艾司西酞普兰和氟西汀对抑郁症的疗效和认知改善情况对比

目的对比艾司西酞普兰和氟西汀对抑郁症的疗效和对认知改善的作用。方法将2017年1月～2019年1月我院收治的抑郁症患者60例随机分为2组,每组30例。对照组采用氟西汀治疗,观察组采用艾司西酞普兰治疗。比较两组治疗前后HAMD、MoCA评分情况、临床疗效、生活质量以及不良反应。结果治疗前观察组和对照组HAMD、MoCA评分上无明显差异(P=0.457/0.624),治疗后观察组优于对照组(P=0.000);对照组有效率为86.67%,优于观察组的63.33%(P=0.000);观察组在情感职能、生理、躯体、社会等功能评分上优于对照组(P=0.000);观察组不良反应发生率为6.67%,低于对照组的23.33%(P=0.000)。结论与氟西汀相比,艾司西酞普兰可快速改善抑郁症患者的抑郁症状和认知功能,提升患者生活质量,且不良反应较少。     

艾司西酞普兰与氟西汀治疗老年期抑郁症对照研究

目的观察艾司西酞普兰治疗老年期抑郁症的疗效和安全性。方法采用随机对照、开放标签设计,103例老年抑郁症患者随机分到艾司西酞普兰治疗组和氟西汀治疗组,治疗8周。汉密尔顿抑郁量表（HAMD）和汉密尔顿焦虑量表（HAMA）评估患者疗效,意向治疗分析法（Intent to Treat Analysis,ITT）处理研究数据。对中途退出或失访的病例按照末次观察推进法（Last Observation Carried Forward,LOCF）处理缺失值。结果治疗8周脱落率艾司西酞普兰组低于氟西汀组,差异有统计学显著性（21％：41％,χ^2=4．82,P〈0．028）;完成8周疗效观察的病例,艾司西酞普兰组有效率为90．3％;氟西汀组有效率86．6％,两组差异无统计学差异（χ^2=1．282,P=0．673）;ITT分析显示两组8周时疗效显著性差异,艾司西酞普兰治疗组抑郁和焦虑症状评分改善的时间早于氟西汀组,且不良反应率低于氟西汀组。结论艾司西酞普兰治疗老年抑郁症患者疗效和耐受性均优于氟西汀。     

抗抑郁药物治疗惊恐障碍的疗效及可接受性的网状Meta分析

目的评价抗抑郁药物治疗惊恐障碍的疗效及可接受性。方法电子检索Medline、Embase、Cochrane Library、中国生物医学文献数据库、中国知网等中英文数据库,纳入抗抑郁药物治疗惊恐障碍的头对头随机对照试验,依据Cochrane 5.1.0版质量评价标准评价纳入文献的质量并进行偏倚评价,采用Stata 14.2软件进行网状Meta分析。结果共25个研究进入网状Meta分析,涉及10种药物,分别为米氮平、帕罗西汀、氯丙咪嗪、西酞普兰、氟西汀、文拉法辛、艾司西酞普兰、舍曲林、瑞波西汀、安非他酮。分析结果显示,有效性较好的药物为艾司西酞普兰、氟西汀、文拉法辛、帕罗西汀,但药物两两比较差异均无统计学意义(P>0.05);减分效果最佳的药物为氟西汀、艾司西酞普兰、米氮平、安非他酮,与氯丙咪嗪比较,氟西汀[MD=4.27(1.12,7.43)]、艾司西酞普兰[MD=3.84(1.49,6.19)]、米氮平[MD=3.42(0.83,6.01)]、帕罗西汀[MD=2.81(0.82,4.80)]、文拉法辛[MD=2.06(0.11,4.02)]在减分效果方面具有明显优势,可以显著降低HAMA评分,其他两两比较差异均无统计学意义(P>0.05);耐受性较好的药物是帕罗西汀,其次是文拉法辛、艾司西酞普兰,但药物两两比较差异均无统计学意义(P>0.05)。结论作为治疗惊恐障碍的一线治疗药物,帕罗西汀、文拉法辛、艾司西酞普兰兼具疗效和安全性,为可供选择的有效药物。     

艾司西酞普兰治疗惊恐障碍疗效观察

目的 了解艾司西酞普兰治疗惊恐障碍的疗效和安全性.方法 将患者随机分为艾司西酞普兰组或西酞普兰组,疗程12周,使用汉密尔顿焦虑量表(HAMA)、惊恐相关症状量表(PASS)、不良反应量表(TESS)在两组患者治疗前及治疗第1、2、4、8、12周进行评分.结果 艾司西酞普兰组有效率为84.21%,司西酞普兰组有效率为81.08%,无统计学意义(χ＜'2＞=0.13,P＞0.05).治疗2周时,艾司西酞普兰组HAMA评分低于对照组,有统计学意义(t=2.87,P＜0.01).治疗2、4周时艾司西酞普兰组PASS评分低于对照组,有统计学意义(P＜0.05).结论 艾司西酞普兰治疗惊恐障碍同西酞普兰同样安全有效,和西酞普兰相比,能更快地控制患者的焦虑症状和惊恐障碍的核心症状.     

淫羊藿苷对脂多糖+γ-干扰素复合诱导的BV2小胶质细胞的调节作用

目的研究淫羊藿苷(icariin,ICA)对细菌脂多糖(lipopolysaccharide,LPS)加γ-干扰素(interferon-γ,IFN-γ)复合诱导小鼠小胶质细胞系BV2细胞炎性反应模型的调节作用。方法采用LPS+IFN-γ复合诱导小鼠小胶质细胞系BV2细胞,构建拟神经炎性反应的小胶质细胞活化的体外细胞模型。将传代培养的BV2细胞分为对照组、LPS+IFN-γ模型组(模型组)以及不同浓度ICA 1、2、4、8、16、32、64、128、256μmol/L干预组。采用CCK8法检测各组细胞存活率,采用ELISA法检测各组细胞培养上清中NO水平,采用免疫荧光染色技术观察BV2细胞CD16/32蛋白表达情况。结果与对照组比较,模型组BV2细胞培养上清中NO水平明显高[(16.46±0.73)μmol/L vs.(2.55±0.41)μmol/L;t=16.59,P0.01],与模型组比较,ICA 16、32、64μmol/L干预组其NO表达水平明显降低[分别为(13.76±0.55)、(12.66±0.51)、(10.60±0.46)μmol/L;P0.05,P0.01,P0.01)]。与对照组比较,模型组CD16/32表达增加[(5823.00±109.99)vs.(118.60±89.04);t=48.77,P0.01];与模型组比较,ICA 32、64μmol/L干预组小胶质细胞CD16/32蛋白表达均明显降低(分别为3327.67±126.73、2725.00±139.37,均P0.01)。结论 ICA能够显著抑制活化的小胶质细胞释放NO,抑制小胶质细胞CD16/32表达,对LPS+IFN-γ复合诱导BV2小胶质细胞具有调节作用。     

艾司西酞普兰联合氟西汀对脑梗死患者认知功能障碍伴发抑郁的临床疗效分析

目的探讨氟西汀联合艾司西酞普兰治疗脑梗死患者认知功能障碍伴发抑郁的临床疗效分。方法选取我院2015年1月至2016年6月收治的脑梗死认知功能障碍伴发抑郁患者80例,根据治疗方法的不同分为氟西汀组(n=40)和联合组(n=40),氟西汀组给予氟西汀治疗,联合组在氟西汀组的基础上联用艾司西酞普兰治疗,两组均服药8周,采用汉密尔顿抑郁量表(HAMD)评价两组患者治疗前及治疗8周后抑郁程度,并采用蒙特利尔认知评估量表(Mo CA)、Barthel指数(BI)评定两组患者治疗前后的认知功能恢复及日常生活能力情况,比较两组患者的治疗有效率,并观察两组患者的不良反应发生情况。结果治疗前两组患者HAMD评分相比差异无统计学意义(P0.05),治疗8周后联合组HAMD评分较氟西汀组显著降低(P0.05);两组患者治疗后Mo CA及BI评分均较治疗前升高,且联合组Mo CA及BI评分明显优于氟西汀组(P0.05);两组不良反应发生率相比差异无统计学意义(P0.05)。结论氟西汀联合艾司西酞普兰治疗脑梗死认知功能障碍伴发抑郁症患者疗效显著,能明显减轻抑郁程度,改善患者认知功能,提高患者的生活能力,且起效快,不良反应少。     

艾司西酞普兰与西酞普兰治疗抑郁症的随机、双盲对照研究

目的:观察艾司西酞普兰与西酞普兰治疗抑郁症的疗效及安全性. 方法:将42例抑郁症患者随机分为艾司西酞普兰组20例(艾司西酞普兰治疗)和西酞普兰组22例(西酞普兰治疗),疗程6周.于治疗前及治疗1、2、4和6周分别采用17项汉密尔顿抑郁量表(HAMD)和治疗中出现的症状量表(TESS)评定疗效和不良反应. 结果治疗6周,艾司西酞普兰组和西酞普兰组的HAMD总分分别从治疗前(23.06±2.22)分和(22.78 ±2.03)分降至(7.76 ±2.98)分和(7.90±3.11)分;两组有效率分别为80.0％和77.3％(x2=0.046,P=0.830),痊愈率分别为50.0％和45.5％(x2=1.828,P=0.176).两组间不良反应差异无统计学意义(P＞0.05). 结论:艾司西酞普兰与西酞普兰抗抑郁疗效相同,但艾司西酞普兰起效更快.     

西酞普兰、氟西汀对NGF诱导的PC12细胞活性以及TH和pERK1／2表达的影响

目的观察西酞普兰和氟西汀两种药物对PC12细胞活力及酪氨酸羟化酶（TH）和磷酸化细胞外信号调节激酶（pERK1／2）表达的影响。方法以NGF诱导后的PC12细胞作为细胞模型,给予5,10,20,50gm不同剂量西酞普兰和氟西汀,分别进行直接作用和保护作用处理24或48h（直接作用为直接给予不同剂量齐拉西酮,保护作用为直接作用后再进行12h的去血清损伤）。采用细胞计数试剂盒-8（CCK-8）检测细胞活性,免疫组织化学检测TH和pERK1／2的表达水平的变化。结果分别处理24h后,两种药物在剂量为20μm时均可促进PC12细胞的活性（与对照组相比较,P〈0．01）,而且相同浓度的两种药物对细胞活力的作用没有统计学差异（P〉0．05）。药物作用48h后,西酞普兰10μm组对PC12细胞活力具有保护作用（与对照组相比较,P〈0．05）,西酞普兰20μm组对PC12细胞活力的促进作用和保护作用均高于氟西汀20μm组（P〈0．05）,而且氟西汀在作用48h后对细胞表现出毒性作用（与对照组相比较P〈0．01）;PC12细胞TH和pERK1／2的表达随着药物浓度5μm到20μm逐渐升高,但是在药物浓度为50μm时表达下降,其中氟西汀50μm时TH和pERK1／2的表达低于对照组（P〈0．01）;西酞普兰20μm组TH和pERK1／2的表达均高于氟西汀20μm组（P〈0．05）。结论中剂量的西酞普兰和氟西汀两种药物对PC12细胞活力都有促进作用,都可促进TH的表达,而且这种作用可能是通过ERK途径产生的;西酞普兰对PC12细胞的保护作用优于氟西汀,而且高剂量的氟西汀表现出细胞毒性作用。     

艾司西酞普兰与氟西汀对抑郁症患者疗效及血清 脑源性神经营养因子、炎性反应因子的影响

目的 分析艾司西酞普兰与氟西汀治疗抑郁症患者临床疗效及对患者血清脑源性神经营 养因子（BDNF）、炎性反应因子的影响。方法 以2017 年1 月至2018 年11 月在我院精神科收治的抑郁 症患者118 例为研究对象，按照随机数字表法分为观察组59 例和对照组59 例，对照组患者采用氟西汀 治疗，观察组采用艾司西酞普兰治疗，两组均治疗6 周，观察治疗后两组临床疗效，比较治疗前后两组 血清BDNF、神经功能相关因子（S100B）及炎性反应因子［白细胞介素2、6（IL-2、IL-6）、肿瘤坏死因子α （TNF-α）］水平的变化，记录治疗前后汉密顿抑郁量表（HAMD）评分和不良反应量表（TESS）评分变化。 结果 观察组经艾司西酞普兰治疗后总有效率为86.44%，对照组经氟西汀治疗后总有效率为76.27%， 两组比较差异无统计学意义（χ2=2.011，P＞ 0.05）；两组治疗后血清BDNF 水平与治疗前相比明显升高， S100B 水平下降（P＜ 0.01），观察组治疗后血清BDNF水平明显高于对照组（P＜ 0.01），而S100B 水平明显 低于对照组（P ＜ 0.01）。两组治疗后IL-2、IL-6、TNF-α水平与治疗前相比明显降低，观察组治疗后各 炎性因子水平明显低于对照组（P＜ 0.01）。治疗3 周、6 周后两组HAMD 评分与治疗前相比均明显降低 （P＜ 0.01），在治疗3 周后观察组HAMD 评分明显低于对照组（P ＜ 0.01），在治疗6 周后两组HAMD 评分 比较差异无统计学意义（P＞0.05），观察组治疗期间TESS评分略低于对照组，但差异无统计学意义（P＞ 0.05）。结论 艾司西酞普兰与氟西汀治疗抑郁症均具有显著疗效，且安全性相当，相较于氟西汀，艾司 西酞普兰治疗后患者血清BDNF 明显升高，炎性因子水平明显降低，且起效快。     

艾司西酞普兰与帕罗西汀治疗老年抑郁症对比分析

目的 探讨艾司西酞普兰与帕罗西汀治疗老年抑郁症患者的临床效果.方法 选取2012-01-2012-12我院收治的老年抑郁症患者88例,随机分为艾司西酞普兰组和帕罗西汀组,每组44例.艾司西酞普兰组采用草酸艾司西酞普兰片治疗,帕罗西汀组采用盐酸帕罗西汀片治疗,比较2组患者的临床疗效和并发症发生情况.结果 艾司西酞普兰组痊愈率和总有效率分别为52.27%、93.18%,均明显高于帕罗西汀组的36.36%、77.27%,差异均具有统计学意义（P＜0.05）;艾司西酞普兰组口干、恶心、头痛、出汗、便秘等不良反应发生率较帕罗西汀组均呈不同程度降低,但差异均无统计学意义（P＞0.05）.结论 艾司西酞普兰治疗老年抑郁症,其疗效确切,效果显著,安全性高,是老年抑郁症患者较为理想的临床治疗药物.     

The involvement of 5-HT2-receptor sites in the activation of cat platelets

5-Hydroxytryptamine (5-HT) induces a concentration-dependent aggregation/release of/by cat platelets (Km = 6.2 × 10^?7 M); this activation is inhibited (Kl = 5.24 × 10^?9 M) or reversed by ketanserin, a selective 5-HT₂ receptor antagonist.Comparison of the inhibition of specific [³H]ketanserin binding to cat platelet membranes and rat pre-frontal cortex membranes with that of 5-HT-induced aggregation of cat platelets obtained with various drugs, displaying various receptor binding profiles, reveals a highly significant correlation between the ligand binding and the physiological response (Spearman correlation coefficient r = 0.92 and r = 0.91 respectively, P < 0.0001; n = 14) ; inhibition of platelet activation by 5-HT and of uptake of 5-HT are not correlated. Secondary aggregation induced by ADP as well as collagen-induced aggregation are inhibited by the 5-HT receptor antagonists suggesting a primary role of 5-HT in the secondary platelet recruitment subsequent to a release reaction.This study demonstrates a functional role for the 5-HT₂ receptors in the primary activation of the platelets by 5-HT and in the secondary aggregation induced by other agonists, especially in platelets superreactive to 5-HT₂ receptor activation.     

Left hand movements and right hemisphere activation in unilateral spatial neglect: a test of the interhemispheric imbalance hypothesis

The aim of the present study was to check one of the main assumptions of the interhemispheric imbalance hypothesis, namely, the prediction that the severity of neglect should be reduced by conditions activating the right hemisphere. To achieve this, a group of neglect patients was studied using a slightly modified version of the limb activation technique. The (verbal or visuo-spatial) nature of the stimuli to be processed by the patient and the (left or right) side of space where the left hand moved were considered as the critical variables to check the interhemispheric imbalance hypothesis.Three traditional and one new methods were used to measure changes induced in the severity of neglect by the material to be processed or by the side of space where the left hand moved. The traditional methods, all based on counting omissions, consisted of measuring: (a) the overall number of omissions; (b) the number of omissions made on the left half sheet; or (c) the difference between the omissions made on the left and right sides of the sheet. The new index, based on the notion of the 'attentional field' and defined as the spatial distribution of stimuli detected by the patient, was operationally measured by computing the distance between each stimulus crossed out by the patient and the right margin of the sheet. The study was conducted by rating the severity of neglect in 42 cancellation sheets which had used, respectively letters (N=21) and small geometric figures (N=21) as targets. The two sets of cancellation sheets were obtained from seven neglect patients during a limb activation task requiring the cancellation of a given target in three different conditions: (a) baseline; (b) active movements of the left hand in the left half space; (c) active movements of the left hand in the right half space.Results were at variance with the predictions based on Kinsbourne's model, since the verbal or visual spatial nature of the material to be processed did not influence the severity of unilateral spatial neglect (USN) and since left hand movements produced a significant reduction in the severity of neglect only when these movements were made on the left side of space.     

Sympathetic activation of unmyelinated mechanoreceptors in cat skin

In single unit recordings from the saphenous nerve in anesthetized cats, afferent units were functionally identified as unmyelinated (C) mechanoreceptors. All units responded to stimulation of the sympathetic trunk with a repetitive discharge which was maintained throughout the period of stimulation. This discharge was asynchronous with respect to efferent activity and was unaffected by brief occlusion of the arterial blood supply. The mechanism underlying the strong excitatory action of the sympathetic system on these afferents is not known although changes in blood flow and temperature can be ruled out. It is suggested that the primary function of these afferents may be to signal conditions within the skin for regulatory purposes rather than to encode external mechanical events.     

Cerebral Lateralization Index Based on Intensity of Bold Signal of FMRI

This study proposes a new cerebral lateralization index (LI) on the basis of neural activation intensity. Eight right-handed male college students (mean age 23.5 years) and 10 right-handed male college students (the mean age 25.1 years) participated in this study of visuospatial and verbal tasks, respectively. Functional brain images were taken from 3T MRI using the single-shot EPI method. A cerebral LI based on neural activation area (i.e., number of activated voxels) and another based on neural activation intensity (i.e., intensity of BOLD (blood oxygen level dependent)) were calculated for both cognition tasks. The result of calculating a cerebral LI based on neural activation area suggested that the right hemisphere is dominant during visuospatial tasks and the left hemisphere is dominant during verbal tasks. When a cerebral LI was computed on the basis of the neural activation intensity, it was shown that the area of cerebral lateralization closely related to visuospatial tasks is the superior parietal lobe, and the area of cerebral lateralization closely related to verbal tasks is the inferior and middle frontal lobe. Since the proposed method can determine the dominance of the cerebrum by each area, it can be helpful to determine cerebral lateralization accurately and easily.     

蚓激酶对动脉粥样硬化及纤溶活性的干预研究

目的探讨蚓激酶对动脉粥样硬化(Arteriosclerosis,AS)及纤溶活性的干预作用。方法将经彩超确诊的AS患者随机分为蚓激酶治疗组88例和对照组64例,观察治疗前后两组的血清纤维蛋白原(fibrinogen,Fbg)水平、组织型纤溶酶原激活剂(tissue-tipe plasminogen activator,tPA)、组织型纤溶酶原抑制剂(plasminogen activator inhibitor,PAI)活性、颈动脉内膜中层厚度(intima-media thickness,IMT)、斑块crouse评分变化情况。结果治疗组治疗后血清Fbg水平、tPA、PAI活性、颈动脉IMT、crouse评分改善明显优于对照组;不稳定性斑块组疗效好于稳定性斑块组。结论蚓激酶能延缓、逆转动脉粥样硬化并纠正纤溶紊乱。     

Platelet activation by circulating levels of hormones: a possible link in coronary heart disease

Blood platelets participating in the formation of haemostatic plugs or thrombi are likely to be exposed to combinations of several agonists. We have found that platelet aggregation and the release reaction are enhanced by combinations of the hormones adrenaline, noradrenaline, vasopressin and 5 hydroxytryptamine acting synergistically at levels obtained in circulating blood for three of these hormones. If surges of adrenaline and other hormones sensitize platelets this may provide a link between some of the risk factors and coronary heart disease.