Abstract:Parkinson disease is a common neurodegenerative disease among the middle-aged and the elderly. Because of its high prevalence rate， high disability rate and difficulty of early diagnosis， Parkinson disease puts heavy burden on patient's family and the whole society. This article reviews the latest diagnosis and treatment of Parkinson disease， in order to make a better understanding of the disease and serve the patients.

Abstract:Objective To investigate the main influencing factors of cognitive dysfunction（ CD） after acute ischemic stroke（ AIS）. Methods A total of 160 patients with AIS in Wuxi Branch of Zhongda Hospital Affiliated to Southeast University from January 2015 to January 2018 were selected. The patients were followed up for 90 days. The cognitive function of all patients was evaluated. Logistic regression analysis were applied to analyze the effects of AIS condition， vascular risk factors， serum biochemical indicators， lesion location and other clinical data on the occurrence of CD. Results In this study， 35.0%（ 56/160） of 160 AIS patients developed cognitive impairment 90 days later. Increased age， less than 12 years of education， history of alcohol abuse， anemia and dyskinesia all lead to increased incidence of cognitive dysfunction（ P＜ 0.05）. Univariate analysis showed that the level of education， alcohol consumption， age， dyskinesia， hypersensitive C-reactive protein（ hs-CRP）， homocysteine（ Hcy）， occipital lobe（ left）， temporal lobe（ left）， dorsal thalamus， posterior thalamus and frontal lobe（ left） were associated with the occurrence of CD in AIS patients 90 days after diagnosis. Multivariate regression analysis showed that education level， age alcohol consumption， dyskinesia， hs-CRP， Hcy， occipital lobe（ left）， dorsal thalamus and frontal lobe（ left） were the risk factors for CD in AIS patients 90 days after diagnosis. Conclusions Understanding the basic information of AIS patients， the location of the lesion and the level of Hcy and hs-CRP in the body， and taking corresponding measures are of great significance to reduce the occurrence of cognitive impairment.

Abstract:Objective To explore the prevalence rate of social anxiety disorder（ SAD） among secondary vocational students in Daqing and to discuss the relationship among parenting style， fear of negative evaluation， self acceptance and social anxiety disorder. Methods A total of 1 800 students from 5 secondary vocational schools in Daqing were investigated by questionnaires including Egma Minnen av Bardndosnauppforstran （EMBU）， Fear of Negativity Evaluation Scale（ FNE）， the Self Acceptance Questionnaire（ SAQ） and the Interaction Anxiety Scale（ IAS）. According to the two screening criteria of IAS and BSPS， the students were divided into high， mid and low SAD groups for DSM- Ⅳ diagnostic interview. The scores of SAD and non- SAD groups were compared to explore the related factors of SAD. Results Total of 1 617 valid questionnaires were recovered， and the valid rate was 89.8%. The point prevalence of SAD among secondary vocational school students in Daqing was 19.89%（ 95%CI： 0.191-0.207）. There was no significant difference between the gender and only-child in the prevalence rate of SAD（ χ2=0，P=0.983；χ2=1.062，P=0.303）. A binary Logistic regression was employed for all of the independent variables with the dependent variable was whether to be diagnosed as SAD by SCID. Finally， four factors， self-acceptance， self-evaluation， fear of negative evaluation and mother's preference entered the regression equation stepwise. Conclusions The point prevalence rate of SAD was 19.85% in Daqing secondary vocational school students. The factors of self-acceptance， selfevaluation， fear of negative evaluation and mother's preference could influence the onset of SAD.

Abstract:Objective To investigate the clinical characteristics of Parkinson disease（ PD） patients accompanied with cognitive impairment（ CI） and the sleeping status. Methods A total of 394 patients with PD in Beijing Tiantan Hospital from May 2014 to May 2017 were enrolled. According to CI level， the patients were divided into PD without cognitive impairment（ PD-NCI） group（ n=94，23.86%）， PD with mild cognitive impairment（ PD-MCI） group（ n=177，44.92%）， and PD with dementia（ PDD） group（ n=123，31.22%）. The demographic data of the patients were collected and the cognitive function of the patients was evaluated by Montreal Cognitive Assessment Scale（ MoCA）. The general cognitive function and the cognitive domains of the three groups were compared. Sleep status was assessed by video polysomnography（ v-PSG）. The correlation between the total score of MoCA scale， cognitive domain score and the results of v-PSG in patients with PD and CI was analyzed. Results There was no statistical significance in the differences in gender， age of onset， education level and duration of disease among the 3 groups（ P＞0.05）. The total score of MoCA scale in PD-NCI group， PD-MCI group and PDD group decreased one by one（ 22.20±4.99），（17.17± 4.36） and（ 10.73±4.85） （F=143.146，P ＜ 0.01）. The scores of MoCA scale in each cognitive field were significantly decreased in turn （P＜ 0.01）. Compared with PD-NCI group， PD-MCI group had less total sleep time， lower sleep efficiency and increased arousal frequency（ P＜0.05）. Compared with PD-MCI group， PDD group had less total sleep time， lower sleep efficiency and increased arousal frequency（ P＜ 0.05）. The sleep efficiency of PD-CI patients was positively correlated with the total score of MoCA scale， visual spatial function， executive function， delayed recall and attention score（ P＜ 0.05）. The number of arousal in PD-CI patients was negatively correlated with the total score of MoCA scale， delayed recall and attention score（ P＜0.05）. Conclusions The incidence of CI was higher in PD patients. The overall cognitive function and cognitive fields of PD patients with CI were significantly impaired. The total sleep time decreased， the sleep efficiency decreased， and the number of awakenings increased， which was related to the impairment of the overall cognitive function and some cognitive fields.

Abstract:Objective To compare the characteristics of eye movement and body sway of patients with Parkinson disease（ PD） and progressive supranuclear palsy（ PSP）. Methods A cross-sectional study was conducted in a sequential group of patients with PD and PSP. The patients were tested for the horizontal movement of the eyeball and the somatic swinging. Collect the results， and compare the differences between PD group， PSP group， and that of the health group. Results PD group consisted of 18 PD patients［ male： 11， age： 67 （60， 71） years dd］. PSP group consisted of 9 patients with PSP［ male： 7， age： 74（ 66， 78.5）years old］. Healthy group consists of 44 healthy people［ male： 15， age： 67.5（ 62， 71）years old］. The results of hierarchical regression analysis showed that the difference of eye movement index and somatic swinging index between healthy people and PD patients was statistically significant（ P＜ 0.01） after controlling the potential effects of age and sex. The difference of eye movement index between healthy people and PSP patients was statistically significant（ P ＜0.01）. There was no significant difference of the body swinging index between healthy people and PSP patients（ P ＞ 0.05）. There was no statistical significance of either eye movement index or body swinging index between the PD patients and the PSP patients（ P＞0.05）. Conclusions The combination of eye movement and body sway examinations might be helpful to identify PSP from PD.

Abstract:Depression is a frequent non-motor symptom of Parkinson disease（ PD）. It may have serious impacts on the quality of life of PD patients and their caregivers. Depressive symptoms in PD often remain unrecognized， as a result， it remains untreated. Although there are many selectable drugs and methods for the treatment of PD depression， there is no evidence of high quality evidence-based medicine. This review illustrates progress of PD depression treatment from respects of drugs， rTMS， deep brain stimulation， electroshock， cognitive behavioral therapy and so on.

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Abstract:Objective To explore the risk factors related to stroke and provide evidence for early diagnosis and prevention of post-stroke depression. Methods An extensive search for related literature from the Wanfang data， CNKI， VIP， Medline， PubMed， Embase and the Cochrane Library was performed. The odds ratio（ OR） of related factors in the literature and the confidence interval（ 95%CI） were further extracted. The role of each factor in post-stroke depression was evaluated by combining OR and 95% CI. Egger's test and sensitivity analysis was used to evaluated the risk of bias and the stability of the results. Results The results of Meta analysis showed that the risk factors for post-stroke depression included basal nuclei lesion（ OR=2.83）， frontal lobe lesion（OR=2.47）， multiple lesions（ OR=2.76）， high modified Rankin Scale（ mRS） score（ OR=2.17）， lacked family support（ OR=1.48）， high-sensitivity C-reactive protein（ OR=1.35）， female（ OR=1.66）， high homocysteine （OR=1.17）， high leptin（ OR=1.16）， high body mass index（ OR=1.16）， age（ OR=1.07）. While high education level （OR=0.91） may have a protective effect on post-stroke depression. Conclusions Basal nuclei lesion， multiple lesions， frontal lobe lesion， high mRS score， lacked family support， high-sensitivity c-reactive protein， female， high homocysteine， high leptin， body mass index， age are all risk factors for post-stroke depression， while education level may have protective effect on post-stroke depression.

Abstract:Objective To explore the mental health knowledge awareness of the guardians of patients with severe mental disorders. Methods A total of 279 guardians of patients with severe mental disorders in Chongqing were recruited from December 2017 to June 2018. All the participants were investigated with general information questionnaire and mental health knowledge questionnaire. Results The 279 guardians took care of 240 patients with severe mental disorders， among which 39（ 16.2%） patients had two guardians. The guardians' age were（ 54.70±15.26） years. The education level of 144 people was primary school and below， accounting for 51.6%， 89 was junior high school， accounting for 31.9%， 33 was high school and secondary school， accounting for 11.8%， and 13 was college and above， accounting for 4.6%. The duration of care was（ 156.29±61.77） months. The guardians' awareness rate of mental health knowledge was 76.2%. The awareness rate of mental health knowledge among guardians of different educational levels is different in different items. The correctness of some items is related to the different time of care and the age of guardian. Conclusions The direct guardians of patients with severe mental disorders show the characteristics of small number of guardians， older age， lower education level and longer care time. Educational level， age and time of care had influence on the awareness rate of mental health knowledge.

Abstract:Objective To explore the effects of vagus nerve stimulation by electroacupuncture on clinical efficacy and expression level of inflammatory factors in adolescent depression patients. Methods A total of 78 adolescent depression patients were randomly divided into experimental（ vagus nerve stimulation by electroacupuncture + Sertraline， n=40） and control group（ Sertraline， n=38）. All the patients were evaluated at the baseline and 4 weeks after treatment. The Positive and Negative Syndrome Scale（ PANSS） and Hamilton Depression Scale（ HAMD-17） were applied to evaluate efficacy. ELISA was used to detect the expression level of IL-1α，TNF-α，IL-6，IL-2. Results The effective rate of the experimental group was 80.0%（ 32/40）， and that of the control group was 57.9%（ 22/38）. The difference was statistically significant（ χ2=4.470，P=0.034）. The negative factor， the general psychopathology and the total score of PANSS and the total score of HAMD-17 of the 2 groups all decreased than before treatment（ P＜0.05）. The general psychopathology and the total score of PANSS and the total score of HAMD-17 of the experimental group were lower than those of the control group （P＜ 0.05）. IL-1α，TNF-α，IL-6， IL-2 of the experimental group decreased than before the treatment and those of the control group after treatment（ P＜ 0.05）. Conclusions Vagus nerve stimulation by electroacupuncture can improve depressive symptoms in adolescents， possibly by reducing the level of inflammatory factors.

Abstract:Objective To explore the correlation of the polymorhisms of brain-derived neurotrophic factor（ BDNF） gene rs2030324 and rs11030101 with the pathogenesis and clinical symptoms of schizophrenia. Methods A total of 200 patients with schizophrenia from Qiqihar Mental Health Center（ case group） and 200 healthy controls（ control group） were recruited from January 2017 to January 2018. Five milliliters of venous blood was extracted from each study object to extract genomic DNA. Primers were designed for the upstream and downstream of rs2030324 and rs11030101. PCR amplification was performed to compare the gene frequency distribution and genotype distribution of two loci between the two groups. Clinical symptoms were evaluated by Positive and Negative Syndrome Scale（ PANSS） in the case group， and the correlation between PANSS score and different genotypes was analyzed. Results The frequency distribution and genotype distribution of rs2030324 and rs11030101 had statistical significance（ P＜ 0.05） between the two groups. The A alleles at the two sites were all susceptible to schizophrenia， with OR values of 1.532 and 1.391，95%CI（ 1.154-2.034） and（ 1.027-1.883）， respectively. Patients with rs11030101 AT genotype were associated with PANSS negative symptom score， and patients with AT genotype had the highest negative symptom score. Conclusions The polymorphisms of BDNF gene rs2030324 and rs11030101 are correlated with the incidence of schizophrenia in the Han population， and the alleles A of both sites may be the susceptible alleles of the onset of schizophrenia. rs11030101 polymorphism may affect the clinical manifestations of schizophrenia.

Abstract:Objective To investigate the effects of metformin on cognitive function in schizophrenic patients with diabetes. Methods A total of 100 schizophrenic patients with diabetes who were hospitalized in Jinshan Mental Health Center of Shanghai from January 2016 to December 2017 were selected as the study subjects. The patients were divided into control group and observation group with 50 cases in each group by random number table method. The control group was given atypical antipsychotic drugs as well as conventional hypoglycemic drugs and placebo， while the observation group was given atypical antipsychotic drug as well as conventional hypoglycemic drugs and metformin. The fasting blood glucose（ FPG）， postprandial 2 h sugar （2 hPG）， glycosylated hemoglobin（ HbA1c）， and repetitive complete neuropsychological status test（ RBANS） scores were observed before and after treatment in the two groups， and the adverse reactions in the two groups during the treatment were statistically analyzed. Results The levels of FPG， 2 hPG， and HbA1c in the two groups were significantly lower than those before the treatment（ P＜0.05）. The decrease in the observation group was more obvious than that in the control group at the same time（ P＜0.05）. The scores of immediate memory， visual span， speech function， attention function and RBANS in the two groups were significantly higher than those before treatment（ P＜0.05）， and the increase in the observation group was more obvious than that in the control group at the same time. There were no serious adverse reactions such as hypoglycemia， abnormal liver and kidney functions， the safety of the two groups was good. Conclusions Patients with schizophrenia and diabetes mellitus treated with metformin on the basis of routine treatment can improve cognitive function， with good safety.

Abstract:Objective To investigate the levels of free triiodothyronine（ FT3）， free thyroxine（ FT4） and thyroid stimulating hormone（ TSH） in patients with depression of different severity. Methods The 105 first episode depression inpatients in the First Specialized Hospital of Harbin from September 2017 to April 2018 and the employees who participated in the physical examination in the hospital in October 2017 were selected as the research subjects. The depression patients were divided into 3 sub-groups according to the Hamilton Depression Scale（ HAMD-24） score， namely mild depression group（ n=33）， moderate depression group（ n=44） and severe depression group（ n=28）. The levels of FT3， FT4 and TSH were tested by Autolumo A2000. Results There was no significant difference in TSH among the four groups（ F=0.687，P=0.561）. The FT3 level of the severe depression group was higher than that of the healthy group， the mild depression group and the moderate depression group（ P ＜ 0.01）. There was no statistical significance in the difference of FT3 among the health group， mild depression group and moderate depression group（ P＞0.05）. The level of FT4 of the 3 depression groups were all higher than that of the health group（ P＜0.05）， however there was no statistical significance in the difference among the 3 depression groups（ P＞0.05）. Conclusions The relative level of FT4 in serum may indicate the existence of depressive symptoms， while the relative level of FT3 in serum of depressive patients may indicate the severity of the disease.

Abstract:Objective To investigate the effects of computerized cognitive remediation therapy （CCRT） on cognition function， symptoms and conversion in ultra-high-risk（ UHR） patients of schizophrenia. Methods A total of 112 UHR individuals and first-degree relatives of schizophrenia were selected from the outpatient department of the Seventh People's Hospital of Dalian from March 2016 to February 2017. According to the random number table， the research subjects were divided into CCRT group（ 57 cases） and control group （55 cases）. The subjects in the two groups were given CCRT intervention and health education respectively from 3 months. The cognitive function assessment and symptom assessment were carried out at baseline， the 3rd， and the 12th month after intervention using MATRICS Consensus Cognitive Battery（ MCCB） and the Scale of Prodromal Symptoms（ SOPS）. The conversion assessments was conducted at the 3rd，6th and 12th months， and the conversion rates were compared. Results After intervention， the four dimensions of information processing speed， attention/alertness， working memory and reasoning and problem-solving ability in the MCCB score of the CCRT group were significantly improved. There were statistical differences between the two groups after intervention， and the differences before and after intervention were statistically significant（ P ＜ 0.05）. The positive symptoms and disintegration symptoms of SOPS in the CCRT group were significantly improved compared with baseline and control group， and lasted for 12 months（ P ＜ 0.05）. The conversion rate of both groups showed an upward trend. At the 3rd and 6th month， the control group（ 12.7%， 18.1%） was significantly higher than the CCRT group（ 5.3%， 1.8%）， and the difference was statistically significant（ P＜ 0.05）. At the 12th month， the control group（ 20.0%） was still higher than the CCRT group（ 12.3%）， but the difference was not statistically significant（ P＞ 0.05）. Conclusions CCRT intervention in UHR patients with schizophrenia can effectively improve their cognitive function， positive symptoms and reduce conversion rate to some extent. The long-term efficacy needs further verification.

Abstract:Vocational rehabilitation is crucial for fully recovery of patients with severe mental health disorders. This paper makes a systematic analysis by using SWOT（ Strenths Weaknesses Opportunities Threats） strategy analysis matrix combination， and puts forward corresponding development strategies based on the identification of the advantages and disadvantages of internal environment， the opportunities and threats of the external environment and other factors of the occupational rehabilitation model. That is， through strengthening top-level system design， strengthening community health services， encouraging social participation and strengthening public awareness， to attach importance to personnel training， establish evaluation system， perfect incentive and compensation mechanism， and establish information exchange platform， so as to provide guarantee for carrying out supportive vocational rehabilitation services for patients with severe mental disorders.

Abstract:Schizophrenia is a kind of chronic serious mental disease with impaired cognitive， emotional， behavioral and social functions. Animal models of schizophrenia have been widely used in the study of etiology， mechanism of drug action and new drug development. Good animal model construction will help to solve the difficult problems in disease research. This article reviews the relationship between the types of animal models of schizophrenia and the pathogenesis of schizophrenia， and provides literature basis for the study of animal experimental studies of schizophrenia

Abstract:Physical therapy for refractory schizophrenia includes electroshock therapy， repetitive transcranial magnetic stimulation， magnetic spasm therapy and deep brain stimulation. This article summarizes the definition， efficacy and adverse reactions of these physical therapies， and provides support for further optimization of physical combination therapy strategies for refractory schizophrenia in the future.

Abstract:Substance addiction is a chronic recurrent brain disease that has great difficulties in treatment. In addition to regular medical treatment， psychological intervention is also essential. "Screening， Brief Intervention， and Referral to Treatment"（ SBIRT） is an emerging form of screening-intervention that has been used as an adjunct to treatment in the field of substance addiction. This article reviews the application of the SBIRT comprehensive intervention model in the field of substance addiction.

Abstract:Increasing evidence suggests that slow-wave sleep（ SWS） plays an important neurophysiological role， such as participating in energy storage， hormone release， regulating immunity and eliminating toxic metabolites of the central nervous system. SWS can selectively improve declarative memory. Impaired SWS is associated with a significant increase of β-amyloid 40. In clinical aspects， SWS disturbance is frequent in sleep parasomnias， dementia and fibromyalgia. This paper introduces slow wave sleep from electrophysiological characteristics， physiological functions and clinical perspectives， and some methods that can be used to regulate slow wave sleep in order to better diagnose and treat slow wave sleep disorders.

Abstract:Suicide is a complex social phenomenon， which is affected by psychological， biological and environmental factors. To date， the best method for clinicians to assess a patient's suicide risk is to screen for a patient's history of attempted suicide. However， recent studies have found that neurobiology may have predictive value for suicide risk. This paper summarizes the research on suicide risk biomarkers in China and abroad.

Abstract:Mitochondria are energy processing plants for cells. Mitochondrial metabolism is closely related to mitochondrial dynamics which plays the key role in nervous system development. Recent studies show that mitochondrial dynamics disorders has been thought to contribute to the pathophysiology of schizophrenia.This article discusses the influence of mitochondrial dynamics on nervous system development， and review recent work suggesting the relation between aberrant mitochondrial dynamics and schizophrenia.

Abstract:Insomnia is a common clinical problem. It can be comorbid with other psychiatric disorders such as major depressive disorder（ MDD） and anxiety disorder（ AD）， which leads to hard definition of causality between insomnia and MDD/AD. In view of the mutual relationship between insomnia and MDD/ AD， Comprehensive intervention of both insomnia and MDD/AD has become a new trend. Trazodone， an antidepressant with sedative and hypnotic effects， is widely used in management of insomnia， depression and anxiety. In order to standardize the clinical practice of trazodone in treatment of insomnia， the experts committee of comorbid insomnia reviewed recent evidence and recommendations of guildelines， summarized the pharmacokinetics data， pharmacological effects and clinical applications of trazodone. After repeated discussions by the committee， the consensus was finally completed， which can provide useful clinical suggestion to physicians.

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