[The influence of interaction between polygenic risk score and intestinal fungal microbiota on the risk of schizophrenia].

Objective: To investigate the effect of interaction between polygenic risk score (PRS) and intestinal fungal microbiota on the risk of Schizophrenia (SCH). Methods: A case-control study was carried out. Drug-naïve, first-episode SCH patients were selected from the Psychiatric Department of the First Affiliated Hospital of Zhengzhou University between October 2017 and October 2019. Meanwhile, healthy controls (HCs) were recruited from local communities through online advertisement or physical examination center. Intestinal fungal microbiota was characterized by the 18S rRNA sequencing platform. The association of fungal microbial dysbiosis (F_MD) index, α-diversity indices and PRS with SCH was detected by logistic regression analysis. Results: A total of 137 SCH patients (62 males and 75 females) and 76 HCs (31 males and 45 females) were included in the study. The age of SCH patients and HCs was (22.5±7.5) years and (22.8±2.3) years, respectively. The results of logistic regression analysis revealed that PRS (OR=1.111, 95%CI: 1.036-1.178, P=0.002) and the increase of F_MD index (OR=1.200, 95%CI: 1.124-1.281, P<0.001) were risk factors for developing SCH. The increase of fungal α-diversity Shannon (OR=0.813, 95%CI: 0.755-0.874, P<0.001) index, Simpson index (OR=0.218, 95%CI: 0.091-0.523, P<0.001) and abundance of key Aspergillus (OR=0.928, 95%CI: 0.864-0.996, P=0.040) decreased the risk of SCH. Aspergillus abundance was positively correlated with cognitive domains including working memory (r=0.280, P=0.001), verbal learning (r=0.253, P=0.003), reasoning and problem solving (r=0.191, P=0.028). Conclusion: The increase of PRS may increase the risk of SCH. The increase of fungal α-diversity indices and Aspergillus abundance may decrease the risk of SCH. The interaction between PRS and intestinal fungi (Shannon index, Simpson index and Aspergillus) is a related factor for the risk of SCH.

[Establishment of diagnostic model for schizophrenia based on neurotrophic factor and other biomarkers].

Objective: To construct a diagnostic model of schizophrenia (SCZ) based on biomarkers such as serum neurotrophic factor. Methods: Patients of schizophrenia (SCZ group) and healthy controls (HC group) who were admitted to the First Affiliated Hospital of Zhengzhou University from January 2017 to December 2019 were prospectively selected. In the SCZ group, the mental symptoms were assessed by the positive and negative symptom scale (PANSS), cognitive function was assessed by the MATRICS consensus cognitive battery (MCCB), brain-derived neurotrophic factor (BDNF), glial cell derived neurotrophic factor (GDNF), fasting glucose (FGB) and fasting insulin (FINS) levels were detected, and insulin resistance (HOMA-IR) was calculated. The same methods were used to evaluate cognitive function, measure BDNF, GDNF, FGB and FINS levels, and calculate HOMA-IR in HC group. The indexes with statistically significant differences between the two groups were selected to be included in the model. The diagnostic model was constructed by machine learning and verified by cross-validation method, the receiver operating curve (ROC) was plotted, and the area under the curve (AUC), sensitivity and specificity were calculated. Results: (1) A total of 142 patients (70 males and 72 females) with schizophrenia were finally included, and aged (25±4) years. Meanwhile, 140 healthy controls (72 males and 68 females) were also enrolled, and aged (26±4) years. In SCZ group, scores in all areas of cognitive function were lower than those in HC group (all P<0.001), the levels of serum BDNF and GDNF [(6.7±1.8) ng/ml and (405±93) pg/ml] were also lower than those in HC group [(12.3±3.2) ng/ml and (574±139) pg/ml] (both P<0.001), but the levels of FINS and HOMA-IR [(8.4±0.8) µU/ml and 1.7±0.3] were higher than those in HC group [(6.7±0.9) µU/ml and 1.4±0.3] (both P<0.001). (2) Correlation analysis showed that the level of serum BDNF had a negative correlation with negative symptom scores and total scores (r=-0.31, P<0.001; r=-0.17, P=0.040), but had a positive correlation with attention/alertness (CPT-IP) T scores, working memory (WSM-Ⅲ) T scores and visual learning (BVMT) T scores in SCZ group (r=0.39, 0.37 and 0.29, all P<0.001). The level of serum GDNF also had a positive correlation with CPT-IP T scores, WSM-Ⅲ T scores and BVMT T scores (r=0.32, P<0.001; r=0.23, P=0.007; r=0.40, P<0.001). The values of HOMA-IR had a positive correlation with social cognition (MSCEIT) T scores in SCZ group (r=0.18, P=0.033). (3) AUC of the early diagnosis model constructed by combining BDNF, GDNF and HOMA-IR was 0.890 (95%CI: 0.832-0.940), the accuracy was 0.89, the sensitivity and specificity was 0.94 and 0.82, respectively. Conclusion: The final diagnostic model based on biomarkers of serum neurotrophic factor has good diagnostic efficiency for SCZ, but large-scale independent sample verification is still needed.

[The facility design and operation effect of control vehicle emissions hazard in test section of automobile assembly workshop].

The hazard of vehicle emissions mainly come from the four wheel positioning, drum test and vehicle emissions test sections in automobile assembly workshop, which can lead to abnormal hemoglobin and hepatic insufficiency in workers. We researched on preventing toxic gases technologies for the vehicle emissions generated by these three sections, designed the ventilation facilities, and then detected and evaluated the operation effect, thereby improving the working environment, ensuring the occupational health of workers, and providing scientific basis for the control of vehicle emissions hazards.

[Incidence and cause of abnormal cholesterol in children aged 2-18 years in a single center].

OBJECTIVE: To investigate the abnormality and distribution of plasma cholesterol levels in single-center hospitalized children. METHODS: The blood lipid levels of children aged 2-18 years who had blood lipid test results in Peking University First Hospital from June 2016 to June 2019 were etrospectively analyzed. Cholesterol oxidase method was used for total cholesterol, and high-density lipoprotein cholesterol and low-density lipoprotein cholesterol were detected by clearance method. The counting data were compared with chi-square test. RESULTS: The survey had involved 11 829 children (7 087 were boys and 4 742 were girls). 1 822 (15.4%) children were with elevated total cholesterol, 1 371 (11.6%) children with elevated low-density lipoprotein cholesterol, and 2 798 (23.7%) children with high-density lipoprotein cholesterol reduction. The total number of the children with abnormal cholesterol levels was 4 427 (37.4%). Among the 7 835 children who visited hospital due to the disease not commonly inducing dyslipidemia, 731 (9.3%) had elevated TC, 561 (7.2%) had elevated LDL-C, 1 886 (24.1%) had decreased HDL-C, and 2 576 (32.9%) had abnormal cholesterol levels. Among the children with different diseases, the difference in the incidence of abnormal cholesterol was statistically significant. The top three main groups of the children with increased total cholesterol and low-density lipoprotein cholesterol were "dyslipidemia", "urinary tract disease", and "nutritional disease"; The top three main groups of the children with reduced high-density lipoprotein cholesterol were "respiratory diseases", "dyslipidemia", "hematological diseases and malignant tumors". Among the 1 257 blood li-pid test results sent by other departments, 300 cases had abnormal cholesterol levels (23.8%). Among them, there were 70 children with hypercholesterolemia (5.6%), 44 children with increased low-density lipoprotein cholesterol (3.5%), and 224 children with reduced high-density lipoprotein cholesterol (17.8%). There were 365 (4.6%) children with low-density lipoprotein cholesterol ≥140 mg/dL (3.6 mmol/L) who needed to further exclude familiar hypercholesterolemia among the children who visited hospitals due to the disease not commonly inducing dyslipidemia. CONCLUSION: Children in hospitals have a high incidence of cholesterol abnormalities. Doctors need to pay more attention to the cholesterol diagnosis and management regardless of the discipline, which not only helps to control secondary hypercholesterolemia, but also provides the possibility of detecting familial hypercholesterolemia in time.

[A multicenter study on the tolerance of intravenous low-dose cyclophosphamide in systemic lupus erythematosus].

OBJECTIVE: To compare the safety of low-dose cyclophosphamide and high-dose cyclophosphamide in the treatment of systemic lupus erythematosus (SLE). METHODS: A total of 1 022 patients with systemic lupus erythematosus from 24 hospitals in China between March 2017 to July 2018 were enrolled. Their clinical manifestations, laboratory tests, adverse events, reasons for stopping receiving intravenous cyclophosphamide and comorbidities were collected. Among them, 506 SLE patients received short-interval low-dose intravenous cyclophosphamide therapy (SILD IV-CYC, 400 mg every two weeks), and 256 patients underwent high-dose cyclophosphamide therapy (HD IV-CYC, 500 mg/m2 of body surface area every month), the side effects between the two groups were compared, the remaining 260 SLE patients were treated with IV-CYC irregularly. Moreover, a total of 377 patients in SILD IV-CYC group and 214 patients in HD IV-CYC group had medical records of the reasons for stopping recei-ving IV-CYC. The reasons for stopping receiving IV-CYC in these two groups were analyzed. RESULTS: In this study, only 40.27%(238/591)of the SLE patients stopped receiving intravenous cyclophosphamide for the causes of disease improvement, however, up to 33.67% (199/591) of the patients for the reason of drug-related side effects. There were 83 patients out of 214 (38.79%) with high-dose intravenous cyclophosphamide treatment who stopped receiving IV-CYC for the drug-related side effects, which was significantly higher than that in the low-dose cyclophosphamide group (30.77%, 116/337, P=0.048). Of theses 506 patients in SILD IV-CYC group, 88 (17.39%) patients experienced gastrointestinal reactions, 66 (13.04%) suffered from infections, 49 (9.68%) had myelosuppression and 68 (13.44%) had alopecia, respectively. Among the 256 patients in the HD IV-CYC group, 80 (31.25%) experienced gastrointestinal reactions, 57 (22.27%) suffered from infections, 51 (19.92%) had myelosuppression and 49 (19.14%) had alopecia. Moreover, 71 (25.18%) of 282 female patients with age between 16 to 45 years in SILD IV-CYC group had abnormal menstruation, while menstrual disorder occurred in 39.72% (56/141) patients of HD IV-CYC group. There was no difference of drug-induced hepatic injury, hemorrhagic cystitis and fatigue between the two groups. CONCLUSION: Low-dose cyclophosphamide showed a lower prevalence of adverse events than high-dose cyclophosphamide in systemic lupus erythematosus patients.

[Prognostic value of pulmonary hemodynamic parameters for predicting survival in acute coronary syndrome].

Objective: To explore the characteristics and prognostic value of pulmonary hemodynamics in patients with acute coronary syndrome (ACS). Methods: From a prospective multicenter registry study of pulmonary hypertension due to left heart disease, consecutive ACS patients who underwent coronary angiography in combination with left and right heart catheterization during hospitalization between January 2013 and November 2016 were involved. The primary endpoint was all-cause mortality. The prognostic variables identified by the Lasso analysis were included in the Global Registry of Acute Coronary Events (GRACE) score. Model performance was evaluated before and after the addition of hemodynamic parameters. Results: A total of 251 patients were enrolled, with age of (63.7±11.5) years. A total of 198 males (78.9%) and 53 females (21.1%) were recruited, and the median follow-up time was 34.7 months. Right heart catheterization-assessed mean pulmonary arterial pressure (mPAP), systolic pulmonary arterial pressure (sPAP) and diastolic pressure gradient (DPG) were found to be significant predictors for survival in ACS. Adjusted for age and sex, the adjusted HR (95%CI) of mPAP, sPAP and DPG were 1.068 (1.015-1.123), 1.033 (1.002-1.065) and 1.094 (1.008-1.187), respectively (P<0.05). Applied to the present cohort of 251 patients, the median of the GRACE score was 123 points, with a C-index of 0.703 (95%CI: 0.615-0.791) for predicting mortality. After the addition of mPAP or DPG to the GRACE score, the C-index increased to 0.715 (95%CI: 0.629-0.801) or 0.711 (95%CI: 0.625-0.797), respectively. When comparing two models before and after the addition of mPAP or DPG, the integrated discriminatory index (IDI) was 4.3% (95%CI: 0.2%-13.5%, P=0.030) and 3.0% (95%CI: 0.2%-11.1%, P=0.020), respectively. Conclusion: Pulmonary hemodynamics can be predictive for survival in ACS patients, providing incremental prognostic value to risk assessment in ACS.

Growth phase-dependent surface properties of Legionella pneumophila and their role in adhesion to stainless steel coated QCM-D sensors.

Legionella pneumophila cell surface hydrophobicity and charge are important determinants of their mobility and persistence in engineered water systems (EWS). These surface properties may differ depending on the growth phase of L. pneumophila resulting in variable adhesion and persistence within EWS. We describe the growth-dependent variations in L. pneumophila cell surface hydrophobicity and surface charge using the microbial adhesion to hydrocarbon assay and microelectrophoresis, respectively, and their role in cell adhesion to stainless steel using a quartz crystal microbalance with dissipation (QCM-D) monitoring instrument. We observed a steady increase in L. pneumophila hydrophobicity during their lifecycle in culture media. Cell surfaces of stationary phase L. pneumophila were significantly more hydrophobic than their lag and midexponential counterparts. No significant changes in L. pneumophila cell surface charge were noted. Morphology of L. pneumophila remained relatively constant throughout their lifecycle. In the QCM-D study, lag and exponential phase L. pneumophila weakly adhered to stainless steel surfaces resulting in viscoelastic layers. In contrast, stationary phase bacteria were tightly and irreversibly bound to the surfaces, forming rigid layers. Our results suggest that the stationary phase of L. pneumophila would highly favour their adhesion to plumbing surfaces and persistence in EWS.

[Effect of the correlation between gut microbiota and folic acid in first-episode schizophrenia].

Objective: To explore the effects of gut microbiota and the serum level of folicacid on psychiatric symptoms in first-episode, drug-free schizophrenic (SCZ) patients. Methods: A total of 100 first-episode, drug-free SCZ patients (SCZ group) from the First Affiliated Hospital of Zhengzhou University and 90 demographically matched healthy individuals (healthy control group) were enrolled. The serum level of folic acid was measured by the electrochemical luminescence method.Positive and Negative Syndrome Scale (PANSS) was used to assess the psychiatric symptoms and Matrics Consensus Cognitive Battery (MCCB) was used to evaluate cognitive function. Bacterial DNA was extracted from the fecal samples for high-through put sequencing of the 16S rRNA.The effects of gut microbiota and folic acid on the psychiatric symptoms and cognitive function in SCZ patients were explored. Results: A total of 41 males and 59 females, with an age of (22.6±8.2) years were included in the patient group, and 32 males and 58 females with an age of (23.0±3.0) years were included in the healthy control group. The fasting folic acid level inserum of the SCZ group was lower than that of healthy control group [6.92(4.98, 8.49) µg/L vs 8.93(7.13, 13.37) µg/L,P<0.001]. The relative abundance of genus Bifidobacterium[0.005(0.003, 0.013) vs 0.014(0.004, 0.031)] and genus Bacteroides[0.015(0.001, 0.091) vs 0.083(0.029, 0.193)]was lower in the SCZ group than that of the healthy control group (both P<0.001). In comparison with the healthy control group, scores of cognitive function in the seven domains were significantly lower in the SCZ group (all P<0.05). In the patient group, the serum level of folic acid was negatively related to the negative symptom score(r=-0.378, P<0.001), but had a positive correlation with the score of speed of processing (r=0.310, P=0.011).In the SCZ group, the relative abundance of the genus Bifidobacterium was positively correlated with the serum level of folic acid (r=0.374,P<0.001) and the score of speed of processing(r=0.330,P=0.003) respectively, but was negatively correlated with the general psychopathology score (r=-0.326, P=0.001). The results of multiple linear regression analysis showed that the interaction term between folic acid and genus Bifidobacteriumin in SCZ patients were correlated with the general psychopathology score, with a regression coefficient of -29.240 (F=8.655, P=0.007). There was no statistical correlation between the aforementioned interaction term and cognitive function (both P>0.05). Conclusion: In first-episode, drug-free SCZ patients, there were decreases in the serum folic acid level and the relative abundance of genus Bifidobacterium, which were related to the psychiatric symptoms, suggesting that these two substances can be used as potential objective indicators for evaluating psychiatric symptoms.

Retrospective Analysis on Traumatic Rupture of Intracranial Internal Carotid Artery in 11 Cases.

ABSTRACT: Objective To retrospectively analyze the characteristics of the traumatic rupture of intracranial internal carotid artery in order to provide reference for forensic expertise examination and identification. Methods A total of 11 autopsy cases of traumatic rupture of intracranial internal carotid artery were collected. The gender, age, cause of injury, blood loss on the scene, location of internal carotid artery rupture, hardening degree of the rupture of the wall, brain injury, blood ethanol content and cause of death were also recorded. Results All 11 cases died on the scene, of which 7 died from traffic accidents, 2 falls from height and 2 from bare handed injuries. None of the 11 victims suffered serious head and body surface injury. The internal carotid artery rupture in the 9 cases of traffic injury and fall from height injury occurred in the cavernous segment. In all these cases, there were transverse fractures of the middle cranial fossa with the carotid sulcus involved, and minor intracranial hemorrhage and brain contusion. In 2 cases of bare handed injuries, internal carotid artery rupture occurred in the ophthalmic artery segment, accompanied by fatal intracranial hemorrhage and diffuse axonal injury, but no skull fracture. All 11 cases showed full-thickness rupture of the vessel wall, and the long axis of the wounds was perpendicular to those of the artery. Conclusion The incidence of intracranial internal carotid artery rupture in high-energy trauma events such as traffic accidents and high falls deserves attention. Injuries of the cavernous segment or ophthalmic segment might be more common. The main injury mechanism of intracranial internal carotid artery rupture might be that the blood vessels were pulled and the bone fragments caused damage.

Forensic Analysis of 105 Autopsy Cases of Psychiatric Patients.

ABSTRACT: Objective To provide reference for medical and health services and forensic expertise, the causes and manners of death of psychiatric patients were analyzed retrospectively. Methods A total of 105 autopsy cases of psychiatric patients accepted and settled by Institute of Forensic Science of Criminal Investigation Police University of China from 2004 to 2019 were collected. The cases were divided into four groups： disease death, suicidal death, accidental death and homicidal death. The common causes of death of each group were statistically analyzed and the differences in age, disease duration, body mass index （BMI） and gender among the groups were assessed. Results Of the 105 cases, 60 were male and 45 were female, the course of psychosis was （12.9±10.4） years, the age of the deceased was （51.3±11.4） years, and 61.0% was schizophrenic. There were 50 cases （47.6%） in the disease death group, in which the psychiatric patients were the oldest and had the longest course of psychosis and lowest BMI. Pulmonary thromboembolism, respiratory infections, and cardiogenic disease were the most common causes of death in the group. There were 26 accidental deaths （24.8%）, among which traffic accidents were the most common cause of death. There were 15 homicidal deaths （14.3%）, all of which were male, with craniocerebral injury being the most common cause of death. There were 14 suicidal deaths （13.3%）. In suicidal death group, the age of the deceased was the youngest, the course of psychosis was the shortest and falling from the height was the most common way to commit suicide. Conclusion Understanding the common causes of death of psychiatric patients may contribute to developing measures to reduce the mortality rate of the population. It is necessary to investigate the age, course of psychosis and gender of the deceased when assessing the manner of death.

[A case of paralytic intestinal obstruction caused by nifedipine poisoning].

Nifedipine is a typical dihydropyridine calcium antagonist, and large doses of intake can cause poisoning. This article retrospectively analyzed the clinical data of a patient with nifedipine poisoning complicated with paralytic intestinal obstruction admitted to the First Affiliated Hospital of Jilin University in October 2020. When the patient was admitted to the hospital, the symptoms of poisoning were decreased blood pressure and shock, followed by severe paralytic intestinal obstruction. Finally, after active hemoperfusion combined with hemofiltration and symptomatic supportive treatment, the patient's condition improved and was discharged. There was no discomfort in the follow-up 2 months later.

[Antiviral treatment for hepatitis C among injecting drug users in the era of direct-acting antiviral agents].

HCV prevalence among people who inject drugs (PWID) is up to 67%. PWID is a population that needs priority attention to achieve the World Health Organization's goal of eliminating viral hepatitis as a public health threat by 2030. Although the SVR of HCV patients treated with direct-acting antiviral drugs (DAAs) can reach over 95%, especially in medical practice, there are still major obstacles to PWID treatment, because PWID is usually accompanied with concurrent infection, multiple-genotype infections, low compliance, substance abuse, methadone maintenance therapy, and risky behavior and re-infection conditions. Therefore, physicians often concern that these factors will affect the treatment efficacy, and refuse to provide hepatitis C treatment in PWID. This article reviews the relevant studies status and effects of hepatitis C treatment in PWID with different infection states and special behavior characteristics, and further highlights that the multidisciplinary cooperation for hepatitis C treatment in PWID is safe and effective, and can ensure treatment compliance.

[Analysis of baseline characteristics and treatment status of hepatitis C in sentinel hospitals from 2017 to 2019].

Objective: To understand the hepatitis C diagnosis type, progression and treatment in medical institutions. Methods: Monitoring posts were set up in the secondary and tertiary-level hospitals in some parts of the country. Reported infectious diseases cases of hepatitis C in sentinel hospitals during the three consecutive years from 2017 to 2019 were investigated to understand their general demographic characteristics, diagnosis, liver fibrosis degree, and treatment. The diagnosis, treatment and related factors were analyzed by chi square test and trend. Results: A total of 16 241 cases of hepatitis C were investigated in three years. Among them, 7 538 cases were clinically diagnosed (46.41%) and 8703 cases (53.59%) were confirmed as hepatitis C. Among the confirmed cases, 60 cases (0.69%) were acute and 8643 cases (99.31%) were chronic. In the past three years, the proportion of cases diagnosed by liver diseases related departments decreased from 62.23% to 40.01%, while the proportion of medical and surgical cases of non-liver diseases increased from less than 30% to nearly 60%. The proportion of confirmed cases in secondary hospitals (26.27%) was significantly lower than that in tertiary hospitals (62.48%), and the difference was statistically significant (χ (2) = 1594.833, P < 0.001). There were also differences in the proportion of confirmed cases in different regions (P < 0.001). The cases with FIB-4 > 3.25 accounted for 35.78%, and the proportion was increased significantly with age (χ (2) trend = 1159.624, P < 0.001). The average proportion of antiviral treatment was less than 10%, and the proportion of antiviral treatment in secondary hospitals was very low (2.13%); however, the proportion of liver-protective monotherapy treatment was decreased from 30.40% in 2017 to 11.14% in 2019, and the difference was statistically significant (P < 0.001). Conclusion: The large-scale screening of hepatitis C by medical institutions is increasing year by year, but only about half of the cases can be diagnosed, and the diagnostic capacity of secondary hospitals is particularly unsatisfactory. Most of the confirmed cases are chronic hepatitis C, and more than one third of them have abnormal liver fibrosis indicators, and the proportion increases with age. The proportion of antiviral treatment for hepatitis C is lower in secondary than tertiary-level hospitals. Therefore, there is an urgent need to raise the attention of both parties (doctors and patients) to enhance diagnostic capabilities and expand the coverage of antiviral treatment for hepatitis C.

[Study on cognition, willingness to test and influencing factors of hepatitis C based on social software for men who have sex with men].

Objective: To understand the cognition, willingness to test and influencing factors of hepatitis C (HCV) based on social software for men who have sex with men (MSM). Methods: An online questionnaire was used to investigate the target population of Blued platform users, including general demographic characteristics, sexual behavior, drug abuse behavior, cognition of hepatitis C prevention and treatment, past hepatitis C testing status and future testing willingness. There were 14 questions in the cognition part, and answering 10 or more questions were defined as "knowing" . Cognition rate, willingness to test and related influencing factors of hepatitis C were analyzed in different characteristics population. Data were analyzed by univariate and multivariate logistic regression. Results: A total of 1800 valid questionnaires were completed, of which 58.9% (1 061/1 800) had heard of hepatitis C, and the overall cognition rate of hepatitis C was 33.5% (603/1 800). The cognition rate of hepatitis C among those aged 30 years old, monthly income among RMB 5 000~10 000, high school education or above, and previous HIV testing [42.5% (371/873), 36.7% (191/520), 35.1% (584/1 663) and 37.4% (544/1453)] was considerably higher than those of the corresponding low-age, low-income, low-educated, not having HIV testing and not insisting on condom use, and the differences were statistically significant (P < 0.05). The proportion of respondents who were willing to undergo hepatitis C testing in the next 3 months was 82.5% (851/1 031). The proportion of respondents who were tested for HIV in the past, had anal sex in the past 6 months and had high-risk behaviors [85.2% (766/899), 86.1% (609/707) and 86.6% (610/704)] was considerably higher than those who had not been tested for HIV, had no anal sex and had no high-risk behaviors in the past 6 months, and the differences were statistically significant (P < 0.05). Conclusion: The survey respondents have a low cognition rate of hepatitis C, but have a higher willingness to test. Targeted publicity and education should be strengthened for this population, and convenient conditions should be provided to promote regular testing.

[A case of colchicine poisoning complicated with extra pontine myelinolysis].

To analyze the clinical presentation and the treatment process of one case of colchicine poisoning complicated with extra pontine myelinolysis and discuss its pathogenesis. Increasing the attention of hyponatremia caused by colchicine poisoning is of great significance for improving the prognosis and quality of life of patients.

Mutation update and long-term outcome after treatment with active vitamin D3 in Chinese patients with pseudovitamin D-deficiency rickets (PDDR).

Pseudovitamin D-deficiency rickets is a rare disease which is caused by CYP27B1. In this study, we identified 9 mutations in 7 PDDR patients. In addition, we observed the response to long-term treatment of calcitriol in 15 Chinese patients with PDDR, which showed that the biochemical abnormalities had been corrected satisfactorily after 1-year treatment. INTRODUCTION: Pseudovitamin D-deficiency rickets is a rare autosomal recessive disorder resulting from a defect in 25-hydroxyvitamin D 1α-hydroxylase, which is encoded by CYP27B1. The purpose of this study was to identify the CYP27B1 mutations and investigate the response to long-term treatment of calcitriol in Chinese patients with PDDR. METHODS: We investigated CYP27B1 mutations in seven individuals from six separate families. To investigate the response to long-term (13 years) treatment with calcitriol in PDDR patients, we additionally collected clinical data of eight families from our previous report and analyzed their biochemical parameter and radiographic changes during the treatment. RESULTS: Nine different mutations were identified: two novel missense mutations (G194R, R259L), three novel and one reported deletion mutations (c1442delA, c1504delA, c311-321del, and c. 48-60del), two novel nonsense mutations (c.85G>T, c.580G>T), and a reported insertion mutation (c1325-1332insCCCACCC). The statistical analysis revealed that parathyroid hormone (PTH) and ALP significantly decreased after 6-month and 1-year treatment with calcitriol respectively. Urine calcium was measured in all the patients without kidney stones being documented. After 6-year treatment, the radiographic abnormalities had also been improved. Two patients who had reached their final height are both with short stature (height Z-score below - 2.0). CONCLUSIONS: We identified seven novel mutations of CYP27B1 gene in seven Chinese PDDR families. Our findings revealed after 1-year treatment of active vitamin D3, PTH and ALP significantly decreased. The correction of the biochemical abnormalities had not improved the final height satisfactorily.

[Effect of clinical characteristics on relapse of alcohol dependence: a prospective cohort study].

OBJECTIVE: To investigate whether craving and demographic factors to predict relapse in alcohol dependence. METHODS: This study was a prospective cohort study. From August 2017 to August 2018, 158 Han male inpatients who met the diagnositic and statistical manual disorders-fourth version(DSM-IV) alcohol dependence diagnostic criteria were recruited from three mental hospitals in China. The participants were interviewed at baseline and followed up by telephone after 3 months for assessment. The baseline assessment after the acute withdrawal period included demographic data and alcohol-related data, clinical institute withdrawal assessment-advanced revised (CIWA-Ar), withdrawal and cue-induced craving on visual analog scale (VAS), Michigan alcoholism screening test (MAST), self-rating anxiety scale (SAS), self-rating depression scale (SDS) and alcohol urge questionnaire (AUQ). According to the follow-up results, "relapse" was defined as the consumption of beverages containing ethanol at any time during the follow-up study, and "time to relapse" was defined as the number of days from the first drinking to the baseline. Whether relapse occurred and the time to relapse were the primary endpoints. Cox proportional hazard regression model was used to analyze the factors affecting the relapse of alcohol dependence. RESULTS: In the study, 158 alcohol dependence patients were finally included, age from 21 to 60 years, with the mean age of (40.31±9.14) years. The relapse rate was 63.7% three months after baseline assessment. According to Cox univariate analysis and multivariate analysis, the age (OR=0.975, P=0.030) and CIWA-Ar scores (OR=1.126, P=0.010) significantly predicted relapse. And there was no significant difference in education level, marital status, withdrawal and cue-induced craving on VAS, SAS and SDS between the relapse group and the non-relapse group (P>0.05). CONCLUSION: Age and severity of alcohol-dependent withdrawal symptoms during hospitalization are significantly related to relapse for alcohol in alcohol-dependent patients. To be exact, the older age is a protective factor, that is to say, the younger patients are prone to relapse, while the risk of relapse is raised by the higher severity of withdrawal symptoms. However, neither cue-induced nor withdrawal craving can predict relapse of alcohol-dependent patients.

[Correlation among serum levels of Irisin, insulin resistance and abdominal obesityin patients with first-episode schizophrenia].

Objective: To explore the possible role of Irisin in antipsychotic drug-induced insulin resistance and abdominal obesity in patients with schizophrenia and to provide a theoretical basis for the prevention of antipsychotic drug-induced obesity. Methods: Fifty-five patients with first-episode schizophrenia, from the First Affiliated Hospital of Zhengzhou University, between January 2016 and December 2017, were admitted as well as fifty healthy controls during the same period. Serum Irisin levels were measured by enzyme-linked immunosorbent assay (ELISA). Fasting blood glucose (FBG), fasting insulin (INS), homeostasis model assessment of insulin resistance (HOMA-IR) and triglyceride (TG), total cholesterol (TCHO), highdensity lipoprotein (HDL), low density lipoprotein (LDL) were detected. Results: The average Irisin level ((233±228) mmol/L) was higher than that in the normal control group ((124±89) mmol/L) (P<0.05).Repeated measurement analysis of variance showed that the average levels of the height, waist, FBG, INS, TCHO, TG, HDL, LDL, BMI, HOMA-IR and Irisin at the end of the 12(th) and 24(th) week's treatment were higher than baseline (P<0.05). After correlation analysis, the level of Irisinat baseline was positively correlated with HOMA-IR (r=0.383, P<0.05). At the 12(th) week, the level of Irisin was positively correlated with waist circumference, and HOMA-IR (r=0.360, r=0.475, all P<0.05). Multiple linear regression analysis showed that at the 12(th) week's treatment, compared with the baseline period, changes of Irisin was positively correlated with waist circumference and HOMA-IR, respectively (ß=0.453, ß=0.420, both P<0.05). Conclusion: Irisin may be involved in the process of metabolic regulation and bean early predictor of antipsychotic drug-induced insulin resistance and abdominal obesity.

[Effects of oxidative stress on cognitive impairment in first episode schizophrenia].

Objective: To observe the relationship between serum oxidative stress as well as brain-derived neurotrophic factor (BDNF) and cognitive function in first-episode drug-free schizophrenics, and to explore the possible effect of oxidative stress in cognitive impairment of first-episode schizophrenia. Methods: A total of 125 first-episode drug-free schizophrenics (schizophrenia group) from the First Affiliated Hospital of Zhengzhou University and 80 healthy individuals (control group) were enrolled. The serum concentration of oxidized glutathione (GSSG) was measured by the Microenzyme method the serum concentration of nitric oxide (NO) was measured by one-step method, the BDNF level was measured by enzyme linked immunosorbent assay and Matrics Consensus Cognitive Battery(MCCB) was used to evaluate the cognitive function. Results: (1)The serum level of BDNF in schizophrenia group (2 763±1 728 pg/ml) was significantly lower than that in control group (4 165±1 299 pg/ml)(P<0.001). And the serum levels of GSSG and NO in schizophrenia group ((36±9), (81±65) µmol/L) were significantly higher than that in control group ((27±11), (24±16) µmol/L) (P<0.001). In comparison with the control group scores were significantly lower in the seven domains of cognitive function in the schizophrenia group (all P<0.001). (2)After controlling the confounding factors like age, gender, cultural differences and course of disease by partial correlation analysis, the correlation analysis showed that: serum level of BDNF in schizophrenia group had positive correlation with Information processing rate T points, attentional facilitating T points, working memory T points and Reasoning and problem solving T points (r=0.417, 0.206, 0.247, 0.318, all P<0.05). In schizophrenia group the serum level of GSSG had a negative correlation with information processing rate T points and reasoning and problem solving T points (r=-0.321, -0.231, all P<0.05). The serum level of NO was negatively related to Information processing rate T points working memory T points Verbal learning T points(r=-0.201, -0.193, -0.237, all P<0.05). Conclusions: Oxidative stress may be involved in the cognitive impairment of schizophrenia Oxidation products are risk factors for cognitive impairment of schizophrenia and BDNF is a protective factor of cognitive function.

Hemoglobin A1c predicts hemorrhagic transformation and poor outcomes after acute anterior stroke.

BACKGROUND AND PURPOSE: Hemorrhagic transformation (HT) is a major complication of acute ischaemic stroke that is potentially related to clinical deterioration. The objective of this study was to assess whether chronic hyperglycemia is a predictive factor of HT in patients with acute anterior stroke. METHODS: Patients with acute anterior stroke were included in this study. Hemoglobin A1c (HbA1c) was measured in the morning after hospitalization. HT was detected by computed tomography scans or gradient echo magnetic resonance imaging performed 4 (±2) days after onset. Univariate and multivariate logistic regression analyses were used to assess the risks for HT and short-term outcomes. RESULTS: Of the 426 patients included, 93 (21.8%) had HT: 61 (14.3%) presented with hemorrhagic infarction and 32 (7.5%) presented with parenchymal hematoma. A total of 54 patients received thrombolytic treatment and 18 (33.3%) were found to have HT. In the multivariate analysis, HbA1c [odds ratio (OR), 1.294; 95% confidence interval (CI), 1.097-1.528], infarction size (OR, 3.358; 95% CI, 1.748-6.449) and thrombolytic therapy (OR, 3.469; 95% CI, 1.757-6.847) were predictors of HT. The predictive effect of HbA1c on HT was still observed in both groups when patients were stratified according to the levels of fasting blood glucose. HbA1c was found to be a predictor of poor outcomes in the multilogistic regression analysis (OR, 1.482; 95% CI, 1.228-1.788). CONCLUSIONS: Higher HbA1c was independently related to HT and poor neurological outcomes in patients with ischaemic stroke. These findings have significant implications for the treatment of diabetes and glucose management in patients with diabetes mellitus and/or acute ischaemic stroke.