Objective To evaluate the efficacy of Gateway balloon dilation in the treatment of symptomatic severe stenosis of middle cerebral artery.Methods The clinical data and imaging materials of 98 patients with severe symptomatic stenosis of the middle cerebral artery,who were admitted to the Second Affiliated Hospital of Nanchang University of China from May 2019 to August 2022 to receive Gateway balloon dilation,were retrospectively analyzed.The diameter of the narrowed artery before and after Gateway balloon dilation treatment,peak systolic blood flow velocity(PSV),end-diastolic blood flow velocity(EDV),Mori classification of stenosis lesion,operation-related complications,imaging manifestations and clinical follow-up results were analyzed.Results Of the 98 patients,Mori type A was seen in 83(84.69％)and Mori type Bin 15(15.31％).Successful Gateway balloon dilation procedure was accomplished in all patients.After surgery,the symptoms were improved or stabilized to varying degrees.The mean residual lumen diameter of the stenosis lesion was significantly increased from preoperative(2.01±0.13)mm to postoperative(2.33±0.25)mm,the stenosis ratio was remarkably decreased from preoperative(81.28±15.17)％to postoperative(50.24±12.83)％,the PSV and EDV were strikingly decreased from preoperative(251.01±60.13)cm/s and(104.28±32.25)cm/s to postoperative(155.33±53.28)cm/s and(70.24±36.33)cm/s respectively,the differences were statistically significant(all P＜0.05).Seven patients developed surgical complications,which were improved in short time.The patients were followed up for 10 months,modified Rankin Scale(mRS)score of ≤2 points was obtained in 88 patients(89.79％),indicating that the patients had a good quality of life as well as a good functional recovery.Conclusion For the treatment of symptomatic severe stenosis of middle cerebral artery,Gateway balloon dilation carries a significant long-term therapeutic effect with fewer surgical complications.Therefore,Gateway balloon dilation is an effective treatment for this type of disease.

Major depressive disorder (MDD), is characterized by high incidence rate, high suicide rate, and high disability rate, however, the underlying pathogenesis of MDD is still unclear. Based on the diathesis-stress model of depression, epigenetic mechanisms strongly explain the integration of genes and environment in the development of depression. However, depression has a high degree of clinical heterogeneity, with individuals of different ages presenting different symptoms and epigenetic changes. As a dynamic molecular marker that varies with age and environmental experience, epigenetics helps to elucidate the unique and complex disease pathogenesis of depression at different ages. Therefore, this paper aims to review relevant epigenetic studies of depression at different ages of onset to explore its potential age-specific association mechanism, in order to provide a theoretical basis for the formulation of accurate intervention measures for patients with MDD at different ages.

Major depressive disorder (MDD), is characterized by high incidence rate, high suicide rate, and high disability rate, however, the underlying pathogenesis of MDD is still unclear. Based on the diathesis-stress model of depression, epigenetic mechanisms strongly explain the integration of genes and environment in the development of depression. However, depression has a high degree of clinical heterogeneity, with individuals of different ages presenting different symptoms and epigenetic changes. As a dynamic molecular marker that varies with age and environmental experience, epigenetics helps to elucidate the unique and complex disease pathogenesis of depression at different ages. Therefore, this paper aims to review relevant epigenetic studies of depression at different ages of onset to explore its potential age-specific association mechanism, in order to provide a theoretical basis for the formulation of accurate intervention measures for patients with MDD at different ages.

A novel RNA virus, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is responsible for the ongoing outbreak of coronavirus disease 2019 (COVID-19). Population genetic analysis could be useful for investigating the origin and evolutionary dynamics of COVID-19. However, due to extensive sampling bias and existence of infection clusters during the epidemic spread, direct applications of existing approaches can lead to biased parameter estima-tions and data misinterpretation. In this study, we first present robust estimator for the time to the most recent common ancestor (TMRCA) and the mutation rate, and then apply the approach to analyze 12,909 genomic sequences of SARS-CoV-2. The mutation rate is inferred to be 8.69 × 10-4 per site per year with a 95％ confidence interval (CI) of [8.61 × 10-4, 8.77 × 10-4], and the TMRCA of the samples inferred to be Nov 28, 2019 with a 95％ CI of [Oct 20, 2019, Dec 9, 2019]. The results indicate that COVID-19 might originate earlier than and outside of Wuhan Seafood Market. We further demonstrate that genetic polymorphism patterns, including the enrichment of specific haplotypes and the temporal allele frequency trajectories generated from infection clusters, are similar to those caused by evolutionary forces such as natural selection. Our results show that population genetic methods need to be developed to efficiently detangle the effects of sampling bias and infection clusters to gain insights into the evolutionary mechanism ofSARS-CoV-2. Software for implementing VirusMuT can be downloaded at https://bigd.big.ac.cn/biocode/tools/BT007081.

Objective:To investigate the character and prevalence of cognitive impairment of patients with bipolar Ⅱ depression (BD-Ⅱ).Methods:124 patients diagnosed as bipolar Ⅱ depression according to the DSM-5 criteria and 124 demographically matched healthy subjects were recruited. Seven cognitive functions were assessed with the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery(MCCB) in all participants, including speed of processing (SOP), attention vigilance (AV), working memory (WM), verbal learning (VER), visual learning (VIS), reasoning problem solving (RPS), and social cognition (SC), and the composite. Analysis of covariance was used to test the differences in cognitive function. The number and percentage of cognitive domains impairment which was defined as the cognitive domains scored below standard values by 1, 1.5 and 2 standard deviation (SD) were explored.Results:(1) BD-Ⅱ patients were significantly impaired on seven MCCB domains and the composite scores compared with HC (all P<0.01). Correlation analysis showed that the scores of VER, RPS negatively correlated to the number of episodes ( r=-0.212, P=0.018; r=-0.183, P=0.042); (2) Most healthy control participants were not impaired on any 2 cognitive domains at 1.5 SD (79.84%,99/124) and 2 SD (92.74%,115/124) cut-offs, with the 2.42%-6.45% cognitive impairment at the 1.5 SD cut-off, and 0-4.84% at the 2 SD cut-off accordingly. (3) At the 1.5 SD cut-off, 33.06%,41/124 of the BD-Ⅱ patients were cognitively impaired in two or more domains, while at the 2.0 SD cut-off, 14.52%,18/124 of patients were cognitively impaired. Meanwhile, the incidence of impairment in various cognitive domains was 9.68%-24.19% and 3.23%-15.32%, of which the incidence rate of visual learning impairment was 12.90%, and the incidence rate of impairment in working memory and social cognition was 24.19%. Conclusions:Participants with BD-Ⅱ depression were generally impaired on a greater number of cognitive domains with a higher percentage than the healthy controls, especially on the cognitive domains of working memory, visual learning, and social cognition. And the domains of verbal learning and reasoning problem solving were negatively correlated with the number of episodes.

Objective:To investigate the character and prevalence of cognitive impairment of patients with bipolar Ⅱ depression (BD-Ⅱ).Methods:124 patients diagnosed as bipolar Ⅱ depression according to the DSM-5 criteria and 124 demographically matched healthy subjects were recruited. Seven cognitive functions were assessed with the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery(MCCB) in all participants, including speed of processing (SOP), attention vigilance (AV), working memory (WM), verbal learning (VER), visual learning (VIS), reasoning problem solving (RPS), and social cognition (SC), and the composite. Analysis of covariance was used to test the differences in cognitive function. The number and percentage of cognitive domains impairment which was defined as the cognitive domains scored below standard values by 1, 1.5 and 2 standard deviation (SD) were explored.Results:(1) BD-Ⅱ patients were significantly impaired on seven MCCB domains and the composite scores compared with HC (all P<0.01). Correlation analysis showed that the scores of VER, RPS negatively correlated to the number of episodes ( r=-0.212, P=0.018; r=-0.183, P=0.042); (2) Most healthy control participants were not impaired on any 2 cognitive domains at 1.5 SD (79.84%,99/124) and 2 SD (92.74%,115/124) cut-offs, with the 2.42%-6.45% cognitive impairment at the 1.5 SD cut-off, and 0-4.84% at the 2 SD cut-off accordingly. (3) At the 1.5 SD cut-off, 33.06%,41/124 of the BD-Ⅱ patients were cognitively impaired in two or more domains, while at the 2.0 SD cut-off, 14.52%,18/124 of patients were cognitively impaired. Meanwhile, the incidence of impairment in various cognitive domains was 9.68%-24.19% and 3.23%-15.32%, of which the incidence rate of visual learning impairment was 12.90%, and the incidence rate of impairment in working memory and social cognition was 24.19%. Conclusions:Participants with BD-Ⅱ depression were generally impaired on a greater number of cognitive domains with a higher percentage than the healthy controls, especially on the cognitive domains of working memory, visual learning, and social cognition. And the domains of verbal learning and reasoning problem solving were negatively correlated with the number of episodes.