing references for further exploring the possible neurobiological mechanisms of the two disorders and the possible neural pathways of their comorbidities.

Abstract:Neurosurgical patients are prone to acquired infectious diseases due to a variety of factors such as indwelling catheters， long-term bedridden， and low resistance， leading to a poor prognosis. Traditional pathogen detection methods take a long time to detect pathogens and have a low positive rate， making it easy to delay treatment. As a method of detecting pathogens， metagenomic next-generation sequencing（ mNGS） is characterized by fast detection speed and high sensitivity， which can effectively detect pathogens and provide clinicians with a basis for antibiotic use. This paper analyzes the effectiveness of mNGS in the diagnosis and treatment of acquired infectious diseases in neurosurgical patients， with a view to providing a reference for the future treatment of acquired infectious diseases in neurosurgical patients.

Abstract: