Abstract:Objective To explore the value of serum insulin like growth factor 1 （IGF-1） and fibroblast growth factor 9 （FGF-9） in differential diagnosis of bipolar depression and unipolar depression in adolescents. Methods From September 2022 to September 2023， a total of 50 adolescent patients with unipolar depression who received outpatient or inpatient treatment at Harbin First Specialized Hospital were selected as the unipolar depression group， while 50 adolescent patients with bipolar depression as the bipolar depression group. During the same period， 50 healthy adolescents who underwent health examinations at the Physical Examination Center of the First Affiliated Hospital of Harbin Medical University were selected as the control group. The levels of serum IGF-1、FGF-9， interleukin-6 （IL-6） and tumor necrosis factor α （TNF-α） and monocyte chemoattractant protein-1 （MCP-1） were measured in each group. The 24-items of Hamilton Depression Scale （HAMD-24） was used to assess the severity of depression. Spearman correlation analysis was used to investigate the correlation between serum IGF-1 and FGF-9 levels， inflammatory factors， and HAMD-24 scores in patients with unipolar and bipolar depression. The area under the curve （AUC） of receiver operating characteristic （ROC） of serum IGF-1 and FGF-9 levels in diagnosing unipolar and bipolar depression in adolescents were analyzed. Results The serum levels of IGF-1， FGF-9， and IL-6 in the bipolar depression group were higher than those in the unipolar depression group and control group. The serum FGF-9 levels in the unipolar depression group were higher than those in the control group. Serum TNF-αlevels in bipolar depression group and unipolar depression group were higher than those in the control group. The differences of the above were all statistically significant （P＜ 0.05）. There was no statistically significant difference in serum MCP-1 levels among the three groups of subjects （P＞ 0.05）. The serum IGF-1 and FGF-9 levels were positively correlated with IL-6 and HAMD-24 scores in patients with unipolar depression and bipolar depression （r=0.354 to 0.730； P＜ 0.05）. The AUC of FGF-9 in diagnosing unipolar depression in adolescents was 0.672， with a sensitivity of 46% and a specificity of 98%. The AUC of IGF-1 and FGF-9 in diagnosing bipolar depression in adolescents were 0.711 and 0.792， respectively， with sensitivity of 40% and 58%， specificity of 80% and 98%， respectively. The AUC for the combined diagnosis of bipolar depression in adolescents by IGF-1 and FGF-9 was 0.805. Conclusions IGF-1 may be a predictive factor for distinguishing between bipolar depression and unipolar depression. FGF-9 has implications for the diagnosis of bipolar depression and unipolar depression， and the combination of FGF-9 and IGF-1 has high clinical value in diagnosing adolescent bipolar depression.

Abstract:Objective To explore the effect of Rab27b on the secretion of brain-derived neurotrophic factor （BDNF） in mouse astrocytes. Methods Quantitative PCR and immunofluorescence staining were used to detect the mRNA expression and distribution of Rab27a and Rab27b， two subtypes of Rab27 molecules， in the cerebral cortex and hippocampus of wild-type mice. Immunofluorescence staining was used to detect the expression of Rab27b in astrocytes in the hippocampus of wild-type mice. Western blot method was used to detect the expression of BDNF in astrocytes and PSD95 and Synapsin1， synaptic plasticity markers in the hippocampus of Rab27b gene knockout mice. Enzyme-linked immunosorbent assay （ELISA） method was used to detect the secretion of BDNF in astrocytes of Rab27b gene knockout mice， and to clarify the effect of Rab27b gene knockout on BDNF secretion levels in astrocytes. Results The results of quantitative PCR and immunofluorescence staining showed that the mRNA levels and fluorescence intensity of Rab27b in the cerebral cortex and hippocampus of wild-type mice were higher than those of Rab27a， and the differences were statistically significant （P＜ 0.01）. The immunofluorescence results showed that Rab27b was co expressed with the astrocyte marker GFAP. Western blot results showed that there was no statistically significant difference in the total amount of BDNF in astrocytes of Rab27b gene knockout mice compared to wild-type mice （P＞ 0.05）. The ELISA results showed that the secretion level of BDNF in astrocytes of Rab27b gene knockout mice was lower than that of wild-type mice， and the difference was statistically significant （P ＜ 0.05）. Western blot results showed that the expression levels of PSD95 and Synapsin1 in the hippocampus of Rab27b gene knockout mice were lower than those of wild-type mice， and the differences were statistically significant （P ＜ 0.01）. Conclusions Rab27b regulates the secretion of BDNF from mouse astrocytes and improves synaptic plasticity.

Abstract:Objective To explore the effect of Sirt1 on the expression of synaptic vesicle protein and its function at presynaptic sites. Methods Endogenous Sirt1 expression in SH-SY5Y cells was activated using CRISPRa technology. The cells were divided into aSirt #1， aSirt1#2， aSirt1#3， and aSirt1#NC groups by transfection with aSirt1 plasmid， and a blank control （Mock） group was set up. Lactate dehydrogenase was used to detect cytotoxicity， and Western blot was used to detect the expression levels of synaptic vesicle protein and autophagy related proteins. Results The cytotoxicity of the aSirt1#1 and aSirt1#3 groups was lower than that of the aSirt1#NC group， and the difference was statistically significant （P ＜ 0.05）. The expression levels of Sirt1， synaptophysin， vesicle associated membrane protein 2 （VAMP2）， and alpha-synuclein （α-Syn） in cells of aSirt1#1 group were higher than those of the Mock group， and the difference was statistically significant （P＜ 0.05）. The expression levels of autophagy related proteins Atg13 and Becln1 in SH-SY5Y cells of aSirt1#1 group were higher than those in the Mock group， and the expression levels of autophagy substrate SQSTM1 were lower than those in the Mock group， with statistical differences （all P＜0.05）. The P-AMPK/AMPK and P-ULK1/ ULK1 ratio in SH-SY5Y cells of aSirt1#1 group were higher than those in the Mock group， and the differences were statistically significant （P ＜ 0.05）. Conclusions Sirt1 can regulate autophagy by activating the AMPKULK1 pathway， affecting the expression of synaptic vesicle proteins， promoting synaptic vesicle circulation， and affecting the function of presynaptic sites.

Abstract:Objective To evaluate the clinical efficacy of butylphthalide in patients with cancer and ischemic stroke. Methods From June 2021 to June 2023， a prospective study was conducted on 86 patients with cancer and ischemic stroke admitted to the First Department of Neurology of Tangshan People's Hospital. The patients were divided into a butylphthalide group （n=43） and a control group （n=43） using random number table method. The control group received comprehensive treatment such as antithrombotic therapy， stable plaque therapy， symptomatic hypoglycemic and antihypertensive therapy according to the patient's condition. The butylphthalide group was treated with 100 ml butylphthalide and sodium chloride injection twice a day in addition to the control group. This study used the National Institute of Health Stroke Scale （NIHSS） to evaluate the neurological deficits in patients， and recorded related complications and evaluated prognosis. Detected the serum interleukin （IL）-6， IL-8， tumor necrosis factor-α （TNF-α） and soluble growth stimulation expressed gene 2 （sST2） factors in patients before treatment （upon admission） and after treatment （14 days after admission）， and calculate the difference to evaluate the effect of butylphthalide on inflammatory cytokine levels. Results After 24 hours， 7 days， and 14 days of treatment， the NIHSS score gradually decreased in patients of the butylphthalide group. Compared with the control group， the NIHSS score of patients in the butylphthalide group decreased 14 days after treatment ［6（4，10） vs 10（4，12） points］， and the difference was statistically significant （P ＜ 0.05）. There was no statistically significant difference in the incidence of intracranial hemorrhage between the patients in the butylphthalide group ［4.65%（2/43）］ and the control group ［2.33%（1/43）］（P ＞ 0.05）. Before and after the treatment， the difference levels of IL-6， IL-8， TNF-α and sST2 factors of patients in butylphthalide group were higher than those in the control group， and the differences were statistically significant （all P ＜ 0.05）. Conclusions For patients with cancer and ischemic stroke， butylphthalide can improve their neurological symptoms and reduce serum levels of IL-6， IL-8， TNF-α and sST2 factors without increasing the bleeding rate. It plays a positive role in improving the prognosis of patients with cancer and ischemic stroke.

Abstract:Objective To analyzethe effects of group painting therapy on negative symptoms， social function， and insight in hospitalized patients with schizophrenia during rehabilitation stage. Methods A total of 130 inpatients with schizophrenia during rehabilitation in the Department of Sleep Disorder and Department of Rehabilitation in Wuhan Mental Health Center from February to August 2023 were selected as the research subjects. Using a random number table method， the patients were divided into a control group （n=65） and a study group （n=65）， and received routine treatment nursing and combined group painting treatment， respectively. Before and 4 months after the intervention， the Positive and Negative Symptom Scale （PANSS）， Social Disability Schedule Scale （SDSS）， and Insight and Treatment Attitude Questionnaire （ITAQ） were used to compare the clinical symptoms， social function， and insight towards the disease between the two groups of patients. Results A total of 125 patients completed the study， including 63 in the study group and 62 in the control group. There was no statistically significant difference in PANSS subscales， SDSS， and ITAQ scores between the two groups of patients before the intervention （P＞ 0.05）. The PANSS negative symptom subscale score of the control group patients after the intervention was lower than that before the intervention， and the difference was statistically significant （P＜0.01）. After the intervention， the PANSS negative symptom subscale and SDSS score of the study group were lower than those of the control group and before the intervention， and the ITAQ score was higher than those of the control group and before the intervention， with statistically significant differences （P＜ 0.01）. Conclusions Group painting therapy can improve the negative symptoms， social function，insight and treatment attitude of schizophrenic inpatients in rehabilitation stage.

Abstract:Schizophrenia places a heavy burden on the patients' caregivers. Caregiver burden will not only affect the physical and mental health of caregivers but also affect the quality of care provided by caregivers， thus affecting the long-term outcome of patients with schizophrenia. At present， there have been many different assessment tools for caregiver burden of schizophrenia （including general tools and specific tools）. This paper reviews and compares these tools from different aspects such as content， characteristics， and application situations. This paper also analyzed the limitations of these tools and put forward suggestions， with the expectation to guide the assessment and intervention of caregiver burden of schizophrenia in China.

Abstract:Primary insomnia （PI） is a common sleep disorder， and its neuropathological mechanisms are not yet clear. Resting-state functional magnetic resonance imaging （rs-fMRI） is one of the powerful methods for studying the neuropathological mechanisms of PI. This article summarizes the current research on rs-fMRI in PI patients from two perspectives of local brain regions and brain networks， so as to provide a theoretical and research basis for further exploring the neuropathological mechanisms of PI.

Abstract:Histone deacetylase 3 （HDAC3） is an epigenetic negative regulatory factor associated with cognitive impairment， widely expressed in the amygdala， hippocampus， and cortex. The activated HDAC3 has neurotoxic effects and negatively regulates the formation of cognition and memory. This paper reviews the mechanism of HDAC3 in cognitive impairment and explores the development prospects of HDAC3 inhibitor therapy.

Abstract:Worldwide， the incidence of insomnia disorder is high， which causes serious harm to people's physical and mental health. At present， cognitive behavioral therapy for insomnia （CBT-I） is the preferred treatment method for insomnia disorders， which has the advantages of safety， effectiveness， and long duration of treatment effects. This paper reviews the research status of insomnia disorders， the concept and form of CBT-I， and its clinical application in insomnia disorders， so as to provide reference for clinicians and insomnia patients to choose cognitive behavioral therapy and promote the standardized application and development of CBT-I.

Abstract:Non-suicidal self-injury （NSSI） has a profound impact on individual physical and mental health， especially among adolescents who are at high risk， and has become a serious public health problem. Numerous studies have consistently demonstrated that family environmental factors play a crucial role in the onset and progression of NSSI behaviors in adolescents. This article reviews the relationship between family environmental factors and adolescent NSSI， providing a basis for the prevention of NSSI and family intervention.

Abstract:Cellular senescence and abnormal glucose metabolism in the brain are early features of Alzheimer's disease （AD）， and this feature may precede β-amyloid deposition or tau phosphorylation. Vascular endothelial growth factor （VEGF） can alleviate cognitive dysfunction in AD patients by nourishing nerves， improving glucose metabolism in the brain， and resisting toxic effects of β-amyloid on neurons. This paper reviews the mechanism of VEGF in improving cognitive dysfunction in AD patients， so as to deepen clinical understanding of the disease and provide reference for exploring new therapeutic targets and methods.

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