Objective To investigate the effects of mirtazapine ccombined with psychological treatment on depression of patients with epilepsy.Methods 102 patients with epilepsy and complicated with depression were divided into the control group and trial group with 51 cases in each group.The control group received conventional mirtazapine and the trial group received mirtazapine combined with psychological therapy.The course was six weeks.The follow-up was performed six months after treatment and all patients were evaluated with Hamilton Depression Scale(HAMD)and Clinical Global Impression(CGI-SI).The side effects were evaluated with Treatment Emergent Symptom Scale(TESS).Results After the treatment of six weeks,the HAMD and CGI-SI scores of patients of the two groups significantly increased(P<0.05)and the scores of the trial group increased more significantly than that of the cintrol group(P<0.05)six months later.Conclusion The effect of mirtazapine combined with psychological therapy on depression of patients with epilepsy is obvious.

Objective To compare the curative effects and safety of mirtazapine and fluoxetine in treatment of elderly depressive patients with insomnia.Methods 92 cases of elderly depressive patients with insomnia were randomly divided into two groups: the mirtazapine treatment group and the fluoxetine treatment group. The period of treatment was six weeks. The antidepressant effect was assessed with the drop rate of Hamilton Depression Scale (HAMD),the effect of improving sleep was assessed with HAMD sleep disturbance factor and the Pittsburgh Sleep Index (PSQI), and the administration of security was assessed with vice Treatment Emergent Symptom Scale (TESS).Results After treatment, the effective rate of the mirtazapine group was 90.9% (40/44), that of the fluoxetine group was 84.1% (37/44). In the end of 1st, 2nd, and 4th weeks after treatment, the difference between the two groups were significant (P<0.001). At the end of 6th week, the difference was not significant (P>0.05) in HAMD; the difference was significant in HAMD sleep disturbance factor and PSQI score (P<0.05).Conclusion The clinical effects of mirtazapine in treatment of depression are similar to that of fluoxetine, but mirtazapine takes effects fast, can improve the symptoms of insomnia, has higher safety and better compliance, and is more appropriate for the depressive elderly patients with insomnia than fluoxetine.

Objective:To explore the diagnostic value of chromosome karyotype analysis, chromosomal microarray analysis (CMA) and whole exome sequencing (WES) in microcephaly.Methods:A total of 9 cases of microcephaly fetuses diagnosed by prenatal ultrasound or children with microcephaly diagnosed after birth were selected from the Sixth Affiliated Hospital of Guangzhou Medical University from January 2014 to August 2022.Karyotype analysis and/or CMA were used to detect. The cases with negative karyotype analysis and CMA results were further sequenced by trio-based WES (Trio-WES). Then the coding genes contained in the pathogenic copy number variation (CNV) fragments were analyzed by gene ontology (GO) enrichment. The genes related to the development of the central nervous system contained in the pathogenic CNV and the pathogenic genes found by Trio-WES were combined for gene interaction network analysis.Results:In this study, 9 cases of microcephaly were recruited, with the time of diagnosis ranged from 23 weeks of gestation to 7 years after birth, and the head circumference of fetus or children ranged from 18.3 to 42.5 cm (-7SD to -2SD). Karyotype analysis was detected in all 9 cases and no abnormality result was found. Eight cases were detected by CMA, and one abnormal was found. Five cases were detected by Trio-WES, and two cases were detected with likely pathogenic genes. The GO enrichment analysis of the coding gene in the 4p16.3 microdeletion (pathogenic CNV) region showed that: in biological process, it was mainly concentrated in phototransduction, visible light; in terms of molecular function, it was mainly concentrated in fibroblast growth factor binding; in terms of cell components, it was mainly concentrated in rough endoplasmic reticulum. Gene interaction network analysis suggested that CDC42 gene could interact with CTBP1, HTT and ASPM gene.Conclusions:CMA could be used as a first-line detection technique for microcephaly. When the results of chromosome karyotype analysis and/or CMA are negative, Trio-WES could improve the detection rate of pathogenicity of microcephaly.