Background: Factors related to medication adherence in patients with schizophrenia have always been key to the treatment and rehabilitation of these patients. However, the treatment modes in different countries are not the same, and there is no research on the factors influencing medication adherence under different mental health service modes. Objectives: The purpose of this study was to explore medication adherence and its influencing factors in patients with schizophrenia in the Chinese institutional environment. Methods: We conducted a cross-sectional study of hospitalized persons living with schizophrenia from November 2018 to January 2019. A systematic sampling method was used to select 217 hospitalized persons living with schizophrenia. The Medication Adherence Rating Scale (MARS), Positive and Negative Syndrome Scale (PANSS), General Self-Efficacy Scale (GSES), Schizophrenia Quality of Life Scale (SQLS), and Scale of Social Skills for Psychiatric Inpatients (SSPI) were used to explore medication compliance and its influencing factors in the Chinese institutional environment. Results: The descriptive analysis and ANOVA showed that there were no significant differences in medication adherence when assessed by demographic characteristics such as sex, marital status, and education level (p > 0.05). A correlation analysis showed that there was no significant correlation between medication adherence and mental symptoms (p > 0.05) but that there was a positive correlation with self-efficacy, quality of life, and activities of daily living (p < 0.01). The linear regression analysis showed that self-efficacy, psychosocial factors, symptoms/side effects, and activities of daily living had significant effects on medication adherence (F = 30.210, p < 0.001). Conclusions: Our findings show that the self-efficacy, quality of life, and social function of patients with schizophrenia are important self-factors influencing medication adherence in the Chinese institutional environment.

To investigate the correlation between hypertension development and the progression of mild cognitive impairment (MCI) to dementia in middle-aged and elderly people. A population-based longitudinal cognition survey of people aged 55+ was conducted. The hypertension onset age was estimated by self-reported information and medical insurance card records. To study the effect of later-onset hypertension on dementia, the incidence of dementia was compared between the two groups. Of 277 hypertensive MCI participants without dementia, 56 (20.22%) progressed to dementia (MCIp) over the 6-year follow-up. The proportion of MCIp participants in the old-age-onset hypertension group (≥65 years) was higher than that in the middle-age-onset hypertension group (27.0 vs. 15.4%, respectively; X² = 5.538, P = 0.019). In the old-age-onset hypertension group, the proportion of MCIp without diabetes mellitus was higher than those with diabetes mellitus (24.7 vs. 12.6%, respectively; X² = 5.321, P = 0.021) and those with increased pulse pressure was higher than those without increased pulse pressure (33.3 vs. 15.4%, respectively; X² = 3.902, P = 0.048). However, the cox proportional hazard showed that older age was the only risk factor for MCIp (HR = 0.618, p = 0.000). These results suggest that individuals with later-onset hypertension may have greater cognition decline, even with blood pressure maintained at 130/80 mmHg with antihypertensive management.

Objectives. In this study, we aimed to conduct a 6‐year follow‐up and acquire a large sample dataset to analyze the most important demographic factors and cognitive function scale variables associated with mild cognitive impairment (MCI) progression for an elderly cohort (age ≥ 60 years old). Patients and Methods. We analyzed the subjects who had participated in a survey in 2011 and were successfully contacted in the later survey in 2017. For each subject, the basic demographic information was recorded, including sex, age, education level, marital status, working status, income level, and physical mental illness history. Cognitive assessments were performed using the following scales if possible: (1) the mini‐mental state examination (MMSE) scale, (2) Montreal cognitive assessment (MoCA), (3) the clinical dementia rating (CDR) scale, and (4) Hamilton Depression Scale (HAMD‐17). Results. The progression outcomes were different between sexes, among age brackets, education degrees, occupations types, and income levels; different progression groups had distinct children numbers (p < 0.001), heights (p < 0.05), and body weights (p < 0.01); the positive ends six years later were positively related to better performance in the MoCA and MMSE scales (progressed vs stable p < 0.01). Moreover, we constructed some indicators using age, MoCA, and MMSE scores, which showed an efficiency in predicting the progression outcomes. Conclusions. In conclusion, the MCI progression outcomes were associated with sex, age, education degrees, occupations types, income level, children number, height, and weight. MoCA and MMSE scales are supporting tools to predict the progression outcomes, especially combined with the demographic data.

Objective: To explore potential molecular mechanisms and novel biomarkers of mild cognitive impairment (MCI) and Alzheimer’s disease (AD). Methods: The mRNA expression datasets GSE63060 and GSE63061 and the miRNA expression dataset GSE120584 were obtained from the Gene Expression Omnibus database. The differentially expressed genes (DEGs) and miRNA (DEmiRs) were identified in the normal, MCI, and AD groups. Mfuzz clustering and weighted correlation network analyses (WGCNA) were conducted, followed by pathway and functional enrichment analyses and miRNA-mRNA network construction. Furthermore, phenotypic correlation analysis and experimental verification were performed on key DEGs and DEmiRs. Results: In total, 3,000 intersected DEGs from GSE63060/GSE63061 and 817 DEmiRs from GSE120584 were obtained. Mfuzz and WGCNA analyses revealed 106 DEGs including ribosomal protein L11 (RPL11) and 28 DEmiRs including miR-6764-5p. These DEGs and DEmiRs were mainly enriched in pathways like Ribosome. Moreover, 5 key DEGs including cytohesin 4 (CYTH4) and 6 crucial DEmiRs including miR-6734-3p were identified by miRNA–mRNA interaction network analysis. Phenotypic correlation analysis showed that CYTH4 and miR-6734-3p were correlated with patients’ age. The results of quantitative polymerase chain reaction analysis confirmed that RPL11 expression was significantly downregulated in the MCI and AD groups compared to that in the normal group, while the expression of CYTH4, miR-6764-5p, and miR-6734-3p was remarkably upregulated in the MCI and AD groups. Conclusions: miR-6764-5p might contribute to MCI and AD by targeting RPL11 in the ribosome pathway. Therefore, miR-6734-3p and its target mRNA CYTH4 might be used as novel biomarkers for MCI and AD.

SUMMARY : Aim: The serotonin selective reuptake inhibitor fluoxetine (Flx) has tried to treat patients suffered acute ischemic stroke because of its possible neuroprotective actions. However, besides the neuroprotective effect, Flx at high concentration also induces some actions in contradiction to neuroprotection in the brain. The purpose of this study was to investigate whether Flx presents neuroprotective effect against 3‐nitropropionic acid (3‐NP)‐induced hypoxic brain injury, and what is the most suitable dosage of Flx.Methods: Mouse model was established by subacute systemic administration of 3‐NP. Rotarod and pole tests were used to evaluate motor deficit. The oxidative stress and oxidative DNA damage were assessed respectively by measuring malondialdehyde and 8‐hydroxydeoxyguanosine content in brain homogenates.Results: According to measurements in the rotarod test, 7 days pretreatment plus 5 days treatment of Flx at low (2.5 mg/kg/day) and, to a lesser degree, medium (5 mg/kg/day) doses exerted a rapid and strong protection against the neurotoxicity induced by 3‐NP, whereas Flx at high dose (10mg/kg/day) showed a much late and light effect. Similarly, in the pole test, Flx at 2.5 mg/kg/day had the strongest protective effects. Again, only Flx administration at 2.5 mg/kg/day canceled out the enhancement of malondialdehyde and 8‐hydroxydeoxyguanosine in striatum following 3‐NP neurotoxication.Conclusions: Flx attenuated the motor deficits induced by 3‐NP in a dose‐dependent manner. In contrary to the high dose, Flx at the lower doses had a more remarkable effect against 3‐NP insult, similar to acute ischemic stroke.

Background: Recently, the community rehabilitation model for schizophrenia patients has become increasingly popular, and the Shanghai Pudong New Area has developed a relatively complete community rehabilitation model. This study analyzed the correlation between family function and subjective quality of life in the rehabilitation of patients living with schizophrenia in the community. Methods: This study evaluated persons living with schizophrenia using the Family Assessment Device and the Subjective Quality of Life Scale. A convenient sampling method was used to select 281 rehabilitation patients living with schizophrenia in the community and 166 hospitalized persons living with schizophrenia. Results: There was a significant difference in the Family Assessment Device scores between rehabilitation patients living with schizophrenia in the community and hospitalized persons living with schizophrenia (p < 0.0001). The difference in the scores of the subjective quality of life assessment between rehabilitation patients living with schizophrenia in the community and hospitalized persons living with schizophrenia was not statistically significant (p > 0.05). The regression analysis showed that quality of family function had a significant effect on the subjective quality of life in rehabilitation patients living with schizophrenia in the community and hospitalized persons living with schizophrenia. (F = 10.770 p < 0.001), (F = 2.960 p < 0.01). Conclusions: The quality of family function plays an important role in improving the subjective quality of life in rehabilitation patients living with schizophrenia in the community. It may be beneficial to add some methods to improve family function in the current model of rehabilitation in the community.