We continuously selected 156 patients who were first diagnosed with schizophrenia at the Bethune International Peace Hospital of PLA (Clinical Branch no. 256, Hebei, China) from January 2013 to January 2016, in line with the diagnostic criteria for schizophrenia in the tenth edition of the International Classification of Diseases. We eliminated those with severe underlying diseases such as hypertension, diabetes, cardiovascular and cerebrovascular disease, liver and kidney dysfunction, autoimmune diseases, pregnant and lactating women who did not tolerate anti-psychotic drugs and NC-ECT treatment, those that voluntarily dropped out of the study or were involved in other studies, as well as any individuals with unhealthy clinical data. The present study was approved by the ethics committee of the Bethune International Peace Hospital of PLA, patients or their families. According to their treatments, they were divided into drug group (70 cases) and drug combined with MECT group (combined group). In addition, 70 cases of healthy volunteers (control group) were selected according to the closest matching method based on 1:1 of age and gender; abd 86 cases according to age and gender 1:1 the closest matching method in 70 cases of healthy volunteers (control group). The drug group was composed of 33 male patients and 37 female patients, aged from 45 to 73 years. Their average age was 60.5±14.2 years; the duration of disease was 1–13 months, and the average was 5.6±2.4 months. There were 36 cases mainly with positive symptoms, and 34 cases of negative symptoms. The combined group consisted of 42 male patients and 44 female patients aged from 43 to 75 years. Their average age was 62.2±15.6 years. The course of disease was 2–16 months, and the average was 6.0±2.8 months. There were 40 cases with positive symptoms and 46 cases of negative symptoms. In the control group, there were 32 males and 38 females, aged from 42 to 77 years. Their average age was 63.3±16.3 years. The data collected from different groups were comparable.

Drug treatment consisted of anti-psychotic drugs, such as risperidone 2–8, quetiapine 300–750, ziprasidone 80–160 or aripiprazole 10–30 mg/day; for the control group, we used the electric spasm therapeutic instrument, Thymatron^®IV Systems (Somatics, LLC, Venice, FL, USA) and DGX mode, firstly placing electrodes on double temporal region of the patients and giving them intravenous anesthesia and neuromuscular blockade according to the weight of patients and the standard of etomidate fat emulsion 0.15 mg/kg of their weight. After anesthesia was completed, limb fasciculation disappeared, muscles were loosened, and the treatment began. The treatment was administered up to 6 times, 3 times a week.

ELISA method was used to detect the levels of IL-1, IL-4, IL-6 and IL-10 before and after the treatment. We drew 5 ml blood of peripheral elbow following fasting, the blood was centrifuged for 10 min at the speed of 3,000 r/min and preserved at −20°C. We used the kits produced by Shanghai Chen Yi Biological Technology Co., Ltd., and RT-6100 type enzyme standard analyzer of Rayto Life and Analytical Sciences Co., Ltd. (Nanshan, Shenzhen, China) in strict accordance with the advise given in the kits.

The positive and negative symptom scale (PANSS) was used to evaluate the effect, including the total score of PANSS, the reduction rate and the effective rate. The reduction rate was indicated as: >75% indicated complete remission, 50–75% significant improvement, 25–50% improvement, and <25% invalid. PANSS had 30 items including positive scale of 7 items (P1-P7), negative scale of 7 items (N1-N7), and general psychopathology table of 16 items (G1-G16). All the items were assessed in the mode of 7 levels from 1 to 7. The α coefficients of each scale varied from 0.83 to 0.73, the split half reliability was 0.80, and the re-test reliability index varied from 0.77 to 0.89.

The statistics analysis was made by SPSS 20.0 software (SPSS, Inc., Chicago, IL, USA), measurement data are expressed as mean ± standard deviation, single factor ANOVA analysis was used in the comparisons between different groups, paired t test was used in inter-comparison; The data were expressed as percentage, the comparison between groups were tested by χ², ranked data were compared by the rank sum test. The Pearson test was used for the related analysis of measurement. P<0.05 was considered to indicate a statistically significant difference.

Before treatment, IL-1 and IL-6 levels of the drug group and combined group were significantly higher than those of the control group, and the differences had statistical significance (P<0.05); compared with the control group, where the differences of IL-4 and IL-10 had no statistical significance. The difference of each factor of the drug and combined groups had no statistical significance. The differences of IL-6, IL-10 and IL-1 of the drug group before treatment and after treatment had no statistical significance while IL-4 significantly increased. The differences of IL-1 and IL-10 levels of the combined group were not statistically significant compared to those before treatment while IL-4 and IL-6 were significantly increased. The difference of each factor of the control group before and after treatment had no statistical significance. After treatment, IL-1, IL-4 and IL-6 of the drug and combined groups were significantly higher than those in the control group, and the differences had statistical significance (P<0.05). The difference of IL-10 compared with the control group was not statistically significant. IL-1, IL-4 and IL-6 levels of the combined group were significantly higher than those of the drug group, and the differences had statistical significance (P<0.05) (Table I).

After comparing the PANSS scores of the two groups before treatment, the difference was not statistically significant. PANSS scores of the two groups after treatment decreased, the combined group decreased more significantly, and the difference had statistical significance (P<0.05). The reduction rate of the combined group was significantly higher than that of the drug group, and the difference was statistically significant (P<0.05) (Table II). The total effective rate of the combined group was significantly higher than that of the drug group, and was statistically significant (P<0.05) (Table III).

IL-1, IL-4, IL-6 and IL-10 levels of the drug and combined groups had no correlation with the PANSS score before treatment and the variation of IL-1, IL-4, IL-6 and IL-10 of the drug and combined groups had no correlation with the reduction rate of the PANSS.