Abstract:Antidepressants are the first-line treatment choice for depression. However， most antidepressants have many adverse reactions， including cardiac metabolic effects and weight gain. Antidepressants have different risks of weight gain， and there are differences in the same category of antidepressants. Current research results show that histamine and serotonin play a key role in adverse reactions of weight gain， beyond the previously thought ways of promoting appetite. Therefore， paying attention to the side effect of weight gain is an important factor in choosing antidepressants. This article reviews the mechanism of the effect of commonly used antidepressants on body weight.

Abstract:Objective To study the changes of vitamin C（ VC） levels and sodium vitamin C transporter 2（ SVCT2） protein levels in cerebrospinal fluid（ CSF） and important brain regions of rats after 4 days of binge drinking and ethanol withdrawal. Methods A total of 30 healthy wistar rats were randomly divided into 5 groups： control group（ Group A）， binge drinking for 4 days（ Group B）， withdrawal 1 day after 4-day binge drinking（ Group C）， withdrawal 2 days after 4-day binge drinking（ Group D）， withdrawal 7 days after 4-day binge drinking（ group E）. There were 6 rats in each group. Rats in group B， C， D and E were given ethanol by gavage for 4 days at a concentration of 25% W/V and gavage once every 8 hours for 4 days. Group A was given equal-volume distilled water. Y maze experiment was used to evaluate the spatial working memory of rats. The concentration of intracellular VC in cerebrospinal fluid， prefrontal cortex， parietal cortex， temporal cortex and hippocampus of rats in each group was detected by HPLC combined with electrochemical detector（ HPLC-ECD）， and the protein level of SVCT2 in each brain area of rats was detected by Western blotting. Results In the Y maze experiment， the rate of spontaneous response alternations of rats in group C and D was（ 24.64±11.51）% and（ 41.48±13.01）%， respectively， which were significantly lower than that in group A（ 75.47±8.61）%. The rate of spontaneous response alternations of rats in group E（ 61.64±15.11）% was close to normal， and there is no statistically significant difference between group E and group A（ P＜ 0.05）. The content of VC in CSF of rats in group B was（ 204.54±25.51） μmol/L， which was significantly higher than that in group A（ 145.57±18.98） μmol/L. The CSF VC levels in group C and group D were（ 90.24±15.45）μmol/L and（ 86.93±14.53） μmol/L， respectively， lower than those in group A and group B， and the differences were statistically significant（ P ＜ 0.001）. The CSF VC level of group E was （135.80±17.16）μmol/L. There was no significant difference in the content of VC in CSF between group A and group E（ P＜ 0.05）. The VC levels in brain tissue homogenates（ intracellular） in prefrontal cortex， parietal cortex and hippocampus showed the same trend in group B， which were（ 1.18±0.13） μmol/g，（ 1.14±0.12） μmol/g， （1.20±0.20） μmol/g， respectively， and were all significantly lower than those in group A［ （1.64±0.11） μmol/g， （1.62±0.13） μmol/g，（ 2.06±0.27） μmol/g］. The VC levels in brain tissue homogenates（ intracellular） in prefrontal cortex， parietal cortex and hippocampus of group C after ethanol withdrawal［ （1.20±0.29） μmol/g， （1.05±0.06） μmol/g，（ 1.21±0.15） μmol/g， respectively］recovered to some extent， but still significantly lower than those of group A（ P＜ 0.01）. In group C， the level of VC in temporal cortex［ （1.37±0.04） μmol/g］ was significantly higher than that in parietal cortex（ P ＜ 0.05）. In group D， the level of VC in all brain regions increased， and the level of VC in prefrontal cortex was significantly higher than that in parietal cortex ［（1.63±0.24） μmol/g vs（ 1.26±0.16） μmol/g， P ＜ 0.05］. The levels of VC in prefrontal cortex， parietal cortex， temporal cortex and hippocampus in group E were（ 1.72±0.19） μmol/g，（ 1.43±0.22） μmol/g， （1.67±0.19） μmol/g and（ 1.86±0.22）μmol/g， respectively， significantly higher than those in group B（ all P ＜ 0.01）， and gradually returned to normal level. The level of VC in hippocampus was significantly higher than that in parietal cortex（ P＜0.05）. Western blot results showed that compared with group A， the protein of SVCT2 in prefrontal cortex， parietal cortex of group B， group C and group D， and in hippocampus of group C， group D and group E was significantly increased（ P＜0.05）. Conclusions Binge drinking for 4 days can cause brain damage in rats. The VC level in CSF and brain tissue homogenates of each brain region present a negative correlation dynamic change process after ethanol treatment. During ethanol treatment process， the expression of SVCT2 protein is up-regulated， which will help the VC in the CSF to be transported to the neurons in each brain region to play an antioxidant role.

Abstract:Objective To explore the choice of different types of hospitals when seek medical treatment at the first time for depression patients in Beijing. Methods Patients with depression diagnosed in the outpatient clinics of 14 medical institutions in Beijing from February 2019 to August 2019 were recruited as research subjects. A self-made questionnaire was applied to investigate the choice of different types of hospitals when seek medical treatment at the first time for depression patients， and to analyze the reasons. Results A total of 4 317 people participated in the survey， and 2 770 people filled in the survey， and were included in the analysis. 42.58%（ 1 061/2 492） of the patients chose general hospital for their first visits， with the main reason of convenience（ 238 person-times）. 32.10%（ 800/2 492） of the patients chose psychiatric hospitals for their first visit. The main reason was that psychiatric hospitals or doctors were more professional（ 577 persontimes）. Among the patients who chose a psychiatric hospital for their first visit， the proportions of patients with Beijing Medical Insurance（ 72.16%， 425/589）， under 45 years old（ 89.25%， 714/800）， with bachelor degree or above（ 84.63%， 556/657）， self-rating moderate（ 46.40%， 316/681） and severe（ 16.89%， 115/681） were all higher than those of patients choosing general hospitals. The differences were statistically significant（ P＜0.05）. Conclusions The proportion of depressive patients who choose a general hospital for the first time is higher than psychiatric hospital. Beijing， high education， youth， moderate and severe patients are more inclined to choose to visit psychiatric hospitals.

Abstract:Objective To explore the functional connection characteristics of left and right amygdala in first-episode of childhood and adolescent patients with depressive disorder by rest state functional magnetic resonance imaging， and to analyze the correlation between abnormal functional connectivity and depressive symptoms. Methods From Octorber 2015 to June 2019， a total of 21 outpatients and inpatients with firstepisode childhood and adolescent depressive disorder in Mental Health Center of the First Hospital of Hebei Medical University were selected as the patient group， and 20 healthy children and adolescents were recruited as the control group. All the subjects were scanned by resting-state functional magnetic resonance imaging（ fMRI）. The left and right amygdalas were used as the brain regions of interest for the whole brain functional connectivity analysis to compare the functional connectivity differences between the two groups. The 24-item Hamilton Depression Scale（ HAMD-24） was used to evaluate the severity of depressive symptoms of the patient group， so as to analyze the correlation between depressive symptoms and functional connectivity of left and right amygdala. Results Compared with the controls group， the functional connections between the right amygdala and right superior frontal gyrus， left superior frontal gyrus， right middle temporal gyrus were reduced（ t=-4.49，-4.54， -4.91， GRF corrected， all P ＜ 0.05）； the functional connections between the left amygdala and right precuneus， left dorsolateral prefrontal lobe were reduced（ t=-6.40，-5.51， GRF corrected， all P ＜ 0.05）. The functional connectivity between the right amygdala and the right middle temporal gyrus were negatively correlated with the HAMD-24 score（ r=-0.920，P＜0.05， Bonferroni corrected）. Conclusions The abnormal functional connectivity of bilateral amygdala at resting-state in first-episode of childhood and adolescent patients with depressive disorder and the decreased functional connectivity between the right amygdala and the right middle temporal gyrus are related to the severity of depressive symptoms.

Abstract:Objective To explore the changes of olfactory function in depression before and after treatment， and to preliminarily explore the correlation between olfactory function and depression severity， inhibition control and emotional response. Methods A total of 35 patients with unipolar onset depression in Shanghai Yangpu Mental Health Center and Jiading Central Hospital from January 2017 to August 2018 were selected as depression group， and 33 healthy adults matched with depression group in gender， age and education level were selected as healthy control group. 17-item Hamilton Depression Rating Scale（ HAMD-17）， Hamilton Anxiety Rating Scale（ HAMA）， Chinese Smell Identification Test（ CSIT） and emotional Stroop test （EST） were applied to evaluated the levels of depression， anxiety， olfactory and the response time of Stroop task under emotional interference， at the baseline before treatment and follow-up 3 months after treatment. SPSS 17.0 software was used to analyze and process the data. Multiple linear regression analysis was used to analyze the correlation between age， HAMD-17， HAMA， emotional Stroop task response time at baseline and olfactory test results. Results At baseline， the total CSIT score of the depression group was lower than that of the control group at baseline［ 7（ 6， 9） vs 9（ 8， 9）， P ＜ 0.001］， while there was no statistically significant difference between the two groups 3 months after treatment［ 8（ 8， 9） vs 9（ 8， 9）， P=0.22］. At baseline， the mean response time（ MRT） of emotional Stroop test in depression group was higher than that in healthy control group（ P＜0.001）. There were no statistically significant differences in POS-C［ （539.0±109.0） ms vs（ 489.7±132.1） ms］ and POS-I［ （538.1±98.2） ms vs（ 494.7±135.3） ms］ between the two groups（ P=0.10， 0.13） at follow-up. At the same time， the differences in NEG-C［ （573.0±149.2） ms vs（ 474.8±111.7） ms］， NEG-I［ （530.9±112.7） ms vs（ 474.9±94.0） ms］ and NEU［ （532.2±114.0） ms vs（ 476.2±101.5） ms］ between the two groups were statistically significant（ t=3.06，2.22，2.14；P ＜ 0.01）， prompting the results were still longer than those of the control group. The final regression model obtained by the multiple linear regression analysis had included two independent variables with age and NEG-C （F=10.811， adjusted R2=0.366，P ＜ 0.05） at baseline level of depression. Conclusions The patients with depression have olfactory function and inhibition and control function damage during the attack period， and it will improve with the improvement of the disease. The result of multiple linear regression suggested that in addition to age， the inhibitory control function might be the key influencing factor of the olfactory function， rather than the emotional severity assessed by the scales（ HAMD-17 and HAMA）.

Abstract:Objective To explore the effects of medical ozone on behaviors of depression model mice and its related mechanisms. Methods A total of 30 healthy male ICR mice were selected to establish depression model， and randomly divided into Sham group（ no depression treatment + normal saline）， model group（ depression treatment + normal saline）， and low， medium， and high concentration groups（ depression treatment + intraperitoneal injection of 60μg/ml， 80μg/ml and 100μg/ml medical ozone）， with six mice in each group. Depressive behaviors of mice were detected by open field experiment and behavioral despair experiment. Pathological changes in the hippocampus of mice were observed by HE staining. The levels of inflammatory cytokines of interleukin-1β（ IL-1β）， interleukin-6（ IL-6） and tumor necrosis factor-α（ TNF-α） in hippocampus of mice were detected by Western blot. Results The open field behavior experiment results of depression model mice showed that the number of horizontal crossing lattice， the number of uprights， and the number of modifications in model group were significantly less than those in Sham group（ P＜ 0.05）， and the number of defecation grains was significantly more than that in Sham group（ P＜0.05）， and the indexes in medium and high concentration groups were significantly better than those in model group（ P＜0.05）， and there were no significant differences between low concentration group and model group（ P ＞ 0.05）. The behavioral despair experiment results showed that the 4 min continuous immobility time of mice in model group after experiment was significantly longer than that in Sham group（ P ＜ 0.05）， and the time in each concentration group was significantly shorter than that in model group（ P＜0.05）. Among them， the mice in high concentration group had the largest difference. The results of body mass test showed that the body mass on the 0 d， the 7th d， the 14th d and the 21st d of mice in model group was significantly lower than that in Sham group（ P＜0.05）. On the 21st d， the body mass in high concentration group was significantly higher than that in model group（ P＜ 0.05）， and there was no significant difference in the rest of the time compared with that in model group（ P ＞ 0.05）. On the 7th d， the 14th d and the 21st d， there was no significant difference among low and medium concentration groups and model group（ P＞0.05）. The results of microscope observation showed that the number of microglia in the hippocampus of model group was significantly more than that of Sham group［ （23.64±3.57） vs（ 18.11±2.92）］（ P ＜ 0.05）， and that of high concentration group（ 17.27±2.69） was significantly less than that of model group（ P＜0.05）， and there was no significant difference among low（ 20.03±3.21） and medium （22.58±3.84） concentration groups and model group（ P＞0.05）. Western blot results showed that the levels of inflammatory factors IL-1β， IL-6， and TNF-α of hippocampus of model group were significantly higher than those of Sham group（ P ＜ 0.05）， and those of high concentration group were significantly lower than those of model group（ P＜ 0.05）， and there was no significant difference among low and medium concentration groups and model group（ P ＞ 0.05）. Conclusions High-concentration medical ozone can improve depression-like behaviors in depression model mice， and its possible related mechanism is related to the down-regulation of expression of inflammatory levels factors in brain tissue.

Abstract:Depression is a kind of severe mental illness that seriously endangers human physical and mental health， and its pathophysiological mechanism is extremely complex. The antidepressant effect of SIRT1 （Sirtuin 1， Silent Information Regulator Factor 2-related enzyme I） has been widely demonstrated， but its mechanism is still unclear. The regulatory role of miR-124 has also been found to be important in the onset of depression. The purpose of this paper is to introduce how SIRT1 regulates miR-124， alleviates the pathological changes of hypothalamic-pituitary-adrenal axis（ HPA axis） hyperfunction and neurotrophic factor deficiency， exerts antidepressant function. The elucidation of this mechanism could provide important clues for depression pathogenesis research and drug development.

Abstract:Objective To investigate the relationship between serum potassium levels and nutritional status of alcohol dependence patients in psychiatric departments. Methods A total of 213 alcohol-dependent patients admitted to the Mental Health Center of the First Hospital of Hebei Medical University from July 2016 to June 2019 were selected. Patients were screened for nutritional risk using the Nutritional Risk Screening Scale （NRS 2002）. Patients were divided into study group（ NRS ≥ 3， n=76） and control group（ NRS ＜ 3， n=137）. Serum potassium levels were measured on admission， day 2， day 7， and 1 month. Serum potassium level and the incidence of hypokalemia were compared between the two groups. Results There were 80 cases of hypokalemia （37.56%） in the two groups. The prevalence of hypokalemia in the study group was 47.37%（ 36/76）， which was higher than 32.12%（ 44/137） in the control group（ χ2=4.848，P=0.028）. The average serum potassium level of the study group was lower than that of the control group on admission and day 2 after admission（ P＜0.01）. There was no significant difference in serum potassium level between the two groups on day 7 and 1 month after admission（ P＞ 0.05）. The blood potassium level of the study group was the lowest on day 2（ P＜ 0.05）. Multivariate logistic regression analysis showed that average daily alcohol consumption（ OR=1.657， P=0.041）， duration of alcohol dependence（ OR=1.066， P=0.031） and NRS 2002 score（ OR=1.414， P=0.014） were the risk factors for hypokalemia， while average daily food intake（ OR=0.455，P=0.003） was a protective factor for hypokalemia. Conclusions Alcohol dependent patients are prone to malnutrition and have significantly higher incidence of hypokalemia. Nutritional risk screening and continuous potassium assessment in alcohol-dependent patients deserve attention.

Abstract:Objective To explore the predictive relationship between pressure perception and loneliness of college students by longitudinal study. Methods From October 2018 to June 2019， senior college students（ juniors and seniors） from three universities in Heilongjiang Province were selected as the research objects by convenience sampling method. Three questionnaires were conducted with an interval of 4 months. The first test was conducted in October 2018（ T1）， and 912 valid subjects were obtained. The second test time（ T2） was February 2019， and 873 valid subjects were obtained. The third test time（ T3） was June 2019， and 806 valid subjects were obtained. The sample adopted in the study was 742 students who participated in all the tests. A oneyear follow-up study was conducted on the 742 college students with Chinese Perceived Stress Scale（ including two dimensions of tension and out of control） and UCLA loneliness scale. The data were analyzed by repeated measurement variance， Pearson correlation analysis and cross-lagged regression analysis. Results （1） The variance analysis results showed that there were significant differences in pressure perception and loneliness before and after measurement（ F=4.85， P＜ 0.05； F=29.65，P＜ 0.05）， but no significant differences in gender （F=0.06，P＞0.05； F=0.41，P＞0.05）（. 2） Correlation analysis of the three times of survey showed that there was a significant positive correlation between stress perception and loneliness（ P＜0.01）；（ 3）Cross-lagged regression analysis indicated that T1 pressure perception significantly predicted T2 pressure perception（ β=0.45，P＜0.01） and T2 loneliness（ β=0.17， P＜0.01）. T1 loneliness had a significant predictive effect on T2 pressure perception （β=0.22， P＜0.01） and T2 loneliness（ β=0.59， P＜0.01）. T2 pressure perception had a significant predictive effect on T3 pressure perception（ β=0.47，P＜0.01） and T3 loneliness（ β=0.21， P＜0.01）. T2 loneliness had a significant predictive effect on T3 pressure perception（ β=0.20， P＜0.01） and T3 loneliness（ β=0.51， P＜0.01）. T1 tension had a significant predictive effect on T2 tension（ β=0.35， P＜0.01）， but not on T2 loneliness（ β=0.04， P＞0.05）. T1 loneliness had a significant predictive effect on T2 tension（ β=0.18，P＜0.01） and T2 loneliness （β=0.67， P ＜ 0.01）. T2 tension had a significant predictive effect on T3 tension（ β=0.35，P ＜ 0.01） and T3 loneliness（ β=0.10，P＜0.01）. T2 loneliness had a significant predictive effect on T3 tension（ β=0.21，P＜0.01） and T3 loneliness（ β=0.59， P＜0.01）. T1 loss of control had a significant predictive effect on T2 loss of control （β=0.37， P＜0.01） and T2 loneliness（ β=0.14， P＜0.01）. T1 loneliness had a significant predictive effect on T2 loss of control（ β=0.22， P＜0.01） and T2 loneliness（ β=0.63， P＜0.01）. T2 loss of control had significant predictive effect on T3 loss of control（ β=0.33， P＜0.01） and T3 loneliness（ β=0.14， P＜0.01）. T2 loneliness had a significant predictive effect on T3 loss of control（ β=0.15， P＜0.01） and T3 loneliness（ β=0.57， P＜0.01）. Conclusions There is a causal relationship between pressure perception and loneliness among college students.

Abstract:Objective To summarize the clinical and imaging features of secondary restless legs syndrome（ RLS） after acute cerebral infarction. Methods The clinical manifestations， MRI images and treatment plans of 20 patients with RLS after acute cerebral infarction treated by Beijing Friendship Hospital from January 2012 to January 2019 were analyzed retrospectively， to summarize their clinical features. Results The average age of the 20 patients with secondary RLS after acute cerebral infarction was（ 62.65±9.40） years old， including 12 males and 8 females， with a male to female ratio of 3∶2. The infarctions were located in the pons， radial crown， centrum semiovale， thalamus， putamen and occipital lobe. All 20 patients had limb paralysis on the contralateral side of the infarction， and 12 patients had dysesthesia of the limb contralateral to the infarct lesion. RLS occurred in the contralateral side of infarct in 12 patients and in both limbs in 8 patients. Among them， 15 patients were treated with dopaminergic drugs， and the clinical symptoms of RLS were significantly improved after treatment. Conclusions The common infarct sites of secondary RLS after acute cerebral infarction are the pons（ mostly parabrachial nucleus involvement）， centrum semiovale and basal ganglia. Compared with idiopathic RLS， secondary RLS after acute cerebral infarction is mostly unilateral， which can affect upper limbs， and dopaminergic drugs are effective.

Abstract:The reality monitoring is essential to keeping our daily lives in balance. It can help us identify our thoughts， feelings and imaginations， and distinguish them from real experiences or events told by others. When the reality monitoring errors occur， individual often misidentifies internal generated events as real， ranging from experiences of confusing reality with imagination to psychotic symptoms such as auditory hallucination， the degree of which depends on the reality-monitoring ability. The reality-monitoring ability of patients with schizophrenia is obviously impaired. Research on reality monitoring can help us better understand the brain mechanism of schizophrenia and find new targets for intervention. Therefore， this paper will review the research progress on the deficiency of reality monitoring in schizophrenia.

Abstract:Intolerance of uncertainty， as a cross diagnostic risk factor， is associated with a variety of mental disorders， but the neural mechanism is still unclear. In order to further clarify the relationship between intolerance of uncertainty and brain function and structure， this paper reviews the research progress of MRI on intolerance of uncertainty， including the relationship between intolerance of uncertainty and brain regions such as insula， amygdala， anterior cingulate gyrus， prefrontal lobe and striatum.

Abstract:Anxiety disorders are among the most prevalent mental diseases， which can seriously affect people's daily work and life. However， the pathogenesis is still unclear. In recent years， it has been found that there is a certain relationship between NRG1 / ErbB4 signaling pathway and anxiety disorders. This paper reviews the research in this field at home and abroad.

Abstract:Alzheimer disease（ AD） is one of the most common neurodegenerative diseases， which often has an insidious onset and is lack of effective treatments. Mild cognitive impairment（ MCI）， which partly can develop into AD， is a state of cognitive impairment between normal aging and dementia. The major core clinical symptoms of AD include memory impairment， cognitive dysfunction， changes of personality and behavior. Many studies have shown that AD may be accompanied by sensory disturbances， such as smell， vision， hearing， etc.， among which olfactory disturbances may be one of the early clinical symptoms of MCI or AD， and MCI and AD patients may have sensation-related electrophysiological changes. This article reviews the progress of sensory disturbance and related electrophysiological change in MCI and AD patients.

Abstract:Increased serum homocysteine level is a risk factor for vascular endothelial dysfunction. It has a similar pathological process to the endothelial function damage of large arteries and small arteries. Compared with large artery endothelial cells， small artery endothelial cells were more sensitive to serum homocysteine. Therefore， it is important to study the correlation between cerebral small vessel disease and serum homocysteine level. Many studies in China and abroad have confirmed that the level of homocysteine is related to the imaging subtypes of cerebral small vessel disease， cognitive dysfunction， and the occurrence and development of dementia. This article reviews the relationship between cerebral small vessel disease and serum homocysteine level， which is of great significance to the clinical diagnosis and treatment of cerebral small vessel disease.