Objective To study the liver fat content (LFC) in schizophrenia patients during olanzapine or aripipra?zol treatment, and to explore the relation between LFC and insulin resistance (IR). Methods Schizophrenia patients were randomly administered with olanzapine (10~25 mg/d, n=57) or aripiprazole (15~30 mg/d, n=47) for eight weeks. All sub?jects underwent sonographic quantification of LFC and homeostasis model assessment of insulin resistance index (HOMA-IR) once 0, 4, 8 weeks of treatment. Results Compared with baseline, the levels of HOMA-IR significantly in?creased after a 4-week and an 8-week of olanzapine treatment, and so did the LFC after an 8-week of olanzapine treat?ment (P<0.05). The levels of LFC (P>0.05) or HOMA-IR (P>0.05) did not significantly changed at week 4 and 8 in ar?ipiprazol group. The increment of LFC, HOMA-IR at week 8 was significantly higher in olanzapine group than that in ar?ipiprazol group (P<0.05). The change of LFC after 8-weeks olanzapine treatment was positively correlated with the change of HOMA-IR (r=0.298, P=0.036). Conclusion Olanzapine treatment increases whereas aripiprazol has little ef?fect on liver fat and insulin resistance in schizophrenia.

Objective To assess attitudes and its related factors of Chinese military personnel on homosexual served in the military.Methods 1362 enlisted military personnel,selected from land force by cluster sampiing,were interviewed by Military Personnel's Attitudes Toward Homosexuals in the Military Scale(ATHM).Results The attitudes of the present sample toward homosexual served in the military were found to be negative(the total score on the ATHM scale was (29.28 ± 6.59).The threat dimension made the biggest contribution to the negative attitude,followed by the comfort dimension.Marital status was negatively related to the total scores of ATHM (r =-0.067,P ＜ 0.05),and other demographic variables such as age,only child,nationality,childhood environment,education level,years of service,and military rank were not associated with attitudes toward homosexuals in the military (r =-0.01,0.002,-0.035,-0.041,-0.015,-0.041,-0.039,P ＞ 0.05).Further multiple linear regression analysis found that marital status was one of the attitudes' predictors.Conclusion Because of the threat and discomfort with homosexual,the attitudes toward homosexual in the military are mildly negative,and marital status correlate with it.

Objective To investigate the diagnosis and treatment of ectopic opening of the common bile duct in the duodenal bulb.Methods The clinical data of 3 patients who were admitted to the Binzhou People's Hospital and 9 patients who were admitted to the Tianjin People's Hospital from January 2006 to December 2013 with ectopic opening of the common bile duct in the duodenal bulb were retrospectively analyzed.Seven patients had choledocholithiasis and 5 had stenosis at the end of common bile duct.The medical histories and clinical features in patients were analyzed and routine blood test and serum liver function test were done.All the patients received the endoscopic retrograde cholangiopancreatography (ERCP) examination and were cured.All the patients were followed up via outpatient examination and telephone interview up to August 2014.Results Six patients had histories of cholangitis recurrence and 2 had histories of duodenal ulcer recurrence.All the patients had pain in the right hypochondriac region of the abdomen.Seven patients had fever,chills,skin yellowing sclera and tenderness in the right hypochondriac region of the abdomen.The levels of alkaline phosphatase (ALP) and glutamyltranspeptidase (GGT) in 11 patients,the levels of TBil and DBil in 8 patients and the count of WBC in 7 patients were increased.(1) The results of ERCP showed as follows:there was no papillar opening at the second and third segment of duodenum.The crack-like opening located at the duodenal post-bulb with rough and erosive mucosal surfaces and intermittent outflow of bile.Duodenal ulcer was detected in 5 patients and duodenal bulb metamorphosis in 3 patients.All the 12 patients received successfully intubations.(2)The results of retrograde cholangiography showed as follows:the end of common bile duct of 12 patients was taper and sickle-shaped.Intra-and extrahepatic bile duct dilation was detected in 10 patients,choledocholithiasis in 7 patients and clear findings for the pancreatic duct in 5 patients.Among the 12 patients,8 received balloon dilation (5 with stenosis at the end of common bile duct,3 with choledocholithiasis),3 received laparoscopic common bile duct exploration (LCBDE) combined with cholangioenterostomy due to diameter of stone more than 1.5 cm and ectopic opening stenosis of the common bile duct in the duodenal bulb.One patient was treated by percutaneous transhepatic cholangiography (PTC) lithotomy of common bile duct after unsuccessful ERCP without bleeding and pancreatitis-related complications.The symptoms of cholangitis in 3 patients were alleviated after balloon dilation,2 patients had recurrence of cholangitis and were cured by Roux-en-Y cholangioenterostomy.The mean open surgery time and mean duration of postoperative hospital stay in 5 patients were 85 minutes (range,60-150 minutes) and 10 days (range,8-14 days),respectively.All the 12 patients were followed up with a median time of 38 months (range,8-90 months).During the follow-up,10 patients survived well without recurrence of cholangitis and cholelithiasis.Two patients had recurrence of cholangitis at postoperative month 2 and month 14,including 1 patient with the recurrence of common bile duct sand-like stones,and they were readmitted to hospital and treated by Roux-en-Y cholangioenterostomy without recurrence by follow-up.Conclusions The clinical symptoms of ectopic opening of the common bile duct in the duodenal bulb included recurrence of cholangitis,duodenal ulcer history,pain in the right hypochondriac region of the abdomen,skin yellowing sclera,abnormal liver function,crack-like openings in the duodenal bulb by ERCP examination with outflow of bile,cholangiography-guided taper and sickle-shaped end of common bile duct.The treatment should be aimed at the concomitant diseases.

Objective To explore the effect of childhood abuse on suicidal ideation and the influencing factors among recruits.Methods Through stratified sampling,505 recruits in Nanjing were tested by childhood Trauma Questionnaire (CTQ),Simplified Coping Style Questionnaire (SCSQ),Social Support Rating Scale (SSRS),Self-rating Idea of Suicide Scale(SIOSS) and Beck Hopelessness Scale (BHS).Results 1.The scores of suicidal ideation and hopelessness in recruits who had childhood abuse were significantly higher than those in control group ((5.56±4.58) vs (2.11±2.79),(5.93±3.01)vs (3.10±2.27),P＜0.01).2.The score of positive coping in recruits who had childhood abuse was significantly lower than that in control group(18.98±6.16 vs 23.27±7.45; P＜0.05).The score of negative coping in recruits who had childhood abuse was significantly higher than that in control group(9.27±5.04 vs 23.27±7.45; P＜0.01).3.The scores of social support in recruits who had childhood abuse were significantly lower than that in control group ((69.38± 10.43),(20.16±3.97),(25.73±3.68),(22.82±5.52) vs(75.55±9.67),(23.25±2.50),(27.56±3.51),(24.67±5.33) ; P＜0.05).4.The score of total CTQ was positively correlated with suicidal ideation,hopelessness,negative coping(r=0.379,0.402,0.228; P＜0.01),but negatively correlated with active coping style,social support(r=-0.285,-0.302; P＜0.01).Conclusion The recruits who had childhood abuse are susceptible to suicidal ideation.The negative coping style and lacking of social support may be the main factors to the suicidal ideation.

Objective To evaluate the harmful effects of olanzapine and quetiapine therapeusis on swallowing ability in patients with Alzheimer'disease (AD).Methods AD inpatients with behavioral and psychological symptoms were randomly divided into two groups,treated with olanzapine (n=42) or quetiapine (n=38) for 6 weeks.The patients were assessed with Kubota's water swallowing test and arterial oxygen saturation(SaO2) monitoring pre and pro treatment.Results After treatment,a significant higher score of water swallowing test (t =2.682,2.040;both P＜ 0.05)in either of two groups,and a significant raised degrade of SaO2 only in olanzapine group(t=4.313,P＜0.01)but not in quetiapine group (P＞0.05)were observed.There was a significant higher degrade of SaO2 in olanzapine group than that in quetiapine group (t=2.155,P＜0.05)at 6 weekend of the study.Before pharmacon,about 29％ (23/80) AD subjects were diagnosed as dysphagia.After pharmacon,more emerging dysphagia patients were surveyed in olanzapine group compared with that in quetiapine group(9/31 vs 2/26,x2=4.135,P＜0.05).No significant change (both P＞0.05) in scores of mini-mental state examination(MMSE) and a significant reduced score(t=3.019,2.867;both P＜0.01)of behavioral pathology in Alzheimer'disease rating scale (BEHAVE-AD) were found in both two groups at the end of study.There was no difference among the two groups with regard to score of MMSE or BEHAVE-AD after treatment(both P＞0.05).Conclusion Either olanzapine or quetiapine therapeutics might do some harmful effects on swallowing function in patients with AD,especially the former.

Objective To investigate the possible role of plasma leptin and total cholesterol in the pathophysiology of attempted suicide in depressive episode patients. Methods The subjects were 25 depressive episode patients who had recently attempted suicide and 30 depressive episode patients without suicide attempt. The Hamilton Depression Rating Scale-24 items ( HAMD24 ), Beck Helpless Rating Scale (BHS) and Self-rating Idea of Suicide Scale (SIOSS) were used to evaluate the severity of symptoms. In addition, 32 individuals who took part in health examination were selected as health control group. Body height and weight were measured to get body mass index (BMI) of all objects, and plasma leptin and total cholesterol were measured by venous blood before taking pill. Results (1)HAMD score , BHS score and SIOSS score in patients with attempted suicide were higher than patients without suicide (P ＜ 0.01 ). (2) The total cholesterol and plasma leptin in patients with attempted suicide ( (3.3 ±0.9)mmol/L, (6.1 ±3.7)μg/L)were lower than that in patients without suicide( (3.6± 1.2)mmol/L, (9.4 ± 4.4)μg/L; P ＜ 0.05 ～ 0. 0l ), while total cholesterol and leptin in patients without suicide attempt ( (3.6 ± 1.2 ) mmol/L, ( 9.4 ± 4.4 ) μg/L) were lower than that in normal controls ( ( 4.8 ± 0.9 )mmol/L, ( 13.4 ± 6.7 ) μg/L; P ＜ 0.05 ～ 0.01 ). (3) Plasma leptin and total cholesterol of all patients were positively correlated with BMI(P＜0.01 ). Moreover, plasma leptin and total cholesterol in patients with attempted suicide and patients without attempted suicide were inversely positively correlated with HAMD score , BHS score and SIOSS score. Plasma leptin was significantly positively correlated with total cholesterol in patients with attempted suicide and patients without suicide, but there was no significant difference in normal controls(P＞ 0. 05). Conclusion The results suggest that decreased plasma leptin is related to the pathophysiology of attempted suicide in depressive episode patients.

The clinical data of 5 patients with autoimmune encephalitis admitted to the psychiatric department of the 904th Hospital of the Joint Logistics Service Force from January 2016 to June 2020 were retrospectively analyzed. Among 5 patients, 4 had stress psychological events within one month before the onset, and 3 had precursor symptoms such as fever and vomiting. They were all characterized by rapid progress of atypical mental and behavioral abnormalities and cognitive impairment. In terms of neurological symptoms, 1 case had faciobrachial dystonic seizures (FBDS), 3 cases had seizures, 2 cases had involuntary movement, and 4 cases had autonomic dysfunction, including central hypopnea, arrhythmia, blood pressure instability and paroxysmal facial flushing. Most neurological symptoms occur within 1 month of the onset. MRI revealed abnormalities in cerebral cortex, thalamus, temporal lobe and insular lobe in 4 cases; EEG demonstrated bilateral short-range medium amplitude θ wave in 2 cases. Abnormal cerebrospinal fluid (CSF) pressure was detected in 4 cases and 2 cases had abnormal cell number CSF. Three patients had positive anti-N-methyl-D-aspartate receptor (NMDAR) antibody, one patient had positive anti-LGI1 antibody, and one patient had positive anti-γ-aminobutyric acid B receptor (GABA BR) antibody. One case was discharged automatically, the remaining 4 patients were treated with glucocorticoid or combined with gamma globulin and cyclophosphamide, antiepileptic drugs, antipsychotic drugs and other symptomatic treatment, and their symptoms were relieved. Patients were followed up for six months, there was slightly slow residual reaction in 2 cases and personality change in 1 case. Autoimmune encephalitis characterized by mental symptoms is likely to be misdiagnosed as mental disorders. Clinicians should identify symptoms different from mental disorders, taking into account of the possibility of autoimmune encephalitis, to make early diagnosis and treatment.

Objective:To investigate the value of large-scale brain network research based on independent component analysis (ICA) in discovering the changes of intrinsic functional connections within and between resting-state networks (RSNs) in first-episode untreated adult patients with major depressive disorder (MDD).Methods:From January 2019 to June 2021, twenty-three patients with MDD (MDD group) and 30 healthy volunteers (HC group) matched with gender, age and years of education were selected. All participants underwent resting-state brain function imaging (rs-fMRI), and the MDD group completed the 17-item Hamilton depression scale(HAMD-17). The independent component analysis (ICA) method was used to analyze rs-fMRI data, and meaningful RSNs were obtained. SPM12 and Gift softwares were used to compare the strength of intrinsic functional connection within and between the RSNs of the MDD group and HC group, and the Pearson correlation analysis was conducted by IBM SPSS statistics 25.0 to evaluate the correlation between the functional connection strength and HAMD-17 scores in MDD group.Results:Compared with the HC group, intrinsic functional connection strength of medial prefrontal cortex (mPFC) (MNI: x, y, z=-6, 54, 25)in MDD group was significantly enhanced, while the intrinsic functional connection strength of the left angular gyrus (AG) (MNI: x, y, z=-48, -66, 21), the left precuneus (PCu) (MNI: x, y, z=-6, -63, 33), the left dorsolateral prefrontal cortex (dlPFC) (MNI: x, y, z=-36, 12, 51)and the right anterior insula (AI) (MNI: x, y, z=36, 21, 0)were significantly weakened. Compared with the HC group, functional connection strength between posterior default mode net work(pDMN) and anterior default mode network(aDMN) in MDD group was significantly weakened ( t=-2.206, P=0.032), and function connection strength between pDMN and left frontal parietal network(lFPN) was significantly strengthened ( t=2.318, P=0.025). In MDD group, intrinsic functional connection strength of mPFC and the functional connection strength of pDMN-lFPN were positively correlated with the HAMD-17 score ( r=0.524, P=0.010; r=0.441, P=0.035). Conclusion:Large-scale brain network study based on the ICA can find abnormal functional connections within and between RSNs in first-episode untreated adult patients with MDD, and provide objective imaging markers for the clinical diagnosis and treatment of MDD.