Abstract:Cerebral stroke rehabilitation always is an important and difficult point for the rehabilitation treatment. As the development of neurorehabilitation science， and the implementation of new technology and concept， the rehabilitation of cerebral stroke has improved and enhanced dramatically in the mechanism， diagnosis，and the treatment. This article describes the recent new development of neurorehabilitation science from the fours aspects of cerebral stroke： rehabilitation mechanism， rehabilitation evaluation， rehabilitation therapy， rehabilitation management modes . Of them， the research to rehabilitation mechanism of cerebral stroke always is the hot topic in the rehabilitation area . Furthermore， the article elaborates the rehabilitation mechanism of cerebral stroke from neutral plasticity and long-tem enhancement， cell factor， rehabilitation training， and functional magnetic resonance imaging etc. Looking forward to the future， the development of neurorehabilitation science still need our persistent endeavor.

Abstract:Objective To investigate the abnormality of the cingulate-precuneus functional connection in the first-episode depressive disorder patients and their first-degree relatives. Methods From June 2016 to February 2018， 23 patients with first-episode untreated depressive disorder， 17 first-degree relatives without depressive disorder and 28 healthy people without family history were examined by resting-state functional magnetic resonance imaging（ fMRI）. HAMD-24 was used to assess the severity of the illness. Results There were differences in functional connectivity between the cingulate gyrus and the left and right precuneus among the three groups of subjects. Compared with healthy controls， the functional connectivity of the left anterior cuneal lobe was increased in the first-degree relatives， and the functional connectivity of the left and right anterior cuneal lobe was increased in the patient group. Compared with the first-degree relatives group， the functional connectivity increased significantly in the right precuneus in the patient group. Partial correlation analysis revealed that the cingulate-precuneus functional connection was positively related to the severity of the depressive disorder（ r=0.493， P=0.027）. Conclusions The onset of the depressive disorder is related to the increase of functional connectivity between the cingulum and the precuneus， which is related to the severity of the disease. The cingulate-left precuneus functional connectivity may be a possible genetic pathological mechanism.

Abstract:Objective To study the difference of cognitive function between the elderly with depression and anxiety symptoms in Beijing community and the elderly without depression and anxiety symptoms， and to analyze the incidence of depression and anxiety and its impact on cognitive function. Methods From October 2017 to January 2018， a questionnaire survey was conducted in the elderly aged 60 and above from 6 communities of Beijing using convenience sampling method. The survey included a self-made general data questionnaire， Patient Health Questionnaire-9（ PHQ-9）， Generalized Anxiety Disorder-7（ GAD-7） and Perceived Deficit Questionnaire-5（ PDQ-5） to investigate depression， anxiety and cognitive impairment in the elderly. Results A total of 622 patients were recruited. The detection rate of depressive symptoms， anxiety symptoms， depression complicated with anxiety and cognitive impairment was 8.36%（ 52/622）， 12.54%（ 78/622）， 5.95% （37/622） and 43.73%（ 272/622） respectively. The cognitive impairment in female was more than in male， and the difference was statistically significant（ χ2=5.19，P＜ 0.01）. The proportion of cognitive impairment in patients with positive depressive symptoms（ 44/52， 84.61%） was higher than that in negative ones（ 228/570， 40.00%）， and the difference was statistically significant（ χ2=38.55， P ＜ 0.01）. The proportion of cognitive impairment in patients with positive anxiety symptoms（ 67/78， 85.90%） was higher than that in negative ones（ 205/544，37.68%）， and the difference was statistically significant（ χ2=64.44， P＜ 0.01）. The result of Logistic regression analysis showed that the risk factors of cognitive impairment in the elderly were female（ OR=1.98， 95%CI=1.21- 3.25， P ＜ 0.01） and anxiety symptoms（ OR=27.89， 95%CI=3.54-219.45， P ＜ 0.01）. Conclusions PHQ- 9 and GAD-7 can effectively detect depression and anxiety symptoms in the elderly， and PDQ-5 can detect cognitive impairment in the elderly as early as possible. Cognitive impairment was more pronounced in female with anxiety symptoms.

Abstract:Objective To investigate the value of using video fluoroscopic swallowing study（ VFSS） and fiberoptic endoscopic evaluation of swallowing（ FEES） in the assessment of swallowing function in patients with stroke. Methods From June 2014 to October 2016， a total of 108 stroke patients were randomly divided into experimental group and control group with 54 cases in each. The control group was evaluated with VFSS. The experimental group was evaluated on the basis of the control group with VFSS and FEES. According to the assessment results， all patients received targeted treatment and rehabilitation training. The detection rate of aspiration， the swallowing function before and after treatment and the difference of curative effect of the two groups were compared. Results Compared with the control group（ 22.22%）， the detection rate of aspiration in experimental group（ 50.00%） was significantly higher， and the difference was statistically significant （χ2=15.62， P ＜ 0.01）. After treatment， the VFSS scores in both groups were significantly higher than those before treatment（ P＜0.05）. The VFSS scores of the experimental group were significantly higher than those of the control group（ P＜0.01）. The total effective rate of the experimental group（ 87.03%） was significantly higher than that of the control group（ 70.37%）， and the difference was statistically significant（ χ2=3.31， P=0.042）. Conclusions VFSS combined with FEES has an extremely important value in the evaluation of swallowing function after stroke， and it is worth to be popularized clinically.

Abstract:Objective To analyze the syndromes of vascular dementia（ VD） patients， and to observe the acupuncture effect on cognitive function and life skills. Methods From January to December 2014， a total of 90 inpatients and outpatients from TCM Rehabilitation Center of Beijing Rehabilitation Hospital of Capital Medical University were selected， and divided into acupuncture group and acupoint injection group. The patients of the two groups were treated with acupuncture and acupoint injection respectively for 4 continuous weeks. Traditional Chinese Medicine Syndrome Score Scale（ TCMSSS） was applied to analyze. Mini-mental State Examination（ MMSE）， Montreal Cognitive Assessment（ MoCA） and Activity of Daily Living Scale（ ADL） were compared between the two groups before and after treatment. Results Vascular dementia syndrome has blood stasis blocking collaterals， internal obstruction of phlegm turbidity， deficiency of liver and kidney， stagnation of liver-qi and insufficiency of Qi and blood. Blood stasis blocking collaterals occupies the first place in this observation（ 40%）. The differences in the scores of MoCA， MMSE and ADL before and after treatment were statistically significant（ P＜0.05）. However， there was no statistical significance between the acupoint injection group and the acupuncture group（ P＞0.05）. Conclusions The mechanism of vascular dementia syndrome is toxic pathogen obstruction when deficiency. Acupuncture and acupoint injection have good effect VD.

Abstract:Objective To analyze the effects of Computer Assisted Rehabilitation Environment （CAREN） and traditional Chinese medicine therapy on spastic hemiplegic patients after stroke. Methods A total of 90 patients with post stroke myodystonia treated in Sichuan 81 Rehabilitation Center from March 2015 to March 2016 were selected and grouped by digital random method. In group A（ n=30）， CAREN combined with traditional Chinese medicine therapy was applied. In group B（ n=30）， traditional Chinese medicine acupuncture and moxibustion combined with physical therapy was applied. In group C（ n=30）， the patients were treated with the CAREN combined with traditional physical therapy. The efficacy was evaluated by mobile ability assessment （Functional Independence Measure， FIM）， modified Barthel Index and muscle tension assessment（ modified Ashworth scale）. Results The scores of muscle tension assessment（ modified Ashworth scale）， daily living ability（ modified Barthel Index） and mobile ability assessment（ FIM） of group A were all better than those in group B and C. At the same time， group B was better than group C in the assessment of the above scales， and the differences between groups were statistically significant（ P＜ 0.05）. Conclusions CAREN rehabilitation system combined with traditional Chinese medicine therapy has obvious clinical effect on the recovery of unilateral spasticity of hemiplegic patients after stroke.

Abstract:Objective To compare the difference between low-energy electroconvulsive therapy（ LECT） and modified electroconvulsive therapy（ MECT） in the efficacy and adverse reactions of schizophrenia in female patients. Methods The female patients with schizophrenia enrolled were randomly divided into LECT group and MECT group， with 20 cases in each group. The LECT group energy setting was 2.8 joules. The energy Joule of the conventional MECT group was set to be slightly larger than 1/2 of the patients' age. Adverse effects were assessed by the rate of decline in the Positive and Negative Symptoms Scale（ PANSS）， and the adverse reactions were recorded. Results The scores of the LECT group and the MECT group were（ 3.3±1.5） and（ 4.4±2.0） respectively on the negative symptom scale（ PANSS-N）， and the difference was statistically significant（ t=2.059， P=0.046）. The scores of LECT group and the MECT group on the positive symptom scale（ PANSS-P） and the general psychopathological symptom scale（ PANSS-G） were［ （7.1±2.7） vs（ 9.0±3.8）］ and［ （10.5±3.8） vs （13.0±5.2）］ respectively， there was no statistical significance. The number of adverse reactions in the LECT group and the MECT group was 6 and 58 respectively， and the difference between groups was statistically significant（ χ2=15.000，P＜ 0.001）. Conclusions LECT was not inferior to conventional MECT in efficacy， but significantly decreased in adverse reactions.

Abstract:Objective To explore the influence on adolescent depression and comorbidity anxiety caused by family environment. Methods In December 2014， using cluster sampling method， general social data questionnaire， Depression Self Rating Scale for Children， Self-rating Anxiety Acale（ SAS）， Family Environment Scale Chinese version（ FES-CV） were applied among 170 junior school students from Xinxiang， Henan. Results A total of 27 students had depressive mood among 167 valid questionnaires， 9 for female and 18 for male. The score of familial environmental intimacy factors in the depressive mood group was significantly lower than that in the normal control group（ t=4.51，P＜0.05）. Contradiction of depression group was obviously higher than that of normal control group（ t=-4.33，P＜0.05）. There was no significant difference on intimacy and contradiction factor score between non-comorbidity anxiety group comorbidity anxiety group. Conclusions The warmth and contradictory of adolescent family is an important factor affecting adolescent depression and comorbidity anxiety.

Abstract:Objective To explore the effects of tumor necrosis factor（ TNF）-α on proliferation and differentiation of human induced neural stem cells（ iNSCs） reprogrammed from peripheral blood mononuclear cells. Methods The human peripheral blood mononculear cells were reprogrammed to obtain iNSCs. Immunohistochemical technique was used to observe the proliferation of TNF-α and the direction of differentiation to neurons and oligodendrocytes. Results A low dose of TNF-αcan promote iNSCs proliferation and differentiate to a oligodendrocyte fate. High dose of TNF-αcan induced apoptosis of iNSCs. Conclusions Different dose of TNF-α has different effect on human iNSCs， which is important for human iNSCs application.

Abstract:Objective To investigate the domestic application of cognitive behavioral therapy （CBT） for schizophrenia by Delphi method， in order to further standardize CBT for schizophrenia in China. Methods Expert consultant questionnaire was formulated on the basis of literature review and experts discussion. After two rounds of expert consultation， the technical components were evaluated comprehensively from four different dimensions： operability， frequency of use， contribution to therapeutic effect and acceptability of visitors， sorted according to the comprehensive technical rank. Descriptive statistical analysis was used to analyze the basic information of experts， the degree of concentration and coordination of experts' opinion. Reliability of the study was appraised by analyzing initiative and authority of experts. Results The average authority coefficient of the 23 experts was 0.84， and the initiative coefficient was 100%. After two rounds' of expert consultation， the techniques with variation coefficient over 0.30 in four dimensions were reduced significantly. The overall coordination coefficient of the four dimensions ranged from 0.4 to 0.5. 46 technique components were sorted according to integrated rank size. The top 35 technical components reach expert consensus in all dimensions except behavioral activation and voice diary. There was a certain degree of disagreement for the techniques ranking from 36 to 46 in treating negative symptoms. Conclusions The experts exert high enthusiasm into the study and have a high authority level. The result of the study is reliable. The coordination of the experts' opinions is high. The weights of techniques are determined and the rank of 46 technique components is achieved through two rounds of expert consultation.

Abstract:Objective To investigate the relationship between neutrophil lymphocyte ratio（ NLR） and intracranial and extracranial atherosclerosis stenosis in patients with cerebral infarction. Methods A total of 202 patients with acute ischemic stroke who were hospitalized in the Neurology Department of Shengjing Hospital of China Medical University from June 2016 to June 2017 were selected as cerebral infarction group. According to the subtype classification criteria of the Trial of Org 10 172 in Acute Stroke Treatment（ TOAST）， the cerebral infarction group was divided into large artery atherosclerotic（ LAA） cerebral infarction group and non-LAA group. Meanwhile 109 patients without cerebral arteriosclerosis and cerebral infarction were selected as the control group. 32 patients in the atherosclerotic cerebral infarction group were followed up. The NLR values were reviewed in outpatient clinic from 1 to 6 months after onset， and the NLR level in acute and recovery phase was compared. According to head MRA and carotid ultrasound， the patients were divided into simple intracranial atherosclerotic stenosis group， simple extracranial atherosclerotic stenosis group， intracranial and extracranial atherosclerotic stenosis group， non-stenosis group. The general clinical characteristics of the groups were compared， and the variables（ P＜0.05） were included in multivariate Logistic regression analysis. The cerebral infarction group was divided into different subgroups according to the location and degree of atherosclerosis， and the NLR level was compared. Results The NLR level of cerebral infarction group was significantly higher than that in the control group（ P＜0.05）. There was no significant difference in the NLR level between the recovery period and the acute phase of cerebral infarction in the follow-up patients（ P＞0.05）. Multivariate Logistic regression analysis of intracranial atherosclerotic stenosis showed that NLR was significantly associated with intracranial atherosclerosis after adjusting for other risk factors（ OR=2.393， 95%CI=1.389-4.123，P＜0.05）. There was no significant difference in NLR between two groups with different atherosclerotic stenosis sites and degrees（ P＞ 0.05）. Conclusions The level of NLR is associated with cerebral infarction， but not related to acute cerebral infarction. NLR is the risk factor of cerebral atherosclerosis and may be an independent predictor of intracranial atherosclerotic stenosis. There is no correlation between NLR and the position and extent of atherosclerosis.

Abstract:Objective To observe the curative effects of cyclophosphamide treatment in myasthenia gravis（ MG） with thymoma and adverse reactions in the treatment. Methods A total of 50 cases of myasthenia gravis patients that had proved thymoma by pathology after thymectomy were given cyclophosphamide sequential therapy. Cyclophosphamide was given intravenously at a dose of 0.20 g/d（ twice a week）， gradually increased to 0.80 g/d（ once a week） till the total dose was 10 g， and continued at a dose of 0.80 g/d（ once a month） until the total dose was 20.4 g. The severity and efficacy of myasthenia were evaluated according to clinical absolute score and relative score， and adverse drug reactions were observed. Results Compared with the clinical absolute scores of prior treatment（ 20.44±8.80）， when the total treatment dose reaches 6 g， 10 g， 20.4 g， the clinical absolute scores were（ 14.20±8.68），（ 10.96±8.27） and（ 3.84±4.44） respectively， which were significantly reduced（ P ＜ 0.05）. Comparing the clinical absolute scores of the total dose 6 g and 10 g with 20.4 g， the difference was statistically significant（ P＜0.05）. The effective rate of 50 cases at the total dose 6 g， 10 g and 20.4 g were 70%， 78% and 94% respectively. With the increase of the cyclophosphamide dosages， the curative effect was more obvious， and the adverse reactions were mild and tolerable. Conclusions The curative effect of cyclophosphamide medicine for MG with thymoma is obviously. The greater the total dose， the better the curative effect. When cyclophosphamide total dose reaches 20.4 g， the curative effect is remarkable with less adverse reactions. It was worthy of recommendation.

Abstract:Objective To investigate the clinical effects of dynamic psychotherapy combined with fluvoxamine in the treatment of obsessive-compulsive disorder（ OCD） and the influence on the psychological defense mechanism. Methods A total of 80 OCD patients who were treated in Mental Health Center of Xi'an City from January 2012 to December 2016 were selected and randomly divided into two groups according to the order of adnission with 40 cases in each. The control group was given fluorosamine therapy， while the observation group were treated with dynamic psychotherapy combined with fluorosamine therapy. The clinical effects of the two groups were determined by Yale-Brown Obsessive Compulsive Scale（ Y-BOCS） and Hamilton Anxiety Scale（ HAMA） before and at 1st， 4th， 8th week after treatment. The Defense Style Questionnaire（ DSQ） was recorded before and after treatment in two groups. Results The scores of Y-BOCS and HAMA at the 4th and 8th week after treatment decreased in both group， and the scores of the observation group were obviously lower than those of the control group， with statistical significance（ P＜ 0.05）. After 8 weeks of treatment， the total effective rate of the observation group（ 72.5%） was higher than that of the control group（ 52.5%）， and the difference was statistically significant（ χ2=4.501， P=0.034）. After 8 weeks of treatment， the mature defense mechanism increased and the immature defense mechanism decreased in both groups， and the observation group was superior to the control group， the difference was statistically significant（ P ＜ 0.05）. Conclusions The clinical effects of dynamic psychotherapy combined with fluvoxamine in treatment of obsessive-compulsive disorder was obviously better than the single use of fluvoxamine， which could significantly improve patients' psychological defense mechanism.

Abstract:Objective To explore the effects of closed training on coping style and quality of life in patients with schizophrenia during rehabilitation. Methods A total of 100 patients with schizophrenia who were treated in Wuhan Mental Health Center from July 2014 to July 2017 were selected and randomly divided into two groups according to the digital randon table method， with 50 cases in each. The patients in the control group were given routine nursing care. Closed training was carried out in the observation group on the basis of the control group. The scores of Morningside Rehabilitation Status Scale（ MRSS）， Coping Style Questionnaire （CSQ）， APGAR and Generic Quality of Life Inventory-74（ GQOLI-74） were compared between the two groups. Results The dependence， inactivity， symptomatic behavior abnormalities and social score of MRSS in the observation group were significantly lower than those in the control group（ P＜0.05）. There was no significant difference in the scores of CSQ， APGAR， GQOLI-74 between the two groups before training（ P＞0.05）. After the training， both groups improved significantly， and the scores of the observation group were significantly higher than those in the control group（ P ＜ 0.05）. Conclusions Closed training can effectively improve the coping style and quality of life in convalescent patients with schizophrenia.

Abstract:Objective To evaluate the clinical efficacy of argatroban combined with aspirin and clopidogrel on the treatment of antiplatelet therapy in acute cerebral infarction， and explore the active and effective treatment of acute cerebral infarction. Methods A total of 80 patients with acute cerebral infarction were recruited and randomly divided into two groups. One is argatroban with aspirin and clopidogrel group（ the treatment group， 40 cases） and the other is aspirin and clopidogrel group（ the control group， 40 cases）. To evaluate the therapeutic effect，NIHSS scores were performed 7 and 14 days before and after treatment in both two groups， ADL scores were performed before and 14 days after treatment. Results The NIHSS score of the treatment group was significantly lower than that of the control group 14 days after treatment（ P＜ 0.05）；The ADL score of treatment group was significantly higher than that of the control group 14 days after treatmen（t P＜0.01）； There was no obvious adverse reaction in both groups. Conclusions It is safe and effective to treat acute progressive cerebral infarction with argatroban combined with aspirin and clopidogrel. It is more effective than aspirin and clopidogrel treatment and to be worthy of clinical promotion.

Abstract:Patients with bipolar disorder generally have a decline in social functioning， affecting patients' return to society. This article reviews the main characteristics， neural mechanisms and current interventions of social cognitive impairment in bipolar disorder.

Abstract:The functional stability of many signal transduction pathways is the biological basis for maintaining normal cognitive function. Ubiquitin proteasome pathway（ UPP） dysfunction will lead to protein degradation disorder， neuronal stability distruction， and neuronal degeneration and necrosis. In this paper， the mechanism of UPP in cognitive impairment is illustrated， through introducing the relationship between the key molecules in synaptic plasticity and UPP.

Abstract:Medical and health journal articles are mostly referenced. The most common sources of journals are journals. The article introduces the catalogue specification of journals as reference documents.