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Objective To investigate the effects of duration of untreated psychiatry (DUP) on the white matter integrity in first-episode medication-free patients with schizophrenia. Methods The Chinese version of Nottingham Onset Schedule was used to assess the DUP of 39 first-episode medication-free patients with schizophrenia. According to the median of DUP, the 39 patients were grouped into long-DUP group and short-DUP group. Diffusion weighted images of the 39 patients' whole brains were acquired with a Half-Fourier Acquired Single-Shot Turbo Spin Echo (HASTE) sequence.After being preprocessed with DTI-studio and statistical parametric mapping software (SPM5), the fractional anisotropy (FA) images of the 2 groups were compared by two-sample t-test with SPM5 software. The differences of gender, age, education level and total scores of Positive and Negative Syndrome Scale (PANSS) scores between the 2 groups were also detected. Results No significant difference was noted on gender, age, education level, PANSS scores between the 2 groups (P＞0.05).Subjects of long-DUP group showed significantly reduced FA value in the right anterior cingulate fasciculus (x=8, y=40, z=24) and left prefrontal white matter thresholded (x=32, y=34, z=4) as compared with that of short-DUP group at a level of P＜0.001 (uncorrected). Conclusion Extension of the duration of DUP will reduce the white matter integrity in first-episode medication-free patients with schizophrenia.
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<p><b>BACKGROUND</b>Fungal keratitis is a rare but serious corneal disease that may result in loss of vision. The poor prognosis might be due to limited treatment option. This study aimed to evaluate the clinical efficacy of 0.25% terbinafine eye drops comparing with 5% natamycin suspension on fungal keratitis.</p><p><b>METHODS</b>A retrospective clinical trial was performed on 90 patients presenting with direct smear and/or culture positive fungal keratitis at Beijing Tongren Hospital, Beijing, China from January 2006 to May 2008. Corneal ulcers were categorized as mild or severe. Forty-five patients were treated with topical terbinafine and the next 45 cases received topical natamycin hourly.</p><p><b>RESULTS</b>Filamentous fungi were found in corneal scrapings among all 90 cases. Fungal cultures were positive in 64 patients (71%). Species of Fusarium and Aspergillus were the principal isolates. Forty (89%) patients showed favorable response to terbinafine, while forty-two (93%) patients exhibited favorable response to natamycin (P > 0.05). The mean course of treatment was significantly showed in the terbinafine treatment group than natamycin group ((26.5 +/- 11.2) days versus (19.3 +/- 6.4) days; P < 0.05). In terbinafine group, twenty patients with ulcers smaller than 4 mm had favorable outcome, while 20 of 25 patients with ulcers more than 4 mm in diameter had favorable response (P < 0.05). Twenty-seven patients with depth of infiltration less than half of stroma thickness had favorable response to terbinafine, while 13 of 18 patients with depth of infiltration more than half of stroma responded to terbinafine. This difference was statistically significant (P < 0.05).</p><p><b>CONCLUSIONS</b>Our findings suggest that topical terbinafine is an effective antifungal drug for the management of filamentous mycotic keratitis, particularly in cases with smaller and shallower ulcers. Its mean duration of treatment was longer than natamycin.</p>