Abstract:Schizophrenia is a lifelong diseasewith unknown etiology. Cognitive impairment is the third kind of core symptoms besides positive and negative symptoms. The strategy of cognitive rehabilitation for patients with schizophrenia has become a hot topic in the field of psychiatry. This article reviews the strategies of cognitive rehabilitation in schizophrenia

Abstract:Objective To investigate the effect of silent information regulator 1 （SIRT1） on microglia in Status epilepticus （SE） and its mechanism. Methods The rat SE model was induced by lithiumpilocarpine injection. The activation of microglia in brain tissues of control and SE rats was observed by immunohistochemistry. Microglial activation model was established by lipopolysaccharide （LPS）. PcDNA-SIRT1 and si-SIRT1 vectors were constructed and transfected into rat microglia cells. The expression of SIRT1 in the rat hippocampus and microglia was determined by qRT-PCR. The expression levels of the activation markers of microglia （Iba1） and NF-κB p65 and IκBα were detected by Western blot， and levels of the inflammatory factors （IL-1β， IL-6 and TNF-α） were detected by ELISA. Results Comparing with the control group， the mRNA expression of SIRT1 in the hippocampus of SE rats was significantly decreased， while the protein expression of Iba1 was significantly increased. The number of Iba1 positive cells in CA1 and CA2 regions in the control group was （180±21） /mm2 and （190±18） /mm2 ， as （412±35） /mm2 and （470±37） /mm2 in the SE group. The difference in Iba1 positive cells in CA1 and CA2 regions between the two groups was statistically significant （P ＜ 0.05）. Similarly， the expression level of SIRT1 in LPS activated microglia was significantly decreased， while the expression level of Iba1 protein was significantly increased， with statistical significance （P ＜ 0.05）. pcDNA-SIRT1 and si-SIRT1 were transfected into the post-microglia cells activated by LPS. The levels of IL-1β （50.0±3.3） ng/L， IL-6 （55.0±3.2） ng/L and TNF-α （56.1±3.0）ng/L in LPS+pcDNA-SIRT1 were significantly lower than those in LPS group and LPS+pcDNA-NC group （P＜ 0.05）. The levels of IL-1β （98.2±4.3） ng/L， IL-6 （108.1±4.5） ng/L and TNF-α （124.5±4.1） ng/L in LPS+si-SIRT1 group were significantly higher than those in LPS group and LPS+si-NC group （P ＜ 0.05）. Besides， the NF-κB p65 expression in LPS+pcDNASIRT1 group was significantly lower than that in LPS group and LPS+pcDNA-NC group， while the IκBα expression was higher than those two groups （P ＜ 0.05）. However， the NF-κB p65 expression in LPS+siSIRT1 group was significantly higher than that in LPS group and LPS+si-NC group， while the IκBα expression was lower than those two groups （P ＜ 0.05）. After giving the NF-κB pathway activator （Aconine）， compared with the LPS+pcDNA-SIRT1 group， the expression of Iba1 in the LPS+pcDNA-SIRT1+Aconine group was significantly increased （P＜ 0.05）. The expression levels of IL-1β were significantly higher in the LPS+pcDNASIRT1+Aconine group ［（72.2±4.3） ng/L， IL-6 （80.1±4.0） ng/L， and TNF-α （87.2±4.5） ng/L］ than that in the LPS + pcDNA-SIRT1 group ［IL-1β （50.1±2.3） ng/L， IL-6 （55.0±3.4） ng/L， and TNF-α （56.3±4.9） ng/L］ （P＜ 0.05）. Conclusions SIRT1 could inhibit the activation of microglia in SE rats by inhibiting the NF-κB pathway.

Abstract:Objective To describe the characteristics of patients with suicidal tendency in general hospitals， and to analyze the risk factors of suicidal behaviors in these patients. Methods A total of 680 cases with suicidal tendency were collected from inpatients in NanfangHopsital Affiliated to Southern Medical University from October 2012 to October 2017. According to the occurrence of suicidal behavior， the sample was divided into suicidal tendency group （without suicidal behavior， n=527） and suicidal behavior group （with suicidal behavior， n=153）. Data were collected on their gender， age， marital status， household registration， admission department， suicide inducement， suicide pattern， mental illness， physical illness and significant mental symptoms. Univariate analysis was used to compare the socio-demographic and clinical characteristics of the two groups. Binary logistic regression analysis was used to explore the risk factors of suicide behavior. Results The samples in suicidal tendencygroup were mainly female （351，66.6%）， married （458，77.4%）， psychiatric inpatients （392，74.4%）， and suffering from depression （349，66.2%）. In the suicide behavior group， there was a significant difference in suicide pattern between men and women （χ2 =12.489，P=0.014）. Men were more than women choosing the way of jumping off the building. On the other hand， women were more among those using drugs and wrist-cutting. Logistic regression analysis showed that intensive care unit （ICU） inpatient （OR=7.844， 95%CI：2.240-27.475， P=0.001）， frustration in marriage （OR=3.646， 95%CI：1.217-10.917， P=0.021）， tumor （OR=4.620， 95%CI：1.552-13.755， P=0.006）， bipolar disorder （OR=3.734， 95%CI：1.157-12.052， P=0.028） were risk factors of suicide. Conclusions Among the patients with suicidal tendency， ICU inpatient， bipolar disorder， tumor， marriage and love setback are the risk factors of suicidal behavior. Men and women tend to choose different suicide pattern. It requires more attention in clinical practice， and targeted preventive measures.

Abstract:Objective To evaluate the cognitive function and anxiety， depression and mental symptoms of people at high risk of schizophrenia， and provide scientific basis for early intervention of this population. Methods A total of 109 healthy children of schizophrenia outpatients and inpatients from the First Affiliated Hospital of China Medical University and Shenyang Mental Health Center were selected as the genetic high-risk group （HR） of schizophrenia. A healthy control group （HC） of 109 healthy children matched with age， gender， and years of education were recruited by advertising. The two groups completed the Wisconsin Card Sorting Test （WCST）， MATRICS Consensus Cognitive Battery （MCCB）， Hamilton Anxiety Scale （HAMA）， Hamilton Depression Scale （HAMD-17）， and Brief Psychiatric Rating Scale （BPRS）. The general demographic data， cognitive status， and clinical characteristics of the two groups of subjects were analyzed. Results （1）The total number of correct （Z=-4.54，P＜ 0.01）， correct classification （Z=-3.78，P＜ 0.01）， total number of errors （Z=-4.49，P ＜ 0.01）， the number of persistent errors （Z=-3.91，P ＜ 0.01） and the number of non-persistent errors （Z=-3.38，P＜ 0.01） were significantly different for the HR group from the HC group， （2）The HR group's total score of MCCB （t=11.58，P＜ 0.01）， symbol coding （t=11.25，P＜ 0.01）， visual spatial memory （t=4.59， P=0.04）， and continuous operation test （t=6.18，P=0.02） were significantly lower than those of the HC group；the total HAMA score （t=2.54，P＜ 0.01）. （3）The total HAMD-17 score （t=3.03，P＜ 0.01）， the somatic anxiety factors （t=2.70，P ＜ 0.01） and core depression factors （t=3.04，P ＜ 0.01） in the depression scale in the HR group were significantly higher than those in the HC group. （4） The total score of BPRS （t=3.14，P ＜ 0.01）， anxiety and depression factor scores （t=2.90，P＜ 0.01） in the HR group were significantly higher than the HC group. Conclusions Cognitive functions are impaired in individuals at high risk of schizophrenia and anxiety， depression， and mental symptoms are higher than the healthy population.

Abstract:Objective To explore the effect of semi-closed management on negative symptoms and social function in chronic schizophrenic patients with long-term hospitalization. Methods A total of 80 patients with chronic schizophrenia hospitalized in Shanghai Fengxian District Mental Health Center from September 2017 to September 2018 were enrolled prospectively. All the subjects were divided into the intervention group （n=40） and the control group （n=40）. The intervention group was given antipsychotics combined with semi closed intervention and farm labor management， while the control group was given antipsychotics combined with closed management for 12 months. All subjects were assessed by the Positive and Negative Symptom Scale （PANSS）， Scale of Social Function of Psychosis Inpatients （SSFPI）， and Insight and Treatment Attitude Questionnaire （ITAQ） before and after the intervention. Results The results of repeated measurement analysis of variance showed that the positive symptom factors indicating statistical significance in group main effect （F=4.887， P=0.030）， while the negative symptom factors indication statistical significance in both time and group interaction effect （F=6.249， P=0.015）. The score of negative symptoms of the intervention group decreased at the end of the 12th month. There was no significant difference in time main effect， group main effect， time and group interaction between the two groups （P＞ 0.05）. The social activity skills of SSFPI showed that there was significant difference in the main effect of time （F=9.648， P=0.003）， however there was no significant difference in the main effect of group and the interaction effect between group and time （P＞0.05）. There was no significant difference in the main effect of time， group main effect， time and group interaction between the two groups （P＞0.05）. The total score of ITAQ showed significant difference in time and group interaction effect （F=36.865， P＜0.001）. Conclusions Semi-closed management and farm labor can effectively improve the negative symptoms， selfknowledge and treatment attitude of long-term inpatients with chronic schizophrenia， but have no significant impact on social function.

Abstract:Objective To explore the efficacy and safety of repetitive transcranial magnetic stimulation （rTMS） in reducing tobacco dependence in schizophrenic inpatients. Methods A total of 82 male schizophrenic patients with smoking in the closed psychiatric ward of Wuhan University People's Hospital from October 2018 to May 2019 were enrolled in the randomized， double-blind control study. All patients met the diagnostic criteria for schizophrenia and tobacco dependence. The patients were randomly divided into treatment group （41 cases） and control group （41 cases） by random number table. The treatment group was given high frequency rTMS stimulation （10 Hz， 110% motor threshold）， left prefrontal dorsolateral cortex stimulation， 5 times per week， for 4 weeks of treatment and 8 weeks of observation， while the control group received rTMS pseudo stimulation treatment. The average number of daily smoking before and after treatment， Fagerstrom Test for Nicotine Dependence （FTND）， Tobacco Craving Questionnaire （TCQ） and positive and negative symptoms scale （PANSS） were compared between the two groups to evaluate the efficacy and mental status of the two groups. The incidence of adverse reactions was compared between the two groups to evaluate the safety. Results Among 41 cases， 3 cases fell off in the treatment group and 5 cases in the control group. The reasons of falling off were 4 cases discharged in advance， 2 cases disobedience and 2 cases with relapse of mental symptoms who were not suitable to continue the trial. Finally， there were 38 cases in the treatment group and 36 cases in the control group. There were statistically significant differences between the two groups in the number of daily smoking， the scores of FTND and TCQ self-assessment scale before and after treatment （F value of interaction effect was 61.398， 43.117 and 77.144， respectively， P＜ 0.01）. The number of daily smoking， the scores of FTND and TCQ self-assessment scale after treatment of the treatment group were significantly lower than those of the control group at the 2nd treatment week， the 4th treatment week and the 8th week ［the number of daily smoking at the 2nd treatment week， the 4th treatment week and the 8th week of the treatment group and the control group： （20.37±4.82）， （16.71±4.05） （17.21±4.07） vs. （27.72±7.21）， （27.17±7.11）， （26.06±5.86）； the score of FTND： （5.53±1.13）， （4.21±1.02）， （4.34±0.84） vs. （7.11±1.47）， （7.06±1.43）， （7.06±1.53）； the score of TCQ： （62.74±4.20）， （55.26±4.92）， （54.97±5.03） vs. （68.14±6.57）， （66.94±6.01）， （66.31±5.87）］， with statistical significance （P ＜ 0.01）. There was no significant difference in PANSS score （including total score， positive scale score， negative scale score and general scale score） between the two groups after 4 weeks of treatment （P＞ 0.05）. There were 7 cases （18.4%） of adverse reactions in the treatment group， including 4 cases of headache， 2 cases of insomnia and 1 case of restlessness. There were 4 cases （11.1%） of adverse reactions in the control group， including 2 cases of nausea， 1 case of insomnia and 1 case of restlessness. There was no significant difference in the total incidence of adverse reactions between the two groups （χ2 =0.781， P＞ 0.05）. All the adverse reactions were not treated and self-relieved. Conclusions High frequency rTMS treatment can reduce the amount of daily smoking and the level of tobacco craving in schizophrenic patients， with good safety.

Abstract:Objective To compare the visual nystagmus （VNG） manifestations of vestibular migraine （VM） and healthy subjects， and to clarify the diagnostic value of VNG in VM. Methods A prospective analysis of 55 patients with VM and 45 healthy patients who were treated in the Department of Neurology in the Affiliated People's Hospital of Xinxiang Medical University from August 2018 to August 2019 was conducted. All subjects were were examined with VNG under the permitted conditions， including optokinetic test （saccade test， stationary tracking experime， optokinetic nystagmus examination）， vestibular function test （caloric test， head shaking nystagmus）， spontaneous nystagmus test， evoked nystagmus test （static position nystagmus）. χ2 test was used to compare the differences in VNG results between the two groups. Results There was no significant demographic difference between VM group and healthy subjects group （P ＞ 0.05）. Saccade test： There were 17 abnormalities in the VM group （30.9%） and 3 （6.7%） in the healthy subjects group （χ2 =9.091，P ＜ 0.05）. Stationary tracking experiment： There were 20 patients （36.4%） were abnormal in the VM group， and 5 （11.1%） in the healthy group （χ2 =8.418，P＜ 0.05）. Optokinetic nystagmus examination： There were 24 cases （43.6%） were abnormal in the VM group， and 6 （13.3%） in the healthy group （χ2 =10.823，P ＜ 0.05）. Caloric test： There were 13 cases （23.6%） were abnormal in the VM group， 2 （3.6%） in the healthy subject group （χ2 =7.150， P＜ 0.05）. Head shaking nystagmus： There were 11 cases （20.0%） were abnormal in the VM group ， 2 （3.6%） in the healthy subject group（χ2 =5.295， P＜ 0.05）； Spontaneous nystagmus： There were 10 patients （18.2%） were abnormal in the VM group， and 4 （8.9%） in the healthy subject group （χ2 =1.775，P ＞ 0.05）. Static position nystagmus： There were 22 abnormalities （40.0%） in the VM group and 7 （16.5%） in the healthy subject group （χ2 =7.183， P＜ 0.05）. Conclusions The abnormal rate of total VNG examination in the VM group was higher than that in the healthy subject group， indicating that the VNG examination is helpful for the diagnosis of VM， and its performance suggests signs of damage to the center and periphery of VM patients.

Abstract:Objective To investigate the neuroprotective effect of clopidogrel on cerebral ischemiareperfusion injury in rats based on PI3K/Akt pathway. Methods Rat models of cerebral ischemia reperfusion were established and randomly divided into model group， clopidogrel group， LY294002 （PI3K/Akt pathway inhibitor） group and clopidogrel + LY294002 group， with 12 rats in each group， and another 12 SD rats were used as sham operation group. After grouping， all rats were scored for neurological deficit and blood was taken from caudal vein to execute the rats. Hematoxylin-eosin （HE） staining was used to detect the pathological changes of neurons in each group， the infarct size of brain tissue was measured by TTC staining， enzyme-linked immunosorbent assay （ELISA） was used to detect the levels of serum central nervous specific protein （S100β）， neuron specific enolase （NSE）， interleukin-6 （IL-6）， and tumor necrosis factor-α （TNF-α）， and the expression of PI3K/Akt pathway protein in brain tissue was detected by Western blotting. Results Compared with shamoperated group， neuron necrosis and nuclear contraction decreased in model group； neurological deficit score， cerebral infarction area， levels of serum S100β， NSE， IL-6 and TNF-α increased significantly （P ＜ 0.05），while p-PI3K/PI3K and p-Akt/Akt decreased significantly （P ＜ 0.05）. Compared with the model group， the pathological damage of neurons in clopidogrel group was alleviated； neurological deficit score， cerebral infarction area， levels of serum S100β， NSE， IL-6 and TNF-α decreased significantly （P ＜ 0.05）， while p-PI3K/PI3K and p-Akt/Akt increased significantly （P ＜ 0.05）. Neuronal pathological damage in LY294002 group was aggravated； neurological deficit score， cerebral infarction area， levels of serum S100β， NSE， IL-6 and TNF-α increased significantly （P＜ 0.05）， while p-PI3K/PI3K and p-Akt/Akt decreased significantly （P ＜ 0.05）. Compared with LY294002 group， the pathological damage of neurons in clopidogrel + LY294002 group was alleviated； the neurological deficit score， cerebral infarction area， levels of serum S100β， NSE， IL-6 and TNF-α decreased significantly （P＜ 0.05）， while p-PI3K/PI3K and p-Akt/Akt increased significantly （P ＜ 0.05）. Compared with clopidogrel group， neuropathological damage was aggravated in clopidogrel + LY294002 group； neurological deficit score， cerebral infarction area， levels of serum S100β， NSE， IL-6 and TNF-α increased significantly （P ＜ 0.05）， while p-PI3K/PI3K and p-Akt/Akt decreased significantly （P ＜ 0.05）. Conclusions Clopidogrel can alleviate cerebral ischemia-reperfusion injury and protect brain tissue by activating PI3K/Akt pathway in rats.

Abstract:Alzheimer Disease（AD） is a common disease in the elderly with cognitive decline as the main change， causing huge burden to the family and society. Sleep disorder is one of the important clinical manifestations of AD， which is highly intertwined with its occurrence and development. The occurrence of sleep disorder will affect various physiological and psychological functions， thus causing a series of changes in cognitive functions. This paper reviews the related literature of sleep and AD， in the view of discovering the possible association mechanism between sleep disorder and AD.

Abstract:The functional activity of central serotonin is closely related to affective disorders， and the loudness dependence of auditory evoked potentials can reflect the functional activity of central serotonin， which provides a new method and basis for the diagnosis and prediction of treatment response of affective disorders. The loudness dependence of auditory evoked potentials and its application in depression and bipolar disorder are reviewed in this paper.

Abstract:Alzheimer disease （AD）， a chronic neurodegenerative disorder， is the main cause of dementia. Various factors contribute to AD with poor clinical prognosis. LncRNAs， a kind of non-coding intergenic RNA， are involved in various pathophysiologic processes， such as cancer， neural system disease， cardiovascular disease and aging via transcriptional and post-transcriptional mechanisms. The relationship between lncRNAs and the development of AD was first raised in 1992， and the role of different lncRNAs in AD has received extensive attention. This paper summarizes the studies regarding lncRNAs and AD during last decades and hope to get novel insights into prevention and treatment of AD.

Abstract:Stroke is the leading cause of permanent disability. Stroke in progression （SIP） is one of the most lethal and disabling type. Studying the clinical and imaging manifestations of SIP has become a core issue of clinicians. This paper reviews the research progress of the disease development of the patients with SIP by using a variety of imaging techniques.

Abstract:

Abstract: