Pharmacological treatment of neuropsychiatric symptoms of dementia: a network meta-analysis.

BACKGROUND: Pharmacological treatments are very common to be used for alleviating neuropsychiatric symptoms (NPS) in dementia. However, decision on drug selection is still a matter of controversy. AIMS: To summarise the comparative efficacy and acceptability of currently available monotherapy drug regimens for reducing NPS in dementia. METHOD: We searched PubMed, MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials between inception and 26 December 2022 without language restrictions; and reference lists scanned from selected studies and systematic reviews. Double-blind randomised controlled trials were identified from electronic databases for reporting NPS outcomes in people with dementia. Primary outcomes were efficacy and acceptability. Confidence in the evidence was assessed using Confidence in Network Meta-Analysis (CINeMA). RESULTS: We included 59 trials (15,781 participants; mean age, 76.6 years) and 15 different drugs in quantitative syntheses. Risperidone (standardised mean difference [SMD] -0.20, 95% credible interval [CrI] -0.40 to -0.10) and galantamine (-0.20, -0.39 to -0.02) were more effective than placebo in short-term treatment (median duration: 12 weeks). Galantamine (odds ratio [OR] 1.95, 95% CrI 1.38-2.94) and rivastigmine (1.87, 1.24-2.99) were associated with more dropouts than placebo, and some active drugs. Most of the results were rated as low or very low according to CINeMA. CONCLUSIONS: Despite the scarcity of high-quality evidence, risperidone is probably the best pharmacological option to consider for alleviating NPS in people with dementia in short-term treatment when considering the risk-benefit profile of drugs.

Opinions and clinical practice of functional movement disorders: a nationwide survey of clinicians in China.

BACKGROUND: There is rare reports about opinions and clinical practice of functional movement disorders (FMD) in China. The present survey aimed to investigate the views of FMD in Chinese clinicians. METHODS: The Chinese version survey of FMD were conducted in nationwide practitioners by means of an online questionnaire. RESULTS: Four hundred and thirty-four Chinese clinicians completed a 21-item questionnaire probing diagnostic and management issues in FMD. More than 80% of respondents considered that atypical movement disorder, multiple somatizations, and emotional disturbance were essential or absolutely necessary for clinically definite diagnosis of FMD. About three quarters of respondents requested standard neurological investigations to rule out organic causes. Over half believed that prior diagnosis of an organic disorder (59.9%), lack of associated non-physiologic deficits (51.8%), and evidence of physical injury (50.0%) were 'very influential' or 'extremely influential' for a non-FMD diagnosis. The majority (77.4%) of the respondents may refer patients to a neuropsychiatrist or psychiatrist experienced in FMD, followed by psychologist or psychotherapist experienced in FMD (53.2%). However, lack of guidelines, physician knowledge, and training often limited clinicians' ability in managing patients with FMD. Early diagnosis of FMD, identification and management of concurrent psychiatric disorder, and acceptance of the diagnosis by the patient were considered most important for predicting a favorable prognosis. CONCLUSIONS: Opinions and clinical practice of Chinese practitioners not only varied among Chinese neurologists, but also differed from international peers. Combined efforts are needed to promote related research and establish practice guidelines in China in the future.

Factors influencing quality of life in Chinese patients with persistent somatoform pain disorder.

This cross-sectional survey aimed to explore quality of life (QoL) and its correlated factors in Chinese patients with persistent somatoform pain disorder (PSPD) and their related correlation factors in Shanghai, China. A total of 60 patients were assessed with Short Form (36) health survey (SF-36) for QoL, medical outcomes study pain measurement (MOSPM) for pain symptoms, Hamilton depression scale - 17 items (HAMD) for depression and Hamilton anxiety scale (HAMA) for anxiety. Results were as follows: (1) Patients scored significantly lower on all SF-36 subscales' scores ( p < .01) apart from the mental health and vitality subscales; (2) With the exception of the general health subscale, SF-36 subscales' scores were negatively correlated with the total score of MOSPM, three factor scores of MOSPM, and total scores of HAMD and HAMA; (3) PSPD patients with severe depression had significantly lower scores (p < .01) on SF-36 subscales' scores (except for GH subscale) and component summary scores as compared to PSPD patients with none or moderate depression; and (4) Multiple linear stepwise regression revealed that SF-36's physical component summary (PCS) subscale correlated with patients' age and MOSPM total score while SF-36's mental component summary (MCS) subscale correlated with total scores of HAMD and MOSPM total score. In sum, PSPD patients had a lower QoL as compared to general population. Pain, depression, and anxiety were significantly correlated with QoL of PSPD patients while age, pain, and depression were important factors influencing PCS and MCS.

Temporal and spatial variations and influencing factors of gross primary productivity in Changbai Mountain Nature Reserve, China.

Changbai Mountain Nature Reserve (CNR) is a typical temperate forest ecosystem, and gross primary production (GPP) of which is closely related to topography and climate change. Research on the spatio-temporal variations and influencing factors of GPP in the CNR is of great significance for assessing growth status of vegetation and the quality of ecological environment. We calculated GPP in CNR using the vegetation photosynthesis model (VPM), and analyzed the influences of slope, altitude, temperature, precipitation, and total radiation. The results showed that the range of annual average GPP in CNR was 63-1706 g C·m-2·a-1 from 2000 to 2020 and that GPP decreased with the increases of altitude. Temperature played the most important role in driving the spatial varia-tion of GPP, with a significant positive correlation with GPP. During the study period, the overall annual GPP showed a significant increase trend in CNR, with an average annual increase of 13 g C·m-2·a-1. The areas with increase of annual GPP accounted for 79.9% of the total area, and the area proportion of annual GPP increase differed in each plant functional type. Annual precipitation was significantly negatively correlated with GPP in 43.2% of CNR, while annual mean temperature and annual total radiation were significantly positively correlated with GPP in 47.2% and 82.4% of CNR. GPP would increase continuously in CNR under the scenario of future global warming.

[Effects of repetitive transcranial magnetic stimulation with different paradigms on the cognitive function and psychotic symptoms of schizophrenia patients].

OBJECTIVE: To evaluate the effect of different paradigms of repetitive transcranial magnetic stimulation (rTMS) on the treatment of schizophrenia through assessing cognitive function and psychotic symptoms. METHODS: Eighty patients diagnosed with schizophrenia were randomly assigned to four groups, which were sham intervention group, theta burst stimulation (TBS) group, 10 Hz group and 20 Hz group. All the subjects were exposed to 5 daily treatments at 80% of motor threshold over the left dorsolateral prefrontal cortex with a total stimuli of 1 200 per day, while being maintained on their former antipsychotic treatment. Visual spatial working memory test and verbal fluency test were applied to evaluate the cognitive function, while Positive and Negative Symptom Scale (PANSS) was used to assess the psychotic symptoms. RESULTS: 20 Hz of rTMS could improve the visual spatial working memory of schizophrenia patients (t=-2.469,P=0.024). Only patients in TBS group showed significant improvement of verbal fluency test after rTMS treatment (t=-4.538,P=0.000). The negative symptoms were alleviated significantly both in TBS and 10 Hz groups (TBS: t=5.373,P=0.000; 10 Hz: t=2.272,P=0.036). General psychopathology symptoms were improved significantly both in 10 Hz and 20 Hz groups (10 Hz:t=2.725,P=0.014;20 Hz:t=3.632,P=0.002). CONCLUSION: The effects of rTMS on the cognitive function and psychotic symptoms of schizophrenia vary according to the changes in stimulus parameters, suggesting that rTMS could provide a new way for the individual therapy of schizophrenia.

The peripheral messenger RNA expression of glycogen synthase kinase-3ß genes in Alzheimer's disease patients: a preliminary study.

OBJECTIVE: To explore the peripheral leucocytic messenger RNA (mRNA) expression of glycogen synthase kinase-3ß (GSK-3ß) gene in Alzheimer's disease (AD) patients. METHODS: Using TaqMan relative quantitative real-time polymerase chain reaction, we analyzed leucocytic gene expression of GSK-3ß in 48 AD patients and 49 healthy controls. Clinical data of AD patients were also collected. RESULTS: The mRNA expression level of the GSK-3ß gene was significantly higher in the AD group (3.13±0.62) than in the normal group (2.77±0.77). Correlational analyses showed that the mRNA expression level of GSK-3ß gene in AD patients was associated with the age of onset (P=0.047), age (P=0.055), and Behavioral Pathology in Alzheimer's Disease Rating Scale total score (P=0.062) and subscores: aggressiveness score (P=0.073) and anxieties and phobias score (P=0.067). Through multivariate regression model, older age, higher anxieties and phobias score and aggressiveness score were associated with higher mRNA expression level of GSK-3ß gene. CONCLUSION: In AD patients, the mRNA expression level of the GSK-3ß gene is increased and may be related to age and behavioural pathology in AD.

Prevalence of developmental dyslexia in primary school children: a protocol for systematic review and meta-analysis.

BACKGROUND: Developmental dyslexia (DD) is a specific impairment during the acquisition of reading skills and may have a lifelong negative impact on individuals. Reliable estimates of the prevalence of DD serve as the basis for evidence-based health resource allocation and policy making. However, the prevalence of DD in primary school children varies largely across studies. Moreover, it is unclear whether there are differences in prevalence in different genders and writing systems. Hence, the present study aims to conduct a systematic review and meta-analysis to assess the global prevalence of DD and to explore related factors. METHODS: We will undertake a comprehensive literature search in 14 databases, including EMBASE, PubMed, Web of Science, China National Knowledge Infrastructure and Cochrane, from their inception to June 2021. Cross-sectional and longitudinal studies that describe the prevalence of DD will be eligible. The quality of the included observational studies will be assessed using the Strengthening the Reporting of Observational Studies in Epidemiology statement. The risk of bias will be determined by sensitivity analysis to identify publication bias. RESULTS: One meta-analysis will be conducted to estimate the prevalence of DD in primary school children. Heterogeneity will be assessed in terms of the properties of subjects (e.g., gender, grade and writing system) and method of diagnosis in the included primary studies. Subgroup analyses will also be performed for population and secondary outcomes. CONCLUSION: The results will synthesize the prevalence of DD and provide information for policy-makers and public health specialists.

Modified acupuncture therapy, long-term acupoint stimulation versus sham control for weight control: a multicenter, randomized controlled trial.

Objective: Long-term acupoint stimulation (LAS), also called embedding acupuncture, is a modified acupuncture technique. The preliminary results have demonstrated its efficacy in body-weight control. However, the low quality of available trials limited its application. This study aimed to evaluate the efficacy and safety of LAS in body-weight control by using a randomized, parallel, sham-controlled clinical trial design. Methods: This was a randomized, single-blind, sham-controlled clinical trial including 84 adult participants (18-60 years) with a body mass index (BMI) of ≥ 24 kg/m2 conducted in three general hospitals in Shanghai, China. Participants were equally assigned to receive LAS or sham LAS (SLAS) once per 10 days, eight times in total. After completion, an additional intervention with a 3-month follow-up period was set to examine the continued effect of LAS. The primary outcome was the change in body weight from baseline to treatment endpoint within the intention-to-treat (ITT) analysis. Secondary outcomes contained changes in waist-to-hip ratio (WHR), lipid metabolism, and visceral and subcutaneous adipose tissues. Results: From 14 May 2018 to 03 November 2019, 84 participants out of 201 screened individuals met the eligibility criteria, were randomized, and were analyzed (42 participants in each group). From baseline to treatment endpoint, the body-weight reduction in the LAS group was significantly larger than in the sham control (net difference: 1.57 kg, 95% CI: 0.29-2.86, p = 0.012). The superior weight reduction effect persisted in the follow-up period (net difference: 3.20 kg, 95% CI: 1.17-5.21, p = 0.001). LAS therapy also showed improvement in triglyceride and subcutaneous adipose tissue (SAT) compared with sham control. One participant in the LAS group reported a slightly uncomfortable and tingling sensation after the additional intervention. No other adverse events (AEs) were documented. Conclusion: LAS, a modified acupuncture technique, is safe and effective in body-weight control. It could be used as an alternative choice to classical acupuncture for obesity management. Clinical Trial Registration: [www.chictr.org.cn], identifier [ChiCTR1800015498].

Imbalance Model of Heart Rate Variability and Pulse Wave Velocity in Psychotic and Nonpsychotic Disorders.

OBJECTIVES: Patients with psychiatric disorders have an increased risk of cardiovascular pathologies. A bidirectional feedback model between the brain and heart exists widely in both psychotic and nonpsychotic disorders. The aim of this study was to compare heart rate variability (HRV) and pulse wave velocity (PWV) functions between patients with psychotic and nonpsychotic disorders and to investigate whether subgroups defined by HRV and PWV features improve the transdiagnostic psychopathology of psychiatric classification. METHODS: In total, 3448 consecutive patients who visited psychiatric or psychological health services with psychotic (N = 1839) and nonpsychotic disorders (N = 1609) and were drug-free for at least 2 weeks were selected. HRV and PWV indicators were measured via finger photoplethysmography during a 5-minute period of rest. Canonical variates were generated through HRV and PWV indicators by canonical correlation analysis (CCA). RESULTS: All HRV indicators but none of the PWV indicators were significantly reduced in the psychotic group relative to those in the nonpsychotic group. After adjusting for age, gender, and body mass index, many indices of HRV were significantly reduced in the psychotic group compared with those in the nonpsychotic group. CCA analysis revealed 2 subgroups defined by distinct and relatively homogeneous patterns along HRV and PWV dimensions and comprising 19.0% (subgroup 1, n = 655) and 80.9% (subgroup 2, n = 2781) of the sample, each with distinctive features of HRV and PWV functions. CONCLUSIONS: HRV functions are significantly impaired among psychiatric patients, especially in those with psychosis. Our results highlight important subgroups of psychiatric patients that have distinct features of HRV and PWV which transcend current diagnostic boundaries.

Differential sensory gating functions between smokers and non-smokers among drug-naive first episode schizophrenic patients.

Although an acute effect of cigarette smoking and nicotine on sensory gating of schizophrenias has been investigated in published papers, the chronic effect of cigarette smoking on this phenomenon has not yet been reported. We report the effects of chronic cigarette smoking, without new acute exposure before testing, on sensory gating using the P50 auditory evoked potential in a group of drug-naive first episode schizophrenic smokers and healthy smokers. Sensory gating was evaluated using auditory P50 suppression elicited using the conditioning (S1)-testing (S2) paradigm. Fifty six male drug-naive first episode schizophrenic patients were compared to 41 healthy male controls. Patients were classified into subgroups of current smokers (n=18) and non-smokers (n=38) to explore the effects of smoking on sensory gating. All subjects did not smoke a cigarette for at least 1h prior to testing. Schizophrenic patients showed an increased S2 amplitude and a poorer sensory gating as measured by both S2/S1 ratio and S1-S2 difference of P50 amplitude, as compared to healthy controls. However, smokers showed an increased S1 amplitude and better sensory gating than did non-smokers both in schizophrenia patients and healthy controls. Our findings support a sensory gating deficit among first episode schizophrenic patients. However, it was less pronounced among schizophrenic patients who were current cigarette smokers, suggesting a positive effect of chronic cigarette smoking on ameliorating this sensory gating deficit in schizophrenia. Our findings of the present study present new evidence supporting the self-medication hypothesis of self-medication by cigarette smoking in schizophrenia to possibly ameliorate pre-existing functional deficits.

Purification and characterization of a bifunctional alginate lyase from Pseudoalteromonas sp. SM0524.

An alginate lyase-producing bacterial strain, Pseudoalteromonas sp. SM0524, was screened from marine rotten kelp. In an optimized condition, the production of alginate lyase from Pseudoalteromonas sp. SM0524 reached 62.6 U/mL, suggesting that strain SM0524 is a good producer of alginate lyases. The bifunctional alginate lyase aly-SJ02 secreted by strain SM0524 was purified. Aly-SJ02 had an apparent molecular mass of 32 kDa. The optimal temperature and pH of aly-SJ02 toward sodium alginate was 50 °C and 8.5, respectively. The half life period of aly-SJ02 was 41 min at 40 °C and 20 min at 50 °C. Aly-SJ02 was most stable at pH 8.0. N-terminal sequence analysis suggested that aly-SJ02 may be an alginate lyase of polysaccharide lyase family 18. Aly-SJ02 showed activities toward both polyG (α-l-guluronic acid) and polyM (ß-D-mannuronic acid), indicating that it is a bifunctional alginate lyase. Aly-SJ02 had lower K(m) toward polyG than toward polyM and sodium alginate. Thin layer chromatography and ESI-MS analyses showed that aly-SJ02 mainly released dimers and trimers from polyM and alginate, and trimers and tetramers from polyG, which suggests that aly-SJ02 may be a good tool to produce dimers and trimers from alginate.

Prevalence, risk and protective factors for mild cognitive impairment in a population-based study of Singaporean elderly.

The prevalence of dementia has been widely reported, and its potential risk and protective factors are well-characterized. However, there is a scarcity of related information regarding mild cognitive impairment (MCI). Thus this population-based study aimed to determine the prevalences of MCI and its subtypes, as well as to identify the risk and protective factors for MCI in the Chinese elderly population of Singapore. Results showed that the overall prevalence of MCI was 12.5%, while the gender-adjusted prevalence of MCI was 12.3%. Gender was found to be significantly associated with the subtypes of MCI, with males more likely to have amnestic MCI and females more likely to have non-amnestic MCI. Older age, lower educational levels, lower social activity levels, depression, hypertension, hyperlipidemia, diabetes and stroke were found to be risk factors for MCI in univariate analysis. However, multivariable analysis showed that only hypertension and stroke were the significant risk factors for MCI. Higher educational levels and active social engagements were significant protective factors for MCI in multivariable analysis. Age and depression had boundary significant associations with the prevalence of MCI. After adjusting for gender, the influence of hypertension, stroke, social engagement, age and depression on MCI remained unchanged, except that education became a boundary significant lower risk factor of MCI development. In conclusion, this study presented the prevalence, risk and protective factors for MCI among Singaporean Chinese older adults, which facilitates the screening of vulnerable groups for MCI.

Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) in gynecologic surgeries: A systematic review.

Natural orifice transluminal endoscopic surgery (NOTES) is a significant innovation in the field of minimally invasive surgery. Transvaginal NOTES has gained the most popularity than other transluminal natural orifices such as mouth, rectum, urinary tract or vagina. Since vNOTES is introduced, many surgeons have developed the technique in various gynecologic surgeries. The aim is to collect the growing evidences of vNOTES in gynecological surgeries and highlight vNOTES with an acceptable safety profile. In the present literature review, the search was carried out using the PubMed database with the following keywords: "natural orifice transluminal endoscopic surgery", "NOTES", "natural orifice" and "gynecologic surgery". The current status of vNOTES in gynecologic surgeries was investigated. A total of 33 studies with 628 cases were included in the review. Our outcomes showed that vNOTES had been performed successfully in a series of surgical procedures including salpingectomy, ovarian cystectomy, myomectomy, hysterectomy, lymphadenectomy and sacrocolpopexy. Advances in technology have improved the feasibility of vNOTES as a treatment option for gynecologic surgeries. When the technical limitations are overcome, wide application of vNOTES is expected to increase. Further prospective and comparative studies are needed to clarify the application of the techniques in gynecologic surgeries.

Prognostic values of immune scores and immune microenvironment-related genes for hepatocellular carcinoma.

It is crucial to grasp the characteristics of tumour immune microenvironment to improve effects of immunotherapy. In this study, the immune and stromal scores of 371 cases were calculated for quantitative analysis of immune and stromal cell infiltration in the tumour microenvironment of hepatocellular carcinoma (HCC). The weighted gene co-expression network analysis and protein-protein interaction network were analysed to identify immune microenvironment-related genes. The results showed that patients with high immune scores had a higher 4-year recurrence-free rate. TP53, CTNNB1, and AXIN1 mutations significantly varied with immune scores. In immune score-related modules analysis, Kyoto encyclopaedia of genes and genomes pathways and gene ontology terms were closely related to immune processes, tumorigenesis, and metastasis. Twelve new immune microenvironment-related genes were identified and had significantly positive correlations with seven immune checkpoint genes. In prognostic analysis, eleven immune microenvironment-related genes exhibited high expression, nine of which were validated in the GSE62232 dataset and were significantly associated with a good prognosis. Our findings suggest that calculating immune score and stromal score could help to determine tumour purity and immune cell infiltration in the tumour microenvironment. Nine immune microenvironment-related genes identified in this study had potential as prognostic markers for HCC.

[Anxiety disease: decreased of functional connectivity in left superior temporal gyrus (GTs) and right GTs].

OBJECTIVE: Neuronal circuits involved in the pathophysiology of anxiety are not yet fully understood. We used functional connectivity MRI to explore the characteristic of functional connectivity in anxiety disorders patient and the neural mechanism of this disease. This work was selected as an oral presentation in 2006 ISMRM. METHODS: Twenty right-handed subjects were included in this study, and were divided into two groups. The anxiety (P) group (n = 10; 7 male, mean age 42 years) consisted of patients meeting DSM-IV criteria for a principal diagnosis of anxiety disorder. The control (C) group consisted of volunteers free of psychiatric symptoms, and was matched on age and gender (n = 10; 7 male) with the panic patients. The subjects underwent noninvasive functional magnetic resonance imaging while listening actively to (1): emotionally neutral word alternating with no word as the control condition (CN, PN), and (2): threat-related words alternating with emotionally neutral word as the experimental condition (CT, PT). Each word was presented in pseudorandom order in each 16 s block of 12 words of the same type. Eight alternating blocks of neutral words were presented for about 256 s. The subject was only asked to passively listen to each word. All MRI data were obtained on a 1.5-Tesla scanner Data analysis was performed with SPM99 to find significant activations in two tasks for two groups. Based on group t-test, we chose two anatomically defined regions: left superior temporal gyrus (GTs) and right GTs. Then, based on individual t-map, the voxel with the largest t-value within two regions was taken as the subject-specific peak voxel. We define clusters based on faces and edges, but not corners, so each voxel has 18 neighbors. Subject-specific averaged time series were extracted by averaging the time series of 19 voxels. Since healthy control subjects showed no significant activation (corrected, P < 0.05) during processing of anxiety word to neutral word, region of interest during processing of neutral word to no word was used as substitution. The connectivity degree eta(i j) between the node i and the node j is used to identify the change of the functional connectivity associated with differential tasks, which calculated by using the methods that have developed by ourselves. Moreover, we just consider coherence in low-frequency (0-0.15 Hz). RESULTS: The activation brain regions have been reported in our previous work. Patients were significant different from normal controls on two experiments. The connectivity degree of left Gts and right Gts in two tasks across all subjects was calculated. Comparing during processing neutral word to blank, a significant decrease (P < 0.001) in functional degree was observed during processing of threaten word to neutral word (eta = 0.5636 for CN, eta = 0.555 for CT, eta = 0.5616 for PN, eta = 0.4926 for PT). Especially, the greater decrease connectivity degree was identified for patient group compared with normal control during threat-related words alternating with emotionally neutral word condition. The connectivity degree identifies that functional interactions change with differential task. CONCLUSION: This result suggests decreased functional connectivity among left superior temporal gyrus and right GTs during processing of anxiety word to neutral word in anxiety patients. This dysfunction may mediate the neural mechanism of this sort of disease.

MicroRNA-494 acts as a tumor suppressor in pancreatic cancer, inhibiting epithelial-mesenchymal transition, migration and invasion by binding to SDC1.

Pancreatic cancer (PC) is the fourth most common cause of cancer­related mortality in the industrialized world. Emerging evidence indicates that a variety of microRNAs (miRNAs or miRs) are involved in the development of PC. The aim of the present study was to elucidate the mechanisms through which miR­494 affects the epithelial­mesenchymal transition (EMT) and invasion of PC cells by binding to syndecan 1 (SDC1). PC tissues and pancreatitis tissues were collected, and the regulatory effects of miR­494 on SDC1 were validated using bioinformatics analysis and a dual­luciferase report gene assay. The cell line with the highest SDC1 expression was selected for use in the following experiments. The role of miR­494 in EMT was assessed by measuring the expression of SDC1, E­cadherin and vimentin. Cell proliferation was assessed using a cell counting kit (CCK)­8 assay, migration was measured using a scratch test, invasion was assessed with a Transwell assay and apoptosis was detected by flow cytometry. Finally, a xenograft tumor model was constructed in nude mice to observe tumor growth in vivo. We found that SDC1 protein expression was significantly higher in the PC tissues. SDC1 was verified as a target gene of miR­494. The SW1990 cell line was selected for use in further experiments as it had the lowest miR­494 expression and the highest SDC1 expression. Our results also demonstrated that miR­494 overexpression and SDC1 silencing significantly decreased the mRNA and protein expression of SDC1 and vimentin in SW1990 cells, while it increased E­cadherin expression and apoptosis, and inhibited cell growth, migration, invasion and tumor growth. On the whole, the findings of this study demonstrated that miR­494 is able to downregulate SDC1 expression, thereby inhibiting the progression of PC. These findings reveal a novel mechanism through which miR­494 affects the development of PC and may thus provide a basis for the application of miR­494 in pancreatic oncology.

Altered default mode network activity in patient with anxiety disorders: an fMRI study.

Anxiety disorder, a common mental disorder in our clinical practice, is characterized by unprovoked anxiety. Medial prefrontal cortex (MPFC) and posterior cingulate cortex (PCC), which closely involved in emotional processing, are critical regions in the default mode network. We used functional magnetic resonance imaging (fMRI) to investigate whether default mode network activity is altered in patients with anxiety disorder. Ten anxiety patients and 10 healthy controls underwent fMRI while listening to emotionally neutral words alternating with rest (Experiment 1) and threat-related words alternating with emotionally neutral words (Experiment 2). In Experiment 1, regions of deactivation were observed in patients and controls. In Experiment 2, regions of deactivation were observed only in patients. The observed deactivation patterns in the two experiments, which included MPFC, PCC, and inferior parietal cortex, were similar and consistent with the default model network. Less deactivation in MPFC and greater deactivation in PCC were observed for patients group comparing to controls in Experiment 1. Our observations suggest that the default model network is altered in anxiety patients and dysfunction in MPFC and PCC may play an important role in anxiety psychopathology.

Corrigendum: Diagnostic Value of microRNA for Alzheimer's Disease: A Systematic Review and Meta-Analysis.

[This corrects the article on p. 13 in vol. 8, PMID: 26903857.].

[Outcome and cognitive changes of mild cognitive impairment in the elderly: a follow-up study of 47 cases].

OBJECTIVE: To examine the cognitive changes and outcome of mild cognitive impairment (MCI) in the elderly and to explore the predictive factors of development from MCI into dementia. METHOD: A cross-sectional and longitudinal parallel cohort study design was conducted among 47 patients with MCI (MCI group), aged 72.4 +/- 7.1, and 50 sex, marital status, and professional structure-matched normal controls (NC group), aged 67.9 +/- 5.3, using the Neuropsychological Battery of Cognitive Assessment Instruments developed by World Health Organization (WHO-BCAI) and the Wechsler Memory Scale (WMS) to assess the cognitive function. Follow-up was conducted for 34.0 +/- 1.8 months. The diagnosis of dementia was based on the criteria in the Diagnostic and Statistical Manual-IV. RESULTS: Dementia was diagnosed in 13 of the 47 MCI patients with a prevalence rate of 27.7%, significantly higher than that in the NC group (2.0%, 1/50, P < 0.01). The mean total score of mini-mental status examination (MMSE) of the MCI group decreased by 2.2 +/- 3.7, significantly more than that of the NC group (1.0 +/- 1.9, P < 0.01). The mean total mental quotient (MQ) of the MCI group decreased by 12.6 +/- 17.3, significantly more than that of the NC group (3.9 +/- 8.4, P < 0.01). The values of MMSE and MQ of the 13 cases in the MCI group who developed into dementia patients decreased by 5.5 +/- 2.8 and 30.0 +/- 18.0 respectively. The WHO-BCAI assessment demonstrated that the scores of performance of verbal learning, verbal fluency, visual reasoning, trail making, sorting and spatial construct tests of the cases in the MCI group who developed into dementia patients were significantly poorer than those of the NC group (P < 0.01). Logistic analysis based on the baseline assessment suggested that the total score of MMSE and its subtest of orientation, score of orientation memory of WMS, and the scores of performance of trail making, attention, and delayed recall tested by WHO-BCAI were all statistically significant predictive factors for MCI converting into dementia (P < 0.01 or 0.05). The predictive accuracy rates of MMSE, WMS, and WHO-BCAI were 70.3%, 78.4% and 90.7% respectively. CONCLUSION: MCI diagnosed based on the criteria of pure MCI modified by the authors is indeed a transitional state from normal aging to dementia, especially Alzheimer's type of dementia. The cognitive change for MCI converting into dementia is characterized in the areas of orientation, attention, speech and executive function. These predictive factors for MCI to develop dementia are valuable in early detection and prevention of dementia in the elderly.

[Prefrontal and superior temporal lobe hyperactivity as a biological substrate of generalized anxiety disorders].

OBJECTIVE: To explore the potential mechanism of generalized anxiety disorders (GAD). METHODS: Ten GAD patients and 10 sex- and age-matched healthy persons underwent functional magnetic resonance imaging (fMRI) study in 2 stages by block design: auditory presentation of the stimulation task. In experiment 1 emotionally neutral words were given and then alternated with a no word period for 8 cycles. In experiment 2 emotionally neutral words and threat-related words were given alternately for 8 cycles. The subjects were asked to listen carefully and then judge their subjective feeling in mind. By the end of experiment they were asked to fill in a state anxiety inventory (STAI-S) so as to calculate the STAI-S scores. RESULTS: The mean STI-S score of the patients in the experiment 1 was 57 +/- 5, significantly higher than that of the healthy persons (37 +/- 3, P < 0.01); and the mean STAI-S score in the experiment 2 of the patients was 66 +/- 6, significantly higher than that of the healthy persons (41 +/- 4, P < 0.01). The fMRI findings showed that in the experiment 1 the activated cerebral regions of the 2 groups were mostly overlapped, including bilateral superior temporal gyri (BA22/42) and middle temporal gyri (BA21), premotor areas (B46), and supplementary motor areas (BA6), and cerebellar hemisphere, and left inferior prefrontal gyrus (BA44/45). However, the activation intensity levels (mean T values) of the bilateral superior temporal gyri of the patients were both significantly higher than those of the control (for the left side: P = 0.051, and for the right side: P = 0.035). In addition, activation of the dorsal lateral prefrontal cortex (BA8/9) and bilateral inferior parietal lobules (BA39/40). In the experiment 2 activation of brain areas could be seen only in the patients, including bilateral superior temporal gyri, middle temporal gyri, inferior prefrontal gyri, inferior parietal lobules, anterior motor areas, supplemental motor areas, and anterior cingulate gyri (BA8/24/32), and left dorsal lateral prefrontal cortex. No significantly activated brain area could be shown in the control at the same stringent statistic level (P < 0.01, uncorrected); however, when the threshold value (P value) was reduced to 0.01, the left anterior cingulate gyrus (BA24/32), posterior cingulate gyrus (BA29/30), and inferior parietal lobules (BA40) were all significantly activated. CONCLUSION: Dysfunction of superior temporal lobe and dorsal prefrontal cortex, characterized by hyperactivity in response to outer stimuli, may play an important role in the psychopathologic mechanism of GAD.