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Objective:To investigate the effects of paliperidone combined with dexzopiclone on plasma neurotrophic factors and neurotransmitters in schizophrenic patients with insomnia.Methods:Sixty schizophrenic patients with insomnia who received treatment in Ningbo Kangning Hospital, China between January 2020 and December 2020 were included in this study. They were randomly assigned to receive treatment with either dexzopiclone tablets combined with risperidone tablets (control group, n = 30) or paliperidone tablets combined with dexzopiclone tablets (observation group, n = 30) for 8 successive weeks. The Positive and Negative Syndrome Scale (PANSS) was used to evaluate the severity of schizophrenia. Change in PANSS score post-treatment relative to pre-treatment was compared between the control and treatment groups. The Pittsburgh Sleep Quality Index (PSQI) score was used to evaluate sleepiness before and after treatment. Change in PSQI score post-treatment relative to pre-treatment was compared between the control and treatment groups. Before and after treatment, serum brain-derived neurotrophic factor, neurotrophic factor 3, nerve growth factor, dopamine and serotonin levels were compared between the control and observation groups. Results:After treatment, PANSS score in the observation group was significantly lower than that in the control group [(52.71 ± 6.41) points vs. (60.34 ± 6.25) points, t = 4.668, P < 0.05]. PSQI score in the observation group [(8.83 ± 2.43) points] was significantly lower than that in the control group ( t = 4.567, P < 0.05). After treatment, serum brain-derived neurotrophic factor, neurotrophic factor 3 and nerve growth factor levels in the observation group were (4 752.79 ± 136.27) ng/L, (173.64 ± 15.88) ng/L, and (39.14 ± 2.23) ng/L, respectively, which were significantly higher than those in the control group [(4 417.85 ± 138.54) ng/L), (150.06 ± 15.49) ng/L, (37.51 ± 2.17) ng/L, t = 9.441, 5.822, 2.869, all P < 0.05]. After treatment, serum dopamine and serotonin levels in the observation group were (70.25 ± 6.41) ng/L and (43.42 ± 7.11) ng/L, respectively, which were significantly higher than those in the control group [(63.44 ± 6.03) ng/L, (35.59 ± 6.89) ng/L, t = 4.238, 4.332, both P < 0.05). Conclusion:Paliperidone tablets combined with dexzopiclone tablets exhibit good efficacy in the management of schizophrenic patients with insomnia. The combined therapy can effectively reduce the symptoms of schizophrenia complicated by insomnia, increase serum neurotrophic factor level, regulate serum neurotransmitter level, and thereby improve the mental state of patients.
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Objective To investigate the imaging characteristics of nontraumatic spontaneous intramural hematoma of small bowel secondary to warfarin therapy.Methods The retrospective and descriptive study was conducted.The clinical data of 12 patients with nontraumatic spontaneous intramural hematoma of small bowel secondary to warfarin therapy who were admitted to the First People's Hospital of Wenling (11 patients) and Taizhou Hospital of Zhejiang Province (1 patient) between January 2010 and December 2016 were collected.Patients received plain and enhanced scans of computed tomography (CT).Patients stopped warfarin therapy,received intramuscular injection of vitamin K1 and fresh-frozen plasma transfusion.Observation indicators:(1) primary signs of CT:① small bowel wall thickening;② increased density of small bowel wall;(2) secondary signs of CT:intestine lumen stenosis,intestinal pneumatosis,perienteric changes and other concomitant signs;(3) treatment situations.Measurement data with normal distribution were represented as (x)±s.Measurement data with skewed distribution were described as M (range).Results Twelve patients received total abdomen plain scans of CT,and 7 received total abdomen enhanced scans of CT.(1) Primary signs of CT:① Small bowel wall thickening.CT of 12 patients showed solitary,homogeneously symmetric,consecutive and diffuse thickening of small bowel wall,including ileal involvement in 7 patients and jejunum involvement in 5 patients.Ascending part of duodenum of 3 patients involved the 2nd and 3rd groups small bowel.The average length of involved small bowel was 30.7 cm (range,11.0-58.0 cm).There was no multifocal thickening or colonic involvement.Of 12 patients,10 and 2 showed moderate thickening (thickness was 1.0-2.0 cm) and severe thickening (thickness ＞ 2.0 cm),and the thickest small bowel wall was 2.5 cm.② Increased density of small bowel wall.Twelve patients showed varying degrees of increased density of small bowel wall,with an average value of 49.7 HU (range,36.0-63.4 HU).Of 12 patients,homogeneously increased whole layer density of small bowel wall were detected in 4 patients,higher submucous layer density of small bowel compared with serosal layer density in 4 patients,and all of the above characteristics in 4 patients.Enhanced scans of CT in 7 patients showed enhancement in small bowel mucosal layer and serosal layer,no obvious enhancement in the submucous layer of small bowel wall,clear layers,and a target sign when small bowel lumen was perpendicular to scan slice,including 5 patients with obvious enhancement in small bowel mucosal layer,spring-like change,and clear imaging in portal vein phase.(2) Secondary signs of CT:① Intestine lumen stenosis:12 patients had varying degrees of intestine lumen stenosis.Five patients were complicated with small bowel obstruction,showing a gas-liquid level.② Intestinal pneumatosis:2 of 12 patients showed patchy and mottled gas shadow.③ Perienteric changes and other concomitant signs:12 patients showed obviously increased fat density in surrounding area of involved small bowel and corresponding mesenteric area,and indistinct outside small bowel,including 8 with lots of lath-like high density shadow in surrounding area of small bowel and mesenteric area.The varying degrees of hemoperitoneum were seen in 12 patients.(3) Treatment situations:of 12 patients,9 underwent correct treatments,8 of them were improved,and 1 of them with persistently severe abdominal pain underwent urgent explorative laparotomy,showing hemorrhage and necrosis,and then underwent surgery;3 didn't undergo correct treatment,without improved or severe symptoms.Conclusion Patients undergoing anticoagulant therapy show acute abdominal pain with abnormal coagulation function,small bowel wall thickening and increased density by CT scans,hemoperitoneum complicated with intestine lumen stenosis,small bowel obstruction and hematocele in surrounding area of small bowel and mesenteric area,these are highly indicative of nontraumatic spontaneous intramural hematoma of small bowel secondary to warfarin therapy.
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Objective To investigate the effects of methylation inhibitor 5-Aza-2'-deoxycytidine (5-Aza-dC) on biological behavior of esophageal squamous carcinoma cell (ESCC) lines KYSE140 and KYSE150. Methods KYSE140 and KYSE150 cell lines were divided into the blank group, the control group and the experimental group. The cells in the blank group didn't do the treatment, and the cells in the control group were added to DMSO 2 μmol/L, while in the experimental group, cells were treated with different concentration (1, 2, 3 and 4 μmol/L) of 5-Aza-dC which affected respectively at different time (24, 48, 72 and 96 h). Cell proliferation was detected by using methyl thiazolyl tetrazolium (MTT) assay and the optimal drug concentration and time point were selected. Transwell assay was performed to detect the change of cell migration and invasion. Flow cytometry was used to observe the effects of drugs on cell apoptosis and cell cycle.The expression of PARP,Caspase-3,CCNB-1,and CCNE-1 were detected by Western blot. Results MTT result showed that the effective function time of 5-Aza-dC on KYSE140 and KYSE150 was 96 h at the concentration of 4 μmol/L. Under this condition, the cell ability of migration and invasion was decreased significantly. The migrated cell number of KYSE140 and KYSE150 respectively in the blank group, the control group and the experimental group was (193.3±8.6), (184.0±10.4), (61.7±7.1) and (112.0±6.4), (101.3± 7.9), (26.3±5.7). The invasive cell number was (47.3±7.3), (38.7±5.1), (8.0±3.9) and (83.3±6.8), (74.7±5.7), (21.0±2.7), respectively. The difference was statistically significant (P <0.05). Flow cytometry revealed that 5-Aza-dC increased the apoptosis of KYSE140 and KYSE150. The apoptosis rate of the blank group, the control group and the experimental group was (2.8±0.3) %, (11.2±0.7) %, (18.6±0.6) % for KYSE140 and (2.7±0.4)%,(9.8±0.4)%,(17.7±0.5)% for KYSE150.Compared with the other two groups,the cell number of G2/M phase in the experimental group was increased remarkably (P < 0.05). PARP and Caspase-3 were sheared evidently and the protein expression of CCNB-1 was up-regulated while the expression of CCNE-1 was down-regulated in the experimental group. Conclusion 5-Aza-dC can inhibit the proliferation and promote apoptosis of ESCC cells.
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Objective To study the effect of olanzapine combined with repetitive transcranial magnetic stimulation(rTMS) in the treatment of phonism dominated schizophrenia.Methods From August 2015 to November 2016,112 patients with phonism based schizophrenia in Ningbo Kangning Hospital were selected in the research . According to the different treatment ,the patients were divided into observation group and control group ,with 56 cases in each group.The observation group was treated with olanzapine combined with rTMS chemotherapy ,the control group was treated with olanzapine.Before and after treatment,the positive and negative symptom scale ( PANSS) score, Wisconsin Card Sorting Test ( WCST) score of the two groups were observed.The clinical efficacy was compared between the two groups.Results Before treatment,there were no statistically significant differences in PANSS score and WCST score between the two groups ( all P＞0.05).After treatment for 1 week,2 weeks,4 weeks,the PANSS scores of the two groups were significantly lower than those before treatment (F＝170.710,106.028,28.530,30.328, 25.806,10.832,203.342,372.253,all P＜0.05).The PANSS scores decreased more significantly in the observation group.After treatment for 1,2,4 weeks,the scores of positive symptoms in the observation group were (25.95 ±3.50)points, (24.72 ±4.50)points and(16.51 ±2.70)points,respectively,which were significantly lower than those in the control group[(27.27 ±2.03)points,(27.80 ±5.37)points,(19.53 ±3.07)points](t＝2.441,3.290,5.528,all P＜0.05).After treatment for 1 week,2 weeks,4 weeks,the continuous response scores in the observation group were (45.62 ±5.41)points,(44.69 ±4.91) points,(35.89 ±3.30) points,respectively,which were significantly lower than those in the control group[(50.61 ±5.35)points,(46.80 ±5.14)points,(42.70 ±5.04)points](t＝4.908, 2.221,8.459,all P＜0.05).The scores of continuous errors in the observation group were (49.47 ±4.59) points, (46.53 ±6.05) points and (36.35 ±5.18) points,respectively,which were lower than those in the control group [(83.1 ±6.58)points,(81.85 ±6.70)points and (76.86 ±76.86)points](t＝31.369,29.279,38.464,all P＜0.05).After treatment for 1 week,2 weeks,the classification scores in the observation group were (4.21 ±2.03) points and (5.35 ±2.23) points,respectively,which were significantly higher than those in the control group [(3.35 ±1.24)points and (3.95 ±1.24)points] (t＝2.705,4.106,all P＜0.05).The effective rate was 91.0%in the observation group ,which was 89.2%in the control group,there was no statistically significant difference (χ2＝0.022,P＞0.05).Conclusion Olanzapine combined with rTMS is effective in the treatment of schizophrenia ,and olanzapine combined with rTMS is more effective in improving the cognitive ability of patients than olanzapine alone .
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Objective@#To explore correlation between chest CT score and oxygenation index in patients with acute hydrogen sulphide poisoning, whether CT score can be applied to assess acute lung injury after acute hydrogen sulfide poisoning and provide basis and reference.@*Methods@#The clinic and a series of CT datas of 32 acute hydrogen sulphide poisoning cases were retrospectively analysed and compared, According to GBZ31-2002 (the diagnostic standard of occupational H2S acute poisoning) , these patients were divided into 2 grouds including moderate groud and severe groud; The CT score were improved, referenceing the scoring criteria of the chest X-ray; The difference of the CT score and the oxygenation index were analyzed between moderate and severe group in the acute phase and the disperse phase; The correlation between CT score and oxygenation index were analyzed.@*Results@#The CT score in moderate poisoning group were lower than severe group (2.26±1.37 vs 10.44±2.55, 1.34±0.65 vs 4.55±2.45, all P<0.05) in the acute phase and the dissipation phase.The oxygen index of the 19 cases in the acute phase were 307.55±28.29, and the oxygen index of the 8 cases in the dissipation phase was 435.75±37.00; The oxygen index of the 9 cases in the acute phase and the dissipation phase were respectively 193.17±36.41, 347.67±44.49. The oxygen partial pressure and oxygenation index in severe group were significantly lower than those in moderate group (all P<0.01) in the acute phase and the dissipation phase. Pearman correlation analysis showed that the CT score were negatively correlated to the oxygen index in the acute phase and the dissipation phase, respectively (r=-0.97、-0.75, all P<0.01) .@*Conclusions@#The CT score of lung injury and oxygenation index is negatively correlated. The CT score can be used to evaluate the degree of lung injury, and can be used in the evaluation of acute lung injury after acute hydrogen sulfide poisoning.
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Objective To investigate the association between catechol-O-methyltransferase (COMT) Val158Met polymorphism and the memery function of schizophrenia treated with Aripiprazole.Methods Schizophrenic patients were diagnosed in according to Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV).A total of 78 Chinese Han subjects were involved in this study.The polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP) was used to identify COMT genotypes.The Chinese revised version of Wechsler Memory Scale (WMS-RC) was used twice to evaluate the memory function of patients treated with Aripiprazole alone before and after drug treatment for 8 weeks.ANOVA,rank sum test and t-test were used to statistical analysis.Results There was statistical difference of cumulative memory among the three groups (F=12.371,P=0.002),and Met/Met genotype showed much poorer cumulative memory than Val/Met and Val/Val genotypes (Z=-3.168,-2.641 ; P=0.002,0.008,respectively) Memory function was significantly improved after patients been treated with Aripiprazole except the associative memory(P＜0.05).Met/Met genotype showed more improvement of cumulative memory than other genotypes after Aripiprazole treatment (t=4.203,P＜0.01 ; t=3.024,P ＜0.01,respectively).Conclusions There may be a relationship between COMT Val158Met polymorphism and the memory function of schizophrenia in Aripiprazole treatment.Met/Met genotype of schizophrenia showed worst cumulative memory but best responsiveness in Aripiprazole treatment.
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Objective To analyse the changes in bilateral optic radiation and visual cortex in patients with primary glaucoma detected by magnetization transfer imaging ( MTI ),and try to explore the influence of the disease on posterior visual pathway.Methods MTI was performed in 20 patients with primary glaucoma with normal signal on conventional magnetic resonance imaging (MRI).The same scanning was performed in 31matched healthy controls.MTI was obtained using spoiled gradient recalled acquisition sequence (SPGR).Magnetization transfer ratio ( MTR ) of bilateral optic radiation and visual cortex was measured after post-processing.The MTR value differences of the same area between two groups were compared by independent-sample t test or Satterthwaite t test if variances were not equality.Result The MTR value in the left and right optic radiation were ( 32.8 ± 2.2 ) ％ and ( 32.7 ± 2.0 ) ％ in the glaucoma group,(34.6 ± 1.4 )％ and (34.8 ± 1.3 )％ in the control group.There was a statistically significant difference between the two groups (left t =3.284,right t =4.040 ;P ＜ 0.01).The MTR value of the left and right visual cortex were ( 30.1± 2.0 ) ％ and ( 30.8 ± 1.8 ) ％ in the glaucoma goup,and (32.3 ± 1.2 )％ and (32.4 ± 1.2 )％ in the control group.Statistically significant difference was found between the two groups ( left t =4.319,right t =3.445 ;P ＜ 0.01).Conclusions Potential neuropathology changes occurring in the posterior visual pathway of patients with glaucoma indicate that the whole visual pathway may be involved by glaucoma.The micro physiological changes can be detected by MTI which can not be found by conventional MRI.It is a useful method of studying trans-synaptic damage of visual pathway n vivo glaucoma which provides more information for guiding the clinic diagnosis,cure and prognosis of glaucoma.
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Objective To approach CT features of brain in premature infants.Methods 30 premature infants were examined by helical CT with low dose.The morphology of brain was observed and the density of brain tissue was also measured.Results Premature infants had thin cerebral cortex and shallow sulci.The density of white matter showed lower CT density,the average CT value was(14.36?1.91) HU and CT value of the white matter tended to increase with fetal age.7 cases(fetal age