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Electroconvulsive therapy (ECT) is a physical therapy method with rapid onset and remarkable effect for schizophrenia(SZ). It is widely used in patients with agitated impulses, stupor and refractory patients with poor drug treatment effect. The neurophysiological mechanism of ECT effect has not been elucidated. In the past decade, the magnetic resonance imaging (MRI) studies of ECT for SZ have been gradually reported in domestic and international journal, involving magnetic resonance spectroscopy, structural state and resting state analysis, preliminary findings suggest that there may be a correlation between ECT efficacy and structural and functional brain changes, mainly involving morphological changes in brain regions such as the thalamus, hippocampus, insula and left medial prefrontal lobe, as well as functional changes in core resting state networks, particularly the dorsal frontoparietal network, default network and limbic network. More research and exploration are needed in the future to provide valuable clues to further explore the therapeutic mechanism of ECT treatment.
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Objective:To investigate the effects of theta burst stimulation(TBS)mode repeated transcranial magnetic stimulation (r-TMS) in the left prefrontal on negative symptoms and cognitive function in the elderly chronic schizophrenic patients.Methods:Totally 48 patients with stable chronic senile schizophrenia (24 cases in r-TMS treatment group and 24 cases in r-TMS pseudo stimulation control group) were selected. The treatment group was given the TBS mode r-TMS performed in the left dorsolateral prefrontal cortex. The control group was given pseudo stimulation at the same site. Before and after treatment, the brief psychiatric rating scale(BPRS), scale for assessment of negative symptoms(SANS), and positive and negative syndrome scale(PANSS)were used to assess mental symptoms, while Mattis-dementia rating scale(MDRS-2)and social adaptation functioning evaluation(SAFE)were used to assess cognitive function and social function. SPSS 20.0 was used for statistical analysis.Comparisons of the differences between inter groups and intra groups were conducted by independent sample t test and paired t-test. Results:(1)There were significant differences in the total score of PANSS scale((60.17±3.73), (56.67±3.12)), the negative symptom subscale score of PANSS((20.88±2.94), (17.96±2.33)) and the score of SANS((30.67±1.66), (30.25±1.45)) before and after treatment in the treatment group (all P<0.05). The D-value before and after treatment in the scores of BPRS ( t=3.513, P=0.001), PANSS ( t=6.048, P<0.01), negative symptom subscale ( t=6.610, P<0.01) and SANS ( t=8.239, P<0.01) were significantly different between the two groups. (2)There were significant differences in the scores of MDRS-2 and its sub scales before and after treatment in the treatment group (all P<0.05). The D-value before and after treatment in the scores of MDRS-2 ( t=6.216, P<0.01), attention ( t=4.596, P<0.01), start/maintain ( t=6.424, P<0.01), concept formation ( t=3.974, P<0.01), construction( t=2.194, P=0.033) and memory ( t=3.162, P=0.003) were significantly different between the two groups.(3)There was no significant difference in the SAFE score between the treatment group and the control group before and after treatment ( t=0.138, 0.142, both P>0.05). Conclusion:TBS can improve the negative symptoms and cognitive function in patients with the elderly chronic schizophrenic, but the effect of social function is not clear.
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Objective To explore the establishment of a two-way referral system for the treatment of cervical diseases within a medical alliance. The two-way referral system was introduced to reduce the morbidity and mortality of cervical cancer through better management of patients'who have tested positive for cervical disease, screening effectively for early diagnosis and treatment of cervical precancerous lesions, and providing early interventions for cervical cancer patients. Methods The control group consisted of 2, 515 patients who had screened positive for cervical disease between January 2018 and December 2018 at one of four community health service centers that were not within the medical alliance. The experimental group consisted of 2, 384 patients who had screened positive for cervical disease at one of four community health service centers in the medical alliance. The control group was treated using the original management mode;the experimental group's treatment was managed within the two-way referral system, which included standardized screening, referral, follow-up, health education, and professional training. The hospital visit rates, time intervals from diagnosis to the start of interventions, detection rates, and treatment rates were observed for both groups of women. Results The hospital visit rates, detection rates, and treatment rates were higher for those in the experimental group than the control group. The time interval from receiving a diagnosis to the first hospital visit was (16.9±11.5) days for patients in the experimental group and (25.7±20.9)days for those in the control group. The difference was a statistically significant (-0.05). Conclusion The management of cases in a two-way referral system within a medical alliance facilitates patients receiving earlier diagnosis and treatment for cervical pre-cancerous lesions and malignant tumors. Such efficiency improvements may reduce morbidity and mortality as well as help control medical costs, all of which have long-term economic and social significance.
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Antipsychotics treatment significantly increases the risk of sudden cardiac death in psy-chiatric patients,especially in elder patients. This paper reviews the major clinical risk factors of sudden car-diac death including myocardial infarction,QT interval prolongation and venous thromboembolism,as well as discusses the possible pharmacological mechanisms. We should focus on assessing somatic factors at the on-set of treatment and during maintenance therapy,and choose the antipsychotics reasonably to reduce the pos-sibility of sudden cardiac death.
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Objective ToexploretheCTcharacteristicsoftracheobronchialtuberculosis(TBTB)withdifferentpathologicaltypes. Methods CTdataof80patientsdiagnosedasTBTBbybronchoscopywereanalyzedretrospectively.Results CTcharacteristicsofTBTBwere follows:(1)Directsignsweredetectedin127cases.Therewere47cases(37.0%)withbronchialwallthickening,57cases(44.9%) withbronchiostenosisand23cases(18.1%)withbronchialocclusion.ForactiveTBTB,therewereonly2caseswithbronchialwall thickeningand1casewithbronchiostenosisin9casesintypeⅠ,40cases(31.5%)withbronchialwallthickeningandbronchiostenosisintypeⅡ, 41cases(32.3%)withallthreedirectsignsintypeⅢ.AmongstableTBTB,22cases (17.3%)withbronchialwallthickeningand bronchiostenosisintypeⅣ;TherewerefewcasesintypeⅤ,butallwithbronchialocclusion.(2)Indirectsign:54cases(45.4%)with bronchialdisseminated,13cases(10.9%)withdestroyedlung,25cases(21.0%)withcavities,27cases(22.7%)withmediastinallymphnodes enlargementamongthe119cases.BronchialdisseminatedlesionsinactiveTBTBweresignificantlymorethandestroyedlungandcavitylesions (P<0.01).Conclusion DifferentpathologicaltypesofTBTBhavedifferentCTcharacteristics.ActiveTBTBischaracterizedbydirectsignsand oftenaccompaniedwithindirectsignssuchasbronchialdissemination.
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Objective To explore the prevalence,socio-demographic and clinical characteristics of deficit schizophrenia in Chinese community-dwelling patients with schizophrenia. Methods Five hundred and three community-dwelling patients with schizophrenia were recruited in a cross-sectional study in Yuhua-tai District of Nanjing,and deficit schizophrenia was confirmed by Chinese version of the Schedule for the Deficit Syndrome (SDS). Their socio-demographic and clinical characteristics were collected. All patients' psychopathology was assessed by Positive and Negative Syndrome Scale (PANSS). Results The current prevalence of community-dwelling patients with deficit schizophrenia was 0. 67‰. Deficit schizophrenia had significantly higher hospitalizations((2. 4±1. 3)times,(1. 9±0. 9)times),PANSS negative scores((28. 4± 8. 1),(17. 7±6. 3)),PANSS total score((96. 5±17. 3),(87. 3±18. 1)) than non-deficit schizophrenia(all P<0. 05),while non-deficit schizophrenia had higher currently smoking rate,positive scores,marriage per-centage and age of onset( all P<0. 05) . Further multiple logistic regression analysis indicated that male sex, age of onset,smoking and negative PANSS score were independently associated with deficit schizophrenia. Conclusion The study showed that deficit schizophrenia is very common in Chinese psychiatric outpatients. The results partially support deficit schizophrenia as an independent subtype of schizophrenia.
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Objective To explore the effects of early intervention with heparin on function of coagulopathy, liver and kidney as well as the prognosis in rats with exertional heatstroke (EHS) under the ambient air of high temperature and low humidity. Methods 108 healthy SPF male Sprague-Dawley (SD) rats were randomly divided into normal temperature control group, EHS + normal saline (NS) group and EHS + heparin group. Of which 54 rats were collected for survival analysis (18 rats in each group), the weight change and 8-hour survival rate were observed,and Kaplan-Meier survival curves were drawn. Other 54 rats were collected for intervention experiment, the rats in each group were subdivided into 0, 1, 2 hours subgroups according to the time points of intervention with heparin after model reproduction, with 6 rats in each subgroup. The rats were placed in an artificial experiment cabin with northwest special environment, and the temperature and the relative humidity were (25.0±1.0) ℃ and (35±5)%, respectively, in normal temperature control group, and the rats were not treated in the cabin. The rats in EHS + NS group and EHS + heparin group kept running in the cabin which temperature and relative humidity were set at (43.0±0.5)℃ and (35±5)% until the anus temperature of rats reached 43.0 ℃, and then the rats were placed in room temperature. The rats were injected with 1 mL/kg NS or 250 U/kg heparin sodium injection through their caudal veins at 0, 1, and 2 hours, respectively, and then the blood was collected after 1.5 hours to determine the biochemical parameters including coagulation, liver and kidney as well as platelet count (PLT). Results ① The weight loss of EHS + NS group and EHS + heparin group was more significant than that of normal temperature control group (g: 8.28±1.41, 8.39±1.38 vs. 2.06±1.06, both P < 0.05), but there was no significant difference between EHS + NS group and EHS + heparin group. ② As the time went on after modeling, serum creatinine (SCr), blood urea nitrogen (BUN), alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase (CK), activated partial thromboplastin time (APTT), and D-dimer of EHS rats showed a tendency of increasing, but fibrinogen (FBG), antithrombin Ⅲ (ATⅢ) and PLT were decreased gradually, which were obviously abnormal as compared with those at corresponding time point of the normal temperature control group. Heparin intervention 0 hour after modeling could improve the function of liver and kidney, FBG, D-dimer, ATⅢ and PLT, but APTT was prolonged further. The SCr, BUN, ALT, AST and CK in EHS 2 hours + heparin group were still better than EHS + NS group [SCr (μmol/L): 93.33±7.69 vs. 110.50±13.56, BUN (mmol/L): 20.55±1.35 vs. 24.88±2.41, ALT (U/L): 322.17±36.36 vs. 492.33±64.19, AST (U/L): 1 252.33±240.86 vs. 2 725.67±461.17, CK (U/L):1 4628.67±2 784.68 vs. 2 6843.00±2 637.16, all P < 0.01], APTT was significantly prolonged (s: 51.83±6.11 vs. 33.83±4.31, P < 0.01), and ATⅢ and PLT were significantly increased [ATⅢ: (78.03±9.15)% vs. (64.28±12.55)%, PLT (×109/L): 457.67±32.33 vs. 415.83±26.45, both P < 0.05], however, there was no obvious influence on FBG or D-dimer. ③ The rats in normal temperature control group were all survived within 8 hours, and all dead in EHS + NS group. The survival rate of rats given heparin intervention at 0, 1, 2 hours after successfully modeling was 50.0%, 33.3% and 0%, respectively. Kaplan-Meier survival curve analysis showed that 8-hour cumulative survival rate in EHS 0 hour, 1 hour + heparin groups was higher than that in EHS 0 hour, 1 hour + NS groups (χ12 = 7.930, P1= 0.005; χ22 = 4.408, P2= 0.036), however, there was no significant difference between EHS 2 hours + heparin group and EHS 2 hours + NS group (χ2= 2.660, P = 0.103). Conclusion Early heparin intervention can improve the coagulation function and organ function of EHS rats, while improving the survival rate of rats, indicating the earlier intervention of heparin, the better prognosis of rats is.
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Objective This study examined the prevalence of underweight and its related risk factors of community-dwelling patients with schizophrenia. Methods Five hundred and three community-dwelling patients with schizophrenia and 323 healthy controls were recruited in a cross-sectional study. Body mass index less than 18.5 was defined as underweight. Their demographic and clinical data including anthropometric data, plasma glucose and lipid parameters were collected. The Positive and Negative Syndrome Scale (PANSS) was used to assess patients' psychopathology. Results The prevalence of underweight was 9.9% (50/503) in schizophrenia patients versus 1.5% (5/323) in the control group ( P<0.01). Further logistic regression analysis showed that male ( OR=2.43, 95%CI:1.74~3.39), smoking behavior (OR=1.50, 95%CI: 1.21~1.86), hospitalization times (OR=1.18, 95% CI: 1.06~1.31), PANSS negative score (OR=1.09, 95% CI: 1.04~1.14) were significant predictors for underweight (all P<0.05). Conclusion The prevalence of underweight is higher in Chinese patients with schizophrenia than in the general population. Some demographic and clinical variables are risk factors for underweight in schizophrenia.
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Objective To investigate the association between DNA methylation of matrix metallo-proteinase 9(MMP-9) gene and cognitive function including continuous attention,cognitive flexibility and visuospatial memory in patients with chronic schizophrenia.Methods 71 male schizophrenia patients and 69 healthy controls were recruited and detected their cognitive function.Pyrosequencing was used to determine DNA methylation at CpG site in exon 4 and exon 5 of MMP-9 gene.RT-qPCR was used to detect MMP-9 gene expression.Clinical symptoms were assessed by BPRS.Results (1) Cognitive function including Trail Making Test A,Trail Making Test B,Stroop words only,Stroop colors only,Stroop interference,Spatial Processing Block design and Block Design all scores were significantly lower in schizophrenia patients with schizophrenia than those in health controls (P＜0.01);(2) The MMP-9 gene expression in PBMCs was significantly higher in schizophrenia patients (1.31± 0.48) than that in health control (1.11 ± 0.45,P＜ 0.05).The DNA methylation of CpG4-1,CpG4-2,CpG4-3,CpG4-4,CpG4-5,CpG5-1,CpG5-2,CpG5-4 of MMP-9 gene in schizophrenia patients were lower than those in health controls (P＜0.01).(3)DNA methylation of CpG4-3 was positive correlated with Stroop interference (r=0.324,P＜0.01) in health controls.Correlation analysis showed that DNA methylation of CpG4-1 was negatively correlated with sustained attention function (r =-0.329,P＜0.01),cognitive flexibility (r =-0.337,P＜ 0.01) and visuospatial memory (r =-0.308,P＜ 0.05) in schizophrenia patients.There were positive correlations between DNA methylation of CpG4-5 (r=0.305,P＜0.05),CpG5-1 (r=0.262,P＜0.05),CpG5-3 (r=0.260,P＜0.05),average DNA methylation at exon 5 (r=0.288,P＜0.05) and visuospatial memory.DNA methylation of CpG5-4 was positive correlated with sustained attention function (r=0.251,P＜0.05) and visuospatial memory (r=0.350,P＜ 0.01) respectively.Conclusion Male patients with schizophrenia suffer from extensive cognitive impairment,and methylation of MMP-9 gene may be associated with cognitive impairment of schizophrenia.
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Objective To define the variables associated with preterm infants with patent ductus arteriosus (PDA) and identify the optimal timing for PDA closure clinically.Methods Three hundred and fifty-three premature babies with gestational age ＜ 32 weeks in Ba Yi Children's Hospital,Beijing Military General Hospital,from February 2011 to January 2013 were selected.Among them the PDA patients with degree of cardiovascular dysfunction using a scoring system (CVD) ≥3 scores at 48 hour life by using the cardiovascular dysfunction scoring systerm received primary drug treatment with 1-3 cycles Ibuprofen.If drug treatment failed or contraindicated,underwent surgical closure.Gestational age,body weight,presence of symptomatic hypotension,drug treatment or surgical closure were analyzed to see whether these factors were related to clinical outcomes,including hospital mortality,necrotizing enterocolitis (NEC),intraventricular hemorrhage(IVH),retinopathy(ROP) and bronchopulmonary dysplasia(BPD) at 36 weeks.Data were analyzed with Kruskal-Walls test,Wilcoxon signed rank test,Pearson x2 test,Fisher's exact test,Friedman,Halton,Logistic regression model.Results In the PDA patients with CVD≥3 scores persistently,the effectiveness of Ibuprofen was lower as time went on,PDA and BPD(OR =3.163,P =0.002),ROP(OR =2.557,P =0.007) were related markedly,and surgical treatment was possibly required.When CVD scores ≥ 3 after birth,drug treatment for one cycle was effective in 169 cases(47.8％),52 cases (14.7％) for two cycles,and 44 cases(12.5％) required surgical ligation after drug treatment failed.Such patients had younger gestational age [(29.4 ± 2.4) weeks vs (30.7 ± 1.4) weeks,P ＜ 0.000 1],and lower body weight at birth [(1 450 ± 577) g vs (1 750 ± 508) g,P =0.004).Conclusions The prolonged patency of the ductus arteriosus in preterm infants is related to an increase for IVH,BPD and ROP.Surgical ligation of PDA is a safe and effective treatment and should be done soon after two complete cycles of Ibuprofen,especially in selected patients who CVD ≥3 scores,to reduce the possibility of BPD and ROP occurence.
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Objective To compare cognitive function and alexithymia between the schizophrenic patients treated with chlorpromazine and those treated with clozapine. Methods The patients with schizophrenia in stable condition that received maintenance treatment either with chlorpromazine or clozapine and normal control subjects were recruited (n=24 per group). Neuropsychological tests, including Digit Vigilance Test, Controlled Oral Word Association Test, Trail Making Test-A&B (TMT-A&B), Animal Naming Test, Stroop Color-Word Test, Block Design and Spatial Span Test were used to assess the participant’s cognitive function. The twenty-item Toronto Alexithymia Scale (TAS-20) were used to evaluate the participant’s alexithymia. Results The significant differences were found between the patients and the controls in all items of cognitive function and all factor scores of TAS-20 (P0.05). Multivari? ate linear regression analysis showed that in the clozapine group, attention function associated with the total score of TAS (β=-0.20, P<0.05), executive function associated with TAS factor 1 (β=-0.26, P=0.03), spatial function associated with TAS factor 2 (β=-0.24, P<0.01). In the chlorpromazine group, attention function associated with TAS factor 2 (β=-1.24, P<0.01), executive function associated with TAS factor 2 (β=-0.33, P=0.02). Conclusions Patients with schizophrenia in maintenance period have widely cognitive impairment and alexithymia, both of which are related to each other.
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Objective To explore the effect of postweaning enriched environment and citalopram treatment during juvenility on the behaviour of male rats exposed to early adverse stress. Methods The newborn pups were randomly divided into maternal separation group (MS) and non-maternal separation group (NMS). Offspring were weaned on PND22 and housed in same-rearing groups under either standard or enriched conditions or citalopram treatment until adulthood. All of them were examined by sucrose consumption test, forced swimming test (FST) and morris water maze test (MWZ). Results (1) MS had significantly less consumption of sucrose intake (ml/g)(0.013 ±0.006, n = 10), compared with the following five groups (MS + EE (0.023 ±0.012, n = 8); MS + Drug (0.027 ±0.012, n = 9); NMS (0.022 ± 0. 007, n=11);NMS + EE (0.023 ±0.007, n = 7); NMS + Drug (0.032 ±0.011),n=7)), NMS + Drug had significantly increased the radio of sucrose consumption on NMS group. (2)The immobility in FST were longer in MS-experienced groups (MS (140. 19 ± 37.01) s, n = 8); MS + EE (129.41 ±29.50)s, n = 6) ;NMS + Drug (128.83 ±26. 11)s, n = 6)) than three non-MS groups (NMS (96.28 ±35.63)s,n = 7); NMS + EE (94.17 ±24. 87)s, n = 6) ;NMS + Drug (93.00 ±34. 21)s, n = 6)). (3) MS had shorter time and shorter percentage of distance spent in target quadrant in MWZ,citalopram treatment markedly improved spatial memory on NMS group. Conclusion Maternal separation applied in newborn rats induces a broad spectrum of behavioral changes reminiscent of depressive symptoms in humans, which might be reversed to some extent by EE and antidepressant in young adults.
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Object To develop a method for the quantitative determination of salvianolic acid A in rat plasma. Methods HPLC method and Hypersil ODS column (4 6 mm?200 mm, 10 ?m) were used, the mobile phase was acetontrile water (1∶2 65, adjusted pH to 2 5 with formic acid), at a flow rate of 0 9 mL/min, the UV detection wavelength was 285 nm. Cinnamic acid was used as internal standard. Results The recovery of the method was in the range of 98 9%～106 9%, the recovery of the extraction was over 83%. The within day precision and the day to day precision were both lower than 8 4%. Conclusion The method is appropriate for the determination of salvianolic acid A when pharmacokinetics of salvianolic acid A is studied in rat plasma.
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Objective: To study the preparation and releasing properties of total salvanolic acid. Methods: The tablets were prepared using HPMC, MCC, CETOS, and CMS-Na as excipients. Results: The releasing rate of the tablets was conformed to zero kinetics. Conclusion: The study was found to be effective in the process of total salvanolic acid gastric residential tablets.
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Objective:To clone human canstatin cDNA,express it as fusion protein in E.coli,purify the fusion protein and determine its biological activity.Methods:Total RNA was extracted from Chinese placenta tissue.The canstatin cDNA was amplified by RT-PCR,then cloned into pTYB1 and sequenced;Prokaryotic expression vector pTYB1-hCAN was constructed;fusion protein was expressed by using IPTG induction and purified by chitin column.The biological activity of the purified fusion protein was identified by using the chick embryo chorioallantoic membrane assay(CAM).Results:RT-PCR product was about 700 bp,its sequence was the same as that of canstatin reported.Prokaryotic expression vector pTYB1-hCAN of human canstatin was constructed successfully,and the fusion canstatin protein was expressed in E.coli.The purity of the protein was 91.6%.The fusion protein could suppress the angiogenesis in CAM.Conclusion:The active human Canstatin is cloned and expressed as a bioactive form.
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36 rabbits were divided into control and experimental groups.In the experimen-tal group,the left renal artery was ligated or the left renal artery and vein wereligated simultaneously.All the animals were alive.After 3—8 months of the opera-tion,the rabbits were killed.The establishment of collateral circulation and theanatomical,histological and histochemical changes of the kidny were observed.The resultsobtained were as follows:1.Ligation of the left renal vessels causes atrophy of theleft kidney on account of the failure of collateral circulation establishment.Theright kidney of the experimental group showed obviously compensatory hypertrophy.The weight of the compensatory hypertrophied kidneys obviously increased.2.Thecompensatory hypertrophic growth of kidneys is due to the hypertrophy of existingn(?)phrons and the hyperplasia connective tissue.3.comparison of the controls,inthe JGI,PAS and AlP reactions with the compensatory hypertrophied kidneys,there were no striking differences.The results suggest that the compensatory hyper-trophied kidneys were normal at least on the renin secretion and reabsorption func-tion.