Abstract:Objective　To investigate the antidepressive effects of repetitive Transcranial Magnetic Stimulation（rTMS）combined with Sertraline （Ser）in rat model of Chronic Unpredictable Stress （CUS）rats as well as the influence on levels of 5-HIAA and 5-HT in cortex. Methods　Totals of 40 adult male Sprague Dawley rats were randomly divided into five groups：Sham group，CUS group，CUS+rTMS group，CUS+S-er group and CUS+rTMS+Ser group. Rats in Sham group were treated with fake rTMS for consecutive 7 d after28 d normal breeding. Rats in CUS group and CUS+Ser group were treated with fake rTMS for consecutive 7 d after successful modeling. And rats in CUS+rTMS group and CUS+rTMS+Ser group were treated with rTMS with the same frequency and intensity of rTMS stimulation for consecutive 7 d after successful modeling. In addition，rats in CUS+Ser group and CUS+rTMS+Ser group received Ser ［10 mg/（kg·d）］intraperitoneally injection for7 d and other groups were injected intraperitoneally with the same dose of saline. Then the sugar preference test and open field test were performed to examine the behaviors. Meanwhile，at the end of the behavioral test，rats were sacrificed and the levels of 5-HIAA and 5-HT in cortex were measured by Enzyme Linked Immunosorbent Assay（ELISA）. Results　（1）The sucrose preference percentage of the CUS group was significantly less than that of other groups （P＜0.05）. But there were no significant differences between CUS+rTMS group，CUS+Ser group and CUS+rTMS+Ser group （P＞0.05）.（2）The fraction of central distance and the time exploring in center of the CUS group was significantly reduced than that of other groups （P＜0.05）. And there was no significant difference between CUS+rTMS group and CUS+Ser group （P＞0.05）.（3）Compared with CUS group，the cortical levels of 5-HIAA in CUS+rTMS and CUS+rTMS+Ser group were significantly reduced （P＜0.01）. And there was signif-icant difference between CUS+Ser group and CUS+rTMS+Ser group （P＜ 0.05）. Meanwhile，the levels of 5-HT in CUS group was significantly reduced than that of other groups（P＜ 0.05）. Conclusions　rTMS combined with Sertraline could ameliorate the depression-like behavior of CUS rats and this effect may be related with the up-regulation of 5-HT and down-regulating of 5-HIAA in cortex.

Abstract:Objective　To study the relationship between expression of miR-182 in prefrontal cor-tex and alcohol dependence in rats and explore the possible mechanism. Methods　Totals of 60 rats were randomly divided into 3 groups：continuous alcohol group （n=20），withdrawal group （n=20）and control group（n=20）. Lavage was used to build alcohol dependence model. Real-time quantitative PCR was used to detect the expression of miR-182 and BDNF mRNA in prefrontal cortex of alcohol dependent rats. Pearson analysis wascarried out to analyse the correlation between expression of miR-182 and BDNF mRNA. Results　The expres-sion of miR-182 was significantly different among three groups（F=44.79，P＜0.01）. Significant differences were found between each two groups （P＜ 0.05）. Compared with control group，the expression of BDNF mRNA was significantly decreased in continuous alcohol group （P＜ 0.05）. The expression of miR-182 and BDNF mRNA was not correlated（P＜ 0.05）. Conclusions　The expression of miR-182 in prefrontal cortex of alcohol depen-dent rats is decreased. miR-182 may be involoved in the pathogenesis of alcohol dependence.

Abstract:Objective To investigate the correlation between myopathological changes and clinicalmanifestations in Pseudohypertrophy Muscular Dystrophy （PMD）patients. Methods A total of 37 patients with PMD（15 DMD cases and 22 BMD cases）were recruited in Affiliated Drum Tower Hospital，Nanjing University Medical School from January 2010 to November 2016．They were assessed with Modified Gardner-Medwin and Walton （GM-W）scale and underwent muscle biopsies. The correlation between GM-W and age，course of disease，internal nuclei and the ratio of hypertrophy factor/atrophy factor was examined. Statistical analysisof pathological changes were calculated between the groups of GM-W ≥ 4 and GM-W ≤ 3. Results GM-W had significant correlations with age （r=0.453，P=0.005），course of disease（r=0.578，P＜ 0.001）. 21 patients in GM-W ≥ 4 group showed mild （n=1），moderate（n=6）and severe（n=14）degree of internal nuclei. The ratio of hypertrophy/atrophy factor was 2.09 （1.71，3.41）. 16 patients in GM-W ≤ 3 group showed mild（n=8）， moderate（n=5）and severe（n=3）degree of internal nuclei. The ratio of hypertrophy /atrophy factor was 1.77 （1.51， 2.47）. GM-W was correlated with nuclear translocation and hypertrophy factor/atrophy factor（r=0.589，0.615； P＜0.001）. Significant differences were observed in internal nuclei and hypertrophy factor/atrophy factor between the groups of GM-W ≥ 4 and GM-W ≤ 3（Z=-4.860，61.00；P ≤ 0.001）. Conclusions The pathologicalchanges of patients with PMD are correlated with the severity of clinical manifestations. GM-W contributes toassess the severity and progression of PMD.

Abstract:Objective To investigate psychiatrists’perspectives towards conditions of using restraints， which is “act of disturbing medical order”and“no available alternatives”，according to Article 40 of the Mental Health Law of the People’s Republic of China，in order to provide basis for the improvement of related law and documents. Methods Psychiatrists from 6 psychiatric hospitals in Shanghai were surveyed by self-designedquestionnaire. And 393 questionnaires were withdrawn. Results “Attack others impulsively，destructing things，trying to run out of wards，pandemonium brake out，influencing other patients’rest，entanglingdoctors and nurses repeatedly，refusing to take medicine and refusing examinations”were considered as “act of disturbing medical order”in more than 50% psychiatrists. Effects of medical treatment or other treatments being not obvious（93.9%），invalid verbal dissuasion by medical staff （88.8%），limited manpower in wards （58.0%）and failing to take other measures owing to the urgent time（83.7%）were defined as“no available alternatives”by over 50% psychiatrists. Psychiatrists of different genders，educational background and titles showed significant differences on comprehension in “refusing rehabilitation activities”，“influencing other patients’rest”and “invalid verbal dissuasion by medical staff”，and“trying to run out of wards”and“limited manpower in wards”. Conclusions Psychiatrists’understanding on the conditions of using restraints is different. Thus it’s importantto perfect the Mental Health Law and promulgate detailed legal articles to regulate psychiatrists’behavior.

Abstract:Objective　To explore the relationship between social support，self-efficiency，clinical symptoms，executive function and aggressive behavior in young schizophrenia patients. Methods　Totals of 107 schizophrenia patients of 16-44 years old were chosen randomly. And the general information，social sup-ports，self-efficiency，clinical symptoms and executive function were evaluated. And aggressive behavior wasdetected 6 months later again. The predictive factors of aggressive behavior in young schizophrenia patients after 6 months were analysed. Results　Scores of objective support and subjective support were higher in non-aggres-sive behavior group，while scores of positive symptom，general pathological symptom and AT-2-I were higher in aggressive behavior group （P＜0.05）. The objective support，positive symptom and inhibition function could predict aggressive behavior in young schizophrenia patients after 6 months. Conclusions　The objective sup-port，positive symptom and inhibition function predictive are factors of aggressive behavior in young schizophre-nia patients after 6 months.

Abstract:Objective　To find better diagnostic methods and criteria by re-evaluation for initial clinical dementia diagnosis. Methods　Totals of 22 subjects diagnosed as mild neurodegenerative non-vasculardementia from June 2011 to June 2012 were included. Brain PIB and FDG PET，CSF test and neuropsychological tests were assessed in all patients. MMSE test was measured every 1-2 years untill April 2017. Results　The diagnosis of 7 out of 22 subjects was changed. 4 patients diagnosed with Alzheimer disease （AD）changed to dementia with Lewy bodies （DLB），while 2 AD patients and 1 behavioural variant frontotemporal dementia （bvFTD）patientchanged to unspecified dementia （UNS）. There were significant differences between changed and non-changed team in educational level，Aβ42 concentration，comprehension test，episodic memory test and reductions in regional cerebral glucose metabolism（P＜0.05）. Conclusions　Brain PET imaging and CSF test have guiding significance for re-evaluation for clinical dementia diagnosis.

Abstract:Objective To evaluate the characteristics of EMG on bilateral extremities tonic seizures in patients with localization-related epilepsy. Methods A total of 74 seizures in 22 localization-related epilepsy patients were included in observed group. 57 seizures of 6 patients who had generalized epileptic discharge were included in control group. After quantitative and qualitative analysis of the EMG，the positive rate of lateralizationand its significance were evaluated. Results During the typical tonic phase of seizures，the motor unit action potential of muscles appeared in the form of build-up. The initial EMG activities in 83.8%（62/74）seizures were of lateralizing signs to the side contralateral to the seizure onset. In observed group，the build-up duration ofinitial tonic EMG activities was 3 s and the difference of bilateral tonic EMG activities was 2.44 s. While in control group，it was 0.89 s and 0.14 s. There were statistically significant differences between two groups. In observed group，the positive rate of lateralization based on BETS’s EMG in the lateral cortex epilepsy group was higher than that in parasagittal cortex epilepsy group （88.2% vs. 73.9%）. Conclusions The asymmetric EMGis an objective and sensitive lateralizing sign. When the difference of bilateral tonic EMG activities is longer than 250 ms，it is possible that the epilepsy has a focal origin.

Abstract:Objective To investigate the predictive value of apparent dispersion coefficient（ADC）and fractional anisotropy（FA）in the treatment of postoperative hemorrhage. Methods Totals of 76 patients whounderwent neurosurgical treatment of cerebral hemorrhage in Department of Neurosurgery，Yan’an People’s Hospital were analyzed retrospectively. Patients were divided into good prognosis group and poor prognosis group according to their prognosis. The ADC and FA values of patients with intracerebral hemorrhage were measured by magnetic resonance diffusion tensor imaging. The predictive value of ADC and FA in the treatment of cerebral hemorrhage was analyzed. Results The rate of cerebral hemorrhage eliminating was 82.9%. Logistic regression analysis showed that ADC，FA，diabetes mellitus and hypertension were prognostic factors of postoperativecerebral hemorrhage. The area under the curve of FA diagnosed cerebral hemorrhage was 0.804 （95%CI： 0.710-0.899），ADC was 0.771（95%CI：0.669-0.872），while ADC+FA was 0.872（95%CI：0.791-0.953）. Conclusions ADC and FA have certain clinical values in predicting the curative effect of cerebral hemorrhage.

Abstract:Objective To understand the clinical characteristics and outcomes of electrocardiogram（ECG）abnormalities induced by Olanzapine in children. Methods Medical records of patients who had hospitalized in Department of Childhood Psychiatry，Urumqi Fourth People’s Hospital and treated witholanzapine for the first time from June 2012 to June 2016 were collected and retrospectively analyzed. Theincidence，characteristics，treatments and outcomes of ECG abnormalities were analyzed. Results A total of 198 patients were enrolled into this study. The total incidenee of ECG abnormalities was 57.07% and thedifference between the low dose and high dose groups was statistically significant（P＜ 0.01）. The incidences in the 1，2 and 3 months were 53.98%，24.78% and 21.24% respectively. There were statistical significancebetween the low dose and high dose groups in the 1，3 months （P＜ 0.05）. No statistical significance was found in abnormal ECG between olanzapine high dose and low dose groups after double and triple combinations （P＞ 0.05）. The main characteristics of abnormal ECG induced by Olanzapine were sinus tachycardia，ST-T changes， T wave changes and sinus arrhythmia，etc. The clinical symptoms were completely relieved after dressing change and symptomatic treatment in 133 patients. Conclusions Sinus arrhythmia，ST-T changes and T wave changes are more common in ECG abnormalities caused by Olanzapine. ECG abnormalities are related with the dosage， and could return entirely to normal after proper treatment.

Abstract:目的评价注射用 A型肉毒毒素缓解脊髓损伤（SCI）患者神经病理性疼痛（NP）的可行性。方法选择 2013年 4月 ~2016年 1月在荆州市第二人民医院就诊的SCI伴 NP患者 47例，随机分为试验组 24例和对照组 23例，分别给予注射用 A型肉毒毒素 200 U和生理盐水皮下注射，疗程 8周，评价治疗前和治疗 4周、8周后疼痛视觉模拟评分（VAS）、疼痛性质和生存质量。结果所有患者均顺利完成治疗。混合效应模型分析显示，试验组和对照组治疗前后不同时点 VAS评分、 VAS评分下降百分比、疼痛感觉、疼痛情感和总分差异均有统计学意义（P＜ 0.05）。重复测量效应分析显示，两组治疗前后各指标差异仍有统计学意义（P＜ 0.05）。分组与测量时点交互效应分析显示，两组各指标随时间变化趋势不同（P＜ 0.05）。以治疗前 WHO生存质量评估量表（WHOQOL）评分为协变量，治疗后第 8周试验组的生理领域、心理领域、环境领域评分高于对照组，差异有统计学意义（P＜ 0.05）社会关系领域组间比较差异无统计学意义（P＞ 0.05）。结论 A型肉毒毒素皮下注射能有效缓解 SCI患NP症状，镇痛效果优于安慰剂。

Abstract:目的研究血清同型半胱氨酸（Hcy）水平对首次抑郁发作患者认知功能的影响。方法选取 119例首次抑郁发作患者（病例组）及 117例健康志愿者（对照组）采用酶联免疫法测定两组患者的血清 Hcy水平，采用蒙特利尔认知评估量表（MoCA）进行认知功能评定。结果，与对照组相比，病例组患者血清 Hcy水平升高，MoCA量表的视空间 /执行功能、注意、抽象能力、延迟回忆、定向力和总分评分较低，异有统计学意义（P＜ 0.05）。病例组中高同型半胱氨酸血症（HHcy）组患者 MoCA量表的视空间 /执行功差能、注意、抽象能力、延迟回忆、定向力和总分评分较非 HHcy组低，差异有统计学意义（P＜ 0.05）。病例组血清 Hcy水平与 MoCA量表的视空间 /执行功能、注意、抽象能力、延迟回忆、定向力和总分评分呈负相关（r=-0.234~-0.215，P＜ 0.05）。结论首次抑郁发作患者存在认知功能障碍，血清Hcy代谢失衡与抑郁发作患者认知功能障碍相关。

Abstract:目的探讨颈股脉搏波传导速度（cfPWV）与社区老年人认知功能障碍的关系。方法取上海市60岁以上681名社区老年人为研究对象，采用简易智能精神状态检查量表（MMSE）评价其认选知功能，根据MMSE评分将研究对象分为认知功能障碍组（n=149）和认知功能正常组（n=532）。应用动脉硬化检测仪测量cfPWV。结果认知功能障碍组的cfPWV高于认知功能正常组［（ 13.1±3.4）m/s比（10.5±2.7）m/s］，差异有统计学意义（P＜0.01）。随着 cfPWV的升高，认知功能障碍的发生率逐渐增加（P＜0.01）。多因素Logistic回归分析结果提示， cfPWV与老年人的认知功能障碍之间具有独立相关性（OR=1.83，95%CI：1.16~2.90；P＜0.01）。结论 cfPWV与社区老年人认知功能有关，检测cfPWV可能有助于认知功能障碍的筛查。

Abstract:目的探究影响急性脑梗死后非溶栓患者出血转化的相关因素。方法选取攀枝花学院附属医院 2013年 12月~2015年 12月收治的急性脑梗死后非溶栓患者 120例。根据患者是否发生出血转化，分为出血转化组（n=41）和非出血转化组（n=79）。对两组的吸烟史、饮酒史、高脂血症、血压、空腹血糖、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）等进行单因素和多因素分析。结果出血转化组有吸烟史、饮酒史、高脂血症及心房颤动者多于非出血转化组（χ 2=47.71，24.04，16.38，27.27； P＜ 0.01）；与非出血转化组相比，出血转化组的 LDL-C及空腹血糖水平较高（t=4.65、5.74，P＜ 0.01），梗死面积较大（χ 2=35.60，P＜0.01）；多因素分析显示，心房颤动（OR=4.14，95%CI=2.06~8.31，P＜ 0.01）、脑空腹血糖（OR=2.92，95%CI=1.36~6.26，P＜ 0.01）、LDL-C（OR=4.81，95%CI=2.72~8.49，P＜ 0.01）及大面积梗死（OR=3.00，95%CI=1.60~5.63，P＜ 0.01）为急性脑梗死后非溶栓患者出血转化的独立危险因素。结论心房颤动、空腹血糖水平、 LDL-C及大面积脑梗死是急性脑梗死后非溶栓患者出血转化的独立危险因素。

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