Abstract:Schizophrenia is a severe mental disease with unclear pathophysiology. In recent years， there has been growing evidence showed that schizophrenia was associated with inflammation and tryptophankynurenine pathway. Kynurenic acid， the bioactive metabolite of tryptophan， is an endogenous antagonist of N-methyl-D-aspartic acid receptor（ NMDAR）. The abnormalities of tryptophan-kynurenine metabolism with inflammatory may lead to the disability of NMDAR， which may be one of the pathogenesis of schizophrenia. Therefore， tryptophan-kynurenine metabolic pathway and inflammation can be used as drug targets for the treatment of schizophrenia. This review discusses the tryptophan-kynurenine metabolic pathway， the effect of inflammation on kynurenine metabolism in schizophrenia， the drug treatment effect targeting kynurenine pathway and inflammation， and summarizes the research progress of tryptophan-kynurenine pathway and inflammatory in schizophrenia.

Abstract:Objective To explore the value of the qualitative scoring of Mini-Mental State Examination （MMSE） pentagon test（ QSPT） in the differential diagnosis of dementia with lewy bodies（ DLB） and Alzheimer disease（ AD）. Methods Patients who met the inclusion criteria in the Department of Neurology， Xuanwu Hospital， Capital Medical University from January 2018 to August 2021 were selected as the research objects. A total of 61 patients with DLB and 71 patients with AD were analyzed retrospectively. The gender， age， years of education， MMSE， Montreal Cognitive Assessment Scale（ MoCA） and Clinical Dementia Assessment Scale（ CDR） were compared between the two groups. At the same time， the scores of sub items in the scale that can reflect visualspatial impairment were recorded， including connection test， cube copy， clock drawing test in MoCA， and pentagon copy test in MMSE. The MMSE pentagon images of these patients were further scored according to QSPT and modified QSPT， and compared between the two groups. In the meantime， the above indexes were compared between the two groups of patients with mild cognitive impairment（ CDR=0.5）. Multivariate stepwise Logistic regression was used to analyze the differential efficacy of QSPT or modified QSPT combined with other clinical psychological evaluation on DLB and AD. The area under the receiver operating characteristic curve（ AUC） was used to predict the differentiation effect of QSPT and modified QSPT on the two diseases. Results There were significant differences between DLB and AD patients in connection test， cube copy， clock drawing test， pentagon copy test， QSPT， improved QSPT scores and gender（ P＜0.01）. There was no significant difference in scores of MMSE， scores of MoCA， age and education（ P ＞ 0.05）. The sensitivity of QSPT in differentiating DLB and AD was 71.8%， the specificity was 67.2%， the area under ROC curve（ AUC） was 0.682（ 95%CI=0.584-0.772）， and the cut-off value was 9.5. The sensitivity of modified QSPT in differentiating DLB and AD was 68.9%， the specificity was 84.5%， the AUC was 0.780（ 95%CI=0.696-0.862）， and the cutoff value was 8.5. Logistic regression analysis showed that modified QSPT and cube copy were related to the distinction between the two diseases. There were significant differences between DLB and AD patients with mild cognitive impairment in connection test， cube copy， pentagon copy test， QSPT and modified QSPT（ P＜0.05）. There was no significant difference between the two groups in gender， age， year of education， scores of MMSE and MoCA（ P＞0.05）. The sensitivity， specificity and AUC of modified QSPT in differentiating mild cognitive impairment patients in DLB and AD groups were 64.7%， 91.3% and 0.714（ 95%CI=0.533-0.894） respectively. Conclusions QSPT is valuable in the differential diagnosis of DLB and AD， however the accuracy and efficacy remains to be evaluated. The modified QSPT method has higher accuracy and diagnostic efficiency， and can be used for the early identification in the neuropsychological assessment of the two diseases.

Abstract:Objective To analyze the change of gait parameters and gait patterns of motor cognitive risk syndrome （MCRS） in patients with cerebral small vessel disease （CSVD）. Methods A total of 42 CSVD patients with white matter lesions （WML） were selected from the Department of Neurology of the 7th Medical Center of the PLA General Hospital from 1st September 2020 to 1st June 2021. All the patients were divided into MCRS positive group （n=24） and MCRS negative group （n=18）. The Mini-Mental State Examination （MMSE） and Fazekas scores of the two groups were compared. The velocity （cm/s）， cadence （steps/min）， stride length （cm） and stride time （s） of single task walking （STW） and dual task walking （DTW） were compared. The dual task cost （DTC） and walk ratio （WR） were calculated. Binary Logistic regression was used to analyze the independent risk factors of MCRS in patients with CSVD. Results The MMSE score ［28 （27， 30） vs 26 （26， 27）］， WR of DTW ［9.046 （8.775， 9.582） （cm·min）/step vs 8.230 （7.232， 8.878） （cm·min）/step］， velocity of DTW ［（93.611±19.560） cm/s vs （82.167±16.531） cm/s］of the MCRS negative group were all higher than those of the MCRS positive group， and the differences were statistically significant （P ＜ 0.05）. Binary Logistic regression indicated that the WR of DTW （OR=0.422， 95%CI： 0.182-0.978， P=0.044） and MMSE score （OR=0.276， 95%CI： 0.099-0.764， P=0.013） were both independent risk factors of MCRS of CSVD patients. After general data adjusting， WR of DTW （OR=0.286， 95%CI： 0.089-0.920， P=0.036） and MMSE score （OR=0.193， 95%CI： 0.045- 0.816， P=0.022） were still independent risk factors of MCRS of CSVD patients. The velocity ［（91.595± 19.251） cm/s vs （87.071±18.569） cm/s］， and stride length ［（98.214±14.447） cm vs （93.524±12.968） cm］of STW were significantly higher than those of DTW in the 42 patients （P＜0.01）， and the effect value was medium （Cohen's d=0.239， 0.342）. Conclusions CSVD patients are more prone to gait disorders during DTW， mainly manifested in the reduction of velocity and step length and the change of gait pattern. WR is an independent risk factor for MCRS. With the increase of WR of DTW， the risk of MCRS increases.

Abstract:Auditory verbal hallucinations are the sensory perceptions of hearing voices without external stimuli， and one of the major symptoms of schizophrenia. Some of patients with auditory hallucinations suffer from insignificant efficacy or poor compliance with antipsychotic drugs， and new strategies are needed for clinical treatment. This review summarizes the research progress of brain abnormalities related to auditory verbal hallucination in schizophrenia and non drug intervention， including repetitive transcranial magnetic stimulation， cognitive behavioral therapy and cognitive training， to provide new ideas for the treatment.

Abstract:Patients with schizophrenia have severe social cognitive deficits， and the impairment of facial emotion recognition is an important aspect of social cognitive impairment. This symptom exists stably in the population of different stages of schizophrenia. Quantified event-related potentials are used to explore the mechanism of facial emotion recognition deficits and to deepen the understanding of the disease. This article reviews the features and mechanisms of facial emotion recognition deficits and event-related potentials in schizophrenia.

Abstract:Schizophrenia is a serious mental disorder， which imposes an extremely heavy economic burden on patients， families and society. Persons with schizophrenia commonly need continuing rehabilitation therapy after discharged from hospital， and community is the primary place where these rehabilitation therapies are provided. Therefore， the establishment of a scientific and effective community rehabilitation model for schizophrenia has become an important subject around the world. Thus， we reviewed recent papers of community rehabilitation models of schizophrenia at home and abroad， aiming to provide a new basis for the establishment and improvement of community mental health service system in China.

Abstract:Schizophrenia is a serious mental disorder with the characteristics of difficult rehabilitation and high recurrence rate. In addition to drug therapy， cognitive behavioral therapy（ CBT） is more and more widely used in the treatment of schizophrenia. Although the cognitive behavioral therapy for schizophrenia has made some progress， there are still some obstacles， and research results are not the same. By reviewing the related literature of CBT for schizophrenia， this paper summarized the current status， existing obstacles， and future prospects of CBT research for schizophrenia. Its aim is to provide a reference for clinical application and related research to improve schizophrenic patients' symptoms and mood in the future.

Abstract:Objective To explore the relationship between cognitive function and insomnia in patients with major depressive disorder. Methods A total of 101 patients with major depressive disorder（ MDD）， who were admitted to the outpatient clinic of Beijing Anding Hospital Affiliated to Capital Medical University from September 2014 to September 2016， were recruited. Repeatable Battery for the Assessment of Neuropsychological Status（ RBANS） and the Hamilton Depression Scale-17（ HAMD-17） were used to evaluate cognitive function and sleep quality. According to the sleep disturbance factor， they were divided into insomnia group（ n=45） and noninsomnia（ n=56） group. The RBANS and HAMD-17 scores of the two groups were compared. Kendall's tau-b correlation analysis and Pearson correlation analysis were used to explore the relationship between the cognitive function and insomnia in patients with MDD. Stratified regression analysis was used to analyze the relationship between sex， marital status， years of education， total course of disease， number of attacks， insomnia and list recognition in patients with MDD. Results There was a statistically significant difference in the HAMD-17 score［ 15.00（ 5.00， 21.00） points vs 2.00（ 0， 6.50） points］， the total score of RBANS［ 82.00（ 71.00， 90.00）points vs 87.00（ 82.25， 95.00） points］， list recall［ 5.00（ 3.00， 7.00） points vs 6.00（ 4.00， 7.75） points］， list recognition ［19.00（ 18.00， 20.00） points vs 20.00（ 19.00， 20.00） points］ between insomnia group and non-insomnia group（ all P＜ 0.05）. List recall score（ r=-0.170， P＜ 0.05） and list recognition score（ r=-0.265， P＜ 0.05） were negative correlated with insomnia； semantic fluency（ r=-0.198， P＜ 0.05） and list recognition score（ r= -0.250， P＜ 0.05） were negative correlated with sleep disturbance. The results of stratified regression analysis （R=0.519， R2=0.269， F=5.712， P ＜ 0.05） showed a statistically significant result that insomnia， marital status， total course of disease and years of education were the predictors of list recognition score（ P＜0.05）. Conclusions Cognitive function is related to insomnia in patients with MDD.

Abstract:Objective To explore the mediating effect of self-esteem between life events and school adjustment in senior high school students， so as to provide empirical basis for improving their school adjustment. Methods A total of 1 192 senior 1 and senior 2 students from two senior high schools in Jinan in Shandong Province were selected in November 2019 as research objects by the convenient sampling method. Questionnaire of School Adjustment for High School Students（ QSAHSS）， Self-esteem Scale for High School Students and Multidimensional Life Events Rating Questionnaire for Middle School Students were used. Pearson correlation analysis was used to explore the relationship between self-esteem， life events and school adjustment. SPSS 24.0 and model 4 in Process v3.3 were used to test the mediating effect. Results The QSAHSS score of boys was higher than that of girls［ （238.04±22.76） points vs（ 235.01±20.38） points］， and the QSAHSS score of key senior high school students was higher than that of ordinary high school students［ （237.98±20.51） points vs （234.05±23.23） points］. The differences were statistically significant（ t=2.42， P ＜ 0.05）； There was no statistically significant difference in the school adjustment between senior 1 and senior 2［ （237.30±20.24） points vs （235.59±23.15） points； t=1.358， P ＞ 0.05］. The correlation analysis results showed that life events had a statistically significant negative correlations with self-esteem and school adjustment（ r=-0.41， r=-0.19， P ＜ 0.05）， and self-esteem had a statistically significant positive correlation with school adjustment（ r=0.16， P ＜ 0.05）. High school students' self-esteem played a partial mediating role between life events and school adjustment， and the mediating effect accounted for 24.73% of the total effect. Conclusions High school students' self-esteem plays a partial mediating role between life events and school adjustment. In the process of education， improving the self-esteem of high school students can be an effective way to promote their school adjustment

Abstract:Objective To explore the correlation between different mood states and immune and stress factors in bipolar disorder， so as to provide clues for exploring the potential pathophysiological mechanism of different mood states. Methods This study is a retrospective study. A total of 1 989 patients with bipolar disorder hospitalized in Beijing Anding Hospital Affiliated to Capital Medical University from January to December 2018 were selected as the research objects. Among them， there were 1 182 patients in manic phase， 536 patients in depressive phase and 271 patients in mixed phase. Demographic data and biochemical indicators were compared among three different mood state groups. The biochemical indicators included C-reactive protein（ CRP）， complement 3（ C3）， complement 4（ C4）， immunoglobulin M（ IgM）， immunoglobulin G（ IgG）， immunoglobulin A（ IgA）， adrenocorticotropic hormone（ ACTH） and cortisol. Multiple Logistic regression analyses were performed to analyze the control confounding factors， and clarify the effects of biochemical indexes on different mood states of bipolar disorder. Results The differences in age， CRP， C3， C4， IgM， IgA， ACTH were statistically significant among the three groups（ P ＜ 0.05）. Comparing with bipolar depressive group， IgA（ OR=1.220， 95%CI=1.094-1.360）， C4（ OR=7.281， 95%CI=1.203-44.067） and ACTH（ OR=0.996， 95%CI=0.994-0.998） were the influencing factors to the bipolar manic group（ P ＜ 0.05）. C3（ OR=0.246， 95%CI=0.115-0.523）， ACTH（ OR=0.996， 95%CI=0.993-0.999） were the influencing factors to the mixed group（ P＜ 0.05）. Conclusions There are differences in levels of inflammatory and stress factors in patients with bipolar disorder in different mood states. Patients with mixed biphasic episodes were associated with lower C3 levels， bipolar depressive episodes were associated with higher ACTH levels， and bipolar manic episodes were associated with higher IgA levels.

Abstract:Objective To investigate the relationship between systemic immune inflammatory index（ SII）， D-Dimer（ D-D） and the severity and prognosis of young patients with acute cerebral infarction. Methods A total of 182 young patients with acute cerebral infarction treated in the Department of Neurology of the Affiliated Hospital of Xuzhou Medical University from March 2019 to March 2021 were recruited. All the research subjects were divided into mild group（ 143 cases） and moderate/severe group according to National Institutes of Health Stroke Scale（ NIHSS） score. According to the infarct volume， they were divided into small volume group（ 77 cases）， medium volume group（ 75 cases） and large volume group（ 30 cases）. After 3 months of follow-up， according to the modified Rankin Scale（ mRS） score， they were divided into good prognosis group（ 131 cases） and poor prognosis group（ 51 cases）. The relationship between SII， D-D and the severity of cerebral infarction， the volume of infarct focus and prognosis was analyzed. The multivariate Logistic regression analysis affecting the prognosis of cerebral infarction was further carried out. The sensitivity and specificity of SII and D-D were evaluated by receiver operating characteristic curve（ ROC）， and the best cut-off value was determined. Results In young patients with acute cerebral infarction， the levels of SII and D-D in patients with moderate/severe neurological deficit were significantly higher than those in mild group［ 1 019.27（ 763.11， 2 538.15） vs 578.20（ 398.63， 886.49）， 0.41（ 0.19， 0.86） μg/L vs 0.18（ 0.09， 0.34）μg/L， P＜ 0.05］. The level of SII in the large volume group was higher than that in the small volume group and the medium volume group ［1 187.28（ 730.05， 2251.80） vs 565.13（ 369.81， 741.89）， 696.25（ 441.22， 1 072.71）， P＜ 0.05］. The level of D-D in the large volume group was higher than that in the small volume group［ 0.36（ 0.18， 0.89） μg/L vs 0.15（ 0.07， 0.34） μg/L， P＜0.05］. Logistic regression analysis showed that the increase of SII and D-D were independent risk factors for poor prognosis（ P＜0.05）. The area under the curve（ AUC） of SII and D-D in ROC analysis to predict the poor prognosis of young patients with cerebral infarction were 0.789（ 95%CI： 0.712- 0.866） and 0.757（ 95%CI： 0.681-0.833）， respectively. The best critical values of serum SII and D-D to predict the poor prognosis of young patients with acute cerebral infarction were 781.4 and 0.16 μg/L， respectively. Conclusions The levels of D-D and SII in young patients with acute cerebral infarction are related to the severity of the disease and the volume of cerebral infarction， and have a certain predictive value for the shortterm prognosis.

Abstract:As the main active component of cannabis， cannabinoids are a unique group of terpenoid secondary metabolites with complex activities in cannabis. Since the discovery that cannabinoids can treat certain mental disorders， revealing the medicinal mechanism of cannabinoids in the treatment of mental disorders has gradually become a hot scientific issue in related fields. However， as of now， there is still insufficient evidence to support the medicinal efficacy and safety of any one cannabinoid component. At present， basic and clinical researches on cannabinoids for the treatment of mental disorders are emerging in an endless stream， and the academic community's understanding of the medicinal mechanism and clinical application potential of cannabinoids is deepening. This article aims to review the basic and clinical research on cannabinoids（ mainly around the two main cannabinoid components of tetrahydrocannabinol and cannabidiol） in the treatment of mental disorders at home and abroad， and summarize the research progress of cannabinoids in the treatment of mental disorders， with a view to guiding the next step of research direction and clinical practice in related fields.

Abstract:Intracranial hypotension syndrome and cerebral venous thrombosis are both low incidence neurological diseases. The incidence rate of isolated cortical vein thrombosis is only about 5% of all cerebral venous system thrombosis. Intracranial hypotension syndrome complicated with isolated cortical vein thrombosis is very rare in clinic. This paper reports a case of intracranial hypotension syndrome complicated with isolated cortical vein thrombosis and seizures. The symptoms improved after rehydration， anticoagulation and antiepileptic treatment. In order to provide reference for clinical diagnosis and treatment of these diseases， relevant literatures were reviewed and summarized.