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Substantial evidence supports the neurodevelopmental hypothesis of schizophrenia. Meanwhile, progressive neurodegenerative processes have also been reported, leading to the hypothesis that neurodegeneration is a characteristic component in the neuropathology of schizophrenia. However, a major challenge for the neurodegenerative hypothesis is that antipsychotic drugs used by patients have profound impact on brain structures. To clarify this potential confounding factor, we measured the cortical thickness across the whole brain using high-resolution T1-weighted magnetic resonance imaging in 145 first-episode and treatment-naïve patients with schizophrenia and 147 healthy controls. The results showed that, in the patient group, the frontal, temporal, parietal, and cingulate gyri displayed a significant age-related reduction of cortical thickness. In the control group, age-related cortical thickness reduction was mostly located in the frontal, temporal, and cingulate gyri, albeit to a lesser extent. Importantly, relative to healthy controls, patients exhibited a significantly smaller age-related cortical thickness in the anterior cingulate, inferior temporal, and insular gyri in the right hemisphere. These results provide evidence supporting the existence of neurodegenerative processes in schizophrenia and suggest that these processes already occur in the early stage of the illness.
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Objective To observe the clinical curative effect of traditional Chinese medicine hot compress combined with moxibustion in the treatment of urinary retention after orthopedic surgery.Methods 56 patients with postoperative uroschesis who underwent orthopedic surgerywere randomly divided into observation group and control group, and 28 cases in each group.All patients underwent pelvic muscle training, psychological counseling before surgery, and physical therapy with conventional methods such as induction of urination after surgery.The control group was treated with moxibustion Ququan acupoint, and the observation group was treated with Chinese herbal medicine hot compress on the basis of the above treatment.The patients in both two groups were treated for 28 days.At the end of the treatment, the clinical efficacy of the two groups was evaluated, also the time of first voiding after operation, the average effective time, urinary tract infection and urinary catheter replacement rate were compared.Results The total effective rate was 92.86% in the observation group and 78.57% in the control group.The effective rate in the observation group was higher than that in the control group (x2=46.86,P0.05).The urinary catheter replacement rate in the observation group was 7.14%,which was lower than 21.43% in the control group,the difference was statistical significance(x2=2.33,P<0.05).Conclusion The clinical curative effect of traditional Chinese medicine hot compress combined with moxibustion in the treatment of urinary retention after orthopedic surgery is better than moxibustion alone.The time of first urination and the average time of effect are shortened, and the rate of urinary catheter replacement is reduced.It is effective, simply and conductively to clinical use.
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<p><b>OBJECTIVE</b>To assess the association of impairment of surface area of first-episode schizophrenia(SZ) with polymorphisms of COMT gene, and the difference in the impaired patterns between familial patients with schizophrenia(FPS) and sporadic patients with schizophrenia(SPS).</p><p><b>METHODS</b>Ninety-eight patients with first-episode SZ(FPS=40, SPS=58) and 78 healthy controls were recruited. COMT gene was genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Participants were scanned for 3.0T magnetic resonance images. Freesurfer software was used to analyze the difference in brain surface area between SZ and controls, its association with COMT genotypes, and the difference between SPS, FPS and control groups. Multiple tests were corrected using a Monte Carlo simulation at P<0.05.</p><p><b>RESULTS</b>Compared with controls, SZ showed decreased surface area in right occipital cortex and left prefrontal cortex. No association was found between COMT polymorphisms and whole brain area difference. Among the three subgroups, SPS showed smaller left prefrontal area compared with both FPS and control groups. Patients with SPS also showed significant area reduction in right occipital lobe compared with controls.</p><p><b>CONCLUSION</b>Surface area impairment can be found in those with first-episode SZ, but without association with COMT gene polymorphisms. The SPS have more severe area impairment than FPS, indicating that SPS and FPS may be attributed to different etiological mechanisms.</p>
Subject(s)
Adult , Female , Humans , Male , Young Adult , Brain , Diagnostic Imaging , Catechol O-Methyltransferase , Genetics , Magnetic Resonance Imaging , Polymorphism, Restriction Fragment Length , Radiography , Schizophrenia , Diagnostic Imaging , GeneticsABSTRACT
Objective To investigate the relationship between the white matter fiber connectivity of the anterior commissure (AC) and schizophrenia, and to explore the role of AC connectivity in cognitive functions in first-episode schizophrenia. Methods Twenty-four patients with first-episode schizophrenia and 29 healthy controls underwent diffu-sion tensor imaging (DTI) to measure fractional anisotropy (FA). Fiber tracking was then used to reconstruct the white matter fiber connectivity of AC to examine the white matter integrity. We also analyzed the relationship between AC integ-rity and cognitive function. Results Compared to healthy controls, patients with first-episode schizophrenia had a signifi-cant reduction in mean FA of AC tracts [(0.48±0.07) vs. (0.54±0.05),P=0.002],longer completion time in trail making test(TMT)[TMT_A: (55.19 ± 19.15) vs. (36.61 ± 11.72), P<0.001;TMT_B: (88.84 ± 38.92) vs. (53.75 ± 23.41), P<0.001] and worse performance in logical memory test [immediate logical memory score:(6.12±3.85) vs. (11.69±3.68), P<0.001;delay logical memory score:(3.33±3.16) vs. (9.83±4.15), P<0.001]. In addition, there was negatively correlation of mean FA of AC tracts with TMT_A completion time (r=-0.458, P=0.037) or TMT_B completion time (r=-0.541, P=0.011) in patients with schizophrenia, but not in controls. Conclusion This study supports the disconnection hypothesis of schizo-phrenia. The deficit of AC microstructure integrity may be partly responsible for impaired executive functions in schizo-phrenia, suggesting that the integrity of white matter fiber is an important endophenotype of schizophrenia.
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Objective To investigate the difference in cognitive functions between first-episode schizophrenia pa-tients with and without family history. Methods One hundred twenty-seven patients with first-episode schizophrenia were recruited, including 40 patients with family history and 87 sporadic patients. Ninety-six matched normal subjects served as controls. Seven subscales of the Wechsler Adult Intelligence Scale-Revised in China (WAIS-RC) were used to assess the cognitive functions of all subjects. Positive and Negative Symptom Scale (PANSS) was used to assess patients ’ symptoms. The relationship between clinical symptoms and cognitive deficits was analyzed. Results There was no signifi-cant difference in the PANSS scores between familial patients and sporadic patients [(91.51±14.07) vs. (87.23±16.37), P>0.05]. The scores of full intelligence quotient (IQ), verbal IQ and operation IQ were lower in patient groups than in con-trol group (all P0.05). Conclusion The patients with schizophrenia have significant intelligence deficits in the early stages. Cognitive deficits are associated with the disease severity in sporadic patients while are independent of clinical symptoms in familial patients.
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[Objective] To discuss the effect of point application therapy and massage combined with little dosage of midazolam in the sedation for polydactylism replantation. [Method] Select 82 patients, randomly divide them into control and observation groups, n=41 for each. The control group only took midazolam for sedation;the other one, point application therapy and massage combined with little dosage of midazolam; observe both sedation effect, side effects and comfort degree. [Result] By comparing both groups, the observation group was better than control one on sedation effect, side effect rate and comfort degree. [Conclusion] Taking point application therapy and massage combined with little dosage of midazolam had good sedation and high comfort degree, with little side effects, fit for sedation in polydactylism replantation under continual brachial plexus anesthesia.