A 65-year-old female patient with paranoid schizophrenia switched to amisulpride due to poor treatment efficacy with risperidone, and gradually increased the dosage (0.1 g twice daily for 3 days, 0.2 g, twice daily for 2 days, and finally 0.4 g in the morning and 0.2 g in the evening). After 4 days of medication, electrocardiogram showed sinus bradycardia, with heart rate 49 beats/min and QT interval 492 ms; after 7 days of medication, dynamic electrocardiogram showed heart rate 25 beats/min (average heart rate 42 beats/min) and sinus arrest (207 R-R intervals greater than 2.0 s, with a maximum of 2.47 s). Sinus arrest in the patient mostly occurred at night. Amisulpride was reduced to 0.2 g once daily orally, and ECG monitoring was given. The next day, echocardiography showed left ventricular dyskinesia, mild mitral regurgitation, and abnormal left ventricular filling. It was considered that sinus arrest may be related to amisulpride. The drug was discontinued immediately, the dose of olanzapine increased from 5 mg/d to 10 mg/d, and other treatments remain unchanged. On the day after discontinuation of amisulpride, the number of sinus arrest in electrocardiogram monitoring significantly decreased compared to before. Three days after discontinuation, no sinus arrest was found on the dynamic electrocardiogram; 26 days later, the ECG showed sinus rhythm, with a heart rate of 60 beats/min.

A 65-year-old female patient with paranoid schizophrenia switched to amisulpride due to poor treatment efficacy with risperidone, and gradually increased the dosage (0.1 g twice daily for 3 days, 0.2 g, twice daily for 2 days, and finally 0.4 g in the morning and 0.2 g in the evening). After 4 days of medication, electrocardiogram showed sinus bradycardia, with heart rate 49 beats/min and QT interval 492 ms; after 7 days of medication, dynamic electrocardiogram showed heart rate 25 beats/min (average heart rate 42 beats/min) and sinus arrest (207 R-R intervals greater than 2.0 s, with a maximum of 2.47 s). Sinus arrest in the patient mostly occurred at night. Amisulpride was reduced to 0.2 g once daily orally, and ECG monitoring was given. The next day, echocardiography showed left ventricular dyskinesia, mild mitral regurgitation, and abnormal left ventricular filling. It was considered that sinus arrest may be related to amisulpride. The drug was discontinued immediately, the dose of olanzapine increased from 5 mg/d to 10 mg/d, and other treatments remain unchanged. On the day after discontinuation of amisulpride, the number of sinus arrest in electrocardiogram monitoring significantly decreased compared to before. Three days after discontinuation, no sinus arrest was found on the dynamic electrocardiogram; 26 days later, the ECG showed sinus rhythm, with a heart rate of 60 beats/min.

Aminopeptidase N,a zinc-dependent exopeptidase,is highly expressed in many kinds of tumors,which involves in the degradation of extracellular matrix barriers and angiogenesis and promotes the invasion and metastasis of cancer cells.Aminopeptidase N inhibitors can induce apoptosis and inhibit the invasion and metastasis of tumor cells,which has become an attractive target for anti-tumor therapy.