Abstract:Objective To explore the effects of transcranial direct current stimulation（ tDCS） intervention on cognitive function in schizophrenic patients. Methods A total of 39 schizophrenic patients with cognitive impairment were randomly assigned into active tDCS group and sham tDCS group. All patients received daily active-tDCS or sham-tDCS on 10 consecutive work days as an adjunctive therapy to treatment as usual. The anode was placed over the left dorsolateral prefrontal cortex with the cathode over the right supraorbital ridge. The active tDCS was given continuously for 20 min at 2 mA. For the sham tDCS， the electric current lasted only 40 seconds though the electrodes remained in place for 20 min. The MATRICS Consensus Cognitive Battery （MCCB）， the Paced Auditory Serial Addition Task（ PASAT）， the CogState Battery， and the Reading the Mind In the Eyes Test（ RMET） were administered at baseline and four weeks after the last session to evaluate the changes in cognitive functions. Results The patients in the active tDCS group showed a non-significant superiority over those in the sham tDCS group in most of the cognitive domains at the four-week follow-up. Nevertheless， only processing speed yielded a trend preferring the active tDCS group（ F=4.087， P=0.051）. In the active tDCS group， a better global cognitive function at baseline predicted a higher MCCB composite score at the follow-up （Z=0.085，P=0.011）. Conclusions There remained some cognitive modulation effects four weeks after the end of 10 sessions of tDCS. However， larger sample studies are on demand to confirm our findings.

Abstract:Objective To investigate the characteristics of neurobiochemical metabolites in the forebrain of patients with first-episode drug-naive schizophrenia and their correlation with cognitive function. Methods The study group included 33 patients（ 19 males and 14 females） of the first-episode drug-naive schizophrenic patients. The control group recruited 33 healthy adults（ 14 males and 19 females） who met the inclusion criteria. The levels of N-acetyl aspartate（ NAA）， choline complex（ Cho）， creatine（ Cr） in the left prefrontal and thalamus were measured by hydrogen-proton magnetic resonance spectroscopy（ 1H-MRS） The level of complex（ Cr） and phosphorylated creatine complex（ Cr2）， and calculate the NAA/Cr value， Cho/Cr value， Cr2/Cr value， NAA/Cho value. The Cognitive Function was evaluated by a Graphic Recognition Memory （PRM） test module in the Cambridge Neuropsychological Automated Complete Test（ CANTAB）. Results The Cr2 / Cr value（ 1.15±0.87） in the left frontal lobe of the study group was higher than that in the control group （0.72±0.46）， and the difference was statistically difference（ P＜0.05）. There were no significant differences in NAA/Cr value， Cho/Cr value， NAA/Cho value， and NAA/Cho value， Cho/Cr value， Cr2/Cr value， NAA/Cho value（ P＞ 0.05）. The correct rate of PRM in CANTAB cognitive test was lower in patients（ 82.81±15.44）% than in controls（ 95.20±6.26）%， with significant difference（ P ＜ 0.05）. Pearson correlation analysis showed that the PRM correct rate was negatively correlated with the left frontal lobe Cho/Cr value（ r=-0.424，P＜0.05） and positively correlated with the left prefrontal NAA/Cho value（ r=0.473，P ＜ 0.01）. PANSS total score was positively correlated with the left frontal lobe NAA/Cr value（ r=0.538，P ＜ 0.01） and positively correlated with the left prefrontal Cho/Cr value（ r=0.450，P ＜ 0.01）. Conclusions The left frontal lobe part of the neurobiochemical metabolites were lower than the normal control group， suggesting that patients with firstepisode schizophrenia neuronal cell membrane phosphorylation before treatment appeared abnormal. Correlation analysis further confirmed that the cognitive function of patients with first-episode schizophrenia before medication was correlated with the presence of prefrontal-related brain function.

Abstract:Objective Two methods of combined magnetic resonance proton spectroscopy（ 1H-MRS） and T2 signal intensity were used to study the prefrontal cortex of first episode schizophrenic patients， and to explore the changes and potential relationships of the patients with schizophrenia. Methods Thirty-four firstepisode drug-free schizophrenics and thirty-five healthy subjects were enrolled and underwent 1H-MRS and FSE-T2 sequencing. All subjects underwent 1H-MRS and fast spin echo T2 sequences in the prefrontal cortex respectively. The metabolic indexes of prefrontal cortex and the changes of T2 signal intensity in patients with schizophrenia were explored. Additionally， the correlation between the related positive indexes and PANSS score were analyzed. Results Compared with the control group， the ratio of NAA/Cr of bilateral prefrontal cortex of the patients with schizophrenia decreased significantly， and the difference was statistically significant （P ＜ 0.05）. While there was no significant difference in Cho/Cr of bilateral prefrontal cortex between the two groups（ P＞0.05）. There were significant differences of the T2 signal intensity in the in the upper frontal（ t=2.07， 2.18；P ＜ 0.05），while there were no significant differences in the middle frontal and inferior frontal（ P ＞ 0.05）. The MRI-T2 signal intensity in the left upper frontal was positively related to the negative syndrome scale and total score of PANSS（ r=0.57，0.49；P ＜ 0.05）. Conclusions The combination of the 1H-MRS and T2 sequencing in prefrontal cortex of patients with first-episode schizophrenics can become a new idea in the early diagnosis of schizophrenia， and this idea may explain the causal relationship between the neuronal metabolic abnormalities and pathologic changes of the prefrontal cortex in schizophrenics.

Abstract:Objective To investigate the correlation between the polymorphism of 5-HTT gene-linked polymorphic region（ 5-HTTLPR） gene and cognitive impairment in the patients with bipolar disorder（ BPD）. Methods The technique of polymerase chain reaction-restriction fragment length polymorphism（ PCR-RFLP） was applied to identify the genotypes for the polymophism of 5-HTTLPR gene in 100 patients with BPD and 100 healthy subjects. We assessed cognitive function of the subjects by event related potentia（ ERP）. Hamilton Rating Scale for Depression（ HAMD） and Bech-Rafaelsen Mania Rating Scale（ BRMS） were respectively used to determine the severity of depressive and manic phase for the BPD patients. Results The frequency of 5-HTTLPR genotypes and allelic gene were mot significantly different between BPD patients and healthy subjects（ P ＞ 0.05）. The BRMS scores of manic phase were significantly associated with the latency of ERP P3（ r=0.321， P＜ 0.01）. The HAMD scores of depressive phase were significantly associated with the latency and amplitude of ERP N1， ERP N2， ERP N3 and ERP P3（ r=0.637， 0.379， 0.472， 0.572， 0.433； P＜0.05）. Compared to patients with SS genotype， patients carrying LL gneotype were tend to have manic phase（ OR=2.471，P＜0.05）. The comprehensive analysis of disordered multi classification Logistic regression models showed that only the P3 amplitude of manic phase entered the regression equation（ P=0.033）， and the remaining variables did not enter. Conclusions The polymophism of 5-HTTLPR gene is not associated with BPD risk and ERP. Impairment of cognitive function occurs in all patients with bipolar disorder. The patients with depressive phase have more damage of cognitive function， and compared to SS genotype， the BPD patients carrying LL genotype are inclined to get manic phase.

Abstract:Objective To evaluate the effectiveness of case management on the schizophrenia patients in community and its health economic effects. Methods From March to June 2015， 50 patients with schizophrenia in Nanlang and Dongsheng town were recruited into case management group. According to the principle of economic and population matching， another 50 patients with schizophrenia in Minzhong town were randomly selected into control group and given basic management services required by the state. The patients of two groups have been followed up for 2 years. All patients were evaluated with the Positive and Negative Symptoms Scale（ PANSS） and a self-designed questionnaire on admission， 1 and 2 years after admission for patients' symptoms and the cost of treatment. The number of inpatients and the time of hospitalization of were compared between the two groups. Results It is shown in the repeated measurement of variance analysis that the intergroup effect， time effect and interaction effect of the two groups were statistically significant in PANSS score， direct cost， indirect cost and total cost（ P＜0.05）. There were statistically difference in each indicators at the time of 1 and 2 years after adimssion（ P ＜ 0.05）. The direct cost， indirect cost and total cost of case management were lower than that of the control group. In the second year， the hospitalization time of the case management group was significantly lower than that of the control group， with statistical significance（ P＜0.05）. There was no difference in hospitalization rate between the two groups. Conclusions Case management can improve the symptoms of schizophrenia patients in community， reduce the length of hospital stay， and reduce the direct and indirect economic cost.

Abstract:Objective To compare the effects of music therapy on behavioral and psychological symptoms of patients with different severity of dementia. Methods A total of 80 dementiapatients in Chongqing Mental Health Hospital from January 2017 to June 2017 were selected. On the basis of psychotropic medication treatment， all the patients enrolled received music therapy for 12 weeks. Neuropsychiatric Inventory（NPI） and Clinical Dementia Rating scale（ CDR） were applied to assess patients' behavioral and psychological symptoms and the severity of dementia respectively. The scores of NPI of patients with different severity of dementia were compared. Results After intervention， the NPI scores of all 3 groups of patients with mild， moderate and severe dementia increased than before， however there was no significant difference among the 3 dementia groups （P＞ 0.05）. Conclusions Music therapy is effective onbehavioral and psychological symptomsin patients with different severity of dementia.

Abstract:Objective To investigate the detection rate of depression symptom in clinical research associate in China， and to analyze the job stress source， so as to discuss the relationship between the depression status and job stress source. Methods An online questionnaire survey was conducted on clinical research associate for general information and the source of depression and job stress， adopting Self-rating Depression Scale（ SDS） and Stress Diagnostic Survey via WenJuanXing software. Results A total of 533 clinical research associates were surveyed and the depression detection rate was 57.22%. The results of single factor analysis showed that gender， number of research sites and the 6 factors of job stress source have influence on the depression symptom detection rate of clinical research associate. The results of multiple factors analysis showed that role ambiguity， quantitative overloaded， qualitative role overloaded and attention to career development were at moderate and high stress levels， which were the high risk factors of mild and moderate depression symptoms in clinical research associate. Conclusions Currently， the depression detection rate is relatively high in clinical research associate in China and the general trend is not optimistic. It is suggested to enhance the reasonable assessment of clinical research associate's psychological health level.

Abstract:Objective To explore the personality traits of patients with treatment-resistant depression （TRD）. Methods Personality was assessed using the Minnesota Personality Inventory（ MMPI） in 32 patients with TRD， 31 patients with non-TRD depression and 32 normal controls. Results There was no significant difference in the factors of no answer（ Q）， fraudulent check-up（ F） and correction score（ K） between treatmentresistant depression and non-treatment-resistant depression， but were different from normal controls （P＜0.05）.There was no statistical significance in the 7 clinical factors of hypochondria（ HS）， depression（ D）， hysteria（ HY）， psychosis（ Pd）， neurasthenia（ PT）， schizophrenia（ Si） and social introversion（ Si） between the two groups with depression. However， there differences with the control group were statistically significant （P＜0.05）. The difference of paranoid factor（ Pa） was statistically significant among the there groups（ P＜0.05）. Conclusions Patients with TRD show a high paranoid characteristic， which is helpful for its diagnosis and treatment.

Abstract:Objective To investigate the relationship between serum homocysteine（ Hcy） and seizure control as well as cognitive impairment in patients with epilepsy（ MCI）. Methods A total of 128 cases of epilepsy patients were enrolled and assessed for cognitive function with Mini-Mental State Evaluation Scale （MMSE）. According to the existence of MCI， all the subjects were assigned into MCI group（ n=46）， and non-MCI group（ n=82）. The levels of folic acid， Hcy， vitamin B12 in serum of patients were determined by chemiluminescence immunoassay. The correlation between serum Hcy and the score of MMSE were analyzed by Pearson correlation analysis. High homocysteine（ HHcy） epilepsy patients were treated with folic acid and vitamin B. The serum Hcy level and the seizure frequency were analyzed before treatment， 3 months and 6 months after treatment. Results The serum Hcy level of HHcy patients at 3 months and 6 months after treatment decreased significantly， so as the seizure frequency（ P ＜ 0.01）. Compared with non-MCI group， serum folic level and vitamin B12 decreased significantly（P＜0.05）， while the Hcy level increased（ P＜0.01）. When serum Hcy was less than 15.00 μmol/L， there was no significant correlation with MMSE（ r=-0.18， P＞ 0.05）. When serum Hcy level was between 15.0～20.0 μmol/L and over 20.0 μmol/L，there was a negative correlation between MMSE and serum Hcy level（ r=-0.39，-0.56；P＜0.05）. Conclusions Giving vitamin B12 intervention to HHcy epilepsy patients can reduce serum Hcy levels and the frequency of seizures. Whether the level of Hcy in epileptic patients can be used as a biological predictor of MCI in epileptic patients still needs to be classified accurately.

Abstract:Objective To investigate the effect of microvascular decompression（ MVD） on the treatment of hemifacial spasm（ HFS） associated with the vertebral artery complex. Methods We retrospectively analyzed the data of 1 033 patients with HFS admitted to the General Aviation Hospital from May 2014 to August 2016. According to the responsibility vascular， the patients were divided into vertebral artery complex group （208 cases） and non-vertebral artery complex group（ 825 cases）. Patients were followed up for 12 to 28 months. The effect of MVD was compared between the two groups. Results The difference in age between the two groups was not statistically significant， but the proportion of males in the vertebral artery complex group was higher（ 54.3% vs 20.5%） and more frequent on the left side（ 81.7% vs 51.0%）. The difference was statistically significant（ P＜0.01）. The satisfaction rate of MVD in vertebral artery complex group was 95.1%（ 198/208）， and the failure rate was 1.9%（ 4/208）. There was no significant difference between the vertebral artery complex group and non-vertebral artery complex group（ 94.9%， 1.2%）. There was no significant difference in short-term and long-term complications between the two groups（ P＞ 0.05）. Conclusions In terms of surgical cure rate and complications， the MVD results are similar between the vertebral artery complex group and the non-vertebral artery complex group. The MVD can be used as one safe and effective method for treating compression type of vertebral artery complex HFS.

Abstract:Objective To explore the correlation between adult attachment and non-suicidal self-injury （NSSI） in university students. Methods A total of 85 college students with self-injury（ self injured behavior group） and 85 college students without self-injury（ control group） matched by age and sex were selected as the research subjects in a university in Haidian District of Beijing. The Experience in Close Relationship-Revised Version（ ECR-R） and self injurious behavior questionnaire were applied to exam the occurrence and frequency of NSSI. Results The attachment style distribution was securely 27 cases（ 31.8%）， preoccupied 19 case（s 22.4%）， dismissing 26 cases（ 30.6%） and fearful 13 cases（ 15.3%）. The difference of attachment style distribution between self injured behavior group and control group was statistically significant（ P ＜0.05）. There were significant differences in the number of self-injury behaviors among students with different attachment styles （χ2=11.397，P＜ 0.05）. NSSI is associated with insecure attachment. Conclusions Insecure adult attachment styles are the majority in university students with NSSI and it is the related factor of the self-injury behavior.

Abstract:Death obsession is a type of death-themed compulsive thinking， the assessment tool of which is the Death Obsession Scale（ DOS）. The impact factors of death obsession are divided into environmental factors and individual factors. Environmental factors include the different regions and the stability of local political environments. Individual factors can be divided into whether individuals have religious beliefs， whether individuals are pessimistic or optimistic and gender factors. This paper reviews the concept， assessment tool and influencing factors of death obsession.

Abstract:Depression has caused great harm to people's physical and mental health. The existing western antidepressants can not meet the needs of all patients. The role of traditional Chinese medicine prescriptions and medicines in the treatment of depression has aroused widespread concern. This article summarizes several currently used traditional Chinese medicine formulas and reviews their clinical efficacy and mechanism of action.

Abstract:In recent years， studies on the relationship between of red blood cells distribution width （RDW） and stroke have shown that RDW may be related to the onset and prognosis of stroke， and that inflammatory reaction， oxidative stress， and arteriosclerosis may be the main mechanisms involved. RDW may be used as a further predictor for our clinical judgment of the condition and prognosis of stroke patients.

Abstract:The central nervous system pericytes are important components of the blood-brain barrier. They play an important role in vasoconstriction， regulation of cerebral blood flow， and maintenance of the integrity of the blood-brain barrier. In recent years， increasing evidences prove that pericytes play a variety of roles in the pathogenesis of ischemic stroke. In this paper， the characteristics of pericytes and the role of pericytes in the course of ischemic stroke are briefly introduced.

Abstract:Age-related macular degeneration（ AMD） is a kind of age-related blinding degenerative fundus lesions， the prevalence rate of which increases with age. In recent years，the correlation between AMD and Alzheimer disease（ AD） has become a hot spot. This paper statesthe clinical features and epidemiology， the correlation and mechanism， so as to improve the awareness of AMD and AD.

Abstract:Autism spectrum disorder（ ASD） is a group of neurodevelopmental disorders with unknown etiology. Previous studies have suggested that abnormal brain functional connectivity may be the pathological basis of ASD. It has been seen of great significance that collaboration among different brain regions for cognitive tasks. Electroencephalogram（ EEG） coherence is regarded as the expression of that collaboration， which can be used as evaluation index of brain connectivity， and has wide application prospect of neuropsychological mechanism in autism.

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