Abstract:Objective To study the expression characteristics and clinical significance of miR-26b and miR-30e in serum of patients with Alzheimer disease（ AD）. Methods A total of 200 patients with senile dementia admitted to our hospital from June 2015 to September 2017 were selected for the study. Among them， 100 patients with AD were assigned as AD group， the other 100 patients with mild cognitive impairment（ MCI） were assigned as MCI group. Another 100 patients who took health examination in our hospital during the same period were assigned as NC group. Real-time fluorescence quantitative polymerase chain reaction（ qRT-PCR） was used to detect the expression levels of miR-26b and miR-30e in serum of each group. The general clinical data and the contents of triglyceride（ TG）， total cholesterol（ TC）， low density lipoprotein cholesterol（ LDL-C）， high density lipoprotein cholesterol（ HDL-C）， homocysteine（ Hcy） and adiponectin（ ANP） were compared among the three groups. Pearson correlation analysis was used to analyze the correlations between serum miR-26b， miR-30e and biochemical parameters in AD patients. The risk factors of AD were analyzed by binary logistic regression. Results Compared with NC group， the levels of serum Hcy and LDL-C in AD group and MCI group increased significantly， while the level of ANP decreased significantly（ P ＜ 0.05）. The levels of serum miR-26b in AD group and MCI group were 0.51（ 0.15，0.86） and 0.79（ 0.21，1.14） respectively， which were significantly lower than that in NC group 1.06（ 0.42， 1.32）（ P＜0.05）. The levels of serum miR-26b in AD group were significantly lower than that of MCI group（ P＜0.05）. The level of serum miR-30e in AD and MCI groups were 1.27（ 0.53，1.72） and 1.02（ 0.35，1.65）， which were significantly lower than those in NC group 0.86（ 0.43，1.32）（ P＜0.05）. The serum level of miR-30e in AD group was significantly higher than that in MCI group（ P＜0.05）. The expression level of miR-26b was positively correlated with ANP（ r=0.626，P＜0.05）， and negatively correlated with LDL-C and Hcy（ r=-0.517，-0.523，P＜0.05）. The expression level of miR-30e was positively correlated with LDL-C and Hcy values（ r=0.536，0.644，P＜ 0.05）， while negatively correlated with ANP values and the expression level of miR-26b（ r=-0.732，-0.563，P＜ 0.05）. Logistic regression analysis showed that Hcy， LDL-C， miR- 26b and miR-30e were independent risk factors for AD（ P＜ 0.05）. And ANP was protective factor for AD（ P＜ 0.05）. Conclusions The expression of miR-26b in serum of AD patients is significantly down-regulated， the expression of miR-30e is significantly up-regulated. Both miR-26b and miR-30e are related to the occurrence and development of AD.

Abstract:Objective To explore the molecular mechanism of hippocampal histone deacetylase （HDACs） related to the decline of brain learning and memory caused by repeated mild traumatic brain injury （rMTBI）. Methods The changes of hippocampal HDAC activity and learning and memory ability at 48 hours and 4 weeks after rMTBI in rats were analyzed using the rat rMTBI model and new thing recognition detection. We used tricostatin A（ TSA）， a pan HDAC inhibitor， to observe the effect of TSA on HDAC activity and learning and memory ability. Results rMTBI increased the mRNA levels of different subtypes of HDAC 2-5 and HDAC 11 at different time points， with the increase of the activity of HDAC in nucleus and cytoplasm. However， compared with the Sham group（ 1.02±0.14）， the mRNA level of HDAC8 decreased significantly to（ 0.47±0.09） 4 weeks after injury（ t=8.095，P ＜ 0.001）. After treatment with TSA， the learning and memory deficit and HDAC activity caused by rmtbi returned to normal. Conclusions rMTBI may up-regulate the activity of some HDAC subtypes， resulting in impaired learning and memory ability， while HDAC activity inhibitors have potential in the treatment of cognitive defects caused by rMTB.

Abstract:Objective To study the significance of neuroendoscope-assisted microsurgery in the treatment of epidermoid cyst of cerebellopontine angle. Methods A total of 23 patients with epidermoid cyst of cerebellopontine angle were treated by neuroendoscope-assisted microsurgery. Tumor was gross-total resected under the microscope， and the residual tumor was removed by neuroendoscopy. Results After microscopic resection of the tumor， 18 cases were still found to have residual tumor through neuroendoscopy， and the tumor was further completely removed under endoscopy. Within a month after the operation， 18 cases of original symptoms disappeared， two cases of facial paralysis and one case of diplopia were relieved. One patient presented with delayed facial paralysis in one week after operation， and the patient recovered after a month of follow-up. Conclusions Endoscopic microsurgical resection of epidermoid cyst of cerebellopontine angle can prevent tumor residue， reduce complications and protect nerve function.

Abstract:Objective To discuss the correlation between serum hypoxia inducible factor 1alpha （HIF-1α）， soluble leukocyte differentiation antigen 40 Ligand（ sCD40L）， chemokine CC motif ligand 3（ CCL3） levels and the infarction site and neural dysfunction in patients with acute cerebral infarction. Methods A total of 80 patients with acute cerebral infarction treated in our hospital from January 2015 to January 2018 were selected as the observation group， and 65 healthy patients in our hospital were selected as the control group. The correlation between serum HIF-1α，sCD40L，CCL3 and infarct site and neurological dysfunction was analyzed. Results Serum levels of HIF-1α， sCD40L and CCL3 in the observation group were significantly higher than those in the control group（ P＜0.05）. Serum levels of HIF-1α， sCD40L and CCL3 in subcortical infarction group were significantly higher than those in cortical infarction group（ P＜0.05）. Serum levels of HIF- 1α， sCD40L and CCL3 in patients with severe neurological impairment were significantly higher than those in patients with mild and moderate neurological impairment（ P＜0.05）. When the infarction site and nerve function defect were taken as dependent variables， and serum HIF-1α， sCD40L and CCL3 were taken as independent variables， the correlation analysis results showed that serum HIF-1α， sCD40L and CCL3 were positively correlated with the infarction site and nerve function defect（ P ＜ 0.05）. Conclusions In patients with acute cerebral infarction， there is a close relationship between the expression of HIF-1 alpha， sCD40L and CCL3 and the severity of the disease， which can promote the progression of the disease.

Abstract:Objective To retrospectively analyze the effects of paroxysmal sympathetic hyperactivity （PSH）on the level of consciousness， functional prognosis and complications of patients with severe stroke. Methods Patients with severe stroke transferred from the neurological intensive care unit（ NICU） to our department for rehabilitation from January 2018 to January 2019 were selected. The baseline information， coma recovery scale-revised（ CRS-R）， functional independence measure（ FIM） and Glasgow outcome scale（ GOS） were compared at admission and at discharge， and the incidence of complications during hospitalization were compared between the PSH group（ n=11） and the non-PSH group（n=25）. Results Patients with PSH were younger［ （43.60±7.21） vs.（ 63.25±16.13）， P=0.023］. There was no significant difference between the PSH group and the non-PSH group in CRS-R， FIM and GOS score at admission and at discharge（ P＜0.05）. There were significant differences in the incidence of hydrocephalus， gastrointestinal tract disease and hypertonia at the unaffected side， which were all higher in the PSH group（ 6/11 vs.12.00%，P=0.021；8/11 vs. 20.00%， P=0.034；5/11 vs. 4.00%， P=0.006， respectively）. Conclusions PSH did not show any obvious negative effect on the arousal level and functional outcomes in patients with severe stroke. Severe stroke patients with PSH are more likely to have hydrocephalus， gastrointestinal diseases， and hypertonia on the unaffected side. However， given the small sample size of this study， it is necessary to expand the sample size for further observation.

Abstract:Objective To systematically review the efficacy of vortioxetine in the treatment of depressive disorder. Methods We conducted a Meta-analysis comparing vortioxetine versus placebo in the treatment of depressive disorder. The randomized controlled trials（ RCT） were searched up to March 2019 in PubMed， Embase， Cochrane Library， CNKI and Wanfang database. Results A total of 13 RCTs involving 6 261 patients with depressive disorder were identified. The response rate with vortioxetine was significantly higher for 5 mg（ RR=1.31，95%CI=1.15-1.49，P＜ 0.01）， 10 mg（ RR=1.39，95%CI=1.26-1.54，P＜ 0.01）， 20 mg doses（ RR=1.51，95%CI=1.20-1.90，P＜0.01） compared to placebo. Remission rates were significantly higher for the 10 mg group（ RR=1.37，95%CI=1.19-1.57，P＜0.01） and the 20 mg group（ RR=1.55，95%CI： 1.15-2.10，P ＜ 0.01） compared to placebo. Conclusions Vortioxetine was significantly more effective than placebo for acute treatment of depressive disorder. Nonetheless， more clinical studies of longer observation duration are needed to validate our result.

Abstract:Objective To explore the effects of outdoor aerobic exercise combined with psychiatric rehabilitation therapy on mental recovery of inpatients with chronic schizophrenia. Methods From June 2015 to March 2018， 200 schizophrenics hospitalized in the mental health center of our hospital were divided into exercise group and control group with random number table method， with 100 cases in each. During the hospitalization， they were treated with drugs combined with psychiatric rehabilitation therapy. On this basis， patients in the exercise group were given outdoor aerobic exercise intervention. The condition of mental recovery was evaluated with the Positive and Negative Symptom Scale（ PANSS）， Self-rating Anxiety Scale（ SAS）， Selfrating Depression Scale（ SDS） and Nurses' Observation Scale for Inpatient Evaluation（ NOSIE-30） before the intervention and at 3 months after the intervention. Results After intervention， there was no significant differences in the scores of positive scale， negative scale or general psychopathology scale between the two groups in PANSS（ t=1.858，1.909，1.867，P＞0.05）. However， the total score of PANSS of the exercise group was significantly lower than that of the control group（ t=3.196，P＜ 0.05）. The SAS and SDS scores of the exercise group after intervention were significantly lower than those of the control group（ t=3.251，3.925，P＜0.05）. Compared with the control group， the increase of social ability， social interest and personal tidyness scores， decrease of irritability， tardiness， depression and psychoticism scores in NOSIE-30 were more obvious in the exercise group after the intervention（ t=5.606，7.527，5.706，3.630，8.183，10.389，6.029，P＜0.05）. Conclusions Outdoor aerobic exercise combined with psychiatric rehabilitation therapy is beneficial to stabilize the condition of inpatients with chronic schizophrenia， improve their psychological symptoms and promote mental recovery.

Abstract:Objective To analyze the application value of rotational digital subtraction angiography （DSA） three-dimensional（ 3D） reconstruction in the diagnosis and identification of cerebrovascular diseases. Methods From January 2016 to January 2018， a total of 80 patients with suspected cerebrovascular disease in the radiotherapy intervention room of our hospital were selected. All patients were examined with conventional DSA and rotational DSA 3D reconstruction technologies. The display results and diagnosis positive rate of cerebrovascular disease by the two examination methods were observed. The relationship between the aneurysmal neck and the parent artery displayed by the two methods was compared. Results Conventional DSA found 59 cases of intracranial aneurysms（ 59 aneurysms）， including 6 cases of middle cerebral artery occlusion， 4 cases of arteriovenous malformations and 11 cases of suspected cerebrovascular diseases. The rotational DSA 3D reconstruction technology showed 61 cases of intracranial aneurysms including 2 cases of multiple aneurysms （65 aneurysms in total： 25 in intracervical and posterior communicating arteries， 6 in middle cerebral arteries， 23 in frontal and anterior communicating arteries， 7 in basilar arteries and 4 in vertebral arteries）， 8 cases of middle cerebral artery occlusion， 6 cases of arteriovenous malformations（ 3 cases of parietal cerebral arteriovenous malformations， 1 case of occipital cerebral arteriovenous malformations， 1 case of temporal lobe cerebral arteriovenous malformations， 1 case of cerebellar arteriovenous malformations）， 3 cases of moyamoya disease（ clear abnormal blood vessels） and 2 cases of cavernous sinus fistula（ clear fistula location and reflux veins）. The diagnosis positive rate（ 100%） of cerebrovascular diseases by rotational DSA 3D reconstruction was significantly higher than that of conventional DSA（ 91.25%）（ χ2=5.378，P ＜ 0.05）. For the relationship between the aneurysmal neck and the parent artery， the clear display rate of DSA 3D reconstruction（ 100%） was significantly higher than that of conventional DSA（ 49.15%）（ χ2=43.040，P＜ 0.05）. Conclusions Rotational DSA 3D reconstruction can visually and clearly display lesions in the brain， and provide more accurate and effective guidance for the identification and clinical diagnosis and treatment of cerebrovascular diseases.

Abstract:Oppositional defiant disorder（ ODD） is a common psychological disorder in children， which appears in early childhood， reaches its peak in adolescence. The main clinical manifestations are disobedience， confrontation， passive resistance， irritability or provocation. Although ODD has no serious illegal or offensive behavior， it will still bring great trouble to children's family， school and social life. Parents and schools often lack awareness of ODD， which leads to low rate of treatment and lack of early effective intervention. This paper reviews the pathogenesis， clinical characteristics， diagnosis and treatment of ODD.

Abstract:Dementia is a progressive neurodegenerative disease，and the management of dementia patients has become a new public health problem and challenge. Home management is a community-based professional care service， mainly in the form of case management and self-management， which is in the early stage in China. Therefore， a better understanding of home management can provide a reference for home care practice of dementia patients.

Abstract:Vascular endothelial growth factors（ VEGF） family plays a significant role in the development of cerebral infarction. It has been found that different subtypes of VEGF are involved in the process of angiogenesis， nutrient metabolism， lymphangiogenesis， neuroprotection， and inflammation inhibition during brain injury. This family-specific biological role provides a new idea for the treatment of cerebral infarction. This article reviews the corresponding roles of various subtypes of vascular endothelial growth factor in the development of cerebral infarction， and at the same time， the ongoing efforts to address these hotspot targets of VEGF and their limitations in therapeutic terms have been highlighted.

Abstract:Schizophrenia is a serious mental illness， most of them are accompanied by cognitive impairment， which places a great burden on patients， families and society. Schizophrenia has a high heritable rate. In the past decade， many genetic variants associated with schizophrenia have been discovered， leading to a better understanding of the complexity of its genetic structure. Recent studies have also shown that genetic variants associated with schizophrenia affect cognitive ability. Further study on the effect of these genes on cognitive function will help us to understand the effect of genetic factors on cognitive dysfunction in schizophrenia. The purpose of this study was to investigate the relationship between CUB and SUSHI multiple domains-1（ CSMD1） gene polymorphism and schizophrenia and its cognitive impairment.

Abstract:Alzheimer disease（ AD） is a common neurodegenerative disease characterized by progressive cognitive impairment. Its high incidence and poor prognosis place a heavy burden on society and families. Therefore， early identification and early intervention of subjects who are at risk but have not shown symptoms is of critical significance， and magnetic resonance imaging（ MRI） will play a vital role in this regard. In recent years， some machine learning（ ML） methods have been proposed to apply different types of MRI features for AD conversion prediction. Multimodal MRI plays an increasingly important role in the diagnosis of AD. The research progress of AD clinical multimodal imaging is reviewed.