Abstract:Objective To investigate the effects of interaction between monoamine oxidase A rs1137070 gene polymorphism and childhood abuse on impulsive aggressive behavior in Uygur bipolar disorder patients. Methods The data of environmental exposures were collected with questionnaires. The polymerase chain reaction（ PCR） product direct sequencing was used to detect the polymorphism of the MAOA gene rs1137070 loci in 184 bipolar disorder with violent patients and 326 bipolar disorder without violent patients. The risk factors of impulsive aggression in Uygur bipolar disorder patients in Xinjiang were screened. The interaction between rs1137070 and childhood abuse was identified by interaction indicators. Results The frequency of rs1137070 allele in Xinjiang Uighur male of two groups group was statistically significant （χ2=11.499， P=0.001）. The frequency difference of rs1137070 genotype（ χ2=14.677， P=0.001） and allele （χ2=17.753， P ＜ 0.001） in the Uygur women of two groups was statistically significant. Childhood abuse was a risk factor for impulsive aggression in Uygur bipolar disorder in Xinjiang（ χ2=9.770， P=0.002）. There was a positive interaction between childhood abuse and rs1137070 gene polymorphism. RERI， AP and S were 1.18， 0.146 and 1.20 respectively. Conclusions The occurrence of impulsive aggressive behavior in Xinjiang Uygur bipolar disorder patients is the result of the combination of childhood abuse and genetic risk factors.

Abstract:Objective To evaluate the effects of residual symptoms on the recovery of social function in patients with depression after clinical treatment of acute remission after 8 to 12 weeks. Methods This study was a multicenter， two-phase study. The first cycle was cross-sectional survey（ from September 2014 to April 2015） and the second cycle was cohort study（ from September 2015 to August 2017）. The assessment data of the subjects at the end of acute period in this 8 to 12 week treatment of depressive episode was chosen as the baseline for all the subjects. Patients were assessed for Brief 16-Item Quick Inventory of Depressive Symptomatology Self- Report（ QIDS-SR16）， Patient Health Questionnaire-15（ PHQ-15） and Sheehan Disability Scale（ SDS）. Any 9 dimensions of QIDS-SR16 in excess of 1 was taken as a single residual symptom standard， and the total score of SDS over 6， item score over 2 was taken as functional impairment standard. Results A total of 925 subjects were enrolled and divided into two groups based on their functional impairment. There were still about 24.22% （224/925） of those with functional injury. Physical symptoms， recurrence patients， sleep problems， lacking of interest， fatigue and anxiety and other factors affect the subject's functional remission. Conclusions Residual symptoms in patients who achieve clinical remission after acute phase are the influencing factors of their functional impairment.

Abstract:Objective To investigate the molecular mechanism of calcine kinase II（ CaMKII） in improving the memory function of mice with Parkinson disease（ PD）， and to explore the possible mechanism underlying this effect， which will provide a new idea to treat PD. Methods 6-OHDA was stereotactically injected into the left striatum of mouse to prepare the lateral PD mouse model. Then the valid PD model was selected by cylinder test. All valid PD（ n=32） mice were divided into four groups： PD+ no-Ex group（ n=8）， PD+Low-Ex group（ n=8）， PD+Medium-Ex group（ n=8） and PD+High-Ex（ n=8）. Another group of shamoperated mice were involved as control（ n=8， injection of saline at the same site）. Through the analysis and evaluation of their behavioral results， the hippocampus of mice in sham-operated group， PD+no-Ex group and PD + Low-Ex group were selected for Western blot to detect the phosphorylation levels of cAMP-response element binding protein（ CREB）， the extracellular signal-regulated kinase1/2（ ERK1/2）， Tyrosine hydroxylase （TH） and calmodulin kinase Ⅱ（ CaMKII）. Results The navigation test of Morris water maze showed that the mean escape latency of each group was gradually decreased with the prolongation of training time. Different speed of treadmill exercise all improved the memory of mice especially the low speed exercise（ P＜ 0.05）. In addition， spatial probe test showed that compared with mice in sham-operated group， the number of times through the platform were decreased in mice of PD + no-Ex group， and the difference was statistically significant （P ＜ 0.05）. Western blot results showed that the levels of phosphorylated CREB， ERK1/2， CaMKII and TH were decreased in PD mice compared to sham-operated mice（ P＜0.05）. However， compared with PD+no-Ex group， the indicators above in PD+Low-Ex group increased significantly， and the difference was statistically significant（ P＜0.01）. Conclusions Low-exercise training was effective to improve memory in PD mice， which is because that low-exercise training could enhance the activity of PKA pathway， so as to improve the cognition function of PD mice.

Abstract:Objective This study evaluated the efficacy and safety of various antipsychotic drugs in the treatment of tic disorders by Meta analysis. Methods RCTs evaluating antipsychotic drugs for TDs were identified from PubMed， Embase， Cochrane library， four Chinese database， relevant reference lists and the references of systematic reviews. We used Stata to perform meta-analysis. Results After removing duplicates， screening titles and abstracts， and reading full texts， 60 RCTs met the inclusion criteria， Total of 4 077 patients were included. The age of participants ranged from 2 to 65 years. The publication year was between 1978 and 2015. The sample size ranged from 4 to 180（ median 61）. There was no statistical significant difference in improving tic severity between the groups of risperidone vs haloperidol（ P=0.54）， aripiprazole vs haloperidol（ P=0.45）， tiapride hydrochloride vs haloperidol（ P=0.52）， piperidin vs haloperidol（ P=0.67）， olanzapine vs haloperidol（ P=0.15）， piperidin vs placebo（ P=0.06）. Quetiapine was better than haloperidol， aripiprazole was better than tiapride hydrochloride， risperidone and haloperidol were superior to placebo in improving the tic symptom score， and the differences were statistically significant（ P＜0.05）. Totally 42 RCTs reported adverse reactions. Atypical antipsychotic drugs were well tolerated without serious adverse effects. Conclusions Typical antipsychotics were efficacious in the reduction of tic severity， however the adverse effects（ AE） restricted its clinical application. Atypical antipsychotics（ risperidone， aripiprazole， olanzapine， ziprasidone， quetiapine） significantly improve tic symptoms with fewer AEs. The efficacy of risperidone and aripiprazole were supported by strong evidence and quetiapine is a promising therapy for TDs. Ziprasidone and olanzapine are also effective， but the evidence is lacking. The current evidence of antipsychotics in the treatment of TDs is lacking and the quality is not high， long-term efficacy and safety need to be confirmed in further.

Abstract:Objective To understand the anxiety and depression symptoms of outpatients in comprehensive medical institutions. Methods Non-probabilistic sampling method was used to investigate outpatients of 19 3A hospitals in 12 cities in China from March to August 2017. The survey was delivered to patient's cell phone through free WIFI in out-patient department. The internet panel survey was an anonymous and non-probability survey which contains PHQ-9 and GAD-7 scales. Results A total of 32 631 patients completed both PHQ-9 and GAD-7. 8 945 patients were screened as positive for depression， with a 27.41% positive rate. 70.30% of the patients were accompanied by moderate or above anxiety symptoms. Positive rate of anxiety was 38.29%， and 6 285（ 19.26%） patients were screened as positive for both depression and anxiety. The comorbidity was 19.26%. Positive rate was high in female than in male slightly. Conclusions The positive rate of depression or anxiety are quite high in patients of 3A general hospitals， and the comorbidity is also critical.

Abstract:Objective To investigate the influencing factors of patients' sleep quality before operation. Methods A total of 886 patients scheduled for elective surgery from June 1， 2017 to October 1， 2017 were selected by stratified random sampling method. The general data of the patients was collected and a questionnaire survey was conducted on the day before operation， including the Medical Outcomes Study Sleep Scale（ MOS-SS）， the self-designed sleep-related factors questionnaire， Visual Analogue Scale（ VAS）， Hospital Anxiety and Depression Scale（ HADS）. Results The sleep problems index（ SPI） and the incidence of sleep disorder one month before operation were 35.8（ 28.3， 45.3） and 63.1%（ 559/886） respectively. Those indicators one week before operation were 37.7（ 30.2，47.2） and 67.7%（ 600/886） respectively. The differences were statistically significant（ Z=-5.367，χ2=60.749； P ＜ 0.01）. It is indicated in the self-designed sleeprelated factors questionnaire that the factors of noise， the sleep environment changes， the discomfort caused by illness and the roommates influencing sleep quality comprised 34.1%， 25.4%， 23.8% and 14.7% respectively. Multivariate Logistic regression analysis showed that occupation， religion， anxiety and depression affected the quality of sleep in one month before surgery， and gender， pain level during activity， anxiety， depression and the department of surgery affected the quality of sleep in one week before surgery. Conclusions Preoperative sleep disorder is very prevalent and related to multiple factors.

Abstract:Objective To identify efficacy and value of early rehabilitation in the treatment of severe stroke. Methods A total of 134 cases of severe stroke patients were recruited for early rehabilitation， including cognitive function training， motor function training and daily life activity training. The Mini-Mental State Examination （MMSE）， the FugI-Meyer Assessment（ FMA） and the Barthel Index（ BI） were applied 24 hours before treatment and 4 weeks after treatment. Results Comparing the results before and after the patients' early rehabilitation， MMSE［ （19.16±8.86） vs（ 22.33±7.36）］， FAM［ （34.08±22.21） vs（ 53.96±24.79）］， BI［ （35.38±19.83） vs （61.78±18.88）］. The scores were significantly increased after treatment， and the differences were statistically significant（ P ＜ 0.05）. Conclusions Early rehabilitation plays a significant role in reducing post-stroke cognition and motor dysfunction， and can reduce the disability rate and improve patients' quality of life.

Abstract:Objective To investigate the effects of ultralow-frequency transcranial magnetic stimulation （TMS） on sleep deprivation-induced anxiety and cognitive capability deficit in rats. Methods A total of 18 SD rats were randomly divided into three groups： control group， sham group and TMS group. The sleep deprivation model was established by using improved multi-platform sleep deprivation method and the head of rat was stimulated by a homemade portable TMS instrument. TMS was performed once a day with 15 consecutive single stimulation（ interval between two single stimulation was 30 s） for 6 consecutive days. Body weight was monitored during the experiment. Behavioral analysis such as open field test， elevated plus maze and Morris water maze were adopted to evaluate the anxiety and cognitive capability in rats. Results Compared with con group， the body weight of sham group significantly decreased after 5 days' sleep deprivation. The results of open field test and elevated plus maze test showed that compared with con group， the percentage time in central area， percentage time in open arms， and percentage entries into open arms significantly decreased in sham group after 5 days' sleep deprivation. Morris water maze test showed that compared with con group， the latency to platform significantly increased， meanwhile， the duration in target quadrant significantly decreased in sham group after 6 days' sleep deprivation. There was no significant difference in above all indexes was found between TMS group and sham group. Conclusions Under this experimental condition， the ultralow-frequency TMS intervention cannot improve sleep deprivation induced anxiety and cognitive capability deficit in rats.

Abstract:Objective To explore the relationship between FT3 level and intracranial and extracranial atherosclerotic stenosis in patients with acute cerebral infarction. Methods A total of 148 cases of acute cerebral infarction were selected as the experimental group， and 97 cases of non-acute cerebral infarction admitted in the same period were treated as the control group. The general clinical features of the two groups were compared， and the variables（ P＜0.05） were included in the regression analysis. According to the location and degree of arteriosclerosis， the experimental group was divided into subgroups to compare the level of FT3. Results The level of FT3 and TSH in patients with acute cerebral infarction was significantly lower than that in the control group（ P＜0.05）. The result of Logistic regression analysis showed that FT3 was the protective factor of acute cerebral infarction（ OR=0.060， 95%CI=0.019-0.191， P＜0.001）， and an independent protective factor for arteriosclerosis in FT3 acute cerebral infarction（ OR=0.049，95%CI=0.015-0.157，P＜0.001）. There was no significant difference in the location and degree of intracranial arteriosclerosis and the degree of arteriosclerosis between the carotid arteries（ P＞0.05）. The level of FT3 showed a decrease trend， as the degree of carotid stenosis increased. Conclusions The level of FT3 in patients with acute cerebral infarction decreases， and FT3 is a protective factor for acute cerebral infarction. The level of FT3 is not related to the location and degree of intracranial stenosis and the degree of carotid artery stenosis in acute cerebral infarction.

Abstract:Objective To observed hemodynamic changes in the posterior circulation infarction patients with vertebral artery dominance（ VAD）. Methods According to magnetic resonance angiography （MRA） and the diagnostic criteria of VAD， 156 patients with posterior circulation infarction（ PCI）， dizziness and headache were divided into VAD group（ n=86） and non-VAD group（ n=70）. All enrolled subjects were performed transcranial Doppler ultrasound（ TCD） examination. Results The values of systolic velocity（ Vs）， mean velocity （Vm） and diastolic velocity（ Vd） in the dominant VA of VAD group were higher than those in the non-dominant VA of VAD group and bilateral VA of non-VAD group（ P＜0.05）. Compared with bosic artery of two groups，the level of Vd and Vm in the VAD group were less than those in the non-VAD group（ P＜0.05）， and the level of pulsatility index（ PI） and resistance index（ RI） were higher than those in the non-VAD group（ P＜0.05）. There were no significant difference in Vs、Vd、Vm、PI and RI of posterior cerebral artery（ PCA） in two groups（ P＞ 0.05）. Conclusions There are cerebral hemodynamic changes in VAD patients. The blood flow velocity of the dominant VA is faster than that of non-dominant VA， which may be due to posterior circulation infarction.

Abstract:Objective To explore the correlation between lipopolysaccharide（ LPS） in blood endotoxin and cerebrospinal fluid（ CSF） and schizophrenia. Methods The blood and cerebrospinal fluid test results of 6 schizophrenic patients with positive blood LPS test were retrospectively analyzed. Results The LPS in blood was 0.063-0.669 EU/ml， and the LPS in CSF was 0-1.018 EU/ml. There were 4 positive cases. There were 3 cases of White Blood Count（ WBC） higher than 10×109/L，and 1 patient of neutrophile granulocyte（ NE%） more than 70%. The antistreptolysin O（ ASO） were from 25 to 606 IU/ml， moreover 1 patient' ASO were higher than 116 IU/ml. Conclusions The LPS in CSF are positive in some schizophrenic patients who were positive hematal LPS. Therefore we assume that infection may be related to schizophrenia， and the brain external infection may be the pathogenesis of schizophrenia.

Abstract:In order to explore the mode and effect of clinical teaching for professional physicians of neurodegenerative disease， this article makes a comprehensive analysis of the unique experience of training neurodegenerative diseases in Xuanwu hospital， Capital Medical University， including strict access system， systematic theoretical training， training of clinical and scientific research ability. It adopts various forms and multi-level teaching methods， so as to achieve the teaching purpose of comprehensive skills， standard of diagnosis and treatment， clinical level and scientific research ability.

Abstract:Dementia is a common disease in the elderly with cognitive impairment as the main manifestation. The incidence rate is increasing year by year， which causes great economic burden to the society. Improving the ability of medical students to diagnose and treat dementia is an important basis for the prevention and treatment of this disease， and an important link in the professional education of neurology. This paper systematically reviews the necessity and feasibility of multidisciplinary integrated problem-based learning （PBL） mode in dementia diagnosis teaching so as to explore the object of education， teaching content and course setting of the multi-disciplinary integrated PBL， which is of great significance for improving the feasibility and practicality of medical education for clinical practice.

Abstract:Alzheimer disease（ AD） is a kind of degenerative nervous system disease in elderly patients， with unclear mechanism and limited treatment. Drug therapy is limited by kinds of adverse reactions， so physiotherapy and cognitive intervention becomes a more acceptable treatment for patients. In recent years， some studies show that repetitive transcranial magnetic stimulation（ rTMS） can improve the cognitive function， behavior， and psychological symptoms of AD to some extent. Therefore， it is proposed to make a summary of the relevant progress here.

Abstract:Clinically， hypothyroidism（ HM） is not uncommon， but sometimes it is difficult to be diagnosed. Careful medical history and proper blood test are helpful for clinical diagnosis of HM. Although electromyography is not specific， it is useful in assessing the degree of neuromuscular impairment. MRI and muscle biopsy are helpful for differential diagnosis. The prognosis of HM is good. Thyroid hormone replacement therapy is the key treatment. The therapeutic effect is also an important basis for diagnosing HM. This article reviews the pathogenesis， clinical manifestations， diagnosis and differential diagnosis， treatment and prognosis of HM.

Abstract:The incidence of sleep disorders after stroke is high， which has obvious effect on the ability of rehabilitation and daily living after stroke. The pathogenesis of sleep disorders after stroke is complex and not very clear. At the same time， there are many treatment methods. Patients need to be assessed individually and given corresponding treatment methods to obtain satisfactory results.

Abstract:Depression， as a common mental disorder in modern world， is becoming a heavy burden for individuals， families and society because of its high prevalence. As a traditional philosophic and mental exercise， Yoga has obvious effects on the treatment of depression. As a result， this article tries to summarize the progressive researches of the application of Yoga in the treatment of depression.

Abstract:Current studies on bulimia nervosa（ BED） have found that the onset and maintenance of overeating are related to negative emotions and maladaptive emotions. DSM-5 diagnostic criteria for bulimia nervosa suggest that BED can only be diagnosed with overeating and negative emotions. The aim of this study is to review the results of related researches on emotion regulation in patients with bulimia nervosa（ BED） and provide reference for clinical practice.