Clinical features and treatment status of adolescent patients with bipolar disorder / 四川精神卫生

BackgroundGender and age differences in the clinical manifestations of patients with bipolar disorder can affect the clinical diagnosis and treatment process. The current treatment effect of bipolar disorder in adolescents is not ideal， which has become the main reason for disability during the learning period. ObjectiveTo analyze the clinical features and medication therapy status of bipolar disorder in adolescents， and to provide references to support for personalized diagnosis and treatment. MethodsOn January 16， 2023， 1 169 patients with bipolar disorder who were hospitalized at Beijing Anding Hospital Affiliated Capital Medical University from January 1， 2014 to December 31， 2017 were retrospectively enrolled. Medical records were collected and analyzed to compare the clinical features among patients of different gender and age groups， and to explore the differences in medication use among patients of different genders in different types of seizures. ResultsMale patients reported a larger proportion of manic episodes， and a smaller proportion of depressive episodes than female patients （P<0.05）.Female patients reported a larger proportion of non-suicidal self-harm behaviors than male patients （χ2=7.761， P<0.01）.And patients in low-age group featured a larger proportion of mixed seizures， impulsive behaviors and family history of bipolar disorders along with a smaller proportion of manic episodes than those in high-age group （P<0.05 or 0.01）. High-age group had a longer average length of hospital stay than low-age group （t=-2.930， P<0.01）. In manic episode patients， males were found to have a larger proportion of valproate and atypical antipsychotic drug administration than females （P<0.01）. Among atypical antipsychotic drugs， males accounted for a larger proportion of administration of risperidone and olanzapine （χ2=26.957） than females （P<0.05 or 0.01）， while females constituted a larger proportion of administration of quetiapine （χ2=14.865） and aripiprazole than males （P<0.01）. In depressive episode patients， females had a larger proportion of administration of olanzapine than males （P<0.01）. In patients with mixed seizures， females occupied a larger proportion of administration of lithium carbonate than males （χ2=9.253， P<0.01）， and males exhibited a larger proportion of administration of valproate than females （P<0.05）. ConclusionDifferences have been shown in diagnostic classification and concomitant symptoms among adolescent bipolar disorder of different genders and ages. Furthermore， medications of lithium carbonate， valproate， atypical antipsychotic and other drugs differ by gender among adolescents of different subtypes of bipolar disorder. ［Funded by Key Special Project of the National Key R&D Program of the Ministry of Science and Technology for "Major Chronic Non communicable Disease Prevention and Control Research" （number， 2017YFC1311101）］

Learning Situation Analysis on "Living Will" and "Hospice Care" in Teaching Practice of Geriatrics / 中国医学伦理学

Objective: To investigate the cognitive status of "living will" and "hospice care" among geriatrics students with different identities, and to provide a basis for improving teaching in corresponding sections of geriatric medicine. Methods:An online questionnaire was used to collect data from 426 students participating in specific courses in geriatric medicine and compare their differences in understanding of different issues. Results: There was no statistically significant difference in the understanding of the concept of "living will" among students with different identities (χ2=5.84, P=0.054). In terms of the concept of "hospice care" , geriatricians and general practitioners had a better understanding than that of medical undergraduates (χ2=37.932, P<0.001). Compared to geriatricians and medical undergraduates, general practitioners had a lower level of autonomy in deciding whether to use life support treatment, and the difference was statistically significant (χ2=28.737, P<0.001). There was a statistically significant difference between general practitioners and medical undergraduates in the understanding of "signing living will" (χ2=12.75, P=0.01). Conclusion: The promotion of "living will" and "hospice care" in humanities courses of medical undergraduate and continuing medical education needs to be strengthened, and the popularization and publicity among the general public should be enhanced to lay the groundwork for improving the quality of hospice care.

Effects of acute-phase monotherapy and combination therapy on quality of life in patients with depressive disorders / 四川精神卫生

BackgroundThe treatment of patients with depressive disorders is short of targeted outcome assessment. As a secondary outcome that is guided by patient values， quality of life is thus of relatively high evaluative value. In China， there exists a lack of large sample prospective cohort studies evaluating the effect of different treatment protocols on quality of life in patients with acute depressive disorder. ObjectiveTo explore the effects of monotherapy and combination therapy on the quality of life of patients with depressive disorder in acute phase， so as to provide references for optimizing the outcome of treatment for such patients. MethodsA prospective follow-up cohort study from August 24， 2020 to November 29， 2021 was conducted， including 1 330 patients from 22 hospitals across 18 cities in China. All these patients met the diagnostic criteria for depressive episodes， recurrent depressive disorder from the Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5）. Patients were divided into monotherapy group （n=969） and combination therapy group （n=361） according to the acute phase treatment protocol. At baseline， the end of the first half month as well as the 1st， 2nd， 3rd， 6th， 9th and 12th months of treatment， patients were assessed with Inventory of Depressive Symptomatology Self-report （IDS-SR30）， Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form （Q-LES-Q-SF）， Concise Health Risk Tracking Scale （CHRT） and Siehan Disability Scale （SDS）. Frequency， Intensity， and Burden of Side Effects Rating （FIBSER） was adopted for assessment at each visit time point of treatment. Spearman correlation analysis was adopted to examine the correlation of quality of life with suicide risk， adverse reactions and impaired social functioning among patients. ResultsAt the end of three months of treatment， the Q-LES-Q-SF score of monotherapy group was higher than that of combination therapy group， and the difference was statistically significant （Z=2.008， P<0.05）. The time effects of both treatment protocols possessed statistical significance （F=111.393， P<0.01）. At the end of three months of treatment， the Q-LES-Q-SF score was negatively correlated with CHRT and SDS scores， respectively， in both monotherapy group and combination treatment group （r=-0.660， -0.712， -0.634， -0.718， P<0.01）. ConclusionBoth monotherapy and combination therapy can facilitate the improvement of the life quality of patients with acute depressive disorder， but monotherapy may achieve better than the combination therapy in this aspect. ［Funded by The National Key Research and Development Program of China "Research on the Prevention and Control of Major Chronic Non-communicable Diseases" （number， 2017YFC1311101）］

Intervention effect of network mental health education based rehabilitation platform on patients with bipolar disorder in remission stage / 中华健康管理学杂志

Objective:To analyze the intervention effect of rehabilitation platform-based online psycho-education on patients with bipolar disorder (BD) in remission stage.Methods:In this randomized controlled study, 91 patients with BD in remission stage who attended the community health center in Xicheng District, Beijing from July to August 2021 were randomly divided into a test group (46 cases) and a control group (45 cases) according to a 1∶1 ratio using the random number table. Baseline data were collected from both groups, and the control group received conventional medication and community telephone follow-up, while the test group was given online mental health education in the form of a WeChat subscription number on this basis, including BD mental health education course push (twice a week) and disease self-management (daily recording of mood, sleep, medication, exercise and gratitude diary), and the intervention period was 6 months in both groups. During the intervention, one patient in the test group was admitted to hospital due to exacerbation of mental illness and the trial was terminated. A total of 90 cases were included in the study. The scores of Medication Adherence Rating Scale (MARS), Hamilton Depression Scale (HAMD), Young Mania Rating Scale (YMRS) and Perceived Devaluation-Discrimination Scale (PDD) were assessed at baseline, after 3 months and 6 months of intervention in both groups, respectively. And the differences in baseline data between the two groups were compared using two independent samples t test and χ2 test, and the repeated-measures ANOVA was used to compare the differences in MARS, HAMD, YMRS, and PDD scores between the two groups before and after the intervention, and to analyze the intervention effects of network mental health education based on the rehabilitation platform on patients in remission stage of BD. Results:After 6 months of intervention, MARS scores in the test group was significantly higher than that in the control group [(8.47±1.75) vs (7.47±1.85)], and was significantly higher than that at baseline (7.36±2.13) and after 3 months of intervention (8.04±1.68) (all P<0.05). YMRS and PDD scores in the test group were significantly lower than those at baseline after 3 and 6 months of intervention [YMRS, 2.0(1.0,4.0),2.0(0,3.0) vs 3.0(1.0,5.5); PDD, (31.18±4.65), (30.13±4.76) vs (32.51±4.51)] (all P<0.05); the differences in YMRS and PDD scores in the control group were not statistically significant (all P>0.05). There was no statistically significant difference in HAMD scores between the two groups before and after the intervention (all P>0.05). Conclusion:Combining mental health education based on rehabilitation platform with conventional medication and community management can significantly improve the medication compliance of patients with BD in remission stage, and improve their manic symptoms and reduce the stigma of the disease.

Analysis of NSFC-supported programs in the field of psychiatry from 2011 to 2019 / 中华医学科研管理杂志

Objective:To explore the trend of psychiatry development by analyzing the funding of the National Natural Science Foundation of China (NSFC) from 2011 to 2019, including key programs, general programs, young scientists funds, and talent programs, to provide a reference for the determination of research direction for researchers and the improvement of project management for research managers.Methods:The information on key programs, general programs, young scientists funds, and talent programs in psychiatry from 2011-2019 were retrieved from the NSFC management system and the NSFC result inquiry system of LetPub from 2011 to 2019 and analyzed for their research directions and contents.Results:Total of 947 programs in psychiatry were funded from 2011 to 2019, including 12 key programs, 396 general programs, 335 young scientists funds, and 35 talent programs. The approved programs showed a cyclical fluctuation trend from year to year. The numbers and funding of programs in psychiatry were significantly lower than those of other medical disciplines. The research content gradually changed from basic research to applied basic research. The approved programs were mainly concentrated in research institutions in Beijing and Shanghai. The requirements for program leaders and supporting institutions varied for different program types.Conclusions:NSFC promotes the overall development of research levels in psychiatry with an increasing demand for applied basic research and uneven development of research levels in different regions. Psychiatric talent training and discipline construction need to be strengthened urgently.

A study on the correlation between semantic distance and cognitive function in schizophrenia / 中华行为医学与脑科学杂志

Objective:To investigate the relationship between lexical semantic processing abnormalities and cognitive function and clinical symptoms in schizophrenia based on the activation diffusion model and semantic distance.Methods:All subjects matched with demographic data were randomly divided into experiment group( n=27) and control group( n=30). The semantic distance of words of different semantic categories and lexical categories were assigned at a level of 1-7.The semantic distance between the two groups was analyzed by repeated measures of variance, and the correlation analysis was conducted on the scores of the MATRICS Consensus Cognitive Battery (MCCB) and positive and negative syndrome scale (PANSS) in the experimental group. Results:The main effects of the groups in semantic distance were statistically significant( F(1, 55)=7.460, P=0.008, ηp2=0.981). The semantic distance in the experimental group (3.672±0.105)was lower than that in the control group (4.068±0.100). The main effect of the semantic category was statistically significant( F(1, 55)= 833.37, P<0.01, ηp2=0.938), and the semantic distance in the relative condition (1.965±0.074) was lower than that in the unrelative condition(5.775±0.117). Under the relative condition, concrete semantic deviation was negatively correlated with the total score of MCCB( r=-0.405, P=0.036)and speech learning ( r=-0.569, P=0.002). Abstract semantic deviation was negatively correlated with speech learning( r=-0.429, P=0.026). Under the unrelative condition, concrete semantic deviation was negatively correlated with MCCB total score ( r=-0.597, P=0.001), speech learning( r=-0.399, P=0.039)and other dimensions.Abstract semantic deviation was negatively correlated with MCCB total score( r=-0.593, P=0.001) and speech learning( r=-0.285, P=0.050). Under the relative condition, the abstract semantic deviation was positively correlated with the general symptom scale score( r=0.448, P=0.019). Under the unrelative condition, abstract vocabulary semantic deviation was positively correlated with PANSS total score( r=0.120, P=0.010), negative scale score( r=0.047, P=0.030) and general symptom scale score ( r=0.306, P=0.010). Conclusion:The semantic distance of lexical processing is abnormal in schizophrenia. The semantic deviation is related to the cognitive function index and symptom index.

Study on gamma oscillation in depression / 中华行为医学与脑科学杂志

Depression is a kind of mental disease which is characterized by significant and lasting low mood.As for the diagnosis and treatment feedback, it mainly relies on symptomatological indicators at present.It is of great significance to find sensitive and reliable biomarkers to improve the level of clinical diagnosis and treatment.In recent years, the new findings of gamma oscillation in patients with depression can be summarized as follows: (1) The generation and regulation of gamma oscillation depend on the interaction between excitatory glutamatergic neurons and inhibitory GABAergic interneurons.(2) Under some conditions, for example, with the help of cognitive tasks, auditory steady state response and new methods of data analysis, gamma oscillation can be used to distinguish the patients with depression from healthy subjects, distinguish the patients with depression from that with bipolar disorder and identify the individuals who have suicidal thoughts or attempts in patients with depression.(3) Various methods of drug or not for depression both can cause the change of gamma oscillation.However, it should be noted that there are still many problems to be solved in using gamma oscillation as a biomarker of depression.

Establishment of the Chinese facial emotion images database with intensity classification / 中国心理卫生杂志

Objective: To establish an intensity-classified Chinese facial emotion image database and provide materials for emotional researches in China. Methods: Firstly, under the guidance of professional director, 22 professional dramatic actors put up seven kinds of emotion, including anger, disgust, fear, sadness, surprise, happy and calm. The process of facial emotional performance of actors were filmed by a high-speed camera. Then we made screen captures according to the intensity of emotion performed by the actors. A total of 814 black-and-white photographs with same size and gray level were made after we removed the irrelevant parts to the facial features. Each kind of emotion contains six levels of intensity scoring from 1 to 6. Totally, 112 healthy volunteers were recruited to evaluate the emotional intensity, pleasure and arousal of all images via a visual scale ranged from 0 to 100. Results: A Chinese face emotional intensity hierarchical picture library was set up, which contained 2 sublibraries. The first library was consisted of 436 images with hierarchical emotional intensity images collected from different performers. The second one was built with 640 images, in which the hierarchical emotional intensity image was collected from same actor/actress. Both image libraries had corresponding scores for intensity, pleasure, and arousal. Furthermore, both exhibited a high degree of internal consistency in reliability analysis (with a Cronbach' s alpha value larger than 0. 9). Conclusion: The present study has established an intensity-classified Chinese facial emotion image database with good recognition degree and psychological measurement attribution, which could provide materials for emotional researches in China.

Electric field simulation and analysis of modified electroconvulsive therapy and magnetic seizure therapy in a realistic human head model / 生物医学工程学杂志

Modified electroconvulsive therapy (MECT) and magnetic seizure therapy (MST) are effective treatments for severe major depression. MECT has better efficacy in the treatment than MST, but it has cognitive and memorial side effects while MST does not. To study the causes of these different outcomes, this study contrasted the electric filed strength and spatial distribution induced by MECT and MST in a realistic human head model. Electric field strength induced by MECT and MST are simulated by the finite element method, which was based on a realistic human head model obtained by magnetic resonance imaging. The electrode configuration of MECT is standard bifrontal stimulation configuration, and the coil configuration of MST is circular. Maps of the ratio of the electric field strength to neural activation threshold are obtained to evaluate the stimulation strength and stimulation focality in brain regions. The stimulation strength induced by MECT is stronger than MST, and the activated region is wider. MECT stimulation strength in gray matter is 17.817 times of that by MST, and MECT stimulation strength in white matter is 23.312 times of that by MST. As well, MECT stimulation strength in hippocampi is 35.162 times of that by MST. More than 99.999% of the brain volume is stimulated at suprathreshold by MECT. However, MST activated only 0.700% of the brain volume. The stimulation strength induced by MECT is stronger than MST, and the activated region is wider may be the reason that MECT has better effectiveness. Nevertheless, the stronger stimulation strength in hippocampi induced by MECT may be the reason that MECT is more likely to give rise to side effects. Based on the results of this study, it is expected that a more accurate clinical quantitative treatment scheme should be studied in the future.

The influence of NS-398 combined with DHA on the apoptosis of bile duct cancer cells QBC939 through inhibiting β-catenin and c-myc / 中华普通外科杂志

Objective To investigate the effect of NS-398 combined with docosahexaenoic acid (DHA) on apoptosis of cholangiocarcinoma QBC939 cells and its mechanism.Methods In vitro,cultured cholangiocarcinoma QBC939 cells were exposed to 0,25,50,100,150 and 200 μmol/L NS-398 with 0,15,30,45,60 and 75 μg/ml DHA respectively.The absorbance of the QBC939 cells were measured by CCK8 and its growth inhibition ratio were calculated.Flow cytometry was applied to detect cell apoptosis.The level of β-catenin and c-myc mRNA and protein were measured by real-time PCR,Western blot and enzyme-linked immunoabsordent assay respectively.Results Exposure to NS-398 combined with DHA suppressed the growth of QBC939 cells.When NS-398 was at 100 μmol/L and DHA at 45 pμg/ml,the relative growth inhibition rate of QBC939 cells was 90％ (F =5.85,P ＜ 0.05).NS-398 combined with DHA promoted QBC939 cells apoptosis at the early stage (F =8.16,P ＜ 0.01).Real-time PCR could detect low β-catenin and c-myc expression in QBC939 cells disposed by NS-398 combined with DHA (F =7.61,P ＜0.01),(F =7.92,P ＜0.01).NS-398 combined with DHA decreased β-catenin (F =7.75,P ＜ 0.01),(F=8.17,P＜0.01) and c-myc (F=8.76,P＜0.01),(F=8.12,P＜0.01) protein expression in QBC939 cells.Conclusion NS-398 combined with DHA promoted apoptosis and inhibit proliferation of cholangiocarcinoma cells QBC939 in vitro possibly through downregulated mRNA and protein expression of β-catenin and c-myc.

Long-term outcome of very old coronary heart disease patients after percutenous coronary intervetion / 中华老年心脑血管病杂志

Objective To assess the effect of PCI on quality of life in very old CHD patients.Methods One hundred and ninety-six ≥80 years old CHD patients were divided into PCI group (n=92) and drug therapy group (n=104).Their clinical data were retrospectively analyzed.The patients were followed up for 12 months during which non-event survival rate,readmission rate,and incidence of recurrent arrhythmia,cardiogenic death,bleeding events were recorded.Results The incidence of 3-vessel lesions and serum creatinine level were significantly higher in PCI group than in drug therapy group (70.65％ vs 25.00％,82.63±25.35 μmol/L vs 71.09±22.71 μmol/L,P＜0.01).The non-event survival rate was significantly higher while the readmission rate was significantly lower in PCI group than in drug therapy group (66.30％ vs 50.96％,25.00％ vs 44.23％,P＜0.05).No significant difference was found in recurrent arrhythmia and cardiogenic death between the two groups (P＞0.05).Conclusion PCI can effectively improve the quality of life in very old CHD patients.

Neurocognitive functioning impairment in patients with moderate to severe late-onset depression / 中国心理卫生杂志

Objective:To investigate the damaging traits of cognitive function in late-onset depression.Methods:In this cross-sectional study,30 elderly out-and in-patients whose first onset of major depression occurred at 60 years of age and older were included as the case group,and 30 age-and gender-matched normal elderly people were included as the controls.The diagnoses of moderate to severe depressive episode or recurrent depression were made according to the International Statistical Classification of Diseases and Related Health Problems,Tenth Revision (ICD-10) diagnostic criteria.The Wisconsin Card Sorting Test (WCST),Stroop Test and Verbal Fluency Test (VFT) were used to assess attentional set shifting,attentional inhibition and working memory.The severity of depression was evaluated with the Hamilton Depression Scale-17(HAMD-17).Results:The performance scores of errors,perseverative responses,perseverative errors,percent of perseverative errors in the WCST were significantly higher in the patient group then in the control group[(61 ± 23) vs.(41 ± 25),(44 ± 27) vs.(27± 19),(36 ± 20) vs.(23 ± 16),(28 ± 15) vs.(19 ± 11),P ＜ 0.01].The scores of conceptual level responses [(36±24) vs.(54 ±26)],the correct scores of consistent group in Stroop test[(19 ±3) vs.(20 ±2)] and the scores of VFT in WCST[(10 ±2) vs.(11 ±2)] were lower in the patient group than in the control group (Ps ＜0.01).The scores of perseverative responses in the WCST were positively correlated with retardation factor scores(r =0.38,P ＜ 0.05).The correct scores of consistent group in the Stroop test were negatively correlated with retardation factor scores(r =-0.41,P ＜ 0.05).The scores of VFT were negatively correlated with retardation factor scores(r =-0.52,P ＜ 0.01).Conclusion:There may be impairment of cognitive function in late-onset depression,especially severe executive dysfunction.

Effects of Pharmacogenomics on Individualized Drug Treatment / 中国药师

Pharmacogenomics is a discipline studying the influence of genetic differences on drug effectiveness .It promises to op-timize the effect of medicine and reduce side effects .It is one of the most effective ways to predict the drug reaction in human body by using pharmacogenomics , which can achieve the goal of precision medicine .With the rapid development of the genetical test technolo-gies, the in vitro individual genome testing projects with the properties of high throughput , and measurable and low cost are better to be applied in medical practice and guiding for making individualized medicine plan .The study elucidated the progress in single nucleotide polymorphism and its clinical application , and focused on the strategic effects of pharmacogenomics on individualized treatment and gene diversity for guiding medicine .

Efficacy and adverse reactions of different stimulus dosage of modified electroconvulsive therapy for depressive episode / 中华行为医学与脑科学杂志

Objective To evaluate the antidepressant efficacy and adverse reactions of 3 different stimulus dosage of modified electroconvulsive therapy ( MECT) in patients with depressive episode. Methods 120 patients with depressive episode were randomized into low dosage group ( n=40) ,medium dosage group ( n=40) and high dosage group ( n=40) . Low dosage were 50%× age,medium dosage was 70%×age,high dosage was 80%×age . All patients received 6 treatments. Hamilton depression scale?17(HAMD?17) was used to evaluate the clinical symptoms at baseline,3 and 6 treatments. Effects and adverse reactions were compared among three groups.Results Compared with baseline the HAMD?17 scores of the 3 groups were significantly improved after 6 treatments( t=24.026, P=0.000;t=26.541, P=0.000;t=25.904, P=0.000) , but there were no statistically significant differences among the three dosage groups(F=0.409, P=0.665). Compared with low dosage group((27.2±5.4)%),the HAMD?17 scores reductive ratio of medium dosage group((34.3±6.8)%) and high dosage group((33.9±6.9)%)) were significantly improved after 3 treat?ments ( t=-5.513, P=0.000;t=-4.785, P=0.000). Compared with the low dosage group,the incidence rate of headache,nausea and vomiting,delirium were significantly higher in high dosage groups( headache:χ2=14.532, P=0.000;nausea and vomiting:χ2=13.333, P=0.000;delirium:χ2=14.907, P=0.000) . The re?covery time was significantly longer in medium dosage group ( ( 10. 5 ± 1. 6 ) min ) and high dosage group ((11.2±1.8)min) than that in low dosage group((8.8±1.2)min)( t=-5.144,=0.000;t=-6.889, P=0.000).Conclusion Different stimulus dosage of MECT for depressive episode has equivalent curative effect after 6 treatment . Medium dosage and high dosage treatments appear to have an early onset of efficacy,but may also be associated with more adverse reactions.

Meta-analysis of Efficacy and Safety of Tiotropium Bromide in the Treatment of COPD / 中国药房

OBJECTIVE:To evaluate the efficacy and safety of tiotropium bromide in the treatment of COPD patients and pro-vide evidence-based reference for the clinical treatment. METHODS:PubMed,EMBase,Medline,Cochrane Library,CJFD,Wan-Fang and VIP database were retrieved to collect the randomized controlled trial(RCT)of tiotropium bromide(test group)vs. place-bo(control group)in the treatment of COPD. The data was extracted and the quality was evaluated by Rev Man 5.0 software. RE-SULTS:A total of 19 studies were included,involving 16 318 patients. Meta-analysis shows that the FEV1[MD=0.13,95%CI (0.12,0.14),P<0.001],FVC[MD=0.20,95%CI(0.20,0.25),P<0.001] in test group were higher than control group,SGRQ score [MD=-2.94,95%CI(-3.38,-2.49),P<0.001] and COPD exacerbation rate[RR=0.83,95%CI(0.77,0.90),P<0.001] in test group were lower than those in control group ,but the dry mouth rate was higher than that of control group[RR=2.07,95%CI(1.34, 3.20),P<0.001],there were significant differences in 2 groups . CONCLUSIONS:Tiotropium bromide has good efficacy in the treatment of COPD. However,it may cause dry mouth. Due to the methodological limitations of included studies,it remians to be further verified by large-sample and high-quality RCT.

Prevalence of depression in coronary heart disease in China: a systematic review and meta-analysis / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Coronary heart diseases (CHD) have been identified as one of topmost diseases affecting the Chinese population. However, depression in CHD has not been reported and there are limited high quality empirical studies in China focused on the prevalence of the comorbidity. This study aimed to estimate the pooled prevalence of depression with CHD in China.</p><p><b>METHODS</b>Systematic review and meta-analysis of published epidemiologic studies on the depression in CHD patients in China were conducted. The research findings dated before 30 September 2013 were obtained from Ovid Medline, EMBASE and two Chinese electronic publication libraries WANFANG and CNKI. We used "cardiovascular disease", "depression" and "China" as the search themes in Ovid Medline and EMBASE and "cardiovascular disease" and "depression" in WANFANG and CNKI. Random-effects meta-analysis was used to estimate the prevalence of depression in CHD patients.</p><p><b>RESULTS</b>Twenty-seven studies were included in the review. Twenty-three studies had 5 236 participants who were hospitalized and four studies had 1 353 participants from community. The overall prevalence of depression in CHD from hospital was 51% (95% CI: 0.43, 0.58; I-squared = 97%, P = 0.000).The prevalence of depression in CHD from community ranged between 34.6% to 45.8%, and the severe depression was found ranging between 3.1% to 11.2%.</p><p><b>CONCLUSIONS</b>On comparing data with other countries, the prevalence of depression in CHD among admitted patients in China was found to be high. The physicians and healthcare providers should pay more attention to the "physical-mental" health of the CHD patients.</p>

Effect of ouabain on the pathogenesis of hypertension in rats / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Ouabain and digoxin are important cardiac glycoside and related to many cardiovascular diseases. The purpose of this study was to investigate the changes of sodium pump α-subunit expression in rats and compare the effects of ouabain (OUA) and digoxin (DIG) on the development of hypertension.</p><p><b>METHODS</b>In situ hybridization was performed. Specific sequence oligonucleotide probe tailing with a Dig-dUTP hybrid to target nucleic acids of the sodium pump α-subunit. According to counting positive particles sodium pump subunit expression was analyzed with statistical methods.</p><p><b>RESULTS</b>On day 16 of drug administration, the blood pressure of rats increased significantly in the OUA group. In the DIG group, the blood pressure revealed no significant difference when compared to the control group. In addition, the effects of OUA and DIG on sodium pump α-subunit RNA expression in tissues differed.</p><p><b>CONCLUSIONS</b>OUA and DIG can not only change the configuration of the sodium pump to depress their activity, but also influence their gene expression which is important in the mechanism of hypertension. This may be a key point in the pathogenesis of hypertension in the manner in which OUA differs from DIG and changes the sodium pump gene expression in the arteries and kidneys of rats.</p>

Treatment with 1Hz repetitive transcranial magnetive stimulation in auditory hallucination of schizophrenia: A double blind, randomized controlled trial / 中国心理卫生杂志

Objective: To examine the therapeutic effects of dual dorsolateral prefrontal repetitive transcranial magnetic stimulation (rTMS) on auditory hallucinations experienced by schizophrenic patients. Methods: A double-blind randomized controlled study was conducted. Totally 25 schizophrenic patients met DSM-Ⅳ criteria for schizophrenia and had anditory hallucination with stable antipsychotic drugs treatment were recruited. Subjects were grouped into active treatment subgroup and sham subgroup randomly. Measurements including the Positive and Negative Symptom Scale (PANSS) for clinical symptom and the Treatment Emergent Symptom Scale (TESS) for side-effects were evaluated Results: Totally 25 subjects completed the trial. The treatment efficiency of active treatment group was higher than that of sham group (75% vs. 31%) .No overt side effects of rTMS were observed. Conclusion: It is effective for rTMS to treat schizophrenia with auditory hallucination at 1Hz. rTMS may be a new selection of schizophrenia treatment.

Effectiveness of application of case management for hypertension in the elderly / 中华全科医师杂志

Objective To explore application of case management for hypertension in the elderly.Methods In total, 106 elderly patients with hypertension treated at outpatient and inpatient departments of the First Affiliated Hospital of Xian Jiaotong University were recruited during January to October 2007, and divided randomly into two groups, one with conventional management and the other with case management.Patients with conventional treatment accepted routine diagnostic and therapeutic procedures and were followed-up passively, and patients with case management accepted integrated therapy and active interview provided by a team with a cardiovascular specialist as core, were followed-up actively and their medical records were kept in files. Percentage of the patients with blood pressure lowered to meet criteria of effectiveness and their improvement in depression and anxiety status and quality of life were evaluated two years after management for the two groups. Results Percentage of patients with their blood pressure lowered to meet effective criteria increased significantly in both of the groups, from 32. 8% to 67.5% in patients with conventional management and from 33.7% to 83.4% in those with case management ( P = 0. 007 ),respectively. Scores of self-rating anxiety scale ( SAS) and self-rating depression scale (SDS) decreased in patients of the both groups, from 57 ± 10 and 56 ± 11 before management to 40 ±9 and 48 ± 10 after it,respectively in patients of conventional management ( P = 0. 032 ), and from 56 ± 10 and 57 ± 10 before management to 35 ±9 and 40 ± 9 after it ( P = 0. 008 ), respectively in those with case management; and scores of quality of life improved in patients of the two group, from 65 ± 13 before management to 85 ± 14 after it in those with conventional management, and from 64 ± 13 before management to 98 ± 14 after it in those with case management ( P = 0.017 ), respectively. Conclusions Case management is better for chronic diseases and recommended in management for the elderly with hypertension, which can improve their targets of blood pressure lowering, decrease their scores of SAS and SDS and improve their quality of life,with an integrated, in-depth, continuous management.

Effect of ouabain at different concentrations on human vascular endothelial cells / 中国病理生理杂志

AIM: To study the effect of ouabain at different concentrations on human vascular endothelial cells (HUVEC), and early endothelial responses to ouabain in physiological concentration by genomic-scale gene expression analysis. METHODS: The proliferation of HUVEC was determined by MTT method. The vitality of cells was determined by LDH, and PCNA was assessed by using immunohistochemistry. The response of endothelial cells to ouabain was explored with a complementary DNA microarray representing ~8 464 different human genes. RESULTS: Ouabain stimulated the proliferation of HUVEC at physiological concentration (0.3-0.9 nmol/L). Ouabain at pathological concentration (0.9-1.8 nmol/L) inhibited proliferation and induced cellular swelling and apoptosis. However, the effect of ouabain at the concentration of 10 nmol/L also stimulated proliferation. The results of mRNA profiles analysis indicated that 340 of genes were differentially expressed, among them 145 were upregulated and 6 were upregulated significantly. The upregulated genes were mainly related to cellular metabolism and gene transcription. CONCLUSIONS: Ouabain has important role in controlling the growth and metabolism of vascular endothelial cell and vascular remodeling in the pathogenesis of hypertension.