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Objective To explore the correlation between non-alcoholic fatty liver disease(NAFLD)and cognitive impairment.Methods The research on the correlation between NAFLD and cognitive impairment was searched on China National Knowledge Infrastructure,WanFang Data,VIP,China Biology Medicine,PubMed,Web of Science,Embase,and Cochrane Library.This study screened and evaluated literature according to inclusion criteria,and extracted data.Meta-analysis was performed using StatMP 17 software.Results A total of 13 articles were included,with a total of 73 219 patients.The meta-analysis showed a correlation between NAFLD and cognitive impairment with a statistically significant[OR=1.49,95%CI(1.16,1.92),P＜0.05].The subgroup analysis revealed that in cross-sectional studies[OR=2.14,95%CI(1.24,3.67),P＜0.05],North America[OR=1.61,95%CI(1.32,1.98),P＜0.05],imaging/pathological diagnostic methods[OR=1.58,95%CI(1.04,2.41),P＜0.05],fatty liver index diagnostic methods[OR=1.60,95%CI(1.13,2.26),P＜0.05],and Mini Mental State Examination[OR=1.35,95%CI(1.01,1.82),P＜0.05]and patients with mild cognitive impairment[OR=1.41,95%CI(1.05,1.90),P＜0.05],NAFLD was positively correlated with cognitive impairment,and the differences were statistically significant.Conclusions NAFLD is related to cognitive impairment,which has guiding significance for effectively preventing and controlling cognitive dysfunction in NAFLD populations.
The pathogenesis involves neuroinflammation,synaptic plasticity and nerve regeneration.However,the diagnosis and treatment of these diseases are difficult,and the prognosis is poor.As a result,it is particularly important to find new biomarkers and therapeutic methods.Exosomes,as nanoscale membranous vesicles secreted by cells themselves,not only play an important role in the pathophysiological processes of various diseases,but also participate in the occurrence and development of mental disorders.This paper summarizes the research progress on the role of exosomes in the diagnosis and treatment of common mental disorders,providing specific theoretical references for the precise application of exosomes in the diagnosis and treatment of mental disorders in the futures.
Schizophrenia is a serious mental disorder,and cognitive impairment is one of the typical clinical manifestations of the disease.The visual system is involved in various cognitive processes.As an important component of the visual system,fixation stability is closely correlated with cognitive function.In recent years,cognitive function and fixation stability are key trends in the study of schizophrenia,and many scholars are committed to using them as indicators for early recognition,diagnosis,and assess treatment and prognosis of schizophrenia.This paper reviews the methods and key points of research on cognitive function and fixation stability in schizophrenia,explores the relationship between cognitive function and fixation stability in patients with schizophrenia,and makes prospects for using fixation stability-related eye movement indicators to guide the diagnosis and treatment of schizophrenia.
Objective To explore the correlation between the geriatric nutritional risk index(GNRI)and unplanned readmission(readmission)in elderly stroke patients.Methods The clinical data of 307 elderly stroke patients admitted to the Yancheng Third People's Hospital,Jiangsu Province from June 2019 to May 2022 were retrospectively analyzed.According to the median GNRI of all patients,they were divided into a normal GNRI group(GNRI≥92)and a low GNRI group(GNRI＜92).The propensity score matching(PSM)was used to obtain two sets of samples with 13 variables balanced,such as age and albumin at admission.Logistic regression was used to analyze the impact of GNRI on readmission before and after PSM.The predictive value of GNRI on readmission was evaluated using the area under the receiver operating characteristic(ROC)curve(AUC)alone and after adjusting for other covariates.Results Among 307 elderly stroke patients,the GNRI was(92.62±25.30),and 43.32%(133/307)patients had normal GNRI.After PSM,a total of 126 pairs were successfully matched.There was no statistical difference between the two groups in age,body mass index,diabetes,hospital stay,surgical treatment ratio,albumin and other clinical data(P＞0.05).After PSM,the readmission rate of the low GNRI group was 28.57%(36/126),which was higher than the 11.90%(15/126)of the normal GNRI group,and the difference was statistically significant(χ2=10.841,P=0.001).Logistic regression analysis after PSM showed that in Model 1,which only included GNRI,the readmission risk of patients with low GNRI increased by 2.232 times compared to those with normal GNRI,and the difference was statistically significant[OR=3.232,95%CI(1.701,6.138),P=0.001].In Model 2,after adjusting for age and gender,the readmission risk of patients with low GNRI increased by 2.206 times compared to those with normal GNRI,and the difference was statistically significant[OR=3.206,95%CI(1.674,6.138),P=0.001].In Model 3,after adjusting for all variables such as age and gender,the readmission risk of patients with low GNRI increased by 2.052 times compared to those with normal GNRI,with a statistically significant difference[OR=3.052,95%CI(1.469,6.339),P=0.003].ROC curve analysis showed that the predicted AUC for readmission of Model 1 was 0.821[95%CI(0.755,0.886)].After adjusting for covariates using Model 2 and Model 3,the predicted AUC for readmission were 0.828[95%CI(0.770,0.886)]and 0.847[95%CI(0.797,0.898)],respectively.The AUC of Model 3 was higher than that of Model 1 and Model 2,and the difference was statistically significant(Z=3.036,2.457;P=0.002,0.014).Conclusions GNRI can effectively predict the readmission of elderly stroke patients and has an important warning role,which may guide medical and nursing staff in nutritional management of elderly stroke patients.
Objective To explore the risk factors of non-suicidal self-injury(NSSI)in depressive disorder with mixed features(DMX).Methods A total of 100 patients with DMX who visited the Depression Clinic of Beijing Anding Hospital affiliated to Capital Medical University from May 4,2021 to July 29,2022 were selected as the research subject.Patients were divided into NSSI group(n=39)and non-NSSI group(n=61)based on whether NSSI occurred.The depression,anxiety,manic severity,and suicide ideation risk of patients were evaluated using four other-rating scales,including the 17-item Hamilton Depression Rating Scale(HAMD-17),Hamilton Anxiety Scale(HAMA),Young Mania Rating Scale(YMRS),and Columbia Suicide Severity Rating Scale(C-SSRS).The severity of depression,anxiety,and anhedonia in patients was evaluated using three self-assessment scales,including the Patient Health Questionnare 9-item Scale(PHQ-9),Generalized Anxiety Disorder 7-item Scale(GAD-7),and Snaith-Hamilton Pleasure Scale(SHAPS).Multivariate Logistic regression model was used to analyze the risk factors for NSSI in patients with DMX.Results There was a statistically significant difference between the two groups in terms of age,residential pattern,age of onset,HAMD-17 score,PHQ-9 score,SHAPS score,and suicide ideation risk level(P＜0.05).Multivariate Logistic regression analysis showed that young age[OR=0.900,95%CI(0.829,0.977),P=0.012],high HAMD-17 score[OR=1.361,95%CI(1.013,1.829),P=0.042],and high SHAPS score[OR=1.147,95%CI(1.078,1.215),P＜0.001]were risk factors for NSSI in patients with DMXs.Conclusions Young age,severe depression,and severe anhedonia are risk factors for NSSI in patients with DMXs,and attention should be paid to DMX patients with this feature in the clinic and early intervention should be made to minimize the occurrence of NSSI.
Fatigue is a common symptom in patients with multiple sclerosis,characterized by subjective exhausted and insufficient physical and/or mental energy.It is an important cause of disability and unemployment,seriously affecting the quality of life of patients with multiple sclerosis.Psychological disorders are one of the important reasons for the persistence and deterioration of fatigue in patients with multiple sclerosis.Previous studies have explored psychological interventions for multiple sclerosis fatigue,such as cognitive-behavioral therapy,mindfulness therapy,relaxation therapy,self-management projects,and guiding imagination,which have shown certain effects in improving fatigue in multiple sclerosis patients.This paper reviews the psychological intervention methods and effects on fatigue in multiple sclerosis patients both domestically and internationally,aiming to provide theoretical basis for future research on psychological intervention for fatigue in patients with multiple sclerosis.
Alexithymia is a personality characteristic that is difficult to express and recognize emotions.This personality characteristic is closely related to various mental disorders and can affect the effectiveness of treatment for mental disorders,prolong the course of treatment,and increase the risk of suicide.At present,the mechanism of alexithymia is not clear,and the unknow etiology and lack of objective indicators for diagnosis are urgent problems that need to be addressed in clinical diagnosis and treatment.Positron emission tomography,magnetic resonance imaging,and other imaging techniques are important objective means for studying alexithymia.This paper reviews the neuroimaging advances in alexithymia from the aspects of cerebral hemisphere,limbic system,and other brain regions,aiming to provide reference for the evaluation and intervention of alexithymia.
Alzheimer disease(AD)is a common form of elderly dementia that currently lacks effective treatment.Therefore,early diagnosis and intervention are particularly important.Currently,peripheral biomarkers are becoming a research hotspot in AD.Recent studies have shown that plasma p-tau217 plays an important role in the early diagnosis,differentiation,treatment monitoring,and prognosis evaluation of AD,and has good application prospects.However,further standardization of laboratory protocols and optimal cut-off values need to be determined.This paper reviews the above progress,aiming to provide a basis for clinical applications.
Emotional disorders are a collective term for various psychological disorders characterized by emotional abnormalities,including depression disorder,anxiety disorder,and obsessive-compulsive disorder.The metacognitive theory suggests that the generation and maintenance of emotional disorders are related to cognitive attention syndrome.Metacognitive therapy focuses on different aspects of cognitive attention syndrome in emotional disorders,mainly using delay techniques,attention training techniques,and mindfulness separation techniques.This paper elaborates on the mechanisms of repetitive negative thinking,attention bias towards threatening information,and self-regulation strategies in cognitive attention syndrome,as well as their role in emotional disorders,aiming to gain a deep understanding of cognitive attention syndrome and provide a basis for the treatment of patients with emotional disorders.
Objective To explore the cognitive function of patients with bipolar disorder Ⅰ depressive episodes and major depressive disorder(MDD),as well as its relationship with thyroid function and clinical features.Methods From June 2021 to August 2022,45 patients with bipolar disorder Ⅰ depressive episodes who visited the outpatient and inpatient departments of Wuhan Mental Health Centre were selected as the bipolar disorder depressive episode group,and 45 patients with MDD were selected as the MDD group.During the same period,54 healthy individuals were recruited as the control group in hospitals and society.This study compared the thyroid function indicators among three groups of subjects,the Hamilton Depression Scale(HAMD)and Hamilton Anxiety Scale(HAMA)scores between two groups of patients,and the cognitive function of the three groups of subjects using the Measurement and Treatment Research to Improve Cognition in Schizophrenia(MATRICS)Consensus Cognitive Battery(MCCB).Pearson correlation was used to examine the correlation among MCCB scores and HAMD scores,HAMA scores and thyroid stimulating hormone(TSH)in two groups of patients,and multiple linear regression was used to analyze the influencing factors of cognitive function in both groups of patients.Results In the bipolar disorder depressive episode group and MDD group,the HAMD and HAMA scores of patients were higher than those in the control group[21.0(19.0,27.0)vs 22.0(19.0,25.0)vs 0(0,0),15.0(8.0,18.0)vs 15.0(9.0,16.0)vs 0(0,0)],and the thyroid stimulating hormone(TSH)was lower than that in the control group[(2.38±1.85)vs(3.29±2.37)vs(3.35±0.81)μ IU/ml],and the differences were statistically significant(P＜0.05).The scores of speed of processing,working memory,verbal learning,visual Learning,reasoning and problem-solving,and social cognition of the bipolar disorder depressive episode group and MDD group were lower than those of the control group[(29.40±13.85)vs(37.87±10.99)vs(50.24±8.29),(31.80±9.24)vs(30.49±8.42)vs(46.72±9.56),(31.24±8.61)vs(32.89±9.04)vs(44.13±7.78),(24.00±8.47)vs(25.96±6.64)vs(42.96±6.91),(35.16±11.35)vs(40.02±9.84)vs(51.50±7.09),(43.64±11.20)vs(46.53±10.54)vs(52.33±9.85)],and the differences were statistically significant(P＜0.05).The speed of processing,reasoning and problem-solving scores of the bipolar disorder depressive episode group were lower than those of the MDD group,with statistically significant differences(P＜0.01).In bipolar disorder depressive episode group,the HAMD score was negatively correlated with scores of the speed of processing,working memory,verbal learning,reasoning and problem-solving(r=-0.456 to-0.315,P＜0.05),the HAMA fscore was positively correlated with the score of verbal learning(r=0.441,P＜0.05),and the differences were statistically significant.In the MDD group,the HAMD score was negatively correlated with speed of processing and visual Learning,and the differences were statistically significant(r=-0.568,-0.336;P＜0.05).There was no correlation between cognitive function and TSH levels in patients in the bipolar disorder depressive episode and MDD groups(P＞0.05).Multiple linear regression showed that the HAMD score was a factor affecting the speed of processing,working memory,reasoning and problem-solving,and verbal learning of patients with bipolar disorder depressive episodes with a statistical difference(P＜0.05),while the HAMA score was a factor influencing verbal learning in patients with bipolar disorder depressive episodes.The HAMD score was a factor affecting the speed of processing and visual learning of MDD patients,while a history of alcohol consumption was a factor influencing the reasoning and problem-solving with a statistical difference(P＜0.05).Conclusions Patients with bipolar disorderⅠ depressive episodes and MDD have significant cognitive impairment,with the former having more severe impairments in processing speed and problem-solving skill,and lower TSH levels.Symptoms of depression,anxiety,and alcohol consumption may be influencing factors on cognitive function.Early assessment and intervention of cognitive function are necessary in clinical diagnosis and treatment,and regular monitoring of thyroid function and evaluation of emotional scales are needed to assist diagnosis and treatment and promote cognitive function recovery.
With the development of digital three-dimensional(3D)technology,neurosurgery has entered a stage of development where preoperative model reconstruction is combined with clinical surgical approach research.The diagnostic rate of tumors in the cerebellopontine angle region is gradually increasing,and the therapeutic focus has shifted from complete surgical resection to preserving neural function.Research on sigmoid sinus is becoming increasingly important.However,there are few big data studies on measuring the anatomy of relevant populations.This paper reviews existing domestic and international literature,providing theoretical basis for establishing a database of sigmoid sinus anatomy,enhancing neurosurgeons'understanding of the cerebellopontine angle region,and developing new methods for resection of tumors in the cerebellopontine angle region.
创伤性脑损伤患者由于原发性损伤引起的炎症、水肿和局部缺血等而处于进一步恶化的风险中,这种下游损伤称为继发性脑损伤,在无反应和镇静的神经重症患者中常被漏诊,因此神经危重症管理至关重要.现回顾关于神经危重症管理的研究进展,并对脑多模态监测、脑灌注压与脑血管自动调节、生物标志物、预防癫痫、亚低温治疗、营养支持、水电解质紊乱及酸碱失衡等进行综述.
目的 探讨首发精神分裂症患者血清miR-124、miR-381水平及其诊断价值.方法 选取2019年5月至2021年5月于重庆市精神卫生中心入院治疗的91例首发精神分裂症患者为首发精神分裂症组,选取同期于我院健康体检的70名志愿者作为对照组.采用RT-qPCR检测两组受试者的血清miR-124、miR-381水平.采用阳性与阴性症状量表(PANSS)评估首发精神分裂症组患者的病情,并根据得分将患者分为轻度组(n=38)、中度组(n=29)、重度组(n=24).采用Spearman相关分析首发精神分裂症患者血清miR-124、miR-381水平与PANSS得分的相关性.采用二项Logistic回归分析首发精神分裂症患者发病的影响因素.采用受试者工作特征(ROC)曲线分析血清miR-124、miR-381水平对重度首发精神分裂症的诊断价值.结果 首发精神分裂症组患者的血清miR-124水平低于对照组,miR-381高于对照组,差异均有统计学意义(t=7.022、11.192;P均＜0.01).中度组、重度组的血清miR-124水平低于轻度组,miR-381水平高于轻度组,差异有统计学意义(P＜0.05);重度组血清miR-124水平低于中度组,miR-381水平高于中度组,差异有统计学意义(P＜0.05).患者的阳性症状得分、阴性症状得分、抑郁情绪得分、兴奋状态得分、认知功能得分、PANSS得分总分与血清miR-124水平呈负相关(P＜0.05),与血清miR-381水平呈正相关(P＜0.05).miR-381是首发精神分裂症的危险因素(OR=0.682,95%CI=0.511～0.910,P＜0.05),miR-124是保护因素(OR=2.248,95%CI=1.125～4.490,P＜0.05).血清miR-124、miR-381以及两者联合诊断重度首发精神分裂症的ROC曲线下面积分别为0.877、0.781、0.935,联合诊断的敏感度为95.83%,特异性为82.09%,两者联合优于血清miR-124、miR-381各自单独诊断(Z两者联合-miR-124=2.197,P两者联合-miR-124=0.028;Z两者联合-miR-381=2.927,P两者联合-miR-381=0.003).结论 首发精神分裂症患者的血清miR-124水平较低,与病情严重程度呈负相关;血清miR-381水平较高,与病情严重程度呈正相关.血清miR-124、miR-381水平可作为诊断重度首发精神分裂症、判断病情严重程度的标志物.
双相障碍是一种常见精神疾病.目前双相障碍的诊断主要依靠临床经验,其早期识别率、诊断率较低.语言信号特征在双相障碍与健康人群中存在差异,且随着患者情绪和疾病状态变化而改变,具有成为双相障碍客观评估指标的潜力.现对语音识别技术的基本概念及方法,以及语音识别在双相障碍中的研究进展进行介绍,旨在从中发现反映双相障碍的语音特征类别,为建立双相障碍客观评估体系提供依据.
目的 探讨脑挫伤患者伤后24 h内缺氧诱导因子-1α(HIF-1α)、miRNA-21水平变化与患者预后的关系.方法 选取2021年3月至2022年11月在青海省人民医院神经外科住院治疗的30例脑挫伤患者为脑挫伤组,同期选取在我院体检中心体检的15名健康人群为健康对照组.分别采用酶联免疫吸附试验和逆转录-聚合酶链式反应检测两组血清HIF-1α和miRNA-21水平.患者的创伤严重程度采用格拉斯哥昏迷评分(GCS)评估,并根据入院后7 d GCS评分变化将患者分为GCS评分减少组(n=14)和增加组(n=16).患者伤后30 d格拉斯哥预后评分(GOS)1～3分定义为预后不良.采用Spearman相关分析脑挫伤患者GCS评分与HIF-1α、miRNA-21之间的关系,通过多因素Logistic回归分析患者预后不良的影响因素,采用受试者工作特征(ROC)曲线评估miRNA-21和HIF-1α对脑挫伤患者预后不良的诊断价值.结果 脑挫伤组的血清HIF-1α、miRNA-21水平高于健康对照组,差异有统计学意义(t=-5.991、-6.722;P＜0.05).患者血清HIF-1α、miRNA-21水平与GCS评分、GOS评分呈负相关(r=-0.74、-0.54、-0.51、-0.62;P＜0.001),血清HIF-1α、miRNA-21水平呈正相关(r=0.50,P＜0.001).入院后7 d,GCS评分增加组的HIF-1α水平低于GCS评分减少组,差异有统计学意义(P＜0.05);两组的miRNA-21水平比较,差异无统计学意义(P＞0.05).血清HIF-1α水平为305.00 pg/ml、miRNA-21水平为3.95,区分30 d预后不良患者的特异度和敏感度分别为90.5%和66.7%、95.2%和66.7%.结论 血清HIF-1α和miRNA-21有助于脑挫伤的预后预测.
述情障碍是指个体在情感体验、情感识别和情感表达中存在困难和不足,是精神疾病的影响因素之一.童年创伤、早期适应不良图式等社会心理因素与述情障碍的发生密切相关.本文对童年创伤、早期适应不良图式与述情障碍的关系进行综述,以深入探究相关心理因素在述情障碍中的作用机制,为后续的心理治疗和干预提供新的方向.
目的 分析父母婚姻适应与青少年抑郁症状的关系,以及母亲抑郁症状在其中的中介作用.方法 于2021年11-12月选取河南省某高中的学生及其母亲为研究对象.采用洛克-华莱士婚姻适应量表(LW)、儿童抑郁量表(CDI)调查青少年的父母婚姻适应水平、抑郁症状,采用流调中心抑郁量表(CES-D)调查青少年母亲的抑郁症状.采用Spearman相关分析青少年抑郁症状、父母婚姻适应与母亲抑郁症状之间的相关性.采用SPSS中Process 3.3插件进行中介效应检验.结果 本研究获得1 039份有效的匹配问卷.1 039名青少年父母的LW得分为[84(71,95)]分,CDI得分为[13(8,18)]分,1 039名青少年母亲的CES-D得分为[3(0,12)]分.21.56%(224/1 039)的青少年CDI得分≥19分,20.31%(211/1 039)的母亲CES-D得分≥16分.相关分析结果显示,青少年父母婚姻适应与青少年抑郁症状、母亲抑郁症状呈负相关(r=-0.10、-0.48;P＜0.01),母亲抑郁症状与青少年抑郁症状呈正相关(r=0.12,P＜0.01).母亲抑郁症状在青少年父母婚姻适应与青少年抑郁症状之间的中介效应显著(95%CI=-0.031～-0.004),效应量为-0.017,占总效应的51.43%.结论 父母婚姻失调可通过增加母亲抑郁症状来增加青少年抑郁的风险,需关注婚姻关系及家庭环境对青少年情绪的影响.
