Abstract:Consultation-liaison psychiatry（ CLP） is a branch of psychiatry. This paper makes a brief review of the development history of CLP， looking for the gap between domestic and international， and puts forward the future development direction and suggestions of CLP from the perspective of clinical and medical education.

Abstract:Objective Using binocular competition paradigm to study sensory perception， so as to explore whether repetitive transcranial magnetic stimulation（ rTMS） can change the average switching time of binocular competition in patients with Parkinson disease. Methods A total of 12 patients with Parkinson disease（ 6 males and 6 females） were enrolled in this study. All subjects received rTMS therapy for 14 days. The stimuli of rTMS therapy was persistent theta-burst stimulation， and the rTMS treatments were complemented under navigation. The average switching time for binocular rivalry， and the mean scores of Hamilton Anxiety Scale（ HAMA）， Hamilton Depression Scale-17（ HAMD-17）， Unified Pakinson disease Rating Scale Ⅲ （UPDRS Ⅲ） were evaluated without taking medicine before and after the treatment. Results The mean score of UPDRSⅢ before the treatment was（ 29.25±12.02）， while the mean score of UPDRSⅢ after the treatment was（ 24.00±11.63）. The difference was statistically significant（ t=2.644， P＜0.05）. The mean scores of HAMA and HAMD-17 before the treatment were（ 9.08±3.09） and（ 9.75±3.52） respectively， while the mean scores of HAMA and HAMD-17 after the treatment were（ 8.50±3.29） and（ 8.75±3.22） respectively. The difference in HAMA and HAMD-17 scores before and after treatment was not statistically significant（ t=1.074，1.225；P＞ 0.05）. The average switching time for binocular rivalry before and after the treatment was（ 5.50±1.47） s and （4.06±1.21） s respectively. The mean switching time of binocular competition after treatment was significantly shorter than that before treatment， and the difference was statistically significant（ t=3.743，P ＜ 0.05）. Conclusions rTMS intervention on auxiliary motor area could accelerate the switching of binocular competition in patients with Parkinson disease.

Abstract:Objective To investigate the effect of hyperbaric oxygen（ HBO） preconditioning on isoflurane（ ISO）- induced cognitive impairment in middle-aged mice， and the effects of hyperbaric oxygen （HBO） pretreatment on the protein expression and mRNA levels of brain-derived neurotrophic factor（ BDNF） and glial cell-derived neurotrophic factor（ GDNF） in hippocampus. Methods A total of 32 male 8-month-old C57BL/6J mice were randomly divided into four groups by random number table with 8 in each group： sham group， HBO group， ISO group and HBO+ISO group. Mice in HBO group and ESPs+HBO group were put into hyperbaric oxygen chamber for 1 h（ 2.5 atmospheres， 100% O2）， while those in control group were intervened by atmospheric pressure（ simulating other processes and environmental conditions except pressure and oxygen concentration） for 1 h， which lasted for 5 days. On the third day after HBO or atmospheric air intervention， mice in each group were given water maze training for 3 days. 24 hours after the last water maze training， the cognitive impairment models were established by isoflurane inhalation anesthesia in ISO group and HBO+ISO group， while the other two groups inhaled control gas. After 24 hours， the cognitive function was detected by water maze， and the protein expression and mRNA levels of BDNF and GDNF in hippocampus of mice were detected by Western blot and real-time quantitative polymerase chain reaction（ qPCR）. Results （1） There was no significant difference in the total movement distance and average movement speed in water maze test among each group（ P＞0.05）； the relative time dwell time in target quatrant in the ISO group was（ 26.74±10.52）%， which was significantly lower than that in the sham group（ 48.33.74±9.21）%（ P ＜ 0.01）， while that in HBO+ISO group（ 39.06±8.38）% was significantly higher than that in ISO group（ P ＜ 0.05）.（ 2） The relative expression levels of BDNF（ 0.56±0.09） and GDNF（ 0.52±0.10） in hippocampus of ISO group were significantly lower than those in sham group and HBO+ISO group（ P＜0.01 or 0.05）（. 3） The relative mRNA levels of BDNF（ 0.51±0.08） and GDNF（ 0.25±0.09） in hippocampus of ISO group were also significantly lower than those in sham group and HBO+ISO group（ P＜ 0.01）.（ 4） There was no significant difference between sham group and HBO group in the above parameters（ P＞0.05）. Conclusions Hyperbaric oxygen preconditioning may improve isoflurane induced cognitive impairment by regulating the expression of BDNF and GDNF in hippocampus.

Abstract:Objective To investigate the impact of fluoxetine on the compositions of phosphatidylethanolamine （PE） in prefrontal cortex（ PFC） of rats with chronic unpredictable stress（ CUS）. Methods A total of 18 SD rats were randomly divided into control group（ Sham）， model group（ CUS） and fluoxetine group（ Flx） by random number table method. CUS group and Flx group received CUS stimulus， and each group received intraperitoneal injection of normal saline（ 1 ml/kg） or fluoxetine（ 10 mg/kg） for 14 consecutive days， while Sham group did not received CUS， but received intraperitoneal injection of normal saline every day. The rats were killed after 14 days and the PFC was isolated for lipomics analysis. The relative concentrations of total PE and different molecules in the PFC of each group were compared. Results （1） Compared to Sham group［ （10.50±7.32）×1011］， the relative concentrations of PE in the CUS group［ （11.95±8.46）×1011］ was significantly reduced（ P＜0.01）， while the difference to Flx group［ （10.31±9.16）×1011］ was not significant（ P＞0.05）.（ 2） Compared to Sham group， the relative concentrations of 3 PE small molecules decreased in CUS group， which are PE（ 36：4p）（ 68.67±14.68）， PE（ 38：3p）（49.73±19.55）， PE（ 38：4p）（76.10±7.84） respectively， with statistical significance（ P＜0.05）. （3） Compared to CUS group， the relative concentrations of 6 PE small molecules decreased in Flx group， which are PE（ 36：4）（72.53±10.22）， PE（ 36：2）（87.86±8.26）， PE（ 38：5p）（75.66±9.53）， PE（ 38：5）（89.93±9.79）， PE（ 38：4）（86.55±15.40）， PE（ 40：7p）（81.57±7.55）respectively， with statistical significance（ P ＜ 0.05）.（ 4） Compared to Sham group， the relative concentrations of 6 PE small molecules decreased in Flx group， which are PE（ 38：4p）（75.85±5.63）， PE（ 38：3p）（44.22±12.61）， PE（ 38：4）（82.49±9.41）， PE（ 40：5p） （78.01±5.31）， PE（ 36：4）（ 76.00±6.34）， PE（ 38：6）（77.45±13.06）， with statistical significance（ P＜0.05）. Conclusions Fluoxetine can regulate the level of PE in prefrontal cortex of CUS model rats.

Abstract:Objective To explore the relationship between childhood abuse and social support in depressed and non-depressed people. Methods In this study， non matched case-control study was used to study the subjects who met the inclusion criteria in Beijing Anding Hospital from January 2014 to December 2017. A total of 224 patients with depression and 214 patients without depression were enrolled. The basic information（ age， gender， marital status， education level， work status， smoking history and body mass index）， disease history and family history of mental illness were collected by questionnaire（ self-made）. The Chinese version of the Childhood Trauma Questionnaire（ CTQ-SF） was used to evaluate the menstrual status before the age of 16. Social support rating scale（ SSRS） was used to evaluate the social support of the subjects in their past life state， including three dimensions： objective support， subjective support and support utilization. Univariate analysis was used to compare the basic data， CTQ-SF and SSRS scores between depression patients and non depression patients. Multivariate logistic regression analysis was used to analyze the factors influencing the occurrence of depression in adult patients. Results The number of depressive patients with childhood abuse（ 93 cases， 41.52%） was more than that of non depression patients（ 51 cases， 23.8%）， the difference was statistically significant（ χ2=15.51，P＜ 0.01）. Multivariate logistic regression analysis showed that childhood abuse was an important risk factor for adult depression（ OR=2.030， 95%CI：1.302-3.164）. The total score of social support （32.33±7.45）， subjective support［ 8（6，10）］， objective support［ 17（14，21） score］ and support utilization score ［6（5，8）］ of depression patients were lower than those of non depression group［ （36.79±6.24）， 9（7，11）， 20（17， 23）， 8（6，9）， respectively］， and the differences were statistically significant（ P＜ 0.01）. The scores of social support（ 30.41±7.99）， subjective support［ 7（5，9）］， objective support［ （16.57±4.78）］ in depression patients with childhood abuse were lower than those without childhood abuse［ （33.70±6.76）， 9（7，10），（18.53±4.35）］， and the differences were statistically significant（ P＜0.01）. In non depression patients， the score of subjective support of the patients with childhood abuse［ 8（6，10）］ was lower than that of the patients without childhood abuse［ 9（7，11）］， the difference was statistically significant（ P＜0.01）. Conclusions Childhood abuse is an important risk factor affecting depression and social support in adulthood.

Abstract:As a chronic mental disease， depression has the characteristics of high morbidity， high recurrence rate， and high suicide and disability rate. Drug therapy， as the main treatment method at present， has been attracting the attention of clinical medical workers for its onset rate（its rapid onset and slow response）. Rational use of antidepressants can enhance patients' medication compliance and reduce their suicide risk. This paper summarizes the research progress on the overview of the onset time of various antidepressants， the relevant factors affecting the onset time of antidepressants， and the mechanism by which individual antidepressant synergist accelerates the onset time of antidepressants， so as to provide reference for medical staff and literature basis for accurate decision-making of drug use.

Abstract:Depressive disorder is a highly recurring disease that has a major impact on personal and public health. In recent years， with the in-depth research on the recurrence of depression， it has been found that there are multiple risk factors affecting the recurrence of depression. This paper reviews the multiple risk factors depression recurrence.

Abstract:Objective To investigate the predictive value of levels of ten cerebrospinal fluid（ CSF） cytokines including interleukin-6（ IL-6） on relapse and conversion to multiple sclerosis（ MS） of patients with clinical isolated syndrome（ CIS）. Methods A total of 33 patients with acute CIS admitted to Beijing Tiantan Hospital Affiliated to Capital Medical University from January 2015 to August 2017 were retrospectively enrolled， including 9 males and 24 females， with a median age of 35 years old. The CSF levels of IL-6， IL-4， IL-2， IL-10， IL-13， IL-17A， IL-21， IL-23， and interferon-γ（ IFN-γ） were detected by Luminex liquid chip method. The level of transforming growth factor beta 1（ TGF-β1） was detected by enzyme-linked immunosorbent assay（ ELISA）. The patients were followed up in outpatient service， and the relapse and conversion to MS were recorded. The difference of CSF cytokines between relapse and non relapse patients was compared. Receiver operating characteristic（ ROC） curve and Cox regression models were used to analyze the predictive value of CSF cytokines on the the relapse and conversion to MS of CIS patients. Results The median follow-up time of the enrolled patients was 23.4（ 17.6， 29.1） months. 11 CIS cases（ 33.3%） had clinical relapse during the follow-up period， and 4 cases were diagnosed as MS. Although no clinical recurrence was found in other 2 patients， follow-up MR revealed new lesions， which were diagnosed as MS. The level of CSF IL-6 in patients with relapse was significantly higher than that in patients without relapse［ 1.9（ 1.4，7.9） ng/L vs. 1.1（ 0.9，1.5） ng/L； Z=-2.904，P=0.003］. ROC curve analysis showed that the optimal cut-off value of IL-6 was 1.37 ng/L. However， Uni-variate Cox regression showed that CSF IL-6 ＞ 1.37 ng/L could not predict the relapse of CIS （HR=1.54， 95%CI： 0.40-5.92，P=0.533）. There was no significant difference in CSF IL-6 and the other 9 cytokines between the patients with conversion to MS and those without conversion to MS（ all P ＞ 0.05）. Conclusions Ten cytokines such as IL-6 in CIF investigated in this study may not be markers for predicting the relapse or conversion to MS of CIS patients.

Abstract:Objective To explore the status and influencing factors of occupational burnout among primary level mental health workers in Chongqing. Methods By using the method of cluster random sampling， 18 districts and counties（ Hechuan， Banan， Fuling， Jiangbei， Rongchang， Shapingba， Wuxi， Youyang， Yunyang， Wanzhou， Beibei， Nan'an， Qijiang， Wushan， Xiushan， Yuzhong， Chengkou， Jiulongpo） were randomly selected from 39 districts and counties in Chongqing city. 18 districts and counties includes 5 main urban areas， 7 poverty-stricken areas and 6 other areas（ neither main urban areas nor poverty-stricken areas）. All 500 primang mental health workers in 18 districts and counties were investigated. The general situation questionnaire and occupational burnout scale（ MBI-GS） were used to evaluate the status of occupational burnout of workers. Pearson bivariate correlation analysis and Spearman rank correlation analysis were used to analyze the correlation between occupational burnout and sociodemographic variables. Co-variance analysis was used to compare occupational burnout with different demographic characteristics， and multiple linear regression was used to analyze the influencing factors of occupational burnout. Results According to the inclusion and exclusion criteria， 478 of 500 primary mental health workers who had informed consent to participate in the study and completed the effective questionnaire， the effective rate was 95.6%.（ 1） Among the 478 mental health workers， 41.0%（ 196 cases） were mild occupational burnout， 59.0%（ 282 cases） were moderate and severe occupational burnout. Among them， 68.8%（ 329 cases） were emotional exhaustion， 48.3%（ 231 cases） were cynical， 39.5%（ 189 cases） were low sense of achievement.（ 2） Cynicism was negatively correlated with working years（ r=-0.175） and education level（ r=-0.332）. Emotional exhaustion was negatively correlated with working years（ r=-0.163） and education level（ r=-0.371）. Low sense of achievement was negatively correlated with education level（ r=-0.103）. The differences were all statistically significant（ all P＜ 0.05）.（ 3） The differences of cynicism and emotional exhaustion in different marital status（ F=11.274，11.820） and living conditions （F=24.032，34.689） were statistically significant（ all P＜ 0.05）.（ 4） Multiple linear regression analysis showed that single， remarriage， divorce， widowed marriage status were the risk factors of cynicism（ t=2.306，3.570， P＜0.01）. Living in the main urban area（ t=-5.294， P＜0.01）， higher education（ t=-4.398， P＜0.01）， and long working years of mental health prevention and treatment（ t=-2.430， P=0.015） were protective factors of cynicism； Remarriage， divorce， widowed marriage status（ t=4.063， P＜ 0.01）， long working years（ t=2.710， P=0.007） and living in other areas（ t=3.005， P=0.003） were the risk factors of emotional exhaustion. Living in the main urban area（ t=-5.917， P＜0.01）， high age（ t=-2.313， P=0.021）， higher education（ t=-5.361， P＜0.01） and long working years in intensive prevention（ t=-2.416，P=0.016） was the protective factor of emotional exhaustion； Remarriage， divorce， widowed marriage status（ t=2.074， P=0.039） and junior professional title （t=2.100， P=0.036） were the risk factors of low sense of achievement. Conclusions There are different degrees of occupational burnout among the primary level mental health workers in Chongqing， and their emotional exhaustion is more obvious. Occupational burnout is affected by many factors. Long working years and high education level have a protective effect on occupational burnout.

Abstract:With the development of neuroimaging technology， considerable progress has been made on the exploration of aggressive or violence behavior in schizophrenia patients. However， due to the particularity of schizophrenic aggressive patients， there are some limitations in previous neuroimaging studies. Functional nearinfrared spectroscopy（ fNIRS） has its unique strengths in the study of schizophrenic aggressive behaovir. This paper reviews the research progress of fNIRS of aggressive behavior in schizophrenia.

Abstract:Multiple sleep latency test（ MSLT） is an objective evaluation and a standard tool of the daytime sleepiness. Polysomnography（ PSG） was used to conduct multiple sleep latency test. The sleep frequency， average sleep latency， and the latency and frequency of rapid eye movement（ REM） sleep were analyzed. The severity of sleepiness could be displayed by MSLT with the length of the sleep latency， which is more objective and repeatable. Now MSLT has been widely used in clinical diagnosis of narcolepsy， the severity evaluation of daytime sleepiness and obstructive sleep apnea-hypopnea syndrome， and the efficacy evaluation of drugs such as psychostimulants.

Abstract:Maintenance of wakefulness test（ MWT） is of great value in evaluating the awakening ability of the daytime. It is mainly used to the evaluation of the awakening ability of a particular profession and to evaluate the therapeutic effect of excessive daytime sleepiness（ EDS） patients. This article reviews the monitoring methods， clinical application and research progress of MWT， and compares the difference between MWT and multiple sleep latency test（ MSLT）.

Abstract:Stress is the body's response to challenges and has a significant impact on the body. However the choice of anti-anxiety， depression and mood stabilizers is narrow， and there are many problems such as side effects and slow onset. The emotional regulation of opioid receptors has become a hot topic in recent years. Previous studies at home and abroad mainly focus on δ-opioid receptors， while κ-opioid receptors' emotional regulation has been paid more attention in recent years. In this paper， the molecular pathways of stress related to κ-opioid receptors and the interactions between different brain regions are reviewed in order to provide support for further research.

Abstract:Alzheimer disease is a kind of neurodegenerative disorder characterized by memory loss and cognitive impairment. Due to the inefficiency of traditional drug therapy， cell therapy is a new way to treat Alzheimer disease. In view of the fact that current research on Alzheimer disease mainly focuses on the mechanism of tool cell therapy for Alzheimer disease and tool cell screening， there is little summary of transplantation methods. In this paper， the methods of tool cell transplantation are summarized.