Abstract:Objective To investigate the stigma of patients with chronic insomnia disorder（ CID） and its related influencing factors. Methods From September 2019 to June 2020， a total of 72 patients with CID in the outpatient or inpatient department of sleep disorders in a 3A hospital in Anhui were recruited as the CID group， and 72 healthy subjects who underwent physical examination at the same time in the hospital were selected as the control group. The Chronic Stigma Scale was used to evaluate the stigma of chronic diseases； the Pittsburgh Sleep Quality Index（ PSQI） and MOS 36 Short-form Health Survey（ SF-36） were used to evaluate sleep quality and the quality of life； the Montreal Cognitive Assessment Scale（ MoCA） and 17 items of Hamilton Depression Scale（ HAMD-17） were used to evaluate for overall cognitive function and depression. Results The stigma score of CID patients was（ 38.6±11.7）， which was higher than that of the control group（ 24.2±0.6）（ t= -6.747，P＜0.001）. The PSQI score of CID patients was 16.0（ 15.0， 18.0）， which was higher than that of the control group 7.0（ 5.0， 8.0）（ Z=-11.687，P ＜0.001）. The MOCA score of CID patients was（ 22.3±4.5）， which was lower than that of the control group（ 25.3±2.1）（ t=5.168，P＜0.001）. The scores of SF-36 components （Physical functioning， Role-Physical， Body pain， General health， Vitality， Social Functioning， Role- Emotional， Mental Health， Health Changes） of the CID group were all lower than those of the control group （P＜ 0.001）. Partial correlation analysis showed that the stigma in the CID group was positively correlated with age， disease course， PSQI score and HAMD-17 score（ P＜0.001）， and negatively correlated with education level， MOCA score and SF-36 score（P＜ 0.05）. Multivariate regression analysis showed that the disease course and SF-36 mental health domain were risk factors for stigma（ P＜0.001）. Conclusions Patients with CID have stigma， which is affected by the course of disease， the quality of life， depressed mood and sleep quality.

Abstract:Objective To investigate the current situation of medication adherence of outpatients with depression / bipolar disorder， and explore the influencing factors of medication adherence. Methods A total of six 3A psychiatric hospitals or general hospitals， including Beijing Anding Hospital Affiliated to Capital Medical University， Nanjing Brain Hospital， the First Affiliated Hospital of Kunming Medical College， Guangzhou Psychiatric Hospital， the First Affiliated Hospital of Harbin Medical University and Xijing Hospital Affiliated to the Fourth Military Medical University， were selected as research centers by multicenter continuous enrollment. From October 2015 to March 2016， the outpatients with depression / bipolar disorder from every center were interviewed， and the medication compliance and related factors were statistically analyzed. Results A total of 1 206 valid data were collected， of which 758 cases（ 62.85%） had poor medication compliance， and the proportion of bipolar disorder and depression was 56.49%（ 296/524） and 67.74%（ 462/682） respectively. The differences between the two groups in age， education level， disease diagnosis， the number of attacks within 2 years， the course of the attack， the severity of depression， insight， and the type of hospital were statistically significant（ P＜ 0.05）. Multivariate analysis showed that the risk of non-compliance was lower in patients with bachelor degree or below（ OR=0.719， 95%CI： 0.542-0.953， P＜0.05）； the risk of non-compliance was lower in patients with 2 episodes with last 2 years（ OR=0.424， 95%CI： 0.251-0.716， P＜0.01）； the risk of non-compliance was lower in patients with moderate to severe depression（ OR=0.444， 95%CI： 0.327-0.603， P＜0.01）； the risk of non-compliance was lower in general hospital patients than in psychiatric hospital patients（ OR=0.328， 95%CI： 0.241-0.447， P＜ 0.01）； the risk of non-compliance was higher in depression patients than in bipolar disorder patients（ OR=1.659， 95%CI： 1.205-2.284， P＜0.01）. Conclusions The medication adherence of outpatients with major depressive disorder or bipolar disorder is not optimistic. The related factors include the type of disease， the severity of the current attack， the number of previous attacks， the type of hospital， and the level of education. It is necessary to take measures to improve the medication adherence of patients with depression and bipolar disorder.

Abstract:Objective To investigate the correlation between prominent hypointense vessels sign （PHVS） on susceptibility-weighted imaging（ SWI） and early neurological deterioration（ END） in patients with acute middle cerebral artery（ MCA） infarction. Methods Patients with acute MCA cerebral infarction admitted to the stroke ward of our hospital from September 2017 to September 2020 with complete data were retrospectively collected. The location and number of PHVS were quantitatively recorded using the modified SWI-ASPECT score. The patients were divided into END group and non-END group according to whether END occurred within 7 days after admission， and the independent correlation between PHVS and END was analyzed. Results A total of 240 patients with acute MCA cerebral infarction were included， including 67 patients in the END group and 173 patients in the non-END group. Univariate analysis showed that the differences in positive rate of PHVS， hypertension， admission NIHSS score， main artery stenosis and peripheral blood neutrophil/ lymphocyte ratio（ NLR） between END group and non-END group were statistically significant（ P ＜ 0.05）. Multivariate logistic regression analysis showed that positive rate of PHVS（ OR=4.925， 95%CI：2.525-9.607）， NIHSS score at admission（ OR=1.182， 95%CI：1.059-1.319）， NLR（ OR=1.148， 95%CI：1.017-1.295）， severe stenosis of main artery（ OR=2.620， 95%CI：1.185-5.793） and occlusion（ OR=4.643， 95%CI：1.662-12.975） were the risk factors of end in patients with acute MCA cerebral infarction Independent risk factors. In the subgroup analysis of PHVS positive patients， the modified SWI-ASPECT score in END group was higher than that in non-end group， and the difference was statistically significant（ P＜0.05）. Conclusions PHVS shown by SWI indicates an increased risk of END in patients with acute MCA cerebral infarction， which should be paid attention to.

Abstract:Objective To investigate the correlation between blood pressure（ BP） in 24 hours after intravenous thrombolysis and early neurological deterioration in patients with acute ischemic stroke（ AIS）. Methods A total of 353 AIS patients admitted to Xuanwu Hospital Capital Medical University from November 1st， 2018 to September 30th， 2019 were enrolled by continuous and convenience sampling method. Logistic regression analysis was used to analyze the relationship between the blood pressure at admission， immediately after thrombolysis， in 24 hours， at daytime and nighttime after controlling confounding factors and the occurrence of early neurological deterioration. Results After adjusting for confounding factors， systolic blood pressure（ SBP） at admission（ OR=5.018， 95%CI：1.183-21.282，P=0.029）， diastolic blood pressure （DBP） at admission（ OR=4.691， 95%CI：1.106-19.886，P=0.036）， SBP at immediate time upon completion of thrombolysis（ OR=4.851， 95%CI：1.137-20.695，P=0.033）， DBP at immediate time upon completion of thrombolysis（ OR=4.918， 95%CI：1.158-20.885，P=0.031） and 24 hour average SBP（ OR=1.021， 95%CI： 1.002-1.040，P=0.033） were the risks affecting neurological deterioration. Conclusions BP during intravenous thrombolysis in AIS patients was independently associated with the occurrence of early neurological function deterioration.

Abstract:Stroke is still the second leading cause of death in the world， seriously threatening human health. The most common related diseases that cause stroke include atherosclerosis， hypertension， atrial fibrillation， diabetes， etc. At present， the main treatment methods for acute ischemic stroke include thrombolytic therapy and mechanical thrombectomy therapy. However， due to the limitation of the treatment time window and the damage caused by ischemia-reperfusion， it is urgent to find new treatment methods from the potential molecular mechanism of stroke， so as to provide effective treatments for stroke and reduce the harm caused by stroke to the population. Long non-coding RNA（ LncRNA） is a kind of RNA that is located in the nucleus or cytoplasm and has no coding ability. The growth arrest-specific 5（ GAS5） is a member of the LncRNA family. Studies have shown that LncRNA GAS5（ Long non-coding RNA GAS5） can participate in the cell cycle， proliferation and apoptosis processes directly or indirectly， leading to the occurrence and development of stroke and various diseases. This article reviews its role in the occurrence and development of stroke and related diseases， aiming to reveal the role of LncRNA GAS5 as a potential biomarker and therapeutic target in stroke.

Abstract:Deglutition disorders is one of the common dysfunctions in stroke patients. Transcranial magnetic stimulation（ TMS） is a common treatment for deglutition disorders after stroke. Theta burst stimulation is a stimulation mode of TMS， which has the advantages of short time， low intensity and high safety. It has been used in the clinical treatment of patients with deglutition disorders after stroke. This paper reviews the domestic and foreign researches on Theta burst stimulation treatment of swallowing dysfunction after stroke， and reviews its efficacy， mechanism and safety.

Abstract:Most young people with stroke do not have the common risk factors of cerebrovascular disease， and the etiology is mainly uncommon or unclear. As the overall incidence of stroke in young people is increasing year by year， and the recurrence rate of stroke is also related to the prevention and control of the etiology. Therefore， it is particularly important to conduct in-depth research on the etiology of cryptogenic ischemic stroke（ CIS） in young people and to prevent and treat it. This paper reviews the research progress of the etiology of CIS in young people reported in recent years.

Abstract:Objective To analyze the clinical effect of low glycemic index diet combined with antipsychotics in the treatment of schizophrenia. Methods From September 2019 to August 2020， 80 schizophrenic patients who were hospitalized in Shanghai Huangpu Mental Health Center were selected as the research objects. They were divided into control group and observation group with 40 cases in each group by random number table method. The observation group was given low glycemic index diet therapy on the basis of the original antipsychotic drug treatment， while the control group was given ordinary ward diet on the basis of the original antipsychotic drug treatment. The therapeutic effects of the two groups were compared. Results After dietary treatment， the total scores of the Positive and negative symptom scale（ PANSS） and the scores of positive symptom factors， negative symptom factors and general psychopathological symptom factors of the observation group showed a downward trend. After repeated measures analysis of variance， the PANSS total score showed that the differences in the main effects， time main effects， time and group interaction effects were statistically significant（ F1=6.783，P1=0.011；F2=41.378，P2＜0.001；F3=41.378，P3＜0.001）； positive symptom factor scores show that the main effect of time and the difference between time and group interaction are statistically significant （F1=10.302，P1＜0.001；F2=6.483， P3＜0.001）， the main effect difference between groups No statistical significance （F=0.384， P=0.537）； negative symptom factor scores showed that the differences in the main effects and the interaction effects of time and grouping between groups were statistically significan（t F1=4.655， P1=0.035；F2=37.087， P3＜0.001）， the main effect of time was not statistically significant（ F=2.594， P=0.054）； general psychopathological symptom factors showed that the main effect of time and the interaction effect between time and group were statistically significant（ F1=36.177，P1＜0.001； F2=37.087， P2＜0.001）， the main effect difference between the groups was not statistically significant（ F=3.670， P=0.071）. Starting from the 8th weekend， the differences between the groups of PANSS total score， negative symptom factor score and general psychopathological symptom factor score were statistically significant. At the end of the 8th week， they were（ t1=3.507， P1=0.001； t2=2.126，P2=0.037；t3=2.839，P3=0.006）， respectively（ t1=4.337，P1=0.001；t2=3.201，P2=0.002；t3=3.000， P3=0.004）. Starting from the 4th weekend， the PANSS total scores， positive symptom factor scores and general psychopathological symptom factor scores of the observation group were statistically significant compared with those before treatment. At the 4th weekend， they were（ t1=7.481；t2=3.616；t3=5.430，P ＜ 0.05）， at the 8th weekend（ t1=7.649；t2=4.572；t3=7.531，P＜0.05）， at the 12th weekend（ t1=7.564；t2=4.869； t3=7.622，P＜0.05）. During the study， there were no serious adverse reactions such as hypoglycemia， and no abnormalities in liver and kidney function， and the safety was good. Conclusions The low glycemic index diet may increase the effect of antipsychotic drugs in improving mental symptoms， and may have a certain effect on the further improvement of negative and positive symptoms. It may be an effective treatment plan with good safety.

Abstract:Objective To explore the effect of comprehensive intervention on burden of care and quality of life of Alzheimer disease caregivers. Methods From January 2020 to June 2020， 180 caregivers were recruited from the elderly clinic of Chongqing Mental Health Center. They were randomized into comprehensive intervention group（ 90 cases） and control group（ 90 cases）. The study group received comprehensive intervention， and the control group received supportive psychological intervention. Zarit Caregiver Burden Interview（ ZBI） and WHO Quality of Life Scale BREF（ WHOQOL-BREF） were used before intervention and 3 and 6 months after intervention. Results The results of repeated measurement ANOVA showed that there were statistically significant in ZBI and WHOQOL-BREF scores between the two groups（ F=4.365，5.446； P＜0.05）. The differences in time main effec（t F=328.428， 24.779； P＜0.05） and interaction（ F=26.170，21.786； P＜0.05） were statistically significant. Conclusions Comprehensive intervention can reduce the burden of care and improve the quality of life of Alzheimer disease caregivers.

Abstract:Sleep disorders are common in bipolar disorder. Sleep disorders may be a predictor of the first episode and recurrence of patients with bipolar disorder. At the same time， sleep disorders have many adverse effects on patients with bipolar disorder. At present， the pathogenesis of sleep disorders in bipolar disorder is not yet fully understood， and there are few treatment methods.This article summarizes the pathogenesis and treatment status of sleep disorders in bipolar disorder， in order to provide clinical reference for optimizing the sleep treatment of bipolar disorder.

Abstract:Dementia patients are prone to various behavioral and psychological symptoms， which increase the burden of caregivers and reduce the quality of life of patients. Therefore， behavioral and psychological symptoms have become the focus and difficulty in the treatment and nursing of dementia patients. Foreign studies have shown that attachment styles are closely related to psychiatric and behavioral abnormalities in dementia patients， while there are fewer relevant studies in China. This paper reviews relevant studies from the perspective of adult attachment. This paper reviews the related research from the perspective of adult attachment， introduces the adult attachment theory， types and dimensions， evaluation tools， and explores the impact of adult attachment on patients with dementia， so as to improve the understanding of the application of adult attachment theory to explain the behavioral and psychological symptoms of dementia， and to provide reference for the further development of dementia care system based on adult attachment theory.

Abstract:Autism spectrum disorder（ ASD） is a group of severe and highly heterogeneous neurodevelopmental disorders， which is the result of a combination of genetic factors and complex environmental factors. The pathologic mechanisms are still unclear. A large number of studies suggest that epigenetic mechanisms， especially abnormal miRNA expression in specific brain regions， may be involved in the occurrence and development of ASD， and circulating miRNA is expected to be a biological marker for early diagnosis.

Abstract:Moderate stress is beneficial to the survival and development of individuals. But it will lead to chronic stress， social dysfunction and increase the risk of mental illness， especially anxiety disorders and related disorders when the stress level beyond what an individual can bear or repeated exposure to stress. Current research has found that dysregulation of the oxytocinergic system is associated with the development and maintenance of anxiety related psychiatric disorders. This article describes the relationship between oxytocin （OXT） and anxiety disorder related social dysfunction， the mechanism of oxytocin in anxiety disorder related diseases， and the progress and deficiency of related research， hoping to help improve the understanding of anxiety disorder related diseases， provide information for the future research of oxytocin system， and develop individualized prevention and treatment strategies based on oxytocin treatment.

Abstract:Pain is a common problem in patients with dementia， which can lead to behavioral and psychological symptoms in severe cases. The pain assessment in dementia needs to combine self-report with observational assessment. This paper reviews the self-report and observational assessment of dementia pain， so as to provide reference for objective evaluation of the effect of dementia pain intervention.