Minor stroke has a high incidence, accounting for up to 50% of acute ischemic stroke (AIS). The symptoms are typically mild at the initial onset, with significant concealment, and thus are easily overlooked by patients, leading to delayed medical intervention. However, minor stroke is associated with a high recurrence rate and susceptibility to early neurological deterioration (END), which may rapidly worsen the condition. This often results in missing the optimal treatment window and unfavorable prognoses. Currently, controversies persist regarding standardized treatment strategies for minor stroke, as inappropriate interventions could increase the risk of disability and mortality. This article reviews recent research advances in treatment plans for patients with a National Institutes of Health Stroke Scale (NIHSS) score ≤5, aiming to summarize the latest evidence and provide references for clinical practice.

Objective:To investigate the effect of olanzapine (OLZ) on the differentially-expressed circRNAs in prefrontal cortex of schizophrenia mouse models and predict the target genes.Methods:SPF grade C57BL/6 mice, 7~8 weeks-old, 20 male mice and 45 female mice were recruited and breeded offspring.Forty-four double-stimulation induced schizophrenia-like mouse models, the offspring mice exposed to dual stress were divided into the schizophrenia group(SZ group, n=23) and the olanzapine intervention group (SZ+ OLZ group, n=21), while the mice raised under normal conditions served as the control group (NC group, n=22). Whole transcriptome sequencing was used to sequence the expression level of RNAs from the prefrontal cortex of the mice. RT-qPCR was applied to verify the differentially-expressed circRNAs, then the target genes of miRNAs which have binding site to verified circRNAs were predicted. Results:RNA-seq results showed that there were 137 differentially-expressed circRNAs compared with NC group, 62 were significantly high-expressed and 75 were low-expressed. circRNA_06886 showed significant low-expressed in SZ group compared with NC group( Z=-3.259, P<0.01), and significant high-expressed in SZ+ OLZ group compared with SZ group( Z=-4.765, P<0.01). Bioinformatics analysis of miRNA target genes showed that the target genes were involved in the pathways related to neural pathways such as dopamine, glutamate and MAPK signaling pathways. Conclusions:There are differentially expressed circRNAs in the prefrontal cortex of schizophrenia mouse models, and circRNA_06886 is low-expressed in the prefrontal cortex of schizophrenia mice, Camk2b-201 and Plcb1-003 are the potential genes of circRNA_06886 involved in the regulation of schizophrenia pathogenesis by dopamine pathway.

Objective:To investigate the effect of olanzapine (OLZ) on the differentially-expressed circRNAs in prefrontal cortex of schizophrenia mouse models and predict the target genes.Methods:SPF grade C57BL/6 mice, 7~8 weeks-old, 20 male mice and 45 female mice were recruited and breeded offspring.Forty-four double-stimulation induced schizophrenia-like mouse models, the offspring mice exposed to dual stress were divided into the schizophrenia group(SZ group, n=23) and the olanzapine intervention group (SZ+ OLZ group, n=21), while the mice raised under normal conditions served as the control group (NC group, n=22). Whole transcriptome sequencing was used to sequence the expression level of RNAs from the prefrontal cortex of the mice. RT-qPCR was applied to verify the differentially-expressed circRNAs, then the target genes of miRNAs which have binding site to verified circRNAs were predicted. Results:RNA-seq results showed that there were 137 differentially-expressed circRNAs compared with NC group, 62 were significantly high-expressed and 75 were low-expressed. circRNA_06886 showed significant low-expressed in SZ group compared with NC group( Z=-3.259, P<0.01), and significant high-expressed in SZ+ OLZ group compared with SZ group( Z=-4.765, P<0.01). Bioinformatics analysis of miRNA target genes showed that the target genes were involved in the pathways related to neural pathways such as dopamine, glutamate and MAPK signaling pathways. Conclusions:There are differentially expressed circRNAs in the prefrontal cortex of schizophrenia mouse models, and circRNA_06886 is low-expressed in the prefrontal cortex of schizophrenia mice, Camk2b-201 and Plcb1-003 are the potential genes of circRNA_06886 involved in the regulation of schizophrenia pathogenesis by dopamine pathway.

Minor stroke has a high incidence, accounting for up to 50% of acute ischemic stroke (AIS). The symptoms are typically mild at the initial onset, with significant concealment, and thus are easily overlooked by patients, leading to delayed medical intervention. However, minor stroke is associated with a high recurrence rate and susceptibility to early neurological deterioration (END), which may rapidly worsen the condition. This often results in missing the optimal treatment window and unfavorable prognoses. Currently, controversies persist regarding standardized treatment strategies for minor stroke, as inappropriate interventions could increase the risk of disability and mortality. This article reviews recent research advances in treatment plans for patients with a National Institutes of Health Stroke Scale (NIHSS) score ≤5, aiming to summarize the latest evidence and provide references for clinical practice.

Objective:To investigate the correlation between the prognosis of late-onset depression(LOD)in the elderly and lncRNA expression levels and coping styles.Methods:Differential expression of lncRNAs in peripheral blood of LOD 92 patients was detected by a real-time quantitative PCR(qPCR)detection system, and the Hamilton Depression Scale(HAMD)and the Trait Coping Style Questionnaire(TCSQ)were used for psychological assessment.Results:Compared with the control group, the expression levels of TCONS_00019174(7.55 vs.4.36), ENST00000566208(6.48 vs.3.26), ENST00000517573(8.33 vs.5.32)and NONHSAT142707(6.78 vs.3.26)in elderly patients of the LOD group were significantly down-regulated( Z=5.09, 5.87, 4.35, 6.44, P<0.05); Compared with the low-expression subgroup, scores of anxiety/somatization[(3.83±1.40) vs.(6.39±2.35)], diurnal variation[(0.22±0.42) vs.(0.83±0.94)], retardation[(5.74±0.96) vs.(6.48±1.28)], hopelessness[(2.78±0.67) vs.(4.52±1.56)]and HAMD[(20.39±1.75) vs.(26.83±4.88)]in the high-expression subgroup were significantly lower( t=-4.50, -2.84, -2.22, -4.90, -5.96, P<0.05). The ΔCT value of TCONS_00019174 was negatively correlated with the reduction rates of anxiety/somatization, diurnal variation, retardation, sleep disturbance, hopelessness and HAMD( r=-0.40-0.66, P<0.05). The ΔCT value of ENST00000566208 was negatively correlated with the reduction rates of anxiety/somatization, sleep disturbance, hopelessness and HAMD( r=-0.47-0.62, P<0.01). The ΔCT values of ENST00000517573, NONHSAT034045 and NONHSAT142707 were negatively correlated with the reduction rates of retardation, sleep disturbance, hopelessness and HAMD( r=-0.39-0.76, P<0.05). The positive coping style was positively correlated with the reduction rates of HAMD, anxiety/somatization, retardation, sleep disturbance and hopelessness( r=0.38-0.55), while the negative coping style was negatively correlated with the reduction rates of HAMD, anxiety/somatization, sleep disturbance and hopelessness( r=-0.39-0.67, P<0.05). When TCONS_00019174, ENST00000566208, NONHSAT034045, NONHSAT142707, positive coping and negative coping were taken into the regression equation as variables for HAMD reduction, it was found that they were able to explain 32.4% of the variance for the reduction rate of the total HAMD score( t=-8.713, -3.584, -3.864, -2.257, 5.675, -2.357, P<0.05). Conclusions:TCONS_00019174, ENST00000566208, NONHSAT034045, NONHSAT142707, positive coping style and negative coping style are predictors of the prognosis of LOD in the elderly.

Objective:To compare the effectiveness of intravenous thrombolysis(IVT)alone versus mechanical thrombectomy(MT)in treating acute large vessel occlusive stroke(AIS-LVO).Amd to analyze the factors that are associated with the prognosis of MT.Methods:A total of 197 patients with acute ischemic stroke with large vessel occlusion(AIS-LVO)who received intravenous thrombolysis(IVT)and/or mechanical thrombectomy(MT)at the Stroke Center of the Second Hospital of Dalian Medical University from April 2016 to July 2021 were included in this retrospective analysis.Baseline data, clinical data, and 90-day Modified Rankin Scale(mRS)scores were collected for each group.The efficacy and risk of IVT alone and MT were compared using univariate and multivariate logistic regression analysis.Additionally, factors influencing the prognosis of MT were identified.Results:A total of 197 patients who met the inclusion criteria were included in this study.Out of these, 62 patients were in the IVT alone group and 135 patients were in the MT group.The results of the univariate analysis showed that the MT group had lower admission systolic blood pressure(147±23 vs.158±27 mmHg, P=0.003), higher baseline NIHSS score[15(12, 19) vs.12(8, 16), P=0.003], and there were also differences in vascular occlusion between the two groups( χ2=15.504, P=0.004).Specifically, the middle cerebral artery and basilar artery occlusion were higher in the MT group.In terms of outcome, the MT group had a higher percentage of good outcomes at 90 days[53(39%) vs.13(21%), χ2=6.381, P=0.012], and there was no significant difference in symptomatic intracranial hemorrhage(sICH)and mortality within 90 days.Among the 135 patients who underwent MT, 53 patients were classified as having a good prognosis, while 82 patients were classified as having a poor prognosis.Multivariate analysis revealed that age( OR=1.078, 95% CI: 1.025-1.133, P=0.003), neutrophil to lymphocyte ratio(NLR)( OR=1.164, 95% CI: 1.013-1.338, P=0.032), time from onset to recanalization( OR=1.004, 95% CI: 1.000-1.007, P=0.049), sICH( OR=15.585, 95% CI: 1.397-173.865, P=0.026), ASPECTS/pc-ASPECTS score( OR=0.524, 95% CI: 0.017-0.582, P=0.024), and good recanalization( OR=0.099, 95% CI: 1.718-59.046, P=0.010)were identified as independent prognostic factors.The results indicate that percutaneous transluminal angioplasty, stent implantation, and the use of tirofiban and butylphthalide did not significantly affect the prognosis of the MT group. Conclusions:The use of mechanical thrombectomy(MT)in patients with acute ischemic stroke due to large vessel occlusion(AIS-LVO)is more effective than intravenous thrombolysis(IVT)alone and has a similar safety profile.However, there are certain factors that can influence the prognosis of MT treatment.Older age, higher neutrophil-to-lymphocyte ratio(NLR), longer time from symptom onset to recanalization, and the occurrence of postoperative symptomatic intracranial hemorrhage(sICH)were identified as independent predictors of poor prognosis in MT treatment.On the other hand, a higher ASPECTS/pc-ASPECTS score and successful recanalization were found to be protective factors associated with a favorable prognosis in MT treatment.

Objective:To establish neurodevelopmental mice model of schizophrenia(SZ) with prepulse inhibition(PPI) deficits and investigate the effectiveness of olanzapine on PPI disruption.Methods:On the 9th day of pregnancy of SPF grade C57BL/6 mice, female mice were injected with polyinosinic acid poly (I∶C) (6 mg/kg) through tail vein for immune stimulation. The stress model was constructed by chronic unpredictable mild stress 30-40 d after birth (PND30-40). The offspring mice were divided into pregnancy immune stimulation + adolescent stress group (P + S + group), pregnancy immune stimulation group (P + S- group), adolescent stress group (P-S+ group) and non stimulation group (P-S-group), with 18 mice in each group. The mice in P+ S+ group were divided into OLZ intervention group (OLZ group) and non-OLZ intervention group (non-OLZ group), with 9 mice in each group. The PPI function of mice was detected by acoustic startle reflex test after modeling and OLZ intervention. Adopt StatView Version 5.0 software for data analysis, and multi factors analysis of variance was used to test the main effect, interactive effect and simple effect of each factor.Results:The main effects of maternal Poly(I: C) immune activation and pubertal chronic unpredictable stress were significant( F(1, 330)=47.72, P<0.01), and there was a significant interaction between the two factors( F(1, 330)=14.80, P<0.01), simple effect analysis showed that average percent prepulse inhibition (PPI%) in P+ S+ group((15.42±6.13)%) was significantly decreased compared with groups of P+ S-((27.33±4.58)%), P-S+ ((31.17±3.97)%) and P-S-((47.14±12.28)%)(all P<0.01). There was significant gender difference in Prepulse inhibition(PPI)score( F(1, 396)=61.94, P<0.01), in male and female mice, average startle reactivity of Pulse under Prepulse+ Pulse influence of distinct intensities was significantly different( F(1, 198)=18.68, 18.44, P<0.01), and the maternal Poly(I∶C) immune activation had a significant main effect( F(1, 198)=32.18, 12.58, P<0.01) and interaction with pubertal chronic unpredictable stress( F(1, 198)=34.54, 11.39, P<0.01), simple effect analysis suggested that the average startle reactivity of Prepulse+ Pulse in P+ S+ group(0.47±0.12) was significantly higher than other three groups(P+ S-: 0.36±0.11, P-S+ : (0.25±0.22), P-S-: (0.31±0.19)) in male mice( P<0.01) and in P-S+ group was significantly higher than the other three groups in female mice ( P<0.01). OLZ treatment could efficiently reverse the deficits on PPI by increasing PPI%( F(1, 165)=18.24, P<0.01), OLZ could reduce PPI score in male "dual-hit" model mice( F(1, 102)=21.81, P<0.01)and raise it in female( F(1, 102)=4.88, P<0.05). Conclusion:OLZ can reverse PPI deficits in schizophrenic neurodevelopmental model mice, and in the evaluation of PPI function in the model mice through PPI of acoustic startle reflex, PPI% has better stability and reactivity to OLZ intervention.

Objective:To explore personality change and its association with lncRNA expression of peripheral blood mononuclear cells in patients with epilepsy.Methods:Fifty-eight epilepsy patients recruited by the convenient sampling were assessed utilizing personality diagnostic questionnaire(PDQ) for personality change screening.The expression levels of lncRNA in peripheral blood of study group and the controls were investigated by qRT-PCR.Descriptive statistical analysis, correlation analysis, regression analysis and ROC analysis were employed for data processing.Results:There were 9 of schizoid (S≥4), 11 of schizotypal(S≥5), 17 of paranoid (S≥4) and 15 of compulsive (S≥4) personality change in epilepsy patients, and 52 patients had different types personality changes(89.66%).Schizoid, schizotypal, paranoid and compulsive personality changes were negatively correlated with expression levels of NONHSAG012869(PR3), NONHSAT006265(PR4), ENST00000581634(PR6) and ENST00000524610(PR8) ( r=-0.46--0.71, P<0.05 or 0.01).PR1, PR3, and PR8 had significant predictive effects on schizoid personality change ( P<0.01), PR4, PR8 had a significant predictive effect on schizotypal personality change ( P<0.01), PR3, PR4 and PR6 had significant predictive effects on paranoid personality change( P<0.05), and PR4, PR5, PR8 had significant predictive effects on compulsive personality change ( P<0.05).The effects of lncRNAs on the personality change variance accounted for 0.36, 0.30, 0.40, 0.20 respectively.ROC curve analysis of the diagnostic value of lncRNA expression level on personality change in the epilepsy group showed that NONHSAG012869 (PR3), NONHSAT006265(PR4), ENST00000581634(PR6) and ENST00000524610(PR8) had certain diagnostic value for personality change.The area under curve(AUC)=0.650-0.682, P<0.05, 95% CI: 0.546-0.784. Conclusion:Schizoid, schizotypal, paranoid, and compulsive personality change are common in epileptic patients, and the expression level of peripheral blood lncRNA has a certain diagnostic value for personality change.

Objective:To explore the effects of expression level of long noncoding RNA (lncRNA) in peripheral blood mononuclear cells (PBMCs), chronic stress in childhood on cognitive function for providing scientific basis of prevention, intervention and rehabilitation of cognitive impairment in schizophrenia patients.Methods:Quantitative real-time PCR (qPCR) was used to screen lncRNA expression in peripheral blood mononuclear cells (PBMCs) of 100 schizophrenic patients who was recruited by convenient sampling, and all the patients were assessed by Montreal cognitive assessment-Beijing version (MoCA) and childhood chronic stress questionnaire (CCSQ). Mann-Whitney test, t-test, correlation analysis and regression analysis were employed for data processing. Results:The ΔCt values of NONHSAT089447(5.07), NONHSAT041499(8.56) were higher ( Z=-2.38, -2.07, P<0.05) and scores of all three CCSQ dimensions were lower in higher MoCA goup than those in lower MOCA group (peer bullying: 42.36±11.13 vs 50.84±9.09, abuse and neglect: 55.08±14.22 vs 69.56±13.45, adverse life events: 47.64±12.21 vs 55.80±13.92, t=-2.20--3.70, P<0.05 or 0.01). The ΔCt value of NONHSAT089447, NONHSAT041499 positively correlated with scores of visuospatial-executive, language, abstraction and delayed recall ( r=0.43-0.75, P<0.01). All three CCSQ dimensions negatively correlated with scores of visuospatial-executive, attention, language, abstract thinking and delayed recall ( r=-0.40--0.62, P<0.05 or 0.01). Multiple regression analysis showed that the ΔCt valueof NONHSAT089447, abuse and neglect in childhood significantly predicted the total score of MOCA, which could explained 31.9% of variation ( t=4.31, 5.89, P=0.007, 0.001). The ΔCt value of NONHSAT089447, NONHSAT041499 negatively correlated with peer bullying, abuse and neglect in childhood ( r=-0.39--0.53, all P<0.01). Conclusion:There are correlation in NONHSAT089447, NONHSAT041499 and chronic stress in childhood in patients with schizophrenia, which can jointly predict their cognitive function.

Objective To confirm expression alteration of long non-coding RNA( lncRNA) in pe-ripheral blood mononuclear cells (PBMCs) of generalized anxiety disorder( GAD) patients and anti-anxiety treatment effects on aberrant expression of lncRNAs. Methods Real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR) was employed in 80 GAD patients and 40 healthy participants to con-firm 10 aberrant lncRNAs screened by microarray expression profiling. And 26 out of all the 80 GAD patients were recruited for lncRNA expression level testing and Hamilton Anxiety Scale(HAMA) assessments before and after 6 weeks’ treatment. Results Six of ten lncRNAs selected by array profiling (lncRNA4(7. 44± 2. 26),lncRNA5(6. 83±2. 28),lncRNA6(8. 09±2. 30),lncRNA8(9. 10±2. 36),lncRNA9(7. 66±2. 12), lncRNA10(7. 34±2. 12)) were verified by qRT-PCR that the lncRNA expression levels were significantly up regulated in GAD patients compared with healthy controls ( Z=-3. 022--1. 996,P<0. 05 or 0. 01),and lncRNA4(9. 73 ± 2. 53),lncRNA6 ( 9. 91 ± 2. 01), lncRNA8 ( 10. 48 ± 1. 68), lncRNA9 ( 9. 02 ± 1. 58), lncRNA10(9. 04 ± 2. 08) were down regulated significantly after 6 weeks’ anti-anxiety treatment ( Z=-3. 180--2. 530,P<0. 05 or 0. 01) along with signicant reduction of total HAMA score (11. 19±8. 37),di-mension scores of somatic anxiety(5. 31±4. 76),psychic anxiety(5. 88±3. 82) (t=5. 502-5. 971,P<0. 01). The alterations of lncRNA4,lncRNA6,lncRNA8,lncRNA9,lncRNA10 were positively correlated with that of HAMA total score and psychic anxiety score(r=0. 39-0. 69,P<0. 05 or 0. 01),and alteration of lncRNA6, lncRNA8,lncRNA10 had positive correlation with that of somatic anxiety score(r=0. 44-0. 59,P<0. 01). Conclusion The expression level of lncRNA4,lncRNA5,lncRNA6,lncRNA8,lncRNA9,lncRNA10 are up-regulation in PBMCs of GAD patients and anti-anxiety treatment can reverse the expression level of lncRNAs. Alteration of lncRNA expression has osculatory association with improvement of anxious symptom.