Treatment of a patient with cancer pain based on the concept of psychosomatic medicine： a case report / 四川精神卫生

This paper reported a case of psychosomatic medicine-based comprehensive treatment for a patient with gynecological malignant tumor suffering severe left hip pain after surgery and radiotherapy， with the aim of demonstrating the pathophysiological classification of pain arising from pathological damage， and providing references for the clinical study and practice of the psychosomatic multi-dimensional treatment mode for clinical "organic pain". This case suggested that the onset of pain， even in the presence of pathological damage， also involved a combination of pathological damage， somatic manifestations of anxiety and individual cognitive biases.

Association of CHRNA4 gene polymorphisms with response to antidepressant among ethnic Han Chinese / 中华医学遗传学杂志

Objective@#To assess the association of single nucleotide polymorphisms (SNPs) CHRNA4 gene with response to selective serotonin re-uptake inhibitors (SSRIs) for the treatment of major depressive disorder (MDD).@*Methods@#For 304 patients receiving drug treatment for major depression, 2 SNPs, namely rs4522666 and rs4603829, of the CHRNA4 gene were determined by matrix-assisted laser desorption/ionization time of flight (MALDI-TOF) mass spectrometry. HAMD-17 was adopted as the primary rating tool to evaluate the severity of depression on the baseline and at the end of 1st, 2nd, 4th and 6th weeks treatment.@*Results@#The frequency of GG genotype/G allele for rs4522666 differed significantly from that of TT and GT genotypes/T allele between responders and non-responders (P =0.015 and P=0.006, respectively). No significant difference was found in genotypic and allelic frequencies of rs4603829 between the two groups (P > 0.05).@*Conclusion@#SNPs of the CHRNA4 gene may play an important role in the response to antidepressant drugs among ethnic Han Chinese with MDD.

Association of CHRNA4 gene polymorphisms with response to antidepressant among ethnic Han Chinese / 中华医学遗传学杂志

OBJECTIVE@#To assess the association of single nucleotide polymorphisms (SNPs) CHRNA4 gene with response to selective serotonin re-uptake inhibitors (SSRIs) for the treatment of major depressive disorder (MDD).@*METHODS@#For 304 patients receiving drug treatment for major depression, 2 SNPs, namely rs4522666 and rs4603829, of the CHRNA4 gene were determined by matrix-assisted laser desorption/ionization time of flight (MALDI-TOF) mass spectrometry. HAMD-17 was adopted as the primary rating tool to evaluate the severity of depression on the baseline and at the end of 1st, 2nd, 4th and 6th weeks treatment.@*RESULTS@#The frequency of GG genotype/G allele for rs4522666 differed significantly from that of TT and GT genotypes/T allele between responders and non-responders (P=0.015 and P=0.006, respectively). No significant difference was found in genotypic and allelic frequencies of rs4603829 between the two groups (P> 0.05).@*CONCLUSION@#SNPs of the CHRNA4 gene may play an important role in the response to antidepressant drugs among ethnic Han Chinese with MDD.

Association of TPH2 gene polymorphism with response to antidepressant treatment among ethnic Han Chinese population / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To assess the association of TPH2 gene polymorphisms with the response or remission to selective serotonin reuptake inhibitors (SSRIs) drugs during treatment of major depressive disorder.</p><p><b>METHODS</b>For 304 patients receiving SSRIs treatment for major depression disorder, 3 single nucleotide polymorphisms (SNPs) (rs1007023, rs1023990 and rs4570625) in the TPH2 gene were genotyped by MALDI-TOF mass spectrometry using a MassArray Analyzer 4 system. HAMD-17 was adopted as the primary rating tool to evaluate the severity of depression on the baseline and at the end of 1st, 2nd, 4th and 6th week of treatment.</p><p><b>RESULTS</b>The frequency of GG genotype/G allele for rs4570625 differed significantly with the frequency of TT and GT genotypes/T allele between responders and non-responders (P=0.013 and 0.007, respectively). Genotypic and allelic frequencies of the other polymorphisms did not differ significantly between the two groups (P>0.05). No association of TPH2 gene polymorphism with remission was found with the 3 SNPs.</p><p><b>CONCLUSION</b>The polymorphisms of TPH2 gene may play an important role in response to antidepressant drug therapy.</p>

Research progress of premature infant apnea / 国际儿科学杂志

The mechanism of apnea in premature infants is complicated.Central nervous system undevelopment is the fundamental cause of apnea.Some other factors such as infection and anemia also could lead to apnea.At present,caffeine is used to treat premature apnea,and other drugs and methods also have certain effect.In this paper,we reviews pathogenesis and treatment of premature apnea,in order to provide new understanding of the pathogenesis and prevention of apnea.

The 5-HTT gene polymorphisms correlated with the clinical manifestations of depression / 中华行为医学与脑科学杂志

Objective To determine the potential correlation of 5-HTT gene polymorphisms (5-HTTLPR and STin2) with clinical manifestations in depression.Methods A total of 401 depressed patients,all of Chinese Han region,were collected and genotyped by polymerase chain reactions (PCR).All patients were evaluated using a 17-item Hamilton depression rating scale (HAMD-17) and Hamilton anxiety rating scale (HAMA),and then associated analysis was applied.Results (1) The age of onset in patients with L/S genotype of 5-HTLPR polymorphism were much younger than that of patients with L/L and S/S genotype (F=3.281,P=0.039).Besides,there was also a significant difference of HAMA1 (anxious mood) scores among patients with different genotypes for 5-HTTLPR polymorphism,where the scores of those with L/S genotype were the highest (2.34±0.80,P=0.010).(2) The scores of HAMD10 (mental anxiety),HAMA1 (anxious mood),HAMA3 (fear) and mental anxiety factor were higher in patients with 12/10 genotype than patients with 12/12 and 10/10 genotype for STin2 polymorphism (2.40±0.83,2.38±0.90,1.42± 1.04,14.60±4.26 respectively;P value:0.014,0.044,0.03 and 0.006 respectively).The scores of HAMD10(mental anxiety) and mental anxiety factor were (2.11±0.77),(12.96±3.78) in the 12/12 genotype patients,and significantly lower than that in the 12/10 genotype patients (adjustedPvalue:0.018,0.006).Conclusions A positive association of the 5-HTT polymorphisms with anxious symptoms in depressed patients is revealed.These findings might provide some evidences for the clinical phenotype and optimization of depression treatment.

Comparison of calculated and measured resting energy expenditure in patients with type 2 diabetes mellitus / 中华临床营养杂志

Objective To evaluate the accuracy of prediction equations in calculating energy expenditure in elderly patients with type 2 diabetes mellitus (T2DM).Methods In 75 elderly T2DM patients hospitalized in our hospital between August 2014 and August 2015,the resting energy expenditure (REE)measured with indirect calorimetry was compared with those calculated with six different prediction equations.Statistical analysis was performed with paired t-test,the percentage of individual coincidence,and BlandAltman method.Results The measured REE of the patients was (1 513.2 ± 240.6) kcal/d.There were statistically significant differences between the measured REE and the values predicted with Harris-Benedict,Owen,Mifflin,and Liu equations (all P ＜ 0.05),while no statistically significant differences were observed between the measured REE and the values predicted with FAO/WHO/UNU and Schofield equations (both P ＞0.05).FAO/WHO/UNU equation showed the smallest average difference from the measured value (-18.9 kcal/d),but the 95％ consistency limit (-363.3 kcal/d,325.5 kcal/d) was still beyond the acceptable clinical range.Conclusion The accuracy of prediction equations in estimating REE in elderly patients with T2DM may be dissatisfactory.

Brain cortical thickness abnormalities in first-episode, never-medicated, adult major depressive disorder patients / 中华放射学杂志

Objective Present study aimed to characterize the alteration of cortical thickness in first-episode, never-medicated, adult patients with major depressive disorder (MDD), and explore whether such deficits were related with their disease duration and clinical symptom severity. Methods Thirty-seven adult MDD patients were recruited from March 2013 to August 2015 as patient group, and 41 healthy volunteers were as control group. All the patients underwent three-dimensional spoiled gradient recalled (3D-SPGR) sequences, and the images were acquired. Constructions of the cortical surface were developed from 3D-SPGR images using FreeSurfer software, and the thickness of the entire cortex was measured according to the automated surface reconstruction, transformation, and high-resolution inter-subject alignment procedures. Finally, cortical thickness was compared between the two groups, and the relativity between clinical symptom severity, disease progression and clinical scores were analyzed using the General Linear Model (GLM). Results Our results revealed a significant increase in cortical thickness(P0.05). Conclusion Excluding the impact of treatment, our study showed that the cortical thickness change was mainly located in the prefrontal-limbic system in the in early course of MDD.

Observation of the effect of ulinastatin in the treatment of children with severe pneumonia / 中国基层医药

Objective To observe the effect of ulinastatin in the treatment of children with severe pneumonia. Methods 86 children with severe pneumonia were divided into two groups according to the hospital card number:treatment group(n=45) and control group(n=41).All of them were given routine treatment,while the patients of the treatment group were given ulinastatin(5 000 U· kg-1 · time-1 ,1-2times/d,7d) in addition.The time of tem-perature drop to normal,the time of dyspnea improve,the time of dyspnea disappear,the time of lung rale disappear and length of hospital stay were observed.Then,the therapeutic effect was evaluated after treatment for 7 days.Results The treatment group had 21 cases excellence,21 cases improvement and 3 cases failure, the total effective rate was 93.33%,the control group had 17 cases excellence,15 cases improvement and 9 cases failure,the total effective rate was 78.04%,there was significant difference between the two groups(χ2 =4.17,P<0.05).The time of temperature drop to normal,the time of dyspnea improve,the time of dyspnea disappear,the time of lung rale disappear and length of hospital stay in the treatment group were (3.37 ±1.51)d,(3.12 ±1.72)d,(7.15 ±2.45)d,(10.75 ±2.47)d, respectively,which in the control group were (5.02 ±1.78)d,(4.82 ±1.51)d,(9.08 ±2.85)d,(13.22 ±2.85)d, there were significant differences between the two groups(t=4.71,4.91,3.42,4.41,all P<0.01).Conclusion Ulinastatin has good effect on children with severe pneumonia.It has value in application.

Effect of group cognitive behavioral therapy on blood glucose levels, anxiety and depression in patients with type 2 diabetes mellitus / 中华全科医师杂志

Objective To evaluate the clinical effect of group cognitive behavioral therapy on blood glucose levels,anxiety and depression in patients with type2 diabetes mellitus.Methods Ninety three patients with type 2 diabetes mellitus were recruited and randomly divided into intervention group (n =48) and control group (n =45).Both groups received diabetes health education,patients in intervention group received additional group cognitive behavioral therapy.The glucose tolerance,glycosylated hemoglobin A1c were measured; the HAMA(Hamilton Anxiety Scale)scores,HAMD(Hamilton Depression Scale)scores and CSQ (Coping Styles Questionnaire) scores in patients were analyzed before and 6 months after treatment.Results After 6-month treatment the fasting blood glucose (6.33 mmol/L vs.5.94 mmol/L),1 h postprandial plasma glucose(12.40 mmol/L vs.11.46 rmool/L),2 h postprandial plasma glucose (10.24 mmol/L vs.9.13 mmol/L),A1 c (6.31％ vs.6.07％) in intervention group were decreased significantly,compared to baseline values (all P ＜ 0.05).The HAMA total score (9.98 vs.8.14),somatic anxiety (3.98 vs.3.48),psychic anxiety(6.00 vs.4.67),HAMD total score(10.74 vs.6.93),anxiety somatic(5.02 vs.3.26),block(2.24 vs.1.38)and sleep disorders(2.40 vs.1.40)in intervention group were all decreased significantly(P ＜ 0.01 or 0.05).There were significant differences in HAMA total score (8.14 vs.9.15),HAMD total score(6.93 vs.9.33),anxiety somatic(3.26 vs.4.38),block(1.38 vs.1.98)and sleep disorders(1.40 vs.2.03)between the intervention group and control group(P ＜ 0.01 or 0.05).And the negative coping style scores in intervention group was also lower than that of the baseline (26.74 vs..29.43).Conclusion The group cognitive behavioral therapy combined with diabetes health education for patients with type 2 diabetes mellitus may improve the glucose metabolism and depression and anxiety status of patients.

Inlfuence of coping style and social support on quality of life in patients with impaired glucose tolerance / 中南大学学报(医学版)

Objective:To explore how coping style and social support influence the quality of life in patients with impaired glucose tolerance, which act respectively as the internal and external mediating ways. Methods:A total of 283 patients with impaired glucose tolerance from 6 Three-A hospitals in China were surveyed with self-rating anxiety scale, self-rating depression scale, trait coping style questionnaire, social support scale, and WHOQOL-BREF. Results:Biographic data failed to predict the quality of life in patients with impaired glucose tolerance, while anxiety, depression, social support and coping style significantly influenced their quality of life. Conclusion:The fact that emotional disorder, social support and coping style influence the quality of life in patients with type 2 diabetes also exists in patients with impaired glucose tolerance.

Matching analysis of event related potentials in patients with bipolar disorder / 生物医学工程学杂志

The present paper is to investigate the variation characteristics and clinical application of event related potentials (ERPs) in patients with bipolar disorder. A total of 70 patients with bipolar disorder, with 39 patients in manic phase and 31 patients in depressive phase, and 50 health volunteers were recruited in the case-control study. The ERPs, such as P300, MMN, CNV, P50, were recorded by the Nihon Kohden evoked potential instrument. Compared with the healthy volunteers' latency in the control group, the latency of MMN, CNV, N2, P3a, P3b was longer in the manic phase group; the latency of MMN, CNV, P3a and P3b were longer and the amplitude of CNV was lower in the depressive phase group. The S2/S1 value of P50 obviously increased among the manic phase patients. With manic phase or depression phase of bipolar disorder, the variation characteristics of ERPs were different. The features of ERP reflect the cognitive dysfunction and sensory gating impairment of patient's brain. The results provide neural electrophysiological basis for clinical diagnosis and therapy of bipolar disorder.

Epidemiological investigation on depression among 6～16 years old children and adolescents in Chengdu / 中国心理卫生杂志

Objective: To explore the prevalence and co-morbidity in depression disorder among children and adolescents in Chengdu City. Methods: Using a one-phase design, 4S8S children and adolescents in grades 1～10 were assessed with the Strength and Difficulty questionnaire (SDQ) and Development and Well-Being Assessment (DAWBA) . A structured interview with verbatim reports was reviewed by clinicians so that information from parents, teachers, and children were combined in a manner that emulated the clinical process. Results: (1) The rate of depressive disorder was 1.2% , and that in girls was much higher than that in boys after 12 years old (2.56% vs. 1.42%) . (2) The rate of depressive disorder increased with age from 0.10% (6～8 years) to 2.59% (≥ 15 years) . (3) The co-morbidity was 40% . The most common comorbidity diagnosis was anxiety disorders (29.1%) and behavior disorders (25.5%) . Conclusion: The prevalence of depressive disorder among children and adolescents in Chengdu is 1.2%. Gender and age may be the related factors. The co-morbidity is common in children and adolescents with depression disorder.

Effects of repeatedly forced swim stress on CNV-like potential in rats / 中华行为医学与脑科学杂志

Objective To explore whether there were abnormalities of behavioral tests and CNV-like potential in stressed rats following repeatedly forced swim stress.Methods Forty male rats were randomly divided into 4 groups: the control groups (Control-1 and Control-2) and the stress groups ( Stress-1 and Stress-2).Rats in stress groups were administered to repeatedly forced swim 7 or 14 days respectively.Body weight gain, saccharin preference test and open field test were performed.After being anesthetized with urethane, CNV-like potentials were elicited by condition-test stimulus.Results Results of behavioral tests displayed less body weights (F =253.60, P＜0.001 ) and less saccharine solution intake (F= 13.67, P=0.001 ) in stressed group rats and significant effects of stress on the number of crossing squares, the duration of rearing and the number of grooming in open field test.CNV amplitudes were lower in the stressed rats than those in control (F=21.312, P＜0.01 ).Conclusion This study provides an important evidence of changes of CNV-like potential in depressed rats following repeatedly forced swim stress.Based on this study, ER Ps should be taken into consideration and applied as the useful tools in the research work of depressed animal models.

Brain functions in major depressive disorder: a resting-state functional magnetic resonance imaging study / 生物医学工程学杂志

This study sought to reveal the difference in resting-state brain functions between subjects with major depressive disorder and normal controls. Fifty-three depressed patients diagnosed with DSM-IV and 38 normal controls underwent resting-state functional magnetic resonance imaging (fMRI), and the data were analyzed using a new method called Regional Homogeneity (ReHo). Then voxel wised comparison was made to derive the resting-state brain function differences between groups. Compared with normal controls, depressed subjects showed decreased ReHo in bilateral anterior cingulate cortex (ACC), left medial frontal gyrus, and left middle temporal gyrus. Significant decreased ReHo in ACC might suggest less spontaneous neuronal activities or lower baseline brain activities of ACC in depressed subjects in comparison with normal controls.

Effect of antipsychotic drugs on life quality of schizophrenic patients: one year follow-up study / 中南大学学报(医学版)

OBJECTIVE@#To compare the effect of 7 antipsychotic drugs on the life quality of schizophrenia patients including chlorpromazine, sulpiride, clozapine, risperidone, olanzapine, quetiapine, and aripiprazole.@*METHODS@#A total of 1,227 stable schizophrenic patients within 5 years onset who took 1 of the 7 study medications as maintenance treatment were followed up for 1 year at 10 China sites. Patients were evaluated by the short form-36 health survey (SF-36) at the baseline and at the end of 1 year.@*RESULTS@#The life quality was improved obviously at the end of the follow-up. There was significant difference in body pain, vitality, and mental health (P<0.05) among these antipsychotic drugs.@*CONCLUSION@#All 7 antipsychotic drugs can improve the life quality of schizophrenia patients. Atypical antipsychotic drugs, especially olazapine and quetiapine, are superior to typical antipsychotic drugs in improving life quality.

Non-invasive MR perfusion study in patients with depression / 中华放射学杂志

Objective To investigate the brain perfusion changes in patients with refractory depressive disorder (RDD) and non-refractory depressive disorder (NDD) using arterial spin labeling (ASL).Methods Present study included 12 patients with RDD, 37 patients with NDD and 42 controls,and their age, sex and handedness were matched among the three groups.FAIR sequences were performed using a 3 T MR imaging system with an 8 channel phase array head coiL The labelled and controled images were subtracted and then averaged to obtain perfusion-weighted images.The first 2 images were excluded to avoid T, equilibrium effects and then voxel based analysis was performed using SPM2. One way ANOVA analysis using age as covariance ( thresholded at P ＜ 0.01 uncorrected) was performed.Results Patients with NDD showed regional alteration of the brain perfusion, mainly involved in two frontal subcortical circuits, i.e. significantly decreased perfusion in the left frontal and thalamus (the limbic thalamo-cortical circuit) whereas significantly increased perfusion in bilateral hippocampi, fight lentiform and left anterior cingulated gyros (the limbic-striatal-pallidal-thalamic circuit).In contrast, patients with RDD presented significantly decreased perfusion involving bilateral frontal areas (the limbic-thalamo-cortieal circuit) whereby no significantly increased perfusion areas were observed.Conclusion In addition to the reported experimental evidences, our results suggest that the RDD is associated with inactivity of bilateral frontal areas, while the NDD is associated with inactivity of left frontal areas and overactivity of bilateral limbic system.

Examining the comorbidity of attention deficit and hyperactivity disorder and conduct disorder in a population-based twin sample / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To examine three possible causes of the relationship between attention deficit and hyperactivity disorder and conduct disorder: additive genetic factors(A), common environmental factors(C) and individual-specific environmental factors(E).</p><p><b>METHODS</b>One hundred and forty pairs of twins from the Southwestern China Twin Registry were examined with the parent-rated Strength and Difficulties Questionnaire (SDQ). The cross-twin within-variable, within-twin cross-variable and cross-twin cross-variable correlations were calculated. Using structural equation modelling, bivariate models were fitted. The best fitting model was chosen based on likelihood and parsimony.</p><p><b>RESULTS</b>The observed phenotypic correlation between HYPER and COND was 0.44 (95% CI: 0.09, 0.27), with genetic factors accounting for about 70% of the observed correlation. Bivariate model fitting quantified the genetic correlation between HYPER and COND at 0.76 (95% CI: 0.31, 1) and the individual-specific environmental correlation at 0.28 (95% CI: 0.02, 0.51).</p><p><b>CONCLUSION</b>In children, three different genetic factors may exist: one that solely affects the liability to hyperactivity behaviour, one that has only an effect on conduct behaviour and one that influences both hyperactivity and conduct behaviour. Our results suggests that most of the environmental factors that increase the risk of hyperactivity behaviour do not influence conduct behaviour and vice versa.</p>

A Living Skill Training Scheme for the Patients Recovering from Schizophrenia / 中国康复理论与实践

@#The healing training was an important method to improve living ability and quality of life of patients with schizophrenia.This article introduced a living skill training scheme applied in out-patients whose course of disease shorter than 5 years.

Correlation factor analysis of mental stress reaction of patients during acute burn period / 中国组织工程研究

BACKGROUND: There is often a physical and psychosocial effect in burn injury, and the degree of mental stress reaction is related to social support, individual experience and personality characteristics.OBJECTIVE: To investigate the mental stress reaction, the degree of social support and the Minnesota Multiphasic Personality Inventory (MMPI)personality characteristics in acute burn patients, and to analysis the influence factor of mental stress reaction.DESIGN: Cross-sectional study.SETTING: West China Mental Health Center of Sichuan University, Burn Department of Mianyang Municipal Central Hospital, and Burn Department of General Hospital of Panzhihua Iron and Steel Company.PARTICIPANTS: From April 2003 to April 2005, totally 104 mild, moderate or severe burn patients, including 92 males and 12 females, aged 12-60 years, selected from Mianyang Central Hospital and Department of burn of General Hospital of Panzhihua Iron & Steel Co., Ltd took part in the study.METHODS: The emotional problems and personality characteristics were measured with the Hamilton Rating Scale for Depression (HAMD), the Hamilton Rating Scale for Anxiety (HAMA), the Minnesote Multiphasic Personality Inventory (MMPI), the Social Support Rating Scale (SS) as well as general clinical data,by the rating scales 3 day after burn. The patients were divided into anxiety-depression group (n=51) and normal emotion group (n=53) according to their anxiety-depression scores (anxious score＞ 7,depressive score＞ 8), those influencing factor included burning total area,age, sex and society support, Stepwise Regression was introduced to get the main factors that influenced mental stress reaction.MAIN OUTCOME MEASURES: ① Scores of each scale and comparison of general clinical data in each group; ② stepwise regression analysis of depression and anxiety of burn patients.RESULTS: Data of Totally 104 patients was entered the final analysis. ①The scores were 10.4±2.46 and 16.8±5.94 of anxious and depressive patients during acute burn period, which were higher than those in normal group (4.29±2.26, 5.48±2.06, P=0.01). ② The main influential factor for depression were burning area and social supporting availability, and those for anxiety were age, burning area, social supporting availability and subjective social supporting degree. ③ MMPI test results show that T scores in anxiety-depression group were below 60 points, however T-scores were above 60 points in normal group including cheating points, hypomania,schizophrenia, psychasthenia and paranoid ideation CONCLUSION: Burn is a mental crisis to burn patients, which can lead to abnormal emotional reaction and personality change. The depressive and anxious score are positively related with burning area, and are negatively correlated with society supporting availability. The good social support system is benefit to over mental crisis period.