Study on the Efficacy of Shugan Jieyu Capsules Combined with Trazodone in Patients with Post-Stroke Depression and Insomnia

Objective:To analyze the effectiveness of applying ShuGan JieYu Capsules(SGJYC)combined with trazodone in patients with post-stroke depression(PSD)with insomnia.Methods:60 cases of PSD with insomnia patients admitted to the hospital from May 2022 to May 2023 were selected and randomly divided into a reference group(trazodone)and a research group(SGJYC combined with trazodone)of 30 cases each.Statistics were analyzed using the Hamilton Depression Rating Scale(HAM-D),Pittsburgh Sleep Quality Index(PSQI),and Activities of Daily Living(ADL)scale before treatment and 4,8,and 12 weeks after treatment.Results:Before treatment,The results of HAM-D,PSQI,and ADL scale studies in the two groups before treatment were not statistically significant(P>0.05);4,8,and 12 weeks after treatment,the results of HAM-D and PSQI studies in the research group were lower than that of the reference group,and the results of ADL scale studies were higher than that of the reference group.There was a significant difference between the groups(P<0.05).The total adverse reaction rate of the research group was lower than that of the reference group,and there was a significant difference between the groups(P<0.05).Conclusion:The combination of SGJYC and trazodone reduced depression in post-stroke patients,corrected insomnia,improved sleep quality,was safe,and had a low rate of adverse reactions.

Research Progress in the Treatment of Poststroke Depression with Traditional Chinese Medicine

In recent years,the incidence rate of stroke has increased year by year.Post stroke depres‐sion is one of its main complications,which seriously affects the recovery of physiological functions and quality of life of stroke patients.Traditional Chinese medicine has signifi‐cant therapeutic effects in treating this disease.This article provides a classification and review of traditional Chinese medicine treatment methods for post-stroke depression,and looks forward to the current problems.

Impact of depression on in-hospital outcomes for adults with type 2 myocardial infarction:A United States population-based analysis

BACKGROUND Type 2 myocardial infarction(T2MI)is an ischemic myocardial injury in the context of oxygen supply/demand mismatch in the absence of a primary coronary event.However,though there is a rising prevalence of depression and its potential association with type 1 myocardial infarction(T1MI),data remains nonexistent to evaluate the asso-ciation with T2MI.AIM To identify the prevalence and risk of T2MI in adults with depression and its impact on the in-hospital outcomes.METHODS We queried the National Inpatient Sample(2019)to identify T2MI hospitalizations using Internal Classification of Diseases-10 codes in hospitalized adults(≥18 years).In addition,we compared sociodemographic and comorbidities in the T2MI cohort with vs without comorbid depression.Finally,we used multivariate regression analysis to study the odds of T2MI hospitalizations with vs without depression and in-hospital outcomes(all-cause mortality,cardiogenic shock,cardiac arrest,and stroke),adjusting for confounders.Statistical significance was RESULTS There were 331145 adult T2MI hospitalizations after excluding T1MI(median age:73 years,52.8%male,69.9%white);41405(12.5%)had depression,the remainder;289740 did not have depression.Multivariate analysis revealed lower odds of T2MI in patients with depression vs without[adjusted odds ratio(aOR)=0.88,95%confidence interval(CI):0.86-0.90,P=0.001].There was the equal prevalence of prior MI with any revascularization and a similar prevalence of peripheral vascular disease in the cohorts with depression vs without depression.There is a greater prevalence of stroke in patients with depression(10.1%)vs those without(8.6%).There was a slightly higher prevalence of hyperlipidemia in patients with depression vs without depression(56.5%vs 48.9%),as well as obesity(21.3%vs 17.9%).There was generally equal prevalence of hypertension and type 2 diabetes mellitus in both cohorts.There was no significant difference in elective and non-elective admissions frequency between cohorts.Patients with depression vs without depression also showed a lower risk of all-cause mortality(aOR=0.75,95%CI:0.67-0.83,P=0.001),cardiogenic shock(aOR=0.65,95%CI:0.56-0.76,P=0.001),cardiac arrest(aOR=0.77,95%CI:0.67-0.89,P=0.001)as well as stroke(aOR=0.79,95%CI:0.70-0.89,P=0.001).CONCLUSION This study revealed a significantly lower risk of T2MI in patients with depression compared to patients without depression by decreasing adverse in-hospital outcomes such as all-cause mortality,cardiogenic shock,cardiac arrest,and stroke in patients with depression.

Relationship between serum neutrophil gelatinase-associated lipocalin levels and cognitive impairment, anxiety, and depressive symptoms in acute ischemic stroke

BACKGROUND Acute ischemic stroke(AIS)is a significant global health issue with increasing incidence owing to aging populations and rising cardiovascular risk factors.In addition to physical impairments,AIS frequently leads to neuropsychiatric co-mplications,such as cognitive impairment,anxiety,and depressive symptoms,which adversely affect patients’quality of life and rehabilitation.Neutrophil ge-latinase-associated lipocalin(NGAL)has emerged as a potential biomarker for various conditions,including AIS.This study investigated the association bet-ween serum NGAL levels at admission and neuropsychiatric complications in patients with AIS.neuropsychiatric complications in patients with AIS.METHODS Between January 2022 and December 2023,150 patients with AIS were enrolled.Serum NGAL levels were measured at admission using an enzyme-linked immu-nosorbent assay.Cognitive function was assessed using the Mini-Mental State Examination,while anxiety and depressive symptoms were evaluated using the Hospital Anxiety and Depression Scale at discharge.The relationship between serum NGAL levels and cognitive impairment,anxiety,and depressive symptoms was analyzed using multivariate logistic regression,adjusted for potential con-founders of age,sex,body mass index,smoking status,hypertension,diabetes mellitus,dyslipidemia,previous stroke,and stroke severity.RESULTS The mean age of the participants was 65.4±10.2 years,and 58%were males.Prevalence rates of cognitive impairment,anxiety,and depressive symptoms at discharge were 34.7%,28.0%,and 32.0%,respectively.Serum NGAL levels were significantly higher in patients with cognitive impairment(median:5.6 ng/mL vs 3.2 ng/mL,P<0.001),anxiety(median:5.1 ng/mL vs 3.5 ng/mL,P=0.002),and depressive symptoms(median:5.4 ng/mL vs 3.3 ng/mL,P<0.001),compared to those without these conditions.Multivariate logistic regression analysis showed that higher serum NGAL levels at admission were independently associated with cognitive impairment[odds ratio(OR)=1.42,95%confidence interval(CI):1.18-1.71,P<0.001],anxiety(OR=1.28,95%CI:1.09-1.51,P=0.003),and depressive symptoms(OR=1.39,95%CI:1.16-1.67,P<0.001)after adjusting for potential confounders.CONCLUSION Elevated serum NGAL levels were independently associated with cognitive impairment,anxiety,and depressive symptoms in patients with AIS;and may function as potential biomarkers for patients at risk.

The effects of Xingnao Jieyu capsules on post-stroke depression are similar to those of fluoxetine

The Xingnao Jieyu capsule has been shown to effectively relieve neurologic impairments and les- sen depression. It remains poorly understood whether this capsule can be used to treat post-stroke depression. Thus, in the present study, we established a rat model of post-stroke depression using left middle cerebral artery occlusions in combination of chronic unpredictable stress and solitary housing during development. Experimental rats received intragastric perfusion with 0.82, 0.41, and 0.20 g/kg Xingnao Jieyu capsules separately dissolved in 2 mL distilled water. Fluoxetine served as a positive control. The treatment was conducted over 28 days. Sugar water consumption test, open-field test, real-time fluorescent quantitative PCR and immunohistochemical staining results demonstrated that intragastric perfusion with various doses of Xingnao Jieyu capsules increased sugar water consumption, voluntary behaviors and synaptotagmin mRNA and protein expression in rats with post-stroke depression. These therapeutic effects were similar to those of fluoxetine. These results indicate that Xingnao Jieyu capsules upregulate synaptotagmin expression in hip pocampi of rats with post-stroke depression, and exert antidepressant effects.

Fluoxetine for poststroke depression A randomized placebo controlled clinical trial

BACKGROUND： Studies have demonstrated that poststroke depression（PSD） may be related with the disequilibrium between noradrenaline and 5-hydroxytryptamine （5-HT） caused by cerebral injury. The injured regions involve noradrenergic and 5-hydroxytryptaminergic neurons as well as conduction pathway. The levels of noradrenaline and 5-HT would be decreased. OBJECTIVE： To observe the effect of fluoxetine on preventing against PSD and recovery of neurologic function, and analyze the relationship of fluoxetine and the 5-HT level. DESIGN： A randomized controlled clinical trial. SETTING： Department of Neurology, First Hospital Affiliated to Soochow University. PARTICIPANTS： Ninety consecutive patients, 47 female and 43 male, were recruited who admitted to hospital for recent stroke in the Department of Neurology, First Affiliated Hospital of Soochow University between September 2003 and February 2005. Subjects were aged （64±7） years, ranging from 47 to 79 years old. They all met the diagnosis criteria of various cerebrovascular diseases formulated in the 4th National Cerebrovascular Disease Conference and confirmed as stroke by skull CT or MRI; The time from onset to tentative administration was less than 7 days; The patients had clear consciousness, without obvious language disorder, They were randomized into treatment group （n =48） and placebo group （n =42）. METHODS： ①All the patients were given routine treatment according to treatment guideline of cerebrovascular disease after admission. Patients in the treatment group and placebo group received 20 mg/d fluoxetine and placebo （component： vitamin C） for 8 weeks, respectively. ② Neurologic deficit was assessed according to 24-item Hamilton Rating Scale for Depression （HAMD） and Activity of Daily Living Scale （ADL） before and at 2,4 and 8 weeks after test, separately; Meanwhile, the levels of platelet 5-HT and plasma 5-HT were determined. Grading criteria of HAMD intergral depression： non-depression 〈 8 points; mild depression 8 - 20 points; moderate depression 21 - 35 points; severe depression 〉 35 points. ADL was assessed with Barthel index score （full mark 100 points）. Higher points indicated better incidence and smaller dependence. Neurologic deficit score was made according to scoring criteria of neurologic deficit formulated in 1995 4th National Cerebrovascular Disease Conference： a score of 0 - 15 indicated a mild focal neurologic deficit, a score of 16 - 30 a moderate focal neurologic deficit, and a score of 31 - 45 a severe focal deficit. MAIN OUTCOME MEASURES： Scores of HAMD, ADL and neurologic deficit, and levels of plasma and platelet 5-HT of patients from 2 groups before, 2,4 and 8 weeks after test. RESULRS： Seventy-three of 90 randomized patients participated in the final analysis. In the treatment group, 11 patients dropped out due to insufficient clinical response （n =4）, somatic side effects （n =2）, intervening medical illness （n =1）, hypomania （n =3）, and other reasons （n =2）. In the placebo group, 6 patients existed due to insufficient clinical response （n =2）, somatic side effects （n =1） and other reasons （n =3）. ① Before treatment, there were no significant differences in scores of HAMD, DAL and neurologic deficit in patients between two groups （P 〉 0.05）. After 8 weeks of treatment, the scores of HAMD, DAL and neurologic deficit in the treatment group were significantly different from those in the placebo group （12.6±5.3 vs. 16.3 ±3.7; 8.6±6.4 vs. 11.2±6.4; 60.4±12.5 vs. 52.3±13.5, P 〈 0.01）. ② After 8 weeks of treatment, platelet 5-HT level of patients in the treatment group was significantly lower than that in the placebo group [（325.3 ± 110.5） mg/L vs. （653.6±138.4） mg/L, P 〈 0.05], while there were no significant differences in plasma 5-HT between two groups （P 〉 0.05）. CONCLUSION： Early fluoxetine treatment obviously retards PSD. The increase of platelet 5-HT level promotes the recovery of neurologic function.

Stroke and depression: A bidirectional link

A number of studies have assessed the influence of depression on the risk of cardiovascular disease. A growing literature indicates a link between depression and cerebrovascular events, although the direction of this association remains unclear. Numerous data have emerged suggesting an association between depressive symptoms and subsequent risk of stroke, thus leading to the hypothesis that a direct causality between depression and stroke exists. Notwithstanding, how depression may act as a risk factor for stroke is still unclear. Depression might be linked to stroke via neuroendocrine and inflammation effects, through correlation with major comorbidities such as hypertensionand diabetes or by intervention of lifestyle behavioral mediators. Finally, antidepressant medications have recently drawn attention for a possible association with increased risk of stroke, although such findings remain uncertain. Depression has been also established as an important consequence after stroke, exerting a significant adverse impact on the course of motor recovery, social functioning and, overall, on quality of life. Post stroke depression occurs in nearly one third of stroke cases, but the exact mechanism leading to depression after stroke is still incompletely understood. In this article, we will review contemporary epidemiologic studies, discuss potential mechanisms and specific aspects of the complex relation between depression and stroke.

Study of Factor Associated with Post Stroke Depression in the Teaching Hospital of Fann (Dakar-Senegal)

Introduction: Strokes are becoming more common in Africa, they are often accompanied by depressive symptoms, hence the need to investigate the factors associated with it for better management and prevention. Methodology: We conducted a prospective cross-sectional study amongst patients hospitalized with stroke at the Neurology/Neuroscience Clinic of the FANN UNHC (Dakar) in 2016. After a clinical diagnosis, patients are subjected to socio-demographic questionnaire and were administered with modified Rankin and MADRS scores. Results: Among the patients, 33.7% had Post-Stroke Depression, most were aged 50 to 70 years, male and married. History of stroke and depression was strongly associated with Post-Stroke Depression, while functional or cognitive impairment caused by stroke contributed to the development of Post Stroke depression. The type of ischemic or haemorrhagic stroke did not appear to affect the occurrence of the Post-Stroke Depression, but Post-Stroke Depression was more frequent in subjects with a left hemispheric lesion 47.8% (p Discussion: The occurrence of a Post-Stroke Depression is a factor of poor prognosis, early diagnosis and holistic care lead to improved quality of life.

Family functioning and depression in primary caregivers of stroke patients in China

Objective:To determine the relationship between family functioning and depression in primary caregivers of stroke survivors in China.Design:Baseline cross-sectional data from an intervention study for stroke survivors and their families were used.Setting:Neurology inpatient service of a large urban hospital.Participants:Stroke survivors(n=180),each with a primary caregiver,were enrolled in this study.The mean age of stroke survivors was 65.60 years,and the mean age of primary caregivers was 57.60 years.Interventions:Not applicable.Methods:The Family Assessment Device(FAD)and Center for Epidemiologic Studies Depression Scale(CES-D),respectively,were used.Results:Following a stroke of a family member,71%of caregivers experienced depressive symptoms.Higher depression severity in caregivers was linked to caregiver education,stroke survivor ADLs,and family functioning.Conclusion:Assessment of family functioning may help determine which caregivers are most at risk for developing depressive syndrome.

miR-137, a new target for post-stroke depression?

Expression of miR-137 is downregulated in brain tissue from patients with depression and suicidal behavior, and is also downregulated in peripheral blood from stroke patients. However, it is not yet known if miR-137 acts as a bridge between stroke and depression. To test this, we used middle cerebral artery occlusion and chronic mild stress to establish a post-stroke depression model in rats. Compared with controls, we found significantly lower miR-137 levels in the brain and peripheral blood from post-stroke depression rats. Injection of a miR-137 antagonist into the brain ventricles upregulated miR-137 levels, and improved behavioral changes in post-stroke depression rats. Luciferase assays showed miR-137 bound to the 3＇UTR of Grin2A, regulating Grin2A expression in a neuronal cell line. Grin2A gene overexpression in the brain of post-stroke depression rats, no- ticeably suppressed the inhibitory effect of miR-137 on post-stroke depression. Overall, our results show that miR-137 suppresses Grin2A protein expression through binding to Grin2A mRNA, thereby exerting an inhibitory effect on post-stroke depression. Our results offer a new therapeutic direction for post-stroke depression.

Electroacupuncture at the Wangu (GB 12) acupoint suppresses expression of inflammatory factors in the hippocampus and frontal lobe of rats with post-stroke depression

Electroacupuncture was performed at the Wangu （GB 12） acupoint, whose position is similar to the cerebellar fastigial nucleus in rats with post-stroke depression. Results showed that the expression of nuclear factor-κB and the levels of tumor necrosis factor-α and interleukin-1β decreased. Simultaneously, the extent of edema in the hippocampus and frontal lobe decreased, and the morphology of the nerve cells recovered to near normal. In addition, fluoxetine treatment displayed a similar effect on post-stroke depression as electroacupuncture at GB 12 acupoint. The results indicate that electroacupuncture at GB 12 acupoint can reduce the levels of cytokines in the hippocampus and frontal lobe of rats with post-stroke depression, and thus provide a neuroprotective effect on post-stroke depression.

Relative factors analysis of depression after stroke

Objective To study the relative factors of concomitant depression after stroke.Methods Using Geriatric depression Scale(GDS)and SSS,we scored 121storke cases who were treated from January 2001to De cember 2001,in which 54cases were co ncomitant with depres-sion,assessed defect and promotion degree of nervous function,and obse rved relationship between number of lesion and onset of depression.Result Incidence of depression of cerebral hemarrhage patients was apparently higher than that of cerebral infarction patients(P <0.05),there was no apparent difference in lesion locat ion and concomitant depression(P >0.05),incidence of concomitant depression of stroke patients with multiple lesions was apparently hig her than that of stroke patients with single lesion.Conclusion Concomitant depression of stroke pa tients is related to location,number of lesio ns and severity of stroke.

Metabolic changes of prefrontal cerebral lobe,white matter and cerebellum in patients with post-stroke depression A proton magnetic resonance spectroscopy study

BACKGROUND： Proton magnetic resonance spectroscopy （IH-MRS） non-invasively detects changes in chemical substances in the brain, which reflects the pathological metabolism.OBJECTIVE： To investigate changes in N-acetyl-aspartate （NAA）, choline （Cho）, creatine （Cr）, and myoinositol （MI） in the gray and white matter of cerebral prefrontal lobe and cerebellum of patients with differential degrees of post-stroke depression （PSD） using ^1H-MRS. DESIGN： A case control study. SETTING： The First Affiliated Hospital of the Dalian Medical University. PARTICIPANTS： A total of 38 patients with stroke （28 male and l0 female patients, aged 40 to 79 years） were selected from the Department of Neurology, 1st Affiliated Hospital, Dalian Medical University, from February to October in 2004. All subjects met the DSM-IV criteria for cerebrovascular disease and depression. The degree of depression was defined according to Hamilton criteria. 38 patients with PSD were divided into two groups according to the time after ischemia, 20 patients in the acute group with less than 10 days after ischemic attack （mild： 16 patients, moderate/severe： 4 patients） and 18 patients in the chronic group with more than l l days after ischemic attack （mild： 15 patients, moderate/severe： 3 patients）. Seventeen healthy volunteers with matching age from 41 to 80 years were examined as a control group. The study was approved by the Medical Ethics Committee of the University Medical Center Utrecht, and each participant signed an informed consent form. METHODS： Spectra were acquired by multi-voxel point-resolved spectroscopy （PRESS） sequence with GE signal.5T MR/i, localized in prefrontal cerebral lobe and cerebellum. Values of NAA, Cho, MI, and Cr ere compared between different graded PSD patients and control subjects with one-way analysis of variance in software SPSS 11.5. MAIN OUTCOME MEASURES： Metabolite concentration in different brain regions of interest. Difference in metabolites between distinctly graded PSD patients and control subjects. Exclusion of age-effects on metabolites. RESULTS： Metabolite concentrations of different brain regions： A significant rise in the Cho/Cr ratio was detected in the acute and chronic group compared to the control group. The ratio change was more significant in the acute group （P 〈 0.05）. There was no significant difference between these three groups for other metabolites detected by IH-MRS in the right frontal white matter, bilateral frontal grey matter, and cerebellum （P 〉 0.05）. Comparison of metabolite levels among differently graded PSD patients and control subjects： a significant increase in the Cho/Cr ratio was detected in the left frontal white matter compared to the control group （P 〈 0.05）. There was no significant difference in age between patients in the stroke groups and the control group （P 〉 0.05）, and similarly, there was no significant correlation between age and absolute or relative values in the control group （P 〉 0.05）. CONCLUSION： Abnormalities of frontal lobe in PSD were located in the white matter. There was early abnormality of metabolic substance in PSD.

Effects of aquatic exercise on depression and anxiety in ischemic stroke subjects

Background: Stroke ranks third and is the leading cause of permanent disability in western countries. Furthermore there are no treatments for the psychosocial effects of this pathology. Purpose: Analyse the effect of an aquatic exercise program in depression and trace and state anxiety in subjects who suffered an ischemic stroke. Methods: Two groups were analyzed: experimental group (EG) n = 15, 50.3 ± 9.1 years;control group (CG) n = 13, 52.5 ± 7.7 years. EG underwent a 12-week aquatic exercise program. Both groups were evaluated in pre and post- treatment using Beck Depression Inventory (BDI) and Trace State Anxiety Inventory (IDATE). Wilcoxon signed-rank and Mann-Whitney tests were used to compare moments and groups, respec- tively. Results: The BDI scores of aquatic activities were: pre-treatment, 17.4 ± 7.7 and 16.9 ± 8.6 for the EG and CG, respectively;post-treat- ment, 13.2 + 7.1 and 16.4 + 7.9 for the EG and CG, respectively. The IDATE scores for anxiety trace in strength training were: pre-treatment, 43.2 + 12.5 and 42.9 + 12.2 for the EG and CG, respec- tively;post-treatment, 39.7 + 7.1 and 42.6 + 12.1 for the EG and CG, respectively. The IDATE scores for anxiety state in strength training were: pre-treatment, 46.9 + 7.6 and 47.4 + 8.1 for the EG and CG, respectively;post-treatment, 44.4 + 7.9 and 47.5 + 8.0 for the EG and CG, respectively. Significant differences were found in pre and post-treatment values in the EG and between groups in the depression and trace and state anxiety levels in post-treatment (p Conclusions: Aquatic physical activity contributes to an improvement of the levels of depression and anxiety in people who suffered a stroke.

Correlation between social support and depression in elderly stroke patients in the sequelae stage from five communities of Shanghai, China

Using a convenience sampling method, 81 aged patients who were between 6 and 24 months post-stroke were selected from five communities of Shanghai, China. The correlations between social support and depression, as well as other influential factors, were investigated. Results revealed that 46% （37/81） of the stroke patients suffered from depression. Depression was correlated with social support total scores and the two domains of subjective support and utilization. Older age, male gender, low income, absence of spouse and cerebral hemorrhage were risk factors for depression and identify more vulnerable groups.

Apolipoprotein E polymorphisms increase the risk of post-stroke depression

Recent reports have shown that apolipoprotein E （APOE） polymorphisms are involved in neurodegenerative disease. However, it is unclear whether APOE affects post-stroke depression. Accordingly, we hypothesized that APOE polymorphisms modify the risk of post-stroke depression. Here, we performed a hospital-based case-control study （including 76 cerebral infarction cases with post-stroke depression, 88 cerebral infarction cases without post-stroke depression, and 109 controls without any evidence of post-stroke depression or cerebral infarction） to determine possible association between APOE rs429358 and rs7412 polymorphisms and risk of post-stroke depression. Our findings show no difference among the groups with regards genotype distribution of the rs7412 polymorphism. In contrast, APOE genotypes with rs429358-C alleles increased the risk of post-stroke depression. Further, the rs429358 polymorphism was associated with significantly decreased regional cerebral blood flow values in the left temporal lobe of post-stroke depression cases. Additionally, the rs429358 polymorphism was not only associated with depression severity, but with increasing serum levels of total cholesterol. These resuits suggest that the APOE rs429358 polymorphism is associated with increased risk of developing post-stroke depression, and that APOE rs429358-C allele genotypes may be detrimental to recovery of nerve function after stoke. Indeed, these findings provide clinical data for future post-stroke depression gene interventions.

CLINICAL STUDY ON ACUPUNCTURE IN THE TREATMENT OF POST-STROKE DEPRESSION WITH THE METHOD OF ACTIVATING THE DU MERIDIAN AND CLEARING THE MIND

Objective: To observe the therapeutic effect of acupuncture in the treatment of post-stroke depression (PSD) with the method of activating the Du Meridian and clearing the mind. Methods: Two hundred and thirty one cases of PSD were randomly divided into two groups, acupuncture and control groups. In acupuncture group, Baihui (百会 GV 20), Dazhui (大椎 GV 14), Neiguan (内关 PC 6), Taichong (太冲 LR 3) and Shenmen (神门 HT 7) were selected as the main points to invigorate flow of qi in the Du Meridian and clear the mind. Patients in the control group received Fluoxetine orally, 20 mg once per-day. In addition, the same routine treatments were given to both groups, strengthened with rehabilitation exercises as early as possible; 8 weeks constituted one therapeutic course. HAMD and severity of neuro-functional defect of each case were evaluated before and 8-week after the treatment. Results: The total effective rate of acupuncture group was 92.37%, the control group, 72.88%. According to χ2 test, the difference between the two groups was remarkably significant (P<0.05). Conclusion: Acupuncture therapy of activating the Du Meridian and clearing the mind in the treatment of PSD was safe and effective.

Ginkgo Leaf Extract and Armillariella Mellea Powders Oral(银杏蜜环口服溶液) attenuates inflammation of microglia in habenular nucleus through CX3CL1-CX3CR1 axis in post stroke depression

OBJECTIVE The Ginkgo Leaf Extract and Armillariella Mellea Powders Oral(Yinxingmihuan Koufu Rongye,YXMH),a representative drug for"Treating both Brain and Heart",showed considerable clinical effects in isch⁃emic cardiovascular and cerebral vascular diseases.Recently,it is reported that YXMH has the potential for treating myocardial and cerebral ischemia related mental disorders,such as post stroke depression(PSD)and chronic heart disease(CHD)associated anxiety disorder.However,its mechanism has not been clearly elucidated.Meanwhile,increasing evidence revealed that there are close functional links between depression and habenular nucleus.The present study investigates the underlying mechanism of YXMH on attenuating the inflammation of microglia in habenular nucleus through CX3CL1-CX3CR1 axis in in a rat model of PSD.METHODS Rats were randomly devided into sham group,model group,Ginaton group(18 mg·kg^-1),Armillariella Mellea group(600 mg·kg-1),Fluoxetine group(10 mg·kg^-1),YXMH high-dose group(618 mg·kg^-1)and YXMH low-dose group(309 mg·kg^-1).The PSD model was induced by transarterial microembolization combined with sleep deprivation(2-Chloro-D-phenylalanine,PCPA,IH,200 mg·kg^-1,for 3 times,before the behavior test)in SD male rats.Then rats were treated with corresponding medicaments through gavage once a day until 3 weeks later,followed by body mass measurement,neurological deficit score evaluation,gripping strength and thermal withdrawl latency measurement,as well as depression related behavioral indicators,the open field test(OFT)and sucrose preference test.The pathological morphological changes of habenular nucleus was observed by HE staining,the expression of IBA-1 was measured and analyzed by immunohistochemistry staining,and alterations of proteins and genes related to the CX3CL1-CX3CR1 axis were analyzed using Western blotting(CX3CL1,CX3CR1)and real-time polymerase chain reaction(PCR)(CX3CL1,CX3CR1).RESULTS Compared with the sham group,rats in the model group manifested as decreased body mass,deficient neurological behavior and gripping strength,reduced loco⁃motor activity and sugar water consumption,as well as elevated thermal withdrawl latency(P<0.05,P<0.01).Mean⁃while,the pathological morphology of the habenular nucleus on the ischemic hemisphere showed significant neuronal degeneration,microglial proliferation,inflammatory cells and glia cells infiltration,together with up-regualted expression of IBA-1,CX3CL1,CX3CR1 protein and CX3CL1,CX3CR1 mRNA.YXMH attenuated inflammation of microglia in habenular nucleus through improving pathological morphology,inhibiting IBA-1 activation,down-regulating the expres⁃sion of CX3CL1 and CX3CR1 proteins and genes,and thus improved the behavior performance of ischemic injury and depression.CONCLUSION YXMH ameliorates neurological deficit and depressive behavior in rat model of PSD induced by transarterial microembolization combined with sleep deprivation,and the mechanism is probably related to attenu⁃ating inflammation of microglia in habenular nucleus through CX3CL1-CX3CR1 axis.

Melatoninergic Antidepressant in Post-Stroke Depression Therapy

This paper presents the results of the effects of Melitor (25 mg during two months) on the psychic-emotional state, cerebral hemodynamic and bioelectrical activity of the brain in 30 patients (average age 66.2 ± 3.2 years) with ischemic post-stroke depression. It has been found that this drug possesses a multimodal action which is characterized by the decrease of the level of depression, widening of the range of social-environmental activity, improvement of the cerebral blood circulation and harmonization of the brain electrogenesis. In the patients with right versus left hemisphere stroke, the effect of Melitor on the functional state of the brain was more pronounced. Based on the results obtained in our study, we can recommend Melitor to use it in complex scheme of rehabilitation care of patients of the given nosological category.