A clinical study of trazodone replacement treatment on benzodiazepine drugs dependence in senile patient / 中华行为医学与脑科学杂志

Objective To explore the efficacy of trazodone replacement treatment on benzodiazepine drugs dependence and effect of cognitive function on senile patients.Methods 51 senile patients with benzodiazepine drugs dependence were assigned with dosage tacho-decrement and replaced by trazodone.The patients were discontinuanced taking benzodiazepine in 14 days and taken at a draught of trazodone before retiring about 6 months.Clinical effect and side effects were assessed with the Pittsburgh sleep quality index (PSQJ) and treatment emergent symptom scale(TESS) before and after treatment.Cognitive function was evaluated with Wechsler intelligence scale for adult-Chinese revised (WAIS-RC) and Wechsler mermory scale for adult-Chinese revised ( WMS-RC ) once before and after treatment.Results The scores total PSQJ( ( 13.17 ± 3.70),( 11.05 ± 3.48 ) ),the sleep quality( (2.36 ± 0.33 ),( 1.91 ± 0.29 ) ),daily function disorder,sleep disorder were significantly lower than before treatment while the other factor scores were not significantly changed.Trazodone wes effective without severe side effects and dependence.The study group showed significantly lower scores in learning,calculation,the signs of figure,wood puzzles,long-term memory,short-term memory,immediate memory,memory quotient in the assessment of cognitive function than after treatmemt (P ＜ 0.05 ).Conclusion Trazodone is an ideal medicine to senile insomnia.

Effect of rheumatoid arthritis associated HLA-DRβ1 subtypes on protein kinase A signaling / 中华内科杂志

Objective　To investigate the impact of rheumatoid arthritis (RA)-associated HLA-DRβ1*0401,*0402,*0403 and*0404 subtypes on protein kinase A (PKA) signaling. Methods　To detect the activities of adenylate cyclase (AC), cAMP and PKA in transfectants expressing rheumatoid arthritis-associated HLA-DRβ1 subtypes and their mutants. Results　The levels of AC, cAMP and PKA of HLA-DRβ1*0401 and*0404 transfectants were significant lower than that of HLA-DRβ1*0402 and*0403 transfectants (P＜0.01). The mutant HLA-DRβ1*0403 tranfectants expressing DRRAE or QRRAA secreted lower levels of PKA, cAMP and AC (P＜0.01). Conclusion　RA-associated HLA-DRβ1*0401 and*0404 expression suppressed intracelluar PKA signaling pathway, and may mediate abnormal intracellular signaling in rheumatoid arthritis.