ABSTRACT
ObjectiveTo evaluate the efficacy and safety of agomelatin and selective serotonin reuptake inhibitors （SSRIs） in the treatment of depressive disorder via network Meta-analysis. MethodsThe literature databases such as China National Knowledge Network （CNKI）， Wanfang Data Knowledge Service Platform， VIP Database for Chinese Technical Periodical （VIP）， Chinese Biomedical Literature Database （CBM）， PubMed， Embase and Cochrane Library were searched from the inception to November 2021. Based on the preset inclusion and exclusion criteria， literature screening， quality assessment of methodology and data extraction were conducted by two researchers separately， then statistical analysis was carried out using ADDIS software. ResultsA total of 7 256 patients with depressive disorder in 22 randomized controlled trials were included. According to the consistency assessed in Bayesian network Meta-analysis and the estimation of the probability of being the best treatment， escitalopram （P=0.63） ranked first for response rate and paroxetine （P=0.31） was associated with the best ranking for cure rate in terms of the effectiveness， meantime， paroxetine （P=0.44） had the highest adverse events risk and sertraline （P=0.74） had the highest study drop-outs proportion in terms of safety. ConclusionEscitalopram and paroxetine may be superior to sertraline， agomelatine， citalopram and fluoxetine in the treatment of depressive disorder， furthermore， paroxetine and sertraline demonstrate poor safety profiles.
ABSTRACT
It is proposed that following peripheral nerve injury abnormal sprouting of Aβ fiber primary afferent neurons in the spinal cord contributes to the allodynia that often occurs with such injury. The present investigation is to determine whether this sprouting is reversal after compression of peripheral nerve was relieved. In a rat model of neuropathic pain made by rat sciatic nerve compression,chorela toxin B subunit conjugated horseradish peroxidase (CB-HRP) was used to trace the termination of Afiber primary afferents and sections were reacted for using tetramethylbenzidine (TMB) as the chromagen. We demonstrated that the compression to the sciatic nerve also results in hyperalgesia and novel transganglionic CB-HRP staining in laminae Ⅱ, and this sprouting can not be reversed by decompression. This structural reorganization in central nervous system and its irreversible character may contribute to the development and maintenance of neuropathic pain.