Antipsychotic Medications in Major Depression and the Association with Treatment Satisfaction and Quality of Life: Findings of Three National Surveys on Use of Psychotropics in China Between 2002 and 2012 / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Optimizing treatment outcomes for depression requires understanding of how evidence-based treatments are utilized in clinical practice. Antipsychotic medications concurrent with antidepressant treatment are frequently used in major depression, but few studies have investigated trends and patterns of their use over time. This study aimed to examine the prescription patterns of antipsychotic medications for major depression in China from 2002 to 2012 and their association with treatment satisfaction and quality of life (QOL).</p><p><b>METHODS</b>A total of 3655 subjects with major depression treated in 45 Chinese psychiatric hospitals/centers nationwide were interviewed between 2002 and 2012. Patients' socio-demographic and clinical characteristics including psychopathology, medication side effects, satisfaction with treatment and QOL were recorded using a standardized protocol and data collection.</p><p><b>RESULTS</b>The frequency of antipsychotic use was 24.9% in the whole sample; the corresponding figures were 17.1%, 20.3%, and 32.8% in 2002, 2006, and 2012, respectively (χ2 = 90.3, df = 2, P < 0.001). Multiple logistic regression analyses revealed that patients on concurrent antipsychotics had significantly more delusions or hallucinations, longer illness duration, greater side effects, and more likely to be treated as inpatients and in major hospitals (i.e., Level-III hospital). Antipsychotic use was associated with lower treatment satisfaction while there was no significant difference with respect to physical and mental QOL between the antipsychotic and nonantipsychotic groups.</p><p><b>CONCLUSIONS</b>Concurrent antipsychotic use was found in about one in four treated depressed patients in China, which has increased over a 10-year period. Considering the association of drug-induced side effects and the lack of patients' and relatives' satisfaction with antipsychotic treatment, further examination of the rationale and appropriateness of the use of antipsychotics in depression is needed.</p>

Study of clinical practical model of urinary system injury / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>In order to improve the clinical treatment level of urinary system injury, it is necessary to build up an animal model of urinary system wound, which is not only analogous to real clinical practice, but also simple and practical.</p><p><b>METHODS</b>We have developed the third generation of firearm fragment wound generator based on the first and the second producer. The best explosive charge of the blank cartridge was selected by gradient powder loading experiments. The firearm fragment injuries were made to the bulbous urethra of 10 New Zealand male rabbits. One week preoperatively and 2, 4 and 8 weeks postoperatively, all the animals underwent urethroscopy and urethrography. At 2, 4 and 8 weeks postoperatively, two animals were randomly selected and killed, and the urethra was cut off for pathological examination.</p><p><b>RESULTS</b>The shooting distance of the third generation of firearm fragment wound generator is 2 cm. The best explosive charge of the blank cartridge is 1 g of nitrocotton. All rabbits survived the procedures and stayed alive until they were killed. Injuries were limited to bulbous urethra and distal urethra. Round damaged areas, 1-1.5 cm in length, on the ventral wall were observed. Ureteroscopy results showed that canal diameter gradually shrank by over 50% in 9 rabbits. The rate of success was 90%. Urethrography result noted that a 1-1.3 cm stricture was formed at the bulbous urethra. Histology results of injured stricture urethra showed that fibrous connective tissue hyperplasia and hyaline degeneration caused further stricture in the canal.</p><p><b>CONCLUSIONS</b>The third generation of firearm fragment wound generator imitates the bullet firing process and is more accurate and repeatable. The corresponding rabbit model of traumatic complex urethral stricture simulates the real complex clinical conditions. This animal model provides a standardized platform for clinical researches on treating traumatic injuries to the urinary system.</p>

Prevalence of low back pain among soldiers at an army base / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Low back pain (LBP) is a major medical and social problem among working populations and is associated with high medical expense, loss of productivity, and disability. The aim of this study is to investigate the prevalence of LBP among soldiers and evaluate the possible causative factors in military training. The results may provide an insight into changes needed in military training that will reduce the occurrence of LBP among soldiers.</p><p><b>METHODS</b>A cross-sectional survey was conducted in a group of young soldiers in China to estimate the prevalence of LBP and evaluate possible causative factors in military training.</p><p><b>RESULTS</b>The survey was distributed to 1659 soldiers, of whom 1624 responded. LBP was reported by 425 of the 1624 (26.2%) soldiers. The prevalence of LBP was higher in the armored force (51.3%) than in the artillery (27.5%) or infantry (11.9%). A multivariate logical regression analysis identified night training, 5 km cross-country race, and grenade-throwing training as military training risk factors for LBP.</p><p><b>CONCLUSIONS</b>The relatively high incidence of LBP among soldiers was related to night training, 5 km racing, and grenade throwing. Modifications in these training methods should enhance the health of recruits and lower the incidence of LBP.</p>

Use of Clozapine for the Treatment of Schizophrenia: Findings of the 2006 Research on the China Psychotropic Prescription Studies

OBJECTIVE: Clozapine is one of the most commonly used antipsychotic drugs in China. To date, few studies have investigated the patterns the prescription of clozapine nationwide. The present study examined these patterns in China in 2006 and identified the demographic and clinical characteristics associated with the use of clozapine. METHODS: Using a standardized protocol and data collection procedure, we surveyed 5,898 patients with schizophrenia in 10 provinces with differing levels of economic development. RESULTS: Overall, clozapine had been prescribed for 31.9% (n=1,883) of the patients; however we found considerable variation among the 10 provinces. The frequency of clozapine use was highest in Sichuan (39.3%) and lowest in Beijing (17.3%). The mean daily dose of clozapine was 210.36+/-128.72 mg/day, and 25.1% of the patients were treated with clozapine in combination with other antipsychotics. Compared with the group not receiving clozapine, clozapine-user had been treated for longer durations and had experienced a greater number of relapses and hospitalizations. Furthermore, those in the clozapine-user had lower family incomes, were less able to seek psychiatric services, and more likely to be male and have a positive family history of schizophrenia. A multiple logistic regression analysis revealed that age, sex, professional help-seeking behaviors, duration of illness, economic status, educational level, and clinical manifestations were associated with the use of clozapine. CONCLUSION: Clozapine use is common in China. However, use of the antipsychotic varies among provinces, and demographic and clinical factors play important roles in the prescription of clozapine.

Factors That Influence the Prescription of Antipsychotics for Patients with Schizophrenia in China

OBJECTIVE: To investigate the patterns of antipsychotic use in China and to analyze the factors that influence antipsychotic prescriptions. METHODS: A standardized survey was conducted from May 20 to 24 2002 in five different regions of China with varying economic levels. The patterns of antipsychotic medication use were analyzed in a sample of 4,779 patients with schizophrenia. The survey gathered information on demographic characteristics, clinical profiles, and antipsychotic medications prescribed. Multiple logistic regression was used to analyze factors related to patterns of antipsychotic medication use. RESULTS: A plurality of patients with schizophrenia was treated with clozapine (39%); this was followed by risperidone, sulpride, chlorpromazine, perphenazine, and haloperidol. More than 56.3% of patients were treated with only one atypical antipsychotic. The mean daily dose of chlorpromazine was 365+/-253 mg (mean+/-standard deviation), and 6.5% of patients were treated with depot injections of typical antipsychotic medications. A total of 73.7% (n=3,523) of patients with schizophrenia received monotherapy, 24.8% (n=1,183) received two antipsychotics, 1.1% (n=52) received three antipsychotics, and one received four different antipsychotics. Patients often simultaneously received other classes of medications including anticholinergic agents, benzodiazepines, beta-blockers, antidepressants, and mood stabilizers. Economic status and clinical symptoms were the main factors that contributed to the patterns of antipsychotic prescription. CONCLUSION: The present study suggests that atypical antipsychotic medications, especially clozapine, are the primary psychiatric treatments of choice in the management of schizophrenia in China. Moreover, the economic status and clinical profile of the patient are the major factors affecting the prescription of antipsychotic medication.

Influence of distal tibiofibular synostosis on ankle function / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To study the influence of distal tibiofibular synostosis on ankle function.</p><p><b>METHODS</b>From October 1998 to October 2004, a total of 281 consecutive patients underwent operations because of ankle fractures or distal fractures of the tibia and fibula. Distal tibiofibular synostosis occurred after operation in 8 patients. The duration of follow-up averaged 20.6 months (14-44 months). The ankle function was assessed on the basis of functional rating system described by Mazur.(1)</p><p><b>RESULTS</b>According to Mazur's ankle evaluation system, 4 patients achieved an excellent result, 2 a good result and 2 a fair result. The dorsiflexion of the synostosis ankle reduced by 8.26 degrees as compared with that of the contralateral ankle, and there was little influence on the plantar flexion. All the patients had a normal gait.</p><p><b>CONCLUSION</b>The distal tibiofibular synostosis after the operation of ankle fractures or distal fractures of the tibia and fibula usually gives rise to few symptoms and needs no specific treatment.</p>

Treatment of displaced radial head fractures by internal fixation with absorbable pins / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To study the effect of internal fixation with absorbable pins on treatment of displaced radial head fractures.</p><p><b>METHODS</b>From May 1999 to May 2004, 16 patients with displaced radial head fractures (Mason types II and III) were treated with internal fixation by absorbable pins. The duration of follow-up averaged 22.6 months (12-58 months). The outcome was assessed on the basis of elbow motion, radiographic findings and the functional rating score delineated by Broberg and Morrey.</p><p><b>RESULTS</b>All fractures healed within 10 months without avascular necrosis of radial head. The mean elbow flexion loss was 15 degrees (0 degrees-35 degrees), and pronation and supination decreased by 10 degrees (0 degrees-30 degrees) on average compared with those of the contralateral elbow. Five patients had an excellent result, 6 a good result, and 3 a fair result according to the criteria of Borberg and Morrey.</p><p><b>CONCLUSIONS</b>Internal fixation with absorbable pins is an effective method in treating displaced radial head fractures. It can maintain the biomechanical stability of forearm, improve the elbow function and avoid second operation.</p>

Expression and Significance of Apoptosis Related Gene BAG-1 in Digestive Tract Cancer by Tissue Microarray / 中国康复理论与实践

@#ObjectiveTo detect BAG1 expressions in digestive tract cancer by tissue microarray and to evaluate its clinical significance.MethodsTissue microarray of digestive tract cancer and normal tissues were analyzed by DAKO Envision system immunohistochemical staining for apoptosis related gene BAG-1 expression.ResultsThe positive rate of BAG-1 expression among esophagus cancer,gastric cancer and rectal cancer were higher than that of normal tissues respectively(P<0.01).ConclusionThere is an overexpression of BAG-1 in digestive tract cancer,which suggest that apoptosis related gene BAG-1 may be related to these cancer.

Repair of acute spinal cord injury promoted by transplantation of olfactory ensheathing glia / 中国医学科学院学报

<p><b>OBJECTIVES</b>To observe olfactory ensheathing glia (OEG) survival and repair in vivo for spinal cord injury after OEG transplantation.</p><p><b>METHODS</b>The OEG was cultured with the olfactory bulb of Wistar neonate rats. The spinal cords contusion was made in group A, B, and C with the New York University impactor, then complete transection was performed in the contusion area in group A. OEG labeled by Hoechst was transplanted in group A and B. In group C, DMEM were injected. In group D, laminectomies were done without cord contusion and transection. The functional recovery of the spinal cord injury [Basso, Beattie, Bresnahan (BBB) Locomotor Rating Scale scores] and changes of body weight were observed. The tissue sections were done 24 weeks postoperatively. HE staining, neurofibril (NF) immunohistochemical staining, and silver staining were performed respectively to observe the pathologic changes and axon regeneration. The survival of OEG labeled by Hoechst was observed under the fluorescence microscope.</p><p><b>RESULTS</b>Locomotive behaviour improved 4 weeks postoperatively. The BBB locomotion scores of group A and B were significantly higher than that of group C in all periods (from 4 weeks to 24 weeks) (P < 0.01). Sixteen weeks after operation, the BBB locomotion scores became stable and showed no change. HE staining showed that the area of spinal cord injury was disorder and the number of nerve cell was more in group A and B. In group C, there was the obvious cavum and few wring nerve fiber in the area of spinal cord injury. The nerve fibers innervated to the injuried area in group A and B were more than that of group C, but less than that of group D. A great number of OEG labeled by Hoechst were observed around spinal injuried area under fluorescence microscope. After operation, the body weight reduced in every group. The body weight of group D had recovered after 2 weeks and gradully increased. After 4 weeks, the body weight in group A, B, and C decreased to the minimum and were significantly less than that of group D (P < 0.01). After this, body weight in group A and B increased and was significantly more than that of group C (P < 0.05).</p><p><b>CONCLUSIONS</b>OEG transplantation can promote the axons regeneration and the recovery of locomotion function in experimental spinal cord injuries.</p>

Transmission disequilibrium test of polymorphisms of serotonin transporter gene and schizophrenia based on family trios / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To investigate the relationship between two polymorphisms (Intronic VNTR and 5-HTTLPR) of the serotonin transporter gene and schizophrenia.</p><p><b>METHODS</b>A set of 314 schizophrenic trio samples collected from Shanghai, Xi'an and Jilin regions of China independently was subjected to analysis of the polymorphisms by transmission/disequilibrium test(TDT).</p><p><b>RESULTS</b>No significantly preferential transmission of any allele was detected from both polymorphisms investigated.</p><p><b>CONCLUSION</b>The results suggest that the serotonin transporter gene is unlikely to have a major contribution to susceptibility to schizophrenia in Han Chinese population.</p>