【Objective】 To elucidate the possible role of arginine and histidine in the pathogenesis of schizophrenia by exploring the serum levels of semi-essential amino acids (arginine and histidine) in patients with schizophrenia and their correlation with psychiatric symptoms. 【Methods】 We selected 72 inpatients with schizophrenia admitted to The First Affiliated Hospital of Xi’an Jiaotong University from March 2021 to October 2022 and 72 healthy volunteers enrolled in Yanta Community during the same period as the research subjects. Serum arginine and histidine levels were measured in patients with schizophrenia and healthy controls using serum liquid chromatography-mass spectrometry (LC-MS). We used the Positive and Negative Symptom Scale (PANSS) to evaluate the mental symptoms of patients with schizophrenia and analyzed the correlation of serum arginine and histidine levels with disease course, frequency of onset, and PANSS score. 【Results】 The levels of serum arginine (P<0.001) and histidine (P=0.011) in the schizophrenia group were significantly lower than those in the control group. The levels of serum arginine and histidine were significantly negatively correlated with the frequency of onset (rs=-0.410, rs=-0.262), total score of PANSS (rs=-0.298, rs=-0.256), positive factors (rs=-0.299, rs=-0.234) and cognitive impairment factors (rs=-0.251, rs=-0.296). In addition, serum arginine levels had significantly negative correlation with anxiety and depression factors (rs=-0.269, P<0.05). 【Conclusion】 The serum levels of arginine and histidine in patients with schizophrenia are significantly lower than those in healthy individuals, and are negatively correlated with overall mental symptoms, severity of positive symptoms and cognitive impairment. The severity of anxiety and depression symptoms is negatively correlated with arginine levels. The detection of serum arginine and histidine can provide reference for the diagnosis and assessment of the severity of schizophrenia in the future.

Object:This study aims to compare the efficacy, acceptability and tolerability of cognitive behavior therapy (CBT), pharmacotherapy, and their combination therapy for acute panic disorder via network Meta-analysis.Methods:Electronic databases including PubMed, Web of Science, Embase, Cochrane Library, CNKI, and Wanfang Data were searched for relevant randomized controlled clinical trials from their inception up to March 24, 2021. The outcomes were efficacy (remission rate and response rate), acceptability and tolerability. Network Meta-analysis was adopted with random effects, and estimated relative risk (RR) for all effects of CBT, CBT plus medications, selective serotonin-reuptake inhibitors(SSRIs), serotonin-noradrenaline-reuptake inhibitors(SNRIs), tricyclic antidepressants(TCAs), monoamine oxidase inhibitors(MAOI), benzodiazepines(BZD), noradrenergic-reuptake inhibitors(NRI), and others. This study used gemtc package in R for network analysis, Review Manager for quality assessment, and GRADEPro for evidence assessment, respectively.Results:Identified citations (7 173) included 72 trials comprising 12 293 patients. The treatment measures with higher remission rate and response rate than placebo included CBT+drug( RR:2.4, 95% CI: 1.7-3.5), CBT( RR:1.8, 95% CI:1.4-2.3), SNRI( RR:1.8, 95% CI:1.5-2.2), BZD( RR:1.6, 95% CI:1.4-1.9), SSRI( RR:1.5, 95% CI:1.4-1.7), TCA( RR:1.5, 95% CI: 1.4-1.8)(remission rate in brackets); Among them, CBT combined with medications was better than SSRI, SNRI and TCA. The acceptability of BZD was better than placebo but its tolerability was inferior. Besides, the tolerability of SSRI and TCA was inferior to placebo. Conclusions:CBT combined with medications is more effective than BZD alone and the antidepressants alone. CBT combined with medications may selected the first-line treatment for panic disorder.

【Objective】 To study the relationship between quality of life and clinical symptoms of patients with the first-episode depression. 【Methods】 The untreated patients (n=36) with the first-episode depression and the depression patients (n=71) on drug treatment were included according to the strict screening and exclusion criteria. Subjects in control group (n=59), who matched in age, gender and education, were included according to the corresponding enrollment criteria. World Health Organization Quality of Life—Brief (WHOQOL-BREF) and The Social Adaptation Self-evaluation Scale (SASS) were used to evaluate all the subjects. The Hamilton Depression Rating Scale (HAMD), The Hamilton Anxiety Scale (HAMA) and Montgomery-Asberg Depression Rating Scale (MADRS) were used to evaluate the depressive patients. 【Results】 There was no significant difference in age or education level between all the groups. The quality of life was significantly lower in the first group and the treatment group than in the control group; no significant difference was found between patients in the two depression groups. Correlation analysis showed that the total scores of physiology, environment and quality of life in the first group and the treatment group were negatively correlated with HAMD, HAMA and MADRS. SASS was positively correlated with the total scores of physiology, psychology, environment and quality of life. 【Conclusion】 The quality of life and social adaptation of patients with the first-episode depression and those with depression after treatment were significantly reduced. More serious depression symptoms are linked to the worse quality of life, while better social adaptation is linked to the better quality of life.

【Objective】 To investigate and compare the effects and mechanisms of risperidone and haloperidol on early socially isolated mice. 【Methods】 C57BL/6 mice aged 3 weeks were raised in single cages after weaning for social isolation （SI）， and the control （GH） group was raised normally. Eight weeks later （mouse adult）， the mice received intraperitoneal injection of equal volumes of normal saline （NS）， risperidone （RIS） and haloperidol （HA）. Then they were divided into four groups： GH+NS， SI+NS， SI+RIS， and SI+HA. The dose of risperidone and haloperidol was 0.1 mg/kg and 0.2 mg/kg， respectively. After administration for 14 days， through the open field experiment， elevated plus maze experiment， forced swimming experiment， nesting experiment， social interaction experiment， novel object discrimination experiment， and prepulse suppression experiment， the mice’s schizophrenia-like behavior was evaluated in terms of autonomous activities， emotions， cognition， and social behavior. We also detected dopamine type 2 receptor （D2R） and the N-methyl-D-aspartate receptor subunit NR1 in the prefrontal cortex （PFC） and nucleus accumbens （NAc）. 【Results】 Compared with those in GH group， the anxiety-like behavior and depression-like behavior of SI mice were significantly increased （P<0.05）， while the nesting ability was significantly decreased （P<0.05） and social interaction and avoidance behavior were significantly reduced （P<0.05）； the cognitive function of PPI was impaired （P<0.05）. Compared with haloperidol， risperidone improved not only depression-like behavior and PPI impairment， but also anxiety-like behavior， nesting ability， social interaction， and avoidance behavior. In SI+RIS and SI+HAL groups， the content of D2R in NAC decreased significantly， and the difference of NR1 in PFC disappeared compared with the control group. 【Conclusion】 Early SI is a good model for simulating schizophrenia. Risperidone has a better intervention effect than haloperidol； risperidone and haloperidol may exert their effects through D2R and NR1.

Object:This study aims to compare the efficacy, acceptability and tolerability of cognitive behavior therapy (CBT), pharmacotherapy, and their combination therapy for acute panic disorder via network Meta-analysis.Methods:Electronic databases including PubMed, Web of Science, Embase, Cochrane Library, CNKI, and Wanfang Data were searched for relevant randomized controlled clinical trials from their inception up to March 24, 2021. The outcomes were efficacy (remission rate and response rate), acceptability and tolerability. Network Meta-analysis was adopted with random effects, and estimated relative risk (RR) for all effects of CBT, CBT plus medications, selective serotonin-reuptake inhibitors(SSRIs), serotonin-noradrenaline-reuptake inhibitors(SNRIs), tricyclic antidepressants(TCAs), monoamine oxidase inhibitors(MAOI), benzodiazepines(BZD), noradrenergic-reuptake inhibitors(NRI), and others. This study used gemtc package in R for network analysis, Review Manager for quality assessment, and GRADEPro for evidence assessment, respectively.Results:Identified citations (7 173) included 72 trials comprising 12 293 patients. The treatment measures with higher remission rate and response rate than placebo included CBT+drug( RR:2.4, 95% CI: 1.7-3.5), CBT( RR:1.8, 95% CI:1.4-2.3), SNRI( RR:1.8, 95% CI:1.5-2.2), BZD( RR:1.6, 95% CI:1.4-1.9), SSRI( RR:1.5, 95% CI:1.4-1.7), TCA( RR:1.5, 95% CI: 1.4-1.8)(remission rate in brackets); Among them, CBT combined with medications was better than SSRI, SNRI and TCA. The acceptability of BZD was better than placebo but its tolerability was inferior. Besides, the tolerability of SSRI and TCA was inferior to placebo. Conclusions:CBT combined with medications is more effective than BZD alone and the antidepressants alone. CBT combined with medications may selected the first-line treatment for panic disorder.

Objective To investigate the prevalence and characters of residual physical symptoms in Chinese depressive patients after acute treatment and the influence on the quality of life and social function.Methods In the multi-centers cross-sectional study,1 503 adult depressive outpatients,from 11 hospitals,who had been treated by antidepressants for 8-12 weeks with significant improvement of at least 50％ by Self-rating Visual Analog Scale were involved.The group with residual physical symptoms could be differentiated by Brief 16-Item Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR16) ＞5,while the QIDS-SR16 of remission group was ≤5.The QIDS-SR16,Patient Health Questionnaire-15 (PHQ-15),Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) and Sheehan Disability Scale (SDS) were used to assess the depressive symptoms,physical symptoms and social function.Results 49.8％ (748/1 503) patients had residual physical symptoms (PHQ-15＞4).The most common physical symptoms (PHQ-15≥1) were feeling tired or having low energy (56.3％,846/1 503),trouble sleeping (50.6％,760/1 503),headache(43.6％,655 / 1 503),constipation,loose stools or diarrhea(41.3％,620/1 503),feeling heart pound or race (37.6％,565/1 503),dizziness (34.0％,511/ 1 503),nausea,gas or indigestion (33.6％,505/1 503),etc.The 75.7％ (555/733) of the physical symptoms (PHQ-15＞4) in residual group was significantly higher than the 25.1％ (193/770;x2=385.38,P＜0.01) in remission group.The differences on social function (t=2.77-10.47) and life quality (t=3.04-11.41) between two groups were significant (P＜0.01).Generalized linear regression analysis showed that gender (female),present history of first episode were related to better social function,and the factors related to both social function and quality of life included residual depressive symptoms,residual physical symptoms of different severity,comorbid medical conditions,age,duration of antidepressant treatment for this episode.Conclusion The rate of residual physical symptoms is higher in patients with major depression who responded to acute phase treatment.The more severe the residual physical symptoms,the worse the quality of life and social function.It suggests that physical symptoms be focused in order to achieve clinical recovery.

Objective To investigate the prevalence and characters of residual physical symptoms in Chinese depressive patients after acute treatment and the influence on the quality of life and social function.Methods In the multi-centers cross-sectional study,1 503 adult depressive outpatients,from 11 hospitals,who had been treated by antidepressants for 8-12 weeks with significant improvement of at least 50％ by Self-rating Visual Analog Scale were involved.The group with residual physical symptoms could be differentiated by Brief 16-Item Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR16) ＞5,while the QIDS-SR16 of remission group was ≤5.The QIDS-SR16,Patient Health Questionnaire-15 (PHQ-15),Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) and Sheehan Disability Scale (SDS) were used to assess the depressive symptoms,physical symptoms and social function.Results 49.8％ (748/1 503) patients had residual physical symptoms (PHQ-15＞4).The most common physical symptoms (PHQ-15≥1) were feeling tired or having low energy (56.3％,846/1 503),trouble sleeping (50.6％,760/1 503),headache(43.6％,655 / 1 503),constipation,loose stools or diarrhea(41.3％,620/1 503),feeling heart pound or race (37.6％,565/1 503),dizziness (34.0％,511/ 1 503),nausea,gas or indigestion (33.6％,505/1 503),etc.The 75.7％ (555/733) of the physical symptoms (PHQ-15＞4) in residual group was significantly higher than the 25.1％ (193/770;x2=385.38,P＜0.01) in remission group.The differences on social function (t=2.77-10.47) and life quality (t=3.04-11.41) between two groups were significant (P＜0.01).Generalized linear regression analysis showed that gender (female),present history of first episode were related to better social function,and the factors related to both social function and quality of life included residual depressive symptoms,residual physical symptoms of different severity,comorbid medical conditions,age,duration of antidepressant treatment for this episode.Conclusion The rate of residual physical symptoms is higher in patients with major depression who responded to acute phase treatment.The more severe the residual physical symptoms,the worse the quality of life and social function.It suggests that physical symptoms be focused in order to achieve clinical recovery.

Objective To identify the changes in composition of gut microbiome in patients with different clinical phases of bipolar disorder(BD). Method A total of 28 healthy controls and 31 BD patients including 19 patients with manic episode(BDM group)and 12 patients with depressive episode (BDD group), were enrolled in this study. Baseline characteristics and diet were collected from all participants. Stool samples were collected to extract genomic DNA for PCR and bioinformatics analysis. 16S rRNA sequencing technology was used to obtain gut microbiome diversity among groups subsequently. QIIME was used to calculate observed species index,shannon index,simpson index,psylogenetic diversity index for each group.Linear discriminant analysis(LDA)using LEfSe software was screening for differences species among four groups. Results There was no significant difference between baseline characteristics and diet among four groups. Comparison of gut microbiome alpha diversity among groups, the gut microbiome diversity of BD group were all significantly higher than that in healthy control group,including observed species index(312.0±71.0 vs.229.3±38.6,t=5.475,P<0.01),shannon index(4.9±0.8 vs.3.7±0.9,t=5.747,P<0.01),simpson index(0.9±0.1 vs.0.8±0.1,t=4.446,P<0.01),psylogenetic diversity index(23.7±4.6 vs. 20.2±5.2,t=2.715,P<0.01),especially in BDM group.In composition of gut microbiome(LDA>4,P<0.05)the relative abundance of proteobacteria, ruminococcus, veillonella and lanchnospira in BD group were significantly higher than that in controls, but the relative abundance of bacteroides was significantly lower than that in controls. The relative abundance of enterobacteriaceae, ruminococcus, megamonas and bifidobacterium adolescentis in BDM groups were significantly higher than that in controls,while the relative abundance of bacteroides was significantly lower.The relative abundance of selenomonadales,lachnospira, eubacrerium and plebeius in BDD group were significantly higher than that in controls, while the relative abundance of plebeius was significantly lower. The relative abundance of eschericha coli and bifidobacterium adolescentis of BDM group were significantly higher than that in BDD group, while the relative abundance of stercoris in BDD group was significantly higher than that in BDM group. Conclusion The gut microbiome diversity of patients with BD may be increased and the abundance of several bacterial species changed.

Objective To identify the changes in composition of gut microbiome in patients with different clinical phases of bipolar disorder(BD). Method A total of 28 healthy controls and 31 BD patients including 19 patients with manic episode(BDM group)and 12 patients with depressive episode (BDD group), were enrolled in this study. Baseline characteristics and diet were collected from all participants. Stool samples were collected to extract genomic DNA for PCR and bioinformatics analysis. 16S rRNA sequencing technology was used to obtain gut microbiome diversity among groups subsequently. QIIME was used to calculate observed species index,shannon index,simpson index,psylogenetic diversity index for each group.Linear discriminant analysis(LDA)using LEfSe software was screening for differences species among four groups. Results There was no significant difference between baseline characteristics and diet among four groups. Comparison of gut microbiome alpha diversity among groups, the gut microbiome diversity of BD group were all significantly higher than that in healthy control group,including observed species index(312.0±71.0 vs.229.3±38.6,t=5.475,P<0.01),shannon index(4.9±0.8 vs.3.7±0.9,t=5.747,P<0.01),simpson index(0.9±0.1 vs.0.8±0.1,t=4.446,P<0.01),psylogenetic diversity index(23.7±4.6 vs. 20.2±5.2,t=2.715,P<0.01),especially in BDM group.In composition of gut microbiome(LDA>4,P<0.05)the relative abundance of proteobacteria, ruminococcus, veillonella and lanchnospira in BD group were significantly higher than that in controls, but the relative abundance of bacteroides was significantly lower than that in controls. The relative abundance of enterobacteriaceae, ruminococcus, megamonas and bifidobacterium adolescentis in BDM groups were significantly higher than that in controls,while the relative abundance of bacteroides was significantly lower.The relative abundance of selenomonadales,lachnospira, eubacrerium and plebeius in BDD group were significantly higher than that in controls, while the relative abundance of plebeius was significantly lower. The relative abundance of eschericha coli and bifidobacterium adolescentis of BDM group were significantly higher than that in BDD group, while the relative abundance of stercoris in BDD group was significantly higher than that in BDM group. Conclusion The gut microbiome diversity of patients with BD may be increased and the abundance of several bacterial species changed.

Amisulpride,a kind of the second generation antipsychotics,was marketed in China in 2010.A series of clinical research and experience before and after listed,especially the data based on Chinese population,provided evidence for the generalization and application of amisulpride.In order to optimize the clinical application of amisulpride,and improve the prognosis of patients,Expert Advice on the Practical Use of Amisulpride in the Treatment of Schizophrenia is presented here.This advice is based on the recent evidence and clinical experience,for guiding the clinical medication of amisulpride.