Abstract:Schizophrenia was a kind of severe psychiatry disorder. At present， the clinical treatment of positive symptoms has a good effect， but the treatment of negative symptoms and cognitive symptoms has little effect. Substantial evidence from basic and clinical research suggests that aerobic exercise significantly improved cognitive function in patients with schizophrenia. Therefore， this paper elaborates on the potential mechanism of aerobic exercise to improve cognitive function， in order to provide reference for in-depth research and intervention of cognitive impairment in schizophrenia in the future.

Abstract:Objective To investigate the effect of iron deposition and blood flow in subthalamic nucleus （STN） and globus pallidus internus （GPi） on motor symptoms of early and middle stage of Parkinson disease （PD）. Andto analyzethe relation between iron deposition and blood flow of PD. Methods A total of 34 PD patients hospitalized in Neurorehabilitation Center of Beijing Rehabilitation Hospital affiliated to Capital Medical University， who were diagnosed as stage Ⅰ to Ⅲ according to Hoehn-Yahr （H-Y）， from July to October 2020 were recruited as PD group， and another 17 healthy people were enrolled as control group in the same period. All subjects underwent whole-brain MR conventional sequence， 3D T1 Bravo， quantitative magnetic resonance imaging （QSM） and 3D arterial spin labeling （3D-ASL） sequence scanning. Based on the map of basal ganglia subregion， QSM and 3D-ASL imaging methods， the QSM and CBF values of STN and GPi were extracted by Matlab software and user-defined code. All patients' motor symptoms were assessed by H-Y Scale， MDS-UPDRS Ⅱ and Ⅲ， 10-meter walking speed and 3D gait analysis （including step frequency， step speed， step time， swing phase， contralateral support phase and step length）. Pearson correlation or Spearman correlation were used to analyze the correlation between imaging indexes and motor symptoms in PD patients. Results There were no significant differences in age and gender between the two groups （P＞ 0.05）. The QSM values in STN and GPi， and the CBF value in GPi of PD group were higher than those of the control group ［0.008 （0， 0.019） ppm vs -0.003 （-0.015， 0.009） ppm； -0.003 （-0.011， 0.009） ppm vs -0.014 （-0.023， -0.007） ppm； 0.715 （0.657， 0.790） vs 0.617 （0.584， 0.704）］， and the differences were statistically significant （P＜ 0.05）. The CBF values in STN and GPi of PD patients were positively correlated with MDS-UPDRS Ⅱ （r=0.352， 0.376； P＜ 0.05）. The QSM value in GPi was positively correlated with step time （r=0.381， P＜ 0.05）. The QSM value in GPi of PD patients were negatively correlated with 10-meter walking speed， step speed， step frequency and step length （r=-0.475， -0.584， -0.462， -0.533； P＜ 0.05）. There was no correlation between the QSM value and the CBF value of STN and GPi in PD patients （P＞ 0.05）. Conclusions The simultaneous assessment of iron deposition and CBF in specific brain regions of PD patients in early and middle stage by QSM and 3D-ASL is of certain value， and may help monitor the progress of PD. However， the exact relationship between the content of iron brain and blood flow in PD remains to be further studied.

Abstract:Objective To explore whether patients with white matter hyperintensity （WMH） have characteristic dyskinesia through simple digital writing and painting tasks. Methods A total of 82 WMH patients hospitalized in the Department of Neurology of the Seventh Medical Center of PLA General Hospital from April 2020 to April 2021 were enrolled. All patients were divided into low load group （n=42）， medium load group （n=20） and high load group （n=20） according to the scores of Fazekas. WACOM touch screen and electronic pen were used for writing and painting test， and MovAlyzeR software was used to record and process kinematic parameters. The speed， pressure and average tortuosity of the three groups were compared； The pressure and speed of the third and fourth strokes of the Chinese character " 正 "； Write the vertical and horizontal size of the Chinese character " 永 "； The average normalized jerk （ANJ） and sub motion sum when painting Archimedes spiral， and analyze the differences between WMH and writing and painting parameters. Spearman correlation was used to analyze the correlation between WMH degree and writing and painting parameters. Results There were significant differences in the average tortuosity of signature， the speed of signature and the speed of writing the fourth stroke of " 正 " in low load， medium load and high load groups ［0.2 （0.1， 0.4） vs 0.3 （0.2， 0.4） vs 0.4 （0.2， 0.6）； 1.6 （1.4，2.3） cm/s vs 1.5 （1.2， 2.0） cm/s vs 1.2 （1.1， 1.6） cm/s； 1.4 （1.2，1.8）cm/s vs 1.3 （0.9， 1.7）cm/s vs 0.9 （0.8， 1.4）cm/s］ （Z=9.571， 10.726， 12.478； P＜ 0.01）. The difference of vertical size of " 永 " among the three groups ［（1 611.3±405.0）cm vs （1 474.1±512.8）cm vs （1 286.8±470.1）cm］ were statistically significant （F=3.580，P＜ 0.05）. The difference of ANJ and sub motion sum when painting Archimedes spiral among the three groups ［30.9 （22.2， 51.3） vs 44.6 （23.2， 80.8） vs 52.8 （31.2， 100.8）； 8.0 （2.5， 11.5） vs 11.0 （5.0， 17.0） vs 12.0 （9.3， 15.8）］ were statistically significant （Z=7.636， 7.792； P ＜ 0.05）. The correlation analysis showed that the degree of WMH was positively correlated with the average tortuosity of signature， spiral ANJ， spiral sub motion （r=0.366， 0.301，0.300；P＜ 0.01）， and negatively correlated with the speed of signature， the speed of writing the fourth stroke of " 正 " character and the vertical size of " 永 " character （r= -0.307，-0.307，-0.287；P＜ 0.01）. Conclusions With the increasing severity of WNH， writing and painting deteriorated significantly， and writing disorders mainly exist in the vertical direction.

Abstract:Objective To investigate the changes of amine β hydroxylase activity （DβH） in patients with schizophrenia and clinical ultra-high risk individuals and its relationship with psychotic symptoms. Methods 61 schizophrenia patients admitted to Beijing Anding Hospital affiliated to Capital Medical University， 35 clinical ultra-high risk participants and 86 sex-matched healthy controls were included in this study， which is designed by the cross-sectional group research method. To analyze the effect of long-term administration of antipsychotics on DβH， 39 patients with chronic schizophrenia were also included. The Positive and Negative Syndrome Scale （PANSS） was used to evaluate the psychotic symptoms of the patients. The plasma DβH activity was detected by high performance liquid chromatography and electrochemistry in participants. The differences of plasma DβH activity and psychotic symptoms among first-episode schizophrenia patients， clinical ultra-high risk individuals， and the healthy controls were analyzed. Further comparison of the plasma DβH activity between first-episode untreated schizophrenia patients and chronic treated schizophrenia patients were carried out to analyze the impact of antipsychotics on plasma DβH activity. Results There was a statistically significant difference （F=6.591， P=0.002） in plasma DβH activities among first-episode schizophrenia patients ［（12.35±8.55）nmol/（ml·min）］， clinical ultra-high risk individuals ［（19.59± 13.95） nmol/（ml·min）］ and healthy controls ［（17.51±11.04） nmol/（ml·min）］. The plasma DβH activity in schizophrenia patients was significantly lower than those of healthy controls （P ＜ 0.05） and the clinical ultrahigh risk individuals （P ＜ 0.01）. However， there was no statistically significant difference in plasma DβH activities between clinical ultra-high risk individuals and healthy controls （P＞ 0.05）. No significant correlations were found between plasma DβH activity and course of disease， positive symptoms， negative symptoms， and general psychotic symptoms in schizophrenia patients （P ＞ 0.05）. Plasma DβH activity in the first-episode untreated patients was significantly lower than those in the first-episode treated patients （t=2.023， P=0.048） and the chronic treated patients ［（18.52±7.00） nmol/（ml·min）， F=7.053， P=0.010］. Conclusions Plasma DβH activity in first-episode untreated schizophrenia patients significantly decreased compared with that in the healthy controls. Short-term or long-term treatment of antipsychotics could increase plasma DβH activity in schizophrenia patients.

Abstract:Objective To preliminarily explore the possible effect of betahistine on body weight and lipid metabolism in male schizophrenics treated with olanzapine. Methods A total of 41 male patients with schizophrenics hospitalized in Beijing Huilongguan Hospital from September 2020 to September 2021 were selected. A 4-week open-ended trail were carried out with additional betahistine 16 mg， 3 times per day， based on single drug treatment with olanzapine for 4 months and over. Fasting full blood examination， fasting blood sugar， triglyceride， total cholesterol， liver function and other indicators were tested at baseline and the end of 4 weeks' treatment. At the same time， fasting weight， height， abdominal circumference， and blood pressure were measured， and body mass index （BMI） were calculated. Clinical symptoms were assessed at baseline and over 4 weeks using the Positive and Negative Symptom Scale （PANSS）. The results of each index before and after the test were statistically analyzed by paired-sample t test. Results After 4 weeks of betahistine intervention， patients' body weight ［（70.1±6.7） kg vs （71.7±7.5） kg］， BMI ［（24.7±2.1） kg/m2 vs （25.2±2.4） kg/m2 ］， and total cholesterol ［（4.3±0.8） mmol/L vs （4.6±0.8） mmol/L］ were all lower than those before treatment， and the differences were statistically significant （t=4.52，3.97，2.47； P＜ 0.05）. There was no significant difference in PANSS total score， blood routine index and alanine aminotransferase before and after treatment with betahistine （P ＞ 0.05）. Conclusions Betahistine may improve the body weight and cholesterol of male patients with schizophrenia caused by olanzapine.

Abstract:The identification of schizophrenia and early psychosis depends heavily on the subjective judgment of symptomatology， and there is a lack of biomarkers that can be used in clinic. Mismatch negativity is generated by the brain's automatic response to the change of auditory stimulation beyond a specific threshold， which has a clear and prominent defect in chronic schizophrenia， but the study of its related indicators in early psychosis is still in the early stage. This paper aims to summarize the application progress of related indicators of auditory mismatch negativity in the recognition of different stages of schizophrenia，and provide references for further research.

Abstract:Deficit schizophrenia is a subtype of primary schizophrenia， whose main clinical features are primary， persistent negative symptoms. Compared with non-deficit schizophrenia， patients with deficit schizophrenia have earlier onset age， more severe cognitive disorders， more obvious long-term mental recession， and a heavier disease burden. Through the retrieval and analysis of the existing literature both in China and abroad， this paper reviews the pathogenesis， diagnosis， and therapy of deficit schizophrenia， in order to improve the early recognition of the disease and strengthen intervention.

Abstract:Objective To systematically investigate the diagnostic value of GeneXpert MTB/RIF essays in cerebrospinal fluid for tuberculous meningitis. Methods Relevant Chinese and English publications from the establishment of the database up to November 2021 about the diagnostic accuracy of GeneXpert MTB/RIF essays to tuberculous meningitis were searched in Pubmed，OVid， Embase， Scopus，Web of Science， Cochrane Library， CNKI，VIP and Wanfang databases. Then RevMan 5.3 and Meta-Disc 1.4 software were used to assess the quality of studies and conduct statistical analysis respectively. Sensitivity，specificity，positive likelihood ratio（PLR），negative likelihood ratio （NLR） and diagnostic odds of radio （DOR） were pooled. Summary receiver operating characteristic （SROC） curves and area under the curve （AUC） were calculated. Results A total of 28 articles were recruited， including 5 137 specimens from clinical patients. Meta-analysis showed that the pooled sensitivity and specificity of GeneXpert MTB/RIF essays for diagnosing tuberculous meningitis is 0.412 （95%CI： 0.392-0.431） and 0.967 （95%CI： 0.961-0.973） respectively.When using composite neference standard as the diagnostic standard，the pooled sensitivity and specificity is 0.362 （95%CI： 0.340-0.384） and 0.973 （95%CI：0.964-0.980）.When using the culture of mycobacterium tuberculosis as the standard， the pooled sensitivity and specificity is 0.589 （95%CI： 0.547-0.630） and 0.961 （95%CI： 0.950-0.970）. After centrifugation of cerebrospinal fluid， the pooled sensitivity and specificity is 0.431（95%CI： 0.405-0.456） and 0.966 （95%CI： 0.957-0.973）. In the case of HIV infection， the pooled sensitivity and specificity is 0.405（95%CI：0.375- 0.434） and 0.967 （95%CI： 0.956-0.976）. Conclusions GeneXpert MTB/RIF essays plays a valuable value in the diagnosis of tuberculous meningitis if the cerebrospinal fluid is centrifuged. It is recommended to diagnose tuberculous meningitis by using GeneXpert MTB/RIF essays in cerebrospinal fluid.

Abstract:Objective To explore and analyze the related factors of suicidal behavior in hospitalized patients with early adult bipolar disorder. Methods A total of 521 inpatients with bipolar disorder in early adulthood （aged between 18 to 25） in Beijing Anding Hospital affiliated to Capital Medical University from January to December 2018 were recruited as the research subjects. They were divided into suicide group （n=140） and no suicide group （n=381） according to whether they had ever committed suicide. The general data and disease subtypes of the two groups were compared. The risk factors related to suicide in early adult patients with bipolar disorder were analyzed by binary Logistic regression analysis. Results Compared with the suicide group， there were more female in the suicide group ［70% （98/140） vs 47.8% （182/381）， χ2 =20.350， P＜ 0.01］， more impulsive personality ［29.3% （41/140） vs 19.2% （73/381）， χ2 =6.141， P=0.013］， and there were more people with a history of major trauma ［14.3% （20/140） vs 4.5% （17/381）， χ2 =16.941， P＜ 0.01］. The differences were statistically significant. Binary Logistic regression analysis showed female ［OR=0.375， 95%CI （0.226-0.564）］， impulsive personality ［OR=0.603， 95%CI （0.377-0.963）］， history of major trauma ［OR=0.295， 95%CI （0.144-0.604）］were the independent risk factors for suicidal behavior in patients with bipolar disorder in early adulthood （P＜ 0.05）. Conclusions Patients with bipolar disorder in early adulthood who are females， have longer disease course， have impulsive personality， and have a history of major trauma are at higher risk of suicide.

Abstract:Objective To explore the circadian rhythm disorder and brain functional connectivity （FC） changes of young female nurses on long-term night shift， and analyze the correlation between them. Methods A prospective case control design was adopted， a total of 9 female nurses on night shift duty and 9 age-matched female nurses on day shift were included as the research objects. The Pittsburgh Sleep Quality Index （PSQI） and Epworth Sleepiness Scale （ESS） were completed. The levels of serum melatonin and cortisol were collected at 5 time points （2：00， 6：00， 10：00， 16：00 and 22：00） within 24 hours， and the whole brain was scanned with resting fMRI. The hypothalamus was used as the seed area for brain FC analysis. Spearman correlation analysis was used to analyze the correlation between brain FC and serum cortisol and melatonin levels of nurses in the two groups， as well as the correlation between age， PSQI score， ESS score and working years of nurses on night shift. Results The PSQI and ESS scores of the night shift nurse were higher than those of the day shift nurse ［（8.44±3.90） vs （3.11±1.9）； 8.0（6.0， 11.0） vs 5.0（2.0， 2.5）］， and the differences were statistically significant （P＜ 0.01）. The serum melatonin level of the night shift nurse was lower than that of the day shift nurse ［（135.18±20.84） pg/ml vs （185.83±25.97） pg/ml］， the difference was statistically significant （F=69.653，P ＜ 0.01）， and the rhythm curve was disordered. The serum cortisol level of the night shift nurse was higher than that of the day shift nurse ［（7.64±0.60） nmol/L vs （6.84±0.75） nmol/L］， and the difference was statistically significant （F=211.081， P＜ 0.01）. The brain FC from hypothalamus to right cingulate gyrus， right putamen and cerebellar vermis of the night shift nurse was stronger than that of the day shift nurse， the difference was statistically significant （P＜ 0.05）. The FC enhancement from hypothalamus to cerebellar vermis of the night shift nurses was positively correlated with ESS score （r=0.501， P=0.034）. Conclusions Nurses on long-term night shift may have decreased sleep quality， decreased melatonin level at night and cortisol rhythm disorder， accompanied by resting brain FC changes.

Abstract:Objective To investigate the effect of self-made simple stereotactic instrument assisted neuroendoscopy in the treatment of basal ganglia cerebral hemorrhage. Methods The surgical data of 40 patients with hypertensive cerebral hemorrhage in the basal ganglia area from January 2019 to December 2020 in the Pukou District Central Hospital of Nanjing were collected retrospectively. According to different surgical methods， they were divided into observation group （22 cases） and control group （18 cases）. Patients in the observation group underwent endoscopic simple brain stereotactic instrument to remove the hematoma； the control group underwent conventional bone flap craniotomy to remove the hematoma. The preoperative baseline data， operation time， intraoperative blood loss， hematoma clearance rate， and postoperative complications of the two groups were compared. Glasgow Outcome Scale-Extended （GOS-E） was used to compare the rate of good GOS-E scores of the two groups. Results The operation time of the observation group was shorter than that of the control group ［（65.8±10.5） min vs （125.3±20.4） min］； blood loss of the observation group was less than that of the control group ［（50.2±10.6） ml vs （295.3±18.5） ml］； The clearance rate of hematoma of the observation group was higher than that of the control group ［（88.2±3.8）% vs （70.3±5.6）%］； The differences were statistically significant （All P＜ 0.01）. The rate of good GOS-E score at 3 months after operation was higher than that of the control group ［72.7% （16/22） vs 7/18］， and the difference was statistically significant （P＜0.05）. There was no statistically significant difference in the incidence of postoperative complications between the two groups ［13.6%（3/22） vs 3/18；P＞ 0.05］. Conclusions Compared with conventional craniotomy for hematoma removal， simple brain stereotactic instrument assisted neuroendoscopy for the treatment of hypertensive basal ganglia cerebral hemorrhage has the advantages such as shortening the operation time， less intraoperative bleeding， high hematoma removal rate， and improving the patient's short-term prognosis.

Abstract:Transcranial alternating current stimulation is a non-invasive form of brain stimulation that can use sinusoidal and bipolar alternating currents to stimulate cortical neurons， regulate endogenous brain oscillations， and induce synaptic plasticity changes， help to relieve symptoms such as depression， anxiety， delusions， and dementia. This article reviews its clinical application and mechanism in depression， schizophrenia， and other diseases to help us understand the progress and deficiency of current research， and provide some hints for future clinical application.

Abstract:Alzheimer disease （AD） is a common progressive degenerative disease of central nervous system， with progressive cognitive decline as the main clinical feature， and is the main cause of dementia. Amnestic mild cognitive impairment （a-MCI） is a subtype of mild cognitive impairment （MCI）. Studies have shown that most of a-MCI will progress to AD， and active intervention of a-MCI is the key to delay or reduce the occurrence of AD. Currently， the drugs used for the treatment of amnestic MCI （a-MCI） lack large sample evidence-based medical evidence， and clinical researchers are paying more and more attention to the research of cognitive training in the field of non-drug treatment of a-MCI. The research of cognitive training has broad application prospect in the non-drug intervention of patients with a-MCI. This paper reviews the research progress of cognitive training in the clinical application of patients with a-MCI.

Abstract:Alzheimer disease （AD） is a age-related progressive neurodegenerative disease， which is clinically manifested as memory impairment and behavioral disorders. It seriously endanger the physical and mental health and life quality of the elderly worldwide and represent a challenge for the public health. Current studies have shown that neuroinflammatory immune response plays an important role in the pathogenesis of AD. This paper reviews the role of neuroinflammation and immune factors in the pathogenesis of AD， in order to provide new clues for the prevention and treatment of AD.