Objective To assess whether metformin prevents body weight gain in patients with schizophrenia who are treated with second-generation antipsychotics(SGA).Methods The randomized controlled trials (RCT) about metformin for prevention of weight gain with SGA for schizophrenia from January 1998 to July 2012 were selected in the Cochrane Library,Medline,Wanfang Data,CNKI and VIP.Two reviewers independently screened the literatures,extracted the data,and evaluated the methodological quality.Than meta-analyses were conducted by using RevMan 5.1 software and Stata 12.0 software.Results The total 7 RCTs were selected and 394 patients were involved.The results of meta-analyses showed that the efficacy of the metformin group was superior to that of the control group in lessen body mass (MD =-3.07,95％ CI:-4.17,-1.98,Z =5.50,P ＜ 0.01),BWI (MD =-1.21,95％ CI:-1.50,-0.92,Z=8.18,P＜0.01) with significant differences.Conclusion Metformin addition therapy is effective in attenuating SGA-induced weight gain.

Objective To develop a method of studying fiber projecting in the spinal cord duiring chicken embryo development.Methods At embryonic incubation 3 day (E3), pCAGGS-green fluorescent protein (GFP) plasmid was injected into the spinal cord using in vivo electroporation.Three days after transfection (E6), GFP-positive embryos were collected under a stereo fluorescence microscope .Subsequently , the spinal cord was separated from the embryos and cut from the roof plate as an open book .After fixed with 4%paraformaldehyde ( PFA) for one hour , the opened spinal cords were used for immunohistochemistry with N-cadherin antibody and with DAPI for nuclei .Finally, the nerve fiber projecting was photographed and analyzed under a fluorescence microscope . Results Based on the opened spinal cord and immunostaining in the cryosection , we observed that the nerve fibers projected across the midline of the floor plate and reached to the sulcus terminalis along the white matter of the contra side .The immunoreaction against N-cadherin indicated that overexpression of GFP has no significant effect on chicken embryonic development .Conclusion A new method to study fiber projecting in the developing chicken spinal cord is established successfully in this study .

Objective To characterize the changes in the dimensions during systolic and diastolic periods in the aorta with ECG-gated multi-detector CTA scans.Methods The CT angiograms of 115 patients (78 males,mean age 55.2 ± 9.4 years;37 females,mean age 60.1 ± 8.5 years) both in systolic and diastolic periods were obtained on a 64-slice ECG-gated multi-detector CT scanner.The diameters were measured at four anatomic levels of the aorta.(Level A:1 mm proximal to the innominate artery;Level B:1 mm distal to the left common carotid artery;Level C:1 mm distal to the left subclavian artery;Level D:10cm distal to the left subclavian artery).On each level,the maximal and the minimal diameters were measured both in systolic and diastolic periods.Results The paired sample t test results showed a significant difference between the systolic and diastolic diameters in all individual subjects on every level (P ＜0.001).The mean maximum diameter changes were 1.95％ (range-2.0％ to 7.0％),2.12％ (range-3.0％ to 6.0％),1.88％(range-1.0％ to 8.0％)and2.47％(range-3.0％ to 10.0％)at level A,B,C and D,respectively.The mean minimum diameter changes were 1.43％ (range-3.0％ to 5.0％),2.67％ (range-2.0％ to 11.0％),1.75％ (range-14.0％ to 9.0％)and 2.99％ (range -2.0％ to 11.0％) at level A,B,C and D,respectively.Conclusions The differences of the aortic diameters between systolic and diastolic periods are significant.The pulsatility of aorta in Chinese population may be different from published Western literature.

A 87-day-old female patient presented with patchy erythema on the right body and ipsilateral limb deformity after birth, and visited the hospital in January 2012. Skin examination showed obvious red plaques on the right lower abdomen, right buttock, right perineum, right leg and right foot, with yellow scales on the surface and clear boundaries, and there was no obvious exudation or odor; pale yellow verrucous hyperplasia was observed on the right lower jaw, right neck, right axilla, and on the back of the first to fourth fingers of the right hand; only 1 interphalangeal joint and no nail plate was observed on the second, third and fourth toes of the right foot. The X-ray of the right foot showed deformity and bone defects. The patient was diagnosed with CHILD syndrome, and treated with intermittent oral acitretin capsules, and topical vaseline ointment, tacalcitol ointment and weak-potency glucocorticoid ointment for more than 6 years. The skin lesions regressed during treatment, but occurred repeatedly after withdrawal. Thereafter, the patient was switched to simvastatin ointment for 2 years. The skin lesions increased proportionally with the increase of age, and the affected limb grew a little more rapidly than the healthy limb. By January 2020, the skin lesions on the right lower jaw, right neck, and the first to fourth fingers of the right hand had subsided, but new band-like hypertrophic verrucous plaques occurred on the fifth finger of the right hand; the skin lesions on the right leg were slightly improved, and no involvement of other systems was observed.

Objective To evaluate the clinical application value of reflectance confocal microscopy(RCM) in the diagnosis of several common diseases manifesting as papules in children, including lichen nitidus, verruca planae, lichen striatus, milium, molluscum contagiosum and lichen pilaris. Methods A total of 579 children clinically characterized by papules were recruited into this study. RCM was used to observe lesions and perilesional normal skin. The RCM features of 6 diseases manifesting as papules were analyzed and compared. Results Based on RCM images, 236 patients were diagnosed with lichen nitidus, 70 with verruca planae, 123 with lichen striatus, 40 with milium, 53 with molluscum contagiosum and 57 with lichen pilaris. All the 6 diseases had typical RCM features. Concretely speaking, RCM images of lichen nitidus lesions showed infiltration of dense inflammatory cells and melanophages in enlarged dermal papillae. In RCM images of verruca planae lesions, cells in the granular and spinous layers were arranged in concentric circles, giving a rose cluster?like appearance. RCM images of lichen striatus lesions revealed focal swelling of stratum spinosum, absent or local liquifaction degeneration of basal cells, and clustering of a moderate number of inflammatory cells in the superficial dermis. In RCM images of milium lesions, well?circumscribed round or oval structures containing highly but nonuniformly refractive materials could be seen in the dermis. RCM images of molluscum contagiosum lesions showed intact cystoid structures containing highly refractive molluscum bodies. Lowly to moderately refractive cutin ? like materials were observed along with the dilation of hair follicle infundibula in RCM images of lichen pilaris lesions. In RCM images, the 6 diseases were distinguished mainly based on structural features(patterns and refractivity)of skin lesions shown by continuous vertical scanning. Conclusion RCM is of great value to the diagnosis of diseases manifesting as papules in children.

Objective To study the expression of BDNF and TrkB in hippocampal microglia cells of poststroke depression (PSD) rats.Methods Forty healthy adult SD rats were randomly divided into normal group,depression group,stroke group and PSD group (10 in each group).Expression of BDNF and TrkB in OX42-marked hippocampal microglia cells of PSD rats was detected with immunofluorescence staining on day 29 and 57 after a MCAO model rats was established and a chronic stress depression model of rats was established by chronic unpredictable mild stress (CUMS) combined with separate breeding.Results The absorbance value of BDNF and TrkB was 83.35t5.74 and 82.35±5.74 respectively in PSD group on day 29 after the CUMS of rats was established,which was significantly lower than other 3 groups (P＜0.05),and was significantly higher in depression group than in stroke group (141.23±9.16 vs 133.31±7.89;141.23± 8.07 vs 128.62±6.92,P＜0.05).The absorbance value of BDNF and TrkB was 81.63±7.19 and 74.43±7.42 respectively in PSD group on day 57 after the CUMS of rats was established,which was lower than in other 3 groups,and was significantly lower in stroke group than normal group and depression group (93.36±7.56 vs 124.11±11.39、116.65±10.55,87.14±6.56 vs 112.58± 10.99、108.05±10.57,P＜0.05).Conclusion Hippocampal microglia cells play an important role in the pathogenesis of PSD by down-regulating the expression of BDNF and TrkB in PSD rats.

Objective To explore the clinical value of adaptive statistical iterative reconstruction(ASIR)combined with automatic tube current modulation in low dose scan of chest CT.Methods 80 patients who underwent chest CT scan were randomly divided into four groups,with a noise index(NI)of 14,16,18,and 20,respectively.Automatic tube current modulation technique for chest CT scan was adopted for all patients.The standard dose group,with a NI of 14,was reconstructed with FBP.While the low-dose groups,with a NI of 16,18 and 20,were reconstructed with four ASIR levels(20% ASIR,40% ASIR,60% ASIR and 80% ASIR) in each group.The volume CT dose index(CTDIvol),dose length product(DLP)and effective dose(ED)were recorded of the four groups.The signal-to-noise ratio(SNR)and contrast-to-noise ratio(CNR)were calculated of the different reconstruction groups. Two radiologists with more than five years of work experience blindly scored the subjective image quality.Results Effective dose of the four groups with different NI were(3.29 ± 1.21)mSv,(3.10 ± 1.07)mSv,(2.20 ± 0.82)mSv and(1.97 ± 1.21)mSv,respectively. In all the reconstruction groups,when NI was constant,the greater the ASIR,the lower the SD.When ASIR percentage was constant, the SD was increased and the SNR was reduced along with NI rising up.When the parameters were set as NI 18 and ASIR 60%,the SD would be smaller and SNR would be higher than that of a standard dose group.In aspect of the scores from subjective image quality evaluation,there was no significant difference(P> 0.05).The average ED was decreased by about 33.2% when compared to the standard dose group.Conclusion Combining automatic tube current modulation with ASIR has a certain clinical practicality.When the NI is set at 18 and ASIR is 60%,the image quality can be optimal for not only satisfying the requirements of clinical diagnosis, but also reducing radiation dose in chest CT scanning.

Objective:To evaluate the clinical efficacy of 1 064 nm/755 nm dual wavelength laser on hair removal.Methods:A total of 60 patients aged 18-52 (30±7) years in our hospital from January 2017 to December 2017 were collected. 1 064 nm and 755 nm laser hair removal was performed at the same symmetrical areas or two different areas in the same patient. We performed 6 sessions of laser treatment at 6-week intervals and the effect was evaluated 6 weeks after the last session.Results:The hair removal efficacy was 96.7% (58 cases) at 1 064 nm, 96.7% (58 cases) at 755 nm laser treatment. There was no significant difference in the effective rate between two wavelengths laser hair removal methods ( P>0.05). The incidence of pigmentation was 1.7% (1 case) at 1 064 nm laser and was 3.3% (2 cases) at 755 nm laser without significant difference ( P>0.05). No hypopigmentation, blister or scar appeared in all patients. The total satisfactory rate was 95.0% (57 cases) at 1 064 nm, 98.3% (59 cases) at 755 nm laser treatment, respectively. Conclusions:1 064 nm/755 nm dual wavelength laser has definite therapeutic effect and safety on hair removal.

Objective: To elucidate age and sex specific characteristics in fat free mass (FFM) among middle and high school adolescents in Yinchuan City, China, and to provide a scientific basis for healthy development, chronic disease prevention and intervention in children and adolescents. Methods: Using a convenient cluster sampling method, 1 175 middle and high school adolescents, aged 10 to 20 years old, from Yinchuan, China, were selected to participate in a questionnaire survey and physical examination, which involved body composition by bioelectrical impedance analysis(BIA). Results: For adolescents aged 12 to 18 years, FFM and the fat free mass percentage (FFMP) of boys increased with age(from 39.78 to 52.63 kg; 77.51% to 83.80%, respectively), the age trends of the FFM and FFMP of body parts were in the similar pattern, and were significantly higher than those of girls(all P <0.05). In girls, the FFM reached a peak of 40.96 kg at 15 years old, and decreased slightly between the ages of 15 and 18 years, the age trends of the FFM of body parts were in the similar pattern, and the FFMP decreased with age (from 75.63% to 71.91 %). In addition, in girls, the age trends of the FFMP of left and right legs were the same as the general trend, while the FFMP of left and right arms increased with age. The FFMP of the trunk reached a minimum of 29.93% at 15 years old and increased from 15 to 18 years old(all P <0.05). Conclusion For middle and high school adolescents aged 12 to 18 years old in Yinchuan City, China, the distribution of FFM changed in accordance with age and gender differences, in accordance with the characteristics of the adolescents growth and development.

Objective: To explore the relationship between different mutation characteristics and clinical phenotype of children with Dravet syndrome (DS) with SCN1A gene mutation, and to summarize the drug efficacy. Methods: The clinical data of children diagnosed as DS from the Department of Pediatrics Neurology, the Third Affi-liated Hospital of Zhengzhou University from January 2014 to May 2018 were collected.The peripheral blood DNA of the children was detected by adopting next generation sequencing for epilepsy-related gene-panel, while the parents′ were screened by using Sanger sequencing for family verification.Multiple ligation-dependent probe amplification technology was used to detect large fragment variation of SCN1A gene if the mutations of the children were negative.The Gesell scale and cavity Wechsler intelligence scale for children(C-WISC) were used to evaluate the intelligence of children. Results: A total of 50 cases of DS were collected, 38 cases of them were positive for SCN1A mutation, and the mutation rate was 76.0%(38/50 cases), of which, the missense mutation[50.0%(19/38 cases)] and frameshift mutation[28.9%(11/38 cases)] were dominant.The average onset age of 50 patients was 6 months, of which onset of seizures was triggered by fever(temperature>37.5 ℃) in 68.0%(34/50 cases)of children, the history of seizures in hot baths was found in 60.0%(30/50 cases) of children, status epilepticus was found in 74.0%(37/50 cases), cluster-like episodes was found in 80.0%(40/50 cases), ≥2 seizure types was found in 92.0%(46/50 cases). Mental retarda-tion was found in most of the children, of which 30.0% (15/50 cases) were mild mental retardation, 38.0% (19/50 cases) were moderate mental retardation, 14.0% (7/50 cases)were severe intelligence retardation.Interictal abnormalities of electroencephalogram(EEG) before 1 year old was found in 24.0%(12/50 cases), and the average age of EEG abnormalities was 30.12 months old; the top three drug efficacy rates were 70.0% (28/40 cases) of Topiramate, 48.0% (24/50 cases) of Sodium Valproate, 45.7% (16/35 cases) Clonazepam or Clobazam.The time of onset of myoclonus and atypical absence of the truncation mutation group was earlier than that of the missense mutation group(14.75 months vs.21.20 months; 16.82 months vs.26.00 months), and the difference was statistically significant(P<0.05). The proportion of clustered episodes in the truncation mutation group was higher than that in the missense mutation group [94.7%(18/19 cases)vs.63.2%(12/19 cases)], and the difference was statistically significant (P<0.05). There was no significant correlation between the SCN1A gene mutation (type and position) and age of onset, type of seizure, proportion of convulsion persistence, the mental development or abnormal proportion of EEG and seizure frequency before 1 year old(all P>0.05). Conclusions The SCN1A gene mutation rate is high in children with DS, and the SCN1A gene mutation characteristics has a certain correlation with DS clinical phenotype.Topiramate is the most effective drug among children with DS.