BackgroundCompromised neurocognition is a core feature of schizophrenia. With increasing studies researching cognitive function of Chinese patients with first-episode schizophrenia (FES) using MATRICS Consensus Cognitive Battery (MCCB), it is not clear about the level and pattern of cognitive impairment among this population.AimTo provide a meta-analysis systematically analysing studies of neurocognitive function using MCCB in Chinese patients with FES.MethodsAn independent literature search of both Chinese and English databases up to 13 March 2019 was conducted by two reviewers. Standardised mean difference (SMD) was calculated using the random effects model to evaluate the effect size.Results56 studies (FES=3167, healthy controls (HC)=3017) were included and analysed. No study was rated as ‘high quality’ according to Strengthening the Reporting of Observational Studies in Epidemiology. Compared with HCs, Chinese patients with FES showed impairment with large effect size in overall cognition (SMD=−1.60, 95% CI −1.82 to −1.38, I2=67%) and all seven cognitive domains, with the SMD ranging from −0.87 to −1.41. In nine MCCB subtests, patients with FES showed significant difference in Symbol Coding (SMD=−1.90), Trail Making Test (TMT) (SMD=−1.36), Continuous Performance Test-Identical Pairs (SMD=−1.33), Hopkins Verbal Learning Test (SMD=−1.24), Brief Visuospatial Memory Test (SMD=−1.18), Mazes (SMD=−1.16), Category Fluency (SMD=−1.01), Spatial Span (SMD=−0.69) and Mayer-Salovey-Caruso Emotional Intelligence Test (SMD=−0.38).ConclusionsOur meta-analysis demonstrates that Chinese patients with FES show neurocognitive deficits across all seven MCCB cognitive domains and all nine subtests, particularly in two neurocognitive domains: speed of processing and attention/vigilance, with the least impairment shown in social cognition. Symbol Coding and TMT may be the most sensitive tests to detect cognitive deficit in Chinese patients with FES.

Aberrant expressions of long non-coding RNAs (lncRNAs) are the culprits of carcinogenesis via regulating the tumor suppressor or oncogene. LncRNA nuclear enriched abundant transcript 1 (NEAT1) has been identified to be an oncogene to promote tumor growth and metastasis of many cancers. However, the clinical significance and function of NEAT1 in osteosarcoma (OS) remain to be discovered. We here collected OS tissues (=40) and adjacent non-tumor tissues (=20) to determine the expression of NEAT1 and its clinical significance. NEAT1 was overexpressed in OS tissues, which positively correlated with tumor size, Enneking stage, and distant metastasis of OS patients. The elevated level of NEAT1 was confirmed in OS cell lines including MG63 and HOS Knockdown of NEAT1 by two siRNAs induced impaired cell vitalities, promoted the apoptosis, and G/G arrest in two cell lines, which was associated with inhibited anti-apoptosis signals BCL-2 pathway and cell cycle-related cyclin D1 (CCND1) signals. Moreover, the tumor suppressor was negatively regulated and inhibited by NEAT1 in OS. Suppression of could up-regulate the expressions of its target genes and to antagonize the effects of NEAT1 knockdown. Furthermore, overexpressed NEAT1 reduced the sensitivity of cisplatin (DDP) and inhibited DDP-induced apoptosis and cell cycle arrest via The results also confirmed that knockdown of NEAT1 sensitized the OS cells to DPP-induced tumor regression, delayed the tumor growth with reduced levels of Ki-67, BCL-2, and cyclin D1 signals, suggesting that NEAT1 is an oncogene and chemotherapy resistant factor in OS.

AbstractObjectiveTo perform a prospective non-randomized comparison of the effectiveness and safety of combined neurokinin-1 antagonist aprepitant treatment with the standard multiple-day cisplatin regimen for the prevention of cisplatin-induced nausea and vomiting (CINV).MethodsPatients being administered 3-day cisplatin-based chemotherapy (25 mg/m2/d) who had never received aprepitant were given either the standard regimen (tropisetron and dexamethasone) or the aprepitant regimen (aprepitant plus tropisetron and dexamethasone). The primary endpoint was the complete response (CR) in the overall phase (OP, 0–120 h) between the combined aprepitant triple regimen group and the standard group. Secondary endpoints were the CR in the acute phase (AP, 0–24 h) and delay phase (DP, 25–120 h) between the two groups. The first time of vomiting was also compared by Kaplan–Meier curves. The impact of CINV on the quality of life was assessed by the Functional Living Index-Emesis (FLIE). Aprepitant-related adverse effects (AEs) were also recorded.ResultsA CR was achieved by 80.0% in the aprepitant group compared with 56.0% in the standard group during the OP (P =0.018)as well as during the DP. However, during the AP, the aprepitant and standard therapy groups achieved identical CR rates (98.0%, P =1.000). A longer time to first emesis was documented for the aprepitant group than for the standard group. No effect of CINV on quality of life as assessed by FLIE was reported by 44.7% of aprepitant therapy patients and 24.0% of standard therapy patients (P=0.035). The main aprepitant-related AEs were fatigue and constipation, but there was no significant difference between groups.ConclusionCombined aprepitant therapy is recommended for the prevention of multiple-day CINV because of its improved CINV control rate and safety.

For more than 50 years, pharmacotherapy for major depressive disorder (MDD) has narrowly focused on enhancing monoaminergic neurotransmission resulting in more than 30 FDA-approved treatments. In contrast, the glutamatergic, non-competitive Nmethyl d-aspartate (NMDA) receptor antagonist ketamine has been "repurposed" as a rapid acting antidepressant 1 ; the enantiomer S-ketamine, or esketamine, is now FDA-approved for treatment-resistant unipolar depression (TRD). These drugs have fundamentally changed the landscape of community-based practice for TRD. A growing number of psychiatrists, anesthesiologists, Certified Registered Nurse Anesthetists, and sometimes even emergency department physicians, are providing off-label infusions to patients for a wide range of diagnoses including bipolar depression, posttraumatic stress disorder, obsessive-compulsive disorder (OCD), chronic pain, cocaine dependency, and suicidality.Poorly monitored use of this medication for varied indications and in unusual dosing schedules and formulations is increasing, given the wide availability of ketamine and esketamine. 2,3 We present a case of high-dose ketamine associated with the development of hypomania in a patient with Bipolar II disorder (BPII), emphasizing the importance of the appropriate use of ketamine and the risk of treatment-emergent mania.