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Objective:To investigate the characteristics of obesity in adolescents with major depressive disorder (MDD) and its association with the depressed severity.Methods:A total of 278 adolescents with MDD were recruited according to the inclusion and exclusion criteria. Their demographic data were collected and 24-item Hamilton depression scale (HAMD-24) was used to evaluate their severity of depression. According to the body mass index (BMI) classification standard of adolescents in China, all subjects were classified into four groups(wasting group, normal BMI group, overweight group and obesity group). SPSS 26.0 statistical software was used for data analysis. The Kruskal-Wallis test and the Chi-square test were separately used for the comparison of the four groups.Spearman correlation was used to explore the relationship between BMI and HAMD-24 scores and severity.Results:Among 278 adolescents with MDD, the prevalence of body abnormality was 32.4% (90/278), among which wasting, overweight and obesity were 9.0% (25/278), 14.4% (40/278) and 9.0% (25/278) respectively. There were statistically differences in gender ( χ2=17.018, P<0.001), HAMD-24 scores ( H=9.427, P=0.024) and depressed severity( H=8.508, P=0.037) among the four groups. Multiple comparisons showed that there were only statistically differences between obesity group and normal BMI group, that was the prevalence of obesity in males was higher than that in females ( χ2=13.631, P<0.001), and the level in HAMD-24 scores ( Z=2.956, P=0.003) and depressed severity ( Z=2.832, P=0.005) was lower in obesity group than that in normal BMI group.Spearman correlation analysis showed that BMI was negatively correlated with HAMD-24 scores ( r=-0.162, P=0.007). Conclusion:There is gender difference in obesity rates among the adolescent patients with first-episode untreated MDD. And the obese patients are less depressed than those with normal BMI.
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Objective@#To investigate the changes of brain activity in adolescents with first-episode major depressive disorder (MDD) and its significance.@*Methods@#Totally 42 first-episode MDD patients with suicidal ideation (SU group), 17 MDD patients without suicidal ideation (NSU group) and 29 healthy controls (HC group) were examined by psychological assessment and resting-state functional magnetic resonance imaging (fMRI). The differences of brain functional activities between the three groups were compared by amplitude of low frequency fluctuation(ALFF). The relationship between the difference of zALFF value in brain regions and the severity of depression, intensity of suicidal ideation were further analyzed.@*Results@#The zALFF values in the left hippocampus(MNI: x=-21, y=-33, z=0) and left Frontal_Sup_Medial(MNI: x=3, y=33, z=63) of the three groups were significantly abnormal (P<0.001, k>20, uncorrected). The results of Post-hoc test showed that the zALFF value of left hippocampus increased significantly (F=28.931) and decreased significantly in left Frontal_Sup_Medial(F=16.648)in SU group , compared with NSU group and HC group(P<0.001, Bonferroni correction). There was no significant difference in zALFF value between HC group and NSU group(P>0.05). In SU group, the zALFF values of left hippocampus and left Frontal_Sup_Medial were not correlated with total scores of HAMD-24(r=-0.214, -0.103) and suicide ideation intensity factor scores(r=0.115, -0.055)(P>0.05).@*Conclusion@#Abnormal autonomic nervous activity exists in left hippocampus and left Frontal_Sup_Medial in adolescent MDD patients with suicidal ideation, which may be the neurological basis and biological index of suicidal ideation.
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Objective To study the resting-state functional connectivity( FC) changes of anterior cingulate cortex(ACC) and amygdala in adolescent patients with medication-naive first-episode major de-pressive disorder(MDD).Methods Medication-naive first-episode MDD adolescents( n＝30) and pair-wise matched healthy controls(HCs,n＝29) underwent resting-state functional magnetic resonance images(fM-RI).To study whether there were different in FC changes between amygdala and ACC and whole brain re-gions,and whether abnormal FC was related to clinical characteristics.Results Compared with HCs,the ado-lescent MDD patients showed decreased FC between the left amygdala and right thalamus( MNI x,y,z:15,－21,18)(t＝－2.85)and increased FC between the left amygdala and the bilateral temporal middle gyrus,left occipital gyrus,right medial prefrontal cortex(MPFC)(MNI x,y,z:9,66,15) ( t＝2.80).The right amygdale showed decreased FC with bilateral middle frontal gyrus,left caudate(MNI x,y,z:－15,－9,21)(t＝－2.53), right thalamus(MNI x,y,z:12,－36,12)(t＝－3.01),right cerebellum(MNI x,y,z:3,－84,－33)(t＝－2.45) and increased FC with right temporal middle gyrus,right MPFC( MNI x,y,z:6,69,12) ( t＝2.41).The left ACC showed decreased FC with left cerebellum( MNI x,y,z:12,－87,－24) ( t＝－2.36),left frontal inferior triangle gyrus,right frontal inferior orbital gyrus and increased FC with right frontal middle orbital gyrus.The right ACC showed decreased FC with left caudate(MNI x,y,z:－15,21,6)(t＝－2.29),right temporal middle gyrus,right MPFC(MNI x,y,z:9,54,36)(t＝－2.29),right frontal inferior orbital gyrus,right angular(MNI x,y,z:45,－51,21)(t＝－3.01),left dorsolateral prefrontal cortex(MNI x,y,z:－21,33,36) ( t＝－2.61).The increased FC between the left amygdale and bilateral temporal middle gyrus showed positive correlation with the score of HAMD(r＝0.50,P＜0.05;r＝0.45,P＜0.05).And the FC between the right amygdale and right middle frontal gyrus was positive correlation with duration of disease( r＝0.63,P＜0.05).Conclusion There is widespread FC disorder in amygdala and ACC in adolescents patients with first-episode depression.Abnor-mal FC changes may be the neuropathological mechanism of depression.
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Objective To sum up nursing experience of cerebrospinal fluid drainage in patients with aortic dissection with paraplegia after sun′s operation. Methods Retrospective analysis of 17 cases of clinical nursing care from January 2014 to December 2016, summing up related nursing experience includingintensive care of cerebrospinal fluid drainage, observation of limb movement and muscle strength, monitoring complications, maintain stable hemodynamics, strengthen the life nursing during hospitalization, in order to ensure the drainage of cerebrospinal fluid. Results 2 deaths, Recovery of different degrees of paraplegia or paresis in 12 and persistent paraplegia in 12 out of the other 15 patients, 9 patients recovered and discharged,6 cases transferred to rehabilitation hospital. Conclusions Careful nursing of cerebrospinal fluid drainage can improve paraplegia or lower extremity paresis caused by spinal cord ischemia,and promote patients′rehabilitation.
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Objective To study the correlation between 5-serotonin transporter ( 5-HTT) gene pol-ymorphism and the first episode major depressive disorder ( MDD ) and cognitive function in adolescent. Methods 5-HTT genotype and allele were detected by polymerase chain reaction ( PCR) amplification of 76 patients with first episode of MDD and 73 normal controls. Case control method was used to analyze the correlation between different genotypes and the onset, the clinical features, and cognitive function. Result-s There was no significant difference between 5-HTTLPR genotype frequencies for the 41 cases of type S/S (53.9%),27 cases of type L/S(35.5%),8 cases of type L/L(10.5%)of case group and 5-HTTLPR geno-type frequencies for the 38 cases of type S/S(52.1%),18 cases of type L/S(24.7%),17 cases of type L/L (23.3%) of control group(P>0.05).Patients with S/S type,L/S type had significantly higher sleep scores than those of patients with type L/L(P=0.005,P=0.001). Agitation score in patients with S/S type group was significantly higher than that in patients with S/L,L/L(P=0.000,P=0.001);patients with S/S inferior-ity scores were significantly lower than those of patients with S/L,L/L(P=0.002,P=0.006). There was no significant difference in cognitive function among three groups. Conclusions In Chinese Han population, there may be no direct association between 5-HTTLPR gene polymorphism and susceptibility to MDD and its cognitive function in adolescents. S/S and L/S patients may be prone to sleep problems,type S/S patients may be prone to irritability and type L/L patients may be prone to inferiority.
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Objective To investigate the abnormal brain activity of first-episode depression by rest-ing state functional magnetic resonance imaging ( fMRI) .Methods Twenty-one adolescent participants diag-nosed with depression(AD) and 18 healthy controls ( HC) were recruited.Resting state fMRI brain scans were performed on all participants.Regional homogeneity ( ReHo) approach was applied to preprocess the fMRI datasets.The value of ReHo maps were obtained in the whole brain.Results ReHo values in the AD group were higher than those in the healthy controls in the right inferior temporal gyrus ( MINI:66,-24,-20) ,left upper cingulate cortex (-27,47,-6) ,frontal polar (-24,59,14) ,after upper left cingulate cortex (-1,-16,35),after the bottom left cingulate cortex (-2,-38,32),left praecuneus (-1,-48,65) com-pared with that in the healthy controls (P<0.05) .ReHo in the AD group decreased in the right middle tempo-ral gyrus (45,-34,32) compared with that in the healthy controls (P<0.05).Conclusion Extensive ReHo abnormalities were found in the brains of patients with first-episode,drug-naive depression,and these abnor-malities in spontaneous neural activity may contribute to the neuropathology of adolescent depression.