Deutetrabenazine(DTBZ)is a selective oral small molecule inhibitor of vesicular monoamine transporter 2(VMAT2).Its pharmacological action works by inhibiting VMAT2,thereby reducing the release of presynaptic dopamine and alleviating tardive dyskinesia symptoms caused by long-term use of dopamine receptor antagonists.Compared with tetrabenazine,DTBZ has longer half-life,lower peak plasma concentration,and smaller plasma concentration fluctuations.Clinical studies demonstrate that DTBZ significantly improves abnormal involuntary movement in patients with tardive dyskinesia and has a favourable safety profile.Based on available clinical evidence and practical experience,this paper discuss the common questions about DTBZ including the suitable population,dose,duration of treatment,combination administration with antipsychotics,efficacy assessment and application in special populations.This article aimed to provide guidance and recommendations on clinical application of DTBZ for clinicians.

Objective:To investigate the feasibility of transcatheter edge-to-edge repair (TEER) using a short-clip strategy for patients with moderate-to-severe or greater degenerative mitral regurgitation caused by commissural prolapse.Methods:This retrospective study included patients with severe mitral regurgitation secondary to commissural prolapse who underwent TEER at the Second Affiliated Hospital of Zhejiang University School of Medicine between September 2022 and July 2024. Preoperative clinical and imaging data, intraoperative details, procedural outcomes, and 1-month postoperative follow-up results were collected.Results:A total of 19 patients were enrolled, aged (74.1±6.1) years, including 12 males. Among them, 10 patients had external commissural prolapse, and 9 patients had internal commissural prolapse. Preoperatively, all patients exhibited severe mitral regurgitation (4+), with an effective regurgitant orifice area of (0.55±0.17) cm2, left atrial volume of (104.77±36.57) ml, left ventricular end-diastolic volume of (102.29±32.47) ml, left ventricular end-diastolic dimension of (5.34±0.59) mm, and prolapse width of (1.18±0.34) cm. All procedures utilized short clips (NTR or NTW clips) to target the prolapsed commissural region and were completed successfully without intraoperative complications. At 1-month follow-up, no mortality, stroke, single-leaflet device attachment, myocardial infarction, or unplanned mitral reintervention occurred. Mitral regurgitation severity improved to ≤2+ in all patients, with left atrial volume of (74.49±33.83) ml, left ventricular end-diastolic volume of (85.90±18.05) ml, and left ventricular end-diastolic dimension of (4.93±0.37) mm (all P<0.05). Conclusion:The short-clip strategy, focusing on precise clip placement at the commissural interface, is feasible and effective for TEER in patients with severe mitral regurgitation due to commissural prolapse.

Deutetrabenazine(DTBZ)is a selective oral small molecule inhibitor of vesicular monoamine transporter 2(VMAT2).Its pharmacological action works by inhibiting VMAT2,thereby reducing the release of presynaptic dopamine and alleviating tardive dyskinesia symptoms caused by long-term use of dopamine receptor antagonists.Compared with tetrabenazine,DTBZ has longer half-life,lower peak plasma concentration,and smaller plasma concentration fluctuations.Clinical studies demonstrate that DTBZ significantly improves abnormal involuntary movement in patients with tardive dyskinesia and has a favourable safety profile.Based on available clinical evidence and practical experience,this paper discuss the common questions about DTBZ including the suitable population,dose,duration of treatment,combination administration with antipsychotics,efficacy assessment and application in special populations.This article aimed to provide guidance and recommendations on clinical application of DTBZ for clinicians.

Objective:To investigate the feasibility of transcatheter edge-to-edge repair (TEER) using a short-clip strategy for patients with moderate-to-severe or greater degenerative mitral regurgitation caused by commissural prolapse.Methods:This retrospective study included patients with severe mitral regurgitation secondary to commissural prolapse who underwent TEER at the Second Affiliated Hospital of Zhejiang University School of Medicine between September 2022 and July 2024. Preoperative clinical and imaging data, intraoperative details, procedural outcomes, and 1-month postoperative follow-up results were collected.Results:A total of 19 patients were enrolled, aged (74.1±6.1) years, including 12 males. Among them, 10 patients had external commissural prolapse, and 9 patients had internal commissural prolapse. Preoperatively, all patients exhibited severe mitral regurgitation (4+), with an effective regurgitant orifice area of (0.55±0.17) cm2, left atrial volume of (104.77±36.57) ml, left ventricular end-diastolic volume of (102.29±32.47) ml, left ventricular end-diastolic dimension of (5.34±0.59) mm, and prolapse width of (1.18±0.34) cm. All procedures utilized short clips (NTR or NTW clips) to target the prolapsed commissural region and were completed successfully without intraoperative complications. At 1-month follow-up, no mortality, stroke, single-leaflet device attachment, myocardial infarction, or unplanned mitral reintervention occurred. Mitral regurgitation severity improved to ≤2+ in all patients, with left atrial volume of (74.49±33.83) ml, left ventricular end-diastolic volume of (85.90±18.05) ml, and left ventricular end-diastolic dimension of (4.93±0.37) mm (all P<0.05). Conclusion:The short-clip strategy, focusing on precise clip placement at the commissural interface, is feasible and effective for TEER in patients with severe mitral regurgitation due to commissural prolapse.

As a novel neuromodulation technology,the application of deep brain stimulation(DBS)in treatment-resistant psychiatric disorders has received widespread attention in recent years.Based on the current research frontiers,this review puts forward several unique and insightful issues of DBS in psychiatric disorders,including therapeutic targets,stimulation modes,closed-loop modulation,and long-term efficacy in order to provide suggestions and perspectives for future research directions.

Psychosurgery, the neurosurgical treatment for psychiatric disorders, has a long and controversial history. The review introduces the birth of psychosurgery, the rise and fall of the frontal lobotomy and the transition to the modern era of psychosurgery, due to the development of the stereotactic instruments, and the different psychosurgical procedures. Today, recent advances in neuromodulation may provide an opportunity for psychosurgery to become a more attractive option for the treatment of psychiatric diseases. Current states in China and prospects of psychosurgery are also discussed.

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.

Objective This report aimed at exploring the risk factors impact on metabolic co-morbidities of bipolar disorder (BD).Methods An cross-sectional study was conducted on a total of 206 inpatients and outpatients mnet the DSM-Ⅳ-TR criteria for BD,meanwhile matched 167 healthy controls in age,gender and education.Self-made questionnaire was used to collect data such as general demographic data,clinical information,blood lipid and glucose indexes.The criterion of metabolic syndrome (MetS) and hyperlipidemia was referred to the Chinese adult dyslipidemia prevention guideline proposed at 2007,the international physical activity questionnaire was used to assess activity level,then compaed between groups.And the Chi-square test,one-way analysis of variance and binary Logistic regression analysis were used in our statistical analysis.Results The rate of MetS in BD group was higher than control group significantly (25.7％ vs.9.6％,x2=14.90,P＜0.01),and so was the related metabolic components include body mass index (BMI) (F=11.70,P＜0.01),triglyceride (F=12.17,P＜0.01),the ratio of triglyceride/high-density lipoprotein-C (F=16.17,P＜0.01),systolic pressure (F=37.81,P＜0.01),diastolic pressure (F=57.89,P＜ 0.01),but no difference was found in total cholesterol,low density lipoprotein,blood-glucose,glycated hemoglobin and hyperlipidemia.BD group showed significantly more eating food (x2=19.38,P＜0.01),meaty (x2=14.67,P＜0.01) and insomnia (x2=24.12,P＜0.01),but no difference was found in levels of activity.A binary logistic regression analysis showed BMI (OR=1.562,P＜0.01),gender(OR=8.162,P＜0.01)and total duration (OR=1.011,P＜0.01) were major independent risk factors for MetS.Conclusion It indicafed higher risk of comorbid with MetS in BD patients.Gender,BMI,and total medication time may be the main risk factors.

Objective This report aimed at exploring the risk factors impact on metabolic co-morbidities of bipolar disorder (BD).Methods An cross-sectional study was conducted on a total of 206 inpatients and outpatients mnet the DSM-Ⅳ-TR criteria for BD,meanwhile matched 167 healthy controls in age,gender and education.Self-made questionnaire was used to collect data such as general demographic data,clinical information,blood lipid and glucose indexes.The criterion of metabolic syndrome (MetS) and hyperlipidemia was referred to the Chinese adult dyslipidemia prevention guideline proposed at 2007,the international physical activity questionnaire was used to assess activity level,then compaed between groups.And the Chi-square test,one-way analysis of variance and binary Logistic regression analysis were used in our statistical analysis.Results The rate of MetS in BD group was higher than control group significantly (25.7％ vs.9.6％,x2=14.90,P＜0.01),and so was the related metabolic components include body mass index (BMI) (F=11.70,P＜0.01),triglyceride (F=12.17,P＜0.01),the ratio of triglyceride/high-density lipoprotein-C (F=16.17,P＜0.01),systolic pressure (F=37.81,P＜0.01),diastolic pressure (F=57.89,P＜ 0.01),but no difference was found in total cholesterol,low density lipoprotein,blood-glucose,glycated hemoglobin and hyperlipidemia.BD group showed significantly more eating food (x2=19.38,P＜0.01),meaty (x2=14.67,P＜0.01) and insomnia (x2=24.12,P＜0.01),but no difference was found in levels of activity.A binary logistic regression analysis showed BMI (OR=1.562,P＜0.01),gender(OR=8.162,P＜0.01)and total duration (OR=1.011,P＜0.01) were major independent risk factors for MetS.Conclusion It indicafed higher risk of comorbid with MetS in BD patients.Gender,BMI,and total medication time may be the main risk factors.