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Nanjing, China

Wang W.,Nanjing Medical University | Li Q.,Nanjing Medical University | Pan Y.,Nanjing Medical University | Zhu D.,Nanjing Brain Hospital | Wang L.,Nanjing Medical University
Respirology | Year: 2013

Background and objective: Sleep disorders are a complicated and major public health concern affecting millions of individuals. Obstructive sleep apnoea (OSA) is a common but still under-recognized disease which can cause intermittent nocturnal hypercapnia. Neuropeptides play critical roles in neurotransmission, acting as transmitters or modulators. Results from recent studies have implicated several neuropeptides in sleep and breathing regulation, including orexin, neuropeptides Y and galanin. Therefore, the present study aimed to evaluate the influence of hypercapnia on these neuropeptides and their receptors in order to assess their potential role in the pathogenesis of OSA. Methods: Fifteen C57BL/6J mice were randomly divided into three groups and exposed to moderate hypercapnia (5% CO2 with balanced room air), or severe hypercapnia (10% CO2 with balanced room air) or room air for 3 h (9:00-12:00 h), respectively. Immediately following exposure the brainstem and hypothalamus were excised for real-time reverse transcription polymerase chain reaction and western blot analyses. Results: In the hypothalamus gene expression including galanin, orexin and neuropeptide Y receptor 1 (NPYR1) was downregulated by hypercapnia. However, protein and mRNA levels of orexin-A receptor were upregulated by severe hypercapnia. In the brainstem only NPYR1 mRNA expression was decreased in moderate hypercapnia compared with that in severe hypercapnia. Conclusions: These findings suggest that hypercapnia can affect these neuropeptides and their receptors, especially the orexin and orexin-A receptor. The potential relationships between these peptides and OSA are worthy of further investigation. © 2012 The Authors. Respirology © 2012 Asian Pacific Society of Respirology.

Zhang X.R.,Nanjing Southeast University | Zhang X.R.,Queens University of Belfast | Zhang Z.J.,Nanjing Southeast University | Jenkins T.A.,Queens University of Belfast | And 2 more authors.
European Neuropsychopharmacology | Year: 2010

Antipsychotic drug treatment may be associated with common and problematic sexual dysfunction, especially impotence, which can diminish quality of life and lead to treatment noncompliance. Nitric oxide synthase (NOS) is an important cellular modulator of erectile function. We have therefore investigated the effect of antipsychotic drug on activity and gene expression of NOS in rat penile tissues. The activity of constitutive NOS was significantly suppressed below control by a 21 days administration of 1 mg/kg haloperidol, which also significantly decreased expression of endothelial NOS (eNOS) and neural NOS mRNA. Risperidone at 0.5 mg/kg also reduced eNOS mRNA expression. Haloperidol or risperidone did not change gene expression and activity of inducible NOS (iNOS). Quetiapine significantly increased activity and mRNA expression of iNOS with 20 and 40 mg/kg doses. These preliminary results have important implications for enhancing our understanding of mechanisms by which antipsychotic drugs induce sexual dysfunction. © 2009 Elsevier B.V.

Chen Y.,U.S. Center for Disease Control and Prevention | Ma F.,U.S. Center for Disease Control and Prevention | Zhang J.,U.S. Center for Disease Control and Prevention | Chu X.,Peoples Hospital of Jiangsu Province | Xu Y.,Nanjing Brain Hospital
European Journal of Neurology | Year: 2014

Background and purpose: It is important to have an estimate of the incidence of Guillain-Barré syndrome (GBS) because of the expansion of vaccination programs and the associated risks of vaccine-related GBS. Incidence information in Asia, especially in China, is scarce. This study attempts to describe GBS incidence in large Chinese populations located in three geographically different and moderately distant areas of the same province. Methods: The surveyed areas were Nanjing, Yancheng and Xuzhou, which are three cities in Jiangsu province in China. Nanjing is in the south of Jiangsu province, Yancheng is in the middle and Xuzhou is in the north. The survey was carried out in regions that might have received patients meeting the case definition from 2008 to 2010. The population numbers came from the local Bureau of Statistics. Data analysis was conducted in 2011. Results: The incidence of GBS was 0.59 cases per 100 000 person-years. The GBS incidence increased with age amongst people <80 years old. Males had a higher incidence of GBS than females. GBS incidence in Nanjing was the highest amongst the three regions. Conclusions: The incidence rates in parts of Jiangsu province were lower than those in Europe and North America. There was one peak in incidence amongst older adults (70-80 years). Geographical differences in GBS incidence rates may be related to socioeconomic status. There were no significant seasonal variations of incidence in Jiangsu. © 2013 EFNS.

Guo X.,Central South University | Zhai J.,Central South University | Zhai J.,Jining Medical College | Liu Z.,Central South University | And 17 more authors.
Archives of General Psychiatry | Year: 2010

Context: Antipsychotic drugs are limited in their ability to improve the overall outcome of schizophrenia. Adding psychosocial treatment may produce greater improvement in functional outcome than does medication treatment alone. Objective: To evaluate the effectiveness of antipsychotic medication alone vs combined with psychosocial intervention on outcomes of early-stage schizophrenia. Design: Randomized controlled trial. Setting: Ten clinical sites in China. Participants: Clinical sample of 1268 patients with early-stage schizophrenia treated from January 1, 2005, through October 31, 2007. Intervention: Patients were randomly assigned to receive antipsychotic medication treatment only or antipsychotic medication plus 12 months of psychosocial intervention consisting of psychoeducation, family intervention, skills training, and cognitive behavior therapy administered during 48 group sessions. Main Outcome Measures: The rate of treatment discontinuation or change due to any cause, relapse or remission, and assessments of insight, treatment adherence, quality of life, and social functioning. Results: The rates of treatment discontinuation or change due to any cause were 32.8% in the combined treatment group and 46.8% in the medication-alone group. Comparisons with medication treatment alone showed lower risk of any-cause discontinuation with combined treatment (hazard ratio, 0.62; 95% confidence interval, 0.52-0.74; P < .001) and lower risk of relapse with combined treatment (0.57; 0.44-0.74; P < .001). The combined treatment group exhibited greater improvement in insight (P < .001), social functioning (P = .002), activities of daily living (P < .001), and 4 domains of quality of life as measured by the Medical Outcomes Study 36-Item Short Form Health Survey (all P ≤ .02). Furthermore, a significantly higher proportion of patients receiving combined treatment obtained employment or accessed education (P = .001). Conclusion: Compared with those receiving medication only, patients with early-stage schizophrenia receiving medication and psychosocial intervention have a lower rate of treatment discontinuation or change, a lower risk of relapse, and improved insight, quality of life, and social functioning. Trial Registration: clinicaltrials.gov Identifier: NCT00654576 ©2010 American Medical Association. All rights reserved.

Li H.,Shanghai JiaoTong University | Luo J.,Fudan University | Wang C.,Beijing Anding Hospital | Xie S.,Nanjing Brain Hospital | And 5 more authors.
Schizophrenia Research | Year: 2014

Objective: Antipsychotics, such as aripiprazole and risperidone, are often used to treat individuals with schizophrenia. The efficacy as well as safety of aripiprazole in Western populations has been described. The objective of this study is to investigate the efficacy, safety, and tolerability of aripiprazole and risperidone in Chinese Han schizophrenia subjects in mainland China. Method: The 6-week, double-blind, randomized, parallel study was conducted in 5 medical centers in mainland China from November 2007 to March 2011. A total of 279 subjects with a primary DSM-IV diagnosis of schizophrenia were randomly assigned (with a randomization ratio of 1:1) to aripiprazole (n. = 139) or risperidone (n. = 140). Efficacy measurements included the Positive and Negative Syndrome Scale (PANSS) total, positive, negative and general psychopathology subscale scores, and Clinical Global Impressions-Severity of Illness (CGI-S), and Improvement scale scores. Extrapyramidal symptoms (EPS), weight gain, serum prolactin level, QTc interval, and self-reported adverse events were also assessed as measures of safety and tolerability. Results: Both the aripiprazole and risperidone groups showed statistically significant improvement of PANSS total, positive, negative, general psychopathology subscale scores, and CGI-S scores from baseline to the endpoint (all p<. 0.01). Significant improvement was noted in the first week for both treatment groups. There were no significant differences in efficacy measurements between the two treatment groups. Mean change of PANSS total scores from baseline to the endpoint was - 26.8. ±. 18.1 for aripiprazole and - 30.0. ±. 17.7 for risperidone, (p= 0.1475). The responder rate was 71% (n. = 99) and 76% (n. = 107) for aripiprazole and risperidone, respectively, (p= 0.323). The incidences of EPS were similar in the aripiprazole (25%, n. = 35) and risperidone groups (24%, n. = 34), respectively (p= 0.757). No clinically meaningful effects on QTc interval, QRS duration, or PR interval were observed in either treatment groups. However, the incidence of clinically significant weight gain (p= 0.0118) and hyperprolactinemia (p<. 0.001) in the aripiprazole group was significantly lower than in the risperidone group. Conclusion: The study demonstrated that aripiprazole, as well as risperidone, had rapid and persistent efficacy for psychotic symptoms from the first week of therapy. There may be poor efficacy for aripiprazole compared with risperidone for overall improvement, but there were no significant differences in this study. Aripiprazole showed good tolerability with less weight gain and hyperprolactinemia compared with risperidone. The overall efficacy and safety of aripiprazole in Chinese Han schizophrenia subjects were similar to that reported in Western populations. © 2014.

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