Abstract:The hypothalamus is a vital neuroendocrine center in the human body,playing a crucial regulatory role in the autonomic nervous system and endocrine system.Surgery for tumors in the hypothalamic region remains one of the most challenging neurosurgical procedures to date.Surgical damage to the hypothalamus often leads to hypopituitarism,water-electrolyte imbalances,hypothalamic obesity,thermoregulatory disorder,abnormal sleep rhythms,and emotional disturbances.Autonomic nervous system dysfunction plays a significant role in the pathogenesis of the aforementioned complications.Heart rate variability,urinary catecholamine metabolites,and microneurography are currently the most commonly used methods for assessing autonomic nervous system activity.Currently,evidence indicates that patients with hypothalamic injury exhibit autonomic nervous dysfunction,but there is no consensus on the specific type of dysfunction.Modulation of autonomic nervous system activity holds promise as a novel therapeutic target for patients with hypothalamic injury,and accurate assessment of autonomic nervous function represents a crucial step in developing treatment plans for these patients.

Abstract:Objective To investigate the effect of different numbers of target cells on the cytotoxicity of NK-92MI against target cells at the same effector-to-target(E∶T)ratio and its potential underlying mechanisms.Methods Under standard 4-hour cytotoxicity conditions,NK-92MI cells were co-cultured with K562,BNI 2-4-S,BNI 1-3-S,and BNI 19-1-S cells in quantities of 20 000,10 000,5 000,and 2 500 cells,respectively,and the lysis ratio of target cells was detected to determine the cytotoxic efficacy of NK-92MI.NK-92MI was coupled with K562 and BNI 19-1-S cells in quantities of 2 500,5 000,10 000,and 20 000 to investigate the binding of NK-92MI to target cells.Results In the cytotoxicity assay,when the number of target cells was 2 500,5 000,10 000,and 20 000,the lysis ratios of NK-92MI co-cultured with K562 cells were(16.62±2.09)%,(20.84±1.36)%,(31.00±2.01)%,and(47.80±1.30)%,respectively;the lysis ratios of NK-92MI co-cultured with BNI 2-4-S cells were(29.94±2.27)%,(39.64±2.47)%,(49.29±1.27)%,and(64.25±1.92)%,respectively;the lysis ratios of NK-92MI co-cultured with BNI 1-3-S cells were(41.81±3.59)%,(48.59±3.41)%,(57.10±3.25)%,and(64.55±1.90)%,respectively;the lysis ratios of NK-92MI co-cultured with BNI 19-1-S cells were(41.39±2.39)%,(47.85±3.15)%,(54.09±0.67)%,and(57.82±2.48)%,respectively.The cytotoxic efficacy of NK-92MI increased with the number of target cells,with statistically significant differences(all P＜0.01).In the cell-coupling assay,when the target cell numbers were 2,500,5,000,10,000,and 20 000,the binding ratios of NK-92MI to K562 cells were(1.85±0.11)%,(5.30±0.37)%,(7.79±0.08)%,and(13.10±0.30)%,respectively.In the cell coupling assay,when the target cell numbers were 2 500,5 000,10 000,and 20 000,the binding ratios of NK-92MI to K562 cells were(1.85±0.11)%,(5.30±0.37)%,(7.79±0.08)%,and(13.10±0.30)%,respectively;and the binding ratios of NK-92MI to BNI 19-1-S cells were(2.58±0.21)%,(6.69±0.31)%,(8.46±0.20)%,and(13.37±0.78)%,respectively.As the number of target cells increased,the binding of NK-92MI to target cells significantly increased,with statistically significant differences(all P＜0.01).Conclusions At the same E∶T ratio,varying numbers of target cells influence the degree of contact between NK-92MI and target cells,thereby affecting the cytotoxic efficacy of NK-92MI against them.At the same E:T ratio,the greater the number of target cells,the more extensive the contact between NK-92MI and target cells,and the higher the cytotoxic efficacy of NK-92MI against them.

Abstract:Glioma is a malignant brain tumor originating from glial cells,characterized by high invasiveness,difficulty in complete surgical resection,and high resistance to conventional radiotherapy and chemotherapy.Currently,immunotherapy has become one of the hot topics in glioma research.Monoclonal antibodies block tumor cell proliferation signaling pathways by binding to cell surface antigen-antibody,such as immune checkpoint inhibitors.Chimeric antigen receptor T-cell(CAR-T)therapy has also demonstrated potential in treating gliomas,but its clinical efficacy remains to be improved due to challenges such as antigen heterogeneity and immune escape.In addition,multiple ongoing clinical trials are exploring novel therapeutic strategies,such as combining oncolytic viruses,vaccine therapies,and gene editing technologies to enhance the efficacy of immunotherapy.This paper summarizes the principles and clinical trials of immunotherapy approaches for glioma and proposes potential directions for future research to inform clinical treatment strategies.

Abstract:Objective To explore independent prognostic factors in elderly patients with glioblastoma(GBM),so as to provide a prognostic assessment program for this population.Methods Clinical data from 180 elderly GBM patients in the Fifth Ward,Department of Neuro-oncology,Capital Medical University,between June 2006 and June 2021 were retrospectively analyzed.Patients were divided into four groups:Group A(patients with recurrent GBM),Group B(patients diagnosed with primary GBM after presenting for epilepsy),Group C(patients diagnosed with primary GBM after presenting for neurological disorders including hemiplegia,aphasia,and cognitive impairment),and Group D(patients diagnosed with primary GBM after presenting for other symptoms such as headache and/or vomiting).General information,median survival time,and pathological diagnosis were obtained from hospitalization and follow-up records.Single-factor and multi-factor Cox regression analysis and Kaplan-Meier survival analysis were performed using SPSS 27.0 to evaluate the association of various risk factors with the prognosis of elderly GBM patients.Results The median overall survival among 180 GBM patients was 353 days,with a mean overall survival of 550 days.Univariate Cox regression analysis showed that age[HR=1.038,95%CI(1.001,1.077),P=0.044],postoperative radiotherapy[HR=0.388,95%CI(0.255,0.592),P＜0.001],postoperative chemotherapy[HR=0.530,95%CI(0.347,0.810),P=0.003],tumor molecular pathology O6-methylguanine-DNA methyltransferase(MGMT)promoter methylation status[HR=0.632,95%CI(0.432,0.926),P=0.019],postoperative Karnofsky Performance Status(KPS)score[HR=0.972,95%CI(0.957,0.987),P＜0.001],degree of tumor resection[HR=0.951,95%CI(0.940,0.962),P＜0.001]were prognostic factors for elderly patients with GBM.Subgroup analysis revealed that elderly GBM patients diagnosed due to headache,vomiting,or incidental findings exhibited longer survival times than other subgroups,with statistically significant differences(P＜0.05).Survival times among other subgroups showed no statistically significant differences(all P＞0.05).Based on the Chinese Glioma Genome Atlas(CGGA)database,factors influencing overall survival prognosis in elderly GBM patients were analyzed,and a total of 64 patients were included,with a median overall survival of 373 days and a mean overall survival of 598 days.Univariate and multivariate Cox regression analysis revealed that postoperative radiotherapy[HR=0.258,95%CI(0.098,0.676),P=0.006]and postoperative chemotherapy[HR=0.294,95%CI(0.146,0.594),P＜0.001]were identified as independent factors influencing overall survival in elderly GBM patients,demonstrating favorable prognostic effects.Analysis of Kaplan-Meier survival curve for postoperative radiotherapy and postoperative chemotherapy in patients enrolled in the CGGA database indicated that both postoperative radiotherapy and postoperative chemotherapy significantly prolonged overall survival.Conclusions For elderly GBM patients,undergoing maximal tumor resection while preserving neurological function,followed by postoperative chemoradiotherapy,significantly prolongs survival times.Under these conditions,younger patients demonstrate longer survival times.

Abstract:Anhedonia as one of the transdiagnostic symptoms is very common in patients with mood disorders.Traditional psychological assessment and treatment of patients with mood disorders focused on symptom dimensions and reduction of negative emotions,often in the form of face-to-face therapy with a therapist.In recent years,scholars have explored positive psychotherapeutic programs for anhedonia through the study of intrinsic reward mechanism.With the help of the Internet,computers,virtual reality and other emerging technologies,it has become possible to realize targeted digital psychotherapy.This article reviews the most recent psychological assessments and digital psychotherapeutic programs within this field with the aim of introducing potential reward mechanisms for anhedonia symptoms in patients with mood disorders.

Abstract:Objective To explore the prevalence of anxiety and depression in patients with post-stroke dysphagia and to analyze the factors affecting anxiety and depression in patients with post-stroke dysphagia from multiple perspectives.Methods A questionnaire survey of 226 patients with post-stroke dysphagia in 14 Class Ⅲ Grade A hospitals in 8 cities of Jiangsu Province from October 2023 to May 2024 was conducted using convenience sampling method.A total of 221 valid questionnaires were recovered.Logistic regression model and decision tree model were established respectively to obtain the influencing factors of anxiety and depression under the results of the two models,and the comparison of predictive performance and the comparison of receiver operating characteristic curve were conducted.Results The prevalence of anxiety and depression in patients with post-stroke dysphagia was 61.5%(136/221).Logistic regression model showed that intermittent tube feeding[OR=0.307,95%CI(0.110,0.853)],water swallow test result gradeⅣ[OR=2.645,95%CI(1.226,5.703)],type D personality[OR=4.485,95%CI(1.732,11.608)],and high perceived social support[OR=0.522,95%CI(0.277,0.984)]were the influencing factors of anxiety and depression,and the differences were statistically significant(P＜0.05).Decision tree model showed type D personality was the main factor influencing anxiety and depression,followed by eating style,water swallow test results,perceived social support and personality traits,with a statistically significant difference(P＜0.05).The area under the receiver operating characteristic curve was＞0.7 for both models and the difference in predictive performance was not statistically significant(P＞0.05).Conclusions The prevalence rate of anxiety and depression in patients with post-stroke dysphagia is high.Combining Logistic regression model with decision tree model to guide clinical practice enables early identification and prevention of anxiety and depression in patients,and late targeted intervention.

Abstract:Objective To establish a machine learning model using radiomics features extracted from preoperative MRI to predict the expression levels of the key immune checkpoint,programmed death receptor-1(PD-1)gene,in patients with glioma.Methods From January to August 2024,133 patients were retrospectively collected from The Cancer Genome Atlas(TCGA)database.Using the random sampling"sample function"in R software,patients were randomly assigned in a 2∶1 ratio to training group(89 cases)and validation group(44 cases).Feature selection and predictive model construction were performed using the LASSO algorithm.The predictive performance of the model was evaluated on the training and validation sets using the receiver operating characteristic(ROC)curve.The clinical practicality of the model was assessed through decision curve analysis.Results Six radiomics features were selected using the LASSO algorithm,and a predictive model was constructed.Six radiomics features were selected using the LASSO algorithm,and a predictive model was constructed.ROC curve analysis on the training and validation sets yielded C-index values of 0.815 and 0.728,respectively,with accuracy rates of 80.9%and 72.7%.Conclusions The expression level of PD-1,a key immune checkpoint in glioma patients,can be predicted using preoperative MRI data and radiomics technology.

Abstract:Gliomas are the most common intracranial primary malignant tumors in adults.Among these,glioblastoma(GBM)is highly malignant and carries an extremely poor prognosis.The current standard treatment for GBM involves maximal safe resection followed by adjuvant temozolomide chemotherapy and synchronous radiotherapy,but long-term outcomes remain poor.In recent years,immunotherapy has demonstrated significant potential in treating various non-glioblastoma tumors,with adoptive cellar immunotherapy achieving particularly promising clinical efficacy.In the field of adoptive cellar immunotherapy for gliomas,significant progress has been achieved in numerous preclinical studies and clinical trials.However,compared to other tumors,gliomas present a series of technical bottlenecks and efficacy limitations for the clinical application of adoptive cellar immunotherapy due to their unique biological characteristics.Nevertheless,adoptive cellar immunotherapy has opened new directions for research into treatment strategies for gliomas and offers potential hope for improving patient prognosis.

Abstract:Gliomas account for approximately 80%of all malignant intracranial tumors,with strong invasiveness and poor prognosis,posing significant challenges to clinical diagnosis and treatment.Traditional imaging and pathological grading often prove inadequate in addressing the significant intra-and intertumoral heterogeneity.Multi-omics(such as genomics,transcriptomics,proteomics,metabolomics)provide an integrated perspective for subtyping,risk stratification,and efficacy/recurrence monitoring,thereby accelerating the translation of novel therapies and precision medicine strategies into clinical applications for gliomas.However,challenges such as batch effects in sample preprocessing,inconsistent cross-platform standards,insufficient data integration and interpretability,and the integration of complex results into clinical pathways continue to hinder its implementation.This paper summarizes the key value and limitations of multi-omics testing in the practical context of precision diagnosis and treatment for gliomas,emphasizes standardized sample delivery,quality control,and reporting processes,providing guidance and recommendations for the clinical application of multi-omics testing.

Abstract:Objective To explore the characteristics of compliance with long-acting injections of paliperidone palmitate in community-dwelling schizophrenia patients under policy support.Methods The study population comprised schizophrenia patients who received paliperidone palmitate injections at designated hospitals under the long-acting medication policy in Baoshan District,Shanghai from August 2020 to December 2022.Through a one-year real-world follow-up,patients'general demographic information,clinical data,and treatment status with paliperidone palmitate were collected.Univariate analysis and multivariate Logistic regression analysis were employed to investigate factors influencing compliance with long-acting injections of paliperidone palmitate among community-dwelling schizophrenia patients.Results A total of 259 patients with schizophrenia were included in the study,with 5 lost to follow-up.Among patients receiving standardized treatment with paliperidone palmitate long-acting injection,161(63.39%)maintained continuous treatment for one year(compliance group),while 93(36.61%)discontinued treatment(discontinuation group).Statistically significant differences were observed between compliance group and discontinuation group in terms of home supervision,self-awareness,social functioning,and number of oral medications(all P＜0.05).Multivariate Logistic regression analysis indicated that weak home supervision[OR=2.06,95%CI(1.03,4.15)],lack of self-awareness[OR=2.53,95%CI(1.03,6.23)],and number of oral medications≥4[OR=3.85,95%CI(1.33,11.16)]were risk factors for poor treatment compliance with paliperidone palmitate(all P＜0.05).Conclusions Home supervision,self-awareness,and number of oral medications are factors associated with treatment compliance with paliperidone palmitate among community-dwelling schizophrenia patients.

Abstract:Post-stroke gastrointestinal dysfunction is a consequence of an imbalance in the brain-gut axis involving autonomic dysfunction,amplified neuroinflammation,impaired intestinal barrier,and abnormal metabolism of flora.Abnormal bidirectional regulation between the central nervous system and the gastrointestinal tract allows gastrointestinal dysfunction and post-stroke neurologic damage to reinforce each other in a continuous pathological cycle.Recent studies targeting the brain-gut axis have revealed the potential roles of autonomic regulation,immune-inflammatory modulation and intestinal microecological repair in gastrointestinal dysfunction,providing new ideas for optimizing intervention strategies.Future research should further focus on the dynamic regulation mechanism of the brain-gut axis and explore the synergistic effects of multidimensional interventions,with the aim of providing precise theoretical support and therapeutic direction for the improvement of the brain-gut axis and the recovery of post-stroke neurological function.

Abstract:Objective To explore the correlation between sensory abnormalities and symptoms,behaviors,and function in children with autism spectrum disorder(ASD).Methods A total of 696 children aged 4 to 6 years with ASD who underwent rehabilitation training at the Guangdong Provincial Maternal and Child Health Hospital from March 2022 to March 2024 were selected as study subjects.The children's sensory integration ability,behavior,and functional independence were evaluated using the Sensory Integration Ability Rating Scale for Children,Autism Behavior Checklist(ABC),Children Neuropsychological Behavioral Scale,Social Responsiveness Scale(SRS),and Wee Functional Independence Measure(WeeFM).Based on the total scores of the Sensory Integration Ability Rating Scale for Children,children were divided into mild disorder group(≥90 points,n=104),moderate disorder group(＞60 to＜90 points,n=267),and severe disorder group(≤60 points,n=325).Differences in scores of ABC,Children Neuropsychological Behavioral Scale,SRS,and WeeFIM among the three groups of pediatric patients were compared.Pearson correlation was used to analyze the correlation between scores on the Sensory Integration Ability Rating Scale for Children and scores on the ABC,Children Neuropsychological Behavioral Scale,SRS,and WeeFIM.Results Statistically significant differences were observed in ABC,Children Neuropsychological Behavioral Scale,SRS,and WeeFIM scores among the three groups of pediatric patients(F=905.384,304.753,303.085,5 111.844;all P＜0.05).The total scores of the Sensory Integration Ability Rating Scale for Children showed positive correlations with both the ABC total score and the SRS total score(r=0.640,0.744;both P＜0.05).The total score of the Sensory Integration Ability Rating Scale for Children showed negative correlations with each functional domain of the Children Neuropsychological Behavioral Scale and the total score of the WeeFIM(r=-0.857,-0.567,-0.685,-0.754,-0.522;all P＜0.05).Conclusions Sensory abnormalities are prevalent among children with ASD,and the severity of sensory abnormalities correlates positively with symptoms,behaviors,and function defects.

Abstract:Objective To analyze the morphological changes in the cerebral cortex of depressive disorder adolescents with non-suicidal self-injury(NSSI)behaviors based on surface-based morphometry(SBM)and its relationship with NSSI behaviors and clinical diagnostic value.Methods This study was prospective.From September 2022 to January 2024,70 depressive disorder adolescents with NSSI behaviors(nsMDD group)at Suzhou Guangji Hospital,China,were included for the assessment of NSSI function scale,addiction scale,and cranial magnetic resonance 3D-T1-weighted imaging scan.During the same period,35 healthy volunteers were collected as a healthy control group(HC group)and underwent MRI scanning.All subjects were analyzed using the Computational Anatomy Toolbox 12(CAT 12)in the Statistical Parametric Mapping 12(SPM 12)software package.Two independent samples t-test was used to compare the morphological parameters of the cortical surface in nsMDD group and HC group.Pearson correlation was used to analyze differential cortical surface morphometric parameters with NSSI function scores and addiction scores.The value of differential cortical surface morphometric parameters for diagnosing depressive disorder adolescents with NSSI behaviors was analyzed using the receiver operating characteristic(ROC)curve.Results Compared with HC group,nsMDD group had a decrease in cortical thickness in the rostral part of the right anterior cingulate cortex[(2.639±0.145)mm vs.(2.704±0.157)mm;t=2.090,P=0.039],an increase in cortical fold index in the caudal part of the left anterior cingulate cortex[(28.400±2.025)vs.(27.574±1.709);t=-2.027,P=0.041],a decrease in gyrus indices in the right supramarginal gyrus and the right transverse temporal gyrus[(3.063±0.133)vs.(3.124±0.145),(4.706±0.270)vs.(4.862±0.167);t=2.135,P=0.035;t=3.125,P=0.002],and a decrease in the fractal dimensions of the left paracentral lobule[(2.540±0.130)vs.(2.606±0.081);t=3.210,P=0.002],and the differences were statistically significant.Correlation analysis showed that the cortical thickness of the rostral part of the right anterior cingulate cortex was negatively correlated with the NSSI function score,addiction score,and HAMD-24 score(r=-0.570,-0.630,-0.401;all P<0.001),and the gyrus index of the right transverse temporal gyrus was positively correlated with the NSSI function score(r=0.248,P<0.05),and the differences were statistically significant.Multiple linear regression analysis showed that the NSSI function score(t=-3.267,P=0.002)and addiction score(t=-4.628,P<0.001)negatively predicted the cortical thickness of the rostral part of the right anterior cingulate cortex,and the difference was statistically significant.The ROC curve analysis showed that the area under the ROC curve predicted by the joint model of five metrics,including cortical thickness of the rostral part of the right anterior cingulate cortex,cortical fold index in the caudal part of the left anterior cingulate cortex,gyrus indices in the right supramarginal gyrus and the right transverse temporal gyrus,and fractal dimension of the left paracentral lobule was 0.773.Conclusions The cortical thickness of the rostral part of the right anterior cingulate cortex is closely related to the occurrence and severity of NSSI behaviors in depressive disorder adolescents,or may provide an important entry point for early clinical diagnosis of the disease.

Abstract:Objective To explore the characteristics of sleep-wake circadian rhythms in depressive disorder patients and their influencing factors.Methods A total of 382 patients with depressive disorder who participated in a cohort study from March 2021 to October 2022 at Beijing Anding Hospital,Capital Medical University were included.Patients were categorized into evening type(n=153,MEQ 16-41),intermediate type(n=187,MEQ 42-58),and morning type(n=42,MEQ 59-86)based on the Morningness-Eveningness Questionnaire(MEQ)scores.Socio-demographic features,clinical features,non-suicidal self-injurious behaviors,17-item Hamilton Depression Scale(HAMD-17),Hamilton Anxiety Scale(HAMA),Patient Health Questionnaire-9(PHQ-9),Generalized Anxiety Disorder-7(GAD-7),and Sheehan Disability Scale(SDS)scores were collected.Differences in clinical features and symptoms between the three groups were compared.Logistic regression was used to analyze the factors influencing sleep-wake circadian rhythm characteristics.Results The differences in age,marital status,smoking history,and age of onset among the three groups were statistically significant(χ2/H=32.458,14.339,6.643,and 26.329;all P<0.05).Multiple Logistic regression analysis showed that age≤25 years[OR=2.387,95％CI(1.013,5.629),P<0.05],smoking history[OR=1.728,95％CI(1.012,2.950),P<0.05],and non-suicidal self-injurious behaviors in the current episode[OR=1.870,95％CI(1.007,3.473),P<0.05]were risk factors for patients with evening type,and low level of anxiety/somatization[OR=0.847,95％CI(0.741,0.968),P<0.05]was a protective factor for patients with evening type,and age>35 years[OR=4.584,95％CI(1.885,11.145),P<0.05]was a risk factor for patients with morning type,and all of these differences were statistically significant.Conclusions Age≤25 years,smoking history,non-suicidal self-injurious behavior in the current episode,and low level of anxiety/somatization are influencing factors in depressive disorder patients with evening type,and age>35 years of age is an influencing factor in depressive disorder patients with morning type.

Abstract:Objective To explore the relationship between the levels of serum nucleotide-binding oligomerization domain-like receptor 4(NLRC4)and Krüpple-like factor 5(KLF5)in patients with acute ischemic stroke(AIS)and the progression of the disease and short-term prognosis.Methods A total of 126 patients with AIS and 126 healthy volunteers who underwent physical examinations at Zibo Central Hospital from January 2020 to January 2023 were selected as the study group and the control group,respectively.The groups were classified based on the National Institutes of Health Stroke Scale(NIHSS)assessment criteria.Among the 126 AIS patients,46 were in the mild group(NIHSS score 0-5),59 in the moderate group(NIHSS score 5-20),and 21 in the severe group(NIHSS score 20-46).The prognosis of the patients was evaluated based on the modified Rankin Scale(mRS)criteria,81 patients were classified into the good prognosis group(mRS score<3),and 45 into the poor prognosis group(mRS score≥3).The levels of NLRC4 and KLF5 were detected by enzyme-linked immunosorbent assay(ELISA).Spearman and Pearson correlation analyses were used to investigate the correlations between the serum levels of NLRC4 and KLF5 in AIS patients and the infarction area,high-density lipoprotein cholesterol(HDL-C),time from onset to hospital admission,and disease severity.Multivariate Logistic regression was used to explore the influencing factors of poor prognosis in AIS patients.The receiver operating characteristic(ROC)curve was used to evaluate the predictive value of NLRC4 and KLF5 for the prognosis of patients.Results The serum levels of NLRC4(9.64±1.53)ng/ml and KLF5(5.36±1.20)ng/ml in the study group were significantly higher than those in the control group NLRC4(6.31±1.25)ng/ml,KLF5(1.85±0.31)ng/ml,with statistically significant differences(t=18.919,31.789,all P<0.05).The serum levels of NLRC4 and KLF5 in severe AIS patients were higher than those in moderate and mild AIS patients,with statistically significant differences(F=113.423,126.402,all P<0.05).In the poor prognosis group,62.2％(28/45)of patients had an infarction area>4 cm2,64.4％(29/45)had an NIHSS score>20 at admission,and the time from onset to hospital admission was(4.51±0.78)h,NLRC4 level was(10.58±1.25)ng/ml,and KLF5 level was(6.63±1.61)ng/ml,which were all higher than those in the good prognosis group 38.3％(31/81),40.7％(33/81),(3.46±0.45)h,(9.12±1.36)ng/ml,(4.66±1.28)ng/ml,with statistically significant differences(χ2/t=6.665,6.503,9.594,5.940,7.536,all P<0.05).The HDL-C level in the poor prognosis group(1.59±0.15)mmol/L was lower than that in the good prognosis group(1.84±0.17)mmol/L,with a statistically significant difference(t=8.240,P<0.05).The serum levels of NLRC4 and KLF5 in AIS patients were positively correlated with the infarction area,time from onset to hospital admission,and disease severity(r=0.625,0.586,0.618,0.637,0.644,0.622,all P<0.05),and negatively correlated with the HDL-C level(r=-0.654,-0.619,all P<0.05).Infarction area>4 cm2(OR=2.456,95％CI:1.332-4.527,P<0.001),long time from onset to hospital admission(OR=2.457,95％CI:1.403-4.304,P=0.002),high NLRC4 level(OR=4.319,95％CI:1.892-9.857,P<0.001),and high KLF5 level(OR=3.998,95％CI:1.959-8.160,P<0.001)were identified as risk factors affecting the prognosis of AIS patients,while high HDL-C level(OR=0.427,95％CI:0.251-0.726,P=0.002)was a protective factor.The area under the curve(AUC)for predicting the prognosis of AIS patients by serum NLRC4 and KLF5 was 0.816 and 0.838,respectively.The AUC for predicting the prognosis of AIS patients by the combination of NLRC4 and KLF5 was 0.931,which was superior to that of NLRC4 and KLF5 alone(ZNLRC4=2.675,ZKLF5=2.211,all P<0.05).Conclusions NLRC4 and KLF5 levels in the serum of AIS patients increase with the severity of the disease and are closely related to the prognosis of patients.

Abstract:The compression of the optic pathway by the sellar masses can lead to visual dysfunction,with the most common lesion being pituitary adenoma.Tumor compression on different parts can cause different types of visual dysfunction,typically manifested as bilateral temporal visual field defects.Visual acuity and visual field examination are crucial in clinical evaluation,but are often limited by subjective and equipment factors.Optical coherence tomography(OCT),a non-contact,non-invasive imaging technique,provides an important basis for early diagnosis by assessing the thickness of the retinal nerve fiber layer(RNFL)around the optic disc and the thickness changes of the macular ganglion cell complex(GCC).Optical coherence tomography angiography(OCTA)further provides quantitative indexes by detecting the density of blood vessels at different levels of the retina.Also,it provides an important quantitative basis for early diagnosis and assessment of treatment effects,significantly improving the sensitivity and accuracy of visual function assessment.In recent years,the application value of OCT and OCTA techniques in the evaluation of visual function in patients with sellar mass has gradually emerged.This article mainly explores the latest progress of OCT and OCTA techniques in evaluating the visual function of patients with sellar masses,in order to provide clinicians with a more comprehensive visual function assessment plan,thereby improving the treatment effect and quality of life of patients.

Abstract:Objective To explore the impact of parental marital status and post-traumatic stress symptoms on psychotic-like experiences of college students,so as to provide a reference for the prevention of mental health problems in children from families with unstable marital status.Methods This study was a cross-sectional study.Using cluster sampling,all students in 16 schools of a university in northern China were selected from March to April 2023 for the study.The survey was conducted using the Post-Traumatic Stress Disorder Checklist-Civilian Version and the 15-Item Positive Subscale of the Community Assessment of Psychic Experiences.Logistic regression analysis was used to explore the factors influencing psychotic-like experiences.Process 3.3 plug-in in SPSS 22.0 was used for the mediating effect test.A total of 21 573 valid questionnaires were included in the analysis.Results The positive rates of psychotic-like experiences and subthreshold post-traumatic stress disorder(PTSD)in university students were 8.26％(1 782/21 573)and 14.92％(3 219/21 573),respectively.Differences in rates of subthreshold PTSD across gender,educational level,family history of mental illness,and parental marital status were statistically significant(χ2=54.00,224.15,87.63,299.77;all P<0.05).Differences in rates of high psychotic-like experiences were statistically significant across gender,educational level,home location,family history of mental illness,and parental marital status(χ2=7.36,215.56,13.08,61.76,183.72;all P<0.05).Univariate and multivariate Logistic regression analyses revealed that unstable parental marital status[OR=2.20,95％CI(1.96,2.47);OR=1.53,95％CI(1.35,1.74)]and subthreshold PTSD[OR=10.10,95％CI(9.11,11.20);OR=8.99,95％CI(8.09,9.99)]were risk factors for high psychotic-like experiences,and the differences were statistically significant(all P<0.05).Controlling for the confounding variables of gender,age,education level,home location,only child,and family history of mental illness,unstable parental marital status positively predicted post-traumatic stress symptoms(β=4.41,P<0.001),post-traumatic stress symptoms positively predicted psychotic-like experiences,(β=0.19,P<0.001),and unstable parental marital status positively predicted psychotic-like experience(β=1.24,P<0.001),with all statistical differences.The mediating effect test showed that post-traumatic stress symptoms and each dimension(trauma re-experience symptoms,avoidance and numbness symptoms,and increased alertness symptoms)partially mediated the parental marital status of university students and psychotic-like experiences,with mediating effects accounting for 66.94％,52.42％,58.87％,and 56.45％of the total effect,respectively.Conclusions Parental marital status,post-traumatic stress symptoms,and psychotic-like experiences in university students are closely related.Post-traumatic stress symptoms can partially mediate the effect of parental marital status on psychotic-like experiences among university students.

Abstract:Objective To explore the effect of intermittent theta burst stimulation(iTBS)on cognitive function in older adults through meta-analysis.Methods Randomized controlled trials were collected in PubMed,Embase,Cochrane Library,China National Knowledge Infrastructure,WanFang Data,VIP and Chinese Clinical Trial Registry website,the search period was from database establishment to July 19,2024.Meta-analysis was performed using Review Manager 5.4.Results A total of 12 papers were included,totaling 458 elderly subjects,including 231 in experimental group and 227 in control group.Meta-analysis showed that iTBS improved overall cognitive function[standardized mean difference(SMD)=0.68,95％CI(0.35,1.01),P<0.001],memory[SMD=0.68,95％CI(0.26,1.10),P=0.001],visuospatial function[SMD=0.56,95％CI(0.22,0.90),P=0.001],language function[SMD=0.41,95％CI(0.11,0.70),P=0.008],and attention function[SMD=0.81,95％CI(0.41,1.22),P<0.001]in older adults,and the differences were statistically significant.Analysis for various populations showed that iTBS improved cognitive function in patients with Alzheimer's disease[SMD=0.69,95％CI(0.32,1.06),P<0.001],and cerebrovascular disease[SMD=1.19,95％CI(0.78,1.59),P<0.001)with statistical differences.Conclusions iTBS can improve overall cognitive function,memory,visuospatial function,language function,and attention function in older adults.Meanwhile,iTBS can improve cognitive function in patients with Alzheimer's disease and cerebrovascular disease,with limited improvement in healthy and depressive disorder populations.