Background Agitation is very common in patients with acute stage schizophrenia, and injection of antipsychotics and clonazepam is widely used. Network meta-analysis of these comparisons among three injection treatment...Background Agitation is very common in patients with acute stage schizophrenia, and injection of antipsychotics and clonazepam is widely used. Network meta-analysis of these comparisons among three injection treatments has been seldom reported.Aim To compare the efficacy and safety of various injections for agitation symptoms in Chinese patients with schizophrenia.Methods Searches were made in PubMed, Embase and Web of Knowledge, Cochrane Library, Wanfang data, CNKI, SinoMed and VIP databases up to 18 February 2018. Standard search strategies were performed by two reviewers according to the Cochrane Review Group. The Consolidated Standards of Reporting Trials statement was used to assess the methodological quality of the studies. STATA was used to perform meta-analysis. The Cochrane Grades of Recommendation, Assessment, Development and Evaluation(GRADE) was used to assess the strength of evidence.Results A total of 15 studies were included in the network meta-analysis. There were 11 studies comparing ziprasidone with haloperidol, and four studies comparing haloperidol with clonazepam. The results showed that ziprasidone is more effective than haloperidol and clonazepam(sucra: 77.2, 72.8 and 0) in the treatment of agitation symptoms. There was the effect size(standardised mean difference(SMD)) in the three groups: haloperidol: SMD=2.278, 95% CI 1.836 to 2.719; ziprasidone: SMD=2.536, 95% CI 2.082 to 2.990; and clonazepam: SMD=1.360, 95% CI 0.127 to 2.593. The acceptability was assessed by the incidence of excessive sedation, which showed that ziprasidone and haloperidol were similar with both being superior to clonazepam(sucra: 0.3, 0.7 and 99.0). Ziprasidone had significantly less adverse effects than haloperidol in effects of extrapyramidal system(EPS)(z=5.01, p<0.001). There were no statistically significant differences between haloperidol and ziprasidone in tachycardia and abnormal ECG(z=1.69, p=0.091; z=0.87, p=0.386; respectively). Based on GRADE, the strength of the evidence for primary outcome was ‘medium'.Conclusion Our results suggested that ziprasidone was more suitable than haloperidol and clonazepam in the treatment of agitation symptoms in Chinese patients with schizophrenia, according to the efficacy and acceptability of these three intramuscular injection medications.展开更多
Ample evidence suggests that gender affects the incidence,susceptibility,presentation,diagnosis and severity of many psychiatric disorders.Schizophrenia is one of the most prevalent severe mental disorders,with an inc...Ample evidence suggests that gender affects the incidence,susceptibility,presentation,diagnosis and severity of many psychiatric disorders.Schizophrenia is one of the most prevalent severe mental disorders,with an incidence of 0.7%–1%among the total population,which causes suffering and pecuniary losses.12 It has long been known that the age of schizophrenia onset differs in women compared with men.Some life events,such as pregnancy,fertility and menopause,are unique to women and can affect the onset and course of mental disorders.展开更多
Background Central neurocytoma accounts for 0.1% of primary brain tumor that often occurs in young adults. Surgery is the main treatment for central neurocytoma and the rate of 5-year survival reaches up to over 90%. ...Background Central neurocytoma accounts for 0.1% of primary brain tumor that often occurs in young adults. Surgery is the main treatment for central neurocytoma and the rate of 5-year survival reaches up to over 90%. This study aimed to assess the effect of transcortical frontal approach to surgical resection of central neurocytoma on emotion and cognitive function 5 years after surgery. Methods Telephone following-up visits were used in this study. By means of neuropsychological testing, assayed emotion, memory and abstract thinking ability of 18 patients undergoing central neurocytoma resection by transcortical frontal approach for 5 years or more, with another 21 normal cases as control group were enrolled. The data were analyzed statisticaJly by paired t test with SPSS11.5. Results Patients whose central neurocytoma was removed by transcortical frontal approach were not affected on calculating ability 5 years after operation while ability of memory declined sharply （P=-0.000）, the older, the more sharply （P=0.036）. Ability of abstract thinking was significantly reduced （P=0.000）, the older, the more significantly as well （P=-0.012）; additionally, anxiety and depression occurred in patients rather more than those of control group （P=0.000）, especially cognitive impairment. Conclusions Transcortical frontal approach for surgical resection of central neurocytoma has certain long-term influence on patients＇ life quality, vulnerable to anxiety, depression and cognitive impairment, the severity of which was correlated to age. Therefore, imDrovina suroical aoDroach will be of value for better Iona-term life aualitv of oatients.展开更多
Objective To investigate the features of regional cerebral metabolic rate of glucose (rCMRglc) in patients with mild cognitive impairment(MCI) by positron emission-tomography and its relationship with neuropsychologi...Objective To investigate the features of regional cerebral metabolic rate of glucose (rCMRglc) in patients with mild cognitive impairment(MCI) by positron emission-tomography and its relationship with neuropsychological test.Methods Positron emission tomography,mini-mental state examination and Wechsler memory scale were applied in 10 patients with MCI and 10 healthy volunteers as the control group. Results Scores of mini-mental state examination and Wechsler memory scale in MCI patients were lower than those in the control group ( P <0.01). rCMRglc of the left orbital gyrus,right middle temporal gyrus and right putamen was lower in the MCI group than in the control group ( P <0.05). Correlation analysis in the MCI group indicated that rCMRglc of many brain regions such as the orbital gyrus,putamen,left hippocampus and parahippocampal gyrus,cingulate gyrus,left amygdaloid body,precentral gyrus,postcentral gyrus,and medial occipitotemporal gyrus in MCI patients,were correlated negatively with age; while the rCMRglc of many parts of the brain such as the left putamen,temporal lobe,anterior cingulate gyrus,left insular lobe,amygdaloid body,precentral gyrus,postcentral gyrus and medial occipitotemporal gyrus were correlated positively with mini-mental state examination; and rCMRglc of the left putamen,temporal lobe,left insular lobe,precentral gyrus and postcentral gyrus were correlated positively with Wechsler memory scale. The right putamen,the right inferior temporal gyrus,precentral gyrus,and left postcentral gyrus were correlated positively with the length of education. However,only rCMRglc of the left amygdaloid body were correlated positively with gender. Conclusion The rCMRglc was lower in the orbital gyrus and putamen of MCI patients. Their rCMRglc were correlated with their cognitive impairment severity,age,length of education and sex.展开更多
基金Shanghai Municipal Hospital's Emerging Frontier Technology Joint Research Project(SHDC12012109)Shanghai Open Project of Key Laboratory of Severe Psychiatry(13dz2260500)
文摘Background Agitation is very common in patients with acute stage schizophrenia, and injection of antipsychotics and clonazepam is widely used. Network meta-analysis of these comparisons among three injection treatments has been seldom reported.Aim To compare the efficacy and safety of various injections for agitation symptoms in Chinese patients with schizophrenia.Methods Searches were made in PubMed, Embase and Web of Knowledge, Cochrane Library, Wanfang data, CNKI, SinoMed and VIP databases up to 18 February 2018. Standard search strategies were performed by two reviewers according to the Cochrane Review Group. The Consolidated Standards of Reporting Trials statement was used to assess the methodological quality of the studies. STATA was used to perform meta-analysis. The Cochrane Grades of Recommendation, Assessment, Development and Evaluation(GRADE) was used to assess the strength of evidence.Results A total of 15 studies were included in the network meta-analysis. There were 11 studies comparing ziprasidone with haloperidol, and four studies comparing haloperidol with clonazepam. The results showed that ziprasidone is more effective than haloperidol and clonazepam(sucra: 77.2, 72.8 and 0) in the treatment of agitation symptoms. There was the effect size(standardised mean difference(SMD)) in the three groups: haloperidol: SMD=2.278, 95% CI 1.836 to 2.719; ziprasidone: SMD=2.536, 95% CI 2.082 to 2.990; and clonazepam: SMD=1.360, 95% CI 0.127 to 2.593. The acceptability was assessed by the incidence of excessive sedation, which showed that ziprasidone and haloperidol were similar with both being superior to clonazepam(sucra: 0.3, 0.7 and 99.0). Ziprasidone had significantly less adverse effects than haloperidol in effects of extrapyramidal system(EPS)(z=5.01, p<0.001). There were no statistically significant differences between haloperidol and ziprasidone in tachycardia and abnormal ECG(z=1.69, p=0.091; z=0.87, p=0.386; respectively). Based on GRADE, the strength of the evidence for primary outcome was ‘medium'.Conclusion Our results suggested that ziprasidone was more suitable than haloperidol and clonazepam in the treatment of agitation symptoms in Chinese patients with schizophrenia, according to the efficacy and acceptability of these three intramuscular injection medications.
基金supported by the Shanghai Science and Technology Innovation Action Plan Natural Science Fund Project(21ZR1455400)Jiangsu Province Science and Technology Plan Project Key R&D Programme(BE2020661).
文摘Ample evidence suggests that gender affects the incidence,susceptibility,presentation,diagnosis and severity of many psychiatric disorders.Schizophrenia is one of the most prevalent severe mental disorders,with an incidence of 0.7%–1%among the total population,which causes suffering and pecuniary losses.12 It has long been known that the age of schizophrenia onset differs in women compared with men.Some life events,such as pregnancy,fertility and menopause,are unique to women and can affect the onset and course of mental disorders.
基金funded by the Shanghai Municipal Commission of Health and Family Planning“Effect of cognitive psychological intervention on the anxiety of the postpartum pregnant women at high risk”project.Project number:2009107
基金This work was supported by grants from the Project for Science and Technology Commission of Shanghai Municipality （No. 10JC1402200 and No. 08411953600）, the Project for the National Science Foundation for Distinguished Young Scholars of China （No. 81025013）, the Project for the National Natural Science Foundation of China （No. 30872655）, the Project for National ＂985＂ Engineering of China, the ＂Dawn Tracking＂ Program of Shanghai Education Commission, China （No. 10GG01）.
文摘Background Central neurocytoma accounts for 0.1% of primary brain tumor that often occurs in young adults. Surgery is the main treatment for central neurocytoma and the rate of 5-year survival reaches up to over 90%. This study aimed to assess the effect of transcortical frontal approach to surgical resection of central neurocytoma on emotion and cognitive function 5 years after surgery. Methods Telephone following-up visits were used in this study. By means of neuropsychological testing, assayed emotion, memory and abstract thinking ability of 18 patients undergoing central neurocytoma resection by transcortical frontal approach for 5 years or more, with another 21 normal cases as control group were enrolled. The data were analyzed statisticaJly by paired t test with SPSS11.5. Results Patients whose central neurocytoma was removed by transcortical frontal approach were not affected on calculating ability 5 years after operation while ability of memory declined sharply （P=-0.000）, the older, the more sharply （P=0.036）. Ability of abstract thinking was significantly reduced （P=0.000）, the older, the more significantly as well （P=-0.012）; additionally, anxiety and depression occurred in patients rather more than those of control group （P=0.000）, especially cognitive impairment. Conclusions Transcortical frontal approach for surgical resection of central neurocytoma has certain long-term influence on patients＇ life quality, vulnerable to anxiety, depression and cognitive impairment, the severity of which was correlated to age. Therefore, imDrovina suroical aoDroach will be of value for better Iona-term life aualitv of oatients.
文摘Objective To investigate the features of regional cerebral metabolic rate of glucose (rCMRglc) in patients with mild cognitive impairment(MCI) by positron emission-tomography and its relationship with neuropsychological test.Methods Positron emission tomography,mini-mental state examination and Wechsler memory scale were applied in 10 patients with MCI and 10 healthy volunteers as the control group. Results Scores of mini-mental state examination and Wechsler memory scale in MCI patients were lower than those in the control group ( P <0.01). rCMRglc of the left orbital gyrus,right middle temporal gyrus and right putamen was lower in the MCI group than in the control group ( P <0.05). Correlation analysis in the MCI group indicated that rCMRglc of many brain regions such as the orbital gyrus,putamen,left hippocampus and parahippocampal gyrus,cingulate gyrus,left amygdaloid body,precentral gyrus,postcentral gyrus,and medial occipitotemporal gyrus in MCI patients,were correlated negatively with age; while the rCMRglc of many parts of the brain such as the left putamen,temporal lobe,anterior cingulate gyrus,left insular lobe,amygdaloid body,precentral gyrus,postcentral gyrus and medial occipitotemporal gyrus were correlated positively with mini-mental state examination; and rCMRglc of the left putamen,temporal lobe,left insular lobe,precentral gyrus and postcentral gyrus were correlated positively with Wechsler memory scale. The right putamen,the right inferior temporal gyrus,precentral gyrus,and left postcentral gyrus were correlated positively with the length of education. However,only rCMRglc of the left amygdaloid body were correlated positively with gender. Conclusion The rCMRglc was lower in the orbital gyrus and putamen of MCI patients. Their rCMRglc were correlated with their cognitive impairment severity,age,length of education and sex.
