【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.

Objective To investigate the effect of peripheral blood bile acids on the cognitive function of schizophrenia patients.Methods Targeted metabolomics was adopted to analyze the total level of primary and secondary serum bile acid metabolites collected from 23 schizophrenia patients and 23 health control individuals.The MATRICS Consensus Cognitive Battery(MCCB)was adopted to evaluate the subjects'cognitive function in five dimensions.Results We found that the schizophrenia patients had impaired cognitive functions in multiple dimensions including speed of processing,working memory,reasoning and problem solving,and visual learning.Compared with the health control group,serum levels of cholic acid(CA)and chenodeoxycholic acid(CDCA)were significantly lower in patients with schizophrenia,while serum level of glycocholic acid(GCA)was significantly higher,and the ratio of deoxycholic acid(DCA)to CA was higher(3.04 vs.1.16).Speed of processing,working memory,reasoning and problem solving,and visual learning abilities were significantly negatively correlated with serum levels of multiple primary bile acids including taurocholic acid(TCA),GCA,glycochenodeoxycholic acid(GCDCA)and taurochenodeoxycholic acid(TCDCA),after adjustments of age,sex,and body mass index.Conclusion The bile acid profile of schizophrenia patients is obvious,and the decrease in neuroprotective bile acids(namely,CA and CDCA)and the up-regulation of cytotoxic bile acid(i.e.,GCA)may impair the cognitive function of schizophrenia patients.

Objective To examine the joint effects of parent-child relationship and environmental sensitivity(ES)on adolescent mental health from the perspective of sensitivity X family conflict interaction.Methods In 2023,we investigated 7,010 adolescents from six junior high schools in Shaanxi Province,China.Self-reported questionnaires were used to assess parent-child relationship,ES,and adolescent mental health.ES was assessed by Highly Sensitive Child Scale(HSC);Patient Health Questionnaire-9(PHQ-9),Strengths and Difficulties Questionnaire(SDQ),and Happiness index were used to measure depression,externalizing problems,and subjective well-being.Results ① Girls'ES scores were significantly higher than boys'(t=-7.504,P＜0.01).② When predicting depression and externalizing problems,the main effects of parent-child relationship and ES in adolescents were significant(b=-0.263,0.237,0.332,P＜0.001;b=0.201,0.220,P＜0.001),and the interaction between family conflicts and ES was significant(b=-0.072,P＜0.05;b=0.092,P＜0.05).(3)Widaman's confirmatory and competitive approach results showed the significant interaction of sensitivity X family conflict with depression and externalizing problems,which were consistent with the differential susceptibility and diathesis-stress framework,respectively(BIC=2 170.98,2 162.6).Conclusion Adolescents with high environmental sensitivity suffer more from high family conflict and benefit more from low family conflicts.These sensitive adolescents can be described as having developmentally susceptibility rather than vulnerability.

【Objective】 To revise the Highly Sensitive Child (HSC) Scale for Chinese Adolescents and investigate the role of adolescents’ sensitivity to environmental influences. 【Methods】 The HSC Scale was translated into Chinese. A total of 2166 adolescents in Xi’an were selected for exploratory factor, confirmatory factor analyses and reliability analysis. The participants were 609 healthy adolescents and 105 depressive adolescents aged 14-17 years, who were evaluated with the HSC scale and PHQ-9 scale as well as sleep duration and academic achievement questions. 【Results】 First, the factor structure (CFI=0.989, GFI=0.977, AGFI=0.958, TLI=0.983, RMSEA=0.042, RMR=0.050) indicated that HSC scale was a reliable measure of environmental sensitivity. The results supported a bifactor model with a general sensitivity factor and three group factors. Second, the Cronbach α was 0.892, and the test-retest reliability coefficient was 0.743. Third, depressive adolescents had a significantly higher HSC score, compared with the healthy ones (F=15.1, P<0.01). Fourth, the relationship between BMI and adolescent adjustment was moderated by environmental sensitivity. Simple slope analysis showed that when the level of environmental sensitivity was higher, weight gain could predict adolescents’ emotional, sleep and academic problems. 【Conclusion】 The Chinese version of HSC has good psychometric characteristics and may be applied in Chinese adolescents. Environmental sensitivity may be a personality factor that influences depressive symptoms in adolescents.

【Objective】 To explore the effect of childhood maltreatment on clinical symptoms and early efficacy of antipsychotics in patients with schizophrenia. 【Methods】 Totally 73 schizophrenic patients were divided into mild maltreatment group(n=42) and severe maltreatment group(n=31) according to the Child Trauma Questionnaire(CTQ). The Positive and Negative Symptom Scale(PANSS) and Clinical Global Impression(CGI) were measured and compared between the two groups at baseline and 3 weeks after antipsychotic treatment to analyze the correlation between child maltreatment experience and mental symptoms and the response to early treatment of antipsychotics. 【Results】 PANSS positive factor score(P=0.026) and cognitive deficit factor score (P=0.042) were significantly higher in severe abuse group than in mild abuse group. The positive factor was significantly positively correlated with emotional abuse factor in CTQ score(r=0.257, P=0.028), and the cognitive deficit factor was significantly positively correlated with emotional neglect factor(r=0.283, P=0.015). After antipsychotic treatment, the reduction rate of PANSS negative factor in severe abuse group was significantly lower than that in mild abuse group(P=0.035), and had the highest correlation with CTQ physical abuse factor(r=-0.302, P=0.011). 【Conclusion】 The severity of childhood maltreatment experienced by schizophrenic patients is more related to positive symptoms and cognitive deficits, and more childhood maltreatment experience will affect the improvement of negative symptoms by antipsychotics, suggesting a poor prognosis.

【Objective】 To investigate the association of depressive symptoms with the predicted risk of coronary heart disease in middle-aged and elderly Chinese based on a large community study. 【Methods】 A total of 2532 cases in the group without depression and 2758 cases in the group with depression were included. We compared the two groups in general demographics, information related to coronary heart disease risk, and physical function and ability to perform daily living. We also analyzed the factors associated with coronary heart disease risk by linear regression. 【Results】 ① Demographic information: The group with depression had a higher mean age, a higher proportion of women, more people with poor marital status, and a higher number of comorbid chronic diseases compared with the group without depression (all P<0.05). ② Risk indicators related to coronary heart disease: The group with depression had more people with diabetes and a significantly higher systolic blood pressure compared with the group without depression (P<0.05). The two groups did not significantly differ in the proportion of smokers, diastolic blood pressure, LDL-C, or HDL-C (all P>0.05). The risk of coronary heart disease was significantly higher in the group with depression than in the group without depression (P<0.05). ③ Physical function and ability of daily living: The physical function score, physical self-care score, and instrumental daily living ability were significantly higher in the group with depression than in the group without depression (all P<0.001). ④ Linear regression showed that except for gender, age, marital status, comorbid diabetes, smoking, systolic and diastolic blood pressure, HDL-C and LDL-C were associated with risk of coronary heart disease (P<0.05); CESD was the only factor associated with the risk of coronary heart disease [B=0.019, 95% CI: (0.015, 0.032), P=0.032]. 【Conclusion】 The risk of coronary heart disease is higher in middle-aged and elderly people with depressive symptoms than in those without depressive symptoms. Having depressive symptoms is one of the risk factors for coronary heart disease in middle-aged and elderly people.

【Objective】 To analyze the changes of gut microbes in patients with postpartum depression so as to explore the relationship between postpartum depression and gut microbes. 【Methods】 A total of 60 postpartum subjects were recruited to participate in this study. The depression status of the participants was scored using the Edinburgh Postpartum Depression Scale (EPDS). Those with a score ≥13 were included in the postpartum depression group (PPD group), while those with a score less than 13 were included in the postpartum healthy control group (PPHC group). The feces of these 60 subjects were collected, and the fecal whole genome DNA was extracted for 16S rDNA sequencing. The data of changes in the bacterial diversity between the groups were obtained, and the possible correlation between the changes of intestinal microbes and postpartum depression was analyzed. 【Results】 The number of microorganisms in PPD patients was significantly reduced (P<0.001); the Chao1 index (P<0.001) and ACE index (P<0.001) of α diversity decreased significantly. There were also significant differences in β diversity between the two groups. Analysis of the bacteria in the groups showed that Acetanaerobacterium, Adlercreutzia, Allobaculum, Alloprevotella, Bifidobacterium, Christensenella, Escherichia, Eubacterium, Faecalicatena, Fusobacterium, Haemophilus, Intestinimonas, Lactobacillus, Megamonas, Monoglobumus, Muribaculum, Oscillospira, Paraprevotella, Streptococcus, Raoultibacter, Ruminococcus and Stomatobaculum were significantly enriched in PPHC group. In contrast, Kineothrix, Lachnoclostridium, Acinetobacter, Aquisphaera, Enterococcus, and Mucispirillum were enriched in PPD group. RDA/CCA analysis showed that EPDS was positively correlated with Prevotella, Kineothrix, and Alistipes, but negatively correlated with Lachnospira. 【Conclusion】 This study found that the intestinal flora of patients with postpartum depression was significantly disrupted, and there was a correlation between the intestinal flora and postpartum depression symptom score. Therefore, intestinal microbial markers may contribute to the diagnosis and treatment of patients with postpartum depression.

【Objective】 To investigate the relationship between rapid eye movement sleep (REM) and the incidence of angina pectoris (AP) in different genders. 【Methods】 We recruited 2710 participants from the Sleep Heart Health Study with an average age of (61.7±10.9)y, of whom 1 103 (40.7%) were male and 1 607(59.3%) were female. The participants were divided into grade 1 (<20%), grade 2 (20%-25%), and grade 3 (>25%) according to the percentage of REM sleep time (REM%). Complete polysomnography data and medical records were collected for all the participants. Multivariate logistic regression analysis was used to characterize the independent association between REM% and the occurrence of AP. 【Results】 REM% in the three groups varied significantly in age, body mass index (BMI), smoking, AHI, diabetes, and hypertension (P<0.05). In addition, the incidence of AP in patients with grade 3 of REM% was significantly higher than those with grade 1 and 2 in both men and women. After adjusting for covariates such as age, ethnicity, AHI, marital status, education level, BMI, diabetes, hypertension, and smoking status, multiple logistic regression analysis showed that REM% >25% in women was closely related to AP (OR=1.523; 95% CI:1.132-2.051, P=0.006). 【Conclusion】 Participants with REM sleep time >25% have a significantly increased prevalence of AP in women, but not in men.

【Objective】 To study the correlation of clinical symptoms and cognitive functions with serum inflammatory factors in schizophrenia. 【Methods】 A total of 42 SCz patients (case group) and 47 healthy controls (control group) were enrolled in this study. We used enzyme-linked immunosorbent assay (ELSA) to determine six inflammatory factors in serum. PANSS was used to assess clinical symptoms and MCCB was used to assess the patients’ cognitive functions. 【Results】 ① Inflammatory factors: The serum levels of IL-1β, IL-4, IL-6 and IL-8 were significantly higher in case group than in control group (P<0.01). ② Cognitive functions: The scores of Trail Making Test, Hopkins Verbal Learning Test, Symbol Coding, Spatial Span, Brief Visuospatial Memory Test, Assessment Battery-Mazes, Category Fluency and Test-Managing Emotions of case group were significantly lower than those of control group (P<0.05). ③ Correlation between serum inflammatory factors and clinical symptoms: There was no correlation between serum inflammatory factors and psychiatric symptoms in schizophrenia. ④ Correlation between serum inflammatory factors and cognitive functions: The levels of IL-6 (rs=-0.33, P<0.05) and IL-8 (rs=-0.50, P<0.01) in case group were significantly negatively correlated with the scores of Space Scan test. 【Conclusion】 Patients with schizophrenia are presented with immune dysfunction, and the latter is correlated with cognitive impairments.