Long-term effects of antipsychotics on mortality in patients with schizophrenia: a systematic review and meta-analysis

Objective: To gather current evidence on the impact of antipsychotics on long-term mortality in patients with schizophrenia. Methods: We systematically searched for articles in Embase, PubMed, and PsycINFO reporting the long-term mortality (follow-up > 1 year) of patients with schizophrenia who were using any antipsychotics. We then conducted multiple meta-analyses to determine differences in long-term mortality between different types of antipsychotics. Results: We identified 45 articles that provided unadjusted long-term mortality rates, including 46,171 deaths during 2,394,911 person-years. The pooled mortality rate was 9.9 (95%CI = 7.4-12.7) per 1,000 person-years. The unadjusted crude mortality rate of antipsychotic drug users was lower than that of non-users (risk ratio [RR] = 0.546, 95%CI = 0.480-0.621), first-generation antipsychotics caused higher all-cause mortality than second-generation antipsychotics (RR = 1.485, 95%CI = 1.361-1.620), and polypharmacy had better effects than monotherapy on long-term mortality (RR = 0.796, 95%CI = 0.689-0.921). As for the causes of death, heart disease and cardiovascular disease ranked highest among cause-specific mortality (5.6 per 1,000 person-years). Conclusion: Since antipsychotics had a beneficial effect on long-term mortality in schizophrenia, greater precaution should be taken with patients who do not take them. However, since disease severity, comorbidities, and other confounding factors cannot be fully controlled, further research and verification are needed.

A comparative study of sagittal spinal-pelvic parameters between patients with adolescent idiopathic scoliosis and healthy controls / Un estudio comparativo de los parámetros sagitales de la columna vertebral-pélvic entre pacientes adolescentes con escoliosis idiopática y controles sanos

This study aimed to investigate the sagittal spinal-pelvic morphological changes, as well as the relationship between pelvic anatomical changes and the spinal-pelvic plane in patients with adolescent idiopathic scoliosis (AIS), in order to provide guidelines for orthopedic surgery in AIS. X-ray data were collected for retrospective analysis from 30 patients diagnosed as AIS in the Departments of Radiology at the Second Affiliated Hospital of Inner Mongolia Medical University and the Inner Mongolia International Mongolian Medical Hospital from April 2014 to November 2018, along with 30 normal adolescents as control. Pelvic parameters, including pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS), a spinal parameter, lumbar lordosis (LL), and anatomical parameters, including sacral width (SW) and femoral head- sacrum distance (FH-S), were measured. The spinal-pelvic parameters were compared between AIS patients and normal controls and also between male and female AIS patients. Pearson correlation was performed to analyze correlation between spinal-pelvic parameters and between spinal-pelvic parameters and anatomical parameters in both AIS patients and normal controls. PT was significantly lower in AIS patients than in normal controls (P < 0.05), whereas no significant difference was found in the other spinal-pelvic parameters, i. e. , LL, PI, and SS. There was a significant difference in PT between sexes in AIS patients. SS was significantly correlated with LL in EIA patients (P < 0.05, r > 0.5). SS was significantly correlated with LL and PI, and PT with LL, PI, and SS in normal controls (all P < 0.05), and there was no significant correlation between the other sagittal spinal-pelvic parameters (P > 0.05). FH-S was significantly correlated with LL, PI, SS, and PT in AIS patients (all P < 0.05). AIS affects some of the sagittal spinalpelvic parameters and anatomical parameters. In AIS, there is a significant correlation between the spinal-pelvic parameters, and the anatomical parameter is significantly correlated with multiple spinal-pelvic parameters.

Este estudio tuvo como objetivo investigar los cambios morfológicos sagitales de la columna vertebral-pélvica, así como la relación entre los cambios anatómicos pélvicos y el plano espinal-pélvico en pacientes con escoliosis idiopática adolescente (EIA), con el fin de proporcionar pautas para la cirugía ortopédica en AIS. Se obtuvieron los datos de rayos X para el análisis retrospectivo de 30 pacientes diagnosticados como EIA en los Departamentos de Radiología del hospital Second Affiliated Hospital of Inner Mongolia Medical University y el hospital Inner Mongolia International Mongolian Medical Hospital, desde abril de 2014 hasta noviembre del 2018, junto con 30 adolescentes normales como control. Se midieron los parámetros pélvicos, que incluyeron incidencia pélvica (IP), inclinación pélvica (P) y pendiente sacra (PS), un parámetro espinal, lordosis lumbar (LL) y parámetros anatómicos, que incluyeron el ancho sacro (AS) y la distancia del sacro cabeza femoral (FH-S). Los parámetros espinalpélvicos se compararon entre los pacientes con EIA y los controles normales, como también entre pacientes con EIA masculinos y femeninos. La correlación de Pearson se realizó para analizar la correlación entre los parámetros espinal-pélvicos y entre los parámetros espinal-pélvicos y los parámetros anatómicos tanto en pacientes con EIA como en controles normales. PT fue significativamente menor en pacientes con EIA que en los controles normales (P <0,05), mientras que no se encontraron diferencias significativas en los otros parámetros espinal-pélvicos, i. mi. , LL, PI y SS. Hubo una diferencia significativa en PT en pacientes de ambos sexos con EIA. SS se correlacionó significativamente con LL en pacientes con EIA (P <0,05, r> 0,5). SS se correlacionó significativamente con LL y PI, y PT con LL, PI y SS en controles normales (todos P <0,05), y no hubo correlación significativa entre los otros parámetros sagitales de la columna vertebral-pélvica (P> 0,05) FH-S se correlacionó significativamente con LL, PI, SS y PT en pacientes con EIA (todos P <0,05). EIA afecta algunos de los parámetros sagitales de la columna vertebral-pélvica y los parámetros anatómicos. En EIA, existe una correlación significativa entre los parámetros espinal-pélvicos, y el parámetro anatómico se correlaciona significativamente con múltiples parámetros espinales-pélvicos.

A micro-CT study of different regions of the atlas / Un estudio de micro-CT de diferentes regiones del atlas

This study aimed to examine the differences in bone microarchitecture between different regions of the atlas in 28 dry atlas specimens using micro-CT, in order to explain the mechanism of the predilection sites of atlas fractures from the morphological point of view. A total of 28 dry specimens of intact adult atlas were randomly selected, scanned by micro-CT, and divided into a region from the anterior arch midpoint (AAM) to the lateral masses (LM), a LM region, and a region from the LM to the posterior arch midpoint (PAM). Trabecular thickness, separation, number, connectivity, and structure model index were measured for each of the three regions using the built-in software of the CT scanner. Trabecular thickness was all measured to be 0.11 ± 0.00 mm for AAM to LM, LM, and LM to PAM. Trabecular separation: AAM to LM > LM to PAM > LM. Trabecular number: LM > LM to PAM > AAM to LM. Connectivity: LM > LM to PAM > AAM to LM. Structure model index: LM > LM to PAM > AAM to LM. A lower trabecular number and connectivity and higher trabecular separation were seen in the anterior and posterior arches of the atlas, in which higher fracture rates were reported. By contrast, a higher trabecular number and connectivity and lower trabecular separation were seen in the lateral masses, in which lower fracture rates were reported.

Este estudio tuvo como objetivo examinar las diferencias en la microarquitectura ósea entre diferentes regiones del atlas en 28 muestras de atlas secas utilizando micro-CT, con el fin de informar el área de mayor frecuencia en las fracturas de atlas, desde el punto de vista morfológico. Se seleccionaron al azar un total de 28 muestras secas de atlas adultos intactas las que se escanearon por micro-CT y se dividieron en una región desde el punto medio del arco anterior (MAA) hasta las masas laterales (ML), una región ML y una región desde el ML hasta el punto medio del arco posterior (MAP). Se midió el grosor trabecular, la separación, el número, la conectividad y el índice del modelo de estructura para cada una de las tres regiones utilizando el software incorporado del escáner CT. El grosor trabecular se midió en 0,11 ± 0,00 mm para MAA a ML, ML y ML a MAP. Separación trabecular: MAA a ML> ML a MAP> ML. Número trabecular: ML> ML a MAP> MAA a ML. Conectividad: ML> ML a MAP> MAA a ML. Índice del modelo de estructura: ML> ML a MAP> MAA a ML. Se observó un menor número de estructuras trabeculares y conectividad y una mayor separación trabecular en los arcos anterior y posterior del atlas, en los que se informaron tasas de fracturas más altas. Por el contrario, se observó un mayor número de estructuras trabeculares y conectividad, y una menor separación trabecular en las masas laterales, en las que se observó un número menor de fracturas.

Micro-architecture study of the normal infant auditory ossicles with micro-computed tomography / Estudio de microarquitectura de los osículos auditivos infantiles normales con tomografía microcomputarizada

This study aimed to investigate the micro-anatomical morphology of ossicular chain in term fetus using micro-CT, in order to analyze the parameters of internal ossicular structure that may affect sound conduction.Four ossicular chains from two term fetuses were scanned by micro-CT. The related structural parameters of the trabeculae within the incus and malleus were calculated and compared. The fine anatomical structure of the auditory ossicles was analyzed.The microstructure of each auditory ossicles in term fetuses was clearly revealed by micro-CT. A marrow cavity was observed in the incus and malleus. In statistical analysis of the structural parameters of trabeculae in the incus and malleus, significant differences were found in BS/BV and Tb.Th (P < 0.05). Micro-CT enables the visualization of internal ossicular structure. The auditory ossicles in term fetus has good bone quality. The obtained bone structure data will help to clarify the physiological functions of normal fetal auditory ossicles.

Este estudio tuvo como objetivo investigar la morfología microanatómica de la cadena osicular en el feto a término con micro-CT, con el fin de analizar los parámetros de la estructura osicular interna que pueden afectar la conducción del sonido. Cuatro cadenas osiculares de dos fetos a término fueron examinadas por micro-CT. Se calcularon y compararon los parámetros estructurales relacionados de las trabéculas dentro de los incus y malleus. Se analizó la estructura anatómica fina de los osículos. Se observó claramente la microestructura de cada osículo en los fetos y la cavidad medular en el incus y el malleus. En el análisis estadístico de los parámetros estructurales de las trabéculas en el incus y el malleus, se encontraron diferencias significativas en BS / BV y Tb.Th (P <0,05). Micro-CT permite la visualización de la estructura osicular interna. Los osículos en el feto a término tienen buena calidad ósea. Los datos obtenidos de la estructura ósea ayudarán para aclarar las funciones fisiológicas de los osículos auditivos fetales normales.

Aberrant Activation of Cdc2/cyclin B1 Is Involved in Initiation of Cytoskeletal Pathology in Murine Niemann-Pick Disease Type C / 华中科技大学学报（医学）（英德文版）

Niemann-Pick disease type C (NPC) is a fatal,neurovisceral lipid storage disease,neuropathologically characterized by cytoplasmic sequestration of glycolipids in neurons,progressive neuronal loss,neurofibrillary tangles (NFTs) formation,and axonal spheroids (AS).Cytoskeletal pathology including accumulation of hyperphosphorylated cytoskeletal proteins is a neuropathological hallmark of the mouse model of NPC (npc mice).With a goal of elucidating the mechanisms underlying the lesion formation,we investigated the temporal and spatial characteristics of cytoskeletal lesions and the roles of cdc2,cdk4,and cdk5 in lesion formation in young npc mice.Cytoskeletal lesions were detectable in npc mice at three weeks of age.Importantly,concomitant activation of cdc2/cyclin B 1 kinase and accumulation of a subsequently generated cohort of phospho-epitopes were detected.The activation of cdk4/cyclin D1 and cdk5/p25 kinases was observed during the fourth week of life in npc mice,and this activation contributed to the lesion formation.We concluded that the progression of cytoskeletal pathology in npc mice older than four weeks is accelerated by the cumulative effect of cdc2,cdk4,and cdk5 activation.Furthermore,cdc2/cyclin B1 may act as a key initial player one week earlier.Targeting cell cycle activation may be beneficial to slow down the NPC pathogenesis.

Anatomical characteristics of infra-lamina ridge in Chinese population / Características anatómicas del puente infra-laminar en la población china

The aim of our study was to observe the occurrence rate and morphological characteristics of Infra-Lamina ridge (ILR) in Chinese population and provide a comprehensive reference for its clinical implication. Vertebrae columns of 82 sets of Chinese adult skeletons were collected. The shape of ILR was classified into three types; the occurrence of it in different sides and sexes were counted. The length, width, thickness of ILR were measured using a caliper with 0.02 mm accuracy. The ILR was usually found to occur from C7 to L5, with its frequency higher from T8 to 12, and highest at T10being up to 80.5%. There was significant statistical difference to the occurrence rate by side, sex and vertebral level. The largest values in its length and width were from T9 to T12. The ILR at T10 was largest in dimensions, being 4.1±2.1 mm in length and 4.4±2.3 mm in width. The ILR is more frequently detected in female and at the left side, at the lower thoracic spine with a larger dimension.

El objetivo de nuestro estudio fue observar la tasa de incidencia y características morfológicas del puente infra-laminar (PIL) en la población china y ofrecer una referencia completa por su implicación clínica. Se utilizaron 82 series de vértebras pertenecientes a esqueletos adultos chinos. La forma del PIL se clasificó en tres tipos; además se cuantificó la presenciade la misma en diferentes lados y sexos. La longitud, ancho y grosor del PIL se midieron utilizando un caliper con 0,02 mm de precisión. Se encontró que el PIL por lo general se producía desde C7 a L5 , con una mayor frecuencia entre T8 y T12, la más alta en T10 donde alcanzó el 80,5%. No hubo diferencia estadísticamente significativa en la tasa de ocurrencia según lado, sexo y el nivel de la vértebra. Los mayores valores de longitud y ancho fueron de T9 a T12. El PIL en T10 tuvo las mayores dimensiones, con una longitud de 4,1±2,1 mm y ancho de 4,4±2,3 mm. El PIL se detecta con mayor frecuencia en mujeres y la lado izquierdo, con una mayor dimensión en la columna torácica inferior.