Abstract:Objective To explore the role of baseline interleukin 1β （IL-1β） and interleukin 6 （IL-6） levels in predicting the efficacy of non-convulsively modified electroconvulsive therapy （MECT） for Geriatric depression with suicidal ideation. Methods A total of 58 elderly patients with depression admitted to the Geriatric Psychiatric Department of Beijing Anding Hospital Affiliated to Capital Medical University from June 1st， 2021 to May 31th， 2022 were included in this project. All patients had suicidal ideation （the score of the Self-rating Idea of Suicide Scale ≥ 12 points） and received 5-8 MECT treatment. Blood samples， demographic data and clinical symptom evaluation data were collected before treatment and 2 weeks after treatment， and baseline levels of IL-1β and IL-6 were measured. Cut-off value of baseline IL-6 level was analyzed using receiver operating characteristic （ROC） curves. Binomial Logistic regression model was used to analyze the relationship between baseline level of IL-6 and clinical efficacy. Results After 2 weeks of MECT treatment， 53.4% （31/58） of patients showed effective treatment， while 46.6% （27/58） of patients showed ineffective treatment； 89.7% （52/58） of patients had undetectable IL-1β. The proportion of male patients in the effective group was lower than that in the ineffective group ［25.8% （8/31） vs 51.9% （14/27）］， and baseline IL-6 level was higher than those in the ineffective group ［10.11 （0， 38.94） pg/ml vs 0 （0， 6.46） pg/ml］， with statistically significant differences（χ2 =4.158， Z=-2.925； P ＜ 0.05）. The area under the ROC curve for predicting the efficacy of MECT with baseline IL-6 level was 0.714 （95%CI=0.576 to 0.852）， and the cut-off value of baseline IL-6 level was 7.49 pg/ml. The sensitivity and specificity for predicting efficacy were 0.677 and 0.815， respectively. Binomial Logistic regression analysis showed that male （OR=0.147， 95%CI=0.025 to 0.874， P ＜ 0.05） and baseline IL-6 level ≥ 7.49 pg/ml （OR=17.261， 95%CI=2.966 to 100.440， P ＜ 0.01） were effective risk factors for MECT treatment in elderly depression patients with suicidal ideation. Conclusions In the treatment of geriatric depression with suicidal ideation， there is a certain relationship between serum baseline IL-6 level ≥ 7.49 pg/ml and MECT efficacy， which can be used to predict the prognosis of elderly depression patients with suicidal ideation.

Abstract:Objective To explore the influence of violence experience within 6 months prior to onset of bipolar disorder on life satisfaction and social function. Methods A total of 240 bipolar disorder patients who underwent 12 weeks of effective treatment in the acute phase from June 2014 to June 2017 at Beijing Anding Hospital affiliated with Capital Medical University were selected as the research subjects. A self-designed general data questionnaire was applied to collect demographic and clinical data. The Sexual and Physical Violence Questionnaire was applied to collect the violence experience within 6 months prior to the onset this time. Residual symptoms were assessed by 17-items Hamilton Depression Rating Scale （HAMD-17） and Young Mania Rating Scale （YMRS） and life satisfaction and social function were assessed by WHO Quality of Life-BREF （WHOQOL-BREF） and Sheehan Disability Scale （SDS） at baseline， 3 months and 6 months. Results Within 6 months prior to the onset， 38.8% （93/240） of patients experienced violence， of which 28.0% （26/93） had experienced sexual violence， 72.0% （67/93） had experienced physical violence， and 80.6% （75/93） had experienced sexual and physical violence. There is a statistically significant difference in marital status， suicidal attitudes， suicide plans， and total number of episodes in the past three years between patients with and without violent experiences （P＜ 0.05）. A total of 194 patients were included in the analysis at a 3-month follow-up， and 171 patients were included in the analysis at a 6-month follow-up. There was a statistically significant difference in the total HAMD-17 score between patients with and without violent experiences at baseline and 3-month follow-up （Z=-2.24，-1.99；P ＜ 0.05）， while there was no statistically significant difference in the total HAMD-17 score at 6-month follow-up （Z=-1.28，P ＞ 0.05）. There was no statistically significant difference in the total YMRS scores between the two groups of patients at three time points （Z=-0.81，-1.13， -1.00；P＞ 0.05）. Patients with violent experiences had lower scores in the psychological， social relations， and environmental fields in WHOQOL-BREF at baseline and 3-month follow-up compared to patients without violent experiences， with a statistically significant difference （Z=-3.65-2.16；P ＜ 0.05）. Among them， the scores in the social relations field were still lower than those in patients without violent experiences at 6-month follow-up， with a statistically significant difference （Z=-2.28， P＜ 0.05）. The proportion of cases of work/study， social life， and family life damage in patients with violent experiences at 3-month follow-up is higher than that in patients without violent experiences， and the difference is statistically significant （χ2 =4.22-6.63； P ＜ 0.05）. There was no statistically significant difference in the work/study， social life， and family life damage between the two groups at baseline and 6-month follow-up （χ2 =0.06-1.78； P ＞ 0.05）. Conclusions The experience of violence within 6 months prior to this episode had a significant impact on the life satisfaction and social function of bipolar disorder patients in the acute phase within 3 months after treatment， and the impact gradually disappeared after 6 months.

Abstract:Objective To investigate the current situation and related influencing factors of internet addiction among medical students. Methods From October 11 to November 7， 2021， a total of 7 201 undergraduate medical students from sophomores to seniors at Hebei Medical University were selected as the research subjects. A self-made general situation questionnaire was used to collect general information， and the Chinese version of the Internet Addiction Scale （IAT）， Pittsburgh Sleep Quality Index （PSQI）， Self-Rating Anxiety Scale （SAS）， and Self-Rating Depression Scale （SDS） were used to evaluate the internet addiction status， sleep quality， anxiety， and depressive mood of medical students. Medical students with IAT scores of 20-39 were included in the non-internet addiction group， 40-69 in the suspected addiction group， and 70- 100 in the addiction group. The influencing factors of internet addiction among medical students were analyzed by multiple Logistic regression analyses. Results A total of 24.8% （1 788/7 201） of medical students had internet usage issues （IAT ≥ 40 points）， with suspected addicts accounting for 23.9% （1 721/7 201） and addicts accounting for 0.9% （67/7 201）. There was a statistically significant difference in gender， personality， relationship， family upbringing style， campus bullying experience， alcohol consumption， daily physical exercise， learning pressure， interpersonal relationship pressure， sleep quality， anxiety， and depression among three groups of medical students （P＜0.05）. Multiple Logistic regression analysis showed that anxiety （OR=4.866， 95%CI=2.067-3.779）， depression （OR=6.038， 95%CI=3.278-11.121）， poor interpersonal relationship （OR=4.023， 95%CI=1.259-3.733）， doting family （OR=3.147， 95%CI=1.150-8.606）， poor sleep quality （OR=2.168， 95%CI=1.259-3.733）， school bullying （OR=1.938， 95%CI=1.059-3.548）， daily physical exercise （OR=0.386， 95%CI=0.220-0.678） were influencing factors of internet addiction （P＜ 0.05）. Conclusions The issue of internet use among medical students cannot be ignored， and anxiety and depression are the main risk factors for their internet addiction.

Abstract:Objective To investigate the disease characteristics， treatment status and unmet clinical needs of depression patients with suicidal ideation and suicidal attempt in China from the perspective of psychiatrists. Methods This was a cross-sectional study based on the electronic questionnaire survey. Using convenience sampling method， psychiatrists of 3A general hospitals or psychiatric hospitals across 24 provinces/municipalities in China were selected as the research subjects from December 2020 to January 2021. The electronic questionnaire was designed based on literature review and clinical practice， then reviewed and completed by an expert advisory committee. This questionnaire was used to collect basic information about psychiatrists， the composition of patients with depression， the clinical characteristics of patients with suicidal ideation and attempted suicide， the current clinical diagnosis and treatment status of patients with suicidal ideation and attempted suicide， and the clinical needs and expectations of doctors and patients. This study distributed 317 questionnaires and collected 209 valid questionnaires， with a valid recovery rate of 65.9%. Results There were 29.2%（61/209） and 10.0%（21/209） psychiatrists consider that more than half of the depression patients have suicidal ideation and suicidal attempt， respectively. While 58.4%（122/209） and 16.3% （34/209） psychiatrists believe that more than half of the depression patients in hospital had suicidal ideation and suicidal attempt， respectively. 46.9%（98/209） of psychiatrists consider that 10%-30% of patients with MDD with suicidal ideation would develop to suicidal attempt. It was believed that common risk factors for attempted suicide include past suicide history， worsening depressive symptoms， major negative life events， family history of suicide， and concomitant mental disorders. At present， the most commonly used treatment methods for depression patients with suicidal ideation and suicidal attempt are drug therapy combined with psychological therapy and drug therapy combined with modified electroconvulsive therapy. The three characteristics psychiatrists expect for future new drugs are fast-acting， to help patients return to normal school， work， life and social functions， and to reduce risk of recurrence. Conclusions There is inconsistency in the management of depression patients with suicidal ideation and suicidal attempt， and there is lack of timely and effective assessment tools and clinical interventions. In the future， in-depth research is needed around the above-mentioned bottleneck issues， and at the same time， standardized diagnosis and treatment models should be developed to shorten the differences in treatment levels between hospitals and psychiatrists， which is also an effective way to improve patient prognosis.

Abstract:Objective To explore the effect of integrated medical care model on mood disorders and sleep quality in patients with hyperthyroidism. Methods A total of 69 patients with hyperthyroidism hospitalized in the Department of Endocrinology of Handan First Hospital from August 2019 to August 2021 were selected by convenience sampling method. All the patients were divided into control group （n=34） and study group （n=35） by random number table method. The control group adopted the routine medical care mode， and the study group adopted the integrated medical care mode on the basis of medical treatment for 3 months. The changes of Depression， Anxiety and Stress Scale （DASS-21）， and Pittsburgh Sleep Quality Index （PSQI） were compared between the two groups before and after the intervention. Results Before the intervention， there was no significant difference in the scores of DASS-21 and PSQI between the control group and the study group ［（31.05±7.52） vs （30.35±6.85）， （14.91±1.94） vs （15.06±2.06）］（t=0.404， -0.369； P＞ 0.05）. After the intervention， the scores of DASS-21 and PSQI of the study group were （18.62±4.25） and （7.26±0.90）， and those of the control group were （24.95±5.25） and （10.53±1.13）. The scores of DASS-21 and PSQI after the intervention of both groups were lower than those before the intervention， and the scores of the study group were lower than those of the control group， with statistical significance （P ＜ 0.01）. Conclusions The implementation of integrated medical care model while medication treatment can effectively alleviate the negative emotions of hyperthyroidism patients and improve their sleep quality.

Abstract:Multiple sclerosis （MS） is an immune-mediated disease characterized by inflammatory demyelination of the central nervous system， which mainly involves white matter and causes neurological dysfunction. At present， the treatment strategy for MS is mainly disease-modifying therapy （DMT）， which can alleviate the disease process but cannot cure the disease. As a lifelong disease， the rational application of MS drugs is very important to control the patient's condition and improve the neurological symptoms of patients. In this review， we summarized both domestic and overseas literature reports in recent years， and reviewed the drugs for the treatment of multiple sclerosis， aiming to provide the basis for rational drug use and the best treatment scheme for patients. In addition， we further review potential drugs for MS in clinical trials or pre-clinical studies and combine the latest research progress on the pathogenesis and new targets of MS to provide literature references for exploring new therapeutic strategies targeting the central nervous system.

Abstract:Depressive disorder is one of the serious mental diseases， and its mechanism involves psychological， physiological and social aspects. Early life stress caused by traumatic events is a major risk factor for depression. Studies have shown that patients with depression exhibit telomere shortening， which may be related to the occurrence of depression， especially with exposure to early traumatic events. This paper describes the relationship between early traumatic events and telomere length and depression， and reviews the related mechanisms of early traumatic events affecting telomere length， so as to explore the genetic and pathological mechanisms related to the two， and provide important clinical reference significance for the prevention and treatment of depression.

Abstract:Hyperprolactinemia is a common adverse reaction of antipsychotics in children and adolescents with mental disorders. It will affect the normal development of children and adolescents， such as skeletal dysplasia， irregular menstruation， etc，thereby reducing the quality of life and compliance， affecting the prognosis and increasing the socio-economic burden. Therefore， early identification and timely intervention are very important in clinical practice. This article reviews the effects of common antipsychotics on serum prolactin levels in children and adolescents， their possible mechanisms and treatment， aiming to investigate the characteristics and mechanisms of prolactin fluctuations in children and adolescents， and provide some basis for individual treatment.

Abstract:Non-suicidal self-injury （NSSI） is a poorly adapted emotional regulation strategy that is commonly seen in the adolescent population and seriously endangers the physical and mental health of adolescents. Attachment has a profound impact on the psychological development of individual adolescents and is of great significance in understanding their emotional regulation methods. This article reviews the interrelationships among attachment， emotional regulation， and NSSI， aiming to provide reference for the prevention and control of adolescent NSSI.

Abstract:Schizophrenia is a common mental disorder， and cognitive function is significant in elderly patients under the dual effects of disease and age. This article reviews the research progress on cognitive function in elderly patients with schizophrenia in the past 5 years， including the clinical manifestations， evaluation methods， influencing factors， and intervention measures of cognitive dysfunction， aiming to provide a basis for improving the quality of life of patients.

Abstract:Intracerebral hemorrhage is characterized by high morbidity and mortality. Inflammatory response is closely related to the course of intracerebral hemorrhage. After intracerebral hemorrhage， white blood cells release inflammatory and cytotoxic mediators， which promote capillary permeability， cell swelling and damage the blood-brain barrier， enhance edema around the lesion， and then affect the clinical course of intracerebral hemorrhage. Thus， evaluation of inflammatory markers is helpful for the development and prognosis of intracerebral hemorrhage. In the inflammatory response， neutrophils and lymphocytes are the two main players， and the neutrophil to lymphocyte ratio （NLR） integrates the information of both neutrophils and lymphocytes， is a reliable indicator of inflammatory response， and the ratio has certain potential value in clinical application. This article reviews the relevant mechanism and prognosis of NLR after intracerebral hemorrhage in combination with related research in recent years.

Abstract:Exosomes are nanoscale extracellular vesicles containing a variety of bioactive substances that are widely involved in intercellular material transport and information transfer， and play an important role in a variety of pathophysiological processes. Mood disorders often result in difficulty in recognition， unclear diagnosis， and difficult treatment due to their clinical complexity. There are differences in the quantity and phenotype of exosomes between patients with mood disorders and healthy controls. This article reviews the relevant research on exosomes in patients with mood disorders， and explores the possibility of exosomes from different sources as biological diagnostic markers as well as therapeutic targets for mood disorders.

Abstract:Many diseases are accompanied by cognitive impairment during their occurrence and development， and cognitive impairment has adverse effects on the course and prognosis of the disease. The N-methyl-D-aspartate receptor 2B subunit （GRIN2B） gene is associated with synaptic plasticity and therefore has a potential association with cognitive impairment. This article reviews the research on the correlation between GRIN2B gene expression， gene polymorphism， and epigenetics with cognitive impairment， in order to explore the potential mechanisms of cognitive impairment.

Abstract:Stroke-heart syndrome is defined as a cardiovascular complication occurring within 30 days after stroke， including acute myocardial injury， acute coronary syndrome， cardiac insufficiency， arrhythmia， etc. Recent studies indicated that autonomic dysfunction， brain-gut axis damage， and inflammation may be involved in its pathogenesis. However， its etiology and prognosis are still not well elucidated. In addition， the stroke-heart syndrome may lead to a series of long-term complications like myocardial infarction， chronic cardiac dysfunction， cerebral white matter lesions， cognitive impairment， etc.， which can affect the prognosis of patients. This article reviews the research progress on the pathogenesis， long-term complications， and early risk assessment methods of stroke cardiac syndrome， aiming to deepen the understanding of this disease and provide reference for the development of more prevention and treatment methods in the future.