ObjectiveTo investigate the influence on efficacy and quality of life of amisulpride in schizophrenia with predominantly negative symptoms.MethodsSeventy cases of schizophrenia with predominantly negative symptoms were randomly assigned to amisulpride group and clozapine group for 12weeks.The clinical efficacy and side effects were evaluated with SANS,BPRS and TESS before and 1,2,4,8,12 weeks after treatment respectively. GQOLI-74 were used to evaluate the patients' quality of life before and after drug administration.ResultsFor the last assessment,the score of BPRS decrease to 30.68 ±4.62 in amisulpride group,was significantly lower than the beginning(P＜0.01 ) ; the score of BPRS decrease to 31.31 ±4.78 in clozapine group,was significantly lower than the beginning (P ＜ 0.01 ).Two groups showed similar effects,with no significance.12weeks after treatment,the scores of emotional dull,poverty of thought,volition abulia,interest-social lack,attention dysfunction in amisulpride group were 12.31 ± 4.43,9.66 ± 3.07,8.91 ± 2.56,10.29 ± 2.68,5.58 ± 1.43 ; and the scores of emotional dull,poverty of thought,volition abulia,interest-social lack,attention dysfunction in clozapine group were 14.62 ± 4.27,9.32 ± 2.81,8.22 ± 2.60,9.54 ± 2.67,6.62 ± 1.59,and the efficacy of amisulpride in emotional dull and attention dysfunction were better than those of clozapine.And the scores of material life,physical function,psychological function,social function in amisulpride group were not higher than those in clozapine group(P＞ 0.05).And the scores of four domains in GQOLI-74 had been improved significantly in two groups(P＜0.01).The domains of physical function,psychological function,and social function in amisulpride was superior to clozapine(P＜0.01).The side effects were more in clozapine group than those in amisulpride group.ConclusionAmisulpride is as effective as clozapine for the treatment of schizophrenia with predominantly negative symptoms,but it has more advantage than clozapine to improve emotional dull,attention dysfunction and quality of life in schizophrenia with predominantly negative symptoms.

OBJECTIVE: To analyze the clinical features and variants of ABCD1 gene in a Chinese pedigree affected with X-linked adrenoleukodystrophy. METHODS: Clinical data of the proband were collected and analyzed. Potential variant of the ABCD1 gene were analyzed by PCR and Sanger sequencing of the proband, his parents and 100 unrelated healthy individuals. RESULTS: The prominent features of the proband included cerebellar and brainstem lesions, along with increased serum level of very-long chain fatty acids. He was found to harbor a hemizygous c.1509delG (p.L504Sfs*54) variant of the ABCD1 gene, for which his mother was heterozygous. The same variant was not detected in his father and 100 healthy controls. CONCLUSION X-linked adrenoleukodystrophy has a variety of clinical manifestations. Discovery of the c.1509delG (p.L504Sfs*54), as a novel pathogenic variant of the ABCD1 gene, has enabled diagnosis and genetic counseling for this pedigree.
Adrenoleukodystrophy/genetics* ; Asians/genetics* ; China ; Female ; Genetic Testing ; Humans ; Male ; Mutation ; Pedigree

Objective To understand the compliance of highly active anti-retroviral therapy (HAART) and influencing factors in people living with HIV/AIDS (PLWHA) in Nanjing. Methods PLWHA receiving HAART in No. 2 Hospital of Nanjing during May-June 2014 were recruited in this study. Self-administrated questionnaire was used to collect the data about HAART compliance and socio-demographic characteristics of PLWHA surveyed. Descriptive and multivariate statistical analysis were conducted to examine the effects of the factors on self-reported HAART adherence. Results A total of 276 PLWHA were surveyed,According to the evaluation criterion of Center for Adherence Support Evaluation (CASE),252 cases showed good compliance (91.3%). logistic regression analysis revealed that smoking,progress of the disease and side effects,reminding of taking drug and age were correlated with self-reported HAART adherence. Conclusion It is suggested to strengthen the education about antiviral therapy compliance in PLWHA with mild infection and those who are smokers and young,suffer from side effects,have no reminding methods for taking drug.

OBJECTIVETo understand the incidence of drop out of antiretroviral therapy (ART) in people living with AIDS/HIV and related factors in Nanjing, Jiangsu province, and Yuncheng, Shanxi province.

METHODSRetrospective cohort analysis was conducted. The cumulative incidence curves of drop out of ART, mortality and drug withdrawal were drawn with Kaplan-Meier method. The related factors were identified with Cox proportional hazards regression model.

RESULTSA total of 1 006 patients were included in Yuncheng, the median length of ART follow-up was 49.59 months (QR: 20.02-92.84), and 976 patients were included in Nanjing, the median length of ART follow-up was 19.93 months (QR: 11.48-34.07). The cumulative incidence of drop out of ART at 3 months, 6 months, 1 year, 2 years, 4 years, 8 years after ART was 8.19%, 9.23%, 11.08%, 13.75%, 17.74%, 27.66% in Yuncheng, and 3.01%, 5.17%, 7.47%, 10.97%, 17.45%, 28.72% in Nanjing respectively. Age, marital status, infection route, baseline CD4 cell count, the clinical stage classified by WHO at the end of the observation were correlated with the drop out of ART.

CONCLUSIONIn order to reduce the drop out of ART among people living with AIDS/HIV, it is necessary to conduct effective interventions targeting the patients with young age, the patients who divorced/widowed, the patients who were intravenous drug users, the patients with higher CD4 cell count at the beginning of ART and clinical stage III or IV at the end of the follow-up and increase the coverage of HIV test.

Acquired Immunodeficiency Syndrome ; drug therapy ; Anti-Retroviral Agents ; administration & dosage ; CD4 Lymphocyte Count ; China ; Communicable Diseases ; Humans ; Incidence ; Medication Adherence ; Proportional Hazards Models ; Retrospective Studies

OBJECTIVETo understand the economic burden caused by antiretroviral treatment for people living with HIV/AIDS and influencing factors in Nanjing.

METHODSPeople living with HIV/AIDS were divided into two groups, HIV infected patients and AIDS patients. The data about their direct medical expenditure, direct non-medical expenditure and indirect economic loss in the past year were collected. Univariate and multivariate analysis were conducted to identify the potential influencing factors.

RESULTSThe median of direct medical expenditure and total costs for 133 HIV infected patients were 1,200 yuan RMB and 1,972 yuan RMB respectively. The median of direct medical expenditure and total costs for 145 AIDS patients were 1 060 yuan RMB and 2 826 yuan RMB respectively. The differences in direct medical expenditure and total costs between HIV infected patients and AIDS patients showed no statistical significance. The results from univariate analysis indicated that the sample source influenced total costs significantly. Multivariate analysis showed that onset time and CD level were negatively correlated with direct medical expenditure. The patients infected through heterosexual contact had more direct medical expenditure than those infected through homosexual contact. The patients receiving HIV test in hospitals had more direct medical expenditure than those receiving volunteer counseling and testing.

CONCLUSIONFurther efforts should be made to expand HIV testing and treatment coverage in order to detect HIV infections as early as possible. Early antiretroviral treatment should be given to HIV infected patients to maintain their immunity and reduce their medical expenditure.

Acquired Immunodeficiency Syndrome ; drug therapy ; economics ; Anti-Retroviral Agents ; economics ; therapeutic use ; China ; Cost of Illness ; Counseling ; HIV Infections ; drug therapy ; economics ; Health Expenditures ; statistics & numerical data ; Heterosexuality ; Humans ; Mass Screening ; Voluntary Programs