OBJECTIVE Major depressive disorder(MDD) is a highly heterogeneous mental illness.Further classification may help characterize its heterogeneity.The purpose of this study was to examine metabolomic and brain connectom...OBJECTIVE Major depressive disorder(MDD) is a highly heterogeneous mental illness.Further classification may help characterize its heterogeneity.The purpose of this study was to examine metabolomic and brain connectomic associations with traditional Chinese medicine(TCM) diagnostic classification of MDD.METHODS Fifty unmedicated depressed patients were classified into Liver Qi Stagnation(LQS,n=30) and Heart and Spleen Deficiency(HSD,n=20) subtypes according to TCM diagnosis.Healthy volunteers(n=28) were included as controls.Gas chromatography-mass spectrometry(GC-MS) and diffusion tensor imaging were used to detect serum and urinary metabolomic profiles and whole-brain white matter connectivity,respectively.RESULTS In metabolomic analysis,28 metabolites were identified for good separations between TCM subtypes and healthy controls in serum and urine samples.While both TCM subtypes had similar profiles in proteinogenic branched-chain amino acids and energy metabolism-related metabolites that were differentiated from healthy controls,the LQS subtype additionally differed from healthy controls in multiple amino acid metabolites that are involved in the biosynthesis of monoamine and amino acid neurotransmitters.Several metabolites are differentially associated with the two subtypes.In connectomic analysis,The LQS subtype showed significant differences in multiple network metrics of the angular gyrus,middle occipital gyrus,calcarine sulcus,and Heschl′ s gyrus when compared to the other two groups.The HSD subtype had markedly greater regional connectivity of the insula,parahippocampal gyrus,and posterior cingulate gyrus than the other two groups,and microstructural abnormalities of the frontal medial orbital gyrus and middle temporal pole.The insular betweenness centrality was strongly inversely correlated with the severity of depression and dichotomized the two subtypes at the optimal cutoff value with acceptable sensitivity and specificity.CONCLUSION The LQS subtype may represent an MDD subpopulation mainly characterized by abnormalities in the biosynthesis of monoamine and amino acid neurotransmitters,closer associations with stress-related pathophysiology,and aberrant connectivity of the audiovisual perception-related temporal-occipital network,whereas the HSD subtype is more closely associated with hyperconnectivity and microstructural abnormalities of the limbicparalimbic network.Certain metabolomic and connectomic variables are potential biomarkers for TCM diagnostic subtypes which is perhaps an alternative classification for depressive disorders.展开更多
Background:Chemotherapy-induced cognitive impairment,also known as“chemobrain,”is a common side effect.Over the past five years,we have conducted a series of studies to explore its pathophysiological mechanisms and ...Background:Chemotherapy-induced cognitive impairment,also known as“chemobrain,”is a common side effect.Over the past five years,we have conducted a series of studies to explore its pathophysiological mechanisms and the effects of the two natural compounds,resveratrol and ginsenoside Rg1,in preventing chemobrain in animal models.We also have completed a clinical trial evaluating the efficacy of acupuncture prevention of chemobrain in breast cancer patients undergoing chemotherapy.Methods:for animal studies,a mouse model of chemobrain was developed with three injections of docetaxel,adriamycin,and cyclophosphamide(DAC)in combination at a 2-day interval.Resveratrol or Rg1 was given one week prior to DAC regimen for three weeks.Behavioral paradigms,in vivo neuroimaging,cytokine and molecular examinations were used to detect the effects of DAC and natural compounds.In a randomised controlled trial,60 breast cancer patients who were undergoing chemotherapy were randomly assigned to comprehensive acupuncture treatment(CAT,n=30)and control treatment with least acupuncture stimulation(LAS,n=30)for 2 sessions per week for 8 weeks.Cognitive performance was assessed using the Montreal Cognitive Assessment(MoCA)at baseline and once biweekly thereafter.Results:①Animal model:Cotreatment with both natural compounds significantly improved chemobrain-like behavior in water maze test.In vivo neuroimaging revealed that natural compounds reversed DAC-induced decreases in prefrontal and hippocampal neuronal activity and ameliorated cortical neuronal dendritic spine elimination.They normalized DAC-caused abnormalities in the expression of multiple neuroplasticity biomarkers in the two brain regions.Resveratrol and Rg1 suppressed DAC-induced elevation of the proinflammatory cytokines tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6),but increased levels of the anti-inflammatory cytokines IL-4 and IL-10 in multiple sera and brain tissues.They also modulated cytokine mediators and inhibited DAC-induced microglial polarization from M2 to M1 phenotypes.②Clinical trial:CAT-treated patients had significantly or marginal significantly greater improvement on total score on MoCA,score on attention and delayed recall subscale than LAS group at multiple assessment points.Conclusions:Resveratrol and Rg1 exert their antichemobrain effects in an association with the inhibition of neuroinflammation by modulating microglia-mediated cytokines and the related upstream mediators,protecting neuronal activity and promoting neuroplasticity in particular brain regions associated with cognition processing.Acupuncture therapy may be an effective intervention in preventing and ameliorating展开更多
Objective: To evaluate the efficacy and safety of essential oil treatment for type Ⅲ chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS). Methods: A randomized controlled trial was conducted from December 2014 ...Objective: To evaluate the efficacy and safety of essential oil treatment for type Ⅲ chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS). Methods: A randomized controlled trial was conducted from December 2014 to October 2015. Seventy type Ⅲ CP/CPPS patients were assigned to the essential oil group(35 cases) or almond placebo oil control group(35 cases) by a random number table. The oil was smeared by self-massage on the suprapubic and sacral region once a day for 4 weeks. The National Institutes of Health Chronic Prostatitis Syndrome Index(NIH-CPSI) and expressed prostatic secretions(EPS) were examined. The primary outcome was NIH-CPSI pain domain. The secondary outcomes included other NIH-CPSI domains and laboratory examinations of EPS. Adverse events were also observed. Results: Sixty-six subjects completed the full 4-week treatment. There was no significant difference between almond oil control and essential oil groups in terms of the total score of NIH-CPSI, pain, quality of life and urination domain scores of NIH-CPSI and EPS examinations(P>0.05). In the essential oil group, pain between rectum and testicles(perineum) in the domain of pain or discomfort was significantly reduced at week 2 and week 4 compared with almond oil control group(P<0.01). No serious adverse events occurred. Conclusion: The essential oil may reduce the pain or discomfort in the perineum region in patients with CP/CPPS.展开更多
基金National Natural Science Foundation of China(81403502)General Research Fund ofResearch Grants Council of Hong Kong (17124418).
文摘OBJECTIVE Major depressive disorder(MDD) is a highly heterogeneous mental illness.Further classification may help characterize its heterogeneity.The purpose of this study was to examine metabolomic and brain connectomic associations with traditional Chinese medicine(TCM) diagnostic classification of MDD.METHODS Fifty unmedicated depressed patients were classified into Liver Qi Stagnation(LQS,n=30) and Heart and Spleen Deficiency(HSD,n=20) subtypes according to TCM diagnosis.Healthy volunteers(n=28) were included as controls.Gas chromatography-mass spectrometry(GC-MS) and diffusion tensor imaging were used to detect serum and urinary metabolomic profiles and whole-brain white matter connectivity,respectively.RESULTS In metabolomic analysis,28 metabolites were identified for good separations between TCM subtypes and healthy controls in serum and urine samples.While both TCM subtypes had similar profiles in proteinogenic branched-chain amino acids and energy metabolism-related metabolites that were differentiated from healthy controls,the LQS subtype additionally differed from healthy controls in multiple amino acid metabolites that are involved in the biosynthesis of monoamine and amino acid neurotransmitters.Several metabolites are differentially associated with the two subtypes.In connectomic analysis,The LQS subtype showed significant differences in multiple network metrics of the angular gyrus,middle occipital gyrus,calcarine sulcus,and Heschl′ s gyrus when compared to the other two groups.The HSD subtype had markedly greater regional connectivity of the insula,parahippocampal gyrus,and posterior cingulate gyrus than the other two groups,and microstructural abnormalities of the frontal medial orbital gyrus and middle temporal pole.The insular betweenness centrality was strongly inversely correlated with the severity of depression and dichotomized the two subtypes at the optimal cutoff value with acceptable sensitivity and specificity.CONCLUSION The LQS subtype may represent an MDD subpopulation mainly characterized by abnormalities in the biosynthesis of monoamine and amino acid neurotransmitters,closer associations with stress-related pathophysiology,and aberrant connectivity of the audiovisual perception-related temporal-occipital network,whereas the HSD subtype is more closely associated with hyperconnectivity and microstructural abnormalities of the limbicparalimbic network.Certain metabolomic and connectomic variables are potential biomarkers for TCM diagnostic subtypes which is perhaps an alternative classification for depressive disorders.
文摘Background:Chemotherapy-induced cognitive impairment,also known as“chemobrain,”is a common side effect.Over the past five years,we have conducted a series of studies to explore its pathophysiological mechanisms and the effects of the two natural compounds,resveratrol and ginsenoside Rg1,in preventing chemobrain in animal models.We also have completed a clinical trial evaluating the efficacy of acupuncture prevention of chemobrain in breast cancer patients undergoing chemotherapy.Methods:for animal studies,a mouse model of chemobrain was developed with three injections of docetaxel,adriamycin,and cyclophosphamide(DAC)in combination at a 2-day interval.Resveratrol or Rg1 was given one week prior to DAC regimen for three weeks.Behavioral paradigms,in vivo neuroimaging,cytokine and molecular examinations were used to detect the effects of DAC and natural compounds.In a randomised controlled trial,60 breast cancer patients who were undergoing chemotherapy were randomly assigned to comprehensive acupuncture treatment(CAT,n=30)and control treatment with least acupuncture stimulation(LAS,n=30)for 2 sessions per week for 8 weeks.Cognitive performance was assessed using the Montreal Cognitive Assessment(MoCA)at baseline and once biweekly thereafter.Results:①Animal model:Cotreatment with both natural compounds significantly improved chemobrain-like behavior in water maze test.In vivo neuroimaging revealed that natural compounds reversed DAC-induced decreases in prefrontal and hippocampal neuronal activity and ameliorated cortical neuronal dendritic spine elimination.They normalized DAC-caused abnormalities in the expression of multiple neuroplasticity biomarkers in the two brain regions.Resveratrol and Rg1 suppressed DAC-induced elevation of the proinflammatory cytokines tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6),but increased levels of the anti-inflammatory cytokines IL-4 and IL-10 in multiple sera and brain tissues.They also modulated cytokine mediators and inhibited DAC-induced microglial polarization from M2 to M1 phenotypes.②Clinical trial:CAT-treated patients had significantly or marginal significantly greater improvement on total score on MoCA,score on attention and delayed recall subscale than LAS group at multiple assessment points.Conclusions:Resveratrol and Rg1 exert their antichemobrain effects in an association with the inhibition of neuroinflammation by modulating microglia-mediated cytokines and the related upstream mediators,protecting neuronal activity and promoting neuroplasticity in particular brain regions associated with cognition processing.Acupuncture therapy may be an effective intervention in preventing and ameliorating
文摘Objective: To evaluate the efficacy and safety of essential oil treatment for type Ⅲ chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS). Methods: A randomized controlled trial was conducted from December 2014 to October 2015. Seventy type Ⅲ CP/CPPS patients were assigned to the essential oil group(35 cases) or almond placebo oil control group(35 cases) by a random number table. The oil was smeared by self-massage on the suprapubic and sacral region once a day for 4 weeks. The National Institutes of Health Chronic Prostatitis Syndrome Index(NIH-CPSI) and expressed prostatic secretions(EPS) were examined. The primary outcome was NIH-CPSI pain domain. The secondary outcomes included other NIH-CPSI domains and laboratory examinations of EPS. Adverse events were also observed. Results: Sixty-six subjects completed the full 4-week treatment. There was no significant difference between almond oil control and essential oil groups in terms of the total score of NIH-CPSI, pain, quality of life and urination domain scores of NIH-CPSI and EPS examinations(P>0.05). In the essential oil group, pain between rectum and testicles(perineum) in the domain of pain or discomfort was significantly reduced at week 2 and week 4 compared with almond oil control group(P<0.01). No serious adverse events occurred. Conclusion: The essential oil may reduce the pain or discomfort in the perineum region in patients with CP/CPPS.
