Abstract:Objective To investigate the association between earthquake stress during pregnancy and the methylation status of NR3C1 exon 1F promoter and the influence on glucolipid metabolism in adulthood. Methods From January 2014 to March 2015， 100 cases of earthquake stress during pregnancy were selected as the earthquake stress group， and 76 cases without earthquake stress were selected as the control group. According to the pregnant period of earthquake， the pregnant women were divided into early pregnancy exposure group（ 41 cases）， mid pregnancy exposure group（ 30 cases） and late pregnancy exposure group（ 29 cases）. The methylation degree of NR3C1 promoter region was detected by bisulfite sequencing， and the metabolic indexes such as height， weight， BMI， blood pressure， fasting blood glucose and blood lipid were collected. Rusults NR3C1 methylation level of prenatal earthquake exposure group was significantly higher than that of the control group， and the difference was statistically significant（ P ＜ 0.05）. After comparison of subgroups， the methylation degree of NR3C1 promoter in the second trimester exposure group was higher than that in the early and late pregnancy groups， and the differences were statistically significant（ P ＜ 0.01）. The BMI and total cholesterol of adult in earthquake stress group were higher than those in control group， the difference was statistically significant（ P＜ 0.01）. Pearson correlation analysis showed that the methylation degree of NR3C1 promoter region was positively correlated with total cholesterol（ r=0.256， P ＜ 0.05） in maternal earthquake stress group， while it was positively correlated with triglyceride and total cholesterol in the second trimester exposure group（ r=0.406， 0.378， P＜0.05）. Conclusions There was significant association between increased NR3C1 exon 1F methylation and glucolipid metabolism in adulthood with prenatal earthquake stress.

Abstract:Objective To establish a rat model of hippocampal injury in schizophrenia， and to investigate the protein phosphorylation activity of protein kinase B（ PKB/Akt） and forkhead box Os（ FoxOs） protein in the model brain. Methods Healthy male Sprague-Dawley rats were randomly divided into two groups： the neonatal ventral hippocampus lesion（ NVHL） and the control group， with 8 rats in each group. The model of NVHL was established by stereotactic injection with ibotenic acid. At 56-60 days， the rats were subjected to spontaneous activity， pre pulse inhibition（ PPI） and other behavioral tests. Three days after the test， the brain tissue was taken for morphological observation. Akt/FoxOs phosphorylation levels in cortex and striatum were measured by Western blot. Rusults Compared with the control group， the ventral hippocampus of NVHL rats was significantly damaged. Amphetamine induced spontaneous exploration activity increased ［（1 014±72） times vs.（ 753±87） times， P ＜ 0.01］， PPI was impaired［ PP6：（ 5.04±3.24）% vs. （22.08±14.26）%， PP9：（ 11.26±5.24）% vs.（ 25.16±13.45）%， PP12：（ 8.17±10.45）% vs.（ 29.16±10.25）%， all P＜ 0.01］ in the NVHL group. The phosphorylation levels of Akt/FoxO1 in cerebral cortex and Akt/FoxO1/ FOXO3a in striatum were decreased（ P ＜ 0.05）. Conclusions Ventral hippocampal injury is a widely used animal model of schizophrenia. After hippocampal injury， Akt/FoxOs protein phosphorylation levels in cortex and striatum of rats decreased， which further indicated that this pathway was involved in the process of schizophrenia.

Abstract:Objective To explore the influencing factors of microembolic signal in patients with acute cerebral infarction and its relationship with short-term prognosis. Methods A total of 118 patients with acute cerebral infarction admitted to the Neurology Department of the Second Affiliated Hospital of Wannan Medical College from January 2019 to January 2020 were prospectively enrolled as the research objects. All of them were monitored by transcranial Doppler for microembolic signals. According to whether the microembolic signals were positive， they were were divided into positive group and negative group. Uni-variate and multivariate logistic regression were used to analyze the influencing factors of microembolic signal； After 6 months of follow-up， the recurrence of cerebral infarction was observed. The relationship between the positive microembolic signal and the recurrence of cerebral infarction was analyzed by Kaplan-Meier survival curve. Rusults There were 36 of the 118（ 30.51%） patients with acute cerebral infarction had positive microembolic signals. Carotid artery plaque ［69.44%（ 25/36）］， severe stenosis rate of carotid artery［ 55.56%（ 20/36）］， platelet（ PLT）［ （278.84±26.93）×109/L］， high sensitivity C-reactive protein（ hs-CRP） level［ （13.87±3.58） mg/L］， and the National Institutes of Health Stroke Scale（ NIHSS） score（ 5.93±1.17） in the positive group were significantly higher than those in the negative group［ 29.27%（ 24/82）， 20.73%（ 17/82），（ 215.48±16.53）×109/L，（ 9.87±2.07） mg/L， （4.88±0.58）］； high-density lipoprotein cholesterol（ HDL-C） level in the positive group［ （0.91±0.33） mmol /L］ was lower than that of the negative group［ （1.23±0.65） mmol/L］. The differences were statistically significant （all P＜0.05）. According to multivariate logistic regression analysis results， carotid artery plaque（ OR=7.425， 95%CI： 2.892-28.882）， severe stenosis（ OR=2.692， 95%CI：1.362-8.736）， and high PLT level（ OR=8.462， 95%CI：1.425-16.465） were all independent risk factors of positive microembolic signals（ all P ＜ 0.05）. All patients were followed up， and 15 cases of cerebral infarction recurred， of which the positive group was 22.22% （8/36）， higher than 8.54%（ 7/82） of the negative group. The difference was statistically significant（ χ2=4.223， P=0.040）. Kaplan-Meier survival curve analysis and Log-rank test showed that patients in positive group were more likely to have cerebral infarction recurrence than those in negative group（ P＜0.05）. Conclusions The positive microembolic signals in patients with acute cerebral infarction are related to carotid plaque， severe stenosis and high level of platelets， suggesting that these patients have a worse short-term prognosis and require closer follow-up to strictly control risk factors.

Abstract:Objective To systematically evaluate the efficacy and safety of escitalopram compared with paroxetine in the treatment of elderly patients with depression， so as to provide evidence-based reference for drug selection in the treatment of elderly patients with depression. Methods By retrieving from China National Knowledge Infrastructure（ CNKI）， Wanfang database， China Biology Medicine（ CBM） database， VIP database， PubMed and The Cochrane Library， randomized controlled trials（ RCTs） of escitalopram（ experimental group） campared with paroxetine（ control group） in the treatment of elderly patients with depression were collected. After the data extraction and quality evaluation of the studies meeting the inclusion criteria， the Rev Man 5.3 statistical software was used for meta-analysis. Rusults A total of 10 RCTs involving 823 patients were included. Meta-analysis results showed that， in the experimental group， the recovery rate（ OR=1.83， 95%CI： 1.26-2.65）， HAMD score（ OR=-2.80， 95%CI：-3.50--2.11）， GDS score（ OR=-2.03， 95%CI：-3.12--0.93）， total adverse reaction rate（ OR=0.45， 95%CI：0.36-0.58）， the incidence of xerostomia（ OR=0.32， 95%CI： 0.15-0.69）， The incidence of dizziness（ OR=0.38，95%CI：0.17-0.86）， the incidence of anorexia（ OR=0.35， 95%CI：0.16-0.79）， the incidence of nausea（ OR=0.40，95%CI：0.24-0.69）， the incidence of headache （OR=0.36， 95%CI： 0.14-0.95）， the incidence of fatigue（ OR=0.39， 95%CI： 0.19-0.80）， The incidence of constipation（ OR=0.34， 95%CI：0.17-0.69） were significantly lower than the control group， and the differences were statistically significan（t all P＜0.05）. In the experimental group， the significant effective rate（ OR=0.91， 95%CI： 0.63-1.31，P=0.62）， the incidence of drowsiness（ OR=0.57， 95%CI： 0.22-1.50，P=0.26） and the incidence of tachycardia（ OR=0.38， 95%CI： 0.14-1.02，P=0.05） had no statistically significant differences compared with those in the control group. Conclusions Existing evidence shows that escitalopram has certain advantages in efficacy and safety compared with paroxetine in the treatment of elderly patients with depression.

Abstract:Objective To examine the associations between the brain-derived neurotrophic factor （BDNF） level， gene polymorphism， and cognitive function in patients with late-life depression. Methods From April 2014 to January 2016， inpatients or outpatients over and 60 years old with first-episode depression from Beijing Anding Hospital affiliated to Capital Medical University were enrolled in this study. The severity of depression and cognitive function were assessed using Hamilton Depression Scale（ HAMD-17）， the verbal fluency test， trail making tests（ TMT） A-B， the Stroop color-word test and Wisconsin card sorting test. Blood samples were collected to determine the level of serum BDNF， and DNA was extracted to determine the single nucleotide polymorphism（ SNP） of BDNF rs6265 gene. Rusults A total of 80 patients were enrolled in this study. No significant associations were found between BDNF rs6265 and the severity of depression（ P＞0.05）. The total score of HAMD-17 was negatively correlated with verbal fluency test and WCST persistent errors（ r= -0.239，-0.226）， and the differences were statistically significant（ P＜0.05）. Patients with VAL/MET on rs6265 performed significantly worse on TMT A-B than that in patients with VAL/VAL（ P＜0.05）. The serum BDNF is not significantly correlated to cognitive function（ P＞0.05）， while it is negatively correlated with the HAMD-17 total score（ P＜0.05）. Conclusions BDNF rs6265 gene polymorphism is associated with cognitive impairment in patients with late-life depression， but not with BDNF level， suggesting that BDNF may affect cognitive function in elderly depression through other mechanisms.

Abstract:Nonconvulsive electrotherapy（ NET） is a modified electroconvulsive therapy technique which uses the electrical stimulation lower than the seizure threshold. It has obvious effect and less adverse cognitive reaction. In this paper， the theoretical basis， determination of the electrical stimulation， efficacy and safety， and mechanism of action of NET for depression are reviewed.

Abstract:In recent years， studies have found that adolescent obesity and depression generally have a two-way connection， that is， when one situation occurs， the risk of the other situation significantly increases. It is found that the two have a lot in common in genetics， inflammatory factors， hormones and social environment. Analyzing the correlation between the two and its causes in adolescence may not only become an important target for obesity and depression treatment， but also can even prevent the occurrence of both. Yet， more evidence is needed to support this theory. In this paper， the correlation and related causes of adolescent obesity and depression are illustrated.

Abstract:Depression has the highest incidence among mental diseases. It has strong destructive power and high disability rate. It is one of the main diseases of global medical burden. It is found that adiponectin is not only the pathogenesis of metabolic diseases， but also closely related to the occurrence and development of depression. This article reviews the relationship between depression and adiponectin， and the related research progress at home and abroad.

Abstract:Objective To explore the characteristics and influencing factors of family cohesion and adaptability of adolescent bipolar disorder patients， so as to provide reference for clinical treatment of patients with bipolar disorder. Methods The Family Adaptability and Cohesion Evaluation Scale（ FACES） and the Family Assessment Device（ FAD） were used to evaluate the adolescent patients with bipolar disorder and the ordinary adolescent families. The scores of family cohesion dimension were divided into alienation， independence， intimacy and entanglement from low to high， while the scores of adaptability dimension were divided into fossilization， structure， flexibility and confusion from low to high. FAD has seven subscales， including communication， role， problem solving， emotional response， emotional involvement， behavior control and total function. The lower the score of each subscale， the healthier the family is in this dimension. Multivariate logistic regression analysis was carried out to analyze the influencing factors of family cohesion， adaptability and family type by SPSS 20.0 statistical software. Rusults In terms of cohesion， the distribution of alienation， independence， intimacy and entanglement between patient families and healthy families was statistically significant（ Z=-3.42，P ＜ 0.01）. The alienation of patient families was associated with problem solving（ OR=7.24， 95%CI=1.79-29.67） and role score（ OR=3.86， 95%CI=1.63-5.56）. The severity of family alienation increases with the scores of problem solving and role. In terms of adaptability， the distribution of fossilization， structure， flexibility and confusion was statistically significant between patient families and healthy families（ Z=-4.36，P＜0.01）. The fossilization of patient families was associated with age（ OR=1.36，95% CI= 1.09-1.69）， rural area（ OR=0.35， 95%CI=1.96-0.16）， problem solving（ OR=8.08，95%CI=0.55-3.63）， role （OR=58.56，95%CI=0.14-0.85） and behavioral control（ OR=0.15，95%CI=0.03-0.69）. The fossilization of family is more serious when they have higher age and higher scores in problem solving and role dimensions. Compared with rural families， urban families are more rigid and have higher scores of behavior control， and the more likely they are to be confused. In terms of family type， the distribution of extreme， intermediate and balanced type was statistically significant between patient families and ordinary families（ χ2=27.39，P＜ 0.01）. The polarization of patient families was associated with roles（ OR=45.49， 95%CI=2.50-82.99） and emotional intervention（ OR=0.11，95%CI=0.02-0.74）. Conclusions The family cohesion of adolescents with bipolar disorder were affected by role and problem solving， and the adaptability were affected by age， region， problem solving， role and behavior control， which should be considered in psychological intervention.

Abstract:Objective To investigate the efficacy of repeated transcranial magnetic stimulation （rTMS） combined with risperidone under theta burst stimulationin（ TBS） mode in the treatment of first-episode schizophrenia， and to observe the changes of serum prolactin（ PRL） levels. Methods From January 2019 to December 2019， a total of 100 patients with first-episode schizophrenia in Jingmen NO.2 People's Hospital were randomly divided into study group and control group， with 50 patients in each group. Before treatment， Positive And Negative Syndrome Scale（ PANSS） scale was used to evaluate the patients， and plasma PRL was detected. The patients in both groups were treated with risperidone oral liquid. The study group was treated with rTMS under TBS mode for four weeks， and at the end of 2 weeks and 4 weeks after treatment， psychological assessment was carried out and plasma PRL was detected. Patients were followed up for 4 weeks after rTMS treatment， and plasma PRL was redetected. Rusults （1） There was no statistically significant difference on the total score and factor score of PANSS scale between the two groups before treatment， but there was statistically significant difference in time effect between the two groups after treatment（ all P＜0.05）. In the comparison of effects between groups， there were statistically significant differences in negative symptoms（ F=4.419；P ＜ 0.05）， but there was no statistically significant difference in the other factors and the total score of PANSS（ all P ＞ 0.05）. In the comparison of interactive effects， there were statistically significant differences in the total score of PANSS and the scores of all factors（ all P＜0.05）.（ 2） There was no statistically significant difference in serum PRL between the two groups before treatment， but there were statistically significant differences in time effect， intergroup effect， and interaction effect between the two groups after treatment（ Ftime=558.270， Fgroup=70.257，Finteraction=51.863， all P ＜ 0.05）. After treatment， there were statistically significant differences in serum PRL between the two groups at different time points（ t1=43.296，t2=78.881，t3=92.162；P ＜ 0.05）. Conclusions rTMS therapy under TBS mode can improve the negative symptoms of first-episode schizophrenia， delay the increase of plasma PRL caused by risperidone， and have slight adverse reactions. However， the long-term efficacy is difficult to maintain.

Abstract:Objective To investigate the efficacy and safety of high-frequency repetitive transcranial magnetic stimulation（ rTMS） in the treatment of post-withdrawal anxiety， depression and hunger in methamphetamine（ MA） dependent patients. Methods A total of 47 cases of male MA dependent detoxification patients in Bengbu Compulsory Isolation and Rehabilitation Center were prospectively selected. All the subjects were divided into study group and control group according to the random number table method. The study group received systematic high-frequency（ 10 Hz） rTMS treatment， while the control group received sham rTMS treatment for 3 times a week and a total of 4 weeks. Self-rating Anxiety Scale（ SAS）， Self-rating Depression Scale（ SDS） and Visual Analogue Scale（ VAS） were used to assess anxiety， depression and psychological craving at baseline and at the end of the fourth week of treatment， respectively. Adverse drug reactions were recorded by adverse drug reactions questionnaire（ ADR） during the intervention. Rusults At the end of the fourth week of treatment， SAS score（ 43.17±8.60）， SDS score（ 48.00±8.12） and VAS score［ 1.00（ 0，2.75）］ in the study group were lower than those at baseline［ SAS score（ 46.71±8.64）， SDS score（ 52.96±7.66） and VAS score 4.00（ 2.00，5.75）］with statistically significant differences（ all P＜0.05）. SAS score， SDS score and VAS score of the study group at the end of the fourth week of treatment were all lower than those of the control group［ （48.74±8.92）， SDS scores（ 53.13±6.61） and VAS scores 4.00（0， 6.00）］with statistically significant differences（ P ＜0.05）. There was no statistically significant difference in SAS， SDS and VAS scores of the control group at the end of the fourth week compared with those at baseline（ all P＞0.05）. There were 8 cases （33.33%） of adverse reactions in the study group， including 6 cases of headache， 1 case of dizziness and 1 case of tinnitus， which could be tolerated by the patients； no adverse reactions occurred in the control group. Conclusions High-frequency rTMS can improve the anxiety， depression and craving of methamphetaminedependent patients. Mild adverse reactions are common.

Abstract:Objective To explore the application effect of case-based learning（ CBL） method in standardized training of residents in epilepsy learning compared with conventional education mode. Methods A total of 50 residents who rotated in the Epilepsy Sub-specialty of Xuanwu Hospital from 2018 to 2020 were divided into two groups. Among them， 25 residents enrolled in 2019 were the CBL teaching group and received the CBL education mode. 25 residents enrolled in 2018 were the conventional teaching group and received conventional teaching mode. The study period of both groups lasted for 3 months. At the end， there were theoretical examination， practical examination and questionnaire survey as evaluation methods. Rusults There was no statistically significant difference in theoretical examination scores between CBL teaching group and conventional teaching group［ CBL teaching group（ 89.8±3.1）， conventional teaching group（ 89.7±2.7）；t=0.14， P=0.89］， but the practical examination scores of the CBL teaching group were significantly better than those of the conventional teaching group［ CBL teaching group（ 89.2±2.6）， conventional teaching group（ 85.1±2.3）； t=5.98，P ＜ 0.05］. The results of the questionnaire survey showed that residents who accepted CBL teaching mode had more interest in epilepsy learning， higher learning initiative and more obvious improvement of clinical thinking ability. Conclusions CBL teaching method has more advantages in the training of epilepsy subspecialist residents， which is conducive to cultivate their clinical thinking and enhance their ability of clinical diagnosis and treatment. It enables the residents to complete the tasks required by the standardized training program at a higher level， and increases their learning satisfaction.

Abstract:Alcohol use disorder（ AUD） is the most common addiction disorder worldwide. Long-term heavy drinking can cause physical， mental and family social harm， which has become one of the important causes of death. Although a growing number of studies suggest that there is functional impairment in the brain of patients with AUD， this abnormality has not been systematically discussed. This paper reviews the research progress of functional imaging studies on AUD at home and abroad based on MRI and summarizes the imaging characteristics. It is hoped that it could help clinicians fully understand the changes of functional imaging in patients with AUD and contribute to clinical diagnosis and treatment.

Abstract:Schizophrenia is a psychiatric disease with high recurrence rate， high disability rate and high disease burden. Reasonable and effective rehabilitation treatment is the key to reduce the recurrence rate， disability rate， and burden of disease for schizophrenia patients. It is also an important factor affecting the prognosis of patients. Painting therapy is often used in the rehabilitation of patients with schizophrenia. This paper reviews the application of painting therapy in schizophrenia.

Abstract:Although a large number of antipsychotics are used for the treatment of mental disorders currently， the compliance of patients is poor due to the adverse drug reactions， administration methods， and other factors. Transdermal drug delivery can reduce the first-pass effect of liver， avoid gastrointestinal irritation， make the blood concentration more stable， and is convenient， because of which the compliance of patients is greatly increased. Blonanserin is a second generation antipsychotic drug， which can improve the positive， negative and cognitive symptoms of schizophrenia effectively. Blonanserin transdermal patch has completed phase 3 clinical trials， with high efficacy and safety，and there are great prospects for drug treatment of mental disorders. In this paper， the research status of blonanserin transdermal patch is reviewed.

Abstract:With the arrival of the third wave of cognitive behavioral therapy， more and more mindfulness-based psychotherapy has been applied to social anxiety disorder. Mindfulness-based psychotherapy mainly includes mindfulness-based stress reduction therapy， mindfulness-based cognitive therapy and acceptance and commitment therapy. Some studies have shown that mindfulness-based psychotherapy can reduce symptoms of social anxiety and increase self-esteem， mindfulness skills， and mental flexibility. In this paper， the definition of mindfulness， the introduction of mindfulness therapy and the application of mindfulness therapy in social anxiety disorder are illustrated.