Abstract:Bipolar disorder（ BD） is a severe mental disorder characterized primarily by recurrent mood swings， with a prolonged course and high recurrence rate. Epidemiological evidence indicates that individuals with BD have a significantly higher risk of developing physical diseases compared to the general population. These comorbidities exhibit a multisystem clustering pattern and exert a substantial impact on functional outcomes and mortality risk. The comorbidity relationship between BD and physical diseases is relatively complex， and its mechanisms may involve pathological and physiological changes in BD patients， adverse drug reactions， shared biological mechanisms， or unhealthy lifestyles. Accordingly， this paper reviews the epidemiological characteristics and potential mechanisms of BD and common physical disease comorbidities， analyzes the management difficulties posed by comorbidity in diagnostic identification， medication selection， treatment adherence， and medical collaboration， and proposes clinical response strategies centered on early risk stratification， regular physical monitoring， and multidisciplinary integrated care， aiming to provide references for improving the long-term outcome of BD patients.

Abstract:Objective To compare the characteristics of attempted suicide in patients with schizophrenia， major depressive disorder， and bipolar disorder， to provide a scientific basis for developing suicide prevention frameworks for patients with different mental illnesses and to promote the further advancement of suicide prevention efforts. Methods This study was a cross-sectional study. From October 2022 to October 2024， 256 patients were enrolled from Beijing Huilongguan Hospital， Tianjin Anding Hospital， and the First Hospital of Shanxi Medical University. All patients met the diagnostic criteria for schizophrenia， major depressive disorder， or bipolar disorder as outlined in the Diagnostic and Statistical Manual of Mental Disorders， Fourth Edition（ DSM- Ⅳ） and reported a history of suicide attempts. Demographic characteristics， clinical features， and characteristics of the most recent suicide attempt were collected through patient interviews. Multiple Logistic regression analysis was conducted to compare clinical and suicide attempt characteristics across groups. Results This study included patients who reported suicide attempts， including 57 patients with schizophrenia， 140 patients with major depressive disorder and 59 patients with bipolar disorder. Compared with major depressive disorder group and bipolar disorder group， individuals with schizophrenia exhibited a higher proportion of "very few" suicidal ideation before their most recent attempted suicide［ 29.8%（17/57） vs. 7.9%（11/140） and 16.9%（10/59）］， with a statistically significant difference（ χ2=27.00， P＜ 0.01）. The proportion of individuals with attempted suicide in major depressive disorder group was higher than that in schizophrenia group［ 65.2%（90/140） vs. 45.6%（26/57）］， and the intensity of suicide intention was also higher than that in schizophrenia group［ 14.0（11.0，15.8） vs. 12.0（11.0，14.0）］， with statistically significant differences（ χ2/ H=6.39，7.10； both P ＜ 0.05）. The primary methods of suicide attempts across the three patient groups were low-lethality methods such as medication and cutting［ 66.7%（38/57）， 68.6%（96/140）， 67.8%（40/59）］， with no statistically significant differences（ χ2=0.37，P ＞ 0.05）. Multiple Logistic regression analysis revealed that compared with major depressive disorder group， patients with schizophrenia were significantly more likely to experience infrequent suicidal ideation before suicide attempts［ OR（95%CI）=15.47（1.25，191.52）］. Compared with major depressive disorder group or bipolar disorder group， schizophrenia group had lower levels of depressive disorder［ OR（95%CI）=0.77（0.69，0.86）， 0.82（0.73，0.92）］， higher levels of hallucinations［ OR （95%CI）=1.09（1.04，1.15）， 1.07（1.02，1.11）］， and higher levels of delusions［ OR（95%CI）=1.07（1.01，1.14）， 1.08（1.01，1.16）］. The level of social support in schizophrenia group was lower than that in bipolar disorder group［ OR（95%CI）=0.86（0.79，0.95）］. Conclusions Patients with schizophrenia exhibited significantly lower frequencies of suicidal ideation before attempting suicide compared to those with MDD and BD. Lowlethal methods such as medication and cutting were main methods of attempted suicide among all three groups. Therefore， suicide prevention efforts should strengthen the standardized management of medications and sharp objects to reduce accessibility risks. For patients with schizophrenia specifically， it is necessary to move beyond the suicide ideation-centered risk assessment model， and integrate their psychiatric symptoms to establish a more comprehensive evaluation and prevention system， which will facilitate precise suicide intervention for patients with different mental disorders.

Abstract:Objective To explore the relationship between inferiority complex and ventromedial prefrontal cortex（ vmPFC） neurometabolites and personality traits in patients with bipolar depression. Methods From February 2024 to March 2025， 40 patients with bipolar depression who were either outpatient or inpatient at the Department of Clinical Psychology of People's Hospital of Xinjiang Uygur Autonomous Region were selected as study subjects. Patients were grouped based on their inferiority complex scores on the 24-item Hamilton Depression Rating Scale（ HAMD-24）. Those with an inferiority complex score ＞ 1 were assigned to the inferiority complex group， while those with an inferiority complex score ≤ 1 were assigned to the non-inferiority complex group. Each group comprised 20 patients. General Information Questionnaire and Eysenck Personality Questionnaire were used to collect patients' general information and evaluate their personality traits. The 1H-magnetic resonance spectroscopy（ 1H-MRS） was used to detect the ratios of N-acetyl-aspartate （NAA）/creatine（ Cr）， choline（ Cho）/Cr， myo-inositol（ mI）/Cr， and glutamate/glutamine（ Glx）/Cr in the vmPFC. Results Patients with bipolar disorder experiencing inferiority complex had a mean mI/Cr value of 0.43（ 0.35， 0.52）， which was statistically lower than the 0.52（ 0.43， 0.59） in patients without inferiority complex（ Z=-2.124， P＜ 0.05）. Compared with non-inferiority complex group， inferiority complex group scored lower on introversion extraversion score［ （42.75±6.97） vs.（ 51.75±10.04）］， with a statistically significant difference（ t=3.294， P＜0.05）. Correlation analysis revealed that NAA/Cr in non-inferiority complex group were negatively correlated with disease duration and age（ r=-0.474， -0.511； both P＜0.05）， mI/Cr positively correlated with neuroticism scores（ r=0.576， P ＜ 0.01）， and Cho/Cr positively correlated with age（ r=0.613， P ＜ 0.01）， all differences were statistically significant. Multivariate Logistic regression analysis showed that introversion extroversion was an influencing factor of inferiority complex in patients with bipolar depression， with a statistical difference ［OR=0.870， 95%CI（ 0.782， 0.968）， P ＜ 0.05］. Conclusions Low mI/Cr values in the vmPFC may be associated with inferiority complex in patients with bipolar depression. The inferiority complex in patients with bipolar depression is associated with introversion extroversion personality traits， and extroversion may serve as a protective factor against this inferiority complex in such patients.

Abstract:Objective To explore the neuro-metabolism and thyroid function in female adolescents with bipolar depression and obsessive-compulsive symptoms（ OCS）. Methods From January 2024 to February 2025， 35 female adolescents with bipolar depression who received outpatient or inpatient treatment at the Department of Clinical Psychology of People's Hospital of Xinjiang Uygur Autonomous Region were selected as study subjects. According to whether there was significant OCS and the Children's Yale-Brown Obsessive Compulsive Scale（ CY-BOCS） score， patients were divided into an OCS group（ n=20， CY-BOCS score ≥16） and non- OCS group（ n=15， CY-BOCS score≤7）. The 24-item Hamilton Depression Scale（ HAMD-24） and Young Mania Rating Scale（ YMRS） were used to assess patients' depressive and manic symptoms， respectively. 1H-magnetic resonance spectroscopy（ 1H-MRS） was employed to assess metabolic levels of N-acetyl-aspartate（ NAA）， choline（ Cho）， myo-inositol（ mI）， and glutamate/glutamine complex（ Glx）， and creatine（Cr） in the ventromedial prefrontal cortex（ vmPFC） of patients. Chemiluminescent immunoassay was utilized to detect serum thyroid function indicators. Binary Logistic regression was used to examine the association between neuro-metabolism， thyroid function， and OCS. The calibration and discriminatory performance of the model were assessed using the Hosmer-Lemeshow test and receiver operating characteristic（ ROC） curve. Results Patients in OCS group had higher HAMD-24 scores［ （26.8±5.8） vs.（ 23.2±3.9）］ and longer disease duration［ 3.0（ 1.0，5.0） years vs. 1.0（ 0.5，2.0） years］ than those in non-OCS group， with statistically significant differences（ t=-2.070， Z= -2.190； both P＜ 0.05）. Patients in OCS group exhibited lower NAA/Cr values and FT3 levels compared to non- OCS group［ 1.56（ 1.18， 1.72） vs. 1.87（ 1.72，2.04），（ 3.13±0.49） vs（. 3.48±0.50）］， with statistically significant differences（ Z=-3.200， t=2.049； both P＜0.05）. Binary Logistic regression analysis revealed that the NAA/Cr value［ OR=0.091， 95%CI（ 0.014，0.588）， P=0.012）］ was a protective factor for patients with OCS， with a statistically significant difference（ Hosmer-Lemeshow test χ2=9.00， P=0.253； area under the ROC curve was 0.820， P ＜ 0.001）. Conclusions Among female adolescents with bipolar depression， those with comorbid OCS exhibit severe depression， long disease duration， and low NAA/Cr values and serum FT3 levels in vmPFC. Decreased NAA/Cr is independently associated with comorbid OCS， suggesting its potential as a biological marker for identifying such comorbidities.

Abstract:Objective To explore the relationship between the brain biochemical metabolism of the ventromedial prefrontal cortex（ vmPFC） and childhood trauma in pediatric bipolar disorder using 1H-magnetic resonance spectroscopy（ 1H-MRS）. Methods From March to September 2023， 43 children and adolescent patients with bipolar disorder who were either outpatient or inpatient at the Department of Clinical Psychology of People's Hospital of Xinjiang Uygur Autonomous Region were selected as study subjects. Childhood Trauma Questionnaire（ CTQ） was used to assess the childhood trauma in children and adolescents with bipolar disorder， subsequently dividing patients into a trauma group（ n=20） and a non-trauma group（ n=23）. Using 1H-MRS， the ratios of the vmPFC neurometabolites N-acetyl-aspartate（ NAA）/creatinine（ Cr）， myo-inositol（ mI）/Cr， and choline（ Cho）/Cr were compared between the two groups of patients. Results There were no statistically significant differences between the two groups of patients in terms of age， gender， only-child status， place of residence， years of education， age at onset， disease duration， or family history（ all P ＞ 0.05）. The NAA/ Cr value in trauma group was（ 1.49±0.17）， which was statistically lower than that in non-trauma group ［（1.67±0.10）］（ t=4.397，P ＜ 0.001）. There was no statistically significant difference in Cho/Cr and mI/Cr values between the two groups of patients（ both P＞0.05）. Conclusions Compared to patients without trauma， those with trauma may exhibit lower levels of NAA in the vmPFC.

Abstract:Adolescent bipolar disorder（ BD） exhibits complex pathophysiological associations with overweight/obesity in brain-metabolism， involving maternal pregnancy， brain structure， cerebral blood flow， blood lipids， and appetite hormones. This paper reviews the relationship between adolescent BD and overweight/ obesity in terms of brain-metabolism and treatment， and explores potential research directions.

Abstract:Objective To explore the prognostic value of peripheral blood neutrophil-to-lymphocyte ratio（ NLR）， platelet-to-lymphocyte ratio（ PLR）， systemic immune-inflammation index（ SII）， and systemic inflammatory response index（ SIRI） in patients with myasthenia gravis（ MG）. Methods Clinical data from 117 MG patients admitted to the Affiliated Hospital of Xuzhou Medical University between September 2018 and June 2022 were retrospectively analyzed. All patients underwent blood routine examination upon admission， with calculation of the NLR， PLR， SII and SIRI. The severity of MG was assessed using the Myasthenia Gravis Foundation of America（ MGFA） clinical classification. The Myasthenia Gravis Foundation of America-Post Intervention Status（ MGFA-PIS） was used to assess the prognosis of MG patients. Complete stable remission， pharmacological remission， and minimal manifestations were considered favorable prognoses， while states below minimal manifestations were considered poor prognoses. Patient prognosis was recorded through telephone and outpatient follow-up. Logistic regression model was employed to analyze the data， and receiver operating characteristic（ ROC） curve was used to evaluate the discriminatory efficacy of various immune markers in predicting the prognosis of MG patients. Based on the optimal cutoff values from the ROC curves of each model， samples were divided into high-expression and low-expression groups for further intergroup comparative analysis and Spearman correlation analysis. Results The favorable prognosis group（ 85 cases） and the poor prognosis group（ 32 cases） exhibited statistically significant differences in disease classification， disease duration， hematological indicators（ white blood cell count， neutrophil count， lymphocyte count）， NLR， PLR， SII， and SIRI（ P ＜ 0.05）. ROC curve analysis indicated that NLR and SIRI demonstrated good efficacy in predicting the prognosis of MG. The optimal cutoff value for NLR was 3.62， with an area under the curve（ AUC） of 0.765， specificity of 84.7%， and sensitivity of 71.9%. The optimal cutoff value for SIRI was 1.08， with an AUC of 0.754， specificity of 75.3%， and sensitivity of 71.9%. Based on optimal cutoff values（ NLR： 3.62， PLR： 128.33， SII： 962.42， SIRI： 1.08）， the results showed that the high and low NLR and SIRI groups were all statistically correlated with the duration of MG and MGFA clinical classification， the high and low SII group was startistically correlated with MGFA clinical classification（ all P＜0.05）. Spearman correlation analysis showed that SII was strongly positively correlated with prognosis（ ρ=0.555，P＜0.001）， SIRI（ ρ=0.447，P＜0.001） was moderately positively correlated with NLR（ ρ=0.386，P ＜ 0.001）， and PLR was weakly positively correlated with prognosis（ ρ=0.271，P=0.003）， with statistically significant differences. Conclusions NLR， PLR， SII， and SIRI can serve as important immune markers for prognostic evaluation of patients with MG. In particular， NLR and SIRI demonstrate strong predictive value， aiding clinicians in evaluating patients' prognostic risk and providing reference for developing personalized treatment plans.

Abstract:Early screening for mild cognitive impairment（ MCI） is important in preventing the onset of dementia or slowing its progression. Numerous studies have shown that balance function evaluation has an important role in the identification and early warning of patients with MCI. Currently， MCI screening in China is still dominated by neuropsychological scales， which fails to reflect the research and application value of balance function-related indicators in MCI screening. By reviewing and analyzing the previous literature， this paper starts from the dimensions of balance function in MCI patients to clarify the concept of balance function， the neurological basis of balance abnormalities in MCI patients， the commonly used balance assessment methods， and the correlation between balance function and cognitive function， with the aim of providing a theoretical basis for the future development of a balance function-based early screening tool for MCI.

Abstract:Traumatic brain injury is the most common neurosurgical disease， characterized by high morbidity and mortality. On the basis of primary external force injury， secondary brain injury arises from pathophysiological changes such as oxidative stress， apoptosis， and neuroinflammation， leading to impaired cellular function and brain function. Therefore， finding ways to improve the treatment of secondary brain injury has become particularly important. Autophagy is the process of cell self-phagocytosis. Increasing evidence indicates that the autophagy pathway following traumatic brain injury can affect pathophysiological processes such as oxidative stress， apoptosis， neuroinflammation and so on. This paper reviews the autophagy process and research on autophagy in traumatic brain injury， aiming to identify novel therapeutic targets for traumatic brain injury.

Abstract:Sleep disorders are a critical public health issue， and their association with quality of life is receiving increasing attention. Research suggests that diet is one of the factors affecting sleep， and adjusting diet to improve sleep quality is a relatively simple， feasible， and widely accepted intervention strategy. This paper summarizes and analyzes existing research and explores the regulatory effects of the three major nutrients and typical dietary patterns on sleep quality， duration， and structure. Research has found that a high-carbohydrate diet may be associated with increased rapid eye movement sleep， while dietary fiber helps prolong slow-wave sleep time； the Mediterranean diet rich in fruits and vegetables improves sleep quality through anti-inflammatory and antioxidant effects； the ketogenic diet shows potential for stabilizing sleep in specific populations. Future research should consider the bidirectional effects between sleep and diet， focusing on differences in their mutual influence among different populations， and observing the impact of dietary patterns on sleep in natural conditions through cohort studies.

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