青少年抑郁症患者性激素受体基因微卫星多态性与功能失调性认知的关系

目的探讨青春期首发的青少年抑郁症患者性激素受体基因微卫星多态性是否与功能失调性认知存在联系。方法采用聚合酶链式反应（PcR）结合毛细管电泳和基因扫描技术。检测青春期首发的青少年抑郁症患者雄激素受体（AR）、雌激素受体α（ERα）、雌激素受体β（ERβ）基因重复序列多态性的重复片段长度。应用《功能失调性态度问卷》（DAS）对青少年抑郁症患者进行评估，并把评估结果和微卫星多态片段长度进行相关性和对照性分析。结果1．女性患者ERβ基因微卫星多态性与DAS总分呈显著仉相关；2．对各位点等位基因分长短片段作组间比较。发现ERα短片段组DAS总分显著高于长片段组。男性患者不存在这种差异性。3．AR受体与功能失调性认知不存在这种联系。结论女性青少年ERα、ERβ受体基因微卫星多态可能与功能失调性认知存在联系，而男性青年抑郁症患者可能不存在这种联系。     

案例教学法在药剂科临床实习中的应用效果分析

目的研究案例教学法(CBL)在药剂科临床实习中的应用效果。方法将本院2018年1月-12月实习生252例随机分为两组各126例,其中观察组采用CBL进行教学,对照组则给予传统教学方法,比较两组实习后教学成绩和实习生学习主动性。结果干预后,观察组抗菌药物、激素类药物、抗心律失常药物、抗肿瘤药物及解毒药物考核成绩均高于对照组;观察组学习积极主动性量表学习驱动力、深入学习、控制学习、扎实学习评分及总分高于对照组,差异均有统计学意义(P<0.05)。结论CBL用于药剂科临床实习可有效提升实习生学习兴趣和主动性,从而提升其临床知识掌握水平和运用能力。     

硫化氢保护被ATP损伤的PC12细胞

目的:观察硫化氢的供体硫氢化钠(Na HS)对三磷酸腺苷(ATP)诱导的PC12细胞活力、胞内Ca2+浓度([Ca2+]i)及膜通透性的变化,探讨硫化氢神经保护作用的嘌呤信号机制。方法:将对数生长期高分化的PC12细胞,随机分为4组,分别为(1)正常对照组:常规培养,不进行ATP处理;(2)ATP组:接种细胞24 h后ATP处理;(3)Na HS+ATP组:Na HS预先孵育30 min后再用ATP处理,并且Na HS始终存在于反应体系中;(4)KN-62(P2X7受体阻断剂)+ATP组:KN-62预先孵育30 min,其余同Na HS+ATP组。MTT检测各组细胞活力,Fura-2/AM荧光染料检测各组[Ca2+]i,检测荧光染料YO-PRO-1的相对荧光单位以反映膜的通透性。结果:(1)0.3mmol/L ATP对细胞活力无影响,但1、3、5、10 mmol/L ATP则呈浓度依赖式明显降低细胞活力,200μmol/L Na HS干预可明显逆转ATP引起的细胞活力下降(P0.05),而800μmol/L Na HS预处理则加剧ATP对PC12细胞的损伤(P0.05)。(2)ATP处理PC12细胞会引起[Ca2+]i迅速升高并且呈浓度依赖性,Na HS预处理能对抗ATP引起的[Ca2+]i升高(P0.05)。(3)随着ATP浓度的增加及作用时间的延长,PC12细胞内YO-PRO-1的荧光强度显著增加,Na HS预处理可明显减少细胞对YO-PRO-1的摄取(P0.05)。结论:硫化氢可保护ATP损伤的PC12细胞,可能与其抑制[Ca2+]i升高和YO-PRO-1荧光增强有关。     

Laparoscopic versus open pancreatoduodenectomy: an individual participant data meta-analysis of randomized controlled trials

BackgroundRandomized trials have compared laparoscopic pancreatoduodenectomy (LPD) to open pancreatoduodenectomy (OPD) with conflicting results. An IPDMA may give more insight into the differences between LPD and OPD, and could identify high-risk subgroups.MethodsA systematic literature search was performed in the Pubmed, Embase, and the Cochrane library databases (October 2019). Out of 1410 studies, three randomized trials were identified. Primary outcome was major complications (Clavien-Dindo grade ≥ III). Subgroup analyses were performed for high-risk subgroups including patients with BMI of ≥25 kg/m2, pancreatic duct <3 mm, age ≥70 years, and malignancy.ResultsData from 224 patients were collected. After LPD, major complications occurred in 33/114 (29%) patients compared to 34/110 (31%) patients after OPD (adjusted odds ratio (OR) 0.62; 95% confidence interval (CI) 0.3–1.4, P = 0.257). No differences were seen for major complications and 90-day mortality LPD 8 (7%) vs OPD 4 (4%) (adjusted OR 0.2; 95% CI 0.02–1.3, P = 0.080). With LPD, operative time was longer (420 vs 318 min, p < 0.001) and hospital stay was shorter (mean difference ?6.97 days). Outcomes remained stable in the high-risk subgroups.ConclusionLPD did not reduce the rate of major postoperative complications as compared to OPD. LPD increased operative time and shortened hospital stay with 7 days.     

Increased regional homogeneity modulated by metacognitive training predicts therapeutic efficacy in patients with schizophrenia

European Archives of Psychiatry and Clinical Neuroscience - Previous studies have demonstrated the efficacy of metacognitive training (MCT) in schizophrenia. However, the underlying mechanisms...     

孕酮对缺血/再灌注脑损伤大鼠脑磁共振波谱和ATP-P2X7R信号通路的影响

目的 探讨孕酮（progesterone,PROG）对缺血/再灌注（ischemia-reperfusion,I/R）脑损伤大鼠的神经保护作用及其可能机制。方法 138只大鼠随机等分为假手术（Sham）组、大脑中动脉栓塞（middle cerebral artery occlusion,MCAO）组和PROG+MCAO组,分别采用Longa法和Morris水迷宫试验评估大鼠运动功能和认知功能;脑组织TTC染色法、磁共振波谱（magnetic resonance spectroscopy,MRS）法和Annexin V-FITC/PI双染法评估神经细胞损伤情况;ELISA法检测脑脊液ATP、IL-6、TNF-α和COX-2含量;Western blotting法检测脑组织P2X₇R和NF-κB蛋白表达的变化。结果 与MCAO组相比,PROG+MCAO组大鼠Longa评分（第5~7天）和Morris水迷宫试验潜伏期（第4~7天）下降（P<0.05或P<0.01）,而目标交叉次数增高（P<0.05）;PROG+MCAO组大鼠NAA/Cr和Cho/Cr比值较MCAO组升高,脑梗死体积和细胞凋亡率较MCAO组明显降低（P<0.05）;MCAO组脑脊液ATP、COX-2、TNF-α和IL-6的含量明显高于Sham组,PROG+MCAO组上述指标含量明显低于MCAO组（P<0.05）;MCAO组脑组织P2X₇R和NF-κB蛋白的表达水平高于Sham组,而其在PROG+MCAO组表达水平又明显低于MCAO组（P<0.05）。结论 PROG通过降低神经细胞凋亡率、减轻神经元损伤及髓鞘降解而改善I/R脑损伤大鼠运动和认知功能,这一保护作用与其抑制ATP-P2X₇R信号通路密切相关。     

Cognitive-coping therapy for obsessive–compulsive disorder: A randomized controlled trial

Pharmacotherapy and cognitive-behavioral therapy (CBT) are widely used to treat obsessive–compulsive disorder (OCD). These treatments have helped many patients with OCD, but there still is room for improvement. Recently, a promising psychotherapy for OCD, cognitive-coping therapy (CCT), has been developed. Pharmacotherapy plus CCT (PCCT) demonstrates higher efficacy in a shorter period of time and lower relapses than pharmacotherapy or pharmacotherapy plus CBT. In this randomized controlled trial, we investigated the efficacy of CCT for OCD treatment. One hundred and forty-five OCD patients were randomly assigned into two groups: pharmacotherapy (N = 72) and PCCT (N = 73). In each group, drug-resistant (DR) and non-drug-resistant (NDR) OCD were further analyzed to examine the efficacy of CCT. Some clinical features and the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) were blindly assessed pre-treatment and post-treatment at week 1, 2, 3, 4, and 12. The Y-BOCS scores were significantly lower in PCCT than in the pharmacotherapy group at any post-treatment time-point (P < 0.001). Compared with pre-treatment, the Y-BOCS scores were significantly reduced at any time-point (P < 0.001) in PCCT group, but only at week 12 (P < 0.001) in the pharmacotherapy group. In the PCCT group, there were no differences between DR and NDR groups' Y-BOCS scores at any post-treatment time-point. The response rates and remission rates were higher in PCCT than in the pharmacotherapy group. Three variables, the number of weeks of treatment, insight, and disregarding of obsessions, were significantly correlated with the Y-BOCS score. Therefore, CCT might be a potential treatment for OCD.     

单磷酸阿糖腺苷联合布地奈德治疗小儿毛细支气管炎的临床研究

目的探讨单磷酸阿糖腺苷联合布地奈德治疗小儿毛细支气管炎的临床疗效。方法选取2014年9月—2016年9月沈阳医学院附属中心医院儿科收治的毛细支气管炎患者151例,随机分成对照组(75例)和治疗组(76例)。对照组雾化吸入吸入用布地奈德混悬液,0.5 mg加入生理盐水3 m L,1次/d,10 min/次。治疗组在对照组的基础上静脉滴注注射用单磷酸阿糖腺苷,0.1 g加入5%葡萄糖溶液100 m L中,1次/d。所有患者均治疗1周。观察两组患者临床效果,对比两组治疗前后症状消失时间、住院时间、炎性指标以及不良反应情况。结果治疗后,对照组和治疗组总有效率分别为84.00%和96.05%,两组总有效率比较差异具有统计学意义(P0.05)。治疗后,治疗组患儿的退热时间、湿啰音消失时间、喘息消失时间和咳嗽消失时间以及住院时间均明显短于对照组,两组比较差异具有统计学意义(P0.05)。治疗后,两组患儿肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)以及IL-8指标均明显降低(P0.05);且治疗组的降低程度明显优于对照组,两组比较差异有统计学意义(P0.05)。结论单磷酸阿糖腺苷联合布地奈德治疗小儿毛细支气管炎,在临床症状消失时间、住院时间以及炎症因子水平改善方面上均优于单独使用布地奈德治疗,具有一定的临床推广应用价值。     

Changes in pro-inflammatory cytokines and body weight during 6-month risperidone treatment in drug naïve, first-episode schizophrenia

Objective

The present study aimed to examine the changes in pro-inflammatory cytokines and body weight during 6-month risperidone treatment in drug naïve, first-episode schizophrenia.

Methods

Sixty-two drug naïve, first-episode schizophrenia (SZ group) and 60 healthy individuals (control group) were enrolled in the study. Serum interleukin-1β (IL-1β), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) levels, and body weight were measured at baseline for both groups, and repeated for the SZ group at five different time points during 6-month risperidone treatment.

Results

At baseline, serum IL-1β, IL-6, and TNF-α levels in the SZ group (53.28?±?12.62, 33.98?±?14.13, 50.08?±?12.86 pg/mL, respectively) were significantly higher than those in the control group (23.49?±?15.27, 15.53?±?7.16, 32.12?±?15.23 pg/mL, respectively) (p's?<?0.001). Within the SZ group, serum IL-1β levels decreased significantly at 2 weeks (48.02?±?16.00 pg/mL, p?<?0.01) and 1 month (44.70?±?16.63 pg/mL, p?<?0.001), but then gradually increased at 2 months (48.49?±?18.87 pg/mL), 3 months (50.59?±?18.48 pg/mL) and 6 months (53.64?±?16.22 pg/mL) to the levels comparable to baseline; serum IL-6 levels changed significantly over the course of treatment (p?=?0.001), but reached the levels comparable to baseline at 6 months (37.13?±?13.23 pg/mL); serum levels of TNF-α increased significantly at 3 months (55.02?±?16.69 pg/mL, p?<?0.01) and 6 months (58.69?±?13.57 pg/mL, p?<?0.001); steady and significant weight gain was observed at each follow-up time point (p's?<?0.001), from 56.71?±?9.25 kg at baseline to 62.72?±?9.53 kg at 6 months.

Conclusions

Risperidone treatment is associated with changes in serum pro-inflammatory cytokines levels and weight. There is an initial anti-inflammatory effect that reduces with treatment, potentially due to its weight gain side effect.