Protocol on transcranial alternating current stimulation for the treatment of major depressive disorder: a randomized controlled trial / 中华医学杂志(英文版)

BACKGROUND@#Transcranial alternating current stimulation (tACS) offers a new approach for adult patients with major depressive disorder (MDD). The study is to evaluate the efficacy and safety of tACS treating MDD.@*METHODS@#This is an 8-week, double-blind, randomized, placebo-controlled study. Ninety-two drug-naive patients with MDD aged 18 to 65 years will receive 20 daily 40-min, 77.5-Hz, 15-mA sessions of active or sham tACS targeting the forehead and both mastoid areas on weekdays for 4 consecutive weeks (week 4), following a 4-week observation period (week 8). The primary outcome is the remission rate defined as the 17-item Hamilton depression rating scale (HDRS-17) score ≤7 at week 8. Secondary outcomes are the rates of response at weeks 4 and 8 and rate of remission at week 4 based on HDRS-17, the proportion of participants having improvement in the clinical global impression-improvement, the change in HDRS-17 score (range, 0-52, with higher scores indicating more depression) over the study, and variations of brain imaging and neurocognition from baseline to week 4. Safety will be assessed by vital signs at weeks 4 and 8, and adverse events will be collected during the entire study.@*DISCUSSION@#The tACS applied in this trial may have treatment effects on MDD with minimal side effects.@*TRIAL REGISTRATION@#Chinese Clinical Trial Registry, ChiCTR1800016479; http://www.chictr.org.cn/showproj.aspx?proj=22048.

Expressions and clinical implications of kruppel-like factor 6 and APC in human colorectal carcinoma / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To investigate the expressions and clinical implications of kruppel-like factor 6(KLF-6) and APC in human colorectal carcinoma.</p><p><b>METHODS</b>The expressions of KLF-6 and APC in tumor and normal tissues from 32 patients with colorectal carcinoma were investigated by RT-PCR and immunohistochemical technique.</p><p><b>RESULTS</b>The expression rates of KLF-6 and APC mRNA were 37.5% and 34.3% in tumor tissue, 96.9% and 93.8% respectively in normal tissues (both P< 0.05). The expression rates of KLF-6 and APC protein were 28.1% and 25.0% in colorectal carcinomas, 81.3% and 84.43% respectively in normal tissues (both P< 0.05). There was a significant correlation between the expressions of KLF-6 and APC in colorectal carcinomas (P < 0.05). The expressions of KLF-6 and APC were significantly correlated with tumor differentiation, depth of infiltration, lymph node metastasis and clinical stage (P< 0.05).</p><p><b>CONCLUSION</b>Down-regulations of KLF-6 and APC might play an important role in the carcinogenesis, development, metastasis of human colorectal carcinoma.</p>

Predictors at nadir of severity on patients with Guillain-Barr? syndrome / 中华神经科杂志

Objective To explore the factors relating to the severity of Guillain-Barr? syndrome (GBS) (i.e. of being the mild form or in need of mechanical ventilation), and to find the predictors in early clinical presentations and laboratory investigations as to guiding the early management of GBS. Methods All 123 cases of patients with GBS admitted to Xuanwu Hospital from 1996-2002 were collected, and divided into two groups based on the international criteria for different severity of GBS. Mildly affected patients (i.e. able to walk unaided during the whole course or the Medical Research Council [MRC] muscle power grading scale≥4 in both lower limbs at nadir) and ventilated patients (i.e. in need of mechanical ventilation) were divided in this study. Characteristics of each group in early clinical presentations and laboratory investigations were analyzed in univariate conditional Logistic model in order to find out the predictors. Results In all 123 patients studied, 32 were having mild GBS; 29 severe GBS (i.e. in need of mechanical ventilation during the course). Men (P=0.047) and patients without bulbar dysfunction (P=0.002) were more likely to become mild GBS. The possibility of being mild form was 3.33∶1 between man and woman, 1∶20.17 between those with and without bulbar dysfunction. Patients with bulbar dysfunction (P