目的 探索miR137基因多态性与中国汉族精神分裂症患者阴性症状的关系.方法 采用多重连接酶检测反应技术(iMLDR)对498例精神分裂症患者(病例组)和548名健康对照者(对照组)miR137基因rs1625579位点开展基因分型检测,采用阴性症状评定量表(SANS)评定病例组原发性阴性症状.结果 两组miR137基因rs1625579位点GG、GT、TT基因型分布频率比较差异有统计学意义(P<0.05);两组G、T等位基因分布频率比较差异无统计学意义(P>0.05).携带rs1625579位点GT、GG基因型和TT基因型的患者SANS各维度评分比较差异未发现有统计学意义(P>0.05).结论 miR137基因位点多态性可能和精神分裂症起病相关,与患者阴性症状可能无关.

Abstract Purpose: The serotonin system and parenting styles have been reported to be involved in the pathogenesis of anorexia nervosa (AN). The study was aimed to explore the effect of the methylation of the promoter region of serotonin transporter gene (SLC6A4), also called 5-HTTLPR, parenting styles as well as their interaction on AN.Methods: 91 AN patients (ANs) and 87 healthy controls (HCs) were recruited, from whom 41 ANs and 40 HCs completed the environmental assessment. 5-HTTLPR methylation levels, clinical symptoms and environmental factors were assessed at baseline for all participants. 5-HTTLPR methylation was measured by MassArray methods and clinical symptoms were mainly evaluated by the EDE-Q6.0 scale. Environmental assessment is the parenting attitudes and behaviors used by the EMBU scale.Results: ANs had higher methylation at CpG 11, CpG 24.25, CpG 31.32 and CpG_mean than HCs (P=0.039, 0.042, 0.018, 0.001). Furthermore, it was the binge/purging subtype that revealed significant hypermethylation at CpG 24.25 and CpG_mean (P=0.027, 0.031). Both CpG11 methylation level and the parenting styles of refusal denial, overprotection for father were both positively correlated the EDEQ-6.0 scores in ANs (P=0.047, 0.018). Besides, their interaction analysis found, it was the overprotection, not the refusal denial for father that significantly associated with EDEQ-6.0 scores in ANs (P=0.030).Conclusions: Our study provided preliminary evidence that 5-HTTLPR DNA methylation at CpG11 and parenting styles of refusal denial, overprotection for father played vital roles in AN pathogenesis. Their interaction analysis indicated it was father’s overprotection that significantly associated with the clinical symptoms in ANs.

Objectives: Major depressive disorder (MDD) is a serious mental disorder, and there is a great difficulty to diagnose and treat. Hitherto, relatively few studies have explored the correlation between the levels of plasma cell adhesion molecules and MDD. Methods: Thirty outpatients with acute episodes of MDD in Shanghai Mental Health Center and 34 healthy volunteers from the community were recruited as subjects. Protein microarray technology was applied to compared the differences in plasma levels of 17 kinds of adhesion molecular proteins between the two groups. Meanwhile, the diagnostic value of different proteins in depression was discussed by using the receiver operating characteristic curve. Results: The levels of Carcinoembryonic Antigen Related Cell Adhesion Molecule-1(CEACAM-1) and Neural Cell Adhesion Molecule (NrCAM) in MDD patients were significantly higher than those in healthy controls ( P < 0.05). The area under ROC curve of CEACAM-1 combined with NrCAM was 0.723, with the sensitivity 0.800 and the specificity 0.676. Conclusion: The plasma levels of CEACAM-1 and NrCAM were significantly up-regulated in MDD, and their combined application was of potential diagnostic value, deserving to expand the sample size for further verification.

Background Aripiprazole (ARI) is often prescribed alone or in combination with other second-generation antipsychotics (SGAs) to treat patients with schizophrenia. However, this may increase the potential clinical significance of drug–drug interactions. Therapeutic drug monitoring (TDM) is an important and fundamental tool both when administering ARI alone and in combination with other SGAs to monitor ARI pharmacokinetics, adjust the dosage and thereby achieve more effective and safer treatment. Aims This study retrospectively investigated the effects of four SGA comedications (clozapine, risperidone, quetiapine (QTP) and olanzapine) and other potential factors (sex, age and ARI dose) on the serum concentrations of ARI and dehydroaripiprazole (DARI) in Chinese patients with schizophrenia using TDM data. Methods High-performance liquid chromatography was used to test the serum concentrations of ARI, DARI and ARI+DARI. In addition, steady-state dose-adjusted serum concentrations (ie, concentration-to-dose ratios, C:D ratios) of ARI, DARI and ARI+DARI; sex; age; ARI dose and SGA comedication dose between 299 inpatients with schizophrenia who received ARI or SGA comedication were all collected and analysed. Spearman’s correlation and multiple linear regression analysis were used to evaluate bivariate associations between ARI dose and serum ARI and DARI concentrations and describe the effect of independent variables on serum ARI and DARI concentrations, respectively. Results There were significant differences in the C:D ratios of ARI (χ2=−3.21, p=0.001) and ARI+DARI (χ2=−2.50, p=0.01) between the ARI and SGA groups, as well as in the C:D ratios of ARI (χ2=−3.59, p<0.001) and ARI+DARI (χ2=−3.10, p=0.002) between the female patients in the two groups. Of the four SGAs, only QTP had significant effects on the C:D ratios of ARI (Z=−4.12, p<0.001) and ARI+DARI (Z=−3.62, p<0.001) when compared with the ARI group in the whole sample and on the C:D ratios of ARI, DARI and ARI+DARI (Z=−3.96, p<0.001; Z=−2.22, p=0.03; Z=−3.75, p<0.001, respectively) in women when compared with their counterparts in the ARI group. Conclusion Comedication with SGAs resulted in lower C:D ratios of ARI and ARI+DARI compared with ARI monotherapy, and comedication with QTP resulted in lower C:D ratios of ARI and ARI+DARI than ARI monotherapy. Despite this statistical significance of our findings, whether the presently observed effect has clinical significance requires exploration by further research. TDM and dosage regulation of ARI should be performed in Chinese inpatients with schizophrenia who are receiving SGA comedication (especially QTP) to maintain a safe and effective dose-adjusted serum concentration of ARI and DARI.

OBJECTIVES:This study is to find the correlation among BDNF metabolism, early trauma, and current stress status of OCD patients. As well as to study the BDNF metabolism-stress related pathological mechanism in OCD development.METHODS:A total of 140 participants were recruited in this study, including 64 drug-naïve OCD patients (OCDs) and 76 healthy controls (HCs). The clinical data of the subjects were measured using YBOCS, CTQ, and PSS. The plasma mBDNF and proBDNF values were measured by ELISA while the M/P ratio was calculated.RESULTS:The mBDNF, proBDNF plasma levels, and M/P ratio of unmedicated OCD individuals decreased evidently comparing with HCs. Also, positive associations were found between PSS and CTQ and between CTQ and M/P ratio. The negative correlation included proBDNF and PSS as well as proBDNF and CTQ. Intermediary analysis generated by SPSS has showed that the perceived stress played a complete mediating role between early trauma and plasma M/P ratio levels, and the mediating effect was 0.043 in non-medication OCD patients.CONCLUSIONS:Findings from this study suggested that early trauma experience and stress state work together in regulating BDNF metabolism level in OCD patients. The nucleus accumbens and reward loop are also pivotal in the pathogenesis of OCD.

Abstract BackgroudThe serotonin system has been reported to be involved in the pathogenesis of anorexia nervosa (AN). The promoter region of serotonin transporter gene (SLC6A4), also called 5-HTTLPR, responsible for serotonin reuptake, has received much attention, especially 5-HTTLPR methylation, which was associated with abnormal eating behaviors. The study was aimed to explore the association between 5-HTTLPR methylation and AN, as well as its predictive effect on therapeutic response.Methods91 AN patients and 87 healthy controls (HCs) were recruited. Only 30 patients completed the 12-week follow-up. 5-HTTLPR methylation levels and clinical symptoms were assessed at baseline for all participants, at the fourth and the twelfth week for follow-up patients. 5-HTTLPR methylation was measured by MassArray methods and clinical symptoms were mainly evaluated by the EDE-Q6.0 scale. ResultsAN patients had higher methylation at CpG 11, CpG 24.25, CpG 31.32 and CpG_mean than healthy controls (P=0.039, 0.042, 0.018, 0.001). Furthermore, it was the binge/purging subtype that revealed significant hypermethylation at CpG4 and CpG_mean (P=0.027, 0.031). However, it failed to discover significant differences between AN-R and AN-BP groups at all units. Besides, CpG 11 methylation level was positively correlated with EDEQ-6.0 total score in patients (r=0.226, P=0.047). The methylation level of CpG11, CpG26.27.28, CpG31.32, CpG33.34.35.36 and CpG_mean decreased after treatment, but not significantly. 5-HTTLPR methylation was not significantly different between the two groups after treatment.ConclusionsOur study provided preliminary evidence that 5-HTTLPR methylation played vital roles in AN pathogenesis. The characteristic of 5-HTTLPR among untreated AN patients was hypermethylation. However, whether it is the biomarker to distinguish the subtypes and therapeutic response of AN needs further investigation.

目的:探讨精神分裂症患者脑源性神经营养因子(BDNF)与事件相关脑电位N400和临床症状之间的关系.方法:对58例精神分裂症患者(患者组)及60名健康对照(正常对照组)进行N400测查,采用酶联夹心免疫吸附法测定血清BDNF水平.使用阳性和阴性症状量表(PANSS)评定患者的临床症状.结果:患者组血清BDNF水平低于正常对照组,差异有统计学意义(P<0.05).在Fz点,患者组N400中异音形似异义的匹配潜伏期延迟(P<0.05);N400中异音异形同义的匹配潜伏期和波幅以及非匹配波幅下降(P<0.05或P<0.01).BDNF水平变化值与PANSS总分及各因子分变化值无相关性(P均>0.05).患者组血清BDNF水平与Fz点N400波幅与潜伏期呈正相关(P<0.05或P<0.01).结论:精神分裂症患者血清BDNF水平降低与其N400变异及认知功能损害有关.

目的·探讨西酞普兰对抑郁症患者外周血miRNA-16/5-羟色胺转运体(serotonin transporter,SERT)通路相关指标的影响.方法·将未服药的抑郁症患者45例(未服药病例组)、经药物治疗的抑郁症患者32例(药物治疗组)及健康对照者32名(健康对照组)纳入研究,行汉密尔顿抑郁量表17项(Hamilton Depression Scale-17 items,HAMD-17)评估.采用荧光定量PCR检测血浆miRNA-16表达水平,采用Western blotting检测血小板中SERT蛋白表达水平.对未服药病例组中医师处方予以西酞普兰治疗的14例患者进行2个月的随访,随访结束后进行HAMD-17评估,检测血浆miRNA-16及血小板SERT蛋白的表达水平.结果· 血浆miRNA-16表达水平在3组之间比较,差异无统计学意义(F=0.421,P=0.657);血小板SERT蛋白表达水平在3组之间比较,差异无统计学意义(F=0.112,P=0.894).随访研究结果显示:14例处方予以西酞普兰治疗的患者,2个月后HAMD-17评分降低(Z=-3.187,P=0.001),血浆miRNA-16表达水平升高(t=2.455,P=0.032),血小板SERT蛋白表达水平无变化(t=-0.750,P=0.470).结论·5-羟色胺再摄取抑制剂类药物西酞普兰对抑郁症患者血浆miRNA-16的表达具有下调作用;血小板5-羟色胺的减少并非是由血小板膜上SERT蛋白减少这一变化引起,可能与SERT功能降低有关.

Objective To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on the negative symptoms of chronic schizophrenia and on the P300 component of schizophrenics' event-related potentials (ERPs).Methods Ninety convalescing schizophrenia patients were randomly divided into a 5 Hz group,a 10 Hz group and a 15 Hz group,each of 30.The three groups were treated with the corresponding 5 Hz,10 Hz or 15 Hz rTMS once a day,five times a week for five consecutive weeks.The P300 ERPs of all three groups were tested before and after the treatment.Any curative effect was evaluated using the scale for the assessment of negative symptoms (SANS).Results After the treatment,the average SANS score of the 10 Hz group was significantly different from that before the treatment and also from those of the other two groups after the treatment.After the treatment,significant improvement was also observed in the amplitude of P300 in the 10 Hz group.The treatment's effectiveness was negatively correlated with age and longer course of the disease.Conelusion rTMS at 10 Hz is the most effective of the protocols tested for improving the negative symptoms of schizophrenia and improving cognitive functioning.

Currently, the choice of medical treatment for major depressive disorder (MDD) is primarily based on a trial-and-error process. Thus, identification of individual factors capable of predicting treatment response is of great clinical relevance. Recent work points towards beclin-1 and inflammatory factors as potential biomarkers of antidepressant treatment response. The primary aim of the study was to investigate whether pre-treatment serum levels of beclin-1 and inflammatory factors could predict antidepressant treatment response in Chinese Han patients with MDD. Forty patients with MDD were treated with either a selective serotonin reuptake inhibitor (SSRI) (paroxetine in 20 cases) or a serotonin–norepinephrine reuptake inhibitor (SNRI) (duloxetine in 13 cases and venlafaxine in 7 cases). Depression scores and serum levels of beclin-1 were measured at the baseline and after 8 weeks of antidepressant treatment. Serum C-reactive protein (CRP), interleukin (IL)-1B, and IL-6 levels were determined using enzyme-linked immunosorbent assay kits at the baseline. Twenty-seven patients were identified as treatment responders, whereas 13 were identified as non-responders after 8 weeks of antidepressant treatment. Baseline serum beclin-1 levels were significantly higher in non-responders than in responders (p = 0.001), whereas no differences were found in baseline serum CRP, IL-1B, or IL-6 levels between responders and non-responders. There were no significant correlations between baseline levels of beclin-1 and baseline IL-1β, IL-6, and CRP levels—neither in the total sample nor in responder and non-responder groups. Moreover, logistic regression models and a random forest model showed that baseline serum beclin-1, but not inflammatory factors, was an independent and the most important predictor for antidepressant treatment response. Furthermore, serum beclin-1 levels were significantly increased in responders (p = 0.027) but not in non-responders after 8 weeks of treatment (p = 0.221). Baseline serum beclin-1 levels may be a predictive biomarker of antidepressant response in patients with MDD. Moreover, beclin-1 may be involved in the therapeutic effect of antidepressant drugs.

Objectives: The nature of the diagnostic classification of mood disorder is a typical dichotomous data problem and the method of combining different dimensions of evidences to make judgments might be more statistically reliable. In this paper, we aimed to explore whether peripheral neurotrophic factors could be helpful for early detection of bipolar depression. Methods: A screening method combining peripheral biomarkers and clinical characteristics was applied in 30 patients with major depressive disorder (MDD) and 23 patients with depressive episode of bipolar disorder. By a model-based algorithm, some information was extracted from the dataset and used as a "model" to approach penalized regression model for stably differential diagnosis for bipolar depression. Results: A simple and efficient model of approaching the diagnosis of individuals with depressive symptoms was established with a fitting degree (90.58%) and an acceptable cross-validation error rate. Neurotrophic factors of our interest were successfully screened out from the feature selection and optimized model performance as reliable predictive variables. Conclusion: It seems to be feasible to combine different types of clinical characteristics with biomarkers in order to detect bipolarity of all depressive episodes. Neurotrophic factors of our interest presented its stable discriminant potentiality in unipolar and bipolar depression, deserving validation analysis in larger samples.

目的:探讨神经性厌食症(AN)患者的血浆催产素(OT)水平及其与临床特征的关系.方法:采用酶联免疫法分别测定41例AN患者治疗前和随访时血浆OT水平,通过自身前后对照,分析AN患者前后3次血浆OT水平改变及其与临床特征变化之间的关系. 结果:随访1个月及3个月时血浆OT水平分别为(90.10±30.54) pg/ml和(93.65±42.15) pg/ml,较治疗前(86.54±32.45) pg/ml有所升高,但差异无统计学意义(P＞0.05);随访前后血浆OT水平及临床症状变化程度无相关性(P均＞0.05). 结论:AN患者存在OT系统代谢异常,随着AN治疗3个月后症状改善,血浆OT水平无明显变化,提示血浆OT水平有可能是AN的一个属性指标.

BACKGROUND:Repetitive transcranial magnetic stimulation (rTMS) and event-related potentials (ERPs) are a noninvasive technique that widely used in neurophysiological field. Although rTMS has shown clinical utility for a number of neurological conditions, Recently,there was little understanding of the the efficacy of rTMS on Schizophrenia(SZ) and the change of ERP between before and after rTMS treatment. The objective of this study was to investigate the characteristics of N400, mismatch negativity (MMN), and P300 before and after treatment with rTMS in SZ. METHODS:One hundred and twenty-seven SZ patients hospitalized in Shanghai Mental Health Center from March 2015 to July 2017, divided into two groups (85 patients were recruited as rTMS group and 42 were recruited as sham rTMS [ShrTMS] group) and 76 normal controls (NCs) who were the staff and refresher staff in our hospital were recruited at the same time. A Chinese-made rTMS and a Runjie WJ-1 ERPs instrument were used in the present experiment. N400 was elicited by congruent and noncongruent Chinese idioms. After rTMS treatment, N400, P300, and MMN characteristics were compared with those before treatment and NC group. RESULTS:Compared with NC, the SZ patients exhibited delays in N400, P300, and MMN latency and decreased N400, P300, and MMN amplitudes in their frontal area (P < 0.05). After 25 rTMS treatments, N400 amplitudes in the frontal area (elicited by idioms with same phonic and different shape and meaning and with different phonic, shape, and meaning) were increased in the SZ patients (P < 0.05). However, there was no significant change in N400 before and after treatment with ShrTMS in SZ patients (P > 0.05). Amplitudes for MMN and target P300 also increased in SZ patients after rTMS treatment (P < 0.05). CONCLUSIONS:Based on our preliminary findings, we believe that the combined usage of N400, MMN, and P300 could be a valuable index and an electrophysiological reference in evaluating the effects of rTMS treatment in SZ patients.

Background: Risperidone and paliperidone have been the mainstay treatment for schizophrenia and their potential role in neuroprotection could be associated with brain-derived neurotrophic factor (BDNF) and N400 (an event-related brain potential component). So far, different effects on both BDNF and N400 were reported in relation to various antipsychotic treatments. However, few studies have been conducted on the mechanism of risperidone and paliperidone on BDNF and N400. This study aimed to compare the effects of risperidone and paliperidone on BDNF and the N400 component of the event-related brain potential in patients with first-episode schizophrenia. Methods: Ninety-eight patients with first-episode schizophrenia were randomly divided into the risperidone and paliperidone groups and treated with risperidone and paliperidone, respectively, for 12 weeks. Serum BDNF level, the latency, and amplitude of the N400 event-related potential before and after the treatment and Positive and Negative Syndrome Scale (PANSS) scores were compared between the two groups. Results: A total of 94 patients were included in the final analysis (47 patients in each group). After the treatment, the serum BDNF levels in both groups increased (all P < 0.01), while no significant difference in serum BDNF level was found between the groups before and after the treatment (all P > 0.05). After the treatment, N400 amplitudes were increased (from 4.73 ± 2.86 μv and 4.51 ± 4.63 μv to 5.35 ± 4.18 μv and 5.52 ± 3.08 μv, respectively) under congruent condition in both risperidone and paliperidone groups (all P < 0.01). Under incongruent conditions, the N400 latencies were shortened in the paliperidone group (from 424.13 ± 110.42 ms to 4.7.41 ± 154.59 ms, P < 0.05), and the N400 amplitudes were increased in the risperidone group (from 5.80 ± 3.50 μv to 7.17 ± 5.51 μv, P < 0.01). After treatment, the total PANSS score in both groups decreased significantly (all P < 0.01), but the difference between the groups was not significant (P > 0.05). A negative correlation between the reduction rate of the PANSS score and the increase in serum BDNF level after the treatment was found in the paliperidone group but not in the risperidone group. Conclusions: Both risperidone and paliperidone could increase the serum BDNF levels in patients with first-episode schizophrenia and improve their cognitive function (N400 latency and amplitude), but their antipsychotic mechanisms might differ.

Background: Metabolic factors in the kynurenine pathway (KP) have been widely accepted as being a major mechanism in Major Depressive Disorder (MDD). However, the effects of these metabolites on the degree and pattern of MDD are still poorly understood, partly due to the elusiveness of the level of metabolites when diagnosing depression. This study aimed to explore a novel diagnostic method analyzing peripheral blood with mass spectrometry to assess metabolites from KP in patients with MDD and Bipolar Depression (BD). Methods: Thirty-three patients with MDD, 20 patients with BD, and 23 healthy control participants were enrolled Metabolic factors of KP from plasma including tryptophan (TRP), kynurenine (KYN), kynurenic acid (KYNA), and quinolinic acid (QUIN) were analyzed by UPLC-3Q-MS, and levels compared across three groups. Correlation between HAMD scores and metabolite levels conducted. Receiver operating characteristic (ROC) curve was used to determine the diagnostic value of metabolic factors in MDD. Results: Levels of KYNA, QUIN, KYNA/QUIN, and KYNA/KYN were statistically different across the three groups (P < 0.05); HAMD scores and TRP, KYN, KYNA/QUIN levels were negatively correlated in the MDD group (r = -0.633, -0.477, -0.418, P < 0.05); Accuracy of KYNA diagnosing MDD was 82.5% with the optimal diagnostic value being 15.48 ng/ml. Diagnostic accuracy was increased to 83.6% when KYNA and QUIN levels were used in combination. Conclusion: This results indicate that metabolic factors of KP play a crucial role in the occurrence and development of MDD, supporting the metabolic imbalance hypothesis of MDD. Furthermore, our study also provides a new diagnostic method to study MDD based on plasma KYNA level, and suggests that KYNA would be a potential biomarker in diagnosing depression patients.

AIM To compare the effects of paliperidone and risperidone on brain-derived neurotrophic factor (BDNF) and event-related brain potential N400 in patients with first-episode schizophrenia.METHODS Totally 90 patients with first-episode schizophrenia were randomly divid ed into the paliperidone group and the risperidone group, treated with paliperidone (6-12 mg·d-1) and risperidone (3-6 mg·d-1) respectively for 12 weeks.Serum BDNF concentrations and event-related potential N400 latency and amplitude were compared between the two groups before and after the treatment, and the relationship between them and scores of Positive and Negative Symptoms Scale (PANSS) were calculated.RESULTS There were 3 patients in each group dropped out, due to the irresistance of the adverse drug reactions.After the treatment, the levels of serum BDNF in both groups significantly increased (P ＜ 0.01), while no significant difference was found between the two groups (P＞ 0.05).The N400 latency reduced and N400 amplitude increased in congruent condition in the two groups (P ＜ 0.01), and under the incongruent conditions, the N400 latency was shortened (P ＜ 0.05) in the paliperidone group and the N400 amplitude of the risperidone group was increased (P ＜ 0.01).After the treatment, the total scores of PANSS in both groups decreased significantly (P ＜ 0.01), but the difference between the groups was not significant (P＞ 0.05).A positive correlation between the rate of PANSS reduction and the increasing value of serum BDNF after the treatment was found in the paliperidone group (r = 0.417, P ＜ 0.05), but it was not found in the risperidone group (r = 0.103, P = 0.516).CONCLUSION Both paliperidone and risperidone could increase the serum BDNF concentration in patients with schizophrenia and improve the cognitive function of patients (N400 latency and amplitude).

Objective To investigate the correlation between plasma inflammatory markers and aggressive behavior in schizophrenia patients. Methods A total of 50 schizophrenia patients and 40 age-and gender-matched healthy individuals were recruited in the study. Positive and Negative Syndrome Scale (PANSS) and Modified Overt Aggression Scale (MOAS) were applied to assess patients' schizophrenia symptoms and aggressive behaviors. Plasma levels of IL-6 and IL-10 were measured with enzyme-linked immunosorbent assay (ELISA). Levels of plasma inflammatory markers were compared between schizophrenics and healthy controls. Furthermore, the correlation between inflammatory cytokines and aggressive behavior was calculated by Spearman's correlation analysis. Results Levels of plasma IL-6 and IL-6/IL-10 ratio were significantly higher in subjects with schizophrenia compared with healthy control subjects (P<0.01), while the concentration of IL-10 were lower in schizophrenia patients (P<0.01). Schizophrenia patients with aggressive behavior had significant higher IL-6 and IL-6/IL-10 ratio than patients without aggressive behavior (P< 0.05). IL-6 levels were positively correlated with total score and aggression against others score of MOAS (r=0.363,P=0.010;r=0.309,P=0.029). Plasma levels of IL-10 were inversely correlated with aggression against objects score of MOAS (r=-0.281,P=0.048). IL-6/IL-10 ratio was positively related to total score, aggression against objects score and aggression against others score of MOAS (r=0.523,P<0.01;r=0.421,P=0.002;r=0.303,P=0.033). Conclusions Schizophrenia and aggression were associated with immune inflammatory response imbalances. IL-6, IL-10 and their ratio could be potential biomarkers for schizophrenia and aggressive behavior.

目的 目的探讨青少年冲动性攻击行为与生活应激水平及血清脑源性神经营养因子(BDNF)水平的相关性.方法 选取51名有冲动性攻击行为的学生为研究组,53名无冲动性攻击行为的学生为对照组.采用修改版外显行为攻击量表(MOAS)和修订版Barratt冲动量表(BIS-11)分别评估受试者的攻击行为和冲动性,青少年生活事件量表(ASLEC)调查受试者近半年内的生活应激水平,同时采用酶联免疫吸附试验法检测血清BDNF水平.结果 研究组ASLEC总分及人际关系、受惩罚、健康适应因子分均高于对照组(P<0.05).MOAS总分与ASLEC总分及人际关系、受惩罚因子呈正相关(P<0.05),与BDNF呈负相关(P<0.05).BIS-11总分与ASLEC总分、人际关系、受惩罚、健康适应因子呈正相关(P<0.05).BDNF水平在应激和攻击行为之间的中介效应不显著.结论 应激是青少年冲动性攻击行为的重要影响因素,而BDNF在其产生中可能起间接作用.

Background Schizophrenia is a chronic debilitating disease. The pathogenesis and treatment may be associated with inflammatory cytokines. There are few studies focusing on the prediction of cytokines in response to antipsychotics. Aim To investigate whether cytokines would predict response to antipsychotics. Methods Cross-sectional and natural observational cohort studies were applied to:(1) compare the baseline levels of serum IL-1β, TNF-α and MCP-1 between schizophrenia (n=64) and healthy controls (n=53); (2) To investigate the impact of baseline cytokines to psychopathology following olanzapine and risperidone monotherapy. Results (1) Baseline MCP-1 level of patients with schizophrenia was significantly higher than healthy controls (t=2.62, p=0.010), while no significance was found in IL-1β (t=1.43, p=0.154) and TNF-α (t=0.79, p=0.434); (2) Pretreatment level of MCP-1 significantly correlated with PANSS-G reduction following 4 weeks' of risperidone monotherapy (r =-0.658; p<0.001) but not olanzapine monotherapy (r =-0.031; p=0.855); (3) Further stepwise multiple linear regression analysis indicated that higher MCP-1 level prior to treatment was a significant predictor of less PANSS-G reduction in schizophrenia patients following risperidone monotherapy (adjusted R2= 0.409, β = -0.658, p <0.001), but not in the olanzapine group. Conclusion MCP-1 may play a role in the pathogenesis of schizophrenia. Pretreatment level of MCP-1 may serve as a biomarker indicating response to risperidone treatment.