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Falls have long been a significant safety concern worldwide, not only compromising the physical and psychological health of older adults and limiting their social engagement but also imposing substantial economic and caregiving burdens. Evidence on fall risk perception among Chinese community-dwelling older adults remains limited, especially for those transitioning to community living after hospital discharge. This research examined the subtypes of fall risk perception of Chinese community-dwelling older adults in the post-discharge transition and to explore subgroup characteristics and associated factors. A cross-sectional survey was conducted between January 2024 to March 2025 in Hangzhou, Zhejiang Province. A self-designed questionnaire was used to collect demographic and health-related information, The Fall Risk Perception Scale for Community-dwelling Older Adults was used to assess the fall risk perception, the objective fall risk was assessed by Morse Fall Scale. Latent profile analysis (LPA) was performed to extract latent classes of fall risk perception, and multinomial regression analyses were used to identify differences between these categories. A total of 468 older adults were included, with 56.0% were male. Three fall risk perception subtypes were identified by LPA: Low Perception-Social Context Desensitized Type (29.2%), Moderate Perception - Balanced Type (43.4%), and High Perception - Bio-behaviorally Salient Type (27.4%). Individuals who were aged with 70-79 (OR = 0.46, 95% CI: 0.27-0.77), with college education or above (OR = 0.31, 95% CI: 0.13-0.76), those who underwent surgery during hospitalization (OR = 0.26, 95% CI: 0.15-0.43), reported difficulty falling asleep (OR = 0.40, 95% CI: 0.20-0.82), and those with a history of falls (OR = 0.44, 95% CI: 0.24-0.81) were significantly more likely to be in the High Perception - Bio-behaviorally Salient Type. Compared to objective fall risk level, a third of participants (31.4%) correctly estimated their fall risk, 23.1% overestimated it and 45.5% underestimated it. Most older adults possess a Moderate Perception - Balanced Type toward fall risk. Key determinants of heightened risk perception included advanced age, higher education, fall history, and recent surgical experience. Tailored, profile-specific risk communication strategies are essential to improve perceptual accuracy during the hospital-to-home transition may support post-discharge fall prevention. Show less

The apolipoprotein E (APOE) gene represents the strongest genetic determinant of sporadic Alzheimer's disease (AD), yet its interaction with sex-specific endocrine factors remains poorly understood. Lifetime estrogen exposure, estimated through reproductive lifespan, may modulate neurodegenerative risk, but findings are inconsistent. Previous studies have examined reproductive factors and APOE interactions in relation to cognitive outcomes, but dose-dependent effects across all APOE alleles (ε2, ε3, ε4) in clinically diagnosed AD patients remain underexplored. This study investigates the joint effects of reproductive lifespan, age at natural menopause (ANM), and APOE genotype on AD risk in females. A total of 396 female participants (103 with AD, 293 cognitively healthy controls) were retrospectively analyzed. Demographic, clinical, and reproductive data were extracted from medical records. APOE genotyping was performed by sequencing rs429358 and rs7412 polymorphisms. Logistic regression models tested associations between ANM, reproductive lifespan, and AD diagnosis, adjusting for education, body mass index (BMI), smoking, diabetes, hypertension, and number of children. Moderation analyses assessed the interaction between reproductive variables and APOE ε2, ε3, and ε4 alleles, and were followed by simple slope analyses to clarify the direction of significant effects. AD females exhibited later ANM (50.3 ± 4.4 vs. 48.3 ± 6.2 years; This work provides novel evidence that extended ovarian function is associated with increased AD vulnerability in females, particularly among APOE ε4 carriers. These findings highlight a dose-dependent, genotype-specific interaction between reproductive aging and neurodegeneration, suggesting APOE as a molecular bridge linking estrogenic exposure and AD risk. Show less

Hispanic/Latino (H/L) adults are more likely than non-Hispanic White individuals to have Alzheimer's disease (AD), yet fewer than one in five H/L adults has apolipoprotein E ( Community-residing, Spanish-preferring Mexican/Mexican American adults ( Participants recognized AD as a memory disorder influenced by aging and genes but were largely unfamiliar with AD genetic testing. Testing was viewed as useful for diagnosis rather than future risk prediction, with limited perceived value for cognitively normal individuals without a family history. Despite this limited familiarity, participants expressed interest in AD research involving genetic testing. Findings suggested a perceived responsibility to use AD genetic testing despite limited awareness of its purposes, applications, and clinical implications. Participants' responses reflected a present-oriented health disposition: Genetic testing was viewed as appropriate once symptoms emerge rather than as a proactive tool for anticipating future decline, consistent with current clinical practice outside autosomal dominant AD. Educational materials co-created by community members and researchers may address these gaps by explaining both limitations of genetic testing in isolation and its potential future applications, including how genetic and multimodal biomarker data may inform risk estimation and prevention-focused decision-making. This approach may foster a future-oriented health disposition while remaining responsive to social and structural contexts. Future work is needed among other H/L heritage groups with differing social and structural experiences, migration histories, and language primacy. Show less

This study employed a person-centered approach to identify latent profiles of academic burnout among Chinese university students and to examine the associations between academic burnout profiles and smartphone addiction, sleep quality, and mindfulness. A sample of 2,948 Chinese university students was recruited to complete measures of academic burnout, smartphone addiction, sleep quality, and mindfulness. Latent profile analysis (LPA) was used to identify distinct burnout profiles, and multinomial logistic regression was used to analyze factors associated with profile membership. Three distinct profiles of academic burnout were identified: a Low Burnout profile (18.15%), a Medium Burnout profile (50.88%), and a High Burnout profile (30.97%). The profiles differed significantly on all correlates, with the high burnout group exhibiting the most severe smartphone addiction, the poorest sleep quality, and the lowest mindfulness. Regression analysis revealed that higher smartphone addiction and poorer sleep quality were significantly associated with membership in the Medium and High Burnout profiles relative to the Low Burnout profile, whereas higher mindfulness was significantly associated with lower likelihood of belonging to higher burnout profiles. Academic burnout among Chinese university students is a heterogeneous experience, with a majority falling into an at-risk or intermediate state. Smartphone addiction, poor sleep, and low mindfulness are associated with higher burnout risk. These findings highlight the need for universities to develop targeted, profile-based interventions to provide precise and effective mental health support. However, due to the cross-sectional design, causal relationships cannot be inferred. Show less

To investigate the association between quantitative retinal vascular parameters and coronary artery disease (CAD) and to evaluate the efficacy of a retinal phenotype-based diagnostic model as a non-invasive tool for early CAD screening. A retrospective cross-sectional study. A single-centre study conducted at the Cardiovascular Center of Beijing Tongren Hospital, Capital Medical University, China, between January and October 2024. 417 patients with suspected angina undergoing their first coronary angiography (CAG) were enrolled. Inclusion criteria were age >18 years and high-quality fundus photography within 24 hours pre-CAG. Major exclusions were prior coronary interventions, severe systemic/valvular heart diseases and ocular conditions impairing retinal vascular visualisation. The primary outcome was the association between quantitative retinal vascular parameters and the presence of CAD (defined as ≥50% stenosis). Secondary outcomes included the diagnostic performance area under the receiver operating characteristic curve (AUROC) of three predictive models: one based on quantitative retinal vascular parameters alone, one based on traditional risk factors and a combined model integrating both retinal and clinical variables. This study enrolled 417 patients undergoing initial CAG. Compared with non-CAD controls (n=190), patients with CAD (n=227) had higher prevalence of hypertension, dyslipidaemia and diabetes, along with elevated levels of fasting blood glucose, lipoprotein(a) (Lp(a)), triglyceride (TG) and glycated haemoglobin (HbA1c) (all p<0.05). Quantitative fundus analysis revealed that multiple retinal vascular parameters were independently associated with CAD after multivariable adjustment, including fractal dimension (FD), vessel density (VD) and specific zonal measures of vessel diameter and tortuosity (all p<0.05). Multivariable logistic regression incorporating both fundus and clinical variables identified the following independent predictors of CAD: a decrease in FD (OR=0.26, 95% CI 0.16 to 0.41, p<0.01), reduced optic disc long-to-short axis ratio (OR=0.04, 95% CI 0.004 to 0.46, p=0.01) and optic disc-to-macula distance (OR=0.91, 95% CI 0.86 to 0.97, p<0.01), male sex, dyslipidaemia and elevated levels of Lp(a), TG, low-density lipoprotein cholesterol and HbA1c (all p<0.05). The final diagnostic model achieved an AUROC of 0.802 (95% CI 0.76 to 0.845), with a sensitivity of 0.797 and a specificity of 0.679 at the optimal cut-off. Internal validation via bootstrap resampling (1000 iterations) confirmed the robustness of the identified predictors. Our findings, derived from an artificial intelligence-based fully automated quantitative retinal vascular parameters measurement method, revealed that multiple quantitative fundus parameters-including FD, VD and other morphological parameters were significantly associated with CAD risk. The CAD diagnostic model we developed demonstrates strong performance and high interpretability, making it suitable for early CAD screening and diagnosis. Show less

Patients with type 2 diabetes mellitus (T2DM) face a significantly elevated risk of developing cognitive impairment (CI), which has been recognized as an independent risk factor for dementia. Current glucose-lowering medications are limited by poor central nervous system penetration, delayed intervention, and single-target approaches, highlighting an urgent need for safe and effective complementary strategies. Exercise therapy, leveraging its advantage in "metabolic-neural bidirectional regulation," demonstrates considerable potential in ameliorating T2DM-related CI. This article systematically reviews basic and clinical research from the past decade, revealing that: ① Aerobic exercise, Tai Chi, and dual-task training can all significantly improve global cognitive scores (MoCA, MMSE), with effect sizes increasing over longer intervention periods; ② Tai Chi yields the most comprehensive benefits in memory, executive function, and balance-fall prevention, with an adherence rate as high as 79.6%; ③ Exercise exerts its effects through multi-target mechanisms, including upregulation of BDNF/IGF-1, suppression of IL-6/TNF-α, restoration of blood-brain barrier integrity, remodeling of the gut microbiota-butyrate-brain axis, and enhancement of mitophagy. Future research should focus on large-sample, multi-center, long-term follow-up studies to establish personalized exercise prescriptions based on genetic-metabolic-microbiota profiles. Integrating digital health technologies will enable remote monitoring and precise implementation, thereby providing an evidence-based foundation for constructing an integrated "metabolic-cognitive" prevention and treatment model. Show less

The purpose of our study was to assess if spinacetin (SPC), a flavonoid found in spinach, can alleviate the cyclophosphamide (CYP)-induced changes in cystometric and inflammatory parameters indicative of the development of hemorrhagic cystitis. The animal experiments were conducted in female Wistar rats. The cohort of 60 animals was grouped as follows: I-control, II-CYP group, III-SPC group, and IV-CYP + SPC group. The cystometry and biochemical analyses were performed after a fortnight of SPC administration. SPC was found to restore normal cystometric parameters in CYP-induced cystitis and, similarly, it normalized c-Fos expression changes in the central micturition regions. SPC further prevented a massive increase in the bladder wall thickness/permeability due to exposition to CYP administration. CYP instillation resulted in the elevation of biomarkers found in urine (brain-derived neurotrophic factor, BDNF, and nerve growth factor, NGF), and in the bladder detrusor muscle (Rho kinase and vesicular acetylcholine transporter, VAChT), which were successfully restored after administration of SPC. As for the biomarkers in the bladder urothelium, the CYP-induced increases in TNF-α, IL-1β, IL-6, calcitonin gene-related peptide (CGRP), malondialdehyde, 3-nitrotyrosine, insulin-like growth factor-binding protein 3 (IGFBP-3), occludin, organic cation transporter 3 (OCT-3), orosomucoid-1 (ORM1), pituitary adenylate cyclase receptor 1 (PAC1), synaptosomal-associated protein 23 (SNAP23), SNAP25, and synaptic vesicle glycoprotein (SV2A) levels were attenuated by SPC. Finally, CYP administration resulted in a decrease in the heparin-binding EGF-like growth factor (HB-EGF), hemopexin (HPX), T-H protein, and tight junction protein (Z01), and we noted the successful restoration of all these changes in concentrations after application of SPC. In summary, SPC robustly mitigated cyclophosphamide (CYP)-induced cystometric dysfunction and biochemical alterations characteristic of iatrogenic hemorrhagic cystitis. These findings position SPC as a compelling therapeutic candidate and warrant further translational investigation for the management of CYP-induced bladder injury. Show less

Traits that are detrimental for health may persist in populations because they are advantageous for reproduction. Apolipoprotein E is a protein involved in lipid metabolism, and it is encoded by a polymorphic gene (ApoE) with three alleles: ApoE2, ApoE3, and ApoE4. ApoE4 allele is associated with elevated cholesterol levels, and increased risk of various metabolic and age-related diseases, such as cardiovascular disease and dementia. Because lipids are crucial for steroid hormone synthesis and thus the ovarian function, ApoE4 allele may be associated with enhanced fertility. Therefore, we hypothesize that women with different ApoE genotypes will exhibit differences in reproductive history traits. Participants included 360 postreproductive women aged 45-92 from a Polish rural population living at the Mogielica Human Ecology Study Site. General linear models were used to test differences in age at menarche, age at first reproduction, number of children born, mean interbirth interval and age at last reproduction across different ApoE genotypes. No significant differences were observed between ApoE genotypes in any of the tested reproductive history parameters. Although some of the previous research has suggested that carriers of ApoE4 have more successful reproduction, we found no evidence supporting such an association among postreproductive aged women from a traditional, agricultural community. It is possible that ApoE4 may confer reproductive advantages only under specific ecological or lifestyle conditions, such as high pathogen burden or low-energy diet. Show less

While physical inactivity represents a global health concern, the relationship between structured sports participation and overall physical activity patterns remains unclear. This study examined whether football practice enhances adherence to physical activity guidelines and influences lifestyle activity patterns beyond structured practice sessions. Twenty-seven participants [football players (EG) Show less

Ketamine holds promise for the treatment of post-traumatic stress disorder (PTSD), but challenges remain in delivery and sustained effects. This controlled study evaluates a novel intranasal formulation, employing AmyloLipid nanovesicles (ALN) to enhance ketamine's therapeutic efficacy in a predator-scent stress (PSS) rat model of PTSD. A total of 130 rats underwent PSS or sham-PSS exposure, followed by intranasal administration of ketamine-ALN (4.8, 2.4, 1.2 and 0.6 mg/kg), unloaded-ALN, saline, or standard ketamine three times weekly for two weeks, starting seven days post-trauma. Behavioral assessments, including the elevated plus maze, acoustic startle response, and contextual freezing tests, were complemented by immunohistochemical and Golgi-Cox analyses of hippocampal and paraventricular nucleus (PVN) tissues. Low-dose ketamine-ALN (0.6 mg/kg) significantly reduced anxiety-like behaviors, hyperarousal, and the prevalence of PTSD-like responses (extreme behavior responses) by 45% compared to unloaded-ALN controls. Unlike standard ketamine, ALN-mediated delivery bypassed the blood-brain barrier, enhancing bioavailability and sustaining therapeutic benefit. Mechanistically, ketamine-ALN normalized the expression of hyperpolarization-activated cyclic nucleotide-gated (HCN1) channels-which were upregulated in the CA1 stratum lacunosum-moleculare (SLM) post-PSS-thereby stabilizing neuronal excitability. This normalization of HCN1, critical for regulating neuronal excitability and membrane potential, was accompanied by increased levels of brain-derived neurotrophic factor (BDNF) and neuropeptide Y (NPY), enhancing neuroplasticity and dendritic complexity. These findings demonstrate that ALN-based intranasal delivery of ketamine is more effective than standard administration, particularly at low doses. The results suggest that low-dose ketamine-ALN modulates a hippocampal circuit involving HCN1, BDNF, and NPY to foster adaptive stress responses. Collectively, ketamine-ALN represents a promising targeted therapy for PTSD, with HCN1 channels as a key mediator of stress-induced neuronal dysfunction and ketamine's therapeutic action, thus advancing the prospects for precision treatment of stress-related disorders. Show less

Mild behavioral impairment (MBI) constitutes a late-life transition state that is associated with an increased risk of cognitive impairment and dementia. Herein, we cross-sectionally describe the MBI construct and its relationship with cognitive status in Mexican-Mestizos (MM) older adults. Participants were classified according to their cognitive and behavioral statuses using tests administered to older adults and their informants. Show less

Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized primarily by deterioration in memory, cognition, and learning ability. Its etiology is complex and influenced by multiple factors, including genetics and environment. With advancing research into mitochondrial function and mechanisms, impaired mitophagy has been proposed as a significant mechanism contributing to AD. The ApoE ε4 allele, a high-risk genetic factor for AD, may play a key role in disease pathogenesis by inducing mitophagy dysfunction and apoptosis. From the perspective of APOE gene polymorphisms, this study investigates abnormal changes in mitochondrial function and autophagy in humanized APOE4 mice primary astrocytes under oxidative stress, as well as the regulatory effect of curcumin (Cur) on mitophagy and oxidative stress-induced apoptosis, thereby exploring its potential to ameliorate AD through targeting mitophagy. Mitochondrial function analysis revealed that APOE4 expression reduced the antioxidant capacity and respiratory function of primary astrocytes, leading to mitochondrial membrane damage, intracellular reactive oxygen species (ROS) accumulation, and decreased ATP production. Curcumin effectively protected mitochondrial integrity, reduced the number of damaged mitochondria, improved overall mitochondrial function, and helped maintain mitochondrial homeostasis involving in PINK1/Parkin pathway. Regarding autophagy and apoptosis, curcumin was shown to restore autophagic flux, mitigate autophagy disruption caused by oxidative stress, and reverse early-stage apoptosis. Show less

Individuals differ in their sensitivity to external stimuli. The Highly Sensitive Child (HSC) scale can be used to measure sensitivity in children and adolescents. However, the German version has yet to be validated. We examined the psychometric properties of the German self- and the parent report version of the HSC. Measurement invariance (MI) across age groups was tested for the parent report version and latent profile analysis (LPA) was used to identify sensitivity groups. Pooled data from German-speaking countries ( The online version contains supplementary material available at 10.1007/s12144-026-09244-w. Show less

Mind-body exercises (MBEs), including Tai Chi (TC), Qigong (QG), Yoga (YG), and Mindfulness-Based Stress Reduction (MBSR), show promise in neuropsychiatric rehabilitation by modulating neuroinflammation. This study systematically examines the effects of MBEs on neuroinflammation-related biomarkers in neuropsychiatric disorders, aiming to identify optimal modalities, dosages, and key moderators. Databases were systematically searched for eligible RCTs from inception until February 2025. Data were analyzed using R packages (" Twenty-nine RCTs involving 2253 participants were included. MBEs significantly reduced IL-6 [standardized mean difference (SMD) = -0.47] and IL-1β [SMD = -0.90], while increasing BDNF [SMD = 1.08] and IL-10 [SMD = 0.87]. Effects on TNF-α [SMD = -0.33] and CRP [SMD = -0.12] showed a non-significant trend toward benefit. Dosages between 600 and 1000 MET-min/week yielded the most pronounced anti-inflammatory effects. Network meta-analysis ranked TC and MBSR as the most effective for reducing proinflammatory cytokines, while QG showed the greatest benefits for neurotrophic outcomes. Participant characteristics (age, population, clinical conditions) and MBE parameters (duration, frequency, session length) significantly moderated neuroprotective effects. MBEs effectively reduce proinflammatory cytokines (IL-1β, IL-6) and enhance anti-inflammatory cytokine (IL-10) and neurotrophic factor (BDNF) in neuropsychiatric disorders. The optimal dosage ranges from 600 to 1000 MET-min/week. Given the impact of participant characteristics and MBE parameters, personalized prescriptions may enhance clinical outcomes and long-term neuroprotective effects. Show less

Although traditional rehabilitation training can partially improve motor function in patients with post-stroke motor disorders, its impact on neural plasticity remains limited. Transcutaneous auricular vagus nerve stimulation (taVNS), a non-invasive method targeting the auricular branch of the vagus nerve, represents a promising neuromodulatory approach. This prospective study aimed to assess the therapeutic effects of taVNS on functional recovery in this population. A total of 147 patients with post-stroke motor disorders were consecutively enrolled between February 2023 and November 2024. After excluding 8 dropouts, 139 patients were randomly assigned via a random number table to either an electrical stimulation group (taVNS group) or a rehabilitation group (conventional training). The taVNS group initially included 73 patients, with 3 dropouts yielding a final sample of 70. The rehabilitation group initially included 74 patients, with 5 dropouts resulting in 69 participants. All participants underwent comprehensive assessments at baseline and following a 4-week intervention period. Outcome measures encompassed neuroelectrophysiological parameters (motor evoked potential latency and amplitude), clinical functional evaluations (Action Research Arm Test, Fugl-Meyer Assessment for Upper Extremity, Modified Barthel Index), serum biomarker levels (brain-derived neurotrophic factor, S100 calcium-binding protein β), and systematic documentation of adverse events. Based on post-treatment Fugl-Meyer Assessment-Upper Extremity (FMA-UE) scores, patients were further categorized into improvement and non-improvement subgroups for additional comparative analysis. Pearson correlation analysis was utilized to examine potential relationships between functional scores, neurophysiological data, and biomarker concentrations. Baseline characteristics were comparable between groups ( taVNS is an effective and safe adjunctive therapy for post-stroke motor recovery. It enhances neuroelectrophysiological function, improves motor and daily living abilities, and favorably modulates biomarkers of neural injury and repair. The consistent correlations among functional, neurophysiological, and biochemical outcomes highlight an integrated recovery pathway, supporting the integration of taVNS into standard neurorehabilitation protocols. Show less

Traumatic spinal cord injury (SCI) induces neuronal apoptosis and neuroinflammation, which exacerbate secondary damage and hinder functional recovery. Efficient clearance of apoptotic cells and modulation of the inflammatory microenvironment of spinal cord are essential for promoting tissue repair. This study aimed to investigate whether Midkine (MDK), a heparin-binding growth factor, facilitates functional recovery after SCI and explores the underlying mechanisms. A rat model of moderate SCI was established using Allen's impact method. Lentiviral vectors were used to overexpress MDK in the spinal cord. Behavioral assessments, including BBB score and gait analysis, were performed to evaluate motor function recovery. Motor evoked potentials (MEPs) serve as a neurophysiological tool for evaluating the functional integrity of the corticospinal tract. In vivo and in vitro experiments were conducted to assess microglial efferocytosis and elucidate the underlying molecular mechanisms. Transcriptomic bioinformatic analysis suggests that SCI is characterized by pronounced accumulation of apoptotic cells and robust neuroinflammatory responses, whereas single-cell analysis implicates MDK as a key contributor to neurorepair after SCI. MDK expression is dynamically regulated following SCI, with an early upregulation followed by a gradual decline over time, its location predominantly observed around microglial cells. Functionally, MDK overexpression significantly enhances motor recovery after SCI, accompanied by reduced neuroinflammation, decreased neuronal apoptosis, and improved neuroprotection. Mechanistically, MDK promotes microglial efferocytosis both in vivo and in vitro, activates the AKT/mTOR signaling pathway, upregulates BDNF and LRP-1 expression, and facilitates microglial polarization toward an anti-inflammatory M2 phenotype. Notably, inhibition of LRP-1 with receptor-associated protein (RAP) abolished the efferocytic and neuroprotective effects of recombinant MDK, highlighting LRP-1 as a key mediator of MDK's actions in microglia. Our study unveils the MDK/LRP-1/efferocytosis axis as a previously unrecognized therapeutic target for SCI. By orchestrating apoptotic cell clearance, dampening neuroinflammation, and fostering neuroprotection, this axis critically shapes the post-injury microenvironment to facilitate recovery. These findings suggest that MDK-centered therapy may represent a strategy for spinal cord repair, with LRP-1 modulation offering precise control over microglial responses. Show less

Depression, a global mental disorder, is linked to gut-brain axis (GBA) dysfunction. This review explores how traditional Chinese medicine (TCM)-including single herbs (eg, Astragalus membranaceus, Lycium barbarum), herbal formulas (eg, Xiaoyaosan, Xiaochaihu Decoction), and acupuncture-alleviates depression via the GBA, focusing on neuroscience-relevant mechanisms (inflammation, neurotrophy). A systematic literature search was conducted on PubMed, China National Knowledge Infrastructure (CNKI), and Embase from database inception to July 2025. Keywords included ["Traditional Chinese Medicine" or "TCM" or "herb" or "herbal extracts" or "Chinese herbal formulas"], ["depression" or "Depressive like behavior"], ["immune regulation"], ["inflammatory reaction"], ["neuroregeneration" or "nerve" or "neurotransmitter"]. Including peer-reviewed studies on human/animal models, articles that do not meet the requirements are excluded. A total of 307 eligible studies were included. TCM regulates gut microbiota composition-eg, increasing Lactobacillus and Bifidobacterium while reducing pathogenic taxa. Mechanistically, TCM inhibits pro-inflammatory pathways: herbs (eg, Astragalus membranaceus) and formulas (eg, Xiaoyaosan) downregulate IL-6, TNF-α, and IL-1β via suppressing NLRP3 inflammasome and TLR4/NF-κB signaling. They also enhance anti-inflammatory IL-10, elevate neurotransmitters (5-HT, DA), and upregulate BDNF. Acupuncture mirrors these effects, reducing plasma IL-6/TNF-α and restoring microbial balance to improve depressive behaviors. TCM alleviates depression by integrating gut microbiota modulation, inflammatory suppression, and neuroprotection through the GBA. This review highlights TCM's potential as a safe, alternative therapy for depression and identifies directions for standardized, large-scale clinical validation. Show less

While a growing body of literature suggests a role for infections in Alzheimer's disease (AD), microbial contributions to AD remains a contentious topic, in part due to challenges in reconciling the positive evidence with studies reporting null findings. Here, we examine the evidence that argues against a role for infections in AD, while offering mechanistic hypotheses that may account for both the negative and positive findings, including dysregulated host immunity and gene-environment interactions of AD-associated genes. Show less

Pituitary macroadenomas often cause visual pathway impairment due to optic chiasm compression. The association between systemic neurotrophic factors and visual recovery remains insufficiently explored. This prospective observational cohort study included 53 patients (106 eyes); 36 patients (72 eyes) completed a 12-month follow-up. Patients were assigned to a treatment group (surgical and/or pharmacological; Show less

The progressive accumulation of physiological stress as we age, known as allostatic load, is linked to an increased risk of dementia. Fostering brain resilience through physical exercise can counteract allostatic load and improve adaptation to age-related brain alterations. Fibronectin type III domain-containing protein 5 (FNDC5)/irisin is a neuroprotective exercise-linked hormone found in extracellular vesicles (EV-FNDC5/irisin). Here, we sought to analyse EV-FNDC5/irisin in ageing as a promising biomarker of brain resilience. We measured exercise-associated factors, including EV-FNDC5/irisin, brain-derived neurotrophic factor (BDNF), and cathepsin B in the serum of 31 young (18-28 years) and 19 older subjects (65-79 years). Levels of FNDC5/irisin in serum-derived EVs are markedly reduced in older subjects compared to young ( Show less