Objective:Using surface-based morphometry (SBM), this study longitudinally tracks dynamic changes in whole-brain cortical morphological parameters in depression patients before and after vortioxetine treatment. Through three-dimensional topological characterization, we investigate the neuroanatomical correlations between cortical structural reorganization and improvements in affective symptoms and cognitive functions.Methods:Prospectively collected clinical data from 22 outpatients with depression (10 males and 12 females, aged 18-50 years, mean age 28.1±9.1) who attended Beijing Huilongguan Hospital clinic from October 2018 to December 2019. An age-matched healthy control group ( n=21; 10 males and 11 females, aged 22-44 years, mean age 30.8±6.6) was recruited concurrently. The Hamilton Rating Scale for Anxiety (HAMA), the 17-item Hamilton Depression Scale (HAMD 17), and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) were used to evaluate the severity of depressive symptoms and cognitive function in patients. Structural magnetic resonance imaging (sMRI) was performed to assess brain structural indices in depression patients before and after vortioxetine treatment, as well as in healthy controls. Whole-brain cortical structure measurements were calculated for all subjects using CAT12 software. Paired-sample t-tests were used to compare changes in cortical structure and clinical scale scores in depression patients before and after treatment, and two-sample t-tests were conducted to compare whole-brain cortical structure differences between patients (pre-and post-treatment) and healthy controls. Multiple regression analysis in SPM 12 was applied to examine the correlation between post-treatment cortical structural indices and clinical and cognitive scale scores in patients. Spearman correlation analysis was used to evaluate the correlation between changes in whole-brain cortical structure and cognitive function before and after vortioxetine treatment. Results:After vortioxetine treatment, patients with depression exhibited significant reductions in HAMA and HAMD 17 scores, along with significant increases in immediate memory, delayed memory, and total RBANS scores, with statistically significant differences observed ( t=8.43, 12.28, -4.71, -2.41, -3.86 respectively; all P<0.05), while there were no significant changes in visual span, language function, or attention ( P>0.05). Compared to healthy controls, depression patients showed a significantly reduced gyrification index in the right insula/superior temporal gyrus before treatment (28.74±1.20 vs 27.44±1.17; t=4.47, P<0.001), but no significant differences in whole-brain cortical structure were observed before and after treatment or between post-treatment patients and healthy controls ( P>0.05). Correlation analysis indicated that fractal dimension was negatively correlated with HAMA and HAMD 17 scores after treatment, while gyrification index was positively correlated with HAMD 17 ( rpartial=-0.79, -0.83, 0.72; P<0.05). Visual span was positively correlated with fractal dimension ( rpartial=0.78) and negatively correlated with gyrification index ( rpartial=-0.73, P<0.05). Sulcal depth was negatively correlated with attention and RBANS total scores ( rpartial=-0.77, -0.75; P<0.05). Additionally, changes in gyrification index in the left fusiform gyrus were positively correlated with changes in attention ( r=0.51), changes in gyrification index in the left posterior cingulate gyrus were positively correlated with changes in immediate memory ( r=0.58), and changes in sulcal depth in the left superior frontal gyrus were negatively correlated with changes in language ability ( r=-0.79) (both P<0.05). Conclusion:Vortioxetine treatment can improve anxiety and depressive symptoms in depression patients, as well as enhance certain cognitive functions, while also affecting cortical structure in the specific cortical area. Changes in cortical structure after vortioxetine treatment are closely related to clinical symptom improvement and cognitive function changes.

Objective:Using surface-based morphometry (SBM), this study longitudinally tracks dynamic changes in whole-brain cortical morphological parameters in depression patients before and after vortioxetine treatment. Through three-dimensional topological characterization, we investigate the neuroanatomical correlations between cortical structural reorganization and improvements in affective symptoms and cognitive functions.Methods:Prospectively collected clinical data from 22 outpatients with depression (10 males and 12 females, aged 18-50 years, mean age 28.1±9.1) who attended Beijing Huilongguan Hospital clinic from October 2018 to December 2019. An age-matched healthy control group ( n=21; 10 males and 11 females, aged 22-44 years, mean age 30.8±6.6) was recruited concurrently. The Hamilton Rating Scale for Anxiety (HAMA), the 17-item Hamilton Depression Scale (HAMD 17), and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) were used to evaluate the severity of depressive symptoms and cognitive function in patients. Structural magnetic resonance imaging (sMRI) was performed to assess brain structural indices in depression patients before and after vortioxetine treatment, as well as in healthy controls. Whole-brain cortical structure measurements were calculated for all subjects using CAT12 software. Paired-sample t-tests were used to compare changes in cortical structure and clinical scale scores in depression patients before and after treatment, and two-sample t-tests were conducted to compare whole-brain cortical structure differences between patients (pre-and post-treatment) and healthy controls. Multiple regression analysis in SPM 12 was applied to examine the correlation between post-treatment cortical structural indices and clinical and cognitive scale scores in patients. Spearman correlation analysis was used to evaluate the correlation between changes in whole-brain cortical structure and cognitive function before and after vortioxetine treatment. Results:After vortioxetine treatment, patients with depression exhibited significant reductions in HAMA and HAMD 17 scores, along with significant increases in immediate memory, delayed memory, and total RBANS scores, with statistically significant differences observed ( t=8.43, 12.28, -4.71, -2.41, -3.86 respectively; all P<0.05), while there were no significant changes in visual span, language function, or attention ( P>0.05). Compared to healthy controls, depression patients showed a significantly reduced gyrification index in the right insula/superior temporal gyrus before treatment (28.74±1.20 vs 27.44±1.17; t=4.47, P<0.001), but no significant differences in whole-brain cortical structure were observed before and after treatment or between post-treatment patients and healthy controls ( P>0.05). Correlation analysis indicated that fractal dimension was negatively correlated with HAMA and HAMD 17 scores after treatment, while gyrification index was positively correlated with HAMD 17 ( rpartial=-0.79, -0.83, 0.72; P<0.05). Visual span was positively correlated with fractal dimension ( rpartial=0.78) and negatively correlated with gyrification index ( rpartial=-0.73, P<0.05). Sulcal depth was negatively correlated with attention and RBANS total scores ( rpartial=-0.77, -0.75; P<0.05). Additionally, changes in gyrification index in the left fusiform gyrus were positively correlated with changes in attention ( r=0.51), changes in gyrification index in the left posterior cingulate gyrus were positively correlated with changes in immediate memory ( r=0.58), and changes in sulcal depth in the left superior frontal gyrus were negatively correlated with changes in language ability ( r=-0.79) (both P<0.05). Conclusion:Vortioxetine treatment can improve anxiety and depressive symptoms in depression patients, as well as enhance certain cognitive functions, while also affecting cortical structure in the specific cortical area. Changes in cortical structure after vortioxetine treatment are closely related to clinical symptom improvement and cognitive function changes.

Objective To study the characteristics of spontaneous neural activity of schizophrenia patients under resting state,and to explore the neuropathological mechanism of brain dysfunction in schizophrenia with violent behaviors based on the methods of the amplitude of low frequency fluctuation (ALFF) and the fractional amplitude of low frequency fluctuation (fALFF),using resting state functional magnetic resonance imaging (rs-fMRI).Methods Thirty-five patients diagnosed with schizophrenia by ICD-10 were included in the study,and divided into the violent and non-violent group by the Modified Overt Aggression Scale (MOAS) score.The Positive and Negative Symptom Scale (PANSS) was used to assess the severity of clinical symptoms.The DPABI V2.3 (Data Processing & Analysis of Brain Imaging,DPABI) software was run on MATLAB2017b platform,the MRI data were preprocessed and were analyzed by ALFF and fALFF.Two-sample t-test was compared by DPABI software to recognize the differences between the two groups.The Pearson correlation analysis of ALFF/fALFF and PANSS scores were carried out.Results Compared with non-violent group (n=17),the ALFF values decreased in the Parietal_Sup_R and Parietal_Inf_R (AAL),and the fALFF increased in the bilateral inferior cerebellum lobe and Thalamus_L(AAL) in violent group (n=18).All the results were corrected by GRF (voxel level P＜0.01,cluster level P＜0.05).Pearson correlation analysis shows that the ALFF values of all schizophrenia (n=35) were positively correlated with PANSS-NS in the right inferior cerebellum lobe,Vermis,and Temporal_Mid_R (AAL,r=0.437,0.610,0.656 respectively).And the fALFF values of all schizophrenia (n=35) were negatively correlated with PANSS-NS in the Angular_R (AAL,r=-0.723) and positively correlated with PANSS-P7 scores in the Frontal_Sup_Medial_L (AAL,r=0.647) respectively.All the results were corrected by GRF (voxel level P＜0.01,cluster level P＜0.05).Conclusions The ALFF/fALFF abnormalities of schizophrenia patients with violent behaviors are in multiple brain regions,suggesting that violent schizophrenia patients may have abnormal spontaneous neural activity in several brain regions.

Objective:To explore the neuropathological mechanism of brain dysfunction in schizophrenia with violent behaviors based on the methods of surface-based morphometry, using structural magnetic resonance imaging.Methods:Thirty-eight patients diagnosed with schizophrenia by ICD-10 were included in the study. The Modified Overt Aggression Scale (MOAS) was used to assess patient′s violent behaviors. Patients were divided into two groups based on the total score of MOAS, the violent and non-violent group. The CAT12 software was employed to recognize the cortex thickness and fractal dimension values differences between the two groups. Correlated analysis of cortex thickness/fractal dimension and PANSS scores were carried out.Results:Compared with non-violent group ( n=18), the cortex thickness values of the violent group ( n=20) decreased in the left lingual ( t=4.11, P=0.000 11), insula ( t=3.48, P=0.000 66), precentral ( t=3.52, P=0.000 60) and right precentral ( t=3.94, P=0.000 18), supramarginal ( t=3.72, P=0.000 34), postcentral ( t=3.72, P=0.000 34), inferiorparietal gyrus region ( t=3.64, P=0.000 43; P<0.001, uncorrected); the cortex fractal dimension of the violent group increased in the left postcentral ( t=3.86, P=0.000 23) and decreased in the right precuneus ( t=3.62, P=0.000 44; P<0.001, uncorrected). The PANSS psychopathology scores were positively correlated with the cortex fractal dimension value of left postcentral ( r=0.56, P=0.000 17), and total scores were positively correlated with the cortex fractal dimension value in the left postcentral ( r=0.53, P=0.000 40) and the left fusiform ( r=0.50, P=0.000 47); the cortex fractal dimension value of right superiorparietal ( r=0.62, P=0.000 03), inferiorparietal ( r=0.62, P=0.000 03), postcentral( r=0.57, P=0.000 12), inferiortemporal ( r=0.56, P=0.000 17) were positively correlated with PANSS negative scores. Conclusion:The brain structural differences between schizophrenia patients with violent behaviors and those without suggest that schizophrenia patients show abnormal distribution, density and connectivity of neurons across cortical layers.

Objective To study the characteristics of spontaneous neural activity of schizophrenia patients under resting state,and to explore the neuropathological mechanism of brain dysfunction in schizophrenia with violent behaviors based on the methods of the amplitude of low frequency fluctuation (ALFF) and the fractional amplitude of low frequency fluctuation (fALFF),using resting state functional magnetic resonance imaging (rs-fMRI).Methods Thirty-five patients diagnosed with schizophrenia by ICD-10 were included in the study,and divided into the violent and non-violent group by the Modified Overt Aggression Scale (MOAS) score.The Positive and Negative Symptom Scale (PANSS) was used to assess the severity of clinical symptoms.The DPABI V2.3 (Data Processing & Analysis of Brain Imaging,DPABI) software was run on MATLAB2017b platform,the MRI data were preprocessed and were analyzed by ALFF and fALFF.Two-sample t-test was compared by DPABI software to recognize the differences between the two groups.The Pearson correlation analysis of ALFF/fALFF and PANSS scores were carried out.Results Compared with non-violent group (n=17),the ALFF values decreased in the Parietal_Sup_R and Parietal_Inf_R (AAL),and the fALFF increased in the bilateral inferior cerebellum lobe and Thalamus_L(AAL) in violent group (n=18).All the results were corrected by GRF (voxel level P＜0.01,cluster level P＜0.05).Pearson correlation analysis shows that the ALFF values of all schizophrenia (n=35) were positively correlated with PANSS-NS in the right inferior cerebellum lobe,Vermis,and Temporal_Mid_R (AAL,r=0.437,0.610,0.656 respectively).And the fALFF values of all schizophrenia (n=35) were negatively correlated with PANSS-NS in the Angular_R (AAL,r=-0.723) and positively correlated with PANSS-P7 scores in the Frontal_Sup_Medial_L (AAL,r=0.647) respectively.All the results were corrected by GRF (voxel level P＜0.01,cluster level P＜0.05).Conclusions The ALFF/fALFF abnormalities of schizophrenia patients with violent behaviors are in multiple brain regions,suggesting that violent schizophrenia patients may have abnormal spontaneous neural activity in several brain regions.

Objective:To explore the neuropathological mechanism of brain dysfunction in schizophrenia with violent behaviors based on the methods of surface-based morphometry, using structural magnetic resonance imaging.Methods:Thirty-eight patients diagnosed with schizophrenia by ICD-10 were included in the study. The Modified Overt Aggression Scale (MOAS) was used to assess patient′s violent behaviors. Patients were divided into two groups based on the total score of MOAS, the violent and non-violent group. The CAT12 software was employed to recognize the cortex thickness and fractal dimension values differences between the two groups. Correlated analysis of cortex thickness/fractal dimension and PANSS scores were carried out.Results:Compared with non-violent group ( n=18), the cortex thickness values of the violent group ( n=20) decreased in the left lingual ( t=4.11, P=0.000 11), insula ( t=3.48, P=0.000 66), precentral ( t=3.52, P=0.000 60) and right precentral ( t=3.94, P=0.000 18), supramarginal ( t=3.72, P=0.000 34), postcentral ( t=3.72, P=0.000 34), inferiorparietal gyrus region ( t=3.64, P=0.000 43; P<0.001, uncorrected); the cortex fractal dimension of the violent group increased in the left postcentral ( t=3.86, P=0.000 23) and decreased in the right precuneus ( t=3.62, P=0.000 44; P<0.001, uncorrected). The PANSS psychopathology scores were positively correlated with the cortex fractal dimension value of left postcentral ( r=0.56, P=0.000 17), and total scores were positively correlated with the cortex fractal dimension value in the left postcentral ( r=0.53, P=0.000 40) and the left fusiform ( r=0.50, P=0.000 47); the cortex fractal dimension value of right superiorparietal ( r=0.62, P=0.000 03), inferiorparietal ( r=0.62, P=0.000 03), postcentral( r=0.57, P=0.000 12), inferiortemporal ( r=0.56, P=0.000 17) were positively correlated with PANSS negative scores. Conclusion:The brain structural differences between schizophrenia patients with violent behaviors and those without suggest that schizophrenia patients show abnormal distribution, density and connectivity of neurons across cortical layers.

Objective To investigate the clinical efficacy and its security on different kinds of atomization with mucosolvan and chymotrypsin in treating neonatal pneumonia.Methods Seventy-eight neonates who were diagnosed as neonatal pneumonia were divided into treatment group (n =39) and control group (n =39) by random number table method from Jul 2011 to Aug 2013 in our hospital.The control group was treated with chymotrypsin atomization,and the treatment group was treated with compression atomizing to inhale mucosolvan.The treatment effects of two groups were compared.Results Compared with the control group after treatment for 24 h,48 h,72 h,the treatment group had more significant increasing in PaO2,more decreasing in PaCO2 and more significant improvement in oxygenation index.There were statistical significances between the two groups(P ＜ 0.01).The treatment group spent shorter time in remission of symptoms,disappear of signs and hospital stay than that of the control group(P ＜ 0.05).In the treatment group,25 cases were markedly improved,9 cases were effective,5 cases were invalid.The effective rate was 87.2％.In the control group,14 cases were markedly effective,6 cases were effective,19 cases were invalid.The effective rate was 51.3％.The effective rate was significant difference between the two groups (P ＜ 0.01).The adverse drug reactions were not found in the process of treatment for two groups.Conclusion Mucosolvan atomizing inhalation has a better treatment effect than chymotrypsin.It can shorten the course of treatment,and is worth promoting the application.