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ObjectiveTo investigate the use of antidepressants in hospitalized patients with depression disorder from 2015 to 2019， and to analyze the changes of these antidepressants and medication regimens， so as to provide references for clinical drug use. MethodsUsing the Beijing-Tianjin-Hebei big data platform， the data of patients with depression in Beijing Anding Hospital， Capital Medical University from 2015 to 2019 were retrospectively analyzed. The changes of different types of drugs and medication regimens were described. ResultsFrom 2015 to 2019， a total of 6 043 cases of eligible patients were enrolled in analysis. Among selective serotonin reuptake inhibitors （SSRIs）， the prescription proportion of sertraline， citalopram and fluoxetine showed a trend of decline （P<0.05 or 0.01）， while the prescription proportion of escitalopram showed a trend of fluctuations （P=0.031）. In serotonin noradrenaline reuptake inhibitors （SNRIs）， the prescription proportion of duloxetine and milnacipran were rising （P<0.01）. The newer antidepressants agomelatine （P=0.001） and voltioxetine （P<0.01） also showed an upward trend. In terms of medication regimen， the proportion of single antidepressants and combined use of two antidepressants showed a downward trend （P<0.01）， while the proportion of antidepressants combined with mood stabilizers， antidepressants combined with mood stabilizers or antipsychotics showed an upward trend （P<0.05 or 0.01）. ConclusionIn the 5 years， the proportion of SSRIs decreased， and the proportion of SNRIs and newer antidepressants increased in hospitalized patients with depression. The proportion of antidepressants combined with mood stabilizers and antipsychotics in treatment regimens showed an increasing trend.
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Objective:To explore the influencing factors for pulmonary complications of patients with Parkinson's disease (PD) after deep brain stimulation (DBS), and to construct a nomogram model for predicting pulmonary complications after DBS.Methods:Two hundred and seventy-two patients with PD accepted DBS, admitted to our hospital from March 2015 to December 2019, were chosen in our study; they were divided into pulmonary complication group ( n=56) and non-pulmonary complication group ( n=216). The clinical data of patients from the two groups were compared retrospectively. Multivariate Logistic regression was used to analyze the risk factors for pulmonary complications of patients with PD after DBS, and a nomogram model was established to predict the risk of pulmonary complications; receiver operating characteristic (ROC) curve was used to analyze the prediction performance of the model. Results:As compared with non-pulmonary complication group, the pulmonary complication group had significantly higher percentages of patients with history of pulmonary disease, preoperative albumin<35 g/L, preoperative forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC)<60%, operation time≥180 min, and age≥70 years, and significantly lower Parkinson's disease sleep scale (PDSS) scores, unified Parkinson's disease rating scale Ⅲ (UPDRS Ⅲ) scores, and preoperative albumin level, and statistically longer postoperative hospital stays ( P<0.05). Multivariate Logistic regression analysis results showed that history of pulmonary disease ( OR=4.230, 95%CI: 2.035-8.207), preoperative albumin<35 g/L ( OR=6.159, 95%CI: 2.570-5.091), preoperative FEV1/FVC<60% ( OR=31.771, 95%CI: 6.702-66.412), operation time≥180 min ( OR=3.550, 95%CI: 2.261-10.065), age≥70 years ( OR=3.714, 95%CI: 1.451-4.827), and PDSS scores ( OR=1.017, 95%CI: 1.351-13.880) were the independent risk factors for pulmonary complications of patients with PD after DBS. Nomogram model established by using the above indicators showed that area under the curve for predicting pulmonary complications of patients with PD after DBS was 0.841 ( 95%CI: 0.774-0.904, P=0.000), with sensitivity of 84.03% and specificity of 75.06%. Conclusion:PD patients with history of pulmonary disease, preoperative albumin<35 g/L, preoperative FEV1/FVC<60%, operation time≥180 min, age≥70 years, and low PDSS scores are trend to have pulmonary complications after DBS; the nomogram model based on the above variables is highly effective in predicting the risk of postoperative pulmonary complications.
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Objective To understand the clinical nutritional status and malnutrition risk factors of Parkinson's disease (PD) patients and construct their risk scoring system.Methods A total of 221 patients with PD admitted to our hospital from January 2015 to January 2019 were enrolled. The nutritional status of the patients was assessed by Mini Nutrition Assessment (MNA), and according to the MNA scores, these patients were divided into well-nourished groups (n=176) and malnourished group (including patients having malnutrition and malnutrition risk,n=45). Single factor analysis and Logistic regression analysis were used to analyze the risk factors; their scoring systems were constructed and Hosmer-Lemeshow goodness of fit test was used. Accuracy and discrimination of evaluation scoring systems were evaluated by area under receiver operating characteristic (ROC) curve.Results A total of 45 patients (20.36％) had malnutrition or risk of malnutrition. Multivariate regression analysis suggested that the course of disease≥9 years, motor symptoms (unified PD rating scale Ⅲ scores≥54), Hoehn-Yahr (H-Y) staging≥4, daily levodopa equivalent dose≥600 mg, scores of non-motor symptom scale (NMSS) scores≥101, and quality of life (39-item PD questionnaire scores≥81) were independent risk factors for malnutrition in PD patients (P<0.05). The constructed risk scoring system scored from 0 to 30, and Hosmer-Lemeshow goodness of fit test were:χ2=6.259,P=0.618; the area under ROC curve was0.830 (95％CI: 0.801-0.860); when the predicted score was 14, Yoden index was the largest (0.517), and the sensitivity and specificity were 75.70％ and 76.00％, respectively.Conclusion sPD patients have a high risk of malnutrition or malnutrition. The risk scoring system based on risk factors has high predictive ability and discriminating ability, and can be used as an important tool for malnutrition risk assessment in PD patients.
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Aim To develop a HPLC method for the determination of the concentration of 1,8-TMP rhein in rat plasma and study the pharmacokinetics of 1,8-TMP rhein in rat plasma after single dose i. v. administration of 1,8-TMP rhein (2, 4, 8 mg·kg - 1 ). Methods Emodin was used as an internal standard. Plasma sam-ples were extracted with methanol and analyzed by HPLC. The mobile phase was methanol - 0. 1% for-mic acid water (78 ∶ 22, V/ V), with a flow rate of 1. 0 mL·min - 1 and UV 275 nm as the detection wave-length. The plasma concentration of 1,8-TMP rhein in rats was determined by HPLC after single-dose intrave-nous injection in rats with 2,4 and 8 mg·kg - 1 of 1,8-TMP rhein, and the pharmacokinetic parameters were caclulated by DAS 2. 1. Results The result of cali-bration curve was linear over the range of 0. 05 ~ 10. 00 mg·L - 1 (r = 0. 996 2). The lower limit of quantifica-tion was 0. 05 mg · L - 1 . The intra-day and inter-day precision (RSD% ) were both lower than 6% , and the extraction recoveries were higher than 88% , respec-tively. The validated method was successfully applied to a pharmacokinetic study after i. v. administration of 1,8-TMP rhein in rats with a dose of 2,4 and 8 mg· kg - 1 . The T1 / 2 was (68. 35 ± 1. 36), (69. 32 ± 2. 1) and (69. 32 ± 2. 03) min, respectively. The AUC0 - t was ( 101. 03 ± 24. 90 ), ( 144. 79 ± 3. 29 ) and (231. 92 ± 19. 30 ) min · mg · L - 1 , respectively. Conclusion A simple and specific HPLC method for the analysis of 1,8-TMP rhein is successfully developed and applied to a pharmacokinetic study in rat plasma.
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Objective To observe the impact of heparanase on glomerular endothelium glycocalyx during sepsis and to investigate the prevention of glycocalyx injury.Methods C57/BL6 mice were injected with lipopolysaccharide (LPS) or tumor necrosis factor-α(TNF-o) and sacrificed one hour later.Glomerular endothelium glycocalyx traced with lanthanum was observed by transmission electron microscope(TEM).Western blotting was used to observe heparanse protein expression of renal cortex tissue.Human renal glomerular endothelial cells (HRGECs) were stimulated with TNF-α and active heparanase protien expression was detected by Western blotting.Mice were administrated with heparin sodium or heparinase Ⅲ and renal endothelium glycocalyx was observed by TEM.Urine during twenty-four hours was collected to measure urinary albumin and creatinine.The ratio of albumin to creatinine was calculated and compared among groups.Results The glomerular endothelium glycocalyx of LPS group and TNF-α group was degradated and the one of podocyte was integrated.Renal cortex tissue heparanase protein expression was significantly increased since one hour after LPS injection (P ＜ 0.01).The protein expression of activited heparanase of HRGECs which were stimulated with TNF-α was increased (P ＜ 0.05).Administration of heparin sodium which could inhibit the activity of heparanase could prevent the glycocalyx form degradation.The ratio of urine albumin to creatinine of heparin sodium group was decreased compared with LPS group (P ＜ 0.05) and the ratio of heparinase Ⅲ group was higher than control group(P ＜ 0.01) as a result of degradation of glomerular endothelium glycocalyx.Conclusions During the early stage of sepsis,TNF-α can induce glomerular endothelium heparanase to increase and active,and consequently the glycocalyx is degradated which leads to albuminuria.Inhibition of heparanase can protect glomerular endothelium glycocalyx and prevent albuminuria.
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Objective To investigate the effects and mechanism of rosiglitazone on carotid intima-media thickness(IMT)in patients with type 2 diabetes mellitus(DM)by carotid ultrssonography.Methods Fifty-nine patienta with obese DM were divided into two groups randomly:patients in control group(n=29)received routine therapy.and patients in treatment group(n=30)received rosiglitzone with routine therapy for 24 months.Carotid IMT was measured by carotid ultrasonography pre-and post-therapy.The level of ma-trix metalloproteinase-9(MMPO)and C-reactive protein(CRP)were assayed.Results Compared with control group,the IMT was decreased following irosiglitazone therapy(P＜0.05).The concentrations of MMP-9 and CRP in patients in the treatment group were (253.4±97.5)ng/L and(1.15±0.96)mg/L,and those in the control group were(361.8±101.7)ng/L and (2.18±2.01)mg/L,which were significantly impmved.Conclusion Rosiglitazone could retard atherosclerosis progression in obese patients with type 2 DM which was achieved through improving MMP-9 and CRP.
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We investigated the release of superxide anion ( O2- ) in human granulocytes stimulated by leukocyte factor ( LF ) and/or concan-avalin A ( Con A ). Some amount of O2- can be released by granulocytes, when LF or Con A was applied alone. The pretreat-ment of granulocytes with a low concentration LF1 potentiated O2-release in granulocytes stimulated by Con A, and the lag time of O2-release was reduced. The results show that the granulocytes were activated by LF. This phenomenon may be related to the curative effects of LF.
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AIM To study the influence of chronic stress on the level of CNTF and CNTF mRNA in hippocampal neurons of rats. METHODS The chronic stress model was established by chronic unpredictable mild stress, openfield test was performed to detect the behavior of rats. Immunohistochemistry and in situ hybridization were used to observe the level of CNTF and CNTF mRNA. RESULTS Compared to control group, the CNTF like immunoreactivity and signals of CNTF mRNA in situ hybridization in the hippocampal neurons of chronic stress group were significantly decreased. CONCLUSION These results show that chronic stress can significantly decrease the level of CNTF and CNTF mRNA in the hippocampal neurons of rats.
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Objective:To elucidate the possible role of galanin in the development of experimental depression in rats. Methods:Openfield was performed to test the behavior of rats. The changes of the galanin level in different brain areas were determined by RIA. The effect of fluoxetine hydrochloride on galanin level were observed by intraperitoneal injection. Results:Compared to control group, the crossing times and rearing times decreased significantly in depressed rats, galanin level decreased remarkably in plasma, hypothalamus, hippocampus, forebrain, parietal lobe and temporal cortex of depressed rats. Intraperitoneal injection of fluoxetine hydrochloride obviously improved the depressed behavior in rats, increased the galanin level in the hippocampus and forebrain of depressed rats. Conclusion:Hippocampus and forebrain may be involved in the development of experimental depression and in the antidepressive effects of fluoxetine hydrochloride.
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Amyotrophic lateral sclerosis is a chronic neurodegenerative disorder characterized by selective death of motor neurons and progressive paralysis. Many hypotheses have been proposed to explain its pathogenesis. In recent years,one of the most studied hypotheses was the inflammatory response accompanying the motor neuron death. Microglia and its interactions with motor neurons play important roles in the development and progression of the inflammatory responses and the disease itself,which results in different new and potent therapeutic strategies of great clinical value.