1.Clinical observations in the treatment of systemic lupus erythematosus with belimumab
Pengchong LI ; Yongtu QUE ; Di WU ; Lidan ZHAO ; Jiaxin ZHOU ; Huaxia YANG ; Li WANG ; Linyi PENG ; Jinjing LIU ; Fengchun ZHANG
Chinese Journal of Rheumatology 2024;28(9):626-630
Objective:To further investigate the safety and efficacy of Belimumab in the treatment of patients with systemic lupus erythematosus (SLE).Methods:All SLE patients treated with Belimumab from May 1, 2020 to February 1, 2022 in Peking Union Medical College Hospital were retrospectively collected and analyzed. The clinical manifestations, the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2000) score, and laboratory test such as levels of anti-dsDNA antibody, the medication before and after Belimumab treatment, adverse events were collected. Normally distributed data were tested using the t-test, otherwise the Wilcoxon paired signed rank test was used. Results:A total of 81 patients were enrolled in this study. The use of belimumab could significantly decrease the SLEDAI-2000 score [10.00(7.75, 12.00) vs. 4.00(3.75, 6.00), Z=-5.38, P<0.001], ESR of SLE patients [19.50(12.75, 32.25) mm/1 h vs. 14.00(7.75, 20.25) mm/1 h, Z=-3.71, P=0.003], anti-dsDNA titer detected by CLIFT [300.00 (117.00, 864.00) vs. 183.00(100.00, 471.00), Z=-4.15, P=0.001], meanwhile, increase the complement C3 [0.78 (0.62, 0.97)g/L vs. 0.69 (0.55, 0.84)g/L, Z=-4.68, P<0.001], and the complement C4 [0.12 (0.08, 0.19)g/L vs. 0.10 (0.05, 0.14)g/L, Z=-4.78, P<0.001]. We also observed that with the use of Belimumab, the dosage of Glucocorticoids decreased significantly, which were [10.00(7.50, 22.50) mg vs. 7.50(5.00, 10.00) mg, Z=-4.90, P<0.001]. In addition, the antibody of IgG, IgA and IgM decreased significantly. Only one patient stopped the administration of Belimumab due to the low level of immunoglobulin. Conclusion:Belimumab can alleviate disease activity of patients with SLE and help in safely tapering the daily dose of glucocorticoid with good safety.
2.Caudate nucleus and thalamus in untreated patients with obsessive-compulsive disorder: a magnetic resonance spectroscopy study
Yuepeng LI ; Xiangyun YANG ; Jie DONG ; Pengchong WANG ; Ping ZHANG ; Weiwei ZHAO ; Zhanjiang LI
Chinese Journal of Behavioral Medicine and Brain Science 2023;32(2):127-132
Objective:To investigate the neurobiochemical metabolites of caudate nucleus and thalamus in patients with obsessive-compulsive disorder and their relationship with obsessive-compulsive symptoms.Methods:From April 2019 to January 2022 in Beijing Anding Hospital, totally 25 untreated patients with obsessive-compulsive disorder were recruited, and 20 healthy controls matched with gender, age and educational background were recruited for the study.The maps of neurobiochemical metabolites of patients and normal controls were collected by hydrogen proton magnetic resonance spectroscopy.With bilateral caudate nucleus and thalamus as brain regions of interest.The relative concentrations of N-acetylaspartic acid (NAA), glutamic acid (Glu) and γ-aminobutyric acid (GABA) were fitted by LCModel software.At the same time, the clinical symptoms of patients were evaluated with Yale-Brown obsessive-compulsive scale (Y-BOCS) and Hamilton anxiety scale (HAMA). SPSS 20.0 software was used for statistical analysis.Independent double sample t-test was used to compare the differences of different nerve biochemical metabolite concentrations between patients with obsessive-compulsive disorders and healthy controls.Pearson correlation analysis was used to explore the correlation between biochemical metabolite concentrations and clinical symptoms. Results:The Glu concentration in the left thalamus of patients with obsessive-compulsive disorder (3.97±0.41) was higher than that of the control group (3.66±0.55)( t=-2.11, P<0.05), while the NAA concentration was (4.87±0.47)lower than that of the control group (5.15±0.44)( t=2.05, P<0.05). The GABA concentrations in the right caudate nucleus (0.50±0.18) and thalamus (0.80±0.19) were lower than those in the control group ((0.63±0.23), (0.96±0.24))( t=2.08, 2.36, both P<0.05). Pearson correlation analysis showed that the Glu concentration in the left caudate nucleus of patients with obsessive-compulsive disorder was positively correlated with the total score of Y-BOCS( r=0.46, P<0.05). Spearman correlation analysis showed that Glu concentration in the right caudate nucleus was positively correlated with the total score of HAMA in patients with obsessive-compulsive disorder ( r=0.46, P<0.05). Conclusion:NAA, Glu and GABA metabolism in caudate nucleus and thalamus are abnormal in patients with obsessive-compulsive disorder, and Glu concentration is positively correlated with the severity of obsessive-compulsive and anxiety symptoms.
3.Application of virtual reality in diagnosis and treatment of obsessive-compulsive disorder
Zijun YAN ; Pengchong WANG ; Zhanjiang LI
Chinese Journal of Behavioral Medicine and Brain Science 2022;31(2):180-186
The application of diagnosis and treatment technology based on virtual reality (VR) in obsessive-compulsive disorder (OCD) has attracted more and more attention from researchers around the world. The preliminary exploration shows that it is a promising auxiliary evaluation and treatment method. From the perspective of effectiveness and suitability, this paper systematically reviewed the research status of the application of VR technology in OCD clinical symptom evaluation, cognitive function evaluation and clinical intervention, discussed the similarities and differences, advantages and limitations between traditional evaluation and treatment methods and VR-based diagnosis and treatment technology, and prospected the new trend of the application of VR technology in OCD diagnosis and treatment, and provided a reference for the introduction, development and application of VR technology in China to improve the effect of OCD diagnosis and treatment.
4.In vitro test of slow-release magnesium chloride of anti-calcification small caliber tissue engineering blood vessels
Yangyang LI ; Yingjie YANG ; Jie LIU ; Zhao YANG ; Pengchong DU ; Liang ZHAO ; Wenbin LI
Chinese Journal of Thoracic and Cardiovascular Surgery 2021;37(5):303-308
Objective:To construct tissue engineering small-caliber anti-calcifiction blood vessels with micron slow-release magnesium chloride.Methods:After decellularizing sheep carotid artery by combining Triton X-100+ deoxycholate sodium salt and DNA/RNA ribozyme, tissue engineering small-caliber vascular scaffold was made, HE staining of elastic fiber and collagen were carried out at the same time, and scanning electron microscope was used to observe the decellularization and the performance of vascular stent. The microemulsion anti-calcification slow-release microsphere particles loaded with magnesium chloride(MgCl 2) were prepared by double emulsion method, ultrasonic breaking, high speed stirring and evaporation method. Detected the particle size, encapsulation rate, drug loading(rate) of the sustained-release microspheres and measured the sustained-release curve. After the artificial small-caliber blood vessel was cross-linked with carbodiimide hydrochloride/succinic imine(EDC/NHS), freeze-drying technology was used to combine the micron slow-release microspheres loaded with MgCl 2 with the vascular scaffold. Observed the combination under the electron microscope, and tested the thickness and tensile strength of the specimen blood vessels. Results:After decellularization, the sheep carotid artery could remove all kinds of cells and maintain the original performance of the scaffold. The averaged particle size of micro-calcium-resistant slow-release microspheres loaded with MgCl 2 was(1.31±0.02)μm, which was relatively uniform. The encapsulation rate of microsphere particles was 82.79%, and the drug loading(rate) was 2.98%, which existed within 25 days slow release, the release rate reached 81.08%. The slow-release microsphere particles loaded with chlorinase could be effectively and tightly combined with small-caliber tissue engineering blood vessels. Conclusion:The slow-release microsphere particles loaded with magnesium chloride made of PLGA as a carrier have the effect of slow-release magnesium ions. It laid the foundation for the construction of anti-calcification tissue engineering small-caliber blood vessels.
5.Characteristics and mechanism of error-related negativity in patients with obsessive-compulsive disorder
Wenwen CAO ; Pengchong WANG ; Xiangyun YANG ; Zhanjiang LI
Chinese Journal of Psychiatry 2021;54(6):409-414
The error-related negativity (ERN) is the medical frontal lobe component of event-related potentials caused by the individual incorrect response. It is an important indicator that reflects the function of performance monitoring. This article reviewed the characteristics and influencing factors of ERN in patients with obsessive-compulsive disorder (OCD), and also discussed the relationship between ERN and the clinical symptoms of OCD, the changes of ERN during treatment, the underlying neurological basis, and the possibility of ERN as an endophenotype of the disorder, thereby providing a new perspective on understanding the pathological mechanisms of OCD.
6.Characteristics and mechanism of error-related negativity in patients with obsessive-compulsive disorder
Wenwen CAO ; Pengchong WANG ; Xiangyun YANG ; Zhanjiang LI
Chinese Journal of Psychiatry 2021;54(6):409-414
The error-related negativity (ERN) is the medical frontal lobe component of event-related potentials caused by the individual incorrect response. It is an important indicator that reflects the function of performance monitoring. This article reviewed the characteristics and influencing factors of ERN in patients with obsessive-compulsive disorder (OCD), and also discussed the relationship between ERN and the clinical symptoms of OCD, the changes of ERN during treatment, the underlying neurological basis, and the possibility of ERN as an endophenotype of the disorder, thereby providing a new perspective on understanding the pathological mechanisms of OCD.
7.Preliminary development of self-screening questionnaire for somatoform symptoms
Ling TAN ; Zhanjiang LI ; Jia LUO ; Xiangyun YANG ; Xue SU ; Xiaojie YANG ; Pengchong WANG ; Xiaoqi LI
Chinese Journal of Behavioral Medicine and Brain Science 2019;28(5):464-469
Objective To develop a simple,multi-dimensional self-screening questionnaire for som-atoform symptoms(SQSS). Methods Based on theoretical framework,the study developed the items of the questionnaire. The first draft of the questionnaire was screened through the expert evaluation method. Four groups of 359 subjects were selected to test the reliability and validity of questionnaire. Results The explor-atory factor analysis showed that the four factors(somatic symptoms,negative perception,illness behavior and social function) were extracted and the interpretable percentage of variance was 61. 165%. The correlation between the subscales and the total scales was 0. 740-0. 887,and the correlation coefficient between the sub-scales was 0. 503-0. 625. The Crobanch's α coefficient of the questionnaire was 0. 926,and the Spearman-Brown score of the questionnaire was 0. 868. The retest correlation coefficient of the total scale was 0. 876. A cutoff of 23 points in the SQSS was identified for screening somatoform disorders, and the sensitivity was 0. 880 and the specificity was 0. 606. Conclusion SQSS has good reliability and validity,and can be prelim-inarily used as a self-screening tool for patients with somatoform symptoms or disorders in clinical settings.
8.Detection rate and characteristics of adult outpatients with multiple somatic symptoms of general hospital in Beijing
Xiangyun YANG ; Zhanjiang LI ; Pengchong WANG ; Ling TAN ; Xiaoqi LI ; Yongdong HU ; Xueqing HAN ; Jianhua HE ; Jian GAO ; Ruixiang CAO ; Yi ZHANG ; Si ZU ; Feihuan CUI ; Shaojuan CUI ; Jing SUN
Chinese Journal of Psychiatry 2019;52(4):253-260
Objective To explore the detection rate and clinical characteristics of multiple somatic symptoms among adult outpatients in cardiology,neurology and GI clinics.Methods The general demographic data and disease-related information of 1 497 patients in Beijing Chaoyang Hospital,Beijing Anzhen Hospital and Beijing Tongren Hospital were collected through continuous inquiry and screening.Physical symptoms and depressive symptoms were assessed by Patient Health Questionnaire-15 (PHQ-15) and Patient Health Questionnaire-9 (PHQ-9).The patients were divided into multiple somatic symptoms group (SOM+group,PHQ-15≥10) and non-multiple somatic symptoms group (SOM-group,PHQ-15<10).The detection rate of multiple somatic symptoms was calculated.Partial correlation analysis was used to analyze the correlation of PHQ-15 with the demographic,course of disease,cumulative number of visits,and the total score of PHQ-9.Results The overall detection rate of multiple somatic symptoms was 32.67% (489/1 497)in the three hospitals,and the highest was found in the department of digestive medicine (37.74%,191/506).There were significant differences in gender (x2=36.85,P<0.01),working status (x2=19.78,P<0.01),visiting department (x2=9.64,P<0.01),first visiting/repeated visiting (x2=6.67,P<0.01),and the total score of PHQ-9 (x2=231.52,P<0.01).The detection rate of female patients was higher than that of male patients.The detection rates of retired patients and patients who had no daily stable work were higher than patients who had daily stable work.The detection rate of re-visited patients was higher than that of first-visited patients.The illness duration (r=0.07,P<0.05,Bonferroni correction) and the total score of PHQ-9 (r=0.66,P<0.05,Bonferroni correction) were positively correlated with the severity of somatic symptoms measured by PHQ-15.Conclusions The detection rate of multiple somatic symptoms was high in general hospitals,especially highest in digestive outpatient clinics,and significantly higher in female,retired,unemployed,re-visited and patients who have depressive symptoms.Depressive symptoms and the illness duration were positively correlated with the severity of somatic symptoms.
9.Detection rate and characteristics of adult outpatients with multiple somatic symptoms of general hospital in Beijing
Xiangyun YANG ; Zhanjiang LI ; Pengchong WANG ; Ling TAN ; Xiaoqi LI ; Yongdong HU ; Xueqing HAN ; Jianhua HE ; Jian GAO ; Ruixiang CAO ; Yi ZHANG ; Si ZU ; Feihuan CUI ; Shaojuan CUI ; Jing SUN
Chinese Journal of Psychiatry 2019;52(4):253-260
Objective To explore the detection rate and clinical characteristics of multiple somatic symptoms among adult outpatients in cardiology,neurology and GI clinics.Methods The general demographic data and disease-related information of 1 497 patients in Beijing Chaoyang Hospital,Beijing Anzhen Hospital and Beijing Tongren Hospital were collected through continuous inquiry and screening.Physical symptoms and depressive symptoms were assessed by Patient Health Questionnaire-15 (PHQ-15) and Patient Health Questionnaire-9 (PHQ-9).The patients were divided into multiple somatic symptoms group (SOM+group,PHQ-15≥10) and non-multiple somatic symptoms group (SOM-group,PHQ-15<10).The detection rate of multiple somatic symptoms was calculated.Partial correlation analysis was used to analyze the correlation of PHQ-15 with the demographic,course of disease,cumulative number of visits,and the total score of PHQ-9.Results The overall detection rate of multiple somatic symptoms was 32.67% (489/1 497)in the three hospitals,and the highest was found in the department of digestive medicine (37.74%,191/506).There were significant differences in gender (x2=36.85,P<0.01),working status (x2=19.78,P<0.01),visiting department (x2=9.64,P<0.01),first visiting/repeated visiting (x2=6.67,P<0.01),and the total score of PHQ-9 (x2=231.52,P<0.01).The detection rate of female patients was higher than that of male patients.The detection rates of retired patients and patients who had no daily stable work were higher than patients who had daily stable work.The detection rate of re-visited patients was higher than that of first-visited patients.The illness duration (r=0.07,P<0.05,Bonferroni correction) and the total score of PHQ-9 (r=0.66,P<0.05,Bonferroni correction) were positively correlated with the severity of somatic symptoms measured by PHQ-15.Conclusions The detection rate of multiple somatic symptoms was high in general hospitals,especially highest in digestive outpatient clinics,and significantly higher in female,retired,unemployed,re-visited and patients who have depressive symptoms.Depressive symptoms and the illness duration were positively correlated with the severity of somatic symptoms.
10.Attentional bias to threat in patients with obsessive-compulsive disorder
Pengchong WANG ; Zhanjiang LI ; Xiangyun YANG ; Yuwei LI ; Yun MA ; Changming WANG
Chinese Journal of Psychiatry 2018;51(5):322-328
Objective In the present study,an eye-tracking methodology was employed to explore attentional bias to threat of obsessive-compulsive disorder (OCD).Methods A total of 30 OCD patients and 30 matched health controls were recruited at the outpatient clinic in Beijing Anding Hospital.The Y-BOCS,Yale-Brown Obsessive Compulsive Scale Symptom Checklist,Obsessive-Compulsive Inventory Revised,Beck Anxiety Inventory,Beck Depression Inventory,were used to assess severity of obsessive-compulsive,anxiety and depression symptoms.Attention bias characteristics were measured by eye-tracking methodology.Results OCD and control group showed no difference in direction of initial fixation for the OCD picture and threat picture (F=0.263,P=0.610).Average pupil diameter of OCD in watching OCD picture and threat picture ((2 345 ± 1 133),(2 365 ± 1 174) units) had no difference with control group ((2 191±761),(2 201±766)units,F=0.338,P=0.563).OCD group performed longer initial gaze duration bias score to symptom-relevant stimulates than control group ((0.41±0.93) ms vs.(-0.41±0.87) ms,t=-3.494,P=0.001).OCD's dwell time bias score of fixations for general threat stimulates was significantly longer than control group ((54.2±4.0)% vs.(50.8±4.2)%,t=3.324,P=0.002),OCD's frequency bias score of fixations for general threat stimulates was also significantly longer than control group((54.3±3.4)% vs.(51.8±4.0)%,t=2.686,P=0.009).Conclusion The results support the theory of maintained attention in OCD attentional biases,as opposed to vigilance theory,OCD patients may not be orient to OCD stimuli any faster than individuals with lower symptom,but once a symptom-relevant stimulates be identified,the OCD patients allocate more attention to it.

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