Abstract:Objective To explore the influencing factors of transition to mania in adolescents with first-episode depressive disorder within six months， providing a basis for early identification and prediction of bipolar disorder. Methods From July 2020 to February 2022， 125 adolescents with first-onset depressive disorder were selected from Hebei Mental Health Center to collect demographic characteristics， disease characteristics， thyroid function， blood homocysteine， whether combination medication was used during acute phase， whether antipsychotic drugs were used during acute phase， whether antidepressants were used alone during acute phase， whether consolidation treatment was received during acute phase， and whether complete remission was achieved. Hamilton Depression Scale-17 （HAMD-17）， Temperament Evaluation of Memphis， Pisa， Paris and San Diego-Auto Questionnaire （TEMPS-A） were used to investigate the severity of depressive symptoms and affective temperament in patients. After six months of follow-up， data such as the total number of disease attacks and transition to mania within six months were recorded. Logistic regression was used to analyze the related factors of transition to mania in adolescents with first-episode depressive disorder within six months. A total of 119 cases were followed up for six months， with a follow-up rate of 95.2% （119/125）. According to transition to mania within six months， adolescents were divided into transition to mania group （21 cases， 17.6%） and non-transition to mania group （98 cases， 82.4%）. Results There was no statistically significant difference in age， place of family residence， relationship with parents， residential form， and body mass index between transition to mania group and non-transition to mania group （all P＞ 0.05）. The proportion of males in the transition to mania group was higher than that in the non-transition to mania group， and the difference was statistically significant （P ＜ 0.05）. The free thyroxine （FT4） and thyroid stimulating hormone （TSH） in non-transition to mania group were lower than those in transition to mania group， and the difference was statistically significant （all P ＜ 0.05）. The proportion of combination medication in acute phase and the proportion of antipsychotic drugs used in the acute phase of non-transition to mania group were higher than those of transition to mania group， and the proportion of antidepressant drugs used alone in the acute phase was lower than that of transition to mania group， and the differences were statistically significant （all P ＜ 0.05）. Within six months， the total number of disease attacks in non-transition to mania group was lower than that in transition to mania group， and the difference was statistically significant （P ＜ 0.05）. Multivariate Logistic regression analysis showed that male （OR=5.688，95%CI=1.426-22.685） and TSH at the time of onset （OR=1.744，95%CI=1.254-2.424） were risk factors for transition to mania in adolescents with first-episode depressive disorder， and the difference was statistically significant （P＜ 0.05）. Conclusions Adolescents with first-episode depressive disorder can develop bipolar disorder. Male and high TSH at the time of onset are risk factors for the transition to mania in adolescents with first-episode depressive disorder.

Abstract:Objective To explore the correlation between sleep quality and cognitive function in schizophrenia patients with metabolic syndrome （MS）. Methods A total of 86 patients with schizophrenia admitted to the Shandong Mental Health Center from January 2023 to January 2024 were selected as participants. According to the presence of MS， patients were divided into MS group （34 cases） and non-MS group （52 cases）， and 47 healthy individuals recruited from the Lixia District Community， Jinan City， Shandong Province during the same period were included as healthy control group. The Positive and Negative Syndrome Scale （PANSS） was used to assess the severity of symptoms in patients with schizophrenia. Pittsburgh Sleep Quality Index （PSQI） was used to evaluate the subjective sleep quality of patients， and a sleep monitor was used to evaluate the objective sleep quality. The cognitive function of patients was evaluated using the Part A and B of the Trail Making Test， Digit Symbol Substitution Test， Animal Naming Fluency Test， and Digit Span Test （forward and backward）. Spearman correlation was used to analyze the correlation between subjective and objective sleep quality and cognitive function in MS patients. Results Patients in MS group had a shorter total sleep time ［363.75 （288.13， 420.75） minutes］ compared to non-MS group ［427.75 （349.88，472.63） minutes］ （Z= -2.615， P=0.009）， lower average oxygen saturation ［95.00 （94.00， 96.00）%］ than non-MS group ［96.00 （95.00， 97.00）%］ （Z=-3.296， P=0.001）， higher apnea hypopnea index ［2.70 （1.58， 7.93） times/h］ than nonMS group ［1.30 （0.40， 4.30） times/h］ （Z=-2.191， P=0.028）， and shorter rapid eye movement sleep duration ［（77.25±21.81） minutes］ than non-MS group ［（88.46±26.74） min］ （t=-2.040，P=0.045）， and the differences were statistically significant. The total score of the PSQI in MS group （9.12±3.66） was higher than that in nonMS group （7.44±3.69） （t=2.065， P=0.042）. Among the factor scores of the PSQI， the sleep quality score ［1.00 （1.00， 2.00） points］ was higher than that of non-MS group ［1.00 （0， 1.00） points］ （Z=-2.537，P=0.011）， and the above differences were statistically significant. There was no statistically significant difference in the scores of other subjective and objective sleep indicators and cognitive function （P ＞ 0.05）. Spearman correlation showed that in MS group， the average oxygen saturation was positively correlated with the score of Digit Symbol Substitution Test （rs=0.355， P=0.039）， the score of the hypnotic drug in the PSQI scale was negatively correlated with Animal Naming Fluency Test scores （rs=-0.447， P=0.008）， the score of the sleep latency was negatively correlated with HDL-C （rs=-0.339， P=0.050）， the score of the sleep quality was negatively correlated with HDL-C （rs=-0.375， P=0.029）， the score of fasting blood glucose was negatively correlated with the score of the Digit Span Forward Test （forward） （rs=-0.431， P=0.011）， and the total score of Positive and Negative Syndrome Scale （PANSS） was positively correlated with the duration of the Trail Making Test B （rs=0.583，P ＜ 0.001）. Conclusions Schizophrenia patients with MS have differences in subjective and objective sleep quality， and there is a certain correlation between subjective and objective sleep quality and cognitive function and metabolic indicators. This suggests that clinicians should pay attention to the influence of MS in the diagnosis and treatment of schizophrenia

Abstract:Objective To explore the potential profile analysis of cognitive load and its influencing factors in patients with acute ischemic stroke during motor imagery rehabilitation training， and to provide reference for optimizing motor imagery rehabilitation program in the later stage. Methods A total of 102 patients with acute ischemic stroke admitted to the Department of Neurology， Xuanwu Hospital， Capital Medical University from February to November 2023 were selected as the research objects. NASA Task Load Index （NASA-TLX） was used to investigate the cognitive load immediately after motor imagery rehabilitation training. Latent profile analysis was used to classify the characteristics. The investigation includes General Information Survey， Modified Rankin Scale （mRS）， National Institutes of Health Stroke Scale （NIHSS）， Barthel Index， 10-item Connor-Davidson Resilience Scale （CD-RISC-10）， Fatigue Severity Scale （FSS）， Stroke Self Efficacy Scale （SSEQ）， Chinese version of Acceptance of Illness Scale （AIS-CHI） and Medical Coping Modes Questionnaire （MCMQ）. Multivariate logistic regression analysis was used to evaluate the influencing factors of cognitive load during motor imagery. Results Among the 102 patients， there were 16 cases with low cognitive load （15.7%）， 42 cases with effort and satisfaction （41.2%）， 11 cases with effort and frustration （10.8%）， and 33 cases with self-sensitivity （32.3%）. There were statistically significant differences in the scores and total scores of NASA-TLX scale among the four categories of cognitive load （P＜ 0.01）. Univariate analysis showed that there were statistically significant differences in cognitive load among patients of different categories in terms of Barthel index， mRS score， FSS score， and SSEQ score （P＜0.05）. Multivariate logistic regression analysis showed that Barthel's index （OR=0.939， 95%CI： 0.900 to 0.979， P=0.003）， fatigue severity （OR=3.990， 95%CI： 1.111 to 14.336， P=0.034）， and rehabilitation self-efficacy （OR=0.896， 95%CI： 0.837 to 0.959， P=0.002） were factors affecting cognitive load in patients with acute ischemic stroke. Conclusions The cognitive load of patients with acute ischemic stroke during motor imagery rehabilitation training can be divided into four potential categories. Barthel index， fatigue severity， and rehabilitation self-efficacy are the influencing factors of cognitive load in patients with acute ischemic stroke undergoing motor imagery training.

Abstract:Objective To evaluate the effects of digital technology interventions on the relapse or recurrent in patients with major depressive disorder. Methods Two researchers independently searched PubMed， Cochrane Library， Embase， PsycINFO， China National Knowledge Infrastructure （CNKI）， Wanfang and China Biology Medicine （CBM） databases for randomized controlled trials on the effect of digital technology interventions on the relapse or recurrent in patients with major depressive disorder from inception to May 26th， 2024. Revised-JADAD scale was used to evaluate the quality of included studies. The GRADE guideline was performed to rate the quality of evidence. The meta-analysis of the effects of digital techrology interventions on relapse or recurent in patients with major depressive disorder was conducted with the "metan" package of Stata MP 18.0 software. Results Seven randomized controlled trials and 1 436 patients were finally included in the data synthesis. The results showed that compared with the control group， digital technology interventions could effectively reduce the proportions of relapses or recurrent in patients with major depressive disorder （RR=0.63， 95%CI=0.47-0.83， I 2 =68.4%， P=0.004）. Subgroup analysis found that different types of digital technologies， study duration and study sites could be the source of heterogeneity. Of them， internet-delivered cognitive behavior therapy and rehabilitation training program had better effects in reducing the proportions of relapses and recurrent in patients with major depressive disorder. Conclusions Digital technology interventions had benefits in improving the relapse and recurrent in patients with major depressive disorder.

Abstract:Objective To systematically review the prevalence of lacunar infarction in Parkinson disease patients. Methods The research on lacunar infarction and Parkinson disease was electronically retrieved in PubMed， Web of Science， The Cochrane Library， Embase， CNKI， WanFang Data， VIP， and China Biomedical Database. The search period was from the establishment of the database to September 2024. After independently screening literature， extracting data， and evaluating the risk of bias for inclusion in the study by two researchers， Stata 17.0 was used to conduct a Meta-analysis of the prevalence of lacunar infarction in Parkinson disease patients. Results A total of 12 articles were included， involving 1 335 Parkinson disease patients. Meta-analysis showed that the overall prevalence of lacunar infarction in Parkinson disease patients was 26.2% ［95%CI （17.9%， 34.6%）］. Subgroup analysis showed that the prevalence of lacunar infarction diagnosed by 3.0T MRI （28.1%） was higher than that diagnosed by 1.5T MRI （20.9%）. The prevalence of lacunar infarction diagnosed according to the International Parkinson and Movement Disorder Society criteria （33.4%） was higher than the UK Brain Banks criteria （20.8%）. The prevalence of lacunar infarction in Parkinson disease in China （32.6%） was higher than that in Japan and South Korea （13.3%）. The prevalence of lacunar infarction in Parkinson disease patients from 2021 to 2023 （28.3%） was higher than that from 2015 to 2020 （24.2%）. The prevalence of lacunar infarction in Parkinson disease patients in cohort studies （47.2%） was higher than that in cross-sectional studies （31.6%） and case-control studies （11.6%）. Conclusions The prevalence of lacunar infarction is relatively high in Parkinson disease patients， so the diagnosis and treatment of cerebral small vessel disease in Parkinson disease patients should be taken seriously.

Abstract:Objective To construct an evaluation index system for psychiatric training effectiveness of general physicians， so as to provide theoretical reference for enriching the evaluation of relevant abilities of general practice physicians. Methods Based on literature research and discussions within the research group， a preliminary index system was formed. The evaluation indicators for the effectiveness of psychiatric training for general practice physicians were developed using the Delphi method to improve the indicator system， and the weight assignment of the indicators was carried out using the Precedence chart. Two rounds of expert consultation were conducted from October to December 2023， and questionnaires were distributed and collected through the Wenjuanxing platform， ultimately resulting in questionnaires with a consensus of opinions. The four primary indicators are the evaluation of teaching objectives and training programs， the evaluation of training methods and teaching models， psychiatric professional knowledge， and clinical skills and medical service evaluation， with weight coefficients of 0.138 1， 0.221 4， 0.288 1， and 0.352 4， respectively. Results A total of 28 experts were consulted， with an expert authority coefficient of 0.95. The effective response rates of the two rounds of consultation questionnaires were both 100%， and the Kendall coordination coefficients of the two rounds of consultation were 0.221 and 0.393， respectively， with a statistically significant difference （P＜ 0.05 for both）. The final evaluation index system for psychiatric training effectiveness of general practice physicians was formed， including four primary indicators and 55 secondary indicators. Conclusions The evaluation index system for psychiatric training effectiveness of general practice physicians is comprehensive， reliable， and practical， which is conducive to improving the recognition， diagnosis， and treatment of mental disorders by general practitioners， reducing the waste of medical resources， and providing good services for patients.

Abstract:In China， there is a significant shortage of epilepsy specialists despite the large number of patients with epilepsy. In the context of the new medical disciplines， it is imperative to cultivate epilepsy specialists who meet the demands of contemporary medical development. In this paper， based on the teaching practice at the Epilepsy Center of Xuanwu Hospital， Capital Medical University， we discuss the training mode for epilepsy specialists in the context of the new medical science from the aspects of education of basic principles in clinical epileptology， as well as the advanced proficiency in the diagnosis and clinical management of epilepsy.

Abstract:Currently， the clinical specialties focused on neurological disorders have not fully met the demand for non-invasive detection methods with high sensitivity and specificity. Circulating cell-free DNA （cfDNA） is a biomarker with significant potential clinical value， as it carries extensive diagnostic and prognostic information， and has been widely applied in the field of neurology. However， the lack of standardized cfDNA analysis protocols among different research institutions has constrained its application in clinical practice. This review aims to systematically discuss the pre-analytical factors that influence cfDNA quality and yield， providing a reference for the specific application of cfDNA in clinical neurology

Abstract:Schizophrenia， as a chronic disabling disease， requires rehabilitation treatment as an essential measure to help patients reintegrate into society. Traditionally， rehabilitation treatment has been mostly conducted face-to-face， but the application of digital technology has expanded the coverage of rehabilitation services， reduced healthcare costs， promoted healthcare equity， and increased treatment opportunities for schizophrenia patients. Currently， digital mental rehabilitation covers rehabilitation related fields such as monitoring and improving treatment compliance， symptom recognition， social skills， cognitive function， and family intervention， and is accepted by the majority of patients. This paper reviews the current status and effectiveness of digital technology in the rehabilitation treatment of schizophrenia， providing a reference for further research.

Abstract:The pathogenesis of schizophrenia is still unclear. Studies have shown that the occurrence and progress of schizophrenia are related to abnormal brain and nervous system function. RELN encoded Reelin protein can participate in the occurrence and progress of schizophrenia by regulating the correct localization of neurons and synaptic plasticity through molecular signaling pathways. This paper reviews the structure and role of RELN gene and Reelin protein in the nervous system， as well as the relationship between RELN gene and schizophrenia， providing ideas for further research on the pathogenesis and clinical treatment of schizophrenia.

Abstract:With the continuous development of modern technology， adolescent internet addiction has gradually become a social and psychological issue that has attracted worldwide attention. At present， the main treatment methods for internet addiction include social psychological therapy， medication therapy， and other treatments. Due to the complexity and individual differences of internet addiction， the comprehensive application of multiple treatment methods may be more effective. Future research should further explore the combined application of various treatment methods to improve the treatment effectiveness of adolescent internet addiction.

Abstract:Psychogenic non-epileptic seizures （PNES） are epileptic events that are easily misdiagnosed as epilepsy， but lack associated EEG changes. The incorrect diagnosis of PNES as epileptic seizures can result in diagnostic delays， unnecessary treatment with anti-seizure medication （ASM）， and unnecessary investigations. This can expose children to potential iatrogenic adverse reactions and pressure of repeated visits to hospital. At present， there is a lack of assessment and management guidelines for children's PNES. To fill this gap， the Pediatric Psychiatric Issues Task Force of the International League Against Epilepsy published "Consensus Recommendations for Assessment and Management of Psychogenic non-epileptic （functional） seizures （PNES） in Children" in 2023. It provides 22 recommendations from three aspects： assessment of PNES， management of PNES， assessment and management of psychopathology in children with PNES. In this paper， the main points of this consensus are interpreted to improve the ability of identifying and managing children's PENS.