抑郁症共病糖尿病患者的皮质醇水平与帕罗西汀治疗疗效的关系

目的：探讨抑郁症共病2型糖尿病患者血清皮质醇水平升高的相关因素及与帕罗西汀抗抑郁疗效的关系。方法选取符合抑郁症合并2型糖尿病患者212例，根据血清皮质醇水平分为皮质醇升高组（ n ＝98）和皮质醇正常组（ n ＝114），采用汉密顿抑郁量表（HAMD）评价抗抑郁程度；检测糖化血红蛋白（HbA1c）水平；通过自制调查问卷调查患者一般情况。2组患者使用抗抑郁药物帕罗西汀治疗8周后使用 HAMD 减分率评估疗效。结果 Lo-gistic 回归分析显示，抑郁症共病2型糖尿病的患者皮质醇升高的相关因素包括年龄、每周运动时间、抑郁症病程、HAMD 评分、HbA1c；帕罗西汀治疗8周后，皮质醇升高组患者的 HAMD 减分率低于皮质醇正常组（ P ﹤0.05），HAMD减分率与 HbA1c 及皮质醇水平呈负相关（ P ﹤0.05）。结论抑郁症共病2型糖尿病患者皮质醇升高的相关因素包括年龄、每周运动时间、抑郁症病程、HAMD 评分、HbA1c，血清皮质醇和 HbA1c 水平较高的患者帕罗西汀疗效不佳。     

抑郁症患者对家属心理状况的影响

目的 探讨抑郁症患者对家属心理状况的影响.方法 采用焦虑自评量表（SAS）、抑郁自评量表（SDS）对60例抑郁症患者家属的心理状况进行测评,并对相关因素进行分析.结果 本组抑郁症患者的家属有42例存在不同程度的焦虑（占70％）、40例存在不同程度的抑郁情绪（占67％）,家属的焦虑、抑郁状态和其与患者的关系、家庭收入呈负相关,与照顾患者的时间、患者的住院次数呈正相关.结论 抑郁症患者家属有不同程度的焦虑、抑郁情绪,并受多种因素影响.护理人员应给予心理疏导,以减轻家属的心理负担.     

2型糖尿病伴抑郁症相关因素分析

目的：探讨糖尿病患者并发抑郁症的各项危险因素。方法：对78例2型糖尿病患者采用汉密尔顿抑郁量表（HAMD-24）进行评定,将之分为抑郁症组和非抑郁症组,对两组患者的一般情况（年龄、文化、性别、有无家族史等）、FPG、2hPG、HbA1c、BMI、糖尿病并发症（视网膜病变、周围神经病变、肾病）数量及糖尿病治疗花费等进行比较。结果：两组相比,女性患者数量、BMI指标、并发症数量、FPG、2hPG、HbA1c、糖尿病治疗总费用等抑郁症组高于非抑郁症组（P〈0.05）,而年龄、文化程度和家族史则无统计学差异（P〉0.05）。结论：2型糖尿病患者中,女性、肥胖、血糖控制差、并发症数量多及治疗花费高的患者更容易患抑郁症。     

老年人脑梗死后抑郁症及影响因素的研究

应用Ｈａｍｉｌｔｏｎ抑郁量表对１０２例老年脑梗死患者的抑郁症进行研究,同时研究其与神经功能缺损程度、病变部位、病灶面积及数目的关系。结果显示：（１）老年人脑梗死后有５８％的患者出现抑郁症状。（２）抑郁症状与神经功能缺损程度成显著正相关（Ｐ〈０．００１）。（３）皮质下梗死,尤其是多发性腔隙梗死,与其他部位梗死相比,更易发生抑郁症。（４）梗死后抑郁症的发生率与腔隙梗死灶的数量及非腔隙梗死的面积有关。老     

团队护理模式对2型糖尿病合并抑郁症患者的干预效果观察

目的观察团队护理模式对2型糖尿病合并抑郁症患者的干预效果。方法采用医护患团队护理模式对糖尿病合并抑郁症患者110例进行护理干预,比较治疗前后抑郁自评量表（SDS）、汉密尔顿抑郁量表（HAMD）评分和血糖水平的变化。结果与治疗前比较,110例患者治疗后FPG、2hPG、HbA1c、SDS和HAMD均显著下降,差异均有统计学意义（P〈0.05）。结论医护患团队护理模式应用于糖尿病合并抑郁症患者的护理中,为患者提供了全面优质的医疗护理服务,使患者的抑郁状态得到了显著改善,血糖水平得到降低,生活质量得到提高,值得在护理领域广泛推广应用。     

产褥期抑郁症的产科影响因素探讨

目的探讨产褥期抑郁症的产科影响因素。方法通过爱丁堡产后抑郁量表对542例产妇进行评定,诊断72例产褥期抑郁症患者,对相关产科因素进行分析。结果产褥期抑郁症发生率为13．28％;不良孕产史、妊娠合并症或妊娠特有疾病、早产、剖宫产与产褥期抑郁症的发生有关（P〈0．05）;孕期参加孕妇学校可以降低产褥期抑郁症的发生（P〈0．05）。结论产褥期抑郁症的发生受多种产科因素的影响;对高危孕妇应注意提前干预,降低其不良影响。     

2型糖尿病患者糖化血红蛋白与抑郁症发病的相关性

目的探讨2型糖尿病患者糖化血红蛋白（HbAlc）与抑郁症发病的相关性。方法选取2型糖尿病患者170例分为两组,其中观察组（HbAlcI〉7％）76例,对照组（HbAlc〈7％）94例。检测所有患者的HbAlc、空腹血糖、血脂、肌酐、尿酸、尿素氮水平。结果两组的性别、年龄、饮酒、尿酸、BMI、血脂等比较差异无统计学意义（P〉0．05）。观察组的抑郁症发病率、尿素氮及肌酐水平高于对照组,差异有统计学意义（P〈0．05）。结论HbAlc高的患者抑郁症发病率高,糖尿病患者应严格控制血糖,对于合并抑郁症者,应积极控制抑郁情绪,以改善预后和减少不良结局。     

应激相关因素与首发青少年抑郁症的关系研究

目的探讨负性生活事件、应对方式与青少年抑郁症首次发作的关系。方法采用青少年生活事件量表（ASLEC）、特质应对方式问卷（TCSQ）对56例首发抑郁症患者和180例正常对照组进行测评。结果抑郁症组在负性生活事件量表中的各因子分均较正常对照组高，抑郁症组患者较多采用消极应对方式，与正常对照组比，差异有显著统计学意义（P〈0．01）。结论负性生活事件，消极应对方式与青少年抑郁首次发作有关。     

西酞普兰治疗2型糖尿病合并抑郁症的疗效

目的探讨西酞普兰治疗2型糖尿病合并抑郁症的疗效。方法选取70例2型糖尿病合并抑郁症患者，随即分为西肽普兰组（实验组）35例、对照组35例，治疗12周，采用糖化血红蛋白（HBA，C）、空腹血糖变异系数（CV-FPG）评价血糖控制情况，汉密尔顿抑郁量表（HAMD）、糖尿病生活质量量表（DQOL）评定药物疗效波动。结果治疗12周后，实验组HBA1C下降明显（7．2±0．6VS8．0±1．1，P〈0．05）、CV—FPG较对照组小（10．7±2．3VS15．9±2．9，P〈0．05），生活质量改善优于实验组（HAMD8．124-2．68vs14．66±3．73，DQOL89±8vs98±10，P〈0．05）。结论西肽普兰能促进2型糖尿病合并抑郁症患者血糖平稳下降，改善患者抑郁症状，提高生活质量。     

糖尿病合并抑郁症应用中医分时辨治疗法治疗的临床效果观察

目的研究糖尿病合并抑郁症应用中医分时辨治疗法治疗的临床效果。方法选取本院2012年11月—2013年12月收治的82例糖尿病合并抑郁症患者,分为两组,对照组41例采用西药治疗,研究组41例采用中药治疗,比较两种治疗方法治疗后效果。结果治疗后研究组患者汉密尔顿抑郁量表（HAMD）、焦虑量表（HAMA）评分、空腹血糖（FPG）、餐后2h血糖（2hPG）、糖化血红蛋白（HbA1C）、三酰甘油（TG）、总胆固醇（TC）均优于对照组,差异有统计学意义（P〈0.05）。结论采用中医分时辨治疗法治疗糖尿病合并抑郁症,可有效改善的血糖水平,改善患者不良心理情绪,治疗效果显著。     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg.kg) or i.p. (50 mg.kg) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) l.h. kg in the male rat and 10.6 (95% CI: 7.5, 15.0) l.h. kg in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p 0.001) in plasma obtained from the male (8.8 2.0%) compared with the female rat (11.7 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

Quantitative in vivo and in vitro sex differences in artemisinin metabolism in rat

1. The pharmacokinetics of the antimalarial compound artemisinin were compared in the male and female Sprague-Dawley rat after single dose i.v. (20 mg x kg(-1)) or i.p. (50 mg x kg(-1)) administration of an emulsion formulation. 2. Plasma clearance of artemisinin was 12.0 (95% confidence interval: 10.4, 13.0) 1 x h(-1) x kg(-1) in the male rat and 10.6 (95% CI: 7.5, 15.0) 1 x h(-1) x kg(-1) in the female rat suggesting high hepatic extraction in combination with erythrocyte uptake or clearance. Artemisinin half-life was approximately 0.5 h after both routes of administration in both sexes. Values for plasma clearance and half-lives did not statistically differ between the sexes. 3. After i.p. administration artemisinin AUCs were 2-fold higher in the female compared with male rat (p < 0.001). Artemisinin disappearance was 3.9-fold greater in microsomes from male compared with female livers and it was inhibited in male microsomes by goat or rabbit serum containing antibodies against CYP2C11 and CYP3A2 but not CYP2B1 or CYP2E1. 4. The unbound fraction of artemisinin in plasma was lower (p < 0.001) in plasma obtained from the male (8.8 +/- 2.0%) compared with the female rat (11.7 +/- 2.2%). 5. The possibility of a marked sex difference, dependent on the route of administration, has to be taken into account in the design and interpretation of toxicological studies of artemisinin in this species.     

休克时血中氧自由基的变化

本实验测定10名休克患者血浆和红细胞的丙二醛(MDA)、血浆总抗的氧化活性(AOA)的含量。结果表明:休克病人红细胞膜和血浆 MDA 含量(4.298±0.722;5.348±0.834)与对照组(3.235±0.682;4.356±1.081)比较明显增高(P<0.05);血浆 AOA(39.65±7.858)与对照组(48.21±10.81)比较明显降低(P<0.01)。提示:休克时,患者机体内自由基反应增强是引起组织细胞损伤的原因之一。     

Interindividual variability in metabolic activation in humans in vivo

In assessing interindividual variability in metabolic activation, the toxic metabolite is often too unstable for conventional analysis. Possible alternatives include a stable product of the reactive metabolite e.g. cysteinyl derivatives of N-acetyl-4-benzoquinoneimine, the toxic metabolite of paracetamol, adducts with DNA or protein, and indirect measurement of the activity of the enzyme(s) producing the active metabolite. An example of the last approach is the use of furafylline, a highly specific inhibitor of human CYP1A2, to determine the extent of the metabolic activation of the cooked food mutagens PhIP and MeIQx. The extent of inhibition, determined from levels of unchanged amine in urine, is an indirect measure of the activity of the activation pathway. Further refinement of this approach, allied to improved measures of the biological process of interest should prove of value in evaluating interindividual variability and its role in the risk assessment process.     

Theophylline kinetics in peripheral tissues in vivo in humans

Several biochemical and cellular effects have been described for methylxanthines under in vitro conditions. However, it is unknown, whether threshold concentrations required to exert these effects are attained in target tissues in vivo. We therefore employed the microdialysis technique for measuring theophylline concentrations in peripheral tissues under in vivo conditions.Following in vitro and in vivo calibration, microdialysis probes were inserted into the medial vastus muscle and into the periumbilical subcutaneous adipose layer of healthy volunteers. Following single oral dose administration of 300 mg or i.v. infusion of 240 mg theophylline, in vivo time courses of theophylline concentrations were monitored in tissues and plasma. Major pharmacokinetic parameters (c_max, t_max, AUC) were calculated for plasma and tissue time courses. The mean AUC_tissue /AUC_plasma-ratio was 0.56 (p.o.) and 0.55 (i.v.) for muscle and 0.55 (p.o.) and 0.72 (i.v.) for subcutaneous adipose tissue.We conclude that microdialysis provides important information on the distribution and the tissue pharmacokinetics of theophylline.Abbreviations FPIA Fluorescence polarisation immuno assay - AUC Area under the curve - t_max Time to peak concentration - c_max Peak concentration     

Changes in angiopoietin expression in glomeruli involved in glomerulosclerosis in rats with daunorubicin-induced nephrosis

AIM: To study the potential pathological role of endogenous angiopoietins in daunorubicin-induced progressive glomerulosclerosis in rats. METHODS: Seventy male Wistar rats were allocated randomly into a daunorubicin group (DRB; n=40) or a control group (n=30). The rats in the DRB group were injected with DRB (15 mg/kg), in their tails. Subsequently, at intervals of 1, 2, 4, 6, 8, and 12 weeks, 5 male Wistar rats in each group were chosen randomly for 24 h urinary protein quantitative measurements (24 h UPQM), and determination of plasma tumor necrosis factor alpha (TNF-alpha), angiopoietin-1 (Ang1), and angiopoietin-2 (Ang2) levels. Kidney sections were examined by electron microscopy, Periodic Acid Schiff (PAS) staining, immunohistochemical staining and in situ hybridization histochemistry. RESULTS: As glomerulosclerosis progressed in the DRB group, expression of Ang1 mRNA and protein in glomeruli decreased and expression of TNF-alpha protein, Ang2 mRNA and protein in glomeruli increased. Expression of Ang1 mRNA and protein in glomeruli were negatively correlated with 24 h UPQM, Fn protein expression, and mean area of extracellular matrix (MAECM). In comparison, expression of Ang2 mRNA and protein in glomeruli were positively correlated with 24 h UPQM, Fn protein expression and MAECM; furthermore, there was a positive correlation between plasma Ang2 and 24 h UPQM. Plasma TNF-alpha and expression of TNF-alpha in glomeruli were positively correlated with expression of Ang2 mRNA and protein in glomeruli. There was a negative correlation between Ang1 protein expression and Ang2 protein expression in glomeruli. CONCLUSION: During DRB-induced glomerulosclerosis, podocyte injury led to a shift in the balance of Ang1 and Ang2 in glomeruli. Increased TNF-alpha in plasma and glomeruli may upregulate Ang2 expression in glomeruli. Elevated Ang2 in both plasma and glomeruli may mediate protein permeability through the glomerular filtration barrier. Moreover, local expression of Ang2 may facilitate the progress of glomerulosclerosis by upregulating a component expression of extracellular matrix.