Objective:To study the reliability, validity of PANSS(Chinese version) and its implication.Methods:105 schizophrenic patients were recruited and were evaluated using PANSS. The principle component analysis and reliability analysis were used to study the factor structure and internal reliability, homogeneity among items.Results:Factor analysis resulted in a five-factor: negative, positive, excitement-hostile, anxiety/depression, cognitive defect. The internal consistency reliability was 0.87 (Cronbach ?). The internal consistency reliability of the 5 dimensions ranged from 0.74～0.90.Conclusion:The structure, validity and reliability of PANSS (Chinese version) are acceptable. PANSS can be used to assess the symptoms of schizophrenia in Chinese patients.

Objective To investigate the therapeutic effect of topiramate on diabetic peripheral neuropathy.MethodsEighty three patients with diabetic peripheral neuropathy were randomly divided into the control group (n=40) and treatment group (n=43). All patients of two groups were given antidiabetic drugs and vitamine B treatment. While the treatment group was added with topiramate orally for 1 month.ResultsThe total effective rate of the treatment group and control group were 90.7% and 67.5% respectively with a significant difference between two groups ( P<0.05). The velocity of sensory and motor conduction of all patients obviously increased after one month treatment, but the nerve conductive velocity of the patients in the treatment group was significantly higher than that in the control group ( P<0.001).ConclusionOn the basis of lowing blood glucose, using topiramate is more effective on diabetic peripheral neurophy and without obvious side effect.

Objective To investigate the effects of repeated neonatal administration of dizocipline maleate (MK-801), the N-methyl-D-aspartate (NMDA) receptor antagonist, on the expression of NMDA receptor subunits NMDAR 1 (NR1), NMDAR2A (NR2A), NMDAR2B (NR2B) and the protein levels of nerve growth factor (NGF) in neonatal rats. Methods Neonatal Sprague-Dawley (SD) rats were randomly divided into research group and control group, with 15 ani-mals in each group. Rats were administrated subcutaneously with MK-801 or normal saline from postnatal day (PND) 5 to PND14 (0.25 mg/kg, twice a day). The expression levels of NR1, NR2A, NR2B and NGF were examined on PND15, PND42 and PND70 in the prefrontal cortex and hippocampus. Results At PND15 (neonatal period), there were no signifi-cant differences in the expression levels of NR1, NR2A, NR2B and NGF in the prefrontal cortex and hippocampus be- tween the two groups (P>0.05). At PND42 (adolescence), NGF protein levels in the prefrontal cortex was significantly low-er in research group than in control group [(56.19±37.87) vs. (152.54±53.92), P<0.01]. At PND70 (adulthood), the expres-sion of NR1, NR2A in the hippocampus was significantly higher in research group than in control group [NR1:(149.55%± 27.00%) vs. (100.00%±32.08%);NR2A:(171.54%±19.85%) vs. (100.00%±51.04%). P<0.05]. Conclusion Neonatal re-peated treatment of MK-801 increases the expression of NMDA receptor subunits NR1, NR2A in the hippocampus in adulthood while decreases the expression of NGF in the prefrontal cortex in adolescence, suggesting that neonatal block-ade of the NMDA receptor may influence the growth and development of the nervous system.

Objective To survey age of menarehe in Pudong district in Shanghai. Methods Data in this study were derived from 56 924 women at age of 20 -81 years in screening for cervical cancer between January 2007 and July 2008 in Pudong district. The age of menarche were recorded in a questionnaire. To investigate the trends in age at menarehe in different socioeconomic status, the subjects were divided into 12 groups in 5-year birth cohorts. The mean menarche age in each group was analyzed by analysis of variance(ANOVA). The percentage of menarche age at 10- 12 years and more than 18 years was analyzed by χ2 method. Results (1 ) The minimum age of menarcbe recorded is 10 years old, and the maximum is 28 years old, with average age of menarche at 15.7 years. In all groups, the smallest average age of menarcbe is 14. 6 years in 26 - 30 years old age group, while the biggest average age of menarche age is 16. 5 years in ＞ 75 years old group; The difference showed statistical significance (P ＜ 0. 01 ). (2) The percentages for participants with early menarehe age (10 - 12 years old) or late menarehe age (＞ 18-year-old menarche) were 1.82% (1034/56 924 ) and 5.20 % (2959/56 924 ) respectively. However, the maximum percentage for early menarche was recorded in 31 -35 years old group (4. 45% ,197/4431 ), only 0. 84% (10/1191 ) of participants in ＞75 years old group was classified as early menarebe. Meanwhile, the lowest percentage for late menarehe was 0. 38% (17/4431 ) in 31 - 35 years old group, and the highest percentage was 14. 70% (91/619) in ＞ 75 years old group. The changes in the percentages for early menarche or late menarche are significantly associated with age differences (P ＜ 0. 01 ). Conclusion The study suggested that the average of onset age of menarche in Pudong district has declined over the past decades in an age-based way, accompanied with the increase of the percentage for early menarche and the decrease of percentage for late menarehe.

Objective To investigate natural spontaneous menopausal age , menstruation span and their relationship with menarche age and parity in Pudong district of Shanghai. Methods From Jan 2007 to Jul 2008, 15 083 spontaneous menopause women undergoing cervical cancer screening were enrolled in this study. The questionnaire included menarche age, parity, spontaneous menopausal age and menstruation span. Those women were divided into four groups based on age, which were group of 56 -60, 61 -65, 66 -70 and more than 70. Analysis of variance (ANOVA) was used for comparing difference between menopausal age and menstruation span. Multiple factor regressions was used to analyze the relationship between menarche age, parity and menopausal age and menstruation span. Results (1) Spontaneous menopausal age: the minimum was 29 years old, the maximum was 61 years old, and the mean age was (50.6 ±3.7)years old. The mean spontaneous menopause age were (50.9 ± 3.4), ( 50.7 ± 3.7 ), (50.0 ± 4.1 ), (49.6 ±4.0) years in groups of 56 -60, 61 -65, 66 -70 and more than 70 years. With the increasing age range in four groups, the increasing trends of menopausal age were observed, which the difference of 1.36 year was shown between groups of 56 - 60 and more than 70 years. (2) Menstruation span: the mean of menstruation span was (34.3 ± 4.1 ) years, which the minimal age of 12 years and maximal age of 48 years were recorded. (34.6 ± 3.8), (34.3 ± 4.1 ), (33.9 ± 4.6), (33.2 ± 4. 5) were observed in groups of 56 - 60,61 -65, 66 -70 and more than 70 years. With the increasing age range in four groups, the increasing trends of menstruation span were observed, which the difference of 1.41 year was shown between groups of 56 –60 and more than 70 years. (3)The impact of menarche age on menopausal age and menstruation span: there was no correlation between menarche age and menopausal age ( r = 0.02); however, menstruation span was found to be negatively correlated with the menarche age ( r = - 0.43 ). (4) The impact of parity on menopausal age and menstruation span: the mean menopausal age of women who had 1 -2 deliveries was significantly higher than those had no delivery or more than 3 deliveries ( P < 0.05 ). However, there was no difference in menopausal age between women with 1 and 2 deliveries or between women without delivery and more than 3 deliveries (P > 0.05). Menstruation span of women with 1 delivery was significantly longer that those with more than 1 delivery( P < 0.05 ), similarly, women with 2 deliveries had longer menstruation span than women without delivery or more than 3 deliveries(P < 0.05 ). There were no difference in menstruation span between women with more than 3 deliveries and without delivery ( P >0.05 ). (5) Multifactor regression analysis for menstruation span: menarche age was correlated with menstruation span negatively ( r = - 0.97,P <0.001 ). There was significantly different menstruation span between group of 61 -65, 66 -70 or more than 70 years and group of 56-60 (r= -0. 18, P=0.020; r= -0.78,P <0.001 and r= - 1.23,P<0.001). Menstruation span in women with 1 -2 deliveries was significantly longer than that of women without delivery or more than 3 deliveries. (6)Multifactor logistic analysis of menopausal age: there was no association between menarche age and menopausal age, however, significant differences were found in mean menopausal age between different groups, which show that menopausal age of group 56 - 60 years was significant higher than the other groups, including age-group 61 -65 years ,66 -70 years and over 70 years ( r = - 0.18, P = 0.020; r = - 0.78,P < 0.001; r = - 1.23, P < 0.001 ). Menopausal age in women with 1 - 2 deliveries was significantly higher than those of women without delivery or with more than 3 deliveries,however, no difference between women with 1 and 2 deliveries or between women without deliveries and more than 3 deliveries was observed. Conclusion (1) Menopausal age and menstruation span exhibited increasing trends in Pudong district of Shanghai. (2) Menarche age and parity were the important factors influencing menopausal age and menstruation span. (3) With younger age of menarche, the menstruation span become longer. (4) Deliveries of 1 -2 times can significantly delay the menopause and prolong menstruation span, however, the multiple deliveries ( ≥ 3 times) had no significant impact on menopausal age and menstruation span.

Objective To analyze the risk factors of socio-demographic and clinical characteristics related to sui?cide risk in misdiagnosed bipolar disorderⅡ(BPⅡ) treated for major depressive disorder. Methods A total of l478 con?secutive major depressive disorder patients were interviewed with the Mini International Neuropsychiatric Interview (MINI) in 13 major mental health centers in China. Of the 1478 patients, 190 patients were diagnosed BPⅡ, who were divided into two groups (nonsuicidal risk and suicidal risk) with the suicidality module of MINI. Logistic regression was performed to evaluate significant risk factors associated with suicide risk in misdiagnosed BPⅡtreated for major depres?sive disorder. Results Of the 190 patients, 116 were in the nonsuicidal risk group and 74 were in the suicidal risk group. In comparison to the nonsuicidal risk group, the suicidal risk group had younger age [(34.45 ± 11.18) vs.(37.23 ± 13.22), P=0.008], earlier age at onset [(26.20 ± 9.16) vs. (30.37 ± 11.59), P=0.007], and more suicidal ideation (82.4%vs. 53.4%, P=0.001). Logistic regression analysis showed that age (OR=0.969,95% CI:0.945~0.993) and depressive epi?sodes with suicidal ideation (OR=4.129,95%CI:2.030~8.397) were significantly associated with suicide risk in patients of misdiagnosed BPⅡtreated for major depressive disorder (P<0.05). Conclusions Younger age, severer suicidal ide?ation may be potential independent risk factors to suicide risk in BPⅡwith misdiagnosed with major depressive disor?der.

Objective To analyze the risk factors of socio-demographic and clinical characteristics related to sui?cidal attempt in major depressive disorder (MDD) patients with anxious characteristics. Methods Based on the anxious module of Mini International Neuropsychiatric Interview (MINI), a total of 728 anxious MDD patients from 13 major men?tal health centers in China were classified as suicidal and non-suicidal attempt groups. Further analyses regarding risk factors of suicidal attempt in anxious MDD patients were performed by the multivariate logistic regression analysis. Re?sults Among the 728 patients with anxious MDD analyzed, 135 (18.5%) of them had suicidal attempt and 593 (81.5%) had non-suicidal attempt. Compared to the non-suicidal attempt group, patients with suicidal attempt had significantly earlier age onset[(32.3 ± 11.9) vs. (35.3 ± 13.1)], more lifetime depression episodes (median:2 vs. 2), more number of ad?missions (median: 1 vs. 0), more frequent depressive episodes (14.8% vs. 7.4%), more atypical characteristics (25.9%vs.15.0%), more suicidal ideation (78.5%vs. 50.3%) and more antidepressant use (81.5%vs. 71.2%). Logistic regression analysis showed that number of admissions (OR=1.18, 95%CI:1.02~1.37), frequent depressive episodes (OR=2.10, 95%CI:1.14~3.68), depressive episodes with suicidal ideation (OR=3.55, 95%CI:2.28~5.54) were associated with suicidal at?tempt in MDD patients with anxious characteristics (P<0.05). Conclusions More number of admissions, more frequent depressive episodes, comorbid suicidal ideation may be risk factors of suicidal attempt in anxious MDD patients.

Objective:To compare the suicidality risk in major depressive disorder (MDD)patients with and without anxious characteristics,and analyze the risk factors of suicidality in MDD patients. Methods:This was a secondary analysis of the data from the Diagnostic Assessment Service for people with Bipolar Disorders in China (DASP),which was initiated by the Chinese Society of Psychiatry (CSP),from September 1,2010 to February 28, 201 1. Based on the anxious module and suicide module of Mini International Neuropsychiatric Interview (M. I. N. I),1 172 MDD patients were classified as suffering from anxious MDD (n=728,62. 1%)and non-anxious MDD(n=444,37. 9%). Logistic regression was employed to examine the risk factors of suicidality in MDD pa-tients. Results:Among the anxious MDD patients,331 (45. 5%)of them had suicidality risk. And 54(12. 2%)of non-anxious MDD patients had suicidality risk. Compare to the non-anxious group,the anxious MDD patients had significantly higher suicidality risk (P<0. 00 1 ). Logistic regression analysis showed that more frequent depressive episodes (OR=2. 07 ),depressive episodes with psychotic symptoms (OR=2. 0 1 ),comorbid with anxious charac-teristics (OR=3. 18)or melancholic characteristics (OR=2. 90)were associated with suicidality risk in patients with MDD. Conclusion:It indicates that the anxious MDD patients may have higher suicidality risk than non-anx-ious MDD patients,and more frequent depressive episodes,depressive episodes with psychotic symptoms,comorbid with anxious characteristics or melancholic characteristics may be risk factors of suicidality in patients with MDD.

Objective To explore the attempted suicide risk factors of socio-demographic and clinical charac-teristics in major depressive disorder patients with atypical features (e.g. increased appetite, weight gain and greater time spent sleeping). Methods This was a secondary analysis of the data from the Diagnostic Assessment Service for People with Bipolar Disorders in China (DASP), which was initiated by the Chinese Society of Psychiatry (CSP) and carried out in 13 major mental health centers in China. Totally 179 patients were diagnosed as atypical major depres-sive disorder patients in all 1172 major depressive disorder patients using Diagnostic and Statistical Manual of Mental Disorder, Fourth Edition (DSM-Ⅳ) by psychiatrists. Suicide attempters and nonattempters were grouped base on the interview results of suicidality module of the Mini International Neuro-psychiatric Interview (MINI). Multiple logistic regression were used to assess association between independent variables and attempted suicide in major depressive disorder patients with atypical features. Results The rater of attempted snicide was 23.5% (42/179) of atypical major depressive disorder patients reported prior or current attempted suicide. Compared to nonattempters, attempters had higher levels of suicidal ideation, postpartum depressive episodes, and the use of antipsychotic, mood stabilizers and benzodiazepines (P<0.05). Logistic regression analysis showed that number of admissions (OR=1.73, 95% CI: 1.093~2.740) and depressive episodes with suicidal ideation (OR=3.90, 95%CI: 1.506~10.092) were significantly associat-ed with attempted suicide in atypical unipolar depression patients (P<0.05). Conclusions High number of admissions and high levels of suicidal ideation may be considered as potential risk factors to identify atypical unipolar depression patients at risk for future suicidal behavior.

Objective： ：To detect the gene mutation in cholangiocarcinoma patients using the next generation sequencing (NGS) technology, and to analyze its correlation to the prognosis of the patients. Methods: From June 2016 to June 2018, 40 patients diagnosed with cholangiocarcinoma received NGS examination to screen the possible mutations (single base mutation, structural variation, copy number variation and gene fusion, etc.). The disease control rates (DCR), progression-free survival (PFS) and overall survival (OS) of the patients, who received the first line therapy, were retrospectively reviewed to analyze the relationship between signaling pathway as well as its genetic variation and the prognosis of cholangiocarcinoma patients. Results: The median PFS of patients with and without TP53 mutation was 11.0 and 8.3 months, respectively (P=0.332), while OS was 14.3 and 32.9 months, respectively (P=0.041). The median PFS of patients with and without PI3K mutations was 8.3 and 11.0 months, respectively (P=0.285), while OS was 14.3 and 37.0 months, respectively (P=0.020). The median PFS of patients with and without mTOR pathway mutations was 6.3 and 10.3 months, respectively (P=0.020), while OS was 15.6 and 19.6 months, respectively (P=0.892). There was no significant effect of pathway-related gene mutations on patients’survival. Conclusion: The prognosis of cholangiocarcinoma patients with TP53 and PI3K pathway activation had obviously poor prognosis than those without. No significant difference was observed between the patients with and without mTOR pathway activation and IDH mutation.