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ObjectiveTo observe the clinical efficacy and safety of Chinese medicinal mixture for dispelling stasis and resolving phlegm combined with western medicine in the treatment of epilepsy combined with cognitive impairment by randomized， double-blind， placebo-controlled， parallel-group trial. MethodA total of 123 inpatients and outpatients with epilepsy complicated with cognitive impairment admitted to the department of neurology at Longhua Hospital from October 2020 to October 2021 were randomly assigned into a control group （62 cases， carbamazepine + placebo） and a treatment group （61 cases， carbamazepine + Quyu Dingxian Zhengtong mixture） by random number table method. In the treatment group， 4 cases were exfoliated and eliminated. In the control group， 3 cases fell off. Finally， 57 cases in the treatment group and 59 cases in the control group were included. The total course of treatment for both groups was 12 weeks. The clinical efficacy， efficacy for traditional Chinese medicine （TCM） syndromes， and incidence of adverse reactions were compared between two groups. The changes of seizure frequency， abnormal rate of electroencephalogram （EEG）， cognitive function score， serum homocysteine （HCY）， folic acid， and vitamin B12 （B12） were measured and compared before and after treatment. ResultAfter 12 weeks of treatment， the treatment group had higher clinical efficacy ［92.98% （53/57） vs 79.66% （47/59）， χ2=4.327， P<0.05］ and efficacy for TCM syndromes ［96.49% （55/57） vs 84.75% （50/59）， χ2=4.660， P<0.05］ than the control group. The treatment group was superior to the control group in reducing the seizure frequency （Z=-3.938， P<0.01） and improving the Montreal cognitive assessment （MoCA） score （t=4.333， P<0.01） and mini-mental state examination （MMSE） score （t=9.531， P<0.01）. The variations in serum HCY， folic acid， and B12 in the treatment group were less than those in the control group （t=-7.233， t=-7.972， t=-6.871， P<0.01）. After treatment， the abnormal rate of EEG in the treatment group was lower than that in the control group （χ2=4.437， P<0.05）. The incidence of adverse reactions in the treatment group （1.75%， 1/57） was lower than that （13.56%， 8/59） in the control group （corrected χ2=4.116， P<0.05）. ConclusionChinese medicinal mixture for dispelling stasis and resolving phlegm in combination with western medicine had better efficacy and safety than western medicine alone in the treatment of epilepsy complicated with cognitive impairment. Specifically， the combination outperformed western medicine alone in terms of clinical efficacy， efficacy for TCM syndromes， reduction in seizure frequency， abnormal rate of EEG， adverse reactions， improvement of cognitive function， and variations in serum folic acid， B12， and HCY values. Chinese medicinal mixture for dispelling stasis and resolving phlegm may improve the clinical efficacy and safety by changing the metabolism of folic acid， B12， and HCY in serum of the patients with epilepsy complicated with cognitive impairment.
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BACKGROUND@#Depression in Parkinson's disease (dPD) is closely related to quality of life. Current studies have suggested that Pingchan Granule (PCG) might be effective for treating dPD.@*OBJECTIVE@#This study determines the efficacy of PCG for depressive symptoms in Parkinson's disease (PD).@*DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS@#This was a randomized, double-blind, placebo-controlled trial, conducted in Longhua Hospital, Shanghai, China. Patients diagnosed with idiopathic PD and clinically significant depressive symptoms (defined by a 24-item Hamilton Rating Scale for Depression [HAM-D] score ≥ 8) were included in this study, randomly assigned to PCG or placebo group in a 1:1 ratio and followed for 24 weeks.@*MAIN OUTCOME MEASURES@#The primary outcome was the change from baseline to week 24 in HAM-D score among the set of patients who completed the study following the treatment protocol (per-protocol set). Secondary outcomes included changes in scores on the Unified Parkinson's Disease Rating Scale (UPDRS) part 2 (UPDRS-II), UPDRS part 3 (UPDRS-III), Parkinson's Disease Sleep Scale (PDSS) and Hamilton Rating Scale for Anxiety (HAM-A), between baseline and week 24.@*RESULTS@#Eighty-six patients were enrolled, and 85 patients were included in the per-protocol set. HAM-D scores decreased by an adjusted mean of 11.77 (standard error [SE] 0.25) in the PCG group and 3.86 (SE 0.25) in the placebo group (between-group difference = 7.91, 95% confidence interval [7.22, 8.80], P < 0.001), in the multivariable linear regression. Improvements in scores on the UPDRS-II, UPDRS-III, PDSS, and HAM-A scales were also observed.@*CONCLUSION@#Treatment with PCG was well tolerated and improved depressive symptoms and motor and other non-motor symptoms in PD.@*TRIAL REGISTRATION@#Chinese Clinical Trial Register: ChiCTR-INR-17011949.
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With the aging of the population,the incidence of cerebral small vessel disease (CSVD) and type 2 diabetes mellitus (T2DM) is increasing year by year.Studies have shown that CSVD is associated with T2DM.Therefore,intervention of T2DM may prevent and control the progression of CSVD and improve cognitive function in patients with CSVD.This article reviews the correlation between T2DM and different phenotypes of CSVD and its mechanism.
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With the aging of the population, the incidence of cerebral small vessel disease (CSVD) and type 2 diabetes mellitus (T2DM) is increasing year by year. Studies have shown that CSVD is associated with T2DM. Therefore, intervention of T2DM may prevent and control the progression of CSVD and improve cognitive function in patients with CSVD. This article reviews the correlation between T2DM and different phenotypes of CSVD and its mechanism.
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Objective To explore herpes simplex virus type 2 (HSV-2) infection and associated factors among people participating premarital physical examination in 2013-2014 in Minhang District of Shanghai.Methods During 2013 to 2014,people participating premarital physical examination in Minhang District were interviewed with questionnaire regarding HIV/AIDS related Knowledge,sexual behaviors,etc.Blood samples were collected to detect HIV,HSV-2 and syphilis.Results A total of 2 116 participants were investigated,among which 92 were infected with HSV-2,with a prevalence rate of 4.35％.The HSV-2 infection rates were 3.69％ and 5.01％ for male and female,respectively.Multivariate logistic regression analysis showed that for the males,education level of high school and below (OR=2.47,95％CI:1.195-5.108),fiancee infected with HSV-2 (OR=9.29,95％CI:4.279-20.164) were more susceptible to HSV-2.For the females,aged above 25 years (OR=9.29,95％CI:4.279-20.164),census register of other cities in China (OR =2.19,95％CI:1.091-4.378),education level of high school and below (OR =3.37,95％CI:1.721-6.596),never used condoms (OR =3.45,95％CI:1.265-9.392),fiance infected with HSV-2 (OR =8.46,95％CI:3.700-19.351) were more susceptible to HSV-2.Conclusions The prevalence of HSV-2 among premarital population is relatively low in Minhang District.However,low condom use rate leads to an increase in the risk of HSV-2 infection when either partner infected with HSV-2,suggesting increasing condom use between affianced couples.
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Objective To understand the trends and epidemiological characteristics of syphilis in Minhang District of Shanghai,so as to provide scientific basis for making control strategies.Methods The data of reported cases of syphilis in Minhang District from 2005 to 2016 were analyzed with epidemiological methods.Results Overall 11 394 cases of syphilis were reported from 2005 to 2016,the incidence was 42.9 per 100 000 person-year.The incidences of Phase Ⅰ,Phase Ⅱ,Phase Ⅲ,genital and latent syphilis were 10.3,13.4,0.3,2.3 and 16.6 per 100 000 person-year,respectively.In 2009,the incidence reached 59.1 per 100 000 person-year and reach peak.The cases were constituted by local residents (62.4％) and residents from other provinces (37.6％),male patients predominated with male/female ratio of 1.1∶1.Most cases were aged from 25 to 54 years old(61.1 ％),and those people older than 54 years were more and more likely to be found infected.Local residents predominated by those who aged 25-64 years (74.2％) and other province predominated by 15-44 years (79.1％),the ratios of male/female were 1.3 ∶ 1 and 0.8 ∶ 1.Female were much younger than male,there were 50.0％ of female and 29.3％ of male who were aged between 15-34 years old.Latent syphilis was mostly reported in local male residents who were older than 55 years,female who were 25-54 years and other provinces' female aged 15-44.Phase Ⅰ and Ⅱ syphilis were mostly reported in local male residents less than 55 years old and other provinces' male less than 65 years old.There were significant difference between residence,sex,age and different kinds of syphilis with P＜0.001.Conclusions The trends of syphilis incidence was increasing before 2009 in Minhang District and then declining and slowing down in recent years.The measure of reinforcing monitor,propaganda and education,active screening syphilis in female and local old man should be taken to control and prevent the spread of syphilis.
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Objective To investigate the quality of life (QOL) and mental health status of patients with HIV/AIDS in Minhang District of Shanghai,and to explore the factors that affect their quality of life.Methods A cross-sectional study was conducted in Minhang District among HIV/AIDS patients.All subjects finished general situation questionnaire,Beck depression inventory (BDI),self rating anxiety scale (SAS),social support scale (SSS) and generic quality of life inventory-74 (GQOLI-74) survey.Results A total of 294 patients were recruited in this study with mean age of (39.6 ± 12.6) years old.Among the subjects,mean score of SAS was 40.5 ± 8.8,higher than national normative score (t =20.8,P＜0.001).The prevalence of anxiety was 13.9％.The mean score of BDI was 8.90 ± 8.59,and the prevalence of depression was 28.6％.The mean score of quality of life (QOL) was 66.6 ± 10.9.Multivariate logistic regression analysis showed that QOL of patients with high school or secondary school was lower than those with college and above education (OR =0.34,95 ％ CI:0.12-0.95).QOL scores of patients with moderate or severe depression were lower than those with less depressed patients,OR values were 0.14(95 ％ CI:0.06-0.34) and 0.07(95 CI:0.03-0.20)respectively.QOL of patients with anxiety was lower than the patients without anxiety (OR =0.10,95 ％CI:0.04-0.27).QOL of patients with high scores of social support was higher than the patients with low scores of social support (OR =3.95,95 ％ CI:1.82-8.59).Conclusions We should pay more attention to the psychological state of patients with HIV/AIDS.The quality of life can be improved by improving social support and reducing the occurrence of anxiety and depression.
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Objective To explore herpes simplex virus type 2 (HSV-2) infection and associated factors among people participating premarital physical examination in 2013-2014 in Minhang District of Shanghai.Methods During 2013 to 2014,people participating premarital physical examination in Minhang District were interviewed with questionnaire regarding HIV/AIDS related Knowledge,sexual behaviors,etc.Blood samples were collected to detect HIV,HSV-2 and syphilis.Results A total of 2 116 participants were investigated,among which 92 were infected with HSV-2,with a prevalence rate of 4.35％.The HSV-2 infection rates were 3.69％ and 5.01％ for male and female,respectively.Multivariate logistic regression analysis showed that for the males,education level of high school and below (OR=2.47,95％CI:1.195-5.108),fiancee infected with HSV-2 (OR=9.29,95％CI:4.279-20.164) were more susceptible to HSV-2.For the females,aged above 25 years (OR=9.29,95％CI:4.279-20.164),census register of other cities in China (OR =2.19,95％CI:1.091-4.378),education level of high school and below (OR =3.37,95％CI:1.721-6.596),never used condoms (OR =3.45,95％CI:1.265-9.392),fiance infected with HSV-2 (OR =8.46,95％CI:3.700-19.351) were more susceptible to HSV-2.Conclusions The prevalence of HSV-2 among premarital population is relatively low in Minhang District.However,low condom use rate leads to an increase in the risk of HSV-2 infection when either partner infected with HSV-2,suggesting increasing condom use between affianced couples.
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Objective To understand the trends and epidemiological characteristics of syphilis in Minhang District of Shanghai,so as to provide scientific basis for making control strategies.Methods The data of reported cases of syphilis in Minhang District from 2005 to 2016 were analyzed with epidemiological methods.Results Overall 11 394 cases of syphilis were reported from 2005 to 2016,the incidence was 42.9 per 100 000 person-year.The incidences of Phase Ⅰ,Phase Ⅱ,Phase Ⅲ,genital and latent syphilis were 10.3,13.4,0.3,2.3 and 16.6 per 100 000 person-year,respectively.In 2009,the incidence reached 59.1 per 100 000 person-year and reach peak.The cases were constituted by local residents (62.4％) and residents from other provinces (37.6％),male patients predominated with male/female ratio of 1.1∶1.Most cases were aged from 25 to 54 years old(61.1 ％),and those people older than 54 years were more and more likely to be found infected.Local residents predominated by those who aged 25-64 years (74.2％) and other province predominated by 15-44 years (79.1％),the ratios of male/female were 1.3 ∶ 1 and 0.8 ∶ 1.Female were much younger than male,there were 50.0％ of female and 29.3％ of male who were aged between 15-34 years old.Latent syphilis was mostly reported in local male residents who were older than 55 years,female who were 25-54 years and other provinces' female aged 15-44.Phase Ⅰ and Ⅱ syphilis were mostly reported in local male residents less than 55 years old and other provinces' male less than 65 years old.There were significant difference between residence,sex,age and different kinds of syphilis with P＜0.001.Conclusions The trends of syphilis incidence was increasing before 2009 in Minhang District and then declining and slowing down in recent years.The measure of reinforcing monitor,propaganda and education,active screening syphilis in female and local old man should be taken to control and prevent the spread of syphilis.
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Objective To investigate the quality of life (QOL) and mental health status of patients with HIV/AIDS in Minhang District of Shanghai,and to explore the factors that affect their quality of life.Methods A cross-sectional study was conducted in Minhang District among HIV/AIDS patients.All subjects finished general situation questionnaire,Beck depression inventory (BDI),self rating anxiety scale (SAS),social support scale (SSS) and generic quality of life inventory-74 (GQOLI-74) survey.Results A total of 294 patients were recruited in this study with mean age of (39.6 ± 12.6) years old.Among the subjects,mean score of SAS was 40.5 ± 8.8,higher than national normative score (t =20.8,P＜0.001).The prevalence of anxiety was 13.9％.The mean score of BDI was 8.90 ± 8.59,and the prevalence of depression was 28.6％.The mean score of quality of life (QOL) was 66.6 ± 10.9.Multivariate logistic regression analysis showed that QOL of patients with high school or secondary school was lower than those with college and above education (OR =0.34,95 ％ CI:0.12-0.95).QOL scores of patients with moderate or severe depression were lower than those with less depressed patients,OR values were 0.14(95 ％ CI:0.06-0.34) and 0.07(95 CI:0.03-0.20)respectively.QOL of patients with anxiety was lower than the patients without anxiety (OR =0.10,95 ％CI:0.04-0.27).QOL of patients with high scores of social support was higher than the patients with low scores of social support (OR =3.95,95 ％ CI:1.82-8.59).Conclusions We should pay more attention to the psychological state of patients with HIV/AIDS.The quality of life can be improved by improving social support and reducing the occurrence of anxiety and depression.