Abstract:Objective To explore the effect of low-frequency stimulation（ LFS） on epilepsy and its possible mechanism. Methods A total of 60 SD rats were randomly divided into control group， epilepsy model group， sham stimulation group and LFS treatment group， with 15 rats in each group. A rat model of epilepsy was established by the method of lithium chloride and pilocarpine. The Racine score and electroencephalogram of rats were recorded. Morris water maze test was used to detect the spatial learning and memory ability of the rats； Hematoxylin eosin（ HE） staining and Nissl staining were used to detect the pathological changes in the hippocampus CA1 area of the rats； TdT mediated dUTP nick end labeling（ TUNEL） staining was used to detect the apoptosis of hippocampal neurons； Western blot was used to detect the expression of RhoA， ROCK1， ROCK2， autophagy and apoptosis-related proteins in the hippocampus of the rats； Reverse Transcription- Polymerase Chain Reaction（ RT-PCR） was used to detect the mRNA expression of RhoA， ROCK1 and ROCK2 in the hippocampus of the rats. Rusults Compared with the control group， rats in the epilepsy model group showed continuous spikes， Racine score（ 4.23±0.29）， escape latency［ （49.36±4.69）s］， neuronal cell apoptosis rate［ （27.52±2.95）%］， expression of B-lymphoma-2（ Bcl-2） related X［ Bax，（0.82±0.07）］， c-caspase3 （1.70±0.15）， microtubule-associated proteins 1A/1B light chain 3B Ⅱ /microtubule-associated proteins 1A/1B light chain 3BⅠ［LC3Ⅱ/LC3Ⅰ，（5.20±0.42）］ and Beclin1（ 0.73±0.05） protein were significantly increased （all P＜0.05）. Expression of RhoA， ROCK1 and ROCK2 mRNA and protein were significantly increased（ all P ＜ 0.05）. Swimming distance［ （240.68±22.91）cm］， platform residence time［ （39.89±2.20）s］， number of neurons（ 17.13±3.14）， number of Nissl bodies（ 6.75±1.09）， protein expression of Bcl-2（ 0.24±0.02） and p62 （0.20±0.02） were significantly reduced（ P＜0.05）； Compared with the sham stimulation group， the wave peak of the rats in the LFS treatment group was significantly decreased， Racine score（ 2.82±0.23）， escape latency ［（34.83±3.85）s］， neuronal cell apoptosis rate［ （9.25±0.91）%］， expression of Bax（ 0.43±0.05）， c-caspase3 （0.53±0.02）， LC3 Ⅱ/LC3 Ⅰ（1.17± 0.11） and Beclin1（ 0.36±0.02） protein were significantly reduced（ P＜ 0.05）. Expression of RhoA， ROCK1 and ROCK2 mRNA and protein were significantly reduced（ P ＜ 0.05）. Swimming distance［ （284.21±22.36） cm］， platform residence time［ （46.85±2.93）s］， the number of neurons （47.00±5.07）， the number of Nissl bodies（ 33.75±2.90）， protein expression of Bcl-2（ 0.87±0.07） and p62 （0.96±0.05） increased significantly（ P＜ 0.05）. Conclusions LFS may regulate autophagy by inhibiting the Rho/ROCK pathway to play an anti-epileptic effect.

Abstract:Objective To explore the effects of low-frequency repetitive transcranial magnetic stimulation（ rTMS） on cognitive of patients with post-stroke memory disorders（ PSMD） and the event-related potential P300. Methods A total of 50 patients with PSMD， who were hospitalized in the rehabilitation department of Xuzhou Central Hospital from September 2019 to June 2020， were prospectively and continuously enrolled， and divided into stimulation group and sham stimulation group with 25 cases each by random number table method. Both groups were given drugs and routine rehabilitation training. The stimulation group was given low-frequency（ 1 Hz） rTMS treatment， and the sham stimulation group was given sham rTMS treatment for 4 weeks. Before and after treatment， evaluations were performed on the Mini Mental State Assessment Scale（ MMSE）， Montreal Cognitive Assessment Scale（ MoCA）， Rivermead Behavioral Memory Scale（ RBMT- Ⅱ）， Modified Barthel Index（ MBI） and P300. Comparison of treatment was made between different groups. Rusults There was no statistically significant difference in MMSE， MoCA， RBMT-Ⅱ and MBI between the two groups before treatment（ all P＞0.05）. After 4 weeks treatment， the scores in stimulation group［ MMSE score （21.52±4.51）， MOCA score（ 16.80±3.88）， RBMT-Ⅱ score（ 17.28±3.30）， MBI score（ 64.60±14.21）， P300 latency period（ 346.04±40.25） ms， amplitude（ 10.76±3.44） μV］ were better than those in sham stimulation group［ MMSE score（ 18.28±4.56）， MOCA score（ 13.92±4.58）， RBMT- Ⅱ score（ 14.52±3.81）， MBI score （52.80±13.93）， P300 latency period（ 383.39±51.23） ms， and amplitude（ 7.28±3.00） μV］. Before and after treatment， the differences of scales results and P300 parameter of the simulation group were all better than those of the sham simulation group［ MMSE score（ 4.68±1.63） vs.（ 2.40±1.61）， MOCA score（ 4.82±1.56） vs. （1.82±1.33）， RBMT-Ⅱ score（ 5.04±1.21） vs（. 2.44±1.85）， MBI score（ 21.80±7.62） vs（. 13.20±6.60）， P300 latency period -45.52（-121.69，-0.67） ms vs. -21.10（-60.61，29.31）ms， and amplitude 5.36（2.08，8.21） μV vs. 1.18（0.12，2.08） μV； all P＜ 0.05］. Conclusions Low-frequency rTMS can improve memory function of PSMD patients， and is more helpful to recovery of daily living ability. P300 can objectively reflect the effect of low-frequency rTMS more on improving memory function.

Abstract:At present， ischemic stroke is the second leading cause of death in the world， and there are many studies on its risk factors， predictors and treatment. As an important part of cholesterol metabolism and cholesterol homeostasis， bile acid may be correlated with the occurrence and development of stroke. This article reviews the current status of researches on the effect of serum total bile acid on ischemic stroke， the mechanism of serum total bile acid and related drugs.

Abstract:Mechanical thrombectomy is one of the effective methods to treat acute ischemic stroke and great vessel obstruction. Blood pressure is an important factor affecting the prognosis of mechanical thrombectomy. Although a large number of studies at home and abroad have suggested that high or low blood pressure before and after mechanical thrombectomy is related to poor prognosis， there is still no unified standardized scheme for the management of blood pressure before and after mechanical thrombectomy， most of which are empirical treatment. In this paper， the influence of blood pressure and its variability on prognosis function before and after mechanical thrombectomy in patients with acute ischemic stroke is reviewed， in order to provide some reference for blood pressure management before and after mechanical thrombectomy.

Abstract:With the rise of positive psychology， the research focus of stroke patients has shifted from negative emotion to positive emotion. From the perspective of positive psychology， this review elaborates the research status， relevant theories， domestic and foreign research progress， domestic research limitations and prospects of stroke patients' sense of meaning in life and post-traumatic growth， in order to provide theoretical reference for the positive psychological intervention program of stroke patients.

Abstract:Stroke is dominated by ischemic stroke， which has a high incidence and recurrence rate. It is a non-communicable disease with increasing mortality and disability rate. Studies have shown that microRNA-125（ miR-125） can participate in various pathophysiological processes of ischemic stroke， and the expression of miR-125 is significantly correlated with the prognosis of intravenous and intravascular thrombolysis. This article summarizes the research progress of the correlation between miR-125 and ischemic stroke.

Abstract:Objective To investigate of effects of dipeptidyl peptidase- Ⅳ （DPP-4） inhibitor saxagliptin on cognitive function in rats with diabetes mellitus complicated with depression（ DD）， and possible mechanisms. Methods A total of 48 specific pathogen free（ SPF） healthy male SD rats were randomly divided into control group， model group， positive drug group and saxagliptin group， with 12 rats in each group. DD model was established by high-fat emulsion by gavage for 14 days， tail vein injection of streptozotocin（ STZ）， and chronic stress for 28 days. In the same period of chronic stress， the rats in the positive drug group were given metformin and fluoxetine capsules by gavage， in the saxagliptin group were given saxagliptin by gavage， and in the model group and the control group were given the same amount of normal saline， once a day for 28 days. The open field experiment and the Morris water maze test were used to detect the ability of exploring the unfamiliar environment and the ability of learning and memory. Morphological changes of hippocampus in rats were observed by hematoxylin-eosin（ HE） staining. The neuronal apoptosis of hippocampus was detected by TdT mediated dUTP nick end labeling（ TUNEL） staining. The levels of IL-1β， IL-6 and TNF-α in hippocampus tissues were detected by enzyme-linked immunosorbent assay（ ELISA）. Rusults Compared with the control group， the number of horizontal crossing grids of the rats in the model group， in the positive drug group and in the saxagliptin group［ （62.25±5.53），（ 85.92±4.58） and（ 78.25±6.02） vs.（ 104.75±6.11）］， and the number of standing vertically［ （7.33±1.97），（ 11.17±1.34） and（ 9.33±2.27） vs.（ 17.50±1.68）］ were decreased（ all P ＜ 0.05）. The escape latency was prolonged［ （51.75±8.01）s，（ 29.58±5.14）s and （35.42±3.48）s vs.（ 18.17±3.43）s； all P ＜ 0.01］， while the target quadrant memory time was shortened ［（51.75±8.01）s，（ 29.58±5.14）s and（ 35.42±3.48）s vs（. 18.17±3.43）s； all P ＜ 0.01］. The neuronal apoptosis index in hippocampus tissues were increased［ （74.66±4.62）%，（ 47.23±6.24）% and（ 39.22±2.80）% vs.（ 9.22±0.87）%； all P ＜ 0.01］， and the levels of IL-1β［ （41.26±5.82）ng/g，（ 21.01±3.84）ng/g and （29.89±7.42）ng/g vs.（ 12.22±5.02）ng/g］， IL-6［ （80.792±3.59）ng/g，（ 50.73±7.18） ng/g and（ 61.69± 6.29）ng/g vs.（ 31.90±4.79）ng/g］and TNF-α［ （90.94±8.72）ng/g，（ 66.57±9.93）ng/g and（ 77.70±6.96）ng/g vs. （49.88±5.24）ng/g］in the hippocampus tissues were increased（ P＜ 0.05 or P＜ 0.01）. Compared with the model group， in the positive drug group and the saxagliptin group， the number of horizontal crossing grids and number of standing vertically were increased（ all P＜0.01）. The escape latency was shortened（ all P＜0.01）， while the target quadrant memory time was prolonged（ all P＜ 0.01）. The neuronal apoptosis index in the hippocampus tissues was decreased（ all P＜ 0.01）， and the levels of IL-1β， IL-6 and TNF-α in the hippocampus tissues were decreased（ P ＜ 0.01）. Conclusions DPP-4 inhibitor Saxagliptin can improve cognitive impairment in rats with DD， and its mechanism may be related to the reduction of hippocampal damage by reducing the inflammation of hippocampus.

Abstract:Objective To explore the potential relationship between sleep and body chronic diseases， by analyzing the current situation of chronic diseases， lifestyle， and behavior of middle-aged people with different sleep characteristics in Hebei Province. Methods Stratified and cluster random sampling method was used to investigate the population aged 18 and above in Hebei Province from June 2018 to September 2018. A total of 5 733 residents were surveyed. Assessment tools include general situation questionnaire， past history of physical and psychiatric diseases， Athens Insomnia Scale questionnaire， Restless Legs Syndrome questionnaire， Sleep Apnea Berlin questionnaire， narcolepsy scale， etc. According to whether it is short sleep or insomnia， They were divided into four groups［ control group（ 4 343，75.8%）， simple short sleep group（ 526， 9.2%）， sleep disorders without short sleep group（ 365，6.4%） and insomnia with short sleep group（499，8.7%）］. The prevalence rate and risk factors of chronic diseases of these four groups were analyzed. Rusults There were significant differences in the prevalence of hypertension， diabetes and cerebrovascular disease among the four groups（ all P＜0.05）. The prevalence rate of chronic diseases were the lowest in the control group. While those in the simple short sleep group， sleep disorders without short sleep group and insomnia with short sleep group were statistically significant compared with the control group（ all P＜0.05）. There were significant differences in age， gender， body mass index（ BMI）， urban and rural residents， education level， occupation， salt intake habits， smoking， drinking and physical exercise among the four groups（ all P ＜ 0.05）； After adjusting for age， gender， BMI， urban and rural residents， living style， education level， occupation， salt intake habits， smoking， drinking and physical exercise， logistic regression analysis showed that sleep disorders without short sleep and insomnia with short sleep were the risk factors of hypertension［ OR（95%CI）： 2.074（ 1.606- 2.679）， 1.689（ 1.346-2.121）］ and diabetes［ OR（95%CI）： 2.273（ 1.508-3.426）， 1.805（ 1.244-2.621）］， all P＜ 0.01； Single short sleep， sleep disorders without short sleep， and insomnia with short sleep were risk factors of cerebrovascular disease［ OR（ 95%CI）： 1.826（ 1.203-2.770）， 2.149（ 1.389-3.324）， 1.613（ 1.068-2.434）， all P ＜ 0.05］. Conclusions The effects of short sleep and insomnia on body may be different. Insomnia is the risk factor of hypertension and diabetes， while short sleep and insomnia are the risk factors of cerebrovascular disease.

Abstract:Objective To evaluate the prevalence of postpartum sleep disorders and postpartum depression in women， and to explore the relationship between postpartum sleep disorders and postpartum depression. Methods A cross-sectional study design was used to investigate the basic data of 252 women who underwent reexamination after childbirth in Xijing Hospital from January 2017 to December 2018. The Pittsburgh Sleep Quality Index（ PSQI） and the Edinburgh Postpartum Depression Scale（ EPDS） were used to evaluate sleep quality and postpartum depressive symptom. EPDS ＞ 9.5 was defined postpartum depression. According to whether postpartum depression occurred， 252 cases were divided into postpartum depression group and non-depression group. Rusults The prevalence of sleep disorders and postpartum depression were 36.1% （91/252） and 25.8%（ 65/252）， respectively. In uni-variate analysis， the PSQI score of postpartum depression group was significantly higher than that of non-depression group［ （8.43±2.37） vs（. 5.76±1.84）；t=9.293，P＜ 0.01］； Except for sleep time subscale， PSQI subscale scores of postpartum depression group were higher than those of non-depression group（ all P＜0.01）； The prevalence of sleep disorder（ PSQI ＞ 7） in postpartum depression group was significantly higher than that in non-depression group［ 52.3%（ 34/65） vs. 30.5%（ 57/187）； χ2=9.960， P=0.002］. Multivariate logistic regression analysis showed that the association between postpartum sleep quality and postpartum depression remained significant after adjusting for sociodemographic variables， perinatal variables and gestational disease variables（ OR=2.35， 95%CI：1.32-4.21）. Conclusions Postpartum sleep disorders were positively associated with postpartum depression. Interventions should be provided as early as possible to reduce the risk of depression for women with postpartum sleep disorders.

Abstract:Panic disorder（ PD） and generalized anxiety disorder（ GAD） are two main types of anxiety disorders. The pathogenesis of these two diseases is complex and often comorbid. Studies have shown that abnormal activation or metabolism in specific location of the brain plays an important role in the pathogenesis of these two diseases. At present， drug therapy and psychological intervention are the main treatment methods for both of them. Although these therapies have certain effects， their efficacy is not obvious enough. In recent years， repetitive transcranial magnetic stimulation（ rTMS）， as a new neuromodulation technique， has been recommended for the treatment of anxiety disorders due to its significant efficacy and safety. The therapeutic mechanisms of rTMS for these two diseases are complex and different. This article aims to summarize and analyze the relevant mechanisms of rTMS in the treatment of PD and GAD， and clarify the similarities and differences between them， in order to provide relevant clues for the precision treatment of PD and GAD in the future.

Abstract:Parkinson disease（ PD） is a neurodegenerative disease， characterized by irreversibility， high incidence and high morbidity. In this context， early identification and intervention are of great significance for ameliorating PD. However， at present， there is a lack of objective laboratory indexes in clinical practice， while the evidence for early disease modification by pharmacotherapy is insufficient. Exosomes are vesicles produced by cells and released to the extracellular， containing abundant bioactive molecules. Central nervous system derived exosomes are an important source for screening markers of disease diagnosis， differential diagnosis， staging and prognosis. Changes in their containing PD signature proteins， such as alpha-synuclein， DJ-1 and RNA molecules reflect the pathophysiological state of the organism. Exosomes from mesenchymal stem cells show the function of tissue repair and neuroprotection， paralleling to that of their parental cells. Meanwhile， therapeutic agents（ such as catalase， dopamine， small interfering RNAs， etc）. can be targeted to the brain by exosomes and act on different pathologic pathways of PD. This paper reviews the recent advances on exosomes in the occurrence， development， diagnosis and treatment of PD， and discusses the current problems and possible future research directions.

Abstract:Amyotrophic lateral sclerosis（ ALS） is a fatal neurodegenerative disease that causes progressive degeneration of motor neurons， eventually leading to death. Natural antioxidants have been shown to protect neurons by reducing oxidative stress and damage in various cell cultures and animal models. In this paper， the therapeutic benefits of natural antioxidants in ALS are reviewed.

Abstract:The causes of foot drop are complex and diverse. Neuro-electrophysiological examination plays an important role in differential diagnosis， treatment selection， and prognosis assessment. This paper reviews the differential diagnosis of foot drop and the application and progress of neuro-electrophysiological examination in the diagnosis of foot ptosis.

Abstract:The bipolar disorder group of the Mental Disease Professional Committee of Zhejiang society of integrated traditional Chinese and Western medicine organized psychiatric and traditional Chinese medicine （TCM） experts. By collecting and screening a large number of literatures on the research of psychiatrists and TCM doctors in Zhejiang Province， combined with the "six depression theory" of Zhejiang medical school， the expert consensus on the treatment of mania in Zhejiang Province was formulated. This will provide constructive suggestions for clinical psychiatric.