ABSTRACT
Objective To explore social function of long-term hospitalized patients with stable schizophrenia and its influential factors to provide scientific evidence for improving social function in long-term hospitalized patients with schizophrenia. Methods A total of 75 long-term hospitalized patients with stable schizophrenia were enrolled. The Social Functional Rating Scale (SFRS), Positive and Negative Syndrome Scale (PANSS), Insight and Treatment Attitude Questionnaire (ITAQ), Rating Scale for Extrapyramdal Side Effects (RSESE) and MATRICS (Measurement and Treatment Research to Improve Cognition in Schizophrenia) Consensus Cognitive Battery (MCCB) were used to assess social function, clinical symptoms and cognitive function of patients. Bivariate correlation analysis and linear regression were used to examine the correlations between social function and clinical symptoms as well as cognitive function. Results The average score of SFRS was (53.6 ±9.3). Linear regression analysis showed that negative symptom of PANSS (B= 0.322, P=0.009), speed of processing (B=-0.428, P<0.001), working memory (B=-0.191, P=0.020)and RESES (B=0.918, P=0.002) were significantly associated with social function. The Sobel test showed significant indirect effects between negative symptom and social function, which were significantly mediated by working memory (Z=3.367, P<0.001) and speed of processing (Z=1.995, P=0.046). Conclusion Social function of long-term hospitalized patients with stable schizophrenia is influenced by negative symptom, speed of processing, working memory and extrapyramdal side effects. There is a mediating effect between PANSS negative symptoms and SFRS in working memory and processing speed.
ABSTRACT
Objective To investigate the effect of reducing antipsychotic dose on clinical symptoms in patients with stable schizophrenia. Methods Seventy-five patients with stable schizophrenia taking olanzapine or risperidone were enrolled. Patients were randomly divided into dose reduction group (37 cases) and maintenance group (38 cases). The dose of the risperidone or olanzapine was gradually reduced by 50％ in the dose reduction group within six months whereas remained unchanged in the maintenance group. The Positive and Negative Symptom Scale (PANSS), Calgary Depression Scale (CDRS), Personal and Social Performance Scale (PSP), Insight and Treatment Attitude Questionnaire (ITAQ) and Extrapyramidal Side Effects Scale (RSESE) were assessed at baseline, 3 months, 6 months and 12 months. Results There were one and two cases dropped out due to the relapse in dose reduction group and in maintenance group, respectively. The recurrence rates were 2.7％ in dose reduction group and 5.3％ in maintenance group (P<0.05). The interaction effects of PANSS positive symptoms, negative symptoms and general pathological symptoms, ITAQ,RSESE, PSP were significant (P<0.05). The main effect of PANSS negative symptoms and PSP group was significant (P<0.05). Compared with the maintenance group, PANSS negative symptoms of the dose reduction group were significantly lower at 6 and 12 months (P<0.05). PSP scores were significantly higher in the dose reduction group than in maintenance group (P<0.05) at 3, 6 and 12 months. Conclusion Reducing the dose of risperidone or olanzapine slowly in patients with stable schizophrenia within six months reduces negative symptoms and adverse reaction, improves social function without increasing positive symptoms.
ABSTRACT
Objective Inflammation plays a critical role in the presence , development and maintenance of atrial fibrillation ( AF) , but it remains unclear what factors induce inflammation in AF patients , especially in those with valvular heart disease ( VHD) . The aim of this paper was to investigate the role of the shedding of Syndecan -4 in left atrial inflammation in patients with valvular atrial fibrillation. Methods Sixty VHD patients scheduled for valvuloplasty or valve replacement surgery were divided into three groups of equal number:sinus rhythm (SR), paroxysmal atrial fibrillation (PaAF), and persistent atrial fibrillation (PeAF).Another 10 pa-tients with congenital heart disease but no valve damage and atrial fibrillation were included in a control group .Baseline clinical data were recorded and tissues were obtained from the left atrial appendage during operation .The expressions of iNOS , HMGB1, and Syn-decan-4 in the left atrium were detected by Western blot , and the pathological changes of the left atrial tissue observed by HE staining . Results Western blot analysis was performed to detect expression levels of proteins .The iNOS level was significantly higher in pa-tients from the paroxysmal AF group (1.61 ±0.10) and persistent AF group (1.67 ±0.08) than those from sinus group (1.06 ± 0.11) and control group (1.02 ±0.12), as was the protein level of HMGB1 (0.63 ±0.05, 0.95 ±0.10, 0.45 ±0.07 and 0.46 ± 0.06 in paroxysmal AF group, persistent AF group, sinus group and controlgroup respectively ).Inflammatory cell infiltration in-creased, while syndecan 4 was down-regulated in AF groups.All these comparisons were significant (P<0.05). Conclusion The decreased expression of Syndecan-4 and enhanced inflammatory response in the left atrial tissue indicate that the shedding of Synde-can-4 may play a role in the presence and development of inflamma-tion in the left atrium .