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The purpose of this study is to suggest the physicians using olanzapine to strengthen the recognition and treatment of restless leg syndrome （RLS） in clinical practice. In this paper， one patient with schizophrenia suffered from RLS during olanzapine administration， which was characterized by unpleasant sensory disturbances in bilateral lower extremity at night， intense urges to move legs， and inability to sleep. After taking gabapentin， the above symptoms were significantly improved.
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Schizophrenia is a kind of neurodevelopmental brain disease with genetic background.Cognitive impairment has always been concerned as the core symptom of schizophrenia, and genetic factors play an important role in the cognitive impairment process of schizophrenia.This paper intends to explore the relationship between various neurotransmitter systems and neurodevelopmental related genes and cognitive impairment in schizophrenia. With " schizophrenia" " cognitive" and " genetic" " dopamine" " glutamate" " serotonin" " norepinephrine" " acetylcholine" " neurodevelopmental" " genome-wide association studies" as key words, the author searched the English and Chinese literatures published from January 2001 to October 2019 in several databases, such as Pubmed, ScienceDirect, CNKI academic journal database, Wanfang academic journal database, and selected the literature that was in line with the review topic after a large number of readings.Meanwhile, the author applied the literature tracing method to search the references of the literature that had been reviewed. Finally, 29 related literatures were included, and it was found that cognitive impairment in schizophrenia is related to multiple neurotransmitter system genes and neurodevelopmental genes, and these genes have different mechanisms of action in the process of cognitive impairment. The occurrence and development of cognitive impairment in schizophrenia involve multiple gene effects. The genetic study of neurotransmitter system and neurodevelopmental level is helpful to explore the pathological mechanism of cognitive impairment in schizophrenia.Future research should focus on how the pathogenesis/candidate genes of schizophrenia affect the neurotransmitter system and neurodevelopmental circuits, and further elucidate the mechanism of genetic factors in the development of cognitive impairment in schizophrenia.
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Objective To explore the relationship between DNA methyctransferace1(DNMT1)gene polymorphism and cognitive function in the first episode, drug-na?ve schizophrenia. Methods One hundred eighty-six first episode, drug-na?ve schizophrenia patients and 182 healthy controls were examined by using polymerase chain reaction (PCR), denaturing polyacrylamide gel electrophoresis and silver staining to determine genotype and allele of DNMT1 gene. Cognitive function was assessed by using the standardized measurement tools—the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB) Chinese version. Comparisons were made on the cognitive function and the genotype and allele distribution of SNP rs2114724 and rs2228611 between schizophrenia group and the control group.The relationship between DNMT1 gene polymorphism and cognitive function was analyzed. Results There was no significant difference of the genotype T/T, T/C, C/C and allele T, C distribution of SNP rs2114724 between schizophrenia group and healthy controls group (P>0.05). There was no significant difference of the genotype G/G, G/A, A/A and allele G, A distribution of SNP rs2228611 between schizophrenia group and healthy control group (P>0.05). There was significant difference in Spatial Span Test (SST) scores(P<0.05)among three different genotype T/T,T/C and C/C of rs2114724 in schizophrenic group.The SST scores of the patients with C/C genotype were higher than that of the patients with T/T or T/C genotype (P<0.05). Conclusion DNMT1 gene polymorphisms is not associated with the first-episode, drug-na?ve schizophrenia, but may be associated with the work memory in cognitive function of schizophrenia in the Chinese Han population.
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Objective To explore the influence of duration of untreated psychosis (DUP)on cognition and social function in first-episode drug-na?ve schizophrenia. Methods Ninety-three first-episode drug-na?ve schizophrenic were enrolled as the schizophrenia group and 93 normal people served as the control group. The Positive and Negative Symptoms Scale (PANSS) were used to assess the degree of mental symptoms. The Matrics Consensus Cognitive Battery (MCCB) was used to evaluate the cognitive function. Personal and Social Performance Scale (PSP) and the Global Assessment Function Scale (GAF) were used to evaluate the social function. Result There were significant differences in scores of Trail Marking Test, Symbol Coding test, Category Fluency test, Stroop color word test, Continuous Performance Test, Spatial Span test, Brief-Visuospatial Memory Test-Revised (HVLT-R), Brief-Visuospatial Memory Test-Revised (BVMT-R) and Maze test between the schizophrenia group and the control group (all P<0.05). There were significant differences in scores of GAF and PSP between the schizophrenia group and the control group (all P<0.05). DUP was negatively related to the score of HVLT-R2 (r=-0.265, P=0.010) or BVMT-R3 (r=-0.328, P=0.001). DUP was negatively related to the scores of GAF score(r=-0.292,P=0.005)or PSP score(r=-0.397,P<0.001). Conclusion There are social function impairment and a wide range of cognitive function impairment in the first-episode drug-na?ve schizophrenic. The length of the DUP is associated with the severity of the social functional and cognitive functional impairment.
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Objective To explore the Kano model analysis in the application of midwife outpatient service quality management. Methods Kano questionnaire was consisted of 24 items, including five parts, environment facilities, service evaluation, service technology, the team service, delivery service′quality. Using the Kano model analysis, the impact factors of the midwife outpatient service quality in five different quality attributes were determined. It included property and had the opposite answer to the question, charisma, essential properties and one property. Results By identifing the quality index classification of the pregnant women with satisfactory service quality to midwife outpatient service, attributable to a property were 1,2,3,4,8,9,10,14,20,21;attributable to mandatory attributes were 13, belonging to the charm of the property had 5,6,7,11,12,15,16,17,18,19,22,23,24. Midwives outpatient had most of charisma attribute, 54.2%(13/24) of the total;The second was one attribute, 41.7% (10/24) of the total. The technology level of midwife was essential attribute. Conclusions Kano mode analysis technology will be introduced to the midwife outpatient service quality management to provide decision reference for improving the quality of the hospital management level, improve maternal satisfaction, improve the obstetric operation efficiency.
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Objective To assess the association between rs7597593 polymorphism of ZNF804A gene and schizophrenia,and to assess the relationship between rs7597593 polymorphism and working memory.Methods Schizophrenia patients and healthy controls were diagnosed in accordance with Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-Ⅳ) ; 767 schizophrenia patients and 690 healthy controls were involved.Restriction fragment length polymorphism (RFLP) was carried out to genotype rs7597593 polymorphism.The cognitive function of working memory was assessed by the N-back task.Statistical analyses were carried out with SPSS19.0 software.Results The study found no significantly different genotype frequencies (x2=1.519,P=0.468) and allele frequencies(x2=1.263,P=0.261) of rs7597593 polymorphism between schizophrenia patients and healthy controls,however in the subgroup of higher IQ (IQ ≥ 110),there were significant different distributions of both genotype and allele (x2 =9.411 and 6.529; P=0.009 and 0.011 respectively).It was also found in this subgroup that risk T allele was associated with more error at 1-back task (F=6.854,P=0.009).Conclusion These results indicated that rs7597593 polymorphism was associated with individuals having spared cognitive function; carriers of T allele had worse cognitive function,which maybe a pathway that it contributes to schizophrenia.
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Psychiatric professional talents are specially needed in China.Attention should be paid to the cultivation of clinical thinking ability in the process of cultivating professional master degree postgraduate majoring in mental health and psychiatry.Following measures can be taken such as using problem-based leaming(PBL) interactive teaching,organizing symposium,urging students to reviewing the language knowledge and logic knowledge,implementing specialized training to promote students' rigorous logical thinking ability,the ability to get information and interpersonal communication ability,strengthening the clinical practice teaching and paying close attention to the analysis and summary after the failure.
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Objective To explore the relationships between brain-derived neurotrophic factor gene G196A polymorphisms and psychopathology and the cognitive function in schizophrenic patients.Methods 224 patients and 220 normal controls were examined with polymerase chain reaction(PCR),denaturing polyacrylamide gel electrophoresis and silver staining to determine genotype and allele of G196A.Clinical symptoms were assessed with the Positive and Negative Symptom Scale (PANSS).Cognitive function was assessed with Wisconsin card sorting test (WCST) and Trail Making Test(CPT).To analyse the differences of the scores of Scale for the Assessment of Positive Symptoms(SAPS) and Scale for the Assessment of Negative Symptoms (SANS) among the patients with the genotype G/G,G/A and A/A.At the same time,the differences of the performance of WCST and CPT were analyzed.Results ①There were no significant differences of the genotypes G/G,G/A and A/A and allele G and A between patients and controls.②There were significant differences of the genotypes A/A between patients with Positive Symptoms and patients with Negative Symptoms (x2 =4.558,P ＜ 0.05).③There were no significant differences in the performances of complete categorizations and persistent wrong numbers of WCST and the performances of CPT among three groups of patients with genotype G/G,G/A and A/A (One-Way ANOVA,all P ＞ 0.05).Conclusion BDNF gene G196A polymorphisms are not associated with schizophrenia and the cognitive function but are associated with positive symptoms of schizophrenia.
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Objective To investigate the stigma in the public about the patients with depression and diabetes.Methods The stigma situation of the publics (workers,peasants,students,intellectuals and others,collect 300 respectively) were assessed for the patients with depression and diabetes with the Struening Belittle Scale.1500 questionnaires were distributed and 1421 effectual questionnaires were retrieved.Results ① A comprehensive compare of public stigma between depression and diabetes showed that about 89.0％ of the public with stigma and 11.0％ of the public without stigma for the patients with depression,about 32.0％ of the public with stigma and 68.0％ of the public without stigma for the patients with diabetes.There were significant differences in frequency of public stigma for two diseases (x2 =744.906,P ＜ 0.01).②There were significant differences in the total scores((52.8 ± 12.4) vs(32.4 ± 13.6),t =5.328,P ＜ 0.01) and subscale scores of the Stmening Belittle Scale (Patient Belittle Scale:(26.5 ± 8.6) vs (12.4 ± 5.6),t =3.276,P ＜ 0.01 ; Family Belittle Scale:(22.8 ±6.4) vs(9.4 ± 5.2),t =2.988,P＜ 0.01) of the public for the patients with depression and diabetes.Conclusion There is serious stigma in the public for patients with depression.It is more serious and extensive than that for patients with diabetes.
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Psychiatric professional talents is specially needed in China.Our university was ratified by ministry of education of people's republic of China in 2011 to cultivate professional master degree postgraduates majoring in mental health and psychiatry.According to the social needs and requirements of ministry of education,we carried out comprehensive reform and exploration in cultivation direction and objective,time management and course offering,cultivating model,examination and evaluation system.Cultivation direction included clinical psychiatry,forensic psychiatry,community psychiatry,behavioral medicine and clinical psychology,which were closely related with social needs.The objective was to cultivate high-grade psychiatric special talents with higher political diathesis,competent clinical skills,certain teaching and research abilities and grasping one foreign language.The total time for cultivating clinical skills should no less than two years and a half.Course offering included degree course and non - degree course,clinical skills,academic activities,teaching practice,medical record arrangement or case analysis essay writing.We developed the cultivating model combining ‘ medicine,study and research' and developed multilevel and comprehensive examination and evaluation system.
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To construct the talent cultivating model of psychiatric major suited to our county's actual situation.Jining medical university has conducted explorations and practices persistently in aspects of cultivating objective,enrollment model,course system,teaching quality monitoring system and inspirational education through more than twenty years maneuver.Jining medical university has initially grasped the basic rules of cultivating talents of psychiatric major and has constructed talent cultivating model of psychiatric majors suited to our country's actual situation.
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ObjectiveTo understand the marriage status marriage quality and marriage adaptation of inpatients with depression.Methods 100 inpatients with depression met the diagnostic criterion of major depression of CCMD-3 and 100 health people were recruited,and investigated by using the self-developed marriage status questionnaire,Olson's marriage quality questionnaire,Loche Wallace marriage adaptation scale and HAMD.Results ( 1 ) The marriage and remarriage rates of the depressive inpatients in female were significant higher than those in male(P＜ 0.05).(2) The score of ENRICH in the depressive inpatients group was significant lower than that in the health control group(P＜ 0.01 ).(3)The rate of the well adaptation of marriage in the depressive inpatients group was 32.0％,which was lower than that in the control group(P＜ 0.01 ).(4) The total score of the EN-RICH was negative correlation with the total score of HAMD( r=- 0.419,P＜ 0.01 ).ConclusionThe marriage status of the depressive inpatients is not fine and maladatative,which is influenced by the depressive symptoms.
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Objective To explore the association between disrupted in schizophrenia 1(DISC1) genepolymorphism and schizophrenia and different subtype depression.To verify if DISC1 gene is the common predisposing gene for schizophrenia and depression.Methods The genotypes and alleles in 260 cases of schizophrenicpatients,96 cases of depressive patients with psychotic symptoms,124 cases of depressive patients without psychotic symptoms,and 100 normal controls were examined with polymerase chain reaction(PCR),denaturing polyacrylamide gel elcctmphoresis separation technique.The association was analyzed between DISC1 gene single nncleotide polymorphisms(SNP) locus rs821616 and schizophrenia and different subtype depression.Results The frequeneies of the genotypes T/T,A/T,and A/A were 3.5%,28.0%and 69.5%respectively,the frequencies of alleles T and A were 9.6%and 90.4% respectively in schizophrenia group.The frequencies of the genotypes T/T,A/T,and A/A were 3.1%,24.0% and 72.9% respectively,the frequencies of alleles T and A were 15.6% and84.4% respectively in depression 1 group;The frequencies of the genotypes T/T,A/T,and A/A were 2.4%,23.4% and 74.2% respectively,the frequencies of alleles T and A were 15.3% and 84.7% respectively in depression 2 group;The frequencies ofthe genotypes T/T,A/T,and A/A were 1.0%,16.0% and 83.0% respectively,the frequencies of alleles T and A were 17.0% and 83.0% respectively in control group.There were significant differences in the frequencies of the genotypes (Chi-Square=8.072,P=0.045)and alleles(Chi-Square=8.564,P=0.036) of DISC1 gene among the four groups with non-parametric Kruskal-Wallis test.After pairwisecomparison each other in the four groups we found that there were significant differences in the frequencies of thegenotypes(Z=-2.802,P=0.005)and alleles(Z=-2.837,P=0.005) of DISC1 gene between patients withschizophrenia and normal controls with non-parametric Mann-Whitney test(two-tailed),there were no significantdifferences between other groups(P>0.05).Conclusion Our results suggest that DISC1 gene polymorphism is associated with schizophrenia significantly,but it is not associated with different subtype depression.This finding do not support the viewpoint that DISC1 gene is the common predisposing gene for schizophrenia and depression.
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@#Objective To compare the efficacy and safety of mirtazapine and buspirone on panic disorder.Methods 86 cases with panic disorder were divided into two groups: the mirtazapine(30～60 mg/d) group and the buspirone(15～30 mg/d) group.Hamilton Anxiety Scale(HAMA) was adopted to evaluate the efficacy.Safety was evaluated with Treatment Emergent Symptom Scale(TESS),laboratorial and physical examination.Results The effective rate of mirtazapine group and buspirone group was 90.7% and 83.7% respectively 8 weeks after treatment(χ2=1.17,P>0.05).The scores of HAMA of the mirtazapine group decreased more than that of the buspirone group 1 or 2 weeks after treatment(tt=2.94,P<0.01 and t=2.49,P<0.05 respectively).At the end of wk,But there was not significant difference between two groups 4 or 8 weeks after treatment(P>0.05).Some mild side-effects were observed in both groups.Conclusion Mirtazapine shows a similar effect to buspirone and takes effect earlier on panic disorder.