Tardive dyskinesia (TD) may reflect an intrinsic neurobiological vulnerability associated with schizophrenia, yet metabolic alterations in the caudate nucleu, a key brain region regulating involuntary movements-remain poorly characterized by proton magnetic resonance spectroscopy (1 H-MRS). We investigated the relationship between caudate nucleus metabolite concentrations and TD symptoms using 1 H-MRS. We recruited 117 patients with schizophrenia, including 67 patients with TD and 50 patients without TD (NT). We also recruited 41 healthy controls (HCs). Absolute metabolite concentrations of N-acetylaspartate plus N-acetyl-aspartyl-glutamate (tNAA), creatine (Cr) and glutamine plus glutamate (Glx) in the caudate nucleus were quantified using a 3.0-T MRI scanner with water signal referencing. Clinical symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS) and the Abnormal Involuntary Movement Scale (AIMS). Among-group differences were analyzed using analysis of covariance with sex, age and years of education as covariates, followed by Bonferroni correction for multiple comparisons. After correction, the adjusted p-value was 0.017. Regression analysis was performed on metabolic indexes in the TD group with disease duration as a covariate. No significant differences in age, sex, or education level were observed among the groups. Additionally, no significant differences in PANSS scores or antipsychotic medication dosage were observed between the TD and NT groups. The TD group exhibited a significantly longer disease duration than the NT group (p < 0.05). Absolute tNAA levels—a marker of neuronal integrity—were significantly lower in the TD group than in the NT group (p < 0.05), while Cr (involved in energy metabolism) and Glx (involved in excitatory neurotransmission) levels did not significantly differ. These findings suggest reduced neuronal viability in the caudate nucleus in TD, though the clinical implications warrant further investigation.

Purpose:Depression is one of the leading causes of avoidable suffering worldwide, and over 50% of patients do not respond to their first antidepressant treatment, which underscores the need for more effective alternatives. This clinical predicament urgently requires an effective solution. The core objective of this study is to clarify the clinical efficacy and application value of the triple reuptake inhibitor toludesvenlafaxine in patients with poor response to the first antidepressant therapy, providing a new basis for treatment options for this refractory group. Methods:This multicenter study included 61 patients meeting Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) criteria for depression. All patients still had a Montgomery Depression Rating Scale (MADRS) score of ≥24 after 4 weeks of treatment with an adequate single initial antidepressant, and were clearly classified as an ineffective or partially effective initial antidepressant treatment. Patients were switched to toludesvenlafaxine for an 8-week treatment period. The primary outcome measure was the change in MADRS score from baseline to 8 weeks. The secondary outcome measures included the changes in the scores of the Hamilton Anxiety Scale (HAMA), the Dimensional Anhedonia Rating Scale (DARS), the Quality of Life Enjoyment and Satisfaction Questionnaire, Short Form (Q-LES-Q-SF), and the Clinical Global Impression of Severity Scale (CGI-S) from baseline to 8 weeks. Results:For such patients that did not respond to the first treatment, significant and rapid efficacy was demonstrated after switching to toludesvenlafaxine. At 8 weeks of treatment, the average MADRS score of the patients decreased by 15.5 points compared with the baseline (95% CI, -17.7 to -13.3; p < 0.0001; Cohen's d = 2.35). Forty-three percent of them met the clinical remission, and 67% achieved a clinical response. More clinically significant is that the therapeutic effect emerged at an early stage-2 weeks (95% CI, -9.4 to -6.4; p < 0.0001; Cohen's d = 1.52) and 4 weeks (95% CI, -13.3 to -9.8; p < 0.0001; Cohen's d = 2.11). After 2 weeks of treatment, there were statistically significant differences in the HAMA, Q-LES-Q-SF, and CGI-S scores at each time point compared with the baseline. The improvement in the DARS score was statistically significant from 4 weeks. In terms of safety, the most common adverse reactions were palpitations, constipation, nausea, vomiting, hypoesthesia, and dizziness, which are mostly mild to moderate and controllable. In particular, the drug significantly improved sexual dysfunction (95% CI, -4.3 to -0.7; p = 0.0071), which is crucial for improving treatment compliance. Conclusion:This study confirmed that toludesvenlafaxine not only has significant clinical efficacy (including early onset, high remission, and response) for patients with depression who did not respond to the first antidepressant treatment, but also has good safety and can improve sexual dysfunction that affects compliance. This result highlights the significant position of toludesvenlafaxine in addressing the key clinical challenge of first treatment failure, providing a highly valuable new option for the subsequent treatment of such patients.

HS-10353 is a novel positive allosteric modulator of γ-aminobutyric acid A receptors that is under development for the treatment of major depressive disorder (MDD). This is a double-blind, randomized, placebo-controlled, phase 1 trial comprising single ascending dose (SAD) and multiple ascending dose (MAD) parts. In SAD, 8 healthy volunteers of each cohort were randomized (6:2) to receive HS-10353 (2–55 mg) or placebo in a fasted state. In MAD, 12 MDD patients of each cohort were randomized (9:3) to receive HS-10353 (15–65 mg/day given for up to 7 days) or placebo. The primary objective was to assess the safety and tolerability of HS-10353. The efficacy endpoint in the MAD part included the change in the total score of the 17-item Hamilton Rating Scale for Depression (HAM-D17) at day 8. Pharmacokinetic (PK) analysis was performed as a secondary objective. Forty-eight healthy participants and forty-eight MDD participants completed the study. The most frequently observed treatment emergent adverse events (TEAEs) in the HS-10353 dose groups (occurring in ≥ 3 cases) included white blood cells urine positive and alanine aminotransferase increased in the SAD part, white blood cell count decreased and somnolence in the MAD part. All adverse events (AEs) were mild to moderate, and there were no serious adverse events or AEs that led to withdrawal from the trial. Treatment with 50 mg of HS-10353 for only 7 days showed therapeutic effects, with a difference of -4.7 (95

This retrospective study evaluated the clinical effectiveness and safety of Dachai Wendan Decoction (DWD) in combination with standard Western Medicine (WM) for the management of metabolic syndrome (MetS) induced by atypical antipsychotic medications. A total of 107 patients diagnosed with schizophrenia according to the International Classification of Diseases, Tenth Revision, and fulfilling the International Diabetes Federation criteria for MetS, were included between January 2020 and December 2024. Patients were allocated to either the WM group (n = 56) or the integrative medicine group receiving DWD in addition to WM (DWD + WM, n = 51). After 8 weeks of treatment, the remission rate of MetS was significantly higher in the DWD + WM group (47.1%) compared with the WM group (25.0%, P = .02). The DWD + WM group demonstrated greater reductions in body weight, body mass index, waist circumference, and blood pressure. Improvements in lipid metabolism were also more pronounced, with greater decreases in triglycerides, total cholesterol, and low-density lipoprotein cholesterol, alongside an increase in high-density lipoprotein cholesterol. Glycemic control, reflected by fasting plasma glucose and glycated hemoglobin, also improved significantly. Psychiatric symptoms remained stable in both groups, with no dosage adjustments of antipsychotics required. Both treatments were well tolerated, and the incidence of adverse events was low and comparable. These findings indicate that adjunctive therapy with DWD is a safe and effective strategy to improve metabolic outcomes in patients with antipsychotic-induced MetS.

Evidence on betahistine for cognitive impairment in schizophrenia is limited. This study evaluated its feasibility, safety, and preliminary efficacy to lay the groundwork for future randomized controlled trials. Thirty-one inpatients with schizophrenia, aged 18-60 years, undergoing treatment with olanzapine received betahistine (16 mg, three times daily) for 12 weeks. Cognitive function, clinical symptoms, and side effects were assessed at baseline and again at 12 weeks postintervention. After 12 weeks of betahistine treatment, patients with schizophrenia showed a significant increase in the total Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery score (p < .01). Increases were observed across multiple cognitive domains, including speed of processing, attention, working memory, verbal and visual learning, and reasoning and problem solving. Reductions in Positive and Negative Syndrome Scale scores were also observed, particularly for negative symptoms and total score (p < .05). Linear regression analysis revealed a significant negative correlation between age and cognitive scores (β = -0.37, p < .05). No adverse effects were reported. In this 12-week, single-arm study, adjunctive betahistine treatment was associated with observed improvements in cognitive performance and reductions in clinical symptom scores during the treatment period in patients with schizophrenia receiving olanzapine. Furthermore, advancing age is a key factor contributing to cognitive decline in the studied population. Betahistine was well-tolerated. This study explores betahistine as an adjunctive treatment for cognitive impairment in schizophrenia, with potential implications for improving cognitive outcomes and informing future treatment strategies. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Abstract Background Treatment-resistant schizophrenia (TRS) is characterized by severe cognitive impairments. However, the underlying mechanisms driving these deficits and strategies to mitigate them remain unclear. Elevated homocysteine levels have also been implicated in disease progression. We aimed to explore the relationship among serum homocysteine levels, working memory, and cortical thickness in patients with TRS. Methods Eighty-five patients with schizophrenia (42 with TRS and 43 with non-TRS [NTRS]) and 58 healthy controls (HCs) were recruited. Serum homocysteine levels were measured using enzymatic cycling. Cortical thickness was assessed using FreeSurfer version 5.3. Mediation analysis was further performed to preliminarily explore the potential interplay among serum homocysteine levels, regional cortical thickness, and working memory performance. Given that the bivariate correlations between homocysteine levels and cortical thickness did not retain significance after false discovery rate (FDR) correction and the cross-sectional design, this analysis aimed to identify potential mediating or suppressive pathways for hypothesis-generating purposes, rather than verifying definite compensatory mechanisms. Results Working memory was significantly impaired in patients with TRS and NTRS compared with HCs. Homocysteine levels were elevated in patients with schizophrenia, particularly in the TRS group. Among individuals with TRS, an inverse relationship was observed between serum homocysteine concentration and working memory ( r = − 0.411, p FDR = 0.02). Our exploratory suppression analyses revealed preliminary statistical links between elevated cortical thickness in the left precentral, postcentral, and precuneus gyri and homocysteine-associated working memory deficits in patients with TRS. These hypothesis-generating observations are constrained by non-significant FDR-corrected correlations and cross-sectional design. Conclusions Our exploratory findings preliminarily indicate that greater cortical thickness within left-hemispheric brain regions may show statistical links to homocysteine-associated working memory deficits in patients with TRS, rather than definitive evidence of partial compensatory mechanisms. Notably, given the cross-sectional study design and non-significant bivariate correlations observed between homocysteine levels and cortical thickness following FDR correction, these results are strictly hypothesis-generating and cannot support causal inferences. The mediation-suppression analysis, performed despite non-significant FDR-adjusted pairwise associations, offers tentative clues regarding potential neural correlation patterns. Further longitudinal or interventional studies are required to validate these preliminary observations.

BackgroundHippocampal neurogenesis shapes adaptation and improves responses to stress. Patients with schizophrenia show marked functional impairment and abnormal stress sensitivity. However, it remains unclear how structural abnormalities in specific hippocampal subregions are related to altered perceived stress and clinical symptoms in schizophrenia.MethodsWe recruited 97 first-episode patients with schizophrenia (FEPS) and 47 healthy controls (HC). Perceived stress and psychopathology were assessed using the Perceived Stress Scale (PSS) and the Positive and Negative Syndrome Scale (PANSS), respectively. Structural MRI was acquired on a 3.0-T scanner, and hippocampal subregions were segmented using validated, standardized protocols. Left and right subregional volumes were summed to obtain calculate bilateral volumes.ResultsCompared to HC, the FEPS group showed higher perceived stress, reduced fimbria volumes, and increased hippocampal tail volumes after adjustment for intracranial volume, age, sex, and education. In HC, several hippocampal subregion volumes were positively correlated with stress perception; however, these associations were absent or disrupted in FEPS. In FEPS, stress perception was positively associated with positive and anxiety/depression symptoms. Additionally, specific hippocampal subfield volume was positively associated with negative symptoms.ConclusionsFEPS was characterized by aberrant perceived stress, altered hippocampal subregional volumes, and disrupted links between stress perception and hippocampal structure. The interrelations among stress, clinical symptoms, and hippocampal subfields suggest altered psychological and neurobiological processes underlying stress regulation processes in FEPS.

Objective: Cognitive impairment occurs throughout the entire course of and affects the work and life of patients with major depressive disorder (MDD). The gut microbiota, kynurenine pathway (KP) and inflammatory response may have important roles in the mechanism of cognitive impairment in MDD patients. Consequently, our goal was to investigate the association among the gut microbiota, inflammation, KP, and cognition in MDD. Method: We enrolled patients with MDD (N = 86) and healthy controls (HCs, N =120) in this research. The study involved participant data regarding the levels of serum inflammatory factors (interleukin [IL]-1 beta, IL-4, IL-6, brain-derived neurotropic factor [BNDF], migration inhibitory factor [MIF], tumor necrosis factor [TNF]-alpha, vascular endothelial growth factor [VEGF]), gut microbiota and cognitive function (MCCB) were collected. Results: Patients demonstrated poorer cognitive function. Gut microbiota, such as Bacteroide, Prevotella, Faecalibacterium and Parabacteroides between MDDs and HCs were significantly different. Moreover, in patients with MDD, we found that different microbiomes were related to cognition and that Acidaminococcus was positively correlated with multiple domains of cognition. Allisonella and Acidaminococcus were significantly positively correlated with BDNF and negatively correlated with MIF. Alloprevotella, Blautia, and Megamonas were positively correlated with kynurenine/tryptophan (KYN/TRP). Acidaminococcus was negatively correlated with 3-hydroxykynurenine (3-HK). BDNF levels was significantly positive correlated with kynurenic acid (KA) and quinolinic acid (QA). Conclusion: The results of the present study suggest that the gut microbiota is associated with cognitive function, cytokine levels and KP metabolism in patients with MDD; however, the mechanism of the interaction between cognition and gut microbiota in MDD patients require further investigation.

Background: Post-traumatic stress disorder (PTSD) is a prevalent mental illness with a high disability rate. The neurobiological abnormalities in PTSD suggest that drug therapy may have certain therapeutic effects. According to the recommendations of clinical guidelines for PTSD, the current clinical preference is for selective serotonin reuptake inhibitors (SSRIs) or serotonin and norepinephrine reuptake inhibitors (SNRIs). Nevertheless, the efficacy of other types of drugs remains uncertain, which impacts the selection of personalized treatment for patients. Objectives: The aim of this meta-analysis was to assess the efficacy and acceptability of drugs with different pharmacological mechanisms in alleviating PTSD symptoms by comparing the response rates and dropout rates of different drug treatment groups in randomized clinical trials. Design: Systematic review and meta-analysis. Methods: We searched and analyzed 52 reports that described the efficacy and acceptability of medication for PTSD. Among these, 49 trials used the dropout rate as an acceptability indicator, and 52 trials used the response rate as an efficacy indicator. Results: In the 49 trials with the dropout rate as the indicator, the dropout rate was 29% (95% confidence interval, 0.26–0.33; n = 3870). In the 52 trials with the response rate as the indicator, the response rate was 39% (95% confidence interval, 0.33–0.45; n = 3808). After drug treatment, the core symptoms of PTSD were significantly improved. This meta-analysis indicated that there was no significant difference between antidepressants and antipsychotics in improving clinical symptoms and acceptability. However, antidepressants may have a slight advantage in efficacy, although with a higher dropout rate. Conclusion: Drug treatment is an effective rehabilitation method for PTSD patients, and individualized drug management should be considered. Trial registration: This systematic evaluation scheme has been registered with PROSPERO (protocol ID: CRD42023462662).

OBJECTIVE:Antipsychotic drugs are the mainstay of schizophrenia treatment; yet, controversy persists regarding their relative efficacy and side effects, and guideline recommendations on efficacy differences are particularly vague. The aim of this trial was to compare seven antipsychotics in acutely ill patients with schizophrenia. METHODS:The authors performed a multicenter (32 hospitals), industry-independent, parallel, assessor-blinded, flexible-dosage randomized trial (Schizophrenia in Non-Occidental Participants). Eligible inpatients 18-45 years of age with schizophrenia experiencing acute exacerbation were recruited and randomized to 6 weeks of monotherapy with one of seven antipsychotic drugs: olanzapine, risperidone, quetiapine, aripiprazole, ziprasidone, perphenazine, and haloperidol. RESULTS:A total of 3,067 patients were randomized, of whom 82% completed follow-up. The mixed model indicated significant differences in the primary outcome percentage change in Positive and Negative Syndrome Scale (PANSS) score between the antipsychotics. At week 6, olanzapine and risperidone showed a significantly higher percentage change in PANSS score than aripiprazole, ziprasidone, and quetiapine (mean differences: 5.52-7.93) but not haloperidol or perphenazine. Olanzapine was associated with the highest risk of weight gain (relative risk: 1.44-3.22). Aripiprazole was associated with lower risk of hyperprolactinemia than all the other drugs (relative risks: 0.11-0.21). Ziprasidone and aripiprazole were associated with lower risks of weight gain and metabolic side effects. Haloperidol was associated with a higher risk of extrapyramidal symptoms than all other drugs (relative risks: 0.13-0.61). Aripiprazole was least sedating (relative risks: 0.30-0.39). Olanzapine and risperidone showed lower all-cause discontinuation rates than ziprasidone and haloperidol (hazard ratios: 0.61-0.73). CONCLUSIONS:This trial fills important knowledge gaps in acute antipsychotic treatment of schizophrenia. It confirms hierarchies in efficacy and side effects of antipsychotics from related evidence.

BACKGROUND:The tryptophan-kynurenine (TRP-KYN) pathway may be implicated in the pathophysiology of cognitive impairment and pain severity in major depressive disorder (MDD); however, few studies have explored the intricacies of their interaction. AIM:To investigate the relationship between the TRP-KYN pathway and cognitive function in MDD patients with and without painful physical symptoms (PPS). METHODS:Seventy patients with MDD were recruited, including 33 and 37 with and without PSS, respectively. The Hamilton Depression Scale, the Hamilton Anxiety Scale, and the Short-form of McGill pain questionnaire (SFMPQ) were used to assess clinical symptoms. Cognitive function was assessed by the MATRICS Consensus Cognitive Battery (MCCB) score. TRP-KYN pathway metabolites' serum levels were measured using high-performance liquid chromatography-tandem mass spectrometry. RESULTS:The with PPS group exhibited significantly higher TRP-KYN ratios than did the without PPS group; in the former, the SFMPQ scores positively and negatively correlated with the TRP-KYN ratio and total MCCB score, respectively. Regression analysis indicated that body mass index and SFMPQ scores were significantly associated with the TRP-KYN ratio, predicting 30% of the variance. CONCLUSION:The TRP-KYN ratio is a potential biomarker for identifying patients with depression accompanied by pain symptoms, and targeting it may represent a novel therapeutic strategy for managing pain in these individuals. Further elucidation of the biological mechanisms underlying cognitive impairment in MDD patients with PPS is warranted.

OBJECTIVE:Cognitive function may decline with age, increasing the risk of dementia. Cognitive training can help to slow down this process. Digital Cognitive Enhancement System (DCES) is a novel home-based adaptive cognitive training system. We aim at evaluating and analyzing the efficacy of DCES in enhancing cognitive functions among the elderly and its neural mechanisms. METHODS:This 10-week study included 64 healthy elderly individuals, conducted as a single-blind, block-randomized controlled trial, registered at the China Clinical Trial Registry (ChiCTR2400091044). Participants were divided into the DCES group and the control group, with sessions occurring 5 days a week, each lasting 0.5 h, for a total of 10 weeks. Cognitive and brain function changes were assessed before and after the intervention, with results analyzed using linear-regression analysis and correlation coefficients calculated. RESULTS:After 10 weeks of intervention, the DCES group showed significant improvements in overall cognitive function, visuospatial function, memory and attention. DCES training significantly reduced fALFF values in the bilateral supramarginal gyrus (SMG). Its enhancement of immediate memory is closely linked to baseline activation levels in the left SMG. CONCLUSION:The DCES training showed positive intervention effects, and changes in bilateral SMG activity may provide neurological support for cognitive ability enhancement.

Temporality is one of the core characteristics of narrative medicine, holding unique practical value in the collection of medical histories for patients with mental illnesses. Temporality encompasses two layers of meaning: physical time and symptom time, with the experience of symptom time further including subjective time and spatiotemporal confusion. Through three specific clinical cases, this paper sequentially addresses physical time, subjective time, and spatiotemporal confusion, detailing the process by which psychiatrists employ narrative communication techniques and methods related to temporality for medical history collection. These methods enable a deep exploration of the patient's disease experience, psychological state, and social background, identifying various manifestations and changes of the disease, and confirming the nature of the disease. Furthermore, it lays a solid foundation for building diagnostic and therapeutic relationship and formulating a treatment plan.

BACKGROUND Blonanserin (BNS) is a well-tolerated and effective drug for treating schizophrenia. AIM To investigate which types of patients would obtain the most benefit from BNS treatment. METHODS A total of 3306 participants were evaluated in a 12-week, prospective, multicenter, open-label post-marketing surveillance study of BNS. Brief psychiatric rating scale (BPRS) scores were calculated to evaluate the effectiveness of BNS, and its safety was assessed with the incidence of adverse drug reactions. Linear regression was used to screen the influencing factors for the reduction of BPRS total score, and logistic regression was used to identify patients with a better response to BNS. RESULTS The baseline BPRS total score (48.8 ± 15.03) decreased to 27.7 ± 10.08 at 12 weeks (P < 0.001). Extrapyramidal symptoms (14.6%) were found to be the most frequent adverse drug reactions. The acute phase, baseline BPRS total score, current episode duration, number of previous episodes, dose of concomitant antipsychotics, and number of types of sedative-hypnotic agents were found to be independent factors affecting the reduction of BPRS total score after treatment initiation. Specifically, patients in the acute phase with baseline BPRS total score ≥ 45, current episode duration < 3 months, and ≤ 3 previous episodes derived greater benefit from 12-week treatment with BNS. CONCLUSION Patients in the acute phase with more severe symptoms, shorter current episode duration, fewer previous episodes, and a lower psychotropic drug load derived the greatest benefit from treatment with BNS.

Background: Patients with schizophrenia may have diverse functional outcomes. However, the long-term functional trajectories of patients with first -episode schizophrenia (FES) are unclear. Methods: We extracted data from the Chinese First -Episode Schizophrenia Trial, a 10 -year prospective study of antipsychotic-naive patients with FES. We applied K means cluster modelling to longitudinal data on the social function of patients with FES and examined associations of the empirically derived trajectories with baseline clinical characteristics of the 10 -year follow-up. Outcomes: Three distinct functional trajectories emerged: improving -favorable (39.3%), improving -poor (17.8%) and improving -stable (42.9%). All three trajectories demonstrated Personal and Social Performance (PSP) score improvement in the first six months. The improving -poor trajectory demonstrated PSP score decline during the second six months and thereafter, while PSP scores in the other two trajectories were mainly stable during the same period. Patients in the improving -favorable trajectory had higher baseline PSP scores than those in the improving -poor trajectory (OR=0.904 [0.852, 0.961], p < 0.05) and the improving -stable trajectory (OR=0.870 [0.825, 0.918], p < 0.001) and were more likely to be female than those in the improving -stable trajectory (OR=2.699 [1.030, 7.074], p < 0.05). Conclusions: Patients with FES demonstrated varied long-term functional recovery profiles. The first year, especially the second half of the first year, is a key period for social function interventions that improve long-term functional outcomes. Male patients and patients with poor baseline function may particularly benefit from such interventions.

ObjectivesThis clinical trial primarily aimed to investigate the effects of blonanserin on social functioning in patients with first-episode schizophrenia.MethodsIn this prospective, multi-centre, single-arm clinical trial study, blonanserin (flexible oral dose ranging from 8mg to 24mg per day) was given 26 weeks. Outcome measures included the Personal and Social Performance (PSP) scale for evaluating social functioning, the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery (MCCB) for measuring neurocognitive performance, and the Positive and Negative Syndrome Scale (PANSS) for assessing symptom severity. The primary endpoint was social function improvement evaluated by PSP scale at the end of blonanserin treatment. And the secondary endpoint was to validate the efficacy and neurocognitive effects of blonanserin. Adverse drug reactions (ADRs) were also recorded and analysed.ResultsA total of 96 patients with first-episode schizophrenia were recruited and proceeded to analysis. Fifty-one participants (53.1%) completed the PSP scale measurements at baseline and week 26. Following 26 weeks of blonanserin treatment, all outcome measurements demonstrated significant improvement during the follow-up period. Notably, PSP scores exhibited a continuous increase up to 68.1% ± 103.7% at the end of the treatment (46.6 ± 14.6 at baseline, 69.4 ± 17.4 at week 26, p<0.001), indicating positive effects on social functioning that were already noticeable by week 8.ConclusionBlonanserin treatment exhibited favourable effects on social functioning in individuals with first-episode schizophrenia. The results suggest that blonanserin was effective treatment options for patients with schizophrenia encountering functional impairments.

Context:Schizophrenia is a common and clinically disabling mental disorder. Many patients with schizophrenia smoke. Research on the effects of smoking on schizophrenia's symptoms are inconsistent. Objective:The study intended to investigate the smoking status of patients with stable schizophrenia to determine the effects of smoking on schizophrenia-related symptoms. Design:The research team performed an case-control study. Setting:The study took place at Beijing Huilongguan Hospital in Beijing, Changping District, China. Participants:Participants were 160 patients at the hospital who had been diagnosed with stable schizophrenia between April 2018 and March 2020. Groups:The research team divided participants into two groups based on their current smoking status: (1) a smoking group with 72 participants and (2) a nonsmoking group with 88 participants. Outcome Measures:The research team: (1) examined the types of antipsychotic drugs that participants received; (2) used a schizophrenia-related scale, the Positive and Negative Syndrome Scale (PANSS), to examine participants' status; (3) examined the smoking habits of the smoking group; and (4) analyzed the correlation between the PANSS score and the smoking group's smoking index. Results:No significant difference existed between the groups in the type of medicine used (P > .05). The smoking group's PANSS total (P = .014), positive symptom (P = .039), and negative symptom (P = .003) scores were significantly lower than those of the nonsmoking group (P < .05). No significant difference existed between the groups in the general psychopathological symptom score (P > .05). The smoking group started smoking between 13 and 24 years of age, with an mean age of 19.11 ± 4.10 years. The group smoked 10-30 cigarettes/d, with a mean smoking amount of 18.4 ± 3.1 cigarettes/d, and the smoking index was 344.7 ± 48.0. The smoking group's smoking index was significantly negatively correlated with the positive symptom, negative symptom, and total PANSS scores (all P = .000). No correlation existed between the smoking index and the general psychopathological symptom score (P > .05). Conclusions:Smoking patients with stable schizophrenia generally exhibit fewer symptoms than nonsmoking patients, which relate to the alleviation of mental tension that smoking can provide.

Background and Hypothesis:Environmental stressors may influence immune surveillance in B lymphocytes and stimulate autoimmune responses via epigenetic DNA methylation modifications in schizophrenia (SCZ). Study Design:A total of 2722, Chinese Han origin subjects were recruited in this study (2005-2011), which included a discovery follow-up cohort with 40 remitters of SCZ (RSCZ), 40 nonremitters of SCZ (NRSCZ), and 40 controls (CTL), and a replication follow-up cohort (64 RSCZ, 16 NRSCZ, and 84 CTL), as well as a case-control validation cohort (1230 SCZ and 1208 CTL). Genomic DNA methylation, target gene mRNA transcripts, and plasma autoantibody levels were measured across cohorts. Study Results:We found extensive differences in global DNA methylation profiles between RSCZ and NRSCZ groups, wherein differential methylation sites (DMS) were enriched with immune cell maturation and activation in the RSCZ group. Out of 2722 participants, the foremost DMS cg14341177 was hyper-methylated in the SCZ group and it inhibited the alternative splicing of its target gene BICD2 and may have increased its autoantigen exposure, leading to an increase in plasma anti-BICD2 IgG antibody levels. The levels of cg14341177 methylation and anti-BICD2 IgG decreased significantly in RSCZ endpoint samples but not in NRSCZ endpoint samples. There are strong positive correlations between cg14341177 methylation, anti-BICD2 IgG, and positive and negative syndrome scale (PANSS) scores in the RSCZ groups, but not in the NRSCZ groups. Conclusions:These data suggest that abnormal DNA methylation could affect autoreactive responses in SCZ, and that cg14341177 methylation and anti-BICD2 IgG levels may potentially serve as useful biomarkers.

目的 北京市属公立医院党支部"双带头人"建设对进一步加强党支部战斗堡垒作用和公立医院高质量发展具有重要意义.本文拟对北京市属公立医院党支部"双带头人"的建设现状进行调查,以期为新时代加强北京市属公立医院党支部"双带头人"建设提供参考.方法 于2022年11-12月从北京市属19家公立医院中每家随机抽取10名党支部书记针对党支部"双带头人"的现状进行问卷调查,并对推进中存在的问题进行分析,同时提出相关优化建议.结果 共发放问卷190份,回收有效问卷174份."双带头人"一肩挑的占比为86.96％;年龄主要集中在36～55岁;43.10％为高级职称;研究生学历占比为53.44％.28.99％的被调查者对"双带头人"机制了解较少;7.25％的人认为党建工作占用工作时间或可有可无;20.29％的被调查者对党建工作能力感到恐慌;50.72％的被调查者认为"双带头人"的身份与职务晋升、职称评聘、评优评先等联系不紧密.党支部工作开展中存在的主要问题是:工作难以创新突破、党建经费使用限制过多和业务工作压力大.结论 北京市属公立医院党支部"双带头人"队伍是一支年轻化的、学历和职称层次较高的队伍.在推进过程中尚存在思想意识水平不足、履职能力有待进一步提升和考核机制不完善等问题.需要进一步加强和理顺.