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The levels of complement component 3, complement component 4, high sensitivity C reactive protein, and uric acid in serum of schizophrenia

Huai TAO ; Fang CHEN ; Hong LUO ; Xiudeng YANG ; Yong LIU ; Yamei TANG

Chinese Journal of Nervous and Mental Diseases.2017;43(9):544-548. doi:10.3969/j.issn.1002-0152.2017.09.008

Objective To examine serum levels of complement component 3(C3), complement component 4(C4), high sensitivity C reactive protein (hs-CRP), and uric acid (UA) in schizophrenia (SZ) patients and study their clinical significance. Methods One hundred forty-four SZ patients were recruited as SZ group. According to use of antipsychotics within four weeks, patients were divided into drug group (77 cases) and non-drug group (67 cases). One hundred forty-seven healthy subjects from health checkup center in the second XiangYa hospital during the same period were selected as control group. The concentrations of serum C3, C4, hs-CRP, and UA from SZ patients and healthy subjects were measured using immuno-scatter turbidmetry, latex-enhanced immunoturbidimetric assay, urea oxidase method, respectively. Results The serum levels of complement C3 and C4 were lower in SZ patients than in control group [(0.99±0.17) g/L vs. (1.03±0.17) g/L、(0.21±0.05) g/L vs. (0.23±0.05) g/L], and the serum levels of UA in serum of was higher in SZ patients than in control group [(351.61±95.90) μmol/L vs. (300.28±39.57) ?mol/L]. The differences had statistical significance (P<0.05, P<0.05, and P<0.001, respectively). The serum levels of C3, C4, hs-CRP, and UA were higher in drug group than in no-drug group [(1.04±0.19) g/L vs. (0.95±0.15) g/L、(0.22±0.06) g/L vs. (0.20±0.05) g/L、1.08(0.33, 5.04) mg/L vs. 0.47(0.28, 1.29) mg/L、(374.54±108.33)μmol/L vs. (331.61±79.03)μmol/L], and the differences had statistical significance (P<0.01).The concentrations of serum hs-CRP and UA were higher in drug group than in control group[1.08(0.33, 5.04) mg/L vs. 0.61(0.33, 1.26) mg/L、(374.54±108.33) μmol/L vs. (300.28±39.57) μmol/L], and differences had statistical significance (P<0.001). Conclusion The serum levels of C3, C4, hs-CRP, and UA in SZ Patients will be of guiding significance for clinical diagnosis of SZ and efficacy evaluation of antipsychotic drugs.

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The study on the correlation of serum levels of tumor necrosis factor with memory in the patients with chronic insomnia disorder

Fang WANG ; Ping QU ; Lan XIA ; hai Gui CHEN

Chinese Journal of Nervous and Mental Diseases.2017;43(9):530-534. doi:10.3969/j.issn.1002-0152.2017.09.005

Objective To explore the changes of serum levels of tumor necrosis factors (sTNF-α and sTNF-β) and their soluble receptors (sTNF-R1 and sTNF-R2), and analyze their relationship with sleep quality and memory in patients with chronic insomnia disorder (CID). Methods Forty-four CID patients and 39 normal controls were enrolled. Pittsburgh Sleep Quality Index (PSQI) and Nine-Box Maze Test were used to assess the insomnia severity and memory functions, respectively. The serum levels of sTNF-α, sTNF-β, sTNF-R1 and sTNF-R2 were examined using protein-chip technology. Results Compared to the controls, CID patients had significantly higher number of errors in spatial working (Z=5.362, P<0.001) and object recognition memories (Z=3.260, P=0.001) in the Nine-Box Maze. In addition, CIDpatients had higher levels of sTNF-αand sTNF-β (Ps<0.001), and lower levels of sTNF-R1 and sTNF-R2 (Ps<0.001). The Spearmen correlation analysis showed that the levels of sTNF-α and sTNF-β were positively correlated with the scores of PSQI (Ps<0.001), whereas the levels of sTNF-R1 and sTNF-R2 were negatively correlated with the scores of PSQI (Ps<0.001). In the CID patients, sTNF-α levels were positively correlated with the errors in both spatial working (γ= 0.380, P=0.017) and object recognition (γ= 0.349, P= 0.030) memories, whereas sTNF-β levels were only positively correlated with the error in spatial working memory (γ=0.414, P=0.009). The levels of sTNF-R1 and sTNF-R2 were not correlated with memory performance (Ps>0.05). Conclusion CID patients have increased levels of sTNF-αand sTNF- whereas have decreased levels of R1 and R2. The elevated sTNF-α and sTNF-β levels are correlated with memory disorders in CID patients.

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Analysis of relative factors associated with the improvement in postoperative vision in patients with meningeal tumors of sellar region invaded the optic canal

Dangqi LIU ; Hui WANG ; Quan HUANG

Chinese Journal of Nervous and Mental Diseases.2017;43(9):526-529. doi:10.3969/j.issn.1002-0152.2017.09.004

Objective To investigate the clinical factors which improved the postoperative vision in patients with meningeal tumor of sellar region invaded the optic canal. Methods Clinical data was collected from medical records of patient with meningeal tumors invaded optic canal from Jan. 2010 to Oct. 2016.A multiple factor analysis with logistic regression method was used to analyze these data. Results There were 55 cases included in the study. Vision was improved in 26 cases including 15 of 17 cases with early epidual optic canal decompression, 5 of 9 cases with Later optic canal decompression and 6 of 29 cases with curettage of optic canal tumor. A univariate analysis showed that resection grade,tumor adhesion and early epidural optic canal decompression were associated with visual improvement. Regression analysis showed that early epidural optic canal decompression was the only factor which could improve postoperative vision. Conclusion Early epidural optic canal decompression should be a good choice to improve the postoperative vision of meningeal tumors of sellar region invaded the optic canal.

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Study on cardiovascular disease risk in inpatients with schizophrenia

Shuai ZHAO ; XiaoQin ZHOU ; Hailong XIA ; Jingjing MU ; Long WANG ; Li ZHU ; Anzhen WANG ; YuXia CHEN ; Wanhong YU

Chinese Journal of Nervous and Mental Diseases.2017;43(9):539-543. doi:10.3969/j.issn.1002-0152.2017.09.007

Objective To describe the cardiovascular risk profile of inpatients with schizophrenia and estimate the 10-year CVD risk in schizophrenia patients. Methods Four hundred sixty-six randomly selected cases of schizophrenia patients and 507 health controls were included in the study. Body mass index (BMI), Fasting blood glucose (FBG), triglyceride (TG),,total cholesterol (TC), smoking rate (smoking people/total people), Framing-ham Risk Score (FRS), high density lipoprotein-cholesterol (HDL-C) and age of the vessel (VA). The 10-year cardiovascular risk(FRS) and age of the vessel (VA) were assessed using the Framing-ham Risk Score. Results 10-year CVD risk was significantly higher in patients with schizophrenia than in control group [(6.71 ±6.95)％ vs. (4.76 ±3.07)％], (P<0.05). Comparing with the control group, smoking prevalence[(41％) vs. (19％)], MS[(25％) vs. (17％)], BMI[(23.67 ±3.61)kg/m2 vs. (21.73±4.11)kg/m2] and VA[(46.7±15.3) vs. (43.7±9.8)] were higher in patients group. SBP[(119.86±14.90)mmHg vs. (128.10±15.41)mmHg] and HDL-C [(1.08±0.27)mmol/L vs. (1.38±0.22)mmol/L] were lower in patients group than in the healthy controls. The FRS score of the patient group was positively correlated with BMI, FBG level and SBP, waist circumference and smoking index (P<0.05) and was negatively correlated with the levels of HDL-C. Multivariate Linear Regression analysis demonstrated that FRS was correlated with FBG (β=0.181,P<0.01)、SBP (β=0.149,P<0.01)、HDL-C (β=-0.107,P<0.01) and smoking index(β=0.554,P<0.01). Conclusion The risk of cardiovascular disease in patients with schizophrenia over the next 10 years is 6.7％, which is significantly higher compared with the control group. Fasting blood glucose, systolic blood pressure, high density lipoprotein, smoking may be associated with 10-year CVD risk of schizophrenia patients.

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Clinical Analysis of 18 cases with orbital apex syndrome

Qitai LONG ; Yifan ZHENG ; Qi WU

Chinese Journal of Nervous and Mental Diseases.2017;43(9):535-538. doi:10.3969/j.issn.1002-0152.2017.09.006

Objective To explore the clinical characteristics, etiology and prognosis of orbit apex syndrome. Methods Clinical data of 18 patients with orbit syndrome was summarized and analyzed. Results All patients developed vision loss, ptosis and diplopia, such as a headache or sore eyes forehead performance. However, the onset symptoms varied including vision decline or loss in 8 cases, headache in 7 cases, eye pain in 1 case, toothache in 1 case, stuffy nose and runny nose in 1 case and exophthalmos in 1 cases. The Causes included trauma in 6 cases (33％), mass lesion in 5 cases (28％), nonspecific inflammation in 1 cases (22％), infection in 3 cases (17％). Vision and eye movements disorder were improved in 5 cases of 6 patients with trauma in which 3 mild cases recovered better and one severe case did not recovered. Of 5 patients with mass lesion, the vision and eye movement were improved in one patients with sphenoid sinus mucocele receiving surgical operation. but not in the rest 4 cases with orbital adenoid cystic carcinoma or osteosarcoma patients receiving either surgical operation or radiotherapy. Of 4 patients with nonspecific inflammatory disease, eye movements were improved in 2 mild cases but not in 2 severe cases. Of 3 infectious diseases, eye movements were improved in 1 mild case. Conclusion Orbital apex syndrome is a heterogeneous disorder with multiple etiologies, presenting with a variety of initial symptoms. The prognosis depends on causes, timely diagnosis, early diagnosis and early treatment.

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Clinical features of Parkinson tremor with rapid eye movement sleep behavior disorder

Di QIAO ; 山东省医学科学院附属济宁市第一人民医院神经内科 ; Xinyan YI ; Xuan ZHANG

Chinese Journal of Nervous and Mental Diseases.2017;43(9):520-525. doi:10.3969/j.issn.1002-0152.2017.09.002

Objective To investigate clinical features of tremors in PD patients with rapid eye movement sleep behavior disorder (RBD) and their response to medication. Methods PD patients were divided into PD with clinically possible (cp) RBD (PD+cpRBD) and PD without cpRBD (PD-cpRBD) according to RBDSQ scale. Hoehn & Yahr (H-Y) grade ,UPDRS-Ⅲ scale and MDS-UPDRS tremor scale were used to evaluate the motor function of the patients and amplitude of rest, kinetic and postural tremors of the first affected limbs. The re-sults were compared between these two groups including the features of the general information and tremor as well as the maximal improvement rate of UPDRS-Ⅲ and MDS-UPDRS tremor scores to acute levodopa chal-lenge test. Results A total of 42 PD patients with tremors were enrolled in this study, including 19 patients in PD+cpRBD group and 23 patients in PD-cpRBD group. There was no significant difference in sex, age, age of onset, duration of disease, UPDRS-Ⅲ score and H-Y grade between two groups (P>0.05). The tremor scores of the "off" state were significantly higher in PD+cpRBD group than in PD-cpRBD group (t=2.379,P=0.022). Compared with PD-cpRBD group, the progression of tremor from one side to other side was faster(u=-2.133,P=0.033)and the amplitude scores of rest and kinetic tremors were higher in PD+cpRBD group (rest tremor :u=-2.956,P=0.003;kinetic tremor:u=-2.657,P=0.008). The maximal improvement rate of UPDRS-Ⅲ and tremor score was significantly higher in PD-cpRBD group than in PD+cpRBD group after taking levodopa/ benserazide (200/50 mg) (UPDRS-Ⅲ:u=-3.134,P=0.002;tremor score: t=-3.189,P=0.003). Conclusion The present study has demonstrated severe tremors especially rest and kinetic tremors and poor response to levodopa in PD patients with cpRBD.

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Clinical, pathological, imaging and genetic analysis of two cases of central core disease with different inheritance modes

Minting LIN ; Haizhu CHEN ; Xiaodan LIN ; Junjie HE ; Guorong XU ; Ning WANG ; Zhiqiang WANG

Chinese Journal of Nervous and Mental Diseases.2017;43(9):513-519. doi:10.3969/j.issn.1002-0152.2017.09.001

Objective To study the clinical, pathological, imaging features of two cases of central core disease (CCD) with different inheritance and to explore the similarities and differences between autosomal recessive CCD (AR-CCD) and autosomal dominant CCD (AD-CCD). Methods Clinical manifestations, family history, muscle MRI and muscle biopsy were collected. Targeted next generation sequencing (NGS) and sanger sequencing were applied for genetic analysis. Co-segregation analysis was further conducted in one family. Results Their common clinical manifestations included childhood early-onset proximal limbs muscle weakness and dystrophy accompanied with facial involvement. The MRI revealed extensive muscular dystrophy and fatty filtration in the both thighs, but not in rectus femoris. Pathology of skeletal muscle showed typical central cores in type Ⅰ muscle fibers and eccentric cores only in AR-CCD. Targeted NGS identified 3 missense mutations in RYR1, including one novel mutation. Conclusion The present study has described clinical and pathological features of two typical CCD patients with different inheritance, which may be associated with the different mutations in RYR1 gene. Targeted NGS apparently improves the genetic diagnosis of CCD.

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The brain MR features and differential diagnosis of sporadic Creutzfeldt-Jakob Disease

Zunsheng ZHANG ; Zhenzhu HU ; Ke LI ; Yong WANG ; Ju LI ; Guosong XUE

Chinese Journal of Nervous and Mental Diseases.2015;(6):331-335. doi:10.3936/j.issn.1002-0152.2015.06.003

Objective To summarize brain magnetic resonance imaging (MRI) features and differential diagnosis of sporadic Creutzfeldt-Jakob disease. Methods The clinic data of 8 probable Creutzfeldt-Jakob disease cases in our hospital were analyzed retrospectively from January 2009 to June 2014. We mainly analysed the characteristics of brain MR and the causes of misdiagnosis. We had followed up the family members of these patients on the progress and progno?sis of disease. We also analyzed the differential diagnosis of sCJD. Results All the patients presented with rapid progres?sive dementia and mental abnormal behavior as the main clinical manifestations. All the patients had abnormal routine EEG and five of them had a periodical sharp wave complexes. The brain MRI of the 8 patients showed high signal intensi?ties in cerebral cortex (and/or basal ganglia) on diffusion weighted images (DWI) and 5 of them had caudate nucleus and (or) putamen involvement. The lesions were first appeared in DWI imaging as“ribbon-like”high signal, followed by Flair as high signal intensities. lesions were low signal intensities on T1WI and high signal intensities on T2WI. Five pa?tients were misdiagnosed. 2 cases were misdiagnosed as having cerebral infarction,1 case was misdiagnosed as having vi?ral encephalitis, 1 case was misdiagnosed as having Alzheimer's disease, 1 case was misdiagnosed as having vertigo and 1 case was misdiagnosed as having corticobasal degeneration. Conclusions The brain MRI of the sCJD patients showed a certain characteristic. DWI is the most sensitive tool in the detection of lesions which is useful in the early diagnosis of this disease. We should distinguish sCJD form ischemic cerebrovascular disease, encephalitis, and other progressive de?mentia identification.

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Efficacy of low-frequency rTMS to the right frontal cortex for depression:a meta-analysis

Yajie LU ; Lin XIA ; Shengjun WU

Chinese Journal of Nervous and Mental Diseases.2015;(6):341-348. doi:10.3936/j.issn.1002-0152.2015.06.005

Objective To systematically assess the efficacy of the low-frequency repetitive transcranial magnetic stimulation (rTMS) to the right frontal cortex for depression. Methods Clinical randomized controlled trials (RCT) studies about low-frequency rTMS to the right dorsolateral prefrontal cortex (DLPFC) for depression were collected from database such as PubMed, SCI, CBM, CNKI, and VIP. The meta-analysis using the software of RevMan 5.2 was conducted to com?pare the response rate of low-frequency rTMS to the right DLPFC with sham stimulation and high-frequency rTMS to the left DLPFC, respectively. Results Nine RCT studies with 156 patients in low-frequency rTMS group and 162 patients in sham stimulation group were included. Meta-analysis showed that low-frequency rTMS to the right DLPFC significantly improved response rate compared with sham stimulation(RR=2.15,95%CI:1.57~2.95,P<0.01). Eleven RCT studies with 178 patients in low-frequency rTMS group and 200 patients in high-frequency group were included. There was no significant difference in response rate between the two groups(RR=0.80,95%CI:0.63~1.02,P=0.07). Conclusion The efficacy of low-frequency rTMS to the right frontal cortex for depression is significant but the efficacy is not superior in comparison with the high-frequency rTMS to left DLPFC.

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The role of imaging features of cerebral infarction in predicting the progressive cerebral infarction

Yingsheng ZHANG ; Kai WANG

Chinese Journal of Nervous and Mental Diseases.2015;(6):326-330. doi:10.3936/j.issn.1002-0152.2015.06.002

Objective To investigate the role of imaging characteristics of cerebral infarction in different regions in predicting the progressive cerebral infarction (PCI). Methods Patients with cerebral infarction were selected in the De?partment of Neurology of Hefei third People’s Hospital from January 2010 to June 2014. Brain MRI were examined the location of cerebral infarction. Patients were then classified into four groups accordingly:cortical infarction, basal gangli?on infarction, coronaradiata infarction and posterior infarction. Patients were further divided into PCI group and non-PCI group according to their clinical manifestations. MRI imaging features and risk factors were analyzed and compared be?tween PCI group and non-PCI group. Results A total of 150 patients with cerebral infarction were enrolled, including 99 cases of non-PCI and 51 cases of PCI. According to the Brain imaging classification, there were 46 cases of cortical in?farction, 25 cases of coronaradiata infarction, 47 cases of basal ganglion infarction and 32 cases of posterior infarction. There were significant differences in subtype cerebral infarction between PCI group and non-PCI group(χ2=19.239,P=
0.001). The percent of cortical infarction were significantly higher in PCI group compared to the non-PCI group. Cortical infarction was correlated to PCI and the value of R and P was 0.170 and 0.026, respectively. Logistic regression revealed that Imaging of subtypes of cerebral infarction was correlative with PCI (P=0.002). The frequency of progression was sig?nificantly increased in cortical infarction than in other subtypes of cerebral infarction (P=0.002). The trend was still sig?nificant even after adjustment for age and blood glucose, (P=0.014). Conclusion The location of cerebral infarction is closely correlated to PCI in which cortical infarction is more likely to develop PCI.

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