Bile secretion is dependent on the coordinated functions of a number of hepatobiliary transport systems. Cholestasis may be caused by an impairment of bile secretion, an obstruction of bile flow or a combination of th...Bile secretion is dependent on the coordinated functions of a number of hepatobiliary transport systems. Cholestasis may be caused by an impairment of bile secretion, an obstruction of bile flow or a combination of the two. The common consequence of all forms of cholestasis is retention of bile acids and other potentially toxic compounds in the hepatooltes leading to apoptosis or necrosis of hepatocytes and eventually to chronic cholestatic liver disease. In certain cholestatic disorders there is also leakage of bile acids into the peribiliary space causing portal inflammation and fibrosis. The following pharmacological targets for treatment of intrahepatic cholestasis can be identified： stimulation of orthograde biliary secretion and retrograde secretion of bile acids and other toxic cholephils into the systemic circulation for excretion via the kidneys to reduce their retention in the hepatocytes; stimulation of the metabolism of hydrophobic bile acids and other toxic compounds to more hydrophilic, less toxic metabolites; protection of injured cholangiocytes against toxic effects of bile; inhibition of apoptosis caused by elevated levels of cytotoxic bile acids; inhibition of fibrosis caused by leakage of bile acids into the peribiliary space. The clinical results of ursodeoxcholic acid therapy of primary biliary cirrhosis may be regarded as the first success of this strategy.展开更多
Neuromyelitis optica spectrum disorder(NMOSD)is an inflammatory disorder of the central nervous system predominantly targeting optic nerves and the spinal cord.The prevalence of the disease is much higher in Asia than...Neuromyelitis optica spectrum disorder(NMOSD)is an inflammatory disorder of the central nervous system predominantly targeting optic nerves and the spinal cord.The prevalence of the disease is much higher in Asia than in other parts of the world.Pain can be detected in more than 80%of NMOSD patients,with evoked pain mostly being caused by painful tonic muscle spasms and neuropathic pain as the most characteristic types.Depression is often comorbid with pain,and their comorbidity can severely influence quality of life.In recent years,studies have found considerable overlaps between the mechanisms of pain and depression;however,their association remains unclear.This article reviews the epidemiology,mechanism,evaluation and treatment of paindepression comorbidity in NMOSD patients.展开更多
Depression is a common medical problem and is more prevalent among patients with coronary artery disease. Whether early detection and treatment of depression will enhance cardiovascular outcome is uncertain. Obviously...Depression is a common medical problem and is more prevalent among patients with coronary artery disease. Whether early detection and treatment of depression will enhance cardiovascular outcome is uncertain. Obviously, the safety and efficacy of the anti-depression drugs is an important link. This article reviews the patho-physiologic and behavioural links between depression and cardiovascular disease progression, the treatment of depression, and the potential benefits of anti-depressants in patients with coronary disease.展开更多
Investigation of depression prevalence in end stage renal disease （ESRD） patients treated with two different methods, hemodialysis （HD） and continuous ambulatory peritoneal dialysis （CAPD） is conducted. We inves...Investigation of depression prevalence in end stage renal disease （ESRD） patients treated with two different methods, hemodialysis （HD） and continuous ambulatory peritoneal dialysis （CAPD） is conducted. We investigated whether the dialysis adequacy （Kt/v） and serum hemoglobin level had any correlation with depression severity. Psychiatric interview was performed on 30 HD and 30 CAPD patients. Hamilton depression rating scale （HAMD） was used to evaluate depression symptoms. Kt/v and serum hemoglobin level were detected. Half of HD patients were depressive, while depression wasn＇t found in any CAPD patient. Hemoglobin was in positive correlation with the HAMD, while Kt/v was in negative correlation with the HAMD. Patients on CAPD had less depressive symptoms. Good dialysis adequacy diminish depressive symptoms.展开更多
AIM： To explore the prevalence of post-partumdepression （PPD） in coeliac disease （CD）. METHODS： we performed a case-control study evaluating the prevalence of PPD in CD patients on gluten-free diet （GFD） comp...AIM： To explore the prevalence of post-partumdepression （PPD） in coeliac disease （CD）. METHODS： we performed a case-control study evaluating the prevalence of PPD in CD patients on gluten-free diet （GFD） compared to that of healthy subjects experiencing a recent delivery. All participants were interviewed about menstrual features, modality and outcome of delivery and were evaluated for PPD by Edinburgh Postnatal Depression Scale （EPDS）. RESULTS： The study included 70 CD patients on GFD （group A） and 70 controls （group B）. PPD was present in 47.1% of CD women and in 14.3% of controls （P 〈 0.01; OR = 3.3）. Mean EPDS score was higher in CD compared to the controls （mean score： group A 9.9 ± 5.9; group B 6.7 ± 3.7; P 〈 0.01）. A signifcant association was observed between PPD and menstrual disorders in CD （69.7% vs 18.9%; P 〈 0.001; OR = 3.6）.CONCLUSION： PPD is frequent in CD women on GFD, particularly in those with previous menstrual disorders. we suggest screening for PPD in CD for early detection and treatment of this condition.展开更多
in Japan, the number of depression patients has markedly increased over the last 10 years, and depression is now a major social concern. Moreover, there are concerns that patients with depression are not always seekin...in Japan, the number of depression patients has markedly increased over the last 10 years, and depression is now a major social concern. Moreover, there are concerns that patients with depression are not always seeking the treatment they need, in part due to the stigma associated with the illness. Despite of increasing public awareness of depression, the stigma has not lessened, but has changed in form. Previous studies report that depression which was once viewed as a special psychiatric illness is now viewed as a ＂common＂ mental illness. The author, too, believes that the nature of the stigmatization has changed in recent years to become more complex and ultimately continues to present a barrier to treatment for people with depression. This study aims to explore how the stigmatization has changed by examining one specific aspect in society that may have contributed to this change, namely, the media＇s portrayal of depression. The author presents and discusses clear examples of how the Japanese media＇s portrayals of depression have changed, particularly over the last 20 to 30 years, and discusses how media influence could have contributed to the shifts in stigmatization, with reference to labeling theory and growing social isolation.展开更多
Decreased hedonic and motivational capacity,namely anhedonia,is one of the cardinal features for patients with major depressive disorder（MDD）.Recent studies suggest that this reduced ability to experience pleasure i...Decreased hedonic and motivational capacity,namely anhedonia,is one of the cardinal features for patients with major depressive disorder（MDD）.Recent studies suggest that this reduced ability to experience pleasure is also a marker or endophenotype for MDD and represents a genetic predisposition to this disorder.Dr.展开更多
文摘Bile secretion is dependent on the coordinated functions of a number of hepatobiliary transport systems. Cholestasis may be caused by an impairment of bile secretion, an obstruction of bile flow or a combination of the two. The common consequence of all forms of cholestasis is retention of bile acids and other potentially toxic compounds in the hepatooltes leading to apoptosis or necrosis of hepatocytes and eventually to chronic cholestatic liver disease. In certain cholestatic disorders there is also leakage of bile acids into the peribiliary space causing portal inflammation and fibrosis. The following pharmacological targets for treatment of intrahepatic cholestasis can be identified： stimulation of orthograde biliary secretion and retrograde secretion of bile acids and other toxic cholephils into the systemic circulation for excretion via the kidneys to reduce their retention in the hepatocytes; stimulation of the metabolism of hydrophobic bile acids and other toxic compounds to more hydrophilic, less toxic metabolites; protection of injured cholangiocytes against toxic effects of bile; inhibition of apoptosis caused by elevated levels of cytotoxic bile acids; inhibition of fibrosis caused by leakage of bile acids into the peribiliary space. The clinical results of ursodeoxcholic acid therapy of primary biliary cirrhosis may be regarded as the first success of this strategy.
基金Supported by the Fundamental Research Funds for the Central Universities(3332021015)。
文摘Neuromyelitis optica spectrum disorder(NMOSD)is an inflammatory disorder of the central nervous system predominantly targeting optic nerves and the spinal cord.The prevalence of the disease is much higher in Asia than in other parts of the world.Pain can be detected in more than 80%of NMOSD patients,with evoked pain mostly being caused by painful tonic muscle spasms and neuropathic pain as the most characteristic types.Depression is often comorbid with pain,and their comorbidity can severely influence quality of life.In recent years,studies have found considerable overlaps between the mechanisms of pain and depression;however,their association remains unclear.This article reviews the epidemiology,mechanism,evaluation and treatment of paindepression comorbidity in NMOSD patients.
文摘Depression is a common medical problem and is more prevalent among patients with coronary artery disease. Whether early detection and treatment of depression will enhance cardiovascular outcome is uncertain. Obviously, the safety and efficacy of the anti-depression drugs is an important link. This article reviews the patho-physiologic and behavioural links between depression and cardiovascular disease progression, the treatment of depression, and the potential benefits of anti-depressants in patients with coronary disease.
文摘Investigation of depression prevalence in end stage renal disease （ESRD） patients treated with two different methods, hemodialysis （HD） and continuous ambulatory peritoneal dialysis （CAPD） is conducted. We investigated whether the dialysis adequacy （Kt/v） and serum hemoglobin level had any correlation with depression severity. Psychiatric interview was performed on 30 HD and 30 CAPD patients. Hamilton depression rating scale （HAMD） was used to evaluate depression symptoms. Kt/v and serum hemoglobin level were detected. Half of HD patients were depressive, while depression wasn＇t found in any CAPD patient. Hemoglobin was in positive correlation with the HAMD, while Kt/v was in negative correlation with the HAMD. Patients on CAPD had less depressive symptoms. Good dialysis adequacy diminish depressive symptoms.
文摘AIM： To explore the prevalence of post-partumdepression （PPD） in coeliac disease （CD）. METHODS： we performed a case-control study evaluating the prevalence of PPD in CD patients on gluten-free diet （GFD） compared to that of healthy subjects experiencing a recent delivery. All participants were interviewed about menstrual features, modality and outcome of delivery and were evaluated for PPD by Edinburgh Postnatal Depression Scale （EPDS）. RESULTS： The study included 70 CD patients on GFD （group A） and 70 controls （group B）. PPD was present in 47.1% of CD women and in 14.3% of controls （P 〈 0.01; OR = 3.3）. Mean EPDS score was higher in CD compared to the controls （mean score： group A 9.9 ± 5.9; group B 6.7 ± 3.7; P 〈 0.01）. A signifcant association was observed between PPD and menstrual disorders in CD （69.7% vs 18.9%; P 〈 0.001; OR = 3.6）.CONCLUSION： PPD is frequent in CD women on GFD, particularly in those with previous menstrual disorders. we suggest screening for PPD in CD for early detection and treatment of this condition.
文摘in Japan, the number of depression patients has markedly increased over the last 10 years, and depression is now a major social concern. Moreover, there are concerns that patients with depression are not always seeking the treatment they need, in part due to the stigma associated with the illness. Despite of increasing public awareness of depression, the stigma has not lessened, but has changed in form. Previous studies report that depression which was once viewed as a special psychiatric illness is now viewed as a ＂common＂ mental illness. The author, too, believes that the nature of the stigmatization has changed in recent years to become more complex and ultimately continues to present a barrier to treatment for people with depression. This study aims to explore how the stigmatization has changed by examining one specific aspect in society that may have contributed to this change, namely, the media＇s portrayal of depression. The author presents and discusses clear examples of how the Japanese media＇s portrayals of depression have changed, particularly over the last 20 to 30 years, and discusses how media influence could have contributed to the shifts in stigmatization, with reference to labeling theory and growing social isolation.
文摘Decreased hedonic and motivational capacity,namely anhedonia,is one of the cardinal features for patients with major depressive disorder（MDD）.Recent studies suggest that this reduced ability to experience pleasure is also a marker or endophenotype for MDD and represents a genetic predisposition to this disorder.Dr.
