Alzheimer's disease (AD) is the leading neurodegenerative disorder in the nervous system, and there is still a lack of effective therapeutic drugs. Protecting neurons and synapses is crucial in reversing AD progression. Mesenchymal stem cell-derived exosome (MSC-Exo) is rich in various stem cell components such as proteins, RNAs, and DNAs; due to its strong ability in promoting nerve repair and inhibiting neuroinflammation, MSC-Exo is expected to become a potential choice for AD treatment. This article elaborates on the biological characteristics of MSC-Exo and its application and progress in AD treatment, aiming to provide reference for translational medicine research and clinical application of MSC-Exo in AD.

Iron is involved in several activities in the brain, including energy metabolism, neurotransmitter transmission, and myelination. Disorder of peripheral iron metabolism and excessive iron accumulation in the brain can reduce cognitive and behavioral ability through pathological mechanisms such as inflammatory response and abnormal protein expression, leading to cognitive disorders. Quantitative susceptibility mapping (QSM), as a new non-invasive magnetic resonance technique, can quantitatively measure brain iron deposition, clarify the relationship between cognitive disorders and iron homeostasis imbalance, and provide a basis for clinical diagnosis and treatment of the diseases. This article reviews the latest research progress of QSM in brain iron deposition associated with cognitive disorders.

Alzheimer's disease (AD) is a kind of progressive neurodegenerative disease, which has become the leading cause of dementia in the elderly. In recent years, non-invasive brain stimulation (NIBS), including transcranial magnetic stimulation, transcranial electrical stimulation, focused ultrasound stimulation and transcranial photobiomodulation, has been widely used in AD treatment. Although NIBS can improve the clinical symptoms of AD patients, its efficacy is still controversial. This article reviews the latest research progress in role of NIBS in AD so as to provide reference for clinical workers.

After peripheral nerve injury, nerve regeneration is slow, and skeletal muscles gradually atrophy due to long-term lack of nerve innervation, nutrient deficiency, and lack of stimulation of nerve electrical stimulation. Neuregulin-1 (NRG-1) and epidermal growth factor receptor (ErbB) can activate multiple complex intracellular signaling networks to affect the nerves and muscles. This article reviews the regulatory effect of NRG-1/ErbB signaling pathway on peripheral nerves, muscles, and neuromuscular junctions, aiming to provide references for finding new therapeutic target for denervated muscle atrophy.

Objective:To explore the risk factors for in-hospital death after complete recanalization by mechanical thrombectomy and establish a risk prediction model in patients with acute large vessel occlusion stroke of the anterior circulation.Methods:A total of 468 patients with anterior circulation acute large vessel occlusion stroke who underwent mechanical thrombectomy in Stroke Center (Second Affiliated Hospital of Dalian Medical University), Department of Interventional Therapy (First Affiliated Hospital of Dalian Medical University), and Department of Neurointervention and Neurocritical Care (Central Hospital Affiliated to Dalian University of Technology) from January 2016 to November 2023 were selected. All patients achieved complete recanalization (modified thrombolysis in cerebral infarction: grading 3) immediately after thrombectomy. The clinical data, laboratory and imaging results of the patients were collected, and these patients were divided into in-hospital death group ( n=52) and in-hospital survival group ( n=416) according to occurrence of in-hospital death (all-cause death). Univariate analysis and multivariate Logistic regression analysis were used to screen the risk factors for in-hospital death, and a risk prediction model was constructed. Receiver operating characteristic (ROC) curve was used to evaluate the predictive efficacy of the model, calibration curve and Hosmer-Lemeshow test were used to evaluate the accuracy of the model, and decision curve was used to evaluate the clinical utility of the model. Results:Univariate analysis showed that the in-hospital death group had significantly higher proportions of female patients, patients with atrial fibrillation, and patients with symptomatic intracranial hemorrhage compared with the in-hospital survival group (50.0% vs. 31.3%; 57.7% vs. 41.6%; 38.5% vs.11.8%), and significantly higher baseline blood glucose, and National Institutes of Health Stroke Scale score, neutrophil count, and neutrophil/lymphocyte ratio within 24 hours of thrombectomy (8.10 [7.05, 11.79] vs. 7.31[6.46, 9.25], 20 [16, 32] vs. 15 [10, 22], 10.09 [7.87, 13.19] vs. 8.47 [6.73, 10.32], 10.63 [5.87, 15.69] vs. 7.13 [5.16, 10.91], P<0.05). Multivariate Logistic regression analysis showed that female ( OR=2.533, 95% CI: 1.306-4.910, P=0.006), atrial fibrillation history ( OR=1.999, 95% CI: 1.044-3.827, P=0.037), neutrophil count within 24 hours of thrombectomy ( OR=1.162, 95% CI: 1.055-1.279, P=0.002), and symptomatic intracranial hemorrhage ( OR=4.066, 95% CI: 1.897-8.718, P<0.001) were independent risk factors for in-hospital death after complete recanalization; risk prediction model, accordingly, was 0.929×female+0.692×atrial fibrillation history+0.150×neutrophil count+1.403×symptomatic intracranial hemorrhage-5.349 ( P: probability of event occurrence). Area under ROC curve of the model was 0.765 (95% CI: 0.689-0.842, P<0.001); calibration curve and Hosmer-Lemeshow test of the model showed good accuracy ( χ2=7.656, P=0.468); decision curve of the model showed good clinical utility at threshold probability of 0.05-0.90. Conclusion:For patients with acute large vessel occlusion stroke at the anterior circulation complicated with atrial fibrillation, symptomatic intracranial hemorrhage or elevated neutrophil count within 24 hours of thrombectomy, or female patients with acute large vessel occlusion stroke at the anterior circulation, in-hospital death still needs to be highly alert after complete recanalization by mechanical thrombectomy.

In the past 20 years, with the continuous integration of cutting-edge technologies such as new equipments, new materials and artificial intelligence, neurointerventional radiology has developed rapidly. The therapeutic effect of neurointerventional radiology on cerebrovascular diseases such as intracranial aneurysms, cerebral arteriovenous malformations, dural arteriovenous fistulas, acute large vessel occlusive stroke, and head and carotid atherosclerotic stenosis has been continuously improved, and the indications have been gradually expanded. Neurointerventional radiology has become the first-line or even preferred treatment for some diseases. This article reviews the clinical application status and possible development trend of neurointerventional radiology, so as to provide references for clinical practice.

Objective:To investigate the mechanism of recombinant human mesencephalic astrocyte-derived neurotrophic factor (rhMANF) in spinal cord injury (SCI) repair promoted by A2 reactive astrocyte polarization.Methods:One hundred and twenty female SPF SD rats were randomly divided into sham-operated group, SCI group, SCI+control group and SCI+rhMANF group ( n=30 in each group). SCI models were prepared by heavy drop method in the later 3 groups, and 10 μL sterile saline or 10 μL sterile saline+5 μg rhMANF were injected intrathecally in the later 2 groups 30 min after modeling. Basso-Beattie-Bresnahan (BBB) scale was used to evaluate the motor function in each group 1, 3, 7, 14, 21 and 28 days after injection. After behavioral assessment 3 days after injection, the protein expressions of ReIB, p52, phosphorylated (p)-ReIB and p-p52 in the spinal cord tissues were detected by Western blotting, and the expressions of anti-inflammatory cytokine and neurotrophic factor in the spinal cord tissues were detected by ELISA. After behavioral assessment 14 days after injection, immunofluorescent staining was performed to detect the expressions of neuronal nuclear antigen (NeuN), Syn and S100A10 in the spinal cord tissues. After behavioral assessment 28 days after injection, HE staining and uranyl acetate-lead citrate double staining were used to observe the pathological changes of the spinal cord under light microscope and electron microscope, respectively. Results:On 14, 21, and 28 days after injection, the BBB score in the SCI+rhMANF group was significantly higher than that in the SCI group and SCI+control group ( P<0.05). On 3 days after injection, the p-ReiB and p-p52 protein expressions in the SCI+rhMANF group (1.17±0.02 and 1.00±0.07) were significantly higher than those in the SCI group (0.74±0.01 and 0.42±0.11) and SCI+control group (0.79±0.00 and 0.64±0.02, P<0.05); the SCI+rhMANF group had significantly increased interleukin (IL)-4, IL-10, IL-13, neurotrophin-3, transforming growth factor-β and granulocyte colony-stimulating factor expressions ([217.58±16.06] pg/mg, [276.53±15.00]) pg/mg, [178.88±7.03] pg/mg, [172.61±16.43] pg/mg, [241.00±15.80] pg/mg, and [166.63±14.61] pg/mg) compared with the SCI group ([132.15±18.86] pg/mg, [173.48±18.24] pg/mg, [109.01±3.79] pg/mg, [104.64±18.21] pg/mg, [138.09±9.93] pg/mg, and [91.26±11.09] pg/mg), and SCI+control group ([137.80±27.70] pg/mg, [185.78±19.20] pg/mg, [112.44±13.51] pg/mg, [93.13±22.09] pg/mg, [159.48±32.50] pg/mg, and [112.67±18.32] pg/mg, P<0.05). On 14 days after injection, the immunofluorescent staining intensities of NeuN/S100A10, NeuN/Syn in the SCI+rhMANF group (2.51±0.24/2.85±0.27 and 2.48±0.35/1.92±0.32) were significantly higher than those in the SCI group (0.99±0.11/1.00±0.18 and 1.00±0.19/1.00±0.08) and SCI+control group (1.39±0.09/0.93±0.20 and 1.26±0.35/0.94±0.19, P<0.05). Light microscopy showed that the spinal cord nerve tissues in the SCI group and SCI+control group had loose structure, with edema and vacuolar degeneration; those in the sham-operated group and SCI+rhMANF group had dense structure, with round and cone-shaped neurons and large and round nucleus, and without vacuolar degeneration. Transmission electron microscopy showed intact structure of myelin sheath and axon in the sham-operated group, loose and shrunked spinal cord nerve cells (chromatin condensation, and cell membrane bleb formation) in the SCI group and SCI+control group, and relatively complete cell structure in the SCI+rhMANF group. Conclusion:The rhMANF can activate ReIB/P52 nuclear translocation phosphorylation, up-regulate the anti-inflammatory factor and neurotrophic factor expressions, induce the A2 astrocyte polarization, and promote the synaptic growth and spinal cord injury recovery.

Objective:To investigate the incidence of basal ganglia calcification (BGC), and risk factors for BGC in acute ischemic stroke (AIS) patients.Methods:A total of 730 patients with nervous system diseases hospitalized in Department of Neurology, Shanghai Punan Hospital of Pudong New Area from January 2023 to December 2023 were enrolled. These patients were divided into AIS group ( n=380) and non-AIS group ( n=350). Propensity score matching (PSM) was firstly used for 1:1 matching to eliminate the differences in baseline data of these patients; BGC incidence was compared between the two groups. Univariate and multivariate Logistic regression analyses were used to screen the independent risk factors for BGC in AIS patients. Results:After PSM, there were 251 patients in the AIS group and 251 patients in the non-AIS group. No significant difference was noted between the two groups in age, gender, histories of hypertension, diabetes, hyperlipidemia, coronary heart disease, smoking and drinking, ratio of previous stroke, and serum calcium, low-density lipoprotein cholesterol, homocysteine, uric acid, estimated glomerular filtration rate, or parathyroid hormone ( P>0.05). BGC incidence in the AIS group was 33.1% (83/251), with mild BGC in 55 patients (21.9%), moderate BGC in 19 patients (7.6%), and severe BGC in 9 patients (3.6%). BGC incidence in the AIS group was significantly higher than that in the non-AIS group (33.1% vs. 16.7%, P<0.05). Univariate and multivariate Logistic regression analyses showed that female ( OR=1.842, 95% CI: 1.021-3.324, P=0.043) and diabetes ( OR=1.953, 95% CI: 1.205-3.167, P=0.007) were independent risk factors for BGC in AIS patients. Conclusion:Compared with non-AIS patients, AIS patients trend to have BGC; female AIS patients with diabetes mellitus are more likely to have BGC.

Human brain organoids are three-dimensional miniature brain tissue models cultured from human stem cells, containing a variety of nerve cells and specific spatial organization structures, which can simulate key features of human brain development. Faced with the difficulties of obtaining human brain tissues and inability of animal models in reflecting the disease characteristics, brain-like organ models with similarities to brain function and structure have become a valuable tool for studying AD. This article reviews the development of brain-like organ models and their application in AD, and discusses how emerging technologies can achieve breakthroughs in AD research through brain-like organ models, with the aim of providing new ideas for early diagnosis and treatment of AD.

Microglia are specialized immune cells in the brain, primarily responsible for clearing debris and responding to inflammation. One of the pathological features of Alzheimer's disease (AD) is the extensive activation of immune system in the brain, and the dynamic changes and dysfunction of microglia could become key factors for AD progression. This article reviews the research progress of regulated effect of microglial on AD pathology, and summarizes its potential value in AD treatment, in order to provide theoretical basis for exploring new therapeutic strategies and intervention targets for AD.