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Abstract:Objective　To compare the antidepressive effect and cognitive imfluence of modified electroconvulsive therapy（ MECT） and repetitive transcranial magnetic stimulation（ rTMS） on medication- resistant depression patients. Methods　Totals of 40 patients with treatment-refractory and non-psychotic major depression were randomly divided into MECT group and rTMS group. They received two weeks of treatments with either MECT or rTMS and were assessed for efficacy and cognitive impairments before and after 1 and 2 weeks treatment by Hamilton Rating Scale for Depression（ HAMD） and Clinical Memory Scale. Treatment Emergent Symptom Scale（ TESS） was used to evaluate the side-effects. Moreover， medical examination， electrocardiogram and electroencephalogram examination were performed before and after treatment for safety. Results　There was no difference between two groups before and at the end of week 1 and 2 on the total HAMD score（ P=0.610，P=0.235） and cognitive impairment factors（ P=0.639，P=0.793）. However， Clinical Memory Scale score and all factors of rTMS group was improved markedly at the end of week 2（P ＜ 0.05）. Directed memory score， free recall deficit of picture score， image free recall score and portrait character recall score of MECT group was declined at the end of week 2（P＜ 0.05）. And the total score， directed memory score and portrait character recall score of MECT group was lower than that of rTMS group（P＜ 0.05）. There was no significant difference between the two groups on the incidence of nausea， vomiting， headache（ P＞0.05）， and more patients complained of memory decline in the MECT group（ P＜0.05）.Conclusions　rTMS and MECT have similar efficacy in treating treatment-refractory non-psychotic major depression. But rTMS is benefit to the improvement of cognitive performance with more safety than MECT.

Abstract:Objective　To investigate the distribution characteristics and influencing factors of anxious emotion in 18-34 years old males in Chengdu，Sichuan. Methods　By using multi-stage stratified sampling method，4 189 young males aged from 18 to 34 in Chengdu were surveyed. The questionnaire included Hospital Anxiety and Depression Scale (HAD)， the Alcohol Use Disorders Identification Test (AUDIT)，the Drug Use Disorders Identification Test (DUDIT) and self-made general information and questions registration form. Results　The detection rate of anxious emotion was 20.4% among young males in Sichuan， Chengdu. The anxious emotion was related to marriage status， alcohol abuse， drug abuse， long-term physical diseases， whether seen a psychologist， depressive emotion， suicidal attempt， self-injurious behavior， violent behavior in 5 years， score of Adverse Childhood Experience (ACE)， traumatic life events and frequency of eroticism use (P＜ 0.01). Its risk factors included depressive emotion， suicidal attempt， self-injurious behavior， traumatic life events， alcohol abuse and drug abuse（ P＜0.05）. Conclusions　The detection rate of anxious emotion was 20.4% among young males in Sichuan， Chengdu.The influencing factors of anxious emotion were manifold.

Abstract:Objective　To compare the differences of neuropsychological profile between patients with dementia with lewy bodies（ DLB） and Parkinson disease dementia（ PDD）. Methods　A total of 20 DLB patients and 56 PDD patients were recruited in this study. Mini-mental State Examination（ MMSE）， Clock-drawing Test（ CDT）， Neuropsychiatric Inventory（ NPI）， Activities of Daily Living Scale（ ADL）， Hamilton Depression Scale（ HAMD） and Clinical Dementia Rate（ CDR） were used to evaluate the cognitive function. Results　A total of 60% of DLB patients had fluctuant symptoms， significantly higher than PDD patients（ 19.6%， P=0.001）. In the moderate and severe stage of dementia， the NPI scores of DLB group were significantly higher than that of PDD group（ P＜0.05）. In the mild dementia stage， the scores of the family life and personal hobby domain in CDR were higher in PDD patients than that in DLB patients（ P=0.039）. In the moderate and severe stage， the memory score（ P=0.018）， orientation score（ P=0.010） and overall CDR score（ P=0.028） in DLB group were higher than that in PDD group. Conclusions　Comprehensive neuropsychological tests combined with clinical history can help identify DLB and PDD in dementia patients.

Abstract:Objective　To investigate the status of medicine compliance in secondary prevention of ischemic stroke， in order to provide evidence for the secondary prevention. Methods　Data of 242 continuous ischemic stroke patients in Urumqi were prospectively collected. Information of medicine and reasons of ceasing durgs was registered in 12 months. Results　The rate of taking antithrombotic drugs one year after discharged was 55.8%（135/242）. The nationality（ OR=4.007， 95%CI=1.768-9.080）， degree of education（ OR= 2.953， 95%CI=1.493-5.840）， pattern of payment（ OR=0.189， 95%CI=0.060-0.594）， dyslipidemia（ OR=0.424， 95%CI=0.217-0.831） were associated with treatment compliance one year after discharged. The rate of taking stains one year after discharged was 59.9%（145/242）. The degree of education（ OR=3.613， 95%CI=1.844- 7.082）， pattern of payment（ OR=0.254， 95%CI=0.091-0.711）， dyslipidemia（ OR=0.340， 95%CI=0.179-0.648） were associated with compliance of medicine one year after discharged. The rates of taking hypotensor and hypoglycemic agent one year after discharged were 71.9%（138/192） and 64.8%（59/91）. The main reasons of poor compliance of antithrombotic drugs and stains were symptoms improved and ignoring the treatment. The main reasons of poor compliance of hypotensor and hypoglycemic agent were indicators improved and ignoring the treatment. Conclusions　The treatment compliance in secondary prevention of ischemic stroke patients is generally poor. The clinicians should focus on the secondary prevention guidance.

Abstract:Objective　To discuss the risk factors of cerebral microbleeds（ CMBs） in ischemic stroke patients for secondary prevention in order to provide guidance for the prevention and treatment of cerebrovascular disease. Methods　Patients with acute ischemic stroke were enrolled in the study. They received susceptibility weighted imaging（ SWI） within 4d after initiation of antiplatelet treatment. After 12-month follow-up， the patients received SWI again. The presence and number of CMBs at baseline and during follow-up were documented. Results　Totals of 94 patients with acute ischemic stroke were enrolled and 50 patients（ 53.2%） companied CMBs. Bivariate Logistic regression analysis showed that hypertension（ OR=1.2，95%CI=1.07-1.61， P=0.004） and age（ OR=2.2，95%CI=1.25-3.92，P=0.006） were independent risk factors of CMBs. With increasing of age for 10 years， the incidence of CMBs would increase 2.2 times. ROC curve showed that the area under the age curve was 0.695（95%CI=0.588-0.802） and the best cutoff of predictive age was 62 years old. The risk of CMBs increased significantly in patients who was older than 62. There were 22 cases received SWI again after follow- up， and 33 new CMBs lesions were identified. Wilcoxon nonparametric matched-pairs test revealed significant difference between numbers of CMBs before and after follow-up（1 vs 2.5，Z=-3.1，P=0.002）. Conclusions　Patients older than 62， with history of hypertension and antiplatelet agents should be monitored regularly about number and position of CMBs， which could guide secondary prevention and treatment programs.

Abstract:Objective　To study the sleep quality and neurological function of patients with ischemic cerebrovascular disease（ ICVD） combined with restless legs syndrome（ RLS）. Methods　The clinical data of patients with the first-found ICVD were collected and the RLS was diagnosed according to four basic diagnostic criteria set by the international RLS study group. Patients of ICVD combined with RLS were taken as case group and the ones without RLS were taken as control group. The sleep quality and neurologic function between patients in two groups were compared. Results　Totals of 370 patients with acute ICVD were enrolled in this study. 45（12.12%） patients combined with RLS. The scores of Pittsburgh Sleep Quality Index（ PSQI）， sleep quality， sleep efficiency， sleep disorder and use of hypnotic agents， and BMI and proportion of minorities were significantly higher in case group than in contro（l P＜ 0.05）. No significant differences were found in scores of the USA National Institutes of Health Stroke Scale（NIHSS）， Modified Rankin Scale（ mRS） and Barthel Index（ BI） between two groups. Logistic regression analysis showed that sleep disorder and ethnics were risk factors of ICVD combined with RLS. Conclusions　The prevalence of RLS is high in patients with ICVD. The patients with ICVD combined with RLS have poor sleep quality. Sleep disorder and ethnics are risk factors of ICVD combined with RLS.

Abstract:Objective　To investigate the spatial characteristics in schizophrenia patients and their first degree relatives by Near Infrared Spectroscopy（NIRS）. Methods　Subjects who met the inclusion criteria were divided into three groups： the schizophrenia patients（ group A， n=20）， first degree relatives（ group B， n=20） and heathy persons（ group C， n=20）. NIRS combined with Verbal Fluency Test were tested. The changes of oxyhemoglobin（ Oxy-Hb）， deoxy hemoglobin（ Deoxy-Hb） and total hemoglobin（ Total Hb） in three groups were analysed. Results　Significant differences were found in Oxy-Hb（ channel 6， 7， 11， 14， 15）， Deoxy-Hb （channel 11， 18， 20） and Total Hb（ channel 6， 7， 11， 13， 14， 15） in three groups. Oxy-Hb and Total Hb （channel 6， 7， 11， 14， 15） were negative in group C， while were positive in group A. Relative average values of Oxy-Hb and Total Hb（ channel 6， 7） in group C were lower than that in group A and B. Relative average values of Deoxy-Hb（ channel 18， 20） in group A and B were lower than that in group C. Relative average values of Oxy- Hb and Total Hb（ channel 14， 15） and Deoxy-Hb（ channel 11） in group A were higher than that in group B and C. Conclusions　The prefrontal cortex function of schizophrenia patients and their first degree relatives is abnormal. The abnormal activation of dorsal area in the right and slow blood flow of ventral area in left prefrontal lobe may be state markers. The enhanced activation in left ventral prefrontal cortex and blood flow deficiency in right ventrolateral prefrontal cortex can be regarded as candidate biological markers of schizophrenia.

Abstract:Objective　To evaluate the effects of operant-conditioning myofeedback therapy combined with conventional rehabilitation on serum brain-derived neurotrophic factor (BDNF) levels and motor function in patients with cerebral infarction. Methods　A total of 73 patients with primary cerebral infarction were enrolled and were randomly divided into experimental group (EG) (n=38) and control group (CG) (n=35). The subjects in EG group underwent an eight-week myofeedback training. Subjects in both groups followed the same treatment schedule for physical therapy and routine medication. Before the beginning of the experimental protocol and 8 weeks later， serum BDNF levels were measured， neurological function was assessed with the National Institutes of Health Stroke Scale (NIHSS)， motor function was assessed with simplified Fugl-Meyer Motor Assessment (FMA). Results　After 8 weeks， the NIHSS scores were reduced， the serum BDNF levels were elevated and the FMA were improved in the both groups (P＜0.01). While the changes were more significant in the EG group when compared to the CG group(P＜0.05). In addition， in EG group， the variations in NIHSS and FMA were both positively correlated with the changes of serum BDNF levels (r=0.405，0.672；P＜0.05). Conclusions　Operant-conditioning myofeedback therapy combined with conventional rehabilitation therapy may up-regulate the serum BDNF levels， which is beneficial to the recovery of neurological function and improve motor function of patients with cerebral infarction.

Abstract:Objective　To investigate the prevalence and risk factors of depression in elderly patients with type 2 diabetes mellitus（T2DM） . Methods　Totals of 550 elderly T2DM patients in Meilong Community Health Service Center of Shanghai City Hospital from January 2015 to December 2016 were investigated by Patient Health Questionnaire（PHQ-9）. According to PHQ-9 scores， patients were divided into comorbid depression group and non-depression group. Demographic data were compared between two groups. Multivariate Logistic regression analysis was used to explore the risk factors of diabetes combined with depression. Results　The incidence of depression in elderly patients with T2DM was 45.27%. The duration of diabetes mellitus， number of somatic diseases， fasting blood glucose and HbA1C were independent risk factors of comorbid depression in community elderly patients with T2DM（ P＜0.05）. Conclusions　The incidence of depression is high in elderly diabetes patients. In addition to the positive control of blood glucose and HbA1C， possible symptoms of depression should be actively concerned in the guidance and treatment of community elderly diabetes mellitus patients in order to early prevention， early detection and timely treatment.

Abstract:Objective　To explore the related factors that associated with the Bone Mineral Density（ BMD） among the inpatients with schizophrenia， in order to provide better invention for osteopenia and osteoporosis. Methods　Totals of 444 psychiatric inpatients with schizophrenia were selected from wards of the Tianjin Mental Health Center since January 2015 to July 2015. All participants were assessed by self-made questionnaire which included the socioeconomic status， past medical history， medications， dietary status and activity status， in addition of the clinical parameters， such as bone mineral densit（y BMD）， serum prolactin（ PRL） and blood calcium. All participants were divided into 3 groups according to the BMD， and the decision tree model was created to identify the influencing factors of the reduction of BMD. Results　There were 300（67.57%） inpatients with decreasing BMD and 156（35.14%） with osteoporosis“. fracture history” was the first parent node of the model（ χ2=46.347，P＜0.01）.“ drinking coffee and strong tea”（ χ2=55.424，P＜0.01） and“ daily indoor activity” （χ2=31.191，P＜0.01） became the parent nodes on the second layer. On the 3rd layer， the nodes were“ eating bean products”（ χ2=35.801，P＜0.01） and“ serum calcium concentration”（ χ2=25.281，P＜0.01）. Conclusions　The reduction of BMD among inpatients with schizophrenia is serious. The fracture history is quite significant for prevention of osteoporosis. For inpatients with fracture history， the moderate indoor activities are the protective measures. While for the inpatients without it， interventions on dietary are more meaningful in addition to surveillance of serum calcium.

Abstract:Objective　To explore the relationship between first visit time， compliance and different attribution in first-episode schizophrenic patients. Methods　Totals of 100 patients with schizophrenia from March 2013 to March 2015 in Huazhong University of Science and Technology Affiliated Tongji Medical School Mental Health Center were included in this study. All patients were divided into three groups according to the attribution of disease：A group（ individual factor， 27 cases）， B group（ socio-psychological factor， 65 cases） and C group（ supernatural factor， 8 cases）. After one-year follow-up after discharge from hospital， course of disease， recurrence， treatment compliance and effects of rehabilitation were compared. Results　The course of disease in A group was significantly shorter than that in B and C group（ P＜0.05）. The recurrence rate in A and B group was significantly lower than that in C group（ P＜ 0.05）. The drug and return visit compliance in A group was significantly higher than that in B and C group（ P＜0.05）. And drug and return visit compliance in B group was significantly higher than that in C group（ P＜0.05）. No significant differences were found on Insight and Treatment Attitudes Questionnaires（ ITAQ） scores and Social Disability Screening Schedule（ SDSS） scores in three groups before hospitalization（ P＞0.05）. After one year， scores of ITAQ and SDSS in A group were significantly better than that in B and C group， while B group was better than C group（ P＜0.05）. Conclusions　Active individualized propaganda and education on the family dependents of patients with first-episode schizophrenia can improve their cognition of disease and negative attitude， promote them to support the maintenance treatment and improve rehabilitation.

Abstract:现代法制中监护制度在保护精神疾病患者基本权利中起到了重要的作用，但在我国从立法 到实施仍面临一些不足。现通过简要介绍国内外监护制度的现状及我国近年在立法上的完善，探讨目前 我国精神障碍患者监护中存在的问题，并对未来的立法和法律规范的落实提出操作建议。

Abstract:帕金森病（PD）是一种常见的神经退行性疾病，大约90%的PD患者会伴随不同程度的非运 动症状（NMS），通常在运动症状发生前数年就表现出来，这些NMS对PD患者的生活质量造成严重的影响， 并且由于表现隐匿，不易被早期发现。鱼藤酮诱导的PD动物模型复制了PD的主要病理变化——黑质纹 状体的多巴胺能神经元变性、坏死以及残存的神经元内出现路易小体。近年来，这一模型所引起的NMS 也日益引起科学家的关注。现就当前鱼藤酮诱导拟PD鼠科动物模型的NMS表现、病理及应用进行综述。

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Abstract:鞍区位于中颅底中心部位，其解剖结构复杂、功能重要，是垂体瘤、颅咽管瘤、脑膜瘤等肿 瘤的好发部位。对于手术治疗此区病变，经鼻蝶入路利用鼻腔、蝶窦等自然腔隙，能缩短手术入路，较常 规开颅创伤小，现对内镜下扩大经鼻蝶窦鞍区手术所涉及的解剖结构进行综述。

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Abstract:术后认知功能障碍（POCD）是老年人常见的一种严重的神经系统术后并发症，目前发病机 制尚不明确，通常是由多种易感因素和促发因素共同作用的结果，预防的关键是针对高风险因素进行 积极有效的干预，而治疗则是依据可能的发病机制以及借鉴AD的治疗手段。本文对近期国内外关于 POCD的防治研究进展归纳总结，并分别对药物、非药物以及传统医药在POCD中的应用进行综述。