Abstract:Objective To explore the risk factors of non-suicidal self-injury （NSSI） in depressive disorder with mixed features （DMX）. Methods A total of 100 patients with DMX who visited the Depression Clinic of Beijing Anding Hospital affiliated to Capital Medical University from May 4， 2021 to July 29， 2022 were selected as the research subject. Patients were divided into NSSI group （n=39） and non-NSSI group （n=61） based on whether NSSI occurred. The depression， anxiety， manic severity， and suicide ideation risk of patients were evaluated using four other-rating scales， including the 17-item Hamilton Depression Rating Scale （HAMD- 17）， Hamilton Anxiety Scale （HAMA）， Young Mania Rating Scale （YMRS）， and Columbia Suicide Severity Rating Scale （C-SSRS）. The severity of depression， anxiety， and anhedonia in patients was evaluated using three self-assessment scales， including the Patient Health Questionnare 9-item Scale （PHQ-9）， Generalized Anxiety Disorder 7-item Scale （GAD-7）， and Snaith-Hamilton Pleasure Scale （SHAPS）. Multivariate Logistic regression model was used to analyze the risk factors for NSSI in patients with DMX. Results There was a statistically significant difference between the two groups in terms of age， residential pattern， age of onset， HAMD-17 score， PHQ-9 score， SHAPS score， and suicide ideation risk level （P＜ 0.05）. Multivariate Logistic regression analysis showed that young age ［OR=0.900， 95%CI （0.829， 0.977）， P=0.012］， high HAMD-17 score ［OR=1.361， 95%CI （1.013， 1.829）， P=0.042］， and high SHAPS score ［OR=1.147， 95%CI （1.078， 1.215）， P ＜ 0.001］ were risk factors for NSSI in patients with DMXs. Conclusions Young age， severe depression， and severe anhedonia are risk factors for NSSI in patients with DMXs， and attention should be paid to DMX patients with this feature in the clinic and early intervention should be made to minimize the occurrence of NSSI.

Abstract:To explore the cognitive function of patients with bipolar disorder Ⅰ depressive episodes and major depressive disorder （MDD）， as well as its relationship with thyroid function and clinical features. Methods From June 2021 to August 2022， 45 patients with bipolar disorder Ⅰ depressive episodes who visited the outpatient and inpatient departments of Wuhan Mental Health Centre were selected as the bipolar disorder depressive episode group， and 45 patients with MDD were selected as the MDD group. During the same period， 54 healthy individuals were recruited as the control group in hospitals and society. This study compared the thyroid function indicators among three groups of subjects， the Hamilton Depression Scale （HAMD） and Hamilton Anxiety Scale （HAMA） scores between two groups of patients， and the cognitive function of the three groups of subjects using the Measurement and Treatment Research to Improve Cognition in Schizophrenia （MATRICS） Consensus Cognitive Battery （MCCB）. Pearson correlation was used to examine the correlation among MCCB scores and HAMD scores，HAMA scores and thyroid stimulating hormone（TSH） in two groups of patients， and multiple linear regression was used to analyze the influencing factors of cognitive function in both groups of patients. Results In the bipolar disorder depressive episode group and MDD group， the HAMD and HAMA scores of patients were higher than those in the control group ［21.0 （19.0， 27.0） vs 22.0 （19.0， 25.0） vs 0 （0，0）， 15.0 （8.0， 18.0） vs 15.0 （9.0， 16.0） vs 0 （0，0）］， and the thyroid stimulating hormone （TSH） was lower than that in the control group ［（2.38±1.85） vs （3.29±2.37） vs （3.35±0.81） μ IU/ml］， and the differences were statistically significant （P＜ 0.05）. The scores of speed of processing， working memory， verbal learning， visual Learning， reasoning and problem-solving， and social cognition of the bipolar disorder depressive episode group and MDD group were lower than those of the control group ［（29.40±13.85） vs （37.87±10.99） vs （50.24±8.29）， （31.80±9.24） vs （30.49±8.42） vs （46.72±9.56）， （31.24±8.61） vs （32.89±9.04） vs （44.13±7.78）， （24.00±8.47） vs （25.96±6.64） vs （42.96±6.91）， （35.16±11.35） vs （40.02±9.84） vs （51.50±7.09）， （43.64±11.20） vs （46.53±10.54） vs （52.33±9.85）］， and the differences were statistically significant （P＜0.05）. The speed of processing， reasoning and problem-solving scores of the bipolar disorder depressive episode group were lower than those of the MDD group， with statistically significant differences （P＜ 0.01）. In bipolar disorder depressive episode group， the HAMD score was negatively correlated with scores of the speed of processing， working memory， verbal learning， reasoning and problem-solving （r=-0.456 to -0.315， P＜ 0.05）， the HAMA fscore was positively correlated with the score of verbal learning （r=0.441， P＜ 0.05）， and the differences were statistically significant. In the MDD group， the HAMD score was negatively correlated with speed of processing and visual Learning， and the differences were statistically significant （r=-0.568， -0.336； P＜ 0.05）. There was no correlation between cognitive function and TSH levels in patients in the bipolar disorder depressive episode and MDD groups （P ＞ 0.05）. Multiple linear regression showed that the HAMD score was a factor affecting the speed of processing， working memory， reasoning and problem-solving， and verbal learning of patients with bipolar disorder depressive episodes with a statistical difference （P ＜ 0.05）， while the HAMA score was a factor influencing verbal learning in patients with bipolar disorder depressive episodes. The HAMD score was a factor affecting the speed of processing and visual learning of MDD patients， while a history of alcohol consumption was a factor influencing the reasoning and problem-solving with a statistical difference （P＜ 0.05）. Conclusions Patients with bipolar disorder Ⅰ depressive episodes and MDD have significant cognitive impairment， with the former having more severe impairments in processing speed and problem-solving skill， and lower TSH levels. Symptoms of depression， anxiety， and alcohol consumption may be influencing factors on cognitive function. Early assessment and intervention of cognitive function are necessary in clinical diagnosis and treatment， and regular monitoring of thyroid function and evaluation of emotional scales are needed to assist diagnosis and treatment and promote cognitive function recovery.

Abstract:Objective To explore the relationship between suicidal ideation and SLC6A4 gene methylation in children and adolescents with pediatric bipolar disorder （PBD） and depressive episodes. Methods From December 2020 to December 2022， 43 patients with PBD and depressive episodes in the Department of Clinical Psychology of Xinjiang Uygur Autonomous Region People's Hospital were selected as the research subject. The suicidal ideation of patients was evaluated using the Self-rating Idea of Suicide Scale （SIOSS）. Patients with a total score of ≥ 12 and a concealment factor score of ＜ 4 were included in the suicidal ideation group （n=29）， and patients with a total score of ＜ 12 were included in the non-suicidal ideation group （n=14）. Methprimer software was used to predict methylation islands and design methylation primers in the SLC6A4 gene promoter region. The extracted DNA was transformed by sulfite for PCR amplification and pyrophosphate sequencing to determine the methylation CpG site and methylation rate. This study compared the differences in methylation at different sites of the SLC6A4 gene between two groups of patients， and adopted Spearman correlation to analyze the correlation between gene methylation and suicidal ideation. Results Gene methylation testing showed that the methylation sites of the SLC6A4 gene in both groups of patients included CpG1， CpG2.3， CpG4， and CpG5.6 sites. Comparison of gene methylation rates at CpG1， CpG2.3， and CpG4 sites in patients in the suicidal ideation group and the non-suicidal ideation group ［48.28% （14/29） vs 8/14， 96.55% （28/29） vs 14/14， 20.69% （6/29） vs 6/14］ ， the differences were not statistically significant （χ2 =0.297， 0.494， 2.306； P ＞ 0.05） . The rate of gene methylation at the CpG5.6 site was higher in patients in in the suicidal ideation group than in the non-suicidal ideation group ［68.97% （20/29） vs 5/14］ ， and the difference was statistically significant （χ2 =4.289， P ＜ 0.05）. Correlation analysis showed that suicidal ideation in patients with PBD and depressive episodes was not correlated with CpG1， CpG2.3， or CpG4 site methylation in the SLC6A4 gene （r=-0.244， -0.210， -0.281； P ＞ 0.05）， but was positively correlated with CpG5.6 site methylation， and the difference was statistically significant （r=0.312， P＜ 0.05）. Conclusions The suicidal ideation of patients with PBD and depressive episodes is related to the SLC6A4 gene methylation at CpG5.6 site， providing a basis for clarifying the causes of suicidal ideation.

Abstract:Objective To explore the correlation between the geriatric nutritional risk index （GNRI） and unplanned readmission （readmission） in elderly stroke patients. Methods The clinical data of 307 elderly stroke patients admitted to the Yancheng Third People's Hospital， Jiangsu Province from June 2019 to May 2022 were retrospectively analyzed. According to the median GNRI of all patients， they were divided into a normal GNRI group （GNRI≥92） and a low GNRI group （GNRI＜92）. The propensity score matching （PSM） was used to obtain two sets of samples with 13 variables balanced， such as age and albumin at admission. Logistic regression was used to analyze the impact of GNRI on readmission before and after PSM. The predictive value of GNRI on readmission was evaluated using the area under the receiver operating characteristic （ROC） curve （AUC） alone and after adjusting for other covariates. Results Among 307 elderly stroke patients， the GNRI was （92.62±25.30）， and 43.32%（133/307）patients had normal GNRI. After PSM， a total of 126 pairs were successfully matched. There was no statistical difference between the two groups in age， body mass index，diabetes， hospital stay， surgical treatment ratio， albumin and other clinical data （P ＞ 0.05）. After PSM， the readmission rate of the low GNRI group was 28.57% （36/126）， which was higher than the 11.90% （15/126） of the normal GNRI group， and the difference was statistically significant （χ2 =10.841， P=0.001）. Logistic regression analysis after PSM showed that in Model 1， which only included GNRI， the readmission risk of patients with low GNRI increased by 2.232 times compared to those with normal GNRI， and the difference was statistically significant ［OR=3.232，95%CI（1.701，6.138），P=0.001］. In Model 2， after adjusting for age and gender， the readmission risk of patients with low GNRI increased by 2.206 times compared to those with normal GNRI， and the difference was statistically significant ［OR=3.206，95%CI（1.674，6.138），P=0.001］. In Model 3， after adjusting for all variables such as age and gender， the readmission risk of patients with low GNRI increased by 2.052 times compared to those with normal GNRI， with a statistically significant difference ［OR=3.052， 95%CI （1.469， 6.339）， P=0.003］. ROC curve analysis showed that the predicted AUC for readmission of Model 1 was 0.821 ［95%CI （0.755， 0.886）］. After adjusting for covariates using Model 2 and Model 3， the predicted AUC for readmission were 0.828 ［95%CI （0.770， 0.886）］ and 0.847 ［95%CI （0.797， 0.898）］， respectively. The AUC of Model 3 was higher than that of Model 1 and Model 2， and the difference was statistically significant （Z=3.036， 2.457； P=0.002， 0.014）. Conclusions GNRI can effectively predict the readmission of elderly stroke patients and has an important warning role， which may guide medical and nursing staff in nutritional management of elderly stroke patients.

Abstract:Objective To explore the correlation between non-alcoholic fatty liver disease （NAFLD） and cognitive impairment. Methods The research on the correlation between NAFLD and cognitive impairment was searched on China National Knowledge Infrastructure， WanFang Data， VIP， China Biology Medicine， PubMed， Web of Science， Embase， and Cochrane Library. This study screened and evaluated literature according to inclusion criteria， and extracted data. Meta-analysis was performed using StatMP 17 software. Results A total of 13 articles were included， with a total of 73 219 patients. The meta-analysis showed a correlation between NAFLD and cognitive impairment with a statistically significant ［OR=1.49， 95%CI （1.16， 1.92）， P ＜ 0.05］. The subgroup analysis revealed that in cross-sectional studies ［OR=2.14， 95%CI （1.24， 3.67）， P＜ 0.05］， North America ［OR=1.61， 95%CI （1.32， 1.98）， P＜ 0.05］， imaging/pathological diagnostic methods ［OR=1.58， 95%CI （1.04， 2.41）， P＜ 0.05］， fatty liver index diagnostic methods ［OR=1.60， 95%CI （1.13， 2.26）， P＜ 0.05］， and Mini Mental State Examination ［OR=1.35， 95%CI （1.01， 1.82）， P＜ 0.05］ and patients with mild cognitive impairment ［OR=1.41， 95%CI （1.05， 1.90）， P ＜ 0.05］， NAFLD was positively correlated with cognitive impairment， and the differences were statistically significant. Conclusions NAFLD is related to cognitive impairment， which has guiding significance for effectively preventing and controlling cognitive dysfunction in NAFLD populations.

Abstract:The pathogenesis involves neuroinflammation， synaptic plasticity and nerve regeneration. However， the diagnosis and treatment of these diseases are difficult， and the prognosis is poor. As a result， it is particularly important to find new biomarkers and therapeutic methods. Exosomes， as nanoscale membranous vesicles secreted by cells themselves， not only play an important role in the pathophysiological processes of various diseases， but also participate in the occurrence and development of mental disorders. This paper summarizes the research progress on the role of exosomes in the diagnosis and treatment of common mental disorders， providing specific theoretical references for the precise application of exosomes in the diagnosis and treatment of mental disorders in the futures.

Abstract:Schizophrenia is a serious mental disorder， and cognitive impairment is one of the typical clinical manifestations of the disease. The visual system is involved in various cognitive processes. As an important component of the visual system， fixation stability is closely correlated with cognitive function. In recent years， cognitive function and fixation stability are key trends in the study of schizophrenia， and many scholars are committed to using them as indicators for early recognition， diagnosis， and assess treatment and prognosis of schizophrenia. This paper reviews the methods and key points of research on cognitive function and fixation stability in schizophrenia， explores the relationship between cognitive function and fixation stability in patients with schizophrenia， and makes prospects for using fixation stability-related eye movement indicators to guide the diagnosis and treatment of schizophrenia.

Abstract:Alzheimer disease （AD） is a common form of elderly dementia that currently lacks effective treatment. Therefore， early diagnosis and intervention are particularly important. Currently， peripheral biomarkers are becoming a research hotspot in AD. Recent studies have shown that plasma p-tau217 plays an important role in the early diagnosis， differentiation， treatment monitoring， and prognosis evaluation of AD， and has good application prospects. However， further standardization of laboratory protocols and optimal cutoff values need to be determined. This paper reviews the above progress， aiming to provide a basis for clinical applications.

Abstract:Fatigue is a common symptom in patients with multiple sclerosis， characterized by subjective exhausted and insufficient physical and/or mental energy. It is an important cause of disability and unemployment， seriously affecting the quality of life of patients with multiple sclerosis. Psychological disorders are one of the important reasons for the persistence and deterioration of fatigue in patients with multiple sclerosis. Previous studies have explored psychological interventions for multiple sclerosis fatigue， such as cognitive-behavioral therapy， mindfulness therapy， relaxation therapy， self-management projects， and guiding imagination， which have shown certain effects in improving fatigue in multiple sclerosis patients. This paper reviews the psychological intervention methods and effects on fatigue in multiple sclerosis patients both domestically and internationally， aiming to provide theoretical basis for future research on psychological intervention for fatigue in patients with multiple sclerosis.

Abstract:Emotional disorders are a collective term for various psychological disorders characterized by emotional abnormalities， including depression disorder， anxiety disorder， and obsessive-compulsive disorder. The metacognitive theory suggests that the generation and maintenance of emotional disorders are related to cognitive attention syndrome. Metacognitive therapy focuses on different aspects of cognitive attention syndrome in emotional disorders， mainly using delay techniques， attention training techniques， and mindfulness separation techniques. This paper elaborates on the mechanisms of repetitive negative thinking， attention bias towards threatening information， and self-regulation strategies in cognitive attention syndrome， as well as their role in emotional disorders， aiming to gain a deep understanding of cognitive attention syndrome and provide a basis for the treatment of patients with emotional disorders.

Abstract:Alexithymia is a personality characteristic that is difficult to express and recognize emotions. This personality characteristic is closely related to various mental disorders and can affect the effectiveness of treatment for mental disorders， prolong the course of treatment， and increase the risk of suicide. At present， the mechanism of alexithymia is not clear， and the unknow etiology and lack of objective indicators for diagnosis are urgent problems that need to be addressed in clinical diagnosis and treatment. Positron emission tomography， magnetic resonance imaging， and other imaging techniques are important objective means for studying alexithymia. This paper reviews the neuroimaging advances in alexithymia from the aspects of cerebral hemisphere， limbic system， and other brain regions， aiming to provide reference for the evaluation and intervention of alexithymia.

Abstract:With the development of digital three-dimensional （3D） technology， neurosurgery has entered a stage of development where preoperative model reconstruction is combined with clinical surgical approach research. The diagnostic rate of tumors in the cerebellopontine angle region is gradually increasing， and the therapeutic focus has shifted from complete surgical resection to preserving neural function. Research on sigmoid sinus is becoming increasingly important. However， there are few big data studies on measuring the anatomy of relevant populations. This paper reviews existing domestic and international literature， providing theoretical basis for establishing a database of sigmoid sinus anatomy， enhancing neurosurgeons' understanding of the cerebellopontine angle region， and developing new methods for resection of tumors in the cerebellopontine angle region.