Effect and mechanism of moderate intensity physical exercise on depression, anxiety and cognitive function of schizophrenic patients / 中华行为医学与脑科学杂志

Objective:To explore the effect of moderate intensity physical exercise on depression, anxiety and cognitive function of schizophrenic patients and its possible biochemical mechanism.Methods:Totally 148 patients with schizophrenia who were hospitalized in hospital from March 2019 to March 2021 were randomly divided into control group ( n=75) and exercise group ( n=73). The patients of the two groups were given drug treatment and routine exercise according to clinical practice, and the patients in exercise group were given additional medium-intensity physical exercise.Self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to evaluate the poor mental state of the subjects.The verbal fluency task(VFT), digital span test(DST), trail making test-A(TMT-A) and the positive and negative symptom scale (PANSS) were used to evaluate cognitive function.The levels of endocannabinoids (eCBs) receptors were detected by high performance liquid chromatography, and the levels of monoamine neurotransmitters and eCBs in the patients' serum were determined by enzyme-linked immunosorbent assay (ELISA). SPSS 19.0 software was used for statistical analysis.The measurement data between the two groups were compared by t-test and the counting data between the two groups were compared by χ2 test. Results:(1) After effective intervention, the scores of SAS, SDS, TMT-A and PANSS of the two groups were significantly lower than those before intervention, and the difference before and after intervention between the two groups was statistically significant( t=6.00, 6.52, 25.79, 17.03, all P<0.01). The scores of SAS, SDS, TMT-A and PANSS after intervention in the exercise group were significantly lower than those in the control group( t=4.66, 20.88, 6.61, 8.95; all P<0.01). The number of VFT and DST in the two groups after intervention were significantly higher than those before intervention, and the differences before and after intervention between the two groups were statistically significant( t=13.78, 22.76, both P<0.01). After effective intervention, the number of VFT and DST in exercise group were significantly higher than those in the control group( t=5.02, 5.15, both P<0.01). (2) After effective intervention, the contents of monoamine neurotransmitters and eCBs in serum of the two groups were significantly higher than those before intervention, and HVA level ((63.68±6.99) pg/mL), MHPG level ((175.90±16.22) pg/mL), 5-HIAA level ((29.94±4.19) pg/mL) and CBR1 level ((6.70±1.40)μg/L), 2-AG level ((61.90±5.73)pmol/g) and AEA level ((76.48±6.59) pmol/g) in exercise group were significantly higher than those in the control group ((52.97±5.37)pg/mL, (138.50±11.52)pg/mL, (23.87±3.15)pg/mL, (5.71±1.29)μg/L, (52.13±5.14)pmol/g, (67.66±5.88)pmol/g)( t=10.43, 16.21, 10.91, 8.65, all P<0.01). Conclusion:Moderate intensity physical exercise can significantly improve their depression, anxiety and cognitive function, which may be related to regulating the levels of ECBS and their receptors in patients with chronic schizophrenia to increase monoamine neurotransmitters.

Association of metabolic syndrome with chronic kidney disease in premenopausal and postmenopausal women / 南方医科大学学报

OBJECTIVE@#To explore the relationship between metabolic syndrome (MS) and the risk for chronic kidney disease (CKD) in premenopausal and postmenopausal women.@*METHODS@#We conducted a cross-sectional study among 1346 community-based women from June to October 2012 and collected the data of personal history, lifestyle, physical measures and laboratory indicators. The diagnosis of CKD was established for an eGFR of less than 60 mL/min per 1.73 m or albuminuria. The diagnosis of metabolic syndrome was based on the International Diabetes Federation Guide. According to an epidemiological survey in Guangdong province, women older than 48.9 years were classified as having a postmenopausal status. The prevalence of MS and CKD was determined in both the premenopausal and postmenopausal women, and the association between MS and CKD was analyzed using logistic regression models.@*RESULTS@#MS was significantly correlated with CKD in premenopausal women in both unadjusted analyses (OR=3.10, 95% : 1.32-7.28, =0.009) and in analysis after adjustment for potential confounders (OR=4.09, 95% : 1.63- 10.32, =0.003). When adjusted for diabetes, hypertension, and hyperuricemia, no correlation was found between MS and CKD in premenopausal women (OR=1.56, 95% : 0.31-7.63, = 0.592); in the unadjusted analyses, MS was significantly correlated with CKD in postmenopausal women ( < 0.001). After further adjustment for age, education status, current smoking, physical inactivity, and current drinking, MS was still significantly correlated with CKD (OR=2.60, 95% : 1.69-3.99, < 0.001). When adjusted for diabetes, hypertension, and hyperuricemia, the correlation between MS and CKD was still significant (OR=1.61, 95% : 1.09-2.37, =0.018). In the unadjusted model, a high blood pressure (OR=2.77, 95%CI: 1.57-4.89, < 0.001), an elevated serum triglyceride level (OR=1.84, 95%: 1.16-2.90, =0.009) and a high fast glucose level (OR=2.07, 95%: 1.30-3.28, =0.002) were all significantly correlated with CKD in postmenopausal women. After adjusting for age, current smoking, current alcohol use, education status and physical inactivity, a high blood pressure (OR=2.28, 95%: 1.22-4.26, =0.01), a high serum triglyceride level (OR=1.71, 95%: 1.03-2.86, =0.039) and a high fast glucose (OR=2.25, 95%: 1.36-3.73, =0.002) were still significantly correlated with CKD in postmenopausal women. Blood pressure, serum triglyceride level, fast glucose, serum HDL cholesterol level and central obesity were not correlated with CKD in either the unadjusted model or adjusted model in premenopausal women ( > 0.05).@*CONCLUSIONS@#MS is correlated with CKD in both premenopausal and postmenopausal women, and the association is dependent on diabetes, hypertension, and hyperuricemia in premenopausal women but not in postmenopausal women.

Effects of enriched environment on behavior and expression of mitogen-activated protein kinase phosphatase-1 in hippocampus of depression rats / 新乡医学院学报

Objective To investigate the effect of enriched environment (EE) on behavior and expression of mitogenactivated protein kinase phosphatase-1 (MKP-1) in hippocampus of depression rats induced by chronic unpredicted mild stress (CUS) and to provide clues for the molecular mechanism of treating depression.Methods Forty Sprague-Dawley rats were randomly divided into control group,CUS group,fluoxetine group and EE group,with 10 rats in each group.The rats in CUS group,fluoxetine group and EE group were given 8 weeks of CUS,and from the fifth week,the rats in EE group and fluoxetine group were given EE and fluoxetine for 4 weeks,respectively.The changes of behavioristic of the rats in the four groups were evaluated by body mass gain,open field test,and sucrose preference.The expression of MKP-1 in hippocampus was detected by Western blot.Results There was no significant difference in body mass,distance of horizontal movement,the number of upright,the times of passing through the grid and sucrose preference index among the four groups(P ＞ 0.05).After modeling,compared with the control group,the body mass gain,distance of horizontal movement,the number of up-right,the times of passing through the grid and sucrose preference index in the CUS group,fluoxetine group and EE group were decreased significantly(P ＜ 0.05);there was no significant difference in the body mass gain,distance of horizontal movement,the number of up-right,the times of passing through the grid and sucrose preference index among the CUS group,fluoxetine group and EE group(P ＞ 0.05).After intervening by fluoxetine and EE,the body mass gain,distance of horizontal movement,the number of up-right,the times of passing through the grid and sucrose preference index in the CUS group were lower than those in the control group(P ＜0.05);but there was no significant difference in the body mass gain,distance of horizontal movement,the number of up-right,the times of passing through the grid and sucrose preference index between the control group and the fluoxetine group and EE group(P ＞ 0.05).Compared with the CUS group,the body mass gain,distance of horizontal movement,the number of up-right,the times of passing through the grid and sucrose preference index in the fluoxetine group and EE group were higher(P ＜ 0.05);there was no significant difference in the body mass gain,distance of horizontal movement,the number of up-right,the times of passing through the grid and sucrose preference index between the fluoxetine group and EE group (P ＞ 0.05).The expression of MKP-1 in hippocampus of CUS group and EE group was higher than that in the control group (P ＜0.05).There was no significant difference in the expression of MKP-1 in hippocampus between the fluoxetine group and control group(P ＞ 0.05).Compared with the CUS group,the expression of MKP-1 in hippocampus in the fluoxetine group decreased (P ＜ 0.05).There was no significant difference in the expression of MKP-1 in hippocampus between the EE group and CUS group(P ＞0.05).Compared with the fluoxetine group,the expression of MKP-1 in hippocampus in the EE group was higher(P ＜ 0.05).Conclusion EE can significantly improve depressive symptoms in rats,but it has no significant effect on MKP-1 protein expression in hippocampus,and EE may not act on depression by affecting MKP-1.

Feasibility Study of Radiation Dose Reduction in Adult Female Pelvic CT Scan with Low Tube-Voltage and Adaptive Statistical Iterative Reconstruction

OBJECTIVE: To evaluate image quality of female pelvic computed tomography (CT) scans reconstructed with the adaptive statistical iterative reconstruction (ASIR) technique combined with low tube-voltage and to explore the feasibility of its clinical application. MATERIALS AND METHODS: Ninety-four patients were divided into two groups. The study group used 100 kVp, and images were reconstructed with 30%, 50%, 70%, and 90% ASIR. The control group used 120 kVp, and images were reconstructed with 30% ASIR. The noise index was 15 for the study group and 11 for the control group. The CT values and noise levels of different tissues were measured. The contrast to noise ratio (CNR) was calculated. A subjective evaluation was carried out by two experienced radiologists. The CT dose index volume (CTDIvol) was recorded. RESULTS: A 44.7% reduction in CTDIvol was observed in the study group (8.18 +/- 3.58 mGy) compared with that in the control group (14.78 +/- 6.15 mGy). No significant differences were observed in the tissue noise levels and CNR values between the 70% ASIR group and the control group (p = 0.068-1.000). The subjective scores indicated that visibility of small structures, diagnostic confidence, and the overall image quality score in the 70% ASIR group was the best, and were similar to those in the control group (1.87 vs. 1.79, 1.26 vs. 1.28, and 4.53 vs. 4.57; p = 0.122-0.585). No significant difference in diagnostic accuracy was detected between the study group and the control group (42/47 vs. 43/47, p = 1.000). CONCLUSION: Low tube-voltage combined with automatic tube current modulation and 70% ASIR allowed the low CT radiation dose to be reduced by 44.7% without losing image quality on female pelvic scan.

Observation on hemodynamic changes of the portosystemic collaterals before and after endoscopic treatment in patients with gastroesophageal varices / 中华消化杂志

Objective To investigate the hemodynamic changes of protosystemic collaterals before and after endoscopic treatment in patients with gastroesophageal varices using 64-row multidetector computed tomograghy portal venography (MDCTPV) so as to evaluate the efficacy of endoscopic treatment in patients with or without para-esoghageal varices and with or without nonvarices portosystemic collaterals before treatment. Methods Twenty-six patients with gastroesophageal varices, who underwent endoscopic variceal ligation (EVL) for esophageal varices and endoscopic N-butyl-2-cyanoacrylate injection (EBC) for gastric varices between Jan.2007 and Dec. 2009, were enrolled. Sixty four-row MDCT was used to examine the changes of portosystemic collaterals 1 week before and 12 months after endoscopic treatment. The reconstructed images of portosystemic collaterals before and after endoscopic treatment were evaluated. Results Excellent quality of portosystemic collateral vessels on CTPV were obtained in all patients. The mean diameter of left gastric vein decreased from (6.7±1.9) mm to (5.0±1.9) mm after endoscopic treatment,with significant difference (P＜ 0.05). There was no significant difference in outcomes between patients with or without para-esoghageal varices (80% vs 72.7%, P＞0.05) and patients with or without non-varices portosystemic collaterals (82.4% vs 66.7% ,P＞0.05). Conclusions Sixty fourrow MDCTPV may provide important information for option of endoscopic treatment and prognosis.

Survey and Protection of Occupational Risks among Cleaner Employee in Grass-roots Hospitals / 中华医院感染学杂志

OBJECTIVE To reinforce the management of occupational risks among cleaner employec to lower the occurrence of job related exposure.METHODS Set up a survey to estimate the level of the awareness and knowledge among the cleaner employec about job related exposure and protective procedures in the three medical facilities of Yueqing City.RESULTS From 183 cleaner employec,sharp object cuts accounted for 89.6% per year;45.4% of them only had elementary education or less;39.3% of them wore protective gloves voluntarily during daily work.No one followed the hand hygeine procedures.It showed that the contracted cleaning workers had a huge potential occupational risks.CONCLUSIONS Cleaner employec are the weaker point of occupational exposure protection in the hospitals.Enforceing the mandatory immunization and monitoring their occupational risks and exposures can prevent incidence.

Infection Management in Town Hospitals:Problems and Their Solutions / 中华医院感染学杂志

OBJECTIVE To strengthen the infection management in the public and private town hospitals.METHODS We investigated the infection management in the public and private hospitals which are below Grade 2 in our city.RESULTS The problems existing in the infection management in these hostpitals were obvious and severe,mainly including the leaders′ ignorance of the importance of infection management,incomplete organization and regulation,medical workers′ lacking of the related knowledge about infection management,behindhand hospital infection management, monitoring and prevention,and incorrect sterilization.CONCLUSIONS The infection mangement in public and private town hospitals is weak and needed to be strengthened.

Clinical study of a case with chronic and sustained hypernatremia and hypodypsia / 中华内分泌代谢杂志

Water deprivation and loading tests were performed in a patient with sustained hypernatremia and hypodypsia. Results suggested that the regulation of ADH release was still retained despite of the raised threshold, being consistant with the diagnosis of essential hypernatremia. The hypernatremia of this patient was partially improved by dihydrochlorothiazide and desmopression acetate (DDAVP).