Correlation between functional connectivity of the precuneus and early efficacy to antidepressant treatment in patients of major depressive disorder / 四川精神卫生

BackgroundThe activity in precuneus within default mode network has been reported to be associated with antidepressant response， whereas the relationship between the functional network of precuneus and early response to antidepressant medications remains unclear. ObjectiveTo investigate the relationship between precuneus functional connectivity （FC） and early efficacy of antidepressant treatment in patients with major depressive disorder， so as to find a neurobiomarker to predict the early efficacy of antidepressants. MethodsA consecutive sample of 47 patients with major depressive disorder who attended the Mental Health Center， West China Hospital of Sichuan University from July 2017 to February 2019 and fulfilled the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） were recruited. Baseline resting-state functional magnetic resonance imaging scan findings and clinical assessments were recorded in participants. All patients treated with antidepressants for two weeks. Improvement was defined as 20% or greater reduction in baseline 16-item Quick Inventory of Depressive Symptoms Self-Report Scale （QIDS-SR16） by treatment exit， and patients were then classified into early improved group （n=27） and non-improved group （n=20）. FC values of precuneus and whole brain were calculated using bilateral precuneus as seed region， and baseline precuneus FC values were compared between two groups. Pearson correlation analysis was utilized to explore the correlation between FC values in brain regions with statistically significant differences and QIDS-SR16 total scores and reduction rates. ResultsFC values between the left precuneus and left precentral gyrus and between the right precuneus and right fusiform gyrus in early improved group were both higher than those in non-improved group （GRF correction， P<0.01）. The FC valves between the left precuneus and the left precentral gyrus and between the right precuneus and the right fusiform gyrus were positively correlated with QIDS-SR16 reduction rate （r=0.475， 0.297， P<0.05）. ConclusionWeakened FC between the left precuneus and left precentral gyrus and between the right precuneus and right fusiform gyrus are related to poor early efficacy to antidepressant treatment， and FC of precuneus may be a potential predictor of early response to antidepressants. ［Funded by the National Key Research & Development Program of China （number， 2016YFC1307204）； Key Development Project of the Sichuan Provincial Science and Technology Plan （number， 2018SZ0131）］

Study of prefrontal cortex activation characteristics of patients with psychiatric disorders in verbal fluency task using functional near-infrared spectroscopy / 四川精神卫生

BackgroundFunctional near-infrared spectroscopy （fNIRS） is a new generation of imaging tool that can be used to assist the diagnosis of psychiatric disorders. However， whether the patterns of prefrontal cortex activation observed by fNIRS are specific for different psychiatric disorders remains to be explored. ObjectiveTo investigate the characteristics of prefrontal cortex activation in patients with depression， anxiety disorder， bipolar disorder and schizophrenia in verbal fluency task （VFT） using fNIRS. MethodsFrom September to December 2021， 39 patients with schizophrenia， 205 patients with depressive disorder， 212 patients with anxiety disorder and 77 patients with bipolar disorder meeting the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） were recruited in the outpatient and inpatient department of West China Hospital， Sichuan University. fNIRS was used to monitor the prefrontal cortex hemodynamic changes of patients under VFT， and the clinical symptoms of patients were assessed by Symptom Checklist 90 （SCL-90） and Hypomania Checklist-32 items（HCL-32）. Differences in mean oxyhemoglobin （HbO2） concentration and the initial slope from 2 to 7 second during VFT were compared among patients with different diseases， and the correlation between mean HbO2 concentration/initial slope and clinical symptoms was analyzed by partial correlation analysis. ResultsThe concentration of HbO2 in channel 4 （Z=2.828， P=0.028） and channel 6 （Z=2.912， P=0.022） in patients with depression were significantly higher than those in patients with schizophrenia. Patients with anxiety had significantly higher changes in mean HbO2 concentration in channel 4 （Z=3.154， P=0.010）， channel 5 （Z=3.021， P=0.015）， channel 6 （Z=2.980， P=0.017） and of all channels （Z=2.881， P=0.024） than those of schizophrenia patients. There was a statistically significant difference in the initial slope of channel 3 between patients with depressive disorder and those with bipolar disorder （Z=2.691， P=0.039）. Among patients with bipolar disorder， the anger-hostility scores of SCL-90 were negatively correlated with the mean HbO2 concentration changes in channel 4 （r=-0.505， P=0.004）， channel 6 （r=-0.390， P=0.004）， channel 15 （r=-0.546， P=0.002）， channel 16 （r=-0.550， P=0.002） and the mean HbO2 concentration changes of all channels （r=-0.491， P=0.006）. ConclusionPatients with schizophrenia had lower activation in frontopolar and orbitofrontal region than patients with depression and anxiety disorder， and the initial slope of the right frontopolar， inferior frontal and orbitofrontal region in patients with depression is higher than patients with bipolar disorder. In addition， patients with bipolar disorder had less activation in the frontopolar and orbitofrontal lobe， the insular cover of Broca's area and the upper outer frontal cortex， and were more irritable and hostile. ［Funded by 1·3·5 Project for Disciplines of Excellence-Clinical Research Incubation Project， West China Hospital， Sichuan University （number， ZYJC21083）］

Research progress on the addictive characteristics of non-suicidal self-injury in adolescents / 中国神经精神疾病杂志

Non-suicidal self-injury(NSSI)is a behavior that occurs most often in adolescents.Previous studies showed that this behavior has the addictive related characteristics.Interestingly,the addictive nature of NSSI behavior can be assessed using Ottawa selfinjury inventory(OSI),the higher addiction score indicates the more serious NSSI behavior.From the psychological mechanism,different models show that the addictive feature of NSSI behavior may be related to the behavioral reinforcement mechanism and the interaction mechanism of emotion,cognition,and behavior of susceptible individuals.From the neurobiological mechanisms,opioid and dopamine may mediate the addiction characteristics of NSSI,and the brain reward circuit originated in the midbrain system may play a key role.From the perspective of treatment,current psychotherapy may have advantages in alleviating NSSI behavior,while therapeutic drugs and non-invasive neural regulation of substance use disorders may improve NSSI behavior via alleviating behavioral addiction.In conclusion,NSSI may be an addictive disorder,which needs further verification in the future studies.

Brain structural imaging study in schizophrenia patients with violent aggressive behaviors / 中华行为医学与脑科学杂志

Objective To review recent neuroimaging studies of aggressive/violent behaviors in schizophrenia and related the neural circuits of aggressive behaviors,tocusing on structure magnetic resonance imaging (MRI) method,published from 2000 to 2014.Methods A systematic literature search was conducted using articles from PsycINFO,Embase,Pubmed and Cnki pnblished between 2000 and 2014,we usedaggressive, violent, schizophrenia, structure M RI as the key words,to explore the relationship between schizophrenia of aggressive/violent behaviors and the related neural circuits.Results Of the 18 studies included in the analysis,mostly were case-control studies,two were written in Chinese.The neuroimaging literature on aggression in schizophrenia revealed the related grey matter volume of brain areas which contained the frontal lobe,temporal lobe,amygdala,hippocampus,cerebelum and caudate nucleus.Conclusion Findings from the current reviews suggest that the occurrence of violent/aggressive behaviors of schizophrenia were related with serval neural circuits as the frontal-temporal cognitive circuit,Papez circuit,cerebellum advaneed cognitive circuit and caudate nucleus-reward seeking cireuits.However,the precise violent/aggressive neural mechanism has vet to be studied further.

Analysis of Altered Baseline Brain Activity in Drug-Naive Adult Patients with Social Anxiety Disorder Using Resting-State Functional MRI

OBJECTIVE: We hypothesize that the amplitude of low-frequency fluctuations (ALFF) is involved in the altered regional baseline brain function in social anxiety disorder (SAD). The aim of the study was to analyze the altered baseline brain activity in drug-naive adult patients with SAD. METHODS: We investigated spontaneous and baseline brain activities by obtaining the resting-state functional magnetic resonance imaging data of 20 drug-naive adult SAD patients and 19 healthy controls. Voxels were used to analyze the ALFF values using one- and two-sample t-tests. A post-hoc correlation of clinical symptoms was also performed. RESULTS: Our findings show decreased ALFF in the bilateral insula, left medial superior frontal gyrus, left precuneus, left middle temporal gyrus, right middle temporal pole, and left fusiform gyrus of the SAD group. The SAD patients exhibited significantly increased ALFF in the right inferior temporal gyrus, right middle temporal gyrus, bilateral middle occipital gyrus, orbital superior frontal gyrus, right fusiform gyrus, right medial superior frontal gyrus, and left parahippocampal gyrus. Moreover, the Liebowitz Social Anxiety Scale results for the SAD patients were positively correlated with the mean Z values of the right middle occipital and right inferior occipital but showed a negative correlation with the mean Z values of the right superior temporal gyrus and right medial superior frontal gyrus. CONCLUSION: These results of the altered regional baseline brain function in SAD suggest that the regions with abnormal spontaneous activities are involved in the underlying pathophysiology of SAD patients.

Whole brain diffusion tensor imaging in diagnosing social anxiety disorder based on support vector machine / 中华放射学杂志

Objective To evaluate the clinical value of whole-brain diffusion tensor imaging(DTI) in diagnosing patients with social anxiety disorder(SAD) using an automated method based on support vector machine(SVM) classification.Methods Whole brain DTI data were collected from 19 patients with SAD and 19 age-,gender-and education-matched healthy control(HC) subjects.Fractional anisotropy(FA) of whole brain was obtained by input all tensor images into Diffusion Toolkit software.Based upon the characteristics of brain FA,the pattern recognition of brain image data(PROBID) toolbox on the grounds of SVM algorithm was employed to classify the subjects,evaluate the diagnostic value of whole-brain FA data based SVM in diagnosing SAD patients and verify the robustness of the diagnostic results using permutation test with the threshold at P≤0.001.The weight vector score of each voxel was calculated according to the ratio between this voxel and whole brain in FA differences of the two groups.The white matter regions identified by setting the threshold to the top 30％ of the weight vector scores with at least 10 contiguous voxels were demonstrated by MRIcro software.Results Diagnostic accuracy of whole-brain FA based SVM in diagnosing SAD was 92.11％ (35/38) in which the specificity was 94.44％ (17/18),the sensitivity was 90.00％(18/20),the positive likelihood ratio was 17.01,the negative likelihood ratio was 0.11 and the diagnostic index was 184.22％.Permutation test suggested that the diagnostic results were significantly reliable.White matter regions showing major contributions favoring SAD over HC were located in the genu and splenium of the corpus callosum,the left uncinate fasciculus,the left inferior longitudinal fasciculus,the left inferior fronto-occipital fasciculus,bilateral frontal gyri and the left occipital lobe.Whereas,white matter in bilateral anterior cingula,the left middle cerebellar peduncle and the left inferior parietal lobule showed more contributions to diagnose HC than to diagnose SAD.Conclusions As whole brain FA data based on SVM showing a high accuracy in diagnosing SAD,brain DTI characteristics have the potential to be the specific indicators in the diagnosis of SAD.SVM might be used as a tool to verify the reliability of white matter abnormalities and provide regions of interest in DTI study of neurological and psychiatric diseases.

Clinical analysis of stereotactic surgical treatment of treat-resistant obsessive compulsive disorder / 中国神经精神疾病杂志

Objective To investigate the therapeutic effect of stereotactic surgical treatment and postoperative cognitive functions in patients with treat-resistant obsessive compulsive disorder(TRO). Methods Twelve patients with TRO receiving MRI stereotactic bilateral anterior capsulotomy was retrospectively studied. The evaluation was conducted using the Yale-Brown obsessive compulsive rating scale (Y-BOCS),Wechsler Adult Intelligence Scale-Revised in China (WAIS-RC),Wechsler Memory Scale-Revised in China(WMS-R), Modified Version of Wisconsin Card Sorting Tests (M-WCST) before and 6 months after the operation. Results The scores of Y-BOCS was 5.00(1.00,12.25) and 25.00 (20.25,32.00) after and before surgery, respectively. The scores of Y-BOCS were significantly lower after surgery than before (P0.05).There were significant improvements in several cognitive tests after surgery including im-mediately logical memory 20.00(12.50,24.00),delayed logical memory16.50(11.50,21.75),immediately visual reproduc- tion 12.00(11.00,14.00),delayed visual reproduction11.00(8.50,14.00) and block design test scores 36.50(29.75,46.75), immediately logical memory14.00(13.00,18.75),delayed logical memory 14.50 (8.75,17.00),immediately visual reproduc-tion 11.00(6.50,11.75),delayed visual reproduction 8.50(6.25,10.00) and block design test scores 30.50(21.00,41.50) (P<0.05). Conclusions MRI-guided bilateral anterior internal capsulotomy is effective and safe treatment for patients with TRO and can improve their cognitive function.

Prevalence of mental disorders in the male juvenile detention centers of Hunan and Sichuan / 中南大学学报(医学版)

To investigate the prevalence of mental health problems in male violent offenders of Hunan and Sichuan Provinces; and to compare the types and severity of problems between the violent and nonviolent offenders.Methods:Ninety-one violent juvenile offenders and 64 nonviolent juvenile offenders in the juvenile detention centers of Hunan,and 81 violent juvenile offenders in the juvenile detention centers of Sichuan; 39 high school students from a middle school of Hunan Province and 49 from a middle school of Sichuan Province were investigated using the Investigation Screening Inventory for Child Mental Disorder and the Kiddy Schedule for Affective Diseases and Schizophrenia (K-SADS-PL),and classified according to the Diagnostic and Statistical Manual of Mental Disorders.Results:In the Hunan violent group,86.6％ met the criterion of conduct disorder (CD),17.6％ of substance abuse,9.9％ of substance dependence,while in the Hunan nonviolent group,75.0％ met the criterion of CD,and 11.7％ of substance abuse; these were all significantly higher than those of the control group (P＜0.05).In the Sichuan violent group,17.3％ met the criterion of attention deficit/hyperactivity disorder (ADHD),18.5％ of oppositional defiant disorder (ODD),69.1％of CD,and 22.2％ of substance abuse; these were all significantly higher than those of the Sichuan control group.Moreover,63.7％ of Hunan-violent,55.6％ of Sichuan-violent,and 45.0％ of Hunannonviolent offenders had a previous offence records.Conclusion:Mental and behavioral disorders among delinquent youth is becoming a serious problem,and there is an urgent need to develop and implement effective assessment and treatment approaches for juvenile offenders with the aim of reducing offence and recidivism in this population.

The analysis of social anxiety disorder prevalence rates and influencing factors of Chengdu primary school students / 中华行为医学与脑科学杂志

Objective To investigate the point prevalence rate of social anxiety disorder (SAD) in Chengdu primary school, and analyze the influencing factors. Methods Data came from a large representative sample of Chengdu 1441 primary school students, who were selected by stratified cluster sampling methods. They then finished self-compiled questionnaire, strengths and difficulties questionnaire, Eysenck Personality Inventory (EPI) (age 7 ～ 15 ), Egma Minnen ay Bardndosnauppforstran (EMBU) respectively. And then they had the face to face interviews with the trained psychiatrists, according to development and well - being assessment ( DAWBA,Chinese Version). Results Among 1441 Chengdu primary students, 37 of them were diagnosed SAD,with a point prevalence of 2.6% totally. The point prevalence was different in each grades, for 2.7% in grade 3,4. 1% in grade 4,4.1% in grade 5,3.5% in grade 6( z= -2.3, P=0. 023 ). Compared with the normal counterparts ,the SAD students had statistically significance different in pro-socialization ( z = -2. 1, P = 0.035 ), affection(z=- 5.2, P = 0. 001 ) , moral conduct ( z = - 2.8, P = 0. 004 ), peer( z = - 3.1, P = 0.002 ), excessive interference of maternal education ( z = - 3.1, P = 0.002 ), introversion-extroversion ( z = - 2. 0, P = 0. 046 ), neuroticism ( z =- 3.5, P= 0. 000), concealing tendency ( z= - 2.3, P= 0.018 ). Logistic regression analysis showed that: grade,family location, habitual lifestyle over the past years more emotional problem and excessive interference of maternal education were related with SAD occurrence. Conclusion The point prevalence rate of social anxiety disorder among Chengdu primary students is 2.6% ,and it was influenced by a number of factors .

Risk factors for infection in patients with permanent dual hemodialysis catheters / 中华全科医师杂志

Clinical data of 116 patients with implanted permanent dual catheters for hemodialysis,including 18 with infection and 98 non-infection, during January 2006 and July 2009 were retrospectively analyzed to study risk factors for catheter-related bacteremia (CRB). Duration of catheter implantation,primary disease, routine blood examinations and blood biochemical examination of the patients were analyzed between the two groups. COX proportional hazard regression analysis was performed for all predictor variables. Results showed that overall incidence of bacteremic episodes was 0. 314 per 1000 catheter-day.Compared to that in infection group, levels of hemoglobin, plasma albumin, peripheral lymphocyte count and ratio of CD4/CD8 in non-infection group were significantly higher ( all P ＜ 0. 05 ), and OR of CRB were 4. 011 (P =0. 0213) for diabetes mellitus and 7. 181 for hemoglobin level less than 80g/L (P = 0. 0020),respectively. It is suggested that improving nutrition status and correcting anemia for patients with hemodialysis are necessary to reduce CRB.

A Living Skill Training Scheme for the Patients Recovering from Schizophrenia / 中国康复理论与实践

@#The healing training was an important method to improve living ability and quality of life of patients with schizophrenia.This article introduced a living skill training scheme applied in out-patients whose course of disease shorter than 5 years.

Effect of dehydroascorbate on reactive oxygen species in mesangial cell induced by high glucose / 中华肾脏病杂志

Objective To investigate the effect of dehydroascorbate on reactive oxygen species (ROS) in mesangial cell induced by high glucose. Methods Mesangial cells were cultured in RPMI-1640 medium containing 10% newborn calf serum. Intracellular AA and DHA contents were measured with vitamin C assay system. The intracellular formation of ROS was detected with the fluorescent probe CM-H2DCFDA by using confocal microscopy. Activity of AP-1 was detected by EMSA. Results AA entry into cells was not significantly different from background noise. At a DHA concentration of 1 mmol/L, increasing concentrations of glucose competitively inhibited DHA entry into the cells such that the accumulation of DHA was smaller than half maximal at about 22 mmol/L glucose. Cytochalasin B,a kind of hexose transporter inhibitor,inhibited DHA entry into the cells. At a glucose concentration of 25 mmol/L, DHA inhibited intracellular ROS formation in a dose-dependent manner when DHA level was smaller than 4 mmol/L. In addition, the inhibitory effect of DHA on ROS generation was accompanied by lowering AP-1 activity in mesangial cell incubated by high glucose. Conclusions Mesangial cells are DHA dependent. VitC exclusion from mesangial cells through competition of glucose and DHA for common transport mechanism will deprive the cells of the central antioxidant and can lead to ROS accumulation. Proper doses of DHA will protect mesangial cell from injury of high glucose by inhibition on ROS formation and AP-1 activation.

The Protective Effect of Prostaglandin E_1 on Renal Tubules of Early Stage Hypertensive Renal Damage / 中国医师杂志

Objective To investigate the protective effect of prostaglandin E 1 on renal tubules of early stage hypertensive renal damage.Methods Forty-five patients were divided into two groups:Common treatment group who were treated with anti-hypertensive drugs,which were calcium channel blocking agents and angiotensin-converting enzyme inhibitors,and PGE 1 treatment group who were treated with both anti-hypertensive drugs and PGE 1.PGE 1 was given intravenously at dosage of 10?g per day. Two weeks after starting treatment,the urine alpha1 microglobulin(? 1-MG), N-acetyl-beta-glucosaminidase (NAG) and 24 hours total urinary proteins were examined in these two groups.Results After two week treatment, 24 hours total urinary proteins decreased in both groups, however, the urine ? 1-MG, NAG decreased only in PGE 1 treatment group (P

The Renoprotective Mechanism of Mobic in Experimental Type 2 Diabetic Rat / 中国医师杂志

Objective To observe the renal expression of cyclooxygenase-2 (COX-2) in rats with type 2 diabetes, and explore the effect of selective COX-2 inhibitor Mobic on the expression of renal COX-2, matrix metalloproteinase-9(MMP-9), tissue inhibitor of matrix metalloproteinase-1(TIMP-1), TXB 2 and 6-Ket-PGF1?, as well as renal structure and function. Methods All rats were divided into control group, diabetes mellitus group and treatment group. Type 2 diabetic rats were treated with Mobic and vehicle respectively. Immunohistochemistry was used to detect the expression of COX-2,MMP-9 and TIMP-1 in renal tissues. The urinary TXB 2 and 6-Ket-PGF1? concentration was determined by radioimmunoassay at 6th week. Results There were an increasing expression of COX-2, TIMP-1 and decreasing MMP-9 expression in the renal tissue of type 2 diabetic rats. Mobic could increase MMP-9 expression and depress TIMP-1 expression througth inhibiting the expression of COX-2 in the renal tissues of type 2 diabetic rats. Conclusion COX-2 was involved in the pathogenesis of type 2 diabetic nephropathy. Selective COX-2 inhibitor Mobic might exert its renoprotective effects through inhibiting COX-2 activity, decreasing prostagladins systhesis, and modulating MMP-9 and TIMP-1 expression.

The Expression and Significance of OPN and MCP-1 in Lipid -induced Renal Injury / 中国医师杂志

Objective To investigate the expression and significance of osteopontin (OPN) and monocyte chemoattractant protein-1 (MCP-1) in lipid -induced rat renal injury. Method Wistar rats were randomly divided into two groups: normal control rats (C group) and cholesterol fed rats (H group). Twelve weeks later, the 24h total urine protein amount, creatinine clearance rate and the levels of total serum cholesterol, LDL- cholesterol, HDL- cholesterol and triglycerides were measured. Kidney pathological changes were observed by HE and PAS statning. Immunohistochemitry were used to detect the expression of OPN, MCP-1 and ED1. Results Total serum cholesterol level, LDL-cholesterol level and 24h total urine protein amount in H group rats were higher than those in C group rats, and there were no significant difference between two groups in HDL-cholesterol and triglycerides level. Compared with C group rats, the expression of OPN and MCP-1 increased in cortical tubular epithelium of H group rats, and the number of ED1 + cells increased in tubulointerstitium as well. Either OPN or MCP-1 expression was positive correlation with the number of ED1 + cells. Conclusion The expression of OPN and MCP-1 in tubular epithelium increased in hypercholesterolemia rats, which might mediate M? infiltration into tubulointerstitium and lead to interstitial fibrosis.

The effect of irbersartan on the osteopontin and MCP-1 expression in lipid-induced renal injury / 中华老年医学杂志

Objective To investigate the expression of osteopontin(OPN) and monocyte chemoattractant protein-1(MCP-1) and the effect of Irbersartan on them in diet-hypercholesterolemia rats. Methods Wistar rats were divided into three groups: normal control rats(C), cholesterol fed rats(H) and cholesterol fed rats treated with Irbesartan(50 mg ? kg -1 ? d -1 ). Twelve weeks later, we measured the 24 hours total urine protein, creatinine clearance and total serum cholesterol, LDL- cholesterol, HDL- cholesterol and triglycerides. Kidney pathology was observed. Immunohistochemistry was used to analyse the expression of OPN, MCP-1, ED1 +and their relationship. Results (1) Total serum cholesterol, LDL-cholesterol level and 24 h total urine protein in H group rats were higher than that in C group rats, there was no significant difference between two groups in HDL-cholesterol and triglycerides.(2) Compared with C group rats , the expression of OPN and MCP-1 increased in cortical tubular epithelium (2.34?0.25 vs 0.49?0.11; 1.93?0.21 vs 0.49?0.11, P