To identify susceptibility loci for schizophrenia, we performed a two-stage genome-wide association study (GWAS) of schizophrenia in the Han Chinese population (GWAS: 746 individuals with schizophrenia and 1,599 healthy controls; validation: 4,027 individuals with schizophrenia and 5,603 healthy controls). We identified two susceptibility loci for schizophrenia at 6p21-p22.1 (rs1233710 in an intron of ZKSCAN4, P(combined) = 4.76 × 10(-11), odds ratio (OR) = 0.79; rs1635 in an exon of NKAPL, P(combined) = 6.91 × 10(-12), OR = 0.78; rs2142731 in an intron of PGBD1, P(combined) = 5.14 × 10(-10), OR = 0.79) and 11p11.2 (rs11038167 near the 5' UTR of TSPAN18, P(combined) = 1.09 × 10(-11), OR = 1.29; rs11038172, P(combined) = 7.21 × 10(-10), OR = 1.25; rs835784, P(combined) = 2.73 × 10(-11), OR = 1.27). These results add to previous evidence of susceptibility loci for schizophrenia at 6p21-p22.1 in the Han Chinese population. We found that NKAPL and ZKSCAN4 were expressed in postnatal day 0 (P0) mouse brain. These findings may lead to new insights into the pathogenesis of schizophrenia.

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poor sleep quality is associated with negative health outcomes and high treatment burden. this study investigated the prevalence of poor sleep quality and its socio-demographic correlates among older adults in Hebei province, which is a predominantly agricultural region of china. A large-scale cross-sectional epidemiological survey was conducted from April to August 2016. The study used a multistage, stratified, cluster random sampling method. Sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). A total of 3,911 participants were included. The prevalence of poor sleep quality (defined as PSQI > 7) was 21.0% (95% CI 19.7-22.2%), with 22.3% (95% CI 20.9-23.8%) in rural areas and 15.9% (95% CI 13.4-18.4%) in urban areas. Multivariable logistic regression analyses found that female gender (P < 0.001, OR 2.4, 95% CI 2.00-2.82), rural areas (P = 0.002, OR 1.5, 95% CI 1.14-1.86), presence of major medical conditions (P < 0.001, OR 2.4, 95% CI 2.02-2.96) and family history of psychiatric disorders (P < 0.001, OR 2.7, 95% CI 1.60-4.39) were independently associated with higher risk of poor sleep quality. poor sleep quality was common among older adults in Hebei province of china. Regular assessment of sleep quality and accessible sleep treatments for older population should be provided in agricultural areas of china. Older adults are more likely to suffer from poor sleep quality compared to younger adults due to more frequent physical and mental disorders 1. More than half of older adults complain about poor sleep quality 2,3 , including increased awakenings, low sleep efficiency, poor subjective sleep quality and decreased night sleep duration 1,4. Poor sleep quality is associated with negative health outcomes, such as fatigue, low quality of life, risk of medical and psychiatric comorbidities and even mortality 5-7. Sleep quality can be measured with both objective [e.g., polysomnography (PSG)], and subjective instruments [e.g., sleep diary and Pittsburgh Sleep Quality Index (PSQI)] 8. Of these, the PSQI is the most widely used measure of global sleep quality which covers subjective sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbance, daytime dysfunction, and use of sleep medications. Determining the prevalence of poor sleep quality is important for health professionals and policymakers to understand its impact on population health and the need for appropriate preventive strategies and health resource allocations. In the past decade, epidemiological studies have examined the prevalence of poor sleep quality among older adults in various countries. For instance, the prevalence of poor sleep quality in older adults was 37.3% in Japan 9 , while the corresponding figure was 64.3% in Korea 10. Several studies explored sleep quality among older adults in low-and middle-income countries in Africa, Asia and North America, with the prevalence ranging from 7.7% to 40.0% 11-13. As the pattern of sleep problems including poor sleep quality is greatly influenced by

ObjectiveClozapine is one of the most commonly used antipsychotic drugs in China. To date, few studies have investigated the patterns the prescription of clozapine nationwide. The present study examined these patterns in China in 2006 and identified the demographic and clinical characteristics associated with the use of clozapine.MethodsUsing a standardized protocol and data collection procedure, we surveyed 5,898 patients with schizophrenia in 10 provinces with differing levels of economic development.ResultsOverall, clozapine had been prescribed for 31.9% (n=1,883) of the patients; however we found considerable variation among the 10 provinces. The frequency of clozapine use was highest in Sichuan (39.3%) and lowest in Beijing (17.3%). The mean daily dose of clozapine was 210.36±128.72 mg/day, and 25.1% of the patients were treated with clozapine in combination with other antipsychotics. Compared with the group not receiving clozapine, clozapine-user had been treated for longer durations and had experienced a greater number of relapses and hospitalizations. Furthermore, those in the clozapine-user had lower family incomes, were less able to seek psychiatric services, and more likely to be male and have a positive family history of schizophrenia. A multiple logistic regression analysis revealed that age, sex, professional help-seeking behaviors, duration of illness, economic status, educational level, and clinical manifestations were associated with the use of clozapine.ConclusionClozapine use is common in China. However, use of the antipsychotic varies among provinces, and demographic and clinical factors play important roles in the prescription of clozapine.

Electroconvulsive therapy for schizophrenia has increased between 2006 and 2012 in China. Its percentage was higher than the figures reported in most other countries. Reasons for the substantial variations in the frequency of ECT across different provinces in China require further investigations.