Incidence and method of suicide mortality in patients with schizophrenia: a Nationwide Cohort Study

Purpose

Suicide is a leading cause of death in patients with schizophrenia. This nationwide cohort study investigated the incidence of each suicide method in patients with schizophrenia compared with the general population.

Methods

In total, records of 174,039 patients with schizophrenia were obtained from the National Health Insurance Research Database in Taiwan from 2001 to 2016. This schizophrenia cohort was linked with the national mortality database, and 26,926 patients died during this follow-up period. Of the deceased, 3033 had died by suicide. Univariate Cox regression was used to estimate the demographic variables associated with suicide. We estimated the difference in the proportion of each suicide method used in patients with schizophrenia compared with the general population. The incidence and standardized mortality ratio (SMR) of each suicide method were calculated and stratified based on sex.

Results

Patients aged 25–34 years exhibited the highest suicide risk. Compared with the general population, patients with schizophrenia were more likely to commit suicide by jumping and drowning and less likely to use charcoal-burning and hanging. Women showed a higher incidence of suicide by drowning and jumping than did men. Comorbidity with substance use disorders (SUDs) was associated with a high suicide SMR (26.9, 95% confidence interval [CI] = 23.4–28.9), particularly for suicide by jumping (61.2, 95% CI = 48.3–76.3).

Conclusions

Patients with schizophrenia had higher suicide rates for all methods than did the general population. Suicide method differed based on sex. Patients with SUDs exhibit a high SMR for each suicide method and warrant intensive clinical attention.

     

Patient-health care provider communication among patients with newly diagnosed prostate cancer: Findings from a population-based survey

Objective

To examine the multidimensional concept of patient-health care provider (HCP) communication, its effects on patient satisfaction with oncology care services, and related racial differences.

Methods

The current analysis draws from a population-based survey sample of 1011 African American and 1034 Caucasian American men with newly diagnosed prostate cancer. The variables of satisfaction with health care services, interpersonal treatment, contextual knowledge of the patient, and prostate cancer communication were analyzed using multiple-group structural equation modeling.

Results

Regardless of race, patient-HCP communication was related positively to interpersonal treatment by the HCP, HCP's contextual knowledge of the patient, and prostate cancer communication. More positive patient-HCP communication was related to more satisfaction with health care services. Racial differences were significant in the relationships between patient-HCP communication and prostate cancer communication.

Conclusion

Content and interpersonal relationships are important aspects of patient-HCP communication and affect patient satisfaction with oncologic care for prostate cancer.

Practice implications

HCPs need to integrate the transfer of information with emotional support and interpersonal connection when they communicate with men with newly diagnosed prostate cancer.     

TRPV1受体与认知障碍相关性的研究进展

瞬时受体电位香草酸亚型1(TRPV1)受体与外周神经系统疾病的相关性已经得到证实,而近年来越来越多研究也证实TRPV1在中枢神经系统中的重要地位,其在海马区、皮层及中脑的广泛分布更是为TRPV1受体与认知学习记忆功能的相关性架起了桥梁。本文通过综述国内外TRPV1受体在中枢神经系统中的生物学作用,总结其与认知相关疾病的关系,旨在为TRPV1受体是否可作为治疗认知相关疾病的药物靶点提供理论依据。     

Short communication: isolation and phylogenetic analysis of an avian-origin H3N2 canine influenza virus in dog shelter, China

A H3N2 canine influenza virus, A/canine/Guangdong/3/2011 (H3N2), was isolated from roaming dogs in rural China. Sequence and phylogenetic analysis of eight gene segments revealed that the A/canine/Guangdong/3/2011 (H3N2) was most similar to a recent H3N2 canine influenza virus isolated in cats from South Korea, which originated from an avian strain. To our knowledge, this is the first report of an avian-origin H3N2 CIV which was isolated from roaming dogs in China. The epidemiologic information provided herein suggests that continued study is required to determine if this virus could be established in the roaming dog population in rural China and pose potential threats to public health.     

Molecular characteristics and evolutionary analysis of field Marek’s disease virus prevalent in vaccinated chicken flocks in recent years in China

Marek’s disease is a highly contagious, oncogenic, and immunosuppressive avian viral disease. Surveillance of newly registered Marek’s disease virus (MDV) isolates is meaningful for revealing the potential factors involved in increased virulence. Presently, we have focused on the molecular characteristics of all available MDVs from China, including 17 new Henan isolates. Based on Meq, gE, and gI genes, we found that most Chinese isolates contain conserved amino acid point mutations in Meq, such as E⁷⁷, A¹¹⁵, A¹³⁹, R¹⁷⁶, and A²¹⁷, compared to USA virulent MDVs. However, the 59-aa or 60-aa insertions are only found in a few mild MDVs rather than virulent MDVs in China. Further phylogenetic analysis has demonstrated that a different genotype of MDV has been prevalent in China, and for virulent MDVs, their recent evolution has possibly been geographically restricted. Our study has provided more detailed information regarding the field MDVs circulating in China.     

Augmentation of fear extinction by theta-burst transcranial magnetic stimulation of the prefrontal cortex in humans

BackgroundFear extinction alone does not erase the original fear memory. Interventions that enhance extinction can be beneficial for the treatment of fear-related disorders. Repetitive transcranial magnetic stimulation has been shown to improve memory performance. The present study examined the effects of intermittent theta-burst stimulation (iTBS) on fear extinction and the return of fear memory in humans.MethodsNinety-one young healthy volunteers underwent 3 experiments using a randomized controlled experimental design. Participants first acquired fear conditioning, after which they received 30 Hz iTBS before and after extinction training. The iTBS was applied to 1 of 2 targets: the left dorsolateral prefrontal cortex (dlPFC) and the vertex (control). Fear responses were measured 24 hours later and 1 month later.ResultsDuring the spontaneous recovery and reinstatement tests, iTBS of the left dlPFC before and after extinction significantly reduced fear response, whereas iTBS of the vertex had no effect on fear memory performance. This combined approach had a relatively long-lasting effect (i.e., at least 1 month).LimitationsWe did not explore the effect of iTBS of the dlPFC on the expression of fear without extinction training. The neural mechanisms of iTBS with fear extinction to inhibit the fear response are unclear. Our results are preliminary and should be interpreted with caution.ConclusionThe present results showed that 30 Hz iTBS of the left dlPFC enhanced retention of fear extinction. Our study introduces a new intervention for fear memory and suggests that the left dlPFC may be a treatment target for fear-related disorders.     

慢性轻度不可预见性应激对大鼠海马内甘丙肽表达的影响

目的:观察慢性轻度不可预见性应激(chronic unpredictable mild stress,CUMS)对大鼠海马甘丙肽(ga-lanin,Gal)蛋白及mRNA表达的影响,探讨Gal在大鼠实验性抑郁症发病过程中的作用机制。方法:将20只健康雄性SD大鼠,随机分为正常组和模型组,每组10只。孤养结合CUMS 21 d建造抑郁症模型,应用旷场试验和糖水偏好试验检测大鼠行为学变化,使用免疫荧光组织化学方法和逆转录多聚酶链反应(RT-PCR)法测定Gal及Gal mRNA的表达。结果:造模后模型组大鼠运动总路程、中央路程、周边路程及糖水摄入量均较正常组偏低(P<0.05);模型组与正常组相比,海马内Gal及Gal mRNA的表达同样降低(P<0.05)。结论:慢性轻度不可预见性应激可使大鼠海马内Gal及Gal mRNA的表达量下降,推测Gal在抑郁发病过程中可能起到神经保护作用。     

丝胶对Ⅱ型糖尿病大鼠海马生长激素/胰岛素样生长因子-1轴的作用

目的:探讨丝胶对Ⅱ型糖尿病大鼠海马生长激素(GH)/胰岛素样生长因子-1(IGF-1)轴的作用.方法:雄性SD大鼠随机分为正常对照组、糖尿病模型组、丝胶治疗组和阳性对照组.2％链脲佐菌素3d连续腹腔注射的方法建立Ⅱ型糖尿病大鼠模型后,丝胶治疗组和阳性对照组大鼠分别给予丝胶和二甲双胍灌胃治疗35 d.ELISA法检测各组大鼠血清GH和IGF-1水平,免疫印迹和RT-PCR法分别检测大鼠海马GH、生长激素受体(GHR)和IGF-1蛋白和mRNA的表达.结果:与正常对照组大鼠比较,糖尿病模型大鼠血清GH水平、海马GH的表达明显升高,血清IGF-1水平、海马GHR和IGF-1的表达明显降低;与糖尿病模型组大鼠比较,丝胶治疗组大鼠血清GH水平、海马GH的表达明显降低,血清IGF-1水平、海马GHR和IGF-1的表达明显升高.结论:丝胶可通过调节糖尿病海马GH/IGF-1轴的异常变化减轻海马损伤.     

Clinical and immunological characteristics in COVID-19 convalescent patients

European Journal of Clinical Microbiology & Infectious Diseases - The humoral and cellular immunity of convalescent COVID-19 patients is involved in pathogenesis and vaccine immunity. In this...     

DRR1对小鼠神经干细胞分化以及神经元突起形成的影响

目的:本研究旨在阐明肾细胞癌下调蛋白1(DRR1)在小鼠大脑组织中的表达谱及相关生物学功能。方法:首先,通过real time RT-PCR的方法明确在不同发育阶段的小鼠大脑组织中DRR1的表达水平;利用免疫荧光染色法检测DRR1在原代培养的神经干细胞以及神经元中的表达情况。其次,采用real time RT-PCR的方法分别检测DRR1在诱导分化前后的神经干细胞中的表达水平。最后,利用慢病毒感染的方法在原代培养的神经干细胞以及神经元中分别上调或者下调DRR1的表达,进而评价DRR1对原代培养的神经干细胞的分化以及神经元的突起形成的影响。结果:DRR1在各个发育阶段的小鼠大脑组织中均有表达,并且其表达水平随发育呈逐渐上升趋势。DRR1在分化前后的神经干细胞中均表达,但在诱导分化后的细胞中的表达水平显著高于其分化前的表达水平(P<0.01)。同时,过表达DRR1可促进神经干细胞的分化。DRR1在分化成熟的原代神经元的树突以及轴突均有表达,且DRR1的表达水平影响神经元的突起形成(P<0.01)。结论:DRR1在各发育阶段的小鼠大脑及分化前后的神经干细胞中均有表达,其作用与神经干细胞分化调控以及神经元突起形成有关。