Abstract:Objective To explore the effects of fluoxetine on dual stress induced depressive-like and anxiety-like behaviors in Disrupted in Schizophrenia 1（ DISC1） transgenic mice. Methods Sixteen C57BL/6 wild-type mice were randomly assigned into two groups with 8 in each group， the WT-stress group and the WTcontrol group. Sixteen C57BL/6 LBD-DISC1 transgenic mice were also randomly assigned into two groups with 8 in each， the DISC1-stress group and the DISC1-control group. The WT-stress group and the DISC1-stress group received maternal separation and chronic unpredictable mild stress. All mice were treated with fluoxetine for four weeks. The sucrose consumption， the forced swim test and the open field test were used to evaluate the depressive-like and anxiety-like behaviors. Results There was no significant difference in the immobility time in the forced swim test and the migration distance in the centre area in the open field test among each group of mice after the fluoxetine treatment. The preference for sucrose solution in DISC1-stress group and body weight were still low（ P＜ 0.01）. Conclusions Fluoxetine can improve the stress induced anxiety and depression in DISC1 mice. However， it cannot alleviate anhedonia and the loss of body weight.

Abstract:Objective To systematically review the current status of life quality in patients with tic disorder（ TD） in China， so as to provide evidence for improving life quality of TD. Methods We searched Pubmed， Embase， Cochrane library， China Biology Medicine disc（ CBMdisc）， CNKI， VIP and Wanfang databases from inception to June 2017. Studies which assessed the life quality of TD were included， and then descriptive analysis were used to summarized the results. Results A total of 9 studies published from 2002 to 2016， involving 1 273 patients aged from 8 to 16 years old， were included. Seven studies found that the TD patients’ life quality was lower than the healthy control group by using different inventory of subjective life quality（ ISLQ） scales. However only 3 studies analyzed the influencing factors of the life quality of TD. Conclusions TD’ life quality in China is low， compared with the control group. However， the sample sizes are small， different evaluation scales are adopted， and there is lack of analysis of related influencing factors. It is recommended to carry out large sample and multicenter research for further exploration of the quality of life of TD patients and its influencing factors.

Abstract:Objective To investigate the correlation of vertebral artery dominance（VAD） and basilar artery（ BA） curvature with posterior circulation infarction（ PCI）， and to analyze the relationship between VAD of patients with different infarction of the posterior circulation and BA curvature. Methods According to magnetic resonance angiography（ MRA） and the diagnostic criteria of VAD， a total of 156 patients with PCI， dizziness and headache were selected and divided into VAD group（ n=86） and non-VAD group（ n=70）. The incidence of separate territory infarction in posterior circulation and the incidence of BA curvature were compared between the two groups. The relationship between the laterality of posterior infarction and the laterality of VAD of the infarction area in the VAD group was analyzed．It also discussed the correlation of BA curvature with laterality of VAD and PCI. Results A total of 85.1%（ 40/47） patients had an opposite directional relationship between dominant VA and BA curvature， and the direction of BA curvature and VAD was negatively correlated（ r=-0.704， P＜0.01）. The total incidence of PCI in VAD group was significantly higher than that in non-VAD group［ 51.2% （44/86） vs. 22.9%（ 16/70），χ2=13.063，P＜0.01］. The incidences of infarctions in posterior inferior cerebellar artery（ PICA） territory and BA territory were both statistically higher than that in controls， however， there was no difference in superior cerebellar artery（ SCA） and posterior cerebral artery（ PCA） territory infarction between the two groups. The incidence of PCI in BA curvature patients was significantly higher than that in BA straight patients with statistical difference， and the difference of infarction incidence in residual territories was not significant. Conclusions The incidence of BA curvature is higher in VAD patients， and BA usually bends to the opposite side of dominant VA. The incidence of PCI is higher in VAD patients， especially in PICA infarction and BA infarction patients. Most PICA infarctions occurred on the opposite side of dominant VA and the laterality of BA curvature， while the BA pontine branch territory infarction were on the side of dominant VA， which is the opposite side of BA curvature.

Abstract:Objective To investigate the dynamic changes of endoplasmic reticulum stress-related factors， the expression of glucose regulated protein 78（ GRP78） and CCAAT/ enhancer binding protein homologue protein（ CHOP） in rats after cardiac arrest and resuscitation， their relationship with neuronal apoptosis， so as to explore the mechanism of endoplasmic reticulum stress and cerebral ischemia-reperfusion injury. Methods A total of 48 male SD rats were randomly divided into two groups： the group of without cardiopulmonary resuscitation（ CPR）（ control group）（ n=24） and the group of normothermia after CPR（ CPR group）（ n=24）. The CPR model in rats were prepared by esophagus pacing induced ventricular fibrillation. At the time of 6 h， 12 h， 24 h， and 48 h after restoration of spontaneous circulation， the morphology of the surviving neurons in the hippocampal CA1 region of rats was observed by Nissl staining. TUNEL staining was used to observe the apoptosis of hippocampal CA1 neurons in rats and to count the number of positive apoptotic cells. The expression of antigen of GRP78 and CHOP was detected by immunohistochemical method. The expression of GRP78 and CHOP was detected by Western Blot method. Results Compared with control group， the neuronal cell degeneration in the hippocampal CA1 area was more severe in the resuscitation group. Apoptotic cells increased significantly with the increase of reperfusion time. Compared with control group， GRP78 positive cells in the resuscitation group increased gradually at reperfusion 6 h， and increased significantly in 12 h， and then the expression decreased gradually. In the CPR group， CHOP positive cells began to be expressed at the beginning of the reperfusion 6 h， and gradually increased， and increased significantly at 24 h until 48 h. Conclusions Endoplasmic reticulum stress is induced after CA/CPR. It can protect itself at the early stage by upregulated the expression of GRP78 protein， and apoptosis is induced by upregulated apoptosis factor CHOP at the late stage

Abstract:the treatment of schizophrenia and its correlation analysis. Methods A randomized doubleblind controlled study was applied. A total of 67 patients meeting the criteria of ICD-10 for schizophrenia were randomly divided into the Daying tablet group（ n=30） and the placebo group（ n=37）. The participants were treated with Daying tablet add-on risperidone and Daying combined placebo tablet respectively for 12 weeks. The level of dopamine（DA）， 5-hydroxytryptamine（ 5-HT） and 5-hydroxyindoleacetic acid（ 5-HIAA） were measured before and after treatment， at the same time the Positive and Negative Syndrome Scale（ PANSS） was applied to evaluate curative effect. Results After treatment， plasma levels of DA and 5HIAA decreased， and 5-HT increased in the Daying tablet group， while all the measured neurotransmitters of the placebo group decreased. There was no significant difference between the two groups after the treatment（ P＞0.05）. In addition， there was no significant correlation between changes of measured neurotransmitter concentration and the curative effect. Conclusions The changes of plasma neurotransmitters（ including DA， 5-HT and 5-HIAA） have no significant difference between the Daying combined with risperidone group and the placebo group in schizophrenia patients，and there is no significant correlation with efficacy.

Abstract:Objective To analyze the effects of memantine hydrochloride on the Alzheimer disease （AD） patients， the serum S100B protein and the anti-brain anti-body（ABAb） levels， and to discuss the possible effect of S100B and ABAb on the progression of AD. Methods In this study， 32 AD patients（ AD group） and 40 volunteers without cognitive impairment（ control group） were enrolled. AD patients received treatment of memantine hydrochloride（ dose： 10-20mg/d） for 6 months， and were interviewed at the baseline，the 3rd and the 6th month from the beginning of the treatment. The cognitive function and living ability were assessed with Mini- Mental State Examination（ MMSE） and Activity of Daily Living scale（ ADL）. The cognitive function of patients was further evaluated with Alzheimer Disease Assessment Scale Cognitive Sub-scale（ ADAS-Cog）. The serum S100B and ABAb levels were examined by enzyme linked immunosorbent assay（ ELISA）. Results The S100B and ABAb levels of AD patients were markedly increased compared with the control group（ P＜0.01）. Analysis of variance of repeated measures indicated that there were significant differences in the serum S100B［ （0.66±0.17）， （0.58±0.18），（ 0.50±0.14）μg/L；F=35.22，P＜0.01］ and ABAb levels［ （1.93±0.95），（ 1.65±0.81），（ 1.30± 0.70）U/L；F=42.93，P＜ 0.01］among the baseline and the visit points of 3rd and 6th month after the beginning of the treatment， however， there was no significant difference in the scores of the MMSE， ADL and ADAS-Cog. Conclusions Memantine hydrochloride might effect on the progression of patients with moderate and severe AD by decreasing the S100B protein and ABAb levels.

Abstract:Objective To investigate the prevalence and distribution of mental disorders among people aged 18 and over in Wuxi， so as to provide scientific evidence for mental health planning in Wuxi. Methods Multistage stratified cluster random sampling method was used to investigate the population of 18 years old and over in Wuxi. The investigation objects were divided into high risk， medium risk and low risk of mental illness groups by the general health questionnaire survey. The Structured Clinical Interview For Diagnostic and Statistical Manual of Mental Disorders-Ⅳ（ DSM-Ⅳ） Axis I Disorders（ SCID-Ⅰ）， DSM-Ⅳ and the mental retardation/dementia scale were used as diagnostic tools to carry out structured clinical interviews in 100% patients from the high risk group， 40% from the medium risk group and 10% from the low risk group， in order to give diagnosis to various of mental disorders. Results A total of 6 263 people completed the screening and 1 128 completed the diagnosis. The current prevalence rate of mental illness was 12.26%. In addition to organic mental disorders， the highest prevalence was anxiety disorders（ 3.45%）， followed by mood disorders（ 1.89%） and substance use disorders（ 1.33%）. Conclusions The prevalence of mental illness in Wuxi has increased significantly. It has become a common disease and a major public health problem urgently needed to be solved.

Abstract:Objective To explore the effects of high-flux hemodialysis（ HFHD） and convention hemodialysis（ CHD） on depression level and concentration of interleukin-6（ IL-6）， homocysteine（ Hcy）， malondialdehyde（ MDA）， superoxide dismutase（ SOD） in the serum of maintenance hemodialysis（ MHD） patients. Methods A total of 72 MHD patients were divided into HFHD group and CHD group randomly， with 36 patients in each. Before treatment and 6 months after， all the participants were estimated for depression score and concentration of IL-6， Hcy， MDA， SOD in serum when dry weight was reached after dialysis. Results Before treatment， there was no intergroup statistical difference in depression score， concentration of IL-6， Hcy， MDA， SOD in serum（ P ＞ 0.05） between the two groups. After 6-month treatment， the depression score and the serum concentration of IL-6， Hcy， MDA in HFHD group decreased significantly（ P＜0.05）， and the SOD concentration increased（ P＜0.05）. There was no noticeable change of all the indicators of CHD group compared with those before treatment（ P＞0.05）. The depression score and the level of serum IL-6， Hcy， MDA in group HFHD decreased compared with CHD group， and the SOD concentration increased as well（ P＜0.05）. Analysis showed that there was a positive correlation between depression score and IL-6， Hcy， MDA level（r=0.367， 0.463，0.769， respectively）. The correlation between depression score and SOD level was negative（r=-0.571）. Conclusions HFHD can alleviate depression states by eliminating IL-6，Hcy，MDA more efficiently and increasing SOD level than CHD in MHD patients

Abstract:Objective To explore the influencing factors of the disability grade assessment of traumatic brain injury in road traffic accidents. Methods A self-made questionnaire was used to collect related information of patients with traumatic brain injury caused by road traffic accidents， who underwent disability assessment in West China Center of Forensic Medicine Services from January to December 2014. A total of 182 cases（ 70.27%） of all research objects who had completed the Wechsler Adult Intelligence Scale（ WAIS） were allocated to IQ value group， and 77 cases（ 29.73%） who had not completed WAIS were allocated to non-IQ value group. Social demographic characteristics， traumatic brain injury related characteristics and the level of disability were analyzed. According to the result of disability grade assessment， research objects were divided into 4 groups to analyze the difference of injury characteristics. Results A total of 259 cases of traumatic brain injury patients underwent judicial identification. There was no statistical difference in demographic data between the two groups（ including gender， age， place of residence， occupation and education background）（ P＞ 0.05）. However the differences in hospitalization time， Glasgow Coma Scale（ GCS） score， coma time and electroencephalogram（ EEG） characteristics of the patients of different disability grades were statistically significant（ P＜0.05）. Spearman correlation analysis showed that there was a correlation between GCS score， coma time， EEG characteristics， hospitalization time and disability level（ P＜0.05）. Conclusions The assessment of disability grade is correlated with hospitalization time， GCS score， coma time， and the abnormal degree of EEG.

Abstract:Objective In this study， the reliability and validity of Geriatric Depression Scale（ GDS） and Hamilton Depression Scale（ HAMD） in elderly diabetes are compared， aiming to explore a suitable scale for depression evaluation in elderly diabetes. Methods A total of 88 elderly patients with diabetes were selected and assisted to complete GDS-15 and HAMD-17. The evaluation results were analyzed in reliability， validity and the consistency of the evaluation result. Logistic multiple factor regression analysis was used to study the risk factors influencing the results of the two scales. Results The coefficient of Cronbach’s α of GDS-15（0.715） was higher than that of HAMD-17（0.674）. Logistic multiple factor regression analysis showed that the influencing factors of GDS-15 are the numbers of complications， medication adherence scores and HbA1c， while the influencing factors of HAMD-17 were medication adherence scores and sleep quality scores. Conclusions Both GDS-15 and HAMD-17 are effective tools in depression evaluation in elderly patients with diabetes. However， the items of GDS-15 are more concise and objective， and the internal consistency and validity are higher. GDS- 15 is more suitable for the depression evaluation in elderly patients with diabetes in clinical practice.

Abstract:Objective To explore the relationship between sleep misperception and sleep structure in epileptic patients. Methods A total of 102 epileptic patients were recruited in the research. The difference of sleep structure were compared among the group of overestimation， relative accurate estimation and underestimation. Results Sleep misperception occurred in 78% of patients with epilepsy， further， 35% of which were from the underestimation group and 43% from the overestimation group. The rate of generalized tonic-clonic seizures（ GTCS） incidence in the group of under estimation was significantly higher than that in the relative accurate estimation group. Arousal index（ ARI） of sleep stages of Non-rapid eye movement 1（ N1） and N2 tended to increase in turn of overestimation， relative accurate estimation and underestimation group. The ARI of N3 in over estimation group was higher than that in the relative accurate estimation group. Conclusions Sleep misperception occurs in most of epilepsy patients， and patients with GTCS tend to underestimate the sleep duration. Sleep misperception is related to sleep instability enhancement. In addition， sleep underestimation is related to the instability enhancement of N1 and N2 stages of sleep， and sleep over estimation is related to instability enhancement of N3 stages of sleep.

Abstract:Objective To investigate the relationship between intracranial pressure (ICP) monitoring of different parts in patients with craniocerebral injury and therapeutic effect. Methods A total of 82 patients with severe craniocerebral injury were divided into non-monitoring group and monitoring group according to the monitoring of ICP. The monitoring group was divided into intraventricular monitoring group and brain parenchymal monitoring group. The treatment effect of different groups was observed. Results The ICP was significantly lower in the intraventricular monitoring group (10.35±3.32）mmHg than that in the parenchymal group（ 13.46±4.71）mmHg（ t=4.017，P=0.028）. The time and dose of mannitol in the intraventricular monitoring group were significantly lower than those in the parenchymal monitoring group［ （6.05±2.03）d vs （8.46±2.41）d；（ 748.92±126.65）g vs（ 961.72±128.82）g， t=3.011，5.254；P＜ 0.05］. The GCS score of the intraventricular monitoring group on the 7th and the 14th day after surgery was（ 9.11±2.73），（ 12.06±2.37）， which was significantly higher than that of the parenchymal group［ （8.82±2.67），（ 10.09±2.23），t=3.403， 4.562；P ＜ 0.05］. After 6 months follow-up， the total effective rate of the monitoring group was significantly lower than that of the non-monitoring group（ 75.86%，68.97% vs 41.67%；χ2=5.432，6.401；P ＜ 0.05）. The incidence of hydrocephalus in the intraventricular monitoring group was significantly lower than that in the parenchymal group and non-monitoring group（ 10.34% vs 3.45%， 4.17%；χ2=3.709，4.421；P ＜ 0.05）. Conclusions Intracerebral ICP monitoring can significantly reduce the use of mannitol in patients with severe craniocerebral injury， reduce the intracranial hypertension， and the prognosis is good with less complications， which is worthy of clinical application. In addition， brain parenchymal monitoring is second to intraventricular monitoring.

Abstract:Objective To investigate effective prevention and treatment of ischemic brain injury（ IBI） after ruptured aneurysm clipping. Methods By retrospectively analyzing 389 cases of ruptured aneurysm clipping patients’ clinical and image data， who were admitted to our ward from 2014 to 2017， it explored the specific causes and prevention methods of postoperative cerebral ischemic injury. Results There were 27 patients suffered IBI among 389 cases of ruptured aneurysm clipping， with the incidence rate 6.9%， and there were 12 cases of early IBI and 15 cases of late IBI. The main reasons for IBI were the damage of perforating branches， cerebral vasospasm， temporary vascular occlusion， watershed infarction and cerebral thrombosis. Early IBI was mainly caused by the damage of perforating branches， while late IBI was mainly caused by the cerebral vasospasm. Conclusions Combination with application of Doppler ultrasonography，neuroendoscopy， neurophysiological monitoring（ NEPM） can effectively decrease the damage of perforating branches， the ischemic brain damage caused by parent artery stenosis and temporary vascular occlusion. It is also suggested in the research that reducing excessive handling on vessels， removing the hematoma and subarachnoid hemorrhage and discharge the hemorrhagic cerebrospinal fluid by lumbar subarachnoid catheter can effectively prevent cerebral vasospasm. 3H treatment can significantly reduce ischemic brain damage brought by cerebral vasospasm.

Abstract:Objective To analyze the difference of curative effect between oxcarbazepine and lithium carbonate in treating manic episode. Methods The differences of effective rate and symptom improvement were assessed by retrieving database， and a total of 10 items of research data about manic treatment with oxcarbazepine and lithium carbonate were analyzed. Results Through heterogeneity test（ χ2=1.89， df=9， P=0.98， I2=0%），by using the fixed effect model（ WMD=1.02， 95%CI=0.72-1.45，Z=0.10， P=0.92）， it suggested that there was no significant difference in the effective rate of oxcarbazepine and lithium carbonate in the treatment of mania. Through heterogeneity test（ χ2=177.15， df=32， P ＜ 0.01，I2=81.9%）， by using random effect model（ WMD= -0.03， 95%CI=-0.25-0.19，Z=0.26，P=0.79）， it suggested that there was no significant difference in symptom score of treating mania with oxcarbazepine and lithium carbonate. Conclusions The effect of oxcarbazepine and lithium carbonate may be similar in the treatment of mania.

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Abstract:颅脑创伤（TBI）是世界范围内年轻人和成年人致残、致死的最重要的原因之一。TBI死亡率 高，而幸存者常伴有身体的残疾、精神障碍等后遗症，为社会发展带来了沉重的负担。星形胶质细胞是 TBI后参与损伤和修复的主要细胞。近年来关于TBI继发性损害机制中反应性星形胶质细胞的研究逐渐 增多，但仍有许多机制有待阐明，现对TBI后反应性星形胶质细胞参与的几种相关机制进行阐述。

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