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Objective:To observe the changes in oxidative stress and transforming growth factor-<italic>β</italic><sub>1</sub> （TGF-<italic>β</italic><sub>1</sub>）/Smad signaling pathway in hippocampal tissue of senile depressed mice after chronic unpredictable mild stress and to explore the possible anti-depression mechanism of Bushen Shugan prescription. Method:Ninety five-month-old mice were randomly divided into six groups， namely the normal group， senile depression model group， high-， medium-， and low-dose Bushen Shugan prescription groups， and fluoxetine group， with 15 in each group. Mice in all groups， except for the normal group， were exposed to chronic unpredictable mild stress （CUMS） for inducing the senile depression. Since the first day of modeling， the mice in the high-， medium- and low-dose Bushen Shugan prescription groups were gavaged with 19.5， 9.75， 4.87 g·kg<sup>-1</sup> Bushen Shugan prescription， the ones in the fluoxetine group with 0.033 g·kg<sup>-1 </sup>fluoxetine， and those in the normal and senile depression model groups with an equal volume of normal saline for 21 successive days. The behavioral responses of mice in each group were evaluated in the open field test （OFT）， and the hippocampal tissues of mice were collected for testing the relevant indexes. The superoxide dismutase （SOD） content was determined by WST-1 method， malondialdehyde （MDA） content by TBA method， glutathione （GSH） content by micro enzyme-linked immunosorbent assay （ELISA）， and mRNA expression of TGF-<italic>β</italic><sub>1</sub>， Smad2， Smad3， and Smad7 by Real-time polymerase chain reaction （Real-time PCR）. Result:Compared with the normal group， the senile depression model group exhibited significantly lowered horizontal and vertical scores in OFT， decreased SOD and GSH contents in hippocampal tissues， elevated MDA （<italic>P</italic><0.05）， up-regulated TGF-<italic>β</italic><sub>1</sub>， Smad2， and Smad3 mRNA expression， and down-regulated Smad7 （<italic>P</italic><0.05）. Compared with the senile depression model group， Bushen Shugan prescription at the high， medium， and low doses and fluoxetine all increased SOD and GSH contents in mouse hippocampal tissues， decreased the MDA content （<italic>P</italic><0.05）， down-regulated the mRNA expression of TGF-<italic>β</italic><sub>1</sub>， Smad2， and Smad3 in hippocampal tissues， and up-regulated the Smad7 mRNA expression （<italic>P</italic><0.05）. The comparison with the high-dose Bushen Shugan prescription group showed that the SOD and GSH contents in hippocampal tissues of mice in the medium- and low-dose Bushen Shugan prescription groups declined significantly， while the MDA contents rose significantly （<italic>P</italic><0.05）. Besides， the mRNA expression levels of TGF-<italic>β</italic><sub>1</sub>， Smad2 and Smad3 in the hippocampal tissues of mice in the medium- and low-dose Bushen Shugan prescription groups were significantly up-regulated， and those of Smad7 were significantly down-regulated （<italic>P</italic><0.05）. Conclusion:Bushen Shugan prescription alleviates the depression symptoms in aged SAPM8 mice possibly by regulating the hippocampal oxidative stress and TGF-<italic>β</italic><sub>1</sub>/Smad signaling pathway.
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Objective To study the effect on quality of life and medication adherence after using participatory nursing care joint Empathy nursing for senile depression patients.Methods Select 90 cases of patients with depression as the study object in our hospital ,randomly divided them into observation group and control group,45 cases in each group,the observation group received participatory nursing care joint empathy nursing care,control group received conventional care,compared emotional state,the quality of life and treatment compliance in two groups before and after treatment.Results Before treatment,depression and treatment adherence had no obvious difference between two groups,3,7,15 d after treatment,the im-provement in observation group were significantly better than control group,social ability,social interest, personal hygiene,depression score in two groups had no significant difference between in two groups,after intervention four factor score in observation group were significantly lower than the control group,comparison between groups had significant difference,P <0.05).Conclusions Participatory nursing care joint empa-thy nursing care using for senile depression patients can significantly improve the patient's emotional state, improve the treatment compliance and quality of life,has positive significance.
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Objective To investigate the features of event-related potentials (ERP) P300, auditory evoked potential(AEP) and brainstem auditory evoked potential(BAEP) in senile depression patients and the dynamic chan-ges before and after treatment of sertruline. Methods P300, AEP and BAEP were recorded in 31 senile depression patients using Chinese WOND 2000C Instrument, and a comparison between the patients and 33 normal controls in terms of these evoked potentials were made. Some of the depression patients treated with oral intake of sertraline were followed electophysiologically after 12 months of treatment. Results Compared with normal controls, senile depres-sion patients showed delay of latency of P300-P3 and BAEP-Ⅲ, decreased amplitude of P300-P3, AEP-P2 and BA-EP-Ⅲ(P <0.05 or 0.01). The 12-month follow-up measures of ERP showed significant improvement in terms of la-tency and amplitude of P3/P300,AEP-P2 and BAEP-Ⅲ after treatment of sertraline. Conclusion Senile depres-sion patients showed abnormality on several ERP indexes (such as P3/P300, AEP-P2 and BAEP-Ⅲ), and these in-dexes might provide important evidences to monitor the effect of medicine.
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Objective:To compare the efficacy and safety of mirtazapine and mianserine in the treatment of senile depression. Methods:68 senile depressive patients were randomly divided into two groups: 35 in mirtazapine group, 33 in mianserine group. The period of observation was 8 weeks, Efficacy and safety were assessed with HAMD and TESS scales at baseline, week 1, 2, 4, 6 and 8 after treatment. Results: After 8 weeks of treatment, the response rate and significant response rate were respectively 91.4% and 74.3% in mirtazapine group, 87.9% and 72.7% in mianserine group, the difference between groups were not statistically significant. The reduction of HAMD scores after treatment in both group were statistically significant (P 0.05). The common side effectives of mirtazapine were drowsiness, dizziness, increased appetite and weight gain; The common side reactions of mianserine were dizziness, nausea, drowsiness. All the side effects were mild. Conclusions:Mirtazapine and mianserine are equally effective and safe in treating senile depression.
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Among the elderly, affective disorders constitute the most commenly encountered psychiatric illness. Evaluation of Mood in the elderly patients is important because of uniqueness of senile depression. Depression in the elderly may present with various clinical symptoms such as chronic pain, multiple somatic complaints, or even dementia (pseudodementia). Also the seriousness of depression in the elderly is shown by the increase in and success of suicidal attempts among this group. About 15% of the total deaths of patients with affective disorder are due to suicide. Although some elderly depressed individuals presently atypically, most can be diagnosed according to the Washington University research criteria, which form the basis for the DSM-IV. In view of the effective therapies available for depression, it is especially crucial to make the diagnosis and proceed with treatment. The auther also reviewed rating scales of depression.