Design of small molecules targeting molecular chaperone system: review and perspective / 药学学报

Molecular chaperone system, which mainly consist of heat shock proteins family and their cochaperones, is crucial for maintaining proteostasis in life. It assists in folding, maturation and ubiquitin-proteasome-mediated degradation of proteins, thus to play a key role in cell proliferation and apoptosis. Functional disorder of molecular chaperone system is highly relevant to occurrence and development of multiple diseases including cancers, autoimmune disease/inflammatory, infective diseases, neurodegenerative disease, etc. Therefore, molecular chaperone system has long been regarded as potential drug targets. In this review, we outline the progress in the design of small molecules targeting molecular chaperone system and analyze the features of small molecules with different mechanisms. Finally, we put forward expects about potential development directions for future drug design in this field.

Differential Analysis of Macular Structure and Microcirculation in Both Eyes of Patients With Myopic Anisometropia / 中国医学科学院学报

Objective To compare the macular structure and microcirculation in both eyes of the patients with myopic anisometropia.Methods Optical coherence tomography angiography(OCTA)was employed to scan the macular areas in both eyes of 44 patients with myopic anisometropia.The patients were assigned into high and low groups based on the refractive diopter,and the parameters such as retinal thickness,choroidal thickness,vascular density,and perfusion density in the macular areas of both eyes were compared between the two groups.Results Other macular areas except the central and external nasal areas and the choroid of the fovea in the high group were thinner than those in the low group(all P<0.05).There was no statistically significant difference in retinal vascular density or perfusion density in different areas between the two groups(all P>0.05).Conclusion In the patients with myopic anisometropia,most areas of the retina in the case of high myopia is thinner than that in the case of low myopia,while there is no difference in retinal vascular density or perfusion density in both eyes.

Manual Thrombus Density Measurement Depends on the Method of Thrombus Delineation / 대한뇌졸중학회지

No abstract available.

Effect of blocking RAGE on macrophage infiltration of diabetic wound healing / 上海交通大学学报（医学版）

Objective·To investigate the influence of blocking receptor for advanced glycation end products (RAGE) on macrophages infiltration in diabetic wound healing. Methods·Ninety-six male C57BL/6J mice (8-week-old) were divided into diabetic group (n=72) and normal group (n=24) randomly. Diabetic mice were induced by streptozocin multiple intraperitoneal injection. One full-thickness excisional wound (diameter of 9 mm) was created by a sterilized punch. Diabetic mice were divided into 3 groups in which different topical treatments were applied to the wounds. Anti-RAGE antibody were applied in group R, rabbit IgG applied in group I, normal saline applied in group C. Normal mice were applied with saline topically (group N). All treatments were repeated on day 3 and day 7 after wounded. The wound healing conditions were observed. The wound and surrounding tissues from animals in each group were excised on day 1, 3, and 7 after wounded. Immunohistochemistry was utilized to investigate the changes of macrophages infiltration in quantity. Macrophages were also analyzed with respect to morphology by transmission electron microscopy (TEM). Results·① The wound closure ratio of group R was higher than those of group C and group I on day 14 after being wounded (P=0.000). ② On day 1, the numbers of macrophages in group R and group N were both bigger than those of group C and group I, but smaller on day 14 (P=0.000). ③ The morphological characters of macrophages also existed great differences under TEM. Conclusion·Number and morphology of macrophages are both abnormal in diabetic wound in a RAGE pathway depending manner. Based on macrophages, it suggests that impaired healing of diabetic wound is closely related to RAGE pathway.

Comparison of the early effects of bone cement versus cementless prostheses in very elderly patients undergoing total hip arthroplasty / 中华老年医学杂志

Objective To evaluate the early effects of bone cement prostheses versus cementless prostheses in very elderly patients undergoing total hip arthroplasty.Methods A total of 110 patients aged 70 years and over who had undergone hip replacement because of hip disease from March 2011 to March 2013 were selected.104 cases were followed up for 3 years,with 46 cases treated with the bone cement prostheses(Group A) and 58 cases with cementless prostheses(Group B).The conditions before and after surgery were recorded.Postoperative Harris scores were collected to evaluate the function of the hip joint,and the loosening of hip prostheses was detected by x-ray.Results Intraoperative blood loss and postoperative drainage volume were lower in Group A than in Group B [(236.0±26.3) ml vs.(296.0±34.5) m1,(123.0±20.3) ml vs.(156.0±26.4) ml,both P ＜0.05].Harris scores before,6 months,1,2 and 3 years after surgery were(40.2±7.2),(80.3±5.2),(90.2±4.5),(90.6±4.2),and(90.8±3.5) in Group A,and(39.8±6.3),(76.5±8.7),(86.5±5.1),(89.3± 4.8),and(91.0± 4.1) in Group B,respectively.Harris scores 6 months and 1 year after surgery were higher in Group A than in Group B,and there was no significant difference in Harris scores between the two groups 2 and 3 years after surgery(P＞0.05).Pain scores before,6 months,1,2 and 3 years after surgery were(13.5± 5.3),(37.5± 6.2),(38.4±5.3),(39.1 ±2.5) and(39.0±2.1) in Group A and(12.9±6.2),(30.2±8.7),(35.9±6.5),(38.6±4.8) and(39.2±2.6) in Group B,respectively.Pain scores 1 year after surgery was better in Group A than in Group B,and there was no significant difference in pain scores between the two groups 2 and 3 years after surgery(P＞0.05).Bone cement implantation syndrome occurred in 6 cases in Group A,of which 1 case had respiratory and cardiac arrest and was successfully rescued after cardiopulmonary resuscitation.In addition,in Group A,1 case had osteolytic disease 2 years after surgery,and,in Group B,4 cases had proximal femoral fractures and 1 case had osteolytic disease 3 years after surgery.Conclusions For very elderly patients undergoing total hip replacement,satisfactory early therapeutic effects can be achieved by using bone cement or cementless prostheses.Intraoperative blood loss,postoperative drainage volume and Harris scores 1 year after surgery are better with bone cement prostheses than with cementless prostheses.Close attention should be paid to possible development of bone cement implantation syndrome during operation.

Antipsychotic Medications in Major Depression and the Association with Treatment Satisfaction and Quality of Life: Findings of Three National Surveys on Use of Psychotropics in China Between 2002 and 2012 / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Optimizing treatment outcomes for depression requires understanding of how evidence-based treatments are utilized in clinical practice. Antipsychotic medications concurrent with antidepressant treatment are frequently used in major depression, but few studies have investigated trends and patterns of their use over time. This study aimed to examine the prescription patterns of antipsychotic medications for major depression in China from 2002 to 2012 and their association with treatment satisfaction and quality of life (QOL).</p><p><b>METHODS</b>A total of 3655 subjects with major depression treated in 45 Chinese psychiatric hospitals/centers nationwide were interviewed between 2002 and 2012. Patients' socio-demographic and clinical characteristics including psychopathology, medication side effects, satisfaction with treatment and QOL were recorded using a standardized protocol and data collection.</p><p><b>RESULTS</b>The frequency of antipsychotic use was 24.9% in the whole sample; the corresponding figures were 17.1%, 20.3%, and 32.8% in 2002, 2006, and 2012, respectively (χ2 = 90.3, df = 2, P < 0.001). Multiple logistic regression analyses revealed that patients on concurrent antipsychotics had significantly more delusions or hallucinations, longer illness duration, greater side effects, and more likely to be treated as inpatients and in major hospitals (i.e., Level-III hospital). Antipsychotic use was associated with lower treatment satisfaction while there was no significant difference with respect to physical and mental QOL between the antipsychotic and nonantipsychotic groups.</p><p><b>CONCLUSIONS</b>Concurrent antipsychotic use was found in about one in four treated depressed patients in China, which has increased over a 10-year period. Considering the association of drug-induced side effects and the lack of patients' and relatives' satisfaction with antipsychotic treatment, further examination of the rationale and appropriateness of the use of antipsychotics in depression is needed.</p>

Effect of glutamine enriched nutrition support on surgical patients with gastrointestinal tumor: a meta-analysis of randomized controlled trials / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Associations between glutamine (Gln) enriched nutrition support and surgical patients with gastrointestinal (GI) tumor remain controversy. The purpose of this meta-analysis was to assess the effect of Gln enriched nutrition support on surgical patients with GI tumor in term of relevant biochemical indices, immune indices, and clinical outcomes.</p><p><b>METHODS</b>Six databases were systematically searched to find eligible randomized controlled trials (RCTs) from 1966 to May 2014. When estimated the analysis indexes, the relative risk (RR) was used as the effect size of the categorical variable, while the weighted mean difference (MD) was used as the effect size of a continuous variable. Meta-analysis was conducted with Rev Man 5.2.</p><p><b>RESULTS</b>Thirteen RCTs, involving 1034 patients, were included in the meta-analysis. The analysis showed that Gln enriched nutrition support was more effective in increasing serum albumin (MD: 0.10; 95% confidence interval [CI]: 0.02-0.18; P < 0.05), serum prealbumin (MD: 1.98; 95% CI: 1.40-2.55; P < 0.05) and serum transferring (MD: 0.35; 95% CI: 0.12-0.57; P < 0.05), concentration of IgG (MD: 1.26; 95% CI: 0.90-1.63; P < 0.05), IgM (MD: 0.18; 95% CI: 0.11-0.25; P < 0.05), IgA (MD: 0.22; 95% CI: 0.10-0.33; P < 0.05), CD3 + (MD: 3.71; 95% CI: 2.57-4.85; P < 0.05) and CD4/CD8 ratio (MD: 0.27; 95% CI: 0.12-0.42; P < 0.05). Meanwhile, it was more significant in decreasing the incidence of infectious complications (RR: 0.67; 95% CI: 0.50-0.90; P < 0.05) and shortening the length of hospital stay (MD: -1.72; 95% CI: -3.31--0.13; P < 0.05).</p><p><b>CONCLUSIONS</b>Glutamine enriched nutrition support was superior in improving immune function, reducing the incidence of infectious complications and shortening the length of hospital stay, playing an important role in the rehabilitation of surgical GI cancer patients.</p>

In vitro effect of total flavones of Fructus Chorspondiatis on expression of collagen type I and type III mRNA and protein of cultured rat cardiac fibroblasts / 药学学报

This study aims to investigate the effect of total flavones of Fructus Chorspondiatis (TFFC) on the mRNA and protein expression of collagen type I and III of rat cardiac fibroblasts (CFs) induced by angiotensin II (Ang II), and explore its anti-myocardial fibrosis molecular mechanism. Neonatal rat CFs were prepared from Sprague-Dawley rats (1-3 d after birth). The expression of collagen type I and III mRNA and protein were measured by RT-PCR and Western blotting, respectively. The study showed that stimulation of neonatal rat CFs with 100 nmol.L-1 of Ang II for 72 h resulted in a significant increase of the expression of collagen type I and III mRNA and protein. The changes on the expression level were blocked by TFFC. The results demonstrated that TFFC can inhibit myocardial fibrosis induced by Ang II in rats, which is probably associated with the collagen type I and III mRNA and protein levels up-regulated by Ang II, and TFFC was shown to decrease the expression levels of collagen type I and III mRNA and protein.

In vitro effect of total flavones of Fructus Chorspondiatis on expression of collagen type I and type III mRNA and protein of cultured rat cardiac fibroblasts / 药学学报

This study aims to investigate the effect of total flavones of Fructus Chorspondiatis (TFFC) on the mRNA and protein expression of collagen type I and III of rat cardiac fibroblasts (CFs) induced by angiotensin II (Ang II), and explore its anti-myocardial fibrosis molecular mechanism. Neonatal rat CFs were prepared from Sprague-Dawley rats (1-3 d after birth). The expression of collagen type I and III mRNA and protein were measured by RT-PCR and Western blotting, respectively. The study showed that stimulation of neonatal rat CFs with 100 nmol.L-1 of Ang II for 72 h resulted in a significant increase of the expression of collagen type I and III mRNA and protein. The changes on the expression level were blocked by TFFC. The results demonstrated that TFFC can inhibit myocardial fibrosis induced by Ang II in rats, which is probably associated with the collagen type I and III mRNA and protein levels up-regulated by Ang II, and TFFC was shown to decrease the expression levels of collagen type I and III mRNA and protein.

Outcome assessment of health education on drinking-water-borne endemic arsenic poisoning in Jiangsu province in 2010 / 中国地方病学杂志

Objective To evaluate the effect of health education on drinking-water-borne endemic arsenic poisoning in Jiangsu province in 2010.Methods Nine villages(townships) were selected from high-arsenic regions of Jiangsu province,and one primary school in each village(township) and one village from the 9 villages(townships)were selected as investigation points.Thirty pupils in the same class of grade 5 in each school,and 15 housewives in each village were chosen as research subjects.Referring to the health education questionnaire in Technique Scheme of Endemic Disease Prevention Granted by the Central Government in 2010,5 questions were selected.The reason,harm and prevention measures were reflected by the first,second and third questions.The way of knowledge acquisition and the situation of family drinking water were reflected by the forth and fifth questions.The awareness of prevention knowledge of drinking-water-borne endemic arsenic poisoning in pupils and housewives were investigated by calculating the awareness rate.Results Three hundred and nine pupils in the fifth grade and 144housewives were investigated in the baseline survey.Thenumber of response was 927 and 432,respectively; the number of correct answer was 537 and 234,respectively; the awareness rate was 57.93％(537/927) and 54.17％(234/432),respectively.Two hundred and seven pupils in the fifth grade and 135 housewives were investigated in the evaluation survey.The number of response was 810 and 405,respectively; the number of correct answer was 778 and 386,respectively; the awareness rate was 96.05％ (778/810) and 95.31％ (386/405),respectively.Conclusions Health knowledge of drinking-water-borne endemic arsenic poisoning has been improved among pupils and housewives in these areas.

Analysis of surveillance results of drinking-water-borne endemic fluorosis in Jiangsu Province in 2009 / 中国地方病学杂志

Objective To investigate the development trend of drinking-water-borne endemic fluorosis in Jiangsu Province,and to provide the basis for further prevention and treatment of the disease.Methods In 2009,eight major counties were chosen,and in each county all diseased villages were classified into light,moderate and severe disease types according to water fluorine content based on historical data,and one village was chosen from each type.In monitoring villages with improved water,one source water and three tap water samples were collected,respectively.Five water samples were collected in water unimproved monitoring villages according to water well locations of the east,the west,the south,the north and the center.The fluorine content in water was determined according to the Standard Testing Methods for Drinking Water (GB/T 5750-2006).Children aged 8 to 12 were examined for dental fluorosis by Dean method.Residents over the age of 16 were examined for clinical osteofluorosis,and two monitoring counties were chosen,then one village was respectively chosen in each county,and clinically diagnosed patients with skeletal fluorosis were examined again by X-ray.Both clinical and X-ray diagnosis were on the basis of Diagnostic Criteria of Endemic Skeletal Fluorosis (WS 192-2008).Urine samples of 30 children aged 8 to 12 and of 20 adults over the age of 16 were randomly collected and urinary fluoride was determined by F-ion selective electrode method(WS/T 89-1996).Results Of all the 24 villages of 8 counties,20 villages were water improved,and water-improvedprojects ran normally in 18 villages,while scrapped in the rest 2 villages.One hundred and two samples were tested,and the mean of water fluoride in water-improved villages was 1.10 mg/L,while in water unimproved villages and villages with water improved projects scrapped was 1.90 mg/L.The prevalence of dental fluorosis was 42.51％(854/2009).The prevalence of clinical skeletal fluorosis was 23.23％ (2024/8713) and the X-ray detection rate was 32.00％ (24/75).Six hundred and sixty-four urine samples of children were determined,and geometric mean of urinary fluorine was 1.59 mg/L,while 370 adult urine samples were determined,and geometric mean of urinary fluorine was 2.20 mg/L.Conclusions Endemic fluorosis in Jiangsu Province has not been fully controlled and there are signs of recovery.We must pay attention to water improvement measures to reduce fluoride and the management and maintenance of water improvement projects,and further strengthen the prevention and control of endemic fluorosis.

Prognosis of patients with early enteral nutrition after gastrointestinal operation: a meta-analysis / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To systematically assess the effect of early enteral nutrition support after gastrointestinal operation on prognosis.</p><p><b>METHODS</b>The Cochrane Library, PubMed, CBM, CNKI, Wanfang, and VIP databases were retrieved via computer system for randomized controlled trails(RCTs) with early enteral nutrition support to patients undergoing gastrointestinal operation. Quality of studies was evaluated by the Cochrane Jadad rating scale. Nutrition indexes, bowel function indices, postoperative complications, health-economics indices were collected. Meta-analysis was conducted with RevMan 5.2.</p><p><b>RESULTS</b>Eleven relevant RCTs studies with 1087 cases were enrolled, including 541 patients in the study group(early enteral nutrition) and 546 in the control group. Meta-analysis showed that patients in the study group had significantly higher levels of plasma albumin and prealbumin than those in the control group(WMD=2.87, 95%CI:1.03-4.71; WMD=0.04, 95%CI:0.02-0.05). The time of postoperative bowel ventilation in the study group was significantly shorter than that in the control group(WMD=4.10, 95%CI:-5.38--2.82). The postoperative complication rate in the study group was significantly lower as compared to the control group(RR=0.64, 95%CI:0.44-0.93).</p><p><b>CONCLUSION</b>Early enteral nutrition support after gastrointestinal operation is safe and effective, which can improve the nutritional status, promote bowel function return, and reduce postoperative complication rate.</p>

Evaluation of the effects of health education on endemic fluorosis in Jiangsu province in 2011 / 中国地方病学杂志

Objective To evaluate the effect of health education on endemic fluorosis in Jiangsu province,and to provide reference data for further prevention and control of the disease.Methods In 2011,according to history prevalence of endemic fluorosis in Jiangsu province,a total of 10 countries were selected,and 3 townships were chosen in each county.Health educational activities were carried out in the classes of grade 4 - 6 in thecentral primary school.In the meantime,3 villages were chosen in each selected township where the health educational activities in the community were carried out.Before and after the health education activities,questionnaire surveys on knowledge of endemic fluorosis were conducted in each county.Thirty students in one classof the fifth grade in the central primary school were randomly selected,and 15 housewives near the central primaryschool were also randomly selected.Results After the health educational activities,the rates of knowledgeawareness in the students and the housewives were 95.90％ (2946/3072) and 92.85％ ( 1752/1887 ),respectively,and increased significantly compared with those before the intervention[71.53％(2015/2817),77.40％( 1384/1788 ) ],and the difference was statistically significant(x2 =657.337,174.894,all P ＜ 0.01 ).Before the health educational activities,the rates of knowledge awareness in the students were lower than those in the housewives,and the difference was statistically significant (x2 =6.120,P ＜ 0.05 ).After the health educational activities,the rates of knowledge awareness in the students were higher than those in the housewives,and the difference was statistically significant(x2 =21.847,P ＜ 0.01 ).ConclusionsThe rates of knowledge awareness in the students and the housewives are increased significantly after the health educational activities.The consciousness and activity of the target people to take part in preventing and controlling of the endemic fluorosis have been enhanced greatly.The good behaviors in the target people are gradually formed,the desired effect is achieved.

Use of Clozapine for the Treatment of Schizophrenia: Findings of the 2006 Research on the China Psychotropic Prescription Studies

OBJECTIVE: Clozapine is one of the most commonly used antipsychotic drugs in China. To date, few studies have investigated the patterns the prescription of clozapine nationwide. The present study examined these patterns in China in 2006 and identified the demographic and clinical characteristics associated with the use of clozapine. METHODS: Using a standardized protocol and data collection procedure, we surveyed 5,898 patients with schizophrenia in 10 provinces with differing levels of economic development. RESULTS: Overall, clozapine had been prescribed for 31.9% (n=1,883) of the patients; however we found considerable variation among the 10 provinces. The frequency of clozapine use was highest in Sichuan (39.3%) and lowest in Beijing (17.3%). The mean daily dose of clozapine was 210.36+/-128.72 mg/day, and 25.1% of the patients were treated with clozapine in combination with other antipsychotics. Compared with the group not receiving clozapine, clozapine-user had been treated for longer durations and had experienced a greater number of relapses and hospitalizations. Furthermore, those in the clozapine-user had lower family incomes, were less able to seek psychiatric services, and more likely to be male and have a positive family history of schizophrenia. A multiple logistic regression analysis revealed that age, sex, professional help-seeking behaviors, duration of illness, economic status, educational level, and clinical manifestations were associated with the use of clozapine. CONCLUSION: Clozapine use is common in China. However, use of the antipsychotic varies among provinces, and demographic and clinical factors play important roles in the prescription of clozapine.

Drinking-water type endemic fluorosis in Northern Jiangsu province in 2008 : an analysis of survey results / 中国地方病学杂志

Objective To investigate the state of endemic fluorosis, running status of water improvement project to reduce fluoride in Jiangsu province, and to provide a scientific basis for prevention and control of endemic fluorosis. Methods In 2008, in the ten key counties of endemic fluorosis (zone), in Xuzhou,Lianyungang and Suqian, a stratified sampling method was employed to select 40 diseased villages according to their past water fluoride survey data. All children aged 8 to 12 were examined dental fluorosis, and all adults over 16 years were examined clinical skeletal fluorosis. Thirty per cent of the 40 diseased villages were selected, and 20 adults over the age of 16 in each selected village were examined by X-ray, respectively;50% of the 40 diseased villages were selected, and 30 any time urine samples of children aged 8 to 12 in each diseased village were tested urine fluoride. In each city, select a county, the status of water improvement project to reduce fluoride, water supply capacity and coverage in the county were investigated. Results A total of 3560 children aged 8 to 12 were examined, the detection rate of dental fluorosis was 38.51% (1371/3560), tooth defect rate was 5.34% (190/3560), and dental fluorosis index was 0.8. Seven hundred and eight urine samples were tested, the median urinary fluoride was 1.47 mg/L and the range was 0.08 ~ 10.08 mg/L. Clinical detection of skeletal fluorosis was 21.3% among adults over the age of 16, and X-ray detection rate of skeletal fluorosis was 39.2% (123/314).Investigated a total of 248 facilities of centralized water improvement projects, no funds to run or damaged 49, the water fluoride > 1.0 mg/L was 18. Conclusions Endemic fluorosis in Northern Jiangsu province has not been controlled completely, but has a rising trend, we should further strengthen the supervision of water fluoride reduction.

Long term depression of the recurrent inhibition of monosynaptic spinal reflexes after sciatic nerve crush in adult rats / 生理学报

Sciatic nerve injury is a common disease of peripheral nerve in clinic. After nerve injury, there are many dysfunctions in motoneurons and muscles following regeneration. Previous studies mostly investigated the aspects related to the injured nerve, and the effect on the recurrent inhibition (RI) pathway of spine following regeneration was not fully understood. Following reinnervation after temporary sciatic nerve crush, the functional alteration of RI was studied. In adult rats, RI between lateral gastrocnemius-soleus (LG-S) and medial gastrocnemius (MG) motor pools was assessed by conditioning monosynaptic reflexes (MSRs) elicited from the cut dorsal roots and recorded from either the LG-S or MG nerves by antidromic stimulation of the synergist muscle nerve. The following results were obtained. (1) The RI of MSRs in rats was almost lost (<5 weeks) after sciatic nerve crush. Although the RI partially recovered following reinnervation (6 weeks), it remained permanently depressed (up to 14 weeks). (2) Sciatic nerve crush on one side did not affect the contralateral RI. (3) Sciatic nerve crush did not induce any motoneuron loss revealed by immunohistochemistry. Peripheral nerve temporary disconnection causes long term alterations in RI pathway which make up motoneuron's function enhance for the alteration of muscle power and suggests that peripheral nerve injury induces long term plastic changes in the spinal motoneuron circuitry.

Development and interpretation of China medical nutrition therapy guideline for diabetes (2010) / 中国医学科学院学报

Nutritional therapy is the basis for all types of diabetes treatment, but has not been properly applied due to the lack of scientific criteria. In 2010, the China Medical Nutrition Therapy Guideline for Diabetes was successfully developed based on the up-to-dated scientific research evidences (especially those from China) using Oxford Centre for Evidence-Based Medicine grading system. These guidelines cover the nutrition-based prevention and treatment of diabetes and its complication as well as the parenteral and enteral nutritional supports, with an attempt to improve the quality of life and lower the burdens of diabetes and its complications.

Factors That Influence the Prescription of Antipsychotics for Patients with Schizophrenia in China

OBJECTIVE: To investigate the patterns of antipsychotic use in China and to analyze the factors that influence antipsychotic prescriptions. METHODS: A standardized survey was conducted from May 20 to 24 2002 in five different regions of China with varying economic levels. The patterns of antipsychotic medication use were analyzed in a sample of 4,779 patients with schizophrenia. The survey gathered information on demographic characteristics, clinical profiles, and antipsychotic medications prescribed. Multiple logistic regression was used to analyze factors related to patterns of antipsychotic medication use. RESULTS: A plurality of patients with schizophrenia was treated with clozapine (39%); this was followed by risperidone, sulpride, chlorpromazine, perphenazine, and haloperidol. More than 56.3% of patients were treated with only one atypical antipsychotic. The mean daily dose of chlorpromazine was 365+/-253 mg (mean+/-standard deviation), and 6.5% of patients were treated with depot injections of typical antipsychotic medications. A total of 73.7% (n=3,523) of patients with schizophrenia received monotherapy, 24.8% (n=1,183) received two antipsychotics, 1.1% (n=52) received three antipsychotics, and one received four different antipsychotics. Patients often simultaneously received other classes of medications including anticholinergic agents, benzodiazepines, beta-blockers, antidepressants, and mood stabilizers. Economic status and clinical symptoms were the main factors that contributed to the patterns of antipsychotic prescription. CONCLUSION: The present study suggests that atypical antipsychotic medications, especially clozapine, are the primary psychiatric treatments of choice in the management of schizophrenia in China. Moreover, the economic status and clinical profile of the patient are the major factors affecting the prescription of antipsychotic medication.

Evaluation of Reliability and Validity of the Chinese Version of Personal and Social Performance Scale in Patients with Schizophrenia / 中国心理卫生杂志

Objective:To evaluate the reliability and validity of the Chinese version of the Personal and Social Performance scale (PSP-CHN) in patients with schizophrenia.Methods:Totally 165 out-patients and in-patients meeting the DSM-IV-TR criteria for schizophrenia were entered in the study.Ten of subjects was included the intra-rater reliability training.The Global Assessment of Functioning Scale (GAF) was regarded as the' gold standard' to investigate the validity of PSP-CHN,and the Positive and Negative Rating Scale was used to assess the severity of disease to explore the correlative validity,in the other 155 subjects.Five to seven days after the first PSP-CHN interview,the second PSP-CHN was evaluated by another investigator to assess the test-retest reliability among 66 subjects.Twenty-seven subjects with the score of Positive and Negative Syndrome Scale (PANSS) more than 60 were followed up for 8 weeks of standardized pharmacotherapy.By the end of 8 week of treatment,the PANSS and PSP-CHN were assessed again to explore the sensitivity of PSP-CHN.Results:The internal consistency (Cronbach α=0.84) and the inter-rater reliability (κ value=0.56,ICC=0.94 for PSP-CHN total score) were good.The test-retest reliability was high [intraclass correlation coefficient (ICC) of 0.95].The scale showed good construct validity with statistically significant correlations with the Global Assessment of Functioning Scale (GAF) (ICC of 0.95).The PSP-CHN score had a good negative correlation with the PANSS total score(r=-0.79,-0.57,-0.63 and -0.71,respectively,P<0.01).After 8 week treatment,PSP-CHN total score was increased with the improvement of PANSS,and the responder showed higher increasing of PSP-CHN total score (21.2) than those partial responder(10.2),significantly.Conclusion:The Chinese version of the PSP-CHN is a convenient and valid instrument to assess the personal and social functions of stabilized and acute patients with schizophrenia.

The Roles of Cognitive Indicators and Quantitative MRI Measurement in Early Diagnosis of Alzheimer Disease / 中国心理卫生杂志

Objective: To determine the cognitive function and MRI-based measurement of MTL structures in patients with Alzheimer disease (AD) and to find a sensitive cognitive marker or specific MRI-based measurements for early diagnosis of AD. Method:Fifty-two AD patients, 27 VD (vascular dementia) patients and 35 aged matched normal control were recruited. The cognitive functions were evaluated with Alzheimer disease assessment scale-Cognitive portion (ADAS-Cog), Wechsler memory scale-revised and Mini-Mental Status Examination (MMSE). MTL structures, including hippocampal formation, amygdala and parahippocampal gyrus, were measured by MRI volumetric measurements. Result: Compared with VD patients and healthy controls, there was more pronounced reduction of performance on the main cognitive domains in AD patients, which indicated the diffused deficits of AD, including learning and memory, comprehension, language, orientation and concentration. The atrophy of MTL structures was more prominent in AD patients. A moderate diagnostic accuracy of 83.3% was achieved by Fisher's linear discriminant model, which comprised the scores of word recall, recall of test instructions, commands, constructional praxis and orientation in ADAS-Cog, and the performance on picture recall, visual recognition visual reproduction, logic memory and touch test in Wechsler memory test and part of memory in MMSE. In diagnose of AD, MRI based volumetry of left temporal horn of lateral ventricle and amygdalohippocampal complex had the sensitivity of 78.4% and accuracy of 77.1%. When cognitive indicators were combined with MRI based measurement, the diagnostic accuracy increased to 90.5%. Conclusion: AD produces more diffused cognitive deficit and severer atrophy of MTL structure. Combination of cognitive indicator with MRI based measurement can improve accuracy in diagnosis of AD.