The transition from child mental health services to adult mental health services can be challenging for patients. Transition is a critical aspect of continuity of care but little is known of the profile of the patients who makes such transitions and their unique characteristics, which could place special demands on subsequent mental health services. The Adult Neurodevelopmental Service at the Institute of Mental Health, Singapore is the first integrated service for adults with neurodevelopmental disorders and psychiatric co-morbidities in Southeast Asia. This audit aims to analyse the profile and characteristics of patients who have made this transition to ensure that the service addresses their specific needs. Methods: The electronic records of 50 patients who were seen in 2015 were analysed in relation to socio-demographics, diagnosis and psychiatric co morbidities, pharmacotherapy, functioning and illness severity scores. Results: All patients except 3(6%) were seen as outpatients. 41(82%) of whom were male and 9(18%) female with the mean age of 21.1 years (SD±2.68). 32(64%) had autistic spectrum disorder, 28(56%) had intellectual disability and 8(16%) had attention deficit/hyperactivity disorder. Co morbid psychiatric disorders included anxiety disorders (16%), mood disorders (14%), psychotic disorders(8%), and obsessive-compulsive disorders(8%). Risperidone and fluoxetine were the most commonly used antipsychotics and antidepressants respectively. The mean initial clinical global impression score was 4.05(SD±0.87) ± 0.87), and the mean global assessment scale was 53.78(SD±9.42) in patients who were scored. Conclusion: Patients in transition from a child to adult mental health services are a complex and vulnerable group which requires services adapted to their unique needs. Analysing the profile of these patients is critical in evolving the service to meet the needs of this group of young patients to achieve an ideal level of care. ASEAN Journal of Psychiatry, Vol. 18 (1): January – June 2017: XX XX.

Aim To investigate the renoprotective effect of berberine in diabetic nephropathy rat model. Methods The rat model of DN was induced by intra-peritoneal injection of streptozotocin ( STZ ) after fed with high sugar and high fat diet for six weeks. The rats were divided into 5 groups randomly, i. e. normal control group, model group, BBR ( 50 mg · kg-1 ) , BBR ( 100 mg · kg-1 ) and BBR ( 200 mg · kg-1 ) treatment group. The fasting blood glucose ( FBG) was evaluated at 2, 4, 6,8 week respectively. The patho-logical changes in the kidney were determined by PAS staining. The expression of vascular endothelial growth factor ( VEGF) was detected by immunohistochemistry and Western blot respectively. Results Compared with normal control group, the value of FBG, SCr, BUN and UTP of model group were sharply increased.
Compared with model group, the value of FBG in ber-berine different dosage treatment groups were signifi-cantly decreased to various degrees, and berberine dif-ferent dosage treatment could decrease the levels of SCr, BUN and UTP in different degree. Berberine could surpress the alterations of pathological changes in the kidneys and downregulate the expression levels of VEGF in the kidney of diabetic rats with nephropathy. Conclusion Berberine could significantly ameliorate the biochemical indicators and renal injury of the model rats through affecting the abnormal expression levels of VEGF in the kidney.

Aim To investigate the effect of berberine on the expression of nephrin, podocin and intergrinα3β1 in diabetic nephropathy ( DN ) rat model, and further probe in to the renoprotective effects of berber-ine and its potential mechanisms. Methods The rat model of DN was induced by intraperitoneal injection of streptozotocin ( STZ ) after fed with high-sugar and high-fat diet for six weeks. The rats were assigned into 6 groups randomly: normal control group, DN model group, BBR (50,100 and 200 mg·kg-1 ) treatment group and enalaprilat positive control group ( 1 mg · kg-1 ) . The distribution and expression of kidney podocyte related proteins nephrin, podocin and interg-rinα3β1 were detected by immunohistochemical meth-od following electron microscopy observation ( × 1000 ) and high magnification observation( × 400) and West-ern blot. Results The podocyte related protein neph-rin, podocin and intergrin α3β1 were mainly distribu-ted in podocyte, but slightly different. Compared with normal control group, the expresion of podocyte related protein nephrin, podocin and intergrin α3β1 was de-creased obviously; compared with model group, BBR (100 and 200 mg·kg-1 ) treatment group could sig-nificantly suppress the abnormalities of pathological changes of the kidney and upregulate the expression levels of podocyte specific protein nephrin, podocin and intergrin α3β1 in the kidney of diabetic rats with nephropathy. Conclusions Berberine could alleviate the abnormalities of kidney pathological changes and proteinuria production in the DN model rats, which may be related to the upregulation of the expression of the podocyte proteins nephrin, podocin and intergrinα3β1.

Objective To investigate the effect of the histological changes on rat dorsal root ganglia (DRG) after 125I seed brachytherapy.Methods Twelve adult male Sprague-Dawley rats ( 150-180g each) were randomly divided into 6 groups,125I seeds with different activities of 0 (Titanium shell),14.8,18.5,22.2,25.9 and 29.6 MBq were implanted to 6 groups of rats respectively and the behavioral changes of rats were observed.The rats were killed in different periods after implantation,the morphological changes in DRG and surrounding muscle tissue were observed with an Olympus BX51 optical microscope and then the irradiation doses were estimated.Results After 125I seed implantation,the movement function of rats was not affected and the weight of rats gained after 7 days.After the titanium shell implantation,very few mild swelling was induced in neuroganglion cells that still had clear nucleolus and normal cytoplasm.At 14 days after 18.5 MBq seed implantation,cell swelling was more serious and cell dehydrating,nuclear condensation and nuclear fragmentation appeared after 30 days.At 60 days after 29.6 MBq of seed implantation,nuclear dissolution and cytoplasmic shrinkage were induced in a large number of cells.In general,the severity of fibrosis was aggravated with the time post-irradiation and the dose in the muscles around the ganglion.Conclusions After 125I seed implantation,the injury degree of DRG tissue is dose-dependent,and the 125I seed irradiation would have analgesic effect on releasing intractable pain.

During past 50 years,has achieved a great progress and derived some profound lessons worthy of learning and studying for our country.This article introduces the deinstitutionalization processes of mental health institutions,reinstitutionalization and the inspiration for Chinese mental health reform.Introduced the paper are the reform of deinstitutionalization of mental health institutions in USA and some other countries,and the concept of such a reform,pointing out inspirations of such a reform for mental health reform in China.

OBJECTIVETo optimize the formulation of dry powder inhalation of Rehmannia glutinosa oligosaccharides (RGOS-DPI) extracted from traditional Chinese medicinal herbs.

METHODRGOS-DPI was prepared by spray drying technique. Dependent variables such as yield, moisture absorption rate, emptying rate and mean diameter of micropowder were transformed into desirabilities mathematically by Hassan's method. Overall desirability was calculated from the geometric mean of the four desirabilities of each formulation. The effects of influence factors such as the inlet temperature, the contents of mannitol in the total amount of adjuvant and solution density were investigated using central composite design and response surface method. The data of overall desirability were analyzed using multi-linear equation and second-order polynomial equation for selecting the optimal conditions for DPI preparation.

RESULTThe method of second-order polynomial equation was superior to multi-linear equation method in view of the correlation coefficients. Under the optimal conditions, the yield, moisture absorption rate, emptying rate and mean diameter of the RGOS-DPI were 78.60%, 5.93%, 94.20% and 2.537 microm, respectively.

CONCLUSIONThe central composite design can be used to optimize preparation. The optimized process for RGOS-DPI preparation is stable and feasible. The diameter of micropowder is suitable which can meet the demands of pulmonary delivery.

Chemistry, Pharmaceutical ; methods ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Microscopy, Electron, Scanning ; Nebulizers and Vaporizers ; Oligosaccharides ; chemistry ; isolation & purification ; Particle Size ; Powders ; chemistry ; Rehmannia ; chemistry ; Technology, Pharmaceutical ; methods

OBJECTIVETo study the chemical constituents of the whole plant of fresh celery (Apium graveolens).

METHODThe constituents were isolated and purified by silica gel, Sephadex LH-20, ODS column chromatography, PTLC, HPLC, and their structures were elucidated on the basis of spectral evidences.

RESULTTwenty compounds were obtained and identified as falcariondiol (1), (9Z) 1,9-heptadecadiene-4,6-diyne-3,8,11-triol (2), oplopandiol (3), bergapten (4), 5,8-dimethoxy psoralen (5), isofraxidin (6), eugenic acid (7), trans-ferulic acid (8), trans-cinnamic acid (9), p-hydroxyphenylethanol ferulate (10), caffeoylquinic acid (11), 5-p-trans-coumaroylquinic acid (12), sedanolide (13), lunularin (14), lunularic acid (15), 2-(3-methoxy-4-hydroxyphenol)-propane-1,3-diol (16), D-allitol (17), beta-sitosterol (18), benzolic acid (19), succinic acid (20).

CONCLUSIONCompounds 2, 3, 6, 10, 12, 14-17 were isolated from genus Apium for the first time.

Apium graveolens ; chemistry ; Drugs, Chinese Herbal ; analysis ; isolation & purification

Objective To compare the efficacy of different hysteroscopic surgical procedures in the treatment of endometrial polyps. Methods Ninety-two patients with endometrial polyps from January 2016 to December 2017 were selected. Among them, 37 patients with fertility requirements underwent polypectomy with MyoSure as group A; 25 patients without fertility requirements underwent polypectomy with resectoscopic hysteroscopy as group B, and 30 patients underwent polypectomy with hysterosopy and curettage as group C. The duration of the procedure, blood loss and hospital stays, effective rate, recurrence rate and postoperative pregnancy rate of the3 groups were compared. Results There was no significant difference in intraoperative blood loss and hospital stays among the 3 groups (P> 0.05). The duration of the procedure of group A and B was longer than that of group C, and the difference was statistically significant (P < 0.05). The effective rate of treatment was high in all 3 groups, and inter-group comparison indicated no statistically significant difference, but the recurrence rate of group C was significantly higher than that of group A and B. For those with fertility requirements, the pregnancy rate in group A was slightly higher than that in group C within one year after surgery, but the difference was not statistically significant. Conclusion Hysteroscopic procedures of endometrial polypectomy has the advantages of accuracy, safety, effectiveness and rapid recovery. The treatment with MyoSure and resectoscopic hysteroscopy can reduce the recurrence rate of patients effectively. For women with fertility requirements, the treatment with MyoSure can protect the endometrium and improve the postoperative pregnancy rate.