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Table of Content

    21 August 2023, Volume 44 Issue 4
    Research progress of new radioactive tracers for cerebral glioma
    Wang Kai, Yuan Leilei, Chen Qian, Ai Lin
    2023, 44(4):  511-516.  doi:10.3969/j.issn.1006-7795.2023.04.001
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    New positron emission tomography (PET) radiopharmaceuticals have potential clinical application value in the diagnosis and treatment of glioma patients. In addition to commonly used 18F-fluorodeoxyglucose and amino acid tracers, it is still necessary to develop new PET tracers for studying other biological characteristics of glioma, including perfusion, angiogenesis, hypoxia, neuroinflammation, cell proliferation, and tumor invasiveness. At present, these radioactive drugs are still being further explored and need to be validated through clinical trials to achieve their clinical conversion in the diagnosis, treatment, and evaluation of gliomas.
    The effect of androgen levels on mood disorders and sexual dysfunction in peri-and postmenopausal Chinese women
    Wang Zhikun, Ruan Xiangyan, Ju Rui, Yang Yu, Jiang Lingling, Cheng Jiaojiao, Li Yanqiu, Gu Muqing, Liu Lili, Wang Zecheng, Alfred O.Mueck
    2023, 44(4):  517-523.  doi:10.3969/j.issn.1006-7795.2023.04.002
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    Objective To study the effect of peri-and postmenopausal androgen levels on mood disorders and female sexual dysfunction (FSD). Methods From Jan. 2022 to Dec. 2022, a total of 280 women aged 40-65 years who attended the Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University were recruited and divided into 76 premenopausal, 84 perimenopausal and 120 postmenopausal women. Height, weight, blood pressure, waist circumference, and hip circumference were measured. Questionnaires on menopause-related symptoms including mood disorders and sexual dysfunction were administered. The peri-and postmenopausal women were divided into emotional disorders group and control group, sexual dysfunction group and control group. The levels of serum follicle stimulating hormone(FSH), luteinizing hormone(LH), and estradiol(E2) were measured with chemiluminescence immunoassay, and the levels of serum sex hormone binding globulin(SHBG), total testosterone(TT), free testosterone(FT), bioactive testosterone(BT), dehydroepiandrosterone(DHEA), dehydroepiandrosterone sulfate(DHEA-S), androstenedione(A2), and dihydrotestosterone(DHT) were tested with liquid chromatography-tandem mass spectrometry(LC-MS/MS).Results Compared with premenopausal women, the serum levels of FT, BT, A2, DHEA, and DHEA-S were significantly lower in peri- and postmenopausal women (P < 0.05), but not significantly different between peri- and postmenopausal women (P > 0.05). The serum TT levels were slightly lower in peri- and postmenopausal women, but the difference was not significant (P > 0.05). The serum TT levels were negatively correlated with mood disorders (P<0.05) and serum DHEA-S levels were negatively correlated with sexual dysfunction (P<0.05).Conclusions Multiple androgen levels declined in peri- and postmenopausal women, mood disorders were negatively correlated with serum TT levels, and FSD was negatively correlated with serum DHEA-S levels.
    Effects of unilateral and bilateral ovariectomy on adipose tissue and uterine weight in rats
    Yang Yu, Ruan Xiangyan, Cheng Jiaojiao, Xu Xin, Alfred O.Mueck
    2023, 44(4):  524-529.  doi:10.3969/j.issn.1006-7795.2023.04.003
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    Objective  To explore the effects of unilateral and bilateral ovariectomy on the weight of adipose tissue and uterus in rats. Methods  SD rats aged 10-11 weeks were divided into three groups: sham operation (Sham, n=5), unilateral ovariectomy (U-OVX, n =5) and bilateral ovariectomy (B-OVX, n=6). The weight of interscapular brown adipose tissue (BAT), inguinal subcutaneous adipose tissue (SAT), intra-abdominal visceral adipose tissue (IAAT), and uterus were compared one year after operation. Results  Compared with the Sham group, the weight of SAT and IAAT increased in B-OVX group. There was no difference between the Sham group and U-OVX group in SAT and IAAT weight. There was no difference in BAT weight among the three groups. The weight of uterus in B-OVX group was lower than that in the Sham group and U-OVX group, there was no difference between U-OVX group and Sham group. Conclusions  Bilateral ovariectomy increased the weight of subcutaneous and intra-abdominal visceral adipose tissue, but unilateral ovariectomy did not affect the weight of subcutaneous and intra-abdominal visceral adipose tissue. Bilateral ovariectomy and unilateral ovariectomy didn't affect the weight of brown adipose. Unilateral ovariectomy did not cause uterine atrophy.
    Correlation analysis of lumbar bone mineral density with reproductive characteristics and sex hormone levels in perimenopausal and postmenopausal women
    Liu Lili, Ruan Xiangyan, Ju Rui, Yang Yu, Jiang Lingling, Cheng Jiaojiao, Li Yanqiu, Gu Muqing, Wang Zhikun, Wang Zecheng, Alfred O.Mueck
    2023, 44(4):  530-534.  doi:10.3969/j.issn.1006-7795.2023.04.004
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    Objective  To explore the relationship between lumbar bone mineral density (BMD) and reproductive characteristics and sex hormone levels in perimenopausal and postmenopausal women, and to further analyze the influencing factors of bone loss in women during this period. Methods  A total of 328 perimenopausal and postmenopausal women who visited Beijing Obstetrics and Gynecology Hospital, Capital Medical University from October 2021 to February 2023 were selected as subjects. Quantitative computed tomography (QCT) was used to measure lumbar bone density. According to the measurement results, the patients were divided into normal bone mass group and less bone mass group. The age, menarche age, menopausal status, pregnancy history and lactation duration of all subjects were collected with the comprehensive assessment scale of menopausal symptoms. The levels of serum follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), progesterone (P) and total testosterone (T) were measured with automatic chemiluminescence immunoassay. Univariate analysis was used to compare the differences in reproductive characteristics and sex hormone levels between the normal bone mass group and the osteopenia group. Multivariate Logistic regression analysis was used to explore the risk factors of osteopenia.Results  The BMD of postmenopausal women was significantly lower than that of perimenopausal women ( P<0.05). Univariate analysis showed that the age, menarche age, number of deliveries, lactation duration, postmenopause ratio and FSH level of women in the less bone mass group were significantly higher than those in the normal bone mass group ( P <0.05 ). The serum E2 level was significantly lower than that in the normal bone mass group ( P <0.05 ).Multivariate Logistic regression analysis showed that older age ( OR=1.088 ), longer lactation duration ( OR=1.057 ), and postmenopause ( OR=5.716 ) were risk factors for bone loss ( P<0.05 ). Conclusion  Compared with perimenopausal women, postmenopausal women have significantly lower BMD; The BMD in perimenopausal and postmenopausal women is closely related to reproductive characteristics and sex hormone levels. It is suggested that clinicians should pay attention to the changes of BMD in women during this period, so as to improve their quality of life and prevent the occurrence of osteoporosis (OP) through timely and reasonable treatment.
    he effect of iatrogenic premature ovarian insufficiency on lipid metabolism
    Wang Zecheng, Ruan Xiangyan, Li Jing, Jiang Lingling, Alfred O.Mueck
    2023, 44(4):  535-539.  doi:10.3969/j.issn.1006-7795.2023.04.005
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    Objective  To explore the effect of iatrogenic premature ovarian insufficiency on lipid metabolism. Methods  In this study, 94 patients with iatrogenic premature ovarian insufficiency(POI) who visited the Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University from May 2021 to November 2022 were enrolled as observation group, and 94 healthy women of childbearing age who underwent preconception preparation during the same period were recruited as control group. The height and weight of both groups were measured, and fasting blood was drawn to determine total cholesterol (TC), triglycerides (TG), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) were measured. Results  Body mass index (BMI), age and E2 levels were significantly lower in patients with iatrogenic POI (all P < 0.001). TC, TG, LDL-C, FSH and LH levels were significantly higher in observation group (all P < 0.05). There was no significant difference in HDL-C level between two groups(P =0.924).  After correction for BMI and age,the results did not change. The incidence of dyslipidemia was significantly higher in observation group. Conclusions  The proportion of dyslipidemia in patients with iatrogenic POI was significantly higher than that in women of the same reproductive age, suggesting that medical practitioners should pay attention to the chronic disease management of patients with iatrogenic POI and give appropriate individualized treatment measures to reduce the risk of future cardiovascular disease in these patients. More importantly, fertility preservation measures centered on ovarian tissue cryopreservation (OTC) should be taken prior to radiotherapy and chemotherapy.
    Effect of Zi Gui Nv Zhen Capsules on pregnancy outcome in women with diminished ovarian reserve
    Ma Jun, Ruan Xiangyan, Xu Zhongting, Gu Muqing, Alfred O.Mueck
    2023, 44(4):  540-543.  doi:10.3969/j.issn.1006-7795.2023.04.006
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    Objective  To evaluate the effect of Zi Gui Nv Zhen Capsules(ZGNZC) on pregnancy rate and live birth rate in women with diminished ovarian reserve(DOR), and to provide a new method for clinical treatment of DOR. Methods  This study is a prospective randomized trial, 60 DOR patients (aged 20–40 years) were randomly divided into an experimental group (n=30) and a control group (n=30) with a random number table method. The experimental group received oral administration of ZGNZC (3 capsules, tid), while the control group received no medication treatment. Three months later, the data of antral follicle count (AFC) during early follicular phase, thickness of the endometrium(EMT)during ovulation day, anti-Müllerian hormone(AMH)level in the follicular phase, pregnancy rate and live birth rate were collected. Results  At baseline, there was no significantly statistical difference in age, height, weight, and body mass index (BMI) between experimental group and control group (P>0.05). After three months of treatment with ZGNZC, the AMH level in the follicular phase, the EMT in ovulation day, and the AFC during early follicaler phase in the experimental group were significantly higher than those in the control group (P<0.05). After 3 years of follow-up, the pregnancy rate and the live birth rate of the experimental group were also significantly higher than those of the control group (P<0.05). Conclusions  Oral administration of ZGNZC can increase the number of antral follicles, promote endometrial thickness by increasing serum AMH levels in women with DOR, improve ovarian reserve function, raise pregnancy rate and live birth rate of patients. 
    Effect of Orlistat comprehensive intervention on lipoprotein(a) and glycolipid metabolism and hepatorenal function in overweight or obese patients with  polycystic ovary syndrome
    Zhang Mingzhen, Ruan Xiangyan, Min Min, Alfred O. Mueck
    2023, 44(4):  544-549.  doi:10.3969/j.issn.1006-7795.2023.04.007
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    Objective  To access the effect of Orlistat combined with drospirenone/ethinylestradiol tablets (DRSP/EE) on the lipoprotein(a), glycolipid metabolism and hepatorenal function compared to DRSP/EE-alone in overweight or obese patients with polycystic ovary syndrome (PCOS). Methods  We conducted a randomized controlled trial involving 69 overweight or obese PCOS patients. In  principle of comparable baseline characteristics between groups, all participants were randomly assigned into two groups in a 1∶2 ratio, who received DRSP/EE alone as the control group(n=23) and DRSP/EE plus Orlistat as the observation group(n=46) for 12 weeks. Both groups got the same comprehensive intervention regarding diet and physical activities, which is standardized in Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Changes in cardiovascular risk factors including lipoprotein(a)[Lp(a)], weight, waist circumference (WC), total cholesterol (TC), triglycerides (TG), low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), fasting plasma glucose (FPG), fasting insulin (FINS), homocysteine (HCY), and uric acid (UA) were observed before and after different regiments. Results  After 12 weeks of treatment, the Lp(a), LDL-C, FPG, and body weight levels of the observation group decreased significantly compared with the control group (P<0.05). The levels of WC, TC, FINS, UA, and HCY in the observation group decreased, and the FINS level increased in the control group, but there was no significant statistical significance (P>0.05). HDL-C and TG in the two groups were higher than those before treatment, and the difference was not statistically significant (P>0.05). Conclusions  Olistat combined with DRSP/EE can reduce the levels of Lp(a), LDL-C, FPG, and body weight in overweight or obese PCOS patients, which provides evidence for the choice of rational drug use in clinical practice.   
    Effect of Dingkundan on thin endometrium in clomiphene induced ovulation cycle
    Jin Fengyu , Ruan Xiangyan , Qin Shuang , Xu Xin , Yang Yu , Gu Muqing , Li Yanqiu , Du Juan, Cheng Jiaojiao , Yin Xiaodan
    2023, 44(4):  550-554.  doi:10.3969/j.issn.1006-7795.2023.04.008
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    Objective  To explore the effective of Dingkundan on thin endometrium in the clomiphene induced ovulation cycle, and provide basis for clinical practice. Methods  A total of 127 patients who visited department of gynecological endocrinology, with thin endometrium in clomiphene induced ovulation cycle were recruited. Patients were randomly assigned to the control group and the experimental group based on the principle of ensuring basic feature comparable between groups. A total of 64 patients in experimental group were treated with Dingkun Pill+ estrodiol, while a total of 63 patients in control group were treated with estrodiol. The endometrial thickness and type on human chorionic gonadotropin(hCG) day, progesterone level, ovulation rate, and clinical pregnancy rate between the two groups were compared. Results  The average endometrial thickness on hCG day in the experimental group was significantly higher than that in the control group[ (8.30±1.068) mm vs (7.43±1.051)mm, P<0.01]. The proportion of type A endometrium was significantly higher than that of the control group (52.0%  vs  32.7%, P<0.05). The progesterone level in luteal phase was significantly higher than that in the control group [(11.00±1.508)ng/mL  vs  (10.23±2.278)ng/mL, P<0.05]. The ovulation rate and the cumulative clinical pregnancy rate were significantly higher than that of the control group (88.4%  vs  79.7%, P<0.05, and 40.6%  vs  22.2%,P<0.05), respectively. Conclusions  Dingkundan can cooperate with estrogen in the treatment of thin endometrium in the clomiphene reduced ovulation cycle, improve the endometrium type, and increase the ovulation rate of clomiphene, luteal function and clinical pregnancy rate.
    Investigation on awareness of the benefits from lifestyle intervention in patients with polycystic ovary syndrome
    Tian Xuanxuan, Ruan Xiangyan, Jin Jing, Wang Juan, Cheng Jiaojiao
    2023, 44(4):  555-560.  doi:10.3969/j.issn.1006-7795.2023.04.009
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    Objective  To investigate awareness and its influencing factors of the benefits from lifestyle intervention in patients with polycystic ovary syndrome (PCOS) to provide clinical evidence for improving the individualized treatment compliance of PCOS patients. Methods  We investigated 262 confirmed PCOS patients in the Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital from January 2022 to June 2022. A self-made questionnaire was used to investigate the awareness of the benefits from lifestyle intervention. It included 4 domains of improving metabolism, improving endocrine, improving pregnancy status, improving mental status and reducing the risk of long-term complications, with 15 score in total. The demographic characteristics such as body mass index (BMI), education level and income level, PCOS disease-related knowledge, and medical treatment related problems were investigated. Knowledge awareness rate was used to evaluate PCOS patients' awareness of lifestyle intervention, and multiple linear regression analysis was used to evaluate the influencing factors of their cognition degree of lifestyle intervention. Results  Two hundred and sixty-two PCOS women participated in the study, and 234 valid questionnaires were included after screening, with an effective response rate of 89.31%. The mean total score was 6.08±4.25, and the overall awareness rate was 40.53%. The awareness rate of improving metabolism, improving endocrine, improving pregnancy status, and improving mental status and reducing the risk of long-term complications was 58.33%, 36.2%, 36.75%, and 35.0% respectively in 4 domains. Higher education level, higher income level, having more knowledge of PCOS, and having lifestyle intervention goals were positively correlated with the awareness total score(P<0.01), while BMI was negatively correlated with the awareness total score(P=0.022). Conclusions  The awareness of the benefits from lifestyle intervention in PCOS patients was at low level. Medical staff need to advance the understanding of lifestyle intervention and formulate individualized intervention treatment goals in PCOS patients. 
    Research progresses in fertility and pregnancy management in patients with Turner syndrome
    Zhao Yue, Ruan Xiangyan, Gu Muqing, Cheng Jiaojiao, Wang Yuejiao, Jin Jing
    2023, 44(4):  561-567.  doi:10.3969/j.issn.1006-7795.2023.04.010
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    Pregnancy is a key problem for patients with Turner syndrome (TS). Although 4%-7% of TS patients have the possibility of natural pregnancy, most TS patients need oocyte donation and fertility protection (FP). As premature ovarian failure generally occurs early in life of women with TS, and pregnancy can increase the risk of cardiovascular abnormalities, such as aortic dissection or rupture, these patients should be counseled and evaluated as early as possible for discussion of optimal cardiovascular assessment as well as multidisciplinary team management strategies. This supervision mode is also applicable to pre-pregnancy, pregnancy, and post-pregnancy. Ovarian tissue cryopreservation is a viable option for FP in young individuals with TS. This review summarizes the research progresses of fertility and pregnancy management for women with TS. 
    Network analysis of mental and physical symptoms in patients with generalized anxiety disorder
    Li Xue, Feng Zhengtian, Zheng Sisi, Duan Yuhang, Wu Ziyao, Zhu Hong, Jia Hongxiao
    2023, 44(4):  568-577.  doi:10.3969/j.issn.1006-7795.2023.04.011
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    Objective  To explore the core mental and physical symptoms of generalized anxiety disorder (GAD) in the view of traditional Chinese medicine and analyze the relationship between the symptoms. Methods  We collected the clinical symptoms of 500 patients with GAD, and used network analysis method to analyze the core mental symptoms, core physical symptoms, core mental and physical symptoms, and core mental and physical symptoms in the view of traditional Chinese medicine. Results  The core mental symptoms of GAD were as follow: prone to be frightened and afraid, overthinking, early awakening, and agitation. The core physical symptoms were as follow: low back pain, chest tightness, tired and weak spirit, and bitter mouth. Studies on core mental symptoms and physical symptoms suggested that there was a strong correlation between prone to be frightened and afraid and the tired and weak spirit, overthinking and palpitations, agitation and spontaneous sweating, early awakening and low back pain. The integrated network analysis of the core mental symptoms and core physical symptoms suggested that agitation and overthinking had a greater impact on other symptoms throughout the network. Conclusions  GAD is closely related to the kidney, heart, and liver, and clinical treatment should be focused on dialectical treatment of mental symptoms.
    A preliminary study on the therapeutic efficacy of Duloxetine in the treatment of depersonalization-derealization disorder
    Zheng Sisi, Song Mingkang, Song Nan, Zhu Hong, Jia Hongxiao
    2023, 44(4):  578-582.  doi:10.3969/j.issn.1006-7795.2023.04.012
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    Objective  To explore the efficacy and influencing factors of Duloxetine in the treatment of depersonalization-derealization disorder (DPD). Methods  The data were collected from January 2020 to December 2022 for DPD patients treated with Duloxetine at Beijing Anding Hospital,  Capital Medical University. Survival analysis was used to analyze treatment efficacy and influencing factors. Results  A total of 51 patients were included in this study, and 64.7% of the patients showed treatment efficacy. The median effective time was 118 (87, 643) days, and there was a trend of rapid improvement in emotional numbness symptoms. Education level was identified as a significant influencing factor for duloxetine treatment, with HR=0.81 (0.70, 0.95), P=0.008. Conclusions  Duloxetine treatment for DPD, particularly for the patients with emotional numbness as the main complaint, has potential benefits and provides guidance for clinical treatment of DPD.
    Exploration of traditional Chinese medicine syndrome discipline of panic disorder based on Cluster analysis and Bayesian network
    Song Mingkang, Xu Tianchao, Jia Hongxiao, Li Dongdong, Zheng Sisi, Yin Dongqing, Li Xue
    2023, 44(4):  583-589.  doi:10.3969/j.issn.1006-7795.2023.04.013
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    Objective  To explore the traditional Chinese medical (TCM) syndrome discipline of panic disorder. Methods  A standardized TCM syndrome inventory was used to collect symptoms based on the four diagnostic methods from 193 patients who met the criteria for panic disorder. Frequency analysis, Cluster analysis, and Bayesian network were performed, and relevant literatures and expert opinions were incorporated to determine the distribution of syndrome types. Results  The syndrome types of 193 patients with panic disorder involve the syndrome of deficiency of both heart and spleen (33.68%), syndrome of disharmony between heart and kidney (26.94%), syndrome of qi deficiency of heart and gallbladder (16.06%), syndrome of spleen-kidney deficiency (12.95%), syndrome of dampness-heat of spleen and stomach (10.36%). Conclusions  In addition to the syndrome of dampness-heat of spleen and stomach, syndrome types of deficiency seem to be more prominent in panic disorder, comprising syndrome of disharmony between heart and kidney, syndrome of deficiency of both heart and spleen, syndrome of spleen-kidney deficiency, syndrome of qi deficiency of heart and gallbladder. Also, most of the syndrome types are heart-related, involving syndrome of disharmony between heart and kidney, syndrome of deficiency of both heart and spleen, syndrome of qi deficiency of heart and gallbladder.
    The mediating effect of theory of mind between psychotic symptoms and social functioning in stable schizophrenia
    Zhong Jie, Zhu Hong, Hao Jun, Jia Hongxiao
    2023, 44(4):  590-595.  doi:10.3969/j.issn.1006-7795.2023.04.014
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    Objective  To investigate the mediating role of theory of mind between psychotic symptoms and social functioning in stable schizophrenia patients. Methods  Positive and negative syndrome scale (PANSS) was applied to assess patients’ psychiatric symptoms. The number of completed categories on the Wisconsin Card Sorting Test (WCST), the mean response time on the Continuous Performance Test (CPT), and the breadth of numbers on the Wechsler Adult  Intelligence Scale (WAIS) were used to assess the general cognitive function of the patients. Four theory of mind tasks were selected to assess patients’ social cognition: the first-order false belief, the second-order false belief, the faux-pas task, and the reading the mind in eyes test. The Personal and Social Functioning Scale (PSP) was selected to assess the social functioning of patients with schizophrenia. Results  PSP scores were negatively correlated with patients’ negative symptoms (r=-0.453, P<0.001), positively correlated with faux-pas task scores (r=0.544, P=0.010). The faux-pas task scores were negatively correlated with negative symptoms (r=-0.331, P<0.001), and negative symptoms had a direct effect on social functioning (β=-0.470, P<0.01). There was a mediating effect of the aphasia task (β=0.407, P<0.01). Conclusions  Impairment of social functioning in patients with stable schizophrenia is closely related to negative symptoms and social cognition. The faux-pas task partially mediates patients’ psychiatric symptoms and social functioning.
    Predictive role of machine-learning-based theory of mind in acute phase schizophrenia on social functioning
    Zhong Jie, Zhu Hong, Zheng Sisi, Jia Hongxiao
    2023, 44(4):  596-601.  doi:10.3969/j.issn.1006-7795.2023.04.015
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    Objective  To explore the predictive role of machine-learning-algorithm-based mind theory in social function of patients with schizophrenia in the acute phase. Methods  Ninety patients with acute schizophrenia from the outpatient clinic of Beijing An Ding Hospital, Capital Medical University from 2013 to 2017 were selected, and the Positive and Negative Syndrome Scale (PANSS) was used to assess the psychiatric symptoms of the patients with acute schizophrenia.The number of completed categories on the Wisconsin Card Sorting Test (WCST), the mean reaction time on the Continuous Practice Test (CPT), and the number breadth items on the Wechsler Adult Intelligence Scale (WAIS) were selected to assess neurocognition. First-order false belief test, Second-order false belief test, Faux-pas test, and Reading the mind in the eyes test were selected to assess social cognition. The personal and social functioning scale (PSP) was selected to assess social function. The machine learning algorithms was applied to assess the predictive role of psychological theory of competence in acute phase schizophrenia on social functioning. Results  The results of the correlation analysis showed that PSP scores of the acute schizophrenia patients were the negatively correlated with negative symptoms (r=-0.271, P=0.010), the number of WCST (r=-0.128, P=0.328), and positively correlated with faux-pas test(r=0.410, P<0.001). Second-false Belief Test and Faux-pas Test were good predictors of social function in the acute schizophrenia patients. The area under the curve (AUC) value was 80.9%.Conclusions  The impairment of social function in the patients with acute schizophrenia is closely related to the negative symptoms and theory of mind, indicating that the theory of mind is a good predictor of social function in the patients with schizophrenia in the acute phase.
    Psychosocial characteristics associated with relapse of bipolar disorder
    Yan Aiguo, Liu Xinzi, Yin Dongqing, Zhu Hong , Jia Hongxiao , Li Ziyan
    2023, 44(4):  602-608.  doi:10.3969/j.issn.1006-7795.2023.04.016
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    Objective  To explore the psychosocial characteristics affecting relapse of bipolar disorder (BD). Methods  A total of 269 BD patients from the outpatient department of Beijing Anding Hospital Affiliated to Capital Medical University from August 2020 to January 2022 were selected and divided into group of mood episode and group of non-mood episode. The differences of basic information, clinical characteristics, medication compliance, affective temperament, social support, childhood trauma and five-pattern personality of the two groups were analyzed. Then logical regression and mediating effect were used to determine the risk factors related to BD recurrence and the mediating relationship of these factors. Results  Cyclothymic temperament, irritable temperament and Taiyin personality were positively correlated with BD relapse, while objective social support was negatively correlated with BD relapse. There was a direct effect between objective social support and depression, with an effect value -0.08. Both Cyclothymic temperament and Taiyin personality had mediating effects between objective social support and depressive mood, with the mediating values -0.018 and -0.028, respectively, and the total indirect effect was -0.046. The total effect value between objective social support and depressive mood was -0.127, and the mediating effect accounted for 36.2% of the total effect. ConclusionsThe more objective social support BD patients received, the lower the level of depressive mood. Social psychological intervention based on personality and temperament may help to suppress the recurrence of BD caused by poor social support.
    Correlationship between anxiety trait and mental health in patients with severe acute respiratory syndrome coronavirus
    Yang Jingming, Wang Xin, Liu Ligai, Hao Yiwei, Song Rui, Jia Hongxiao
    2023, 44(4):  609-613.  doi:10.3969/j.issn.1006-7795.2023.04.017
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    Objective  To explore the correlation between trait anxiety and mental health status of patients infected with severe acute respiratory syndrome coronavirus, and to provide evidences for early identification and early intervention of psychological symptoms in target population.Methods  A total of  72 cases of mild or common patients diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were selected in two wards of the Beijing Ditan Hospital Capital Medical University. Trait Anxiety Inventory (TAI) was distributed to all patients. Psychiatrists conducted face-to-face structured interviews using Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) with patients who completed the self-assessment questionnaire to evaluate the mental health status. Results  There was statistical significance in TAI scores difference between the  SARS-CoV-2 patients with and without anxiety (P<0.05). The TAI scores  difference between the  SARS-CoV-2 patients with and without depression was also statistically significant (P<0.05).According to correlation analysis,the total scores of TAI significantly correlated with the total scores of HAMD and HAMA. Specifically, the TAI scores of  SARS-CoV-2 patients were positively correlated with mental anxiety, somatic anxiety, anxiety/somatization, cognitive disturbance, sleep disturbance, and  hopelessness.Conclusions  The occurrence and severity of anxiety and depression in patients infected with  SARS-CoV-2 are related to the level of trait anxiety.
    Intervention effect of electroacupuncture on metabolic syndrome induced by new antipsychotics
    Wang Qunsong, Yu Haiyan, Ji Xiangdong, Li Miao, Jiang Yiye
    2023, 44(4):  614-619.  doi:10.3969/j.issn.1006-7795.2023.04.018
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    Objective  To observe the effect of electroacupuncture on metabolic syndrome (MS) induced by new antipsychotics . Methods  A total of 70 patients with MS caused by new antipsychotic drugs were selected and randomly divided into the treatment group (35 cases) and control group (35 cases) with the method of digital table.The control group received diet and exercise intervention, the treatment group also received electroacupuncture besides dietary and exercise interventions.The changes of waist circumference, body mass index (BMI), blood pressure, blood lipid and blood glucose between the two groups were compared before and after treatment. The Short Form 36-item Health Survey (SF-36) score was evaluated before and after treatment.Results  There was no significant difference between the two groups for all indexes (P>0.05). After 56 d of treatment,only the triglyceride (TG) and 2 h postprandial blood glucose (2hPG) significantly decreased in the control group (P<0.05),without significant change in other indexes(P>0.05). However, systolic blood pressure (SBP), diastolic blood pressure (DBP), TG, HDL-C, FPG and 2hPG of the treatment group at every time point after treatment were significantly different from those before treatment (P<0.05). After 56 d of treatment, the waist circumference and BMI of the treatment group were significantly different from those before treatment (P<0.05).Further analysis indicated that,after 56 d of treatment, the waist circumference, BMI, systolic blood pressure, diastolic blood pressure, triglyceride, high density lipoprotein cholesterol, fasting blood glucose and 2hPG of the treatment group were significantly different from those of the control group (P<0.05). After treatment, the SF-36 score in the treatment group was significantly higher than that in the control group (P<0.05).Conclusions  The clinical effect of electroacupuncture in the treatment of metabolic syndrome caused by new antipsychotics is better, and electroacupuncture can reduce waist circumference, BMI, blood pressure, blood glucose and blood lipid. It obviously improved the quality of life with good safety.
    Changes of cervical sagittal parameters of patients in different age groups with cervical spondylotic radiculopathy after anterior cervical discectomy and fusion
    Shi Bin, Liu Chengxin, Wang Shuaikang, Li Xiangyu, Pan Fumin, Zhu Weiguo, Lu Shibao
    2023, 44(4):  620-628.  doi:10.3969/j.issn.1006-7795.2023.04.019
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    Objective  To evaluate the changes of the cervical sagittal alignment and the clinical effect in different age groups with cervical spondylotic radiculopathy after anterior cervical discectomy and fusion (ACDF). Method  Seventy patients with cervical spondylotic radiculopathy from January 2019 to December 2020 were selected and underwent ACDF surgery. The demographic information and surgical data of the patients were recorded. The following sagittal parameters of the cervical spine were measured before operation, after operation and during the last follow-up: the occipital C2 angle (OC2), C2-7 lordosis (CL), T1 slope (T1S), the cervical sagittal vertical axis (cSVA) and segmental angle (SA). The changes of the parameters after ACDF were analyzed. The samples were divided into two groups according to whether they were less than 60 years old or not, and the differences between the elderly and the non-elderly patients were compared. The NDI (Neck Disability Index) and the improvement rate of the modified Japanese orthopaedic association scores for assessment of cervical myelopathy(mJOA) at the last follow-up were used as prognostic evaluation indexes to analyze the influence of the cervical sagittal parameters on the prognosis. Result  The correlation analysis of preoperative parameters showed that SA was positively correlated with CL and T1S. CL was negatively correlated with OC2, T1S-CL and cSVA. OC2 was positively correlated with T1S-CL. T1S was positively correlated with cSVA. The above correlation also existed at the last follow-up. The correlation analysis of postoperative parameter changes showed that △CL was positively correlated with △SA and △T1S, and negatively correlated with △T1S-CL and △cSVA. △CL and △SA were negatively correlated with △T1S-CL and △cSVA, while △T1S was positively correlated with △T1S-CL and △cSVA. There was a negative correlation between △OC2 and △cSVA. In the comparison between 38 non-elderly patients (< 60) and 32 elderly patients (≥60), we found that the loss of CL was more serious in the elderly group, and cSVA has a tendency to increase after the operation. Conclusion  OC2 may be involved in the sagittal compensation of the cervical degeneration and would influence the cervical postoperative recovery. The poor improvement of the sagittal alignment and the loss of cervical kyphosis angle in the elderly patients during the last follow-up may be the reason for the poor cervical function evaluation after surgery.
    Construction and effect of a nomogram clinical prediction model for predicting osteoporosis in asymptomatic elderly women
    Wang Jialin, Pan Fumin, Kong Chao, Lu Shibao
    2023, 44(4):  629-638.  doi:10.3969/j.issn.1006-7795.2023.04.020
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    Objective  To construct and validate a nomogram clinical prediction model dedicated to predicting the exact probability of osteoporosis in asymptomatic postmenopausal elderly women. Methods  Asymptomatic postmenopausal elderly women were recruited into the training (n=319) and validation (n=104) groups. Their clinical characteristics and bone mineral density (BMD) results were collected and analyzed. Univariate and multivariate Logistic regression analysis were performed. Construction of general and dynamic nomogram clinical prediction models. Validate the model through receiver operating characteristic (ROC) curves, calibration curves, decision curve analysis (DCA) curves, and clinical impact curves. Results  Lower education level and lower body weight were independent risk factors. Based on age, education level, and weight, a nomogram clinical prediction model was constructed, which had moderate predictive value [area under the curve (AUC)> 0.7], good calibration, clinical benefit, and clinical impact. The constructed online dynamic nomogram (https://shibaolu.shinyapps.io/DynamicNomogram/) was interactive and easy to generalize Taking the critical value 0.452 obtained from the training group  as the standard for predicting osteoporosis in asymptomatic postmenopausal elderly women, the actual prediction results of the validation group showed that the prediction effect of the nomogram prediction model was relatively close to that of the training group (sensitivity = 0.82, specificity = 0.63), and the predicted results had a medium to high degree of consistency (Kappa value) with the actual results, indicating that the predictive model has certain clinical application value. Conclusions This nomogram clinical prediction model has good practical application value and good generalizability, which could help achieve early prediction, early diagnosis and early treatment of osteoporosis, thus contributing to the bone health of asymptomatic postmenopausal elderly women and promoting the development of public health.
    Effects of different resuscitation methods on frozen exosomes
    Xiao Li, Luo Shumin, Xu Fang, Chen Jing, Xing Enhong , Li weihua
    2023, 44(4):  639-644.  doi:10.3969/j.issn.1006-7795.2023.04.021
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    Objective  To compare the effects of three resuscitation methods (4 ℃, 37 ℃ and room temperature) on frozen exosomes,to clarify the optimal resuscitation way for frozen exosomes. Methods  Frozen plasma was thawed as below three methods: 4 ℃ refrigerator overnight, 37 ℃water bath box, and room temperature. Exosomes were isolated by ultracentrifugation, transmission electron microscope observed exsomes size and morphology, Amnis imaging flow cytometry  detected exosome quantity and percentage (purity). Results  Among the three resuscitation methods, 37 ℃ water bath resuscitation group obtained the highest number and percentage of exosomes, which were statistically higher compared to the 4 ℃ refrigerator resuscitation group and the room temperature resuscitation group (P<0.01). The number and percentage of exosomes obtained from the 4 ℃ refrigerator overnight resuscitation group were the lowest. At the same time, it was found that the number of CD9 positive exsomes in human plasma was significantly higher than that of CD63 positive and CD81 positive exsomes, with statistically significant difference (P<0.05).Conclusions  The 37 ℃ water bath resuscitation method was the best method for frozen exosomes. In human plasma exosomes, CD9 positive exosomes was the highest quantity and percentage subgroup. 

    Effects of Pioglitazone on neuronal damage in the mouse hippocampus after middle cerebral artery occlusion and reperfusion
    Wang Rongliang, Yan Feng, Tian yue, Huang Yuyou, Luo Yumin, Ma Shubei
    2023, 44(4):  645-651.  doi:10.3969/j.issn.1006-7795.2023.04.022
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    Objective  To investigate the potential neuroprotective effects and the underlying mechanisms of Pioglitazone(PGZ) on neuronal damage in mice after cerebral ischemia. Methods  A total of 36 young-aged (2-month) C57 BL/6J mice were randomly divided into 3 group (n=12): sham group, vehicle group, and PGZ group. Mice were treated with PGZ (25 mg/kg) or saline for 7 d by intragastric administration after transient middle cerebral artery occlusion (MCAO). Neurological function was evaluated by Neurological Severity Sores (NSS) at 3, and 7 d after MCAO.Infarction volume and the number of neurons in cortex, striatum, and the hippocampal CA1, CA3, dentate gyms (DG) regions were measured by Nissl staining.Western blotting was used to assess the expression of apoptosis associated protein B-cell leukemia/lymphoma 2 (Bcl2) and Bcl2 associated X protein(Bax) at 7 d after MCAO. Results  Compared to the vehicle-treated mice, PGZ-treated mice didn't exhibit better performance at 3, 7 d after MCAO surgery (P>0.05). However, PGZ reduced infarct volume of the brains, and PGZ also significantly ameliorated neuron loss in cortex and hippocampal CA3 region after cerebral injury compared with the vehicle group (P<0.05). Moreover, PGZ promoted the ratio of Bcl2 and Bax (P<0.05).Conclusions  These results suggest that PGZ treatment alleviated the neuronal damage in hippocampal CA3region of mice with cerebral ischemia-reperfusion injury, which may be explained by PGZ regulated the ratio of Bcl2 and Baxin hippocampus.
    LY6E inhibit the entry of different variants of SARS-CoV-2 mediated by the spike protein
    Liu Yongmei, Zheng Shuangli, Chen Danying, Song Yanjun, Li Xinglin, Qiu Yaruo, Song Chuan, Zhang Yuanyuan, Wang Xi, Zhao Xuesen
    2023, 44(4):  652-662.  doi:10.3969/j.issn.1006-7795.2023.04.023
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    Objective  To investigate the inhibitory effect of lymphocyte antigen 6 complex, locus E (LY6E), on the entry of (severe acute respiratpry syndrome coronavirus 2, SARS-CoV-2) mediated by the spike protein(S)of different variant strains. Methods  Plasmid encoding human angiotensin-converting enzyme 2 (ACE2) molecules was constructed. We established Flp-In T-Rex 293/LY6E inducible expression cell lines and Flp-In T-Rex 293/chloramphenicol acetyltransferase (CAT) inducible expression cell lines, transfected human ACE2 expression plasmid, and detected the expression of ACE2 and LY6E in T-Rex 293 cells by Western blotting. The pseudoviral infection systems of SARS-CoV-2 (Wuhan-Hu-1 strain,D614G variant, Delta variant, and Omicron BA.1, BA.2, BA.2.12.1, BA.3, BA.4/5, BF.7 variant)and Lassa fever virus (LASV) were established to detect the activity of LY6E for inhibiting viral entry by using the luciferase reporter gene. The inhibitory effect of LY6E on SARS-CoV-2 mutant strain spike-mediated syncytium formation was detected by the Nano-Glo® Live Cell Assay System. We constructed the pseudoviral infection systems of influenza A virus (IAV) to detect the inhibitory effect of LY6E on SARS-CoV-2 and its mutants spike protein-mediated entry by using pseudovirus luciferase reporter gene after amphotericin B treatment.Results  Flp-In T-Rex 293/LY6E inducible expression cell line could significantly inhibit the infection of SARS-CoV-2 (Wuhan-Hu-1 strain, D614G strain, Delta strain, and Omicron BA.1 mutantstrain),with statistical differences in relative infection rate between the pseudovirus infection of tetracycline (Tet) treated and non-treated groups(WTpp:t=33.920,P<0.001;D614Gpp:t=31.478,P<0.001;Deltapp:t=30.257,P<0.001; Omicronpp:t=21.041,P<0.001).LY6E significantly inhibited S protein-mediated syncytium formation in different mutant strains of SARS-CoV-2, and the differences in relative fluorescence units between the LY6E-expressing and non-expressing groups were statistically significant (D614G: t=18.90, P<0.001; Delta: t=22.28, P<0.001; BA.1: t=8.995, P<0.001; BA.2: t=13.57, P<0.001; BA.2.12.1: t=15.48, P<0.001; BA.3: t=13.65, P<0.001; BA.4/5: t=16.74, P<0.001; BF.7: t=22.29, P<0.001). Amphotericin B treatment did not alter the inhibitory effect of Flp-In T-Rex 293/LY6E inducible cell line on SARS-CoV-2 (Wuhan-Hu-1strain, D614G strain, Delta strain, and Omicron BA.1 mutantstrain) pseudovirus invasion, nor did it alter the enhancement of IAV infection by LY6E. The difference in the relative infection rate between the IAV pseudovirus infection of tetracycline (Tet) treated and non-treated groups was statistically significant (t=3.343, P<0.05).Conclusions  LY6E could significantly inhibit the infection of SARS-CoV-2 wild-type (Wuhan-Hu-1 strain) and multiple variants (D614G strain, Delta strain, and Omicron strain) and amphotericin B did not alter the inhibitory effect of LY6E on SARS-CoV-2(Wuhan-Hu-1strain, D614G strain, Delta strain, and Omicron strain).
    Clinical importance of ACE2 expression in colon cancer and susceptibility of colon cancer cells to three human coronaviruses using ACE2 as their receptor
    Ning Tingting, Wang Zhaoqing, Zhang Nan, Zhu Shengtao
    2023, 44(4):  663-668.  doi:10.3969/j.issn.1006-7795.2023.04.024
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    Objective  To investigate the expression of angiotensin-converting enzyme 2 (ACE2) in colon cancer and the relationship with prognosis as well as the susceptibility of colon cancer cells to three human coronaviruses who use ACE2 as their receptors. Methods Quantitative real-time Polymerase Chain Reaction, immunohistochemistry and Western blotting were used to explore the expression of ACE2.Databases were used to analyze the relationship between ACE2 expression and the prognosis of colon cancer patients. The susceptibility of colon cancer cells to three human coronaviruses who use ACE2 as receptors was analyzed based on pseudovirions. Results  The expression levels of ACE2 in colon cancer were higher and the expression level was not correlated with prognosis. The susceptibility of Caco2 to severe acute respiratory syndrome coronavirus (SARS-CoV) pseudovirions was higher than that in CCC-HIE-2. Compared with CCC-HIE-2, the susceptibility of colon cancer cells to SARS-CoV-2 was higher, except for that in HCT-15. The susceptibility of all colon cancer cells to human coronaviruses NL63 (HCOV-NL63) was higher than that in CCC-HIE-2. Conclusions The expression level of ACE2 was increased in colon cancer and its expression was not correlated with prognosis. And the susceptibility of most colon cancer cells to three human coronaviruses was increased. 
    Drug-coated balloons in primary percutaneous coronary intervention for acute myocardial infarction
    Zhou Li, Zhu Chao, Wang Fucai, Cui Hehe, Liu Qingbo, Zhao Huiqiang, Chen Hui
    2023, 44(4):  669-675.  doi:10.3969/j.issn.1006-7795.2023.04.025
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    Objective  This study was to evaluate the efficacy of drug-coated balloons(DCB) for acute myocardial infarction (AMI).Methods  A total of 75 AMI patients who underwent primary percutaneous coronary intervention(PCI)with DCB treatment of culprit lesion in Beijing Friendship Hospital, Capital Medical University,  from August 2018 to July 2022 were enrolled in this study. The clinical data, characteristics of coronary artery lesion and prognosis were retrospectively analyzed.Results  The procedural success rate was 100%, and the incidence of clinical adverse events in hospitalization was 8%. During the 30-day follow-up, 2 patients (2.7%) were readmitted for heart failure. During a median follow-up of 16 months, there were 9 cases (12%) of non-fatal myocardial infarction, 5 cases (6.7%) of target lesion revascularization, 4 cases (5.3%) of heart failure readmission, and 3 cases (4%) of stroke. The long-term cumulative main adverse cardiovascular and cerebrovascular events (MACCE) rate was 24%, and the Kaplan-Meier estimated long-term MACCE-free survival rate was 63.6%(47.3%-79.8%). Conclusions  For specific lesions in AMI, such as in-stent occlusion, small vessel disease and bifurcation lesions, DCB angioplasty in primary PCI has a high success rate and a good long-term prognosis.
    Analysis of clinical and prognostic characteristics of patients with cystic neutrophilic granulomatous mastitis
    Shao Shijun, Wu Lili, Wu Xueqing, Wu Xiaoyan, Feng Jiamei, Wan Hua
    2023, 44(4):  676-683.  doi:10.3969/j.issn.1006-7795.2023.04.026
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    Objective  To clarify the clinical and prognostic characteristics of cystic neutrophilic granulomatous mastitis(CNGM). Methods  We retrospectively reviewed 204 patients of non-puerperal mastitis in Department of Breast, Shuguang Hospital, Shanghai University of Traditional Chinese Medicine who underwent surgery from July 2019 to August 2021. Demographic, clinical, imaging, treatment, and outcome data were compared between CNGM group and non-CNGM group. Results  One hundred and four patients (51%) were diagnosed as CNGM. Compared with the non-CNGM group, patients with CNGM were more likely to be parous women, with a higher rate of breastfeeding history (P=0.024).Moreover, breast trauma, larger lesion scope, fever, raised white blood cell counts, C-reactive protein levels, erythrocyte sedimentation rate and rim enhancement of non-mass lesion and retromammary space edema on magnetic resonance imaging(MRI) were more commonly occurred in the CNGM group than those in the non-CNGM group (all P<0.05). Logistic regression analysis revealed that breast trauma history and lesion scope correlated with the characteristics of CNGM.Patients in the CNGM group were prescribed steroids more frequently (55.8%  vs 37.0%,P=0.007) and had longer postoperative recovery time (39.5%  vs 27.0%,P=0.007) and higher rates of contralateral onset (16.3%  vs 8.0%,P=0.011). Conclusions  CNGM is a distinctive but not rare type of non-puerperal mastitis with more severe local and systemic inflammatory symptoms, independent pathological diagnosis should be done to guide appropriate treatment and follow-up measures. 
    Unilateral laminotomy for bilateral decompression assisted by unilateral biportal endoscopy in the treatment of lumbar spinal stenosis
    Tao Luming, Li Dongyue, Zhang Xinuo, Su Qingjun, Hai Yong
    2023, 44(4):  684-689.  doi:10.3969/j.issn.1006-7795.2023.04.027
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    Objective  To investigate the surgical safety and clinical efficacy of unilateral laminotomy for bilateral decompression (ULBD) assisted by unilateral biportal endoscopy (UBE) in the treatment of lumbar spinal stenosis (LSS). Methods  31 patients with lumbar spinal stenosis treated by UBE-assisted ULBD from July 2020 to December 2021 were analyzed retrospectively. There were L3/4 in 1 case, L4/5 in 17 cases and L5/S1 in 13 cases. The Visual Analogue Scale (VAS) for low back pain and leg pain respectively, and Oswestry Disability Index (ODI) were evaluated before operation, 1 month, 3 months and 12 months after operation. The modified MacNab criteria were used for evaluation of the clinical consequences. Lumbar X-ray in the excessive flexion and extension position were reexamined at 12 months after operation. Results  All 31 patients successfully completed the operation, and the time was (101.52 ± 10.57)min. Complications included dural tears in 1 case and transient numbness of lower limbs in 1 case. The average follow-up was (19.97±4.27) months. The VAS score of low back pain decreased from 4.68 ± 1.40 before operation to 2.08 ± 0.68, 1.77 ± 0.48 and 1.36 ± 0.55 at 1 month, 3 months and 12 months after operation, respectively (P <0.05); The VAS score of leg pain decreased from 6.01 ± 1.37 before operation to 2.61 ± 0.68, 2.11 ± 0.74 and 1.67 ± 0.45 at 1 month, 3 months and 12 months after operation, respectively (P<0.05). The ODI score was 57.74 ± 10.82 before operation and decreased to 31.13 ± 3.38, 21.84 ± 3.33 and 17.06 ± 1.60 at 1 month, 3 months and 12 months after operation, respectively (P<0.05). According to the modified MacNab criteria, the final clinical outcome was excellent in 23 cases, good in 4 cases, fair in 4 cases at the follow-up of 12 months, with the excellent and good rate of 87.1%. After 12 months follow-up, no instability of surgical segments was found by lumbar X-ray in the excessive flexion and extension position. Conclusions  ULBD assisted by UBE in the treatment of LSS has a satisfactory clinical effect, maintains the good lumbar stability, and has the advantages of small surgical injury and fast recovery.