A randomized study on the effect of modified behavioral activation treatment for depressive symptoms in rural left-behind elderly

Objective: To evaluate the effectiveness of a modified behavioral activation treatment (MBAT) intervention on reducing depressive symptoms in rural left-behind elderly.

Method: This is a randomized study registered in Chinese Clinical Trial Registry (ChiCTR-IOR-17011289). Eighty rural left-behind elderly people who had a Geriatric Depression Scale (GDS) score between 11 and 25 were randomly assigned to the intervention (n?=?40) and control group (n?=?40). The intervention group received both MBAT and regular treatment for 8 weeks while the control group received regular treatment. Both groups were assessed with the GDS, Beck Anxiety Inventory (BAI), and Oxford Happiness Questionnaire (OHQ) at baseline, immediately post-intervention, and at 3 months post-intervention.

Results: There were a total of 73 participants that completed the intervention. The scores of GDS and BAI decreased significantly, but the scores of OHQ increased significantly in the intervention group after 8 sessions of MBAT (P?<?.01). The reduction in depression symptoms after the intervention was maintained at the 3-month follow-up. Significant differences in GDS, BAI, and OHQ scores were observed between the intervention group and the control group (P?<?.01).

Conclusion: MBAT produced a significantly greater reduction in depressive symptoms than regular care in rural left-behind elderly.

Clinical or methodological significance of this article: A modified behavioral activation (BA) psychotherapy can significantly reduce the recurrence and seriousness of depression symptoms in the left-behind elderly with mild to moderate depression. This study also suggests that further study of the MBAT as an intervention will provide a direction for the management of mental health in rural left-behind elders.     

PERK信号通路介导结肠癌细胞对5-氟尿嘧啶耐药机制的研究

目的:观察PERK蛋白对结肠癌细胞药物敏感性的影响，并进一步探讨其相关作用机制。方法:结肠癌细胞系HCT116分为三组:空白对照（Control）组、下调PERK表达（si-PERK）组、阴性对照（si-NC）组；采用免疫荧光及RT-PCR验证转染效率；利用CCK-8实验检测下调PERK表达后结肠癌细胞对化疗药物5-FU的敏感性变化；Annexin V-FITC凋亡实验检测下调PERK表达对结肠癌细胞凋亡的影响；利用RT-PCR及Western Blot实验检测PERK信号通路中关键分子eIF2α、ATF4、CHOP、XIAP的mRNA及蛋白表达变化。结果:RT-PCR实验表明:与正常对照组相比，si-PERK 组mRNA的表达显著下降（P＜0.05）,免疫荧光提示转染效率达80%以上；CCK-8实验发现与si-NC组相比，5-FU对 si-PERK组细胞的半数抑制浓度（IC50）明显降低（P＜0.01）；Annexin V-FITC凋亡实验发现与si-NC组相比，si-PERK组细胞的凋亡发生率显著升高（P＜0.05）；RT-PCR及Western Blot实验发现与si-NC组相比，si-PERK组细胞中PERK信号通路下游关键分子eIF2α、ATF4、CHOP的mRNA及蛋白表达均明显降低（P＜0.05）。结论:在结肠癌细胞中，抑制PERK表达后，其可能通过下调eIF2α、ATF4、CHOP的表达促进细胞发生凋亡，从而促进细胞对化疗药物5-FU的敏感性。     

基于网络药理学与分子对接技术的石菖蒲治疗癫痫作用机制研究＊

目的 利用网络药理学和分子对接技术研究石菖蒲抗癫痫的有效成分及作用机制。方法 运用中药系统药理数据库及分析平台检索石菖蒲有效成分及主要靶点，通过GeneCards数据库收集癫痫疾病的相关潜在作用靶点，运用Cytoscape.3.7.1和 String绘制石菖蒲-癫痫靶点互作关系图，运用Metascape数据库进行GO和KEGG信号通路富集分析。运用AutoDock Vina 1.1.2软件对石菖蒲主要有效成分与癫痫相关靶标进行分子对接验证；通过构建戊四唑诱导的癫痫模型初步评价石菖蒲提取物及潜在有效成分的抗癫痫作用。结果 由 TCMSP 筛选得到4个有效成分及76个主要靶点。癫痫疾病以“Score”大于1.5分进行筛选得到3685个靶标。GO富集分析得到BP条目10个，细胞CC条目9个，MF条目10个（P<0.01），主要涉及核受体活性、离子通道活性、激素结合、神经递质受体活性、蛋白激酶活性、钙调蛋白结合等。KEGG 富集得到14条通路，主要涉及c型凝集素受体信号通路、雌激素信号通路、Ca²⁺信号通路、逆行内源性大麻素信号通路等。分子对接结果显示，桉脂素、山奈酚和8-异戊烯基山奈酚与癫痫关键靶标GABRA2、PPARG等具有良好的结合活性。动物实验结果表明，石菖蒲水提取物及主要潜在有效成分桉脂素和山奈酚在PTZ致小鼠癫痫模型上显示出较好的抗癫痫活性。结论 本研究通过动物实验验证了石菖蒲提取物和潜在有效成分的抗癫痫活性，并且运用网络药理学和分子对接技术探讨了其抗癫痫作用机制，发现石菖蒲可通过多个成分如桉脂素、山奈酚、8-异戊烯基山奈酚，多靶点如GABA_A、PPARG等，多条通路如雌激素信号通路、钙信号通路对机体产生协调效应从而抑制癫痫的发作。该研究提示石菖蒲治疗癫痫具有多成分、多靶点、多通路特点，为石菖蒲的进一步研究提供数据支撑。     

出院过渡期老年心力衰竭患者相关症状及影响因素的纵向研究

目的调查老年心力衰竭患者出院过渡期心衰相关症状,分析其变化趋势及影响因素。方法采用Memorial心力衰竭症状评估量表、心脏病患者抑郁量表、照护负担问卷和家属照护者照护能力问卷,对219例老年心衰患者及主要家庭照护者,于患者出院前1～2 d、出院后1个月和3个月进行调查。结果患者的心衰相关症状随着出院过渡期的延长呈恶化趋势,与出院前1～2 d相比,出院后1个月和3个月患者的心衰症状总分及各维度得分显著提高(P0.01)。抑郁症状在出院后1个月得分最高(90.31±3.27),随着过渡时间的延长得分逐渐下降(P0.01)。回归分析显示,出院过渡期患者心衰相关症状受患者服药种类、心功能分级和照护能力的影响;抑郁受患者年龄、病程和住院次数的影响(P0.05,P0.01)。结论老年心衰患者出院过渡期心衰相关症状较差且呈动态变化,受多种因素影响。护理人员应该制定针对性的过渡期护理计划,减轻患者症状负担。