Self-Frustration of Expectations in Major Depressive Disorder: The Syncytiopathy Hypothesis of Depression Revisited

This paper is a further elaboration of my model of the pathophysiology of major depressive disorder focusing on imbalances of glial-neuronal interactions in tripartite synapses and the glial network (syncytium). Basically, it is proposed that the connexin proteins building gap junctions in the glial syncytium are underexpressed or dysfunctional in major depression, called syncytiopathy. As a compensatory effect the astrocytic receptors in tripartite synapses are overexpressed. This leads to protracted synaptic information processing because of a relative lack of neurotransmitter substances for the occupancy of astrocytic receptors. Based on a new biophysical formal description of astrocytic receptors as expectation variables it can be shown that the protracted processing of sensory information frustrate the full comprehension of the expected event, since it cannot be grasped in time. Moreover, expectation frustration may stress the glial syncytium aggravating memory impairment. This cyclic process of dysbalanced synaptic information processing is characterized as self-frustration of expectations explanatory for the main cognitive dysfunctions in major depression as slowing down processing speed, deficits in attention and working memory. The main result of the study is that patients with major depression cannot fully acknowledge the existence of an intended event.

Phase Ⅱ study of protracted irinotecan infusion and a low-dose cisplatin for metastatic gastric cancer

AIM: To test protracted irinotecan infusion plus a low-dose cisplatin in this Phase Ⅱ trial to decrease its toxic-ity. METHODS: The eligibility criteria were: (1) histologi-cally proven measurable gastric cancer; (2) performance status of 0 or 1; (3) no prior chemotherapy or comple-tion of prior therapy at least 4 wk before enrollment; (4) adequate function of major organs; (5) no other active malignancy; and (6) written informed consent. The regi-men consisted of irinotecan (60 mg/m2) on d 1 and 15 by 24-h infusion and cisplatin (10 mg/m2) on d 1, 2, 3, 15, 16, and 17. Treatment was repeated every 4 wk. RESULTS: Thirty-one patients were registered between April 2000 and January 2001. The response rate for all 31 patients, 20 patients without prior chemotherapy, and 11 patients with prior chemotherapy was 52% (16/31), 60% (12/20), and 36% (4/11), respectively. The median survival time was 378 d. The median number of courses given to all patients was 2. Grade 4 neutropenia oc-curred in 11 (35%) patients, while grade 3 to 4 diarrhea or nausea occurred in 1 (3%) and 3 (10%) patients, respectively. Fatigue was minimal as grade 1 fatigue was found only in 3 (10%) patients. Other adverse events were mild and no treatment-related deaths occurred.CONCLUSION: This regimen showed a high level of ac-tivity and acceptable toxicity in patients with metastatic gastric cancer.

The bonding bite plate combined with the face mask protracting maxilla to treat skeletal crossbite in the early mixed dentition

Objective： To evaluate the orthopedic effects of a new method to treat skeletal crossbite in the early mixed dentition. Methods ：Twenty cases （5.8-7. 5 years old ） with skeletal crossbite were treated by bonding the bite plate combined with the face mask protracting the upper jaw. Cephalometric radiographs were taken and analyzed before and after treatments. Results： On average, in all 20 cases the maxilla was moved by 2.06 mm forwards the mandible was turned 2.45° downward and backwards the skeletal crossbites were corrected and the facial profiles were improved satisfactorily. The period of treatment was conducted for 1.7 months on average. Conclusion： A good effect can be achieved by bonding bite plate combined with the face mask protracting the upper jaw to treat skeletal crossbite in the early mixed dentition, which will benefit the craniofacial growth and the development of young children.

Protracted Adjuvant Temozolomide in Glioblastoma Multiforme

Purpose: Radiotherapy with concurrent temozolomide (TMZ), followed by 6 cycles of adjuvant TMZ, is the standard of care for newly diagnosed Glioblastoma Mulltiforme (GBM). However tumor progression is the role with median survival of almost 14 months. With lack of effective second line chemotherapy, many physicians and some guidelines advocate prolonged use of adjuvant TMZ more than 6 months. We conduct this study to test the efficacy of protracted adjuvant conventional dose TMZ over the standard 6 doses of adjuvant TMZ. Material and Methods: This phase II trial enrolled patients newly diagnosed as GBM, older than age 18 years, with a Karnofsky performance score (KPS) of ≥60, Neurological Performance Scale (NPS) of ≤3. Patients were randomly assigned to the standard concurrent chemoradiotherapy (CCRT) followed by 6 cycles of adjuvant TMZ or the same treatment with more than 6 cycles of adjuvant chemotherapy extended as long as the patient in good performance, with no unacceptable toxicity, no signs of disease progression. The primary end point was OS. Results: A total of 59 patients were recruited in the study and were randomized in two arms. 29 patients joined arm 1 aiming at receiving CCRT followed by adjuvant 6 cycles TMZ (6 cycles arm) and 30 joined arm 2 aiming at receiving the same treatment with more than 6 cycles of TMZ (>6 cycles). 16 patients managed to complete the adjuvant 6 cycles in arm 1. 19 patients in arm 2, completed the 6 cycles with additive more doses with a median of 11 cycles (range: 8 - 23 cycles). Median PFS was 12.1 months for (6 cycles) arm, and 18.8 months for (>6 cycles) arm, HR 0.88 (95% CI: 1.185 - 4.901) (P 0.015);the overall survival for (6 cycles) arm was 18.1 months, versus 24.1 months, HR 0.70 (95% CI: 1.007 - 4.037) (P 0.048). No significant added toxicity was notice and the 4 weekly TMZ was well tolerated. Conclusion: This study concluded that protracted adjuvant TMZ after concurrent chemoradiotherapy could be a feasible strategy for GBM. This strategy warrants a large phase III randomized trial.

Study on the feasibility of five tones combined with electric acupuncture therapy for drug rehabilitation

Objective:To explore the feasibility of five tones combined with electro-acupuncture for drug rehabilitation.Methods:Search and screen the literature related to drug rehabilitation with musical electrico-acupuncture in PubMed,CNKI,CQVIP and Wanfang data to May 2019,and summarize and analyze the literature.Results:Either music therapy or acupuncture therapy has therapeutic responses respectively,and the combined use of both is more effective than the single-use.Conclusion:The combination of five tones and acupuncture is highly feasible for drug rehabilitation.

Peace and Reconstruction in Afghanistan: An Arduous and Protracted Task

Since early this year, the situation in Afghanistan has been turbulent with operations of the Taliban becoming more

Unravelling the protracted U-Pb zircon geochronological record of high to ultrahigh temperature metamorphic rocks:Implications for provenance investigations

The assessment of detrital zircon age records is a key method in basin analysis,but it is prone to several biases that may compromise accurate sedimentary provenance investigations.High to ultrahigh temperature(HT-UHT)metamorphism(especially if T>850℃)is herein presented as a natural cause of bias in provenance studies based on U-Pb detrital zircon ages,since zircon from rocks submitted to these extreme and often prolonged conditions frequently yield protracted,apparently concordant,geochronological records.Such age spreading can result from disturbance of the primary U-Pb zircon system,likewise from(re)crystallization processes during multiple and/or prolonged metamorphic events.In this contribution,available geochronological data on Archean,Neoproterozoic and Palaeozoic HT-UHT metamorphic rocks,acquired by different techniques(SIMS and LA-ICP-MS)and showing distinct compositions,are reassessed to demonstrate HT-UHT metamorphism may result in modes and age distributions of unclear geological meaning.As a consequence,it may induce misinterpretations on UPb detrital zircon provenance analyses,particularly in sedimentary rocks metamorphosed under such extreme temperature conditions.To evaluate the presence of HT-UHT metamorphism-related bias in the detrital zircon record,we suggest a workflow for data acquisition and interpretation,combining a multi-proxy approach with:(i)in situ U-Pb dating coupled with Hf analyses to retrieve the isotopic composition of the sources,and(ii)the integration of a petrochronological investigation to typify fingerprints of the HT-UHT metamorphic event.The proposed workflow is validated in the investigation of one theoretical and one natural example allowing a better characterization of the sedimentary sources,maximum depositional ages,and the tectonic setting of the basin.Our workflow allows to the appraisal of biases imposed by HT-UHT metamorphism and resulting disturbances in the U-Pb detrital zircon record,particularly for sedimentary rocks that underwent HT-UHT metamorphism and,finally,suggests ways to overcome these issues.

Facemask therapy with miniplate implant anchorage in a patient with maxillary hypoplasia

A reverse headgear is thought to be an effective .treatment approach for skeletal class Ⅲ malocclusion with retruded maxilla. Clinical studies have shown that the changes of occlusion are a combination of skeletal and dental changes： forward movement of the maxilla, proclination of the maxillary incisors, clockwise rotation of the mandible, and retroclination of the mandibular incisors. However, the undesirable dental effects, such as excessive mesial movement and extrusion of maxillary molars and labial tipping of maxillary incisors, have been reported. Most of previous studies have demonstrated that the best time for maxillary protraction is early mixed dentition. The skeletal effect decreases and the dental effect increases with age. So there is a need for an absolute stable anchorage for maxillary orthopedics to produce more skeletal change and less dental movement.

Escitalopram with or without combined electroacupuncture on protracted alcohol withdrawal symptoms(PAWS)among male inpatients with alcohol dependence

Objective:This study is conducted to investigate the effects differences of escitalopram with or without combined electroacupuncture(EA)among male inpatients with a diagnosis of alcohol dependence and comorbid protracted alcohol withdrawal symptoms(PAWS).Methods:A total of 62 participants who met the inclusion criteria were enrolled in a two-arm randomized,placebo controlled,patients-blind trial and allocated to an escitalopram with real-EA group(realEA group,patients=31)and an escitalopram with sham-EA group(sham-EA group,patients=31),respectively.In addition to the oral administration of escitalopram for total four weeks,patients in each group received corresponding EA treatment five days per week and two days off for consecutive four weeks.Both serum homocysteine(Hcy)test and electrophysiological tests,including event-related potentials(ERPs)and exploratory eye movement(EEM)were performed at pre-and post-treatment.Additionally,the global scores of Penn Alcohol Craving Scale(PACS),17-items Hamilton Depression Rating Scale(HAMD-17),and Hamilton Anxiety Scale(HAMA)were used for assessing the subjective emotion experience of patients,respectively.Meanwhile,adverse effects were monitored and recorded.Results:After four-week treatment,the global scores of PACS and HAMD-17 declined significantly in both groups(both P<0.05).Furthermore,the decline in the real-EA group was superior to that in the shamEA group(P<0.05).Meanwhile,the total scores of HAMA only decreased in the real-EA group(P<0.05)but not in the sham-EA group(P>0.05).According to the parameters of ERPs,significant declines for N2PL,P3PL,and P3amp were observed in both two groups(all P<0.05),and the decreases for P3PL and P3amp in the real-EA group was much superior to that in the sham-EA group(both P<0.05).According to the parameters of EEM,significant increase for NEF was observed only in the real-EA group(P<0.05).Besides,there was a dramatic decline for serum Hcy level only in the real-EA group(P<0.05).One case in the sham-EA group withdrew from the trial due to self-reported nausea and bitter taste,and outcomes of the remaining 61 patients were adopted for analysis.Conclusion:(1)Escitalopram with EA may be a potential alternative therapy for mitigating PAWS among male inpatients with alcohol dependence.(2)Escitalopram with EA might improve the alcoholdependence induced cognitive dysfunctions via upregulating the expression of Hcy.

A Case of Intoxication Caused by Aciclovir Overinfusion and Cured by Chinese Medicine

The therapeutic course of an aciclovir-induced acute renal dysfunctional patients was summarized. This had been relieved through a 15-day treatment with Western medicine but with a two-week protracted low fever that was cured by the authors using Chinese medicinal herbs for supplementing qi to support essence, nourishing yin to depress fire, clearing heat, and detoxicating. For the sake of providing a reference to clinical medication, the materials used for the disease were recorded and analyzed to explore the clinical characteristics of Chinese medicine treatment and prevention of anaphylaxis responses, such as the protracted low fever after acute renal dysfunction induced by overinfused aciclovir.

Fifty Patients of Infantile Protracted Chronic Pneumonia Treated withIntegrated Traditional Chinese and Western Medicine

Objective: To investigate the effects of integrated traditional Chinese and Western medicine in treating infantile protracted chronic pneumonia （IPCP）. Methods: One hundred patients of IPCP were divided equally into two groups, the TCM-WM group treated with Maqin Qizhu Decoction combining with antibiotics and the control group treated with antibiotics alone. Efficacy of the two groups was compared after 1 course（15）days） of treatment. Results: The total effective rate of the TCM-WM group was better than that of the control group. Moreover, the days needed in curing coughing, dyspnea, rales and X-ray shadow absorption of the former were fewer than those of the latter. Conclusion: The integrated TCM-WM therapy in treating IPCP could both inhibit the pathogens effectively and improve the humoral immunity and resistant ability of organism.

Elimination plus Transformation——Chinese and Western Medicine Integration Brings Hope to Protracted War on Cancer

Modern medicine has been fighting the battle with cancer for near 200 years, achieved substantial progresses but yet to claim the final victory. Author believes that the battle strategy has the profound impact to the result. Since Virchow discovered the cellular origin of cancer in 1863, cancers are being seeing as a localized disease resulting from foreign invasions whereas eradication therapies have been the dominant practices. However, people neglected the overall relationship between cancer and human body therefore overlooked the solutions from transformation, modulation and regulation point of view.