寒区边防军人睡眠异常对战斗力的影响调查

目的：调查研究寒区边防军人睡眠异常对部队战斗力的影响。方法：用EpiData302软件包制成的电子问卷,采用问答的形式进行调查,在军医指导下利用计算机同步填写。结果：226位边防军人中睡眠异常者为187人,占82.7％。按睡眠异常对战斗力的影响前10种情况依次为影响白天精力、影响情绪、影响站岗、影响训练、影响学习、影响体力（下降）、影响比赛、影响出操、影响食欲、影响思维。结论：边防军入睡眠异常不容忽视,对部队战斗力产生着不良影响。     

肾动脉支架置入术对缺血性肾病患者血ET-1,AT-Ⅱ及肾功能的影响

目的 评价肾动脉支架置入术对缺血性肾病患者血压及肾功能的影响及机制探讨.方法 对11例经肾动脉造影确诊为单侧或双侧肾动脉狭窄(管腔内径减少≥70%)的患者行肾动脉支架置入术,比较术前、术后血压、血肌酐(Scr)及内皮素-1(ET-1)、血管紧张素-Ⅱ(AT-Ⅱ)的变化.结果 11例患者置入支架13枚均获成功,术后6月患者的血压4例治愈,6例改善,1例无效,Scr较术前明显下降(P＜0.05);ET-1、AT-Ⅱ自术后3月起即稳定在低水平,与术前比较有显著性差异(P＜0.05,P＜0.01).结论 肾动脉支架置入术有助于缺血性肾病患者的血压控制,改善肾功能;机制与降低血ET-1、AT-Ⅱ有关.     

5HT1A-mediated stimulation of cortisol release in major depression: use of non-invasive cortisol measurements to predict clinical response

The purpose of the present study was to explore 5HT1A-mediated cortisol release in major depressive disorder (MDD) patients in order to determine whether the degree of 5HT1A-receptor sensitivity can predict response to treatment with selective serotonin reuptake inhibitors (SSRIs). We examined whether the sensitivity of the 5HT1A receptor, as measured by the difference in salivary cortisol levels immediately before and 90 min following the administration of a single dose of the 5HT1A-selective agonist buspirone, predicted treatment outcome following an 8-week, fixed-dose, open trial of the SSRI escitalopram in 17 outpatients with MDD. Change in cortisol levels before and 90 min after the administration of buspirone were not found to predict treatment outcome, whether defined as clinical response (50% or greater reduction in symptom severity), or remission of symptoms. In conclusion, in the present study, we did not find that the change in salivary cortisol levels following the administration of a 5HT1A-selective agonist predicted treatment outcome following an 8-week, fixed-dose, open-label trial of the SSRI escitalopram among outpatients with MDD. Although the 5HT1A-desensetization hypothesis is still a valid one, the results of the present study could not provide any evidence in support.     

Testing anxious depression as a predictor and moderator of symptom improvement in major depressive disorder during treatment with escitalopram

The purpose of this analysis was to explore the potential role of anxious MDD as a treatment predictor and moderator in major depressive disorder (MDD) using a large escitalopram clinical trial dataset. Individual patient-level data from 13 double-blinded, randomized, controlled trials in patients with MDD were pooled. Both univariate, last observation carried forward (LOCF) analyses and repeated measurements analyses without imputation (MMRM) were carried out for change in symptom scores, response and remission rates. Of 3,919 patients, 48.0% were classified as having anxious MDD depression (HAMD) somatization/anxiety subscale score ≥7 at baseline. Patients with anxious MDD were less likely to report symptom improvement on some outcome measures than patients without anxious MDD (predictor analysis). Specifically, the difference in response rates for patients with vs. patients without anxious MDD according to the MADRS (55.6% vs. 57.7%, respectively) was not statistically different. However, the difference in remission rates for patients with versus without anxious MDD according to the MADRS (37.6% vs. 44.1%, respectively) was statistically significant. Escitalopram was more effective than placebo, and as effective as the SSRIs and SNRIs, in the treatment of anxious MDD. The present analysis provides some evidence that the presence of an anxious MDD subtype is a predictor of poor response. There was no difference in the response to treatment of patients with or without anxious MDD to escitalopram, SSRIs, or SNRIs. The present analysis did not support the notion that SNRIs are more effective than escitalopram in the treatment of anxious MDD, nor was there evidence to support treatment moderating effects for anxious MDD.