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Inducible T-cell costimulator(ICOS),a homodimeric protein expressed on the surface of activated T-cells,is being investigated as a potential therapeutic target to treat various cancers.Recent studies have re-ported aberrant increases in the soluble form of ICOS(sICOS)in human serum in disease-state patients,primarily using commercial ELISA kits.However,results from our in-house immunoassay did not show these aberrant increases,leading us to speculate that commercial sICOS ELISAs may be prone to inter-ference.We directly tested that hypothesis and found that one widely used commercial kit yields false-positives and is prone to human anti-mouse antibody interference.We then analyzed a panel of healthy,cancer,chronic hepatitis C virus,systemic lupus erythematosus,and diffuse cutaneous systemic sclerosis human serum using our in-house immunoassay and reported the measured sICOS concentrations in these populations.Since even well characterized immunoassay methods are prone to non-specific interference,we also developed a novel sICOS LC-MS/MS method to confirm the results.Using these orthogonal approaches,we show that sICOS is a low abundance soluble protein that cannot be measured above approximately 20 pg/mL in human serum.
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Objective: Anxiety disorders are the most common group of psychiatric illnesses in children. This study is to observe the effectiveness of Paroxetine in anxiety disorder among teenagers in South India population using Hamilton Anxiety Rating Scale (HAM-A) and to screen the possible risk for paroxetine in anxiety disorder among teenagers. Methods: This study is a prospective observational study that was conducted for a period of 6 mo. Of 84 teenage patients with anxiety disorder assessed using Hamilton Anxiety Rating Scale (HAM-A) were followed-up in an outpatient psychiatric ward. Study population includes both sexes, age group between 13 to 19 y, Teenage patient receiving paroxetine for anxiety disorder were included and patients unwilling to give written informed consent or assent form were excluded. Results: Out of 84 patients the prevalence of symptoms before the drug treatment, 65 patients were falling in very severe category, which was assessed by HAM-A scale. Then reassessed with drug Paroxetine at week 4 and week 8. There was a drastic reduction in the prevalence of symptoms in week 8 than compared to week 4. A significant reduction in body weight was also observed during the study period. Among various side effects, nausea was the prominent risk found during the study. Conclusion: The present study demonstrated that paroxetine is effective and well-tolerated for the treatment of various types of anxiety disorder in teenagers with few side effects.
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OBJECTIVE@#To observe the clinical effects and safety on female depression treated with the combined therapy of acupuncture and the five-element music therapy.@*METHODS@#A total of 120 female patients with depression were randomized into an electroacupuncture (EA) group, an acupuncture group, a five-element music therapy group and a group of the combined therapy of acupuncture and the five-element music therapy (combined therapy group), 30 cases in each one. In the EA group, the electric stimulation of acupuncture was applied at Baihui (GV 20), Shenting (GV 24), Neiguan (PC 6), Shenmen (HT 7), Sanyinjiao (SP 6) and Taichong (LR 3), with disperse-dense wave, 10 Hz/50 Hz, and 0.5 ms in wavelength. The needles were retained for 30 min. In the acupuncture group, the acupoints were same as the EA group, but without electric stimulation. In the five-element music therapy group, the music of tune was adopted in the treatment. In the combined therapy group, the acupuncture treatment and the five-element music therapy were same as the acupuncture group and the five-element music therapy group, in which the music therapy was followed after acupuncture treatment. The treatment was given once a day, at 2 days of interval after every 5 treatments in a week, totally for 8 weeks. The Hamilton depression scale (HAMD), Hamilton anxiety scale (HAMA) before and after treatment and the treatment emergent symptom scale (TESS) after treatment were observed in each group. The clinical effects and safety were compared among the groups.@*RESULTS@#The total effective rate was 86.7% (26/30) in the combined therapy group, better than 66.7% (20/30) in the EA group, 63.3% (19/30) in the acupuncture group and 53.3% (16/30) in the five-element music therapy group (<0.01, <0.05). After treatment, HAMD and HAMA scores were all reduced obviously in the patients of the 4 groups (all <0.01), and the scores in the combined therapy group were lower than the other 3 groups (all <0.01). The TESS score in the combined therapy group was lower than the other 3 groups (all <0.01) and the score in the five-element music therapy group was lower than the EA group and the acupuncture group (both <0.01).@*CONCLUSION@#In the female patients, the combined treatment with acupuncture and the five-element music therapy obviously reduces the severity of depression and anxiety, as well as the adverse reactions. The effects are better than the simple application of EA, acupuncture or music therapy.
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Female , Humans , Acupuncture Therapy , Depression , Therapeutics , Electroacupuncture , Music TherapyABSTRACT
OBJECTIVE:To observe the clinical efficacy and safety of flupirtine maleate combined with amitriptyline in the treatment of thalamic pain after stroke. METHODS:A total of 70 patients with thalamic pain after stroke in our hospital during Jan. 2016-Aug. 2017 were divided into control group(34 cases)and observation group(36 cases)according to random number table. Both groups received secondary prevention therapy of stroke. Based on it,control group was given Amitriptyline hydrochloride tablet 25 mg/time orally,tid. Observation group was additionally given Flupirtine maleate capsule 0.1 g/time orally,tid,on the basis of control group. Treatment course of 2 groups lasted for 4 weeks. VAS,HAMD17 and HAMA14 scores of 2 groups evaluated before treatment,after 1,2,3,4 weeks of treatment Clinical efficacies and the occurrence of ADR were observed in 2 groups. RESULTS:Before treatment,there was no statistical significance in the scores of VAS,HAMD17 or HAMA14 between 2 groups(P>0.05). VAS score and HAMD17 score of observation group after 1,2,3,4 weeks of treatment,those of control group after 2,3 and 4 weeks of treatment were significantly lower than before treatment;the observation group was significantly lower than the control group at different time periods(P<0.05 or P<0.01). HAMA14 score of 2 groups after 2,3,4 weeks of treatment were significantly lower than before treatment;the observation group was significantly lower than the control group at different time periods(P<0.05 or P<0.01). Total efficiency rate(91.67%)of observation group were significantly higher than that(67.65%)of control group(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups (11.76% vs. 11.11%)(P>0.05). CONCLUSIONS:Flupirtine maleate combined with amitriptyline can effectively relieve thalamic pain after stroke,and improve post-stroke,anxiety depression,which are better than control group,and the incidence of ADR is familar to control group.
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Objective To observe the clinical efficacy of Jie Yu Tong Fu (anti-depression and unblocking Fu-organs) needling in treating depression coupled with constipation. Method Sixty-four eligible patients with depression accompanied by constipation were recruited and randomized into a treatment group and a control group at 1:1. Each group had 2 dropout cases, and finally there were 30 complete cases in each group. The treatment group was intervened by Jie Yu Tong Fu needling by selecting Baihui (GV20), Yintang (GV29), Shenmen (HT7), Neiguan (PC6), Hegu (LI4), Sanyinjiao (SP6), Taichong (LR3), Tianshu (ST25), Zusanli (ST36) and Shangjuxu (ST37); the control group was intervened by sham acupuncture. The two groups were treated 3 times a week, for successive 8 weeks, 24 sessions in total. The two groups were evaluated by adopting Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA) and Patient Assessment of Constipation-Symptoms (PAC-SYM) before the intervention, after 4-week and 8-week intervention, and 4 weeks after the whole intervention. Result Before the intervention, there were no significant between-group differences in the scores of HMAD, HAMA and PAC-SYM (P>0.05). The treatment group showed significant improvements in HAMD, HAMA and PAC-SYM scores after 4-week and 8-week treatment, as well as in the 4-week follow-up study compared to the scores before the treatment, and the improvements were more significant than those in the control group (P<0.01,P<0.05). The total effective rate was 90.0% in the treatment group, versus 66.7% in the control group. Conclusion Jie Yu Tong Fu needling can effectively ameliorate the depression and anxiety state and constipation-related symptoms in depression patients.
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Objective To observe the clinical efficacy of scalp cluster needling plus acupuncture at Conception Vessel points in treating generalized anxiety disorder.Method Sixty eligible subjects were divided into a treatment group and a control group by the random number table, 30 cases each. The treatment group was intervened by scalp cluster needling plus acupuncture at Conception Vessel points including Tiantu (CV22), Danzhong (CV17), Zhongwan (CV12) and Xiawan (CV10); in the control group, Shenmen (HT7), Daling (PC7), Neiguan (PC6), Qimen (LR14), Xinshu (BL15), Hegu (LI4) and Taichong (LR3) were selected. The treatments were given once a day, 6 sessions followed by 1-day interval as a treatment course, for successive 8 courses in total. The Hamilton Anxiety Scale (HAMA) scores of the two groups were compared before and after the treatment and in the follow-up study; the clinical efficacies were also compared.Result The treatment protocols in the two groups were both effective in treating generalized anxiety disorder, while the markedly effective rate was significantly higher in the treatment group than in the control group (P<0.05). The HAMA scores after treatment and in the 1-month follow-up study were significantly different from the score before the treatment in both groups (P<0.01). There were significant differences in comparing the HAMA score between the two groups respectively after treatment and in the 1-month follow-up study (P<0.05). Conclusion Scalp cluster needling plus acupuncture at Conception Vessel points shows significant advantage in treating generalized anxiety disorder compared to the ordinary acupuncture method.
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Objective To explore the characteristics and influencing factors of cognitive dysfunction in patients with essential tremor (ET).Methods We recruited ET patients diagnosed by the Department of Neurology of the First Affiliated Hospital of Xi`an Jiaotong University and healthy volunteers who matched the ET patients in age, gender and education level for the study.We recorded all the patients` demographic information, tremor degree, and family history based on the family tree.All the participants were tested by MMSE, MoCA, ADL, HAMD and HAMA.Results There were 88 ET patients and 63 normal subjects included in the study.According to MMSE, 31.82％ of the patients had cognitive dysfunctions, with orientation, short-term memory, calculation ability, language skills, retelling, reading comprehension, three-level command and drawing being significantly lower than those of the healthy volunteers (P<0.01);orientation was the most serious damage in cognitive function domain (K=0.624, S=0.726);three-level command was the least serious damage (K=0.274, S=0.319).According to MoCA, 86.36％ of the ET patients had cognitive dysfunction higher than normal people (P<0.05);visual space and execution, clock drawing task, naming, attention, 100-7, language skills, abstract thinking and orientation were significantly lower than normal people (P<0.01);the most serious damage in cognitive function domain was visual space and execution (K=0.651, S=0.786); the least serious damage cognitive function domain was “100-7” (K=0.406, S=0.484). Education level and age affected cognitive dysfunction (P<0.05). ADL scores showed negative correlation with cognitive function (correlation =－0.375 and －0.383, respectively; P<0.001). After the effects of anxiety and depression were excluded, onset age and tremor grading were correlated with cognitive dysfunction (P<0.05). When the above factors were put into binary Logistic regression model, education level was found to be contributed to the model (P<0.05).Conclusion Patients with ET widely suffer from cognitive impairment. Age, education level, daily life disability, age of onset, and tremor degree classification can affect cognitive dysfunction.
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Objective To observe the clinical efficacy of scalp cluster needling plus acupuncture at Conception Vessel points in treating generalized anxiety disorder.Method Sixty eligible subjects were divided into a treatment group and a control group by the random number table, 30 cases each. The treatment group was intervened by scalp cluster needling plus acupuncture at Conception Vessel points including Tiantu (CV22), Danzhong (CV17), Zhongwan (CV12) and Xiawan (CV10); in the control group, Shenmen (HT7), Daling (PC7), Neiguan (PC6), Qimen (LR14), Xinshu (BL15), Hegu (LI4) and Taichong (LR3) were selected. The treatments were given once a day, 6 sessions followed by 1-day interval as a treatment course, for successive 8 courses in total. The Hamilton Anxiety Scale (HAMA) scores of the two groups were compared before and after the treatment and in the follow-up study; the clinical efficacies were also compared.Result The treatment protocols in the two groups were both effective in treating generalized anxiety disorder, while the markedly effective rate was significantly higher in the treatment group than in the control group (P<0.05). The HAMA scores after treatment and in the 1-month follow-up study were significantly different from the score before the treatment in both groups (P<0.01). There were significant differences in comparing the HAMA score between the two groups respectively after treatment and in the 1-month follow-up study (P<0.05). Conclusion Scalp cluster needling plus acupuncture at Conception Vessel points shows significant advantage in treating generalized anxiety disorder compared to the ordinary acupuncture method.
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To explore the safety and efficacy of tandospirone combined with Jiuweizhenxin granules in the treatment of generalized anxiety disorder. Methods:The patients with generalized anxiety diagnosis were divided into three groups according to the admission order, the combination group(Jiuweizhenxin granules plus tandospirone), Jiuweizhenxin granules group and tandospirone group respectively with 31, 32 and 33 ones. The period of treatment was 4 weeks. All the patients were assessed for efficacy using Hamilton anxiety scale (HAMA). The adverse symptoms were observed before the treatment, in the 2nd, 4th and 6th week and after the treatment. The efficacy and adverse effects in the three groups were also observed. Results: After the 4-week treatment, HAMA score of the three groups was significantly lowered when compared with that before the treatment (P0. 05). The clinical total ef-fective rate and the incidence of adverse drug reactions in the three groups showed no statistically significant difference (P>0. 05). Conclusion:Tandospirone combined with Jiuweizhenxin granules in the treatment of generalized anxiety can effectively improve HAMA score with promising curative effect and adverse reactions, which is worthy of clinical promotion.
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Objective Provided the basis on psychological treatment for the earthquake wounded, through investigated the psychological healthy condition of them in Yushu, Qinghai Province. Method To investigated the 102 cases earthquake wounded from 15 - 18 April 2010 who transported from Yushu, Qinghai to West China hospital of Sichuan University; Accept standard: The wounded (96 cases) who could cooperated this investigative; Adopted the Hamiton anxiety scale( HAMA) to had a review investigation for the wounded in the from of talk, and used the SPSS statistics software to have the Wilcoxon Mann-Whitney test and correlation analysis for the investigation data. Results There were 55 of the 96 cases have been confirmed anxiety, HAMA > 14 points; 16 cases had serious anxiety (HAMA > 29 points); The average score in all of them equal to (17.3 ±10.8) points. And there was a remarkable difference between male and female. The age is possible have related degree with the wounded anxious. What the main in their characteristics of them was Psychic anxiety. Conclusions There was apparent anxiety of them whom came from Yushu, Qinghai, and they needed proactive psychological treatment, female、 middle-aged and elderly need more.
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Thyroid-stimulating hormone (TSH) is the most sensitive marker reflecting thyroid function. TraditionaUy, TSH concentration was measured by the method of RadioImmunoAssay (RIA) with the detection limits around 1 to 2 mIU/L, which was unable to differentiate hyperthyroid status. Since 1980s, owing to the sensitive assay for TSH, immunoradiometric assay (IRMA), it has been possible to detect low concentration of TSH by 0.001 mlU/L. TSH is composed of two glycopeptide subunits, a-subunit and B-subunit. Monoclonal antibodies, directed against two different sites of the TSH peptides, are used in IRMA. One antibody is directed toward the specific B-subunit of TSH molecule and is used to extract it from serum, a second antibody labelled with a radioactive material is then attached to the separated TSH to form "sandwhich" molecule that can be measured. Generally, mouse monoclonal antibodies are used as capture and detection antibodies. Infrequently, when there is heterophilic antibody, i.e. human anti-mouse antibody (HAMA), TSH can be measured as spuriously elevated, since HAMA may form a link between the signal and capture molecules. We report a case of inappropriately elevated TSH concentration due to heterophilic antibody, later diagnosed as Graves disease. A 41-year-old woman visited our clinic with the chief complaints of hand tremor, hyperphagia, weight loss for 3 months. Two years earlier, she underwent total colectomy due to colon cancer and had treat on multiple chemotherapies. The results of thyroid function test shows that TSH was 0.77 mIU/L, free T was 7.1 ng/dL (0.8~1.9), free T was 11.3 pg/mL (0.2~5.5). Thyroid specific auto- antibody results were anti-Tg-Ab 21.3 m/mL(0 100), anti-TPO-Ab 87.9m/mL(0100), TBIAb 7.8% (-15/15). Thyroid scan showed that radioactiveiodine uptake was increased and thyroid gland wasenlarged diffusely. Because TSH level was elevated, further evaluations were performed to differentiate with TSH producing pituitary tumor and pituitary resistance to thyroid hormone. Sellar MRI was normal, TRH stimulation test showed flat response. Since spurious elevation of TSH is possible at the presence of hetrophilic antibody, we rechecked TSH concentration after adding mouse monoclonal antibody to the patients serum with result of TSH less than 0.05 mIU/L. She was able to be diagnosed as Graves disease, and started with methimazole. Three months later, thyroid function test showed that TSH was 10.5 mIU/L, free T4 was 1.0 ng/dL, free T3 was 4.0 pg/mL. TSH level after removal the effect of heterophilic antibody with mouse monoclonal antibody was 0.71 mIU/L. Neutropenia was developed 5 months after methimazole therapy, to stop antithyroid medication. With the plan of radioactive iodine therapy if she relapses, she is being followed with periodic thyroid function test. We report a case of Graves disease with spuriously elevated TSH due to the effect of heterophilic antibodies.