Abstract:Objective To compare the effects of simplified cognitive behavioral therapy（ SCBT） combined with medication， supportive psychotherapy（ SP） combined with medication， and medication therapy alone on the quality of life in patients with major depressive disorder. Methods A randomized controlled trial design was adopted. A total of 120 patients with major depressive disorder were randomly divided into SCBT combined with medication group， SP combined with medication group and medication group. Eight weeks treatment and 12 weeks follow-up were carried out. The quality of life of patients was evaluated from 8 dimensions by health status questionnaire. Rusults Totals of 94 cases were included in the statistical analysis. The number of patients in the three groups were 34， 32 and 28. There were no statistically significant differences in sociodemographic factors， onset patterns， the progression of the disease， and the severity of depression among the three groups（ P ＞ 0.05）. At baseline， the differences of physical function， general health status， and social function were statistically significant（ P＜0.05） among the 3 groups and the score of medication group was lower. At the end of the intervention， the general health status score of SCBT combined with medication group was higher than that of the SP combined with medication group in（ F=3.695， P=0.026）， and the mental health score was higher than that of the medication group（ F=8.409， P＜ 0.05）. At the end of the 12 weeks， the physiological function score of the SCBT combined with medication group was higher than that of the medication group（ F=3.606， P=0.028）. The general health status score was higher than that of the SP combined with medication group（ F=4.762， P=0.009）. The scores of vitality dimension（ F=4.725，P=0.010） and mental health dimension（ F=12.066， P＜0.05） were higher than those of the other two groups. The results of comparison among groups showed that there were statistically significant differences in all 8 dimensions of the life quality in the SCBT combined with medication group（ P ＜ 0.05）. There were statistically significant differences in 3 out of 8 dimensions in the SP combined with medication group and the medication group（ P＜ 0.05）. Conclusions SCBT combined with medication therapy， SP combined with medication therapy and medication therapy alone can effectively improve the quality of life of patients with major depressive disorder. SCBT combined with medication therapy is more effective on improving physical function， general health status， vitality and mental health of patients with major depressive disorder.

Abstract:Objective Based on the voxel-based degree centrality（ DC） analysis， to investigate the characteristics of resting state brain network node centrality and the neuroimaging mechanism of cognitive impairment in patients with first-episode depression. Methods From May 2013 to March 2019， totally 30 patients with first-episode depression in Renming Hospital of Wuhan University（ MD group） and 30 healthy controls（ NC group） were included in the study. All subjects underwent resting-state fMRI. Then Digital Symbol Test（ DST）， Digital Span Test（ DSPT）， and Verbal Fluency Test（ VFT） were performed. The resting state fMRI data were routinely preprocessed， and the DC map of each group was calculated. The DC value and cognitive function test score of the two groups were compared by double sample t-test. Pearson correlation was used to analyze the correlation between the DC value and cognitive function test scores. Results （1）Compared with NC gorup， MD group showed decreased score in DST［ （62.37±10.30） vs（ 70.47±10.12）］， DSPT ［forward：（ 8.20±0.76） vs（ 9.27±1.12）； backward（ 5.30±1.15） vs（ 5.73±1.56）］， and VFT［ （19.50±2.57） vs （22.57±4.45）］， and the differences were statistically significant（ P＜0.01）.（ 2） Compared with NC group， the DC value of the left superior frontal gyrus decreased， while the DC value of the right occipital calarine cortex， right middle cingulate cortex， right striatum increased in patients with first-episode depression（ P＜0.01， AlphaSim correction， voxel number ＞ 55）.（ 3） The Pearson correlation analysis showed that the DC value of the right striatum was negatively correlated with DST score of patients with first-episode depression（ r=-0.48，P=0.01），while the DC value of the left superior frontal gyrus was positively correlated with the DSPT score and VFT score （r=0.38， P=0.04； r=0.41， P=0.03）. Conclusions There are changes in centrality of brain network nodes in patients with first episode of depression. These brain regions are mainly located in the right occipital cortex， the middle of right cingulate gyrus， the right striatum and the left superior frontal gyrus. The changes of the central position of the network nodes in the right striatum and the left superior frontal gyrus are closely related to the cognitive impairment of patients， which will provide a possible neuroimaging basis for exploring the neuroimaging mechanism of cognitive impairment in depression.

Abstract:Objective To analyze the impact of endocrine metabolism on impulsive aggressive behavior of patients with bipolar disorder， and to provide a basis for the future prevention and treatment of such diseases. Methods The medical records of 106 patients with bipolar disorder admitted to Xinjiang Uiger Municipal People's Hospital from April 2018 to December 2019 were retrospectively analyzed as research group， and clinical data of 109 healthy people from the physical examination center during the same period were collected as control group. The endocrine metabolism status were detected. According to whether they had impulsive aggression behavior， the patients with bipolar affective disorder were divided into impulsive aggression behavior group and non-impulsive aggression behavior group. The correlation between endocrine metabolism indicators and their relationship with impulsive aggression behavior were analyzed respectively. Results The levels of ACTH and TSH in the research group were（ 29.56±2.75） pg/ml and（ 3.60±1.22） μIU/ml respectively， which were lower than those in the control group. The levels of cortisol， triiodothyronine and thyroxine were （102.95±6.41） nmol/L，（ 1.51±0.64） ng/ml，（ 82.66±16.34） ng/ml respectively， which were higher than those in the control group（ P＜ 0.05）. Among 106 patients， 23 patients had impulsive aggressive behavior. The levels of ACTH and TSH in the impulsive aggressive behavior group were（ 27.85±2.03） pg/ml and（ 2.64±1.03） μIU/ml respectively， which were lower than those in the non-impulsive aggressive behavior group. The levels of cortisol， triiodothyronine， and thyroxine were（ 103.86±4.36） nmol/L，（ 1.71±0.60） ng/ml， and（ 89.69±16.12） ng/ml respectively， which were higher than those in the non-impulsive aggressive behavior group（ P ＜ 0.05）. Correlation analysis found that there were significant correlations between the various endocrine metabolism related indicators（ P＜0.05）. Regression analysis results showed that abnormal endocrine metabolism was an influencing factor of impulsive aggressive behavior in patients with bipolar disorder（ OR=1.197，1.776，1.024， 1.903，7.414， all P＜ 0.001）. The ROC curve was drawn and showed that the AUC results of the risk of bipolar disorder combined with impulsive aggressive behavior predicted by each endocrine metabolism index were all higher than 0.80， which had certain predictive value. Conclusions Abnormal endocrine metabolism may be the influencing factor of impulsive aggression in patients with bipolar disorder. It can be considered to predict the risk of impulsive aggression in patients with bipolar disorder by detecting endocrine metabolism status， so as to guide the early risk prediction and reasonable intervention of impulsive aggressive behavior in patients with bipolar disorder.

Abstract:Objective To explore the effect of lipopolysaccharide（ LPS） on apoptosis and viability of astrocytes， and to establish an activated astrocyte model. Methods High purity astrocytes were obtained from the brain of 1-day-old rats（ P1）. The astrocytes were inoculated on the culture plates and treated with LPS（ 1 μg/ml） for 24 to 72 hours. According to the experimental requirements， apoptosis was detected using TUNNEL separately in LPS-24 h， control-24 h， LPS-72 h， control-72 h， and then apoptosis rates were calculated； while viability was detected using MTT separately in LPS-0 h， LPS-24 h， and LPS-72 h. Astrocytes were treated with GFAP immunohistochemistry in LPS treatment group and control group. Results The apoptosis rate was（ 7.00±2.23）% in LPS-24 h group and（ 3.26±1.22）% in control-24 h group， and there was no significant difference between the two groups（ P＞0.05）； the apoptosis rate was（ 36.40±5.32）% in LPS-72 h group and（ 4.00±1.59）% in control-72 h group， and the difference was statistically significant（ P ＜ 0.05）； the viability of astrocyte was（ 100.23±5.34）%，（ 91.42±9.88）%，（ 51.21±4.58）% separately in LPS-0 h group， LPS-24 h group， and LPS-72 h group. There was significant difference between LPS-72 h group and other two groups（ P＜ 0.05）. After 24 hours of LPS intervention， astrocytes proliferated， enlarged， and their processes increased. Conclusions Treated with LPS（ 1 μg/ml） for 24 hours， astrocytes did not show obvious apoptosis and decreased viability， but showed activation in morphology. A model of activated astrocytes might be established.

Abstract:Objective To investigate the correlation between CYP2C19 gene polymorphism and olanzapine-induced sinus tachycardia. Methods A total of 241 patients with schizophrenia who were treated with olanzapine alone after admission were selected， including 119 patients with sinus tachycardia（ tachycardia group） and 122 patients without sinus tachycardia（ non-tachycardia group）. Detection and typing of SNP loci rs4244285， rs4986893 and rs12248560 on CYP2C19 gene were carried out， and the genotype and allele distribution between the two groups were analyzed and compared. Results There were no significant differences in gender， age， course of disease and medication between the two groups（ P＞0.05）. There were no significant differences in the distribution of gene frequency and allele frequency between the two groups（ P＞0.05）. Among 3 gene loci， the distribution frequency of *1/*3 in tachycardia group was lower than that in non-tachycardia group［ *1/*1 in tachycardia group（ n=46，38.6%） and non-tachycardia group（ n=38，31.1%）； *1/*3 in tachycardia group（ n=9，7.6%）， non-tachycardia group（ n=19，15.6%）， 95%CI=0. 159-0.964， χ2=4.299， P＜ 0.05］， and the difference was statistically significant. * 1/*17 was not detected in tachycardia group， and the distribution frequency was lower than that in non-tachycardia group，［ *1/*1 in tachycardia group（ n=46，38.6%） and non-tachycardia group（ n=38，31.1%）； *1/*17 in tachycardia group（ n=0，0） and non-tachycardia group（ n=4，3.3%）， P ＜ 0.05］， and the difference was statistically significant. Ultrarapid metabolizer（ UM） was not detected in tachycardia group， and its distribution frequency was lower than that in non-tachycardia group，［ extensive metabolizer（ EM）（ n=46，38.6%）， non-tachycardia group（ n=38，31.1%）； *1/*17 tachycardia group（ n=0，0）， non-tachycardia group（ n=4，3.3%）， P＜0.05］， and the difference was statistically significant. Conclusions *1/*3 and *1/*17 on CYP2C19 gene may reduce the risk of sinus tachycardia after olanzapine administration， and CYP2C19 may be related to olanzapine-induced sinus tachycardia.

Abstract:Objective To investigate the diagnostic value of plasma amyloid β-protein 40（ Aβ40）， Aβ42 and phosphorylated tau protein（ p-tau） in the diagnosis of senile generalized brain atrophy（ GBA） and their correlation with cognitive function. Methods A total of 125 elderly GBA patients admitted to the Department of Neurology of Hubei Jingmen No. 2 People's Hospital， from May 2018 to January 2019， were retrospectively selected. The subjects were divided into GBA-CFI group with 57 cases and GBA-NCFI group with 68 cases according to whether combined with cognitive dysfunction（ CFI）. Another 130 healthy subjects were selected as the control group. The plasma Aβ40， Aβ42 and p-tau levels of all subjects were measured. According to the Mini Mental State Examination（ MMSE） scale， the GBA-CFI group was classified as the severe CFI group（ ≤9 points， n=14）， moderate CFI group（ 10～20 points， n=19） and mild CFI group（ ≥21 points， n=24）. The relationship between plasma Aβ40， Aβ42， p-tau levels and CFI in elderly patients with GBA and the diagnostic value of CFI in elderly patients with GBA was analyzed. Pearson correlation analysis was used to analyze the correlation between Aβ40， Aβ42 and p-tau levels. Multivariate logistic regression analysis was used to analyze the influencing factors of CFI in elderly patients with GBA. Receiver operating characteristic （ROC） curve was used to analyze the diagnostic value of Aβ40， Aβ42 and p-tau levels in elderly GBA with CFI. Results The levels of plasma Aβ40， Aβ42， and p-tau in the GBA-CFI group were significantly higher than those in the GBA-NCFI group and control group， and the levels of plasma Aβ40， Aβ42， and p-tau in the GBANCFI group were significantly higher than those in the control group. The levels of Aβ40， Aβ42， and p-tau of the GAB-CFI group， GBA-NCFI group and the control group was（ 910.33±275.76）μg/L vs（ 798.28±272.73） vs （667.10±240.63）μg/L，（ 89.81±18.32）μg/L vs（ 69.39±14.39） vs（ 47.84±14.88）μg/L，（ 80.21±18.89）ng/L vs（ 58.84±16.20） vs（ 21.52±10.53）ng/L， respectively（ all P ＜0.05）. The levels of plasma Aβ40， Aβ42， and p-tau of patients in the GBA-CFI group increased with the aggravation of CFI. The levels of plasma Aβ40， Aβ42， and p-tau of the severe， moderate and mild CFI group were（ 1134.21±162.20），（ 950.97±247.72）， （747.56±250.47）μg/L；（ 107.71±8.92），（ 95.79±12.28），（ 74.62±13.73）μg/L；（ 104.71±8.21）， （84.52±5.07），（ 62.51±10.14）（ all P＜0.05）. Pearson correlation analysis showed that plasma Aβ40， Aβ42 were positively correlated with p-tau levels in the GBA-CFI group（ r=0.715， 0.655， all P＜0.05）. Multivariate logistic regression analysis showed that Aβ40 （OR=1.653， 95%CI： 1.186-2.302）， Aβ42 （OR=1.064， 95%CI： 1.027-1.103）， p-tau（ OR=1.080， 95%CI： 1.040-1.121） are risk factors for CFI in elderly GBA patients（ all P＜ 0.05）. ROC curve analysis showed that the area under the curve（ AUC） of plasma Aβ40+Aβ42+p-tau level in the diagnosis of elderly GBA was significantly larger than that of Aβ40， Aβ42， and p-tau respectively（ all P＜0.05）， and the sensitivity， specificity and accuracy were also higher than those of Aβ40， Aβ42， and p-tau respectively. Conclusions The levels of plasma Aβ40， Aβ42 and p-tau in elderly GBA patients are significantly increased， which are closely related to the occurrence of CFI. Combined detection can improve the diagnostic value of elderly GBA.

Abstract:With the advancement of education reform and the development of Internet technology， the application of online teaching has become more and more extensive. This article summarizes and discusses the application of the teaching mode of network combined with practice in clinical teaching of neurology. This combined mode is not restricted by time and place， and has high flexibility； diverse teaching forms， high student enthusiasm and participation； strong teaching pertinence and outstanding focus. Blended teaching can complement the advantages of network and practical teaching， increase students' interest， and improve teaching quality. It is a new teaching mode worth promoting.

Abstract:Schizophrenia is a common serious mental illness， with unclear etiology and pathogenesis. At present， increasing evidence shows that there is a certain relationship between schizophrenia and neuroinflammatory response， especially the cytokines involved in inflammatory response. This paper mainly introduces the latest research progress of inflammatory cytokines related to schizophrenia.

Abstract:The subjective quality of life in schizophrenia reflects the patients' satisfaction with personal physical， psychological， social and behavioral functions， which provides a subjective indicator for the mental health system to evaluate clinical outcomes. This paper reviews the assessment instruments and influencing factors of subjective quality of life in schizophrenia， so as to provide reference for the practice of improving the subjective quality of life of patients.

Abstract:Autism spectrum disorders（ ASD） is a neurodevelopmental disorder starting in infancy. In addition to the core symptoms of social interaction disorder， cognitive impairment and repetitive stereotyped behavior， there are also obvious multi-sensory abnormalities. ASD patients with abnormal pain will make repetitive self-injurious behavior， which not only causes serious harm to patients but also their families， causing widespread concern of families and society. Further study on the pain sensitivity of children and the principle and mechanism of pain sensitivity can not only reduce the pain experience of children， but also provide new ideas for the treatment of children with ASD. This paper reviewed the recent studies on the epidemiology， clinical trials， genetics， imaging and the pain sensitivity of ASD animal models. The future study could focus on the optimal intervention scheme， and provide theoretical basis for further clinical promotion.

Abstract:The incidence rate of autism has been increasing year by year. Because of the complexity of its pathogenic causes， the study of autism has become difficult. Studies show that genetic factors account for 50% of the incidence rate of autism. However， there were few animal models that could effectively reflect the etiology. This article reviews the animal models of genotype autism based on copy number variation（ CNV） and single nucleotide variation（ SNVs）， as a new advanced model tool to understand the mechanism of autism in the future.

Abstract:Depressive disorder has become one of the main causes of death and disability in the world， and its pathogenesis has not yet been determined. In recent years， more and more scholars believe that the occurrence of depression may be related to stress response. Stress response may cause changes in plasticity of nerve cells， abnormal regulation of hypothalamus pituitary adrenal axis and changes of neurotransmitter secretion， resulting in brain structure and function disorders， and eventually lead to the occurrence of depression.

Abstract: