Effect of antidepressant treatment on water load test and cortisol changes in patients with functional dyspepsia

BACKGROUND： It has been demonstrated that patients with functional dyspepsia have experiences social life stress events, and accompanied by psychological disorders, mainly manifested as depression and anxiety.Mental factors can lead to excessive gastrointestinal consensual reaction, and result in different brain-gut axis disturbance, and then cause the gastrointestinal sensorimotor abnormality and endocrine changes.OBJECTIVE： To observe the effect of antidepressant treatment on the changes of water load and serum cortisol in patients with functional dyspepsia, and analyze the therapeutic mechanism.DESIGN： A comparative observation.SETTING： The First Affiliated Hospital o Zhengzhou University.PARTICIPANTS： Forty-five patients with functional dyspepsia accompanied by depression were selected from the Department of Gastroenterology, the First Affiliated Hospital of Zhengzhou University from July 2004 to July 2006, and they were 25 - 65 years of age, and their disease courses ranged 1 - 10 years. They were all accorded with the diagnostic standards for Rome Ⅱ functional dyspepsia functional dyspepsia. As the patients＇ will, they were divided into treatment group （n =30, 12 males and 18 females） and control group （n =15, 6 males and 9 females）, and there were no significant differences in the data between the two groups （P 〉 0.05）. The programs were discussed and agreed by the committee of medical ethics of the First Affiliated Hospital of Zhengzhou University. Informed contents were obtained from all the patients.METHODS： In the treatment group, the patients were treated with venlafaxine sustained release capsule （75 mg per day）, and those with sleep disorder were added by benzodiazepines （alprazolam）. In the control group, the patients were given routine treatments of antacid, prokinetics, etc. Before and after 8-week treatment, the following examinations were performed： ① The gastrointestinal symptoms were assessed according to the symptoms; ② The severity of depression was evaluated with Hamilton depression scale （HAMD）; ③The relaxation of proximal stomach was observed using water load test; ④ The serum level of cortisol was detected.MAIN OUTCOME MEASURES： ① Symptom score; ② HAMD score; ③ Water load amount; ④Serum level of cortisol.RESULTS： All the 45 patients were involved in the analysis of results. ① Symptom score： The scores of gastrointestinal symptoms were decreased as compared with those before treatment in both the treatment group and control group （P 〈 0.05）. ② HAMD scores： The scores of HAMD were decreased as compared with those before treatment in both the treatment group and control group （P 〈 0.05）. ③ Water load amount：The total effective rate was significantly higher in the treatment group than the control group （P 〈 0.05）. ④The serum levels of cortisol after treatment were significantly lower than those before treatment in the patients with severe gastrointestinal symptoms in the treatment group and control group （P 〈 0.05）.CONCLUSION： Antidepressants can normalize the cortisol level of patients with functional dyspepsia, and then decrease gastric sensitivity and ameliorates the receptive relaxation of proximal stomach, also increase the water load amount correspondingly, and finally control the gastrointestinal symptoms of functional dyspepsia.

Theoretical and exploratory research on sustainability mental model of the public in China:based on a typical survey in Guangdong province

This article aims to investigate the public's sustainability mental model(SMM), which can reveal the sustainability dilemma from the public respective, other than enterprise or government. In this article, SMM is defined as one's cognitive structure, thinking mode, and behavior tendency when someone deals with sustainability issues. After theoretical analysis, the authors developed reliable and valid measures systematically and conducted a typical survey with 581 participants from college students' families in Guangdong province in China. Based on those samples, the author used the exploratory factor analysis and confirmatory factor analysis to construct a measurement model of SMM, which includes three dimensions, i.e. sustainable cognition, sustainable thinking, and sustainable behavior intention. According to SMM survey and clustering analysis, the results indicate that SMM of those participants is inactive. Even though those samples do not represent the whole country comprehensively, but this survey was sampled typically and they came from around China. So, the authors consider the SMM scores can reflect Chinese people to some extent, leading to the assumption that SMM of Chinese people is not active presently.