Objective:To investigate the cognitive characteristics and related influencing factors in Parkinson′s disease (PD) patients with or without olfactory anosognosia (OA).Methods:A total of 113 PD patients who were treated at the Affiliated Hospital of Yangzhou University between March 2023 and April 2024 were selected. The PD Olfactory Dysfunction Auxiliary Diagnostic Card was used to assess olfactory function. Based on the olfactory identification scores and subjective awareness of olfactory dysfunction, patients were divided into the normosmic group, olfactory dysfunction group, and the later was further divided into olfactory dysfunction without OA (OA-) group, and olfactory dysfunction with OA (OA+) group. The results of the Unified Parkinson′s Disease Rating Scale-Ⅲ (UPDRS-Ⅲ) and Hoehn-Yahr (H-Y) staging assessments of the patients were collected. Non-motor symptoms such as cognitive function, anxiety, depression, sleep disturbances, and constipation were evaluated using relevant scales. Logistic regression analysis was used to explore the related factors affecting OA in PD patients with olfactory decline.Results:The Montreal Cognitive Assessment (MoCA) scores of the olfactory dysfunction group were lower than those of the normosmic group (20.30±4.47 vs 22.64±2.50, t=2.907, P=0.007). The Self-Rating Anxiety Scale scores (39.00±8.60 vs 43.86±10.63, t=2.444, P=0.016), visuospatial and executive function scores (2.35±1.32 vs 2.98±1.42, t=2.263, P=0.026), and orientation scores (4.88±1.14 vs 5.34±1.07, t=2.046, P=0.043) of the OA+ group were lower than those of the OA- group. Logistic regression analysis revealed that lower MoCA scores were an independent risk factor for PD combined with OA ( OR=0.853, 95% CI 0.743-0.980, P=0.024). Conclusions:PD patients with olfactory dysfunction exhibit more severe cognitive impairment. Among them, patients with OA show more significant impairments in visuospatial, executive function and orientation. Cognitive impairment may be an independent risk factor for PD combined with OA.

Objective Patients with acute coronary syndrome(ACS)combined with chronic kidney disease(CKD)are at high risk of major adverse cardiovascular events(MACE),and early prediction is crucial for improving prognosis.Non-invasive detection methods,due to their simplicity and safety,have become important tools for assessing risks in such patients.This study aims to evaluate the application value of non-invasive detection indicators in predicting MACE in ACS patients with CKD.Methods The study included 216 ACS patients with CKD,divided into a Non-MACE group(n=149)and a MACE group(n=67).General patient data,non-invasive detection indicators,electrocardiogram(ECG),and cardiac function indicators were collected.Univariate and multivariate logistic regression analyses were performed to explore the relationship between these indicators and MACE.A nomo-gram prediction model was constructed,and its performance was evaluated using ROC curve analysis,calibration curve,and decision curve analysis.Results Univariate analysis showed that age,BMI,SVR,SVRI,HRV,QTd,SDNN,LVEF,LVEDd,SCOPA-AUT score,and GRACE score were significantly associated with MACE.Multivariate analysis identified SVRI,QTd,SDNN,LVEF,LVEDd,SCOPA-AUT score,and GRACE score as independent risk factors for MACE.ROC curve analysis revealed that the model had an AUC value of 0.979,sensi-tivity of 0.925,specificity of 0.966,and accuracy of 0.9537,indicating high diagnostic accuracy.Calibration curve and decision curve analyses further confirmed the model's reliability.Conclusion Non-invasive detection indicators,including SVRI,QTd,SDNN,LVEF,LVEDd,SCOPA-AUT score,and GRACE score,have significant value in predicting MACE in ACS patients with CKD.The constructed prediction model provides an effective tool for clinical risk assessment.

Objective:To investigate the longitudinal relationship between childhood abuse and suicidal ideation in adolescents, and provide a theoretical basis for the prevention and intervention of suicidal ideation among adolescents.Methods:A self-control study was made.A 1-year follow-up survey was conducted among 2 052 junior high school students in Xinxiang and Fuzhou from November 2023 (T1) to November 2024 (T2) using the Childhood Abuse Questionnaire and the Adolescent Suicidal Ideation Scale.Data were analyzed using cross-lagged modeling.Results:Baseline (T1) and one-year follow-up (T2) assessments showed the mean score for childhood abuse was 42.43±13.34 at T1 and 42.45±15.36 at T2, and the mean score for suicidal ideation was 15.14±6.28 at T1 and 17.46±7.65 at T2.There were positive correlations between T1 childhood abuse and T1 suicidal ideation, T2 childhood abuse, T2 suicidal ideation( r=0.18, 0.35, 0.47), T1 suicidal ideation and T2 childhood abuse, T2 suicidal ideation( r=0.05, 0.44), as well as T2 suicidal ideation and T2 childhood abuse( r=0.26)(all P<0.05). Cross-lagged analysis indicated that childhood abuse at T1 positively predicted suicidal ideation at T2 ( β=0.38, P<0.001), while suicidal ideation at T1 did not predict childhood abuse at T2 ( β=-0.01, P>0.05). Conclusions:Childhood abuse is a precursor to suicidal ideation in adolescents, and childhood experiences of abuse significantly increases the risk of subsequent suicidal ideation.

Objective:To investigate the longitudinal relationship between childhood abuse and suicidal ideation in adolescents, and provide a theoretical basis for the prevention and intervention of suicidal ideation among adolescents.Methods:A self-control study was made.A 1-year follow-up survey was conducted among 2 052 junior high school students in Xinxiang and Fuzhou from November 2023 (T1) to November 2024 (T2) using the Childhood Abuse Questionnaire and the Adolescent Suicidal Ideation Scale.Data were analyzed using cross-lagged modeling.Results:Baseline (T1) and one-year follow-up (T2) assessments showed the mean score for childhood abuse was 42.43±13.34 at T1 and 42.45±15.36 at T2, and the mean score for suicidal ideation was 15.14±6.28 at T1 and 17.46±7.65 at T2.There were positive correlations between T1 childhood abuse and T1 suicidal ideation, T2 childhood abuse, T2 suicidal ideation( r=0.18, 0.35, 0.47), T1 suicidal ideation and T2 childhood abuse, T2 suicidal ideation( r=0.05, 0.44), as well as T2 suicidal ideation and T2 childhood abuse( r=0.26)(all P<0.05). Cross-lagged analysis indicated that childhood abuse at T1 positively predicted suicidal ideation at T2 ( β=0.38, P<0.001), while suicidal ideation at T1 did not predict childhood abuse at T2 ( β=-0.01, P>0.05). Conclusions:Childhood abuse is a precursor to suicidal ideation in adolescents, and childhood experiences of abuse significantly increases the risk of subsequent suicidal ideation.

Objective Patients with acute coronary syndrome(ACS)combined with chronic kidney disease(CKD)are at high risk of major adverse cardiovascular events(MACE),and early prediction is crucial for improving prognosis.Non-invasive detection methods,due to their simplicity and safety,have become important tools for assessing risks in such patients.This study aims to evaluate the application value of non-invasive detection indicators in predicting MACE in ACS patients with CKD.Methods The study included 216 ACS patients with CKD,divided into a Non-MACE group(n=149)and a MACE group(n=67).General patient data,non-invasive detection indicators,electrocardiogram(ECG),and cardiac function indicators were collected.Univariate and multivariate logistic regression analyses were performed to explore the relationship between these indicators and MACE.A nomo-gram prediction model was constructed,and its performance was evaluated using ROC curve analysis,calibration curve,and decision curve analysis.Results Univariate analysis showed that age,BMI,SVR,SVRI,HRV,QTd,SDNN,LVEF,LVEDd,SCOPA-AUT score,and GRACE score were significantly associated with MACE.Multivariate analysis identified SVRI,QTd,SDNN,LVEF,LVEDd,SCOPA-AUT score,and GRACE score as independent risk factors for MACE.ROC curve analysis revealed that the model had an AUC value of 0.979,sensi-tivity of 0.925,specificity of 0.966,and accuracy of 0.9537,indicating high diagnostic accuracy.Calibration curve and decision curve analyses further confirmed the model's reliability.Conclusion Non-invasive detection indicators,including SVRI,QTd,SDNN,LVEF,LVEDd,SCOPA-AUT score,and GRACE score,have significant value in predicting MACE in ACS patients with CKD.The constructed prediction model provides an effective tool for clinical risk assessment.

Objective:To investigate the cognitive characteristics and related influencing factors in Parkinson′s disease (PD) patients with or without olfactory anosognosia (OA).Methods:A total of 113 PD patients who were treated at the Affiliated Hospital of Yangzhou University between March 2023 and April 2024 were selected. The PD Olfactory Dysfunction Auxiliary Diagnostic Card was used to assess olfactory function. Based on the olfactory identification scores and subjective awareness of olfactory dysfunction, patients were divided into the normosmic group, olfactory dysfunction group, and the later was further divided into olfactory dysfunction without OA (OA-) group, and olfactory dysfunction with OA (OA+) group. The results of the Unified Parkinson′s Disease Rating Scale-Ⅲ (UPDRS-Ⅲ) and Hoehn-Yahr (H-Y) staging assessments of the patients were collected. Non-motor symptoms such as cognitive function, anxiety, depression, sleep disturbances, and constipation were evaluated using relevant scales. Logistic regression analysis was used to explore the related factors affecting OA in PD patients with olfactory decline.Results:The Montreal Cognitive Assessment (MoCA) scores of the olfactory dysfunction group were lower than those of the normosmic group (20.30±4.47 vs 22.64±2.50, t=2.907, P=0.007). The Self-Rating Anxiety Scale scores (39.00±8.60 vs 43.86±10.63, t=2.444, P=0.016), visuospatial and executive function scores (2.35±1.32 vs 2.98±1.42, t=2.263, P=0.026), and orientation scores (4.88±1.14 vs 5.34±1.07, t=2.046, P=0.043) of the OA+ group were lower than those of the OA- group. Logistic regression analysis revealed that lower MoCA scores were an independent risk factor for PD combined with OA ( OR=0.853, 95% CI 0.743-0.980, P=0.024). Conclusions:PD patients with olfactory dysfunction exhibit more severe cognitive impairment. Among them, patients with OA show more significant impairments in visuospatial, executive function and orientation. Cognitive impairment may be an independent risk factor for PD combined with OA.

Objective:To explore the dynamic temporal variability of brain functional networks in individuals with internet gaming disorder(IGD)using dynamic functional connectivity density(dFCD).Methods:From January 2019 to December 2021, resting-state functional magnetic resonance imaging data were recruited from 55 patients with IGD and demographically matched 50 healthy controls.Data analysis was performed by IBM SPSS 21.0 software. The functional connectivity density(FCD) combined with sliding window analysis was employed to calculate the temporal variability of global functional connectivity.FCD in whole brain was further devided into ipsilateral and cotralateral parts.The temporal variability of dFCD was further quantified utilizing the standard deviations of whole brain, intra-, and inter-hemispheric FCD. Finally, Pearson correlation analysis was performed between dFCD variance in differential brain regions and clinical behaviors.Results:The inter-hemispheric dFCD in the left posterior cingulate cortex(-0.16±0.24) and the left precuneus(-0.08±0.23) in patients with IGD were lower that those in healthy controls(0.002±0.260, 0.12±0.36)( t=-3.502, -4.160, both P<0.05).And the intra-hemispheric dFCD in the left calcarine, the left precuneus, and the left posterior cingulate cortex in patients with IGD were lower that those in healthy controls( t=-3.809, -4.360, -3.561, all P<0.05).Moreover, abnormal global dFCD variability of the calcarine and ipsilateral dFCD variability of the PCC negatively correlated with the severity of IGD( r=-0.380, -0.413, both P<0.05). Conclusion:Patients with IGD show intra-and inter-hemispheric dFCD differences in the visual attention network and default mode network, which may respond to the underlying neurobiological basis for the presence of cognitive dysfunction and impaired concentration.

Objective:To analyze the clinical features and immunotherapy responsiveness of patients with myelin oligodendrocyte glycoprotein immunoglobulin G-antibody associated disease (MOGAD) with epilepsy, and display the risk factors of epilepsy in MOGAD.Methods:Eighty-nine patients with MOGAD diagnosed at the First Affiliated Hospital of Zhengzhou University between October 2019 and May 2023 were enrolled and classified into 2 groups upon MOGAD with ( n=29) or without epilepsy ( n=60). The Expanded Disability Status Scale (EDSS) and Clinical Assessment Scale for Autoimmune Encephalitis (CASE) were used for evaluation of severity, and EDSS or CASE scores on the 30th day after first-line immunotherapy initiation lower than that on admission were defined as well treatment responsiveness. The differences of general data, clinical manifestations, cerebrospinal fluid (CSF) and peripheral blood biochemical examination results, and immunotherapy reactivity between the 2 groups were thoroughly explicated. In addition, the risk factors of epilepsy in MOGAD were analyzed by univariate and multivariate Logistic regression analysis. Results:Compared with patients with MOGAD without epilepsy, patients with MOGAD with epilepsy were characterized by lower age of onset [24.5(10.3, 34.0) years vs 11.0(6.5, 20.0) years, Z=-2.348, P=0.019], higher percentage of male patients [43.3%(26/60) vs 75.9%(22/29), χ 2=8.326, P=0.004], higher virus infection rate [28.3%(17/60) vs 51.7%(15/29), χ 2=4.645, P=0.031], higher incidence of prodromal symptoms [11.7%(7/60) vs 34.5%(10/29), χ 2=6.586, P=0.010], higher blood-brain barrier breakdown rate [35.0%(21/60) vs 58.6%(17/29), χ 2=4.458, P=0.035], higher percentage of CSF albumin level>450 mg/L [48.3%(29/60) vs 75.9%(22/29), χ 2=6.056, P=0.014] and higher creatine kinase level [45.50(28.50, 69.75) U/L vs 57.50(41.75, 97.25) U/L, Z=-2.349, P=0.019]; more epilepsy [0(0) vs 29/29 (100.0%), χ 2=89.000, P<0.001] and disturbance of consciousness [0(0) vs 6/29(20.7%), χ 2=10.224, P=0.001] as clinical manifestations, and more cerebral cortex lesions [30/60(50.0%) vs 25/29(86.2%), χ 2=10.856, P=0.001] on magnetic resonance imaging. Nevertheless, the patients with MOGAD without epilepsy were featured with more visual impairment [23/60(38.3%) vs 3/29(10.3%), χ 2=7.406, P=0.007], limb weakness [18/60(30.0%) vs 1/29(3.4%), χ 2=8.209, P=0.004], sensory disturbance [15/60(25.0%) vs 0(0), Fisher exact probability test, P=0.002] and more cervical cord lesions [22/60(36.7%) vs 4/29(13.8%), χ 2=4.946, P=0.026] on magnetic resonance imaging. Immunotherapy responsiveness was relatively poor in the MOGAD with epilepsy group [EDSS score lower than that on admission: 15/29(51.7%) vs 46/60(76.7%), χ 2=5.641, P=0.018; CASE score lower than that on admission: 16/29(55.2%) vs 47/60(78.3%), χ 2=5.072, P=0.024] compared with the MOGAD without epilepsy group. Male was the independent risk factor of epilepsy in MOGAD ( OR=7.078, 95% CI 1.709-29.326, P=0.007). Conclusions:Compared with patients with MOGAD without epilepsy, patients with MOGAD with epilepsy reported more male patients, lower age of onset and higher incidence of prodromal symptoms, blood-brain barrier dysfunction rate, virus infection rate, CSF albumin level and creatine kinase level; clinical phenotypes were mainly meningoencephalitis and more cerebral cortex lesions were shown on magnetic resonance imaging. MOGAD with epilepsy was closely related to poor immunotherapy responsiveness, and gender was found to be the independent risk factor for epilepsy in MOGAD.

Biologics are developing rapidly and have demonstrated their unique advantages in the treatment of many diseases. And with common administration, like oral and injection, biological products often have problems in instability, short half-life and poor utilization of the central nervous system, which limits the application scope and development of biological products. Intranasal biologics are promising strategy taking advantages in nasal administration that bypass the restrictions in vivo, like blood-brain-barrier, to improve the drug avalibility in the target site, which have potential to improve efficient delivery and the availability. According to published literature, clinical databases, industry guidelines around the world, this review highlighted the rescent progress in intranasal macromolecular drugs, intranasal vaccine and intranasal cell therapy, which were the main fields of intranasal biologics, offering perspectives suggestions for the further development of this field.

Objective:To evaluate the effect of long non-coding RNA PRMT5-AS1 on ferroptosis of hepatocellular carcinoma cell(HCC) after ionizing irradiation.Methods:The PRMT5-AS1 overexpression model was constructed in MHCC-97H cells and the PRMT5-AS1 knockdown model was constructed in HepG2 cells. X-ray irradiation(IR) was performed with an absorbed dose of 10 Gy and a dose rate of 3 Gy/min. Western blot and qRT-PCR were used to detect gene expression. The effect of PRMT5-AS1 expression on lipid peroxidation and ferroptosis of HCC after IR was detected by Trypan blue staining flow cytometry. The effect of PRMT5-AS1 expression on the death of HCC after IR was detected by CCK-8 assay. Dual luciferase assay to detect the binding of let-7c-5p to PRMT5-AS1 and SLC7A11.Results:Overexpression of PRMT5-AS1 in MHCC-97H cells could significantly reduce cell death induced by IR (Vector vs. PRMT5-AS1: 27.57% vs.18.30%, t=14.94, P<0.05). Knockdown of PRMT5-AS1 in HepG2 cells significantly increased cell death induced by IR (siNC vs. siPRMT5-AS1: 17.26% vs. 28.26%, t=13.63, P<0.05). Flow cytometry result show that overexpression of PRMT5-AS1 can significantly inhibit the increase of intracellular lipid ROS level induced by IR (Vector vs. PRMT5-AS1: 17.01% vs. 12.52%, t=12.80, P<0.05), and knockdown of PRMT5-AS1 significantly increases the lipid ROS level induced by IR (siNC vs. siPRMT5-AS1: 14.54% vs. 17.72%, t=5.93, P<0.05). The result of CCK-8 experiment showed that overexpression of PRMT5-AS1 could significantly inhibit Erastin induced cell activity reduction (Vector vs. PRMT5-AS1: 87.92% vs. 109.06%, t=2.87, P<0.05), and knockdown of PRMT5-AS1 could promote Erastin′s inhibitory effect on cell activity (siNC vs. siPRMT5-AS1: 82.56% vs. 60.58%, t=38.35, P<0.05). Western blot and fluorescent quantitative PCR result showed that the protein and mRNA levels of SLC7A11 were significantly increased after overexpression of PRMT5-AS1 ( t=26.24, P<0.05), and the protein and mRNA levels of SLC7A11 were significantly decreased after knockdown of PRMT5-AS1 ( t=5.60, P<0.05). The correlation between PRMT5-AS1 and let-7c-5p was confirmed by luciferase report gene experiment ( t=9.74, P<0.05). The result of luciferase reporter gene experiment showed that PRMT5-AS1 could form ceRNA network with let-7c-5p to regulate SLC7A11. Let-7c-5p was able to reverse the increase in SLC7A11 expression levels, decrease in Lipid-ROS levels and cell death induced by overexpression of PRMT5-AS1 ( t=3.01, 4.11, P<0.05). And knockdown of SLC7A11 reversed Lipid-ROS inhibition and reduced cell death caused by PRMT5-AS1( t=21.35, 7.15, P<0.05). Conclusions:LncRNA PRMT5-AS1 inhibits IR-induced ferroptosis in HCC through the PRMT5-AS1/let-7c-5p/SLC7A11 axis.