Abstract:The pathological mechanism of Alzheimer disease（ AD） has not been fully elucidated. The gut microbiota plays a key role in the occurrence and progression of AD through neuro-immune-metabolic interactions mediated by the gut-brain axis（ GBA）. This paper systematically reviews the molecular regulatory mechanisms of the microbiota-gut-brain axis： the gut microbiota influences central nervous system function through vagal nerve signaling， immune inflammation regulation， and metabolites（ such as short-chain fatty acids and 5-hydroxytryptamine precursors）. Dysbiosis can induce damage to the blood-brain barrier， neurotransmitter imbalance， and hyperphosphorylation of Tau protein， thereby promoting the pathological progression of AD. Current research in this area still faces challenges such as limitations in technical methods， insufficient sample sizes， and difficulties in translating findings from animal models to clinical practice. In the future， it is necessary to rely on the deep integration of multi-omics technology and clinical medicine， strengthen multiomics integration and interdisciplinary collaboration， and thereby unlock the potential of microbiome medicine in the diagnosis and treatment of AD.

Abstract:Objective To investigate abnormal patterns of functional connectivity（ FC） in the amygdala among patients with chronic insomnia disorder（ CID） and their specific relationship with anxiety symptoms using resting-state functional magnetic resonance imaging（ rs-fMRI）. Methods This study adopted a crosssectional design， selecting 32 CID patients who visited the outpatient department of the First Affiliated Hospital of Hainan Medical University between December 2020 and December 2022 to form the insomnia group. During the same period， 32 age- and gender-matched healthy individuals were recruited to form the control group. All participants underwent rs-fMRI scans. The Pittsburgh Sleep Quality Index（ PSQI）， Hamilton Anxiety Scale（ HAMA）， Insomnia Severity Index（ ISI） and Beck Depression Inventory II（ BDI-Ⅱ） were used to assess the sleep quality， anxiety， severity of insomnia and depressive disorder. A whole-brain FC analysis method using the bilateral amygdalae as seed points was used to compare FC differences between the two groups and to further analyze the correlation between abnormal FC and scale scores. Results The PSQI， ISI， HAMA， and BDI- Ⅱ scores in insomnia group were all higher than those in control group， with statistically significant differences（ t/Z=23.032、-6.896、21.911、4.039； all P＜0.001）. Compared with control group， insomnia group exhibited statistically enhanced FC in the bilateral amygdala and multiple regions of the left parietal cortex （including the angular gyrus and supramarginal gyrus）（ P ＜ 0.05， FDR-corrected）. Analysis of FC revealed that this enhancement shifted from a negative correlation in control group to a positive correlation in insomnia group： left amygdala-left angular gyrus［ control group：（ -0.11±0.14） vs. insomnia group：（ 0.03±0.14）， t=4.050， P ＜ 0.001， Cohen's d=1.01］， right amygdala-left angular gyrus/left supramarginal gyrus［ control group：（ -0.14±0.15） vs. insomnia group：（ 0.03±0.16）， t=4.361， P ＜ 0.001， Cohen's d=1.09］， right amygdala-right supramarginal gyrus［ control group：（ -0.12±0.14） vs. insomnia group：（ 0.04±0.15）， t=4.473， P＜ 0.001， Cohen's d=1.12］. Correlational analysis revealed that in insomnia group， FC of left amygdala and left angular gyrus was statistically positively correlated with HAMA scores（ r=0.412， P=0.019）， whereas it showed no statistically significant correlation with the severity of insomnia（ PSQI and ISI scores）（ P ＞ 0.05）. Conclusions CID patients exhibit a FC pattern transition from physiological antagonism to pathological synergy between the amygdala and key nodes of the default mode network and the attention network（ angular gyrus and supramarginal gyrus）. This abnormal neural circuit reorganization may specifically underlie the neurobiological basis of anxiety symptoms in patients with CID， and holds promise as a potential imaging biomarker for assessing anxiety levels and guiding precision interventions.

Abstract:Objective To explore the correlation between plasma oxidative stress markers and clinical symptoms as well as cognitive function in patients with depression. Methods Using a crosssectional study design， 87 inpatients with depression at Suzhou Guangji Hospital of Soochow University between May 2022 and May 2024 were selected to as depression group. During the same period， 75 healthy individuals from the local area， matched for age and gender， were recruited to as control group. The levels of total superoxide dismutase（ T-SOD）， catalase（ CAT）， total antioxidant capacity（ T-AOC）， hydrogen peroxide（ H2O2）， and hydroxyl radical（ ·OH） in the study subjects' plasma were measured. Cognitive function and the severity of clinical symptoms were assessed using the Repeatable Battery for the Assessment of Neuropsychological Status（ RBANS）， Hamilton Depression Scale-24（ HAMD-24）， and Hamilton Anxiety Scale（ HAMA）. Pearson correlation was used to analyze the correlation between oxidative stress markers and scores on clinical psychological scales. Binary Logistic regression was used to examine the impact of oxidative stress markers on the risk of developing depression. Results The education years of depression group were lower than those of control group， and the difference was statistically significant（ t=-2.360， P ＜ 0.05）. The total score of RBANS（ t=-5.709， P ＜ 0.001） and the scores of immediate memory， visual span， verbal function， attention， and delayed memory in depression group were all lower than those in control group， with statistically significant differences（ t=-4.318， -3.484， -2.281， -5.100， -5.026； all P ＜ 0.05）. In depression group， plasma levels of T-SOD［ （77.94±4.65） U/ml vs.（ 79.88±3.21） U/ml］ and CAT［ （0.71±0.22） U/ml vs.（ 0.88±0.28） U/ml］ were lower than those in control group， and the differences were statistically significant（ F=3.193， 8.100； both P＜ 0.05）. In depression group， plasma levels of T-AOC ［（1.20±0.23） mmol/L vs.（ 1.10±0.10） mmol/L］， H2O2［ （55.08±20.94） mmol/L vs.（ 44.28±18.20） mmol/L］， and ·OH［ （438.19±137.02） U/ml vs.（ 221.39±53.05） U/ml］ were higher than those in control group， with statistically significant differences（ F=4.294， 5.270， 65.230； all P ＜ 0.05）. The HAMD-24 score was statistically negatively correlated with immediate memory scores， delayed memory scores， and the RBANS total score（ r=-0.345， -0.288， and -0.305； all P＜0.05）. The HAMA score was statistically negatively correlated with immediate memory scores， delayed memory scores， visual span scores， attention scores， and the RBANS total score（ r=-0.434， -0.412， -0.257， -0.261， -0.390； all P＜0.05）. Plasma T-SOD levels were statistically negatively correlated with HAMD-24 scores（ r=-0.288， P ＜ 0.05）. Multivariable logistic regression analysis showed that， when ·OH， T-AOC， and T-SOD were entered into the model simultaneously， higher ·OH levels were associated with increased odds of depression［ OR=1.003， 95%C（I 1.002-1.004）， P ＜ 0.001］， whereas higher T-AOC levels［ OR=0.329， 95%C（I 0.206-0.526）， P ＜ 0.001］ and higher T-SOD levels［ OR=0.977， 95%CI（0.960-0.995）， P=0.007］ were associated with lower odds of depression. Conclusions Patients with depression showed an imbalance between oxidant and antioxidant systems， characterized by reduced plasma T-SOD and CAT activities and higher levels of T-AOC， H2O2， and ·OH. T-SOD levels were associated with the severity of depressive symptoms， and greater clinical symptom severity was associated with poorer cognitive function. Multivariable logistic regression suggested that， after adjustment for the other oxidative stress markers included in the model， higher T-AOC and T-SOD levels were associated with lower odds of depression， whereas higher ·OH levels were associated with higher odds.

Abstract:Objective To explore the relationship among different psychotic symptoms in communitydwelling patients with schizophrenia， so as to provide a basis for the development of clinical interventions for schizophrenia. Methods A total of 631 community-dwelling schizophrenia patients from four districts in Shanghai between January and December 2022 were selected as study subjects， and basic information was collected through questionnaires. The Brief Psychiatric Rating Scale（ BPRS） was used to assess patients' psychotic symptoms. Network analysis was used to construct symptom networks and perform network estimation， centrality， and stability analysis to investigate the relationships among disease symptoms. Results Among the enrolled patients， 278 were male（ 44.06%，278/631）； a relatively high proportion had a college/undergraduate degrees or above［ 247 cases（ 39.14%，247/631）］， were married［ 295 cases（ 46.75%，295/631）］， were unemployed［ 430 cases（ 68.15%，430/631）］， and were taking antipsychotic medications［ 610 cases（ 96.67%， 610/631）］. The incidence of anxiety symptoms was the highest among psychotic symptoms， accounting for 45.96%（ 290/631）. In the symptom network， "somatic concern" and "anxiety" were most closely associated， with a normalized partial correlation coefficient of 0.381； "mannerism and posturing" had the highest intensity and proximity， at 1.486 and 2.002， respectively； "mannerism and posturing" and "emotional withdrawal" had the highest mediating effects， both at 2.151； "mannerism and posturing" and "unusual thought content" had the highest expected impact indices， at 1.581 and 1.576， respectively， making them core nodes in the network. Conclusions There is a complex network of associations among psychotic symptoms in community-dwelling patients with schizophrenia. "Mannerism and posturing" and "unusual thought content" are the core symptoms of patients， suggesting that future healthcare professionals can develop precise intervention strategies based on the core symptoms to prevent disease recurrence and promote patient recovery.

Abstract:Objective To analyze the efficacy and safety of direct aspiration thrombectomy （DA） and stent retriever thrombectomy（ SR） in patients with posterior circulation acute ischemic stroke. Methods From January 2024 to February 2025， 138 patients with acute posterior circulatory large vessel occlusion admitted to Nanyang Central Hospital， Henan Medical University were selected as study subjects. Patients were randomly divided into DA group（ 70 cases） and SR group（ 68 cases） using the simple randomization. DA group used a large-diameter aspiration catheter to directly contact the thrombus for negative pressure suction， without using SR. SR group used a retrievable stent to bypass the occluded segment and remove the thrombus， without using DA. Vascular recanalization was defined as a modified Thrombolysis in Cerebral Infarction（ mTICI） score of ≥ 2b. A modified Rankin Scale（ mRS） score of ＞ 2 90 days after treatment indicated a poor prognosis， while a score of ≤ 2 indicated a good prognosis. Two groups of patients were compared in terms of puncture to vascular recanalization time， vascular recanalization grade， good prognosis rate， incidence of complications， 90-day mortality after treatment， National Institutes of Health Stroke Scale（ NIHSS） and Glasgow Coma Scale（ GCS） scores before and after treatment， and their differences. Results Among 138 patients， the vascular recanalization rate in DA group was 88.6%（ 62/70）， which was higher than 85.3%（ 58/68） in SR group， and the difference was not statistically significant（ P＞0.05）. The good prognosis rate of DA group after 90 days of treatment was 51.4%（ 36/70）， which was higher than 48.5%（ 33/68） of SR group， and the difference was not statistically significant（ P＞0.05）. The time from puncture to vascular recanalization in DA group was（ 56.9±3.9） min， which was shorter than that in SR group（ 61.1±5.3） min， and the difference was statistically significant（ t=4.582，P＜0.05）. There were no statistically significant differences between the two groups in terms of postoperative hemorrhagic transformation， symptomatic intracranial hemorrhage， NIHSS score and differences before and after treatment， GCS scores and differences before and after treatment， or 90-day mortality following treatment（ all P＞0.05）. Conclusions DA and SR are equally effective in treating patients with posterior circulation large vessel occlusion， with the former shortening the time for vascular recanalization.

Abstract:Objective To investigate the correlation between parental neglect and social adaptation of junior high school students， and to further analyze the mechanisms of rumination and self-control in this process. Methods Using random sampling， a total of 576 students in Grade 7 through 9 from three junior high schools in Anda City of Heilongjiang Province， were selected as research subjects between March and April 2024. The Child Psychological Abuse and Neglect Scale（ CPANS）， Ruminative Responses Scale（ RRS）， Self-Control Scale （SCS）， and Social Adaptation Scale were used to assess the parental neglect， rumination， self-control， and social adaptation of students. Spearman correlation was used to analyze the correlation between parental neglect， rumination， self-control， and social adaptation in students. A chain mediating model was constructed using AMOS 26.0 software. With parental neglect as the independent variable， social adaptation as the dependent variable， and rumination and self-control as mediating variables， the Bootstrap method（ with 5 000 repeated samples） was used to test the significance of the mediating effect. A total of 576 questionnaires were distributed in this study， and 542 valid questionnaires were finally collected， with a valid response rate of 94.1%. Results The scores of CPANS， RRS， SCS， and Social Adaptation Scale for 542 students were（ 59.34±20.42）， （35.81±11.83），（ 69.53±13.85）， and（ 136.18±24.84）， respectively. Correlation analysis revealed that CPANS score was positively correlated with RRS score and negatively correlated with SCS score and social adaptation scale score， and RRS score was negatively correlated with SCS score and social adaptation scale score， and SCS score was positively correlated with social adaptation scale score（ r=0.445，-0.483，-0.481，-0.553，-0.445， 0.610， all P＜0.01）. Rumination and self-control exerted a chain-mediating effect on parental neglect and social adaptation among junior high school students， accounting for 18.40% of the total effect. Conclusions Parental neglect can directly predict social adaptation of junior high school students， or indirectly influence social adaptation through the chain mediating effect of rumination and self-control.

Abstract:Psychiatric day treatment refers to an open treatment model in which patients receive treatment and care during the day and return home at night. The development of this treatment model in China is still in its early stages. This review summarizes the emergence and development， organizational forms and intervention measures， as well as therapeutic outcomes of psychiatric day treatment， aiming to provide reference for the construction of psychiatric day treatment in China.

Abstract:Post-traumatic stress disorder（ PTSD） is a severe mental illness characterized by recurrent trauma re-experiencing， active avoidance of trauma-related stimuli， negative alterations in cognition and mood， and hyperarousal symptoms. In recent years， neuroimaging studies of trauma-exposed individuals have revealed that the pathological mechanisms of PTSD are closely associated with functional abnormalities in three brain networks： the default mode network， the salience network， and the central executive network. By reviewing and analyzing advances in functional magnetic resonance imaging（ fMRI） studies based on the triple network model， this paper further elucidates the roles of the three networks in the onset and progression of PTSD， aiming to provide reference for future research in related fields.

Abstract:Acute stress disorder（ ASD） is a common acute psychological response after traumatic exposure， and some patients may progress to post-traumatic stress disorder. Early identification and intervention have significant clinical significance. Traumatic stress not only involves abnormal responses in the central nervous system but also affects hepatic metabolic rhythms and gut microbiota homeostasis through the hypothalamic-pituitary-adrenal axis， autonomic nervous system， and circadian rhythm regulatory pathways. At the same time， alterations in gut microbiota composition， as well as hepatic metabolic and inflammatory signals， can also feedback regulate brain function， which is associated with the formation of ASD symptom phenotypes and disease progression. The ratio of Firmicutes to Bacteroides in the gut microbiota exhibits stress type specific changes. Dysregulation of the hepatic clock gene nuclear receptor subfamily 1 group D member 1（ REV-ERBα）， may exacerbate liver-gut dysfunction through bile acid synthesis and lipid metabolism pathways， and interfere with central stress regulation. The liver-gut-brain axis provides a mechanistic framework for explaining the coupling mechanisms between central and peripheral stress responses in ASD. This review summarizes recent advances in ASD research through the lens of the liver-gut-brain axis. It specifically highlights REV-ERBα mediated metabolic rhythm disruption， gut dysbiosis， and neuroimmune effects， aiming to offer novel insights into underlying mechanisms and targeted therapeutic interventions.

Abstract:In recent years， mental disorders among children and adolescents in China have shown a trend toward occurring at young ages and becoming severe， placing a heavy burden on families and society. While traditional rehabilitation models have shown some effectiveness in alleviating symptoms， the persistence or recurrence of the condition remains a pressing challenge in this field. The theory of emotional contagion explains how emotions are transmitted and influence from person to person. Research has shown that these factors are closely related to children's and adolescents' cognition， emotions， and behavior， but have not received sufficient attention in the clinical rehabilitation of mental disorders in this population. This paper systematically reviews the theoretical framework of emotional contagion and its impact on children and adolescents， and explores in depth how to optimize rehabilitation strategies for children and adolescents with mental disorders from the perspective of emotional contagion. Rehabilitation effectiveness can be improved by establishing a positive emotional support system and therapeutic environment， aiming to provide guidance for clinical practice in children and adolescents with mental disorders.

Abstract:Cerebral amyloid angiopathy（ CAA） is a cerebral small-vessel disease characterized by the deposition of amyloid β-protein in the cerebral vascular wall， which is a major cause of cerebral hemorrhage， dementia， and cognitive decline. In recent years， the role of the immune system in CAA has gradually attracted attention. Immune cells not only participate in the clearance of amyloid β-protein， but may also exacerbate the pathological process of CAA through inflammatory responses. This review summarizes the various mechanisms of the immune system in CAA， including the role of immune cells in amyloid β-protein clearance， the impact of immune responses on vascular injury and inflammation， and the potential of immunomodulatory therapeutic strategies， with the aim of providing new insights and targets for the early diagnosis， risk stratification， and treatment of CAA.