Abstract:Bipolar disorder is a severe mental disorder. Impulsivity is an important clinical symptom of bipolar disorder， but its neurological mechanism is still unclear. This paper summarizes the research progress of impulsivity in bipolar disorder from the aspects of clinical factors， event-related potentials， brain imaging， neurotransmitters and genes， and explores the future research directions of impulsivity in bipolar disorder.

Abstract:Objective To explore the metabonomics characters of peripheral blood in withdrawal period of methamphetamine abusers. Methods A total of 40 abstinent methamphetamine abusers were recruited from Shanghai Gaojing Forced Isolation Detoxification Institute， and 40 health controls were recruited from social in July 2017. Gas chromatography- mass spectrometry technology was used to detect metabolic products in serum. Results Compared with heathy controls， the age and body mass index（ BMI） of abstinent methamphetamine abusers were not significant different（ P＞0.05）， but metabolic products in amino acid metabolic pathways and purine metabolic pathways were changed significantly（ FC＞1. 5， P＜0. 05）. Conclusions Methamphetamine abuse influences the metabolic process persistently， amino acid and purine metabolic disturbance still can be observed in the abstinent period.

Abstract:Objective To investigate the changes of estradiol（ E2） and prolactin（ PRL） levels before and after treatment and their relationship with clinical efficacy in bipolar disorder patients. Methods A total of 57 patients（ 36 male， 21 female） who met the diagnostic criteria of international disease classification （Tenth Edition）（ ICD-10） for bipolar disorder in Beijing Huilongguan Hospital from January 2014 to May 2015 were recruited， among which there were 39 cases of bipolar mania and 18 cases of bipolar depression. After admission， patients were treated with drugs for 6 weeks. Depressive symptoms were assessed by Hamilton Depression Scale-24 items（ HAMD-24）， and manic symptoms were assessed by Bech-Rafaelsen Mania Rating Scale（ BRMS）. The serum E2 and PRL levels in peripheral blood were detected by chemiluminescence immunoassay. Results Compared with the baseline， the PRL level decreased after the treatment， and the difference was statistically significant（ P=0.01）， while there was no significant increase in E2（ P＞0.05）. The PRL of the mania phase group decreased， and the difference was statistically significant（ P=0.01）. The changes in PRL and E2 of the depression phase group were not significant（ P＞0.05）. After the treatment， the BRMS score of mania phase group and HAMD score of depression phase group were statistically decreased， and the differences were statistically significant（ P ＜ 0.01）. A positive correlation was found between PRL levels and scores of BRMS before treatment in mania phase group（ r=0.41，P＜ 0.01）. The change level of PRL and E2 before and after treatment in mania phase group was positively correlated with the reduction of BRMS score （r=0.39，P ＜ 0.01；r=0.33，P=0.03）. Conclusions PRL level decreased after the psychiatric medicine treatment in bipolar disorder patients and mania phase patients. There is a correlation between the level of PRL and the manic symptoms and curative effect.

Abstract:Objective To compare the clinical features of patients with epileptic comorbid bipolar disorder and with other mental disorders， so as to provide evidence for early identification and standard treatment in clinical practice for epilepsy comorbid with bipolar disorder. Methods This study was a retrospective study. All patients who were diagnosed as epileptic comorbid bipolar disorder and epilepsy comorbid with other mental disorders in Beijing Anding Hospital were investigated for clinical from 2014 to 2017. The data of patients' medical records were collated and analyzed by self-compiled information questionnaire. Results The differences between patients with epileptic comorbid bipolar disorder and with other mental disorders in education background， age of first episode， whether with high fever， with or without other causes， first diagnosis age of epilepsy， type of seizure， frequency of seizures， whether with the surgical treatment， ideal epilepsy control and IQ scores were statistically significant（ χ2=8.495，4.455，5.343，53.828，6.313，53.828， 17.697，59.889，6.313，8.495；P ＜ 0.05）. Multivariate Logistic regression model analysis showed that age of first episode（ OR=1.537，P=0.011）， ideal epilepsy control（ OR=1.595，P=0.028） were associated with bipolar disorder. Conclusions Patients with epileptic comorbid bipolar disorder have an older age of onset. Ideal epilepsy treatment and early recognition of bipolar disorder are beneficial to the prognosis.

Abstract:Unipolar depression and bipolar disorder both have depressive episodes， and the two are indistinguishable. This article reviews the diagnosis of unipolar and bipolar depression from the perspective of clinical phenomenology， combined with relevant research at home and abroad.

Abstract:Objective To explore the changes of brain function in the specific brain regions of firstepisode depressive patients using resting state magnetic resonance imaging（ MRI） technology. Methods Resting state MRI examination was performed on 20 patients who met the diagnostic criteria of depression and 20 healthy volunteers. The resting state MRI regional homogeneity（ ReHo） was used to compare the ReHo values of the depression group， to find brain regions with increased or reduced specificity. Results Compared with the control group， the brain areas with increased ReHo were posterior cerebellar lobe， inferior temporal gyrus， middle occipital gyrus， lingual gyrus， posterior central gyrus， anterior central gyrus， superior frontal gyrus and parietal lobe. While ReHo decreased in marginal lobe， parahippocampal gyrus， putamen， thalamus，lenticular nucleus， inferior frontal gyrus， middle frontal gyrus， anterior cuneiform lobe and cingulate gyrus. Conclusions ReHo analysis of resting state MRI may discover abnormal brain regions of depression， which may help to explore the pathogenesis of depression.

Abstract:Objective To investigate the risk factors of vascular cognitive impairment with no dementia（ VCIND） in patients with moderate to severe internal carotid artery（ ICA） stenosis， and to provide reference for clinical prevention and treatment of VCIND. Methods A retrospective analysis was made of 56 patients with moderate or severe ICA stenosis admitted from April to December 2017， including 26 with VCIND and 30 without VCIND. The clinical data of the two groups were analyzed by univariate analysis， and the risk factors of VCIND in ICA patients with moderate or severe stenosis were analyzed by Logistic regression. Results Univariate analysis revealed that age， systolic blood pressure， cerebrovascular reserve， homocysteinemia（ Hcy） were relative factors of VCIND in patients with moderate to severe ICA stenosis （P ＜ 0.05）. Logistic regression analysis showed that the patient's impaired cerebrovascular reserve and hyperhomocysteinemia were independent risk factors for VCIND in patients with moderate to severe ICA stenosis （OR=6.333，3.733，P ＜ 0.05）. Conclusions Impaired cerebrovascular reserve and hyperhomocysteinemia were independent risk factors for VCIND in patients with moderate to severe ICA stenosis.

Abstract:Objective To observe the efficacy and safety of sertraline and celecoxib in the treatment of post-stroke depression（ PSD）. Methods From May 2015 to Decemer 2017， a total of 60 patients with PSD in the Neurology Department of the Third Affiliated Hospital of Xinxiang Medical University were randomly divided into study group（ n=30） and control group（ n=30）. Both groups were given conventional medication. The study group was additionally given sertraline and celecoxib， while the control group was given additionally sertraline and placebo for 6 weeks. The efficacy and safety of the two groups were evaluated with the Hamilton Depression table（HAMD） and adverse symptoms scale before treatment and at the 1st， 2nd， 4th， and 6th week after treatment. Results After 6 weeks of treatment， the effective rates of the study group and the control group were 83.3%（ 25/30） and 76.67%（ 23/30） respectively. There was significant statistical difference between the two groups（ χ2=6.75， P＜0.05）. The HAMD score of the study group at the 1st， 2nd， 4th and 6th week after treatment were all lower than those of the control group， and the differences were statistically significant（ P＜0.05）. There was no statistical significance in the difference of incidence of adverse effect［ 23.33%（ 7/30） vs 20.00%（ 6/30）］. In addition， the adverse effects were mild. Conclusions The efficacy of sertraline combined with celecoxib in the treatment of PSD was better than that of sertraline alone. It takes effect more quickly than sertraline alone. But the safety of sertraline combined with celecoxib in the treatment of PSD was comparable to that of sertraline alone.

Abstract:Objective To explore the therapeutic effect of neuromuscular electrical stimulation combined with dietary guidance on dysphagia after stroke. Methods A total of 95 patients with dysphagia after cerebral apoplexy were enrolled in this study from June 2014 to October 2016， and were randomly divided into the study group and the control group. There were 47 cases in the case group and 48 cases in the control group. There were 2 cases of shedding in the case group and 3 cases in the control group due to pulmonary infection. The control group received traditional swallowing rehabilitation training. On the basis of traditional swallowing rehabilitation training， the patients in the case group received neuromuscular electrical stimulation therapy according to the causes of swallowing disorders， combined with corresponding dietary guidance， including improving food characteristics， adjusting patients' eating position， improving feeding methods， choosing eating apparatus， training swallowing skills and so on. To evaluate the efficacy of the treatment， vidio fluoroscopic swallowing study（ VFSS）， Functional Oral Intake Scale（ FOIS） and Videofluoroscopic Dysphagia Scale（ VDS） were applied to evaluate patients with dysphagia after stroke. Results The functional scores of the two groups were significantly improved after the training（ P＜ 0.05）. The functional score of the case group after training was significantly higher than that of the control group（ P ＜ 0.05）. The improvement of the case group was significantly better than that of the control group. Before the intervention of the two groups， the feeding condition and VDS score were not statistically significant（ P ＞ 0.05）. After the intervention， the feeding situation and VDS score of both groups were improved to a certain extent， and the case group was superior to the control group（ P＜0.05）. The total effective rate of the case group was 86.67%， the control group was 68.90%， and the case group was higher than the control group（ χ2=3.38， P=0.026）. Conclusions Neuromuscular electrical stimulation combined with dietary guidance and swallowing training has a better improvement of swallowing dysfunction in patients after stroke than using swallowing training alone.

Abstract:Objective To evaluate the effect of doll intervention on the effect of clinical nursing of psychiatric patients. Methods Between April and October of 2017， a total of 61 female patients hospitalized in the Mental Health Center of Renmin Hospital of Wuhan University were recruited， and randomly divided into intervention group（ n=30） and control group（ n=31）. The patients of the control group received routine nursing care， while the patients of the intervention group were given doll intervention on the basis of routine nursing for 3 weeks. Patients were rated using Nurses' Observation Scale for Inpatient Evaluation（ NOSIE） and Kolcaba General Comfort Questionnaire（ GCQ） for the effect of intervention. Results The result of NOSIE indicated that after 3 weeks' intervention， the scores of social interest， delayed and depressive of the intervention group were（ 20.67±5.81），（ M=6） and（ M=4） respectively， which were all improved than those of the control group （15.16±7.17），（ M=2）， and（ M=2）（ P＜0.05）. The score of GCQ of the intervention group was（ 87.07±9.58）， which was significantly higher than that of the control group（ 79.81±7.94）， and the difference was statistically significant（ P=0.002）. Conclusions Doll intervention method is beneficial to the improvement of patient's comfort level and social interest， the reduction of the patient's delay and depression， and the effects of clinical nursing on the improvement of mental illness.

Abstract:Internet-based cognitive behavioral therapy（ ICBT） is a psychotherapy that evolved from cognitive behavioral therapy（ CBT）. ICBT can improve the availability and acceptability of CBT for mental disorders and other clinical problems， effectively reducing medical and social costs and increasing the costeffectiveness of treatment. This review will introduce the concept， advantages， limitations and theories of ICBT and then systematically review the efficacy and cost-effectiveness of ICBT in the treatment of obsessive compulsive disorder（ OCD） in the past decade， so as to provide reference for the study of ICBT in the treatment of OCD.

Abstract:As a common mental disorder， emotional disorder in children and adolescents is not only related to heredity. Family also plays an irreplaceable role in its occurrence， development and intervention and rehabilitation. According to the classification criteria of DSM-5， emotional disorders and family in children and adolescents， and summarizes the new non-traditional family psychological intervention model with empirical research for emotional disorder in children and adolescents， hoping to provide direction and basis for its clinical research and intervention.

Abstract:Depression seriously affects people's physical and mental health， and its pathogenesis involves neurotransmitter disorder， endocrine， inflammation， oxidative stress and so on. In recent years， the study of depression in the inflammatory immune system has been increasing. NLRP3 inflammatory body plays an important role in the immune system function. This article reviews the mechanism of NLRP3 inflammatory body in the pathogenesis of depression， and provides a new reference for the diagnosis and treatment of depression.

Abstract:Compared with normal aging， there are some characteristic changes in electroencephalography （EEG） of patients with Parkinson disease（ PD）. This paper reviews current clinical studies on the EEG changes of PD in comparison to normal aging， starting with early identification， motor symptoms， and non-motor symptoms. It is hoped that the clinical study of EEG in the field of PD can provide valuable information for understanding the pathophysiological mechanism of the disease and assisting diagnosis and treatment.

Abstract:Post stroke depression（ PSD） refers to a group of affective disorder syndrome after stroke. The diagnosis of PSD depends on the diagnostic criteria of the symptomatology of depression， and disease assessment requires mastering the time and scope of the relevant assessment scale. At present， researches on the risk factors of PSD involve neural function， metabolism， psychosocial and oxidative stress. Prevention of PSD mainly includes drug intervention and psychological intervention. Besides that， physical therapy and traditional Chinese medicine also gradually show the advantages in preventing disease. Identifying high-risk groups and improving interventions for PSD can significantly reduce the incidence， recurrence rate and mortality of PSD， and improve the prognosis of patients with stroke.

Abstract:Intracranial venous sinus thrombosis（ CVST） is a cerebrovascular disease caused by cerebral venous and cerebrospinal fluid malabsorption disorder caused by venous sinus thrombosis. The etiology of CVST is complicated， and nephrotic syndrome（ NS） is considered to be one of the important causes of CVST. At present， there are increasingly cases and studies on NS combined with CVST in China and abroad. Therefore， this article reviews the pathogenesis， diagnosis， treatment and related research progress of adult NS combined with CVST in order to improve clinicians' understanding of NS combined with CVST.

Abstract:Tissue-type plasminogen activator（ tPA） plays an important role in intravenous thrombolysis， and it also regulates many other non-fibrinolytic functions in the central nervous system（ CNS）. Studies have shown that tPA have great effects on the pathological process of Alzheimer disease（ AD）. In recent years， the correlation between tPA and AD has become a hot spot. However， at present， the mechanism about tPA associated with AD is not fully clear. This article reviews related researches on connection between tPA and AD， so as to improve the awareness of it.

Abstract:Migraine without aura is a common primary headache. Repeated episodes may increase the risk of heart and cerebrovascular disease. It may increase the risk of subtle lesions in certain brain regions and may lead to neurological impairment in certain brain regions， which can seriously affect the quality of life of patients. This paper reviews the progress of neuroimaging studies on migraine without aura based on several commonly used brain imaging techniques， aiming to provide imaging help for clinical diagnosis of migraine without aura.

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