Major depressive disorder(MDD) is a common psychiatric disorder with an estimated lifetime prevalence rate in the range of 13% to 16% in the United States population. Patients with MDD often have symptoms such as depr...Major depressive disorder(MDD) is a common psychiatric disorder with an estimated lifetime prevalence rate in the range of 13% to 16% in the United States population. Patients with MDD often have symptoms such as depressed mood, loss of interest or pleasure in usual activities, changes in eating or sleeping patterns, fatigue, difficulty concentrating and thoughts of suicide. Although many pharmacotherapy treatment options are available for MDD, antidepressants can oftencause adverse effects that could affect adherence to the medication. Additionally, it is estimated that MDD is unremitting in 15% of patients and 35% can have recurrent episodes. Given the high rate of recurrence and the adverse effects associated with existing medications, new treatment options for depression are needed. Both levomilnacipran and vortioxetine are new antidepressants that were approved by the food and drug administration in 2013 for the treatment of MDD in adults. Levomilnacipran is a serotonin norepinephrine reuptake inhibitor that was effective in several short term studies and sustained efficacy and tolerability was demonstrated in a 48-wk extension study. Vortioxetine is a multi-modal antidepressant and it is thought to work via inhibition of the serotonin(5-HT) transporter, 5-HT3 A, 5-HT7 and 5-HT1 D antagonist, a 5-HT1 B partial agonist, and a 5-HT1 A agonist. Vortioxetine was effective in the treatment of MDD in both short-term trials as well as in the prevention of relapse in a 24-36 wk trial. Sustained efficacy and tolerability was demonstrated in several long-term open-label trials. Further studies comparing levomilnacipran and vortioxetine to other currently available antidepressants are needed to establish its place in therapy.展开更多
Objective: To explore and analyze the effect of acupoint application combined with microwave treatment on the intestinal barrier dysfunction with moderately severe acute pancreatitis. Methods: A convenient sample of 9...Objective: To explore and analyze the effect of acupoint application combined with microwave treatment on the intestinal barrier dysfunction with moderately severe acute pancreatitis. Methods: A convenient sample of 90 moderately severe acute pancreatitis was selected from March 2017 to December 2017 in the comprehensive hospital with third grade in Tianjin. The patients were divided into group A (acupoint application combined with microwave treatment), group B (acupoint application) and group C (routine nursing). Thirty patients were included in each group. This study need to get the informed consent of the patients. Acupoint application combined with microwave treatment was used, basing on routine nursing measures in group A. Acupoint application was used by the same way and the same traditional Chinese medicine ,basing on routine nursing measures in group B. Routine nursing used in group C. C-reactive protein and the score of intestinal function were measured on 3 th day, 7 th day and 10 th day, after intervention. To record the effective ratio of the treatment after 10 days of intervention. Results: There are significant statistical difference among the three group after intervention (P < 0.05). Conclusion: In some way, acupoint application combined with microwave treatment are able to decrease the time about the recovery of intestinal barrier dysfunction in moderately severe acute pancreatitis and to alleviate the suffering of patients.展开更多
AIM:To examine the links between quality of sleep and the severity of intestinal symptoms in irritable bow-el syndrome(IBS).METHODS:One hundred and forty-two outpatients(110female,32 male)who met the Rome Ⅲ criteria ...AIM:To examine the links between quality of sleep and the severity of intestinal symptoms in irritable bow-el syndrome(IBS).METHODS:One hundred and forty-two outpatients(110female,32 male)who met the Rome Ⅲ criteria for IBS with no psychiatric comorbidity were consecutively en-rolled in this study.Data on age,body mass index(BMI),and a set of life-habit variables were recorded,and IBS symptoms and sleep quality were evaluated using the questionnaires IBS Symptom Severity Score(IBS-SSS)and Pittsburgh Sleep Quality Index(PSQI).The associa-tion between severity of IBS and sleep disturbances was evaluated by comparing the global IBS-SSS and PSQI score(Pearson's correlation and Fisher's exact test)and then analyzing the individual items of the IBS-SSS and PSQI questionnaires by a unitary bowel-sleep model based on item response theory(IRT).RESULTS:IBS-SSS ranged from mild to severe(120-470).The global PSQI score ranged from 1 to 17(median 5),and 60 patients were found to be poor sleepers(PSQI>5).The correlation between the global IBS-SSS and PSQI score indicated a weak association(r=0.2 and 95% CI:-0.03 to 0.35,P<0.05),which becomes stronger using our unitary model.Indeed,the IBS and sleep disturbances severities,estimated as latent variables,resulted significantly high intra-subject cor-relation(posterior mean of r=0.45 and 95% CI:0.17 to 0.70,P<0.05).Moreover,the correlations between patient features(age,sex,BMI,daily coffee and alcohol intake)and IBS and sleep disturbances were also ana-lyzed through our unitary model.Age was a signif icant regressor,with patients≤50 years old showing more severe bowel disturbances(posterior mean=-0.38,P<0.05)and less severe sleep disturbances(posterior mean=0.49,P<0.05)than older patients.Higher daily coffee intake was correlated with a lower sever-ity of bowel disturbances(posterior mean=-0.31,P<0.05).Sex(female)and daily alcohol intake(modest)were correlated with less severe sleep disturbances.CONCLUSION:The unitary bowel-sleep model based on IRT revealed a strong positive correlation between the severity of IBS symptoms and sleep disturbances.展开更多
Depression is one of the most common illnesses affecting college students today. It is often related to low motivation. It can affect the ability to function, think, and feel. In learning process, learners are strongl...Depression is one of the most common illnesses affecting college students today. It is often related to low motivation. It can affect the ability to function, think, and feel. In learning process, learners are strongly affected by motivation. However, there is a group of students that is worthy of being noticed, and it seems that they have no motivation and lose interest in their study and other activities. According to a case study of Mr. WANG, the symptom of his depression was described, and the paper employing motivation theory aims at analyzing the depression severity and what causes depression, in order to uncover the students＇ inner problems and tries to find proper ways to motivate them and help them overcome the feeling of depression. Besides, the paper offers other options for solving the problem, such as speaking with a friend, partner, minister, professional counselor, or psychiatrist to canvass a different perspective展开更多
The homozygous loss of the survival motor neuron 1 （SMN1） gene is the primary cause of spinal muscular atrophy （SMA）, a neuromuscular degenerative disease. A genetically similar gene, SMN2, which is not functional...The homozygous loss of the survival motor neuron 1 （SMN1） gene is the primary cause of spinal muscular atrophy （SMA）, a neuromuscular degenerative disease. A genetically similar gene, SMN2, which is not functionally equivalent in all SMA patients, modifies the clinical SMA phenotypes. We analyzed the methylation levels of 4 CpG islands （CGIs） in SMN2 in 35 Chinese children with SMA by MassARRAY. We found that three CpG units located in CGI 1 （nucleotides （nt） -871, -735） and CGI 4 （nt ＋999） are significantly hypomethylated in SMA type III compared with type I or II children after receiving Bonferroni correction. In addition to the differentially methylated CpG unit of nt -871, the methylation level of the nt -290/-288/-285 unit was negatively correlated with the expression of SMN2 full-length transcripts （SMN2-fl）. In addition, the methylation level at nt ＋938 was inversely proportional to the ratio of SMN2-fl and lacking exon 7 transcripts （SMN2-A7, fl/A7）, and was not associated with the SMN2 transcript levels. Thus, we can conclude that SMN2 methylation may regulate the SMA disease phenotype by modulating its transcription.展开更多
Existing antidepressants seem to have an onset time of several weeks.However,newly found depression-related receptors and pathways may enlighten us to find more rapid-onset antidepressants,in which ketamine is one of ...Existing antidepressants seem to have an onset time of several weeks.However,newly found depression-related receptors and pathways may enlighten us to find more rapid-onset antidepressants,in which ketamine is one of the most potential antidepressants.By intranasal administration,drugs can be directly delivered to the brain via olfactory nerve route,which is proved to be suitable for some antidepressants.Well-designed rapid-onset antidepressants are the urgent requirements of the patients with depression.Intranasal administration,as a potential strategy to deliver antidepressants to brain,can improve drug efficacy and largely shorten the onset time.In this article,we sorted out some new formulation approaches in treating depression with different mechanisms and pathways compared with traditional treating strategies,along with new findings in clinical studies,proving that the combination of rapid-onset antidepressants with intranasal delivery will lead a new trend in treating depression.展开更多
Objective: To study the changes of partial pressure of brain tissue oxygen (PbtO 2) and brain temperature in acute phase of severe head injury during mild hypothermia therapy and the clinical significance. Methods: On...Objective: To study the changes of partial pressure of brain tissue oxygen (PbtO 2) and brain temperature in acute phase of severe head injury during mild hypothermia therapy and the clinical significance. Methods: One hundred and sixteen patients with severe head injury were selected and divided into a mild hypothermia group (n=58), and a control group (n=58) according to odd and even numbers of hospitalization. While mild hypothermia therapy was performed PbtO 2 and brain temperature were monitored for 1 7 days (mean=86 hours), simultaneously, the intracranial pressure, rectum temperature, cerebral perfusion pressure, PaO 2 and PaCO 2 were also monitored. The patients were followed up for 6 months and the prognosis was evaluated with GOS (Glasgow outcome scale). Results: The mean value of PbtO 2 within 24 hour monitoring in the 116 patients was 13.7 mm Hg ± 4.94 mm Hg , lower than the normal value (16 mm Hg ± 40 mm Hg ) The time of PbtO 2 recovering to the normal value in the mild hypothermia group was shortened by 10± 4.15 hours compared with the control group (P< 0.05 ). The survival rate of the mild hypothermia group was 60.43 %, higher than that of the control group ( 46.55 %). After the recovery of the brain temperature, PbtO 2 increased with the rise of the brain temperature. Conclusions: Mild hypothermia can improve the survival rate of severe head injury. The technique of monitoring PbtO 2 and the brain temperature is safe and reliable, and has important clinical significance in judging disease condition and instructing clinical therapy.展开更多
文摘Major depressive disorder(MDD) is a common psychiatric disorder with an estimated lifetime prevalence rate in the range of 13% to 16% in the United States population. Patients with MDD often have symptoms such as depressed mood, loss of interest or pleasure in usual activities, changes in eating or sleeping patterns, fatigue, difficulty concentrating and thoughts of suicide. Although many pharmacotherapy treatment options are available for MDD, antidepressants can oftencause adverse effects that could affect adherence to the medication. Additionally, it is estimated that MDD is unremitting in 15% of patients and 35% can have recurrent episodes. Given the high rate of recurrence and the adverse effects associated with existing medications, new treatment options for depression are needed. Both levomilnacipran and vortioxetine are new antidepressants that were approved by the food and drug administration in 2013 for the treatment of MDD in adults. Levomilnacipran is a serotonin norepinephrine reuptake inhibitor that was effective in several short term studies and sustained efficacy and tolerability was demonstrated in a 48-wk extension study. Vortioxetine is a multi-modal antidepressant and it is thought to work via inhibition of the serotonin(5-HT) transporter, 5-HT3 A, 5-HT7 and 5-HT1 D antagonist, a 5-HT1 B partial agonist, and a 5-HT1 A agonist. Vortioxetine was effective in the treatment of MDD in both short-term trials as well as in the prevention of relapse in a 24-36 wk trial. Sustained efficacy and tolerability was demonstrated in several long-term open-label trials. Further studies comparing levomilnacipran and vortioxetine to other currently available antidepressants are needed to establish its place in therapy.
文摘Objective: To explore and analyze the effect of acupoint application combined with microwave treatment on the intestinal barrier dysfunction with moderately severe acute pancreatitis. Methods: A convenient sample of 90 moderately severe acute pancreatitis was selected from March 2017 to December 2017 in the comprehensive hospital with third grade in Tianjin. The patients were divided into group A (acupoint application combined with microwave treatment), group B (acupoint application) and group C (routine nursing). Thirty patients were included in each group. This study need to get the informed consent of the patients. Acupoint application combined with microwave treatment was used, basing on routine nursing measures in group A. Acupoint application was used by the same way and the same traditional Chinese medicine ,basing on routine nursing measures in group B. Routine nursing used in group C. C-reactive protein and the score of intestinal function were measured on 3 th day, 7 th day and 10 th day, after intervention. To record the effective ratio of the treatment after 10 days of intervention. Results: There are significant statistical difference among the three group after intervention (P < 0.05). Conclusion: In some way, acupoint application combined with microwave treatment are able to decrease the time about the recovery of intestinal barrier dysfunction in moderately severe acute pancreatitis and to alleviate the suffering of patients.
文摘AIM:To examine the links between quality of sleep and the severity of intestinal symptoms in irritable bow-el syndrome(IBS).METHODS:One hundred and forty-two outpatients(110female,32 male)who met the Rome Ⅲ criteria for IBS with no psychiatric comorbidity were consecutively en-rolled in this study.Data on age,body mass index(BMI),and a set of life-habit variables were recorded,and IBS symptoms and sleep quality were evaluated using the questionnaires IBS Symptom Severity Score(IBS-SSS)and Pittsburgh Sleep Quality Index(PSQI).The associa-tion between severity of IBS and sleep disturbances was evaluated by comparing the global IBS-SSS and PSQI score(Pearson's correlation and Fisher's exact test)and then analyzing the individual items of the IBS-SSS and PSQI questionnaires by a unitary bowel-sleep model based on item response theory(IRT).RESULTS:IBS-SSS ranged from mild to severe(120-470).The global PSQI score ranged from 1 to 17(median 5),and 60 patients were found to be poor sleepers(PSQI>5).The correlation between the global IBS-SSS and PSQI score indicated a weak association(r=0.2 and 95% CI:-0.03 to 0.35,P<0.05),which becomes stronger using our unitary model.Indeed,the IBS and sleep disturbances severities,estimated as latent variables,resulted significantly high intra-subject cor-relation(posterior mean of r=0.45 and 95% CI:0.17 to 0.70,P<0.05).Moreover,the correlations between patient features(age,sex,BMI,daily coffee and alcohol intake)and IBS and sleep disturbances were also ana-lyzed through our unitary model.Age was a signif icant regressor,with patients≤50 years old showing more severe bowel disturbances(posterior mean=-0.38,P<0.05)and less severe sleep disturbances(posterior mean=0.49,P<0.05)than older patients.Higher daily coffee intake was correlated with a lower sever-ity of bowel disturbances(posterior mean=-0.31,P<0.05).Sex(female)and daily alcohol intake(modest)were correlated with less severe sleep disturbances.CONCLUSION:The unitary bowel-sleep model based on IRT revealed a strong positive correlation between the severity of IBS symptoms and sleep disturbances.
文摘Depression is one of the most common illnesses affecting college students today. It is often related to low motivation. It can affect the ability to function, think, and feel. In learning process, learners are strongly affected by motivation. However, there is a group of students that is worthy of being noticed, and it seems that they have no motivation and lose interest in their study and other activities. According to a case study of Mr. WANG, the symptom of his depression was described, and the paper employing motivation theory aims at analyzing the depression severity and what causes depression, in order to uncover the students＇ inner problems and tries to find proper ways to motivate them and help them overcome the feeling of depression. Besides, the paper offers other options for solving the problem, such as speaking with a friend, partner, minister, professional counselor, or psychiatrist to canvass a different perspective
基金Project supported by the National Natural Science Foundation of China(Nos.81050034 and 81500979)the Research Foundation of the Capital Institute of Pediatrics(No.Fangxiang-2014-01)the Beijing Talents Fund(No.2014000021469G228)
文摘The homozygous loss of the survival motor neuron 1 （SMN1） gene is the primary cause of spinal muscular atrophy （SMA）, a neuromuscular degenerative disease. A genetically similar gene, SMN2, which is not functionally equivalent in all SMA patients, modifies the clinical SMA phenotypes. We analyzed the methylation levels of 4 CpG islands （CGIs） in SMN2 in 35 Chinese children with SMA by MassARRAY. We found that three CpG units located in CGI 1 （nucleotides （nt） -871, -735） and CGI 4 （nt ＋999） are significantly hypomethylated in SMA type III compared with type I or II children after receiving Bonferroni correction. In addition to the differentially methylated CpG unit of nt -871, the methylation level of the nt -290/-288/-285 unit was negatively correlated with the expression of SMN2 full-length transcripts （SMN2-fl）. In addition, the methylation level at nt ＋938 was inversely proportional to the ratio of SMN2-fl and lacking exon 7 transcripts （SMN2-A7, fl/A7）, and was not associated with the SMN2 transcript levels. Thus, we can conclude that SMN2 methylation may regulate the SMA disease phenotype by modulating its transcription.
基金Open Research Fund of State Key Laboratory of Functions and Applications of Medicinal Plants of Guizhou Medcial University(FAMP201805K)Qian Ke He Platform Talents 20175101。
文摘Existing antidepressants seem to have an onset time of several weeks.However,newly found depression-related receptors and pathways may enlighten us to find more rapid-onset antidepressants,in which ketamine is one of the most potential antidepressants.By intranasal administration,drugs can be directly delivered to the brain via olfactory nerve route,which is proved to be suitable for some antidepressants.Well-designed rapid-onset antidepressants are the urgent requirements of the patients with depression.Intranasal administration,as a potential strategy to deliver antidepressants to brain,can improve drug efficacy and largely shorten the onset time.In this article,we sorted out some new formulation approaches in treating depression with different mechanisms and pathways compared with traditional treating strategies,along with new findings in clinical studies,proving that the combination of rapid-onset antidepressants with intranasal delivery will lead a new trend in treating depression.
文摘Objective: To study the changes of partial pressure of brain tissue oxygen (PbtO 2) and brain temperature in acute phase of severe head injury during mild hypothermia therapy and the clinical significance. Methods: One hundred and sixteen patients with severe head injury were selected and divided into a mild hypothermia group (n=58), and a control group (n=58) according to odd and even numbers of hospitalization. While mild hypothermia therapy was performed PbtO 2 and brain temperature were monitored for 1 7 days (mean=86 hours), simultaneously, the intracranial pressure, rectum temperature, cerebral perfusion pressure, PaO 2 and PaCO 2 were also monitored. The patients were followed up for 6 months and the prognosis was evaluated with GOS (Glasgow outcome scale). Results: The mean value of PbtO 2 within 24 hour monitoring in the 116 patients was 13.7 mm Hg ± 4.94 mm Hg , lower than the normal value (16 mm Hg ± 40 mm Hg ) The time of PbtO 2 recovering to the normal value in the mild hypothermia group was shortened by 10± 4.15 hours compared with the control group (P< 0.05 ). The survival rate of the mild hypothermia group was 60.43 %, higher than that of the control group ( 46.55 %). After the recovery of the brain temperature, PbtO 2 increased with the rise of the brain temperature. Conclusions: Mild hypothermia can improve the survival rate of severe head injury. The technique of monitoring PbtO 2 and the brain temperature is safe and reliable, and has important clinical significance in judging disease condition and instructing clinical therapy.
