Abstract:Objective To investigate the clinical features of patients with tourette syndrome（ TS） with comorbid attention deficit hyperactivity disorder. Methods This study included two parts， retrospective study and cross-sectional study. The demographic data and case characteristics of TS patients who were admitted to Anding Hospital and registered during 2005-2007 was reviewed. A cross-sectional survey of TS patients and their parents was conducted. Patients were assessed by clinicians for Mini International Neuropsychiatric Interview for children and adolescents（ MINI-Kid）， DSM-5 diagnostic assessment， and the Snowman Assessment Scale（ Swanson Nolan and Palham Scale- Ⅳ， SNAP- Ⅳ） assessment. Parents complete the Conners Parents Symptom Questionnaire Assessment. The patients completed the Conners Self-rating Scale and the Child Self- Consciousness Scale Assessment. The clinicians evaluated the severity of tic symptoms using the Yale Global Tic Severity Scale（ YGTSS） and recorded whether they regularly treated TS and took ADHD medications. Results A total of 221 patients were included in the analysis， of which 138（ 62.4%） were TS co-morbidities ADHD patients. There were statistically significant differences between TS co-morbid with ADHD patients and non-comorbid ADHD group in perinatal adverse events， age of onset， age at first diagnosis， first-time treatment， regular therapy and family history of mental illness. The severity of TS comorbid with ADHD was effected by perinatal adverse events， whether had the regular treatment， accepted ADHD drug treatment and family history of mental illness. The proportion of patients with overt symptoms who received ADHD was lower than those with mild symptoms. Conclusions The treatment effect of TS co-morbidities ADHD is related to perinatal adverse events， regular therapy， ADHD treatment and family history of mental illness.

Abstract:Objective To systematically evaluate the efficacy and safety of memantine in the treatment of behavioral and psychological symptoms of dementia（ BPSD） in Alzheimer disease（ AD）. Methods Randomized controlled trials（ RCTs） on methadone for AD in BPSD were collected and retrieved from the databases of Medline， Embase， Cochrane Library（ CENTRAL）， CBMdisc， VIP and CNKI until February 2018. Two researchers independently screened literature， extracted data and evaluated the quality of the included studies. Then， Meta-analysis was performed using RevMan 5.3 software. Results A total of 12 RCTs were included， involving 3 982 patients. Patients in study group were treated with memantine and patients in contrd group were treated with placebo. Meta-analysis showed that memantine can improve the Neuropsychiatric Inventory（ NPI） score of AD patients（ SMD=-0.11， 95%CI=-0.17- -0.04，P=0.001）. There was no statistical difference between the two groups in the number of withdrawn and adverse events after treatment. The differences in the incidence of somnolence， hypertension and weight increased between the two groups were statistically significant. Conclusions Memantine can improve BPSD in AD patients， with good safety. However attention should be paid to the adverse events， including somnolence， hypertension and weight increased. Due to the limitation of quantity and quality of the included studies， the above conclusions are still needed to be verified with more high quality studies.

Abstract:Objective To investigate the experience and efficacy of multi-lobe disconnection of cerebral hemisphere in refractory epilepsy. Methods A retrospective analysis was carried out in 22 patients with refractory epilepsy who underwent multi-lobe disconnection of cerebral hemisphere at Beijing Institute of Functional Neurosurgery from April 2013 to July 2017. The retrospective analysis included the introduction of operative method， the postoperative pathology and curative effect， and the complication records. Results During the follow up， 15 cases were in Engel Ⅰ（ 68%）， 6 in Engel Ⅱ（ 27%）， 1 in Engel Ⅲ（ 5%）. There were four patients of significant exacerbation of hemiplegia postoperatively， one patient of intracranial infection. There was no superficial cerebral hemosiderosis. Conclusions The multi-lobe disconnection of cerebral hemisphere can effectively treat the patients with refractory epilepsy caused by hemispheric lesions. This surgery is particularly indicated to the patients with hemispheric lesion， but without the deficit of the motor， sensory and language functions of the hemisphere.

Abstract:Objective To investigate the levels of interferon-γ（ INF-γ） and tumor necrosis factor-α （TNF-α） in serum of schizophrenic patients without antipsychotics and the correlation between these levels and symptoms. Methods Totals of 38 cases of schizophrenia patients admitted to psychiatric department of the eighth Hospital of Shijiazhuang were selected as subjects from March 2015 to March 2017. Meanwhile， 30 health care workers of the eighth Hospital of Shijiazhuang were selected as control group. Enzyme-linked immunosorbent assay（ ELISA） was used to detect serum levels of INF-γ and TNF-α， and Positive and Negative Symptom Scale（ PANSS） was used to assess the severity of symptoms. Results The level of serum INF-γ［ （288.36±97.84）pg/ml］ in the study group were significantly higher than the control group（ 225.81±76.95）pg/m（l t=2.869， P ＜ 0.05）， meanwhile the level of serum TNF-α［ （8.59±3.35） pg/ml］ in the study group were significantly higher than the control group［ （5.93±2.96）pg/ml］（ t=3.420， P ＜ 0.05）. The serum INF-γ and TNF-α levels were positively correlated with the total score of PANSS， and mainly related to negative symptoms（ P ＜ 0.05）. Conclusions In the early stages of the onset of schizophrenia， the body had inflammatory reaction activated status. The inflammatory reaction may affect the negative symptoms in schizophrenia during acute phase.

Abstract:Objective To observe the influence of cognitive behavioral therapy（ CBT） combined with drugs on performing function in adult patients with attention deficit hyperactivity disorder（ ADHD）. Methods A total of 105 cases of adult patients with ADHD from the Psychology Outpatients Clinic of Armed Police Hospital of Guangdong Province and Guangdong 999 Brain Hospital were selected. According to different treatment regimens， they were divided into combined group， drug group and CBT group， with 35 cases in each group. The drug group was treated with conventional drugs. The CBT group was given CBT. The combined group was given CBT on the basis of drug treatment. The clinical treatment effect and performing function of the three groups were assessed with ADHD scale and Behavior Rating Inventory of Executive Function-Adult （BRIEF-A）. Results The scores of ADHD and BRIEF-A in the three groups after treatment were significantly lower than those before treatment（ P＜0.05）. The score of the combined group was lower than that of the durg group and CBT group（ P＜0.05）. There was no statistical difference between the drug group and CBT group after treatment（ P＞0.05）. Conclusions The cognitive behavioral therapy combined with drug is helpful to improve the performing function such as self monitoring， inhibition， emotional control and so on in adult patients with attention deficit hyperactivity disorder and increase the clinical therapeutic effect.

Abstract:Objective To study and compare the clinical efficacy of lumbar cistern continuous drainage and lumbar puncture drainage for severe subarachnoid hemorrhage after clipping aneurysm. Methods A total of 100 patients with severe subarachnoid hemorrhage from July 2014 to June 2017 in Xuanwu Hospital of Capital Medical University were randomly selected and divided into study group and control group， with 50 cases in each. The patients in the study group underwent continuous lumbar drainage after surgical clipping of aneurysm， while the patients in the control group were treated with lumbar puncture after surgical clipping. The clinical curative effects and complications were compared between the two groups. Results After treatment， the time for headache relief and intracranial pressure reducing to normal of the study group were significantly lower than those of the control group（ P＜0.05）. The total effective rate of the study group（ 78.00%） was significantly higher than that of the control group（ 42.00%）（ χ2=13.50， P＜ 0.05）. The incidence of cerebral vasospasm and hydrocephalus complication was 14.00% and 8.00% respectively， which was significantly lower than that of the control group（ 42.00%，28.00%）（χ2=9.72， 9.07；P＜ 0.05）. There was no significant difference between the two groups in the incidence of rehemorrhage and cerebral infarction（ P＞0.05）. The scores of GCS of both groups before treatment was significantly lower than those after the treatment（ P＜0.05）. The GCS of the study group after treatment was significantly higher than that of control group（ P ＜ 0.05）. Conclusions The continuous lumbar drainage after surgical clipping of aneurysm with high curative rate and low incidence of complications， which can significantly improve the patient's prognosis.

Abstract:Objective To observe the effects of Semen Zizyphi Spinosae Decoction on the expression of Wnt-1 gene and potein in rats with depression models. Methods The chronic mild unpredictable stresses depression in rats models were replicated and divided into the control group， the model group， the fluoxetine group and the low， medium and high doseage of Semen Zizyphi Spinosae Decoction groups. The depression rat models were treated with Semen Zizyphi Spinosae Decoction and fluoxetine. The changes of body weight， sugar consumption and the score before and after the open field experiment were measured. Western blot and Realtime PCR were used to detect the expression of Wnt-1 protein and gene in hippocampus of rats. Results The depression models' weight gain slowed down. The scores of sugar consumption and the behavioral scores in openfield test decreased. The expression of Wnt-1 protein and gene in the hippocampus also decreased. After the treatment of Semen Zizyphi Spinosae Decoction， the body weight of the rats， sugar consumption and the score of open field experiment all increased. The expression of Wnt-1 protein and gene expression was up-regulated. Conclusions Semen Zizyphi Spinosae Decoction can increase the expression of Wnt-1 Protein gene and protein inhippocampus of rats with depression with the reduction of the neuronal cells' apoptosis， which has antidepressant effect.

Abstract:Objective To investigate the clinical efficacy of intravenous recombinant tissue plasminogen activator（ rt-PA） thrombolysis in patients with acute major cerebral artery occlusion and discuss its potential problems. Methods A retrospective study was performed to analyze 165 consecutive patients who received intravenous rt-PA thromblysis in PLA army General Hospital from January 2014 to August 2016. The occlusion site on MRA imaging， National Institute of Health Stroke Scale（ NIHSS） score at admission and 24 hours after thrombolysis， recanalization of occlusion artery after one month， and the modified Rankin scale（ mRS） score after three months were all documented and further compared and analyzed. Results In the 165 patients included， 89 cases were due to major arterial occlusions and the other 76 cases were without major artery occlusion. The NIHSS score of non-aortic occlusion group was significantly improved after intravenous thrombolysis compared with that of aortic occlusion group， and the mRS score was better at 3 months（ P ＜ 0.05）. Of the 89 cases of major artery occlusion， there were 43 cases occluded in internal carotid artery（ ICA）， 25 cases in middle cerebral artery（ MCA） and 21 cases in vertebrobasilar artery（ VBA）. The ICA and MCA groups enjoyed a better 3-month mRS scores compared to VBA group（ P＜ 0.05）. According to pathogenesis of occlusion， 89 cases could be divided into thrombosis subgroup with 69 cases and embolism subgroup with 20 cases. The embolism subgroup enjoyed better 3-month mRS scores compared to thrombosis subgroup （P ＜ 0.05）. Totally 70 cases received recanalization follow-up review， and the recanalization rates was 21.4%. The occlusion sited or occlusion pathogenesis did not show significant difference in recanalization（ P=0.133， 0.779）. Conclusions For acute stroke caused by major artery occlusion， the efficacy of intravenous rt-PA thrombolysis is not obvious in the recanalization rate and 3-month outcome improvements.

Abstract:Objective To investigate the cognitive function in patients with depressive disorder in remission. Methods A total of 130 depressive patients， who were first diagnosed in the General Hospital of Shenyang Military Region from January 2017 to July 2017， and 100 healthy controls were selected as the research subjects. The Hamilton Depression Scale（ HAMD） was used to evaluate the severity of patients. The Wisconsin Card Sorting Test， Stroop Color-Word Test， Trail Making Test， Verbal Fluency Test and Wechsler Memory Scale were used to evaluate information processing speed， word fluency， working memory， cognitive flexibility， link memory， and logical memory of all subjects. Escitalopram Oxalate tablets was used to treat patients. Depressed mood and cognitive function of patients were assessed before treatment and 6 months after. Results Finally 87 cases of the depression group and 69 of the control group were recruited in this research. Before treatment， the cognitive function in depression group was significantly lower than that in healthy control group， with statistical significance（ P ＜ 0.05）. After 6 months of treatment， according to the standard of DSM-5， 75 depressive disorder patients have met the criteria of remission. After 6 months of treatment， the HAMD score of depressive disorder patients decreased from（ 34.52±5.01） to（ 5.01±2.98）， and the difference was statistically significant（ F=23.132， P ＜ 0.05）. However there was no significant difference between the depression groups and the healthy control group（ P=0.689）. After 6 months of treatment， cognitive functions （working memory， cognitive flexibility， connection memory and logical memory instantly / delayed） improved significantly except for information processing speed and word fluency in depressive disorder patients（ P＜0.05）. Conclusions Cognitive impairment（ information processing speed， word fluency， working memory， cognitive flexibility， connection memory and logical memory immediate / delayed） occurs during the onset of depressive disorder. During the remission period， other cognitive functions were significantly improved besides information processing speed and word fluency. The results shows that information processing speed and word fluency were probably the phenotypes of depressive disorder， while other cognitive factors may be state types.

Abstract:Objective To analyze the relationship of the serum hs-CRP， uric acid and homocysteine （Hcy） with fatigue degree and cognitive function of patients with Parkinson disease（ PD）. Methods A total of 120 patients with PD who had been diagnosed in Handan Central Hospital from January 2016 to October 2017 were selected as the study group. Another 50 cases with healthy people participated in physical examination were recruited as the control group at the same time. The serum hs-CRP， uric acid and Hcy were compared between the two groups. The study group can be divided into subgroup A with the score of MMSE equal or less than 20， and subgroup B with the score of MMSE over 20. According the Fatigue Scale-14（ FS-14）， the study group were divided into subgroup C with the score over 8， and subgroup D with the score equal or less than 8. The correlation of serum hs-CRP， uric acid and Hcy with FS-14 score and MMSE scores of patients were analyzed in the study group. Results The serum hs-CRP， Hcy and FS-14 score of the study group were significantly higher than those of the control group. However， the value of uric acid and the score of MMSE of the study group were lower. All the differences were statistically significant（ P＜0.05）. The patients in the subgroup A had a higher serum hs-CRP and Hcy， and a lower serum uric acid， MMSE score and FS-14 score than the patients in the subgroup B， and the differences were statistically significant（ P＜0.05）. The serum uric acid value and the score of FS-14 of the subgroup C were both lower than those of the subgroup D， and the differences were statistically significant（ P＜0.05）. The level of serum hs-CRP and Hcy were negatively correlated with the score of MMSE （r=-0.303， -0.327； P＜0.05）. The blood uric acid was positively correlated with the score of MMSE（ r=0.294， P＜0.05）. There was no correlation between serum hs-CRP， uric acid， Hcy and the score of FS-14（ P＞ 0.05）. Conclusions Serum hs-CRP， uric acid and homocysteine levels were related to cognitive function of PD， but there was no significant correlation with fatigue.

Abstract:CRMP2 is highly expressed in the developing and adult nervous systems and regulates skeletal dynamics by interacting with cytoskeletal proteins. It plays an important role in the development of nervous system and neuroplasticity， and is closely related to the occurrence of many neuropsychiatric diseases. There are many post-translational modifications（ PTMs）， including phosphorylation， oxidation， proteolysis and ubiquitination. Among them， the most important modification is phosphorylation. Phosphorylation of CRMP2 can affect its binding to the cytoskeletal proteins and other downstream molecules， then affect many functions of the nervous system. This article reviews the posttranslational modifications and related signaling pathways.

Abstract:MicroRNA is a large class of small non-coding RNA， and miR-181b is one of the four members of the miR-181 family. In recent years， it has been found that miR-181b is closely related to the occurrence and development of multiple diseases， which could possibly to become the potential biomarker and intervention target. This article reviews the progress in the research on the expression level and the role of miR- 181b in schizophrenia， nervous system diseases， cardiovascular diseases， malignant tumors and other diseases， which may help scholars fully understand the role of miR-181b in the diseases and provide a new way for clinical diagnosis and treatment.

Abstract:Schizophrenia is a serious mental disorder， often accompanied by metabolic syndrome and oxidative stress usually， and metabolic syndrome and oxidative stress can interact. Antioxidants can be used in the treatment of schizophrenia， and it is also effective to metabolic syndrome. This article reviews the research progress of metabolic syndrome and oxidative stress in schizophrenia.

Abstract:Schizophrenia patients have extensive cognitive impairment， which is one of the core symptoms of schizophrenia. Cognitive remediation therapy improves the cognitive ability of schizophrenia by performing a large number of exercises in the cognitive field. This article reviews the effects of cognitive remediation treatment on cognitive function， social function， and psychiatric symptoms in schizophrenia， and changes in brain imaging after cognitive remediation therapy.

Abstract:Dynamic interpersonal therapy（ DIT） adheres to the concepts of psychoanalysis/ psychodynamic and Jungian analysis. It integrates theories of attachment， object relationship， interpersonal psychoanalysis and mentalization. It effectively reduced anxiety and depression in patients with 16 short-term sessions. However， at present Chinese psychiatric or primary medical institutions have not yet use this kind of therapy for psychological treatment of anxiety and depression patients. This article systematically introduces the background， concept and structure of DIT. It also summarizes the progress of related research in foreign countries in order to arouse the interest of domestic scholars and clinical practitioners and provide necessary information for the localization research of DIT.