重性抑郁障碍患者躯体症状与脑源性神经营养因子和炎性因子的相关性研究

背景 大量证据表明抑郁障碍患者的躯体症状的风险比正常人高,但躯体易感性的机制尚不明确。部分研究认为前者脑源性神经营养因子前体(ProBDNF)、炎性因子水平比正常人高,而这是否与伴随的躯体症状有关还没有明确的结论。目的 探讨重性抑郁障碍(MDD)患者躯体症状与脑源性神经营养因子(BDNF)、炎性因子的特征及其相关性。方法 选取2019年2月至2020年12月山西医科大学第一医院精神卫生科门诊或住院部MDD患者59例与同期社区招募的健康志愿者32例作为研究对象。根据躯体化症状自评量表(SSS)将MDD患者分为伴躯体症状抑郁障碍(SD)组37例(SSS总分>36分)和不伴躯体症状抑郁障碍(NSD)组22例(SSS总分≤36分),32例健康志愿者为健康对照组(HC组)。收集临床资料,包括性别、年龄、受教育年限、17项汉密尔顿抑郁量表(HAMD-17)评分、SSS评分、BDNF、ProBDNF与炎性因子[C反应蛋白(CRP)、白介素4(IL-4)、白介素6(IL-6)、白介素10(IL-10)、白介素18(IL-18)、白介素23a(IL-23a)、高迁移率族蛋白B1(HMGB1)、肿瘤...     

智能电针合并阿米替林治疗抑郁症的临床观察

目的　比较智能电针合并阿米替林治疗抑郁症与单纯阿米替林治疗抑郁症的疗效。方法　针药组口服阿米替林(15 0 - 2 5 0 m g/ d)合并智能电针治疗 ;药物组口服阿米替林 ,15 0 - 2 5 0 m g/ d。治疗前后以汉密尔顿抑郁量表 (HAMD)评分 ,并加以比较。结果　治疗前后评分比较 ,两组有显著性差异 (P<0 .0 5 )。结论　智能电针合并阿米替林治疗优于单纯阿米替林治疗抑郁症的疗效。     

Mental Health Multimorbidity among Caregivers of Older Adults During the COVID-19 Epidemic

ObjectiveTo investigate mental health status and associated factors among caregivers of older adults during the COVID-19 epidemic in China.MethodsFrom March 1 to 31, 2020, 916 caregivers of older adults participated in an online cross-sectional survey on the prevalence of anxiety, depression, and sleep problems. The seven-item Generalized Anxiety Disorder Scale (GAD-7) was administered to measure anxiety symptoms, the two-item Patient Health Questionnaire (PHQ-2) was used to assess depressive symptoms, and a self-developed questionnaire was used to assess sleep quality and duration. Six questions about COVID-19-related experiences were used to assess community-level infection contact and the level of exposure to media information. The prevalence rates of anxiety, depression and sleep problems were computed. The Wald χ² were applied to compare the differences between subgroups. Multiple logistic regression analyses were performed to investigate factors associated with anxiety, depression, sleep problems, and multimorbidity.ResultsThe prevalence rates of anxiety, depression, and sleep problems were 46.8%, 29.8%, and 10.8%, respectively. Approximately 263 participants (28.7%) presented with two or more mental health problems. Being female (OR, 2.254; 95% CI, 1.510–3.363), having community-level COVID-19 contact (OR, 1.856; 95% CI, 1.189–2.898), and having a mental disorder (OR, 3.610; 95% CI, 1.644–7.930) were associated with increased risk of multimorbidity among caregivers. Caregivers who preferred positive information (OR, 0.652; 95% CI, 0.472–0.899) had reduced risk of multimorbidity.ConclusionAnxiety and depression were common among caregivers of older adults during the COVID-19 epidemic. Being female and having community-level COVID-19 contact were independent risk factors for experiencing multiple mental health problems. Preexisting mental disorders increased the risk of multimorbidity among caregivers, while enhanced access to positive media information decreased the risk of multimorbidity.     

Potential crowdedness of mechanical thrombectomy and cerebral infarction mortality in Japan: Application of inverted two-step floating catchment area method

ObjectivesThis study aimed to evaluate a stroke medical delivery system based on population coverage and the potential crowdedness index (PCI) of mechanical thrombectomy and investigate the relationship between PCI and cerebral infarction mortality in Japan.Materials and methodsThis cross-sectional study defined 662 facilities and 1605 neurointerventionalists as supply, population aged 55 years or older as demand, and set the reachable area for demand as 120 min in driving time. Multiple regression analysis adjusted for spatial autocorrelation was used to examine the relationship between PCI and cerebral infarction mortality.ResultsIn the 2020 data, 99% of the population aged 55 years or older had access to mechanical thrombectomy (≤120 min), and the PCI ranged from 5876 to 129838, with a median of 30426. From 2020 to 2035, the PCI is estimated to increase (30426 to 32510), decreasing after 2035 (32510 to 29469). The PCI distribution exhibited geographical heterogeneity. High PCI values emerged in eastern Japan. According to regression analysis, the increase in PCI by 1% led to an increase of 0.13% in standardized mortality ratio of cerebral infarction in men. However, PCI did not significantly correlate with cerebral infarction mortality in women.ConclusionsPCI for hospitals based on supply and demand was geographically heterogeneous in Japan. Optimization of PCI contributes equalization of mechanical thrombectomy provision system and may improve cerebral infarction mortality.     

Comparative effectiveness of different acupuncture courses in functional constipation: A Bayesian network meta-analysis of clinical trials

AimThe purpose of this study was to examine the comparative effectiveness of different acupuncture courses for functional constipation (FC).BackgroundThere is a need to optimize the treatment course of acupuncture for FC to improve efficacy and save health resources.MethodsWe performed a systematic electronic search of eight databases from inception to April 2021. Randomized controlled trials comparing acupuncture treatment with sham acupuncture were included. The main outcome indicators were complete spontaneous bowel movement (CSBM), spontaneous bowel movement, Bristol Stool Form Scale (BSFS), responder rate and safety evaluation (SE).ResultsIn this network meta-analysis, 19 studies with 1753 participants and 8 different acupuncture treatments were included. Using the consistency model via Monte Carlo simulation iterations, we found that the effect of acupuncture treatment at 3/4 weeks may be better in terms of CSBM and BSFS. The results of rank probability analysis showed that 6 weeks of treatment may be better for the responder rate, and 2 weeks of treatment may be better for SE. And, subgroup analysis found that, for patients with chronic severe functional constipation (CSFC), 8 weeks of acupuncture treatment may be the best for CSBM.ConclusionsBy indirect comparison, 3/4 weeks of acupuncture treatment may be the optimal course of treatment for FC in terms of improving bowel frequency and stool shape. And for CSFC, 8 weeks of acupuncture treatment may be the best. However, there is still a lack of direct comparison and publication bias that affects the accuracy of research results.     

少数民族预科生的民族认同、社会支持与生活满意度

目的:考查少数民族预科生的民族认同、社会支持和生活满意度的状况,并探讨三者之间的关系,为高校开展少数民族预科生心理健康教育提供依据。方法:选取某民族预科学校少数民族预科生430名,使用少数民族认同问卷中的本民族认同分问卷、社会支持评定量表(SSRS)和青少年学生生活满意度量表(ASLSS)进行施测。结果:ASLSS得分与本民族认同分问卷得分、SSRS得分均呈正相关(r=0.47、0.48,P<0.01)。以民族认同得分作为自变量,社会支持得分和生活满意度得分作为因变量进行回归分析发现,民族认同感分别能够解释社会支持14%和生活满意度22%的变异量;以社会支持得分作为自变量,生活满意度得分作为因变量进行回归分析发现,社会支持能解释生活满意度23%的变异量。社会支持得分的中介效应检验发现,社会支持得分在民族认同得分和生活满意度得分间起部分中介作用,中介效应占总效应的比例为28.12%。结论:民族认同和社会支持与少数民族预科生生活满意度存在相关,增强少数民族预科生的民族认同和社会支持感可有助于提高其生活满意度。