ObjectiveIn this study, we used Mendelian randomization analysis to explore the causal relationships between drug targets and cutaneous melanoma (CM) and subsequently screened for new drug targets for CM. In addition, we verified whether targeted drugs could inhibit the development of CM in CM cells by suppressing the expression of target genes.MethodsThe eQTL data of 2,664 drug target genes (exposures) were sourced from the eQTLGen database. The GWAS summary data for CM (outcome) were obtained from the UK Biobank and FinnGen databases. The inverse-variance weighted (IVW) model was used as the primary analytical method. For the cell experiments, we first conducted RT-PCR and western blot analyses in three CM cell lines to validate the expression of LTA4H. LTA4H was subsequently knocked down and overexpressed in CM cell lines, and the proliferation, migration, invasion, and apoptosis of CM cells were evaluated. Finally, bestatin was used to stimulate CM cells to examine its effect on their malignant functions.ResultsMR, GEO2R, and PheWAS analyses revealed that high expression of LTA4H can promote the development of CM. In cell experiments, compared with normal fibroblasts, melanoma cells highly expressed LTA4H. Moreover, after LTA4H was knocked down in SK-MEL-28 cells, their malignant functions decreased. After LTA4H was overexpressed in A-375 cells, the degree of malignancy increased. Finally, bestatin inhibited the malignancy of A-375 cells through the regulation of LTA4H.ConclusionIn this study, MR analysis revealed that high expression of LTA4H can promote the occurrence of CM. In addition, the results of the cell experiments revealed that bestatin can inhibit the development of melanoma cells by reducing the expression of LTA4H.

Designing heterometallic oxygen-bridge structure (M1-O-M2) to achieve the efficient and stable electrochemical conversion of 5-hydroxymethylfurfural (HMF) to 2,5-furandicarboxylic acid (FDCA) has become an important approach to address the rapid consumption of fossil fuels and mitigate white pollution. However, designing effective M1-O-M2 structures and elucidating their catalytic mechanisms remains a key challenge in this field. In this study, a high oxidation state V-O-Co structure is constructed by doping V into reconstructed CoOOH, which promotes the formation of the active intermediate V-*O. The catalyst achieves a low HMF oxidation onset potential of 1.13 V vs. RHE, the HMF conversion rate reaches 99.6%, the FDCA selectivity reaches 97.8%, and the Faradaic efficiency reaches 97.0% at an applied potential of 1.30 V vs. RHE. Based on this novel design strategy, V-doped Ni2P/NF is further constructed, which also forms the active intermediate V-*O, validating the effectiveness of this strategy. Notably, the oxidation state-controlled V-O-Co structure demonstrates excellent catalytic performance in promoting the efficient conversion of various organic compounds (such as glycerol, glucose, methanol, etc.) into high-value chemicals, providing a precedent for the development of single hetero-oxygen-bridge structures for the effective conversion of various high-value compounds.

The primary aim of our study was to investigate the genetic correlations, colocalized genes, and causal relationships between craniofacial microsomia (CFM) and 33 diseases (including tumours and respiratory, heart, and kidney diseases). On the basis of extensive summary-level data from genome-wide association studies (GWASs), we evaluated the genetic linkage between CFM and a spectrum of 33 medical conditions using linkage disequilibrium score regression (LDSC). We employed PLACO to identify pleiotropic loci and genes associated with CFM and other diseases. These genes were subsequently subjected to Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses. Finally, the causal effect of CFM on the 33 diseases was assessed through Mendelian randomization (MR). We observed a genetic association between CFM and malignant lymphoma, thyroid cancer, and chronic obstructive pulmonary disease. The PLACO analysis identified 172 potential multi-effect loci (P < 5 × 10- 8). Furthermore, the MAGMA analysis of colocalized single nucleotide polymorphisms (SNPs) revealed that 1,760 SNPs shared genes (P < 0.05/18,345 = 2.726e-6). KEGG analysis revealed enrichment of these genes in the calcium signalling pathway. Finally, Mendelian randomization (MR) analysis suggested that CFM may reduce the risk of developing urolithiasis (IVW: OR = 0.989, 95% CI = 0.979-0.999, p = 0.034). Our study reveals for the first time the genetic associations of CFM with three diseases (malignant lymphoma, thyroid cancer and chronic obstructive pulmonary disease) in an Asian population. In addition, we found a common calcium signalling pathway between these three diseases and CFM. These results provide new insights into the pathogenesis and research potential of CFM.

Diabetes significantly increases the risk of serious health issues, including prolonged skin inflammation and delayed wound healing, owing to inferior glucose control and suppression of the immune system. Although traditional hydrogen (H2) therapy is slightly effective, its ability to tailor the release of H2 on the skin is limited. Accordingly, this study proposed a novel strategy for electrocatalytic H2 release under neutral conditions to promote wound healing in diabetic mice and rabbit. Herein, a defect-engineered cobalt phosphide (CoP) catalyst was designed by introducing a neutral single-metal electrocatalytic Hydrogen valence state channel into CoP. By effectively regulating the formation and transfer of *H active species during the CoP catalytic process, a considerable enhancement in neutral electrocatalytic H2 evolution performance was achieved (-78.0 mV@-10.0 mA cm-2). Based on this superior catalytic performance, we developed a flexible electrode (namely, CoP/flexible gold electrode made by screen printing (FGSP) by combining a convenient electrolysis platform with continuous electrolyte supply and FGSP, enabling customized H2 release and accelerating wound healing in diabetic mice and rabbits. Notably, the designed flexible electrode features adjustable dimensions, interchangeable substrates, and material adaptability, meeting the diverse needs of clinical and basic research and demonstrating significant potential for applications in clinical medicine.

HYPOTHESIS:Unilateral costal cartilage harvesting (UCCH) for auricle reconstruction in children tends to cause thoracic deformities. Therefore, our study aimed to develop a novel bilateral costal cartilage harvesting (BCCH) method to prevent and reduce thoracic deformities. METHODS:Patients with unilateral microtia who underwent either UCCH (n = 50) or BCCH (n = 46) were enrolled in this study. The grafts for the BCCH group were harvested from the 6th costal cartilage of the ipsilateral hemithorax and the 7th and 8th cartilage from the other hemithorax. Computed tomography and physical examination were performed to identify any physical deformities in the chest contours post-surgery. The cosmetic appearance of the thoracic scars post-surgery was evaluated using the Scar Cosmesis Assessment and Rating Scale (SCAR) and Visual Analogue Scales (VAS cosmetic). The numerical rating scale (NRS) was used to quantify the pain in donor sites. The reconstructed ears were assessed during the follow-up period. RESULT:None of the patients in the BCCH group developed thoracic deformities, while 16 patients within the UCCH group developed mild (n = 12) or severe (n = 4) thoracic deformities (p < 0.001). The SCAR (3.09 vs. 2.92, p = 0.580) and VAS scores (0.96 vs. 0.90, p = 0.813) did not differ significantly between the two groups. For both treatment arms, the NRS scores were highest on the first-day post-surgery and gradually dropped over the 10 days. No significant differences were found in the NRS scores and the aesthetic outcomes of the reconstructed ears between the two groups. CONCLUSION:The BCCH method effectively reduced the incidence of thoracic deformity at the donor site without increasing postoperative pain and cosmetic concerns for patients. It could be used clinically to improve patient outcomes of costal cartilage grafts. LEVEL OF EVIDENCE:4 Laryngoscope, 134:3572-3580, 2024.

Currently, numerous studies suggest a potential association between the gut microbiota and the progression of melanoma. Hence, our objective was to examine the genetic impact of the gut microbiota on melanoma through the utilization of the Mendelian randomization (MR) approach. This research employed Bacteroides, Streptococcus, Proteobacteria, and Lachnospiraceae as exposure variables and cutaneous melanoma (CM) as the outcome in a two-sample MR analysis. In this MR research, the primary analytical approach was the random-effects inverse-variance weighting (IVW) model. Complementary methods included weighted median, MR Egger, and basic and weighted models. We assessed both heterogeneity and horizontal pleiotropy in our study, scrutinizing whether the analysis results were affected by any individual SNP. The random-effects IVW outcomes indicated that Streptococcus, Bacteroides, Lachnospiraceae and Proteobacteria had no causal relationship with CM, with odds ratios of 1.001 [95% confidence interval (CI) = 0.998–1.004, P = 0.444], 0.999 (95% CI = 0.996–1.002, P = 0.692), 1.001 (95% CI = 0.998–1.003, P = 0.306), and 0.999 (95% CI = 0.997–1.002, P = 0.998), respectively. No analyses exhibited heterogeneity, horizontal pleiotropy, or deviations. Our research determined that Bacteroides, Streptococcus, Proteobacteria, and Lachnospiraceae do not induce CM at the genetic level. However, we cannot dismiss the possibility that these four gut microbiotas might influence CM through other mechanisms.

This study aimed to elucidate the genetic aspects of the relationship between sex hormones and cutaneous melanoma risk, providing valuable insights into this complex association. In this study, we used estradiol, bioavailable testosterone, sex hormone-binding globulin, and total testosterone as the exposure and melanoma as the outcome for two-sample Mendelian randomization analysis. In this study, a random-effects inverse-variance weighting (IVW) model was used as the main analysis model, and the corresponding weighted median, simple mode, weighted mode, and Mendelian randomization‒Egger methods were used as supplementary methods. We assessed both heterogeneity and horizontal pleiotropy in our study, scrutinizing whether the analysis results were affected by any individual single nucleotide polymorphism. The random-effects IVW method indicated that estradiol [odds ratio (OR), 1.000; 95% confidence interval (CI), 0.998–1.003; P = 0.658], bioavailable testosterone (OR = 1.001, 95% CI, 0.999–1.003; P = 0.294), sex hormone-binding globulin (IVW: OR, 1.000; 95% CI, 0.998–1.003; P = 0.658), and total testosterone (IVW: OR, 1.002; 95% CI, 0.999–1.005; P = 0.135) were not genetically linked to cutaneous melanoma. No analyses exhibited heterogeneity, horizontal pleiotropy, or deviations. We were unable to find genetic evidence for a causal relationship between sex hormones and the occurrence of cutaneous melanoma in this study. These results are limited by sample size and population, so the causal relationship between sex hormones and cutaneous melanoma needs to be further studied.

Introduction:Perioperative neurocognitive disorder (PND) has attracted consistently increasing attention worldwide. However, there are few bibliometric studies that systematically evaluate this field. This study aimed to visualize the knowledge structure and research trends in PND through bibliometrics to help understand the future development of basic and clinical research. Methods:Literature related to PND in Web of Science and PubMed from 1990 to 2022 were collected through keywords retrospectively. Additionally, the source information, citation information, etc. of these publications were extracted. Finally, bibliometric analysis was performed by visualization software and statistical software. Results:There were 2837 articles and reviews in total. An exponential rise in PND-related publications was observed. China had the most publication, followed by the US and Germany. The institution with the most output and citations was Harvard University (149 papers, 8966 citations). The most prominent author was Marcantonio Edward R with 66 publications and 5721 citations. The journal with the highest productivity for PND research was Frontiers in Aging Neuroscience followed by Anesthesia and Analgesia. Keywords were identified as six topics, including postoperative delirium, postoperative neurocognitive disorder, cardiac surgery, anaesthesia, orthopedic surgery, and dementia. According to keyword analysis, the most recent popular keywords in PND research were prevention, older patients, emergence delirium, orthopedic surgery, and dexmedetomidine. Conclusions:Publications on PND are increasing at an alarming rate from 1990 to 2022. Current research and future trends will concentrate on the prevention and treatment of PND, as well as PND associated with orthopedic surgery in older adults.

Background:Microtia with constricted ear features represents a challenging congenital deformity characterized by the variable shape and large volume of the remnant cartilage and skin involved. This study aimed to evaluate the efficacy and safety of a method using helix costal cartilage scaffold and postauricular flap advancement for the correction.Methods:This prospective study analyzed the clinical and postoperative data of 121 patients diagnosed with microtia and constricted ear features, treated at the authors' institution between January of 2020 and January of 2023. All patients underwent helix reconstruction using the eighth or ninth costal cartilage combined with postauricular flap advancement. Outcomes were assessed based on the incidence of postoperative complications and auricular aesthetic scores. The aesthetic evaluation of the reshaped auricle was based on a 4-point Likert scale (ie, 1 = poor, 2 = fair, 3 = good, and 4 = excellent).Results:The postoperative follow-up period ranged from 12 months to 3 years (mean, 18.5 months). All patients achieved successful helix expansion, with reconstructed ears showing improved symmetry and shape comparable to the contralateral normal ears. The average aesthetic score was 3.4 of 4. Complications included suture exposure in 8.3% of cases and cartilage protrusion in 4.1%, both managed without significant issues. There were no instances of skin necrosis, costal cartilage exposure, or infection.Conclusion:The combination of helix costal cartilage scaffold and postauricular advancing flap offers a reliable and effective method for correcting microtia with constricted ear features, providing satisfactory aesthetic outcomes with minimal complications.CLINICAL QUESTION/LEVEL OF EVIDENCE:Therapeutic, IV.

Kashin-Beck disease (KBD) is an endochondral osteogenesis disorder characterised by epiphysis damage and secondary deformable arthropathy induced by multiple external factors, among which selenium (Se) and iodine deficiency are important influencing factors. Iodine deficiency is usually accompanied by a low Se content in the soil in the KBD areas of China. Se can reverse oxidative damage to chondrocytes. In addition, Se is related to the bone conversion rate and bone mineral density. Low Se will hinder growth and change bone metabolism, resulting in a decrease in the bone conversion rate and bone mineral density. Thyroid hormone imbalance caused by thyroid dysfunction caused by iodine deficiency can damage bone homeostasis. Compared with Se deficiency alone, Se combined with iodine deficiency can reduce the activity of glutathione peroxidase more effectively, which increases the vulnerability of chondrocytes and other target cells to oxidative stress, resulting in chondrocyte death. Clinical studies have shown that supplementation with Se and iodine is helpful for the prevention and treatment of KBD.

Background: Congenital microtia usually lead to impairment of both appearance and hearing especially for patients with bilateral microtia. The simultaneous combination of auricular reconstruction and bone bridge implantation has been proved effective and satisfied with the patients. We retrospectively analyzed this method and the complication of it. We summarized and found the application of superficial temporal island flap for repairing the bone bridge exposure. Methods: From January 2017 to December 2020, there were 84 patients who underwent the surgery of auricular reconstruction simultaneously combined with bone bridge implantation in the Plastic Surgery Hospital of Chinese Academy of Medical Sciences. And after 12 months follow-up, we evaluated the postoperative effect and collected data on the patients who had bone bridge exposure. We analyzed the reason of the complication and covered the exposed bone bridge with superficial temporal island flap. Results: There were 3 cases (3.6%) of implant exposure and the surgical outcome was satisfactory using the repairment of superficial temporal island flap. All 3 patients were healed in 1-stage surgery, and no further implant exposure occurred after another 12-month follow-up. Conclusions: The method of auricular reconstruction simultaneously combined with bone bridge implant is an optional choice for patients with bilateral microtia, and has a low incidence of implant exposure. The superficial temporal island flap could well fill the dead space and increase the wear resistance of the tissue, and the scar was not obvious. We found and summarized a satisfactory method of repairing the implantation exposure using the superficial temporal island flap. Level of Evidence: Level IV, cases study.

The methylation of adenosine base at the nitrogen-6 position is referred to as “N6-methyladenosine (m6A)” and is one of the most prevalent epigenetic modifications in eukaryotic mRNA and noncoding RNA (ncRNA). Various m6A complex components known as “writers,” “erasers,” and “readers” are involved in the function of m6A. Numerous studies have demonstrated that m6A plays a crucial role in facilitating communication between different cell types, hence influencing the progression of diverse physiological and pathological phenomena. In recent years, a multitude of functions and molecular pathways linked to m6A have been identified in the osteogenic, adipogenic, and chondrogenic differentiation of bone mesenchymal stem cells (BMSCs). Nevertheless, a comprehensive summary of these findings has yet to be provided. In this review, we primarily examined the m6A alteration of transcripts associated with transcription factors (TFs), as well as other crucial genes and pathways that are involved in the differentiation of BMSCs. Meanwhile, the mutual interactive network between m6A modification, miRNAs, and lncRNAs was intensively elucidated. In the last section, given the beneficial effect of m6A modification in osteogenesis and chondrogenesis of BMSCs, we expounded upon the potential utility of m6A-related therapeutic interventions in the identification and management of human musculoskeletal disorders manifesting bone and cartilage destruction, such as osteoporosis, osteomyelitis, osteoarthritis, and bone defect.

The electrocatalytic preparation of hydrogen at different pH values not only achieves excellent device performance but also promotes the application of reactive oxygen species (ROS) clearance and hydrogen anti-inflammation. However, it is difficult to develop materials that simultaneously achieve these excellent properties. Herein, the preparation of beaded necklace-like Co9Se8 microspheres using a general and facile synthetic strategy is reported. The Co9Se8-modified electrode has three applications: efficient water splitting for enhanced performance, ROS scavenging, and hydrogen anti-inflammatory activity. Experiments, high-angle-annular-dark-field scanning transmission electron microscopy, and density functional theory calculations indicate that the reconstructed Co(OH)(2) plays a vital role in the oxygen evolution reaction and that the transition from *O to *OOH is the actual rate-determining step. The Co9Se8 material, with its unique beaded necklace-like structure, exhibits exceptional hydrogen production capabilities in phosphate buffer solution (pH 7.4). In particular, hydrogen produce under neutral conditions can effectively reduce ROS levels and significantly inhibit inflammation-related pathological processes, playing a unique antioxidant and anti-inflammatory role at the cellular level. The obtained results indicate that the as-synthesized Co9Se8 is more suitable for water splitting, ROS scavenging, and hydrogen anti-inflammatory applications, outperforming other transition metal electrodes and rendering practical industrial and clinical applications.

An imbalance between M1 and M2 macrophage polarization is critical in osteoarthritis (OA) development. We investigated the effect of M2 macrophage-derived extracellular vesicles (M2-EVs) to reprogramme macrophages from the M1 to M2 phenotype for OA treatment. M1 macrophages and mouse OA models were treated with M2-EVs. Proteomic analysis was performed to evaluate macrophage polarization in vitro. The OA models were as follows: destabilization of the medial meniscus (DMM) surgery-induced OA and collagenase-induced OA (CIOA). Hyaluronic acid (HA) was used to deliver M2-EVs. M2-EVs decreased macrophage accumulation, repolarized macrophages from the M1 to M2 phenotype, mitigated synovitis, reduced cartilage degradation, alleviated subchondral bone damage, and improved gait abnormalities in the CIOA and DMM models. Moreover, HA increased the retention time of M2-EVs and enhanced the efficiency of M2-EVs in OA treatment. Furthermore, proteomic analysis demonstrated that M2-EVs exhibited a macrophage reprogramming ability similar to IL-4, and the pathways might be the NOD-like receptor (NLR), TNF, NF-κB, and Toll-like receptor (TLR) signaling pathways. M2-EVs reprogrammed macrophages from the M1 to M2 phenotype, which resulted in beneficial effects on cartilage and attenuation of OA severity. In summary, our study indicated that M2-EV-guided reprogramming of macrophages is a promising treatment strategy for OA.

Magnesium (Mg), a nutritional element which is essential for bone development and mineralization, has a role in the progression of osteoporosis. Osteoporosis is a multifactorial disease characterized by significant deterioration of bone microstructure and bone loss. Mg deficiency can affect bone structure in an indirect way through the two main regulators of calcium homeostasis (parathyroid hormone and vitamin D). In human osteoblasts (OBs), parathyroid hormone regulates the expression of receptor activator of nuclear factor-κ B ligand (RANKL) and osteoprotegerin (OPG) to affect osteoclast (OC) formation. In addition, Mg may also affect the vitamin D3 -mediated bone remodeling activity. vitamin D3 usually coordinates the activation of the OB and OC. The unbalanced activation OC leads to bone resorption. The RANK/RANKL/OPG axis is considered to be a key factor in the molecular mechanism of osteoporosis. Mg participates in the pathogenesis of osteoporosis by affecting the regulation of parathyroid hormone and vitamin D levels to affect the RANK/RANKL/OPG axis. Different factors affecting the axis and enhancing OC function led to bone loss and bone tissue microstructure damage, which leads to the occurrence of osteoporosis. Clinical research has shown that Mg supplementation can alleviate the symptoms of osteoporosis to some extent.

Background: For auricular reconstruction surgery using autologous costal cartilage, younger patients typically have a limited amount of costal cartilage available. Objective: We introduce a cartilage-saving technique for fabricating the tragus and antitragus, and evaluate its effectiveness based on aesthetic score and complications. Methods: For tragus fabrication, the residual part of the seventh costal cartilage was reoriented by 90° to increase its height and carved into a seagull-shaped structure. The antitragus was constructed by bending the antihelix and stabilizing it on the broadened base frame. Postoperative aesthetic outcomes and complications were documented and analyzed. Results: This study included a total of 658 patients with lobule-type microtia, of whom 356 (54.1%) were male and 302 (45.9%) were female. The average age was 6.5 ± 0.7 years, and the average follow-up period was 13.6 ± 3.5 months. The average aesthetic outcome score was 9.0 ± 0.7. Wound dehiscence at the tragus was seen in four patients, while circulation disturbance at the incisura intertragica area was noted in six patients. Conclusions: This cartilage-sparing technique demonstrated effectiveness in shaping aesthetic tragus and antitragus.

ABSTRACT:Congenital microtia is the second most common congenital craniofacial deformity, and limb malformation is the most common birth defect. The combination of the 2 deformities is rare. In this study, the authors present 3 cases with a rare combination of congenital microtia and limb malformations and analyze the etiology and treatment of the malformations. There may be genetic homology between these two malformations, and they can be associated with abnormal ectodermal migration. LEVEL OF EVIDENCE:Level IV-case study.

Abstract Ankylosing spondylitis (AS) onset is often accompanied by psychiatric symptoms. In this study, two-sample Mendelian randomization (MR) was used to explore the genetic associations between AS and mental disorders. In this study, AS was regarded as exposure, and 36 mental disorders were regarded as outcomes. All the data were from the 7th version of the FinnGen GWAS summary data. Inverse-variance weighted (IVW), MR‒Egger regression, weight median, simple mode, and weight mode methods were used to determine the genetic associations. The Cochrane Q test, Egger-intercept test, MR pleiotropy residual sum and outlier, and leave-one-out tests were performed for sensitivity tests. The IVW results showed that AS was positively associated with autism, insomnia, depression, bipolar disorder, delirium, anankastic personality disorder, generalized anxiety disorder, anxious personality disorder, and mental and behavioral disorders due to opioids, hallucinogens, sedatives or hypnotics; AS was inversely associated with schizophrenia, persistent delusional disorder, and sexual dysfunction. The sensitivity tests showed these results were stable and robust. This study provides a theoretical basis for the early diagnosis of common mental disorders in patients with AS. It also provides evidence for the impact of inflammation on the central nervous system.

Osteoarthritis (OA) is mainly caused by ageing, strain, trauma, and congenital joint abnormalities, resulting in articular cartilage degeneration. During the pathogenesis of OA, the changes in subchondral bone (SB) are not only secondary manifestations of OA, but also an active part of the disease, and are closely associated with the severity of OA. In different stages of OA, there were microstructural changes in SB. Osteocytes, osteoblasts, and osteoclasts in SB are important in the pathogenesis of OA. The signal transduction mechanism in SB is necessary to maintain the balance of a stable phenotype, extracellular matrix (ECM) synthesis, and bone remodelling between articular cartilage and SB. An imbalance in signal transduction can lead to reduced cartilage quality and SB thickening, which leads to the progression of OA. By understanding changes in SB in OA, researchers are exploring drugs that can regulate these changes, which will help to provide new ideas for the treatment of OA. Cite this article: Bone Joint Res 2023;12(9):536–545.

Abstract Ankylosing spondylitis (AS) onset is often accompanied by psychiatric symptoms. In this study, two-sample Mendelian randomization (MR) was used to explore the genetic associations between AS and mental disorders. In this study, AS was regarded as exposure, and 36 mental disorders were regarded as outcomes. All the data were from the 7th version of the FinnGen GWAS summary data. Inverse-variance weighted (IVW), MR‒Egger regression, weight median, simple mode, and weight mode methods were used to determine the genetic associations. The Cochrane Q test, Egger-intercept test, MR pleiotropy residual sum and outlier, and leave-one-out tests were performed for sensitivity tests. The IVW results showed that AS was positively associated with autism, insomnia, depression, bipolar disorder, delirium, anankastic personality disorder, generalized anxiety disorder, anxious personality disorder, and mental and behavioral disorders due to opioids, hallucinogens, sedatives or hypnotics; AS was inversely associated with schizophrenia, persistent delusional disorder, and sexual dysfunction. The sensitivity tests showed these results were stable and robust. This study provides a theoretical basis for the early diagnosis of common mental disorders in patients with AS. It also provides evidence for the impact of inflammation on the central nervous system.