中药解郁胶囊治疗老年抑郁症的临床疗效观察

目的：观察中药解郁胶囊对老年抑郁症的临床疗效和安全性。方法：选取2020年11月至2021年12月甘肃中医药大学附属医院住院或门诊患者200例作为研究对象,按照纳入标准最终产生研究观察对象100例,健康对照组来自我院组织的年龄在60~80岁的健康体检的老年人100例。观察组中男37例,女63例,对照组中男43例,女57例。对照组采取常规治疗,观察组采取中医综合疗法治疗。对2组患者治疗前后减分情况、中医证候分析、服药及依从情况、不良反应及抑郁焦虑因子等无创性指标的影响。结果：对老年抑郁症的治疗效果主要从汉密尔顿抑郁量表减分情况及证候减分率体现,2组经过12个月中药和抗抑郁综合治疗,中医证候量表减分率（8.2±3.1）和（7.8±3.2）,比对照组的（8.8±3）与（8.4±3.6）,P值为0.001 6和0.001 3,治疗前后均有明显变化,差异有统计学意义（P<0.05）,中医证候量表减分率比较,差异有统计学意义（P<0.05）,从服药后出现的不良反应来看,中医综合观察组应明显低于对照观察组,差异有统计学意义（P<0.05）。从中医组治疗患者的依从性分析,差异有统计学意义（P<0.05）。结论：中药解郁胶囊与中医综合治疗患者治疗效果显著,依从性更佳。     

A prospective longitudinal study of chronic abdominal pain and symptoms after sleeve gastrectomy

BackgroundSleeve gastrectomy (SG) is widely applied. Few studies have evaluated patient-reported abdominal symptoms after SG.ObjectiveTo evaluate the prevalence of chronic abdominal pain (CAP) and symptom characteristics after SG.SettingOslo University Hospital and Voss Hospital.MethodsWe performed a longitudinal prospective cohort study of patients operated on with SG at two tertiary referral centers. For broad assessments of abdominal pain and symptoms, consultations were performed and questionnaires retrieved before and 2 years after SG. The definition of CAP or recurrent abdominal pain lasting for more than 3 months was sustained. Preoperative predictors of CAP were explored.ResultsOf 249 patients at baseline, 207 (83.1%) had follow-up consultations. Mean preoperative body mass index was 43.9 (6.0) kg/m², and 181 patients (72.7%) were female. Total weight loss was 31.9% (10.4%). CAP was reported in 32 of 223 patients (14.3%) before and in 50 of 186 patients (26.9%) after SG (P =.002). All mean gastrointestinal symptoms rating scale questionnaire scores increased after SG, and they were higher in patients with CAP. Symptoms of depression decreased but were more prevalent in patients with CAP at follow-up. Most quality-of-life scores increased after SG. However, patients with CAP had lower scores (except for physical functioning). Preoperative bothersome Gastrointestinal Symptom Rating Scale reflux symptoms, study center, and younger age seemed to predict CAP after SG.ConclusionThe prevalence of patient-reported CAP increased after SG. Patients reporting CAP had reduced quality-of-life scores.     

几个常用执行功能测验在抑郁症中的应用

本文回顾了几个常用执行功能测验在抑郁症研究中的应用情况,包括威斯康星卡片分类测验（WCST）、Stroop色词测验、连线测验（TMT）、Go/no go任务,以及N-back任务。另外,对已有研究中存在的问题进行了讨论和展望。     

Correlation of brain-derived neurotrophic factor with severity of depression and treatment response

BackgroundBrain-derived neurotrophic factor (BDNF) is a modulator of neuroplasticity in the brain. It plays an important role in the pathophysiology of depression through the stress pathway. The information about correlation of BDNF levels with depression severity and treatment response in Indian population is scarce.MethodsConsecutive 60 never treated cases with depression reporting to a large tertiary care psychiatry unit and 60 healthy matched controls from 01 January 2016 to 31 December 2016 were enrolled for study. Sociodemographic data were collected. Diagnosis of depression was carried out as per International Classification of Diseases-10^th revision (ICD-10) diagnostic criteria for research. The Hamilton Rating Scale for Depression (HRSD) was administered and accordingly scored. Venous blood for BDNF levels was collected from all cases and controls. Cases were reassessed after 04 weeks of treatment with HRSD and BDNF levels.ResultsThe mean level of serum BDNF among cases (18.56 ng/ml) was found to be reduced significantly as compared with healthy controls (32.41 ng/ml). The mean serum BDNF level (18.56 ng/ml) in never treated cases was significantly negatively correlated with the median clinical HRSD score (18.5). There was a significant increase in the mean level of serum BDNF after antidepressant treatment.ConclusionThe study has revealed statistically significant low levels of serum BDNF in cases not exposed to treatment with depression compared with healthy controls. There was significant negative correlation of levels of serum BDNF with depression severity. The levels of serum BDNF significantly increased after four weeks of treatment.     

Success Habits of Long-Term Gastric Bypass Patients

Background: By identifying common habits of the most successful long-term gastric bypass patients, one is able to establish more specific guidelines for new patients to follow. The first postoperative year is a critical time that must be dedicated to changing old behavior and forming new, lifelong habits. Methods: 100 gastric bypass patients from 1979 to 1995 participated in a comprehensive survey. Surveys were completed in person, by phone, or in writing. Participants were asked to answer questions regarding their eating, drinking, sleeping, exercise, and personal habits. Results: The survey revealed that specific habits are common in gastric bypass patients who have maintained their weight loss for many years. Conclusion: Identifying and defining the common habits of patients who are successful with long-term weight loss enabled specific guidelines to be established for new patients to implement during the initial weight loss phase, which will contribute to life-long success.     

c-Fos expression in the auditory pathways related to the significance of acoustic signals in rats performing a sensory-motor task

Neuronal activity was established in the auditory pathways in relation to behavioural response and cognitive information processing during a sensory-motor acoustic learning. Rats were trained in three consecutive phases. The first phase was an association between an auditory stimulus and a food reward; the second phase a simple discrimination between two sounds of different frequency components, and the third phase a more complex discrimination involving both spectral and spatial sound dimensions. Auditory stimuli were bursts of complex sounds lasting 500 ms. Neuronal activity related to the behaviourally relevant stimuli was established in 20 "learning" rats undergoing this protocol, which were progressively sacrificed at the beginning, middle and end of each phase. For comparison, activity was also established in four "control" rats exposed to the same stimuli delivered pseudo-randomly, thus carrying no behavioural meaning. Neuronal activity was assessed immunocytochemically using the functional marker Fos. To establish a baseline, two rats were unexposed to controlled acoustic stimulation ("unstimulated" rats). In the superior olivary complex (SOC), inferior colliculus (IC) and medial geniculate body (MGB), the number of Fos-like immunopositive cells was comparable in "learning" and "control" animals, but higher than in the "unstimulated" rats. In the auditory cortex (AC), most prominently in the secondary area Te2, the number of Fos-like positive cells differed between "learning" and "control" rats, suggesting that the auditory cortical areas may be involved in the encoding of the behavioural significance of the acoustic stimuli.     

Dipeptidyl peptidase IV and adenosine deaminase activity. Decrease in depression

Dipeptidyl peptidase IV (DPPIV) and adenosine deaminase (ADA), two T cell associated enzymes, are known to have a possible interaction and play essential roles in immune system functioning. On the other hand, depression has been shown to be accompanied with some immune-inflammatory alterations. In this regard, in order to make a contribution to the understanding of the ongoing immune disturbances in depression, serum DPPIV and ADA activities were determined in minor and major depressives and compared with healthy controls. Both enzyme activities were found to be decreased in major depressives compared to controls while only DPPIV activity was significantly lower in major depressives than the minor depressives. There were significant inverse relationships between enzyme activities and the severity of depression. Moreover, a positive intracorrelation was found between decreased DPPIV and ADA levels. The correlated decrease in DPPIV and ADA, might be a further support for their possible association. Results also suggest that decreased enzyme activities might reflect the impaired immune state in depression while major depressed patients might have a greater tendency to immune dysfunction than the minor depressed ones.     

Inositol reduces depressive-like behaviors in two different animal models of depression

  Rationale: Myo-inositol is an isomer of glucose that is a precursor in the phosphatidylinositol (PIP) cycle, a source of two second messengers: diacylglycerol (DAG) and inositol triphosphate (IP₃). Clinical studies have reported that inositol is effective in relieving symptoms of depression. Objective: The present study examined the effects of inositol on two animal models of depression: the Porsolt forced swim test, a behaviorally based model; and the reserpine-induced immobility model, a pharmacologically based model. Methods and results: Chronic inositol injections (daily for 14 days) of 1.2 g/kg (but not at lower doses) reduced immobility time and increased struggle time in the Porsolt test compared with control animals. The same dose and treatment schedule also reduced complete immobility time but did not affect ambulatory activity in the reserpine test compared with controls. Chronic oral treatment with inositol (10% in food for 14 days) had effects similar to IP inositol in the Porsolt test. Conclusions: The effect of inositol in animal models of depression supports its possible importance as a new treatment for the disorder, and permits research on its mechanisms of action. Received: 31 August 1998 / Final version: 18 November 1998     

Striatal dopamine transporter density in major depression

Rationale: There are no previous data available regarding [¹²³I]β-CIT binding to the dopamine transporter sites in the basal ganglia in depressed patients. Objective: The present study tested the hypothesis that the brain DAT density in depressed patients is lower than that in matched healthy controls. Methods: Fifteen drug-naive outpatients with major depression and 18 healthy controls were investigated using single photon emission computerized tomography (SPECT) with a high-affinity dopamine transporter specific radioligand, ¹²³I-labeled β-CIT (2β-carbomethoxy-3β-(4-iodophenyl)-tropane). Results: We found a significantly higher [¹²³I]β-CIT uptake in both sides of the basal ganglia in patients with major depression than in the controls (Mann-Whitney U-test, P = 0.002 on the right and P = 0.003 on the left). Conclusions: The radioligand uptake reflecting the DAT density was significantly higher among the patients than in the controls. This finding is unexpected, since it is generally believed that monoaminergic neurotransmission is lower in depression, and therefore it could be assumed that a reduction in dopamine transmission would lead to secondary down-regulation of DAT density. However, it is possible that up-regulation of the DAT may be the primary alteration, which leads to lower intrasynaptic dopamine concentration and to lower dopamine neural transmission. Received: 20 October 1998/Final version: 25 January 1999