[Expert consensus on the diagnosis and treatment of respiratory diseases exacerbated by nonsteroidal anti-inflammatory drugs （2024, Chengdu）].

Non-steroidal anti-inflammatory drugs-exacerbated respiratory disease （N-ERD） is a chronic respiratory disease characterized by eosinophilic inflammation, featuring chronic rhinosinusitis （CRS）, asthma, and intolerance to cyclooxygenase 1 （COX-1） inhibitors. The use of these medications can lead to an acute worsening of rhinitis and asthma symptoms. This condition has not yet received sufficient attention in China, with a high rate of misdiagnosis and a lack of related research. The Chinese Rhinology Research Group convened a group of leading young experts in otolaryngology from across the country, based on the latest domestic and international evidence-based medical practices to formulate this consensus.The consensus covers the epidemiology, pathogenesis, clinical manifestations, diagnostic methods, and treatment strategies for N-ERD, including pharmacotherapy, surgery, biologic treatments, and desensitization therapy. The goal is to improve recognition of N-ERD, reduce misdiagnosis, and enhance treatment outcomes.

White and Gray Matter Abnormalities in Young Adult Females with Dependent Personality Disorder: A Diffusion-Tensor Imaging and Voxel-Based Morphometry Study.

We applied diffusion-tensor imaging (DTI) including measurements of fractional anisotropy (FA), a parameter of neuronal fiber integrity, mean diffusivity (MD), a parameter of brain tissue integrity, as well as voxel-based morphometry (VBM), a measure of gray and white matter volume, to provide a basis to improve our understanding of the neurobiological basis of dependent personality disorder (DPD). DTI was performed on young girls with DPD (N = 17) and young female healthy controls (N = 17). Tract-based spatial statistics (TBSS) were used to examine microstructural characteristics. Gray matter volume differences between the two groups were investigated using voxel-based morphometry (VBM). The Pearson correlation analysis was utilized to examine the relationship between distinct brain areas of white matter and gray matter and the Dy score on the MMPI. The DPD had significantly higher fractional anisotropy (FA) values than the HC group in the right retrolenticular part of the internal capsule, right external capsule, the corpus callosum, right posterior thalamic radiation (include optic radiation), right cerebral peduncle (p < 0.05), which was strongly positively correlated with the Dy score of MMPI. The volume of gray matter in the right postcentral gyrus and left cuneus in DPD was significantly increased (p < 0.05), which was strongly positively correlated with the Dy score of MMPI (r1,2= 0.467,0.353; p1,2 = 0.005,0.04). Our results provide new insights into the changes in the brain structure in DPD, which suggests that alterations in the brain structure might implicate the pathophysiology of DPD. Possible visual and somatosensory association with motor nerve circuits in DPD.

Structural brain alterations in young adult males with narcissistic personality disorder: a diffusion tensor imaging study.

PURPOSES: 1. To find a difference in white matter (WM) between young adult males with narcissistic personality disorder (NPD) and healthy controls (HCs). 2. To find some correlations between white matter in the abnormal regions of NPD group and the pathological narcissism inventory (PNI). MATERIALS AND METHODS: Eighteen male participants with NPD (age M = 18.39, SD = 0.164; education M = 12.33, SD = 0.14) were included in our experiment. NPD participants met the DSM-IV criteria for NPD and without other personality disorders evaluated by trained clinical psychiatrists using the Structured Clinical Interview of DSM-IV for Personality Disorders (SCID-II). Moreover, healthy controls were also confirmed to be free of any axis I or II disorders and matched with education level, age and handedness (age M = 18.83 years, SD = 0.246; education M = 12.56, SD = 0.202; all participants were right handed). Those who have had major life events in the last six months, mental and physical illnesses, claustrophobia and oral implants have been excluded. We used tract-based spatial statistics (TBSS) on diffusion tensor images (DTI) and analysis of Pearson correlation between abnormal brain regions of white matter fibers and the pathological narcissism inventory. RESULTS: There was no significant difference in age and education level between NPD and HCs (p > 0.05). There were significant differences in PNI score and its subscales between NPD group and HCs (p < 0.01). Fractional anisotropy (FA) values were found decreased mainly in the right superior longitudinal fasciculus and the bilateral posterior thalamic radiation (include optic radiation). Lower axial diffusivity (AD) values were identified mostly in the left retrolenticular part of internal capsule and the left posterior thalamic radiation (include optic radiation). There existed a significant correlation between DTI data and pathological narcissism inventory. CONCLUSIONS: The decreased brain white matter microstructures among three clusters were found in the association, projection/thalamic and connection pathways of white matter in young adult males with NPD. The abnormal white matter brain regions may be one of the neuropathological basis of the pathogenesis of young males with NPD, and it may be related to white matter development in early adulthood.

Common and distinct patterns of gray matter alterations in borderline personality disorder and posttraumatic stress disorder: A dual meta-analysis.

BACKGROUND: Borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD) are severe psychiatric disorders and often co-occur, either of the two will seriously threaten to public health. However, we lack ample evidences to understand the potential pathophysiologic mechanisms of gray matter (GM) alterations in the two disorders. METHODS: We performed a meta-analysis in both BPD (15 datasets including 442 BPD subjects versus 441 healthy controls) and PTSD (11 datasets including 214 PTSD subjects versus 258 healthy controls) applying anisotropic effect-size-based algorithms (AES-SDM) method. RESULTS: Conjunction analysis found relative GM volume reductions in both disorders in the orbitofrontal gyrus and anterior cingulate cortex, contrarily, differences were predominantly observed that GM volume increased in the posterior cingulate gyrus and precuneus in BPD subjects, and GM volume decreased in the amygdala-hippocampal fear circuit, fusiform gyrus in PTSD subjects. CONCLUSIONS: Group comparisons and conjunction analyses in BPD and PTSD identified same regions of GM volume reductions in the orbitofrontal gyrus and anterior cingulate cortex, which may provide clues for the neurobiological mechanisms and clinical diagnosis underpinning two disorders.

Multiple Frequency Bands Analysis of Large Scale Intrinsic Brain Networks and Its Application in Schizotypal Personality Disorder.

The human brain is a complex system composed by several large scale intrinsic networks with distinct functions. The low frequency oscillation (LFO) signal of blood oxygen level dependent (BOLD), measured through resting-state fMRI, reflects the spontaneous neural activity of these networks. We propose to characterize these networks by applying the multiple frequency bands analysis (MFBA) to the LFO time courses (TCs) resulted from the group independent component analysis (ICA). Specifically, seven networks, including the default model network (DMN), dorsal attention network (DAN), control executive network (CEN), salience network, sensorimotor network, visual network and limbic network, are identified. After the power spectral density (PSD) analysis, the amplitude of low frequency fluctuation (ALFF) and the fractional amplitude of low frequency fluctuation (fALFF) is determined in three bands: <0.1 Hz; slow-5; and slow-4. Moreover, the MFBA method is applied to reveal the frequency-dependent alternations of fALFF for seven networks in schizotypal personality disorder (SPD). It is found that seven networks can be divided into three categories: the advanced cognitive networks, primary sensorimotor networks and limbic networks, and their fALFF successively decreases in both slow-4 and slow-5 bands. Comparing to normal control group, the fALFF of DMN, DAN and CEN in SPD tends to be higher in slow-5 band, but lower in slow-4. Higher fALFF of sensorimotor and visual networks in slow-5, higher fALFF of limbic network in both bands have been observed for SPD group. The results of ALFF are consistent with those of fALFF. The proposed MFBA method may help distinguish networks or oscillators in the human brain, reveal subtle alternations of networks through locating their dominant frequency band, and present potential to interpret the neuropathology disruptions.

Mindful exercise versus non-mindful exercise for schizophrenia: A systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE: To investigate whether the mindful exercise was more beneficial than non-mindful exercise for people with schizophrenia. METHODS: PubMed, Embase, Cochrane Library, and PsycINFO were searched from their onset to April 2017. Randomized controlled trials of schizophrenia were selected. Mindful exercises were yoga, tai chi or qigong. Non-mindful exercises included any type of purely physical exercise. Risk of bias was assessed using criteria in the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS: Seven studies were identified. There were significant differences in favour of mindful exercise in psychiatric symptoms (total PANSS, 2 RCT, n = 101, MD -8.94, low-quality evidence) and "working memory" (1 RCT, n = 194, MD 0.39, low-quality). For outcomes of "attention" and social functioning, there was no clear difference. Four studies reported no adverse events. CONCLUSIONS: Mindful exercise was more beneficial over non-mindful exercise on some outcomes of psychiatric symptoms and cognitive performance for schizophrenia.

Characterization of the Fiber Connectivity Profile of the Cerebral Cortex in Schizotypal Personality Disorder: A Pilot Study.

Schizotypal personality disorder (SPD) is considered one of the classic disconnection syndromes. However, the specific cortical disconnectivity pattern has not been fully investigated. In this study, we aimed to explore significant alterations in whole-cortex structural connectivity in SPD individuals (SPDs) by combining the techniques of brain surface morphometry and white matter tractography. Diffusion and structural MR data were collected from 20 subjects with SPD (all males; age, 19.7 ± 0.9 years) and 18 healthy controls (all males; age, 20.3 ± 1.0 years). To measure the structural connectivity for a given unit area of the cortex, the fiber connectivity density (FiCD) value was proposed and calculated as the sum of the fractional anisotropy of all the fibers connecting to that unit area in tractography. Then, the resultant whole-cortex FiCD maps were compared in a vertex-wise manner between SPDs and controls. Compared with normal controls, SPDs showed significantly decreased FiCD in the rostral middle frontal gyrus (crossing BA 9 and BA 10) and significantly increased FiCD in the anterior part of the fusiform/inferior temporal cortex (P < 0.05, Monte Carlo simulation corrected). Moreover, the gray matter volume extracted from the left rostral middle frontal cluster was observed to be significantly greater in the SPD group (P = 0.02). Overall, this study identifies a decrease in connectivity in the left middle frontal cortex as a key neural deficit at the whole-cortex level in SPD, thus providing insight into its neuropathological basis.

Decreased fractional anisotropy values in two clusters of white matter in patients with schizotypal personality disorder: A DTI study.

OBJECTIVE: To find a difference in fractional anisotropy (FA) between young adult males with schizotypal personality disorder (SPD) and healthy controls (HCs). METHODS: Sixteen males with SPD and sixteen HCs were selected from 3500 freshmen across two universities. The 32 participants were evaluated by the Minnesota Multiphasic Personality Inventory (MMPI) (Chinese Version Sc≥70) and the Schizotypal Personality Questionnaire (SPQ). Structured diagnostic interview was carried out and all the subjects in the SPD group met DSM-IV diagnostic criteria for SPD. All participants underwent brain magnetic resonance imaging, and their diffusion tensor imaging (DTI) data was collected. DTI data was analysed using tract-based spatial statistics (TBSS), and the neurofibre connection from the hippocampus to the right entorhinal cortex was traced. Informed consent was obtained from all participants. RESULTS: (1) SPD and HCs had a significant difference in SPQ symptoms (P<0.05). (2) There was a significant difference in the fractional anisotropy of two clusters of the brain between the two groups (P<0.05). The first cluster included the right pallidum, right retro-lenticular part of the internal capsule, right inferior longitudinal fasciculus (rILF), right posterior parietal lobe, right temporal lobe and right occipital lobe. The second cluster included the right hippocampus, right fornix, and right temporal lobe. (3) FA volume in the rILF positively correlated with scores related to the "lack of friends" subscale of the SPQ. CONCLUSION: These results suggest reduced white matter in two brain clusters of young adult males with SPD. These findings are similar to previous reports on patients experiencing their first schizophrenic episode.

Brain fMRI study of crave induced by cue pictures in online game addicts (male adolescents).

OBJECTIVE: To study crave-related cerebral regions induced by game figure cues in online game addicts. fMRI brain imaging was done when the subjects were shown picture cues of the WoW (World of Warcraft, Version: 4.1.014250) game. METHODS: 10 male addicts of WoW were selected as addicts' group, and 10 other healthy male non-addicts who were matched by age, were used as non-game addicts' group. All volunteers participated in fMRI paradigms. WoW associated cue pictures and neutral pictures were shown. We examined functional cerebral regions activated by the pictures with 3.0 T Philips MRI. The imaging signals' database was analyzed by SPM5. The correlation between game craving scores and different image results were assessed. RESULTS: When the game addicts watch the pictures, some brain areas show increased signal activity namely: dorsolateral prefrontal cortex, bilateral temporal cortex, cerebellum, right inferior parietal lobule, right cuneus, right hippocampus, parahippocampal gyrus, left caudate nucleus. But in these same brain regions we did not observe remarkable activities in the control group. Differential image signal densities of the addict group were subtracted from the health control group, results of which were expressed in the bilateral dorsolateral prefrontal cortex, anterior cingulate cortex, inferior parietal lobe and inferior temporal gyrus, cerebellum, right insular and the right angular gyrus. The increased imaging signal densities were significant and positively correlated with the craving scale scores in the bilateral prefrontal cortex, anterior cingulate cortex and right inferior parietal lobe. CONCLUSIONS: Craving of online game addicts was successfully induced by game cue pictures. Crave related brain areas are: dorsolateral prefrontal cortex, anterior cingulate cortex, and right inferior parietal lobe. The brain regions are overlapped with cognitive and emotion related processing brain areas.

Suicide attempt and n-3 fatty acid levels in red blood cells: a case control study in China.

BACKGROUND: Epidemiologic studies show that low fish intake is a risk factor of suicidality; however, there are no case-control studies investigating suicide attempt risk and tissue n-3 fatty acid levels. METHODS: We recruited 100 suicide-attempt cases and another 100 control patients injured by accidents who were admitted to three hospitals affiliated with Dalian Medical University in Dalian, China. Case and control subjects were matched for age, gender, and smoking status. Those who were inebriated at the time of hospitalization were excluded. Blood was sampled immediately after admission to a hospital. Washed red blood cells (RBCs) were obtained, and the fatty acid composition of the total RBC phospholipid fraction was analyzed by gas chromatography. RESULTS: Eicosapentaenoic acid (EPA) levels in RBC in the case subjects were significantly lower than those of the control subjects (.74 +/-.52% vs. 1.06 +/-.62%, p <.0001). When the highest and lowest quartiles of EPA in RBC were compared, the odds ratios of suicide attempt was.12 in the highest quartile (95% confidence interval:.04-.36, p for trend =.0001) after adjustment for possible confounding factors CONCLUSIONS: Our findings suggest that low n-3 fatty acid levels in tissues were a risk factor of suicide attempt. Further studies including intervention with fish oil are warranted.