Risk Factors of Apathy in Parkinson's Disease / 中国康复理论与实践

Objective:To study the prevalence and related factors of apathy in patients with Parkinson's disease (PD)． Methods:From November, 2017 to December, 2019, 254 PD patients in our hospital were included. According to Starkstein Apathy Scale (SAS), they were divided into apathy group and non-apathy group. Clinical data such as demographic data, motor symptoms, non-motor symptoms and motor complications were collected for comparison between two groups. Logistic regression analysis was performed to investigate the risk factors of apathy in PD. Results:Among 254 PD patients, 124 (48.8%) cases were in apathy. Compared with non-apathy group, apathy group was older in age and age of onset, higher in the scores of Movement Disorder Society United Parkinson's Disease Rating Scale part III (MDS-UPDRS Ⅲ), Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA) and Pittsburgh Sleep Quality Index (PSQI) (t > 2.291, P < 0.05), and lower in the scores of Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) (t > 22.424, P < 0.001). There was no statistically significant difference in gender, time of education, body mass index (BMI), disease course, Hoehn-Yahr (H-Y) stage, wearing-off phenomenon, dyskinesia, on-and-off phenomenon, and the scores of Rapid Eye Movement Sleep Behavior Disorder Screening Questionnaire (RBDQ) and Epworth Sleeping Scale (ESS) between two groups (P > 0.05). Logistic regression analysis showed that the age of disease onset, MoCA and HAMD scores were correlated with apathy in patients with PD (P < 0.05). Conclusion:The presence of apathy in PD may be associated with older age of disease onset, severity of depression and cognitive impairment.

Persistent depression is a predictor of quality of life in stroke survivors: results from a 5-year follow-up study of a Chinese cohort / 中华医学杂志(英文版)

BACKGROUND@#Whether the time course of post-stroke depression (PSD) can be used to predict the quality of life (QoL) of patients with late-stage stroke remains unclear, this study investigated whether persistent depression at 1 year after stroke predicts QoL at 5 years following stroke.@*METHODS@#We analyzed the demographic and clinical data of patients with stroke in 56 hospitals across China that participated in the Prospective Cohort Study on the Incidence and Outcome of Patients with PSD in China Study. Follow-up assessments were performed at the following time points after stroke: in person, 2 weeks, 3 months, 6 months, and 1 year; by telephone, 5 years. National Institutes of Health Stroke Scale (NIHSS) score on admission, recurrence, disability, depression, QoL, and chronic complications were recorded. Depression was diagnosed using the Diagnostic and Statistical Manual of Mental Disorders. QoL was measured using short form-12 (SF-12). Multivariable ordinal logistic regression analysis was used to identify factors that independently affected the physical component summary (PCS) and mental component summary (MCS) scores of the SF-12.@*RESULTS@#Of the 801 patients evaluated in this study, 80 had persistent depression. The multivariable regression analysis of data obtained at 5 years showed that persistent depression at 1 year (odds ratio [OR]: 0.48; 95% confidence interval [CI]: 0.29-0.81) and disability at 5 years (OR: 0.34; 95% CI: 0.23-0.49) were associated with poor MCS scores at 5 years. Old age, a high NIHSS score on admission, disability at 5 years, and stroke recurrence within 5 years were associated with poor PCS scores at the 5-year follow-up.@*CONCLUSIONS@#Persistent depression at the 1-year follow-up could predict poor MCS scores at the 5-year follow-up. The development of interventional strategies targeting post-stroke patients with persistent depression is warranted.

Effects of pungent essential oil from three Chinese herbs on percutaneous absorption of alkaloids from Sophorae Flavescentis Radix / 中国中药杂志

To investigate the effects of essential oil from three kinds of pungent herbs,namely Menthae Haplocalycis Herba,Atractylodis Rhizoma and Cnidii Fructus,on the transdermal absorption in vitro of alkaloids from Sophorae Flavescentis Radix. The modified vertical Franz diffusion cell was used to conduct a transdermal experiment in vitro with the isolated abdominal skin of the SD rats as the transdermal absorption barrier. The effects of such three kinds of pungent essential oil on percutaneous absorption of alkaloids from Sophorae Flavescentis Radix were investigated by determining the content of 6 alkaloids( oxymatrine,oxysophocarpine,N-methylcytisine,sophoridine,matrine,and sophocarpidine) in the transdermal acceptor with ultra-performance liquid chromatography-triple quadruple mass spectrometry( UPLC-TQ-MS) technique simultaneously. With enhancement ratio( ER) as the index,their effects on promoting penetration was as follows: 1% Atractylodis Rhizoma oil > 1% Cnidii Fructus oil > 3% Azone ≈ 3% Atractylodis Rhizoma oil > 5%Atractylodis Rhizoma oil > 3% Cnidii Fructus oil ≈ 5% Cnidii Fructus oil > 3% Menthae Haplocalycis Herba oil > 5% Menthae Haplocalycis Herba oil > 1% Menthae Haplocalycis Herba oil > Blank. The results showed that these three kinds of pungent essential oil could be used as enhancers for alkaloids of Sophorae Flavescentis Radix,providing scientific guidance for improving percutaneous absorption of alkaloids from Sophorae Flavescentis Radix.

Determination of free thiols in animal horn derived traditional Chinese medicines / 中国中药杂志

This present study is to detect the content of free thiols(-SH) in the horn derived traditional Chinese medicines( TCMs) from different animals and different regions by using fluorescence derivatization method. TCEP was used as a disulfide bond reducing agent,while SBD-F as a derivatization reagent. Fluorescent spectrophotometry was used to determine the content of-SH,and the maximum excitation wavelength and emission wavelength were set as 375 and 510 nm,respectively. As a result,under the optimized condition,the extraction of Caprae Hircus Cornu showed the highest free-SH concentration,followed by Bovis Grunniens Cornu,Bubali Cornu,and Elaphuri Davidiani Cornu. In the present study,we point out that the-SH-contained components might be the most important material basis in animal horn derived TCMs. With good accurate,sensitive and rapid properties,the present method can provide reference basis for the quality evaluation of animal horn derived TCMs and guides for the investigation on effective material basis.

Persistent depression is a predictor of quality of life in stroke survivors: results from a 5-year follow-up study of a Chinese cohort / 中华医学杂志(英文版)

Background@#Whether the time course of post-stroke depression (PSD) can be used to predict the quality of life (QoL) of patients with late-stage stroke remains unclear, this study investigated whether persistent depression at 1 year after stroke predicts QoL at 5 years following stroke.@*Methods@#We analyzed the demographic and clinical data of patients with stroke in 56 hospitals across China that participated in the Prospective Cohort Study on the Incidence and Outcome of Patients with PSD in China Study. Follow-up assessments were performed at the following time points after stroke: in person, 2 weeks, 3 months, 6 months, and 1 year; by telephone, 5 years. National Institutes of Health Stroke Scale (NIHSS) score on admission, recurrence, disability, depression, QoL, and chronic complications were recorded. Depression was diagnosed using the Diagnostic and Statistical Manual of Mental Disorders. QoL was measured using short form-12 (SF-12). Multivariable ordinal logistic regression analysis was used to identify factors that independently affected the physical component summary (PCS) and mental component summary (MCS) scores of the SF-12.@*Results@#Of the 801 patients evaluated in this study, 80 had persistent depression. The multivariable regression analysis of data obtained at 5 years showed that persistent depression at 1 year (odds ratio [OR]: 0.48; 95% confidence interval [CI]: 0.29–0.81) and disability at 5 years (OR: 0.34; 95% CI: 0.23–0.49) were associated with poor MCS scores at 5 years. Old age, a high NIHSS score on admission, disability at 5 years, and stroke recurrence within 5 years were associated with poor PCS scores at the 5-year follow-up.@*Conclusions@#Persistent depression at the 1-year follow-up could predict poor MCS scores at the 5-year follow-up. The development of interventional strategies targeting post-stroke patients with persistent depression is warranted.

Identification of metabolites of Reduning injection in rat plasma, bile, urine and feces after intravenous administration / 药学学报

This study was designed to determine the metabolites of Renduining injection in rats. The ultra-high performance liquid chromatography-LTQ Orbitrap mass spectrometric (UHPLC-LTQ-Orbitrap-MS) and mass defect filter techniques were applied to analyze the metabolites of Reduning injection in rat plasma, bile, urine and feces. As a result, we determined 14 metabolites of geniposide, including oxidation, dehydration, hydroxymethylene loss, hydrolysis, ring-opened, cysteine conjugation and glucuronidation conjugation of aglycone; 9 metabolites of geniposidic acid, consisting of dehydration, ring-opened, double-bond reduction and cysteine conjugation; 6 metabolites of secoxylogain including hydrolysis, hydroxymethylene loss, hydroxylation and ethylation; 12 metabolites of chlorogenic acid, containing decarboxylation, hydrolysis, methylation, acetylation, cysteinylglycine conjugation and glutathione conjugation. It provided information for the therapeutic effect of Reduning in vivo.

Killing effect of CIK cells combined with Gemcitabine on QBC939 cells / 中国现代普通外科进展

Objective:To investigate the anti-tumor effects of cytokine-induced kill cells(CIK)methods combined with chemotherapeuticdrug Gemcitabine against Cholangiocarcinoma cancer cell lines QBC-939.Methods:Peripheral blood mononuclear cells(PBMC) of healthy people were stimulated by different cytokines,and were induced into CIK cells.CIK cells were cultured for 14 days as effector cells.The phenotype of CIK cells were analyzed by flow cytometer.QBC939 cells were cultured with the CIK cells at different effector-target ratio or various concentrations of Gemcitabine for 24 and 48 hours.The antitumor effects were measured by CCK8 methods.The expression of Bax was detected by using Western blot.Results:The CD3+CD4+,CD3+CD8+,CD3+HLA-DR+,CD3+CD56+,CD4+CD25+ double positive cel1 was up to 10.89％,60.27％,71.82％,9.03％ and 4.01％ after 14 days' cultivation.The killing effect of CIK and Gemcitabine increased with the increase of effector-target ratio and drug concentration or the extension of time.The killing effect of combination of CIK and Gemcitabine was obviously higher than that of each single factor.The protein levels detected hints of CIK cells and gemcitabine can up-regulated the expression of Bax,and the joint action of both is more significant.Conclusions:CIK cells have strong anti-tumor effect against QBC939 cells by inducing apoptosis of QBC939 cells,and it can enhance the anti-tumor effects of Gemcitabine against QBC939 cells when CIK and Gemcitabine are combined together.

Impact of libido at 2 weeks after stroke on risk of stroke recurrence at 1-year in a chinese stroke cohort study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>There were few studies on the relation between changes in libido and incidence of stroke recurrence. The aim of this study was to investigate the relationship between libido decrease at 2 weeks after stroke and recurrent stroke at 1-year.</p><p><b>METHODS</b>It is a multi-centered, prospective cohort study. The 14 th item of the Hamilton Depression Rating Scale-17 was used to evaluate changes of libido in poststroke patients at 2 weeks. Stroke recurrence was defined as an aggravation of former neurological functional deficit, new local or overall symptoms, or stroke diagnosed at re-admission.</p><p><b>RESULTS</b>Among 2341 enrolled patients, 1757 patients had completed follow-up data, 533 (30.34%) patients had decreased libido at 2 weeks, and 166 (9.45%) patients had recurrent stroke at 1-year. Multivariate logistic regression analysis showed that, compared with patients with normal libido, the odds ratio (OR) of recurrent stroke in patients with decreased libido was reduced by 41% (OR = 0.59, 95% confidence interval [CI]: 0.40-0.87). The correlation was more prominent among male patients (OR = 0.52, 95% CI: 0.31-0.85) and patients of ≥60 years of age (OR = 0.57, 95% CI: 0.35-0.93).</p><p><b>CONCLUSIONS</b>One out of three stroke patients in mainland China has decreased libido at 2 weeks after stroke. Decreased libido is a protective factor for stroke recurrence at 1-year, which is more prominent among older male patients.</p>

Poststroke Depression between Men and Women 2 Weeks after Ischemic Stroke in China / 中国康复理论与实践

@#Objective To analyze the features of poststroke depression (PSD) between men and women after acute ischemic stroke in China. Methods A total of 1917 ischemic stroke patients were enrolled from the Prospective Cohort Study on Incidence and Outcome of Patients with Poststroke Depression in China. The incidence of PSD and the features were compared between male and female patients. The factors related with PSD of every gender were extracted with Logistic regression analysis. Results The incidence of PSD was higher in women than in men (32.9% vs. 26.6%, P<0.01). There was no difference in the stroke score between women and men (P>0.05). The score of Hamilton Depression Scale was higher in the women than in the men, and the features were similar. Logistic regression analysis indicated that the history of heart disease, history of mental disorders and stroke score related with PSD in women, while the age, history of mental disorders, smoking and stroke score in men. Conclusion The incidence and related factors of PSD 2 weeks after ischemic stroke are different between men and women.

Neurological deterioration in the acute phase of minor ischemic stroke is an independent predictor of poor outcomes at 1 year: results from the China National Stroke Registry (CNSR) / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The risk of clinical deterioration still exists in the acute phase despite the fact that patients with minor stroke may display less severe symptoms. The impact of this clinical deterioration on long-term outcomes is unknown. We characterized the clinical features of neurological deterioration (ND) in the acute phase of minor ischemic stroke (MIS) and investigated its impact on mid- and long-term outcomes.</p><p><b>METHODS</b>This was a multi-centered, prospective clinical study involving patients with MIS (the National Institutes of Health Stroke Scale, NIHSS ≤3) recruited from the China National Stroke Registry. Patients were included who had been hospitalized within 24 hours of stroke onset. Baseline characteristics, complication rates during hospitalization, etiology of stroke, as well as 3-, 6-, and 12-month post-stroke outcomes were compared between patients with and without ND during the acute phase.</p><p><b>RESULTS</b>A number of 368 (15.2%) out of 2424 patients included in the study exhibited ND in the acute phase. Compared to patients without ND, patients with ND had longer hospital stay, increased rate of baseline diabetes, and multiple complications. Multivariate Logistic regression indicated that ND in acute phase was an independent factor predictive of increased dependence (adjusted odds ratio = 5.20, 95% CI, 3.51-7.70, P < 0.001) at 12-month post-stroke.</p><p><b>CONCLUSIONS</b>The risk of ND in the acute phase is high in patients with MIS. ND in the acute phase is an independent predictor for poor outcomes at 12 months post-stroke onset.</p>

In-hospital medical complications associated with patient dependency after acute ischemic stroke: data from the China National Stroke Registry / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The mortality of stroke patients is strongly affected by medical complications. However, there are limited data investigating the effect of in-hospital medical complications on the dependency of stroke patients worldwide. We prospectively and systematically investigated the effect of medical complications on dependency of patients at 3, 6 and 12 months after stroke using the China National Stroke Registry (CNSR).</p><p><b>METHODS</b>This prospective cohort study collected data of patients age > 18 years with acute ischemic stroke in 132 clinical centers distributed across 32 provinces and four municipalities (including Hong Kong region) of China, from September 2007 to August 2008. Data on medical complications, dependency and other information were obtained from paper-based registry forms. Medical complications associated with stroke outcomes were assessed using multivariable Logistic regression.</p><p><b>RESULTS</b>Of 11 560 patients with acute ischemic stroke, 1826 (15.80%) presented with in-hospital medical complications. In-hospital medical complications were independent risk factors for dependency of patients at 3 months (adjusted odds ratio (OR) 2.367, 95% confidence interval (CI) 2.021 - 2.771), 6 months (adjusted OR 2.257, 95%CI 1.922 - 2.650), and 12 months (adjusted OR 1.820, 95%CI 1.538 - 2.154) after acute ischemic stroke.</p><p><b>CONCLUSION</b>The results demonstrated that the short-term and long-term dependency of acute ischemic stroke patients is significantly associated with in-hospital medical complications in China.</p>

Effect of in-hospital medical complications on case fatality post-acute ischemic stroke: data from the China National Stroke Registry / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>In-hospital medical complications are associated with poorer clinical outcomes for stroke patients after disease onset. However, few studies from China have reported the effect of these complications on the mortality of patients with acute ischemic stroke. In this prospective work, the China National Stroke Registry Study, we investigated the effect of medical complications on the case fatality of patients with acute ischemic stroke.</p><p><b>METHODS</b>From September 2007 to August 2008, we prospectively obtained the data of patients with acute stroke from 132 clinical centers in China. Medical complications, case fatality and other information recorded at baseline, during hospitalisation, and at 3, 6, and 12 months after stroke onset. Multivariable Logistic regression was performed to analyze the effect of medical complications on the case fatality of patients with acute ischemic stroke.</p><p><b>RESULTS</b>There were 39 741 patients screened, 14 526 patients with acute ischemic stroke recruited, and 11 560 ischemic stroke patients without missing data identified during the 12-month follow-up. Of the 11 560 ischemic patients, 15.8% (1826) had in-hospital medical complications. The most common complication was pneumonia (1373; 11.9% of patients), followed by urinary tract infection and gastrointestinal bleeding. In comparison with patients without complications, stroke patients with complications had a significantly higher risk of death during their hospitalization, and at 3, 6 and 12 months post-stroke. Having any one in-hospital medical complication was an independent risk factor for death in patients with acute ischemic stroke during hospital period (adjusted OR = 6.946; 95%CI 5.181 to 9.314), at 3 months (adjusted OR = 3.843; 95%CI 3.221 to 4.584), 6 months (adjusted OR = 3.492; 95%CI 2.970 to 4.106), and 12 months (adjusted OR = 3.511; 95%CI 3.021 to 4.080). Having multiple complications strongly increased the death risk of patients.</p><p><b>CONCLUSION</b>Short-term and long-term outcomes of acute stroke patients are affected by in-hospital medical complications.</p>

Continuous assessment of cerebral autoregulation in subarachnoid hemorrhage / 中国康复理论与实践

@#ObjectiveTo examined how autoregulation is affected by vasospasm after subarachnoid hemorrhage (SAH) by using transcranial Doppler. MethodsThe moving correlation coefficient between slow changes of arterial blood pressure and mean or systolic flow velocity (FV), termed Mx and Sx, respectively, was used to characterize cerebral autoregulation. Vasospasm was declared when the mean FV increased to more than 120 cm/s and the Lindegaard ratio was more than 3. This occurred in 15 of 32 SAH patients.On the basis of the bilateral transcranial Doppler recordings of the middle cerebral artery in vasospastic patients, Mx and Sx were calculated for baseline and vasospasm. ResultsMx increased during vasospasm (0.46±0.32) and was significantly higher (P=0.03) than at baseline (0.21±0.24) Sx was also increased (0.22±0.26 vs 0.05±0.21,P=0.03). Mx correlated with mean FV (P=0.577, P=0.006) and the Lindegaard ratio (r=0.672,P<0.01).Mx(P=0.006) and Sx (P=0.044) were higher on the vasospastic side compared with the contralateral side.ConclusionThe increased Mx and Sx during cerebral vasospasm demonstrate impaired cerebral autoregulation. Mx and Sx provide additional information on changes in autoregulation in SAH patients.

Multiplication and differentiation into endothelial cells of bone marrow stromal cells of rats in vitro / 中国康复理论与实践

@#ObjectiveTo explore the feasibility of bone marrow stromal cells (BMSC) of rats differentiating into endothelial cells.MethodsBone marrow cells were obtained by an aseptic technique. Afterwards, the obtained cells were divided into two groups: cells in test group were propagated in 1640 medium with recombinant human GM-CSF (rhGM-CSF) (400ng/ml), and that in control group were propagated in medium with 1640 medium only. The differentiated cells were detected by specific immunology marker by immunocytochemistry and immunofluorescence at day 8.ResultsThe differentiated cells demonstrated the characters of endothelial cells under phase contrast microscopy. Cells of the test groups demonstrated specific characters by immunocytochemistry stain.ConclusionBone marrow stromal cells can multiply vigorously and differentiate into cells with endothelial cells characters in the medium with high concentration rhGM-CSF.