1.Effect of measurement site on diagnostic performance of CT-derived fractional flow reserve
Yutao ZHOU ; Na ZHAO ; Yunqiang AN ; Lei SONG ; Chaowei MU ; Jingang CUI ; Tao JIANG ; Li XU ; Hongjie HU ; Lin LI ; Dumin LI ; Wenqiang CHEN ; Lijuan FAN ; Feng ZHANG ; Yang GAO ; Bin LYU
Chinese Journal of Radiology 2025;59(6):704-711
Objective:To investigate the effect of CT-derived fractional flow reserve (CT-FFR) measurement sites on the values and the diagnostic performance, and to determine the optimal measurement site for CT-FFR using invasive FFR as the reference standard.Methods:This study was part of the CT-FFR CHINA clinical trial. Patients with suspected coronary artery disease who were scheduled for invasive coronary angiography (ICA) were prospectively recruited from five clinical centers across the country from November 2018 to March 2020. Each enrolled patient underwent coronary CT angiography (CCTA), CT-FFR, ICA, and invasive pressure wire-based FFR assessments sequentially within one week. Four groups of CT-FFR values were obtained on each enrolled target vessels according to different CT-FFR measurement locations: 1, 2, 3 cm distal to the target lesion, and terminal vessel groups. Spearman and Bland-Altman analyses were used to explore the correlation and consistency of CT-FFR values and FFR values at different measurement sites. The measurement deviation of CT-FFR was also compared. Diagnostic accuracy and performance of CT-FFR, including sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve (AUC), in discriminating myocardial ischemia were analyzed across all measurement site groups on a per-vessel level, using FFR as the reference standard.Results:A total of 289 patients with 345 target lesion vessels were included. According to CCTA, there were 51 target vessels (14.8%) with<50% stenosis, 106 vessels (30.7%) with 50%-69% stenosis, and 188 vessels (54.5%) with stenosis≥70%. At per-vessel level, CT-FFR and FFR values at each measurement position group were highly positively correlated: 1 cm distal to target lesion group, r=0.734 ( P<0.001); 2 cm distal to target lesion group, r=0.732 ( P<0.001); 3 cm distal to target lesion group, r=0.737 ( P<0.001); terminal vessel group was 0.719 ( P<0.001). At per-vessel level, CT-FFR and FFR values of all measurement sites were in good agreement (Bland-Altman analysis results): 1 cm distal to target lesion group, 0.014 (95% LoA 0.002-0.026); 2 cm distal to target lesion group, 0.026 (95% LoA 0.015-0.038); 3 cm distal to target lesion group, 0.040 (95% LoA 0.039-0.051); terminal vessel group, 0.075 (95% LoA 0.064-0.087). And at per-vessel level, the accuracy of diagnosing myocardial ischemia with CT-FFR at 1 cm was highest [84.6% (95% CI 80.4%-88.3%)], and the lowest accuracy in the terminal vessel group [67.0% (95% CI 61.7%-72.0%)]. However, there was no significant difference in the diagnostic accuracy of CT-FFR at 1 cm, 2 cm [80.6% (95% CI 76.1%-84.6%)] and 3 cm [77.5% (95% CI 72.6%-81.7%)]. AUC of CT-FFR at 1 cm distal to the lesion were both highest for global level and moderately stenosis (50%-69%) lesions [0.85 (95% CI 0.81-0.89), 0.84 (95% CI 0.77-0.90)]. And the differences were statistically significant among the four measurement location groups (all P<0.05). Conclusions:The deviation of CT-FFR increases with measurement site distance distal to target lesions. One centimeter distal to the target lesion is the optimal measurement site, and the CT-FFR value here shows the highest diagnostic performance for myocardial ischemic lesions, especially for moderate stenosis.
2.Efficacy of open reduction and internal fixation versus humeral head replacement in the recovery of shoulder joint function in patients with comminuted fractures of the proximal humerus
Chinese Journal of Primary Medicine and Pharmacy 2025;32(3):414-419
Objective:To evaluate the effect of open reduction and internal fixation versus humeral head replacement on postoperative recovery of shoulder joint function in a population of patients with comminuted fractures of the proximal humerus. Methods:This study was a case-control study that retrospectively analyzed data from 80 patients with comminuted fractures of the proximal humerus who underwent surgical treatment at the Department of Orthopedics at Xi'an Gaoxin Hospital from January 2020 to December 2023. The patients were divided into two groups based on the surgical method: the control group ( n = 45) received open reduction and internal fixation, while the observation group ( n = 35) underwent humeral head replacement. Surgery-related indexes, as well as therapeutic effect ratings, shoulder joint mobility, and shoulder joint function 3 months post-surgery, were compared between the two groups. Additionally, the incidence of complications occurring during the treatment was also compared between the two groups. Results:In the observation group, the intraoperative blood loss, surgery duration, postoperative drainage amount, and length of hospital stay were (186.92 ± 28.04) mL, (68.89 ± 10.12) minutes, (57.89 ± 11.25) mL, and (10.18 ± 2.41) days, respectively, all of which were significantly lower than those in the control group, which were (218.23 ± 35.57) mL, (98.26 ± 15.34) minutes, (73.65 ± 13.68) mL, and (12.35 ± 2.92) days ( t = 4.27, 9.78, 5.51, 3.55, all P < 0.05). There was no statistically significant difference in the therapeutic effect between the two groups 3 months post-surgery [97.14% (34/35) vs. 95.56% (43/45), χ2 = 0.04, P > 0.05]. At 3 months post-surgery, the angles of forward elevation, external rotation, and internal rotation in the observation group were (95.42 ± 7.88)°, (61.37 ± 6.56)°, and (74.38 ± 5.01)°, respectively, while in the control group they were (93.68 ± 7.75)°, (60.42 ± 6.87)°, and (73.75 ± 4.92)°, respectively. The differences were not statistically significant between the two groups ( t = -0.98, -0.62, -0.56, all P > 0.05). At 3 months post-surgery, the shoulder function score in the observation group was (73.46 ± 9.15), which was not significantly different from that in the control group [(71.75 ± 8.66), t = -0.85, P > 0.05]. The incidence of complications in the observation group was 2.86% (1/35), which was significantly lower than that in the control group [22.22% (10/45), χ2 = 4.70, P = 0.030). Conclusions:For patients with comminuted fractures of the proximal humerus, both open reduction and internal fixation and humeral head replacement can achieve good shoulder joint function recovery. However, humeral head replacement is more advantageous than open reduction and internal fixation during the perioperative period.
3.Effect of measurement site on diagnostic performance of CT-derived fractional flow reserve
Yutao ZHOU ; Na ZHAO ; Yunqiang AN ; Lei SONG ; Chaowei MU ; Jingang CUI ; Tao JIANG ; Li XU ; Hongjie HU ; Lin LI ; Dumin LI ; Wenqiang CHEN ; Lijuan FAN ; Feng ZHANG ; Yang GAO ; Bin LYU
Chinese Journal of Radiology 2025;59(6):704-711
Objective:To investigate the effect of CT-derived fractional flow reserve (CT-FFR) measurement sites on the values and the diagnostic performance, and to determine the optimal measurement site for CT-FFR using invasive FFR as the reference standard.Methods:This study was part of the CT-FFR CHINA clinical trial. Patients with suspected coronary artery disease who were scheduled for invasive coronary angiography (ICA) were prospectively recruited from five clinical centers across the country from November 2018 to March 2020. Each enrolled patient underwent coronary CT angiography (CCTA), CT-FFR, ICA, and invasive pressure wire-based FFR assessments sequentially within one week. Four groups of CT-FFR values were obtained on each enrolled target vessels according to different CT-FFR measurement locations: 1, 2, 3 cm distal to the target lesion, and terminal vessel groups. Spearman and Bland-Altman analyses were used to explore the correlation and consistency of CT-FFR values and FFR values at different measurement sites. The measurement deviation of CT-FFR was also compared. Diagnostic accuracy and performance of CT-FFR, including sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve (AUC), in discriminating myocardial ischemia were analyzed across all measurement site groups on a per-vessel level, using FFR as the reference standard.Results:A total of 289 patients with 345 target lesion vessels were included. According to CCTA, there were 51 target vessels (14.8%) with<50% stenosis, 106 vessels (30.7%) with 50%-69% stenosis, and 188 vessels (54.5%) with stenosis≥70%. At per-vessel level, CT-FFR and FFR values at each measurement position group were highly positively correlated: 1 cm distal to target lesion group, r=0.734 ( P<0.001); 2 cm distal to target lesion group, r=0.732 ( P<0.001); 3 cm distal to target lesion group, r=0.737 ( P<0.001); terminal vessel group was 0.719 ( P<0.001). At per-vessel level, CT-FFR and FFR values of all measurement sites were in good agreement (Bland-Altman analysis results): 1 cm distal to target lesion group, 0.014 (95% LoA 0.002-0.026); 2 cm distal to target lesion group, 0.026 (95% LoA 0.015-0.038); 3 cm distal to target lesion group, 0.040 (95% LoA 0.039-0.051); terminal vessel group, 0.075 (95% LoA 0.064-0.087). And at per-vessel level, the accuracy of diagnosing myocardial ischemia with CT-FFR at 1 cm was highest [84.6% (95% CI 80.4%-88.3%)], and the lowest accuracy in the terminal vessel group [67.0% (95% CI 61.7%-72.0%)]. However, there was no significant difference in the diagnostic accuracy of CT-FFR at 1 cm, 2 cm [80.6% (95% CI 76.1%-84.6%)] and 3 cm [77.5% (95% CI 72.6%-81.7%)]. AUC of CT-FFR at 1 cm distal to the lesion were both highest for global level and moderately stenosis (50%-69%) lesions [0.85 (95% CI 0.81-0.89), 0.84 (95% CI 0.77-0.90)]. And the differences were statistically significant among the four measurement location groups (all P<0.05). Conclusions:The deviation of CT-FFR increases with measurement site distance distal to target lesions. One centimeter distal to the target lesion is the optimal measurement site, and the CT-FFR value here shows the highest diagnostic performance for myocardial ischemic lesions, especially for moderate stenosis.
4.Efficacy of open reduction and internal fixation versus humeral head replacement in the recovery of shoulder joint function in patients with comminuted fractures of the proximal humerus
Chinese Journal of Primary Medicine and Pharmacy 2025;32(3):414-419
Objective:To evaluate the effect of open reduction and internal fixation versus humeral head replacement on postoperative recovery of shoulder joint function in a population of patients with comminuted fractures of the proximal humerus. Methods:This study was a case-control study that retrospectively analyzed data from 80 patients with comminuted fractures of the proximal humerus who underwent surgical treatment at the Department of Orthopedics at Xi'an Gaoxin Hospital from January 2020 to December 2023. The patients were divided into two groups based on the surgical method: the control group ( n = 45) received open reduction and internal fixation, while the observation group ( n = 35) underwent humeral head replacement. Surgery-related indexes, as well as therapeutic effect ratings, shoulder joint mobility, and shoulder joint function 3 months post-surgery, were compared between the two groups. Additionally, the incidence of complications occurring during the treatment was also compared between the two groups. Results:In the observation group, the intraoperative blood loss, surgery duration, postoperative drainage amount, and length of hospital stay were (186.92 ± 28.04) mL, (68.89 ± 10.12) minutes, (57.89 ± 11.25) mL, and (10.18 ± 2.41) days, respectively, all of which were significantly lower than those in the control group, which were (218.23 ± 35.57) mL, (98.26 ± 15.34) minutes, (73.65 ± 13.68) mL, and (12.35 ± 2.92) days ( t = 4.27, 9.78, 5.51, 3.55, all P < 0.05). There was no statistically significant difference in the therapeutic effect between the two groups 3 months post-surgery [97.14% (34/35) vs. 95.56% (43/45), χ2 = 0.04, P > 0.05]. At 3 months post-surgery, the angles of forward elevation, external rotation, and internal rotation in the observation group were (95.42 ± 7.88)°, (61.37 ± 6.56)°, and (74.38 ± 5.01)°, respectively, while in the control group they were (93.68 ± 7.75)°, (60.42 ± 6.87)°, and (73.75 ± 4.92)°, respectively. The differences were not statistically significant between the two groups ( t = -0.98, -0.62, -0.56, all P > 0.05). At 3 months post-surgery, the shoulder function score in the observation group was (73.46 ± 9.15), which was not significantly different from that in the control group [(71.75 ± 8.66), t = -0.85, P > 0.05]. The incidence of complications in the observation group was 2.86% (1/35), which was significantly lower than that in the control group [22.22% (10/45), χ2 = 4.70, P = 0.030). Conclusions:For patients with comminuted fractures of the proximal humerus, both open reduction and internal fixation and humeral head replacement can achieve good shoulder joint function recovery. However, humeral head replacement is more advantageous than open reduction and internal fixation during the perioperative period.
5.The efficacy, safety, and mechanism of celecoxib as an adjunctive treatment for schizophrenia
Hongyan YU ; Han SHI ; Yongfeng YANG ; Xiujuan WANG ; Yi CHEN ; Ning KANG ; Qing LIU ; Luwen ZHANG ; Minglong SHAO ; Meng SONG ; Yan ZHANG ; Wenqiang LI ; Luxian LYU ; Xi SU
Chinese Journal of Psychiatry 2024;57(7):440-448
Objective:To investigate the efficacy, safety and possible mechanisms of celecoxib as an adjunctive treatment for schizophrenia.Methods:90 schizophrenic inpatients at the second affiliated hospital of Xinxiang Medical College from April 2019 to October 2020 were recruited and randomly assigned to a placebo group or the celecoxib adjunctive treatment group using a random number table. In the placebo group, 46 patients (29 males, 17 females; aged 21-34, mean age 27.46±6.50 years) completed a 6-week follow-up. In the celecoxib group, 44 patients (32 males, 12 females; aged 21-39, mean age 30.52±8.69 years) completed a 6-week follow-up. The Positive and Negative Syndrome Scale (PANSS) was used to assess psychiatric symptoms in both groups. Changes in PANSS score at the end of the treatment were compared to evaluate the efficacy of celecoxib. Metabolic indicators such as weight, body mass index, waist circumference and plasm glucolipid, as well as cardiovascular indicators like blood pressure, electrocardiogram and routine blood tests, and adverse events were collected for the safety evaluation. Serum tumor necrosis factor-α (TNF-α), Interleukin-4 (IL-4) and interferon-γ (IFN-γ) were also tested. Pearson correlation analysis was used to explore the relationship between cytokine levels, PANSS score, PANSS reduction rate [(pre-treatment score-post-treatment score)/pre-treatment score×100%], and the safety measurements in the two groups, analyzing the role of inflammation in celecoxib adjunctive therapy.Results:The change of PANSS positive score at the end of the 6th week was significantly higher in the celecoxib adjuvant treatment group than in the placebo group (-8.00±6.12 vs -4.78±5.19, H=-0.55, P=0.009). The weight changes, body mass index, total cholesterol, and triglycerides over 6 weeks were significantly lower in the celecoxib group compared to the placebo group ( F=-7.37, -7.30, 2.56, -2.54; all P<0.05). No serious adverse events were found in celecoxib adjuvant therapy. In the placebo group, baseline TNF-α levels were positively correlated with baseline negative symptoms and PANSS reduction rate ( r=0.260 and 0.330, both P<0.05), and negatively correlated with the 6-week weight ( r=-0.311, P<0.05); baseline IL-4 levels were positively correlated with the 6-week PANSS total score and the 6-week PANSS negative score ( r=0.320 and 0.397, both P<0.05), and negatively correlated with PANSS reduction rate and 6-week blood glucose ( r=-0.316 and -0.331, both P<0.05); Six-week IFN-γ levels were negatively correlated with low-density lipoprotein levels ( r=-0.306, P<0.05). And no such correlation was found in celecoxib adjuvant group. Conclusion:Celecoxib adjunctive therapy can improve positive symptoms of schizophrenia without causing adverse reactions. Inflammatory state is related to schizophrenia symptoms, treatment efficacy and metabolic abnormalities.
6.A case-control study on the association of indoleamine 2, 3-dioxygenase gene polymorphism with schizophrenia in Chinese Han population
Song LIU ; Zhaonian CHEN ; Xiujuan WANG ; Xiaoge GUO ; Han SHI ; Luwen ZHANG ; Xi SU ; Luxian LYU ; Wenqiang LI ; Yongfeng YANG
Chinese Journal of Psychiatry 2024;57(11):748-754
Objectives:To investigate the association between single nucleotide polymorphisms (SNP) of indoleamine 2,3-dioxygenase( IDO) genes and schizophrenia (SZ) in a Chinese Han population. Methods:Using a case-control study method, 3 700 in-patients with SZ were recruited from January 2010 to December 2021 at the Second Affiliated Hospital of Xinxiang Medical University, and 8 580 healthy controls were recruited from surrounding communities in Xinxiang City. The patient group and control group were matched in gender and age. After collecting peripheral blood from all subjects and extracting genomic DNA, the sample DNA was genotyped using methods such as gene chips and amplification refractory mutation system. The association analysis between IDO gene SNPs and SZ was conducted using the online analysis tool SHEsis. The differences in IDO gene SNP genotype and allele frequency between the two groups were compared using chi-square test. Linkage disequilibrium analysis, haplotype analysis, and Hardy Weinberg equilibrium test were performed using Haploview v4.2 software. A multifactor dimensionality reduction software was used to evaluate the interaction between SNPs and SNP frequencies. Results:In the four SNP loci of IDO gene, there was a significant difference in genotype and allele frequency between the SZ patient and the health control at rs9657182 locus (χ 2=11.81, P=0.003;χ 2=5.54, P=0.019). After Bonferroni correction, the genotype difference at rs9657182 locus still showed statistical significance ( P=0.011). There were no statistically significant differences in genotype and allele frequency among the three SNP locis (rs7820268, rs4503083, and rs10109853). Further stratified by gender, there was no significant difference in genotype frequency between the two groups at the rs9657182. Haplotype analysis revealed that the haplotype of CC and TC (rs9657182 and rs7820268) were significantly different between the two groups (χ 2=3.93,4.78, P=0.048, 0.029). Conclusion:The rs9657182 locus of IDO gene may be a susceptible locus for SZ. The haplotype of CC and TC may be associated with the onset of SZ.
7.Role of histone deacetylase in the sensory gating impairment of offspring during puberty caused by immune activation in pregnant rats
Guanyu WANG ; Senqi LIU ; Yongfeng YANG ; Wenqiang LI ; Luxian LYU ; Xi SU
Journal of Xinxiang Medical College 2024;41(2):101-108
Objective To investigate the expression of histone deacetylase(HDAC)isoforms in the frontal lobe,hippo-campus and liver of offspring rats delivered by rats with maternal immune activation and their correlation with the efficiency of prepulse inhibition(PPI%).Methods Ten pregnant Sprague-Dawley rats were randomly divided into the model group(n=5)and control group(n=5).The rats in the model group were injected with 10 mg·kg-1 polyinosinic-polycytidylic acid(Poly I:C)via the caudal vein on the 9th day of pregnancy,while rats in the control group were given the same volume of sterile physiological saline.After 3 h,blood was collected from the caudal vein,and the levels of interleukin(IL)-1 β,IL-6 and tumor necrosis factor-α(TNF-α)in the plasma of pregnant rats were detected by enzyme-linked immunosorbent assay to evaluate the immune activation status.The pregnant rats in the two groups were fed until natural delivery,the offspring rats were weaned on the 21st day after birth,and the male offspring rats were fed continuously.A prepulse inhibition test was performed at puberty(the 40th day after birth)to evaluate the spatial recognition memory and sensory gating function of the offspring rats.The expression levels of the HDAC gene family in the hippocampus,frontal lobe and liver of offspring rats were detected by real-time fluorescence quantitative polymerase chain reaction.Results The plasma IL-6,IL-1 β and TNF-α levels in the model group were significantly higher than those in the control group(P<0.05).When the prepulse stimulation was 75 dB,the PPI%of the offspring rats at puberty in the model group was significantly lower than that in the control group(P<0.05).When the prepulse stimulation was 80 and 85 dB,there was no significant difference in PPI%between the model group and the control group(P>0.05).In the frontal lobe,the expression levels of HDAC3,HDAC4,HDAC8,HDAC9,HDAC10 and Sirt mRNA in the offspring rats in the model group were significantly lower than those in the control group(P<0.05),while the expression level of HDAC5 mRNA was significantly higher than that in the control group(P<0.05);there were no significant differences in the expression levels of HDAC1,HDAC2,HDAC6,HDAC7 and HDAC11 mRNA between the model group and the control group(P>0.05).In the hippocampus,the offspring rats in the model group had significantly lower expression levels of HDAC1,HDAC8 and HDAC10 mRNA and significantly higher expression levels of HDAC2 and HDAC5 mRNA than those in the control group(P<0.05);there were no significant differences in the expression levels of HDAC3,HDAC4,HDAC6,HDAC7,HDAC9,HDAC11 and Sirt mRNA between the model group and control group(P>0.05).In the liver tissue,the expression levels of HDAC6 and HDAC10 mRNA of the offspring rats in the model group were significantly lower than those in the control group(P<0.05);there were no significant differences in the expression levels of HDAC1,HDAC2,HDAC3,HDAC4,HDAC5,HDAC7,HDAC8,HDAC9,HDAC11 and Sirt mRNA between the model group and the control group(P>0.05).The expression level of HDAC2 mRNA in the hippocampus of offspring rats in the two groups was negatively correlated with PPI%at 75 dB(r=-0.965,P<0.05),the expression levels of HDAC10 and Sirt mRNA in frontal lobe tissues were positively correlated with PPI%at 75dB(r=0.946,0.925;P<0.05).Conclusion Pregnancy Poly I:C infection has significant effects on the expression of HDAC family proteins in offspring rats,and which is related to the impairment of early sensory gating,this may provide new ideas for the research in pathogenesis and drug treatment of schizophrenia.
8.Protective effect and mechanism of Hirudo on mice with non-alcoholic fatty liver disease
Ziyun WEN ; Qianqian HAN ; Qing LYU ; Liang WEI ; Wenqiang NIE ; Min HONG ; Yunyun PAN
China Pharmacy 2024;35(10):1193-1197
OBJECTIVE To explore the protective effects and potential mechanisms of Hirudo on mice with non-alcoholic fatty liver disease (NAFLD) in mice. METHODS The male ApoE-/- mice were randomly divided into the model group and Hirudo low- dose and high-dose groups (0.45, 0.9 g/kg), with 10 mice in each group; another 10 wild-type male C57BL/6J mice were chosen as the control group. The control group was fed with basal maintenance chow and the remaining groups were fed with high-fat chow for 12 weeks to establish the NAFLD model. Each administration group was given corresponding solution intragastrically, once a day, for 8 consecutive weeks. In the 13th week, the body weight and liver weight of mice in each group were measured after the last medication, and the liver index was calculated; the serum levels of nuclear factor-κB (NF-κB), tumor necrosis factor-α (TNF- α), interleukin-1β (IL-1β), IL-6, total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C) were detected; the liver pathomorphological changes were observed; the protein expressions of peroxisome proliferator-activated receptor γ(PPARγ) and silence information regulator type 1 (SIRT1) were detected. RESULTS Compared with the control group, the liver tissue of mice in the model group showed more fat vacuoles and infiltration of inflammatory cells, with significant lipid accumulation; the body weight, liver weight and liver index of the mice, and serum levels of NF-κB, TNF-α, IL-1β, IL-6, TC, TG and LDL-C significantly increased, while the serum level of HDL-C, the protein expressions of PPARγ and SIRT1 in liver tissues significantly decreased (P<0.01). Compared with the model group, the pathological changes in liver tissue of mice were all relieved in Hirudo low-dose and high-dose groups; the body weight, liver weight and liver index, the serum levels of NF-κB, TNF-α, IL-1β, IL-6, TC, TG and LDL-C decreased significantly, while the serum level of HDL-C, the protein expressions of PPARγ and SIRT1 in liver tissue all increased significantly (P<0.05 or P<0.01). CONCLUSIONS Hirudo can regulate liver lipid metabolism and inhibit inflammation by activating the protein expressions of PPARγ and SIRT1, thus having a significant ameliorative effect on NAFLD.
9.Correlation between functional striatal abnormalities scores and symptoms and cognitive function in patients with schizophrenia
Zheng LI ; Qing LIU ; Xiaoge GUO ; Xiujuan WANG ; Xi SU ; Yongfeng YANG ; Wenqiang LI ; Luxian LYU
Journal of Xinxiang Medical College 2024;41(7):640-644
Objective To explore the correlation between functional striatal abnormalities(FSA)scores and symptoms and cognitive function in patients with schizophrenia.Methods A total of 92 patients with schizophrenia admitted to the Second Affiliated Hospital of Xinxiang Medical University from July 2021 to February 2022 were selected as the research subjects,15 patients were excluded due to excessive interference with head movement during image data analysis,and 77 patients were finally included in the statistical analysis.The cognitive function of the patients before treatment and after 8 weeks of treatment was evaluated through a set of cognitive function tests.The severity of symptoms before treatment and after 8 weeks of treatment was evaluated according to the positive and negative symptom scale(PANSS).The patients were divided into the ineffective group(PANSS<50%,n=33)and the effective group(PANSS ≥ 50%,n=44)according to the PANSS reduction rate.Before treatment and 8 weeks after treatment,the resting-state functional magnetic resonance imaging scans were performed,and FSA scores were calculated.Results There was no significant difference in FSA scores of patients between the effective group and the ineffective group before treatment(P>0.05).After 8 weeks of treatment,the FSA scores of patients in the two groups were significantly higher than those before treatment(P<0.05).After 8 weeks of treatment,there was no significant difference in FSA scores of patients between the effective group and the ineffective group(P>0.05).Before treatment and after 8 weeks of treatment,there was no significant correlation between the FSA scores and the total PANSS scores,positive factor scores,negative factor scores and pathological factor scores in the two groups(P>0.05).There was no significant corre-lation between the pre-treatment FSA scores and the differences in positive factor scores,negative factor scores and pathological factor scores before and after treatment in both groups(P>0.05).In the effective group,the FSA score was significantly nega-tively correlated with the spatial span score(P<0.05)and significantly positively correlated with the category fluency score(P<0.05)before treatment;however,there was no significant correlation between the pre-treatment FSA score and the scores of trail making,symbol coding,word learning,maze solving,visuospatial memory,2-digit continuous performance,3-digit continuous performance and 4-digit continuous performance(P>0.05).In the ineffective group,there was a significant negative correlation between the pre-treatment FSA score and the spatial span and 4-digit continuous performance scores(P<0.05),while there was no significant correlation between the pre-treatment FSA score and the scores of trail making,symbol coding,word learning,maze solving,visuospatial memory,category fluency,2-digit continuous performance and 3-digit continuous performance(P>0.05).There was no significant correlation between the FSA score and cognitive function scores after treat-ment in the effective group(P>0.05).There was a significant positive correlation between the FSA score and the trail making score after treatment in the ineffective group(P<0.05),but there was no significant correlation between the FSA score and the scores of symbol coding,word learning,spatial span,maze solving,visuospatial memory,category fluency,2-digit continuous performance,3-digit continuous performance and 4-digit continuous performance(P>0.05).Conclusion FSA scores in patients with schizophrenia increase significantly after treatment.FSA scores may not be related to the severity of symptoms or treatment response,but are correlated with the cognitive function of information processing speed.
10.The efficacy, safety, and mechanism of celecoxib as an adjunctive treatment for schizophrenia
Hongyan YU ; Han SHI ; Yongfeng YANG ; Xiujuan WANG ; Yi CHEN ; Ning KANG ; Qing LIU ; Luwen ZHANG ; Minglong SHAO ; Meng SONG ; Yan ZHANG ; Wenqiang LI ; Luxian LYU ; Xi SU
Chinese Journal of Psychiatry 2024;57(7):440-448
Objective:To investigate the efficacy, safety and possible mechanisms of celecoxib as an adjunctive treatment for schizophrenia.Methods:90 schizophrenic inpatients at the second affiliated hospital of Xinxiang Medical College from April 2019 to October 2020 were recruited and randomly assigned to a placebo group or the celecoxib adjunctive treatment group using a random number table. In the placebo group, 46 patients (29 males, 17 females; aged 21-34, mean age 27.46±6.50 years) completed a 6-week follow-up. In the celecoxib group, 44 patients (32 males, 12 females; aged 21-39, mean age 30.52±8.69 years) completed a 6-week follow-up. The Positive and Negative Syndrome Scale (PANSS) was used to assess psychiatric symptoms in both groups. Changes in PANSS score at the end of the treatment were compared to evaluate the efficacy of celecoxib. Metabolic indicators such as weight, body mass index, waist circumference and plasm glucolipid, as well as cardiovascular indicators like blood pressure, electrocardiogram and routine blood tests, and adverse events were collected for the safety evaluation. Serum tumor necrosis factor-α (TNF-α), Interleukin-4 (IL-4) and interferon-γ (IFN-γ) were also tested. Pearson correlation analysis was used to explore the relationship between cytokine levels, PANSS score, PANSS reduction rate [(pre-treatment score-post-treatment score)/pre-treatment score×100%], and the safety measurements in the two groups, analyzing the role of inflammation in celecoxib adjunctive therapy.Results:The change of PANSS positive score at the end of the 6th week was significantly higher in the celecoxib adjuvant treatment group than in the placebo group (-8.00±6.12 vs -4.78±5.19, H=-0.55, P=0.009). The weight changes, body mass index, total cholesterol, and triglycerides over 6 weeks were significantly lower in the celecoxib group compared to the placebo group ( F=-7.37, -7.30, 2.56, -2.54; all P<0.05). No serious adverse events were found in celecoxib adjuvant therapy. In the placebo group, baseline TNF-α levels were positively correlated with baseline negative symptoms and PANSS reduction rate ( r=0.260 and 0.330, both P<0.05), and negatively correlated with the 6-week weight ( r=-0.311, P<0.05); baseline IL-4 levels were positively correlated with the 6-week PANSS total score and the 6-week PANSS negative score ( r=0.320 and 0.397, both P<0.05), and negatively correlated with PANSS reduction rate and 6-week blood glucose ( r=-0.316 and -0.331, both P<0.05); Six-week IFN-γ levels were negatively correlated with low-density lipoprotein levels ( r=-0.306, P<0.05). And no such correlation was found in celecoxib adjuvant group. Conclusion:Celecoxib adjunctive therapy can improve positive symptoms of schizophrenia without causing adverse reactions. Inflammatory state is related to schizophrenia symptoms, treatment efficacy and metabolic abnormalities.

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