Abstract:Epilepsy syndromes represent a group of epileptic disorders characterized by specific seizure types， electroencephalogram （EEG） patterns， and imaging features. Early diagnosis of epilepsy syndromes is crucial for guiding treatment and prognostic evaluation. However， the vast variety of epilepsy syndromes and their complex clinical presentations pose significant challenges for clinicians in understanding and mastering these conditions. This paper provides a comprehensive review from perspectives such as age of onset， seizure types， and prognosis and constructs a learning framework for the classification of epilepsy syndromes. The aim is to provide reference for the clinical recognition and treatment of epilepsy syndromes.

Abstract:Objective To compare gender differences in residual symptoms in patients with bipolar disorder after acute phase treatment. Methods A total of 242 patients （107 males， 135 females）with bipolar disorder hospitalized at Beijing Anding Hospital， Capital Medical University， from June 2014 to June 2017 were included in the study. The Hamilton Depression Rating Scale-17 （HAMD-17）， Young Mania Rating Scale （YMRS）， and Arizona Sexual Experience Scale （ASEX） were used to assess residual depressive， manic， and sexual symptoms， respectively. Gender differences in residual symptoms were compared. For symptoms showing gender differences， Pearson correlation analysis was performed to examine the relationships between different symptom items and their severity with domains of the World Health Organization Quality of Life Questionnaire （WHOQOL）. Results Although 11.57%（28/242） of patients exhibited residual depressive symptoms， there was no statistically significant gender difference （P＞0.05）. HAMD-17 item comparisons showed that female patients ［21.48%（29/135）］had a higher proportion of somatic symptoms than male patients ［8.41%（9/107）］（P＜ 0.05）. Additionally， 9.50%（23/242） of patients exhibited residual manic symptoms， with a lower proportion in female ［4.44%（6/135）］patients compared to male patients ［15.89%（17/107）］（P=0.003）. YMRS item comparisons revealed that female patients had lower proportions of increased activity-energy， heightened sexual interest， and speech-thought disorder than male patients （all P＜ 0.05）. Furthermore， 45.06% （105/233） of patients exhibited sexual dysfunction， with a marginally higher proportion in female patients ［42.64%（55/135）］compared to male patients ［27.88%（29/107）］（P=0.069）. The proportion of female patients with at least one item score ≥ 5 was higher than that of male patients （P=0.02）. ASEX item comparisons showed that， using a cutoff score of 4， female patients had higher proportions of impaired sexual arousal and orgasm than male patients （all P＜ 0.05）. Using a cutoff score of 5， female patients had higher proportions of impaired sexual desire， sexual arousal， lubrication， orgasm， and satisfaction with orgasm than male patients （all P＜ 0.05）. Further correlation analysis indicated that， in male patients， orgasm was negatively correlated with the psychological domain （r=-0.267，P＜ 0.05）. In female patients， somatic symptoms， sexual arousal， and orgasm were negatively correlated with the psychological and physical health domains （r=-0.280，-0.275，-0.261，-0.077， -0.184， -0.303； all P＜ 0.05）. Conclusions Gender differences exist in residual symptoms after acute phase treatment in patients with bipolar disorder. Female patients are more likely to exhibit residual somatic symptoms and sexual dysfunction， while male patients are more likely to exhibit residual manic symptoms. These residual symptoms are negatively correlated with patients' quality of life.

Abstract:Objective To explore the clinical manifestation and genetic attributes of pediatric patients with epilepsy and developmental backwardness associated with CACNA1A gene variants. Methods The medical records of 12 pediatric patients with CACNA1A gene variant-associated epilepsy with or without developmental backwardness admitted to the Department of Pediatric Internal Medicine of the Third Affiliated Hospital of Zhengzhou University from January 2019 to January 2024 were retrospectively collected， including the type of epileptic seizures， imaging examinations， electrophysiological characteristics， Griffiths Development Scales-Chinese Edition （GDS-C） scores， therapeutic effects， and genetic test results， and clinical and genetic characteristics were analyzed. Peripheral blood was collected from the pediatric patients and their parents， genomic DNA was extracted， whole exome genome sequencing was performed in the family line. Sanger sequencing was used to validate the variant loci and clarify the sources of variants. Results The median age of onset for the 12 pediatric patients with epilepsy was 28.7 months， and the type of seizure was focal and/ or generalized. Among 12 cases， there were 10 cases of missense mutations， one case of mutation near splice site， and one case of mutation in non-coding region. There were four cases of de novo mutations and 8 cases of hereditary mutations. Three cases had a history of status epilepticus. Three cases had cluster seizures during the course of the disease. One case of acute encephalopathy after sustained status epilepticus， with ataxia and tremor of the limbs after awakening. One case had a stroke-like episode. There were 10 cases of abnormal EEG discharges during the interictal period. Ten pediatric patients had varying degrees of developmental delay. After antiepileptic drug treatment， seizures resolved in six cases， and intermittent seizures remained in the remaining six cases. Conclusions CACNA1A gene variant-associated epilepsy may present as focal and/or generalized seizures， often with developmental backwardness， and valproic acid， levetiracetam， and lamotrigine are effective in some pediatric patients. Clinical manifestations and therapeutic effects of epilepsy associated with mutations at different variant loci of the CACNA1A gene differ.

Abstract:In recent years， a large number of epilepsy pathogenic genes have been gradually revealed with the advancement of genetic testing technology. Studies on the clinical phenotypes and pathophysiologic mechanisms associated with epilepsy pathogenic genes have made precision epilepsy treatment possible. In actual clinical practice， early identification of epilepsy pathogenic genes is crucial for effective treatment and the selection of appropriate antiepileptic drugs. This article provides an overview of a variety of currently known epilepsy pathogenic genes that have guided clinical therapy， with a view to helping clinicians select appropriate epilepsy treatment programs.

Abstract:Electrical status epilepticus during sleep （ESES） is a specific electroencephalographic phenomenon appearing as a near-continuous release of spikes and slow waves during wake-sleep phases， and is commonly seen in a variety of epileptic syndromes， with self-limited epilepsy with centrotemporal spikes （SeLECTS）， Landau-Kleffner Syndrome （LKS）， and epileptic encephalopathy with continuous spikes and waves during slow-wave sleep （CSWS）， which are also characterized by varying degrees of neuropsychological impairments. The pathophysiologic mechanism of ESES is still unclear， but with the maturation of gene sequencing， electroencephalography， brain imaging （MRI， MRS）， and other auxiliary detection techniques， important advances have been made in the structural， immunologic， and genetic （CNKSR2， GRIN2A） aspects. As a research hotspot in recent years， targeted therapy has been gradually explored in epileptic syndromes， but no clear guidelines have been formed yet. Therefore， based on the current research status of ESES， this paper reviews the occurrence， progression， diagnosis and treatment of ESES and its characteristic EEG manifestations， with a view to providing references for the formulation of diagnostic and therapeutic programs， and providing ideas for basic research.

Abstract:The gut microbiota plays a crucial role in the onset， treatment， and prognosis of epilepsy. The gut microbiota may influence the onset and progression of epilepsy via the gut-brain axis. The imbalance of gut microbiota in patients with epilepsy is associated with the frequency， severity， and drug responsiveness of seizures. Modulating gut microbiota， such as through drugs， diet or probiotics， may improve the treatment effect of epilepsy. The application of gut microbiota in epilepsy management is still under exploration. Future research needs to further clarify the mechanism of action of both to achieve personalized treatment of epilepsy. This article summarizes and discusses the relationship between gut microbiota and epilepsy， as well as the mechanisms of interaction， with a view to providing new insights into the interaction between epilepsy and gut microbiota

Abstract:Objective To explore the clinical efficacy of low frequency repetitive transcranial magnetic stimulation （LF-rTMS） （1 Hz） combined with escitalopram for sleep disorders in adolescents with depressive. Methods A total of 82 sleep disorders in adolescents with depressive disorder who attended the Department of Comprehensive Psychology of the Kashgar First People's Hospital from January 2023 to January 2024 were retrospectively selected for the study. The study subjects were divided into control group （40 cases， escitalopram） and study group （42 cases， LF-rTMS in combination with escitalopram） according to the treatment method. Clinical efficacy， Hamilton Anxiety Scale （HAMA） scores， Hamilton Depression Scale-17 （HAMD-17） scores， Pittsburgh Sleep Quality Index （PSQI） scores， quality of sleep， polysomnographic indices， quality of life， serum indices， and the incidence of adverse reactions were compared between the two groups. Results The treatment efficiency of study group was higher than that of control group ［90.48% （38/42） vs. 72.50% （29/40）］， and the difference was statistically significant （χ2 =4.430， P ＜ 0.05）. The pre- and posttreatment differences of HAMA， HAMD and PSQI scores in study group were significantly higher than those in control group ［（7.16±1.28） vs. （6.38±1.05）， （12.86±1.60） vs. （8.64±2.35）， （6.63±1.05） vs. （4.97±0.43） scores］， and the differences were all statistically significant （t=3.009， 9.546， 9.283； all P ＜ 0.01）. The preand post-treatment differences in total sleep time （TST）， sleep latency （SL）， number of awakenings （NW）， and awakening time （AT） in study group were higher than those in control group ［（3.01±0.76） h vs. （1.12±0.69） h， （27.34±7.75） min vs. （23.06±1.24） min， （1.68±0.38） times vs. （1.02±0.15） times， （67.53±4.71） min vs. （62.57±4.12） min］， and the differences were statistically significant （t=11.772， 3.450，10.248， 5.065； all P ＜ 0.001）. The pre- and post-treatment differences in the physical， social， emotional， and somatic scores of quality of life in study group were higher than those in control group ［（13.40±3.55） vs. （9.01±1.68）， （20.38±1.01） vs. （12.76±0.73）， （10.93±1.89） vs. （7.12±0.79）， （7.45±2.13） vs. （4.12±1.76） scores］， and the differences were statistically significant （t=7.099， 38.990， 11.834， 7.697； all P ＜ 0.001）. The pre- and post-treatment differences in gamma-aminobutyric acid （GABA），5-hydroxytryptamine （5-HT）， and brain-derived neurotrophic factor （BDNF） in study group was higher than that in control group ［（2.84±0.27） ng/ml vs. （2.31±0.25） ng/ml， （56.44±9.83） ng/ml vs. （36.02±8.35） ng/ml， （6.51±0.24） ng/ml vs. （5.63±0.32） ng/ml］， and the differences were statistically significant （t=9.211， 10.114，14.132； all P ＜ 0.001）. The difference in the incidence of adverse reactions between the two groups was not statistically significant （P ＞ 0.05）. Conclusions Combined treatment with LF-rTMS and Escitalopram for depressive adolescents with sleep disorders can improve their depressive symptoms and sleep quality， enhance the patients' quality of life， and improve relevant serum indexes， which has good clinical application value.

Abstract:Objective To explore the mechanism of adaptive cognitive emotion regulation strategies and psychological flexibility in the relationship between perceived stress and depressive emotion in patients with depressive disorder. Methods Convenience sampling was used to select 204 patients with depressive disorder who attended the Third Hospital of Daqing City of Heilongjiang Province from December 2021 to December 2022 as study subjects. The Chinese Perceived Stress Scale （CPSS）， Comprehensive assessment of Acceptance and Commitment Therapy （CompACT）， Cognitive Emotion Regulation Questionnaire （CERQ）， and Self-Rating Depression Scale （SDS） were used to assess the patients' perceived stress， psychological flexibility， adaptive cognitive emotion regulation strategies， and depressive emotion. Pearson correlation was used to analyze the correlations between perceived stress， psychological flexibility， adaptive cognitive emotion regulation strategies， and depressive emotion. The common method bias testing was performed using the Harman one-way method， the mediating effect analysis was performed using Model 6 in the Process program， and the significance of the mediating effect was tested using the biascorrected bootstrap method. A total of 215 questionnaires were distributed in this study， and 204 valid questionnaires were recovered, with an effective recovery rate of 94.88%（204/215）. Results Perceived stress in 204 depressive disorder patients negatively predicted adaptive cognitive emotion regulation strategies （β= -0.51， P＜ 0.01） and psychological flexibility （β=-0.43， P＜ 0.01） and positively predicted depressive emotion （β=0.36， P＜0.01）. Adaptive emotion regulation strategies positively predicted psychological flexibility （β=0.40， P ＜ 0.01）. Psychological flexibility negatively predicted depressive emotion （β=-0.35， P ＜ 0.01）. The above differences were statistically significant. Psychological flexibility mediated the association between perceived stress and depressive emotion ［95%CI （0.09，0.25）］， with the mediating effect accounting for 24.64% of the total effect. Psychological flexibility and adaptive cognitive emotion regulation strategies had a chain mediating effect between perceived stress and depressive emotion ［95%CI （0.03， 0.15）］， with the mediating effect accounting for 11.59% of the total effect. Conclusions Perceived stress in patients with depressive disorder not only act directly on the depressive emotion， but also indirectly through the chain mediation of adaptive cognitive emotion regulation strategies and psychological flexibility.

Abstract:Objective To explore the positive mental character dimmensions affecting the well-being of junior high school students. Methods In the first week of the new semester during the winter vacation on February 17， 2024， cluster sampling was used to select 405 junior grade one students from a school in Beijing for the study. Engagement， Perseverance， Optimism， Connectedness and Happiness （EPOCH） measure and Middle School Students' Positive Psychological Quality Scale were used to investigate the students' well-being and positive mental characters. Patient Health Questionnaire-9 （PHQ-9） and Generalized Anxiety Disorder-7 （GAD-7） were used to measure mental health. Self-rating Internet Gaming Disorder Scale （IGDS） and Chinese Family Assessment Instrument （CFAI） were used to assess the risk of internet gaming disorder and their family function. The mechanisms of action between positive mental characters， depressive disorder and well-being were analyzed by mediating effects. Pearson correlation and stepwise multiple regression were used to explore positive mental character dimensions that predicted well-being. Results A total of 405 junior grade one students had a total score of （71.35±16.44） on the EPOCH measure. Positive mental characters score and family functions score of junior grade one students were positively correlated with well-being score （r=0.689， 0.591； all P＜0.05）， depressive disorder， anxiety and internet gaming disorder scores were negatively correlated with well-being （r= -0.586，-0.516，-0.320； all P＜ 0.05）. Positive mental characters partially mediated the relationship between depressive disorder and well-being， with an effect value of -0.147， which accounted for 25% of the total effect. Transcendence and altruistic strengths mediated the most significant effect on well-being （P ＜ 0.001）. Conclusions Positive mental characters are highly correlated with junior high school students' well-being， with the dimensions of transcendence and altruistic strengths being the strong predictors of well-being.

Abstract:Modified electroconvulsive therapy （MECT）， a treatment involving electrical stimulation of the brain to induce a seizure-free state， has demonstrated significant efficacy and favorable safety in the management of mood disorders in adolescents. However， its clinical application faces challenges due to stigma， discrepancies in clinician perceptions， inconsistent international policies， and insufficient research evidence. This review systematically summarizes the effectiveness， safety， influencing factors， implementation barriers， and current clinical guidelines for MECT in adolescents with mood disorders. The aim is to provide clinicians with a comprehensive understanding of MECT， clarify misconceptions， optimize clinical decision-making， and offer recommendations to promote standardized use of MECT in adolescent populations.

Abstract:Bipolar disorder （BD） is a chronic recurrent mental disorder that seriously affects the quality of life of patients and is one of the top 10 causes of the global burden of disease. Internet gaming disorder （IGD） is currently a recognized problem that affects the lives and physical and mental health of people who use online games worldwide， and is one of the mental disorders that deserves further research. Currently， the application of structural and functional imaging techniques has been widely studied on brain structure and brain biochemical metabolism in patients with BD and IGD， and brain structural changes such as thinning of the parietal lobe， the anterior cingulate gyrus， the frontal cortex， and reduction in surface area， as well as brain biochemical metabolism changes such as decreased levels of N-acetyl aspartate in the frontal lobe in the patients of the two groups have been found to be both differences， and these changes correlate with clinical features. This paper reviews the characteristic changes in brain structure and brain biochemical metabolites of BD and IGD patients， and explores the similarities and differences between the brain structure and brain biochemical metabolisms of BD and IGD patients， with the aim of providing reference for neuroimaging markers， neurobiological mechanisms， and diagnostic methods and early intervention of the co-morbidity of BD with IGD.

Abstract: