Association between social withdrawal and suicidal ideation in patients with major depressive disorder: The mediational role of emotional symptoms.

BACKGROUND: The study was designed to investigate the associations between social withdrawal, emotional symptoms, and suicide ideation in patients with major depressive disorder (MDD). METHODS: This cross-sectional study included 2678 MDD patients from the National Survey on Symptomatology of Depression (NSSD). Differences in the sociodemographic factors, clinical characteristics, suicide ideation, and emotional symptoms were compared in patients with different frequencies of social withdrawal. Pearson correlation, multiple linear regression analysis, and mediation analysis were employed to assess the contribution of social withdrawal to suicide ideation. RESULTS: MDD patients with a higher frequency of social withdrawal were prone to have a higher frequency of suicide ideation (p for trend <0.001) and history of suicide behavior (p for trend <0.001). Multiple linear regression analysis showed that there was a dose-response relationship between social withdrawal and suicide ideation in MDD patients, but this association became insignificant after adjusting for emotional symptoms. Mediation analysis suggested that all of the emotional symptoms had significant mediating effects on the association between social withdrawal and suicide ideation in MDD patients (p < 0.05). The magnitude of mediation varied between 4.3 % and 64.3 %, with the largest mediating effect in the feeling of despair (64.3 %), helplessness (41.2 %), and loneliness (40.0 %). CONCLUSION: Our study provides evidence that social withdrawal was a common clinical presentation and it may increase the risk for suicide through emotional symptoms in MDD patients. LIMITATIONS: Causal conclusions could not be drawn between social withdrawal, emotional symptoms, and suicide ideation because of the cross-sectional design of the study.

Associations between gastrointestinal symptoms, medication use, and spontaneous drug discontinuation in patients with major depressive disorder in China.

BACKGROUND: The study was designed to investigate the associations between gastrointestinal (GI) symptoms, medication use, and spontaneous drug discontinuation (SDD) in patients with major depressive disorder (MDD). METHODS: This cross-sectional study included 3256 MDD patients from the National Survey on Symptomatology of Depression (NSSD). Differences in the sociodemographic factors, clinical characteristics, medication use, and self-reported reasons for SDD were compared in patients with different frequencies of GI symptoms. A multiple logistic regression analysis was employed to assess the contribution of GI symptoms to the risk of spontaneous drug discontinuation. RESULTS: MDD patients with a higher frequency of GI symptoms were prone to have higher proportions of mood stabilizer and benzodiazepine uses (ps for trend < 0.001) but a lower proportion of SNRI use (pfor trend < 0.001). With the increase in GI symptoms, patients were prone to report worries about long-term side effects (pfor trend < 0.001), with the patients stating ineffective treatments (pfor trend = 0.002) and intolerance of adverse drug reactions (pfor trend = 0.022) as the reasons for SDD. Compared with those patients without GI symptoms, all of the MDD patients with GI symptom frequencies of several days (OR = 1.317; 95 % CI: 1.045-1.660), more than half of all days (OR = 1.305; 95 % CI: 1.005-1.695), and nearly every day (OR = 1.820; 95 %: 1.309-2.531) had an increased risk of SDD. CONCLUSION: GI symptoms are highly associated with drug discontinuation in MDD patients. These findings may have important implications for clinical treatment options, as well as for drug adherence management, in MDD patients.

Analysis on the application of infectious diseases automated-alert and response system in Tianjin during the 13th Five-Year Plan period / 公共卫生与预防医学

Objective To analyze the epidemiological characteristics of automatic warning signals of infectious diseases received in Tianjin during the 13th Five-Year Plan period, and to provide reference for the function optimization of automatic warning system of infectious diseases during the 14th Five-year Plan period． Methods The data of infectious disease automatic early warning signals in Tianjin from 2016 to 2020 were downloaded from the China infectious diseases automated-alert and response system (CIDARS). The characteristics and response of early warning signals were analyzed by descriptive method. Results During the 13th Five-Year Plan period, 23,660 early warning signals were received in Tianjin, involving 39 kinds of infectious diseases, with 100% response rate and 1.10% positive rate of early warning signals. The median response time of warning signal was 0.53 hours (P25-P75: 0.19-1.17h). 95.74% of signals were responded within 2 hours and 98.47% of signals were responded within 24 hours. COVID-19, other infectious diarrhea diseases, dysentery, measles, and scarlet fever were the top five diseases with early warning signals. Conclusion During the 13th Five-Year, the automatic early warning system of infectious diseases in Tianjin runs well and has a high response rate, but the positive rate of early warning signal is low. During the 14th Five-Year，further research is needed to improve the early warning threshold according to the prevention and control needs and epidemic characteristics of different diseases, and to improve early warning positive rate.

Relationship among depression,anxiety and social support in elderly patients from community outpa-tient clinic / 中华行为医学与脑科学杂志

Objective To explore the relationship among depression,anxiety and social support in elderly patients in community outpatient clinic. Methods A total of 551 elderly outpatients from two com-munity health service centers of Hongkou District in Shanghai were evaluated with patient health question-naire-9 (PHQ-9),generalized anxiety disorder-7 (GAD-7),perceived social support scale( PSSS) for de-pression,anxiety,physical health and social support. Results The prevalence rates of depression and anxiety were 26. 1% and 17. 2%,respectively. The scores of PHQ-9 and GAD-7 were 2. 0(4. 0) and 1. 0(2. 0). There were statistically significant differences in the scores of family support,friend support,other support and social support among the elderly patients with different degrees of depression or anxiety (P<0. 01). Fam-ily support(B=-0. 196) and friend support(B=-0. 171) were protective factors of depression in elderly pa-tients in community outpatient clinic. Age,family support and friend support were protective factors of anxiety in elderly patients,while gender and fluctuation of physical diseases were protective factors of anxiety(P<0. 05). Con-clusions The depression and anxiety is intimately related to social support in elderly outpatients. Appropriate measures should be taken to optimize social support,mitigate bad mood negative improve their quality of life.

Comparative study of clinical features between different subtype bipolar patients with first mania episode / 上海交通大学学报（医学版）

Objective·To compare the clinical features between different subtype bipolar patients with first mania episode, and to contribute to early identification of bipolar disorder. Methods·This study was based on the database named as National Bipolar Mania Pathway Survey (BIPAS). From November 2012 to January 2013, bipolar patients from 26 mental health facilities in China were enrolled in current study. The clinical features were compared between mania patients of different subtypes, including hypomania (groupⅠ), mania without psychotic symptoms (groupⅡ), mania with psychotic symptoms (group Ⅲ) and mixed state (group Ⅳ). Results·There was significant difference in the percentage of clinical symptoms between different subtype bipolar patients with first mania episode, especially the mania and anxiety related symptoms. Group Ⅰ, Ⅲ , Ⅳ were further compared with groupⅡ, which was considered as the typical bipolar disorder. The results showed that the mania related symptoms was significantly higher in group Ⅱ, but anxiety related symptoms was significantly higher in group Ⅰ, Ⅲ, Ⅳ. Moreover, Logistic regression analysis revealed that more eloquent or humor and unusually restless could be in favor of the diagnosis of hypomania; younger and mania or hypomania as first episode might be in favor of the diagnosis of mania with psychotic symptoms; older, national minorities and unusually restless could be in favor of the diagnosis of mixed state. Conclusion·The clinical features between different subtype bipolar patients with first mania episode are various, and analysis of the clinical features can contribute to early identification of bipolar disorder.

Adverse reaction caused by rabies vaccine in China: a Meta-analysis / 中华流行病学杂志

Objective To conduct a Meta-analysis on the rate of adverse reaction related to rabies vaccine,so as to provide reference for rabies vaccine immunization in China.Methods We electronically searched databases including CNKI,VIP information resource integration service platform,WanFang Data,CBM,PubMed and The Cochrane Library,to collect studies on Chinese people who had received full rabies vaccination and recording all the adverse reactions,from January 2000 to July 2016.Inclusion and exclusion criteria were strictly followed.Meta-analysis for the adverse reaction rate was performed using the R software.Results A total of 29 related papers had met the inclusion criteria,with no publication bias noticed.A total number of 11 020 cases had adverse reactions,among all the 94 222 respondents,with an incidence of adverse reactions as 1.04％-47.78％.The overall incidence rate of adverse reaction was 9.82％ (95％CI:7.58％-12.72％).A combined local adverse reaction rate appeared as 12.05％ (95％CI:9.26％-15.69％).The systemic adverse reaction rate was 9.06％ (95％CI:7.07％-11.61％).The overall adverse reaction rate on aqueous vaccine was 32.39％ (95％CI:21.88％-47.94％).Combined adverse reaction rate of freeze dried vaccine appeared as 8.65％ (95％CI:4.54％-16.51％).Significant differences were seen between both groups (P＜0.05).Conclusions The local adverse reaction rate caused by rabies vaccination was higher than the systemic adverse reaction rate.The adverse reaction rate of aqueous rabies vaccine was higher than that of freeze dried rabies vaccine.Our results suggested that the aqueous vaccine should gradually be eliminated.

Adverse reaction caused by rabies vaccine in China: a Meta-analysis / 中华流行病学杂志

Objective To conduct a Meta-analysis on the rate of adverse reaction related to rabies vaccine,so as to provide reference for rabies vaccine immunization in China.Methods We electronically searched databases including CNKI,VIP information resource integration service platform,WanFang Data,CBM,PubMed and The Cochrane Library,to collect studies on Chinese people who had received full rabies vaccination and recording all the adverse reactions,from January 2000 to July 2016.Inclusion and exclusion criteria were strictly followed.Meta-analysis for the adverse reaction rate was performed using the R software.Results A total of 29 related papers had met the inclusion criteria,with no publication bias noticed.A total number of 11 020 cases had adverse reactions,among all the 94 222 respondents,with an incidence of adverse reactions as 1.04％-47.78％.The overall incidence rate of adverse reaction was 9.82％ (95％CI:7.58％-12.72％).A combined local adverse reaction rate appeared as 12.05％ (95％CI:9.26％-15.69％).The systemic adverse reaction rate was 9.06％ (95％CI:7.07％-11.61％).The overall adverse reaction rate on aqueous vaccine was 32.39％ (95％CI:21.88％-47.94％).Combined adverse reaction rate of freeze dried vaccine appeared as 8.65％ (95％CI:4.54％-16.51％).Significant differences were seen between both groups (P＜0.05).Conclusions The local adverse reaction rate caused by rabies vaccination was higher than the systemic adverse reaction rate.The adverse reaction rate of aqueous rabies vaccine was higher than that of freeze dried rabies vaccine.Our results suggested that the aqueous vaccine should gradually be eliminated.

Increased Cognition Connectivity Network in Major Depression Disorder: A fMRI Study

OBJECTIVE: Evidence of the brain network involved in cognitive dysfunction has been inconsistent for major depressive disorder (MDD), especially during early stage of MDD. This study seeks to examine abnormal cognition connectivity network (CCN) in MDD within the whole brain. METHODS: Sixteen patients with MDD and 16 health controls were scanned during resting-state using 3.0 T functional magnetic resonance imaging (fMRI). All patients were first episode without any history of antidepressant treatment. Both the left and right dorsolateral prefrontal cortex (DLPFC) were used as individual seeds to identify CCN by the seed-target correlation analysis. Two sample t test was used to calculate between-group differences in CCN using fisher z-transformed correlation maps. RESULTS: The CCN was constructed by bilateral seed DLPFC in two groups separately. Depressed subjects exhibited significantly increased functional connectivity (FC) by left DLPFC in one cluster, overlapping middle frontal gyrus, BA7, BA43, precuneus, BA6, BA40, superior temporal gyrus, BA22, inferior parietal lobule, precentral gyrus, BA4 and cingulate gyrus in left cerebrum. Health controls did not show any cluster with significantly greater FC compared to depressed subjects in left DLPFC network. There was no significant difference of FC in right DLPFC network between depressed subjects and the health controls. CONCLUSION: There are differences in CCN during early stage of MDD, as identified by increased FCs among part of frontal gyrus, parietal cortex, cingulate cortex, and BA43, BA22, BA4 with left DLPFC. These brain areas might be involved in the underlying mechanisms of cognitive dysfunction in MDD.

Clinical analysis of 39 cases with reoperation for thyroid / 中国基层医药

Objective To explore the cause of the thyroid reoperation ,methods,surgical approach ,and the prevention of complications .Methods 39 cases of thyroid reoperation in patients with clinical data were reviewed and analyzed.Results Thyroid papillary carcinoma in 11 cases,follicular carcinoma in 2 cases,nodular 22 cases of thyroid,thyroid adenoma 1 case,3 cases of primary hyperthyroidism .The incidence of transient hypoparathyroidism ac-counted for 2 cases,temporary laryngeal recurrent nerve injury in 2 cases,chyle leakage in 1 case,in total of 12.8%of postoperative complications .Conclusion Improper operation method choice for the first time and the misdiagnosis was the main cause of reoperation , The reoperation of thyroid is difficult and has more complications .Preoperative evaluation and careful operation can prevent the occurrence of complications .

Pharmacoeconomic comparisons of venlafaxine and mirtazapine in patients with treatment-resistant major depression / 中华行为医学与脑科学杂志

Objective To compare the cost-effectiveness and cost-utility of venlafaxine and mirtazapine in patients with treatment-resistant major depression (TRD).Methods One hundred and five patients with TRD were enrolled in this study and grouped into venlafaxine treatment (n=50) and mirtazapine treatment (n=55) based on the double-blind randomization scheme generated by computer.The treatment costs of antidepressants during 8 weeks were calculated,the rates of clinical response and remission were taken as treatment effectiveness,and the quality-adjusted life years (QALYs) as treatment utility.The descriptive analysis and nonparametric test were used to compare the cost-effectiveness and cost-utility of different groups.Results During 8 weeks,the treatment cost of antidepressant was ￥ 1 396.44 for venlafaxine and ￥ 1 206.90 mirtazapine,and the difference between two groups was ￥ 189.54.The cost-effectiveness ratios between venlafaxine and mirtazapine were very close (differed ￥ 0.06 for remission rate and ￥ 1.08 for response rate respectively).There was no significant difference for cost-utility ratios between two groups (physical functioning Z=-0.15,P＞0.05 ; mental health Z=-0.54,P＞0.05).Conclusion Both cost-effectiveness and cost-utility of venlafaxine in patients with TRD are close between venlafaxine and mirtazapine.

Reasons for perioperative death in treatment of acute myocardial infarction by emergent percutaneous coronary intervention / 中华老年医学杂志

ObjectiveTo analyze the dead reasons in treatment of acute myocardial infarction (AMI) by emergent percutaneous coronary intervention (EPCI) during perioperation. Methods The clinical characteristics of the dead patients,results of EPCI and reasons of death were retrospectively analyzed in 473 patients with AMI who received EPCI treatment during March 2004 to March 2011. ResultsAmong the 18 cases(3.8％)dead patients,there were 8 case with three-vessel lesions,5 cases with two-vessel lesions, 2 cases with single vessel lesion and 3 cases with left main lesion. Nine patients were accompanied with hypertensions,5 cases with diabetes mellitus, 1 case with old myocardial infarction, 2 cases with old cerebral infarction, 1 case with chronic obstructive pulmonary disease complicated by severe pneumonia, and 1 case with chronic renal insufficiency. Nine patients died of cardiogenic shocks , 4 cases (22. 2％) of heart ruptures, 2 cases (11.1％) of noreflow,1 case (5.6％) of massive hemorrhage of the upper alimentary tract, 1 case (5.6％) of respiratory failure and 1 cases (5.6％) of refractory ventricular fibrillation.ConclusionsPrimary reasons for perioperative death were cardiac shock and heart rupture in treatment of acute myocardial infarction by EPCI. Multi-vessel lesion, complications with hypertensions and diabetes mellitus may serve as succumbed factors of death.

Association study of dopamine D1 receptor gene and cognitive function of first-episode schizophrenic patients / 中华行为医学与脑科学杂志

Objective To investigate the relationship between cognitive function of first-episode schizophrenic patients and dopamine D1 receptor gene. Methods A total of 112 first-episode schizophrenic patients and 60 healthy controls were evaluated with Wechsler adult intelligence scale ( WAIS-R), Wechsler memory scale (WMS) and Wisconsin card sort test (WCST) ,and genotyped one polymorphism (rs4532) within DRD1 gene using TaqMan SNP genotyping assay. Results There were no significant differences on the frequencies of the genotypes and alleles of rs4532 polymorphism between patients with schizophrenia and normal controls ( x2 =2.90, P=0.35; x2 = 0.01, P= 0. 93 ). There were significant differences in all index of WCST between two groups (P ＜0.01 ). Patients with rs4532G allele had worse WCST performance than those without G allele ((60.9 ± 13.2)%vs (44.9 ±21.3)%, t=4.79, P=0.00002). Conclusion Rs4532 polymorphism of DRD1 gene may be associated with executive function impairment in schizophrenic patients.

Changes in the numbers and distribution of calretinin in the epileptic rat hippocampus.

OBJECTIVES: To examine calretinin (CR)-containingObjectives: To examine cairetinin (CR)-containingnterneuronsthatdegenerate inthe hippocampus in post statusinterneurons that dege nera te in the hippocampusepilepticus (SE) ratsatdifferent time in post status epilepticus (SE) rats at different time points. METHODS: This study was conducted at the Central South University, Xiangya Hospital, Hunan Province, P.R. China between September 2008 and January 2010. Pilocarpine-induced SE was chosen as a model to generate chronic epileptic rats. To determine whether hippocampal neuronal populations are affected by hippocampal seizures, immunohistochemical assays were performed in brain sections obtained from age-matched control (n=50) and epileptic rats (n=170). Nissl stain was used to observe pathological changes of the hippocampus. RESULTS: Our results revealed the most dramatic cell loss to be in the hilar, cornu Ammonis (CA)1, and CA3 areas in the epileptic rats. Quantitative analysis revealed significant differences between control and epileptic rats in the number of CR-positive interneurons. These interneurons were distributed in the hilar, CA1, and CA3 areas and in thedentate gyrus of both control and epileptic rats, but was more numerous in the hippocampus of normal rats. However, a transient increase of CR-positive interneurons was observed in the CA1 between 7 and 15 days post SE. The CR interneurons were mostly located in the hilar and CA1 for epileptic rats, and in the hilus for control rats. CONCLUSIONS: Our data suggest that a different proportion of inhibitory interneurons was observed in the epileptic rat hippocampus, as their numbers differ from controls. These results indicate that the inhibitory circuits in the hippocampus may represent a compensatory response with a role to balance the enhanced excitatory input in the region.

Dynamic changes in glutamate and γ-aminobutyric acid release in the rostral ventromedial medulla in a rat model of incisional pain / 中华麻醉学杂志

Objective To investigate the time-dependent changes in glutamate (Glu) and 7-aminobutyric acid ( GABA) release in the rostral ventromedial medulla in a rat model of incisional pain. Methods Healthy male SD rats weighing 250-300 g were used in this study. Twelve rats in which microdialysis cannulae were implanted in the right rostral ventromedial medulla without neurological deficits were randomly divided into 2 groups ( n = 6 each): group A control and group B incisional pain. In group B an 1 cm long incision was made in the plantar surface of right hindpaw under 1.2% isoflurane anesthesia which was maintained for 5 min. Samples of dialysate were collected before incision (T_0 baseline) and at 3 h, 1 d, 2 d and 3 d after incision was made (T_(1-4)) in both groups for determination of Clu and GABA concentrations (by HPLC). Results In group B Glu and GABA concentrations in the dialysate were significantly increased at 1 d (T_2) and 3 h-3 d (T_(1-4)) respectively as compared with the baseline value at T_0 and were significantly higher than those in group A (control group). Conclusion Incisional pain increases the release of Glu and GABA in the rostral ventromedial medulla which might influence the function of descending pain modulation pathway.

A comparsion study on the social functions promotion of different medicine treatment strategies on the patients with treatment-resistant depression / 中华行为医学与脑科学杂志

Objective To evaluate the effectiveness of different medicine treatment strategies on the social functions promotion on the patients with treatment-resistant depression (TRD). Methods 375 Patients with TRD were randomly grouped into 8 groups, and each group was received 8 weeks different treatment for paroxetine,venlafaxine, mirtazapine, paroxetine plus risperidone, paroxetine plus sodium valproate, paroxetine plus buspirone, paroxetine plus trazodone,or paroxetine plus thyroxine, respectively. The efficacy and social functions were evaluated with HAMD-17, SDSS and SF-36. Results There were significant difference in SDSS scores between 8th week and the baseline( P＜0.01 ) , and for social functions factor scores of SF-36 there was significant difference between 4th ,8th week and the baseline in each groups( P＜0.01 ). There were significant difference in social functions factor scores of SF-36 and subtracting scores between 4th and 8th week in all groups except group paroxetine and group venlafaxine(P ＜ 0.05 or P ＜ 0.01 ). There were significant difference in SDSS subtracting scores at 8th week among 8 groups( paroxetine plus risperidone group 7.05 ± 6.39, mirtazapine group 6.53 ± 4.75, paroxetine plusthyroxine group 5.14 ± 4.94, paroxetine group 5.13 ± 4.94 ,paroxetine plus trazodone group 5.00 ± 4.94, paroxetine plus sodium valproate group 4.60 ± 4.09, venlafaxine group 4.57 ± 4.18, paroxetine plus buspirone group 4.24 ± 4.95 ) ( Z = 2.076, P ＜ 0.05 ), between group paroxetine plus risperidone and group venlafaxine , group paroxetine plus sodium valproate, group paroxetine plus buspirone,as group mirtazapine and group paroxetine plus buspirone(P＜ 0.05 ), respectively. The influencing factors on improving social functions are the severity, improvement of depressive symptoms and latest onset time. Conclusions These 8 treatment strategies all can promote social functions on the patients with TRD. But the intensity and chronological order of improvement werent the same among 8 groups. The influencing factors on improving social functions are the severity, improvement of depressive symptoms and latest onset time.

[Number changes and axonal sprouting of neuropeptide Y interneurons in the hippocampus of pilocarpine-induced rats].

OBJECTIVE: To investigate the role of neuropeptide Y(NPY) positive interneurons in the generation and compensation of temporal lobe epilepsy. METHODS: Pilocarpine-induced rat model was founded. Immunohistochemistry was used to observe the number changes and axonal sprouting of NPY interneurons at different time points in the hippocampus of rats. RESULTS: After lithium-chloride and pilocarpine administration, 92.9% rats were induced status epilepticus (SE) successfully, and the mortality rate was 19.2%. In the experimental group, the number of NPY positive neurons decreased in the hilus of the hippocampus, and was least on 7 d after the SE (P<0.01). In the chronic phase, the number of hilus NPY neurons partially recovered, but was still less than the number in the control group on 60 d after the SE (P<0.05). No evident changes of the number of NPY neurons existed in CA domains (P>0.05) except the loss of them in CA3 area on 7 d after the SE (P>0.05). Increased NPY positive fibers could be seen in the molecular layer of the dentate gyrus on 30 d after the SE. CONCLUSION: NPY interneurons have different sensitivities to the injuries induced by seizures at different time points and domains. Loss of NPY interneurons plays an important role in the generation of temporal lobe epilepsy, while axonal sprouting of them may play a significant role in the compensation of temporal lobe epilepsy.

Number changes and axonal sprouting of neuropeptide Y interneurons in the hippocampus of pilocarpine-induced rats / 中南大学学报(医学版)

OBJECTIVE@#To investigate the role of neuropeptide Y(NPY) positive interneurons in the generation and compensation of temporal lobe epilepsy.@*METHODS@#Pilocarpine-induced rat model was founded. Immunohistochemistry was used to observe the number changes and axonal sprouting of NPY interneurons at different time points in the hippocampus of rats.@*RESULTS@#After lithium-chloride and pilocarpine administration, 92.9% rats were induced status epilepticus (SE) successfully, and the mortality rate was 19.2%. In the experimental group, the number of NPY positive neurons decreased in the hilus of the hippocampus, and was least on 7 d after the SE (P0.05) except the loss of them in CA3 area on 7 d after the SE (P>0.05). Increased NPY positive fibers could be seen in the molecular layer of the dentate gyrus on 30 d after the SE.@*CONCLUSION@#NPY interneurons have different sensitivities to the injuries induced by seizures at different time points and domains. Loss of NPY interneurons plays an important role in the generation of temporal lobe epilepsy, while axonal sprouting of them may play a significant role in the compensation of temporal lobe epilepsy.

Diagnosis of 10 patients with cortical laminar necrosis / 中南大学学报(医学版)

OBJECTIVE@#To analyze the feature of cortical laminar necrosis (CLN) and to decrease the incidence of misdiagnosis and improve the treatment of CLN.@*METHODS@#Ten patients with CLN in Xiangya Hospital of Central South were included in this study from June 2005 to May 2007. The clinical feature, laboratory examination, image manifestation, treatment, and turnover of patients were analysed.@*RESULTS@#CLN might happen at any age. The obstacle of brain energy metabolism with sugar and/or oxygen in central nervous system and heredities or acquired blemish could result in CLN. CLN was characterized in histopathology and imaging.@*CONCLUSION@#Many etiological factors can lead to CLN. It has different clinical features and can be easily misdiagnosed as some other hemorrhagic diseases.

Four-year follow-up study of changes in prescriptions of antidepressants for inpatients with psychosis / 上海交通大学学报（医学版）

Objective To investigate the changes in the prescriptions of antidepressants for inpatients with psychosis from 2005 to 2008. Methods The prescriptions of antidepressants for all the inpatients with psychosis in Shanghai Mental Health Center were investigated by one day survey on each June 1st from 2005 to 2008. The most common diseases treated with antidepressants, the most commonly used antidepressants, the average dosage of antidepressants and the combination use of antidepressants were analysed. Results The most common diseases treated with antidepressants were affective disorder, schizophrenia and neurosis. The prescription rate of tricyclic antidepressants declined year by year, and that of selective serotonin reuptake inhibitors (SSRIs) fluctuated moderately, while that of antidepressants of newer generation with the other transmitter mechanisms such as venlafaxine, mitrazapine and trazodone increased gradually. Single antidepressant prescription was common, while the combination use of antidepressants accounted for a small portion. Combination use of antidepressants with one psychotropics (antipsychotics, mood stabilizer, sedative hypnotics) was common, while with two were less frequently occurred. Conclusion Prescriptions of antidepressants for patients with psychosis hospitalized in Shanghai Mental Health Center from 2005 to 2008 are relatively safe and reasonable. Antidepressants of newer generation have been widely used in clinics, and SSRIs have been serving as the major antidepressants.